1. C - Don't ever let a depressed patient leave without first having assessed their suicide risk. Also, for mild - moderate depression, computerised CBT is first line treatment according to the NICE Guidelines.
2. H - a short history of sob and wheeze in a young child should make you
think of an inhaled foreign body. This cannot always be seen on X-ray, however
you can sometimes see associated collapse.
3. D - lack of wheeze (silent chest) is worrying sign in asthma. It is
important to learn the difference between different severities of acute asthma.
In life threatening asthma as well as initiating treatment for acute asthma it
is also vital to get anaesthetics involved as early as possible.
4. F - most often in children under 2yrs and caused by the virus RSV.
Treatment is supportive. Antibiotics are only useful if superimposed bacterial
infection is suspected.
5. D - minor trauma, fever and a red, hot swollen joint all point towards
septic arthritis.
6. F - perthes disease, 4:1 ratio of boys to girls. Most often occurs
between 4-8yrs. Symptoms of limp and pain in the hip/groin (sometimes referred
to the knee) come on gradually. This is caused by the femoral head losing some
of it's blood supply causing some of the bone cells to die.
7. F - Menorrhagia + low Hb + low MCV should make you think of iron deficiency anaemia
8. J - Sweating, weight loss and diarrhoea, and a low TSH should make you thing of hyperthyroidism. Over production of thyroid hormones, leads to the negative feedback system releasing a low amount of thyroid stimulating hormone.
9. H - Classical history for polycythaemia
10. D - No known HLA association with Type II Diabetes
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