Y3 SAQ Examplify mock

Question 1

Initial management of OA apart from analgesia?

Answer 1

Mobility aids
Physio
Steroid joint injection
Weight loss

Question 2

Why would a spinal anaesthetic be preferred to a general anaesthetic?

Answer 2

Lower cost
Better post-op pain scores
Allergy to general anaesthetic
Contra-indication to general anaesthetic e.g COPD

Question 3

Which two anatomical layers is spinal anaesthetic injections between?

Answer 3

Arachnoid mater and pia mater

Question 4

How do LMWHs work?

Answer 4

Inhibition of clotting factor Xa and/or thrombin

Question 5

Which nerve damage will result in foot drop?

Answer 5

Common peroneal

Question 6

Common peroneal is responsible for sensation where?

Answer 6

Dorsum of the food and lateral leg

Question 7

Malignant diseases for which obesity is a risk factor?

Answer 7

Breast
Ovarian
Endometrial
Bowel

Question 8

Non-malignant diseases for which obesity is a risk factor?

Answer 8

T2DM
HTN
IHD
Stroke
OA
OSA

Question 9

Benefits of exercise in obese patient?

Answer 9

Increase BMR
Reduce risk of diabetes
Reduce risk of cardiovascular disease
Improve mood/ self-esteem

Question 10

Which behavioural theory describes the influence of friends and family on health-related behaviours?

Answer 10

Social learning theory

Question 11

Radiological findings of rheumatoid arthritis?

Answer 11

L – loss of joint space
E – erosions (junta-articular bony erosions)
S – soft tissue swelling
S – soft bones (osteopenia)

Question 12

Clinical signs seen in RA?

Answer 12

Ulnar deviation of digits
Swan neck deformity
Boutonniere deformity
Z- thumb deformity

Question 13

Extra- articular features in RA?

Answer 13

Dry eyes
Episcleritis
Scleritis
Dry mouth
Pleurisy
Lung nodules
Interstitial lung disease
Lymphadenopathy
Enlarged spleen
Tendinitis
Peripheral neuropathy (eg Carpal tunnel syndrome)

Question 14

Questions to ask in suspected hernia?

Answer 14

Is it reducible?
Any similar lumps anywhere?
Any skin changes?
Vomiting or change in bowel habit?

Question 15

Differentials for groin lump?

Answer 15

Saphena varix
Lymphadenopathy
Lipoma
Sebaceous cyst
Femoral artery aneurysm

Question 16

What is the surface anatomy landmark for the deep inguinal ring?

Answer 16

Halfway between the ASIS and pubic tubercle

Question 17

Anaesthesia used for inguinal hernia repair?

Answer 17

Spinal or local

Question 18

Risks of laparoscopic hernia repair?

Answer 18

Conversion to open repair
Damage to surrounding structures (blood vessels, bladder or bowel)
Urinary retention

Question 19

Behavioural strategies to manage children’s constipation?

Answer 19

Scheduled toileting - encourage child to open bowels at pre-planned intervals.

Use of bowel habit diary

Use encouragement and rewards systems - e.g. star charts

Address potential social/ psychological problems

Question 20

What to prescribe child with simple contipation without faecal impaction?

Answer 20

Macrogol (e.g. Movicol, Cosmocol, Laxido)

Question 21

Role of a health visitor?

Answer 21

Offer support and encouragement to families through the early years from pregnancy and birth to primary school.

Question 22

What makes an association more likely to have a causal effect?

Answer 22

The 95% Confidence intervals for the odds ratio do not include the null value of 1

(If 1 is in the confidence interval than it is not significant)

Question 23

Questions to ask about heavy, painful periods?

Answer 23

Sexual history
Pattern of pain
Associated symptoms
Exploration of abnormal bleeding

Question 24

Contra-indications for COCP?

Answer 24

Migraine with aura
Previous history of thrombosis
Hx of breast cancer
Obesity (BMI >35)
Other medication which interacts

Question 25

Advice/info for patients regarding COCP?

Answer 25

How/when to start
Missed pill advice
Interaction with abx
Effect of vomit/diarrhoea on efficacy
Potential side effects
Does not protect against STIs

Question 26

Contraindications to Dix-Hallpike test

Answer 26

MSK problems - back or neck pain
Carotid sinus syncope

Question 27

BPPV cause and mechanism

Answer 27

Small fragments of debris are deposited in the inner ear.

When your head is still the fragments still at the bottom of the canal.

Head movement will sweep the fragments along the fluid-filled canal

This sends confusing messages to the brain causing vertigo.

Question 28

What process within the arterial tree allows for improvement of intermittent claudication (with exercise and walking through the pain)?

Answer 28

Development of collateral vessels

Question 29

Pharmacological mechanism and therapeutic action of aspirin?

Answer 29

Irreversible COX inhibitor, prevents platelet aggregation

Question 30

Where in the lower limbs does rest pain most typically occur? (PAD)

Answer 30

Toes
Foot
Forefoot

Question 31

Why does the affected leg/foot appear redder after leg raise in PAD?

Answer 31

Severe Ischaemia - leads to local vasodilator release, this increases the perfusion of the ischaemic foot.

Question 32

How is pain in ureteric colic and peritonitis different?

Answer 32

Peritonitis - movement worsens pain, patient will lie very still

Ureteric colic - patient writhes/moves around, can’t get comfortable

Question 33

Ureteric colic diagnostic test?

Answer 33

CT KUB

Question 34

What is hydronephrosis?

Answer 34

Dilation of the renal pelvic/ calyceal system
From hydrostatic pressure/ urinary tract obstruction

Question 35

Long term management of COPD?

Answer 35

Annual flu vaccine
Pneuococcal vaccine (One dose only)
Rescue pack
Regular COPD review
Review of inhaler technique
Pulmonary rehabilitation
Optimise current meds

Question 36

Two tests before commencing TB therapy?

Answer 36

LFTs and visual acuity testing

Question 37

What treatment is used in diabetes insipidus when someone has hypernatraemia?

Answer 37

Fluid replacement
Desmopressin

Question 38

Risks of not treating hypernatraemia in patient?

Answer 38

Death
Stroke
Thrombotic episode
LOC
Seizures
Worsening hypernatraemia