1
Q
What stain is used to identify PCP?
A
Silver stain
2
Q
What is an important side effect of ramipril?
A
Angioedema
3
Q
What is a common cause of a posterior shoulder dislocation?
A
Seizure
4
Q
What sign is seen on x-ray of a posterior shoulder dislocation?
A
Light bulb sign
5
Q
What is the most sensitive and specific biomarker for acute pancreatitis?
A
Lipase
amylase is more commonly measured however
6
Q
What is used to reverse benzodiazapine overdose?
A
Fumazenil
7
Q
What is used to treat malignant hyperthermia?
A
Dantrolene
8
Q
What is used to treat serotonin syndrome?
A
Cyproheptadine
9
Q
What are the king college criteria for liver transplant following paracetamol overdose (4)?
A
- Arterial pH < 7.3
or - PT > 100 seconds
AND - Creatinine > 300
AND - Grade 3/4 hepatoencephalopathy
10
Q
How should opioids be given at the end of life?
A
Subcut via syringe driver
50% of dose given orally
11
Q
How would lupus nephritis appear on a renal biopsy?
A
Full house pattern of glomerular depositis (stains positive for IgG, A, M, C3, C1q)
12
Q
Who should be treated for influenza (3)?
A
- Over 65s
- Heart/ liver/ kidney disease
- Immunocompromised
with antiviral agent
13
Q
What type of biceps tendon rupture is more common?
A
Proximal tendon rupture
14
Q
What is myotonic dystrophy?
A
Autosomal dominant trinucleotide repeat disorder
15
Q
How does myotonic dystrophy typically present?
A
Patient unable to release your hand when shaking it
16
Q
What medication can be used to reduce secretions from tumour sites?
A
Glycopyrronium
17
Q
How can pain due to malignancies to bone be managed?
A
IV bisphosphonate (e.g. zolendronate)
18
Q
What bacteria more commonly cause chorioamnionitis (2)?
A
- GBS (e.g. strep agalactiae)
- E. coli
19
Q
What is transient proteinuria?
A
Proteinuria not due to an underlying renal condition, usually due to a febrile illness/ seizures in children
20
Q
How should toxic megacolon be investigated initialy?
A
AXR
21
Q
What is the first line management for PVD?
A
Exercise programme
22
Q
How might a greenstick fracture appear on an x-ray?
A
Bone often bent
23
Q
How often can IM adrenaline be given for anaphylaxis?
A
Every 5 minutes
24
Q
Eating what food can invalidate an eGFR reading?
A
Red meat (as it contains creatinine in the meat)
25
What are the ECG features in arrhythmogenic right ventricular cardiomyopathy (2)?
* T wave inversion in V1-3
* Epsilon wave (positive deflection after QRS)
26
Should vit B12 or folate be replaced first?
B12 then folate
27
Most common cause of viral meningitis in adults?
Enteroviruses (e.g. coxsackie virus)
28
What diruetics should never be prescribed together?
2 potassium sparing diuretics
* Spironolactone
* Amiloride
29
How should asymptomatic bacteriuria be managed in long term catheter patients?
No treatment needed
30
What is a risk of giving insulin bolus in HHS?
Central pontine myelinolysis
*that is why fluids are usually given alone and insulin only given if glucose stops falling*
31
What is the most common endogenous cause of cushings syndrome?
Cushings disease
32
How should a PE be ruled out if the patient has a low chance of having a PE?
PERC (pulmonary embolism rule out criteria)
33
How should patients with phaeochromocytoma and hypertension be managed prior to surgery?
Alpha blockers (e.g. phenoxybenzamine)
34
How is severe/ high risk vs lower risk tumour lysis syndrome managed?
* Lower risk (preventative) = allopurinol
* Higher risk/ severe = rasburicase
35
What are three risk factors for aspiration pneumonia?
* Neurological issue (e.g. stroke/ spinal cord injury)
* Right lower/ middle lobe pneumonia (most vertically displaced)
* Dysphagia
36
How is CKD with proteinuria managed (2)?
1. ACE-i (hypertension + CKD or ACR > 70)
2. SGLT-2 inhibitor
37
How should a patient that does not respond to steroids with polymyalgia rheumatica be treated?
Reconsider diagnosis
38
How does a pleomorphic adenoma present?
Slow growing, painless, mobile mass over parotid gland (anterior to ear)
39
Where is most commonly affected by vilitigo?
Peripheries (hands/ feet/ face)
40
What is most commonly associated with the philadelphia chromosome?
