Wentwest SGPe 1: Applied Knowledge Test Paper

A) Constipation in children may be a sign of systemic disease

B) The parents can be reassured that he will grow out of his symptoms

C) Hirshsprung’s disease always presents in the neonatal period

D) The parents should be trained in the use of enemas to treat any recurrence early

E) Stimulant laxatives are contraindicated in children

A) It always has an organic basis

B) If it is caused by coeliac disease, it is usually associated with diarrhoea

C) It may be caused by hyperthyroidism

D) It may be caused by a urinary tract infection

E) If it is caused by growth hormone deficiency, it is usually apparent only from 6 – 12 months

A) Glaucoma is usually asymptomatic

B) If he has raised intraocular pressure but no signs of glaucoma, he may be reassured

C) It affects approximately 2% of the population

D) Geoff’s treatment should aim to reduce the intraocular pressure and reverse any loss of visual field

E) It is a disease of middle aged and elderly individuals

A) Penicillin V

B) Codeine phosphate

C) Ondansetron

D) Insulin

E) Fluconazole

A) She should be treated with a low dose of fluoxetine

B) She should keep a food diary to try to identify any possible triggers

C) Non steroidal agents may be effective during exacerbations of pain

D) Lack of specific signs on examination suggests that her dyspareunia is psychological

E) Laparoscopy is not indicated

A) The first attack of this condition is usually the most painful

B) It is unlikely to be an STI in view of her normal screen 3 months ago

C) She could be treated with Aciclovir to reduce the severity and duration of the attack

D) Aciclovir will not prevent future recurrence

E) She should remain abstinent or her male partner should use barrier contraception until the condition has resolved

A) Organise your registrar to attend and complete the death certificate as you have a fully booked morning session

B) Organise an immediate ambulance to transfer the body to the morgue

C) Attend to the body as soon as possible today and complete the death certificate

D) Advise the daughter to certify the body straight away

E) Advise the coroner of the death

A) MRI Brain

B) Semen Analysis

C) Depression screening

D) Short Synacthen test

E) FSH and testosterone levels

A) Cellulitis

B) Conjunctivitis

C) Chalazion

D) Sebaceous cyst

E) Basal cell carcinoma

A) He should be treated for a probable septic arthritis and reviewed in 1 week

B) He may have an intra-articular fracture with a haemarthrosis

C) He may have a haemarthrosis in which case he should be screened for haemophilia

D) The injury is unlikely to cause permanent joint damage

E) The joint should not be splinted because this prevents mobilisation

A) The condition is more common in girls than boys

B) Emma may be reassured that no further tests or treatments are necessary and that she will grow out of the condition in time

C) She should have her urine tested

D) Desmopressin is an effective long term treatment

E) It is likely to settle with the onset of menarche

A) Gonorrhoea

B) Chronic prostatits

C) Non specific urethritis

D) Urinary tract infection

E) Balanitis xerotica obliterans

A) Systemic lupus erythematosus

B) Acne vulgaris

C) Rosacea

D) Dermatitis herpetiformis

E) Allergic contact dermatitis

A) Refer urgently for a gynaecologist review

B) Advise a pelvic ultrasound after her next period

C) Refer for a colonoscopy to exclude bowel pathology as a cause of her symptoms

D) Perform a cervical smear with HPV typing

E) Perform an urgent FBE

A) Acute pancreatitis

B) Hiatus hernia

C) Gastroenteritis

D) Abdominal aortic aneurysm

E) Coeliac disease

A) Aspirin

B) Vitamin deficiency

C) Mycoplasma infection

D) Ulcerative colitis

E) Herpes zoster

A) He has urinary retention precipitated by a UTI and should have an indwelling catheter inserted

B) He has urinary retention precipitated by acute prostatic obstruction and should have a suprapubic catheter inserted

C) He has urinary retention and should have a suprapubic catheter inserted due to the likely presence of a UTI

D) He has acute urinary retention most likely caused by constipation and should have a fleet enema

E) He has urinary retention secondary to neurogenic bladder and should have an urgent CT lumbosacral spine

A) Pemphigus

B) Pompholyx

C) Scabies

D) Dermatitis artefacta

E) IgE hypersensitivity

A) Tuberculosis

B) Pneumocystis carinii pneumonia

C) Bronchopneumonia

D) Lung cancer

E) Sarcoidosis

A) TFTs should be performed. If they are normal no further action is necessary at this time. However TFTs should be repeated on a regular basis to detect hypothyroidism or hyperthyroidism

B) If TFTs show a raised TSH, she should be started on Thyroxine and have TFTs repeated in 3 months to assess effect

C) She should be referred for specialist review

D) She is in the acute phase of Hashimoto’s thyroiditis and can be reassured

E) If she is clinically euthyroid this is most probably a physiological goitre

A) Loss of red reflex, reduced visual acuity in the affected eye, blood in the posterior chamber of the affected eye

B) Loss of pupillary reflex in contralateral eye, reduced visual acuity in the affected eye, blood in the posterior chamber of the affected eye

C) AV nipping, blot haemorrhages and flame haemorrhages

D) Reduced visual acuity in the affected eye, blood in the anterior chamber of the affected eye, loss of pupillary reflex in the contralateral eye

E) Splinter haemorrhages, loss of red reflex and blurring of the optic disc

A) Repeated wax accumulation suggests local ear disease for which he should be actively investigated

B) Wax impaction is asymptomatic

C) Wax impaction may be the result of hearing aid use

D) Any patient presenting with ear wax should have ear syringing

E) Ear wax drops should be ceased at least 2 weeks prior to ear syringing

A) DVTs

B) Spinal canal stenosis

C) Multiple myeloma

D) Peripheral vascular disease

E) Age related changes

A) Achilles’ tendonitis usually presents in this way

B) A partial tear will usually show no signs on examination other than tenderness and a swelling in the mid tendon

