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Matt's Path REVERSE > Last Minute > Flashcards

Last Minute Flashcards

1
Q

Ankylosing Spondylitis Monoclonal

A

Etanercept

TNF-alpha inhibitor

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2
Q

Psoriasis Monoclonal

A

Ustekinumab

IL-12/IL-23

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3
Q

anti-­‐proteinase 3

A

Wegner’s

Granulomatosis with polyangiitis

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4
Q

Felty’s

A

Rheumatoid arthritis + hepatosplenomegaly –> Neutropenia

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5
Q

How to monitor the activity of SLE?

A

C3
C4
Anti-dsDNA

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6
Q

Antibody useful to diagnose someone with systemic sclerosis?

A

Anti-Scl-70

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7
Q

Tocilizumab

A

Rheumatoid Arthritis

IL-6R

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8
Q

Denosumab

A

Osteoporosis

RANKL

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9
Q

IFN-gamma

A

Chronic granulomatous disease

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10
Q

Treating Wegner’s

A

Cyclophosphamide

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11
Q

Treatment of hereditary angioedema

A

IV C1 inhibitor

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12
Q

Treatment of oral allergy syndrome

A

Wash out mouth

oral antihistamines

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13
Q

Utricaria

A

H1-antagonist.

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14
Q

Neutralizing antibody in HIV

A

gp120

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15
Q

NON-Neutralizing antibody in HIV

A

p24

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16
Q

Co-receptor for entry of HIV

A

CCR5

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17
Q

Enzyme targeted by HIV treatment

A

protease

reverse transcriptase

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18
Q

C7 complement deficiency

A

Meningitis

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19
Q

CD40L deficiency

A

Hyper IgM syndrome

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20
Q

Asplenic patient vaccines

A

Pneumovax

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21
Q

Vaccine against viral haemagglutinin

A

Influenza

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22
Q

Yellow fever, MMR and BCG

A

Live vaccines

Avoid in immunocomprimised

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23
Q

Live Vaccines

A

Small Yellow Typhoid Chicken BOY MMR

Smallpox

Yellow fever

Typhoid

Chickenpox

BCG

Oral polio

Yellow fever

MMR

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24
Q

Patient gets recurrent infections with negative NBT and dihdrorrhadamine tests

A

Chronic granulomatous disease

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25
Q

Atypical granulomatous infection in previously healthy patien

A

IFN-y receptor deficiency

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26
Q

Serum sickness

A

Type III

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27
Q

Eczema

A

Type I

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28
Q

vaccinia

A

Small pox vaccine

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29
Q

Treatment of temporal arteritis

A

prednisolone

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30
Q

Azathioprine resistant Crohn’s

A

Anti-TNF alpha (Infliximab)

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31
Q

Cytokine responsible for promoting antibody synthesis

A

Ig4?

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32
Q

Promoting eosinophil growth

A

IL-5

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33
Q

AIRE gene causes

A

Auto-immune polyendocrine syndrome type 1 (APS1)

Auto-immune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome / APECED

Antibodies vs parathyroid and adrenal glands Hypoparathyroidism and Addison’s

Antibodies vs IL17 and IL22
Candidiasis

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34
Q

HIV: Uses this receptor on the cell wall to facilitate entry

A

gp120

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35
Q

b. What travel vaccine don’t you give to a person who has ankylosing spondylitis and on TNF alpha inhibitor?

A

Yellow fever

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36
Q

What vaccine do you give to girls at 12-13y?

A

HPV

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37
Q

Vaccine you give every 5 years for splenectomised patients

A

Pneumococcal (Pneumovax)

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38
Q

What is in the routine immunization programme but not given to immunocompromised children?

