1
Q
What condition is often caused by squamous cell carcinoma of the lung?
A
Hypercalcaemia due to PTH-related peptide
Squamous cell carcinoma releases PTH-related peptide, leading to elevated calcium levels.
2
Q
Which type of lung cancer is commonly associated with SIADH?
A
Small cell lung cancer
SIADH is not typically associated with squamous cell carcinoma.
3
Q
Streptococcus bovis infective endocarditis is commonly associated with which type of cancer?
A
Colorectal cancers
This association highlights the importance of screening for colorectal cancer in patients with Streptococcus bovis infections.
4
Q
LEMS is associated with which type of lung cancer?
A
Small cell lung cancer
LEMS (Lambert-Eaton Myasthenic Syndrome) is a paraneoplastic syndrome linked to small cell lung cancer.
5
Q
Gynaecomastia is more commonly associated with which type of lung cancer?
A
Adenocarcinoma of the lung
Gynaecomastia can occur due to hormonal changes related to adenocarcinoma.
6
Q
What is coarctation of the aorta associated with?
A
Turner syndrome
It involves a narrowing of the aorta, leading to complications such as hypertension and heart failure.
7
Q
What are the symptoms of vulvovaginal candidiasis?
A
- Thick white “cottage cheese” discharge
- Vulval itching
- Normal vaginal pH
Especially common in women with diabetes.
8
Q
What is the characteristic rash associated with rubella?
A
- Face-first maculopapular rash
- Lymphadenopathy
- Rash fades within days
These symptoms are indicative of rubella infection.
9
Q
What is the first-line treatment for osteomyelitis?
A
Flucloxacillin
This antibiotic is commonly used for treating osteomyelitis.
10
Q
How should primary genital herpes be treated?
A
Oral aciclovir started within 5 days of symptom onset
Treatment is most effective when initiated early.
11
Q
What are the symptoms of toxic shock syndrome?
A
- Fever
- Diffuse erythroderma
- Hypotension or systemic toxicity
- Multiorgan involvement
Most commonly caused by toxin-producing Staphylococcus aureus.
12
Q
How are genital warts diagnosed?
A
Usually a clinical diagnosis
Confirmation of HPV infection is done through PCR testing for HPV DNA.
13
Q
What is the first-line treatment for uncomplicated Chlamydia trachomatis infection?
A
Doxycycline 100mg twice daily for 7 days
This regimen is effective for treating uncomplicated chlamydial infections.
14
Q
What is required for confirmed Neisseria gonorrhoeae infection?
A
Single-dose IM ceftriaxone
This is due to widespread fluoroquinolone resistance.
15
Q
What is the first-line treatment for early syphilis according to NICE guidance?
A
Single dose of intramuscular benzathine benzylpenicillin
This treatment is recommended for primary, secondary, or early latent syphilis.
16
Q
What strongly suggests gonococcal urethritis?
A
- Acute dysuria
- Thick purulent urethral discharge within days of unprotected sex
These symptoms are indicative of gonococcal infection.
17
Q
What indicates bacterial vaginosis?
A
- Thin grey fishy discharge
- Clue cells
- pH > 4.5
These findings are characteristic of bacterial vaginosis.
18
Q
What suggests oropharyngeal candidiasis with oesophageal involvement?
A
- Creamy white plaques that can be scraped off
- Odynophagia/dysphagia
This condition can be differentiated from oral hairy leukoplakia.
19
Q
What is the treatment for uncomplicated vulvovaginal candidiasis?
A
- Single-dose oral fluconazole
- Intravaginal azole therapy
Both options are effective for treating uncomplicated candidiasis.
20
Q
What are the symptoms of Trichomonas vaginalis infection?
A
- Frothy yellow-green discharge
- Strawberry cervix
- Vulval irritation
These symptoms are classic for Trichomonas vaginalis infection.
21
Q
What strongly suggests chlamydial cervicitis?
A
- Mucopurulent discharge
- Cervical motion tenderness
- Recent unprotected sex
These findings are indicative of chlamydial infection.
22
Q
What is the treatment for sexually active men with epididymo-orchitis and urethral discharge?
A
Ceftriaxone plus doxycycline
This combination treats both gonorrhea and chlamydia.
23
Q
In sexually active men under 35 with epididymo-orchitis, what is the most common cause?
A
Chlamydia trachomatis
This organism is a common sexually transmitted infection that can lead to epididymo-orchitis.
