Recall Last Day

Question 1

50 year Patient with TIA, HTN and high lipids with no DM treatment?

Answer 1

Rovustatin

• Patients < 75 years of age with clinical atherosclerotic cardiovascular disease (includes coronary artery disease, stroke, and peripheral arterial disease)

Question 2

What is Child Pugh score?

Answer 2

Assess level of liver cirrhosis

• Platelets
• Albumin
• Ascites
• Total bilirubin
• Hepatic encephalopathy

Question 3

Management of esophageal varices found on endoscopy?

Answer 3

In the case of non-bleeding = propranolol

Bleeding = after resuscitation efforts, variceal ligation

Question 4

What is hereditary spherocytosis?

Answer 4

• most common cause of hemolytic anemia in northern eastern descent
• autosomal dominant
• membrane defect in RBC -> spherocytosis -> osmotic stress -> hemolysis

Question 5

Best investigation for hereditary spherocytosis?

Answer 5

Eosin-5-maleimide binding test (EMA binding test)

Test of choice

Question 6

Presentation of hereditary spherocytosis?

Answer 6

• jaundice
• splenomegaly LUQ pain
• anemia and pallor

Question 7

Labs indicating hemolytic anemia?

Answer 7

↑ Unconjugated bilirubin
↓ Haptoglobin
↑ LDH

Question 8

Patient first trimester who is stable presents with abdominal pain and previous bleeding with closed cervix -> next best step?

Answer 8

• urine beta HCG
• TVUS

Question 9

Patient on LABA and steroid, with SABA for acute symptoms. What is the next step up in tx?

Answer 9

• increase dose of LABA and ICS

Question 10

Initial test with HCM?

“Young lady, collapsed at sports, father died early with cardiac pathology”

Answer 10

• ECG: initial test
• signs of LVH

Question 11

Diagnostic test

Answer 11

ECHO : best initial and confirmatory test

Question 12

What drugs are contraindicated in HCm?

Answer 12

spironolactone

digoxin

Question 13

What are the indications for carotid endarterectomy?

Answer 13

• patients with severe carotid stenosis
• stroke or TIA

Question 14

When do you find unconjugated bilirubin?

Answer 14

• hemolysis
• intrahepatic lack or impaired conjugation

Crigler-Najjar Syndrome

Gilbert Syndrome

Neonates

Chronic hepatitis

Advanced cirrhosis

Question 15

What are the indications for suprapubic catheter?

Answer 15

• unsuccessful transurethral catheterization
  e.g. urethtral stricture or BPH
• Need for long term indwelling catheter

fractions in pelvis and hematomas

Contraindication:
- bladder cancer
- empty or abnormal bladder position
- Bladder cancer

Question 16

How does Roseola present?

Answer 16

aka sixth disease

3-5 days of fever

maculopapular rash on face, neck and trunk

sudden decrease in temperature and development of a patchy, maculopapular exanthem

cervical lymphadenopathy

Question 17

How often is FOBT performed in 45-74 year olds with average Colorectal cancer risk?

Answer 17

every 2 years

Question 18

Screening for colorectal cancer for moderate risk?

Answer 18

• colonoscopy every 5 years
• starting 10 years before the age of diagnosis of the 1st degree relative OR from age 50
• which ever is earliest

Question 19

Screening for colorectal cancer for high risk?

Answer 19

• colonoscopy every 5 years
• start from age 40 or 10 years before the age of diagnosis in first degree relative
• whichever is earliest

Question 20

How does polymyalgia rheumatica present?

Answer 20

• proximal muscle weakness -> shoulders, hips
• high ESR
• fatigue and weakness
• high possibility of giant cell arteritis

Question 21

If STEMI presents with hypotension, aka cardiogenic shock, what is the management?

Answer 21

• vasopressor e.g. NE
• administer inotropic support -> dobutamine

Question 22

What is stroke recrudescence?

Answer 22

repetition of undesirable conditions -> as patient must’ve had hx of a stroke

Question 23

What is biliary atresia?

Answer 23

• no biliary opening to secrete bile from gallbladder
• leads to prolongued jaundice
• acholic stools
• dark urine

raised conjugated bilirubin