10. Which of the following is not relevant in a medical history in alcohol abuse?
Any problems with your heart?
Any numbness or tingling in your hands or feet?
Any pain in your tummy?
Does anything happen to you if you don't drink for a day or so?
Any history of problems with your liver?
Have you been in a low mood lately?
11. Which of the following is not a feature of alcohol dependence?
Nausea, fits, delirium tremens
Increased amount of alcohol required to achieve same affect
A strong urge/need to drink
Fever, sweating, vomiting, diarrhoea
Anxiety, sweating, tremor/the shakes
12. Which of the following is not a simple opioid?
Ibuprofen
Co-codamol
Paracetamol
13. Which symptoms are not associated with BPH?
Increased frequency of urination at night (nocturia)
Difficulty starting urination
Unable to empty bowels (constipation)
Dribbling at the end of urination
Inability to completely empty the bladder
Frequent or urgent need to urinate
Weak urine stream or a stream that stops and starts
14. Which of the following is untrue about the prostate?
Surgical procedure that involves cutting away a section of the prostate
When prostate becomes enlarged, it can place pressure on the bladder and urethra. This can cause symptoms that affect urination
Not found in woman
It's located between the penis and bladder, and surrounds the urethra (the tube that carries urine from the bladder to the penis)
15. What is not accurate regarding the recovery of an appendectomy?
Laparoscopic surgery patients may experience shoulder tip pain for about a week (due to the gas pumped into the abdomen during the operation
First few days will involve some pain and bruising, which improves over time. Painkillers can be taken if necessary
In most cases patient can return to normal activity in a couple of weeks, although more strenuous activities may need to be avoided for 4 - 6 weeks
May experience short terms constipation (not taking codeine, eating plenty of fibre and staying hydrated can help reduce this). If particularly troublesome, GP can prescribe medication
Open surgery is recommended in patients who are obese
Key hole surgery recovery time is short and most people leave hospital in a few days, and with prompt removal, it is possible to be discharged within 24hrs
Complicated or open surgery discharge may take up to a week
16. Which of the following management ideas are not relevant for an anorexic patient?
Refer to dietician (help gain weight safely)
Give patient a chance to gain weight independently
Take BMI (involves taking weight and height)
Talking therapy (CBT/counselling)
17. Which statement is wrong, referring to an appendectomy?
Open surgery may involve making a larger cut (laparotomy) in the middle of the abdomen to examine organs or in cases where there are problems (e.g. peritonitis)
Open surgery required when appendix has already burst and formed a lump known as the appendix mass, when surgeon isn't very experienced with laparoscopic removal, or with people who have had previous abdominal surgery
After the surgery, the removed appendix is sent to the laboratory. This is routine to check for signs of cancer, but it more a precautionary measure and is rare to find serious problems
Key hole surgery is preferred, making recover rates quicker
Laparoscopic surgery conclusion involves the closure of the incisions with dissolvable stitches. If regular stitches are used, they will need to be removed 7 - 10 days later by GP
Carried out under local anaesthetic, via a laparoscopic surgery or open surgery
Key hole surgery involves 3 or 4 small incisions in your tummy, where a tube (pump gas to inflate abdomen), a laparoscope (tube with camera relaying images to monitor) and small surgical tools are used to remove the appendix
Open surgery uses dissolvable stitches or regular stitches that need to be removed
Open surgery makes a single larger cut in the lower right hand side of the abdomen to remove the appendix
18. Which of the following is not an enquiry into the history of weight loss in anorexia nervosa?
Can you describe your diet for me please? What do you eat fir breakfast, lunch and dinner?
Have you noticed any change in your weight recently?
Do you know how much you currently weigh?
What was your weight before?
Why have you decreased your calorie/food intake?
How is your appetite?
Do you exercise? What exactly do you do? How many times a week an for how many hours each session?
19. "Local anaesthesia carries risk of an allergic reaction or inhaling of stomach contents during an appendectomy, that may lead to pneumonia". Is this statement true or false?
False
True
20. What is the procedure of pain management post-op?
Step down the pain ladder: From strong opioid, to weak opioid, to simple analgesics
NSAIDs given to take home. If pain is not controlled, GP to up dosage. Weekly review
Step up the pain ladder: From simple analgesics, to weak opioid, to strong opioid
Patient controlled analgesia: Patient is charged with medication according to pain. Discontinued in ~6 months or reviewed for stronger options