Year 3 Flashcards

1
Q

Mild learning disability

A

50-69

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Moderate learning disability

A

35-49

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Non-epileptic fit movements

A

Side to side, thrusting of pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Unipolar depression and dexamethasone

A

Dexamethasone will fail to suppress cortisol production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mixed affective disorder

A

Manically depressed (high energy depression)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MSE has what

A

Appearance + behaviour, speech, affect, mood, thoughts, perception, cognitive function, insight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Aversive/defensive

A

Serotonin / NA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Depression and mania are problems with aversive/appetitive

A

Appetitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Where is bipolar thought to affect?

A

Anterior cingulate nucleus (broadmann 24)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

NA precursor

A

Tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

5-HT precursor

A

Tryptophan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What metabolite is only increased in heroin?

A

6-monoacetylmorphine (6 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Acute PTSD vs chronic

A

4 weeks

3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Hebenephric schizophrenia features

A

Babbles nonsense, laughs uncontrollably

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Most common schizophrenia

A

Paranoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Most worrying personality disorder and treatment

A

Group B

DBT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Schizophrenia affects white/grey matter

A

Grey

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Schiz <1 month

A

Schizophreniform or acute and transient psychosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How long to continue meds after single episode of schizophrenia?

A

18 m if no relapses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Schizotypal disorder

A

Overvalued ideas but no delusions or real hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Egodystonic

A

Thoughts aren’t own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Most common mental illness

A

Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diagnostic tool for autism

A

ADOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Disulifram does what?

A

Inhibits acetaldeyde dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the predict score?

A

Predict score = effectiveness of chemo and radiotherapy in breast caner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where are subcutaneous glands in non-lactating breasts?

A

In front of deep fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Histology of non-lactating breast

A

Connective tissue and glandular epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How many lobes in a breast?

A

15-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What separates lobules?

A

Suspensory ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Basic functional unit of breast

A

TDLU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lactiferous sinus =

A

Bulge in lactiferous duct where milk concentrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lobules of non-lactating breast are filled with

A

Acinar cells, secretory epithelium (columnar and cuboidal), myoepithelial cells surround acinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Histology of large ducts

A

Both stratified shamus and cuboidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What can happen to breast during luteal?

A

Small secretions?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is in lactate ?

A
88% water
7% carbs
3.5% lipid 
1.5% protein 
IgA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Protein is secreted into ducts via

A

Eccrine transport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Lipids are secreted via

A

Apocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How deep does breast conservation surgery go?

A

Full thickness to chest wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

If you can’t see cancer with your eyes, how do you excise?

A

Wire guided wide excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why do you give under 35 an US?

A

Breast too dense for mammogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sterotaxis

A

Mammography guided biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Most common breast cancer

A

Ductal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

How is DCIS found?

A

Non-palpable, found on screening (pleomorphic, casting calficiations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Invasive lobular carcinoma histology

A

Indian file pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Modified radial mastectomy preserves what?

A

Pec major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Fibroadenoma confirmation via

A

FNA and US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Phyllodes tumour looks like a ________ and is due to _______ _______

A

Sarcoma

Stromal overgrowth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Fat necrosis histology

A

Foamy macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

LCIS tumour markers

A

ER+
E-cadherin-
CDH1+ (chromosome 16)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

BRCA and breast cancer risk

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Survival if ER positive ?

A

30% better

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

HER2+ cancer has ______ prognosis

A

Worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

FNA or needle core biopsy?

A

Needly core biopsy is more often now

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Fertility treatment for poor swimmers

A

ICSI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

First line fertility treatment

A

IUI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Mullerian tract makes what?

A

Fallopian tubes, mullein inhibiting factor in males makes them disappear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Obstructive male infertility blood

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Non-obstructive male infertility blood

A

High LH/FSH

Low testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Chlamydia treat

A

Doxy 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is implantation bleeding?

A

10 days post ovulation egg implants into uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What does vomiting occur in pregnancy?

A

First trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Treat hyperemesis

A

Cyclizine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What has a large fluid filled antrum?

A

Ovarian follicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is at the centre of the ovaries?

