CAP Flashcards
1
Q
What conditions have a raised lymphocyte coutn in the CSF?
A
viral; TB; MS
2
Q
What causes a very raised protein in the CSF?
A
bacterial
3
Q
What hormone causes enlargement of the mammary glands of the breasts and prepares for lactation?
A
prolactin
4
Q
What are the vitamin K dependent factors?
A
II, VII, IX and X
5
Q
What neurotrasmitter is affected in withdrawal from sedative-hypnotic drugs?
A
reduced GABA
6
Q
What condition is difficult to cross-match blood in?
A
AI haemolytic anaemia
7
Q
What drugs are relatively CI in myeloma?
A
NSAIDs
8
Q
What significantly reduces the incidence of NEC?
A
breast feeding
9
Q
What is the first line investigation for heavy menstrual bleeding?
A
FBC
10
Q
Give an exmplae of an anticholinesterae?
A
galantamine
11
Q
What is inheritance of Wilsons disease?
A
AR
12
Q
What is the inheritance of Beckers muscular dystrophy?
A
X-linked recessive
13
Q
what gene is always affected in Beckers muscular dystrophy?
A
dystrophin
14
Q
What is the inheritance of myoclonic epilepsy with ragged red fibres?
A
mitochondrial
15
Q
What causes the ragged red appearnce of muscle fibres in myoclinc epilepsy with ragged red fibres?
A
clumps of mirochondria
16
Q
What are the features of myoclonic epilepsy with ragged red fibres?
A
progressive myoclonic epilepsy; short stautre; hearing loss; lactic acidosis; exercise intolerance; poor night vision
17
Q
What does patchy reduced attenuation through the brain on SPECT scan indicate?
A
vascualr dementia
18
Q
What other name is cervical dystonia known as?
A
spasmodic torticollis
19
Q
What is cervical dystonia?
A
head turning to one side due to contraction of the SCM
20
Q
What is blepharospasm?
A
twitch or spasm of the eyelid
21
Q
Waht is hemiballismus?
A
uncontrolled flailing of the limbs
22
Q
What causes hemiballismus?
A
structural lesion or metabolic dysfunction of the subthalamic nucleus
23
Q
What does chronic lung disease of infancy mean?
A
preterm infant will need oxygen supplementation beyond 28 days or beyond 36 weeks corrected gestation
24
Q
What forms the outer lining of bone?
A
periosteum
25
What would cause a female with X-linked haemophilia to get symptoms?
normal X- inactivation
26
What is the action of bromocriptine?
dopamine agonist
27
What is morphogenesis?
formation of hte body plan
28
What artery is likely to be damaged with the insertion of lateral abdominal port?
inferior epigastric artery
29
What artery is the inferior epigastric artery a branch of?
external iliac artery
30
What artery is likely to be damaged in excision of Bartholins abscess?
internal pudendal
31
What artery is likely to be damaged during dissection of the lower end of the ureter?
uterine artery
32
What type of contracption is CI in women with a pelvic infection?
intra-uterine devices
33
What is needed if a patient still requires detention after a short term detention order?
complsory treatment order
34
What stage does the embryo implant into the uterus?
blastocyst
35
Where is the lesion in receptive aphasia?
Wernickes
36
What is nominal aphasia?
unable to name familiar objects but language otherwise preserved
37
Where is the lesion in nominal aphasia?
inferior parietal lesion- angular gyrus
38
Which area of the brain is affected first in Alzhemiers?
nucleus basalis of Meynert
39
Where is the main source of cholinergic projections to the rest of hte brain?
nucleus basalis of meynert
40
What is the most common inheritance of hereditary spherocytosis?
autosomal dominait
41
What is seen with a lesion immediately anteiror to the chiasm?
junctional scotoma
42
What is the MOA of memantine?
blocks NMDA-type glutamate receptors
43
What anti-microbial protein is secreted by epithelial cells at mucosal surfaces?
defensins
44
What other disorder are patients with a first degree relative with bipolar also at risk of?
schizoaffective disorder
45
What is Vmax ona graph defined as?
