Questions Flashcards
drugs of abuse- one was a kid with cracked nose and lips
Solvents
designing paeds health programme to reduce death due to accident in primary sch kids, which area focus on: choices were RTA, pedestrian accidents, home appliances etc.
Road traffic accidents
bleeding/unwell post-partum most common cause Atonic Uterus Trauma Infection Endometritis Coagulation Disorders
Uterine atony
80 year old with uterine prolapse. What pessary should she get? She still wants to have sex
Ring
Shelf
Gellhorn
Ring
- 14 year old primary amenorrhoea + ejection systolic murmur
Turners
What gives you macrosomia during pregnacy Pre-eclampsia Infections Gestational Diabetes Alcohol
Gestational Diabetes
- Cyclical pain, no heavy menstrual bleed, never sexually active
Primary Dysmenorrhoea
- Ethics – 14 year old pregnant, comes with sister, wants a TOP. What should you do?
Persuade her to tell her parents if she refuses and gillick competent, you can give her TOP.
- What situation would you use donor eggs?
Premature Ovarian Failure
- What do you test for in Hep B infection antenatally?
HbsAg
HbeAg
Anti-Hbc
HbsAg
- What is not a risk factor for primary PPH?
a. B thalassaemia trait
b. Retained products
c. Sepsis
d. Vaginal tear
e. Multiparity
Thalssaemia
- At antenatal check, woman with BP 150/90, what would you do
Admit and assess
Discharge and follow up next week
Discharge and follow up at the end of pregnancy
Immediate delivery
Admit and assess
Stress incontinence first line management? Pessary Pelvic Floor exercise Oxybutinin Bladder training
Pelvic floor exercises
- What is the treatment for a bartholian abscess
Marsupialisation
- Women with previous GDM what is the best way to investigation her blood glucose? OGTT
OGTT at 16-18 weeks
- Women with spotting otherwise well, what is the most important thing to rule out, 8 weeks pregnant?
Ectopic Pregnancy
13. What type of contraception can increase risk of osteoporosis? COCP Progesterone Pill Depot Implant Copper Coil
Depot
- Women with excessive vomiting, under what circumstance would you admit her?
5% dehydration
Ketonuria
Requires antiemetic
Ketonuria
- What is likely to cause this man’s azoospermia with no significant recent history?
Mumps
Trauma
Malignancy
Mumps
- Menopause treatment – what HRT would you give
a. Premature menopause and wants a bleed
Cyclical oral HRT
- Menopause treatment – what HRT would you give
b. Someone want something for their bones –
Bisphosphonate
- Menopause treatment – what HRT would you give
c. Women with menopausal symptoms, hysterectomised, does not want to take oral tablets
Transdermal Oestrogen HRT
- Menopause treatment – what HRT would you give
d. Perimenopausal women with menopausal symptoms, irregular menstruation, does swimming and does not patch
Cyclical oral HRT
- Menopause treatment – what HRT would you give
e. Women with menopausal symptoms and has eczema
Oral combined HRT
Clue Cells
BV
Strawberry cervix
Trichomonas Vaginalis
Panful multiple lesions on labia
Herpes
white patches on the genitals in woman over 50, no cure
Lichen sclerosus
Curdy white-yellow discharge
Candidiasis
Blue dots on cyst
Nathobian Cyst
Mother with stillborn baby, generalized oedematous when born, mother had fever at 18w with rash on trunk
Parvovirus B19
Smear shows moderate dyskariosis
CIN2
76 year old woman had a brown dishcarge. What is most likely cuase Endometrial Cancer Cervical Cancer Cervical Ectropion Atrophic Vaginitis Infection
Atrophic Vaginitis
47yo women with menorrhagia + dysmenorrhea, US showed multiple fibroids. Management
Myomectomy or Hysterectomy
32 yo has 2 children says shes done with family, had COCOP before
Mirena
c. Women going away for holiday and would like to delay her periods
COCP
a. Mother being prepared for CS, sudden tingling around her mouth?
