SAQ formatives Flashcards
A patient with microcytic anaemia - what questions should be asked in Hx?
History of aspirin or steroids or NSAID ingestion / drug history Menstrual period history Change in bowel habits Abdominal pain / bloating / coeliac History of Inflammatory bowel disease Family history of cancers in first degree relatives Past history of colonic polyps Swallowing difficulty/dysphagia Dyspepsia / acid reflux History of bleeding tendency
3 clinical examination findings relevant to anaemia that may be present?
Pallor of the conjunctiva/nails A tumour mass may be palpable in the abdomen OR middle or lower third rectal tumour may be palpable on PR examination (only 1 mark for 'mass') Tachycardia Koilonychia (spoon shaped nails) Angular stomatitis Ankle oedema Systolic murmur
2 first line investigations to identify the underlying cause of anaemia and weight loss
Flexible sigmoidoscopy / colonoscopy
Chest Xray
OR CT Chest/abdomen/pelvis for metastases
Upper GI endoscopy
Apart from CT, list TWO relevant investigations that may aid in confirming the diagnosis of TIA
MRI head
Carotid Doppler
ECG
Transcranial Doppler
THREE bacteria which are likely to cause otitis media
Streptococcus pneumonia
Moraxella catarrhalis
Haemophilus influenza
State TWO conditions which can cause the red reflex sign in infants to be absent
Congenital cataract
Retinoblastoma
Sx of hyponatraemia?
Gait instability Concentration and cognitive deficits Headache Vomiting Drowsiness Seizures
Ix for hyponatraemia?
Urine dip Urine MC&S Serum osmolality Urine osmolality Urine spot sodium Chest Xray
complication of rapidly correcting hyponatraemia?
Central pontine myelinolysis
What hormone is measured by an early pregnancy test AND what is its function in pregnancy
hCG (human chorionic gonadotrophin) (1 mark)
Acts on corpus luteum to secrete oestrogen and progesterone (1 mark)
THREE most likely pathological conditions that can present with macroscopic haematuria
Urinary tract cancer (bladder / prostate / renal / urethral / ureteric)
Renal stone disease
Urinary tract infection
List TWO early complications of chemotherapy
Nausea / vomiting Mucositis Alopecia (accept hair loss) Infections / neutropenia Thrombocytopenia Diarrhoea / GI upset Anaemia
Name THREE single clinical features on examination that may be indicative of breast malignancy
Firmness or ‘hard’, irregularity
Fixity / immobility / skin dimpling or tethering
Lymphadenopathy (axillary / upper limb)
Nipple change / bleeding from nipple / inversion
Liver mass / hepatomegaly
Ulceration of breast
‘Peau d’orange’
Give THREE specific clinical signs on abdominal examination that would support the diagnosis of ascites in this patient
Shifting dullness Fullness in the flanks Fluid thrill Eversion of the umbilicus Herniae Abdominal striae Divarication of recti Dilated superficial abdominal veins
When establishing a history from the patient, name FOUR other features which may indicate increased risk of HIV.
Any patient who has paid for or been paid for sex
Sex with an individual from area of high HIV prevalence
Sex with an individual with known HIV infection
Sex with a man who has had sex with a man
Concurrent sexually transmitted infection
