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1
Q

what is target HbA1c for diabetics
1. lifestyle
2. metformin
3. otherdrugs that may cause hypo

A

48mmol/mol
48
53

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2
Q

when should sulfonyreas be avoided

A

pregnancy and breastfeeding

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3
Q

what causes long QT in terms of potassium - examples of drugs that do this

A

hypo

amiodarone - TCAs/SSRI, sotalol
erythromycin
haloperidol
ondanestron

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4
Q

management of uncomplicated angina

A

aspirin and a statin
bb or CCB (verapamil if mono dihydro if dual therapy)

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5
Q

when do you not give Iv dex in meningitis

A

immunosuppressed
meningococcal sepsis or septic shock
following surgery

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6
Q

investigation for epiddyimal orchitis and mangement for young and old man

A

young - first void urine NAAT
old - MSSU culture

young - IM cef + 2 weeks of Po doxy
old - quinolone for 2 weeks (prostatis)

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7
Q

mechnasim of action of different diabetic drugs eg sulfy, dpp4 adn pioglitazone

A

sulfy - increase pancreatic insulin secretion
DPP4- decrease peripheral breakdown of incretins
pioglitazone - PPAR - gamma receptor agonist - reduce peripheral insulin resitance

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8
Q

how should amiodarone be given

A

Amiodarone can lead to injection site reactions. It should be preferably given through a central line, and if peripherally should be given through a large bore cannula in a large vein (e.g. antecubital fossa).

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9
Q

when shoudl ACEI be avoided in Heart failure

A

if they have valvular disease

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10
Q

treatment of VF

A

Amiodarone

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11
Q

what would you see on CXR during arotic dissection

A

widened mediastinum

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12
Q

swelling between the sternocleidomastoid muscle and the pharynx

A

brachial cyst

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13
Q

what is seen on ECG in hypercalcaemia

A

short QT

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14
Q

Diagnostic test fro HIV

A

combination tests - HIV p24 antigen and HIV antibody
REPEATED

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15
Q

what is kussmauls sign and what can it be used to differentiate between

A

rise in JVP during inspiration
diff between cardiac tmaponade and constrictive pericarditis
present in constricitve pericarditis

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16
Q

which has a high TIBA iron deficiency anaemia or Anaemia of chronic disease

A

TIBC is high in IDA,

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17
Q

what is mechanism of action of orlistat

A

pancreatic lipase inhibitor

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18
Q

for insulindependent diabtetic hwo often must they check their glucose in long drives

A

every 2 hours

19
Q

if someone with suspected acromegaly has an increase IGF-1 what should be done to confirm diagnosis

A

OGTT and serial GH measurements

20
Q

when is growth hormone therapy given

A

turners
Prader willi
chronic renal insufficiency before puberty

21
Q

if someone has hypothyroid features with low TSH and low T4 what should be investigated and how

A

MRI for pituitary insufficency

22
Q

example fof alpha blocker used in phaechromocytoma

A

phenoxybenzamine

23
Q

treatment for phaeochromocytoma

A

alpha blocker then beta blocker

24
Q

what levels are seen for impaired fasting glucose

A

between 6.1 and 7

25
Q

what BM levels are seen for impaired glucose tolerance

A

between 7.8 and 11.1

26
Q

what hormone are reduced in stress response

A

Testosterone oestrogen and insulin

27
Q

most common side effect of radioiodine therapy in hyperthyroid

A

hypothyroid

28
Q

diagnostic fasting and random glucose levels in symtomatic diabetic patient

A

fasting glucose greater than or equal to 7.0 mmol/l
random glucose greater than or equal to 11.1 mmol/l

29
Q

what is used to stabalise th emocardium in hyperkalames

A

Calcium gluconate

30
Q

in DKA what rate of insulin infusion is used

A

0.1/kg/hr

31
Q

does cushing cause acidosis or alkalosis

A

alkalosis hypokalaemic metablic alkalosis

32
Q

what is fourniers gangrene and whta diabetic drug causes it

A

nec fasciitis on perineum SGLT2

33
Q

what diabetic drug is contraindicated in heart failure

A

pioglitazone

34
Q

how many units of insulin are in 1 ml of standard insulin

A

100 units of insulin

35
Q

what is the max metformin daily dose

A

2g

36
Q

what should be checked if usure over type 1 or 2 diabetes

A

c-peptide and autoantibodies

37
Q

ovarian tumour assoc with meigs

A

fibroma

38
Q

what bloods must be checked in osteoporsis in a man

A

testosterone

39
Q

an isolated rise in bilirubin in response to physiological stress is seen in

A

gilberts syndrome

40
Q

how long before endoscopy shoudl PPI be stopped

A

2 weeks

41
Q

what investigations should be performed before a nissen fundoplication

A

oesophageal pH and manometry

42
Q

culture negative casues of endocarditis

A

coxciella burnetti
HACEK
prev. antibitoics

43
Q

management of endocarditis empirically for:
1. native valve
2. MRSA, septic or pen allergic
3. prosthetic valce

A

native - amox (+ poss gent)
MRSA - vanc and low dose gent
presthetic - rifampicin, gent, vanc

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