p year 2

Question 1

cardioversion vs defibrillaiton

Answer 1

c- synchronised/ awake
d-unsynchronised/emergency

Question 2

2) Epistaxis anterior and posterior packing failed, what artery would you ligate?

Answer 2

Sphenopalatine

Question 3

what type of drugs are tamsulonsin and finasteride?

Answer 3

tamsulosin- alpha blocker
finasteride- 5 alpha reductase

Question 4

finasteride

Answer 4

5-alpha-reductase.

Question 5

normal pressure hyrocehphalus symptoms + treatment?

Answer 5

dementia
incontinence
gait abnormality

vp shunt

Question 6

spastic paraplegia, Spastic diplegia, hemiplegia difference

Answer 6

p- legs
d- all four limbs but mostly legs
h- one side of body

Question 7

1. Pathophysiology of high haemoglobin in pre-eclampsia

Answer 7

In pre-eclampsia, high levels of haemoglobin can be a result of hemoconcentration due to decreased plasma volume, as well as increased erythropoietin production in response to impaired placental blood flow.

Question 8

parkisons dementia vs lewys bodies

Answer 8

parkisons- motor first
lewys pscych first

Question 9

pcos higher risk of which cancer

Answer 9

endometrial

Question 10

what is an imca

Answer 10

An Independent Mental Capacity Advocate (IMCA) is an advocate appointed to act on your behalf if you lack capacity to make certain decisions.

Question 11

how to treat otitis externa fungal?

Answer 11

Antifungal ear drops, such as fluconazole and clotrimazole

Question 12

otitis externa treatment

Answer 12

Mild otitis externa may be treated with acetic acid 2% (available over the counter as EarCalm). Acetic acid has an antifungal and antibacterial effect. This can also be used prophylactically before and after swimming in patients that are prone to otitis externa.

Moderate otitis externa is usually treated with a topical antibiotic and steroid, for example:

Neomycin, dexamethasone and acetic acid (e.g., Otomize spray)
Neomycin and betamethasone
Gentamicin and hydrocortisone
Ciprofloxacin and dexamethasone

serve may need oral

1. Aural toilet + topica antifungal clotrimazole.

Question 13

2) Pregnant woman took spiramycin during pregnancy, baby came out with problems, what infection?

Answer 13

Toxoplasmosis

Question 14

signs of opiod withdrawal?

Answer 14

Features of opioid misuse
rhinorrhoea
needle track marks
pinpoint pupils
drowsiness
watering eyes
yawning

• Dilated pupils + lack of sleep + abdo pain, tachy or brady. Know presentation properly, wasnt typical runny nose etc. (everything runs)

Question 15

treatment resistant psoriasis

Answer 15

Rarely, where topical treatments fail with severe and difficult to control psoriasis, children may be started on unlicensed systemic treatment under the guidance of an experienced specialist. This might include methotrexate, cyclosporine, retinoids or biologic medications.

There are two products that contain both a potent steroid and vitamin D analogue that are commonly prescribed and worth being aware of. These not licensed in children and will be guided by a specialist.

Dovobet
Enstilar

Question 16

5. Anorexic – which of the following is diagnostic  hypokalemaia, low cortisol, high tsh, anaemia

Answer 16

hypokalemia

Question 17

19. Staging of endometrial cancer

Answer 17

MRI pelvis

Question 18

burpropian what is it can u give in epilepsy?

Answer 18

antidpressent and no

Question 19

restrictive lung disease pattern

Answer 19

Reduced FEV1 (<80% of the predicted normal) Reduced FVC (<80% of the predicted normal) FEV1/FVC ratio normal (>0.7)
low tclo

Question 20

14. Chinese and cervical lymph node on left and some ear something

Answer 20

nasopharyngeal carcinoma

Question 21

41. Bacteria in osteomyelitis

Answer 21

Staphylococcus aureus causes most cases of osteomyelitis.

Question 22

53. Treatment of eczema – oral treatment – gave side effect of high creatinine and high urea and hair on face (under chin) in woman  what oral medication caused this

Answer 22

corticostroids

Question 23

58. Rubella treatment in pregnancy – recently exposed to rubella 2 days ago and not vaccinated  give IV tingz

Answer 23

f Human Normal Immunoglobulin (HNIG).

Question 24

1. Stage 3 labour or something and person has high blood pressure – oxytocin, ergometrine, syntometrine (oxytocin+ergometrine)

Answer 24

oxytocin

Question 25

toe extension nerve root

Answer 25

l5

Question 26

61. Kid has squint – eye looking in

Answer 26

hypermetropia

Question 27

1. Patient been on sertraline for 18 months, not getting on with it - what would you give next

Answer 27

another SSRI (citalopram or fluoxetine), if still doesn’t work – mirtazapine or venflaxine (SNRI

Question 28

paeds bls

Answer 28

* paeds * If not breathing normally, 5 rescue breaths * If no signs of life, 15 chest compressions followed by 2 rescue breaths

Question 29

Epistaxis management after pressure attempted, what next

Answer 29

ligate sphenopalatine

Question 30

Psoriasis question, gentleman doesn't want to take anything oral,

Answer 30

Narrow light UV-B

Question 31

Which sign indicates varicose ulcer -

Answer 31

surrounding lipodermatosclerosis

Question 32

1. Which test do you need to do to diagnose menopause in a 51 year old who was 14 months amennorhoea with hot flushes?

Answer 32

none

Question 33

8. Diabetic proliferative retinopathy - how to prevent eyesight damage in later life?

Answer 33

Laser treatment(aka panphotocoagulation because once u got u got it u cant get vision back once u lost it),