A

MMR

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39
Q

Ground glass appearance

A

PCP

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40
Q

Guy has urethritis, arthritis and eye problems

A

Reiter’s syndrome

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41
Q

Gram positive that gives LUT symptoms in women

A

Staphylococcus Saprophyticuss

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42
Q

Gram neg rod UTI

A

E.Coli

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43
Q

Flagellate protozoan that can cross placenta

A

Toxoplasmosis

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44
Q

STI that can cross placenta in third trimester

A

Syphilis

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45
Q

Squamous cells on microscopy

A

=Contamination of sample

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46
Q

Coliform organisms

A

Nitrites

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47
Q

Stone associated infetcion

A

Proteus

Struvite stones

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48
Q

Gas gangrene

A

Clostridium perfringens

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49
Q

Urine antigen detection

A

Legionella

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50
Q

Rust coloured sputum

A

Strep pneumonia

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51
Q

HIV: Enzyme that copies with errors

A

Reverse transcriptase

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52
Q

What is the chemokine that inhibits HIV entry into cells

A

Aminooxypentane (AOP)-MIP-1α

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53
Q

Molluscum contagiosum

A

pox virus

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54
Q

Kaposi’s sarcoma

A

HHV8

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55
Q

gram positive rod

A

Listeria

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56
Q

N. meningitis

A

gram negative cocci

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57
Q

Smoker – gram positive cocci

A

Strep pneumonia

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58
Q

Meningitis, normal glucose, raised lymphocytes, slightly raised protein

A

Herpes

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59
Q

neonatorum ophthalmia

A

Chlamydia trachomatis

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60
Q

What causes hemorrhagic cystitis in kids

A

Adenovirus

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61
Q

Mum had skin infection with a son with a sore throat

A

Strep pyogenes

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62
Q

Guy came back from afganistan with ulcer on his ring finger

A

cutaneous leishmaniasis

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63
Q

Kid had red erythemous, oedematous rash, first on face and crosses the nasal bridge and spread really quickly –

A

N.Meningitis

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64
Q

Livery cyst

A

antamoeba histolytica

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65
Q

Angular stomatitis

A

Folate deficiency /B12

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66
Q

You suspect Acute Intermittent Porphyria. What test?

A

Urine PBG

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67
Q

Jaundiced baby no dysmorphic features

A

Urine amino acids

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68
Q

hypoglycaemic neonate

A

Urine reducing substances

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69
Q

Wet Beri Beri

A

Pulmonary oedema

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70
Q

Dry Beri Beri

A

Neurological symptoms

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71
Q

Bicarb in pyloric stenosis

A

High

> 30

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72
Q

Woman with hypothyroidism, T1DM, adrenal failure

A

Polyendocrinopathy

–> B12 def (pernicious anaemia)

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73
Q

Enzymes - rate-limiting enzyme in haem synthesis?

A

ALA synthase

first enzyme

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74
Q

Deficiency leads to high urate

A

HGPRT

Leysch-Nyhan syndrome

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75
Q

How to diagnose B Thal trait

A

Raised HbA2

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76
Q

Raised amylase

A

Mumps

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77
Q

Impaired glucose tolerance

A
  1. 1-6.9 FASTING

7. 8-11.0 OGTT 2 hours

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78
Q

Diabetes cut-off

A

> 7.0 Fasting

> 11.1 OGTT 2 hours

HbA1c > 6.5% (48mmol/mol)

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79
Q

One that causes hepatic cirrhosis and portal hypertension in some and cardiomyopathy in others?

A

Haemochromatosis

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80
Q

CAH

A

Hyperkalaemia

+ salt losing crisis

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81
Q

Adult T-­‐cell lymphoma

A

JC virus

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82
Q

INR Someone with AF?

A

2.0-3.0

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83
Q

INR: Someone with a prosthetic valve.

A

3.0-4.0

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84
Q

Monitoring: Someone on unfractionated heparin.

A

APTT

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85
Q

Normal Hb - positive sickle solubility test

A

Sickle trait

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86
Q

Low Hb - positive sickle test

A

Sickle cell disease

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87
Q

polychromasia and spherocytes

A

Hereditary spherocytosis

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88
Q

Raised ESR

A

Temporal arteritis

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89
Q

Thalassaemia patient looks tanned and has diabetes

A

Transfusion haemosiderosis

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90
Q

Patient has prolonged APTT, normal PT and normal bleeding time

A

Haemophilia A

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91
Q

Patient has menorrhagia, prolonged APTT, normal PT and prolonged bleeding time. Her mother had similar problems

A

vWF

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92
Q

Elderly Patient is asymptomatic and has generalised lymphadenopathy, with abnormal bloods

