2014 Flashcards
6 risk factors for stroke
a. Hypertension
b. Atrial fibrillation
c. Smoking
d. Hypercholesterolemia
e. Diabetes
f. Hereditary
Patient on amoxicillin for acute otitis media, metformin for Type 2 Diabetes ,
carbamazepine and selegiline. Which drug caused ataxia and nystagmus in patient?
Carbamazepine
How does grapefruit juice affect carbamazepine?
Grapefruit juice would increase the amount of drug the body absorbs which may lead to drug toxicity. Several organic compounds found in grapefruit and specifically in grapefruit juice exert inhibitory action on drug metabolism by the enzyme.
Mechanism of action for selegiline as an anti-depressant:
Selegiline is a selective inhibitor of MAO-B; MAO-B metabolizes dopamine and phenylethylamine. Increased dopamine levels reduce symptoms of depression.
What is another therapeutic use for selegiline?
As an anti-parkinsonian drug
Why is regular CBC necessary for patients on carbamazepine?
risk of agranulocytosis
Why is regular CBC necessary for patients on carbamazepine?
risk of agranulocytosis
Picture of catalase test, gram +ve cocci in clusters.
Name orgamism: Staphylococcus aureus
Give 3 organisms that can cause osteomyelitis:
a. E. Coli
b. Staphylococcus aureus
c. Haemophilus Influenzae
Why do the bacteria affect the metaphysis?
In adults, with closure of the growth plate, infection is mainly in the metaphysis. Because the growth plate is closed, the blood vessels become looping (hairpin loop). These large blood vessels gradually become narrow at the end causing stasis of the blood. Due to stasis, we have exudates which result in a focus of infection.
Which organism causes osteomyelitis in Sickle cell anaemia patients?
Salmonella species
Name the complication of chronic osteomyelitis as seen in the picture:
Maybe pathologic fracture or Epidermoid carcinoma of the fistula.
List 4 other complications of osteomyelitis:
a. Altered bone growth
b. Septic arthritis
c. Osteonecrosis
d. Skin cancer
Name 4 types of fractures:
a. Oblique
b. Comminuted
c. Spiral
d. Compound
List 3 broad categories of wound healing:
a. Procallus
b. Fibrocartilaginous callus
c. Osseous callus
List 5 complications of impaired wound healing:
a. Delayed union
b. Mal-union
c. Fibrous union
d. Non union
e. Soft tissue injury
Patient has osteoporosis. List 3 other metabolic diseases of bone:
a. Osteitis fibrosa cystica
b. Osteomalacia
c. Paget’s disease
Patient has osteoporosis. List 3 other metabolic diseases of bone:
a. Osteitis fibrosa cystica
b. Osteomalacia
c. Paget’s disease
List three broad categories of wound healing
A. Procallus
B. Fibrocartilaginous callus
C. Osseous callus
List 5 complications of impaired wound healing:
a. Delayed union
b. Mal-union
c. Fibrous union
d. Non union
e. Soft tissue injury
Patient has osteoporosis. List 3 other metabolic diseases of bone:
a. Osteitis fibrosa cystica
b. Osteomalacia
c. Paget’s disease
State whether calcium, phosphate and ALP will be normal, low or high:
a. Calcium: normal
b. Phosphate: normal
c. ALP: normal
What’s the role of oestrogen in osteoporosis pathogenesis in menopausal women?
Cytokines recruit osteoclasts to take part in bone resorption. Oestrogen decreases cytokine levels thereby reducing osteoclast recruitment and bone resorption. In menopause, there isn’t any oestrogen to do this and thus, there is increased bone resorption causing osteoporosis.
Name the virus and pathognomic cell seen in Hodgkin’s lymphoma (classical) and Adult T- cell Lymphoma/Leukaemia:
a. Hodgkin’s lymphoma (classical): Reed-Steenberg Cells/ EBV b. Adult T-cell lymphoma/leukaemia: Convoluted lymphocytes/ HTLV1 retrovirus
Comment on the CBC of a patient with normal PT/APTT, reverse neutrophil/lymphocyte ratio, anaemia, thrombocytopenia, leucopenia, neutropenia, etc.
Patient has aplastic anaemia
What blood products would you give this patient?
a. Packed red cells
b. Platelets
What are 2 specific uses of flow cytometry in leukaemia and lymphomas?
a. Determination of surface antigen on cells
b. Distinguish acute myeloid leukaemia from acute lymphoblastic leukaemia
What is the best site for BMAT?
The iliac crest of the pelvic bone
What is the best site for BMAT?
The iliac crest of the pelvic bone
What other test can be performed on the bone marrow aspirate to confirm AML?
Cytogenic studies
What are 5 risk factors of AML?
a. Age (median age 70 years)
b. Ethnicity (Caucasian)
c. Sex (males)
d. Exposure to radiation
e. Smoking
What are 4 features of lymphadenopathy?
a. >2cm (malignant), <2cm (benign)
b. Hard, firm and rubbery consistency
c. Fixed (malignant), Mobile (benign)
d. Usually non-tender (malignant), tender (benign)
Which organ is examined to determine organomegaly?
Spleen
Name 2 tests that will help you stage the lymphoma:
a. Chest Xray
b. PET scanning
What would you put in the lymph node biopsy to fix it?
Formalin
Neutrophil production:
Committed stem cell
Myeloblast
Promyelocyte
Metamyelocyte
Band neutrophil
Mature segmented neutrophil
What are 2 tests to determine the histocompatibility for BMT/SCT
a. Blood group typing and crossmatching
b. Detection of autoantibodies
Gell and Coomb’s Type 4 Hypersensitivity:
Delayed-type hypersensitivity, cell-mediated immune memory response, antibody- independent. Helper T cells (specifically Th1 helper t cells) are activated by an antigen presenting cell. When the antigen is presented again in the future, the memory Th1 cells will activate macrophages and cause an inflammatory response. This ultimately can lead to tissue damage.
What is the pathogenesis of GvHD?
GVHD is an immune-mediated disease resulting from a complex interaction between donor and recipient adaptive immunity. The main effectors are donor T cells, which are activated in the presence of co-stimulatory molecules by a storm of proinflammatory cytokines. Chronic GVHD is a syndrome that mimics the autoimmune diseases. Donor T cells play an important role in its development, but humoral immunity is also implicated. The targets of attack may include host non- HLA antigens like minor histocompatibility antigens. In some studies, host dendritic cells may also be at play. A close relationship exists between the development of chronic GVHD and a helpful graft-versus-tumor/leukemia effect.
Name one specific way the donor could reduce the effect:
. Antithymocyte globulin
Kidney transplant rejected within 8 hours. Name the type of transplant and the mechanism by which it occurs:
a. Hyperacute rejection
b. Preformed anti-HLA antibodies