A

Hilum and medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Where are follicles in ovaries?

A

Cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Uterine and Fallopian tube histology

A

Simple columnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Stratum of uterus endometrium undergoes monthly growth and degeneration

A

Functionalists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Should there be clots in normal menstruation?

A

No, clots are abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Proliferative phase of menstruation

A

Oestrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Luteal phase of menstruation

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Complete mole

A

2 sperm DNA

46 chromosomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

STI needing a proof of cure

A

Gonorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What infections are people with AIDS at increased risk of?

A

Fungal, viral, parasitic, MYCObacterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Toxoplasmosis signs

A

CN palsy, confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

CMV signs

A

Floaters, abdo pain, PR bleed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

How long after sex do you test HIV

A

4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

How long do ovum survive?

A

17-24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Listeria and pregnancy avoid what?

A

Soft cheese, shellfish, pate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Round ligament is remnant of what?

A

Gru vernaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Ribs below pec major?

A

2-6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Preeclampsia risk –> take

A

75 mg aspirin from week 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

T sign placenta with twins

A

Monochorionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Lamba sign

A

Dichorionic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Asymmetrical IUGR suggests

A

Placental insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Prenatal appointment screen

A

Hep, HIV, syphilis, blood group, anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Placenta is made of

A

Trophoblasts and decide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

_____ stimulation releases oxytocin

A

Nipple

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Urogenital system arises from the

A

Intermediate mesoderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What helps testes descend

A

Gubernaculum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Are contractions under hormonal or neuro control?

A

Hormonal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

APH

A

50-1000ml but no shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

1st phase of labour latent vs active

A

0-4cm

4-10cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

How many women experience baby blues?

A

Up to 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Treatment of overactive bladder?

A

Oxybutinyn and tolterodine
Demopressin
Mirabegron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What makes up levator ani?

A

PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Feeding of pre-term baby?

A

Supplements, give small drops of milk to encourage gut maturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

RDS is common before ____ weeks

A

37

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

XRAY in RDS

A

Ground glass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Normal weight of baby

A

2.5-4kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

c. number means

A

Where mutation is in mRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

p. number mean

A

Which amino acid is affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

c.(number, letter>letter) meaning

A

Position of codon and what it has switched to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Liver in neonates is smaller/larger

A

Larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Bowel loops should be _______ than vertebral column otherwise _______

A

Smaller

Dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Why does NEC happen?

A

Unprepared GI tract springs a leak and leads to shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Brown fat

A

Produced in 3rd trimester, provides warmth after birth, between scapula and internal organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

How long can a newborn be blue and not be worrying?

A

5 mins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Initial rhesus of newborn

A

In air up to 10 mins then wrong so use oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Physiological jaundice of newborn?

A

Fetal haemoglobin is breaking down, normal 24h-2weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

Endometrial polyps are common when?

A

Around menopause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Endometroid endometrial cancer precursor

A

Atypia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Brachytherapy?

A

Intrauterine tube under GA, gets radiotherapy closer to cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Ovarian cancer risks

A

> 50, no kids, FMHx, BRCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What divides obturator foramen?

A

Piriformis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Blood supply to uterus?

A

Uterine and ovarian

116
Q

Obturator nerve roots

A

L2-4

117
Q

Sections of uterus

A

Cervix
Isthmus
Corpus

118
Q

Mets to ovary from (3)

A

GI
Pancreas
Breast

119
Q

Leiomyoma cells look like

A

Smooth muscle, long spindle cell, cigar shape

120
Q

CIN and acetic acid

A

Goes white

121
Q

Koiliocyte

A

Big black nucleus, squamous cell infected by HPV

122
Q

PCOS cysts are ________

A

Follicular

123
Q

Which ovarian cancer chemo is renal function dependent?

A

Carboplatin

124
Q

What ovarian cancer chemo drug causes hair loss

A

Paclitaxel

125
Q

Uvula deviates

A

Away

126
Q

Tongue deviates

A

Towards

127
Q

Young man dizzy then collapses

A

Epidural - arterial

128
Q

Corpus callous is _____ matter

A

White

129
Q

What columns cross at spinal levels?

