Previous Exam Qs Flashcards
Who does amniocentesis
Pernatologist
Who repairs 2nd degree tear?
Midwife
Who does post-natal baby checks?
GP
mechanism of action of cyclizine
anti-histamine piperazine derivative with histamine H1 receptor antagonist
mechanism of action of ondasetron
5HT receptor antagonist (serotonin)
mechanism of action of domperidone/prochlorperazine
anti-dopamine Domperidone is a peripheral (d2) & (d3) receptor antagonist
saline components
Na 154
Chlorine 154
potassium 0
glucose components
Na 0
Chlorine 0
potassium 0
hartmanns components
Na 131 Ca 2 K 5 Cl 111 lactate 29
sore throat
pustules on hands & feet
coxsackie
saddle nose
high serum ACE
SARCOID
32 year old female with symmetrical poly arthritis &proteinuria
SLE
female with dactylitis & DIP
psoriatic
male with sternal pain & multiple lytic lesions
malignant myeloma
protein electrophoresis for bence jones proteins
which therapy uses becks triad
CBT
which food interacts with warfarin
green veg (high in vat K)
freudian theory
psychoanalytical
which fruit interferes with statins
grapefruit
surfer who has gradual unilateral hearing loss
exostosis
female who had permanent complete unilateral hearing loss in pregnancy
otosclerosis (pregnancy accelerates it)
hearing loss after getting off a plane
tympanic perforation or glue ear
female with dysphagia & anaemia
patterson Kelly brown
- iron deficiency associated with post-cricoid oesophageal web
bird beak on barium swallow
achalasia
nulliparous woman diabetic, endometrial biopsy thickening
endometrial hyperplasia
endometrial cancer
women with previous breast cancer taking tamoxifen
endometrial hyperplasia
endometrial cancer
mild dyskariosis
repeat test within 6 months
severe dyskariosis
colposcopy
colposcopy shows ulcerated malignant lesion with discharge
LLETZ
man dragged out of river from downing what type of abg
mixed metabolic & respiratory acidosis
man in motercylce crash c spine fine, airway & breathing fine but weak radial pulse, what type of shock
hypovolaemic
give fluids to someone & they rapidly deteriorate
stop fluids
IV furoesemide
adrenaline IM
1:1000 1mg = 1ml
pulse + VT
amoidarone 300mg
bradycardia
atropine 500mcg
why does trimethoprim not work in upper UTI
doesn’t penetrate renal parenchyma
why does antibiotics not help ulcer on foot
needs drainage - abscess is walled off from the drug
rectal too painful to examine, what next?
examine under anaesthesia
blood on toilet paper, pain
anal fissure
ankylosing spondylitis then has bloody diarrhoea for 2 weeks
UC
cruise down river nile then has watery diarrhoea for 6 weeks investigation
urinary/stool microscopy to look for eggs
UPSI then painful red eye & dysuria investigation
first pass urine sample for PCR
man treated with abs for presumed pneumonia smoker returns 6 weeks later still hoarse
refer to ENT urgently
bulls pemphigoid immunofluorescence
linear IgG and C3 at basal membrane
dermatitis herpetiformis immunofluorescence
granular IgA at dermal papillae
stabbed in neck then shoulder pain
axillary nerve
elbow replacement then tingling in ring finger, positive froments
cubital tunnel syndrome
posterior hip dislocation
internal shortening
minimally displaced closed tibial fracture in middle aged
long leg cast delay application 3-5 days to allow swelling to diminish
unstable tibial fracture
operative fixation
ortolani
DDH
palpable sensation of femoral head gliding in and out of acetabular joint
barlow
DDH
adduct & push posteriorly
screening for AAA
abdo US
if > 5.5cm repair
bank pain, small pupils, red eyes
ank spond
treatment for anterior uveitis
topical prednisolone
treatment for acute closed angle glaucoma
IV acetazolamide
prevention of pre-eclampsia
aspirin, hydralazine, labetolol, nifedipine
