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Yr3 Revision > Questions > Flashcards

Questions Flashcards

1
Q

As part of the treatment for NAFLD, NICE recommends the prescription of which following vitamin, due to increased clinical outcomes?

Vitamin A
Vitamin B
Vitamin C
Vitamin D
Vitamin E

A

As part of the treatment for NAFLD, NICE recommends the prescription of which following vitamin, due to increased clinical outcomes?

Vitamin A
Vitamin B
Vitamin C
Vitamin D
Vitamin E

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1
Q

As part of the treatment for NAFLD, NICE recommends the prescription of Vitamin E following due to increased clinical outcomes. Which drug is this often given with and why? [1]

A

Vitamin E and pioglitazone

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2
Q

Hepatitis D requires a co-infection with

Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Hepatitis F

A

Hepatitis D requires a co-infection with

Hepatitis A
Hepatitis B
Hepatitis C
Hepatitis E
Hepatitis F

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3
Q

Which HBV marker is indicative of infection but not immunisation? [1]

A

Hepatitis B core antigen (HBcAg)
- expressed by infected hepatocytes, not used in the vaccination

Core antigen = Caught

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4
Q

Describe the skin colour change in a patient with early compared to later presenting haemochromatosis [1]

A

Bronzed to slate grey pigmentation

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5
Q

There is inappropriately low production of the hormone hepcidin.

A

There is inappropriately low production of the hormone hepcidin.

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6
Q

Which pathology would these nails indicate? [1]

A

Wilsons disease

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7
Q

Which tumour marker indicates HCC? [1]

A

AFP

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8
Q

Which of the following is associated with alcoholic liver disease? [1]

IgA
IgE
IgD
IgM
IgG

A

Which of the following is associated with alcoholic liver disease? [1]

IgA:
IgE
IgD
IgM
IgG

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9
Q

Which of the following is associated with primary biliary cholangitis?? [1]

IgA:
IgE
IgD
IgM
IgG

A

Which of the following is associated with primary biliary cholangitis?? [1]

IgA:
IgE
IgD
IgM
IgG

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10
Q

Which of the following is associated with autoimmune hepatitis? [1]

IgA:
IgE
IgD
IgM
IgG

A

Which of the following is associated with autoimmune hepatitis? [1]

IgA:
IgE
IgD
IgM
IgG

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11
Q

Anti nuclear antibodies (ANA) are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

A

Anti nuclear antibodies (ANA) are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

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12
Q

Anti mitochondrial antibodies are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

A

Anti mitochondrial antibodies are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

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13
Q

Antineutrophilic cytoplasmic antibodies (ANCA) are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

A

Antineutrophilic cytoplasmic antibodies (ANCA) are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

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14
Q

Soluble liver antigens are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

A

Soluble liver antigens are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

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15
Q

Smooth muscle antigens are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

A

Smooth muscle antigens are associated with which of the following?

autoimmune hepatitis
primary biliary cholangitis
alcoholic liver disease
primary sclerosing cholangitis

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16
Q
A
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17
Q

Which of the following treatments for prostate cancer works as an non-steroidal anti-androgen?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works as an non-steroidal anti-androgen?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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18
Q

Which of the following treatments for prostate cancer works is an steroidal anti-androgen?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works is an steroidal anti-androgen?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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19
Q

Which of the following treatments for prostate cancer works is an androgen synthesis inhibitor?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works is an androgen synthesis inhibitor?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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20
Q

Which of the following treatments for prostate cancer works is an GnRH antagonist?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works is an GnRH antagonist?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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21
Q

Which of the following treatments for prostate cancer works is an GnRH agonist?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works is an GnRH agonist?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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22
Q

Which of the following treatments for prostate cancer is normally the option for the treatment of hormone-relapsed metastatic prostate cancer in patients who have no or mild symptoms after androgen deprivation therapy has failed, and before chemotherapy is indicated?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer is normally the option for the treatment of hormone-relapsed metastatic prostate cancer in patients who have no or mild symptoms after androgen deprivation therapy has failed, and before chemotherapy is indicated?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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23
Q

Which of the following treatments for prostate cancer works by preventing DHT binding from intracytoplasmic protein complexes?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

A

Which of the following treatments for prostate cancer works by preventing DHT binding from intracytoplasmic protein complexes?

Cytoproterone acetate
Degarelix
Goserelin
Bicalutamide
Abiraterone

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24
Q

A patient has recent weight loss and anaemia. The doctor suspects a diagnosis of cancer. A CXR is undertaken and is shown below. Due to the CXR, where do you suspect this cancer might have metasised from?

Bladder cancer
Renal cancer
Liver cancer
Pancreatic cancer

A

Renal cancer

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25
Q

A patient has suspected bladder cancer. They have demonstrated visibile haematuria despite UTI treatment. The junior doctor is considering a cytoscope. What would be the next best investigation after this?

Renal USS tract
CT
MRI
PET

A

NVH: Renal USS tract

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26
Q

Patient with severe abdominal pain. What does the image show?

Ascites
Lead pipe colon
Normal gas pattern
Rigler’s/ double wall sign
Thumbprinting

A

Patient with severe abdominal pain. What does the image show?

Rigler’s/ double wall sign

Free gas (pneumoperitoneum) can be seen on both sides of the bowel wall. This is Rigler’s sign or the double wall sign.

Whenever sharp points or triangles of low density are seen adjacent to loops of bowel, pneumoperitoneum should be suspected.

Note: In patients with an acute abdomen an erect chest X-ray is more sensitive for small volumes of free gas.

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27
Q

Patient with severe abdominal pain. What does the image show?

What is the likely pathology?

Ascites
Lead pipe colon
Normal gas pattern
Rigler’s/ double wall sign
Thumbprinting

A

Patient with severe abdominal pain. What does the image show?

Ascites
Lead pipe colon
Normal gas pattern
Rigler’s/ double wall sign
Thumbprinting

Inflammation of the bowel wall leads to thickening of the haustral folds. This results in the radiological sign of thumbprinting, a characteristic finding in patients with active ulcerative colitis.

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28
Q

What is the cause of the abnormal calcification?

Adrenal calcification
Appendicolith
Gallstones
Pancreatic calcification
Staghorn renal calculus

A

What is the cause of the abnormal calcification?

Staghorn renal calculus

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29
Q

24-year-old patient with suspected appendicitis. What does the image show?

Caecal volvulus
Normal appearances
Pneumoperitoneum
Small bowel obstruction
Toxic megacolon

A

24-year-old patient with suspected appendicitis. What does the image show?

Small bowel obstruction

Dilated loops of bowel with valvulae conniventes – lines crossing the full width of the bowel – indicates small bowel obstruction.

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30
Q

Patient with severe abdominal pain. What is the cause of pain demonstrated on this abdominal X-ray?

Caecal volvulus
Normal appearances
Pneumoperitoneum
Small bowel obstruction
Toxic megacolon

A

Patient with severe abdominal pain. What is the cause of pain demonstrated on this abdominal X-ray?

Caecal volvulus
Normal appearances
Pneumoperitoneum
Small bowel obstruction
Toxic megacolon

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31
Q

What is the artifact shown in this image?

Biliary stent
Colonic stent
External tubing
Percutaneous nephrostomy tube
Ureteric stent

A

What is the artifact shown in this image?

Biliary stent
Colonic stent
External tubing
Percutaneous nephrostomy tube
Ureteric stent

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32
Q

Patient with abdominal pain and vomiting. What is the radiological diagnosis?

Caecal volvulus
Large bowel obstruction
Small bowel obstruction
Bowel perforation
Normal

A

Patient with abdominal pain and vomiting. What is the radiological diagnosis?

Caecal volvulus
Large bowel obstruction
Small bowel obstruction
Bowel perforation
Normal

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33
Q

What is the radiological diagnosis?

Sigmoid volvulus
Normal
Ascites
Small bowel obstruction
Pneumoperitoneum

A

What is the radiological diagnosis?

Sigmoid volvulus
Normal
Ascites
Small bowel obstruction
Pneumoperitoneum

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34
Q

What is the cause of the abnormal calcification in this image?

Calcified gallstones
Calcified mesenteric lymph nodes
Pancreatic calcification
Malignant calcification
Calcified uterine fibroid

A

What is the cause of the abnormal calcification in this image?

Calcified gallstones
Calcified mesenteric lymph nodes
Pancreatic calcification
Malignant calcification
Calcified uterine fibroid

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35
Q

Patient with abdominal pain, vomiting, and constipation. What is the radiological diagnosis?

Caecal volvulus
Sigmoid volvulus
Small bowel obstruction
Perforation
Normal

A

Patient with abdominal pain, vomiting, and constipation. What is the radiological diagnosis?

