Year 5 passmed

Question 1

abx of choice to treat mycoplasma

Answer 1

doxy or azithromycin

Question 2

side effects of doxycycline

Answer 2

photosensitivity
discoluration of thyroid gland
fontanelle bulging in infants
tooth discoluration
GI discomfort

dont give them in pregnancy

Question 3

What is the most appropriate test to check for latent tuberculosis?

Answer 3

A TB skin test (“Mantoux”) can show if you have latent TB infection.

Question 4

exmape of a non-lactose fermenting, oxidase-positive, gram-negative bacilli

Answer 4

pseudomonas aeruginosa

Question 5

oxidase negative bacteria common

Answer 5

Oxidase (-) Burkholderia spp.
E. coli.
Proteus spp. Salmonella spp. Shigella spp.

Question 6

oxidase positive bacteria

Answer 6

Oxidase (+) P. aeruginosa. Aeromonas spp.

Question 7

hepatomegaly causes

Answer 7

infections: Hep A, B or C , cytomegalovrius and mononucleosis

Alcohol

autoimmune - sarcoidosis and SLE

Genetic - hemochromatosis, wilsons disease, alpha 1 anti-typrsin

cogestive heart failure and thrombosis

neopalstic; leuakemia, lymphoma , HPC

sicle cell anaemai

pregnancy

amyloidosis

Question 8

generalised liver disease sx

Answer 8

abdominal pain
bruising
fatigeu
itching
jaundice
muscle aches
nausea
poor appetite
swelling

Question 9

splenomegaly causes

Answer 9

malaria
hodgkins
leukaemia
HF
cirrrhosis
tumours
viral bacterial and parastie
SLE and RA
mononcuelosis
suphylis

Question 10

headache, myalgia, fever and a cough. On auscultation her chest is clear but she has a temperature of 38.6ºC - these are all typical flu sx what causes the flu

Answer 10

influenza

Question 11

cause of the common cold

Answer 11

rhinovirus

Question 12

what genital ulcers are painful and whats more common than the other

Answer 12

painful: herpes much more common than chancroid

Question 13

what genital ulcers are painless and whats more common

Answer 13

painless: syphilis more common than lymphogranuloma venereum

behecets also cause ulcers - do not know if painful or not

Question 14

chancroid caused by

Answer 14

Chancroid is a tropical disease caused by Haemophilus ducreyi. It causes painful genital ulcers associated with unilateral, painful inguinal lymph node enlargement. The ulcers typically have a sharply defined, ragged, undermined border.

Question 15

lymes disease abx tx

Answer 15

doxycycline
amox if preg

Question 16

management of pt with bacterial meningitis (4)

Answer 16

IV access to get bloods and cuture
IV abx - cefotaxime if 3m-50 and over 50 cefotaxime and amox
Iv dexamethaone - particularly if pneumococcal - improve outcomes by reducing neurological sx
CT scan

Question 17

when getting an LP what are you looking and testing for

Answer 17

glucose, protein, microscopy and culture
lactate
meningococcal and pneumococcal PCR
enteroviral, herpes simplex and varicella-zoster PCR
consider investigations for TB meningitis

Question 18

what do you give to contacts of meningitis if close contact witin 7 days

Answer 18

oral ciprofloxacin or rifampicin

Question 19

if you have chronic hepatitis what vaaccine should you be offered

Answer 19

one-off pneumoccoal vaccine

Question 20

choice of abx in cellultiis in preg

Answer 20

erythromcyin - if not preg clairthomycin

Question 21

most common cause of viral meningitis

Answer 21

Coxsackievirus or other enteroviruses

Question 22

characterised by a prodrome, abdominal pain and bloody diarrhoea what infection for gi infection

Answer 22

campylobacter

Question 23

bacterial vag tx
can in preg and breastfeed

Answer 23

Metronidazole 400mg bd for 5 days

Question 24

Patient has had a full course of tetanus vaccines, with the last dose < 10 years ago do you need any tetanus tx

Answer 24

no vaccine nor tetanus immunoglobulin is required, regardless of the wound severity

Question 25

Patient has had a full course of tetanus vaccines, with the last dose > 10 years ago do you need vaccine