A

CLL

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93
Q

Elderly patient presents with MASSIVE splenomegaly with low platelets, red cells and normal white cells

A

Myelofibrosis

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94
Q

Pelger Huet cells, hyposegmented neutrophil

A

Myelodyplastic syndrome

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95
Q

Breast Mass. Aspirated. Brown ‘fluid’

A

Galactocele

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96
Q

Halo-sign on x-ray

A

Aspergillosis

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97
Q

CD19+
CD5+
B cells

A

CLL

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98
Q

Ritcher’s transformation

A

CLL
Hairy cell
—> DLBC

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99
Q

Smear Cells

A

CLL

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100
Q

CD5+

A

CLL

Or could be a mantle cell lymphoma!

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101
Q

Binet staging

A

CLL

Stage 1 <3 lymph nodes
Stage 2 >3 lymph nodes
Stage 3 >3 lymph nodes Hb<100

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102
Q

Protein C

A

Inactivates VIIa and V

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103
Q

Antithrombin III

A

Inactivates thrombin

Inactivates IX, X and XI

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104
Q

Tissue factor pathway inhibitor

A

Inhibits factor Xa and TF:VIIa complex

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105
Q

When the integrity of the BBB is disrupted the resultant oedema is described as

A

Vasogenic Oedema

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106
Q

Which of the following types of herniation do not involve cortex?

A

Tonsillar

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107
Q

What percentage of patents who experience a TIA will get a significant infarct within 5 years?

A

33%

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108
Q

What is the most common cause of non-traumatic intraparenchymal haemorrhages?

A

Hypertension

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109
Q

Krukenberg tumours

A

Secondary ovarian tumour

Bilateral metastases composed of mucin producing signet ring cells

most often of gastric origin or breast

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110
Q

HNPCC associated ovarian tumour

A

Mucinous

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111
Q

BRCA associated ovarian tumour

A

Serous cystadenocarcinoma

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112
Q

Most common ovarian cancer

A

Serous cystadenocarcinoma

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113
Q

Type I Ovarian Tumours

A

Low grade, relatively indolent, arise from well characterised precursors (BOT) and endometriosis

Usually present as large stage I tumours

Mutations in K-ras, BRAF, PI3KCA and HER2, PTEN and beta–catenin

Usually have precursors

Include low grade serous, low grade endometrioid, mucinous and tentatively CCC.

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114
Q

Type II Ovarian Tumours

A

High grade mostly of serous type
Aggressive
More than 75% have p53 mutations
No precursor lesions

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115
Q

Type I Endometrial Cancer

A

Type I: 80-85%

Endometrioid, mucinous and secretory adenocarcinomas
Younger age
Are oestrogen dependent
Often associated with atypical endometrial hyperplasia
Low grade tumours, superficially invasive

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116
Q

Type II Endometrial Cancer

A

Type II: 10-15%

Serous and clear cell carcinomas
Older, postmenopausal
Less oestrogen dependent
Arise in atrophic endometrium
High grade, deeper invasion, higher stage
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117
Q

Most common endometrial cancer

A

adenocarcinomas

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118
Q

C2 breast

A

Benign

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119
Q

C5 breast

A

Malignant

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120
Q

Dilated ducts
Periductal inflammation
Filled with secretions

A

Duct ectasia

Benign

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121
Q

Neutrophils (trinucleate cells)
Acute inflammation
+/- abscess

A

Mastitis

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122
Q

Degenerative fat
Foamy macrophages
Giant cells

A

Fat necrosis

Later fibrosis and calcification

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123
Q

Apocrine metaplasia
Adenosis
Epithelial and stromal hyperplasia

A

Fibrocytsic change

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124
Q

Overlapping cells
Excess glandular and stromal proliferation
Leaf-like fonds

A

Phyllodes tumour

Benign

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125
Q

Branching papillary groups
Papillary mass within duct lined by epithelium
Fibrovascular core

A

Intraductal papilloma

Benign

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126
Q

Central zone of scarring
Radiating zone of proliferating glandular tissue
Stellate mass