treatment of eclampsia seizure
magnesium sulphate for 24 hours post seizure
squints first step management
correct refractive error
MS optic neuritis left eye
left central scotoma
man age 21 sounds like MS nystagmus pupils looking different directions
internuclear ophthalmoplegia
heliotrope rash, linear stress on hands, muscle pain
dermatomyositis
woman collapses high potassium low sodium glucose 3.1 daughter says not taking medication
addisonian crisis
girl with acne needing contraception
dianette
white patches on vaginal walls
candida albicans
bilateral red eyes in child
chlamydial conjunctivitis
woman with lesion on leg hard centre getting checked after friend had skin cancer
dermatofibroma
leg ulcers ABPI
> 0.8 for graduated compression
ABPI 0.4
refer to vascular surgeon
psoriasis histo
absent granular layer
hyper proliferation of keratinocyte
who must you inform when detaining emergency mental health act
MHO
someone accident what can you treat under if you can’t get position
common law
chino woman being detained said its not fair and wants help to appeal
advocacy
malaria & typhoid
malarone
haematuria in someone back from abroad
schistomsomiasis
woman taking NSAIDs for hip replacement develops bleeding (ulcer)
acute erosive gastritir
bleading into breast haemophilia b
give factor 9 precipitate
ECG of someone collapsed with hypothermia
J waves
woman with angina pain with history of severe left knee oa
myocardial perfusion scan
pinpoint pupils and needle marks. most likely abg
metabolic acidosis
copd infective exacerbation abg
respiratory acidosis
gastric outlet obstruction abg
metabolic alkalosis
test for easy brushing and puffy face
low dose dexamethasone
sweating, palpitations, headache
urinary catecholamines
phaeochromocytoma
prostate cancer + back pain
spinal cord compression
treat with dexamethasone
best way to measure bp in HDU/ICU
invasive BP monitoring
BP in GP
validated arm cuff
BP test for white coat
24 hour ambulatory care
woman with tiredness pain and muscle stiffness
fibromyalgia
older lady vacant pauses, distracted, lasts for several hours, recover in less than 24 hours
partial status epilepticus
child born 34 weeks with no perinatal complications and normal development now age 1
cruises round furniture
child born 40 weeks no problems 3 months
head control
child with abdominal pain and joint pain and purpuric rash down buttocks and thighs feels slightly unwell
HSP
child 2 weeks old very unwell respiratory distress temp causative organism
bronchiolitis RSV
just born complication happen born and then 20 min later short of breath and needing O2 with fast RR
TTN
child slapped cheek
parovirus b19
child feeding well until moved onto solid food
coeliac disease
biceps reflex
c5
triceps reflex
c7
knee reflex
l4
ankle reflex
s1
scan in someone with prostate cancer and back pain
technetium bone scan
man with chest pain radiating to jaw which investigation
ECG & troponin
man with chest pain relieved by sitting forward. post-MI pericarditis. which investigation? <1 week
ECG
man with chest pain relieved by sitting forward. post-MI pericarditis. which investigation? >1 week
echo
1st line for BPH
alpha blocker tamsulosin
older man with macroscopic haematuria & weight loss
urgent referral to urology
woman with darker buccal mucosa
Addisons
ACTH
IV coamoxiclav and clari for severe pneumonia obs stable for 48 hours
change down to oral doxy
someone being treated with IV fluclox for endocardititis results come back & it’s sensitive to this obs stable
stay on same IV regimen - deep seated infection
pyrexic with tonic clonic fits in the last 48 hours
viral encephalitis
offshore worker who presents with severe sudden onset headache
SAH
31 year old smoker wants oral contraception. previous arterial disease.
