EFA SBAs Flashcards by Gabrielle Moe

Which of the following is a common cause of renal disease in children, and needs to be considered during your paediatric rotation?

Diabetic Glomerulosclerosis
Membranous GN
Focal and Segmental GN
Minimal change glomerulonephritis
Goodpastures syndrome

Minimal change

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Which of the following is useful in an acute attack of gout?
Allopurinol
Colchicine
Aspirin
Probenecid
Bendrofluazide

Colchicine

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Which of the following genetic syndromes does not put you at risk of phaeochromocytoma?

VHL (Von Hippel Lindau)
NF1 (Neurofibromatosis type 1)
MEN1 (Multiple Endocrine Neoplasia type 1)
MEN2 (Multiple Endocrine Neoplasia type 2)
MEN3 (Multiple Endocrine Neoplasia type 3, previously known as 2b)

MEN1

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Which drug can be used in the treatment of benign prostatic hyperplasia (BPH)?

5-alpha reductase inhibitor
Oestradiol
Phosphodiesterase inhibitor (can you name one?)
Beta blockers
Testosterone

5-alpha reductase inhibitor

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Which of these is a Gram positive organism?

E-coli
Haemophilus influenza
Listeria Monocytogenes
Salmonella typhi
Neisseria Meningitidis (Meningococcus)

Listeria Monocytogenes

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A patient has been on Allopurinol 300 mg daily for several months and is well. Which of the following drugs should be avoided and is known to cause dangerous toxicity if taken with allopurinol?

Tamoxifen
Aminophylline
Azathioprine
Phenytoin
Carbamazipine

Azathioprine

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A patient has a large dose of paracetamol and develops liver dysfunction. Which is the most sensitive marker of liver damage?
Bilirubin
Alkaline phosphatase
AST
Prothrombin time (clotting)
GGT

Prothrombin time (clotting)

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A 53 year old European male presents with a recent history of weight loss and sudden onset of abdominal pain and fever. On examination the abdomen is distended with signs of peritonitis. He undergoes emergency laparotomy and and partial resection of small bowel and associated mesentery.

Over the next few days the following laboratory results become available:

FBC and renal profile normal

LDH 12,000u/ml (NR 50-234)

EBV IgG serology positive, HIV 1 antibody positive

The histopathology description of a mesenteric lymph node: The node is effaced and diffusely infiltrated by large lymphoid cells. Under low poor the node has a starry sky appearance. On immunohistochemistry the large cells are positive for CD20, surface Immunoglobulin, myc and EBER (Ebstein Barr Virus encoded small RNAs) the cells are negative for CD3 and CD30. Ki67 expression is 98%. Karyotype analysis reveals t(8;14)(q24;q32).

What is the most likely diagnosis?

Gastric Marginal Zone Lymphoma
Burkitt Lymphoma
Enteropathy associated T cell lymphoma of the small bowel
Diffuse Large B cell Lymphoma
Acute lymphoblastic leukaemia

Burkitt Lymphoma

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Superoxide dismutase 1 is a misfolded protein associated with which condition?

Parkinsons disease
Motor neurone disease
Alzheimer’s disease
Relapsing and remitting multiple sclerosis
Guillain Barre syndrome

Motor neurone disease

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In a test for a disease, which term describes the number of true positives divided by the total number of people that have the disease? (covered in week 0 lecture by Maggie Hancock)
Specificity
Negative predictive value
Sensitivity
Positive predictive value
Z-score

Sensitivity

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Which of the following conditions can cause hypercalcaemia?

a) osteomalacia
b) paget’s disease
c) sarcoidosis
d) secondary hyperparathyroidism
e) osteoporosis

c) sarcoidosis

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By what mechanism does sarcoidosis cause hypercalcaemia?

a) Ectopic expression of 1 alpha hydroxylase
b) Ectopic expression of 25 hydroxylase
c) Very high levels of PTH in the circulation
d) Very high levels of PTH related peptide in the circulation
e) Osteoblast activation

a)Ectopic expression of 1 alpha hydroxylase

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Which of the following is useful in patients with pseudomonas aeruginosa lung infection?