Question 34

7. Timing of oxytocin for 3rd stage

Answer 34

with anterior shoulder

Question 35

14. Varicella exposure in pregnancy - patient not immune = give IVIG

Answer 35

VZIG

Question 36

9. Infective endocarditis presentation

Answer 36

(fever with new murmur)

Question 37

2. Renal artery stenosis imaging?

Answer 37

ANGIOGRAPHY

Question 38

SECTION 4 (72hrs)

Answer 38

You need to be detained under section 4 if: you have a mental disorder it is urgently necessary for you to be admitted to hospital and detained, and waiting for a second doctor to confirm that you need to be admitted to hospital on a section 2 would cause "undesirable delay". You can be sectioned by one doctor only (together with the approved mental health professional) and you can be taken to hospital in an emergency and assessed there.

Question 39

PNEUMONIA sounds

Answer 39

INCREASED VOCAL FREMITUS

Question 40

5. Cardiac tamponade presentation TRIAD

Answer 40

– distended jvp, low bp, muffled heart sounds)

Question 41

21. Commonest cause preterm

Answer 41

Idiopathic / Infection

Question 42

NEC biggest RF

Answer 42

PRETERM

Question 43

17. Most common cause of PID

Answer 43

Chlamydia (more) or gonorrhoea

Question 44

12. Swollen fingers + eosophageal

Answer 44

systemic slerosis

Question 45

how to image acl tear

Answer 45

mri

Question 46

CT show calcification in alcoholic patient

Answer 46

Chronic pancreatitis

Question 47

3. Acne treatment causing blue patch -

Answer 47

minocycline

Question 48

19. Hip problem in 7 year old, trendelenburg +ve →

Answer 48

perthes

Question 49

16. Baby with asymmetrical gluteal creases, what investigation do you do

Answer 49

USS Hip (if under 3 months)- sign of congenital dysplasia of hip

Question 50

14. Hep B Immune marker to indicate Hepatitis division/multiplying -

Answer 50

HbEAg - E = Infectivity

Question 51

pcos treatment after weight loss

Answer 51

Clomifene

Question 52

You are reviewing an elderly man in outpatient clinic who has been referred with a history of rigidity and falls. He reports difficulty in climbing the stairs at home. On examination he is bradykinesic and has axial rigidity. During examination of his cranial nerves you notice he is unable to look upwards. Which of the following the most likely diagnosis?

Answer 52

Progressive supranuclear palsy

Question 53

A 53 year old man has had migraine attacks with severe pain two to three times a week for the last few months, lasting most of the day. Ibuprofen and trying to avoid triggers haven't helped. What would be the most appropriate treatment? Select one: Sumatriptan Naproxen Carbamazepine Codeine phosphate Topiramate

Answer 53

Topiramate As he is having frequent and severe episodes, a prophylactic agent should be considered. Both Topiramate and Propanolol are recommended as standard first line prophylactic agents for patients having more than 3 days a month with disabling headaches.

Question 54

A 57 year old man has suffered a traumatic brain injury. Which of the following acute endocrine dysfunctions commonly develops in this context? Select one: Cerebral salt wasting Hypothyroidism Addison's disease Anterior hypopituitarism Correct! Syndrome of inappropriate ADH

Answer 54

syndrome of inappropriate ADH

Question 55

A 40 year old man develops numbness in the right leg and over four days it spreads to affect both arms and the left leg. He has brisk reflexes and bilateral extensor planter responses. What is the most likely diagnosis? Select one: Guillain-Barre syndrome Vitamin B12 deficiency Acute attack of multiple sclerosis Brain tumour Cervical cord compression

Answer 55

cervival cord compression

Question 56

40 year old man suffered a neck injury in a motorcycle accident resulting in a traumatic C7 incomplete spinal cord injury and subsequently developed a spastic tetraparesis with severe spasticity in his trunk and legs Which of the following is the first line treatment of choice for his spasticity? Select one: Oral Dantrolene Intrathecal Balclofen Oral Baclofen Phenol nerve blockade Botulinum toxin

Answer 56

oral balclofen

Question 57

A 64 year old woman has developed a rest tremor of the left hand hand with some rigidity on that side. Which of her following drugs is the most likely to be responsible? Select one: Salbutamol Metaclopramide Lisinopril Omeprazole Theophylline

Answer 57

metaclopramide

Question 58

A 55YO woman presents with vomiting, abdominal pain, distension and change in bowel motions on a background of unintended weight loss over the last 6 months. Initial management does not resolve her symptoms. Which of the following surgeries is best indicated? Diagnostic laparoscopy Subtotal colectomy Resection of rectosigmoid colon with formation of end colostomy Defunctioning ileostomy Rigid colnoscopy

Answer 58

Resection of rectosigmoid colon with formation of end colostomy

Question 59

A 60YO has recently been diagnosed with bladder cancer. Which of the following is not a risk factor? 2-naphthylamine, 4-aminobiphenyl and benzidine exposure Smoking Recurrent UTI Schistosomiasis Female

Answer 59

female

Question 60

falsley raised psa

Answer 60

smoking

Question 61

A 23YO female accidentally poured boiling water over her arm when she tripped. She has developed burns over her left forearm. o/e the area is red with blisters, there is pain and associated swelling. How severe would you categorise the burns?

Answer 61

superfical partial thickness

Question 62

quinsy treatment

Answer 62

aspirate first

Question 63

expected urinary output

Answer 63

0.5mL/kg per hour

Question 64

breast screening

Answer 64

Every 3 years between 50 and 70