Answer 25

yes but depends

if tetanus prone wound- puncture , foregin body burn , bite : reinforcing dose of vaccine
high-risk wounds- heavy contamination (e.g. compound fractures, delayed surgical intervention, significant degree of devitalised tissue): reinforcing dose of vaccine + tetanus immunoglobulin

Question 26

pneumonia pathogen in alcoholics

Answer 26

klebsiella

Question 27

worsening cellulitis with worsening pain in keeping with physical features what you thinking and who should you refer to

Answer 27

nec fasc and surgeons

Question 28

Chest X-ray shows a partially-filled cavity with a crescent of air post TB

Answer 28

aspergilloma

Question 29

what is metronidazoles affect on warfarin

Answer 29

Metronidazole increases the anticoagulant effect of warfarin
increasing INR as delayed antucoagualtn effect

Question 30

most likely pathogen associated with gangrene

Answer 30

Clostridium perfringens is the most likely pathogen to be associated with gangrene.

Question 31

cavitating lesion causing pneumonia what pathogen

Answer 31

staph aureus

Question 32

Fever, abdominal pain, constipation, ‘rose’ spots

Answer 32

typhoid - salmonella typhi

Question 33

oral herpes what cause

Answer 33

HSV-1 is more commonly associated with oral herpes

Question 34

despite taking penicillin abx - Which organism is he particularly susceptible to, despite taking prophylactic antibiotics?

Answer 34

h.influenzae

Question 35

if HIV is dx when should antiviral therapy be started

Answer 35

Antiretroviral therapy should generally be started as soon as HIV is diagnosed
Prescribe two nucleoside reverse transcriptase inhibitors (NRTI) and a protease inhibitor (PI)

Question 36

one solitary gential keratinised wart - how do you treat

Answer 36

solitary, keratinised warts: cryotherapy

Question 37

if you have multiple non- keratinised warts how do you treat

Answer 37

multiple, non-keratinised warts: topical podophyllum

Question 38

what is lemierre syndrome

Answer 38

Lemierre’s syndrome presents with thrombophlebitis of the internal jugular vein following an anaerobic oropharngeal infection.

Question 39

if abx treatment is needed for a campylobacter infection what should you give

Answer 39

Campylobacter infection is often self-limiting but if severe then treatment with clarithromycin may be indicated

Question 40

The BNF recommends treating invasive diarrhoea (causing bloody diarrhoea and fever) with

Answer 40

ciprofloxacin

Most viral or bacterial gastroenteritis do not require treatment. The BNF recommends antibiotics for bacterial gastroenteritis in severe infections or in immunocompromised patients. Clarithromycin is used for traveller’s diarrhoea and non-invasive diarrhoeal illnesses when treatment is necessary.

Question 41

Erratic blood glucose control, bloating and vomiting think

Answer 41

gastroparesis

Question 42

kocher criteria for septic arthritis

Answer 42

Fever: A temperature of 101.3°F (38.5°C) or higher
Erythrocyte sedimentation rate (ESR): An ESR of more than 40 millimeters per hour (mm/hour)
White blood cell (WBC) count: A WBC count of more than 12,000 cells/mm3
Inability to bear weight: The patient is unable to put weight on the affected si

modified adds on crp

will also have restricted movement needing synvoial fluid sampling, joint imgiign and blood cultures

Question 43

difference between bacterial and viral csf

Answer 43

bacterial low glucose and high protein
vial high glucose and normal protein
fungal low glcuose and high protein

Question 44

cardiac tamponade follows what

Answer 44

truma, MI, TB or inf , lupus, cancer , CKD, surgery

Question 45

risk factors for GI bleed

Answer 45

NSAID, anticagoaulans, SSRI
alcohol and smoke
colitis or ulcers
surger
cancer RF , liver dissease
vomit
radiation tx can increase risk of peptic ulcers

Question 46

how does constrictive pericarditis lead to heart failure

Answer 46

pericardium thickens and stiffens making it difficult for the heart to expand. This prevents the heart chambers from filling with enough blood, which can to lead to heart failure sx such as swelling peipherally taifgue and SOB