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2020 Paper Path Flashcards

1
Q

Which type of necrosis is associated with a MI?

A

c) Coagulative necrosis

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2
Q

25 year old with acute leukaemia requires an allogeneic haematopoietic stem cell transplant. She is mixed Afro-Carribean and European heritage, and has one sibling. What is the chance of the sibling being HLA identical?

A

1:4

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3
Q

Which of the following decreases during pregnancy?
a) Von Willebrand factor
b) Protein S
c) Plasminogen activator inhibitor 1
d) Fibrinogen
e) Factor VIII

A

Protein S

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4
Q

In obstetric practice, the maximum risk of fatal maternal thrombo-embolism occurs at which stage of pregnancy?

A

Post partum

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5
Q

93) Acute GvHD post-allogenic haematopoietic stem cell transplant is mediated by which cell type?

A

Donor T cells

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6
Q

55 year old man started on therapy with DOAC rivaroxaban. What advice would you give regarding monitoring whilst on treatment?

A

No monitoring required

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7
Q

75 year old woman has neutropenic sepsis secondary to myelodysplasia. Her blood count is lower than it was 6 weeks ago, with marked panyctopaenia. Blood film shows numerous large cells of primitive appearance. What is the likely explanation?

A

Progression to AML

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8
Q

55 year old male smoker, on long term frusemide. Investigations - high Hb, high Hct, normal red cell mass. Plasma volume is low. What is the most likely diagnosis?

A

Reactive polycythaemia (pseudo polycythaemia)

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9
Q

Bleeding patient has prolonged APTT and PT, but normal platelet count and normal fibrinogen. What is the most suitable blood component for treatment?
a) Albumin
b) Anti-D
c) Cryoprecipitate
d) Fresh frozen plasma
e) Platelets

A

Fresh frozen plasma

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10
Q

Elderly woman has fever and productive cough in GP. She has pleural rub. Spleen is not palpable, no lymphadenopathy. Her WBC is 15x10^9 with neutrophilia. The Hb concentration is slightly low and platelet count is normal. Blood film - toxic granulation, left shift. CRP is high. What is the diagnosis?
a) AML
b) Aplastic anaemia
c) CML
d) Infectious mononucleosis
e) Reactive neutrophilia

A

Reactive neutrophilia

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11
Q

Describe imatinib

A

An ABL1 tyrosine kinase inhibitor

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12
Q

101) Palpable lymph node in the left supraclavicular fossa in a gastric cancer patient is referred to as?

A

Virchow node

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13
Q

102) What is the most common ovarian tumour?
a) Serous mucinous cystadenocarcinoma
b) Serous cystadenoma
c) Mucinous cystadenoma
d) Mucinous cystadenocarcinoma
e) Brenner tumour

A

Serous cystadenoma

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14
Q

103) An extradural (epidural) haemorrhage is due to damage to which blood vessel/vascular lesion?
a) Middle meningeal artery
b) Middle cerebral artery
c) Internal carotid
d) Bridging veins
e) Berry aneurysm

A

Middle meningeal artery

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15
Q

104) Which virus is associated with the development of nasopharyngeal carcinoma?
a) EBV
b) HBV
c) HHV-8
d) HPV-16
e) HCV

A

EBV

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16
Q

105) Pulmonary oedema due to liver disease is an example of which type of cause of pulmonary oedema?
a) Lymphatic obstruction
b) Indirect injury to alveolar wall
c) Increased hydrostatic pressure
d) Direct injury to alveolar wall
e) Decreased osmotic pressure

A

Increased hydrostatic pressure

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17
Q

106) What is the commonest cause of adult ARDS?
a) Sepsis
b) Trauma
c) Pancreatitis
d) Drug reaction
e) Aspiration

A

Sepsis

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18
Q

107) Which is the commonest glial cell in the CNS?
a) Oligodendrocytes
b) Microglia
c) Ependymal cells
d) Endothelial cells
e) Astrocytes

A

Astrocytes

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19
Q

108) What is the most common cause of mitral valve stenosis?
a) Systemic lupus
b) Rheumatic heart disease
c) Pulmonary hypertension
d) Infective endocarditis
e) Congenital

A

Rheumatic heart disease

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20
Q

What is the inheritance of genetic haemochromatosis?