24
Q
What medication can help with pain and improve sleep quality in fibromyalgia patients?
A
Amitriptyline
Amitriptyline is a tricyclic antidepressant often used for chronic pain management.
25
What effect does **Rifampicin** have on warfarin metabolism?
Increases metabolism, reducing anticoagulant effect
## Footnote
To maintain therapeutic INR levels, the dose of warfarin should be increased.
26
The **radial nerve** is responsible for what functions?
* Wrist extension
* Finger extension
## Footnote
Injury can cause wrist drop and loss of sensation over the posterior arm and forearm.
27
What is the characteristic presentation of **radial nerve palsy**?
Wrist drop and loss of sensation over the posterior arm and forearm
## Footnote
Often caused by compression, such as in 'Saturday night palsy.'
28
The **axillary nerve** affects which functions?
* Shoulder abduction
* Sensation in the regimental badge area
## Footnote
Damage can lead to weakness in shoulder movement.
29
The **median nerve** affects which functions?
* Wrist flexion
* Thumb movements
* Sensation in the lateral palm
## Footnote
Injury can lead to difficulties in hand function.
30
The **musculocutaneous nerve** primarily affects which function?
Elbow flexion
## Footnote
It also affects sensation in the lateral forearm.
31
The **ulnar nerve** affects which functions?
* Flexion and adduction of the wrist
* Sensation in the medial hand
## Footnote
Injury can lead to 'claw hand' deformity.
32
What confirms the diagnosis of **central diabetes insipidus**?
Response to desmopressin, increasing urine osmolality
## Footnote
This indicates a lack of ADH production.
33
Does nephrogenic diabetes insipidus show a response to desmopressin?
No
## Footnote
Nephrogenic diabetes insipidus is due to a lack of response to ADH.
34
What is **primary biliary cirrhosis (PBC)** characterized by?
* Chronic inflammation
* Destruction of intrahepatic bile ducts
## Footnote
Presence of anti-mitochondrial antibodies (AMA) is highly specific for PBC.
35
What is the recommended second-line treatment for **chronic anal fissures**?
Topical diltiazem 2%
## Footnote
This helps relax the internal anal sphincter and promote healing.
36
What does **CA 15-3** indicate when elevated?
Breast cancer, particularly in metastatic disease
## Footnote
It can be used to monitor response to treatment.
37
Which tumor marker is elevated in **hepatocellular carcinoma**?
AFP (Alpha-fetoprotein)
## Footnote
AFP is also elevated in certain germ cell tumors.
38
What is **CA-125** primarily used for?
Ovarian cancer
## Footnote
It is a tumor marker used to monitor treatment response.
39
What does **CEA** indicate when elevated?
Colorectal cancer and other gastrointestinal cancers
## Footnote
CEA is a tumor marker used in cancer diagnosis and monitoring.
40
What is the most common renal tumor in children?
Wilms Tumour (Nephroblastoma)
## Footnote
It presents with a painless abdominal mass, hematuria, and sometimes hypertension.
41
What is the clinical presentation of **retinitis pigmentosa**?
* Night blindness
* Progressive peripheral vision loss
* Retinal pigmentary changes
* Optic disc pallor
* Tunnel vision
## Footnote
It is a genetic disorder affecting rod photoreceptor cells.
42
What condition does **cyclophosphamide** cause, and how is it prevented?
Haemorrhagic cystitis, prevented by Mesna
## Footnote
Mesna binds toxic metabolites in the urine.
43
What does the acronym **PCBRASSS** stand for?
* Phenytoin
* Carbamazepine
* Barbiturates
* Rifampicin
* Alcohol (chronic)
* St John's wort
* Smoking
* Sulfonylureas (gliclazide)
## Footnote
These are substances that can induce cytochrome P450 enzymes.
44
What are the symptoms of **serotonin syndrome**?
* Autonomic instability
* Altered mental state
* Neuromuscular hyperactivity (clonus or myoclonus)
## Footnote
It is a potentially life-threatening condition due to excessive serotonergic activity.
45
A rapidly enlarging painful ulcer with a violaceous border is characteristic of __________.
pyoderma gangrenosum
## Footnote
This condition is often associated with systemic diseases.
46
Teardrop scaly lesions on the trunk in young adults following a recent streptococcal infection indicate __________.
guttate psoriasis
## Footnote
This form of psoriasis often appears suddenly after infections.