a) Ceftriaxone
b) Clarithromycin
c) Gentamicin
d) Metronidazole
e) Flucloxicillin

c)Gentamicin

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A chronic inflammatory bowel disease affecting the large bowel and duodenum is most likely to be:

a) Adenocarcinoma
b) Crohn’s Disease
c) Diverticular Disease
d) Ulcerative Colitis
e) Familial Polyposis coli

b)Crohn’s Disease

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The severity of which of these conditions is measured by the Breslow score?
a)Melanoma
b)Multiple myeloma
c)Peptic ulceration
d)Sarcoidosis
E)Stroke risk in AF patients

a)Melanoma

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Which of the following is a complication of a Berry Aneurysm?

a) haemorrhagic stroke
b) ischaemic stroke
c) subarachnoid haemorrhage
d) subdrual haemorrhage
e) extradural haemorrhage

c) subarachnoid haemorrhage

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In a gastric biopsy from a patient with helicobacter pylori the biopsy is most likely to show:

a) Adenocarcinoma
b) Chronic gastritis
c) Gastric ulcer
d) Lyphoma
e) Squamous cell carcinoma

c)Gastric ulcer

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Where is the enzyme 25-hydroxylase found?

a) Kidney
b) Bone
c) Lung
d) Liver
e) Parathyroid gland

d)Liver

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A patient with diabetes is developing cellulitis. What is the most appropriate antibiotic?

a) Amoxycillin
b) Flucloxacillin
c) Gentamicin
d) Trimethoprim
e) Clarithromycin

b)Flucloxacillin

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Which of the following suggest a microangiopathic haemolytic anaemia?

a) Raised Bilirubin
b) Raised Platelets
c) Raised TIBC
d) Postive Coombes test
e) Raised INR

a)Raised Bilirubin

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A 67-year-old gentleman presents to A&E disorientated. He is unkempt and smells of alcohol. On examination, he is jaundiced, has an enlarged abdomen and spider naevi on his chest. He demonstrates a liver flap.

What is the most likely cause of his confusion?

Hypoalbuminuria
Hyperammoniaemia
Hypercalcaemia
Hypocalcaemia
Hypokalaemia

Hyperammoniaemia

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A patient with liver disease is found to have palmar erythema, dupuytrens contracture, spider naevi and gynaecomastia.

What do these signify?

Chronic stable liver disease
Hepatitis
Liver failure 
Obstruction of bile ducts 
Portal HTN

Chronic stable liver disease

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In which condition would you expect a failure in the production of neutrophils?

Classical NK deficiency
Chronic granulomatous disease
IL-12 deficiency 
Kostmann syndrome
Leukocyte adhesion deficiency

Kostmann syndrome

At what age would a child with severe combined immunodeficiency succumb to infections?

3 months
1 year 
Puberty 
Before birth (in utero)
Immediately after birth (aged 1 day)

3 months

Most common cause of CNA infections? ``` Coxsackie group B Haemophilus influenza B Listeria monocytogenes Nessieria meningitidis Streptococcus pneumoniae ```

Coxsackie group B

A patient has a lumbar puncture. The CSF is slightly turbid. The LP shows 2 erythrocytes, 100 lymphocytes and a protein level of 0.5g/L. What is the most likely diagnosis? ``` Aseptic meningitis normal Purulent meningitis Subarachnoid haemorrhage Tuberculous meningitis ```

Aspetic meningitis

Which of these signs suggest an incompatible blood transfusion? ``` Bradycardia Haematuria Pulmonary oedema Splenomegaly Splinter haemorrhage ```

Haematuria

Anti-D immunoglobulin: a) should be given to all A RhD positive mothers within 72 hours of delivery b) should be given to all O RhD positive mothers within 72 hours of delivery c) should only be given to RhD positive mothers after their second pregnancy d) prevents sensitisation of the mother following placental abruption e) prevents sensitisation of the mother following placental abruption

d) prevents sensitisation of the mother following placental abruption

Which of the following features suggests Ulcerative colitis? ``` Cobblestone mucosa Inflammation confined to mucosa Non-caseating granulomas Skips lesions Transmural inflammation ```