point at whihc reaction intercepts the Y-axis (1/v)
46
How do competitive inhibitors affect the KM and Vmax of an enzyme?
alter Km but not Vmax
47
what is seen on a graph with a non-competitive inhibitor?
crosses X axis at same value as the control reaction
48
What type of swab is done for symptomatic chlamydial testing?
endocervical swab
49
What abnormality of the HPA axis is associated iwht dpression?
cortisol non-suppression following dexamethasone
50
What happens to the adrenal gland in major depression?
enlarges
51
What are the symptoms of carotid sinus hypersensitivty?
dizziness and collapse but not postural sway
52
Waht is first line treatment of a simple partial seizure?
lamotrigine or carbamazepine
53
Is Hodgkins disease associated with a lymphocytosis?
No
54
What is the function of the aversive and defensive systems?
promote survival in the event of threat
55
What neurotransmitter is invovled in the aversive and defensive systems?
serotonin
56
What movements is the L4 nerve root responsible for?
leg extension; patellar reflex and ankle dorsiflexion
57
When is neural tube closure?
4 weeks gestation
58
How does vasa praevia present?
severe fetal distress with small intrapartum bleed following rupture of memrabens
59
Are varicoceles usually painful or painless?
painless
60
What are the essential investigations with pre-eclampsia?
FBC; U&Es and LFTs
61
What is efficacy of a drug?
ability of an agonist to evoke a cellular response
62
What type of biopsy is best for lymph node biopsy in Hodgkins?
excision
63
What causes rouleaux formation?
charge of hte surface of cells is altered due to cell lablelling with proteins
64
What proteins can cause rouleaux formation?
reactive process; paraprotein
65
What is done in the proximal tubule?
regulation of pH and reabsorption of 100% of glucose and amino acids
66
When does the desire to void occur in volume?
250ml
67
What is polyuria defined as?
>2.8L in 24 hours
68
How long is the female urethra?
3-4cm
69
What are the common side effects of thiazides?
postural hypotension; gout; impaired glucose tolerance; impotence and electrolyte imbalance
70
How is norovirus detected?
PCR of stool
71
What type of blood product shouldn't be given when there is a life-threatening haemorrhage on warfarin?
FFP
72
What hormone is used to measure ovarian reserve in IVF?
anti-mullerian hormone
73
What is the function of anti-mullerian hormone in females?
regulates folliculogenesis to form the dominant follicle
74
What are the antibodes against in myastehnia gravis?
post-synaptic ACh receptors
75
What organism produces elementary and reticulate bodies?
chlamydia
76
What are the 4 aspects of the 4AT?
alterness; AMT4; attention; acute change or fluctuating course
77
What is asked in the AMT4?
age; DOB; place; current year
78
What required for a score of 0 on attention?
acheives 7 or more months correctly
79
How many mistakes in the AMT4 gives you a score of 2?
>2 mistakes
80
What drugs are relatively CI in mutltiple pregnancy?
IV beta sympathomimetic drugs
81
What are the common SE of IV beta sympathomimetic drugs?
nausea; HA; vomiting; trembling and palpitations
82
Who are IV beta sympathomimetic drugs relative CI in?
DM; CVS dsiease and multiple pregnnacy
83
What happens if maternal HR exceeds 120/min?
cardiac failure with pulmonary oedema
84
When is carotid endartercomy recommended?
stenoses greater than 70% of diameter
85
What other name is Still's disease known as?
systmeic-onset juvenile idiopathic arthritis
86
What is Still's disease characterised by?
high spiking fevers; salmon coloured rash and arthritis
87
What type of antibody is involved in warm agglutinins?
IgG
88
What DMARDs are assocaited with aplastic anaemia?
gold and lefluonamide
89
What is a midzone nodule in TB known as?
