All Flashcards
1
Q
First line treatment for raynauds
A
CCBs
2
Q
disease of femoral head comprising of necrosis, collapse, repair and remodelling
A
Perthes’ disease
3
Q
Recurrent miscarriage seen in ____ syndrome
A
Anti-phospholipid
4
Q
Fist line treatment for polymyositis rheumatica
A
Oral prednisolone
5
Q
Methotrexate drug class
A
Folate antagonist
6
Q
Felty’s syndrome
A
triad of RA, splenomegaly and neutropenia
7
Q
Screening method for pheochromocytoma
A
plasma metaphrines
8
Q
Addison’s disease diagnosis
A
9am cortisol
9
Q
Headache and unilateral vision loss
A
giant cell arteritis
10
Q
Treatment of gout
A
NSAIDS (if contraindicated colchicine)
11
Q
Medicine causing hypoglycaemia
A
sulphonylureas (gliclazide)
12
Q
Skin condition associated with Addisons
A
vitiligo
13
Q
What is the best initial treatment of an Addisonian crisis?
A
IV fluids and IV steroids
14
Q
which cells secrete pepsin to digest protein
A
chief cells
15
Q
Which layer of deep fascia does the vagus nerve travel within in the neck region?
A
Carotid sheath
16
Q
First line treatment for hyperkalaemia
A
IV calcium glucanoate
17
Q
Acromegaly diagnosis
A
serum IGF-1
18
Q
Rare genetic condition where haem synthesis is affected
A
Acute intermittent porphyria
19
Q
Fall on outstretched hand with dinnerfork deformity
A
Colles / distal radius fracture
20
Q
Diagnostic test and treatment for BPPV
A
Dix-hallpike manouvre, epley manouvre
21
Q
Carbimazole mechanism of action
A
Anti-thyroid agent that inhibits thyroid peroxydase
22
Q
Malignant melanoma treatment
A
Excision biopsy
23
Q
Vertigo, tinnitus, hearing loss and feeling of deep pressure inside the ear
A
Manière’s disease
24
Q
Commonest cause of hyperparathyroidism
A
Parathyroid adenoma
25
Temporal tenderness, jaw claudication, over 60, vision changes
Temporal arteritis (giant cell)
26
Indicator of dermatomyositis disease activity
CK
27
commonest cause of anovulation in women
PCOS
28
Occurs in the elderly and causes bilateral, proximal muscle pain and stiffness without a rise in CK levels
Polymyalgia rheumatica
29
Scoring system used in RA
DAS-28
30
Which cells are dysfunctional in diabetes
Beta cells
31
Fowl smelling discharge and gradual hearing loss (no pain)
Cholesteatoma
32
Skin condition associated with TB
Erythema nosodum
33
Skin peels with pressure
Nikolsky’s sign
34
Appearance of gout in polarised light microscopy
negatively birefringent needle-shaped crystals
35
Most common cause of hyperthyroidism in the UK
Grave's disease
36
Presents with polyuria, polydipsia and headaches. Typically patients are hypertensive, hyperkalaemic and have metabolic alkalosis
hyperaldosteronism
37
Autoimmune cause of hypothyroidism, positive anti-TPO
Hashimo's thyroiditis
38
Wichham's striae (lacy white lines), symmetrically distributed rash, Purple, Pruritic, Papular, Polygonal, Planar (flat topped)
Lichen Planus
39
sulphonylueas side effects
hypoglycaemia, weight gain
40
Test for hypercortisolism (cushings)
overnight dexamethasone test
41
central obesity, proximal myopathy, easy bruising, poor wound healing, abdominal striae, plethoric face, chronic steroid exposure
Cushing's
42
which skin conditions show Koeber phenomenon - skin disease elevation post injury
Psoriasis, vitiligo, lichen planus
43
Positive posterior sag
posterior cruciate ligament injury
44
Primary hyperaldosteronism - refractory hypertension despite multiple anti-hypertensive agents
Conn's syndrome
45
Medication causing abnormal thyroid function
amiodarone
46
First line treatment for type 1 diabetes
basal-bolus insulin
47
Giant cell arteritis treatment
60mg prednisolone
48
Level of HbA1c to diagnose diabetes
6.5% (48mmol/mol)
49
rare granulomatous inflammation causing eosinophilia and positive p-ANCA
Churg-Strauss syndrome (eosinophilic granulomatosis with polyangiitis)
50
Occurs secondary to SLE, causing thromboembolism, thrombocytopenia and mottled lace appearance on legs (lived reticularis)
antiphospholipid syndrome (APS)
51
Single large red patch, followed by generalised pink rash, preceded by viral respiratory illness
pityriasis rosea
52
what drug is given to pregnant women with antiphospholipid syndrome to prevent thrombotic complications
Heparin
53
________________ is diagnosed by low urine osmolality after fluid deprivation but then normalised osmolality after desmopressin is given
Cranial diabetes insipidus
54
