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General Questions Flashcards

1
Q

HLA-A3

A

Haemochromatosis

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2
Q

HLA-B5

A

Behcet’s Syndrome

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3
Q

HLA-B27

A

Ankylosing Spondylitis,
Reiter’s syndrome,
acute anterior uveitis

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4
Q

HLA-DQ2/DQ8

A

Coeliac disease

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5
Q

HLA-DR2

A

Narcolepsy,

Goodpasture Syndrome

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6
Q

HLA-DR3

A

Dermatitis Herpetiformis
Sjogren’s syndrome
primary biliary cirrhosis

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7
Q

HLA-DR4

A

Rheumatoid Arthritis,

T1DM (this is also associated less strongly with HLA-DR3)

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8
Q

Cytotoxic MoA + main SFx: cyclophosphamide

A

MoA: Alkylating agent vs DNA crosslinks
SFx: haemorrhagic cystitis

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9
Q

Cytotoxic MoA + main SFx: Bleomycin

A

MoA: DNA degradation
SFx: lung fibrosis

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10
Q

Cytotoxic MoA + main SFx: Doxorubicin

A

MoA: inhibit DNA synthesis
SFx: cardiomyopathy

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11
Q

Cytotoxic MoA + main SFx: Methotrexate

A

MoA: DHR folate synthesis inhibitor
SFx: fibrosis (lung + liver); myelosuppression

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12
Q

Cytotoxic MoA + main SFx: 5-FU

A

MoA: thymidylate synthase inhibitor
SFx: dermatitis/mucositis

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13
Q

Cytotoxic MoA + main SFx: 6-mercaptopurine

A

MoA: Inhibits purine synthesis
SFx: myelosuppression

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14
Q

Cytotoxic MoA + main SFx: Cytarabine

A

MoA: inhibits DNA polymerase
SFx: myelosuppresion, ataxia

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15
Q

Cytotoxic MoA + main SFx: Vincristine

A

MoA: MT formation inhibitor
SFx: peripheral neuropathy

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16
Q

Cytotoxic MoA + main SFx: Docletaxel

A

MoA: inhibits MT depolymerisation
SFx: neutropenia

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17
Q

Cytotoxic MoA + main SFx: Cisplatin

A

MoA: DNA crosslinking
SFx: ototoxicity

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18
Q

Cytotoxic MoA + main SFx: Hydroxyurea

A

MoA: reduces DNA synthesis
SFx: myelosuppression

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19
Q

Normal anion gap

A

10-18 mmol/L

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20
Q

Raised anion gap causes:

A

Lactate: shock, hypoxia
Ketones: diabetic ketoacidosis, alcohol
Urate: renal failure
Acid poisoning: salicylates, methanol

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21
Q

First line treatment for ethylene glycol poisoning

A

Fomepizole = alcohol dehydrogenase inhibitor

Ethanol replaced
Haemodialysis for refractory cases

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22
Q

Which is associated with hypokalemia and hypertension: Bartter’s syndrome or Liddle syndrome?

A

Liddle syndrome

Bartter and Gitelman’s = hypokalemia without hypertension

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23
Q

Antibiotic vs animal bite

A

Coamoxiclav

Doxy + metro if pen allergic

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24
Q

Name the pathogen:
cutaneous Leishmaniasis -
mucocutaneous Leishmaniasis -
visceral Leishmaniasis -

A 
Cutaneous = L tropica; L mexicana
Mucocutaenous = L braziliensis
Visceral = L donovani
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25
Q

Antibiotic treatment in bacterial meningitis for those penicillin or cephalosporin allergic?

A

Chloramphenicol

26
Q

Klinefelter’s syndrome

A

Klinefelter’s syndrome is associated with karyotype 47, XXY

Features:
often taller than average
lack of secondary sexual characteristics
small, firm testes
infertile
gynaecomastia - increased incidence of breast cancer
elevated gonadotrophin levels
27
Q

T9:22

A

Chronic myeloid leukaemia - 9 ABL (oncogene - an aberrant tyrosine kinase) + 22 B cell receptor

28
Q

T15:17

A

Acute pro-myelocytic leukaemia - 15 Promyelocytic gene + 17 Retinoid acid receptor alpha (Fusion protein binds retinoid acid receptor and promotes transcription).