Spinal block
b. Mother being prepared for CS and has a regional block, sudden tachycardia, SOB, difficulty in breathing and rash
Anaphylaxis
c. Mother had previous CS, sudden abdo pain and abnormal CTG
Uterine rupture
c. Intermittent pain + vomiting in young woman not pregnant
Ovarian torsion
- Kid with fever of >39 what to do next
Full septic screen
Mother with kid who still isn’t speaking, and should have been time ago
Hearing assessment
- Kid fitting for over 5mins, normal glucose, what do you give?
Buccal midazolam
Rectal diazepam
or if IV access, lorazepam
- Asthma management. Kid with acute exacerbation, been given salbutamol and steroids. On listening to the chest, you hear a quiet chest, respiratory rate 60. What to do?
Call PICU, consider intubation
- Dehydration + ill kid – weight 15kg what do you give initially?
300ml IV bolus
- Aspiration pneumonia what would you do?
ABCDE
Bronchoscopy removal, Abx etc….
Strawberry tongue
Kawasaki or Scarlet fever
- What is the purpose of debriefing after a child’s death in resuscitation?
To address emotional needs of everyone in the team
- Child who pass stool every few days, when he does go, stools are pellet like and smelly, what is the likely diagnosis
Constipation
- Child with pruritus ani worse at night, what would you give to treat?
Mebendazole
a. Impetigo management
Topical fusidic acid
Rash involving flexures with satellite pustules treatment
Clotrimazole
Rash not involving the flexures treatment
Zinc and caster oil
Scabies treatment
Entire family with permethrin cream
Chicken pox treatment
None needed, supportive
By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones
Sit without support
8 months
By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones
Walk
18 months
By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones
Hop on one leg
5 years
By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones
Pincer grip
12-18 months.
By WHAT AGE would you refer the following kids if they haven’t achieve the following milestones
Smiles
8 weeks
Intoxicated Kid Investigations
Urine drug screen
Dehydrated, seizures, mother been giving some herbal oral rehydration fluid or something Investigations
Sodium
Sick kid with fever, vomiting, photophobia Investigations
CT Head then LP if not contraindicated
Sick kid with fever, vomiting, photophobia Investigations
CT Head
Resp Problems
Neonate still needing oxygen
Bronchopulmonary Dysplasia
Resp Problems
Ground glass appearance
RDS
Resp Problems
Nitrogen washout test done
Congenital Heart Disease
Resp Problems
Meconium stained liquor
Meconium aspiration
Resp Problems
Meconium stained liquor
Meconium aspiration
large abdominal mass, often incidentally found in an otherwise well child
Wilms tumour
malignant tumour of retinal cells, all bilateral tumours are hereditary, white pupillary reflex noted to replace normal red one or otherwise present with a squint.
Retinoblastoma
in limbs with persistent localised bone pain
Osteoid Sarcoma. More common than Ewings
2-5 years age, insidious presentation over several weeks but may progress rapidly, see malaise, anorexia, pallor, lethargy, infection, bruising, petechiae,
ALL
Arises in midline of posterior fossa – may see through CNS via CSF and 20% have spinal metastases at diagnosis; signs and symptoms may be due to raised ICP and depends on site of tumor e.g. back pain, peripheral weakness.
Medulloblastoma
a. Kid with sore throat, cervical lymphademopathy, been given antibiotics, rash comes on.
EBV
b. Rash that started from behind the ears and spread to trunk, parents are vegetarians and kid goes to school in north London
Measles
a. Intermittent pain, dehydrated, vomited 3 times
Intussusception
Sudden abdo pain, well child, something indentable on the RLQ
Constipation
Scaphoid abdomen in neonate, heart sounds displaced
Diaphragmatic Hernia
- Recurrent abdominal pain, under what circumstances would you refer to CAMHS?