Inflammation confined to mucosa

Which of the following is the largest risk factor for colonic carcinoma? ``` Crohns disease Diverticular disease IBS Peutz Jeghers UC ```

A 60 year old male presents to ED with hypotension and a rash following a dose of propranolol. You suspect anaphylaxis. What test would you like to perform to confirm your diagnosis? ``` Blood histamine level Drug challenge Serial mast cell tryptase Skin prick Urine prostaglandin D2 ```

Serial mast cell tryptase

For which of the following conditions would you choose allogeneic transplantation over autologous transplantation? ``` Acute leukaemia BM failure Chronic leukaemia Myeloma Lymphoma ```

BM failure

Which of the following would cause a rise in Alkaline Phosphatase (ALP)? ``` Alcoholic hepatitis Myocardial infarction Osteoporosis Osteomalacia Viral hepatitis ```

Osteomalacia

A 50 year old male presents with a calcium of 3.0mM (normal range 2.2 – 2.6). PTH level is 3pM (normal range 1.1 – 6.8). What is the likely diagnosis? ``` cancer w/bony mets Multiple myeloma Primary hyperparathyroidism Sarcoidosis Vitamin D excess ```

Primary hyperparathyroidism

``` 8. Name the disorder of calcium handling most commonly seen in patients with end-stage chronic renal failure, in which the plasma calcium is raised. A. Hypoparathyroidism B. Primary Hyperparathyroidism C. Pseudohypoparathyroidism D. Secondary Hyperparathyroidism E. Tertiary Hyperparathyroidism ```

E. Tertiary Hyperparathyroidism

Which of the following conditions is an example of a Polygenic Auto-inflammatory disease? ``` Addisons APS-1 Behcets syndrome Familial Mediterranean Fever Ulcerative colitis ```

Ulcerative colitis

Which of the following is an example of Gel and Coombs Type II hypersensitivity? ``` Anaphylaxis Contact dermatitis Insulin dependent DM Myasthenia gravis SLE ```

Myasthenia gravis

A 32 year old male has a productive cough and shortness of breath. His sputum culture was positive for Pneumocystis jiroveci and he is diagnosed with atypical pneumonia. He has a HIV test performed which is positive. A CD4 count is therefore obtained. At what CD4 count would you expect opportunistic diseases to first present? ``` 200 cells/microlitre 400 cells/microlitre 600 cells/microlitre 800 cells/microlitre 1000 cells/microlitre ```

200 cells/microlitre

What is the mechanism of action of corticosteroids? ``` Inhibits calcineurin Inhibits JAK-STAT signalling Inhibits mTOR inhibitors Inhibits PDE4 inhibitors Inhibits phospholipase A2 ```

Inhibits phospholipase A2

A 65 year old male has a 3 month history of melaena, vomiting and 8kg weight loss. After further investigations, he is diagnosed with Stage II gastric cancer. What is the most common type of gastric cancer? ``` Adenocarcinoma Gastrointestinal stromal tumour (GIST) Lymphoma (MALToma) Neuroendocrine tumours Squamous cell carcinoma ```

Adenocarcinoma

``` 9. Name the peptide hormone responsible for increasing plasma calcium in response to reduced calcium levels by stimulating osteoclast activity. A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Parathyroid Hormone ```

E. Parathyroid Hormone

``` 10. Name the form of vitamin D produced following the action of 1alpha hydroxylase on 25-OH D3 in the kidney. A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Vitamin D3 ```

B. Calcitriol

``` 11. Which of the options acts to stimulate 1alpha hydroxylase activity in the kidney to increase the production of vitamin D3. A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Parathyroid Hormone ```