47
Intensely itchy white atrophic genital plaques in older women are indicative of __________.
lichen sclerosus
## Footnote
This condition can lead to significant discomfort and complications.
48
What condition is indicated by **interdigital erythema with fissuring and scale between toes**?
tinea pedis (athlete's foot)
## Footnote
This condition is commonly known as athlete's foot.
49
What is characterized by **fragile blistering skin on sun-exposed hands** with a history of alcohol use?
porphyria cutanea tarda
## Footnote
This condition is associated with photosensitivity.
50
What condition presents as **hypopigmented scaly patches on the trunk that fail to tan**?
pityriasis versicolor
## Footnote
Treatment involves the use of topical antifungal agents.
51
What is indicated by a **herald patch followed by multiple oval scaly lesions**?
pityriasis rosea
## Footnote
This condition typically starts with a single herald patch.
52
Lichen planus is characterized by the **6 Ps**: what are they?
* pruritic
* purple
* polygonal
* planar
* papules
* plaques
## Footnote
Often, Wickham striae are present.
53
What condition is indicated by **brown patches in flexures in obese patients**?
erythrasma
## Footnote
Treatment is typically with erythromycin.
54
What is described as a **rapidly enlarging painful ulcer with a violaceous undermined edge** in autoimmune disease?
pyoderma gangrenosum
## Footnote
This condition is associated with autoimmune disorders.
55
What condition is characterized by a **face-first maculopapular rash and lymphadenopathy**, with the rash fading within days?
rubella
## Footnote
This viral infection is also known as German measles.
56
What are the complications of **Rifampicin**?
* Orange secretions
* hepatitis
## Footnote
These side effects are important to monitor during treatment.
57
What complication is associated with **Isoniazid**?
peripheral neuropathy
## Footnote
This can be reduced with pyridoxine co-prescription.
58
What complication does **Pyrazinamide** cause?
Gout
## Footnote
This side effect is important to consider in patients with a history of gout.
59
What complication is associated with **Ethambutol**?
optic neuropathy
## Footnote
Regular eye examinations are recommended during treatment.
60
What is **fibromyalgia** described as?
Central sensitisation syndrome
## Footnote
The CNS amplifies pain signals abnormally.
61
Who is most commonly affected by **fibromyalgia**?
Women aged 30–55
## Footnote
This demographic is most frequently diagnosed with the condition.
62
What are the **core features** of fibromyalgia?
* Widespread musculoskeletal pain
* Profound fatigue and unrefreshing sleep
* Normal investigations
## Footnote
These features help in diagnosing fibromyalgia.
63
What are some **associated symptoms** of fibromyalgia?
* Fibro fog
* IBS
* depression
* morning stiffness
* paraesthesia
* bladder urgency
* headaches
## Footnote
These symptoms can vary among individuals.
64
What conditions should be **excluded** when diagnosing fibromyalgia?
* Hypothyroidism
* rheumatoid arthritis
* SLE
* PMR
* inflammatory myopathy
## Footnote
These conditions can present with similar symptoms.
65
What is the **first-line treatment** for fibromyalgia?
* Non-pharmacological approaches
* exercise
* CBT
* sleep hygiene
* physiotherapy
## Footnote
These methods are recommended before considering medication.
66
What are some **pharmacological treatments** for fibromyalgia?
* amitriptyline
* duloxetine
* pregabalin
## Footnote
These medications may be used if non-pharmacological treatments are insufficient.
67
What is **DMD**?
Progressive muscle degeneration due to absent dystrophin protein
## Footnote
DMD stands for Duchenne Muscular Dystrophy.
68
What is the genetic inheritance pattern of **DMD**?
X-linked recessive
## Footnote
Affects boys and is carried by mothers.
69
What protein is absent in **DMD**?
Dystrophin
## Footnote
Its absence causes muscle fibers to tear and die with use.
70
At what age do symptoms of **DMD** typically become apparent?
Age 3–5
## Footnote
Symptoms usually manifest in boys.
71
Name a clinical feature of **DMD** that involves difficulty with movement.
* Proximal muscle weakness
* Gowers' sign
* Pseudohypertrophy of calves
* Waddling gait
## Footnote
These features indicate muscle weakness and compensatory mechanisms.
72
What is **Gowers' sign**?
Walks hands up legs to stand
## Footnote
This sign indicates proximal muscle weakness.
73
What is a significant laboratory finding in **DMD**?