A

Autosomal recessive

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21
Q

110) Which is the commonest cause of pancreatitis in adults? [Q did not specify acute or chronic]

A

Gallstones

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22
Q

111) Brain tumour which most commonly occurs near the surface of the brain and is frequently asymptomatic is most likely to be?

A

Meningioma

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23
Q

112) In IVDU, which valve is characteristically associated with infectious endocarditis?
a) Aortic valve
b) Prosthetic valve
c) Pulmonary valve
d) Mitral valve
e) Tricuspid valve

A

Tricuspid valve

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24
Q

113) Which is the most common skin cancer?
a) Keratoacanthoma
b) Melanoma
c) Metastatic cancer
d) Squamous cell carcinoma
e) Basal cell carcinoma

A

Basal cell carcinoma

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25
Q

Which of the following is NOT normally associated with a diagnosis of multiple myeloma?
a) Anaemia
b) Humoral immune dysfunction
c) Osteolytic bone lesions
d) Renal impairment
e) Splenomegaly

A

Splenomegaly

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26
Q

114) 25 year man is in A&E with abdominal pain and having collapsed, he had a low blood pressure and was in shock. Blood results - low sodium, high potassium, low HCO3-, slightly high urea, high creatinine, slightly low glucose [blood gases were also listed but can’t remember them]. What is the likely diagnosis?
a) Addison’s disease
b) Conn’s syndrome
c) Diabetic ketoacidosis
d) Acute abdomen
e) Cushing’s syndrome

A

Addison’s disease

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27
Q

115) 25 year man is in A&E with abdo pain and having collapsed, he had a low blood pressure and was in shock. Blood results - low sodium, high potassium, low HCO3-, slightly high urea, high creatinine, slightly low glucose [blood gases were also listed but can’t remember them]. What is the cause of his electrolyte abnormalities?
a) Renal loss of sodium
b) Vomiting
c) Renal failure
d) Perforated appendix
e) Dehydration

A

Renal loss of sodium

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28
Q

116) 60 year old man with BMI of 28 has abdo pain. His LFTs - high total BR, high ALP, high ALT, high AST, high GGT, high creatine kinase. What is the most likely diagnosis?
a) Acute pancreatitis
b) Viral hepatitis
c) Alcoholic cirrhosis
d) Haemolytic jaundice
e) Obstructive jaundice due to gallstones

A

Obstructive jaundice due to gallstones

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29
Q

117) Which of the following can cause hypoglycaemia?
a) Atorvastatin
b) Bendrofluazide
c) Glucagon
d) Prednisolone
e) Quinine

A

Quinine

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30
Q

ncreased insulin sensitivity results in low plasma glucose and occurs in which of the following?
a) PCOS
b) Phaeochromocytoma
c) Cushing’s disease
d) ACTH deficiency
e) Acromegaly

A

ACTH deficiency

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31
Q

119) Which one of the following is correct in a patient with moderate alcohol intake?
a) Elevated HDL
b) AST is nearly normal
c) Normal GGT
d) Normal triglycerides
e) Reduced albumin

A

Elevated HDL

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32
Q

Clinical features of hypercalcaemia include which one of the following?
a) Polyuria and polydipsia
b) Tetany
c) Hypotension
d) Diarrhoea
e) Easy bruising

A

Polydipsia and polyuria

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33
Q

122) 40 year old woman has post-partum haemorrhage, unable to breastfeed. Investigations - low cortisol, low ACTH, low prolactin, normal TSH, normal T4. What is the likely diagnosis?
a) Acromegaly
b) Non-functioning pituitary macroadenoma
c) Prolactinoma
d) TSHoma
e) Hypopituitarism