E. Parathyroid Hormone

12. A patient has a positive Coombes test (positive direct antiglobulin test). Which is the most likely diagnosis? A. Auto-immune haemolytic anaemia (AIHA) B. Disseminated intravascular haemolysis (DIC) C. Hereditary spherocytosis D. Micro-angiopathic haemolytic anaemia (MAHA) E. Polycytheamia Rubra Vera

A. Auto-immune haemolytic anaemia (AIHA)

13. Which of the following cause a polycythaemia? A. Adrenal cortical carcinoma B. Colonic carcinoma C. Prostatic carcinoma D. Renal cell carcinoma E. Transitional cell carcinoma of the bladder

D. Renal cell carcinoma

``` 14. What is the specific auto-antigen that is the target of the immune system in Goodpastures syndrome? A. Osteoblasts B. Osteoclasts C. Skin D. Spectrin E. Type IV Collagen ```

E. Type IV Collagen

15. Which of the following is most diagnostic for Rheumatoid arthritis? A. Anti-CCP (cyclic citrullinated peptide) Antibody B. Anti-Centromere Antibody C. Anti-GAD (glutamic acid decarboxylase) Antibody D. Anti-Mitochondrial Antibody E. Rheumatoid Factor

A. Anti-CCP (cyclic citrullinated peptide) Antibody

``` 16. Which of these is particularly associated with longstanding bronchiectasis? A. E-Coli B. Pseudomonas Aeruginosa C. Staph aureus D. Strep pneumoniae E. Strep pyogenes ```

B. Pseudomonas Aeruginosa

``` 17. Which of these is most likely to CAUSE bronchiectasis? A. E-coli B. Pseudomonas Aeruginosa C. Staph aureus D. Strep pneumoniae E. Strep pyogenes ```

C. Staph aureus

Antibodies to phospholipase A2 receptor are associated with what form of glomerulonephritis? ``` A. Crescentic B. Goodpastures disease C. Membranous D. Minimal change E. Rapidly progressive ```

C. Membranous

``` A 40 year old woman has always known cramping pain associated with her periods – which have usually been heavy. Recently this pain has become constant throughout the month, and her periods have become more frequent. She claims never to have used oral contraception and has no children. She is abstaining from sexual intercourse as it is too painful. What is the likely diagnosis? A. Cervical Polyps B. Endometriosis C. Fibroids D. Herpes Virus Infection E. Polycystic Ovary Syndrome ```

B. Endometriosis

``` 19. Which of these is associated with hyperkalaemia? A. Addison’s disease B. Conn’s syndrome C. Ectopic ACTH D. Prostate cancer E. Renal artery stenosis ```

A. Addison’s disease

A 50 year old male has blood tests performed to check his Hepatitis B status. His serological markers show the following: HBsAg negative , anti-HBc negative , anti-HBs positive What do his serological markers confirm? ``` Acute infection Chronic infection Immunity secondary to vaccination Immunity secondary to natural infection Resolving acute infection ```

Immunity secondary to vaccination

A 50 year-old gentleman presents to the GP following surgery 10 days ago. The wound is tender, erythematous and you notice pus discharging. Microscopy and Gram stain of a wound swab demonstrates purple cocci in clusters, which are catalase positive and coagulase negative. What is the most likely organism? a. Staphylococcus aureus b. Staphylococcus epidermidis c. Staphylococcus saprophyticus d. Streptococcus pyogenes e. Streptococcus pneumoniae

b. Staphylococcus epidermidis

A 75 year-old lady presents to ED with shortness of breath, productive cough and fever. On examination, her respiratory rate is 34 and blood pressure is 94/59. Crackles are heard at the left lung base. She is orientated. Blood results show a urea of 9.5. How would you manage this patient? a. Discharge with PO amoxicillin b. Admit for PO amoxicillin and PO clarithromycin c. Admit for IV amoxicillin and IV clarithromycin d. Admit for IV co-amoxiclav and IV clarithromycin e. Admit for IV co-amoxiclav, IV clarithromycin and IV gentamycin

d. Admit for IV co-amoxiclav and IV clarithromycin