CK massively elevated
## Footnote
This is often the first clue in diagnosis.
74
What investigations confirm a diagnosis of **DMD**?
* Genetic testing
* Muscle biopsy
## Footnote
Genetic testing confirms mutation, while muscle biopsy shows absent dystrophin.
75
What are some complications associated with **DMD**?
* Dilated cardiomyopathy
* Respiratory failure
* Wheelchair bound by early teens
## Footnote
These complications significantly impact quality of life.
76
What are the main treatments for **DMD**?
* Steroids (prednisolone / deflazacort)
* Cardiac protection (ACE inhibitor, beta-blocker)
* Gene therapy (ataluren / exon skipping for specific mutations)
## Footnote
Treatments aim to manage symptoms and slow disease progression.
77
According to **NICE guidelines**, which patients aged >55 meet urgent 2-week wait referral criteria for suspected upper GI cancer?
* Weight loss with dyspepsia
* Weight loss with reflux
* Weight loss with upper abdominal pain
* Dysphagia at any age
## Footnote
These criteria are important for early detection of upper gastrointestinal cancers.
78
What is the topical strength of **permethrin** used for lice?
5%
## Footnote
For scabies, the topical strength is 1%.
79
In **Hashimoto’s thyroiditis**, which antibodies are commonly present?
* Anti-thyroglobulin antibodies
* Anti-thyroid peroxidase antibodies
## Footnote
These antibodies are indicative of autoimmune thyroid disease.
80
What should you think of in returning travellers with **bloody diarrhoea**, abdominal cramps, and fever?
Shigella
## Footnote
This pathogen is associated with these symptoms in recent travellers.
81
When should **memantine** be added in moderate Alzheimer’s?
If already on an acetylcholinesterase inhibitor and still declining
## Footnote
Use memantine monotherapy only in severe cases or when AChIs are not tolerated.
82
What is the first-line treatment for **nausea and vomiting** in malignant bowel obstruction?
Hyoscine butylbromide
## Footnote
It reduces smooth muscle spasm and GI secretions.
83
In men with bothersome voiding symptoms and no complications, what does **NICE** recommend starting?
An alpha-blocker such as tamsulosin or alfuzosin
## Footnote
This is recommended for symptom relief.
84
What is the first-line treatment for **mild-to-moderate oral candidiasis**?
Miconazole oral gel
## Footnote
Reserve oral fluconazole for more severe or refractory cases.
85
What is the most common organism in **epiglottitis** today?
Streptococcus species
## Footnote
This change is due to widespread vaccination against Haemophilus influenzae type b.
86
How many days before elective surgery should **clopidogrel** be stopped?
7 days
## Footnote
This allows time for platelet function to recover due to its irreversible platelet inhibition.
87
What does **haematuria** occurring within 1–2 days of a respiratory tract infection strongly suggest?
IgA nephropathy
## Footnote
Post-streptococcal glomerulonephritis presents later (1–2 weeks).
88
What sign does **sigmoid volvulus** show on AXR?
'Coffee bean' sign
## Footnote
This indicates a massively dilated loop of bowel with a central crease pointing towards the right upper quadrant.
89
What should you think of in a young woman with a firm, smooth, mobile breast lump?
Fibroadenoma
## Footnote
Especially if it feels like a 'breast mouse.'
90
What causes **Korsakoff dementia**?
Thiamine deficiency
## Footnote
It causes irreversible damage to the mamillary bodies; always give thiamine before glucose in alcohol-dependent patients.
91
What is the first-line treatment for **limited alopecia areata**?
Topical potent corticosteroids such as betamethasone valerate
## Footnote
These are effective for localized cases.
92
When is **LTOT** offered?
* PaO₂ < 7.3 kPa
* PaO₂ 7.3–8.0 kPa with secondary complications
## Footnote
Complications include polycythaemia, pulmonary hypertension, or cor pulmonale.
93
What is the first-line treatment for a patient with **myasthenia gravis** who is clinically stable?
Pyridostigmine
## Footnote
This is the preferred treatment if the patient is not in crisis.
94
What is the first-line treatment if **intussusception** is confirmed without signs of perforation?
Therapeutic contrast or air enema
## Footnote
It serves both diagnostic and therapeutic purposes.
95
What should be checked before starting **azathioprine**?
TPMT enzyme activity
## Footnote
This is crucial to avoid life-threatening myelosuppression in patients with low or absent TPMT levels.
