Alfred 2017 Exam Flashcards
5 Lacunar Syndromes
- Pure motor hemiparesis
- Unilateral paralysis of arm, face, leg
- Dysarhthria, dysphagia - Pure sensory syndrome
- Unilateral numbness of face, leg, arm - Ataxis hemiparesis
- Unilateral weakness and limb ataxia - Sensorimotor syndrome
- Hemiparesis or hemiplegia of face, arm and leg
- Ipsilateral sensory impairment - Dysarthria-clumsy hand syndrome
- Unilateral facial weakness
- Dysarthria + dysphagia
- Mild hand weakness and clumsiness
What condition is CGRP antibodies associated with
Trigeminal neuralgia
What type of headache is botulinum toxin type A useful for
Chronic migraine (16-30 headache days a month)
Do statin-induced myopathies resolve after cessation of statin
Symptoms should resolve within weeks
If it doesn’t consider immune-mediated necrotising myopathy
What antibodies mediated immune-mediated necrotising myopathy
HMG-CoA reductase antibodies
What is the nature of symptoms in statin-associated myopathy
Bilateral
Large muscle groups
Symptom onset 4-6 weeks after statin initiation
Where are lesions associated with hemiballism located
Subthalamic nucleus
What tumours are associated with RET gain of function mutation
MEN 2A MEN 2B
Medullary thyroid cancer
Phaeochromocytoma
Parathyroid hyperplasia
Ivabradine MOA
Blocks funny channel to prevent sodium influx - reduces action potential
What causes the systolic murmur in ASD
Increased flow from RV across pulmonary valve to pulmonary arteries
P2Y12 inhibitors onset of effect and reversibility
Clopidogrel
- 4 hours, irreversible
Ticagrelor
- 30 mins, reversible
Prasugrel
- 30 mins, irreversible
What medication increases AUC of dabigatran
Verapamil
Morphine to codeine conversion
1:10
Oral morphine 1mg = oral codeine 10mg
Morphine to hydromorphone conversion
5:1
Morphine 5mg = hydromorphone 1mg
Morphine to oxycodone conversion
1.5:1
Oral morphine 15mg = oral oxycodone 10mg
Morphine to tapentadol
1:3
oral morphine 100mg = oral tapentadol 300mg
Morphine to tramadol
1:5
Oral morphine 10mg = 50mg tramadol
Oral morphine to subcut morphine
2-3:1
Oral morphine 30mg = subcut 10-15mg
Oral hydromorphone to subcut hydromorphone
2-3:1
Oral hydromorphone 24mg = subcut hydromorphone 8-12mg
In a drug with low hepatic extraction ratio what effect does doubling the ratio have on bioavailability
Low hepatic extraction ratio = high dose of drug gets through the liver
Doubling or halving extraction rate has little change on bioavailability
What kind of peptides do MHC class I molecules present
Peptides generated in the cytosol by proteasome
What kind of antigens do MHC class II molecules present
Extracellular proteins which are endocytosed, lysosomed and then presented as a peptide on MHC class II
Hereditary angioedema type 1 - C1INH level and functional C1INH assay level
Type 1 is C1 inhibitor deficiency
C1INH level reduced
Functional C1INH assay abnormal
Hereditary angioedema type 2 - C1INH level and functional C1INH assay level
Type 2 is C1 inhibitor dysregulation
C1INH level normal
Functional C1INH assay abnormal
Icatibant MOA
Bradykinin-2 receptor antagonist
Which Ig is lower level in plasma
IgE
Cross-reacting foods in latex allergy
Avocado
Chestnuts
Banana
Kiwi fruit
Fried’s frailty phenotype
Involuntary weight loss >=4.5kg in last year Self-reported exhaustion Slow gait Low physical activity Reduced handgrip strength
Annual conversion rate of MCI to dementia
10%
Neuroimaging for diagnosing Lewy body dementia
FDG PET
Drugs a/w PML
Natalizumab Rituximab Ibrutinib Infliximab Ocrelizumab
Chronic liver disease coagulation changes
Decreased protein C
Reduced platelet
Elevated vWF levels
Decreased factor VII levels
Hepcidin function
Acts to decrease intestinal iron absorption by causing down regulation of
ferroportin on the basolateral membrane of enterocytes
Favourable factors in AML
MDR 1-negative phenotype
t(8:21), inv(16)/t(6:16), t(15:17)
NPM1 mutation CEBPA mutation
Unfavourable factors in AML
MDR 1-positive phenotype Monosomal karyotype Complex karyotype abnormalities t(6:9); t(9:11); inv(3) FLT3/ITD mutation
Which organism does moxifloxacin not have antimicrobial activity against
Pseudomonas aeruginosa
Germ cell tumour hormone profile
Testosterone normal
LH normal
HCG increased
Oestradiol normal
Findings in MLF lesion
- Paramedian pontine reticular formation (PPRF) receives contralateral information from higher centres (frontal eye fields, occipital and parietal lobes, superior colliculus) to send signal to ipsilateral CNVI
- Causes INO
Central cord syndrome UL vs LL weakness
Disproportionate upper limb to lower limb weakness
Lower limb finding in psoas haematoma
Femoral nerve compression and femoral neuropathy
Loss of power in hip flexion and knee extension
Loss of knee jerk reflex
Reduced anterior medial thigh sensation and medial lower leg sensation