POP
persistent vaginal bleeding in mid 50s and IMB
refer to gynae
olanzapine + dry mouth which NT
acetylcholine (anti-muscarininc effects)
PTSD best treatment
eye movement desensitisation reprocessing
man 6 weeks conjunctivitis and conjunctival follicles unresponsive to one week of topical chloramphenicol
chlamydial conjunctivitis
person with contact lenses, red painful eye
bacterial keratitis/corneal ulcer
back pain, red eye
anterior uveitits
what does LH stimulate
testosterone
ovulation
corpus lute secretes
progesterone
sperm stored
epididymis
woman with galactorrhea
prolactin secreting tumour
hypopituitary & bitemproal hemianopia
non-functioning adenoma
sweaty, thick skin, big hands
GH secreting tumour
parkinsons neuotransmitter defect
low dopamine
alzheimers neurotransmitter defect
low acetylcholine
depression neurotransmitter defect
low 5 hydroxytryptamine (serotonin)
compartment syndrome of extensor part of lower leg which structure most affected
deep fibular nerve
old lady constipated for a while and has pain best Ix
abdo xray
akathisia
inner feeling of restlessness
typical anti-psychotics
which disease has degenerated NBM (nucleus basalts meynert)
alzheimers
heritability of schizo
80%
severe frontal lobe change and progressive language impairment Ix
CT
specialist for uterine artery emobolisation
radiologist
CF mutation - who to talk to
geneticists
gynaecology cancer but wants to retain fertility who to talk to
gynaecology monologist
which neurotransmitter in myasthenia gravis
acetylcholine
headache + tingling in arms
migraine with aura
person refuses to change diet even though it will be good for health
health behaviour model
patient had gastric resection now unsteady on feet
B12 deficiency
high ash + TPO antibodies
hashimoto’s
what age do u give fit d supplement until
5?
reduced iodine uptake and recent febrile illness
post-viral thyroiditis
fritty eye & TSH antibodies
graves
cause of polyuria in diabetes
osmotic effect of glucose
treatment of ENT polyps
steroids
sinusitis less than 3 days treatment
decongestants
trauma then blocked nose
septal haematoma
tx - septoplasty
white spidery lesion on mucosa of mouth
lichenoid planus
painless rolled ulcer in mouth
mouth cancer
best topical treatment for dry eczema
lotions
diabetic has diarrhoea
autonomic neuropathy
mid-dilated pupil red eye
acute closed angle glaucoma
deep violaceous and painful eye
scleritis
red eye no pain pool of blood
subconjunctival haemorrhage
name interaction of donepezil and atenolol = hypotension
drug-drug interaction
BDZ causing memory loss name of interaction
idiosyncratic effect
headache and stiff shoulders
PMR with GCA
test = PV
head lagging & dysphonia
MG
test = antiacetylcholine receptor antibodies
which direction are amino acids transcribed in
5’ to 3’ direction
in labour if baby has HR of 5-
emergency c-section
woman not dilating in labour
give oxytocin
CSF gram positive cocci in patient who had splenectomy
pneuomoccal meningitis
orphan Annie nuclei
papillary thyroid cancer
diabetic patient has psychosis
treat with typical eg haloperidol as atypical cause metabolic syndrome
treatment of lower body dementia
acetylcholinesterase inhibitor (-stimgine)
pregnant lade large for dates with sore abdomen
uterine fibroid due to red degeneration
C5 supplies
side of arm
L1 supples
groin
vasomotor rhinitis
elderly thin clear dischard
perennial rhinitis
patient is runny nose with cat
lady has delivered but bleeding heavy
syntometrine
protienuria + hypertension in pregnancy
labetolol
gestations 1st trim
< 12 weeks
pre-term labour
25-37 weeks
post dates
> 42 weeks
epiglottitis
stridor & drooling
rusty brown sputum + severe cough in child
pneumonia
malingering
patient pretending for gain
femoral nerve block weakens which muscles
of anterior thigh - hip flexors (pectinous, iliac, sartorius), knee extensors (quads)
history of PID, ectopic, fears injection contraception
POP
emergency contraception, > 5 days post sex day 16 of cycle
copper coil
heavy periods
mirena
low mood, continual deliberate self harm
schizo
overdose dSH
depression
myeloma would cause
high calcium
deep dyspareunia, fixed retroverted uterus
endometriosis
BMI 38 irregular periods
PCOS
menorrhagia & a pussy discharge
PID
dad has haemophilia and wife pregnant with son which test
none - can’t give it to son (X linked)
mind racing with worries drinks alcohol to calm
generalised anxiety
dismantling electrical equipment because of fear of recording