A

Hypopituitarism

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34
Q

123) 25 year man is in A&E with abdo pain and having collapsed, he had a low blood pressure and was in shock. Blood results - low sodium, high potassium, low HCO3-, slightly high urea, high creatinine, slightly low glucose [blood gases were also listed but can’t remember them]. What is the likely diagnosis?
a) Metabolic acidosis
b) Metabolic alkalosis
c) Respiratory acidosis
d) Respiratory alkalosis
e) Compensated respiratory acidosis

A

Metabolic acidosis

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35
Q

Potassium level in metabolic alkalosis

A

Low

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36
Q

Which of the following is found in obstructive jaundice
a) There is increased bilirubin in urine
b) The stools are dark
c) GGT is usually normal
d) AST is usually normal
e) ALP is usually normal

A

There is increased billirubin in the urine

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37
Q

125) Which of the following is found in haemolytic jaundice
a) Bilirubin is normal
b) AST is raised
c) CK is raised
d) The stools are pale
e) There is increased urobilinogen in urine

A

Increased urobilinogen in urine

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38
Q

126) Which of the following binds to receptors in the adrenal and stimulates aldosterone release?
a) Angiotensin 2
b) ACTH
c) Renin
d) Sodium
e) Calcium

A

Angiotensin 2

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39
Q

127) 40 year old woman has a headache and bitemporal hemianopia. MRI shows 2cm pituitary macroadenoma. Investigations - normal cortisol, normal ACTH, high prolactin of 1400, normal TSH, normal T4. What is the likely diagnosis?
a) Acromegaly
b) Non-functioning pituitary macroadenoma
c) Prolactinoma
d) TSHoma
e) Hypopituitarism

A

Non-functioning pituitary macroadenoma

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40
Q

128) Which type of vaccine should not given to immunosuppressed individuals
a) Vaccine containing lipid adjuvant
b) Toxoid
c) Subunit
d) Live attenuated
e) Conjugate

A

Live attenuated

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41
Q

129) In a histology slide showing antibody mediated rejection of a renal allograft, where is the inflammatory infiltrate seen?
a) Capillaries
b) Capsule
c) Interstitium
d) Tubules
e) Adipose tissue

A

Interstitium

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42
Q

130) Which of the following is a mixed pattern auto-inflammatory auto-immune disease characterised by sacroiliac joint inflammation
a) Ankylosing spondylitis
b) Osteitis condensans illi
c) Osteoarthritis
d) Rheumatoid arthritis
e) Gout

A

Ankylosing spondylitis

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43
Q

131) Routine of a HIV patient should include testing for which leukocyte subset?
a) CD8 T-cells
b) CD4 T-cells
c) B-cells
d) Monocytes9
e) NK cells

A

CD4 T cells

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44
Q

132) Conjugate vaccine of polysaccharide and protein carrier may be used to enhance B-cell immunity to which of the following?
a) HIV
b) TB
c) Rabies
d) Streptococcus pneumoniae
e) Vibrio cholerae

A

Streptococcus pneumoniae

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45
Q

133) 21-year-old woman has joint pain, rashes, fevers, pleuritic chest pain. Blood tests - high ESR, low CRP, high ANA titre, positive dsDNA antibody, low C3 level, low C4 level. What is the likely diagnosis?
a) SLE
b) Systemic sclerosis
c) Lyme arthritis
d) Granulomatosis with polyangiitis
e) Dermatomyositis

A

SLE

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46
Q

Development of auto-antibodies specific for gastric parietal cells is associated with which disease?
a) T1D
b) Rheumatoid arthritis
c) Multiple sclerosis
d) Graves’ disease
e) Pernicious anaemia