If it’s peak and even primary community services don’t work and neither does the health visitor
- Ethics – 78 year old fell and sustained a fractured NoF and refuse surgery, son is a lawyer and says his mother does not have capacity, what should you do?
Assess capacity
- Someone who just started on an antipsychotic and becomes tachycardia, hyperthermia, sweating, urine drug screen negative.
Neuroleptic Malignant Syndrome
- Diagnosed bipolar disorder – sudden renal failure, what do you check?
Lithium Levels
- Starting 21 year old with depression + suicidal idealization on antidepressants, what is your follow up plan?
Review in 1 week
- Someone with acute dystonia what would you give?
Procyclidine
- Someone with bulimia, BMI 22, well and keen to get treatment.
Fluoxetine and CBT
- Someone who lost her husband 7 months ago and started hearing voices of him saying to join him a month ago
Abnormal grief response
- Alcoholic and had previous delirious tremens and wants detox at home what would you do?
Reducing dose of chlordiazepoxide
- Someone with depression and has made plans to end his life comes to your GP surgery with his sister what would you do?
A&E Admission
- Out of the following people, who is likely to commit suicide?
Women
Managerial Workers
People who are not married
People aged 40-50
Someone who likes to drink a glass of wine occassionally
Unmarried person
- If all these children have learning disability, who is most likely to have mental disorder later on?
a. Child with epilepsy
b. Child with long term illness
c. Child with malignancy
Epilepsy
- Women with sudden confusion what would you do first?
Urine dip
Two antipsychotics have failed to work.
Clozapine
Acute dystonia following haloperidol
Procyclidine
Aggressive person needs tranquilisation
Haloperidol
Moderate depression in young adult
Citalopram
a. Who would you refer a schizophrenic patient to if they are being discharged and needs support in the community regarding treatment?
Community psychiatric nurse
b. Someone with schizo and need help organizing their activities after they are being discharged?
OT
c. Girl who overdose in front of her boyfriend after a row, no previous suicide/ self-harm attempts. Good health. Only did it because she wanted attention from her boyfriend.
GP
Lady with CIN II – Moderate dyskariosis. What does this mean?
Increased nuclear: cytoplasmic ratio; Abnormal mitosis
20 week antenatal scan. Which of the following is best description:
Structural Anomaly Scan
Lady has a diagnostic laparotomy. She has suprapubic pain that not even IV painkiller is helping.
Urinary retention
Somali lady comes in doesn’t speak much English says she’s 42 weeks. Examination of abdomen suggests a 32 week uterus. What is next in management?
Admit because she might have HIV which would explain SGA
Overweight lady you notice she’s hirsute
PCOS
Leading cause of maternal mortality in UK
Sepsis
Management of 4 year old with enuresis - dry by day
Reassure. Problematic at 5
Child with Downs has an NJ tube at home. It comes out and needs re-inserting. Who should put it back in?
Should be done at hospital cos XR needs to be done to confirm its in
You’re the duty GP. Mum calls about child with fever/non-blanching rash. What do you do/advise?
Go to A&E
Child diagnosed with functional abdo pain. Associated with school. What’s the best management plan?
Advise them to go to school and come back home if they start to have pains
Child is slow to get dressed. Likes to arrange his toys in a particular way. [
ASD
Child is an arsonist. Gets in fights. Attacks teachers. What is he likely to have at age 20?
Conduct Disorder
Talking about a ~8 month child with cerebral palsy. Which of their milestones is likely to suggest CP
Hand preference
Ortolani test positive. What you do?
USS at 3m
Child with downs in residence. Short term history of attacking people, anger outbursts etc. Best management? [Give antipsychotics; Move her to new home; Send her for neuropsychiatric assessment/therapy; Give antidepressant]
Review with neruopsychiatry
Asthmatic child in A&E. Mother has been giving two puffs of salbutamol with spacer every 4 hours. Description given correlated to severe asthma. What your management? [Inhaled nebs; inhaled adrenaline, Discharge; 10 puffs of salbutamol through spacer]
10 puffs through spacer
Child has inspiratory stridor (doesn’t explicitly state, but gives a description implying this) since birth. Likely cause?
