Alfred 2017 Exam Flashcards

1
Q

5 Lacunar Syndromes

A
  1. Pure motor hemiparesis
    - Unilateral paralysis of arm, face, leg
    - Dysarhthria, dysphagia
  2. Pure sensory syndrome
    - Unilateral numbness of face, leg, arm
  3. Ataxis hemiparesis
    - Unilateral weakness and limb ataxia
  4. Sensorimotor syndrome
    - Hemiparesis or hemiplegia of face, arm and leg
    - Ipsilateral sensory impairment
  5. Dysarthria-clumsy hand syndrome
    - Unilateral facial weakness
    - Dysarthria + dysphagia
    - Mild hand weakness and clumsiness
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2
Q

What condition is CGRP antibodies associated with

A

Trigeminal neuralgia

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3
Q

What type of headache is botulinum toxin type A useful for

A

Chronic migraine (16-30 headache days a month)

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4
Q

Do statin-induced myopathies resolve after cessation of statin

A

Symptoms should resolve within weeks

If it doesn’t consider immune-mediated necrotising myopathy

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5
Q

What antibodies mediated immune-mediated necrotising myopathy

A

HMG-CoA reductase antibodies

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6
Q

What is the nature of symptoms in statin-associated myopathy

A

Bilateral
Large muscle groups
Symptom onset 4-6 weeks after statin initiation

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7
Q

Where are lesions associated with hemiballism located

A

Subthalamic nucleus

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8
Q

What tumours are associated with RET gain of function mutation

A

MEN 2A MEN 2B
Medullary thyroid cancer
Phaeochromocytoma
Parathyroid hyperplasia

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9
Q

Ivabradine MOA

A

Blocks funny channel to prevent sodium influx - reduces action potential

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10
Q

What causes the systolic murmur in ASD

A

Increased flow from RV across pulmonary valve to pulmonary arteries

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11
Q

P2Y12 inhibitors onset of effect and reversibility

A

Clopidogrel
- 4 hours, irreversible

Ticagrelor
- 30 mins, reversible

Prasugrel
- 30 mins, irreversible

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12
Q

What medication increases AUC of dabigatran

A

Verapamil

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13
Q

Morphine to codeine conversion

A

1:10

Oral morphine 1mg = oral codeine 10mg

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14
Q

Morphine to hydromorphone conversion

A

5:1

Morphine 5mg = hydromorphone 1mg

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15
Q

Morphine to oxycodone conversion

A

1.5:1

Oral morphine 15mg = oral oxycodone 10mg

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16
Q

Morphine to tapentadol

A

1:3

oral morphine 100mg = oral tapentadol 300mg

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17
Q

Morphine to tramadol

A

1:5

Oral morphine 10mg = 50mg tramadol

18
Q

Oral morphine to subcut morphine

A

2-3:1

Oral morphine 30mg = subcut 10-15mg

19
Q

Oral hydromorphone to subcut hydromorphone

A

2-3:1

Oral hydromorphone 24mg = subcut hydromorphone 8-12mg

20
Q

In a drug with low hepatic extraction ratio what effect does doubling the ratio have on bioavailability

A

Low hepatic extraction ratio = high dose of drug gets through the liver

Doubling or halving extraction rate has little change on bioavailability

21
Q

What kind of peptides do MHC class I molecules present

A

Peptides generated in the cytosol by proteasome

22
Q

What kind of antigens do MHC class II molecules present

A

Extracellular proteins which are endocytosed, lysosomed and then presented as a peptide on MHC class II

23
Q

Hereditary angioedema type 1 - C1INH level and functional C1INH assay level

A

Type 1 is C1 inhibitor deficiency

C1INH level reduced

Functional C1INH assay abnormal

24
Q

Hereditary angioedema type 2 - C1INH level and functional C1INH assay level

A

Type 2 is C1 inhibitor dysregulation

C1INH level normal

Functional C1INH assay abnormal

25
Q

Icatibant MOA

A

Bradykinin-2 receptor antagonist

26
Q

Which Ig is lower level in plasma

A

IgE

27
Q

Cross-reacting foods in latex allergy

A

Avocado
Chestnuts
Banana
Kiwi fruit

28
Q

Fried’s frailty phenotype

A
Involuntary weight loss >=4.5kg in last year
Self-reported exhaustion
Slow gait
Low physical activity
Reduced handgrip strength
29
Q

Annual conversion rate of MCI to dementia

A

10%

30
Q

Neuroimaging for diagnosing Lewy body dementia

A

FDG PET

31
Q

Drugs a/w PML

A
Natalizumab
Rituximab
Ibrutinib
Infliximab
Ocrelizumab
32
Q

Chronic liver disease coagulation changes

A

Decreased protein C
Reduced platelet
Elevated vWF levels
Decreased factor VII levels

33
Q

Hepcidin function

A

Acts to decrease intestinal iron absorption by causing down regulation of
ferroportin on the basolateral membrane of enterocytes

34
Q

Favourable factors in AML

A

MDR 1-negative phenotype
t(8:21), inv(16)/t(6:16), t(15:17)
NPM1 mutation CEBPA mutation

35
Q

Unfavourable factors in AML

A
MDR 1-positive phenotype
Monosomal karyotype
Complex karyotype abnormalities
t(6:9); t(9:11); inv(3)
FLT3/ITD mutation
36
Q

Which organism does moxifloxacin not have antimicrobial activity against

A

Pseudomonas aeruginosa

37
Q

Germ cell tumour hormone profile

A

Testosterone normal
LH normal
HCG increased
Oestradiol normal

38
Q

Findings in MLF lesion

A
  • 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
39
Q

Central cord syndrome UL vs LL weakness

A

Disproportionate upper limb to lower limb weakness

40
Q

Lower limb finding in psoas haematoma

A

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