A

Anterior corticospinal, spinothalamic

130
Q

What is in basal ganglia?

A

CPGSS

131
Q

Lenticular nucleus

A

P+GP

132
Q

Striatum

A

C+P

133
Q

Glycine is where? Gaba is where?

A

Cortex/brainstem

Cortex/thalamus

134
Q

Spatial summation =

A

of neurones

135
Q

High threshold receptor

A

Pain

136
Q

How are receptive fields defined

A

1=small

2=large

137
Q

SA1

A

Merkel

138
Q

FA1

A

Meissners

139
Q

SA2

A

Ruffini

140
Q

FA2

A

Pacinian

141
Q

What are gamma motor neurones?

A

Maintain stretch in muscle spindles

142
Q

Non-rem sleep features

A

Strong emotional dreams, start of night, MOST IMPORTANT

143
Q

Disturbances in non-rem sleep leads to …. why?

A

Sleep walking

Primitive brain wakes up first

144
Q

Disturbances in REM sleep leads to …

A

Punches and kicks in sleep

145
Q

MRI in MS is every _____ _____

A

3 months

146
Q

GB syndrome exclusively affects the _______

A

PNS

147
Q

Add amox in BM when?

A

Immunocomp

Older than 60

148
Q

What does through SOF?

A

3,4,5(1),6

149
Q

What cranial nerve exits at the pons?

A

5

150
Q

What cranial nerves leave at diencephalon

A

1 and 2

151
Q

Midbrain

A

3 and 4

152
Q

Pontomedullary junction

A

6,7,8

153
Q

Medulla

A

9,10,12

154
Q

What divides images top and bottom?

A

Calcarine sulcus

155
Q

When following stroke are people at most risk of a second?

A

Within 10 days

156
Q

Worst stroke

A

TACI

157
Q

Best stroke

A

Lacunar

158
Q

Main cause of cardioembolic stroke

A

AF

159
Q

Who gets prophylactic migraine treatment?

A

3+ a month

160
Q

Treat SUNCT

A

Gabapentin

Lamotrigine

161
Q

Primary brain cancer

A

Astrocytoma

Meningioma

162
Q

Cerebellopontine angle tumour

A

Schwannoma

163
Q

Kids primary brain tumour and where

A

Medullablastoma

Cerebellar midline

164
Q

What happens to telemeres with age?

A

They shorten

165
Q

Delirium treat

A

Haloperidol

166
Q

Anticholingerics in elderly cause

A

Delirium

167
Q

Gabapentin in elderly causes

A

Sensorineural changes

168
Q

Modified release morphine lasts _____ hours

A

12

169
Q

What % of dementias are vascular

A

25

170
Q

Parkinson’s dementia

A

> 1year otherwise LBD

171
Q

Breakthrough pain should be

A

1/6 of dose

172
Q

Basic drugs example

A

Opioid, BZD

173
Q

Beer’s criteria

A

Prescribe in elderly

174
Q

High stepping gait and Romberg’s + indicates

A

Cervical myelopathy

175
Q

Who gets co-arction of aorta

A

Tuner’s

176
Q

Marfan’s features

A
Bifid uvula
FBN1 mutations
Long narrow face and fingers
High arch palate
Flexible
Pectus excavutum
Scoliosis 
Near sighted
177
Q

Kallman syndrome is due to

A

Deficiency in GnRH

178
Q

Kartagener syndrome

A

Primary ciliary dyskinesia, situs inverses
AR
Neonatal distress, hearing loss, infertility

179
Q

Abduct shoulder muscle

A

Supraspinatus

180
Q

Ph in PE

A

Alkalosis

181
Q

Breast cancer tumour marker

A

Ca15-3

182
Q

Pancreatic cancer marker

A

Ca19-9

183
Q

BNP marker for

A

Heart failure

184
Q

Sarcoid granuloma

A

Non-caseating

185
Q

Main source of hormones in 1st trimester

A

Corpus luteum

186
Q

Placenta in 2nd and 3rd

A

Produces oestrogen and progesterone

187
Q

Anterior pituitary in pregnancy

A

Increases in size, increased TSH

188
Q

Main constituent of gallstones

A

Cholesterole

If pigmented - bilirubin

189
Q

Hypospadias

A

Congenital defect in which urethra opens on ventral side of penis instead of at the tip