Laryngomalacia
Child takes 4 tablets of grandmothers benzodiazepines 4 hours ago. She’s currently asleep, but was fully awake with GCS 15. Your next step? [Activate charcoal; Gastric Lavage; IV flumenazil; admit for monitoring]
Admit to monitor
Afebrile child with D+V. Description alludes to shock. She is 15kg. What do you give her initially? Fluids wise
300ml bolus of saline
7 year old goes to a new school. School complains that he keeps soiling himself. What is most likely reason?
Stool holding
A child who recently started solids has been suffering from constipation. On examination no fecal masses felt per abdomen. Management?
Lifestyle, fluids and all that
What defines a mild learning disability?
IQ 70
Which of the following is not an RF for suicide? [FHx of depression; FHx of suicide; Prev suicide attempt; Male; Heroin-use]
FHx of depression
75 yr lady bought in with daughter. “She”says is anxious, being increasingly forgetful lately in past 3 motnhs, thinks she has dementia.
Depression
You’re a GP. Elderly person presents with a history of the classical signs of Alzheimer’s. What do you do next? [Prescribe donazepil; refer to memory clinic; MRI head; reassure]
Memory clinic
What bloods would you test for, to monitor Lithium toxicity? [U&E/Lithium levels/TFTs, Lithium levels, TFTs, Nothing unless symptomatic, U&E/Lithium, TFT/Lithium]
U+E
or
Lithium Levels
A person with a diagnosis of Bulimia nervosa. BMI 22. Wants to get help after self help measures failed. Management? [CBT; CBT+ Fluoxetine; Fluoxetine; Psychoanalytic therapy]
CBT
A teenage girl takes an OD of paracetamol after being “dumped” by boyfriend. Which feature is likely to suggest further suicide risk? [She got dumped for another girl; She took the OD in front of him saying she wanted to teach him a lesson; N-acetyl cysteine was required; she felt hopeless]
She felt hopeless
oElderly lady consented for operation by GP. Day of op decides not to have it but son insists she should go ahead. What should the doctor do. Options: [act in best interests; take word of the son as consent;
assess the patient’s capacity;]
Assess Capacity
Mum gave birth a few days ago. Says she is concerned that the baby is a “changeling”. Which of the following is most likely to suggest mother is having a psychotic episode
Neologism??
Low FSH and Low LH
Hypothalamic Hypopituitarism. Also seen in exercise, stress and significant weight loss
Raised LH and FSH and no periods
Premature Ovarian Failure
Raised prolactin
Prolactinoma or non-functioning adenoma
N FSH and Moderately raised LH and oligomenorrhoea
PCOS
Nappy rash with satellite lesions Tx
Clotrimazole
Nappy rash with flexural sparing Tx
Zinc and caster oil barrier cream
Chicken Pox Tx
Supportive
Scabies Tx
Permethrin
Impetigo Tx
Fusidic Acid
Two fetal poles, one gestational sac
MCDA
Twin pregnancy; One fetus has polyhydriamnios; Other one has oligohydramnios
Twin-twin transfusion syndrome
Snowstorm appearance in pregnancy
Molar Pregnancy
Most likely effect from cheese reaction due to MAO-I.
Hypertension
Common S/E of clozapine
Hypersalivation
Severe S/E of clozapine
Agranulocytosis
Seizure
CVD Effects
Child bought in by grandmother. Said to have knocked knee in cupboard which has become swollen. His brother had swelling having banged head when he was young.
Haemophilia
Child with posterior rib fractures and some other patterns of injuries
NAI
.Girl with painful hot swollen knee joints. PMH of hot/swollen/painful wrist
Septic Arthritis
Girl not able to weight bear. Recently recovered from viral illness.
