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MSRA LS > key notes > Flashcards

key notes Flashcards

1
Q

investigation in GORD

A

24hr oesophageal pH monitoring is gold standard

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2
Q

Goodpasture’s syndrome
depostis?

A

IgG deposits on renal biopsy
 anti-GBM antibodies

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3
Q

Acute angle closure glaucoma is associated with …?.. where as primary open-angle glaucoma is associated with ..?…..

A

hypermetropia,

myopia

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4
Q

Addison’s disease metabolic inbalance?

A

metabolic acidoosis

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5
Q

Acute myeloid leukaemia - good prognosis translocation

A

15:17

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6
Q

adenosine- what increases effect?
decreases effect?

A

dipyridamole enhances effect
 aminophylline reduces effect

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7
Q

s/e phentolamine?

A

Adrenaline induced ischaemia

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8
Q

ADH site of action

A

collecting ducts

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9
Q

Bartter’s syndrome is associated with …regarding BP…

A

normotension

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10
Q

Bosentan moa?

A

endothelin-1 receptor antagonist

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11
Q

Burkitt’s lymphoma - gene translocation

A

c-myc

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12
Q

CLL - ? is investigation of choice

A

immunophenotyping

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13
Q

Chorea is caused by damage to the

A

basal ganglia, in particular the Caudate nucleus

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14
Q

H. pylori eradication:

A

PPI + amoxicillin + clarithromycin, or
 PPI + metronidazole + clarithromycin

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15
Q

Acute myeloid leukaemia - poor prognosis:

A

deletion of chromosome 5 or 7

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16
Q

Amiodarone - MOA:

A

blocks potassium channels

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17
Q

Angiodysplasia is associated with

A

aortic stenosis

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18
Q

Anti-ribonuclear protein (anti-RNP) =

A

mixed connective tissue disease

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19
Q

Antipsychotics in the elderly - increased risk of

A

stroke and VTE

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20
Q

Aortic stenosis -?…marker of severity

A

S4

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21
Q

Aspergillus clavatus causes

A

malt workers’ lung, a type of EAA Extrinsic allergic alveolitis

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22
Q

Bendroflumethiazide - mechanism of hypokalaemia:

A

 increased sodium reaching the collecting ducts
 activation of the renin-angiotensin-aldosterone

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23
Q

Benzodiazepines enhance the effect of

A

GABA, the main inhibitory neurotransmitter

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24
Q

Beta-blocker overdose management:

A

atropine + glucagon

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25
Q

most common cause of primary hyperaldosteronism

A

Bilateral idiopathic adrenal hyperplasia

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26
Q

Bitemporal hemianopia
 lesion of

upper quadrant defect > lower quadrant defect - tumor?

lower quadrant defect > upper quadrant defect - tumor?

A

optic chiasm

inferior chiasmal compression, commonly a pituitary
tumour

superior chiasmal compression, commonly a
craniopharyngioma

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27
Q

Brush border enzymes:
 maltase:
 sucrase:
 lactase:

A

maltase: glucose + glucose
 sucrase: glucose + fructose
 lactase: glucose + galactose

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28
Q

cancer? common cause of tumour lysis syndrome

A

Burkitt’s lymphoma

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29
Q

CLL - treatment:

A

Fludarabine, Cyclophosphamide and Rituximab (FCR)

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30
Q

CLL is caused by

A

a monoclonal proliferation of B-cell lymphocytes

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31
Q

CML - Philadelphia chromosome -

A

t(9:22)

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32
Q

Causes of villous atrophy (other than coeliacs):

A

tropical sprue, Whipple’s, lymphoma, hypogammaglobulinaemia

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33
Q

Cetuximab - moa?

A

monoclonal antibody against the epidermal growth factor receptor

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34
Q

Chronic myeloid leukaemia tx? moa?

A

imatinib = tyrosine kinase inhibitor

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35
Q

cisplatin- s/e electorlyte inlabance/

A

hypomagnesemia, peripheral neuopthy

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36
Q

Clopidogrel moa?