A

Radial scar

Benign

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127
Q

Ducts filled with atypical epithelial cells

A

DCIS

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128
Q

Infiltrating atypical epithelial cells

A

Invasive breast carcinoma

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129
Q

Most common breast cancer

A

Invasive ductal

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130
Q

Cancer staged into low grade, intermediate, high grade

A

DCIS

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131
Q

Proliferation of fibroepithelium and stromal tissue

A

phylloides tumour

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132
Q

Loss of E.cadherin

A

LCIS

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133
Q

HR PR negative

A

High grade DCIS

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134
Q

Rheumatic valvular disease

A

Mitral valve

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135
Q

Condition caused by a genetic defect in myofilament formation leading to large myocytes

A

Hypertrophic cardiomyopathy

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136
Q

Conditions caused by progressive loss of myocytes

A

Dilated heart failure

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137
Q

Condition of structural calcification causing onset of a murmur late in life

A

Aortic stenosis

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138
Q

35 yr old male presented with a 1 week history of hoarse voice, cough, headache and mild fever. His symptoms were getting worse and he was finding it harder to breathe. He also developed sinus pain.

A

Strep Pneumonia

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139
Q

A 75 year old male non-smoker presented with a cough productive of sputum and fever. He was short of breath and felt a ‘catching’ chest pain upon breathing in. Chest X-ray showed consolidation in the right lower lobe.

A

Strep pneumonia

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140
Q

An otherwise healthy 25 year old female complained of ‘flu like’ symptoms following return from Mexico. She had a headache, weakness and joint pains and had developed a dry cough. Tests detected the presence of cold agglutins.

A

Mycoplasma pneumonia

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141
Q
  1. 25 year HIV positive man presented with a 2 week history of a bloody cough and night sweats. He had lost weight and had a fever. 3 weeks ago he had travelled to Africa to visit family. Chest xray revealed hilar lymphadenopathy and left sided upper lobe shadowing.
A

TB

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142
Q

A 45 year old business man was previously well. One week after staying in a hotel he developed diarrhoea, nausea and weakness. He had a headache and on examination was confused and pyrexial. Tests revealed lymphopaenia and hyponatraemia.

A

Legionella

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143
Q

A 69yr old male smoker is rushed into hospital complaining of severe breathlessness when walking upstairs. He is tachycardic with a reduced pulse volume and you also note that his ankles are considerably swollen.

A

Cardiac failure

144
Q

A 26yr old known I.V. drug user presents with fever, weakness, lassitude and night sweats. On examination you discover a heart murmur

A

Staph Aureus

145
Q

A 7yr old girl complains of a rash on her chest and painful joints. On further questioning you discover she had recovered from a sore throat a fortnight ago

A

Rheumatic fever

146
Q

A young fit 22yr old is rushed into A&E after complaining of a severe chest pain and breathlessness. A loud fourth heart sound is heard.

A

Hypertrophic cardiomyopathy

147
Q

A 55yr old male presents to A&E with a sharp centralised chest pain which is relieved by sitting forwards. A pericardial rub is heard at the left sternal edge.

A

Pericarditis

148
Q

A gram positive bacillus that produces alpha-toxin causing gas gangrene in infected wounds

A

Clostridium perfringens

149
Q

A man punches someone in a pub brawl. The recipient then bites his hand. Later the bite wound becomes infected, with lots of pus and a foul smell. The most likely pathogen is?

A

Anaerobes

150
Q

A gram positive B haemolytic coccus that can cause pharyngitis, erysipelas and cellulitis.

A

Strep pyogenes

151
Q

A 65yr old male is found to have an Hb of 19g/dl on a routine blood test, EPO levels were normal. On examination he is found to have splenomegaly and engorgement of the retinal vein. Bone marrow histology showed increased cellularity of erythroid cells. What is the most likely diagnosis?

A

Polycythaemia rubra vera

152
Q

A 30yr old female was found to have platelets>600x109/L on 3 separate occasions. Her CRP and ESR were within the normal range. She suffered a DVT 3 months ago. What is the likely diagnosis?

A

Essential thrombocythemia

153
Q

Which drug aids in the reduction of platelet number and can cause palpitations and flushing?