190
Q

Blood supply to greater omentum

A

L+R gastroepiploic arteries

191
Q

Epigastric artery supplies

A

Abdominal wall and some of diaphragm

192
Q

Treatment of seizures in eclampsia

A
  1. MS
  2. Phenytoin
  3. Diazepam
193
Q

Coarse vs fine crackles

A

COPD

Fibrosis

194
Q

Lorazepam makes delirium

A

Worse

195
Q

Function of lithium

A

Lowers levels of inositol by inhibiting phosphatidylinositol

196
Q

FBN1 gene on Ch

A

15

Marfans

197
Q

How are platelets formed?

A

Budding from megakaryocytic

198
Q

Chains of adult Hb

A

2b 2a

199
Q

Fetal Hb

A

2a 2g

200
Q

Chromosomes for haemoglobin

A

11+16

201
Q

Ch16 hb

A

2a

202
Q

Alzheimers affects what part of brain?

A

Hippocampus

203
Q

FTD aka ______ dementia

A

Semantic

204
Q

Why do you avoid thiazides in elderly?

A

Hyponatremia

Postural hypotension

205
Q

Why avoid PPI in elderly

A

Hypomag
Increased risk of fractures
B12 anaemia
Increased Cdiff infection

206
Q

Telemeres are at the ________ of the chromosome

A

End

207
Q

What happens when chromosome gets too short?

A

Sesence

208
Q

Hayflick limit?

A

Number of times human cell can divide before stops

209
Q

4AT

A

Alertness
AMT (age, date, place, year)
Attention
Acute change / fluctuate

210
Q

Sedation in delirium manage

A

Haloperidol
Quetipine - Parkinsons /Lewy body
BZD - alc withdrawal

211
Q

Pain manage mild pain

A

Paracetamol

NSAID

212
Q

What is cocodomol

A

Codeine+paracetamol

213
Q

What bone is the supraorbital ridge found on?

A

Frontal

214
Q

Where does blood supply to skin originate from?

A

Hypodermal layer

215
Q

Most caudal of brainstem?

A

Medulla

216
Q

Structure that runs through transverse process of cervical vertebrae

A

Vertebral artery and vein

217
Q

Dermatome of belly button

A

T10

218
Q

Medal 2/3 of external acoustic meatus

A

Temporal

219
Q

Nerve to cricothyroid

A

External laryngeal

220
Q

Medial border of sartorious makes of lateral border of what triangle

A

Femoral

221
Q

Hip joint is

A

Synovial

222
Q

Lesser momentum attaches to

A

Lesser curve of stomach and liver

223
Q

Right brachiocephalic artery branches into

A

Right common carotid and subvlacian

224
Q

Vertebral level is pancreas

A

L1

225
Q

Function of orbiculares oculi

A

Closes eyelid

226
Q

Transumbilical plane

A

L3

227
Q

Cribriform plate

A

Ethmoid

228
Q

How many cervical nerves

A

8

229
Q

Which part of duodenum is major paillae found

A

Descending

230
Q

Which muscle elevates pharynx

A

Sapinophaygneus

231
Q

What artery does the small cardiac vein travel with?

A

Right coronary

232
Q

Tympanic cavity is where?

A

Middle ear

233
Q

How many vertebrae

A

33

234
Q

Second rib tuberosity for

A

Serratus anterior

235
Q

Action of medial rectus

A

Adducts eye

236
Q

How much milk for infant is normal ?

A

150ml/kg/day

237
Q

ECG showing asystole management

A

IV adrenaline/epinephrine

238
Q

Unprovoked DVT manage

A

CT abdomen and pelvis

239
Q

What airway device provides protection for the lungs from regurgitation?