Ghon focus
90
What is the most common reason for TB reactivation?
alcoholism
91
What is Sever's disease?
apophysitis of the calcaneus- painful cartilage break usually in children
92
What is given prophylactically for meningeal disease in ALL?
cranio-spinal irradiation and intrathecal methotrexate
93
Which sex has an adverse prognosis in ALL?
male
94
Where is the rash in HSP commonly seen?
thighs and buttocks
95
why is platelet count reduced in acute leukaemia?
bone marrow infiltration by blasts
96
what happens to the platelet count in Kawasaki disease?
thrombocytosis
97
Whati s seen in the mouth with lead poisoning?
blue lines
98
What type of glomerulonephritis is seen with HSP?
membranoproliferative
99
What typically causes a low AFP, uncojugated oestriol and hCG?
Edwards syndrome
100
what vascular anomaly is seen with Edwards syndrome?
single umbilical artery
101
What does a raised AFP and presence of acetylcholinesterase in the amniotic fluid indicate?
open neural tube defect
102
What typically causes of low AFP, low unconjugated oestriol but elevated hCG?
Down's syndrome
103
What are the causes of an isolated high AFP?
fetal abdo wall defects; multiple pregnnacy and bleeding in pregnnacy
104
What happens to FSH with OCP?
decreased with the raised oestrogen
105
Where are sex binding hormone globulin synthesised?
liver
106
What causes increased sex-hormone binding globulin?
hepatic cirrhosis; hyperthyroidism and oestrogen use
107
what is Mendelson's syndrome?
risk of aspiration
108
What is the function of circoid pressure with MEndelson's syndrome?
occludes oesphagus to reduce regurgitation
109
What are valvulae conniventes?
muscosal folds that cross the full width of the small bowel
110
What imaging should be requested in the setting of an acute abdomen?
erect CXR (perforation)
111
What are the common causes of large bowel obstruction?
colonic carcinoma or diverticular stricture
112
Which leg more commonly gets DVT in pregnnacy?
left
113
Where are DVTs most common in pregnancy?
iliac and femoral veins
114
How is phenytoin initially prescribed?
as an IV infusion for loading
115
What organ is valproate toxic to?
liver
116
what is a side effect of phenobarbitone ?
hyperkinesia
117
Why should vigabatrin not be used long term in children?
SE of visual field defects nad visual impairment
118
Why is regular monitoring of valproate unhelpful?
poor correlation between seizure control and valproate levels
119
What antibody can be raised in juvenile idiopathic arthritis?
ANA
120
What is seen on EEG with hepatic encephalopathy?
delta waves
121
What is the presentation of PAN?
hypertension; nephropathy; vasculitis and mononeuritis multiplex
122
What is seen on angiography with PAN?
multiple aneurysms at vessel bifurcationas
123
What is the inheritance of haemophilia?
X-linked recessive
124
What are the CI to CT contrast?
renal impairment (creat >200); contrast/iodine allergy; pregnnacy
125
What is a cortical osteoma?
benign bone grwoth in the frontal sinus
126
What are Brown tumours?
osteolytic lesions due to hyperparathyroidism
127
Is the renal failure typically associated with membranous nephropathy acute or chronic?
chronic
128
What infections is membranous nephropathy assocaitedi wht?
hep b; malaria
129
What type of nephropathy is assocaited with diabetes?
nephrotic
130
Is hep B or hep C more transmissable by sex?
hep B
131
What is typically seen with amiodarone induced lung disease?
reticulo-nodular shadowing or beads on a string
132
What is athetosis?
slower movements whcih are irregular and writhing
133
What type of matter do cerebral lesions in MS affect?
white
134
What drug is associated iwth placental abruption?
cocaine
135
What drug is assoc. with sustained Ht in pregnnacy ?
amphetamines
136
Which drug is associated with increased PPH?
amphetamines
137
What is a side effect of cimetidine?
gynaecomastia
138
What covers the bare surface of the liver?
coronary ligmaent
139
What is myotonia?
inability to relax limb after contraction
140
What is the treatment for mild von willebrands disease?
desmopressin
141
What is the treatment for active bleeding with warfarin toxicity?
prothrombin complex concentrate
142
Waht is prothrombin complex concentrate?
blood clotting factors II, IX and X
143
What is dry beriberi?
painful distal sensorimotor neuropathy
144
what is wet beriberi?
peripheral oedema; pleural effusions and cardiomyopathy
145
What is the inheritance of G6PD?