A

Pernicious anaemia

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47
Q

135) Gel and Coombs type III hypersensitivity is mediated by which of the following mechanisms?
a) Activation of complement by antibody binding to cellular antigen
b) Cytotoxic T-cell mediated cell destruction
c) Activation of pre-existing IgE bound to antigen
d) Deposition of antibody-antigen complexes in blood vessel walls
e) Modulation of cell function by antibody binding to cell surface receptor

A

Deposition of antibody-antigen complexes in blood vessel walls

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48
Q

ailure to regulate cryopyrin driven activation of neutrophils is characteristic of which of the following diseases?
a) Auto-immune lymphoproliferative syndrome (ALPS)
b) Behcet’s disease
c) Familial Mediterranean fever
d) Microscopic polyangiitis
e) Ulcerative colitis

A

Familial Mediterranean fever
Treat with colchicine

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49
Q

Which of the following monoclonal antibody therapies enhances T-cell immunity and is used in management of some malignancies?
a) Infliximab (anti-TNFalpha)
b) Pembrolizumab (anti-PD1)
c) Rituximab (anti-CD20)
d) Tocilizumab (anti-IL6R)
e) Ustekinumab (anti-IL12/23)

A

Pembrolizumab (anti-PD1)

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50
Q

138) Which one of the following agents is effective as a biological disease modifying anti-rheumatic drug (b-DMARD) as part of rheumatoid arthritis management?
a) Adalimumab (anti-TNFalpha)
b) Basiliximab (anti-CD25)
c) Denosumab (anti-RANKL)
d) Pembrolizumab (anti-PD1)
e) Secukinumab (anti-IL17A)

A

Adalimumab

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51
Q

139) Which one of the following is a standard immunosuppressive regimen for patients who received an allograft?
a) Azathioprine, mycophenolate mofetil, prednisolone
b) Cyclophosphamide, methotrexate, rituximab
c) Cyclosporine, rapamycin, tacrolimus
d) Mycophenolate mofetil, prednisolone, tacrolimus

A

Mycophenolate mofetil, prednisolone, tacrolimus

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52
Q

140) Which of the following exists in an immature form in the periphery where they recognise pathogens, and then mature and become adapted for presenting antigen to T-cells in lymph nodes
a) B-cells
b) Dendritic cells
c) Eosinophils
d) Erythrocytes
e) Plasma cells

A

Dendritic cells
CCR7 is an important cytokine in trafficking DCs

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53
Q

141) Which of the following immune-mediated diseases may respond to treatment with plasmapheresis?
a) Ankylosing spondylitis
b) Goodpasture syndrome
c) IgA vasculitis
d) Sjogren’s syndrome
e) Takayasu’s arteritis

A

Goodpasture syndrome

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54
Q

142) 72-year-old man is a close household contact of someone recently diagnosed with smear positive pulmonary TB. What is his lifetime risk of developing TB?
a) 0.1%
b) 1%
c) 10%
d) 50%
e) 90%

A

10%

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55
Q

143) 72 year old man has returned from a 7 day holiday in Italy. He has signs of pneumonia and Legionella urinary antigen is positive. Which of the following antibacterials is the most appropriate initial therapy?
a) Azithromycin
b) Amoxicillin
c) Ceftriaxone
d) Co-trimoxazole
e) Meropenem

A

Azithromycin

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56
Q

What type of pneumonia can be picked up by urinary antigen testing?

A

Legionella

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57
Q

144) Which hepatitis virus is associated with more severe disease if acquired in pregnancy potentially leading to fulminant hepatic failure and death?
a) Hepatitis A
b) Hepatitis B
c) Hepatitis C
d) Hepatitis D
e) Hepatitis E

A

Hepatitis E

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58
Q

145) Which of the following serological tests is useful in the diagnosis of invasive Candida albicans infections?
a) Beta-D-Glucan
b) Galactomannan
c) RFR
d) TPPA
e) Widal test