schizo
the physiological change in elderly
increasing heterogeneity
which neurotransmitter causes sedation
histamine
patient has taken a drug and has cardiac arrhythmias
amphetamines
which investigation for prolapsed disc
MRI
Pt has had a SAH and has normal CT, which Ix
lumbar puncture as there is no risk of coning
Papilledema, headache and hemiparesis
brain CT
steady state for 1st order
rate of administration = rate of elimination
irritable, callous, no responsibility, expects family to do everything
dissocial personality
binge drinker, self harm, overly sexual, DSH, intense relationships, dependant
borderline
works really heard doesn’t spend many on his wife
OCD PD
patient has increased ET
endometrial biopsy
patient suspects menopaus
check LH/FSH
PCB & IMB which test
colposcopy
man on 3 antihypertensives keeps fainitng
iatrogenic
sudden headache, very dizzy, nerve happened before
vestibular migraine
vertigo & tingling in arms
vertebrobasilar insufficiencey
mum calls police cause kid has her phone
inappropriate emergency response
alcoholic dad, child stays off school to look after him
child carer
depressed mum so dad having sex with kid
inappropriate roles
old lade, constipaition, bleeding, colicky abdominal pain
diverticulitis
alcohol, PMH of gallstones, epigastric pain
pancreatitis
shoulder pain on right and abdominal pain
cholecystitis
biggest risk factor for borderline PD
sexual abuse
in CPR how long should you exhale for rescue breaths
3 secs
which nerve supplies supinator
C6
carpet fitter swelling & pain in knee
bursitis
patient has fibroadenoma next step
reassurance
most likely complication in baby born at 25 weeks
RDS
baby born by c-section most likely complication
TTN
mum was diabetic baby complication
hypoglycaemia in baby
woman has T2DM & on tamoxifen
endometrial cancer
imperforate hymen
endometriosis
DUB best treatment
tranexamic acid
woman cannot cough properly which nerve
recurrent laryngeal
sternocleidomastoid which nerve
CN11
alcoholic confused and drowsy
subdural
boxer unconscious and confused
extradural middle meningeal artery rupture
headache after sex
benign coital cephalgia
headache fever worse on leaning forward
frontal sinusitis
diffuse axonal injury in patient in coma after crash
calcium influx and excitotoxity
bilateral lymphoendema, not hot/swollen, chest rest all normal investigation
pelvic UC
retired chef 40 years leg lymphedema dark angle discolourations
doppler US
flagella under microscope
trichomonas
gram negative diplococci
gonorrhoea
sore ulcers on labia
HSV
loss of lumbar lordosis
ank spond? mechanical back pain?
back pain back giving after lifting
slipped disc
girl having absences at school PMHs generalised tonic clonic
absence seizure
absences at school, throwing cereal in morning
juvenile myoclonic epilepsy
infant had temp 38.9 given abs by gp then seizure
febrile
red rash flexor surface of forearm very itchy
lichen planus
itchy blistering rash sore abode change in bowel
dermatitis herptiformis
child itchy at night excoriations only
scabies
woman ankle ulcer just healed ABPI good on both legs
compression stockings
1-2cm ulcer on leg getting slowly bigger
biopsy
old copd patient abg
type 2 respiratory failure
alcoholic poor memory amnesia
jorsakoffs
detention in old man behavioural changes embarrassing children
fronto-temporal dementia
dementia angina diabetes sudden change in memory
vascular dementia
truisms unilateral pain deviated uvula
quinsy
extra capsular inter trochanteric fracture
slicing screw + plate (DHS)
woman had children N&V then sudden onset dizziness lasting 2 hours
acute labrynthitis
woman had children weakness in face vertigo previous ep weakness
MS
guy gets dizzy standing up
autonomic
Parkinsons disease started on new med with falls
postural hypotension
PR depression
pericarditis
normal CXR + history of chest infection
pneumocystis jirovecii
croup
parainfluenza virus
treatment of giardiasis
metronidazole
person with LD doesn’t understand what pills are for
CMHN/CPN
LD can’t communicate
SALT
swimming in lake Malawi haematuria
schistosomiasis
back from Kenya with fever
malaria (thick/thin blood film)
oil worker white raised patches at back of throat back from africa
hiv
heart failure on ACEI + diuretic
add b blocker
heart failure on ACEI get hyperkalaemia
isorbide mononitrate
pneumonia CURB65 = 0, wheezy and cough, pen allergic
doxycycline
dot & blot haemorrhages on fundoscopy from India BMI >30, BP 150/100
diabetic retinopathy
