Year 2 CAP TEST QUESTIONS FOR PRACTICE (got 63%) Flashcards
The three stages of Dupuytren’s contracture are the early, involutional (active) and the residual (advanced) phase What are the the main cells that predominate the active contractile phase (involutional)?
The myofibroblasts predominate the active phase and are capable of contraction
What are risk factors associated with Dupuytren’s contracture?
Alcohol Smoking Diabetes mellitus
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E - The growth plate is actually a relatively weak part of bone as injuries can result hear
Prepubertal overweight adolescent boy, presents with pain in the groin and the knee with a limp What is the diagnosis?
SUFE -the growth plate is not strong enough to support the adolescents weight and the epiphysis slips
Anthropometric measurements What is used to assess upper extremity muscle strength? What measurement provides an estimate of height?
Hand grip dynamometry - upper extremity muscle strength Ulna length - provides an estimate of the height
What does triceps skinfold thickness estimate?
Triceps skinfold thickness estimates the total body fat
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Waist circumference is the best predictor of cardiovascular risk Mid upper arm circumference reflex muscle mass and subcutaneous fat
Which investigation is not appropriate?
All investigations are appropriate however the initial investigation to be carried out would be D - Urine beta human chorionic gonadotrophin (HCG) to determine whether pregnancy is the cause
What is the likely diagnosis in this scenario also?
History is suggestive of Grave’s disease First step would be to carry out a thyroid function test so D.
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The area missed most frequently is C - Area 3
Behaviour in which a child appears stressed, exhibiting tension movements, activated by departure and return of the caretaker What type of behaviour temperament/attachment is this?
This is disorganised attachment
A child who is tense on return or departure of the mother? What is this type of attachment?
The is disorganized attachement
Readily explores, using carer as a secure base. Cries infrequently. Easily put down after being held. Confident. What is this?
Secure attachment
What are the two types of anxious attachment?
Ambivalent and avoidant attachment
A child who is unsure how to respond to the parent when he or she returns Can be distressed or uncertain Typically explores little and is often wary of strangers Which type of attachemnt is this?
This is anxious ambivalent attachment
Descrbe avoidant attachment?
the child is not distressed when parent enters the room Pays little attention to the parent (treats almost like the stranger)
Child with a positive overall mood. Eats at regular intervals and is readily approachable What is this?
This is an easy temperament child
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Child is tense/distressed on arrival of mother - B disorganized attachment Usually sits alone and is distressed/uncertain on arrival - AMbivalent attachment - F Easy child - Easy temperament - C
When red reflexes are diminished on examination of the eye, what does this make you think in an elderly patient?
Cataracts
If an elderly patient has gradual central vision loss and has haemorrhage on macula with drusen depositis (yellow deposits) What do you think? If there is a central haemorrhage in the macula instead of the drusen depositis, with sudden central visual loss then what do you think?
Think dry age related macular degenration Think wet age related macular degenratiojn
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- F - Cataracts 2. E - Wet age related macular degenration
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A - ulnar neuropathy Ulnar nerve gives sensory innervation to the 4th and 5th digits
When a patients lens becomes sclerotic with age and they can no longer read close work, what is this known as?
This is called presbyopia
Also, what disease is this man likely to have?
B. Pigmentation is due to ACTH Man is likely to have Addison’s disease
What is the most accurate investigation to assess prolapsed discs?
Most accurate - MRI
2The type of compression fracture related to high-energy axial loading spinal trauma that results in disruption of the posterior veertbral body cortex What is this?
This is knwon as a Burst fracture
the eponymous name given to a burst fracture of C1?
Jefferson fracture (axial loading on back or neck eg caused by diving)
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A 65 year old patient complains of left ankle swelling for many months. He has very little pain. There is slight erythema over the ankle and the foot seems insensate. What is the most probable diagnosis?
Charcot arthropathy
What is the other name for charcot arthropathy?
Neuropathic arthropathy
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D - Trochanteric bursitis from the prominent metalwork
What is the most common cause of neonatal jaundice? Name 2other causes?
Physiological jaundice 2 other causes - hypothyoridism and neonatal infection
What is the most common type of psoriasis?
Chronic plaque psoariasis - psoriasis vulgaris
What is the initial treatment for psoriasis if mild?
Topical emollients
What type of psoriasis usually appears about 2to3 weeks after a streptococcal infection and small salmon pink spots all over the skin?
Guttate psoriasis
If psoriasis is well controlled and mild, what is the initial treatment?
The initial treatment would be for emollients
What are the two types of topical agents given for psoriasis? Which is given first?
If under good control then Vitamin D analogue However can give Topical corticosteroids
What is the name of the main vitamin D analogue given for psoriasis? What is the next step for psoriasis if topical treatments fail to work?
Cacipitriol Next step is phototherapy
Very poorly controlled significant plaque psoriaiss managemtn after topicals, phototherapy moves on to what final treatments?
Methotrexate if no contra indications Followed by a biological agent eg adaluminab
Which type of phototherapy has a greater chance of causing cancer?
PUVA