A

Galactomannan

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59
Q

146) Infants under 12 months should not be fed honey due to an increased risk of food poisoning caused which of the following organisms?
a) Campylobacter jejuni
b) Clostridium botulinum
c) Escherichia coli 0157
d) Salmonella typhi
e) Vibrio cholerae

A

Clostridium botulinum

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60
Q

147) 45 year old woman has 2-day history of fever and headache. She returned 5 days ago from a 2 week visit to Ghana. She initially thought she had a cold but her partner brought her in as she is now drowsy and confused. GCS is 11, temperature is 39.1 degrees, HR is 108 bpm, BP is 90/60. Malaria rapid diagnostic test is positive and parasitemia is 10%. Which of the following is the most appropriate initial antimalarial therapy?
a) IV artesunate
b) IV quinine
c) Oral artemether and lumefantrine
d) Oral atovaquone and proguanil
e) Oral mefloquine

A

IV artesunate

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61
Q

148) Which of the following antivirals is used for chronic hepatitis B treatment?
a) Aciclovir
b) Oseltamivir
c) Tenofovir
d) Zanamivir
e) Ribavirin

A

Tenofovir

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62
Q

149) Streptobacillus moniliformis is the causative organism of which of the following infections?
a) Bacillary angiomatosis
b) Lyme disease
c) Q fever
d) Rat bite fever
e) Syphilis

A

Rat bite fever

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63
Q

150) What is the commonest form of prion disease?
a) Fatal familial insomnia
b) Iatrogenic Creutzfeldt-Jakob disease
c) Kuru
d) Sporadic Creutzfeldt-Jakob disease
e) Variant Creutzfeldt-Jakob disease

A

Sporadic Creutzfeld-Jakob disease

64
Q

Middle aged man has pruritus, and has an emergency thrombotic cerebrovascular accident. He has a high Hb, and JAK2 V617F mutation. What is the likely diagnosis?

A

Polycythaemia vera

65
Q

Fatigue and mild jaundice, has spherocytes on blood film. Coombs test positive. Likely diagnosis?

A

Autoimmune haemolytic anaemia

66
Q

Which coagulation factor falls most rapidly after starting warfarin?

A

7

67
Q

What factors does warfarin inhibit?

A

2,7,9,10

68
Q

Young woman requires therapeutic anticoagulation during the 1st trimester of pregnancy. Which anticoagulant should be given?

A

Low molecular weight heparin

69
Q

Imatinib is used for what leukaemia?

A

Chronic myeloid leukaemia

70
Q

Man has fatigue and back pain. Blood results show - high creatinine, low IgG, low IgM, no paraprotein detected (via electrophoresis), low serum kappa light chains, high lamda light chains, low kappa/lamda ratio. What is the likely diagnosis?

A

Amyloidosis

71
Q

Woman has chest pain, SOB, persistent swelling in neck. Large mass in supraclavicular fossa is biopsied - malignant cells with reactive fibrosis and high eosinophils [exact pictures below were included in question]. What is the likely diagnosis?

A

Hodgkin lymphoma (look for reed sternberg cells, which have more than one nucleus)

72
Q

Pregnant women given misoprostol to induce labour. She suddenly has severe shivers, clammy skin, vomiting. Observations - high HR, low BP. Blood results - INR of 1.9, high APTT, low fibrinogen, high D-dimers. What is the most likely obstetric event?

A

DIC

73
Q

At what temperature can platelet transfusions be stored?

A

Room temperature - most likely to have microbes in

74
Q

Pregnant women has amniocentesis, she is group O-ve. What therapeutic intervention is required?

A

Anti-D

75
Q

Woman is group A-ve. She has had two previous pregnancies. What naturally occurring antibody will be present in her blood?

A

Anti-B

76
Q

Infants with sickle cell disease (HbSS) may have splenic sequestration. Why does this not occur before 3 months of age?

A

Newborns have high levels of protective fetal hemoglobin

77
Q

Venetoclax is a BCL2 inhibitor used in CLL. What cellular process does it affect?