A

inhibits ADP binding to platelet receptors

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37
Q

Collapse + ARF → dx? tx?

A

rhabdomyolysis - treat with IV fluids

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38
Q

Complete heart block following an inferior MI vs anterior MI… whihc can pace?

A

inferior is NOT an indication for pacing, unlike with an anterior MI

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39
Q

Congenital toxoplasmosis
features?

A

cerebral calcification
 chorioretinitis

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40
Q

Contraindications to lung cancer surgery include

A

SVC obstruction, FEV < 1.5, MALIGNANT pleural effusion, and vocal cord paralysis

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41
Q

Cyclophosphamide -
s/e and how to prevent it?

A

haemorrhagic cystitis - prevent with mesna

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42
Q

most common and important viral infection in solid organ transplant recipients

A

CMV

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43
Q

DVLA cant drive until
ANIOPLASTY
TIA
POST MI
MULTIPLE TIA

A

ANIOPLASTY 1 week
TIA 1 month
POST MI 1 month
MULTIPLE TIA 3 months

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44
Q

Deletion of chromosome 15
what 2 genetic conditions?

A

Prader-Willi - paternal
 Angelman syndrome - maternal

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45
Q

Dentistry in warfarinised patients -

A

check INR 72 hours before procedure, proceed if INR < 4.0

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46
Q

Dermatomyositis antibodies:

most common?
most specific?

A

ANA most common
anti-Mi-2 most specific

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47
Q

Desmopressiin - moa?

used for cranial diabetes insipidis

A

induces release of von Willebrand’s factor from endothelial cells

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48
Q

Diffuse proliferative glomerulonephritis, causes:

A

post-streptococcal
 SLE

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49
Q

Discoid lupus erythematous - tx 1st and second line?

A

topical steroids → oral hydroxychloroquine

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50
Q

Disproportionate microcytic anaemia - what condition could it be?

A

think beta-thalassaemia trait

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51
Q

Dosulepin antidepresesent why ito aviod?

A

dangerious if OD’d

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52
Q

Drug metabolism
 phase I:
 phase II:

A

Drug metabolism
 phase I: oxidation, reduction, hydrolysis
 phase II: conjugation

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53
Q

EBV: associated malignancies:

A

Burkitt’s lymphoma
 Hodgkin’s lymphoma
 nasopharyngeal carcinoma

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54
Q

cancer in association of HNPCC?

1st and 2nd most common

A
  1. colorectal
    2.endometrial
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55
Q

ch head injury …lucid interval

A

Epidural haematoma - lucid interval

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56
Q

associated with a good prognosis in sarcoidosis

A

erythema nodosum

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57
Q

Ethylene glycol toxicity management -

A

fomepizole

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58
Q

Exenatide moa?

A

Glucagon-like peptide-1 (GLP-1) mimetic

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59
Q

used to monitor respiratory function in Guillain-Barre syndrome

A

FVC

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60
Q

Factor V Leiden mutation results in

A

activated protein C resistance

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61
Q

…?… is the investigation of choice for upper airway compression

A

Flow volume loop

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62
Q

Fomepizole - used in ethylene glycol and methanol poisoning -

MOA?

A

competitive inhibitor of alcohol dehydrogenase

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63
Q

Funnel plots -

A

show publication bias in meta-analyses

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64
Q

signet ring cells

A

Gastric adenocarcinoma -

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65
Q

Gitelman’s syndrome vs Liddle’s syndrome
BP? electrolyte?

A

normotension with hypokalaemia

Liddle’s syndrome: hypokalaemia + hypertension
think short man syndrome-always tense

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66
Q

HIV - multiple ring enhancing lesions =

A

toxoplasmosis

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67
Q

HOCM - drugs to avoid:

A

nitrates, ACE-inhibitors, inotropes

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68
Q

HOCM - poor prognostic factor on echo =

A

septal wall thickness of > 3cm

69
Q

HUS or TTP? Neuro signs point towards

A

TTP Thrombotic Thrombocytopenic Purpura

70
Q

Haemochromatosis is …GENTIC…?

