Core Knowledge and Fundamentals Flashcards

A 40-year-old woman presents with recurrent episodes of flushing, diarrhoea, and wheezing. Urinary 5-HIAA is elevated. What is the most likely diagnosis?

Answer: Carcinoid syndrome

Carcinoid syndrome results from serotonin secretion by metastatic carcinoid tumours, causing flushing, diarrhoea, and elevated urinary 5-HIAA.

A patient with known chronic kidney disease has a potassium of 6.8 mEq/L on repeat testing. The ECG shows peaked T-waves and widened QRS. What is the immediate priority?

Answer: Administer IV calcium gluconate

IV calcium gluconate is given immediately to stabilise the cardiac membrane against the arrhythmogenic effects of severe hyperkalaemia before correcting potassium levels.

Which of the following findings on spirometry is most consistent with obstructive lung disease?

Answer: FEV1/FVC ratio <0.70 with preserved or increased FVC

Obstruction is defined by FEV1/FVC <0.70, reflecting disproportionate reduction in expiratory flow relative to total volume expelled.

A 22-year-old man presents to the emergency department with a psychiatric history, having taken an unknown overdose. He is drowsy with pinpoint pupils and a respiratory rate of 8. What is the immediate treatment?

Answer: IV naloxone

Miosis, CNS depression, and respiratory depression form the classic opioid toxidrome; naloxone is the specific opioid antagonist used for reversal.

Which hepatitis virus is transmitted via the faeco-oral route and is associated with high mortality in pregnant women?

Answer: Hepatitis E

Hepatitis E is faeco-oral transmitted and carries up to 20% mortality in pregnant women, particularly in the third trimester.

A 68-year-old woman develops sudden right-sided weakness and aphasia that fully resolves within 45 minutes. CT head is normal. What is the most appropriate next step?

Answer: Admit for urgent TIA workup including neurovascular imaging within 24 hours

A TIA carries high short-term stroke risk; urgent assessment with ABCD2 scoring, neurovascular imaging, and carotid imaging within 24 hours is mandated.

Which of the following best describes the Gillick competence principle in paediatric medicine?

Answer: A child under 16 may consent if they demonstrate sufficient maturity and understanding

Gillick competence allows a child under 16 to consent to treatment if they have sufficient intelligence and maturity to understand the nature and implications of that treatment.