wriske

Question 1

Non Hodgkin’s lymphoma

Answer 1

• U&E
• LFT
• FBC
• Bone profile
• Blood film
• HIV or EBV
• ESR
• LDH

Question 2

What to say with hip fracture

Answer 2

Loss of shenton’s line, prominent lesser trochanter, consistent with intracapsular transcervical neck of femur fracture (– garden classification I)

Question 3

Right wrist fracture

Answer 3

Transverse fracture of the distal radius, dorsal angulation and displacement of the wrist (‘dinner fork deformity’) consistent with ‘Colle’s fracture’. Do not appear to be any other fractures in ulna or carpal bones. Does not appear to be any involvement with articular surface.

Question 4

Bloods for paracetamol overdose

Answer 4

FBC, U&E, LFT, INR Plasma Paracetamol concentration

Question 5

Bloods for hospital acquired pneumonia

Answer 5

FBC, U&E, LFT, CRP, lactate, blood culture

Question 6

Osteoarthritis of his hand

Answer 6

1. Osteophytes – (bone spurs) are protrusions of bone and cartilage. They typically develop as a reparative response by remaining cartilage, cause pain and limited range of motion in the affected joint.
2. Joint space narrowing – caused by the wearing away of the articular cartilage.
3. Subchondral cysts – are fluid-filled sacs which extrude from the joint. The cysts contain thickened joint material, mostly hyaluronic acid. Traumatised subchondral bone undergoes cystic degeneration.
4. Subchondral sclerosis – Subchondral bone is the layer of bone just below the cartilage. Sclerosis means that there is hardening of tissue

Question 7

Bloods for a heart attack

Answer 7

FBC, U&E, LFT, Troponin, lipids, glucose, TSH

Question 8

Initial management for STEMI

Answer 8

● Aspirin 300mg PO (PR if can’t swallow)
● Glyceryl trinitrate 800 microgram OR 2 puffs S/L
● Morphine sulphate 5mg/10mg IV
● Oxygen 15L NRB if sats <94%

Question 9

Long term treatment for STEMI

Answer 9

● ACE inhibitor – Lisinopril 5mg PO OD or Ramipril 2.5mg PO BD
● Beta-blocker – bisoprolol 5mg PO OD
● Statin – atorvastatin 80mg PO OD
● Dual antiplatelets - aspirin 75mg PO OD and clopidogrel 75mg PO OD

Question 10

Severe asthma blood

Answer 10

FBC, U&E, CRP, arterial blood gas

Question 11

Sepsis/ severe infection

Answer 11

FBC, U&E, CRP, Lactate/VBG, Blood culture
(LFT, glucose)

Question 12

Bloods for testicular cancer

Answer 12

LDH
Beta-HCG (beta human chorionic gonadotrophin
Serum Alpha-Fetoprotein

Question 13

Bloods for antiphospholipid syndrome

Answer 13

● Lupus anticoagulant
● Anticardiolipin antibodies

Question 14

Treatment for hyperkalaemia

Answer 14

● For cardiac stability 🡪 calcium gluconate 10%
● To reduce potassium 🡪 IV insulin infusion with glucose
● Immediate (but short-lasting) reduction in potassium 🡪 nebulised salbutamol (this is unlicensed, but common practise)

Question 15

Bloods for diabetic foot

Answer 15

• Urine albumin:creatinine ratio
• U&E
• LFT
• HbA1C
• Glucose
• Chloesterol or lipid profile
• TFT’s

Question 16

Chronic urticaria

Answer 16

• TFT
• B12/folate
• Total IgE
• C1 esterase inhibitor
• ANA

Question 17

aspirin overdose bloods

Answer 17

• U&E
• LFT
• FBC
• Glucose
• Plasma salicyclate

Question 18

Infective endocarditis bloods

Answer 18

• FBC
• CRP
• ESR
• U&E
• Blood culture
• Rheumatoid factor

Question 19

Iron overdose bloods

Answer 19

• FBC
• U&E
• LFT
• Coagulation screen
• Lactate
• Plasma iron concentration

Question 20

Dengue bloods

Answer 20

• FBC
• LFT
• Coagulation screen
• IgM against dengue

Question 21

Anaemia bloods

Answer 21

• U&E
• Calcium
• Ferritin
• Glucose
• FBC
• tTg-IgA
• Intrinsic factor or TFT

Question 22

Cocaine overdose bloods

Answer 22

• U&E
• LFT
• FBC
• TFT
• Calcium
• Magnesium
• Troponin
• Glucose
• Coagulation screen
• Plasma cocaine
• Creatinine kinase