A

Anagrolide

154
Q

A peripheral blood film of a patient with polycythaemia vera shows a leucoerythroblastic picture with tear drop poikilocytes. What is the likely diagnosis?

A

Myelofibrosis

155
Q

Imatinib can be used in the treatment for which leukaemia?

A

Chronic granulocytic leukaemia

156
Q

What is the correct pathological term for a discontinuation in the epithelial surface?

A

ULCER

157
Q

A 65 year old male with a long history of epigastric pain. Endoscopy reveals 3.2cm of columnar metaplasia in the lower oesophagus. What does this suggest?

A

Barrett’s oesophagus.

158
Q

What is the technical term for a connection between two epithelial surfaces, as occurs in Crohns disease where for example there might be a connection between the bladder and the bowel?

A

Fistula

159
Q

A 46-year old Japanese female is found to have bilateral ovarian masses on imaging of the abdomen and had both ovaries removed. Histology revealed malignant signet ring cells containing mucin in both ovaries. What is the diagnosis?

A

Krukenberg tumour

160
Q

A 50 year-old female was found to have an ovarian mass. On its removal, histology revealed several cell types, including thyroid follicles, hair and teeth. What is the likely diagnosis?

A

Dermoid cyst or Cystic Teratoma

161
Q

A 40 year-old female non-smoker presents with a one week history of fever, shortness of breath and a cough productive of rusty coloured sputum. Microscopy of the sputum is shown (Gram positive diplococci). What is the organism?

A

Streptococcus pneumoniae

162
Q

A 37 year-old man presents with a headache, myalgia and a cough. He is also suffering with nausea, diarrhoea and abdominal pain. On examination he is tachypnoeic and has a pyrexia of 39ºC. Blood tests reveal lymphopenia and hyponatraemia. A gram stain from the patients sputum is shown here (Gram negative rods). CXR shows lobar consolidation. Cold agglutinins are negative. What is the organism?

A

Legionnaires disease or Legionella Pneumophila

163
Q

A 40 year-old woman presents with malaise, muscular pains and diarrhoea with mucus and blood. On examination she has a fever and several distinctive spots on her abdomen (Rose spots). Blood cultures are positive and grow gram negative rods. What is the likely organism?

A

Salmonella Typhae or Typhoid fever.

164
Q

genus of spiral flagellated Gram negative bacteria. Found in the stomach within the mucosa layer. It occurs in the majority of middle-aged people and causes progressive gastritis. Invariably present in duodenal ulceration and usually in gastric ulceration. What is the organism?

A

Helicobacter pylori.

165
Q

A 4 year old girl presents to the A&E with a recurrent chest infection that will not clear. On examination, the house officer notices that she has low set ears, a cleft palate and a murmur. Investigations reveal:

Calcium 1.9 mM (NR 2.2 to 2.6);
Phosphate 1.4 mM (NR 0.8 to 1.4)
PTH 1.1 pM (NR 1.1 to 6.8)

What is the likely diagnosis?

A

Di George syndrome or 22q11.2 deletion syndrome.

166
Q

A 40-year old lady complains of tight fingers and dysphagia, and is thought to have a syndrome associated with Raynaud’s phenomenon, and telangiectasia. What antibody should we measure to confirm this possible diagnosis?

A

Anti-centromere

167
Q

Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel.

A

Acarbose

168
Q

Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4).

A

Gliptins such as alogliptin or sitagliptin

169
Q

A patient presents with weakness and is found to have a potassium of 2.4mM (NR 3.5 to 5.0). What is the likely acid-base abnormality if you check the patients arterial blood gas?

A

Metabolic acidosis

170
Q

A 67-year-old woman presented with confusion 2 days after a cholecystectomy. She had experienced some pain postoperatively, largely relieved by analgesia.

A

SIADH

171
Q

A 51-year old man is having investigations for palliative surgery due to gastric adenocarcinoma. He is found to be anaemic, with high a reticulocyte count and fragmented red blood cells on blood smear. What is this anaemia known as?

A

MAHA

172
Q

In a patient with Hodgkins Lymphoma, the stage of disease is given by the amount of spread, with stage 1 disease involving only one group of nodes, and stage IV disease involving extra nodal spread. What would stage III Hodgkins disease suggest?