A

autosomal recessive

71
Q

Hashimoto’s thyroiditis = LOOK FOR WHAT IN BLOODS AND PRESENTAION?

A

hypothyroidism + goitre + anti-TPO

72
Q

Hemiballism is caused by damage to the

A

subthalamic nucleus

73
Q

Heparin-induced thrombocytopaenia -

moa?

A

antibodies form against complexes of platelet factor 4 (PF4) and heparin

74
Q

Hepatorenal syndrome is primarily caused by

A

splanchnic vasodilation

75
Q

Hereditary angioedema -
deficiency?
screening?

A

C1-INH deficiency

C4 is the best screening test inbetween attacks

76
Q

Hodgkin’s lymphoma -

best prognosis

most common type

A

lymphocyte predominant

nodular sclerosing

77
Q

Homocystinuria -

caused by a deficiency of ?
give what to correct it?

A

cystathionine beta synthase

vitamin B6 (pyridoxine)

78
Q

Horner’s syndrome - anhydrosis determines site of lesion:
 head, arm, trunk =
 just face =
 absent =

A

 head, arm, trunk = central lesion: stroke, syringomyelia
 just face = pre-ganglionic lesion: Pancoast’s, cervical rib
 absent = post-ganglionic lesion: carotid artery

79
Q

Hypertension - step 4

what level of postassium to add the 4th line options?

A

Hypertension - step 4
 K+ < 4.5 then spironolactone
 K+ > 4.5 then higher-dose thiazide-like diuretic

80
Q

means loss of HGV licence, regardless of the circumstances

A

ICD

81
Q

IgM paraproteinaemia -

A

Waldenstrom’s macroglobulinaemia

82
Q

In the primary prevention of CVD using statins aim for a reduction in non-HDL cholesterol of …percentage?…

A

> 40%

83
Q

Insulinoma is diagnosed

A

with supervised prolonged fasting

84
Q

Iron reduces the absorption of

A

thyroxine

85
Q

are the most common cause of occupational asthma

A

Isocyanates

86
Q

JVP:
C wave
giant v waves
x descent
y descent

A

C wave - closure of the tricuspid valve

giant v waves in tricuspid regurgitation

x descent = fall in atrial pressure during ventricular systole

y descent = opening of tricuspid valve

87
Q

Kearns-Sayre syndrome

A

mitochondrial inheritance
 onset < 20-years-old
 external ophthalmoplegia
 retinitis pigmentosa

88
Q

Keloid scars are most common on the

A

sternum

89
Q

Klinefelter’s vs Kallman’s - LH & FSH

A

Klinefelter’s - LH & FSH raised

Kallman’s - LH & FSH low-normal

90
Q

L5 lesion features =

A

loss of foot/big toe dorsiflexion + sensory loss dorsum of the foot

91
Q

LH surge causes

A

ovulation

92
Q

Lateral medullary syndrome

A

PICA lesion - cerebellar signs, contralateral sensory loss & ipsilateral Horner’s

93
Q

Leptin is secreted by

A

adipose tissue

94
Q

Leptospirosis - give abx?

A

penicillin or doxycycline

95
Q

Likelihood ratio for a positive test result

A

= sensitivity / (1 - specificity)

96
Q

the safest TCA in overdosage

A

Lofepramine -

97
Q

Long QT syndrome - usually due

A

to loss-of-function/blockage of K+ channels

98
Q

Lung adenocarcinoma
 most common in ?

location?

A

Lung adenocarcinoma
 most common type in non-smokers
 peripheral lesion

99
Q

Magnesium sulphate - monitor ..?…

A

reflexes + respiratory rate

100
Q

Massive PE + hypotension tx?