Transient Synovitis
Girl not able to weight bear. Some joint(s) hurt. Mum has rheumatoid arthritis.
JIA
Child has reheated rice (no bacillus cereus on option list!!)
Staph Toxin
Kids in the creche all get diarrhoea at around the same time
Rotavirus
Smiling
6 weeks
Sitting Unsupported
8 months
Walking
12 months
2-3 words sentences
2 years
Pincer grip
12 months
28 day child with pale stools
Biliary Atresia
Newbornis blood group AB. Mother is blood group O and jaundiced baby
ABO Incompatibility
Mum had GBS. Baby has jaundice
Sepsis
A child who had jaundice for a few days (day 2-7). He’s fine now.
Physiological
.~8 month who keeps clenching fists and bringing arms out towards parents. (Salam attacks)
West Syndrome
Child falls. Parents pick him but has a tonic-clonic seizure. Is complete well afterwards.
Reflex Anoxic seizure
Child at school. Complains of unusual smell. Then seems to ‘space out’. Afterwards she’s very drowsy and sleeps for a few hours in the school nurses office. She has no recollection of what happened.
Absence Seizure
Redcurrent jelly stools
Intussusception
Diarrhoea after chronic constipation and incontinence
Overflow constipation
Food bits in stool
Toddlers diarrhoea
Student who recently finished exams found disorientated and slurring his words
Alcohol
! 7 year old who refuses to do his homework and stays up late playing Minecraft on his iPad. Parents are worried about him
Normal
Gardasil - what 4 does it protect against. Name the one from the list: HIV, HSV1, HSV2, HPV11 , HPV29?
It’s HPV Vaccine
So HPV11
UTI in first trimester of pregnancy. What would be the safest and most effective treatment? Trimethoprim,
Ciprofloxacin , Doxycycline, Cefalexin, Meropenem
Cirpofloxacin
Nitrofurantoin is the one
19 year old abdo swelling, weight gain, irregular periods usually, can’t remember when last period was, denies
being sexually active. What is the first test you would do?
USS
Girl with cystic ovaries on US and something else. What other symptom would be the best indicator of her
having polycystic ovaries? Dysmenorrhoea, Hirsutism , Obesity, Acne.
Hirsutism
Woman with PCOS. Best medication to increase fertility.
Clomiphene
Woman with signs of premature ovarian failure. What test would be best to confirm this diagnosis: Oestradiol,
Testosterone, FSH , LH
FSH
Man with azoospermia. What would be the most likely cause? Hx of mumps , hx of testicular torsion, Varicocele
Mumps Hx
Post menopausal woman with a PV bleed. What ix should you do? Laparotomy and hysteroscopy, outpatient
US with endometrial biopsy , CT, MRI….
US with endometrial biopsy
Asymptomatic woman, nulliparous, found to have a 5.4cm unilocular ovarian cyst on US, no fhx. Mgmt/Ix?
USS guided cyst aspiration, laparoscopic removal of cyst, discharge and safety-net, rearrange USS in 3
months and Ca12.5 follow-up
Rearrange USS in 3m with Ca125 follow up
Lady with cyclic pain 1 week before her period starts, trying for a baby for one year Diagnosis? ovarian cyst,
endometriosis ,
Endometriosis
Woman 8 weeks after normal vaginal delivery and second degree tear, still bleeding and mild lower pelvic pain.
Diagnosis? Normal menstruation, PID, endometritis , lochia ..
Lochia
What is a 23 week USS useful for? Nuchal thickness for Down’s, congenital heart disease identification ,
predicting position of placenta at term..
CHD Identification
What causes increased urinary volume and frequency in the first trimester? Increased GFR, pressure of uterus
on bladder , glycosuria
Pressure of uterus on bladder
Effect of taking fluoxetine (paroxetine instead?) during pregnancy on baby?
