Difficult Past Questions Flashcards
How to monitor activity of SLE
C3 and C4 levels
Biologic in psoriasis
Ustekinemab (also anti-TNF if psoriatic arthritis)
DMARD for Wegener’s
Cyclophosphamide
Biologic for Chronic Granulomatous Disease
IFN-gamma
Non-neutralising antibodies formed against this HIV protein
p24
Deficiency in these complements increases encapsulated organisms
C5-9
Patient involved in trauma and transfused with O negative blood –> he lost consciousness a few minutes after the transfusion
Splenic Haemorrhage (NOT ABO as O-ve!!)
Antithrombin III deficiency
VTE runs in family
Normal Hb with positive sickle solubility test
Sickle trait
Diagnosis of C. diff
Toxin ELISA (not culture)
STI that can cross placenta in 3rd trimester
Syphillis
Bloody discharge from nipple –> mammogram does not show any lesions
Intraductal Papilloma
Thyroid cancer associated with Ret mutation
Medullary
Thyroid cancer associated with calcitonin staining
Medullary
Rate-limiting enzyme in haem synthesis
ALA synthase
Raised calcium and normal PTH
Primary hyperparathyroidism (inappropriately normal PTH!)
Definition of Impaired Glucose Tolerance
7.8 – 11.1mM
Stellate mass with fibrosis
Radial scar
Breast lump containing epithelium cells
Intraductal papilloma
Gene affected in FAP
APC gene
“Child presenting with a mass in abdomen”
Wilm’s Tumour
What are seen in Haversian lacunae?
Osteocytes
Smoker with raised parathyroid-related polypeptide
Squamous Cell
Investigation for hypotonia and hypoglycaemia in young child
Ketones
Oedema – pic shows red cell casts
Acute glomerulonephritis
Hypoglycaemia in neonates
<2.5
Hypothyroid –> confused/drowsy
Myxoedema coma (too hypothyroid)
Vitamin deficient in Beri Beri
B1
Immune cells which migrate to germinal centre
Dendritic Cells (APCs)
Biologic used in ankylosing spondylitis
Anti-TNF –> anti-IL-17
Cellular-mediated rejection vs GVHD
Cell-mediated = T cells against donor GVHD = T cells against host
Blood product to use if you want to avoid allergic reactions (e.g. donor allergic to proteins)
Washed RBCs = most of plasma, platelets and WBCs removed
Changes in pregnancy
Volume 50% increase
Red cell mass increases
Hb decreases (11 minimum)
WBC increases
Acute Promyelocytic Leukaemia key features (including translocation)
t(15;17)
Responds to all-trans retinoic acid
Gram positive showing increased resistance to vancomycin and teicoplanin
Enterococcus
Cervicitis and discharge
Chlamydia
Normal skin pathogen with low pathogenicity
Staph epidermis
Infection where baby only affected if mum infected <20 weeks (causes hydrops fetalis)
Parvovirus B19
Infection where baby can be asymptomatic initially, but then get problems
Beta herpesvirus (HHV6/7)
Also toxoplasmosis
Also HIV
Cause of aseptic meningitis
90% caused by enterovirus = Coxsackie Group B and Echovirus
Treatment of pseudomonas
Ceftazidime
Glycopeptide used to treat MRSA
Vancomycin
DNA synthesis inhibitor used to treat Pseudomonal infections but bad against anaerobes
Ciprofloxacin
Lady with discharge, no other symptoms, and causative infection found on wet slide microscopy
Bacterial Vaginosis (gardnerella vaginalis)
Positive urinary NAAT test
Chlamydia
Neonatal meningitis, Gram positive chains
Group B streptococcus
Organism targeted by vaccine: virus that resides in pharynx and GIT - 1:100 encephalitis, 1:1000 destruction of motor neurons
Poliovirus
Organism targeted by vaccine: maculopapular rash that starts on face –> can cause encephalitis and pneumonitis
Measles
Organism targeted by vaccine: lockjaw
Clostridium tetani
Mass after acute pancreatitis
Pancreatic pseudocyst
Pancreatic mass and hypoglycaemia
Insulinoma
Pancreatic cancer which metastasises to liver
Tumours in the tail and the body of the pancreas
What deposits in kidneys in Multiple Myeloma?
AL amyloid
Barrett’s changes
Stratified squamous to simple columnar
Radiosensitive testicular cancer in young man
Seminoma
Cancer associated with chronic schisto infection
SCC bladder cancer
Deaf and bowed legs
Paget’s
Post-MI: blood aspirated from pericardium
Cardiac tamponande
Treats lymphoma and rheumatoid
Anti-CD20 (rituximab)
Used to prevent transplant rejection, by blocking T cell proliferation and activation
Anti-CD25 (part of IL-2Rα) = basiliximab
Or calcineurin inhibitor
Kill of cancerous cells and are inhibited by MHC-I
NK Cells
Mutation in FAS Pathway
ALPS = Autoimmune Lymphoproliferative Syndrome
-lymphocytes don’t apoptose –> HIGH lymphocytes
Philadelphia chromosome with 70% blasts
AML crisis
Tear drop poikilocytes and Jak2 mutation
Myelofibrosis
Pregnant with platelets 100 in 3rd trimester, no other problems
Gestational thrombocytopenia
INR target in AF
2.5
INR target for treatment of VTE
2.5
INR target in prosthetic heart valve
2.5