year 2 more passmed

Question 1

first line investigation for a suspected osteoporotic vertebral fracture

Answer 1

x-ray

Question 2

what is the electrolyte abnormality in cushings

Answer 2

hypokalaemia metabolic acidosis

Question 3

how is treatment for addisons changed when the patient is systemically unwell

Answer 3

double the hydrocortisone dose, keep the same fludrocortisone doe

Question 4

which drugs increase the risk of osteonecrosis

Answer 4

steroids

Question 5

what do you think when a diabetic patient presents with erratic blood glucose control, vomiting and bloating

Answer 5

gastroparesis

Question 6

drug treatment for parathyroid adenoma

Answer 6

cinacalcet

Question 7

which thyroid cancer spreads mainly by blood

Answer 7

follicular

Question 8

which type of thyroid cancer cannot be determined if its malignant or not by fine needle aspiration cytology

Answer 8

follicular

Question 9

visual field defect with a pituitary tumour

Answer 9

optic chiasm compression

Question 10

what bacteria causes necrotising fasciitis

Answer 10

panton valentine leukocidin

Question 11

first line investigation for bile coloured vomit in babies

Answer 11

abdo x-ray

Question 12

first line investigation for pyloric stenosis in a baby

Answer 12

abdo ultrasound

Question 13

what is toxic epidermal necrolysis

Answer 13

severe, acute, superficial desquamating eruption often secondary to a drug

Question 14

what is neurogenic pruritus

Answer 14

caused by an effect on the central nervous system receptors such as renal or liver failure, thyroid disease or in association with malignancy

Question 15

absent red reflexes

Answer 15

cataracts

Question 16

painful loss of central vision, large haemorrhage in the fovea

Answer 16

wet ARMD

Question 17

what is a diagnostic sign of proliferative diabetic retinopathy

Answer 17

new vessel growth at disc

Question 18

wrist drop is a response to damage of what nerve

Answer 18

radial

Question 19

claw hand is a response to damage of what nerve

Answer 19

ulnar nerve

Question 20

what pathway is responsible for ketone development in states of insulin depletion

Answer 20

lipolysis

Question 21

function of melanocytes

Answer 21

DNA protection from ultraviolet irradiation

Question 22

which hormone triggers ovulation

Answer 22

LH

Question 23

what bacteria is croup caused by

Answer 23

para-influenzae virus

Question 24

if someone presents with a non-blanching rash, headache, neck stiffness and a strong bounding pulse, what type of shock is this

Answer 24

septic

Question 25

what type of hearing loss can congenital cytomegalovirus cause

Answer 25

sensorineural

Question 26

what is finkelsteins test for

Answer 26

de quervains tensosynovitis

Question 27

what is renal artery stenosis characterised by

Answer 27

refractory hypertension and worsening renal function after being started on an ARB or and ACEi

Question 28

what is a contraindication for renal transplant

Answer 28

metastatic active cancer

Question 29

what drugs should be stopped in AKI

Answer 29

- NSAIDS - metformin - ACEis - gentamicin - ARBs - lithium - digoxin

Question 30

what are the indications for dialysis

Answer 30

Acidosis (severe metabolic acidosis with pH of less than 7.20) Electrolyte imbalance (persistent hyperkalaemia of more than 7 mM Intoxication (poisoning) Oedema (refractory pulmonary oedema) Uraemia (encephalopathy or pericarditis). AEIOU

Question 31

classic presentation of acute interstitial nephritis

Answer 31

- white cell casts are seen - triggered by meds (antibiotics) - non-oliguric - rash - fever - eosinophilia

Question 32

presentation of pyelonephritis

Answer 32

symptoms of lower UTI - dysuria - polyuria - frequency - chills - fever - flank pain

Question 33

what does chronic kidney disease look like on USS

Answer 33

bilateral shrunken kidneys

Question 34

treatment of refractory hyperkalaemia (hyperkalaemia that won't go away)

Answer 34

haemofiltration

Question 35

what can high levels of urea (ureamia) cause

Answer 35

- nausea - vomiting - confusion - seizures - coma

Question 36

what is an indication for renal biopsy

Answer 36

proteinuria and haematuria (with casts) on urine microscopy

Question 37

what is the commonest cause of peritoneal dialysis peritonitis

Answer 37

staph epidermis

Question 38

when should you start dialysis in diabetic patients

Answer 38

when eGFR is less than 10 or 15

Question 39

what does muddy brown casts in urine mean

Answer 39

acute tubular necrosis

Question 40

what is used as a vitamin D supplement in end stage renal disease

Answer 40

alfacalcidol

Question 41

what causes hypercoagulation in nephrotic syndrome

Answer 41

loss of antithrombin III and plasminogen via the kidneys

Question 42

how can alcohol bingeing lead to polyuria

Answer 42

ADH suppression in the posterior pituitary gland leading to polyuria

Question 43

what diuretics act on the proximal convoluted tubule

Answer 43

carbonic anhydrase inhibitor

Question 44

treatment for anaemia in CKD

Answer 44

start oral iron replacement | -after this you can start erythropoietin

Question 45

what does high phosphate levels in CKD cause

Answer 45

osteomalacia

Question 46

management of CKD-mineral bone disease | low calcium high phosphate

Answer 46

low phosphate diet at first

Question 47

what does a rise in urea but not creatinine indicate

Answer 47

dehydration

Question 48

best screening for adult polycystic kidney disease

Answer 48

ultrasound

Question 49

what acid-base disturbance does diarrhoea cause

Answer 49

normal anion gap metabolic acidosis

Question 50

what acid-base disturbance does addisons cause

Answer 50

metabolic acidosis with normal anion gap

Question 51

what does sepsis cause in terms of acid-base distribution

Answer 51

metabolic acidosis with raised anion gap

Question 52

which diuretic for ascites

Answer 52

aldosterone antagonists

Question 53

what is the commonest extra-renal manifestation of ADPKD

Answer 53

liver cysts

Question 54

what does widespread effacement of foot processes indicate

Answer 54

minimal change GN

Question 55

what does myeloma usually present with

Answer 55

anaemia, hypercalcaemia, bone pain, and AKI.

Question 56

first line treatment for blepharitis

Answer 56

- hot compress | - mechanical removal of lid debris

Question 57

- vesicular rash around the eye, which may or may not involve the actual eye itself - Hutchinson's sign: rash on the tip or side of the nose. Indicates nasociliary involvement and is a strong risk factor for ocular involvement what do these indicate

Answer 57

ocular involvement of shingles | -herpes zoster opthalmicus

Question 58

which eye condition is ankylosing spondylitis associated with

Answer 58

anterior uveitis