Caecal volvulus
Sigmoid volvulus
Small bowel obstruction
Perforation
Normal

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36
Q

What is the cause of the area of increased density in the pelvis?

Calcified pelvic kidney
Calcified abdominal lymph node
Calcified uterine fibroid
Ingested barium
Calcified adrenal gland

A

What is the cause of the area of increased density in the pelvis?

Calcified pelvic kidney
Calcified abdominal lymph node
Calcified uterine fibroid
Ingested barium
Calcified adrenal gland

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37
Q

History of abdominal surgery 7 years ago. Presented with a 24 hour history of severe abdominal pain and vomiting. What is the radiological diagnosis?

Small bowel obstruction
Post-operative ileus
Normal
Perforation
Sigmoid volvulus

A

History of abdominal surgery 7 years ago. Presented with a 24 hour history of severe abdominal pain and vomiting. What is the radiological diagnosis?

Small bowel obstruction
Post-operative ileus
Normal
Perforation
Sigmoid volvulus

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38
Q

If you saw these X-ray appearances in the setting of acute abdominal pain, what would be the most appropriate course of action?

Place an abdominal drain
Request abdominal ultrasound
Request abdominal MRI
Resuscitate the patient and inform the surgeons
Take a break

A

If you saw these X-ray appearances in the setting of acute abdominal pain, what would be the most appropriate course of action?

Place an abdominal drain
Request abdominal ultrasound
Request abdominal MRI
Resuscitate the patient and inform the surgeons
Take a break

A large volume of free gas is present under the diaphragm. In the context of acute abdominal pain this finding indicates perforation. Emergency resuscitation and informing the surgeons would be the most appropriate action.

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39
Q

Patient with abdominal pain and vomiting. Which answer best describes the X-ray appearances?

Pneumoperitoneum
Ascites
Psoas abscess
Small bowel obstruction
Normal

A

Patient with abdominal pain and vomiting. Which answer best describes the X-ray appearances?

Pneumoperitoneum
Ascites
Psoas abscess
Small bowel obstruction
Normal

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40
Q

Patient with abdominal pain and absolute constipation. Which answer best describes the X-ray appearances?

Large bowel obstruction
Sigmoid volvulus
Caecal volvulus
Perforation
Small bowel obstruction

A

Patient with abdominal pain and absolute constipation. Which answer best describes the X-ray appearances?

Large bowel obstruction
Sigmoid volvulus
Caecal volvulus
Perforation
Small bowel obstruction

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41
Q

Describe what Rigler’s double wall sign appears like [1]
What does this indicate?

A

Normally only the inner wall of the bowel is visible

If there is pneumoperitoneum both sides of the bowel wall may be visible

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42
Q

What may a liver edge silhouette indicate on an AXR? [1]

A

When perforation of a duodenal ulcer occurs, and
results in a pneumoperitoneum:

Gas collects in Morison’s pouch (the hepato-renal space), and rise on the supine film to the anterior abdominal wall outlining the edge of the liver

diagnostic of duodenal
perforation.

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43
Q

What pathology is indicated in this AXR? [1]

A

False Rigler’s/double wall sign
* Be careful not to mistake the gas within two adjacent bowel segments for Rigler’s sign.
* Gas seen on both sides of the bowel wall is contained within adjacent bowel
* There are no black triangles or sharp angles on the outside of the bowel wall

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44
Q

Describe what is seen in this AXR [3]

A

Small bowel obstruction - features

Centrally located multiple dilated loops of gas filled bowel (arrowheads)
Valvulae conniventes (arrow) are visible - confirming this is small bowel

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45
Q

Describe what is depicted in this AXR [1]

A

Large bowel obstruction

  • Here the colon is dilated down to the level of the distal descending colon. There is the impression of soft tissue density at the level of obstruction (X). No gas is seen within the sigmoid colon.
  • Obstruction is not absolute in this patient as a small volume of gas has reached the rectum (arrow).
  • An obstructing colon carcinoma was confirmed on CT and at surgery.
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46
Q

Which of the following is a caecal and sigmoid volvulus? [2]

A
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47
Q

What sign does this AXR show? [1]
What pathology does this indicate? [1]

A

Mucosal thickening - ‘thumbprinting’
This patient presented with an exacerbation of symptoms of ulcerative colitis.

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48
Q

What sign does this AXR show? [1]
What pathology does this indicate? [1]

A

Lead pipe colon
This patient with ulcerative colitis has a featureless segment of transverse colon with loss of the normal haustral markings.
This ‘lead pipe’ appearance is associated with longstanding ulcerative colitis.

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49
Q

What sign does this AXR show? [1]
What pathology does this indicate? [1]

A

Toxic megacolon
The colon is very dilated in this patient with acute abdominal pain, sepsis, and a known history of ulcerative colitis. The clinical features and X-ray appearances are consistent with toxic megacolon.

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50
Q

Where is the ureteric stone in this AXR? [1]

A
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51
Q

What is depicted here? [1]
State a cause of this [1]

A

Bladder stones form in the bladder as a result of urinary stasis, e.g. bladder outflow obstruction (enlarged prostate) or in patients with a neurogenic bladder (loss of bladder function due to spinal cord injury/disease)

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52
Q

What is depicted in this AXR? [1]
What does this indicate? [1]

A

Vascular calcification
There is striking calcification of the aorta and iliac vessels
This is a sign of generalised atherosclerosis elsewhere in the body

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53
Q

What is depicted in this AXR? [1]
What does this indicate? [1]

A

Abdominal aortic aneurysm - AAA
There is calcification of the dilated aortic wall
Frequently only one side of the aneurysm is visible - as in this image - the other being projected over the spine

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54
Q

What is the cause of the abnormal calcification?

Adrenal calcification
Appendicolith
Gallstones
Pancreatic calcification
Staghorn renal calculus

A

What is the cause of the abnormal calcification?

Adrenal calcification
Appendicolith
Gallstones
Pancreatic calcification
Staghorn renal calculus

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55
Q

What is the cause of the abnormal calcification?

Adrenal calcification
Appendicolith
Gallstones
Pancreatic calcification
Staghorn renal calculus

A

What is the cause of the abnormal calcification?

Adrenal calcification
Appendicolith
Gallstones
Pancreatic calcification
Staghorn renal calculus

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56
Q

What is depicted in this AXR? [1]
What does this indicate? [1]

A

Appendicolith
Appendicoliths are highly predictive of appendicitis in patients presenting with right iliac fossa pain

Appendicoliths are calcific masses in the appendix, formed as a result of the aggregation of faecal particulates and inorganic salts within the lumen of the appendix

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57
Q

What is the artifact shown in this image?
What pathology does it reduce the risk of?

Naso-jejunal tube
Colonic stent
Pig-tail (JJ) stent
Percutaneous nephrostomy tube
Inferior vena cava (IVC) filter

A

Inferior vena cava (IVC) filter
An IVC filter may be used to reduce the risk of large pulmonary emboli

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58
Q

What is the artifact shown in this image?
What pathology does it reduce the risk of?

Naso-jejunal tube
Colonic stent
Pig-tail (JJ) stent
Percutaneous nephrostomy tube
Inferior vena cava (IVC) filter

A

Colonic stent
Large bowel obstruction can be treated with placement of a metallic colonic stent
This is often used as a temporary measure allowing a patient to recover from the effects of obstruction prior to definitive colonic resection

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59
Q

What is the artifact shown in this image?

Naso-jejunal tube
Colonic stent
Pig-tail (JJ) stent
Percutaneous nephrostomy tube
Inferior vena cava (IVC) filter

A

Pig-tail (JJ) stent
A ureteric stent has been placed to relieve ureteric obstruction
The catheter has loops (pig-tails) at both ends which hold it in place

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60
Q

What is the artifact shown in this image?

Naso-jejunal tube
Colonic stent
Pig-tail (JJ) stent
Percutaneous nephrostomy tube
Inferior vena cava (IVC) filter

A

Naso-jejunal tube
Placed for the purpose of enteral feeding
The tube passes through the stomach and forms a C-shape as it navigates the 4 parts of the duodenum (D1-4)
The tube tip lies beyond the duodenojejunal flexure which lies on the left

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61
Q

What is depicted in this AXR? [1]
What does this indicate? [1]

A

Ascites
There is generalised hazy density of the entire abdomen
In the presence of ascites gas within bowel is located centrally

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62
Q

A 45-year-old man presents with symptoms of urinary colic. In the history he has suffered from recurrent episodes of frank haematuria over the past week or so. On examination he has a left loin mass and a varicocele. The most likely diagnosis is:

Renal adenocarcinoma
Renal cortical adenoma
Squamous cell carcinoma of the renal pelvis
Retroperitoneal fibrosis
Nephroblastoma

A

A 45-year-old man presents with symptoms of urinary colic. In the history he has suffered from recurrent episodes of frank haematuria over the past week or so. On examination he has a left loin mass and a varicocele. The most likely diagnosis is:

Renal adenocarcinoma
Renal cortical adenoma
Squamous cell carcinoma of the renal pelvis
Retroperitoneal fibrosis
Nephroblastoma

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63
Q

[] is the most common cause of primary hyperaldosteronism

A

Bilateral idiopathic adrenal hyperplasia is the most common cause of primary hyperaldosteronism

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64
Q

A transjugular intrahepatic portosystemic shunt procedure connects which two vessels?

