Year 4

Question 1

From what week gestation can pregnancy-related blood pressure problems occur?

Answer 1

20

Question 2

Give 2 things a women with endometriosis might mention during a history

Answer 2

• Dysmenorrhoea
• Deep dyspareunia
• Fertility problems

Question 3

What is Meig’s syndrome associated with?

Answer 3

Benign ovarian tumour. Associated with ascites and pleural effusion

Question 4

In Down’s syndrome is the bhCG high or low?

Answer 4

High

Question 5

What screening is done for Down’s syndrome and when?

Answer 5

Nuchal translucency, done at 10-14 weeks

Double test for beta hCG and PAPP-A

Question 6

What drugs facilitate delivery of the placenta and prevent PPH?

Answer 6

Oxytocin and ergometrine

Question 7

What vitamin is teratogenic in high doses? What food type contains this and is thus not recommended in pregnancy?

Answer 7

Vitamin A. In liver.

Question 8

Unopposed oestrogen therapy increases the risk of what kind of cancer?

Answer 8

Endometrial

Question 9

How is chlamydia treated?

Answer 9

Azithromycin or doxycycline

Question 10

When is the COCP contraindicated in postpartum women?

Answer 10

<6/52 postpartum and breastfeeding women

Question 11

What is an absolute contraindication to the copper IUD?

Answer 11

PID

Question 12

In premature ovarian failure what are the gonadotrophin levels (FSH & LH)? What is the estradiol level?

Answer 12

FSH & LH = high

oestradiol = low

Question 13

What can be given prior to surgery to shrink fibroids?

Answer 13

GnRH analogues

Question 14

What immunisations are offered to pregnant women?

Answer 14

Influenza and pertussis

Question 15

When should progesterone levels be checked in a women’s cycle?

Answer 15

7 days before the end

Question 16

What is normal variability in a CTG?

Answer 16

5-15bpm

Question 17

If vagal manoeuvres fail to terminate supraventricular tachycardia what should be done next?

Answer 17

IV adenosine

Question 18

Dry cough and erythema multiforme suggest what pathogen?

Answer 18

Mycoplasma

Question 19

What haematological malignancy is associated with the Philadelphia chromosome - t(9:22) translocation?

Answer 19

CML

Question 20

What abx should a patient who has had a splenectomy take daily?

Answer 20

Pen V

Question 21

What 2 drugs should all patients who have heart failure take, according to NICE?

Answer 21

ACE inhibitor and B blocker

Question 22

What drugs should be given in anaphylaxis?

Answer 22

Adrenaline 500mcg
Hydrocortisone 200mg
Chlorphenamine 10mg

Question 23

What is the triad for normal pressure hydrocephalus?

Answer 23

Urinary incontinence
Dementia
Gait abrnomality

Question 24

What test is best for diagnosing Addison’s?

Answer 24

Short ACTH test

Question 25

Does gliclazide cause: weight gain? Weight loss? Is it weight neutral?

Answer 25

Weight gain

Question 26

What diuretic can cause ototoxicity?

Answer 26

Loop diuretics, e.g. furosemide

Question 27

Reactive arthritis (Reiter's arthritis) is associated with what 3 conditions?