What endocrine condition is frozen shoulder associated with
Diabetes
55
autoimmune blistering skin condition which affects the elderly. More common in those with neurological diseases such as Parkinson's Disease or dementia
Bullous pemphigoid
56
Pulmonary embolism, and other thrombotic complications such as recurrent miscarriage, stroke and myocardial infarction, are associated with ________
Anti-Phospholipid Syndrome
57
(which drug) has a high iodine content and is well recognised to cause thyrotoxicosis (hypothyroidism)
Amiodarone
58
______ has to be screened for and treated first before starting biologics
TB
59
Initial management of DKA involves ___________ in order to correct the hypovolaemia, acidosis, ketonemia and total body hypokalaemia associated with this condition
fluid and potassium replacement
60
(what type of) Retinitis in immunocompromised patient
CMV retinitis
61
Dry mouth, eyes and vagina, parotid gland swelling, positive anti-ro
sjogren’s syndrome
62
_____ causes non-tender goitre due to the action of TSH on the thyroid tissue
Hashimoto's
63
Mid humeral shaft fracture, nerve most likely to be damaged
Radial
64
Scapular winging
long thoracic nerve damage
65
What drug should be avoided with patients on methotrexate
trimethoprim
65
The Keith-Wagener classification is used to stage ________
hypertensive retinopathy
66
DEXA scan results:
>-1
-1 to -2.5
< -2.5
Normal,
osteopenia,
osteoporosis
67
Metabolic side effect of B2 receptor antagonists
Hypokalaemia
68
cortisol binds to ________ in order to be active
Cortisol binding globulin
69
What type of blood pressure activates the renin-angiotensin system
Low
70
what is released in response to hypercalceamia
Calcitonin
71
What gives the most accurate measurement of GFR
Inulin
72
Where is most sodium reabsorbed
Proximal convoluted tubule
73
What hormone increases in response to increased extra cellular fluid volume
ANP
74
What electrolyte imbalance is seen in primary hypoparathyroidism
Hypocalceamia
75
Explain what happens in response to reduced blood pressure in terms of renin and GFR
- increased renin
- this increases angiotensin II production (via RAAS)
- this constricts efferent artériole
-increases hydrostatic pressure to maintain GFR
76
Acetazolamide drug class
Carbonic anhydrase inhibitor
77
PCOS treatment
Combined oral contraceptive pill
78
Most common cause of Cushing syndrome
Iatrogenic
79
What is the action of prostaglandins on afferent arteriole
Dilation
80
When is the supraspinatous muscle responsive
First 20 degrees of shoulder abduction
81
Most likely to be damaged with mid shaft humeral fracture
Radial nerve
82
What is mastoiditis
Infection of mastoid bone (behind ear)
83
Describe Rinne's test
place tuning fork first behind ear then in front
84
What type of hearing loss does Rinne's test check for
Air conduction - Conductive
85
Describe Weber's test
Place tuning fork in middle of forehead - ask where it is loudest
86
What type of hearing loss does Weber's test check for
Bone conduction - Sensorineural (in conductive it is heard in bad ear)
87
What is conductive hearing loss
Loss of air conduction - e.g. otitis external + media, cholesteatoma etc - better in loud environment
88
What is sensorineural hearing loss
Loss of neural transmission (air and bone) e.g. congenital, age related, noise induced, autoimmune - worse in loud environment
89
What does Froment's sign assess?
Ulnar nerve palsy
(piece of paper between thumb and index finger)
90
What does Phalen's test assess?
Carpal tunnel syndrome
(maximum wrist flexion)
91
What does Tinel's sign test for?
Carpal tunnel syndrome
(tap median nerve)
92
What is a boxer fracture?
Pinky fracture (fifth metacarpal)
93
What nerve is likely to be damaged with medial epicondyle fracture?
ulnar
94
What medication should be prescribed with methotrexate
Folic acid
95
what is the normal angle between the femoral head and shaft
130 degrees
96
Which hormone suppresses prolactin?
Dopamine
97
RAsh, fever, eosinophilia, also on PPI
acute interstitial nephritis
98
Most common site of testicular cancer metastasis
Para aortic
99
What must be suspected after any eye surgery?
bacterial endophthalmitis
100
Early skin cancer, red scaly patch
Bowen's disease (squamous cell carcinoma in situ)
101
Temporary red scaly rash usually affecting children and young adults
Pityriasis rosea
102
Which joints are Bouchard's and Heberden's nodes?
