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MSRA > PM Mock 2 > Flashcards

PM Mock 2 Flashcards

1
Q

COPD management

A

SABA or SAMA

If no asthmatic features:
SABA + LABA+ LAMA

If asthmatic features:
SABA/SAMA + LABA+ICS

Then:
SABA
LABA+LAMA+ICS

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2
Q

Transudate vs exudate

A

exudate:
Pleural fluid protein > serum protein
Pleural fluid LDH > serum LDH
Pleural fluid LDH>2/3serum LDH upper limit

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3
Q

Rhabdomyolysis tests

A

AKI raised creatinine
Elevated CK
Myoglobulinuria
Hypocalcaemia
Elevated phophate
Hyperkalaemia
Metabolic acidosis

Rx:
IV fluids
Urinary alkalisation

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4
Q

DKA Mx

A

Fluid replacement
Insulin - fixed rate insulin infusion at 0.1units/kg/hr
Continue long acting insulin, stop short acting insulin.
Once blood glucose <14mmol/l 10% dextrose infusion started
Correct electrolyte disturbance, potassium replacement but slowly due to insulin resulting in hypokalaemia

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5
Q

What precipitates digoxin toxicity

A

Thiazides, amiodarone, verapamil
Hypokalaemia
Renal failure
Hypothyroidism

CF:
Nausea, vomiting, confusion, yellow green vision, gynaecomastia

Mx:
Digibind

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6
Q

Thrombectomy post stroke

A

Target time of 6-24 hours
If there is potential to salvage brain tissue shown by imagin such as CT perfusion or diffusion weighted MRI

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7
Q

Thrombolysis post stroke

A

Administered within 4.5 hours of onset of stroke symptoms
Haemorrhage excluded by scan

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8
Q

Secondary prevention in stroke

A

Clopidogrel

Carotid endarterectomy if
Stroke or TIA in carotid territory and not severely disabled
Consider if carotid stenosis <70% or >50%

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9
Q

Genital wart management

A

Topical podophyllum for non-keratinsed multiple wards
Cryotherapy for solitary keratinised wards.

HPV 6, 11

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10
Q

Reduced fetal movements management

A

Handheld Doppler to check for fetal heartbeat

If no fetal heartbeat, Immediate USS

If fetal heartbeat present CTG for 20 minutes to assess fetal HR
If normal CCTG USS within 24h

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11
Q

Organophosphate insecticide poisoning

A

Salivation
Lacrimation
Urination
Defecation

Bradycardia
Constricted pupils

Rx
Atropine

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12
Q

Asymptomatic bacteruria in catheterised patient Mx

A

No treatment required

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13
Q

Psoriasis Management.

What exacerbates plaque psoriasis?

A

First line:
Potent corticosteroid OD plus vitamin D analogue OD up to 4 weeks
Max 2 weeks if facial

Second line
Vitamin D analogue twice daily

Third line
Potent corticosteroid BD for 4 weeks
Coal tar OD
Short acting dithranol

Secondary care:
Phototherapy
Psoralen +PUVA
- Can cause skin ageing and squamous cell carcinoma

Systemic therapy :
Oral methotrexate esp if arthritis
ciclosporin

Exacerbation:
Trauma
Alcohol
Beta blockers, lithium, ACEi, NSAIDs
Withdrawal of steroids

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14
Q

Management of intracapsular hip fracture

A

Undisplaced:
Fit - internal fixation
Unfit - hemiarthroplasty

Displaced:
Fit: THR
Unfit: Hemiarthroplasty

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15
Q

Management of extracapsular hip fracture

A

Intertrochanteric fracture:
Dynamic hip screw

Reverse oblique, transverse or subtrochanteric:
Intermedullary nail

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16
Q

Garden classification of hip fracture

A

I: stable fracture with impaction
II: Complete fracture but undisplaced
III: Displaced fracture, usually rotated and angulated but still has boney contact
IV: Complete boney disruption

17
Q

Gout vs pseudogout

A

Gout - negatively birefringent needle shaped crystals
First metatasophalangeal joint

Pseudocout - weakly positive birefringent rhomboid shaped crystals
Chondrocalcinosis in pseudogout
Knee, wrist, shoulder

18
Q

Bishops score

A

Assess whether induction requried
Cervical position
Consistency
Effacement
Dilation
Fetal station

<5 unlikely to start labout
8+ cervix ripe for spont labout

19
Q

Induction of labour

A

Membrane sweep - done by midwife in antinatal clinic at 40-41 week

Vaginal prostaglandin E2

Maternal oxytocin infusion - stimulates contraction when cervix primed
Amniotiomy

20
Q

Diabetes medications pre-surgery

Metformin
Gliclazide/sulfonylureas
Gliptin DDP4 inhibitors
Exenatide GLP1 analgoye
Dapagliflozin SGLT2 inhibitors

A

Metformin - take as normal on day of surgery, if TDS omit lunch dose
Gliclazide/sulfonylureas - omit dose day of srugery
Gliptin DDP4 inhibitors - take as normal
Exenatide GLP1 analgoye - take as normal
Dapagliflozin SGLT2 inhibitors - iomit on day of srugery
Lantus Reduce dose by 20%

21
Q

Mastectomy vs Wide local excision

A

Mastectomy:
Multifocal
Central
Large lesion in small breast
DCIS>4cm

Wide local excision:
Solitary
Peripheral
Small lesion in large breast
DCIS<4cm

22
Q

Hormonal therapy in breast cacncer
Biologic therapy

A

Pre/perimenopausal women - tamoxifen - SERM

Post-menopausal women - anastrazole - aromatase inhibitor

Herceptin transtuzumab

23
Q

Hormonal therapy in breast cacncer
Biologic therapy

A

Pre/perimenopausal women - tamoxifen - SERM

Post-menopausal women - anastrazole - aromatase inhibitor

Herceptin transtuzumab if HER2 positive

24
Q

Tricyclic antidepressant overdose
ECG change
Treatment

A

Arrhythmia, seizure, metabolic acidosis

Sinus tachycardia, wide QRS, prolonged QT

Treatment IV sodium bicarbonate

25
Q

BRadycardia management

A

Atropine 500mcg IV
Up to 6 times
Transcutaneous pacing
Isoprenaline, adrenaline infusion
Transvenous pacing

26
Q

Behcet’s disease

A

Oral ulcers, gential ulcers, uveitis

Joint pain

27
Q

Advice post vasectomy

A

Additional contraception until semen analysis reveals azoospermia

28
Q

Asthma diagnosis

A

Spirometry with bronchidilator reversibility
FeNO testing (tests for eosinophilic inflammation)

29
Q

Sife effects of thyroxine

A

OSteoporosis (increased osteoclast activity like PTH)
worsening of angina
AF
Hyperthyroidism

30
Q

FIGO endometria cancer staging

A

I confined to myometrium
II spread beyond myometrium but within uterus
III local spread to regional lymph nodes
IV invasion to bladder/bowel, distant mets

MSRA (7 decks)

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