2017 Flashcards
- After a lady receives a blood transfusion and platelets, she goes home and develops a rash all over [‘several hours later’]
Allergic reaction
- A man after a road traffic accident (Man vs Car) requires a 6 unit transfusion, and then becomes acutely breathless/SOB, with a fever and tachycardia
TRALI
- A Man has had (a diagnosis of) beta thalassemia since 13 months of age. (?and receives regular transfusions?). He presents to an outpatient clinic with malaise and erectile dysfunction
Haemosiderosis
- Alcoholic has an AAA repair, and several days later develops a fever, with low Hb, and jaundice.
Delayed transfusion reaction
- A Lady with myelodysplastic syndrome (MDS) requires regular monthly blood transfusions. 10 minutes after another transfusion (her latest transfusion), she becomes tachycardic, has transfusion site pain, and [hypertensive], what is the cause?
Febrile non-haemolytic transfusion reaction
- A teenage girl who when she goes cross country running gets an erythematous rash on her legs. It is well controlled by antihistamines
Cold urticaria
- Man can eat apple pie. But if he eats fresh apples and pears, he gets inflamed lips
Oral allergy syndroem
- Man has an allergic reaction during surgery and who’s lips becomes swollen/oedematous when blowing up balloons as his daughter’s birthday party
Type I latex allergy
- Bloated after drinking milk but not IgE mediated
Lactose Intolerance
- A girl with a sore throat is given penicillin and develops a rash. She is found to have EBV.
Drug Reaction
- Patient with high IgG paraprotein – (32 or 40) g/dl, back pain and loss of sensation in legs
Multiple Myeloma
- Patient with IgM paraprotein and visual disturbances
Waldenstroms Macroglobulinaemia
- A German lady who is asymptomatic, has low neutrophils, but no abnormal cells on film
Chronic Idiopathic Neutropenia
- A man is injured playing sports. He is found to have pancytopenia and immature myeloid cells on blood film. WCC normal.
AML
- An overweight individual with diabetes has longstanding bone/back pain. They are found to have paraprotein IgA ~8g/dl, and GFR 55mls/min/1.73m^2. FBC normal and albumin normal.
MGUS
Raised IgG proteins with somewhat deranged CRAB signs but not quite there yet
Smouldering Myeloma
Listeria meningitis treatment
Amoxicillin + Gentamycin
Mild CAP treatment
Amoxicillin
Strep Throat treatment
Benzylpenicillin
- Which/What cell sits in (it’s immature form in) the periphery, and when it matures, goes to present things to T cells?
Dendritic Cell
- Which/what cell is inhibited by the presence of MHC1 on cells?
NK Cells
- Which/What cell is increased in cases of a parasitic infection.
Eosinophils
- Which/What cell undergoes positive and negative selection in the thymus.
T lymphocytes
- When there is an infection. This cell is responsible for the production of pus (when it dies).
Neutrophils
- Most common type of malignancy in the breast?
DCIS
- Which/What cancer is also known as non-specific type?
Invasive ductal carcinoma
- Which/What cancer is associated with the presence of E cadherins?
Invasive ductal carcinoma
IF e-cadherins negative, invasive lobular carcinoma
- Breast Cancer which has a high, medium and low stage to it.
DCIS
- Fibro-epithelial tumour with abundant stromal elements.
Phylloides Tumour
boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG.
IFN gamma deficiency
Which of these options causes DIC (in pregnancy)?
ABO incompatibility Maternal idiopathic thrombocytopenia purpura Gestational thrombocytopenia Increased fibrinolysis Amniotic fluid embolism Low Plasma Volume Neutropenia MAHA Iron deficiency anaemia Complement C7 deficiency
Amniotic fluid embolism
Which of these is similar or has an association with HELLP syndrome?
ABO incompatibility Maternal idiopathic thrombocytopenia purpura Gestational thrombocytopenia Increased fibrinolysis Amniotic fluid embolism Low Plasma Volume Neutropenia MAHA Iron deficiency anaemia Complement C7 deficiency
MAHA
Normal change in pregnancy
ABO incompatibility Maternal idiopathic thrombocytopenia purpura Gestational thrombocytopenia Increased fibrinolysis Amniotic fluid embolism Low Plasma Volume Neutropenia MAHA Iron deficiency anaemia Complement C7 deficiency
Increased fibrinolysis
Cause of neonatal thrombocytopenia
ABO incompatibility Maternal idiopathic thrombocytopenia purpura Gestational thrombocytopenia Increased fibrinolysis Amniotic fluid embolism Low Plasma Volume Neutropenia MAHA Iron deficiency anaemia Complement C7 deficiency
ITP
Which/What cancer can the Bruton Tyrosine kinase inhibitor ibrutinib be used in?
a. Bruton’s
b. Chronic myeloid leukaemia (CML)
c. Acute myeloid leukaemia (AML)
d. Acute lymphoblastic leukaemia (ALL)
e. Chronic lymphoblastic leukaemia (CLL)
CLL
Rhesus D negative woman is having a Haematopoietic stem cell transplant (HSCT) and is CMV IgG negative. What is the most important thing to ensure in the transplant?
