Uni revision session Questions

Question 1

Dx DKA

Answer 1

Dx DKA = Diabetes – BG>11 or known diabetes and
Ketonaemia >3 AND acidosis – bicarb <15 or ph<7.3

Question 2

Pathophysiology of primary hyeraldosteronism

Answer 2

Primary hyperaldosteronism – most common treatable and curable form secondary HTN.
Aldosterone production exceeds bodys requirements and is rel autonomous to the renin-angiotensin II system. Therefore excessive sodium reasbrotpion (and water) within distal nephron leading to HTN and suppression on renin-angiotensin II
Urinary loss Potassium and hydrogen ions, exchanged for sodium at distal nephron, may result in hypokalaemia and metabolic alkalosis if severe and prolonged

Question 3

Mx hypoglycaemia

Answer 3

<4 with/without symptoms, conscious and able to swallow should have fast acting carb by mouth (Glucogel)
Can repeat after 15mins up to max 3 times.
Once >4 then give long acting carb to prevent it falling again
Hypoglycaemia that does not respond (<4 after 30-45mins or 3 tx cycles) then IM glucagon or glucose 10% iV infusion
If emergency and decreased LOC then IM glucagon can be given. If this isn’t effective after 10mins give IV glucose 10% infusion.

Question 4

visual defect in pituitary tumour

Answer 4

Bitemporal hemianopia

Question 5

How to diagnose osteoporosis

Answer 5

DEXA

Question 6

How small cell lung cancer affects the body with SIADH

Answer 6

Question 7

Diagnostic test of lung cancer

Answer 7

CT guided lung biopsy

Question 8

Transudative vs exudative pleural effusion

Answer 8

Question 9

Adrenaline doses for allergic reaction (iM injection only)

Answer 9

Question 10

Mx constipation in adults
Rectum empty vs not

Answer 10

Faecal impaction - may need enemas, suppositions or disimpaction

Rectum empty…
Ispaghula husk (eg 6 week trial)
if stops remain hard etc then add or switch to osmotic (macrogol or 2nd line is lactulose)
If stools soft but difficult to pass ir sensation inadequate emptying then stimulant laxative (eg Senna) should be added

Question 11

Management H.Pylori

Answer 11

Omeprazole plus amoxicillin plus clarithromycin (or metronidazole) for 1 week and retest after 6 weeks if ongoing symtpoms

Question 12

Which iBD is skin tags and mouth ulcers seen in

Answer 12

Crohns

Question 13

Diagnosis of spontaneous bacterial peritonitis

Answer 13

Ascitic fluid absolute neutrophil count

Question 14

Answer 14

Immune due to natural infection

Question 15

Answer 15

Immune due to hep B vaccine

Question 16

Answer 16

Acute infection

Question 17

Answer 17

Chronically infected