A

Disease above AND below the diaphragm.

173
Q

A 56 year-old male presents with fever, vomiting and seizures. Examination reveals a well- established ear infection and there is a ‘ring-enhancing’ lesion on the MRI of his brain.

A

Brain abscess

174
Q

A 27 year old patient has a knee effusion drained. The gram stain reveals Gram negative intracellular diplococci. What is the likely organism?

A

Neisseria gonorrhoeae

175
Q

A 40 year old man presents with weight loss, muscle aches and abdominal pain. On examination he has high BP and urine dipstick reveals blood + and protein +. The patient is thought to have a vasculitis and is p-ANCA positive.

A

Eosinophilic Granulomatosis with Polyangiitis. (EGPA)

176
Q

A patient presents with haemoptysis and haematuria. She is thought to have Goodpastures syndrome. What antibody should you look for?

A

Anti glomerular basement membrane.

177
Q

A four-year-old boy presents with a purpuric rash across the legs and buttocks. Two weeks previously you had seen the child about a chest infection. Further examination reveals abdominal pain and haematuria. Serum IgA levels are raised. What is the likely diagnosis?

A

Henoch Schonlein purpura

178
Q

A patient is found to have a positive Coombes (anti-globulin) test. What is the likely diagnosis?

A

Auto-immune haemolytic anaemia

179
Q

Etanercept

TNF-alpha inhibitor

A

Ankylosing Spondylitis Monoclonal

180
Q

Ustekinumab

IL-12/IL-23

A

Psoriasis Monoclonal

181
Q

Wegner’s

Granulomatosis with polyangiitis

A

anti-­‐proteinase 3

182
Q

Rheumatoid arthritis + hepatosplenomegaly –> Neutropenia

A

Felty’s

183
Q

C3
C4
Anti-dsDNA

A

How to monitor the activity of SLE?

184
Q

Anti-Scl-70

A

Antibody useful to diagnose someone with systemic sclerosis?

185
Q

Rheumatoid Arthritis

IL-6R

A

Tocilizumab

186
Q

Osteoporosis

RANKL

A

Denosumab

187
Q

Chronic granulomatous disease

A

IFN-gamma

188
Q

Cyclophosphamide

A

Treating Wegner’s

189
Q

IV C1 inhibitor

A

Treatment of hereditary angioedema

190
Q

Wash out mouth

oral antihistamines

A

Treatment of oral allergy syndrome

191
Q

H1-antagonist.

A

Utricaria

192
Q

gp120

A

Neutralizing antibody in HIV

193
Q

p24

A

NON-Neutralizing antibody in HIV

194
Q

CCR5

A

Co-receptor for entry of HIV

195
Q

protease

reverse transcriptase

A

Enzyme targeted by HIV treatment

196
Q

Meningitis

A

C7 complement deficiency

197
Q

Hyper IgM syndrome

A

CD40L deficiency

198
Q

Pneumovax

A

Asplenic patient vaccines

199
Q

Influenza

A

Vaccine against viral haemagglutinin

200
Q

Live vaccines

Avoid in immunocomprimised

A

Yellow fever, MMR and BCG

201
Q

Small Yellow Typhoid Chicken BOY MMR

Smallpox

Yellow fever

Typhoid

Chickenpox

BCG

Oral polio

Yellow fever

MMR

A

Live Vaccines

202
Q

Chronic granulomatous disease

A

Patient gets recurrent infections with negative NBT and dihdrorrhadamine tests

203
Q

IFN-y receptor deficiency

A

Atypical granulomatous infection in previously healthy patien

204
Q

Type III

A

Serum sickness

205
Q

Type I

A

Eczema

206
Q

Small pox vaccine

A

vaccinia

207
Q

prednisolone

A

Treatment of temporal arteritis

208
Q

Anti-TNF alpha (Infliximab)

A

Azathioprine resistant Crohn’s

209
Q

Ig4?