96
What condition should be considered in an active adolescent with **anterior knee pain** localized to the tibial tuberosity?
Osgood-Schlatter disease
## Footnote
Symptoms worsen with activity and are relieved by rest.
97
What should a sudden onset left-sided **varicocele** in an older man raise suspicion of?
Renal cell carcinoma
## Footnote
This may obstruct venous drainage via the left testicular vein.
98
What is the **gold standard** for confirming gastrointestinal perforation?
CT abdomen and pelvis
## Footnote
It identifies free air, perforation site, and complications.
99
The classic symptoms of **neuroleptic malignant syndrome** include which of the following?
* Hyperthermia
* Autonomic instability
* Severe muscle rigidity with reduced reflexes
* Acute kidney injury
## Footnote
These symptoms occur in patients receiving antipsychotic treatment.
100
Chest pain with elevated troponin following a recent viral illness in a young patient suggests **what condition**?
myocarditis
## Footnote
This is true even in the absence of classic ECG changes.
101
Sudden severe chest pain radiating to the back with an inter-arm blood pressure difference indicates **what condition**?
aortic dissection
## Footnote
This should be assumed until proven otherwise.
102
Facial swelling, raised JVP, and a positive **Pemberton’s sign** in a patient with lung cancer indicate what?
superior vena cava (SVC) obstruction
## Footnote
Urgent steroids are first-line to reduce venous compression.
103
Ischaemic colitis classically presents with which symptoms?
* Crampy abdominal pain
* PR bleeding
* Metabolic acidosis
* Thumb printing on AXR
## Footnote
Often triggered by hypotension or low-flow states such as recent myocardial infarction.
104
In beta-blocker overdose with refractory bradycardia and hypotension, what is the **first-line antidote**?
glucagon
## Footnote
It increases intracellular cAMP independently of beta-receptors.
105
Classic features of **carbon monoxide poisoning** include which symptoms?
* Headache
* Nausea
* Vomiting
* Cherry-red flushed skin
## Footnote
Requires high-flow 100% oxygen to accelerate carboxyhaemoglobin dissociation.
106
A crescent-shaped hyperdense collection on CT with fluctuating confusion is classic for what condition?
subdural haematoma
## Footnote
Especially in older patients or those with coagulopathy or liver disease.
107
What are the classic symptoms of **serotonin syndrome**?
* Altered mental state
* Autonomic instability
* Neuromuscular hyperactivity
## Footnote
Particularly clonus or myoclonus with hyperreflexia.
108
Pancytopenia with a hypocellular, fatty bone marrow is diagnostic of what condition?
aplastic anaemia
## Footnote
Often associated with autoimmune disease or drug exposure.
109
For INR 5–8 with minor bleeding, NICE recommends what action regarding **warfarin**?
* Stop warfarin
* Urgent assessment for vitamin K reversal
## Footnote
PCC or blood products are reserved for major or life-threatening bleeding.
110
Sudden severe abdominal pain with board-like rigidity indicates what condition?
peritonitis from gastrointestinal perforation
## Footnote
Even if amylase is mildly raised.
111
Symptoms of **quinine toxicity** (cinchonism) include which of the following?
* Tinnitus
* Flushing
* Nausea
* QT prolongation
## Footnote
These symptoms are indicative of quinine toxicity.
112
Signs of **basal skull fracture** include which features?
* Peri-orbital bruising (raccoon eyes)
* Mastoid bruising (Battle’s sign)
## Footnote
Mandate a CT head within 1 hour, even if the GCS is normal.
113
A direct blow to the knee with acute pain, swelling, and bruising raises suspicion for what injury?
tibial plateau fracture
## Footnote
This is considered an orthopaedic emergency.
114
A shortened, externally rotated leg with an X-ray showing a fracture just below the femoral head indicates what type of fracture?
intracapsular (subcapital) femoral neck fracture
## Footnote
This type of fracture is significant in clinical practice.
115
T wave flattening or inversion, ST depression, and a prolonged QT interval in a patient with diarrhoea indicate what condition?
hypokalaemia
## Footnote
These ECG changes are classic for hypokalaemia.
116
Irregular cannon A waves indicate what condition?
intermittent atrioventricular dissociation
## Footnote
Most characteristic of ventricular tachycardia, particularly following acute myocardial infarction.
117
Cyclophosphamide requires co-prescription of what to prevent **hemorrhagic cystitis**?
mesna
## Footnote
This is necessary to counteract toxic urinary metabolites.
