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Question 1

Definition of sepsis

Answer 1

SIRS with suspected or confirmed site of infection

Question 2

Definition of SIRS

Answer 2

At least 2 of

• Temp less than 36°C or > 38.3°C
• HR > 90
• RR > 20
• Blood glucose > 7.7mmol/L in the absence of known diabetes
• WCC less than 4 or > 12

Question 3

Definition of severe sepsis

Answer 3

Sepsis with end organ dysfunction or hypoperfusion (indicated by hypotension, lactic acidosis or decreased urine output or others)

Question 4

Definition of septic shock

Answer 4

Severe sepsis failed to respond to IV fluids

Question 5

What does aspirin activate?

Answer 5

Anti-thrombin III - forms a complex which then inhibits factor Xa

Question 6

Neonatal resus compressions - when and rate?

Answer 6

Start with 5 ventilation breaths if not improving and HR below 60bpm then 3:1 compression to ventilation

Question 7

Management regarding variceal bleed

Answer 7

FFP and vit K and terlopressin

Propanolol reduce rebleeding

Question 8

Most common cause of gastroenteritis in children

Answer 8

rotavirus

Question 9

What is the most common drug cause of gynaecomastia

Answer 9

Spironolactone

Question 10

What differentiates mania from hypomania

Answer 10

Psychotic delusions

Question 11

Large transilluminating mass in posterior triangle of neck

Answer 11

Cystic hygroma

Question 12

Features of Pneumocystis jiroveci pneumonia

Answer 12

in HIV patients
dry cough and dyspnoea with fever and very few chest signs
pneumothorax is common complication
exercised induced desaturation common

Question 13

Management of PJP infection

Answer 13

co-trimoxazole
IV pentamidine in severe cases
steroids if hypoxic

Question 14

Prevention of PJP infection

Answer 14

prophylaxis to all patients with CD4 count below 200

Question 15

What is orlistat

Answer 15

Pancreatic lipase inhibitor used to help weight loss in obesity
Side effects include fecal urgency and incontinence

Question 16

What type of drugs can cause lithium toxicity

Answer 16

Drugs which affect renal function because lithium is excreted renally

Question 17

Analgesia of choice for renal colic

Answer 17

Diclofenac

Question 18

What is yellow-green vision a feature of

Answer 18

Digoxin toxicity

Question 19

What can cause digoxin toxicity

Answer 19

Hypokalaemia

Renal failure - drugs which affect renal function

Question 20

Unfractioned and LMWH relationship with potassium

Answer 20

Can cause hyperkalaemia

Question 21

Driving after 1st seizure

Answer 21

6 months off

Question 22

Driving after confirmed epilepsy

Answer 22

12 months seizure free

Question 23

Driving after 2 or more seizures with group 2 vehicles (eg. bus, coach lorry)

Answer 23

10 years seizure free

Question 24

Driving after stroke or TIA

Answer 24

1month and may not need to notify DVLA if no residual deficits

Question 25

Driving after syncope

Answer 25

Simple faint - nothing
One off syncope, explained and treated - 4 weeks
One off unexplained - 6months
Two or more - 12 months

Question 26

What pH is non-invasive ventilation good for

Answer 26

Between 7.25-7.35 - below this need invasive

Question 27

First line treatment of BPH

Answer 27

Alpha blockers eg. tamsulosin or alfuzosin

Question 28

Treatment of non-faliciparum malarias?

Answer 28

non-falciparum malarias are almost always chloroquine sensitive

Question 29

Stridor post-thryoidectomy

Answer 29

Think bleed - Owing to the confined space haematoma’s may rapidly lead to respiratory compromise owing to laryngeal oedema - need to remove sutures otherwise larynx will get obstructed