CML - t(9;22)
*Philadelphia **C**heese **M**akes **L**unch*
*also associated with ALL*
41
What is a side effect of hydroxychloroquine?
Retinopathy = bulls eye maculopathy
42
What biomarker should be used to investigate a repeat infarction of the heart 4-10 days after initial?
CK-MB
*troponin remains elevated for up to 10 days*
43
What is the only recommended H. pylori eradication test?
Urea breath test
44
How should stable angina be investigated (3)?
1. CT coronary angiogram
2. Non-invasive functional imagine (e.g. stress echo)
3. Invasive coronary angiogram
45
What is thought may cause pityriasis rosea?
HHV 7
46
How does pityriasis rosea present?
Herald patch (on trunk) --> erythematous oval scaly lesions with longitudinal diameters on the trunk
*viral illness often preceeds this*
47
How long does pityriasis rosea take to resolve?
6-12 weeks
48
What pneumonia are alcoholics and diabetics most at risk of?
Klebsiella pneumoniae
49
What is seen on an x-ray in those with klebsiella pneumoniae?
Cavitating lesions in upper lobes
50
How should all cases of atypical endometrial hyperplasia be managed?
Hysterectomy + bilateral salpingo-oophrectomy
51
What are some causes of hypokalaemia with alkalosis (4)?
* Loop/ thiazide diuretics
* Cushings
* Vomiting
* Conns (primary hyperaldosteronism)
*Mg deficiency can also cause hypokalaemia - this should be replaced first if deficient*
52
What are some causes of hypokalaemia with acidosis (3)?
* Diarrhoea
* Renal tubular acidosis
* Acetazolamide
53
When should prophylaxis be given to patients with gout?
After first attack
54
What causes slapped cheek syndrome?
Parvovirus B19
55
What antibody is often used to differentiate between type 1 vs 2 diabetes?
Anti-GAD (glutamic acid decarboxylase)
56
What PEP is offered to those exposed to HIV?
4 weeks oral antiretroviral therapy
*HIV testing at 3 months*
57
What is a side effect of metoclopramide?
Galactorrhoea
58
What is a total vs partial anterior circulation stroke (3)?
* Unilateral hemiparesis and/ or hemisensory loss of face/ arms/ legs
* Homonomous hemianopia
* Higher cognitive dysfunction (e.g. dysphasia)
**partial = 2/3; total = 3/3**
*middle/anterior cerebral affected*
59
What is a lacunar stroke (3)?
* Pure motor
* Pure sensory
* Ataxic hemiparesis
60
How does a posterior circulation stroke present (3)?
* Isolated vision change
* Loss of consciousness
* Cerebellar Sx
61
How does lateral medullary syndrome (wallenberg) present (4)?
* Ipsilateral pain + temp (spinothalamic) loss in face
* Contralateral pain + temp (spinothalamic) loss in torso/ limbs
* Ataxia
* Nystagmus
*PICA stroke*
62
How does webers present (2)?
* Ipsilateral CN3 palsy
* Contralateral weakness
*branches of PCA that supply midbrain*
63
How does lateral pontine syndrome present (3)?
* Wallenbergs +
* Hearing loss +
* Ipsilateral facial paralysis
*AICA stroke*
64
What are the different categories of C-section (4)?
* Cat 1 < 30 minutes
* Cat 2 < 75 minutes
* Cat 3 = stable but needed soon
* Cat 4 = elective
65
What are two signs of hypocalcaemia?
* Trousseaus = BP cuff --> hand spasms
* Chvosteks = tap over parotid --> facial twitching
66
What test indicates that hip pain is referred from the lumbar spine?
+ve femoral nerve stretch test
67
What is a side effect of benzodiazapines (4)?
* Drowsiness/ fatigue
* Dizziness/ unsteadiness
* Confusion
* Anterograde amnesia (difficulty forming new memories - like dementia)
68
What is the management of people with coeliacs disease (2)?
* Gluten free diet
* Pneumococcal vaccine every 5 years
69
What treatment can be used for psoriasis long term?
Calcipotriol (vit d analogue)
70
How should hypokalaemia and hypomagnesaemia be managed?
Magnesium replaced and then potassium replaced
*low magnesium prevents potassium from being absorbed*
71
What are the main causes of keratitis (2)?
* Staph aureus
* Pseudomonas aeruginosa (in contact lense wearers)
72
What are the 3 types of graft failure/ rejection in transplant patients?