Persistent pulmonary hypertension
of the newborn ,
Woman with Nexplanon. Most likely reason for wanting to change contraceptive? Weight gain, acne, mood
swings, irregular bleeding
Irregular Bleeding
14 year old girl wants TOP, can’t/will not inform parents. What do you do?
Check competence
Pregnant lady being domestically abused by husband and scared to go home. What do you do in GP? Send
her home and ask her to come back with husband, give her a leaflet about domestic abuse, call and arrange
emergency accommodation
Emergency Accommodation
Woman with tender lump inside her vagina.
Bartholin Cyst
Young woman, pain during sex, ‘Strawberry cervix’ on examination
Trichomonas
Woman with cheesy white discharge
Candida
Old woman complaining of superficial dyspareunia
Atroiphic Vaginitis
Woman with slow growing painless lesions on labia
Genital Warts
Women who has gone through menopause, had a hysterectomy. Wants HRT mainly to prevent steoporosis and treat her hot flushes. Doesn’t want to take tablets.
Continuous HRT
Swimmer wants to treat hot flushes, doesn’t want a patch
COCP
Woman with premature ovarian failure, wants to have periods
COCP
Woman who just wants to treat osteoporosis, 62.
Bisphosphonates
Lady high White cell count, fever, lump in breast
Abscess
General breast tenderness - left sided, breastfeeding
Mastitis
Small slow growing lesion on labia, pregnant lady
Genital Warts
Small painful lump inside vagina of sexually active woman
Bartholin Cyst
Kid who has acne. Topical Antibiotics dont work. What do you give next? (Options: oral tetracycline, bezoyl,
retinoids, oral flucloxacillin etc.)
Retinoids/Oral Tetracycline
Kid with history of anal fissure - what is your first cause of action? - inspect anal region, do DRE with little
finger Inspect anal region
Inspect
A level student has recently come back from nigeria, with symptoms of jaundice, mild anaemia and fever with
malaise,arthralgia. (Options I can remember are Hep A, malaria and influenza)
Malaria
Kid has pain in outer ear, ear was protruding outwards, and there was a lump behind his ear. - was it otitis
externa or mastoiditis? Mastoiditis
Mastoiditis
Kid with temp of 39, cap refill 6s, generally unwell + bulging fontanelles, no description of rash. Options:
Meningococcal septicamia , uti, pnemonia
Sepsis
4yo kid having acute asthma attack, given iv salbutamol and hydrocortisone. Sats still low, no chest sounds on
auscultation. What do you do/give next? IM adrenaline, call for senior help , start atrovent
Call for help
Kid with cervical lymphadenopathy, fever, sore throat, red tongue with white spots. What does she have?
Scarlet Fever, measles , chicken pox.
Measles
Chik who had bulimia. What gives it away? (Options were dental enamel caries , striae, lacerations on a
wrist…)
Dental Enamel Caries
4 month old, about to have 3 batch of primary vaccinations. Which would be a complete contraindication to
having the vaccine? Confirmed history of pertussis as a baby, currently ill with a fever of 38.5 , got a rash at site
of last vaccination, severe cow’s milk allergy,
Current 38.5 fever
Perianal itching especially at night. What’s the best treatment option? (Options: Mebendazole , Cotrimazole)
Mebendazole
5 month old with cough, runny nose, fever. Examination of chest you hear wheeze. What’s the main pathogen
that causes this RTI? Options: Streptococcus Pneumoniae, Respiratory Syncytial Virus , Mycoplasma
pneumoniae
RSV
Unwell kid with indentable mass in left iliac fossa? Constipation , Wilm’s tumour..
Constipation
Kid with URTI and generalised abdo tenderness - appendicitis, mesenteric adenitis , HSP
Mesenteric Adenitis
heart sound not heard, scaphoid chest.
