june 6th

Question 1

what is a paraprotein

Answer 1

a monoclonal immunoglobulin (ormally Ig is polyclonal)

Question 2

how to detect bence jones protein

Answer 2

urine

Question 3

causes of paraproteinaemia

Answer 3

MGUS
Waldenstroms
myeloid
amyloidosis

Question 4

what Ig will be raised on serum in myeloma

Answer 4

IgA /IgG

Question 5

imagine doen in myelom

Answer 5

Whole body MRI and head X-ray

Question 6

% of plasma cells on bone marrow asp in myeloma

Answer 6

> 30%

Question 7

% of plasma cells on bone marrow asp

Answer 7

> 30%

Question 8

Tx of myeloma

Answer 8

steroids to stop light hain production

Question 9

Myeloma symptoms

Answer 9

CRABBI

calcium
renal
anaemia
bleeding
bone
infection

Question 10

gentic conponenet in CML

Answer 10

BCR-ABL1 +ve

Question 11

what haemotological cancer can convert to AML

Answer 11

CML

Question 12

symptoms of polycthameia vera

Answer 12

itch after hot shower
splenomegaly
HTN
arterial and venous thrombosis

Question 13

treatment of polycythameia

Answer 13

aspiring - for clots
venesect
hydroxyurea

Question 14

classic symptoms of essential thrombocythaemia

Answer 14

burning in the hands

Question 15

tx of essential thrombocythaemis

Answer 15

aspirin and hydroxyurea

Question 16

blood film in myelofibrosis

Answer 16

leukoerythroblastic

Question 17

treatment of renal disease in systemic scelrosis

Answer 17

ACEI

Question 18

mangement of acute limb ischaemia 6Ps

Answer 18

pain relief
Iv heaprin
vascular review

Question 19

all NSAIDs except what must be stopped in AKi

Answer 19

aspirin at cardioprotectove dose

Question 20

ix of hydrocele in adult and why

Answer 20

urgent ultrasound as may be secondary to cancer

Question 21

testicular swelling you cant get above

Answer 21

inguinal hernia

Question 22

tx for PMS

Answer 22

COCP

Question 23

isolated fever in a well patient in 24hrs following surgery

Answer 23

physiological response

Question 24

how often do HIV positive women get smears

Answer 24

annually

Question 25

chornic pancreatitis investigation

Answer 25

CT Pancreas

Question 26

what presents with upper lobe fibrosis and what presents with lower lobe

Answer 26

upper - silicosisi
lower - asbestosis and IPF

Question 27

blistering rash with mucosal involvement

Answer 27

pemphigus vulgaris

Question 28

otits externa tx in diabetics

Answer 28

cipro to cover pseudomonas

Question 29

once a patients BM is<14 in DKA whatshould be started

Answer 29

a 10% dextrose infusion at 125ml/hr

Question 30

what is DKA resolution defined as

Answer 30

pH >7.3 and
blood ketones < 0.6 mmol/L and
bicarbonate > 15.0mmol/L

Question 31

what drugs can precipitate renal failure in multiple myeloma

Answer 31

NSAIDs

Question 32

markers tested in tesicular cancer

Answer 32

AFp, LDH and BHCG

Question 33

organism in LTRI in CF

Answer 33

pseudomonas

Question 34

what is used to monitor response in colon cancer

Answer 34

CEA

Question 35

rosacea with predom flushin

Answer 35

top broodinine

Question 36

are innocent murmurs systolic or diastolic

Answer 36

systolic

systolic, soft, short , symptomless, sit/stand variation

Question 37

investigations in SAH

Answer 37

non contrast CT in <6hrs if normal =not SAH
non contrast CT>6 hrs then do LP >12hrs

Question 38

treatment of bain pain from mets

Answer 38

dexamethasone

Question 39

af management in co-existent Hf

Answer 39

rhythm control

Question 40

common complication of SAH

Answer 40

hyponatraemia, torsades

Question 41

things that can trigger G6DP

Answer 41

Sulfa drug, cipro and anti malarials