A

Cytokine responsible for promoting antibody synthesis

210
Q

IL-5

A

Promoting eosinophil growth

211
Q

Auto-immune polyendocrine syndrome type 1 (APS1)

Auto-immune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome / APECED

Antibodies vs parathyroid and adrenal glands Hypoparathyroidism and Addison’s

Antibodies vs IL17 and IL22
Candidiasis

A

AIRE gene causes

212
Q

gp120

A

HIV: Uses this receptor on the cell wall to facilitate entry

213
Q

Yellow fever

A

b. What travel vaccine don’t you give to a person who has ankylosing spondylitis and on TNF alpha inhibitor?

214
Q

HPV

A

What vaccine do you give to girls at 12-13y?

215
Q

Pneumococcal (Pneumovax)

A

Vaccine you give every 5 years for splenectomised patients

216
Q

MMR

A

What is in the routine immunization programme but not given to immunocompromised children?

217
Q

PCP

A

Ground glass appearance

218
Q

Reiter’s syndrome

A

Guy has urethritis, arthritis and eye problems

219
Q

Staphylococcus Saprophyticuss

A

Gram positive that gives LUT symptoms in women

220
Q

E.Coli

A

Gram neg rod UTI

221
Q

Toxoplasmosis

A

Flagellate protozoan that can cross placenta

222
Q

Syphilis

A

STI that can cross placenta in third trimester

223
Q

=Contamination of sample

A

Squamous cells on microscopy

224
Q

Nitrites

A

Coliform organisms

225
Q

Proteus

Struvite stones

A

Stone associated infetcion

226
Q

Clostridium perfringens

A

Gas gangrene

227
Q

Legionella

A

Urine antigen detection

228
Q

Strep pneumonia

A

Rust coloured sputum

229
Q

Reverse transcriptase

A

HIV: Enzyme that copies with errors

230
Q

Aminooxypentane (AOP)-MIP-1α

A

What is the chemokine that inhibits HIV entry into cells

231
Q

pox virus

A

Molluscum contagiosum

232
Q

HHV8

A

Kaposi’s sarcoma

233
Q

Listeria

A

gram positive rod

234
Q

gram negative cocci

A

N. meningitis

235
Q

Strep pneumonia

A

Smoker – gram positive cocci

236
Q

Herpes

A

Meningitis, normal glucose, raised lymphocytes, slightly raised protein

237
Q

Chlamydia trachomatis

A

neonatorum ophthalmia

238
Q

Adenovirus

A

What causes hemorrhagic cystitis in kids

239
Q

Strep pyogenes

A

Mum had skin infection with a son with a sore throat

240
Q

cutaneous leishmaniasis

A

Guy came back from afganistan with ulcer on his ring finger

241
Q

N.Meningitis

A

Kid had red erythemous, oedematous rash, first on face and crosses the nasal bridge and spread really quickly –

242
Q

antamoeba histolytica

A

Livery cyst

243
Q

Folate deficiency /B12

A

Angular stomatitis

244
Q

Urine PBG

A

You suspect Acute Intermittent Porphyria. What test?

245
Q

Urine amino acids

A

Jaundiced baby no dysmorphic features

246
Q

Urine reducing substances

A

hypoglycaemic neonate

247
Q

Pulmonary oedema

A

Wet Beri Beri

248
Q

Neurological symptoms

A

Dry Beri Beri

249
Q

High

> 30

A

Bicarb in pyloric stenosis

250
Q

Polyendocrinopathy

–> B12 def (pernicious anaemia)

A

Woman with hypothyroidism, T1DM, adrenal failure

251
Q

ALA synthase

first enzyme

A

Enzymes - rate-limiting enzyme in haem synthesis?

252
Q

HGPRT

Leysch-Nyhan syndrome

A

Deficiency leads to high urate

253
Q

Raised HbA2

A

How to diagnose B Thal trait

254
Q

Mumps

A

Raised amylase

255
Q
  1. 1-6.9 FASTING

7. 8-11.0 OGTT 2 hours

A

Impaired glucose tolerance

256
Q

> 7.0 Fasting

> 11.1 OGTT 2 hours

HbA1c > 6.5% (48mmol/mol)

A

Diabetes cut-off

257
Q

Haemochromatosis

A

One that causes hepatic cirrhosis and portal hypertension in some and cardiomyopathy in others?

