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Question 1

Schistomiasis

Answer 1

Comon in Middle east and parts of Africa

Granulomas forming around eggs of schistosomes in urinary tract can obstruct urinary tree

Question 2

Actinic keratosis

Answer 2

Flat lesion

Small mildy erythematous patch with keratotic hypertrophy

Question 3

Leukotriene receptor antagonists in management of acute asthma

Answer 3

No

Question 4

Psoriasis 5 characteristic patterns

Answer 4

Distak interphalangeal arthritis
Symmetrical polyarthritis 
Asymmetrical oligoarthritis 
Spondyloarthropathy 
Arthritis mutilans  (severe destructive arthropathy mainly affecting the hands)

Question 5

Ezcema vs psoriasis location

Answer 5

Ezcema more commonly localised to flexures

Psoriatic plaques more typically localised to extensor surfaces

Question 6

Psoriasis annual changes

Answer 6

Worse in winter months as it responds well to sunlight

Question 7

MRI findings of MS

Answer 7

Periventricular white matter lesions not necessarily matching the clinical picture

Question 8

Causes of LBBB

Answer 8

Aortic stenosis
Dilated cardiomyopathy
Chronic HTN
Extensive CAD without MI

Question 9

Blood test results Legionella pneumophila

Answer 9

Hyponatramia
Abnormal LFT (elevated liver enzymes, hypoalbuniamaia)
Elevated Creatinine kinase

Question 10

BPPV pathophysiology

Answer 10

Debris blocking normal flow of endolymph in labyrinth

Only happens when head moves

Question 11

Hallpike manouvere

Answer 11

Reveals nystagmus when pts head is tilted back whilst they face one side and not other

Question 12

Treatment of BPPV

Answer 12

Epley manouvere

Question 13

Wegener granulomatosis

Answer 13

Systemic vasculitis that involves small and medium vessels

TRIAD:
Upper & lower resp tract involvement
Pauci immune glomerulonephritis

pANCA

Question 14

Diagnosis of malaria

Answer 14

3 thick & thin blood films on consecutive days

Question 15

Hepatomegaly with smooth margin

Answer 15

Viral hep 
Biliary tract obstruction 
Hepatic vein thrombosis (budd-chiari syndrome)
Right heart failure 
Myeloproliferative disease

Question 16

Hepatomegaly with craggy border

Answer 16

Hepatic metastatic disease

Polycystic disease

Question 17

Blood vessel supplying SAN, AVN, Right ventricle and inferior part of left ventricle

Answer 17

Right CA

Question 18

Blood vessel supplying LV and Inter-ventricualr septum

Answer 18

LAD

Question 19

N. gonorrhoea shape

Answer 19

Gram -vs cocci

Question 20

N. meningitidis shape

Answer 20

Gram -ve cocci

Question 21

E.coli
Salmonella
H.influennzae
H. pylori

SHAPE

Answer 21

Gram-ve rods

Question 22

C.diff
Listeria

SHAPE

Answer 22

Granm +ve rods

Question 23

Staphylococci
Streptococci

SHAPE

Answer 23

Gram +ve cocci

Question 24

Signs of mitral stenosis

Answer 24

Bifid P-wave
Diastolic opening snap heart sound
Mid-diastolic murmur
Peripheral cyanosis

Question 25

DOuble impulse apex beat

Answer 25

HoCM

Question 26

Bell's Plasy treatment

Answer 26

Steroids, antiviral therapy and eye protection

Question 27

Forehead not spared meaning...

Answer 27

LMN;

Question 28

Imunoglobulin light chains in blood

Answer 28

Multiple myeloma

Question 29

Diagnosis of multiple myeloma

Answer 29

2/3 of the following: 1) Marrow plasmcytosis 2) Serum/urinary Ig-light chains (Bence-Jones protein) 3) Skeletal lesions

Question 30

Indication for commencing HAART in HIV

Answer 30

CD4 < 200 cells/mm^3

Question 31

Most common cause of acute confusion in elderly pt

Answer 31

Chest/urinary tract infeciton

Question 32

Conditions associated with HLA-B27

Answer 32

IBD Psoriasis Uveitis

Question 33

Scleritis

Answer 33

Inflammation of sclera

Question 34

Causes of non-pitting oedema

Answer 34

Lymphoedema | Pretibial myodema

Question 35

Gold standard Ix for GCA

Answer 35

Temporal artery biopsy

Question 36

Management of hypercalcaemia steps

Answer 36

Check pts U+Es BD IV bisphosphonate (causes bone reabsorption) Start loop diuretics Rehydrate with IV saline

Question 37

Clinical features of thalassaemia major

Answer 37

Failure to thrive (insufficient weight gain) lethargy Pallor Jaundice Hepatosplenomegaly Bossing of the skull Maxillary prominence Long bone deformity

Question 38

Osteophytes at DIP joints

Answer 38

Heberden nodes Osteoarthritis

Question 39

Osteophytes at PIP joints

Answer 39

Bouchard nodes Osteoarthritis

Question 40

Trigger finger

Answer 40

Psoriatic arthritis | Rheumatoid arthritis

Question 41

Aphthous ulcers

Answer 41

Common idiopathic benign condition Small, grey, shallow ulcers that dissapear spontaneously Incidence rises dramatically with IBD

Question 42

Impetigo

Answer 42

contagious, superficial infection caused most commonly by Staphylococcus aureus. The infection spreads when lesions burst to release an exudate, which spreads the bacteria outwards and leaves behind the crust.

Question 43

Torsades de pointes causes

Answer 43

``` TCA Amiodarone Long QT syndrome Malnutrition Anti-arrhythmics ```

Question 44

Blast cells

Answer 44

ALL

Question 45

Hyponatraemia and hyperkalaemia in pt with postural hypotension

Answer 45

Possible primary adrenal insufficiency

Question 46

SBP

Answer 46

Pts with ascites are at risk of developing SBP Most common organisms are E.coli and Kleb. Spp

Question 47

Diagnosis of sarcoidosis

Answer 47

Biopsy and histoly showing non-caseating granulomas

Question 48

Diagnosis of Multiple Sclerosis on LP

Answer 48

Oligoclonal bands on electrophoresis

Question 49

Budd-Chiari syndrome

Answer 49

Sudden onset ascites with tender hepatomegaly in absence of jaundice should hold high degree of suspicion

Question 50

Budd-Chiari syndrome aetiology

Answer 50

Effects of hepatic vein outflow obstruction, caused by thrombosis or malignancy ``` RFs: Malignancy Thrombophilias Trauma OCP ```

Question 51

B12 deficiency Sx

Answer 51

Macrocytic anaemia Glossitis Peripheral neuropathy