A

thrombolyse

101
Q

Mechanical valves - target INR:
 aortic:
 mitral:

A

Mechanical valves - target INR:
 aortic: 3.0
 mitral: 3.5

102
Q

Melanoma: single most important prognostic factor

A

the invasion depth of the tumour is the

103
Q

Metastatic bone pain may respond to

A

NSAIDs, bisphosphonates or radiotherapy

104
Q

Mitochondrial diseases follow ..?…inheritance pattern

A

a maternal

105
Q

Most common cause of endocarditis:

A

 Staphylococcus aureus
 Staphylococcus epidermidis if < 2 months post valve surgery

106
Q

Motion sickness - TX?

A

hyoscine > cyclizine > promethazine

107
Q

Motor neuron disease - tx?

which is a better option

A

riluzole

NIV better

108
Q

Mucocutaneous ulceration following travel?

A

Leishmania brasiliensis

basces in the mouth

109
Q

Mycoplasma pneumonia if allergic/intolerant to macrolides -

A

doxycycline

110
Q

Mycoplasma dx? -

A

serology is diagnostic

111
Q

rises first following a myocardial infarction

A

Myoglobin

112
Q

???.. required to diagnose dementia

A

Neuroimaging is

113
Q

Nitric oxide - moa?

A

vasodilation + inhibits platelet aggregation

114
Q

po2 level, sats level… characteristic of methaemoglobinaemia

A

Normal pO2 but decreased oxygen saturation is characteristic of methaemoglobinaemia

115
Q

ethambutol eye s/e

A

OPTIC NURITIS

116
Q

Osteoarthritis - first-line MX?

A

paracetamol + topical NSAIDs (if knee/hand)

117
Q

Osteomyelitis: the imaging modality of choice

A

MRI

118
Q

Painful third nerve palsy =

A

posterior communicating artery aneurysm

119
Q

Paradoxical embolus -
common cuase?
dx?

A

PFO most common cause - do TOE

Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart.

120
Q

Paraneoplastic features of lung cancer
 squamous cell:
 small cell:

A

Paraneoplastic features of lung cancer
 squamous cell: PTHrp, clubbing, HPOA
 small cell: ADH, ACTH, Lambert-Eaton syndrome

121
Q

Patients with Sjogren’s syndrome have an increased risk of ..?..malignancies

A

lymphoid

122
Q

Phaeochromocytoma: dx?

A

do 24 hr urinary metanephrines,

123
Q

Philadelphia translocation, t(9;22) - good prognosis in ..?..

poor prognosis in..?..

A

CML,

AML + ALL

124
Q

Pneumocystis jiroveci pneumonia - ..?.. common complication

A

pneumothorax

125
Q

Polycythaemia rubra vera is associated with a low ..inflammaroty marker..?

A

ESR

126
Q

Post-exposure prophylaxis for HIV:

A

oral antiretroviral therapy for 4 weeks

127
Q

Prinzmetal angina - treatment =

A

dihydropyridine calcium channel blocker

128
Q

Progressive supranuclear palsy: what condition>

A

parkinsonism, impairment of vertical gaze

129
Q

Psoriasis: common triggers are

A

beta-blockers and lithium

130
Q

Pulmonary surfactant - main constituent is

A

dipalmitoyl phosphatidylcholine (DPPC)

131
Q

Pulsus alternans - seen i

A

n left ventricular failure

132
Q

Recommend Adult Life Support (ALS) adrenaline doses
 anaphylaxis:  cardiac arrest:

A

Recommend Adult Life Support (ALS) adrenaline doses
 anaphylaxis: 0.5ml 1:1,000 IM
 cardiac arrest: 10ml 1:10,000 IV or 1ml of 1:1000 IV

133
Q

Refeeding syndrome causes …electrolyte inblance?

A

Refeeding syndrome causes hypophosphataemia

134
Q

Renal stones on x-ray
 cystine stones:
 urate + xanthine stones:

A

Renal stones on x-ray
 cystine stones: semi-opaque
 urate + xanthine stones: radio-lucent

135
Q

Renal tubular acidosis causes a ..?.. anion gap

A

normal

136
Q

Restless leg syndrome - management includes

A

dopamine agonists such as ropinirole

137
Q

Rheumatoid arthritis - HLA ?

key in pathophysiology ?