Internal jugular vein and hepatic vein
Internal jugular vein and portal vein
Hepatic artery and hepatic vein
Hepatic artery and portal vein
Hepatic vein and portal vein

A

A transjugular intrahepatic portosystemic shunt procedure connects which two vessels?

Internal jugular vein and hepatic vein
Internal jugular vein and portal vein
Hepatic artery and hepatic vein
Hepatic artery and portal vein
Hepatic vein and portal vein

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65
Q

Which of the following stone type appears as a stag-horn on x-ray?

Urate
Magnesium ammonium phosphate
Calcium oxalate
Calcium phosphate
Cystine

A

Which of the following stone type appears as a stag-horn on x-ray?

Urate
Magnesium ammonium phosphate
Calcium oxalate
Calcium phosphate
Cystine

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66
Q

What size kidney stone would you watch and wait for management? [1]

A

< 5 mm

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67
Q

A 28-year-old female presents with jaundice. The following results are available: HBsAg +ve, HBeAg +ve, HBeAb −ve, HBc IgM +ve

Which of the following interpretations is most accurate?

Susceptible to hepatitis B

Chronic hepatitis B with low infectivity
Chronic hepatitis B with high infectivity
Previous immunisation against hepatitis B
Natural immunity against hepatitis B

A

A 28-year-old female presents with jaundice. The following results are available: HBsAg +ve, HBeAg +ve, HBeAb −ve, HBc IgM +ve

Which of the following interpretations is most accurate?

Susceptible to hepatitis B

Chronic hepatitis B with low infectivity
Chronic hepatitis B with high infectivity
Previous immunisation against hepatitis B
Natural immunity against hepatitis B

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68
Q

A patient with a history of abdominal surgery develops abdominal pain. A plain abdominal X-ray shows dilated bowel loops. There are lines on the dilated parts of the bowel which cross it.

What is the most likely underlying cause?

Gallstones

Inguinal hernia

Adhesions

Caecal carcinoma

Sigmoid carcinoma

A

A patient with a history of abdominal surgery develops abdominal pain. A plain abdominal X-ray shows dilated bowel loops. There are lines on the dilated parts of the bowel which cross it.

What is the most likely underlying cause?

Gallstones

Inguinal hernia

Adhesions

Caecal carcinoma

Sigmoid carcinoma

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69
Q

A 25-year-old male has presented to the Emergency Department with fever, jaundice and malaise for the past three days. Initial laboratory studies show raised liver enzymes and a low platelet count. He has no recent travel history. A diagnosis of autoimmune hepatitis is being considered.

Which of the following antibodies are most specific for this condition?

Anti-smooth muscle antibodies

Anti-mitochondrial antibodies

Hepatitis A Immunoglobulin M (IgM) antibodies

Anti-nuclear antibody

Anti-Smith antibodies

A

A 25-year-old male has presented to the Emergency Department with fever, jaundice and malaise for the past three days. Initial laboratory studies show raised liver enzymes and a low platelet count. He has no recent travel history. A diagnosis of autoimmune hepatitis is being considered.

Which of the following antibodies are most specific for this condition?

Anti-smooth muscle antibodies

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70
Q

Which of the following is the most appropriate antibiotic for this patient’s infected pressure ulcer?

Ceftriaxone

Ciprofloxacin

Clarithromycin

Flucloxacillin

Nitrofurantoin

A

Which of the following is the most appropriate antibiotic for this patient’s infected pressure ulcer?

Flucloxacillin

The patient has an infected sacral pressure sore. The infection is likely to be superficial with no extension to the underlying bone (which would be concerning for osteomyelitis). Along with cleaning and dressing the wound, culture swabs of the fluid should be taken so antibiotics can be tailored according to microbial sensitivities. Superficial infections are typically treated with oral antibiotics such as flucloxacillin as this is likely to provide coverage for gram-positive bacteria that reside on the skin surface, such as Staphylococcus aureus. As the patient is bed-bound, he should also be assessed for an air mattress.

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71
Q

Define Gilbert’s syndrome [1]

A

Gilbert’s syndrome is an autosomal recessive condition associated with intermittent raised unconjugated bilirubinaemia, resulting from a defective glucuronyl transferase. This is the enzyme involved in conjugation of bilirubin, and so the ability of patients to conjugate bilirubin is significantly reduced.

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72
Q

Gilbert’s syndrome is defined by which four characteristics? [4]

A

The condition is defined by the four following characteristics, necessary for diagnosis:

  • unconjugated hyperbilirubinaemia
  • normal liver function
  • no haemolysis
  • no evidence of liver disease
73
Q

Expalin why in Gilbert’s syndrome, there is absence of bilirubin in the urine?

A

In unaffected individuals following conjugation, conjugated bilirubin is released into the bile and is either excreted in the faeces as stercobilin or reabsorbed in the circulation and excreted by the kidneys in the urine in the form of urobilinogen

In Gilberts: there is a defective glucuronyl transferase. This is the enzyme involved in conjugation of bilirubin, and so the ability of patients to conjugate bilirubin is significantly reduced. Unconjugated bilirubin is non-water-soluble; therefore, it cannot be excreted in the urine.

74
Q

A 55-year-old male alcoholic with known cirrhotic liver disease is admitted to the Gastroenterology Ward with a distended abdomen, jaundice and confusion. On examination, he is clinically jaundiced and has a massively distended abdomen with evidence of a fluid level on percussion. An aspirate of fluid is taken from his abdomen and sent for analysis. Results indicate the fluid is an exudate.

Which of the following is an exudative cause of ascites?

Portal hypertension

Cardiac failure

Fulminant hepatic failure

Budd–Chiari syndrome

Malignancy

A

A 55-year-old male alcoholic with known cirrhotic liver disease is admitted to the Gastroenterology Ward with a distended abdomen, jaundice and confusion. On examination, he is clinically jaundiced and has a massively distended abdomen with evidence of a fluid level on percussion. An aspirate of fluid is taken from his abdomen and sent for analysis. Results indicate the fluid is an exudate.

Which of the following is an exudative cause of ascites?

Malignancy

Ascites is defined as an accumulation of fluid within the peritoneal cavity. The causes can be classified according to the protein content of the fluid: < 30 g/l transudate, >30 g/l exudate. The most common causes of an exudative ascites are infection or malignancy. The above patient scenario would be more in keeping with a malignant cause.

75
Q

What imaging modility is first line for non-pregnant patients for suspected kidney stones?

MRI
XR-KUB
CT-KUB
US

A

What imaging modility is first line for non-pregnant patients for suspected kidney stones?

MRI
XR-KUB
CT-KUB
US

76
Q

What imaging modility is first line for pregnant patients for suspected kidney stones?

MRI
XR-KUB
CT-KUB
US

A

What imaging modility is first line for pregnant patients for suspected kidney stones?

MRI
XR-KUB
CT-KUB
US

77
Q

What is the first line treatment for pregnant person with stone? [1]

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)

A

What is the first line treatment for pregnant person with stone? [1]

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)

78
Q

What is the first line treatment for pregnant person with stone size of less than 2cm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

A

What is the first line treatment for pregnant person with stone size of less than 2cm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

79
Q

What is the first line treatment for pregnant person with stone size of < 5mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

A

What is the first line treatment for pregnant person with stone size of < 5mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

80
Q

What is the first line treatment for person with stone size of 12 mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

A

What is the first line treatment for person with stone size of 12 mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

81
Q

What is the first line treatment for person with stone size of 24 mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

A

What is the first line treatment for person with stone size of 24 mm?

Open surgery
Percutaneous nephrolithotomy (PCNL)
Ureteroscopy (URS)
Shockwave lithotripsy (SWL)
Watchful waiting

82
Q

Which of the following are related to urinary tract infections

Uric acid stones

Cystine stones

Calcium oxalate stones

Calcium carbonate stones

Magnesium carbonate stones

A

Which of the following are related to urinary tract infections

Uric acid stones

Cystine stones

Calcium oxalate stones

Calcium carbonate stones

Magnesium carbonate stones

83
Q

A 48-year-old women presents with recurrent loin pain and fevers. Investigation reveals a staghorn calculus of the left kidney. Infection with which of the following organisms is most likely?

