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Pathology 2017 past paper > EMQs > Flashcards

EMQs Flashcards

1
Q

Blood transfusion - several hours later develops rash all over

A

Allergic reaction

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2
Q

Road traffic accident requiring 6 unit transfusion - Becomes acutely breathless/SOB with a fever and tachycardia

A

Transfusion Related Lung Injury

Tachycardia
Hypotension
Fever
SOB or low sats or bilateral lung infiltrates

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3
Q

Regular transfusions for beta-thalassaemia - presents with malaise and erectile dysfunction

A

Transfusion associated haemosiderosis

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4
Q

Alcoholic has an AAA repair and several days later develops a fever with low Hb and jaundice

A

Delayed haemolytic transfusion reaction

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5
Q

10 mins after transfusion becomes tachycardic, has transfusion site pain and is hypotensive

A

ABO incompatibility

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6
Q

Sickle cell solubility test comes back positive with some clouding of the tested blood

A

Sickle cell trait

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7
Q

African child, low Hb and normal MCV.

Blood is tested by electrophoresis to confirm diagnosis:
v high HBS and low HbF

A

Sickle cell anaemia

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8
Q

Haemolysis after antimilarials / malaria treatment

A

G6PD - Glucose-6-phosphate-dehydrogenase deficiency

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9
Q

Spherocytes, polychromasia and reticulocytosis on blood film

A

Hereditary spherocytosis

Tested with osmotic fragility test

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10
Q

Coeliac disease with uncontrolled diet (ie eats gluten) –> macrocytosis

why?

A

folate deficiency

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11
Q

Teenager goes cross country running and gets an erythematous rash with is well controlled by antihistamines

A

Cold urticaria

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12
Q

Man can eat apple pie but if he eats fresh apples and pears he gets inflamed lips

A

Oral allergy syndrome

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13
Q

Allergic reaction during surgery - also gets swollen lips when blowing up balloons

A

Type 1 hypersensitivity latex allergy

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14
Q

Bloated after drinking milk but not IgE mediated

A

Lactose intolerance

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15
Q

A girl with a sore throat is given penicillin and develops a rash. She is found to have EBV

A

Drug reaction

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16
Q

High IgG paraprotein, back pain and loss of sensation in legs

A

Multiple Myeloma

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17
Q

IgM paraprotein and visual disturbances

A

Lymphoplastic lymphoma (Waldenstrom’s macroglobinaemia)

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18
Q

Asymptomatic, low neutrophils, no abnormal cells on film

A

Chronic idiopathic neutropenia

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19
Q

Pancytopenia and immature myeloid cells on blood film with normal WCC

A

Acute Myeloid Leukaemia

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20
Q

An overweight individual with diabetes has longstanding bone/back pain. They are found to have paraprotein IgA ~8g/dl, and GFR 55
FBC normal and albumin normal.