Answer 27

Chlamydia Gonorrhoea Gastroenteritis

Question 28

Give 5 drugs that should be avoided in renal failure

Answer 28

``` Tetracycline Nitrofurantoin NSAIDS Lithium Metformin ```

Question 29

What can be used to treat infective conjunctivitis?

Answer 29

Topical chloramphenicol

Question 30

What is the most appropriate 1st line treatment for stable angina in a patient with heart failure?

Answer 30

Atenolol

Question 31

What drugs should be used to manage angina?

Answer 31

B-blocker or CCB 1st line Aspirin and statin to all patients if no contraindications GTN to stop attacks

Question 32

Give 4 features of aortic stenosis

Answer 32

Slow rising pulse Narrow pulse pressure ESM Thrill

Question 33

If patients cannot tolerate ACE inhibitor, e.g. due to dry cough, what medication can they be switched to?

Answer 33

A2RB, e.g. losartan

Question 34

What is 1st line treatment for heart failure?

Answer 34

ACE inhibitor and B-blocker

Question 35

What drugs should all patients be offered post MI?

Answer 35

Dual anti platelet therapy ACEI B blocker Statin

Question 36

Give 3 features of Conn's syndrome

Answer 36

Low K+ Htn Alkalosis (high HCO3-)

Question 37

How much adrenaline should be given in cardiac arrest?

Answer 37

1mg

Question 38

When is amiodarone given in cardiac arrest and how much?

Answer 38

After 3rd shock | 300mg

Question 39

What can precipitate guttate psoriasis?

Answer 39

Step infection

Question 40

What drug is best for trigeminal neuralgia?

Answer 40

Carbamazepine

Question 41

What is the mode of action of heparin?

Answer 41

Activates antithrombin 3

Question 42

What is the compression and ventilation rate in newborn resus?

Answer 42

3:1

Question 43

What drug is given in variceal haemorrhage?

Answer 43

Terlipressin

Question 44

What is the Na, K and glucose like in an addisonian crisis? How should this be treated?

Answer 44

Hyponatraemia Hypoglycaemia Hyperkalaemia Treat with hydrocortisone

Question 45

What might be seen in fundoscopy in central retinal artery occlusion?

Answer 45

Cherry red spot on pale retina

Question 46

What will St John's wort do to the INR? What does cranberry juice do?

Answer 46

St John's Wort - Reduce it | Cranberry juice - increase it

Question 47

What does Anti-HBs and Anti-HBc imply in regards to Hep B serology?

Answer 47

Anti-HBs -> implies immunity | Anti-HBc -> implies previous or current infection

Question 48

Where do lesions form in MEN1?

Answer 48

Pituitary Parathyroid Pancreas

Question 49

When is murphy's sign seen?

Answer 49

Acute cholecystitis

Question 50

How many people with Hep C become chronically infected?

Answer 50

80-85%

Question 51

What can be used to distinguish between IBS and IBD in primary care?

Answer 51

Faecal calprotectin -> it's released in the bowel in response to inflammation

Question 52

What drug is often 1st line in treatment for hepatic encephalopathy?

Answer 52

Lactulose. Reduces production and absorption of ammonia from the GI tract

Question 53

Describe some signs and symptoms of PBC

Answer 53

Lethargy, pruritis. Increase in gamma GT and ALP. | M rule -> IgM, anti-Mitochondrial abs, Middle-aged women

Question 54

What bacterium causes amebiasis?

Answer 54

E. histolytica. | Metronidazole to treat

Question 55

Give some features of Kawasaki disease

Answer 55

Strawberry tongue, high fever resistant to anti-pyretics, red cracked lips, red palms and soles, conjunctival infection.

Question 56

What is a complication of Kawasaki disease?

Answer 56

Coronary artery aneurysm. Do an echo

Question 57

What causes Roseola infantum? Give an example history

Answer 57

HHV-6 | High fever, maculopapular rash starting on chest and spreads

Question 58

How is croup managed?

Answer 58

Oral steroids, regardless of severity

Question 59

Herald patch and blisters/red spots on trunk describes what infection?

Answer 59

Pityriasis rosea

Question 60

What is 1st line treatment for Raynauds?

Answer 60

Nifedipine (CCB)

Question 61

Which nerve is implicated in a saturday night palsy? (cannot extend wrist)

Answer 61

Radial

Question 62

Dermatitis herpetiformis is associated with what autoimmune condition?

Answer 62

Coeliac's | IgA autoimmune skin condition

Question 63

What blood abnormalities can amiodarone cause?

Answer 63

TFT abnormalities - either hypo or hyper

Question 64

Isolated unilateral hemiplegia with NO speech or visual defects suggests a lesion where?

Answer 64

Lacunar infarct

Question 65

Amiodarone and nitrofurantoin can both cause what side effect?

Answer 65

Pul. fibrosis

Question 66

When is anti-D prophylaxis given to rhesus -ve women?

Answer 66

28 and 34 weeks

Question 67

What antibody is positive in someone with anti-phospholipid syndrome?

Answer 67

Anti-cardiolipin

Question 68

Which condition is associated with long bleeding time and long APTT, von Willebrand disease or Haemophilia?

Answer 68

von Willebrand disease

Question 69

Where is the mutation in polycythaemia rubra vera?

Answer 69

JAK2 | Splenomegaly, hyper viscosity, pruritus, plethoric appearance

Question 70

In which haem malignancy are Bence-Jones proteins seen?

Answer 70

Multiple myeloma. | High ESR and osteoporosis are suggestive of this

Question 71

What organism is most likely to be responsible in an infective exacerbation of COPD?

Answer 71

H. influenzae

Question 72

What is the most common opportunistic infection in someone with AIDS?

Answer 72

PCP (Pneumocystis jiroveci) | Co-trimoxazole

Question 73

Pneumonia in an alcoholic, what organism?

Answer 73

Klebsiella

Question 74

Tonsillitis, what organism most likely?

Answer 74

Step. pyogenes

Question 75

Central line infections, what organism?

Answer 75

Staph. epidermidis

Question 76

Pneumonia following an episode of flu, what organism most likely?

Answer 76

Staph aureus

Question 77

What is the auto antibody for SLE?

Answer 77

anti ds DNA

Question 78

What is the auto antibody for Sjogrens?

Answer 78

anti-Ro and anti-La

Question 79

What is the auto antibody for Wegner's?

Answer 79

c-ANCA | URTI, LRTI, saddle nose deformity

Question 80

What is the auto antibody for RA?

Answer 80

anti-CCP, | rheumatoid factor

Question 81

What is the auto antibody for dermatomyositis?

Answer 81

anti-Jo1

Question 82

What organism is most likely to cause meningitis in a newborn?

Answer 82

Group B strep

Question 83

What organism is most likely to cause meningitis in infants/children?

Answer 83

Strep. pneumoniae

Question 84

What organism is most likely to cause meningitis in young adults?

Answer 84

N. meningitidis

Question 85

What organism is most likely to cause meningitis in older adults?

Answer 85

S. pneumoniae

Question 86

In what syndrome might you see an isolated raised unconjugated bilirubin with no associated symptoms?

Answer 86

Gilbert's

Question 87

What is the inheritance pattern for Ehler-Danlos? What is it characterised by?

Answer 87

Autosomal dominant | Joint hyper mobility, elastic skin, easy bruising, aortic regurg.

Question 88

What anti sickness medication must be avoided in parkinson's?

Answer 88

Metoclopramide, dopamine antagonist

Question 89

In what type of patients can HONK occur and what is it?

Answer 89

Newly diagnosed T2DM. | Hyperosmolar non ketotic coma. Dehydration and renal failure, severely high glucose

Question 90

What antibiotic can lower the seizure threshold in someone with epilepsy?

Answer 90

Ciprofloxacin

Question 91

Which type of testicular might have a raised bhCG?

Answer 91

Teratomas

Question 92

What is the most common type of lung cancer in non smokers?

Answer 92

Lung adenocarcinoma

Question 93

What organism causes syphilis? How can it be managed?

Answer 93

T. pallidum, a spirochaete. Benzylpenicillin to treat

Question 94

Barrett's oesophagus is premalignant for what?

Answer 94

Adenocarcinoma

Question 95

What vaccine is given to people with Coeliac's disease and why?

Answer 95

Pneumococcal as it's associated with hyposplenism