Staphylococcus saprophyticus
Proteus mirabilis
Klebsiella
E-Coli
Staphylococcus epidermidis

A

A 48-year-old women presents with recurrent loin pain and fevers. Investigation reveals a staghorn calculus of the left kidney. Infection with which of the following organisms is most likely?

Staphylococcus saprophyticus
Proteus mirabilis
Klebsiella
E-Coli
Staphylococcus epidermidis

84
Q

Proteus mirabilis is most likely to cause what type of stone?

Uric acid stones

Cystine stones

Calcium oxalate stones

Calcium carbonate stones

Magnesium carbonate stones

A

Proteus mirabilis is most likely to cause what type of stone?

Uric acid stones

Cystine stones

Calcium oxalate stones

Calcium carbonate stones

Magnesium carbonate stones

85
Q

Which of the following type of UTIs is most likely to have spread haematogenously?
Name two more [2]

Candida albicans
Escherichia coli
Proteus mirabilis
Klebsiella pneumoniae
Staphylococcus saprophyticus

A

Which of the following type of UTIs is most likely to have spread haematogenously?

Candida albicans
AND
Staph. aureus; M. tb

86
Q

Which following treatment for UTIs may cause neonatal haemolysis?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

A

Which following treatment for UTIs may cause neonatal haemolysis?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

87
Q

Which following treatment for UTIs may cause spina bifida?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

A

Which following treatment for UTIs may cause spina bifida?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

88
Q

Which following treatment for UTIs should be avoided in the third trimester of pregnancy?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

A

Which following treatment for UTIs should be avoided in the third trimester of pregnancy?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

89
Q

Which following treatment for UTIs should be avoided in the first trimester of pregnancy?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

A

Which following treatment for UTIs should be avoided in the first trimester of pregnancy?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

90
Q

Which following treatment for UTIs should be avoided in patients with renal impairment?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

A

Which following treatment for UTIs should be avoided in patients with renal impairment?

Cefalexin
Trimethoprim
Amoxicillin
Co-amoxiclav
Nitrofurantoin

91
Q

A 60-year-old man attends the surgical day unit for a loop ileostomy following rectal cancer surgery. He is informed that he will be left with a stoma and that the stoma nurses will explain how this is to be cared for.

What are the correct features of this stoma?

Left iliac fossa, flushed appearance with solid output
Left iliac fossa, spouted appearance with solid output
Right iliac fossa, flushed appearance with liquid output
Right iliac fossa, spouted appearance with liquid output
Right iliac fossa, spouted appearance with solid output

A

A 60-year-old man attends the surgical day unit for a loop ileostomy following rectal cancer surgery. He is informed that he will be left with a stoma and that the stoma nurses will explain how this is to be cared for.

What are the correct features of this stoma?

Right iliac fossa, spouted appearance with liquid output

Colon has a role in the absorption of water from the gastrointestinal tract, with it being bypassed, the stool will be looser and therefore present as a liquid. As the stool is liquid and rich in digestive enzymes it is more likely to irritate the skin, therefore a spout is preferred so that it can drain directly into the stoma bag. It is often located in the right iliac fossa as the ileocecal junction (the connection between the ileum and cecum) is located in the right iliac fossa. Creating an ileostomy in this area allows for the least disruption of the natural digestive process.

92
Q

A 45-year-old man presents to his GP with pain around the site of his stoma. The patient appears systemically well. On examination, there is erythema around his stoma site, located in the right iliac fossa. A close examination of the stoma reveals there are two lumens. One lumen appears to be raised above the skin more than the other and is productive of liquid contents. He has a past medical history of a tumour of the ascending colon, which was removed via a segmental resection and subsequent anastomosis.

What is the most likely type of stoma present?

End colostomy
End ileostomy
Loop colostomy
Loop ileostomy
Urostomy

A

Loop ileostomy

The presence of two lumens in this stoma suggests that it is indeed a loop stoma; end stomas characteristically have only one lumen

93
Q

How can you tell if a stoma if a loop or closed by inspecting the lumens? [2]

A

loop stoma; two lumens

end stomas characteristically have only one lumen

94
Q

A 76-year-old woman presents to the outpatient colonoscopy department following a referral from her GP due to a positive faecal immunochemical test (FIT). Colonoscopy reveals a 3x2 cm mass at the distal end of the transverse colon near the splenic flexure. Histology from a biopsy confirms an isolated adenocarcinoma. Following a multidisciplinary team (MDT) discussion, she is scheduled for surgical resection of the tumour.

What is the most likely surgery that will be performed?

Hartmann’s procedure

Left hemicolectomy

Total colectomy

Transverse colectomy

Wide-local excision of the tumour

A

A 76-year-old woman presents to the outpatient colonoscopy department following a referral from her GP due to a positive faecal immunochemical test (FIT). Colonoscopy reveals a 3x2 cm mass at the distal end of the transverse colon near the splenic flexure. Histology from a biopsy confirms an isolated adenocarcinoma. Following a multidisciplinary team (MDT) discussion, she is scheduled for surgical resection of the tumour.

What is the most likely surgery that will be performed?

Hartmann’s procedure

Left hemicolectomy

Total colectomy

Transverse colectomy:
- It is generally reserved for tumours situated centrally within the transverse colon, whereas lesions at either end are more appropriately managed with right or left hemicolectomies respectively.

Wide-local excision of the tumour

95
Q

Question 8 of 113
A 67-year-old man presents to clinic with a history of blood in the stools and weight loss. He was referred for an urgent colonoscopy, which showed a mass in the distal transverse colon. Biopsy confirmed adenocarcinoma. Further investigation reveals no lymph node involvement or distant metastasis.

What surgery should be offered?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Right hemicolectomy
Total colectomy

A

Question 8 of 113
A 67-year-old man presents to clinic with a history of blood in the stools and weight loss. He was referred for an urgent colonoscopy, which showed a mass in the distal transverse colon. Biopsy confirmed adenocarcinoma. Further investigation reveals no lymph node involvement or distant metastasis.

What surgery should be offered?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Right hemicolectomy
Total colectomy

96
Q

A 78-year-old man presents to the emergency department with intense abdominal pain. He has not passed faeces or wind in the last 48 hours. When asked, he mentions that he has lost some weight recently and in the weeks preceding this event he has been feeling constipated. The team suspects a large bowel obstruction due to cancer and orders a CT scan, that shows a mass in the hepatic flexure.

Which one of the following surgical management plans is the most appropriate for the patient?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

A

A 78-year-old man presents to the emergency department with intense abdominal pain. He has not passed faeces or wind in the last 48 hours. When asked, he mentions that he has lost some weight recently and in the weeks preceding this event he has been feeling constipated. The team suspects a large bowel obstruction due to cancer and orders a CT scan, that shows a mass in the hepatic flexure.

Which one of the following surgical management plans is the most appropriate for the patient?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

97
Q

Which of the following involves removal of the distal transverse and descending colon.

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

A

Right hemicolectomy:
- involves removal of the caecum, ascending and proximal transverse colon.

Left hemicolectomy:
- involves removal of the distal transverse and descending colon.

High anterior resection:
- involves removing the sigmoid colon (may be called a sigmoid colectomy).

Low anterior resection:
- involves removing the sigmoid colon and upper rectum but sparing the lower rectum and anus.

Abdomino-perineal resection (APR):
- involves removing the rectum and anus (plus or minus the sigmoid colon) and suturing over the anus. It leaves the patient with a permanent colostomy.

Hartmann’s procedure:

98
Q

Which of the following involves removal of the distal transverse and descending colon?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

A

Which of the following involves removal of the distal transverse and descending colon?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

99
Q

Which of the following involves removing the sigmoid colon and upper rectum but sparing the lower rectum and anus?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

A

Which of the following involves removing the sigmoid colon and upper rectum but sparing the lower rectum and anus?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

100
Q

Which of the following involves removing the sigmoid colon?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

A

Which of the following involves removing the sigmoid colon?

Hartmann’s procedure
High anterior resection
Left hemicolectomy
Low anterior resection
Right hemicolectomy

101
Q

What is the name of this sign? [1]

What pathology does it indicate? [1]

A

Cullens sign

Cullen’s sign is described as superficial oedema with bruising in the subcutaneous fatty tissue around the peri-umbilical region. This is also known as peri-umbilical ecchymosis. It is most often recognised as a result of haemorrhagic pancreatitis.