* Hyperacute = minutes to hours (due to ABO/ HLA antigens)
* Acute < 6 months - asymptomatic (rise in urea/ creatinine) + HLA mismatch (cytotoxic T cells)
* Chronic > 6 months - antibody mediated fibrosis, or recurrence of original disease
73
What is the position of a femoral hernia?
Below and lateral to pubic tubercle
74
Which medications commonly cause urticaria (4)?
* Aspirin
* Penicillins
* NSAIDs
* Opiates
75
What organisms most commonly cause epididymo-orchitis (3)?
* **Chlamydia**
* **Gonorrhoea**
* **E. coli** - from bladder (if not a sexual risk)
76
What are some differentials for malar/ butterfly rash (4)?
* SLE (spares nasolabial folds)
* Dermatomyositis (affects nasolabial folds)
* Acne rosacea (nose, forehead, cheeks) - flushing prominent --> papules/ pustules
* Mitral stenosis
77
What are some causes of papilloedema (5)?
* Space occupying lesion
* Malignant hypertension
* IIH
* Hydrocephalus
* Hypercapnia (due to increased cerebral blood flow + raised ICP)
*rarely = hypoparathyroid/ hypocalcaemia + vit A toxicity*
78
How should gestational diabetes be managed?
If fasting glucose < 7:
1. Lifestyle modification (1/2 weeks)
2. Metformin
3. Insulin
If fasting glucose > 7:
* INSULIN
79
What is the antidote to pesticide poisoning?
Atropine
80
How should alzheimers be treated (2)?
1. Achase inhibitor (e.g. donepezil, galantamine, rivastigmine)
2. Memantine (NMDA antagonist)
81
When should memantine be started for those with alzheimers (3)?
* As second line dual therapy (if moderate/ severe)
* Monotherapy in severe alzheimers
* If donepezil contraindicated
82
What is a contraindication for donepezil?
Bradycardia
*relative contraindication*
83
What is a side effect of donepezil?
Insomnia
84
How can a myxoedemic coma be differentiated from an addisonian crisis?
Myxoedemic coma:
* Blood glucose normal (reduced in addisonian crisis)
* Raised BMI (low in addisons)
* Oedema present
*Tx = IV hydrocortisone + IV thyroxine*
85
How is seborrhoeic dermatitis managed?
Topical ketoconazole
86
What is tachyphylaxis?
Rapid decrease in response to a drug following repeated administration (e.g. nasal decongestants)
87
What sign on MRCP is seen in pancreatic cancer?
Double duct
88
How is rosacea managed?
Topical ivermectin
89
What substance causes toxicity in antifreeze?
Methanol/ ethylene glycol
90
What are the signs/ symptoms of methanol poisoning (2)?
* Alcohol intoxication Sx (confusion, slurred speech, dizziness)
* Metabolic acidosis
91
How is methanol poisoning treated?
Fomepizole
*used to be treated with ethanol*
92
How is a benzodiazepine overdose treated?
Flumazenil
93
How does acute haemolytic reaction present (3)?
* Fever
* Abdo pain
* Hypotension
*Tx = stop transfusion + supportive care*
94
What are the side effects of PPIs (4)?
* C. diff
* Osteoporosis
* Hyponatraemia, hypomagnesaemia
* Microscopic colitis
95
When should a dextrose infusion be started in the treatment of DKA?
When glucose < 14
96
When should a prolonged pregnancy be considered for induction of labour (2)?
* Membrane sweep (40 weeks for nulliparous, 41 weeks for parous)
* Medical induction after 41 weeks
97
What antibodies is primary biliary colangitis associated with?
Anti mitochondrial antibodies
98
What are anti smooth muscle antibodies associated with?
Autoimmune hepatitis
99
What are the bichemical signs seen in refeeding disorder (3)?
* Hypophosphataemia
* Hypokalaemia
* Hypomagnesaemia
*+ thiamine deficiency*
100
How should an asymptomatic patient with a raised blood glucose (e.g. HbA1C, fasting, random) be managed?
Re-check glucose levels before treatment
101
What type of melanoma is most common under the nails?
Acral lentiginous
102
How are superficial (carcinoma in situ) and invasive carcinoma of the bladder managed?
* Superficial/ in-situ = transurethral removal of bladder tumour (TURBT)
* Invasive = radical cystectomy (or radiotherapy)
103
What cancers does HRT increase the risk of (2)?
* Endometrial (osterogen increases risk - this is reduced by addition of progestogen
* Breast (progestogen increases risk)
*+ increased risk of ovarian cancer*
104
What is the investigation of choice for intersusecption?