Diaphragmatic hernia
Baby was born at 41 weeks via emergency C section due to foetal distress. Needed ventilation straight away.
X ray showed hyper inflated lungs with areas of consolidation. What does he have?
Meconium aspiration
Prem baby, resp distress, CXR looks like ground glass
Surfactant deficiency
Nappy rash flexure sparing
Barrier cream Zinc and caster oil
Nappy rash with satellite lesions
Clotrimazole
Anal itch, worst at night
Mebendazole
Scabies
Permethrin
Chickenpox
Supportive
Suicide risk. What is the highest predictor of doing it again? bad relationship with mum, feeling hopeless about
future, previous self harm
Previous Self Harm
80 year old man with new onset dementia, needs MRI but refuses. You need someone to make decision for
him. - (options: talk to family with his permission, ask independent mental health advocate )
Independent Advocate
Guy who has visual hallucination and likely to fall over. but he is not giving consent to help regarding his falls
and delirium. He wants to leave hosp. Difficult to understand what he is saying Q: what is a big reason that
makes you think he does not have consent? (Options: due to lack of understanding , due to lack of processing,
due to his visual hallucination, due to him not communicating properly)
Lack of understanding
Woman on SSRI, wanted to get pregnant, was wondering what risk it may have on her baby: Stillbirth,
Pulmonary htn of the newborn , delayed labour, hypoglycemia at birth.
Persistent Pulmonary Hypertension of the Newborn
Woman wants to know what risk her baby has of getting schizophrenia, since the baby’s father has it. 7-9%,
12-15%, 20-25%, …
12-15%
Woman 5 weeks postpartum feels very sad, unable to cope, teary. Dx?
PND
What blood test should be frequently done if someone is on Lithium? Thyroid function , liver function, adrenal
function, FBC, U+E
U+E
Guy on medication for schizophrenia get muscle rigidity, altered consciousness, high blood pressure,
tachycardia. Mgmt?
ITU Admission
60 year old woman, short term memory loss, struggling to complete her normal daily tasks, ataxia and
dysphagia. What would you see on MRI? Hippocampal atrophy , lacunar lesions, white matter lesions,
frontotemporal atrophy, general signs concordant with old age..
Hippocampal Atrophy
40 year old man with moderate learning disability. He has a Hb of ~6 (below the normal range). Refuses blood
transfusion but happy to take oral iron therapy. What law do you use to assess his decision (or something
along those lines). [Options: Common Law; Mental Capacity Act ; Mental Health Act; Disability Discrimination
Act; ?European Convention on Human Rights]
Mental Capacity Act
Man who had come into GP for peeling of skin on his hands. Excessive hand washing 6 times daily which has
got worse since his elderly father died 3 months ago following a wound infection(?) post operatively. (Options:
Adjustment Disorder, OCD )
OCD
Man with treatment resistant schizophrenia on clozapine, recently stopped smoking. Most likely consequence?
Agrnulocytosis
Alcoholic comes to GP requesting home detoxification. Previous history of delirium tremens. What would you
do? Prescribe reducing dose of chlordiazepoxide , refer to local specialist alcohol service
Prescribe reducing dose of chlordiazepoxide
Person sees flower on wallpaper - sees them as moving snakes.
Illusion, formication, micropsia, pseudo hallucination, second person auditory hallucination, third
person auditory hallucination
Illusion
Person sees things smaller
Illusion, formication, micropsia, pseudo hallucination, second person auditory hallucination, third
person auditory hallucination
Micropsia
Definition of feel insects under skin.
Illusion, formication, micropsia, pseudo hallucination, second person auditory hallucination, third
person auditory hallucination
Formication
50 y woman ,constant stomach pain, had many ix eg multiple laprascopies with nothing found. Comes to A&E
saying she needs another laproscopy.
Somatisation
Young girl who has come into A&E multiple times with different presentations, nothing found for any of them.
Somatisation
Woman with abdominal pain, weight loss, lethargy and feeling low.