C) MRI would be the investigation of 1st choice

D) Complete ruptures should always be treated surgically

E) Partial tears should always be treated because of the risk of developing a full tear

A) She should be referred immediately to the rheumatologist

B) It is a contraindication to the COCP

C) It is more common in men

D) It may be associated with oesophageal disease

E) It is caused by nutritional vitamin D deficiency

A) Reduced air entry at the L base, dullness to percussion over the L base and bronchial breathing heard above the area

B) Reduced air entry at the L base, bronchial breathing over the L base and stony dull percussion above the area

C) Reduced air entry at the L base and wheeze over the L base

D) Normal air entry in the lung fields, dullness to percussion over the L base and increased vocal fremitus over the L base

E) Normal air entry in the lung fields, dullness to percussion over the L base and reduced vocal fremitus over the L base

A) Unilateral pleural effusions may be an early sign of heart failure

B) It may result from ascites

C) It may result from liver disease

D) It may result from infection

E) Pleural effusions need to be > 10ml to be visible on CXR

A) Most Down syndrome infants are born to women over the age of 30

B) Down syndrome is an autosomal dominant trait

C) Nuchal translucency screening is best performed at 10 weeks gestation

D) All of the above

E) None of the above

A) ABC of resuscitation

B) Check blood glucose

C) High flow oxygen

D) Intranasal midazolam

E) Intramuscular phenytoin

A) Family history is not a risk factor

B) Chronic liver disease is not a risk factor

C) The 4th finger is commonly affected

D) It is unusual in people over the age of 40

E) Surgical fasciectomy is the only management option

A) Cellulitis

B) Chronic venous insufficiency

C) Deep vein thrombosis

D) Gout

E) Intermittent claudication

F) Lymphoedema

G) Raynaud’s phenomenon

H) Ruptured Baker’s cyst

I) Superficial thrombophlebitis

J) Thrombophlebitis obliterans

K) Sarcoma

L) Restless legs

M) Sciatica

N) Spinal canal stenosis

O) Osteoarthritis

A) Cellulitis

B) Chronic venous insufficiency

C) Deep vein thrombosis

D) Gout

E) Intermittent claudication

F) Lymphoedema

G) Raynaud’s phenomenon

H) Ruptured Baker’s cyst

I) Superficial thrombophlebitis

J) Thrombophlebitis obliterans

K) Sarcoma

L) Restless legs

M) Sciatica

N) Spinal canal stenosis

O) Osteoarthritis

A) Cellulitis

B) Chronic venous insufficiency

C) Deep vein thrombosis

D) Gout

E) Intermittent claudication

F) Lymphoedema

G) Raynaud’s phenomenon

H) Ruptured Baker’s cyst

I) Superficial thrombophlebitis

J) Thrombophlebitis obliterans

K) Sarcoma

L) Restless legs

M) Sciatica

N) Spinal canal stenosis

O) Osteoarthritis

A) Cellulitis

B) Chronic venous insufficiency

C) Deep vein thrombosis

D) Gout

E) Intermittent claudication

F) Lymphoedema

G) Raynaud’s phenomenon

H) Ruptured Baker’s cyst

I) Superficial thrombophlebitis

J) Thrombophlebitis obliterans

K) Sarcoma

L) Restless legs

M) Sciatica

N) Spinal canal stenosis

O) Osteoarthritis

A) Cellulitis

B) Chronic venous insufficiency

C) Deep vein thrombosis

D) Gout

E) Intermittent claudication

F) Lymphoedema

G) Raynaud’s phenomenon

H) Ruptured Baker’s cyst

I) Superficial thrombophlebitis

J) Thrombophlebitis obliterans

K) Sarcoma

L) Restless legs

M) Sciatica

N) Spinal canal stenosis

O) Osteoarthritis

A) Cystocoele

B) Neurological incontinence

C) Overflow incontinence

D) Stress incontinence

E) Urethral caruncle

F) Urge incontinence

G) Urinary tract infection

H) Vesicocolic fistula

I) Vesicovaginal fistula

J) Urinary retention

K) Uterine fibroid

L) Bladder carcinoma

M) Enuresis

A) Cystocoele

B) Neurological incontinence

C) Overflow incontinence

D) Stress incontinence

E) Urethral caruncle

F) Urge incontinence

G) Urinary tract infection

H) Vesicocolic fistula

I) Vesicovaginal fistula

J) Urinary retention

K) Uterine fibroid

L) Bladder carcinoma

M) Enuresis

A) Cystocoele

B) Neurological incontinence

C) Overflow incontinence

D) Stress incontinence

E) Urethral caruncle

F) Urge incontinence

G) Urinary tract infection

H) Vesicocolic fistula

I) Vesicovaginal fistula

J) Urinary retention

K) Uterine fibroid

L) Bladder carcinoma

M) Enuresis

A) Cystocoele

B) Neurological incontinence

C) Overflow incontinence

D) Stress incontinence

E) Urethral caruncle

F) Urge incontinence

G) Urinary tract infection

H) Vesicocolic fistula

I) Vesicovaginal fistula

J) Urinary retention

K) Uterine fibroid

L) Bladder carcinoma

M) Enuresis

A) Cystocoele

B) Neurological incontinence

C) Overflow incontinence

D) Stress incontinence

E) Urethral caruncle

F) Urge incontinence

G) Urinary tract infection

H) Vesicocolic fistula

I) Vesicovaginal fistula

J) Urinary retention

K) Uterine fibroid

L) Bladder carcinoma

M) Enuresis