Dunedin 2017

Question 1

Do penicillins or aminoglycosides penetrate the CNS?

Answer 1

No but they still have action in meningitis due to increased permeability of the BBB

Question 2

Where do the AChR antibodies target in myasthenia gravis vs lambert eaton?

Answer 2

MG = post synaptic

Lambert Eaton = pre synaptic

Question 3

What’s Glanzmann’s thombasthenia?

Answer 3

Defect in glycoprotein IIb/IIIa synthesis

Question 4

What is cetuximab?

Answer 4

EGFR inhibitor

Question 5

What renal condition is associated with elevated levels of soluble urokinase plasminogen activator receptor?

Answer 5

FSGS

Question 6

What is Gerstmann’s syndrome and what are the clinical features?

Answer 6

Ischaemic stroke to dominant inferior parietal lobule

Dyscalculia, acalculia, finger agnosia, left-right disorientation

Question 7

What does inhibition of RANK ligand do?

Answer 7

Prevents maturation and activation of osteoclasts

Question 8

What drug enhances osteoblast proliferation?

Answer 8

Romosuzumab

Question 9

What drug preferentially activates osteoblasts rather than osteoclasts?

Answer 9

Teriparatide

Question 10

What complications are reversible in hereditary haemochromatosis?

Answer 10

Left ventricular dysfunction, bronzing skin, hepatomegaly

Question 11

What feature on the ECG is most assocaited with a pre-terminal event in TCA overdose?

Answer 11

QRS > 160ms

Question 12

What are the 3 antibodies associated with systemic sclerosis?

Answer 12

Anti-RNA 3 polymerase

Anti-Scl-70

Anti-Centromere

Question 13

Which steroids have the least mineralcorticoid activity?

Answer 13

ones that ends in methasone

Question 14

What happens to the fT3 in sick euthyroid syndrome?

Answer 14

Decreases because there is increased conversion of fT4 to rT3

Question 15

Where is hepcidin release?

Answer 15

Liver

Question 16

What cytokine leads to the release of hepcidin?

Answer 16

IL-6

Question 17

What is the MOA of hepcidin

Answer 17

Prevents iron transport by:

• Binding to ferroportin causing internalisation and breakdown of ferroportin by lysosomes within the cell
• Ferroportin is required by cells to release intracelullar iron into the circulation -> iron is retained in enterocytes, hepatocytes and macrophages

Question 18

Which cephalosplorins have activity against MRSA?

Answer 18

Ceftaroline - 5th gen

Question 19

What is aneuploidy?

Answer 19

Presence of an abnormal number of chromosomes in a cell

Question 20

What is uniparental disomy?

Answer 20

What someone receives 2 copies of a chromosome or part of a chromosome from 1 parent and no copy from the other parent

Question 21

Further lipid lowering therapies in statin induced necrotising myositis

Answer 21

Do not restart statins

Question 22

Evolocumab

Answer 22

PCSK9 inhibitor

PCSK9 binds to LDL receptors causing internalisation of them and increased LDL in plasma

Question 23

What HAART can cause depression?

Answer 23

Efavirenz

Question 24

What is anticoagulation indicated in membranous nephropathy?

Answer 24

Albumin 25g/L

Question 25

Which gender has higher risk of progression to ESKD in membranous nephropathy?

Answer 25

Females

Question 26

What is the primary treatment for high grade sarcomas?

Answer 26

Excision, then radiotherapy with positive margins

Metastasise to the lungs

Question 27

What cardiac condition is assocaited with Noonan syndrome?

Answer 27

Pulmonary stenosis