Halloween Mix

Question 1

What are the side effects of ACE inhibitors?

Answer 1

Cough, HypERkalaemia

Question 2

What are the side effects of Thiazides?

Answer 2

HyPOnatraemia, HyPOkalaemia, Impaired Glucose Tolerance, Gout

Question 3

What are the side effects of Calcium Channel Blockers?

Answer 3

Headache, ankle oedema, flushing

Question 4

What are the side effects of Beta Blockers?

Answer 4

Bronchospasm (esp in Asthmatics), Fatigue, Cold Peripheries

Question 5

What are the three types of VW Disease?

Answer 5

1) (80% pts) partial reduction of VWF; autosomal dominant 2) abnormal form of VWF, 3) total lack of VWF (autosomal recessive)

Question 6

What are the main signs of VWD?

Answer 6

prolonged bleeding time (epistaxis/menhorragia), decreased factor VIII levels, defective platelet aggregation with ristocetin

Question 7

What is the commonest childhood cancer?

Answer 7

Acute Lymphoid Leukaemia

Question 8

What are the cardinal signs of bone marrow failure?

Answer 8

Anaemia (may be later than other sx as RBCs have longer life than WBCs) ; Bleeding (due to thrombocytopaenia); Bacterial Infections (due to neutropaenia: often commensuals; may be no obvious focus of infection)

Question 9

What is the microscopic marker for AML?

Answer 9

Auer Rods

Question 10

With which type of Leukaemia is the Philadelphia Gene linked?

Answer 10

CML

Question 11

What is the NICE definition of pre-eclampsia

Answer 11

New hypertension presenting after 20 weeks with significant proteinuria; where significant proteinuria is a urinary protein/creatinine ratio of >30mg/mmol or 24 collection of >300mg

Question 12

What are the three main antibodies for SLE?

Answer 12

ANA (Antinuclear Antibody), Anti-dsDNA, Anti-sm

Question 13

What condition is indicated by presence of the Ab Anti-centromere?

Answer 13

Localised Sclerodoma (CREST)

Question 14

What condition is indicated by the presence of the Ab Anti-topoisomerase (Anti-SCL 70)?

Answer 14

Scleroderma (Systemic Sclerosis)

Question 15

What Auto-Ab is present in Wegner’s Granulomatosis?

Answer 15

C-ANCA

Question 16

For what condition is p-ANCA diagnsotic?

Answer 16

Microscopic Polyangitis and Churg-Strauss

Question 17

To which organs does lung cancer usually spread?

Answer 17

Liver, lungs and bone

Question 18

Give four attributes to help differentiate Squamous Cell Carcinoma from other Bronchogenic Carcinomas

Answer 18

• Keratin pearls
• more common in men and associtaed with smoking
• tumour is often central (as are SCC)
• parathyroid like paraneoplastic syndrome

Question 19

Give four attributes to help differentiate Adenocarcinoma from other Bronchogenic Carcinomas

Answer 19

• more common in women and in non-smokers
• often located in the periphery
• tend to be smaller than other bronchogenic carcinomas
• mucin staining is found on histology

Question 20

Give four attributes to help differentiate Small Cell Carcinoma (Oat Cell) from other Bronchogenic Carcinomas

Answer 20

• neoplasm contains small cells containing dark blue nuclei and sparse cytoplasm (Kulchitsky Cells)
• ACTH and ADH are secreted ectopically (neuroendocrine tumour)
• very aggressive - has often metastasized by the time it is diagnosed
• linked to Lambert-Eaton Syndrome

Question 21

In addition to withdrawal of dopamimetics in Parkinson’s Disease, for which three drugs has Malignant Neuroleptic Syndrome been reported

Answer 21

Haloperidol, Chlorpromazine and Flupenthixol Decanoate

Question 22

What disease is associated with the genetic translocation t(15,17)

Answer 22

Acute promyelocitic leukaemia (M3)

Question 23

What genetic abnormality can be found in people with Burkitt’s Lymphoma?

