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Question 1

what is the recommended alcohol consumption for men and women over week?

Answer 1

14 units

Question 2

how do you work out alcohol units?

Answer 2

(%xVol)/1000

Question 3

in a palliative patient how do you manage a bowel obstruction?

Answer 3

analgesia
antiemetics
improve motility with laxative and pro kinetics
decrease gastric secretions (anticholinergics or somatostatin analogue)
NG tube

Question 4

what % of cancer patients does cauda equina syndrome occur?

Answer 4

5%

Question 5

how can you treat neuropathic pain?

Answer 5

TCA e.g amitriptyline
anticonvulsants e.g. gabapentin
steroids e.g. dexamethosone

Question 6

how may you treat an palliative and severely agitated patient?

Answer 6

sedation

Haloperidol , levomepramazine, midazolam

Question 7

name 3 common hospital aqcuired infections

Answer 7

C.diff, MRSA, norovirus

Question 8

is C.diff aerobic or anaerobic?

Answer 8

anaerobic

Question 9

What symptoms does a C.diff infection cause?

Answer 9

mild diarrhoea, pseudomembranous colitis, toxic megacolon

can be an asymptomatic carrier

Question 10

what investigation should you order if you suspect someone has a C.diff infection?

Answer 10

stool test

Question 11

which abx may suppress gut flora allowing C.diff to flourish?

Answer 11

cephalosporins (cef-)
fluoroquinolones- ciprofloxacin
clindamycin
co-amoxiclav

Question 12

how would you manage a patient with C.diff?

Answer 12

stopp offending abx
isolate/PPE
fluid as needed
avoid anti peristaltic agents
consider stopping PPIs
Abx- metronidazole, vancomycin

Question 13

how does the greater omentum respond to perforations?

Answer 13

it moves to plug the area of perforation

Question 14

how can you treat a liver abscess?

Answer 14

open drainage, laparoscopic drainage or interventional radiological percutaneous drainage (best one)
followed by abx

Question 15

whats the 1st line investigation to diagnose Lymes disease?

Answer 15

enzyme-linked immunosorbent assay (ELISA) antibodies to Borrelia burgdorferi

Question 16

what early sign of lymes disease would allow you to diagnose it on clinical exam alone rather than an ELISA test?

Answer 16

presents of erythema chronic migrans (bulls eye rash)

Question 17

what abx would you use in early lyme disease?

Answer 17

doxycycline

amoxicillin if doxy is contraindicated e.g. in pregnancy

Question 18

what abx would you use in disseminated lyme disease?

Answer 18

ceftriaxone

Question 19

what is the investigation of choice to diagnose idiopathic pulmonary fibrosis?

Answer 19

high resolution CT scan