29
Q

T8:14

A

Burkitt’s Lymphoma - 8 c-myc (oncogene) + 14 Ig heavy constant region

30
Q

T14:18

A

Follicular Lymphoma - 14 Ig heavy constant region + 18 Bcl2 (anti-apoptotic gene)

31
Q

T11:14

A
  • Mantle Cell Lymphoma 11 - Cyclin D (oncogene) + 14 Ig heavy constant region
32
Q

Anti-Hu

A

associated with small cell lung carcinoma and neuroblastomas
sensory neuropathy - may be painful
cerebellar syndrome
encephalomyelitis

33
Q

Anti-Yo

A

associated with ovarian and breast cancer

cerebellar syndrome

34
Q

Anti-GAD antibody

A

associated with breast, colorectal and small cell lung carcinoma
stiff person’s syndrome or diffuse hypertonia

35
Q

Anti-Ri

A

associated with breast and small cell lung carcinoma

ocular opsoclonus-myoclonus

36
Q

pH threshold for NIV and invasive ventilation in COPD

A

NIV = 7.25-7.35

Invasive <7.25

37
Q

Sarcoidosis: poor prognosis

A 
insidious onset, symptoms > 6 months
absence of erythema nodosum
extrapulmonary manifestations: e.g. lupus pernio, splenomegaly
CXR: stage III-IV features
black people
38
Q

Pathogen most commonly causing IECOPD

A

Haemophilus influenzae

39
Q

TIA stratification

A 
ABCD2 score
Age >= 60 (1)
BP >= 140/90 (1)
Clinical features: Speech only (1), unilateral weakness (2)
D1: Duration <1hr (1) >1hr (2)
D2: DM (1)

Score >=4 = high risk –> aspirin 300mg + specialist r/v in 24h

40
Q

ECG changes in pericarditis

A

Widespread ‘saddle-shaped’ ST elevation

PR depression = most specific

41
Q

Epsilon wave on ECG

A

Diagnostic for Arrhythmogenic Right Ventricular Cardiomyopathy (ARVD).
Is a positive blip following the QRS complex

42
Q

Hereditary angioedema

A

C1-INH deficiency. Uncontrolled release of bradykinin.

43
Q

Leiner Disease

A

C5 deficiency. recurrent diarrhoea, wasting and seborrhoeic dermatitis

44
Q

Metformin Sfx

A

GI upset - 20%
vitamin B12 malabsorption
Lactic acidosis

45
Q

If neovascularisation is present in macular degeneration what is the investigation of choice?

A

Fluorescein angiography

46
Q

Lesion location: upbeat nystagmus

A

Cerebellar vermis lesion

47
Q

Downbeat nystagmus cause

A

Foramen Magnum lesion: Arnold-Chiari malformation

48
Q

Cluster headache management

A

Management
acute: 100% oxygen, subcutaneous or a nasal triptan
prophylaxis: verapamil, prednisolone
NICE recommend seeking specialist advice from a neurologist if a patient develops cluster headaches with respect to neuroimaging

49
Q

Gitelman syndrome

A

Gitelman’s syndrome is due to a defect in the thiazide-sensitive Na+ Cl- transporter in the distal convoluted tubule.

Features
hypokalaemia
hypomagnesaemia
hypocalciuria
metabolic alkalosis
normotension
50
Q

Homonymous hemianopia: incongruous vs congruous

A

incongruous defects = optic tract lesion; congruous defects = optic radiation lesion or occipital cortex

51
Q

Mixed Beta and alpha blockers

A

Carvedilol; labetalol

52
Q

Actinic keratoses treatment

A

topical fluorouracil cream

topical steroids/imiquimod

53
Q

Trastuzumab SFz

A

Cardiotoxicity - so do an echo before starting

54
Q

Leptospirosis treatment

A

penicllin or doxy

55
Q

Listeria meningitis treatment

A

IV ampicillin/amoxicillin + gentamicin

Cephalosporins not adequate

56
Q

Homocystinuria treatment

A

vitamin B6 (pyridoxine)

57
Q

new onset RA Rx

A

Methotrexate + another DMARD + short-course steroids(+ contraception if child-bearing age)

58
Q

Leprosy antibiotic treatment

A

Triple therapy: dapsone + rifampicin + clofazimine

59
Q

Miller-Fisher syndrome triad

A

Opthalmoplegia + areflexia + ataxia

60
Q

Is coal dust inhalation linked to lung cancer?

61
Q

Dabigatran reversal

A

Praxbind = Idarucizumab

MRCP (2 decks)

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