JMS

Question 1

CA125

Answer 1

Ovarian

Question 2

CA19-9

Answer 2

Pancreatic cancer

Question 3

CA15-3

Answer 3

Breast cancer

Question 4

AFP

Answer 4

hepatocellular

teratoma

Question 5

CEA

Answer 5

CRC

Question 6

S100

Answer 6

Malenoma

shwanoma

Question 7

Bombesin

Answer 7

Small cell lung cancer
Gastric cancer
Neuroblastoma

Question 8

Anti MBP

Answer 8

MS

Question 9

Anti mitochondrial (AMA)

Answer 9

primary bilirary cirrhosis

Question 10

anti-smooth muscle ab

Answer 10

autoimune hepatitis

Question 11

anti-nuclear ab

Answer 11

autoimmune hepatitis

Question 12

Mx of general tonic clonic seizure

Answer 12

volporate

or lamotrigine/carbamezapine

Question 13

Mx of absence seizure

Answer 13

volporate

or ethosuximide

Question 14

Myoclonic seizure mx

Answer 14

valporate

or clonozepam/ lamotrigine

Question 15

Partial seizure mx

Answer 15

carbamezapine or lamotrigine

valporate

Question 16

Ventricular Rate control meds

Answer 16

Beta blocker or calcium channel blocker
digoxin
amiodarone

Question 17

Ventricular rhythm control meds

Answer 17

sotalol
amiodarone
flecainide

Question 18

Anti-Hbc

Answer 18

previous hepetitis infection

Question 19

Anti-Hbs

Answer 19

immunisation

Question 20

Hbs antigen

Answer 20

current infection

Question 21

Hbe antigen

Answer 21

infective

Question 22

Warfarin INR range for VTE?

Answer 22

2. 5-3

3. 5 if recurrent

Question 23

TB pneumonia features

Answer 23

• dry cough

- erythema multiforme (symmetrical target shaped rash with a central blister)

Question 24

klebsiella pneumonia feature

Answer 24

alcoholic

Question 25

sickle cell anaemia sx?

Answer 25

Haemolytic crisis Thrombotic crisis Sequestration crisis Aplastic crisis

Question 26

Sequestration crisis

Answer 26

HbSS - hyposplenism - pooling of blood within spleen and lungs worsening anaemia

Question 27

Aplastic crises

Answer 27

HbSS - caused by infection with parvovirus - sudden fall in haemoglobin

Question 28

Anaphylaxis mx

Answer 28

adults above 12 yo: 500 microg adrenaline IM 200 mg hydrocortisine 20 mg chlorphenamine

Question 29

External otitis mx?

Answer 29

``` Acetic acid if mild If severe (hearing loss), give topical abx +/- steroids ```

Question 30

Gell and coombs hypersensitivity classification

Answer 30

types: 1. anaphylactic: IgE 2. cell bound: IgG or IgM 3. immune complex: IgG or IgA 4. delayed hypersensitivity: T cell mediated 5. antibodies (graves or myasthesia gravis)

Question 31

Gell and coombs hypersensitivity 1

Answer 31

anaphylactic: - Antigen reacts with IgE bound to mast cells - eg TB

Question 32

Gell and coombs hypersensitivity 2

Answer 32

cell bound: - IgG or IgM binds to antigen on cell surface - eg pernicious anaemia

Question 33

Gell and coombs hypersensitivity 3

Answer 33

Immune complex: - Free antigen and antibody (IgG, IgA) combine - eg SLE

Question 34

Gell and coombs hypersensitivity 4

Answer 34

Delayed hypersensitivity: - T-cell mediated - TB

Question 35

Gell and coombs hypersensitivity 5

Answer 35

Antibodies that recognise and bind to the cell surface receptors. - either stimulating them or blocking ligand binding - eg graves or ME

Question 36

Heart failure mx

Answer 36

First line: B blocker and ACEi (if CI: ARB) Second line: add spironolactone or ARB or hydralazine + nitrate Third line: cardiac resynchronisation therapy or digoxin

Question 37

Hypokalaemia ecg

Answer 37

In Hypokalaemia, U have no Pot and no T, but a long PR and a long QT

Question 38

INR 5-8 management

Answer 38

``` If no bleed: - miss 1 or 2 warfarin dose - reduce future dose If minor bleed - stop warfarin - give vit K - restart warfarin when INR<5 ```

Question 39

INR >8 management

Answer 39

If no bleed - stop warfarin + give vit K until INR <5 If minor bleed - stop warfarin + give vit K until INR <5 If major bleed - - stop warfarin + give vit K + prothrombin complex

Question 40

Glucocorticoid/mineralcorticoid activities of common steroids

Answer 40

1. mainly MC: fludrocortisone 2. high MC, some GC: hydrocortisone 3. low MC, high GC: prednisolone 4. Mainly GC: betamethasone/ dexamethasone

Question 41

Dorsal column

Answer 41

fine touch, proprioception and vibratio

Question 42

Spinothalamic

Answer 42

Temp/ crude touch/ pain

Question 43

Stable angina treatment?

Answer 43

statin + aspirin + GTN PNR 1st line: B blocker or CCB (verapamil or diltiazem) 2nd line: B blocker + CCB (nifedipine) 3rd line: ivabradine, nicorandil or ranolazine

Question 44

Which class of drugs cant be given with B blockers?

Answer 44

non-dihydropyridine (E.g verapamil and diltiazem) as could cause complete heart block

Question 45

Breast surgery depend on lump size

Answer 45

If <4cm, wide local excision | If >4cm mastectomy

Question 46

UC sevirity

Answer 46

more than 6 stools/day and: - Temp> 37.8°C - HR> 90 - Hb <105 - ESR >30

Question 47

Haemorrhoids classification

Answer 47

External originate below the dentate line prone to thrombosis, may be painful Internal originate above the dentate line do not generally cause pain

Question 48

Internal haemorrhoids classification

Answer 48

Grade I Do not prolapse out of the anal canal Grade II Prolapse on defecation but reduce spontaneously Grade III Can be manually reduced Grade IV Cannot be reduced

Question 49

Thrombosed haemorrhoids management

Answer 49

If within 72 hours, refer for excision | If more, stool softeners, analgesia and steroids resolves within 10 days