USS
105
Can you break confidentiality when a patient with HIV does not want to tell partners they are HIV +ve?
Yes, but you must discuss this with the patient before doing so
106
What medications are known to cause ototoxicity (5)?
* Aminoglycosides
* Chemotherapy
* Loop diuretics
* Aspirin
* Quinine
107
How is priapism investigated?
Cavernosal blood gas analysis
108
How does transfusion associated graft vs host present (3)?
* Fever
* Erythroderma + desquamation
* Liver dysfunction
*presents in days to weeks*
109
What are the key things to know about femoral hernias (3)?
* Inferolateral to pubic tubercle
* High risk of strangulation (compared to inguinal)
* All must be referred for urgent surgical repair
110
When should steroids be prescribed for those with sarcoidosis (3)?
* Stage 2/3 lung disease
* Eye/ neuro/ cardiac involvement
* Hypercalacemia
111
What electrolyte disturbance is MDMA associated with?
**Hyponatraemia** - due to SIADH
112
What is a side effect of anastazole (aromatase inhibitors)?
Osteoporosis
*used in postenopausal women*
113
What is a side effect of tamoxifen (selective oestrogen receptor modulator) (4)?
* VTE
* Endometrial cancer
* Hot flushes
* Menstrual disturbances
*used in premenopausal women*
114
What is the power of a study and the formular for it?
The probability of correctly rejecting the null hypothesis when it is false/ the probability of detecting a statistically significant difference
**power = 1-probability of type II error**
115
How is anterior uveitis treated (3)?
* Steroid drops
* Cycloplegic drops (dilates pupil)
* Urgent ophthalmology review
116
When should LMWH be initiated after surgery?
6-12 hours
*if they are being used in combination with ted stockings for thromboprophylaxis*
117
What is PTSD vs acute stress reaction?
* PTSD > 4 weeks
* Acute stress reaction < 4 weeks
118
What are the two defects of the abdominal wall in foetuses?
* **Exomphalos** = abdominal contents through the anterior abdominal wall + overed in a sac
* **Gastroschisis** = abdominal contents through anterior abdominal wall lateral to umbilicus, not covered in a sac
119
How is gastroschisis and exophalmus managed?
* Gastroschisis = vagnial delivery + immediate repair
* Exomphalos = c-section at 37 weeks + staged repair
120
Which medication out of spironolactone and metocloramide causes galactorrhoea?
Metoclopramide
*spironolactone not known to cause galactorrhoea*
121
What is the first line long acting reversible contraceptive for people under 18?
Progesterone only implant
*coils not really used in those under 20 due to risk of expulsion*
122
How should pain due to renal colic be managed if NSAIDs are contraindicated?
IV paracetamol
123
How should a patient with stroke caused by AF be managed in the medium - long term?
* Aspirin for 14 days
* Anticoagulation lifelong
*if TIA then start anticoagulation immediately*
124
What level of protein in pleural effusion suggests transudative vs exudative (2)?
* < 30 = transudative (e.g. heart failure, liver cirrhosis, nephrotic syndrome)
* > 30 = exudative (e.g. pneumonia, RA, cancers)
125
How is duct dependant congenital heart defects managed?
Prostaglandin E1
126
How is a thrombosed haemorrhoid managed (2)?
* Excision if < 72 hours
* Otherwise stool softeners + analgesics
127
How should caustic substance injestion (injestion of corrosive substance) be managed?
Endoscopic evaluation
128
What are the 4 extrapyramidal side effects?
* **A**cute **d**ystonia (torticollis, oculogyric crisis)
* **A**kathesia
* **P**arkinsonism
* **T**ardive dyskenesia
129
How is each extrapyramidal side effect treated?
* Acute dystonia = procyclidine
* Tardive dyskenesia = tetrabenazine
*
130
What are the key things to know about diaphragmatic congenital hernia (4)?
* More common on left side
* Increased risks in future siblings
* Recurrance is possible
* Liver in thoraccic cavity + low lung: head ratio are poor prognostic factors
131
How should labour be induced if a women is > 41 weeks (2)?
* Bishop ≤ 6 = vaginal prostaglandins/ oral misoprostol
* Bishop > 6 = amniotomy/ IV oxytocin
132
What are some indications for continuous CTG monitoring in labour?
* Temp > 38 (susepcted sepsis/ chorioamnionitis)
* BP > 160/100
* Oxytocin use
* Fresh vaginal bleeding
* Meconium
133
How can C. jejuni be treated if symptoms are severe?