depression
SSRI
prep woman feels stuff coming down back passage blood on wiping
haemorrhooids
5cm lump from anal verge
cancer
most kidney stones
calcium oxalate
child at party eaten peanut cyanosed SOB trachea deviated
foreign body
someone started on ciprofloxacin + diarrhoea
c. diff
polyhydramnios and no foetal stomach on USS
oesophageal atresia
polyhydramnios and new onset diabetes
gestational diabetes
telling public health about communicable diseases
communitarianism
girl facies dr so he changes care to another dr
deontology
woman dying dr increases morphine to cover pain even though she will die quicker
double effect doctrine
red eye + discharge
conjunctivitisi
pain on eating/shaving
trigeminal neuralgia
clusterheadache
migrainous nerualgia
mid diastolic murmur af loud s1 heart sound most at risk of
cerebral emoboli.stroke
40ish woman still having periods but mood swings & hot flushes which HRT
oral oestrogen + mirena
51 year old woman with hot flushes, night sweats, 18 months since last period- menopause
continuous combined HRT
younger woman still having irregular periods
sequential combined hrt
sore throat asthmatic on steroids
nystatin liquid
long acting increased glucose into muscle fat
insulatard
acarbose side effect
flatulance (works by binding to glucose)
MoA metformin
AMPK & reduced gluconeogenesis
stroke MCA territory classic presentation painful neck horners
carotid dissection
RTA hit on rite side was fine then deteriorated
extradural haematoma
earlier classification of early opioid toxicity
hallucination + drowsy
better with crying in 9 month old baby
laryngomalacia
drooling baby epiglottitis
call 999
mastoiditis
acute admission
cholesteatoma
urgent ENT
pain on eating
dentists
persistent sexual thoughts about woman at his church more he thinks about it, worse it gets, keeps telling you he is in a happy marriage
OCD
thought dystonic
someone to speak to the family about diseases
CPN
treatment of vault prolapse
sacrospinous fixations
best treatment for urthreocele with no other PMH
pelvic floor exercises
PCOS
dianette
28 year old woman no periods for 2 years no other PMHs otherwise well raised GnRH
primary ovarian failure
80 year old woman with nodules on finger joints
x-ray
retired teacher with falls & tremor but not intention termor
Lewy body?
taxi driver getting lost giving wrong change
alzheimer’s
falls when shaving face
carotid sinus massage
5 year old bruising on shin
accidental
- 3 year old had cold, had rash now diffuse bruising, brother has recurrent nosebleeds
ITP
resp depression after orthodontist surgery
40mcg naloxone
boy doesn’t like doing presentations drinking more and more on nights out
social phobia
boy running out in front of cars LD trouble with police inattention
ADHD
woman anxious phoning parents all the time
GAD
totally random panic attacks tingling in fingers sweating palpitations
panic disorder
classic discription of lichen planus
autoimmune process with moss like appearance
girl with hopes on lib
swab for viral PCR
boy with lesion between to then got erythematous round lesion with crusting at edges
skin scraping
impetigo
bacterial swab
target lesions
erythema multiform
IgM depositions in vasculature
legionella
urine antigen test
gardenella
stool microscopy
viral hep
blood serology
drug interactions
BNF
local prescription info
TAF
antepartum haemorrhage tense uterus no foetal heartbeat
placental abruption
antepartum haemorrhage transervse lie
placenta peravia
pelicans fracture & binder mid femur fracture in RDS
fat embolues
treatment of dendritic ulcer
acyclovir
treatment of open angle glaucoma
timolol
farmer has a cat & recurrent rhinisitis
RASST
chronic sinusitis and discharge
CT sinus
allergic rhinitis no previous treatment
steroid inhaler
kid projectile vomiting hungry after crossing centiles/failing to thrive
pyloric stenosis so needs ramsteads pylorotomy
ECG changes in COPD
prominent p wave in leads 2,3, rightward shift of QRS axis, and poor progession of R wave, low voltage QRS complex
hypocalcaemia ecg
u wave
Christmas disease (haemophilia b)
groin pain
CN12 damage
tongue towards (Twelve Tongue Towards)
first column to go in diabetic neuropathy
dorsal column
SOL and increasing ICP
dexamethasone
dusky colon
ischaemic
nutcracker oesophagus
characterized by contractions in the smooth muscle of the oesophagus in a normal sequence but at an excessive amplitude or duration
white spots on soft palate and ear pain is
Ramsay hunt