118
Cisplatin causes renal tubular toxicity leading to which electrolyte imbalances?
* Magnesium wasting
* Hypokalaemia
* Hypocalcaemia
## Footnote
These imbalances are secondary effects of cisplatin treatment.
119
Gastric MALT lymphoma associated with **Helicobacter pylori** should be treated with what initial therapy?
H. pylori eradication therapy
## Footnote
This can lead to complete lymphoma regression in most cases.
120
A signet ring cell appearance on histology is characteristic of what type of cancer?
diffuse-type gastric adenocarcinoma
## Footnote
Often presents with weight loss and dyspepsia.
121
What is the cardiotoxic drug that requires baseline assessment of left ventricular function before starting treatment?
Trastuzumab
## Footnote
This assessment is mandatory due to the risk of cardiotoxicity.
122
Haematuria with polycythaemia, hypercalcaemia, and hypertension is suggestive of what type of cancer?
renal cell carcinoma
## Footnote
Particularly the clear cell subtype, due to ectopic hormone production.
123
A new-onset left-sided varicocele associated with haematuria and flank pain is a classic red flag for what condition?
renal cell carcinoma
## Footnote
This is due to renal vein obstruction.
124
Hypokalaemia and hypomagnesaemia from long-term diuretic use are common triggers for what?
ventricular arrhythmias
## Footnote
Especially in patients with heart failure.
125
Syncope during exercise with a prolonged QTc on ECG is classic for what syndrome?
congenital long QT syndrome
## Footnote
This is a key cause of sudden cardiac death in young people.
126
What is the **1st line treatment** for **uncomplicated Falciparum malaria**?
PO Artemether-lumefantrine
## Footnote
This treatment is recommended for cases that are not severe.
127
What is the **1st line treatment** for **complicated/severe Falciparum malaria**?
IV Artesunate
## Footnote
This is indicated for severe cases of the disease.
128
Severe disease in Falciparum malaria is suggested by parasitaemia greater than _______.
> 2%
## Footnote
This threshold indicates a more severe infection requiring urgent treatment.
129
What is the **autoantibody** associated with **Primary sclerosing cholangitis**?
pANCA +ve
## Footnote
This marker is often found in patients with this condition.
130
In **HFrEF** (EF ≤40%), what class of medication is considered a core disease-modifying therapy?
SGLT2 inhibitors
## Footnote
These should be added regardless of rhythm or diabetes status.
131
Before starting **azathioprine**, what activity should be checked to prevent severe bone marrow suppression?
TPMT activity
## Footnote
This test is crucial for safe administration of the drug.
132
A tympanic membrane with visible air–fluid level and symptoms of hearing difficulty suggests _______.
otitis media with effusion
## Footnote
This condition is characterized by fluid accumulation in the middle ear.
133
Chronic diarrhoea after cholecystectomy or ileal disease/resection may indicate _______.
bile acid malabsorption
## Footnote
This can be investigated with SeHCAT testing.
134
Lichen planus is characterised by the **6 Ps**: pruritic, purple, polygonal, planar papules and _______.
plaques
## Footnote
Often, Wickham striae are also present.
135
Clubbing with painful swelling of the wrists and ankles in a patient with chronic cough is associated with _______.
non-small cell lung cancer
## Footnote
Particularly squamous cell carcinoma is strongly linked to these symptoms.
136
In atrial fibrillation with heart failure, if beta-blocker therapy alone does not achieve adequate rate control, NICE NG196 recommends adding _______.
digoxin
## Footnote
This recommendation is made to enhance rate control.
137
Tinnitus, flushing, nausea, and QT prolongation point to _______.
quinine toxicity (cinchonism)
## Footnote
These symptoms are indicative of toxicity from quinine.
138
Post-surgery day 5–14 with falling platelets suggests _______.
heparin-induced thrombocytopenia
## Footnote
This condition should be considered in the differential diagnosis.
139
In urge incontinence with dementia, it is advised to avoid _______ and consider a beta-3 agonist instead.
anticholinergics
## Footnote
This is due to potential cognitive side effects.
140
Rough scaly plaques on sun-exposed skin in older adults are indicative of _______.
actinic keratosis
## Footnote
This condition is a precursor to skin cancer.
141
The **“Coffee bean sign”** on abdominal X-ray indicates _______.
sigmoid volvulus
## Footnote
This sign is characteristic of this condition.
Finals
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