Clarythromycin
134
What time period must AF have been going on for to consider immediate electrical cardioversion?
< 48 hours
135
How should a patient with fast AF be managed (3)?
* Beta blocker
* Anticoagulation
* If unstable = synchronised DC electrical cardioversion
*if signs of heart failure, consider amiodarone/ digoxin*
136
What are some risk factors for DDH (6)?
* Female
* First born
* Sibling with DDH
* Breech past 36 weeks
* High birth weight (> 5kg)
* Oligohydramnios
137
How are different anticoagulants reversed (4)?
* Warfarin = vitamin K (phytomenadione)
* Rivaroxaban/ apixaban = andexanet alpha
* Dabigatran = idarucizumab
* Heparin = protamine
138
What fistulaes may develop in diverticulitis (2)?
* Colovesical fistulae = faecaluria/ pneumaturia (air bubbles in urine)
* Colovaginal fistula = vaginal passage of faecaes/ flatus
139
How should a patient with a painful red eye who wears contact lenses be managed?
Refer to eye casualty to exclude microbial keratitis
140
What change on ABG does aspirin poisoning cause?
Mixed respiratory alkalosis and metabolic acidosis
141
What is often the first sign of brain metastises?
CN6 palsy
142
How long after UPSI can levonorgestrel and ulipristal acetate be given?
* Levonorgestrel < 3 days
* Ulipristal acetate < 5 days
143
When should a lipoma be investigated with USS?
* Size > 5cm
* Increasing in size
* Pain
* Deep anatomical position
144
What are two medications used to help people addicted to smoking?
* **Varenicline** - nicotinic receptor partial agonist
* **Bupropion** - norepinephrine-dopamine reuptake inhibitor and nicotinic antagonist
*contraindicated in pregnancy*
145
How should a lung abscess be managed if not improving with antibiotics?
Percutaneous drainage of the abscess
146
How is rosacea managed (3)?
* Mild = topical ivermectin
* Severe = topical ivermectin + oral doxycycline
* Flushing predominant = topical brimonidine
147
Why does nephrotic syndrome cause hypercoagulable state?
Loss of antithrombin III through kidneys
148
Where are keloid scars most likely to form?
Sternum
149
What is usually the first line empiracle choice of antiemetic in palliative patients?
Metoclopramide
150
How does pancreatic cancer affect LFTs?
Choleststic picture in LFTs
151
How is a pleural effusion usually initially managed/ investigated?
Pleural aspirate --> chest drain (if exudative)
152
How is typhoid diagnosed?
Blood cultures
153
What are the criteria for discharge after an acute asthma exacerbation (3)?
* PEF > 75%
* Stable on discharge meds (without oxygen) for 12-24 hours
* Inhaler technique checked
154
Which out of IgG and IgM is acute and chronic?
* IgM = acute
* IgG = chronic
*M looks angry therefore acute*
155
How does botulism present (4)?
* Flacid paralysis
* Diplopia
* Ataxia
* Bulbar palsy
*IVDU = big risk factor; Tx = botulism antitoxin*
156
What medication is given for autosomal dominant polycystic kidney disease?
Tolvaptan
157
What are some of the adverse effects of thiazide like diuretics (6)?
* Hyperglycaemia
* Hyponatraemia
* Hypokalaemia
* Hypercalcaemia
* Impotence
* Gout
158
What are some different types of gait (4)?
* Trendelenberg = hip drops on each step
* Antalgic = classic limp, shorten time putting weight on leg
* Ataxic = uncoordinated staggering walk, with wide base
* Waddling = side to side swaying due to weakness in muscles
159
How should a HAP be managed (2)?
* Non-severe/ not high risk = oral co-amox
* Severe/ high risk = IV tazocin/ ceftazidime (3rd gen ceph)/ meropenem
160
Which thyroid cancer has the best prognosis?
Papillary carcinoma
161
What are some triggers of a thyroid storm (4)?
* Infection
* Trauma
* Thyroid surgery
* Acute iodine load e.g. contrast
162
Which patients would be given mechanical vs bioprosthetic heart valves?
* Older patients = bioprosthetic
* Younger = mechanical (lasts longer)
163
What long term medications are given to those with bioprosthetic vs mechanical valves?
* Bioprosthetic = aspirin
* Mechanical = warfarin
164
Which medications can cause digoxin toxicity (6)?
