RACPpastpapers Flashcards
2023
Hyperorality is a feature of which form of dementia?
Frontotemporal
Dementia with lewy body
Alzheimers
Vascular
A- Frontotemporal
2023
The National Institute of Mental Health Measurement and Treatment Research to Improve Cognition in Schizophrenia consensus panel has recently defined five negative symptoms: blunted affect, alogia, asociality, avolition. What is the 5th negative symptom?
A- Alexithymia
B- Anhedonia
C- Anxiety
D- Autism
B- Anhedonia
2023
Young woman with PE, HR 90, SBP 110, Echo shows Right ventricular dilatation, which of the following is most likely to improve her mortality
A- Anticoagulation
B- IVC filter
C- Catheter directed thrombolysis
A- anticoagulation
2023
What thyroid disorder is most likely to result in a euthyroid state post successful treatment with radioactive iodine therapy?
A) Graves’ disease
B) Nontoxic goitre
C) Autonomous nodule
D) Thyroid cancer
C) autonomous nodule
2023
An 85 year old male sees you in an outpatient setting. He is interested in reducing his pill burden. His medical background is significant for chronic renal impairment, atrial fibrillation, treated bladder cancer, chronic urinary retention with a permanent IDC, previous R MCA stroke and hypertension. His current medications include Frusemide, warfarin, atorvastatin, metoprolol, prazosin and enalapril. What is the first medication you would cease?
A) Frusemide
B) Warfarin
C) Atorvastatin
D) Prazosin
D) Prazosin
2023
32 year old female with severe acute pancreatitis, triglycerides 32, has been treated with IV Fluids, Insulin, triglycerides remain elevated, what is next treatment
A) Apheresis
B) Dialysis
C) Fibrates
D) PCSK9 inhibitor
A) Apheresis
2023
What is the most appropriate starting dose of prednisone for a 72 year old female with PMR who weighs 75 kg
A) 5 mg
B) 15 mg
C) 50 mg
D) 75 mg
B) 15 mg
2023
69m with erectile dysfunction. Found to have low testosterone and then high prolactin
Prolactin 77000
Testosterone 5
Other indices normal
Mrib showing compression of pituitary stalk. No compression of optic chiasm
What is the treatment?
A) External beam radiation
B) Surgery
C) Somatostatin analogue
D) Dopamine agonist
D) Dopamine agonist
2023
Nanging is a recreational activity teenagers engage in where they inhale nitrous oxide (LOL). Which vitamin does nanging deplete?
A) B1
B) B6
C) B12
D) Vitamin C
C) B12
2023
A 37 year old man who has a family history of autosomal dominant polycystic kidney disease wishes to
donate a kidney to his sister, who has end stage renal failure.
Genetic testing for autosomal polycystic kidney disease is expensive and time-consuming. In order to preserve
resources and for the best planning for the future of the organ donation for this family, who should be tested for
polycystic kidney disease?
A. The man
B. His sister
C. His mother
D. His father
A) The man
2023
20F receiving CART therapy for ALL. Develops myalgias fevers and headache, and deteriorates despite empiric antibiotics. You suspect cytokine release syndrome. Which of these do you target for treatment?
A) IL10
B) TFN
C) IL6
D) IFN gamma
C) IL6
2023
What finding on EMG is most consistent with axonal nerve injury?
A) Increased F wave latency
B) Increased distal latency
C) Decreased amplitude
D) Reduced velocity of wave
C) Decreased amplitude
2023
Sodium valproate at therapeutic doses is not dialysable. However in acute overdose, sodium valproate is very effective in dialysis. What is the reason for this discrepancy?
A) Hepatotoxicity causing reduced valproate metabolism
B) Higher concentration of toxic metabolites of valproate that is easily dialysed
C) High valproate concentrations caused by saturated protein binding, meaning more valproate is dialysable when not protein bound
D) Hyperammonamia with metabolic acidosis affecting volume of distribution
C) High valproate concentrations caused by saturated protein binding, meaning more valproate is dialysable when not protein bound
2023
What is 4mg of dexamethasone equivalent to in terms of hydrocortisone?
A. 20
B. 40
C. 80
D. 100
D. 100
2023
A 46F with Sjogren’s syndrome develops the following rash on her legs. She has the following blood tests:
ANA 1:640 speckled
RF 300 (<15)
Anti-CCP 8 (<12)
C3 0.3 (low)
C4 0.1 (very low)
Anti-Ro positive
pANCA positive
MPO negative
PR3 negative
Urinalysis: red cell casts
A) Hypocomplementaemic urticarial vasculitis
B) Cryoglobulinaemic vasculitis
C) Microscopic polyangitis
D) Rheumatoid vasculitis
B) Cryoglobulinaemic vasculitis
2023
An elderly lady presents with an L1 compression fracture after lifting groceries. Which of her medications is most likely to contribute to decreased BMD?
A) bisoprolol
B) isosorbide mononitrate
C) metformin
D) pioglitazone
D) pioglitazone
2023
A 64 year old male presents to you with a Hb of 185 and a Haematocrit of 0.55. He has tested positive for the JAK2 V617F mutation. In addition to regular venesection, what is the most appropriate treatment?
a) Aspirin
b) Hydroxyurea
c) Aspirin and Hydroxyurea
d) Aspirin and Ruxolitinib
c) Aspirin and Hydroxyurea
<60 and no mutation –> observe
<60 + mutation –> aspirin
>60 and no mutation –> aspirin +/- hydroxyurea
>60 + mutation –> aspirin + hydroxyurea
2023
Which medication is used as first line therapy in the prophylaxis of idiopathic cyclical vomiting syndrome
A) Amitryptiline
B) Levetiracetam
C) Propanolol
D) Topiramate
A) Amitryptiline
2023
What pathology is suggested by painless asymmetric wasting of the thenar eminence and first dorsal interosseus, with sparing of the hypothenar eminence, in the absence of sensory changes?
A) ALS
B) Multifocal motor neuropathy
C) C8 radiculopathy
D) Median nerve palsy at the wrist
A) ALS
2023
The size of a positive skin prick test clinically correlates to:
A) The likelihood of a reaction
B) Cross reactivity
C) The expected severity of a reaction
D) The patient having has a recent bad reaction
A) The likelihood of a reaction
2023
A man presents with headache and epistaxis. Protein 110, IgM 55 what is the most rapid way to treat?
A) Apheresis
B) Bendamustine
C) Continuous veno veno dialysis
D) High dose methylprednisone
A) Apheresis
2023
A 30 year old woman presents to the Emergency Department with drug overdose. The following is her arterial blood gas analysis (ABG):
pH 7.62
Partial pressure of carbon dioxide 20
Bicarbonate 17
Base excess -4
Sodium 135
Potassium 5.8
Chloride 98
Which drug in overdose is most likely responsible for this metabolic derangement?
A. Gamma hydroxybutyrate (GHB) acid
B. Paracetamol
C. Salicylate
D. Tricyclic antidepressant
C. Salicylate
Combined metabolic acidosis and respiratory alkalosis which is specific for salicylate poisoning
High anion gap metabolic acidosis
2023
32 year old gentleman with long-standing T1DM symptoms presents with nausea, vomiting and early satiety. He has prominent micro vascular complications. He has a normal endoscopy. Next best investigation to confirm gastroparesis?
A) Gastroduodenal Manometry
B) 13C breath test
C) Gastric emptying scintigraphy
D) Barium swallow
C) Gastric emptying scintigraphy