A

HLA DR4

TNF is key in pathophysiology

138
Q

Rituximab - moa?

A

Rituximab - monoclonal antibody against CD20

139
Q

SLE: markers
sensitive ?
specific ?

A

ANA is 99% sensitive

anti-Sm & anti-dsDNA are 99% specific

140
Q

Schistosoma haematobium causes?

A

Schistosoma haematobium causes haematuria

141
Q

Screening for haemochromatosis
 general population:
 family members:

A

Screening for haemochromatosis
 general population: transferrin saturation > ferritin
 family members: HFE genetic testing

142
Q

..?…is the investigation of choice for bile acid malabsorption

A

SeHCAT

143
Q

Second heart sound (S2)
 loud:
 soft:
 fixed split:
 reversed split:

A

Second heart sound (S2)
 loud: hypertension
 soft: AS
 fixed split: ASD
 reversed split: LBBB

144
Q

Severe falciparum malaria - tx

A

intravenous artesunate

145
Q

Statins and what abx? an important and common interaction

A

+ erythromycin/clarithromycin -

146
Q

..?… treatment in Cryptosporidium diarrhoea

A

Supportive therapy

147
Q

Symptom control in non-CF bronchiectasis -

A

inspiratory muscle training + postural drainage

148
Q

Syringomyelia - presentaion?

A

spinothalamic sensory loss (pain and temperature)

149
Q

TTP - first-line tx?

A

plasma exchange

150
Q

Tear-drop poikilocytes =

A

myelofibrosis

151
Q

diagnostic test for acromegaly

A

is an oral glucose tolerance with growth hormone measurements

152
Q

what component in co-trimoxazole causes haemolysis in G6PD

A

sulfamethoxazole

153
Q

Topical steroids
 moderate:
 potent:
 very potent:

A

moderate: Clobetasone butyrate 0.05%
 potent: Betamethasone valerate 0.1%
 very potent: Clobetasol propionate 0.05%

154
Q

Trastuzumab (Herceptin) - ??..?..toxicity is common

A

cardiac

155
Q

Trimethoprim may cause …to do with blood cells..?

A

pantcytopaenia

156
Q

Urinary histamine is used to diagnose

A

systemic mastocytosis

too many mast cells in body

157
Q

normal pressure hydrocephalus

presentation?

A

Urinary incontinence + gait abnormality + dementia

158
Q

Vincristine - s/e

A

peripheral neuropathy

159
Q

Visual field defects:
 left homonymous hemianopia?

 homonymous quadrantanopias: ?

 incongruous defects ?

congruous defects?

A

Visual field defects:
 left homonymous hemianopia means visual field defect to the left, i.e. lesion of right optic tract

 homonymous quadrantanopias: PITS (Parietal-Inferior, Temporal-Superior)

 incongruous defects = optic tract lesion;

congruous defects= optic radiation lesion or occipital cortex

160
Q

Vitamin B12 is actively absorbed in the

A

terminal ileum

161
Q

Warfarin - clotting factors affected mnemonic -

A

1972 (10, 9, 7, 2)

162
Q

used to identify patients at risk of pressure sores

A

Waterlow score -

163
Q

Wiskott-Aldrich syndrome
triad?

A

 recurrent bacterial infections (e.g. Chest)
 eczema
 thrombocytopaenia

164
Q

X-linked recessive conditions - transmission?

A

no male-to-male transmission

Affected males can only have unaffected sons and carrier daughters.

165
Q

Zero-order (saturation) kinetics
drugs?

A

 phenytoin
 alcohol

166
Q

tia managemnt long term

A

clopedogil only after the 300mg aspirin

167
Q

tca overdose?

A

IV bicarb

168
Q

Hirschsprung’s disease presentation?

A

a 10-day-old

abdominal distension and vomiting. He first passed meconium at 72 hours and has not opened is bowels since. An abdominal x-ray shows a dilated colon

169
Q

omphalomesenteric band

A

mikels diverticulum

MSRA LS (22 decks)

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