a. HLA of donor and recipient identical
b. Related to recipient and HLA identical
c. HLA haploidentical
d. CMV IgG negative
e. Donor not Rhesus match
CMV igG Negative
Which of these vaccines must not be given to a pregnant woman:
a. MMR
b. Hep B
c. DTP
MMR
There are 5 special drug treatments. Which drug can be used to treat some malignancies and affects T cell activity?
a. Infliximab
b. Pembrolizumab
c. Rituximab
Rituximab
Which of these is a common finding in someone who has portal hypertension?
a. Splenomegaly
b. Hepatomegaly
c. Spider Naevi in distribution of Superior vena cava (SVC)
d. Hand flapping
e. Jaundice
Portal Hypertension
A man has gout and is kept up at night by it. His symptoms are relieved by ibuprofen, but when he stops taking it, the symptoms come back. His neighbour is on allopurinol, and he would like to be on it too. Which of these medications would need to be altered for them to be able to be prescribed allopurinol?
Azathiprine
Cyclophosphamide
Methotrexate
Aspirin
Azathioprine
Woman over 25 years of age. In theatres you overhear a surgeon who says they have just found one of the most common malignant ovarian tumours: with psammoma bodies
Serous Cystadenocarcinoma
Man presents with ulcers on mouth following treatment with a drug, erythema multiforme but worse
stevens johnsons syndrome
Most common benign ovarian tumour
serous cystadenoma
Most common benign germ cell ovarian tumours in young women
Teratomas
Associated with pseudomyxoma peritonei
Mucinous cystadenocarcinoma
Benign cyst lined by mucin secreting epithelial tumour
Mucinous cystadenoma
Metastases from a gastrointestinal tumour resulting in a mucin-secreting signet-ring cell adenocarcinoma in the ovaries
Krukenburg tumour
germ cell tumour secreting AFP
yolk sac tumour
endometrial hyperplasia due to oestrogen secreting tumour
Granulosa cell tumour
ascites, pleural effusion and tumour in Meigs syndrome
Fibroma
- The wall of vessels expresses anti-thrombotic factors why is this?
a. Because it secretes Tissue factor
b. Because it secrete Thrombomodulin
c. Because it secretes Von Willebrand factor
Walls secrete thrombomodulin
Cushing disease person – Which is the best investigation to confirm the suspected diagnosis?
a. High dose dexamethasone suppression test
b. low dose dexamethasone suppression test,
c. long synacthen test
d. short synacthen test
High dose suppression
- Which vector transmits Trypanosoma brucei rhodesiense?
a. Anopheles mosquitoes
b. Sandfly
c. Tsetse Fly
d. Aedes
Tsetse
- Which of these ions (K, CL, Na, Mg, ,,,,,) is most likely to be outside it’s normal range in an alkalotic picture (& if person is urinating a lot????)?
a. Potassium
b. Calcium
c. Sodium
d. Magnesium
Sodium due to urinating a lot
- 50 year old man with Midshaft femur fracture – what would you find at the site of the break/fracture (or rather, which/what type of cancer does he have)?
a. Neuroblastoma,
b. Osteosarcoma
c. Ewing’s sarcoma
d. Chondrosarcoma
e. Adenocarcinoma
Chondrosarcoma
Because a is wrong. B and C affect young people. e is quite vague
HAP most common pathogen?
Staph Aureus
- Which feature is characteristic of acute lymphoblastic anaemia (ALL) –
a. anaemia and thrombocytopenia
b. neutropenia
c. macrocytosis
d. raised lymphocytes
Neutropenia
Acute Dialysis Indications
Acidosis Electrolyte imbalance Intoxicants Overload Uraemia
What does Denosumab target?
RANK-L receptor activator of nuclear factor kappa b ligand
A [woman or man] develops signs of hyperthyroidism. Bloods show low TSH and high thyroxine. Does not have good uptake on technetium scan. What is the likely diagnosis?
de qurvains thyroiditis
Good uptake on technetium scan and hyperthyroid
Grave’s disease
Which clotting factor falls most rapidly after administering warfarin?
VII
Both mother and grandmother had medullary thyroid carcinoma, and have tested positive for MEN2. What [biomarker/protein] would be raised in the blood to confirm medullary thyroid cancer?
Calcitonin
What drug is used to treat severe falciparum malaria?
Artesunate
Quinine maybe
An African man, with Burkitt’s lymphoma is given Rasburicase. He develops haematuria with irregularly contracted cells. What is the cause?
G6PDD
A patient required an aortic valve replaced 3 months ago. They have now come back a few weeks later with jaundice, Hb-urea (haemoglobinuria), and raised reticulocytes. What is the cause?
Haemolytic Anaemia
What cancer is present if keratin and intercellular bridges are present?
Squamous cell carcinoma
Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?
Psoriasis
Maybe RA
- What zoonotic disease does the Ixodes Tick cause?
Lyme disease
MECP2 mutation causes
Rett Syndrome