A

Tracheal tube

240
Q

Saturation for haemachromatosis

A

Transferrin

241
Q

30 year old has severe headache 24 hours after spinal anaesthetic

A

Low pressure

242
Q

Fasting times for surgery

A

2h clear liquids

6h solids

243
Q

Abnormally high potassium out of blue

A

Repeat - could be due to spurious degeneration in tube

244
Q

Appropriate test to monitor respiratory function

A

FVC

245
Q

Dorsiflex nerve

A

Common perineal

246
Q

Cyclical pain in breasts with brown fluid

A

Fibrocystic disease

247
Q

A 70 year old man has a brief episode of twitching that starts in his left hand and spreads up the arm over 2 minutes, then stops. His arm feels weak for an hour afterwards.

A

Partial stroke

248
Q

Ovarian cancer nodes

A

Para aortic

249
Q

Symptomatic gallstone disease

A

Laparoscopic cholecystectomy

250
Q

A 56 year old woman develops vertigo, nausea, vomiting and intense occipital headache of sudden onset. She is unable to walk without falling. She has a history of hypertension treated with ramipril.

A

Cerebellar stroke

251
Q

Nephrotic syndrome diagnosis via

A

Renal biopsy

252
Q

Recurrent falls, reduced pinprick, brisk reflexes

A

B12 deficiency

253
Q

Venous ulcer presentation

A

Hyperpigmented, lipodermatosclerosis

254
Q

An 82 year old woman has constipation and passes infrequent, hard stools. She has hypertension, overactive bladder symptoms and type 2 diabetes mellitus. She takes amlodipine, doxazosin, gliclazide, metformin and oxybutynin.Whats causing her constipation?

A

Oxybutinyn

255
Q

Lung cancer investigation

A

CXR

CT

256
Q

A 45 year old man with pain caused by cancer has been using opioids to control his pain very successfully. He is taking a regular dose of MST Continus® 60 mg 12-hourly orally. He has been using three breakthrough doses (oral morphine 20 mg) per day for the past week. How should his opioid prescription be adjusted?

A

90 12 hourly and 30 as required 4 hourly (4 hourly should be 1/6 of total day dose)

257
Q

Treat malignant spinal cord compression

A

Dexamethasone

258
Q

Triple assessment of breast lump

A

Clinical exam, breast image, core biopsy

259
Q

Lithium toxicity features

A

Confusion, coarse tremor, jerky leg movements

260
Q

How can lithium toxicity be precipitated?

A

Dehydration

261
Q

IV fluid resuscitation is with what?

A

0.9 NaCl

262
Q

If VF/VT persists after third shock, what do you do?

A

Amiodarone

263
Q

A 17 year old boy has repeated episodes characterised by a funny ‘racing’ sensation in his abdomen, followed by loss of awareness. His girlfriend describes that he has a vacant stare and waves his left arm around in a writhing manner during these attack

A

Right temporal

264
Q

Person on clozapine with severe sore throat

A

FBC

265
Q

Meningitis on LP

A

High pressure, raised protein, excess neutrophils

266
Q

Normal HCO3- excludes a _________ cause of acidosis/alkalosis

A

Metabolic

267
Q

A65yearoldwomanhasaweekofdisorientationanddizziness.Shealso has headaches that are worse when bending over and associated with vomiting. She had a non-small cell lung cancer that was treated with radical radiotherapy two years ago

A

Cerebral mets

268
Q

An66yearoldwomanwithadvancedbowelcanceristakingmorphinesulfate (modified release, 30 mg twice daily) for abdominal pain. She is in the last days of life and is now unable to swallow oral medications. She has not needed any doses for breakthrough pain
Continuous infusion required, how much over 24 hours?