A

Inhibits anti apoptotic proteins

78
Q

Old woman with painless lymphadenopathy. Blood results - normal Hb, normal neutrophils, normal platelets, high lymphocytes. Smear cells present. Lymphocytes are CD5+ve and CD19+ve.

A

CLL

79
Q

Man has returned from India. Whilst abroad, he has malaise and jaundice which self-resolved. He now has fatigue and easy bruising. Blood results - low Hb, normal MCV, low reticulocytes, low WCC, low neutrophils, normal lymphocytes, low platelets. What is the likely diagnosis?

A

Aplastic anaemia due to malarial infection

80
Q

Commonest primary tumour of the heart?

A

Atrial myxoma

81
Q

Most likely cause of mobile mass in young woman’s breast?

A

Fibroadenoma

82
Q

Commonest histological type of primary malignant breast cancer?

A

Invasive ductal carcinoma

83
Q

What type of emphysema is associated with smoking

A

Centriacinar emphysema

84
Q

What is the commonest cause of constrictive pericarditis in the developing world?

A

TB

85
Q

What is the most common cause of nephrotic syndrome in adults that is a glomerular pathology

A

Focal segmental glomerular sclerosis

86
Q

What is the commonest cause of portal vein thrombosis?

A

Cirrhosis

87
Q

Which organism that causes pneumonia and bloody sputum that is associated with alcoholics and diabetics?

A

Klebsiella pneumoniae

88
Q

A dysgerminoma is a type of tumour that affects the ovary. What is the equivalent tumour type in the testes?

A

Seminoma

89
Q

What is the most common histological type of oesophageal cancer in the UK?

A

Adenocarcioma.
Rest of world = SCC

90
Q

Intestinal metaplasia in Barrett’s (columnar-lined) oesophagus is most commonly due to the presence of which cell?

A

Goblet cells

91
Q

Which vascular tumour is associated with infection by HHV8

A

Kaposi sarcoma

92
Q

What is the commonest cause of myocarditis?

A

Viruses eg. influenza

93
Q

Raised AMA antibodies are characteristic of which liver disease?

A

Primary biliary cirrhosis

94
Q

What condition are anti-smooth muscle antibodies associated with?

A

autoimmune hepatitis

95
Q

Which virus characteristically causes encephalitis involving the temporal lobes?

A

Herpes simplex virus 1 (HSV 1)

96
Q

What is the most common cause of hypocalcaemia in the community?

A

Hypoalbuminaemia

97
Q

Which liver enzyme can be measured in the blood and specifically suggests obstructive jaundice if levels are raised?

A

Alkaline phosphatase

98
Q

Addison’s patient is admitted in adrenal crisis. Her BP is low. What fluid should be given?

A

IV 0.9% saline

99
Q

Which adrenal zone produces cortisol?

A

Fasciculata

100
Q

Which adrenal zone produces aldosterone?

A

Glomerulosa

101
Q

Which adrenal zone produces androgens?

A

Reticularis

102
Q

What does the adrenal medulla produce?

A

Catecholamines - adrenaline and noradrenaline

103
Q

Woman has neck pain, which radiates to the upper neck and jaw. Pain is worse on swallowing. She has PMHx of URTI two weeks ago. Investigations - high T4, high T3, low TSH. Technetium scanning of thyroid shows low uptake. What is the likely cause of hyperthyroidism?

A

De Quervain’s/viral thyroiditis

104
Q

What condition occurs in both MEN1 and MEN2a?

A

Parathyroid adenoma/hyperplasia

105
Q

What enzyme does allopurinol inhibit?

A

Xanthine oxidase

106
Q

What vitamin deficiency causes pellagra?

A

Vitamin B3 (nicacin)
Dementia, dermatitis,
Beads around the neck

107
Q

Which hormone increases urinary phosphate excretion?

A

Parathyroid hormone

108
Q

Alcoholic has severe abdominal pain, rigid abdomen - he has acute pancreatitis. What blood test will confirm the diagnosis?