A

Monoclonal-gammopathy of unknown significance

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21
Q

Asymptomatic with isolated rise in unconjugated bilirubin

A

Gilberts

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22
Q

22 yo student with two weeks of fever, anorexia and malaise

Raised ALT>raised ALP+GGT

A

Viral hepatits

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23
Q

Woman with colicky abdo pain

Raised GGT+Billirubin>other raised markers

A

post-hepatic disease eg Acute Cholestasis

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24
Q

57 yo man with haematemesis

High ALT+GGT>raised ALP
low albumin

A

Alcohol induced hepatitis

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25
Q

Headaches with an isolated raised ALP

A

Paget’s

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26
Q

Most common cause of traveller’s diarrhoea

A

Escherichia Coli

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27
Q

Foul smelling diarrhoea and cramping pain 5 days after eating chicken at a BBQ

A

Campylobacter

OR Shigella if bloody diarrhoea

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28
Q

food poisoning after rice

A

Bacillus Cereus

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29
Q

Had surgery which required antibiotics, now has profuse watery diarrhoea

A

Clostridium Difficile

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30
Q

Nurse gets diarrhoea after patients have had similar illness on her ward

A

Norovirus

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31
Q

Antibiotic for Listeria Meningitis

A

Amoxicillin and Gentamycin
OR
Ampicillin and Gentamycin

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32
Q

Treatment for non-Listeria Meningitis

A

< 3 months - IV cefotaxime and amoxicillin or ampicillin

> 3 months - IV ceftriaxone

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33
Q

Antibiotic for mild community acquired pneumonia

A

Amoxicillin

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34
Q

Treatment for Group A Strep / Strep throat

A

Oral Penicillin V
OR
IV Benzylpenicillin and Metronidazole

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35
Q

Cystitis - fully sensitive E. Coli

A

Trimethoprim

Cannot be used in pregnancy

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36
Q

MRSA cellulitis treatment

A

Vancomycin

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37
Q

Methicillin sensitive Staph aureus cellulitis treatment

A

Flucloxacillin

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38
Q

Bicarbonate value in pyloric stenosis

A

HIgh -> metabolic alkalosis

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39
Q

Potassium in DKA

A

HIgh then low following insulin treatment

40
Q

Oral Glucose Tolerance Test

Results seen in Impaired Glucose Tolerance

A

7.7 < IGT > 11.1

Below 7.7 = normal
above 11.1 = suggestive of diabetes

41
Q

Fasting glucose results interpretation

A 
<6.1 = normal
6.1-7.0 = Impaired Fasting Glucose
>7.0 = suggestive of diabetes
42
Q

Oral Glucose tolerance test

before: 4.9
after: 10.0

A

Impaired glucose tolerance

7.7-11.1

43
Q

Teenager presents with several weeks of thirst, increased urination and weight loss

A

T1DM

44
Q

High Na
Low K
High Urine osmolality

A

Conn’s syndrome

45
Q

Metabolic acidosis with high K

A

DKA

46
Q

High sodium
High Potassium
Plasma osmolality ~ 400
Urine osmolality ~ 600

A

SIADH

OR psychogenic polydipsia if history of excessive drinking with no physiological stimuli

47
Q

Cells which immature form is in the periphery and then when it matures presents antigens to T cells

A

Dendritic cells

48
Q

Cell inhibited by the presence of MHC1 on cells

A

Natural Killer cells

49
Q

Increased in parasitic infection

A

Eosinophils

50
Q

Undergoes positive and negative selection in the thymus

A

T lymphocytes

51
Q

Cell responsible for the production of pus

A

neutrophils

52
Q

Cancer associated with Barrett’s Oesophagus

A

Adenocarcinoma

53
Q

Cell changes in the oesophagus due to GORD

A

Metaplasia

54
Q

Stomach changes in pernicious anaemia

A

Atrophic gastritis

55
Q

Cancer associated with H. Pylori

A

MALT lymphomas due to chronic gastritis. t(11:18)

Mucosa Related Lymphoid Tissue

56
Q

Cancer associated with coeliac disease

A

Lymphoma

57
Q

Most common type of malignancy in the breast

A

Invasive ductal carcinoma (75%)

58
Q

Which breast cancer is also known as non-specific type

A

Invasive ductal carcinoma

59
Q

Breast cancer which has a high, medium and low stage

A

Ductal carcinoma in situ

60
Q

Fibro-epithelial tumour with abundant stromal elements

A

Phyllodes tumour

61
Q

E-cadherin test results

A

Positive = invasive ductal carcinoma

Negative = Invasive lobular carcinoma

62
Q

If this enzyme is low, leads to hyperiricemia/rise in blood uric acid

A

HGPRT (Hypoxanthine-guanine phosphoribosyltransferase)

Associated with Lesch–Nyhan syndrome

63
Q

Enzyme which regulates the rate-limiting step in haem biosynthesis

A

ALA Synthase (d-Aminolevulinate Synthase)

64
Q

Raised in osteomalacia

A

ALP (alkaline phosphatase)

65
Q

Enzyme raised in mumps

A

Amylase-S

Amalyse-P is raised in pancreatitis

66
Q

Raised biomarker in Rhabdomyolysis

A

Creatinine kinase

67
Q

Aches all over, diffuse swelling and joint stiffness.

