june 1

Question 1

how to diagnose thalassaemia

Answer 1

High performance liquid chromotography

Question 2

what is HBH disease?
- what thalssaemia
- what casues increased HBH
-buzzword

Answer 2

• only one alpha gene
• alph athalassaemia
• betas form tetramer
• golf ball cells - red cells inclusion bodies

Question 3

skull xray that looks like it has hair on it

Answer 3

beta thalassaemia and sickle cell

Question 4

causes of non megaloblastic macrocytosis

Answer 4

pregnancy
alcohol
liver disease
hypothyroid
marrow failure eg myelodysplasia

Question 5

management of beta-thalassaemia and target

Answer 5

reguar tranfusion to mainain 95-105 and iron chelatin gtherpay to prevent iron overload

Question 6

what is produced form the liver in chronic disease that causes anaemia

Answer 6

hepcidin - increased in inflam and dow regs iron absorption

Question 7

why do you need heparin cover when starting warfarin

Answer 7

takes several dasy to reach therapeutic levels of warfarin- protein c and s drop first so increased clotting risk

Question 8

name the anticoagulant that turn off clotting cascade

Answer 8

antithrombin
protein s and C

Question 9

gold standard to monitor cardiac output

Answer 9

thermodilaution with pulmonary arteyr catheter

Question 10

what is needed for the absorption of vitamin K

Answer 10

bile

Question 11

how is haemophilia inherited

Answer 11

x-linked (men only)

Question 12

most common haemophilia

Answer 12

haemophilia A factor VIII

Question 13

what is rasied in anti-phophilipid Pt or APTT

Answer 13

APTT

Question 14

side effects of heparin

Answer 14

bleeding
thrombocytopenia - see below
osteoporosis and an increased risk of fractures
hyperkalaemia - this is thought to be caused by inhibition of aldosterone secretion

Question 15

name examples of LMWH

Answer 15

daltaparin, enoxaparin, tinzaparin

Question 16

examples of DOAC

Answer 16

dabigatran
apixaban
rivaroxaban
edoxaban

Question 17

what are lymphocyte cells

Answer 17

t cells
b cells
nk cells

Question 18

hearing tests for newborn and school aged kids

Answer 18

newborn - otoacoustic
school - pure tone audiometry

Question 19

how long for sinusitis before giving abx

Answer 19

10 days

Question 20

investigation of cluster headache

Answer 20

MRI with contrast

Question 21

what anti-epileptic makes absence seizures worse

Answer 21

carbamazapine

Question 22

how to differentiate from spider naevi and telangectasia

Answer 22

naevi fill from centre
telangectasia form sides

Question 23

most common cause of viral meningitis in adults - type of virus and examples

Answer 23

enterovirus eg coxsackie , echovirus

Question 24

what glaucoma meds increase uveosacral outflow

Answer 24

pilocarpine (muscarinic receptor ago) and lantanoprost (prosta)

Question 25

diagnosis of acute cholecystis if USS NOT CLEAR

Answer 25

HIDA SCAN

Question 26

yx of delirium in parkinsons patient

Answer 26

quitiepine or clozapine
or lorazepam

Question 27

most common cause of neutropenic sepsis

Answer 27

Staphylococcus epidermidis - lotd of indwelling lines

Question 28

Management of CML and mechanism of action

Answer 28

Imatinib- tyrosine kinase inhibitor

Question 29

risk factors for hodgkins

Answer 29

HIV and EBV

Question 30

what blood markers are raised in hodkinns

Answer 30

eosiniphilia - due to increased IL-5
LDH

Question 31

buzz word for hodgkins what are they

Answer 31

reed sternberg - owl eyes - bi or multi lobed with eosinic inclusions

Question 32

what should always be eamined in a man with RIF pain

Answer 32

scrotum

Question 33

t wave inversion V1-3 inherited disease

Answer 33

ARVD