YR 4 EXAM

Question 1

Which drugs can cause parkinsonism?

Answer 1

those with antidopaminergic effects

eg. typical antipsychotics, metoclopramide

Question 2

what organism causes scarlet fever?

Answer 2

group A strep eg strep pyogenes

Question 3

treat staggered paracetamol overdose

Answer 3

immediate n acetyl cysteine

Question 4

how does ventricular septal defect present?

Answer 4

systolic murmur

signs of heart failure eg hepatomegaly

Question 5

What age does Perthes present?

Answer 5

4-9

Question 6

What exam finding suggests SUFE?

Answer 6

loss of IR

Question 7

what do exclamation mark hairs indicate?

Answer 7

alopecia areata

Question 8

What presents with a white lace on the buccal mucosa?

Answer 8

lichen planus

Question 9

What is the main metabolic disturbance in DKA?

Answer 9

inc lipolysis

Question 10

What antibodies are present in PBC?

Answer 10

AMA

Question 11

what is spondylosisis?

Answer 11

OA of facet joint

Question 12

what is spondylolithesis?

Answer 12

forward slippage of vertebrae

Question 13

which ankle injury is most common?

Answer 13

inversion –> anterior talofibular sprain

Question 14

what congenital problems are most linked with T1DM?

Answer 14

neural tube defect and cardiac disease

Question 15

which CURB65 score should be managed

a) as an outpatient?
b) in a hospital ward?
c) in a high dependency setting?

Answer 15

a) 0-1
b) 2
c) 3

Question 16

how is MODY inherited?

Answer 16

autosomal dominant

Question 17

How does gilbert’s present?

Answer 17

jaundice during periods of stress

Question 18

How does biliary atresia present?

Answer 18

prolonged neonatal jaundice

conjugated bilirubinaemia: pale stools, dark urine

Question 19

How does bronchiectasis present?

Answer 19

daily cough + sputum

Question 20

What is another name for pulmonary fbrosis?

Answer 20

fibrosing alveolitis

Question 21

How is spontaneous bacterial peritonitis investigated?

Answer 21

diagnostic aspiration

Question 22

What can cause hypokalaemia?

Answer 22

loop and thiazides

Question 23

What DMARD is first line in rhuematoid?

Answer 23

methotrexate

Question 24

Should opiate doses be changed in AKI?

Answer 24

reduce as can decrease excretion causing toxicity

Question 25

How is neuroleptic malignant syndrome a) diagnosed? b) treated?

Answer 25

a) raised ck | b) bromocriptine

Question 26

which lobe is implicated first in alzheimer's?

Answer 26

temporal

Question 27

which organism causes pneumonia following flu?

Answer 27

s aureus

Question 28

what is a conversion disorder?

Answer 28

loss of motor/sensory function

Question 29

what is a somatisation disorder?

Answer 29

multiple symptoms

Question 30

how does wernickes present?

Answer 30

opthalmoplegia nystagmus ataxia confusion

Question 31

how does korsakoff present?

Answer 31

amnesia + confabulation

Question 32

how is anterior uveitis managed?

Answer 32

topical steroids and mydriatics

Question 33

Which condition is associated with a) scleritis? b) ant uveitis?

Answer 33

a) rheumatoid | b) IBD

Question 34

manage ? TIA

Answer 34

immediately give 300mg aspirin and refer to specialist in next 24hrs

Question 35

Which antibiotic should not be prescribed with a) methotrexate? b) warfarin?

Answer 35

a) trimethoprim | b) erythromycin

Question 36

Which type of dementia presents with visual hallucinations?

Answer 36

lewy body dementia

Question 37

manage myxoedema coma

Answer 37

levothyroxine and hydrocortisone

Question 38

how should an ectopic with a foetal heartbeat be managed?

Answer 38

surgically

Question 39

what can rapid correction of hyponatraemia cause?

Answer 39

central pontine demyelination

Question 40

what can rapid correction of hypernatraemia cause?

Answer 40

cerebral oedema

Question 41

ACEi and which drug can cause hyperkalaemia?

Answer 41

spironolactone

Question 42

When is postpartum contraception requried from?

Answer 42

21 days

Question 43

how should supraventricular tachycardia be managed?

Answer 43

vagal manoeuvre then 6mg adenosine

Question 44

what causes bilious vomit in first days of life?

Answer 44

malrotation w volvulus

Question 45

How is a suspected PE managed?

Answer 45

DOAC eg rivaroxaban

Question 46

what is the difference between critical and acute limb ischaemia?

Answer 46

critical - constant pain for >2wks acute - 6ps pale pulseless

Question 47

how does left ventricular free wall rupture present?

Answer 47

inc jvp muffled heart sounds acute heart failure

Question 48

which electrolyte disturbance can pancreatitis cause?

Answer 48

hypocalcaemia

Question 49

manage threadworm

Answer 49

oral mebendazole

Question 50

which medication treats a) acute menieres? b) prevents menieres?

Answer 50

a) prochloperazine | b) betahistine

Question 51

What vol of maintenance fluids should be given?

Answer 51

25 ml/kg/day

Question 52

investigate resp function in myasethenic crisis

Answer 52

fvc

Question 53

investigate unprovoked dvt

Answer 53

CT chest abdo pelvis for malignancy

Question 54

which virus is associated with a) nasopharyngeal cancer? b) oropharyngeal cancer?

Answer 54

a) EBV | b) HPV

Question 55

Haematuria + masses in both flanks is indicative of what | and how is it investigated?

Answer 55

AD PKD | US renal tract

Question 56

A 50 year old woman has 6 months of increasing fatigue and pruritus. There is no history of foreign travel, injections or blood transfusions. She drinks minimal amounts of alcohol.She is jaundiced.Investigations:Albumin 32 g/L (35-50)Alanine aminotransferase 60 IU/L (10-50)Alkaline phosphatase 920 IU/L (25-115)Bilirubin 55 μmol/L (<17

Answer 56

PBC

Question 57

A 33 year old woman and her 32 year old husband have a two year history of primary subfertility. She has an irregular menstrual cycle and her cycles have previously been shown to be anovulatory. Tubal patency has been confirmed. She has an elevated serum free androgen index and a reduced serum sex hormone binding globulin. Her body mass index is 44 kg/m2. Her husband is fit and well.What is the most appropriate investigation?

Answer 57

TVUS for ?PCOS

Question 58

Give example of a gram +ve diplococcus

Answer 58

strep pneumoniae

Question 59

A 36 year old man is admitted to a psychiatric unit. His speech is very rapid and he does not pause for breath between sentences. He says to the admitting doctor "You're a doctor, Doctor Who, he's a doctor, I watch him on TV, I like TV".

Answer 59

flight of ideas

Question 60

A 50 year old man has a 3 week history of fresh haematemesis. For 3 months he has been experiencing epigastric pain and early satiety.

Answer 60

gastric cancer

Question 61

A 40 year old man has a painless enlarged left testicle. He was hit in the groin by a football during a game 2 days earlier.There are no groin hernias and the right hemiscrotum is normal. The left testicle has a diffuse swelling in the upper pole that does not transilluminate.

Answer 61

seminoma