A

30

269
Q

A44yearoldwomanhasshootingpaininherleftleg.Shehasanadvanced rectal cancer compressing the sciatic nerve. As part of her end of life care, she is taking morphine sulfate modified release (20 mg twice daily) but requests further medication for the pain

A

Amitriptyline

270
Q

A67yearoldmanpresentstotheEmergencyDepartmentfeelinggenerally unwell with no specific symptoms. He is being treated with neoadjuvant chemotherapy for bowel cancer. He underwent the third cycle 8 days ago.
His temperature is 38.6°C, pulse rate 97 bpm, BP 132/68 mmHg, respiratory rate 12 breaths per minute and oxygen saturation 95% breathing air. Examination is otherwise unremarkable. Blood tests have been taken, but results are not yet available
Diagnosis and treatment

A

NEUTROPENIC SEPSIS

BROAD SPEC ANTIBIOTICS

271
Q

A 33 year old man is found collapsed on the medical ward. He was admitted 3 days ago with urosepsis and is being treated with intravenous antibiotics. He has a history of type 1 diabetes and has been taking his usual doses of subcutaneous insulin
Needs glucose, what do you give?

A

75mL 20% glucose by IV infusion

272
Q

A 36 year old man has recurrent episodes of collapse over 4 months. When laughing, his muscles feel limp and he falls to the floor but remains conscious. He has a history of anxiety and depression and takes citalopram. His father died from an ischaemic stroke aged 59 years

A

Cataplexy

273
Q

A 25 year old man has taken an overdose of 16 paracetamol tablets. He became very sad earlier that day after an argument with a friend. His mood changes between being happy and sad several times per week. He struggles with concentration and gets angry easily. He has frequently been excessively drunk on nights out with friends. He has never experienced psychotic symptoms

A

Borderline

274
Q

How do you confirm norovirus?

A

PCR stool

275
Q

A 78 year old woman has back pain and bilateral leg weakness. She had surgery for breast cancer 14 years ago. She had a minor fall at home a few days ago

A

Spinal cord compression

276
Q

A 28 year old man is investigated for polyuria and polydipsia. He has bipolar disorder for which he has taken lithium for 2 years. What is most useful diagnosis test?

A

Serum calcium first

277
Q

AF long term stroke prevention

A

Apixaban

278
Q

A 92 year old woman has severe neck, chest and back pain and tingling in her left hand following a mechanical fall. She has bruising around her right eye. Diagnosis and management

A

Cerivcal spine fracture

CT neck

279
Q

Endocarditis diagnosis

A

Trans-oesophageal echo

Blood cultures

280
Q

A 47 year old woman has 1 year of increased urinary frequency, urgency and nocturia. She finds that she leaks urine if she is unable to get to the toilet promptly. She had three normal pregnancies with no complications. The perineum appears normal and there is no uterine prolapse. Incontinence is not provoked by coughing or straining. Urinalysis is negative. A post-micturition ultrasound scan of bladder shows minimal residual urine volume
Treatment?

A

Oxybutynyn

281
Q

A 23 year old man attends the sexual health clinic with a painful swelling in his groin and pain when opening his bowels. He had unprotected anal sex with a new male partner 4 weeks ago. He has a perianal ulcer and tender inguinal lymphadenopathy
Diagnosis?

A

Lymphogranuloma venereum

282
Q

A 75 year old man is admitted with weakness in his legs. He has a squamous cell lung cancer treated by radiotherapy 18 months previously. He is cachetic. He has 4 out of 5 power in hip flexion and knee flexion bilaterally. Sensation and reflexes are normal, and sphincter function is preserved. His BMI is 17 kg/m2. MR scan of spine shows destructive bony lesions of T12 and L2–L4 vertebral body
Treatment?

A

Too frail for surgical decompression

Radiotherapy is best treatment option

283
Q

Duodenal vs gastric ulcers

A

Duodenal relieved by eating

Gastric is worse by eating

284
Q

A 65 year old woman with advanced carcinoma of the breast with cerebral and liver metastases is rapidly deteriorating and is recognised to be dying. She becomes confused and agitated
Treatment?

A

Midazolam

285
Q

In which part of the brain are changes most likely to be found in early Alzheimer’s disease?

A

Temporal lobe

286
Q

A researcher is seeking to examine whether long-term mobile phone use is linked to acoustic neuroma risk. The information on mobile phone usage is collected from participants with acoustic neuroma and a comparable group of participants without acoustic neuroma, selected from the general practice register
What kind of study is this?

A

Case-control

287
Q

Amiodarone can cause what in lung?

A

Pulmonary fibrosis