A

Amylase

109
Q

What active enzyme in sarcoidosis patients causes hypercalcaemia?

A

1-alpha hydroxylase

110
Q

What is the commonest cause of hypercalcaemia in the community?

A

Parathyroid adenoma

111
Q

What hormone is produced by fat cells, and has receptors in the hypothalamus?

A

Leptin

112
Q

Deficiency of which plasma protein occurs in patients with liver disease and a movement disorder?

A

Caeruloplasmin

113
Q

Patient has hypertension. Blood results - normal sodium, low potassium, normal urea, normal creatinine, raised aldosterone, renin suppressed. What is the diagnosis?

A

Conn’s

114
Q

Patient has hypertension. Blood results - normal sodium, low potassium, normal urea, normal creatinine, raised aldosterone, renin high. What is the diagnosis?

A

Renal artery stenosis

115
Q

Chronic infection in CF?

A

Chronic infection with Burkholderia cepacia is an important CF-specific contraindication to lung transplantation

116
Q

What is the name for a fully differentiated B-cell that produces antibody?

A

Plasma cell

117
Q

What condition involves the upper and lower airways and kidneys, and is ANCA positive with cytoplasmic staining and is specific for proteinase 3?

A

Wegener’s glomerulonephritis/
Granulomatosis with Polyangiitis

118
Q

Which condition is caused by reactivation of human polyoma virus 2 (John Cunningham (JC) virus) in immunosuppressed people?

A

Progressive multifocal leukcoencephalopathy

119
Q

Which drug should be given as an immediate IM injection to an individual presenting with acute anaphylaxis?

A

Adrenaline

120
Q

Patient has periodic fevers and is found to have a mutation in MEFV. What is the condition?

A

Familial mediterranean fever

121
Q

A woman has Graves’ disease. What antibody should be tested?

A

Anti-TSH receptor antibodies

122
Q

Doctors should measure the level/activity of which enzyme before prescribing azathioprine?

A

Thiopurine methyltransferase (TPMT)

123
Q

Child with recurrent bacterial and fungal infections. A dihydrorhodamine test shows that neutrophils fail to oxidise dihydrorhodamine. What is the likely diagnosis?

A

Chronic granulomatous disease

124
Q

64) Which isotype of antibody is involved in allergies to food and insect venom?

A

IgE

125
Q

5 month baby has failure to thrive and recurrent infections. Investigations - mutation affecting IL2RG gene, which encdoes IL2 common gamma chain. What is the diagnosis?

A

SCID

126
Q

CAR T-cells are engineered to bind to CD19. They have immunoglobulin variable fragments to CD19 linked to cytoplasmic T-cell activation domains. They are effective in treating haem malignancies of which cell type?

A

B cell leukaemias

127
Q

In bare lymphocyte syndrome which affects the HLA class II transactivator, which type of immune cell will be deficient?

A

CD4 T cells

128
Q

68) Mutation of CD40 ligand is associated with which form of primary immunodeficiency?

A

Hyper IgM syndrome

129
Q

Denosumab is a monoclonal antibody specific for RANKL. What condition is it used to treat?

A

Osteoporosis

130
Q

Woman with iron deficiency anaemia is found to have IgA antibodies specific for tissue transglutaminase. What is the underlying condition?

A

Coeliac disease

131
Q

Which class of antibiotics has concentration dependent killing (i.e. the goal of therapy is to maximise peak > MIC)

A

Aminoglycosides

132
Q

Man has recently returned from trip to India, has high fever and abdominal pain but no diarrhoea. His blood cultures - gram-ve bacilli. Malaria rapid diagnostic test is -ve. What is the most appropriate antibiotic therapy?

A

IV ceftriaxone then PO azithromycin (assuming its typhoid)

133
Q

What feature of the MMR vaccine makes it contra-indicated in pregnancy?