Answer 23

t(8,14)

Question 24

What is the name of the Chromosome t(9,22) and with which disease is it associated?

Answer 24

Philadelphia Chromosome: CML

Question 25

What translocation occurs in Mantle Cell Lymphoma?

Answer 25

t(11,14)

Question 26

Define Stage 1, Stage 2 and Stage 3 Hypertension

Answer 26

Stage 1: clinic >140/90: A/HBPM >135/85 Stage 3: clinic>160/110: A/HBPM >150/95 Stage 3: Clinic sys >180 or dia >110

Question 27

What are the four types of Hypersensitivity

Answer 27

I - IgE and release of Mast Cells (anaphylaxis/atopy) II- IgG/IgM (cell bound) - binds to antigen on cell surface (eg Goodpasture's, pernicious anaemia) III - Immune Complex (antigen/antibody combine) - SLE/post strep. glomerulonephritis IV - delayed hypersensitivity. T-Cell mediated - TB, MS, GBS V - Abds that recognise and bind to cell surface receptors - stimulate or block. eg Grave's or Myasthenia gravis

Question 28

What is the definitive test for Addison's Disease?

Answer 28

Short Synthacten Test

Question 29

What electrolyte abnormalities would you expect to see in in Addison's Disease?

Answer 29

HyPERkalaemia, HyPOnatraemia, HyPOglycaemia, Metabolic Acidosis

Question 30

What are the side effects of L-DOPA

Answer 30

Nausea, hypotension, dyskinesias, visual hallucinations, orange pee

Question 31

What type of drug can lead to Impulse Control Disorders

Answer 31

Dopamine Agonists

Question 32

Bilateral Internuclear Opthalmoplegia is pathognomic of which disease?

Answer 32

Multiple Sclerosis (50% if unilateral)

Question 33

Which tract is affected in Internuclear Opthalmoplegia?

Answer 33

The Medial Longitudinal Fasciculus

Question 34

Give and outline of the findings with Internuclear Opthalmoplegia

Answer 34

Internuclear Opthalmoplegia is an impairment in the lateral conjugate gaze caused by a lesion in the Medial Longitudinal Fasciculus. The ipsilateral eye is unable to adduct: nystagmus is seen in the contralateral eye. Convergence is usually intact as the fibres of the medial rectus subnucleus of CNIII are spared.

Question 35

Of psoriatic/reactive arthritis and ankylosing spondylitis, which is predominantly central and which is axial?

Answer 35

AS is predominantly axial: PA/Reactive A are predominantly peripheral

Question 36

Give four differences between Rheumatoid Arthritis and Inflammatory Back Pain

Answer 36

IBP is usually - asymmetrical, involves the spine and sacroiliac joint, large joints in the lower limbs, distal IPs, dactylitis and enthesitis.

Question 37

What are the classic descriptions of the end stage posture and spine in Ankylosing Spondylitis

Answer 37

Question Mark Shaped Posture and Bamboo Spine

Question 38

What are the diagnostic features of Ankylosing Spondylitis

Answer 38

- insidious onset before age of 40 - morning stiffness which improves with exercise - pain at night - which improves during the day - diagnostically moves from sacroiliitis on MRI to radiographic sacroiliitis to syndesmophytes

Question 39

What us Arthritis Mutilans and of which disease is it indicative?

Answer 39

- telescoping of fingers a.r.o bony destruction | - occurs in 5% people with psoriatic arthritis

Question 40

Which bacterial vectors most commonly lead to reactive arthritis?

Answer 40

Shigella, Salmonella, Chlamydia, Yersinia (not strep/viral)

Question 41

What are the clinical features of Reiter's Syndrome?

Answer 41

Urethitis, Arthritis and Conjunctivitis - and/or balanitis and Keratorderma Blennorhagica "Can't see, pee or climb a tree"