A

Rheumatoid arthritis

Anti-CCP
Anti-cyclic citrullinated peptide

68
Q

Dry eyes and parotid swelling

A

Sjogren’s syndrome

anti-Ro and anti-La

69
Q

Man with weakness in gym and ptosis

A

Myesthenia Gravis

Anti-acetylcholine receptor

70
Q

what would you measure in exacerbation of SLE

A

C3 and C4

low in active disease

71
Q

Recurrent infections (chest and ear). No B cells

A

Bruton’s X-linked agammaglobinaemia

72
Q

Abscesses and positive NBT

A

Myeloperoxidase deficiency

Negative NBT = Chronic granulomatous disease

73
Q

Lack of CD4 cells with CD8 and B cells present

A

Bare lymphocyte syndrome

74
Q

A boy’s father has TB. The boy develops a mycobacterium infection following the BCG

A

IFN-gamma receptor deficiency

75
Q

UTI and acute onset costovertebral pain. Pus cells and blood in urine.

A

Acute pylonephritis

76
Q

Loin-to-groin pain, haematuria and pain at end of micturation

A

Renal calculus causing UTI

77
Q

Frank painless haematuria and a palpable mass on one side in adult

A

Renal cell carcinoma

78
Q

Palpable abdominal mass in a 2 yo

A

Wilm’s tumour

79
Q

A man with AF develops fever, nausea, vomiting and pain in his right loin/flank

A

Renal infarct

80
Q

Most common cause of maternal throbocytopenia

A

Gestational thrombocytopenia (70%)

other causes:
Pre-eclampsia (21%)
Maternal idiopathic thrombocytopenia purpura (3%)

81
Q

Cause of DIC in pregnancy

A

Placental abruption or Amniotic fluid embolism

82
Q

HELLP syndrome signs

A

Haemolysis (MAHA)
Elevated Liver enzymes
Low Platelets

83
Q

Normally increased in pregnancy

A

Fibrinogen
Creatinine clearance
ALP

84
Q

Cause of neonatal thrombocytopenia

A

<72 hours = placental insufficiency (reduced platelet production)

> 72 hours = sepsis or necrotising enterocolitis

85
Q

Treatment for herpes simplex virus 1 encephalitis

A

Acyclovir

86
Q

Treatment of herpes zoster in pregnancy

A

Acyclovir

87
Q

Antibiotic used to treat Respiratory syncytial virus (bronchiolitis) in a child

A

Ribavirin

88
Q

Treatment for influenza A

A

Oseltamivir (can be used in asthmatics) or Zanamivir (cannot be used in asthmatics)

89
Q

Abdo pain radiating to back, collapses and dies

A

AAA

90
Q

Progressive memory issues and hypertension

A

multiple cerebral infarcts (vascular dementia)

91
Q

Elderly man with AF develops right flank pain

A

Renal infarct

92
Q

Man with previous MI now has blood in the pericardium

A

Ventricular rupture

93
Q

Girl is acting strangely.

LP shows high lymphocytes and raised protein but normal glucose

A

Viral eg Herpes

94
Q

18 yo with gram negative diplococci causing meningitis

A

Neisseria meningitidis

95
Q

Smoker with gram positive diplococci causing meningitis

A

Strep pneumonia

96
Q

Gram negative rod causing sepsis in a neonate

A

<3 months = E. coli

> 3 months = Haemophilus influenenzae

97
Q

Gram positive rod causing meningitis in a 72 yo

A

Listeria monocytogenes

Pathology 2017 past paper (3 decks)

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