questions

Question 1

location of the caecum

Answer 1

Proximal right colon below the ileocaecal valve

Intraperitoneal

Question 2

arterial supply of caecum

Answer 2

Ileocolic artery

Question 3

right lobe liver blood supply

Answer 3

by right hepatic artery

Question 4

left lobe liver blood supply

Answer 4

by the left hepatic artery

Question 5

endothelin

Answer 5

potent, long-acting vasoconstrictor and bronchoconstrictor

Question 6

what promotes the release of endothelin

Answer 6

angiotensin II
ADH
hypoxia
mechanical shearing forces

Question 7

inhibits the release of endothelin

Answer 7

nitric oxide

prostacyclin

Question 8

physiological role of troponin I

Answer 8

binds to actin to hold the troponin-tropomyosin complex in place

Question 9

treatment of C.difficile

Answer 9

Oral vancomycin

Question 10

sawtooth appearance on ECG

Answer 10

atrial flutter

Question 11

TSH levels with hyperthyroidism

Answer 11

decrease

Question 12

microbial keratitis common history

Answer 12

swimming with contact lenses on

Question 13

non-sedating antihistamine

Answer 13

loratadine

Question 14

presentation of maxillary antral carcinoma

Answer 14

nerve involvement leading to anaesthesia of the check
epistaxis
exposure to wood dust or mites

Question 15

Musculocutaneous nerve typical mechanism of injury

Answer 15

Isolated injury rare - usually injured as part of brachial plexus injury

Question 16

Axillary nerve mechanism of injury

Answer 16

Humeral neck fracture/dislocation

Results in flattened deltoid

Question 17

Radial nerve mechanism of injury

Answer 17

Humeral midshaft fracture

Palsy results in wrist drop

Question 18

Median nerve mechanism of injury

Answer 18

Wrist lesion → carpal tunnel syndrome

Question 19

presentation of carpal tunnel syndrome

Answer 19

pins and needles and pain around the thumb and index finger which is worse at night

Question 20

Ulnar nerve mechanism of injury

Answer 20

medial epicondyle injury

Question 21

rotator cuff muscles

Answer 21

Supraspinatus
Infraspinatus
teres minor
Subscapularis

Question 22

first line treatment of psoriasis

Answer 22

topical steroid and vitamin D eg Calcipotriol

Question 23

effect of insulin on potassium

Answer 23

decreases serum potassium through stimulation of the Na+/K+ ATPase pump

Question 24

associated symptoms with SLE

Answer 24

alopecia
arthralgia 
skin rash 
cytopenia
mouth ulcer

Question 25

Reifenstein syndrome

Answer 25

female breast development and erectile dysfunction

Question 26

presentation of post-streptococcal glomerulonephritis

Answer 26

general malaise, proteinuria, haematuria, and is often preceded by an upper respiratory tract infection by 7-14 days before

Question 27

best way to stop thyroid eye disease

Answer 27

stop smoking

Question 28

what is used to help treat symptoms of graves disease

Answer 28

propanolol

Question 29

definitive treatment of primary hyperparathyroid

Answer 29

remove the parathyroid

Question 30

conservative management of primary hyperparathryoid

Answer 30

cinacalcet

Question 31

Calcitonin

Answer 31

hormone secreted by the parafollicular cells of the thyroid gland reduce blood calcium levels used to treat hypercalcaemia

Question 32

management of CKD

Answer 32

Optimise diabetic control-SGLT-2 Optimise hypertensive control- ACEi, ARB Treat glomerulonephritis

Question 33

side effects of tamsulosin

Answer 33

dizziness postural hypotension sexual dysfunction

Question 34

drug used to prevent repeating kidney stones

Answer 34

bendroflumethaizide

Question 35

CKD on haemodialysis most likely cause of death

Answer 35

ischaemic heart disease

Question 36

Adrenal crisis management

Answer 36

Intensive monitoring Parenteral steroids (IV hydrocortisone 100mg then 100mg every 6hours) IV fluid resuscitation Correct hypoglycaemia

Question 37

most common cause of primary hyperaldosteronism

Answer 37

idiopathic bilateral adrenal hyperplasia

Question 38

what is conn's

Answer 38

primary hyperaldosteronism

Question 39

first line management of displaced ankle fracture

Answer 39

closed reduction ?

Question 40

Ankylosing spondylitis x-ray findings

Answer 40

subchondral erosions, sclerosis | and squaring of lumbar vertebrae

Question 41

flare up of RA management

Answer 41

Intramuscular steroids such as methylprednisolone ?

Question 42

enzyme affected in PCT

Answer 42

uroporphyrinogen decarboxylase

Question 43

investigation for PCT

Answer 43

wood lamps- 1st increased plasma or urinary porphyrins serum iron ferritin level liver biopsy

Question 44

investigation for erythropoietic protoporphyia

Answer 44

fluorocytes | quantitative RBC porphyrins

Question 45

management of erythropoietic protoporphyia

Answer 45

``` keep out of sun/ covered up genetic counselling 6 monthly LFTs and RBC porphyrins carotene liver transplant ```

Question 46

investigation of acute intermittent porphyria

Answer 46

urine test for porphobilinogen (turns red) | raised urinary porphobilinogen

Question 47

treatment for rosacea

Answer 47

topical metronidazole- first line | if ineffective- oral tetracycline

Question 48

treatment for paget's disease

Answer 48

bisphosphonates- risedronate

Question 49

complications from a colles fracture

Answer 49

median nerve compression EPL rupture CRPS loss of grip strength

Question 50

treatment of osteomalacia

Answer 50

vit d therapy with ca& phosphate supplements

Question 51

what DMARD causes interstitial pneumonitis

Answer 51

methotrexate

Question 52

rheumatology drug that cause tarry black stool

Answer 52

NSAIDs

Question 53

bechet's syndrome

Answer 53

visual loss, moutj ulcers and genital ulcers CSR and ESR raised associated with IBD and arthritis

Question 54

lichen planus management

Answer 54

``` Check for drug precipitant – lichenoid drug eruption Emollients Treat symptomatically o Topical steroids- betamethasone? o Oral steroids if extensive - UVB phototherapy ```

Question 55

investigation for ring worm

Answer 55

scarping sent to microscopy + culture

Question 56

investigation for impetigo

Answer 56

swabbed and the sample sent in a bacterial container for microscopy and culture wood lamps- because it is fungal

Question 57

investigation for shingles

Answer 57

swabbed and sent in a viral container for PCR

Question 58

investigation for scabies

Answer 58

skin scrappings for microscopy

Question 59

presentation of porphyria cutanea tarda

Answer 59

photosensitive rash and blisters- face and back of hands white deposits hyperpigmentation hypertrichosis (excessive hair growth)