A

Live atenuated

134
Q

Elderly woman has 24 hour history of headache, confusion, photophobia, fever. Gram stain of CSF shows gram+ve rods. What is the causative organism?

A

Listeria monocytogenes

135
Q

75) Which human herpes virus is associated with post transplant lymphoproliferative disorder?

A

Epstein Barr Virus

136
Q

This vaccine preventable disease causes headache, fever, parotid swelling (unilateral or bilateral). Complications include epididymo-orchitis in postpubertal males and more rarely meningitis. What is the causative organism?

A

Mumps virus

137
Q

Woman has hot, swollen and painful left knee. Gram stain of joint aspirate - gram +ve cocci in clusters. Patient has no drug allergies and MRSA screen is -ve. What narrow spectrum antibiotic is indicated?

A

Flucloxacillin

138
Q

Elderly woman has type 6 stool which is green and mucoid. She is on the 6th day of IV ceftriaxone. What is the likely causative organism?

A

Clostridium difficile

139
Q

Patient receiving chemotherapy for leukaemia. She has prolonged neutropenia and ongoing fever, raised inflammatory markers despite broad antibacterial therapy with meropenem and amikacin. CT scan shows multiple nodules with surrounding hypo-attenuation (halo sign). What is the most likely organism?

A

Aspergillus fumigatus

140
Q

Halo sign on CT?

A

Aspergillus fumigatus

141
Q

Young woman has severe headache, neck stiffness, fever. She is HIV+ve but is poorly compliant with medication, does not attend her appointments. She has yeasts in her CSF. What is the causative organism?

A

Cryptococcus neoformans

142
Q

Aid worker returns from camp in Yemen. He has profuse watery diarrhoea, which looks like water rice has been cooked in. He is very dehydrated. What is the likely cause of his diarrhoea?

A

Vibrio cholerae

143
Q

Infection with which virus in the first 20 weeks of pregnancy causes hydrops fetalis?

A

Parvovirus B19

144
Q

Poorly controlled person with T2DM has headache, sinus pain, periorbital oedema and orbital cellulitis. His symptoms have progressed rapidly. He has purulent discharge from his nose. ENT surgeons bring him to theatre as an emergency. What antifungal therapy should be started ASAP?

A

Amphotericin B

145
Q

4 year old goes on school trip to petting farm, later has bloody diarrhoea and HUS. What is the causative organism?

A

E-coli 0157:H7

146
Q

Young man has headache, neck stiffness and photophobia. He was not confused, did not have features of encephalitis. HSV1 was detected on PCR of CSF obtained from LP. What antiviral should be given?

A

Aciclovir

147
Q

3) Rank cancers as cause of death in UK men according to frequency with (1) being the most common
a) Lung
b) Colon
c) Head and Neck
d) Breast
e) Prostate

A

Lung (1)
Prostate (2)
Colon(3)
Head and Neck(4)
Breast (5)

148
Q

Describe the blood results in myelofibrosis

A

Normally anaemia. High WBC and platelets at time of presentation. Leucoerythroblastic blood film (tear drop cells).

149
Q

In severe bleeding, maintain the platelet count above what?

A

Above 50 x 109/l.

150
Q

In patients with multiple trauma, traumatic brain injury or spontaneous intracerebral haemorrhage maintain the platelet count above what level?

A

Above 100 x 109/l (2C)

151
Q

In patients with bleeding that is not considered severe or life-threatening, consider platelet transfusion if the platelet count is below what level?

A

Below 30 x 109/l (2C)

152
Q

Which joints are spared in RA?

A

RA spares the distal interpharangeal joints (DIPs) and the spine with the exception of the cervical spine

153
Q

What is Onycholysis?

A

When your nail separates from its nail bed. Seen in psoriasis.

154
Q

What bleeds in a subdural haematoma?

A

Bridging veins

155
Q

Treatment for Wilson’s disease?

A

Penicillamine

V Flashcards (17 decks)

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