A 39-year-old patient is taking phenelzine, a monoamine oxidase inhibitor, for the treatment of depression. Which one of the following foods can the patient safely eat?
A. Bovril
B. Cheese
C. Oxo
D. Eggs
E. Broad beans
A 49-year-old female was admitted to the emergency department with confusion. A history is unobtainable due to this confusion, with a Glasgow coma scale score of 13/15. Hospital records note a 2-month background of recurrent urinary tract infections (UTI’s) and recent admission for urosepsis. Her past medical history includes: Type 2 diabetes mellitus, hypertension, hypercholesterolaemia and a hiatus hernia.
On examination the patient is cool peripherally with a cap refill of 3 seconds, dry mucus membranes, heart sounds 1+2+0, vesicular breath sounds, abdomen was soft, but tender over the suprapubic area. There was no rigidity or guarding and bowel sounds were present.
Observations: Respiratory rate 16 breaths per minute, saturations 98% on air, blood pressure 80/58mmHg, heart rate 122 beats per minute, temperature 38.4ºC and capillary glucose 16 mmol/L.
Urine dip showed:
Nitrites +++
Leucocyte esterase +++
Blood +
Glucose +++
Ketones -
Protein -
Which medication is likely to contributing to the cause of her presentations?
A. Metformin
B. Tolbutamide
C. Dapaglifozin
D. Sitagliptin
E. Exanetide
A patient is started on the monoclonal antibody trastuzumab. What is the most likely indication?
A. Crohn’s disease
B. Chronic lymphocytic leukaemia
C. Renal cancer
D. Colorectal cancer
E. Breast cancer
What factors are raised in all interstitial lung disease
A. Acetylcholinestrase
B. RA factor
C. LDH
A 25-year-old Malaysian male was admitted to hospital asan emergency when he noticed that he was completely paralysed for two hours after waking from his sleep in the early hours of the morning. He had experienced this type of severe weakness on four occasions over the past few months, and remarked how they always occurred during sleep and on waking he could not move. He drank four units of alcohol every night. He had recently seen his GP for anxiety attacks and was being coun selled. He emigrated to England in 1994 and worked as a chef. He was single. All his family members were in Malaysia and were well.
On examination, he was thin; otherwise, physical examination was normal. Investigations are shown.
FBC Normal
Sodium 136 mmol/l, Potassium 2 mmol/l,
Urea 5 mmol/l
Bicarbonate 23 mmol/l
TSH <0.1 mu/l
Thyroxine 190 nmol/l
What is the most likely diagnosis?
a.Epilepsy.
b.Periodic paralysis.
c.Cataplexy.
d.Narcolepsy.
e.Brugada’s syndrome.
A 20-year-old woman gave birth to a full term baby who was floppy at birth and required resuscitation followed by assisted ventilation. The mother had ptosis, muscle weakness and bilateral cataracts. Her father also had premature cataracts.
What is the baby’s most likely diagnosis?
a. Galactosaemia.
b. Hypoparathyroidism.
c. Hypothyroidism.
d. Myasthenia gravis.
e. Myotonic dystrophy.