* Amiodarone
* Verapamil
* Diltiazem
* Ciclosporin
* Thiazides
* Loop diuretics
165
What is a strong risk factor for oropharyngeal/ tonsillar cancers?
HPV infection
166
What is the most likely cause of death for those on haemodialysis?
IHD
167
When is warfarin stopped prior to surgery?
5 days
168
What is beta thalassaemia major vs minor (2)?
* Major = transfusion dependant
* Minor/ trait = microcytic anaemia (not transfusion dependant)
*raised HbA2 in both*
169
Which thyroid conditions would cause an increase in uptake of iodine-131 (3)?
* Graves
* Toxic multinodular goitre
* Toxic adenoma
170
Which type of pneumonia causes red blood cell agglutination?
Mycoplasma pneumoniae
171
How should an exacerbation of COPD be managed?
* 5 days of oral pred
* Antibiotics (if infection suspected)
172
What is sick euthyroid syndrome?
Low TSH (can be inappropriately normal), T3 and T4 due to an underlying infection (e.g. pneumonia)
173
How is alcoholic liver disease managed acutely?
Prednisolone
174
What are the indications for placing a chest drain in those with pleural effusion due to infection (3)?
* Cloudy appearance
* pH < 7.2
* Presence of microorganisms on culture
175
What is subclinical hypothyroidism?
TSH raised by T3/4 normal
176
When should subclinical hypothyroidism be treated (2)?
Give levothyroxine if:
* TSH > 10 on 2 occasions > 3 months apart
* TSH 5.5-10 on 2 occasions 3 months apart, symptomatic, and < 65
177
What are the obstructive and restrictive pictures on pulmonary function tests?
* Obstructive = FEV1 significantly decreased; FVC normal; FEV1:FVC decreased
* Restrictive = FEV1 decreased; FVC decreased; FEV1:FVC increased
178
Which antibiotic classes cause long QT (2)?
* Macrolides
* Quinolones
179
How does acute intermittent porphyria present?
* Abdo pain + vomiting
* Motor neuropathy
* Psychiatric Sx
* Urine turns red on standing
*auto dominant condition*
180
What blood result suggests an upper GI bleed rather than a lower?
Urea
181
How should a patient who has a TIA and is on an anticoagulant be investigated?
Immediate CT head (to rule out haemorrhage)
182
What are the new york heart association heart failure classifications?
* Class 1 = no symptoms
* Class 2 = slight limitation of physical activity
* Class 3 = marked limitation of physical activity
* Class 4 = symptoms at rest
183
What should patients starting rituximab be screened for?
Hep B
184
What position are patients with ARDS often put in?
Prone position
*lay on front*
185
What bacteria causes gas gangrene?
Clostridium bacteria
186
How is MRSA treated treated when found with swabs on skin/ nose?
* Skin = chlorhexidine
* Nose = mupirocin
*for 5 days*
187
What are the electrolyte changes in tumour lysis syndrome (4)?
* Hyperkalaemia
* Hyperphosphataemia
* Hypocalcaemia
* Hyperuricaemia
188
What might be seen on a blood film in those with end-stage renal disease?
Burr cells
*spiky RBCs*
189
How should dysplasia on endoscopy be managed?
Endoscopic intervention
190
What is a big risk factor for focal segmental glomerulosclerosis?
HIV infection
*type of nephrotic syndrome*
191
How is UC proctitis remission induced (3)?
1. Topical aminosalicylate
2. Oral aminosalicylate
3. + topical --> oral corticosteroid
192
How is extensive UC remission induced (2)?
1. Topical + oral aminosalicylate
2. Oral corticosteroid
193
How is severe UC remission induced (2)?
Classed as > 6 loose motions per day + systemic upset:
1. IV steroids
2. + IV ciclosporin
194
How should those who have a TIA but have a high bleeding risk/ not suitable for DAPT be managed?
Clopidogrel monotherapy
195
How should a PE in renal impairment be investigated?
V/Q scan
196
How should asthma in an adult be investigated (3 steps)?
1. Eosinophil count OR FeNO
2. Bronchodilator reversibility with spirometry (if not available measure PEF for 2 weeks, variability > 20% = asthma)
3. Refer for bronchial challenge test
197
How is a hyperacute rejection of kidney transplant managed?
Removal of kidney
*it cannot be saved*
198
How is toxoplasmosis treated (2)?
Pyrimethamine + sulphadiazine
199
How can campylobacter be treated?
Clarithromycin
200
How should severe C. diff be treated (2)?
* Oral vanc
* IV metronidazole
Quesmed stuff wrong
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