102
Q

What is the name of this sign? [1]

What pathology does it indicate? [1]

A

Grey-Turner’s sign
Classically it correlates with severe acute necrotizing pancreatitis

103
Q

A 61-year-old library assistant has an increasing frequency of episodes of intermittent abdominal discomfort and bloating. She also complains of associated episodes of diarrhoea, with mucus in the stool but no blood. The pain usually worsens after meals and improves after opening her bowels. She has not lost weight and continues to have a good appetite. She has had a knee replacement for osteoarthritis but no other significant medical history of note. Investigation of the patient’s symptoms reveals diverticular disease.

Which of the following complications is this patient most at risk of developing?

Colocutaneous fistulae

Colorectal carcinoma

Haemorrhoids

Anal fissure

Colovesical fistulae

A

A 61-year-old library assistant has an increasing frequency of episodes of intermittent abdominal discomfort and bloating. She also complains of associated episodes of diarrhoea, with mucus in the stool but no blood. The pain usually worsens after meals and improves after opening her bowels. She has not lost weight and continues to have a good appetite. She has had a knee replacement for osteoarthritis but no other significant medical history of note. Investigation of the patient’s symptoms reveals diverticular disease.

Which of the following complications is this patient most at risk of developing?

Colovesical fistulae

A colovesical fistula is an abnormal connection between the bladder and the colon. It presents with pneumaturia and other lower urinary tract symptoms.

104
Q

Which of the following is considered the most common underlying cause of colovesical fistula?

appendicitis
diverticulitis
colorectal cancer
Crohn disease
radiotherapy
trauma

A

Which of the following is considered the most common underlying cause of colovesical fistula?

appendicitis
diverticulitis
colorectal cancer
Crohn disease
radiotherapy
trauma

105
Q

A 36-year-old female with a history of ulcerative colitis (UC) for seven years seeks guidance on the frequency of colonoscopies in UC. Her UC is currently well-managed, and there is no family history of malignancy. She underwent a routine colonoscopy slightly over one year ago.

What would be the most appropriate date for her next colonoscopy appointment?

As soon as possible – they should be done annually

In one year

In two years

In four years

Colonoscopy is only indicated if the patient’s symptoms deteriorate

A

A 36-year-old female with a history of ulcerative colitis (UC) for seven years seeks guidance on the frequency of colonoscopies in UC. Her UC is currently well-managed, and there is no family history of malignancy. She underwent a routine colonoscopy slightly over one year ago.

What would be the most appropriate date for her next colonoscopy appointment?

In four years

National Institute for Health and Care Excellence (NICE) guidelines recommend a surveillance colonoscopy every five years. Patients at intermediate risk have a surveillance colonoscopy every three years and patients in the high-risk group annually.

106
Q

A 74-year-old male is seen by his General Practitioner with a one-month history of pain on passing urine. His urine dip is positive for blood but negative for leukocytes and nitrites, and he is started on nitrofurantoin for suspected urinary tract infection. His urine culture is negative. Two weeks later, he continues to experience pain in passing urine. His urine dip results are unchanged; blood tests reveal a raised white cell count.

What is the most appropriate management?

Further course of nitrofurantoin

Non-urgent Urology referral

Refer to Urology on the two-week wait pathway

Same-day Urology referral

Trimethoprim

A

A 74-year-old male is seen by his General Practitioner with a one-month history of pain on passing urine. His urine dip is positive for blood but negative for leukocytes and nitrites, and he is started on nitrofurantoin for suspected urinary tract infection. His urine culture is negative. Two weeks later, he continues to experience pain in passing urine. His urine dip results are unchanged; blood tests reveal a raised white cell count.

Refer to Urology on the two-week wait pathway

Referral of this patient under the suspected cancer pathway to Urology is necessary due to suspicious features suggestive of bladder cancer. According to the pathway criteria, patients aged 45 and above should be referred if they present with unexplained visible haematuria without urinary tract infection, visible haematuria that persists or reoccurs after urinary tract infection treatment, or unexplained non-visible haematuria in combination with raised serum white cell count or dysuria (for those over 60 years old). In this case, the persistent dysuria and elevated white cell count raise potential malignancy concerns.

107
Q

A surgeon performing his first appendectomy could not identify the base of the appendix due to massive adhesions in the peritoneal cavity. The consultant suggested identifying the caecum first and then localising the base of the appendix.

Which anatomical structure(s) on the caecum would he have used to find the base of the appendix?

Omental appendages
Haustra coli
Ileal orifice
Semilunar folds
Teniae coli

A

A surgeon performing his first appendectomy could not identify the base of the appendix due to massive adhesions in the peritoneal cavity. The consultant suggested identifying the caecum first and then localising the base of the appendix.

Which anatomical structure(s) on the caecum would he have used to find the base of the appendix?

Omental appendages
Haustra coli
Ileal orifice
Semilunar folds
Teniae coli

The Taeniae coli are three bands of longitudinal muscle on the surface of the large intestine. The large intestine does not have a continuous layer of longitudinal muscle; it has taeniae coli. These three bands meet at the appendix, which projects from the dependent portion of the caecum.

108
Q

A 56-year-old male presents with a high spiking fever for the past two weeks and dull abdominal pain in the right upper quadrant. Blood cultures were negative for the growth of any organisms. The patient gives a poor history, but on imaging, there is noted to be a collection in the liver. Ultrasound-guided biopsy reveals pus, which is described as anchovy sauce.

What is the most likely diagnosis?

Staphylococcus abscess

Amoebic abscess

Aspergillus abscess

Tuberculous abscess

Streptococcal abscess

A

A 56-year-old male presents with a high spiking fever for the past two weeks and dull abdominal pain in the right upper quadrant. Blood cultures were negative for the growth of any organisms. The patient gives a poor history, but on imaging, there is noted to be a collection in the liver. Ultrasound-guided biopsy reveals pus, which is described as anchovy sauce.

What is the most likely diagnosis?

Amoebic abscess

An amoebic liver abscess causes right upper quadrant pain, swinging fever and tenderness. This can occur following amoebic dysentery but does not always do so. Amoebic dysentery causes slowly increasing diarrhoea which can be profuse and bloody. Anchovy sauce pus in the liver is consistent with an amoebic abscess and is the key to this answer.

109
Q

A 55-year-old female presents with a thyroid lump and you have a clinical suspicion of follicular carcinoma of the thyroid.

Which of the following is the best option that fits such a case?

Can be managed by lobectomy

Fine needle aspiration cytology can differentiate between follicular adenoma and carcinoma

The prognosis is poor even if cancer is confined to the gland

Spreads mainly via blood

Spreads mainly via lymphatics

A

A 55-year-old female presents with a thyroid lump and you have a clinical suspicion of follicular carcinoma of the thyroid.

Which of the following is the best option that fits such a case?

Spreads mainly via blood

Follicular carcinoma is a carcinoma that spreads via the haematogenous route. Papillary and medullary carcinomas spread via the lymphatic system; anaplastic cancer spreads locally.

110
Q

What sign indicated global, rather than localised, peritonitis?

Pain worse on inspiration

Rebound tenderness

Guarding

Absent bowel sounds

Constant abdominal pain

A

What sign indicated global, rather than localised, peritonitis?

Absent bowel sounds

Other signs of generalised peritonitis are tenderness to percussion of the abdomen and a generalised rigid, ‘board-like’ abdomen.

111
Q

A 60-year-old male patient is admitted complaining of severe abdominal pain. He is diagnosed with mesenteric vascular occlusion. The small bowel becomes gangrenous and resection is performed.

Which of the following is a complication of this procedure?

Constipation
Scurvy
Weight gain
Nephrolithiasis
Achlorhydria

A

A 60-year-old male patient is admitted complaining of severe abdominal pain. He is diagnosed with mesenteric vascular occlusion. The small bowel becomes gangrenous and resection is performed.

Which of the following is a complication of this procedure?

Your answer was incorrect
Constipation
Scurvy
Weight gain

Nephrolithiasis
Achlorhydria

112
Q

A 33-year-old female is found to have a blood pressure of 180/130 mmHg incidentally on three separate occasions. Her General Practitioner completes the rest of her cardiovascular examination, which was unremarkable. Secondary hypertension causes are investigated, and an abdominal computed tomography (CT) angiogram is performed. This shows a significantly smaller left kidney compared to the right, with the left renal artery displaying a ‘string of beads’ appearance.

What would be the most appropriate management option for this patient?