B - PIP, H - DIP
103
High urine osmolarity after water deprivation test
Primary polydipsia
104
low urine osmolarity after water deprivation, high after desmopressin
Cranial diabetes insipidus
105
low urine osmolarity after water deprivation and after desmopressin
Nephrogenic diabetes insipidus
106
____ hyperthyroidism is caused by thyroid issues, ____ hyperthyroidism is caused by hypothalamus/pituitary stimulating the thyroid gland to overproduce hormones
primary, secondary
107
First line hyperthyroidism treatment
Carmibazole
108
can present on x-ray with regional osteopenia, focal cortical loss and periosteal changes
osteomyelitis
109
anti-ds-DNA
SLE
110
what syndrome commonly occurs in subarachnoid haemorrhage
SIADH
111
Diagnostic investigation tubulointerstitial nephritis
kidney biopsy
112
tetralogy of fallot
right ventricular hypertrophy, ventricular septal defect, right sided outflow obstruction, overriding aorta
113
Aldosterone is low/high in Addisons, ACTH is low/high
low, high
114
crescent formation is the histopathological hallmark of ____ disease
anti-GBM (good pastures)
115
Horner's syndrome triad
miosis, ptosis, anhydrosis
116
diagnostic test for bladder cancer
cystoscopy
117
Polyarteritis nodosa is associated with hepatitis __
B
118
____ inhibits growth hormone release from anterior pituitary
cortisol
119
______ block Na/Cl transport channels in the distal convoluted tubule to prevent sodium reabsorption.
thiazide diuretics
120
What are the HbA1c targets for
- new type 2 diabetics
- patients requiring more than one anti diabetic medication
- 48
- 53 mmol/mol
121
____ is added once patients are settled on metformin if they have cardiovascular disease or heart failure
SGLT-2 inhibitor
122
Second-line treatment for type 2 diabetes
add a sulfonylurea, pioglitazone, DPP-4 inhibitor or SGLT-2 inhibitor.
123
_____ is found on the anterior nasal septum and is an anastomosis of 5 arteries: anterior ethmoidal artery, posterior ethmoidal artery, sphenopalatine artery, greater palatine artery, and the septal branch of the superior labial artery.
littles area
124
The_____ reflex brings near objects into focus through thickening, pupillary constriction and eye convergence
accommodation
125
What is the corneal reflex
bilateral eye blinking in response to unilateral eye stimulation
126
Most common cause of Addison's disease
autoimmune destruction
127
what are renal stones commonly composed of
calcium oxalate
128
neuropathy of the arm caused by injury to the upper group of the brachial plexus
erbs palsy
129
what meds cause osteonecrosis of the jaw
bisphosphonates
130
Patients with ______ are advised to adopt a diet which has
* Low protein
* Low phosphate
* Low sodium
* Low potassium
renal failure
131
____ is released due to reduced renal perfusion
Renin
132
What signals do leptin and ghrelin stimulate
fullness, and hunger
133
_____ is the active form of vitamin D, synthesised in the kidney. It is the calcium-binding protein found in the cytoplasm
calcitriol
134
first line hypertension treatment in CKD
ACE inhibitors
135
Vitamin ____ deficiency causes rickets
D
136
Fibromuscular dysplasia treatment
ballon angioplasty
137
Hyponatraemia, hyperkalaemia and weight loss can indicate _______
Addison's disease
138
A patient develops foot drop following a fibular neck fracture - ______ nerve
common perineal nerve
139
________ increases filtration fraction, through vasoconstriction of the efferent arteriole of the glomerulus to preserve GFR
angiotensin II
140
______ and ______ are innervated by superior gluteal nerve
gluteus medius and minimus
141
_______ supplies the anterior compartment of the lower leg
deep perineal nerve
142
(which antibiotic medication) causes AKI by causing renal cell apoptosis
Gentamicin
143
What are the DAMN drugs? (cause nephrotoxicity)
Diuretics, ACE-inhibitors + ARBs, Metformin, NSAIDS
144
TSH: Low, T4: Low
TSH: High, T4: Low
secondary hypothyroidism
primary hypothyroidism
145
where do carbonic anhydrase inhibitors work?
proximal and distal convoluted tubule
146
what type of renal cancer is mahogany brown with central stellate scar
oncocytoma
147
what transporter do thiazide diuretics block
Na/Cl co-transporter
148
Most common bacterial cause of leg ulcers
strep pyrogens
149
first line drug for prolactinomas
Cabergoline (dopamine antagonist)
150
what test should be done if a patient has recurrent candiditis
diabetes
151
Drug metabolism:
Phase 1: oxidation, reduction and _____. Usually through cyp450. ______ reactions are almost always due to phase 1
Phase 2: _____ to make drug water soluble and enables excretion of drug in urine/bile
hydrolysis, adverse drug
conjugation
152
Internal pudendal and branches from external iliac artery supply the ______. Deep arteries of the penis and branches of the internal pudendal artery (which comes from the internal iliac artery) supply the _____
scrotum, penis
153
ADPKD chromosome(s)
type 1 on 16
type 2 on 4
154
ARPKD chromosome
6
