Inferior Vena Cava Thrombosis Acute Pancreatitis Renal Vein Thrombosis Gastritis Biliary Colic E This condition also can cause splenic problems Consultation models Which of the following components is not part of the Roger Neighbour consultation model ID: 1031957
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1. A 15 year-old girl presents with abdominal pain. She is normally fit and well and currently takes the COCP. The patient is accompanied by her mother who is known to have hereditary spherocytosis. The pain is located in the upper abdomen and is episodic in nature but has become severe today. There has been no change in her bowel habit and no nausea or vomiting. What is the most likely diagnosis?Inferior Vena Cava ThrombosisAcute PancreatitisRenal Vein ThrombosisGastritisBiliary Colic
2. EThis condition also can cause splenic problems
3.
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5. Consultation modelsWhich of the following components is not part of the Roger Neighbour consultation model?Safety nettingHanding overReflectingSummarizingHouse keeping
6. Reflecting is not part of the model
7. Constipation in childrenYou review a 3 yr old girl who is being treated for idiopathic constipation with movicol paediatric plain. Her mother has been increasing the dose but there has been no response. She remains well with normal abdo exam. What is the most appropriate next step?A – Add sennaB- Ask the health visitor to insert a glycerin suppositoryC- Stop movicol and add lactulose and sennaD-Add LactuloseE- Prescribe a one off dose of sodium picosulfate to be given whilst the health visitor is present.
8. A- as senna and movicol have different actions, (movicol and lactulose are both osmotic laxatives_Senna is a stimulant.Lactulose for very young children.
9. Chronic management of patients after MIWhat 3 drugs are the most appropriate to commence for a patient who had an MI last year and has moved from abroad?SimvastatinBisoprololRamiprilClopidogrelAspirinIsosorbide mononitrate
10. Simvastatin, ramipril and aspirin from these choices.
11. ChildrenWhen assessing an 18-month-old child with diarrhoea and vomiting which one of the following signs is most likely to indicate shock? A. TachycardiaB. Sunken eyesC. Reduced skin turgorD.Prolonged capillary refill timeE.Mother reports child is irritable
12. D prolonged cap refill
13. Nocturnal enuresisWhich one of the following statements regarding the use of desmopressin in nocturnal enuresis is correct?A They can be used to gain short-term control in children over the age of 7 yearsB.Urea and electrolytes should be checked prior to commencing treatmentC.Intranasal preparations should be used first-lineD.Children taking desmopressin should not be restricted from drinking fluidsE.Repeat courses should not be offered if there is a relapse
14. A is true.Nasal preps have been assoc with hyponatraemia.Fluid restriction is required nocturnally and within 1 hr pre taking.Nice states not to ck blds/urine osmolality pre initiationCan be used repeatedly after trials without every 3/12
15. Choose the letter which the description fits1. Nurses holding powers which is valid for 6 hours, allowing urgent detention of a patient already under treatment in hospital.2. Empowers the police who find a person in a public place suffering from a mental illness to transfer to a place of safety for assessment. A. Section 3B Section 5 (4)C Section 35D Section 136E Section 137F Section 5 (2)G Section 3
16. BD
17. A 70 year old lady presents to the out of hours centre with a painful left eye. She has a headache and feels sick. You examine her and find the below: What is your diagnosis?A) ConjunctivitisB) IritisC) Retinal detachmentD) Acute glaucomaE) Chronic glaucoma
18. D
19. A patient presents in extremis to reception, she has a widespread rash and stridor. You suspect anaphyaxis, What is your first one management choice?A) Salbutamol nebuliserB) OxygenC) Adrenaline 1:1000 solution IVD) IV fluidsE) Chlorphenamine 10mgF) Hydrocortisone 200mgG) Adrenaline 1:1000 solution IM
20. G
21. A 23-year-old male presents with purulent urethral discharge. A sample of the discharge is shown to be a Gram negative diplococcus. What is the most appropriate antimicobial therapy?A. Ciprofloxacin 500mg BD PO for 7 daysB. Penicillin V 500mg QDS PO for 7 daysC. Doxycycline 100mg BD for 7 daysD. Ciprofloxacin 500mg PO (single dose)E. Cefixime 400mg PO (single dose)
22. E – however at the time of this, GUM clinics are preferentially using IM preps due to increasing resistance profiles and would like to treat all confirmed cases themselves, discuss with them 1st.