Balloon angioplasty

Kidney transplantation

Nephrectomy

Statins

Surgical revascularisation

A

A 33-year-old female is found to have a blood pressure of 180/130 mmHg incidentally on three separate occasions. Her General Practitioner completes the rest of her cardiovascular examination, which was unremarkable. Secondary hypertension causes are investigated, and an abdominal computed tomography (CT) angiogram is performed. This shows a significantly smaller left kidney compared to the right, with the left renal artery displaying a ‘string of beads’ appearance.

What would be the most appropriate management option for this patient?

Balloon angioplasty

Kidney transplantation

Nephrectomy

Statins

Surgical revascularisation

113
Q

A 72-year-old female with a history of diverticular disease undergoes emergency abdominal surgery. When examining this patient after her surgery, you notice she has an end colostomy.

What feature would suggest that this patient has had a Hartmann’s procedure and not an abdominoperineal (AP) resection?

Mid-line scar

End colostomy

Presence of rectum

Rutherford–Morison scar

Presence of solid faeces in stoma bag

A

A 72-year-old female with a history of diverticular disease undergoes emergency abdominal surgery. When examining this patient after her surgery, you notice she has an end colostomy.

What feature would suggest that this patient has had a Hartmann’s procedure and not an abdominoperineal (AP) resection?

Presence of rectum

Complete excision of the rectum and anus is carried out as part of an AP resection. Therefore, the presence of the rectum excludes an AP resection.

114
Q

The Fontaine classification is used to stage which pathology?

A

Critical limb ischaemia

115
Q

A patient describes pain in their lower limb. After you ask them to describe the pain more they describe a cramping in their legs after walking 300 m in distance.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

A

A patient describes pain in their lower limb. After you ask them to describe the pain more they describe a cramping in their legs after walking 300 m in distance.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

116
Q

A patient describes pain in their lower limb. After you ask them to describe the pain more they describe a cramping in their legs when they’re resting.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

A

A patient describes pain in their lower limb. After you ask them to describe the pain more they describe a cramping in their legs when they’re resting.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

117
Q

A patient describes pain in their lower limb. After a clinical exam you find that they have pain walking around the room, but have no rest pain.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

A

A patient describes pain in their lower limb. After a clinical exam you find that they have pain walking around the room, but have no rest pain.

What is their Fontaine classification?

Stage I
Stage IIa
Stage IIb
Stage III
Stage IV

118
Q

What is the name for this test / what does it test?

A

Buergers test for PAD

119
Q

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.8. This PAD can be classified as

Normal
Mild
Moderate
Severe

A

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.8. This PAD can be classified as

Normal
Mild
Moderate
Severe

0.9 – 1.3 is normal
0.6 – 0.9 indicates mild peripheral arterial disease
0.3 – 0.6 indicates moderate to severe peripheral arterial disease
Less than 0.3 indicates severe disease to critical ischaemic

120
Q

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.5. This PAD can be classified as

Normal
Mild
Moderate
Severe

A

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.5. This PAD can be classified as

Normal
Mild
Moderate
Severe

121
Q

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.2. This PAD can be classified as

Normal
Mild
Moderate
Severe

A

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.2. This PAD can be classified as

Normal
Mild
Moderate
Severe

122
Q

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.7. This PAD can be classified as

Normal
Mild
Moderate
Severe

A

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.7. This PAD can be classified as

Normal
Mild
Moderate
Severe

123
Q

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.4 This PAD can be classified as

Normal
Mild
Moderate
Severe

A

A patient has their ABPI measured due to suspeted PAD. The ratio is found to be 0.4 This PAD can be classified as

Normal
Mild
Moderate
Severe

124
Q

Diabetic patients commonly have a score greater than [].
Explain why [1]

A

Greater than 1.3 due to calcification

125
Q

Which of the following presentations is classical for an aortic dissection?

  • Central crushing chest pain, radiating down the left arm, with tachycardia and hypertension
  • A tearing central chest pain, new onset cardiac murmur, and tachycardia
  • Sudden onset dyspnoea with widespread crackles and wheeze
  • A burning pain, spreading from the epigastrium to the central chest, worse when lying down, normal clinical examination
A

Which of the following presentations is classical for an aortic dissection?

  • Central crushing chest pain, radiating down the left arm, with tachycardia and hypertension
  • A tearing central chest pain, new onset cardiac murmur, and tachycardia
  • Sudden onset dyspnoea with widespread crackles and wheeze
  • A burning pain, spreading from the epigastrium to the central chest, worse when lying down, normal clinical examination
126
Q

What is the gold standard imaging modality for first line investigation of a suspected aortic dissection?

ECHO

CT Chest-Abdo-Pelvis

CXR

CT Angiogram

A

What is the gold standard imaging modality for first line investigation of a suspected aortic dissection?

ECHO

CT Chest-Abdo-Pelvis

CXR

CT Angiogram

127
Q

This CT Chest depicts which Standford classification of Aortic Dissection? [1]

Type I

Type II

Type IIIa

Type IIIb

A

Type IIIa

Type III – originates distal to the subclavian artery in the descending aorta
Further subdivided into IIIa which extends distally to the diaphragm and IIIb which extends beyond the diaphragm into the abdominal aorta

128
Q

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

A

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

129
Q

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

A

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

130
Q

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

A

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

131
Q

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

A

What is Debakey classification for aortic dissection is this?

Type I
Type II
Type IIIa
Type IIIB

132
Q

A 65-year-old man attends an abdominal aortic aneurysm (AAA) screening offered by his GP. On ultrasound, it is revealed that he has a supra-renal aneurysm that is 4.9 cm in diameter. When questioned he says he has no symptoms.

How should this patient be managed?

12-monthly ultrasound assessment
3-monthly ultrasound assessment
6-monthly ultrasound assessment
Referral to stop smoking services
Urgent referral to vascular surgery

A

A 65-year-old man attends an abdominal aortic aneurysm (AAA) screening offered by his GP. On ultrasound, it is revealed that he has a supra-renal aneurysm that is 4.9 cm in diameter. When questioned he says he has no symptoms.

How should this patient be managed?

12-monthly ultrasound assessment
3-monthly ultrasound assessment
6-monthly ultrasound assessment
Referral to stop smoking services
Urgent referral to vascular surgery

133
Q

A 55-year-old lady with claudication is assessed and an ABPI is performed. Results show an ABPI value of 1.3. Which of the following conditions may lead to this abnormal result?

Hypothyroidism

Hypercalcaemia

Type 2 diabetes

Peripheral arterial disease

Previous deep vein thrombosis

A

A 55-year-old lady with claudication is assessed and an ABPI is performed. Results show an ABPI value of 1.3. Which of the following conditions may lead to this abnormal result?

Hypothyroidism

Hypercalcaemia

Type 2 diabetes

Peripheral arterial disease

Previous deep vein thrombosis

134
Q

A 38-year-old patient with known peripheral vascular disease presents to the emergency department complaining of pain at rest in his left leg. He is a smoker, however his BMI is 25 kg/m² and he has no other medical history.

On examination, he has absent foot pulses and lower limb pallor.

Critical limb ischaemia is suspected and he undergoes a CT angiogram which reveals a long segmental obstruction.

What is the most appropriate treatment?

Angioplasty with stenting
Aspirin
Balloon angioplasty
Below-knee amputation
Open bypass graft

A

Open bypass graft

135
Q

A 35-year-old man has a 3-week history of progressive pain in his left calf. The pain is worse with activity, present at rest, but relieved by hanging his legs over the bedside. He has a medical history of hypertension and diabetes mellitus.

On examination, the left calf is paler than the right, and pulses are difficult to palpate. A small ulcer is noted on the dorsum aspect of the left foot. The right calf is unaffected. Magnetic resonance angiography demonstrates a stenotic lesion 8 cm in length in the femoral artery.

What is the most appropriate definitive management for this condition?