Malignancy
Man who drinks and takes some drugs. Split up with girlfriends, cutting himself.
Borderline Personality Disorder
40 year old premature ovarian failure and wanted medication to deal with the symptoms of menopause. What would you prescribe her?
HRT
Woman is pregnant and HIV negative at booking but her partner is HIV positive - what do you do?
Tell her to have safe sex
Pregnant woman with itchy feet, what investigation?
LFT’s
Results show azoospermia. How should they be managed? IVF, egg donation, ICSI, IUI
ICSI (Intracytoplasmic Sperm Injection)
IUI (Intrauterine Injection) is when sperm aren’t reaching.
Ovarion Cyst contains hair and teeth.
Teratoma
Ovarian Cyst with ground glass appearance
Endometrioma
Post menopausal woman has bleeding
Atrophic vaginitis or endometrial cancer
70 year old lady has some spotting and says she uses some steroid cream for a “rash down there”
Lichen Sclerosus
Lady is on Tamoxifen, which cancer does this increase the risk of?
Endometrial
STI Green Discharge
Trichomonas
A newborn appears to be in severe respiratory distress and appears blue. Despite being given high flow O2, his saturations remain at 65%.
What is the next best step to take with regards to his management?
• Chest X-Ray
• Infusion of Prostaglandin
• Surgery
• Indomethacin
Infusion of prostaglandin
3 months old baby with signs of HF, systolic murmur that radiates over the praecordium
VSD
What is the most important thing to look at in follow up of HSP? ESR, FBC, urine protein and RBCs, platelets
Urine protein and RBC’s
15 year old boy with short stature. Passing urine 10 times a day with no dysuria. Pale with heart rate at 78bpm, blood pressure at 158/88 and respiratory rate at 14. What is the likely diagnosis? Chronic renal failure, diabetes mellitus, nephroblastoma, acute pyelonephritis, urinary tract infection
Chronic Renal Failure
6 year old child with 24 hour history of left peri-orbital swelling. Had an upper respiratory tract infection last week. Left proptosis, visual acuity was normal and had a fever of 38.9. What is the best diagnostic investigation? CT of nasal orbits, USS of nasal orbits, nasal endoscopy, intraocular pressure measurement, plain x-ray of nasal sinus
CT of Nasal Orbits
Child with 6m of loose stools. Passed one hard blood streaked stool 10 days ago. What investigation? Colonoscopy, stool mc&s, anti TTG, None
None
Infant with episodes of throwing arms forward with fists clenched. Febrile seizure, focal seizure, infantile spasms, partial seizure
Infantile Spasms
Mother worried about 2.5 or 3? year old child’s bed wetting. Dry by day, wets bed at night. What do?
Reassure
Baby with fever of 39, high resp rate, nurse says chest is clear, what investigation do you do? CXR, urinalysis
Urine Dip
Child with fever, white exudate on one tonsil, diagnosis? Tonsillitis, Quinsy, diphtheria
Quinsy
Child with episodes of smelling strange things, hard to communicate with during these episodes, falls asleep for an hour after and doesn’t remember anything. Diagnosis? Focal seizure, absence seizure, tonic clonic, narcolepsy
Focal Seizure
Mother worried 5 year old? son has autism. Which would most support a diagnosis of autism? Child doesn’t make eye contact, child didn’t speak first words until 2 years old and goes to a speech and language therapist, brings a particular toy with him everywhere
Doesn’t speak first word until 2
Mother complains her young child is a fussy eater. She eats soft foods and drinks a lot of milk. Also has been feeling tired recently. Diagnosis?
IDA
Baby is almost a month old and jaundiced. Parents say has been jaundiced since day 2. Stools are grey or white. Diagnosis?
Biliary Atresia
4 year old girl with a high fever that was followed by a rash which has small white dots on a red base. What is the most likely Dx?
Erythema Toxicum
