Content: Dedication Preface List of abbreviations SECTION I Cardiology Define the pacemaker nomenclature of DDD and VVI Give the ECG features of VT Which patients are at risk of infective endocarditis? What are the associated stigmata of infective endocaditis? List the causes of a long QT. How is the QT interval calculated? List the causes of ST elevation Define the Sgarbossa criteria How is death confirmed following cardiac arrest? List the causes of a low voltage ECG Give the risk factors for asystole and symptoms of compromise in a patient with bradycardia List 8 causes of sinus bradycardia Define the ATMIST handover tool A well patient with no arrhythmias is experiencing multiple ICD shocks. What is your management? What does a 'bleeping' ICD indicate? An ICD patient has received no device shocks but is in VT with hypotension. What is your management? What are the ECG findings in hypokalaemia? Give 6 causes of hypokalaemia What are the diagnostic features of Kawasaki disease? SECTION II Dermatology What are the presenting features of HSP? Which children require admission? How should a tick be removed? Describe the presenting features and the skin rash associated with Lyme disease. What descriptors are used in dermatology? Give 5 differential diagnoses of a bullous rash Give the associated causes of Stevens Johnson Give the causes of erythema nodosum SECTION III Endocrinology What are biochemical findings in, and causes of, an acute Addisonian crisis? Give the causes of hypernatraemia, hyponatraemia, hyperchloraemia and hypochloraemia Give 6 possible differential diagnoses of hypoglycaemia in an adult How much fluid would you prescribe for a child with DKA who is 5% dehydrated, weight 38kg, following a 380mls 0.9% saline resuscitation fluid bolus? What are the features of cerebral oedema with DKA? SECTION IV Environmental MEDICINE Differentiate between the features of acute mountain sickness, high altitude cerebral oedema and pulmonary oedema. What information is initially reported from a major incident scene? What are the clinical features of heat stroke? What is the differential diagnosis of hyperpyrexia? Define the ATMIST handover tool SECTION V Gastroenterology How can the risk of re-bleeding and adverse outcome be predicted following an upper GI bleed? Give 6 medical causes of abdominal pain What is the Alvarado score? What are the biochemical findings associated with pyloric stenosis? List the causes of a metabolic alkalosis and the causes of a respiratory alkalosis How is the position of an NG tube checked in adults? List the contraindications for NG tubes. What is the differential of jaundice in pregnancy? Define the grades of encephalopathy What are the causes of priapism and the treatment approach? Give 6 causes of bowel obstruction in neonates Which children are at increased risk of dehydration with diarrhoea and vomiting? When is stool microbiology indicated in a child with D&V? SECTION VI Haematology What are the precipitants of an acute painful sickle crisis? List the types of sickle cell crises Give the acute complications of a blood transfusion Give the differential diagnoses of fever with petechiae in a 4yr old. SECTION VII Infectious diseases When is antibiotic prophylaxis indicated following meningococcal meningitis contact? Describe your approach to the management following a needlestick injury from a discarded needle in a public toilet. Differentiate between SIRS and septic shock Give the EGDT principles State the discharge advice for a well 2 yr old presenting with a fever and presumptive diagnosis of a viral URTI. SECTION VIIIMedicolegal When should the coroner be informed following the death of a patient? What are never events? What is your understanding of Controlled Drugs? SECTION IX Musculoskeletal and injury What are the clinical findings in necrotising fasciitis? Describe the features of Kanavel's sign and the significance of this sign. Give the causes of a Radial Nerve palsy. What are the features of a tetanus prone wound? What is the UK tetanus immunisation schedule? Describe the clinical findings in tetanus Which are the causes of compartment syndrome? Define the following eponyms? What are the findings in the following eponymous fracture? Which burns should be referred to a specialist burns care service? What is the Parkland formula When are ankle / foot / knee x-rays indicated following trauma? Describe the features to identify on a child's elbow radiograph Give the complications and contraindications of intra-osseous needle insertion What are the presenting features of toxic shock syndrome in children and the initial management approach? SECTION X Neurology What are the presenting features of Botulism? Describe the ABCD2 score for TIA List 10 stroke mimics What are the clinical findings in cerebellar lesions? Give 5 causes of cerebellar syndrome Give the presenting features of Guillain-Barre syndrome What can precipitate acute worsening of symptoms in Myasthenia Gravis? What is the DVLA advice following a TIA? List the red flags in an adult presenting with a headache Describe the paediatric Glasgow Coma Scale What is the treatment approach for a fitting child? Give the features in History and examination which would be important to elicit in a 6 year old presenting following a first fit. How would you prepare for the arrival of a sick child? How is weight estimated in a child? SECTION XI Obstetrics and Gynaecology What is the management of chicken pox contact in the second trimester of pregnancy? What is your initial approach on identification of umbilical cord prolapse? Describe the APGAR score Describe the clinical features of pre-eclampsia and the management of an eclamptic seizure What is your approach on identifying shoulder dystocia? List the causes of post partum haemorrhage SECTION XII Ophthalmology What are the findings in retrobulbar haemorrhage? List the differential diagnosis of papiloedema. What are the Caldicott principles? List the causes of, and clinical findings in, central retinal artery occlusion What are the fundoscopy findings in central retinal vein occlusion? Which conditions are associated with central retinal vein occlusion? What is Seidel's test? A patient presents with painful eyes following a day walking in snow. What is the likely diagnosis? SECTION XIII Psychiatry Give organic causes of psychosis What tool can be used to assess suicide risk? How should capacity be assessed? Which factors may be associated with a patient absconding from the ED? Give the differences between sections 2,3,5(2) and 136 of the mental health act. SECTION XIV Respiratory What are the features of life threatening asthma in adults? Describe the clinical features seen with SVCO (Superior Vena Cava Obstruction) Give 6 causes of Pneumomediastinum How can a difficult airway be predicted? Give the causes of the following capnography traces in an intubated patient: Sudden loss of trace, gradually increasing trace, slanted expiratory trace, gradually falling size. Describe the Wells Score for PE and DVT assessment What are the echocardiography findings in a significant PE? Give the contraindications for using non invasive ventilation. Give the causes of cavitating lung lesions How can the severity of pneumonia be assessed? What is the differential diagnosis of new onset stridor in a 3 yr old. Suggest features to differentiate between causes of stridor. Describe the UK childhood immunisation schedule How should a child with croup be initially assessed in the ED? SECTION XV Safeguarding Which features of a bruise in a child would be concerning? Describe concerning burns Who has parental responsibility? What are the Caldicott principles? SECTION XVI Spinal What are the symptoms, precipitants and treatment approach in autonomic dysreflexia? What are the concerning features in a patient with back pain? What are the clinical findings in anterior cord, Brown - Sequard, Central cord syndrome and Cauda equine syndromes? SECTION XVII Toxicology What are the contraindications for the use of activated charcoal? What are the indications for multidose activated charcoal? Give the presenting features of anaphylaxis How do approach the management of accidental injection of epipen into a thumb? What are the features of Wernicke encephalopathy? Give the clinical findings in, and causes of methaemoglobinaemia. What are clinical features in organophosphate poisoning? How can the anion gap be applied? How is the osmolar gap calculated? What are the features of a smoke inhalation injury? What are the indications for starting renal replacement therapy? How much 1% lignocaine can be used for a 7 year old? What are the features of local anaesthetic toxicity? Index