Endovascular revascularization
Femoral artery bypass surgery
Femoral endarterectomy
IV unfractionated heparin
Left lower limb amputation

A

Endovascular revascularization

Peripheral arterial disease with critical limb ischaemia: high-risk patients with short segment stenosis are more suited to endovascular revascularization

136
Q

Name 5 reasons you might see bilateral scars like this

A

Acromegaly
Obesity
Hypothyroidism
Pregnancy
RA

137
Q

Which of the following descriptions of benign or malignant focal lung opacities is correct?

benign: much wider than tall, with scalloped margins
benign: taller than wide, with rounded margins
malignant: microlobulated margins, with sparse, angulated radiations
malignant: polygonal margins, with indrawing of the fissure

A

Which of the following descriptions of benign or malignant focal lung opacities is correct?

benign: much wider than tall, with scalloped margins
benign: taller than wide, with rounded margins
malignant: microlobulated margins, with sparse, angulated radiations
malignant: polygonal margins, with indrawing of the fissure

138
Q

thyroid transcription factor 1 (TTF-1) is expressed in most lung cancer except [] cancer

squamous cell lung cancer

small cell lung cancer

large cell lung cancer

lung adenocarcinoma

A

thyroid transcription factor 1 (TTF-1) is expressed in most lung cancer except [] cancer

squamous cell lung cancer

small cell lung cancer

large cell lung cancer

lung adenocarcinoma

139
Q

Which of the following lung cancers is NOT associated with cigarette smoking?

adenocarcinoma
adenoid cystic carcinoma
adenosquamous carcnioma
large-cell lung cancer
small-cell lung cancer
squamous cell carcinoma

A

Which of the following lung cancers is NOT associated with cigarette smoking?

adenocarcinoma
adenoid cystic carcinoma
adenosquamous carcnioma
large-cell lung cancer
small-cell lung cancer
squamous cell carcinoma

140
Q

In which of the following locations are localized plaques reported to LEAST occur from asbestos exposure?

Trachea and main bronchi
Along the mediastinum
Lateral chest wall
Both hemidiaphragms

A

Trachea and main bronchi

Localized plaques associated with asbestos exposure are most frequently reported in both hemidiaphragms, the lateral chest wall and along the mediastinum.

141
Q

Patients with proliferative diabetic retinopathy and no macular involvement should be treated with []

A

Patients with proliferative diabetic retinopathy and no macular involvement should be treated with panretinal photocoagulation.

142
Q

A patient presents with severe diarrhoea. You suspect C. diff, which is confirmed with C. diff toxins being identified in stool. You perform a blood test to investigate WCC to assess if the infection is severe or not.

Which of the following is the cut off for WCC that would indicate a severe C diff infection?

8 x 10^9
10 x 10^9
12 x 10^9
15 x 10^9
20 x 10^9

A

15 x 10^9

143
Q

A patient presents with legs that they can’t stop moving. You suspect this is because of a deficiency in their diet. What is the most likely?

B12
Folate
Iron
K

A

Restless leg syndrome: IDA

144
Q

A child starts eating mud. This is most likely because they have a deficiency in

B12
Folate
Iron
K

A

Iron: PICA

Pica is the abnormal craving or appetite for non-food substances, such as soil, ice, paint, or clay. It has been reported in up to 55% of patients with IDA.[86] Ingestion of some materials, such as clay, has chelating effects, which can impair the absorption of iron. These cravings correct within 2 weeks of iron replacement.

145
Q

Heinz bodies on a blood film would indicate which cause of anaemia

G6PD deficiency
Pernicious anaemia
Hereditary spherocytosis
Sickle cell anaemia

A

Heinz bodies on a blood film would indicate which cause of anaemia

G6PD deficiency
Pernicious anaemia
Hereditary spherocytosis
Sickle cell anaemia

146
Q

This blood film would indicate

G6PD deficiency
Pernicious anaemia
Hereditary spherocytosis
Sickle cell anaemia

A

G6PD deficiency - Heinz bodies

147
Q

According to NICE guidelines, what hemoglobin level is indicative of anemia in adult males?

A. < 12 g/dL
B. < 13 g/dL
C. < 14 g/dL
D. < 15 g/dL

A

According to NICE guidelines, what hemoglobin level is indicative of anemia in adult males?

A. < 12 g/dL
B. < 13 g/dL
C. < 14 g/dL
D. < 15 g/dL

148
Q

In the context of macrocytic anemias, which laboratory test is crucial for differentiating between vitamin B12 deficiency and folate deficiency?

A. Methylmalonic acid (MMA)
B. Homocysteine levels
C. Serum vitamin B12
D. Reticulocyte count

A

In the context of macrocytic anemias, which laboratory test is crucial for differentiating between vitamin B12 deficiency and folate deficiency?

A. Methylmalonic acid (MMA)
B. Homocysteine levels
C. Serum vitamin B12
D. Reticulocyte count

149
Q

Which type of anemia is characterized by a low serum iron, low total iron-binding capacity (TIBC), and a high transferrin saturation?

A. Iron deficiency anemia
B. Anemia of chronic disease
C. Sideroblastic anemia
D. Thalassemia

A

Which type of anemia is characterized by a low serum iron, low total iron-binding capacity (TIBC), and a high transferrin saturation?

A. Iron deficiency anemia
B. Anemia of chronic disease
C. Sideroblastic anemia
D. Thalassemia

150
Q

According to NICE guidelines, what is the primary confirmatory test for hereditary hemochromatosis?

A. Liver biopsy
B. Serum ferritin
C. Genetic testing (HFE mutations)
D. Iron studies

A

According to NICE guidelines, what is the primary confirmatory test for hereditary hemochromatosis?

A. Liver biopsy
B. Serum ferritin
C. Genetic testing (HFE mutations)
D. Iron studies

151
Q

Which form of thalassemia is characterized by a microcytic hypochromic anemia with target cells on peripheral blood smear?

A. Beta-thalassemia major
B. Alpha-thalassemia minor
C. Beta-thalassemia minor
D. Alpha-thalassemia major

A

Which form of thalassemia is characterized by a microcytic hypochromic anemia with target cells on peripheral blood smear?

A. Beta-thalassemia major
B. Alpha-thalassemia minor
C. Beta-thalassemia minor
D. Alpha-thalassemia major

152
Q

In the diagnosis of aplastic anemia, which parameter is typically reduced in the peripheral blood count?

A. Reticulocyte count
B. White blood cell count
C. Platelet count
D. Hematocrit

A

In the diagnosis of aplastic anemia, which parameter is typically reduced in the peripheral blood count?

A. Reticulocyte count
B. White blood cell count
C. Platelet count
D. Hematocrit

153
Q

What is the primary screening test for sickle cell anemia in newborns, as recommended by NICE guidelines?

A. Hemoglobin electrophoresis
B. High-performance liquid chromatography (HPLC)
C. Sickle solubility test
D. Complete blood count (CBC)

A

What is the primary screening test for sickle cell anemia in newborns, as recommended by NICE guidelines?

A. Hemoglobin electrophoresis
B. High-performance liquid chromatography (HPLC)
C. Sickle solubility test
D. Complete blood count (CBC)

154
Q

According to NICE guidelines, what is the recommended initial test for suspected hemoglobinopathies in newborns?
A. Complete blood count (CBC)
B. High-performance liquid chromatography (HPLC)
C. Osmotic fragility test
D. Hemoglobin electrophoresis

A

Which type of anemia is characterized by a triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal dysfunction?
A. Sickle cell anemia
B. Hemolytic-uremic syndrome
C. Aplastic anemia
D. Polycythemia vera

155
Q

According to NICE guidelines, what is the recommended initial test for suspected hemoglobinopathies in newborns?
A. Complete blood count (CBC)
B. High-performance liquid chromatography (HPLC)
C. Osmotic fragility test
D. Hemoglobin electrophoresis

A

According to NICE guidelines, what is the recommended initial test for suspected hemoglobinopathies in newborns?
A. Complete blood count (CBC)
B. High-performance liquid chromatography (HPLC)
C. Osmotic fragility test
D. Hemoglobin electrophoresis

156
Q
A
157
Q

Which of the following is most associated with Fanconi syndrome (a syndrome of inadequate reabsorption in the proximal renal tubules of the kidney)

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

A

Acute myeloid leukaemia

158
Q

Which of the following is most associated with : exposure to certain toxins (e.g. benzene and organochlorine insecticides)

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

A

Which of the following is most associated with : exposure to certain toxins (e.g. benzene and organochlorine insecticides)

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

159
Q

Which of the following is most associated with : exposure to previous chemotherapy regimens, in particular alkylating agents and topoisomerase-II inhibitors

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

A

Acute myeloid leukaemia

160
Q

According to NICE guidelines, which diagnostic test is recommended for confirming the diagnosis of alpha thalassemia trait?
a) Hemoglobin electrophoresis
b) Molecular genetic testing
c) Complete Blood Count (CBC)
d) Serum Ferritin

A
161
Q

Alpha thalassemia can result from the deletion of alpha-globin genes. What is the most common alpha thalassemia genotype associated with clinical manifestations?
a) αα/αα
b) –/αα
c) –/–
d) α-/α-

A

Alpha thalassemia can result from the deletion of alpha-globin genes. What is the most common alpha thalassemia genotype associated with clinical manifestations?
a) αα/αα
b) –/αα
c) –/–
d) α-/α-

162
Q

In alpha thalassemia, the Hemoglobin H (HbH) disease results from the deletion of three alpha-globin genes. What is the recommended treatment for patients with HbH disease, according to NICE?