X-linked recessive
146
What is haemolysis in G6PD associated with?
nitrofurantoin; dapsone; fava beans; antimalarials
147
What are the causes of a resting tremor?
anxiety; beta-agonists; alcohol; thyrotoxicosis; familial and basal ganglia lesions
148
What is a unilateral parotid swelling commonly caused by?
pleomorphic adenoma
149
What is the investigation for pleomorphic adenoma?
excision biopsy
150
What are the causes of a pulsatile mass in the neck?
carotid artery aneurysm; carotid body tumour (chemodectoma)
151
What is the general diagnosis with hot and cold nodules?
hot- usually adenomas; cold- usually malignant
152
What supplies cricothyroid?
external branch of the superior laryngeal nerve
153
When does the first attack of genital herpes develop after exposure?
2-14 days
154
What is the first step in treatment of acute sinusitis?
decongestnats and nasal sprays eg steroid
155
what effect does aspirin have on warfarin?
potentiates
156
Why does long term tetracycline use potentiate warfarin?
recudes the bacterial production of vitamin K by commensals by the gut
157
What effect does phenytoin have on warfarin?
has been reported to potentiate and inhibit warfarin
158
What is gold standard for investigating suspected renal colic?
CT KUB
159
How is haemochromatosis inherited?
autosomal recessive
160
How is Marfans syndrome inherited?
AD
161
What is seen on ABG with ruptured AAA?
metabolic acidosis with raised anion gap
162
What are the 3 Ps in vasovagal syncope?
posture; provoking factors; prodromal symptoms
163
Can a prolonged PR interval be normal?
common in young athletes
164
What is the most common cardiac abnormality seen with Down's syndrome?
atrioventricular septal defect
165
What are the skin lesions seen with reactive arthritis?
keratoderma blehnorrhagica- vesicles which become hyperkeratotic- palms and soles
166
What antihypertensive can cause profound hypotension when started?
ACEi
167
What drugs are associated with benign intracranial hypertension?
tetracycline; steroids; nitrofuratnoid and OCP
168
What does the CHA2DS2VASc score stand for?
congestive cardiac failure; hypertension; age >74; DM; Stroke; vascular disease; sex (F)
169
What is lateral to the ovaries?
obturator nerves and vessels
170
What is medial to the ovaries?
ovarian ligmanet
171
What is superior to the ovaries?
external iliac vessels
172
What is posterior to the ovaries?
ureters; internal iliac vessels and pelvic wall
173
Where is ovarian pain felt?
periumbilical or can stimulate obturator nerve-inner thigh
174
What conditions express the Kobner phenomenon?
psoriasis; lichen planus; plane warts and vitilgo
175
What is the antibiotic of choice against GAS?
penicillin
176
Give an example of a GAS?
strep. pyogenes
177
What is the effect of trimethoprim?
bacteriostatic
178
What antibiotic is effective against Pseudomonas?
gent
179
What effect do thiazides have on calcium?
increase calcium reabsorption
180
What is the associated risk with renal biopsy/
renal AV fistula
181
What is the most common presentation of renal AV fistula?
hypertension and haematuria
182
What artery lies within the coronary sulcus?
RCA nad LCA
183
What is faecal calprotectin?
substance released from the intestine in inflammation
184
What is new onset hypertension prior to 20 weeks gestation commonly due to?
gestational trophoblastic disease
185
What are the risks of gestational trophoblastic disease?
lung metastases and thyriod dysfunction
186
What condition is renal angiomyolipoma assocaited with?
tuberous sclerosis
187
What is the characteristic feature of a cavitating lesion?
opacity has a lucent (gas filled ) centre
188
What drug is useful in post-herptic neuralgia?
carbamazepine
189
What drugs cause gingival hyperplasia?
phenytoin; nifedipine; ciclosporin
190
How is C1 esterase deficiency inherited?
autosomal dominant
191
What causes oral hairy leukplakia?
EBV
192
When should priamry PCI be given?
if present within 12 hours of onset and primary PCI can be delivered wtihin 120 minutes of time fibrinolysis
