5/5 revision

Question 1

What is the first line treatment for UC?

Answer 1

5 aminosalicylic acid - Sulfasalazine

Question 2

What is the change in Barrett’s oesophagus?

Answer 2

Stratified squamous –> glandular columnar

Question 3

Name a H2 receptor antagonist

Answer 3

Ranitidine

Question 4

Which 2 antibodies are present in coeliac disease?

Answer 4

Anti-endomysial antibody

Tissue transglutaminase

Question 5

Give 5 signs of Coeliac disease

Answer 5

Anaemia
Osteoporosis
Chronic fatigue
Amenorrhoea
Infertility

Question 6

What is Duke’s staging used for and what are the stages?

Answer 6

Colorectal cancer
A - only in mucosa
B - extension through mucosa
C - regional lymph node involvement
D - distant mets

Question 7

Where is appendicitis pain felt?

Answer 7

McBurney’s point - 2/3 from umbilicus to anterior superior iliac spine

Question 8

Explain inflammatory diarrhoea

Answer 8

Blood / mucus in stool
Caused by cytotoxin producing / invasive bacteria
Eg. EHEC, C.difficile, Shigella, Salmonella, Campylobacter

Question 9

Explain non-inflammatory diarrhoea

Answer 9

Watery

ETEC, vibrio cholerae, viruses eg. norovirus

Question 10

What Abx would you give for C.difficile?

Answer 10

Metronidazole or vancomycin

Question 11

What Abx would you give for cholera?

Answer 11

Doxycycline

Question 12

Meningitis treatment

Answer 12

Cefotaxime
+amoxicillin if listeria monocytogenes
+dexamethasone if s.pneumoniae`

Question 13

Migraine treatment

Answer 13

Acute: NSAIDs, Triptans eg. rizatriptan
Prevention: Propanolol / Amitriptyline

Question 14

SAH treatment

Answer 14

Hydrate, BP >160, Nimodipine, CT angiography –> endovascular coiling

Question 15

MS pharmacological treatment

Answer 15

Methylprednisolone for relapses
Beta-interferons
Natalizumab (against VLA-4 receptors)
Baclofen for spasticity

Question 16

3 symptoms that indicate a patient does NOT have MS

Answer 16

Aphasia, hemianopia, muscle wasting

Question 17

Treatment for ischaemic stroke

Answer 17

Alteplase

Question 18

Treatment for partial seizures

Answer 18

Carbamazepine / lamotrigine

Question 19

Treatment for generalised seizures

Answer 19

Sodium valproate / lamotrigine

Question 20

S/E of sodium valproate

Answer 20

Teratogenic

Question 21

What might CSF electrophoresis show in MS?

Answer 21

Oligoclonal IgG bands

Question 22

What is the only disease modifying drug available for MND?

Answer 22

Riluzole - inhibits glutamate release

Question 23

Dementia treatment

Answer 23

Acetylcholine esterase inhibitors - rivastigmine

Question 24

Myasthenia gravis treatment

Answer 24

Acetylcholine esterase inhibitor - pyridostigmine

Relapses: prednisolone

Question 25

Parkinson's treatment

Answer 25

Dopamine agonist - ropinirole Monoamino-oxidase inhibitor - rasagiline L-dopa + co-careldopa (dopamine decarboxylase inhibitor)

Question 26

VSV treatment

Answer 26

Acyclovir

Question 27

Which antibodies are present in Myasthenia gravis?

Answer 27

Anti-ACh receptor antibodies | Muscle-specific tyrosine kinase (MuSK)

Question 28

TIA investigation

Answer 28

Carotid artery doppler US

Question 29

Cluster headache Tx

Answer 29

SC sumatriptan

Question 30

Cluster headache prevention

Answer 30

CCB - Verapamil Avoid alcohol Prednisolone

Question 31

Which liver tests indicate inflammation?

Answer 31

ALT and AST

Question 32

Which liver tests indicate biliary obstruction?

Answer 32

GGT (also high in alcoholic liver disease) and ALP | Bilirubin

Question 33

Which liver tests indicate reduced synthesis by the liver?

Answer 33

Albumin and Prothrombin time

Question 34

What drug can be given for haemochromatosis?

Answer 34

Desferrioxamine

Question 35

What 4 symptoms make up Parkinsonism

Answer 35

Tremor, Rigidity, Bradykinesia and postural instability

Question 36

Which enzyme is low in Wilson's disease?

Answer 36

caeruloplasmin

Question 37

What is the definition of portal hypertension?

Answer 37

blood pressure in the hepatic portal vein >7mmHg

Question 38

What are the 6 symptoms of chronic liver disease / liver failure?

Answer 38

``` Ascites Bruising Clubbing Dupuytren's contracture Jaundice Hepatic encephalopathy - confusion, drowsiness, liver flap ```

Question 39

What does ERCP stand for?

Answer 39

Endoscopic retrograde cholangiopancreatography

Question 40

What medical treatment can be given for varices?

Answer 40

IV Terlipressin

Question 41

What is the diagnostic test for hepatocellular carcinoma?

Answer 41

Enhanced CT

Question 42

Which 3 drugs are given for a H.pylori ulcer?

Answer 42

2 Abx and 1 PPI | Metronidazole, amoxicillin + omeprazole

Question 43

What is the triad of reactive arthritis symptoms?

Answer 43

Conjunctivitis, urethritis, arthritis

Question 44

What does GGT stand for?

Answer 44

gamma-glutamyl transferase

Question 45

What does AST stand for?

Answer 45

Aspartate transaminase

Question 46

What does ALT stand for?

Answer 46

Alanine transaminase