a) Blood transfusion
b) Hydroxyurea
c) Folic Acid supplementation
d) Hematopoietic stem cell transplantation

A

c) Folic Acid supplementation

163
Q

Individuals with alpha thalassemia trait (silent carrier) typically have two affected alpha-globin genes. How does NICE recommend managing asymptomatic individuals with alpha thalassemia trait during pregnancy?

a) Iron supplementation
b) Genetic counseling
c) Folate supplementation
d) Regular blood transfusions

A

Individuals with alpha thalassemia trait (silent carrier) typically have two affected alpha-globin genes. How does NICE recommend managing asymptomatic individuals with alpha thalassemia trait during pregnancy?

a) Iron supplementation
b) Genetic counseling
c) Folate supplementation
d) Regular blood transfusions

164
Q

For couples at risk of having a child with alpha thalassemia, what is the primary method of prenatal diagnosis recommended by NICE?

a) Amniocentesis
b) Chorionic villus sampling (CVS)
c) Non-invasive prenatal testing (NIPT)
d) Ultrasound

A

b) Chorionic villus sampling (CVS)

165
Q

NICE recommends screening for alpha thalassemia in newborns. What is the primary screening test used for this purpose?

a) Hemoglobin electrophoresis
b) Complete Blood Count (CBC)
c) DNA analysis
d) Serum Ferritin

A

NICE recommends screening for alpha thalassemia in newborns. What is the primary screening test used for this purpose?

a) Hemoglobin electrophoresis
b) Complete Blood Count (CBC)
c) DNA analysis
d) Serum Ferritin

166
Q

After the diagnosis of alpha thalassemia, what is the recommended frequency of follow-up monitoring for individuals with alpha thalassemia trait, according to NICE?

a) Every 6 months
b) Annually
c) Biennially
d) Only as needed based on symptoms

A

After the diagnosis of alpha thalassemia, what is the recommended frequency of follow-up monitoring for individuals with alpha thalassemia trait, according to NICE?

a) Every 6 months
b) Annually
c) Biennially
d) Only as needed based on symptoms

167
Q

According to NICE guidelines, which diagnostic test is recommended for confirming the diagnosis of beta thalassemia major?
a) Complete Blood Count (CBC)
b) Hemoglobin electrophoresis
c) Serum Ferritin
d) Molecular genetic testing

A

d) Molecular genetic testing

168
Q

In beta thalassemia major, NICE recommends regular blood transfusions to maintain hemoglobin levels. What is the target pre-transfusion hemoglobin level, according to NICE?
a) 8-9 g/dL
b) 9-10 g/dL
c) 10-11 g/dL
d) 11-12 g/dL

A

In beta thalassemia major, NICE recommends regular blood transfusions to maintain hemoglobin levels. What is the target pre-transfusion hemoglobin level, according to NICE?
a) 8-9 g/dL
b) 9-10 g/dL
c) 10-11 g/dL
d) 11-12 g/dL

169
Q

Individuals with beta thalassemia major are at risk of iron overload due to frequent transfusions. How often does NICE recommend monitoring serum ferritin levels for these patients?
a) Every 3 months
b) Every 6 months
c) Annually
d) Biennially

A

Individuals with beta thalassemia major are at risk of iron overload due to frequent transfusions. How often does NICE recommend monitoring serum ferritin levels for these patients?
a) Every 3 months
b) Every 6 months
c) Annually
d) Biennially

170
Q

To manage iron overload in beta thalassemia major, NICE recommends chelation therapy. Which chelator is commonly used in this setting?
a) Deferoxamine
b) Deferiprone
c) Desferrioxamine
d) Deferasirox

A

To manage iron overload in beta thalassemia major, NICE recommends chelation therapy. Which chelator is commonly used in this setting?
a) Deferoxamine
b) Deferiprone
c) Desferrioxamine
d) Deferasirox

171
Q

NICE recommends folate supplementation in beta thalassemia major. What is the purpose of folate supplementation in these patients?
a) Stimulate erythropoiesis
b) Prevent neural tube defects
c) Enhance iron chelation
d) Reduce oxidative stress

A

NICE recommends folate supplementation in beta thalassemia major. What is the purpose of folate supplementation in these patients?
a) Stimulate erythropoiesis
b) Prevent neural tube defects
c) Enhance iron chelation
d) Reduce oxidative stress

172
Q

In beta thalassemia major, allogeneic bone marrow transplantation is considered a curative option. What is a key requirement for a successful bone marrow transplant?
a) Age over 50 years
b) HLA-matched sibling donor
c) Presence of iron overload
d) Chronic liver disease

A

In beta thalassemia major, allogeneic bone marrow transplantation is considered a curative option. What is a key requirement for a successful bone marrow transplant?
a) Age over 50 years
b) HLA-matched sibling donor
c) Presence of iron overload
d) Chronic liver disease

173
Q

NICE suggests the use of hydroxyurea in beta thalassemia intermedia to reduce transfusion requirements. What is the mechanism of action of hydroxyurea in this context?
a) Stimulation of fetal hemoglobin
b) Inhibition of iron absorption
c) Prevention of bone marrow suppression
d) Induction of erythropoiesis

A

NICE suggests the use of hydroxyurea in beta thalassemia intermedia to reduce transfusion requirements. What is the mechanism of action of hydroxyurea in this context?
a) Stimulation of fetal hemoglobin
b) Inhibition of iron absorption
c) Prevention of bone marrow suppression
d) Induction of erythropoiesis

174
Q

Beta thalassemia major can lead to complications such as endocrine dysfunction. Which endocrine complication is commonly associated with beta thalassemia major, according to NICE?
a) Thyroid dysfunction
b) Diabetes mellitus
c) Growth hormone deficiency
d) Adrenal insufficiency

A

Beta thalassemia major can lead to complications such as endocrine dysfunction. Which endocrine complication is commonly associated with beta thalassemia major, according to NICE?
a) Thyroid dysfunction
b) Diabetes mellitus
c) Growth hormone deficiency
d) Adrenal insufficiency

175
Q

Beta thalassemia major can lead to cardiac complications. How often does NICE recommend cardiac monitoring, including echocardiography, for these patients?

a) Every 2 years
b) Every 5 years
c) Annually
d) Only when symptoms arise

A

Beta thalassemia major can lead to cardiac complications. How often does NICE recommend cardiac monitoring, including echocardiography, for these patients?
a) Every 2 years
b) Every 5 years
c) Annually
d) Only when symptoms arise

176
Q

According to NICE guidelines, which imaging modality is recommended for the initial staging of Hodgkin’s lymphoma?

a) X-ray
b) Computed Tomography (CT)
c) Magnetic Resonance Imaging (MRI)
d) Positron Emission Tomography (PET)

A

According to NICE guidelines, which imaging modality is recommended for the initial staging of Hodgkin’s lymphoma?

a) X-ray
b) Computed Tomography (CT)
c) Magnetic Resonance Imaging (MRI)
d) Positron Emission Tomography (PET)

177
Q

What is the preferred method for obtaining a definitive diagnosis of Hodgkin’s lymphoma, as recommended by NICE?

a) Fine needle aspiration
b) Core needle biopsy
c) Excisional lymph node biopsy
d) Bone marrow biopsy

A

c) Excisional lymph node biopsy

178
Q

NICE provides guidance on follow-up monitoring for Hodgkin’s lymphoma survivors. How often does NICE recommend follow-up appointments during the first two years after treatment?

a) Every 3 months
b) Every 6 months
c) Annually
d) Biennially

A

NICE provides guidance on follow-up monitoring for Hodgkin’s lymphoma survivors. How often does NICE recommend follow-up appointments during the first two years after treatment?

a) Every 3 months
b) Every 6 months
c) Annually
d) Biennially

179
Q

Hodgkin’s lymphoma survivors are at risk of late effects from treatment. What is a common late effect that NICE emphasizes for monitoring?

a) Osteoporosis
b) Cardiomyopathy
c) Peripheral neuropathy
d) Diabetes

A

Hodgkin’s lymphoma survivors are at risk of late effects from treatment. What is a common late effect that NICE emphasizes for monitoring?
a) Osteoporosis
b) Cardiomyopathy
c) Peripheral neuropathy
d) Diabetes

180
Q

In relapsed or refractory Hodgkin’s lymphoma, what is a commonly used salvage chemotherapy regimen according to NICE?

a) ABVD
b) BEACOPP
c) CHOP
d) EPOCH

A

In relapsed or refractory Hodgkin’s lymphoma, what is a commonly used salvage chemotherapy regimen according to NICE?

a) ABVD
b) BEACOPP
c) CHOP
d) EPOCH

Yr3 Revision (37 decks)

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