258
Q

Hyperkalaemia

+ salt losing crisis

A

CAH

259
Q

JC virus

A

Adult T-­‐cell lymphoma

260
Q

2.0-3.0

A

INR Someone with AF?

261
Q

3.0-4.0

A

INR: Someone with a prosthetic valve.

262
Q

APTT

A

Monitoring: Someone on unfractionated heparin.

263
Q

Sickle trait

A

Normal Hb - positive sickle solubility test

264
Q

Sickle cell disease

A

Low Hb - positive sickle test

265
Q

Hereditary spherocytosis

A

polychromasia and spherocytes

266
Q

Temporal arteritis

A

Raised ESR

267
Q

Transfusion haemosiderosis

A

Thalassaemia patient looks tanned and has diabetes

268
Q

Haemophilia A

A

Patient has prolonged APTT, normal PT and normal bleeding time

269
Q

vWF

A

Patient has menorrhagia, prolonged APTT, normal PT and prolonged bleeding time. Her mother had similar problems

270
Q

CLL

A

Elderly Patient is asymptomatic and has generalised lymphadenopathy, with abnormal bloods

271
Q

Myelofibrosis

A

Elderly patient presents with MASSIVE splenomegaly with low platelets, red cells and normal white cells

272
Q

Myelodyplastic syndrome

A

Pelger Huet cells, hyposegmented neutrophil

273
Q

Galactocele

A

Breast Mass. Aspirated. Brown ‘fluid’

274
Q

Aspergillosis

A

Halo-sign on x-ray

275
Q

CLL

A

CD19+
CD5+
B cells

276
Q

CLL
Hairy cell
—> DLBC

A

Ritcher’s transformation

277
Q

CLL

A

Smear Cells

278
Q

CLL

Or could be a mantle cell lymphoma!

A

CD5+

279
Q

CLL

Stage 1 <3 lymph nodes
Stage 2 >3 lymph nodes
Stage 3 >3 lymph nodes Hb<100

A

Binet staging

280
Q

Inactivates VIIa and V

A

Protein C

281
Q

Inactivates thrombin

Inactivates IX, X and XI

A

Antithrombin III

282
Q

Inhibits factor Xa and TF:VIIa complex

A

Tissue factor pathway inhibitor

283
Q

Vasogenic Oedema

A

When the integrity of the BBB is disrupted the resultant oedema is described as

284
Q

Tonsillar

A

Which of the following types of herniation do not involve cortex?

285
Q

33%

A

What percentage of patents who experience a TIA will get a significant infarct within 5 years?

286
Q

Hypertension

A

What is the most common cause of non-traumatic intraparenchymal haemorrhages?

287
Q

Secondary ovarian tumour

Bilateral metastases composed of mucin producing signet ring cells

most often of gastric origin or breast

A

Krukenberg tumours

288
Q

Mucinous

A

HNPCC associated ovarian tumour

289
Q

Serous cystadenocarcinoma

A

BRCA associated ovarian tumour

290
Q

Serous cystadenocarcinoma

A

Most common ovarian cancer

291
Q

Low grade, relatively indolent, arise from well characterised precursors (BOT) and endometriosis

Usually present as large stage I tumours

Mutations in K-ras, BRAF, PI3KCA and HER2, PTEN and beta–catenin

Usually have precursors

Include low grade serous, low grade endometrioid, mucinous and tentatively CCC.

A

Type I Ovarian Tumours

292
Q

High grade mostly of serous type
Aggressive
More than 75% have p53 mutations
No precursor lesions

A

Type II Ovarian Tumours

293
Q

Type I: 80-85%

Endometrioid, mucinous and secretory adenocarcinomas
Younger age
Are oestrogen dependent
Often associated with atypical endometrial hyperplasia
Low grade tumours, superficially invasive

A

Type I Endometrial Cancer

294
Q

Type II: 10-15%

Serous and clear cell carcinomas
Older, postmenopausal
Less oestrogen dependent
Arise in atrophic endometrium
High grade, deeper invasion, higher stage
A

Type II Endometrial Cancer

295
Q

adenocarcinomas

A

Most common endometrial cancer

296
Q

Benign

A

C2 breast

297
Q

Malignant

A

C5 breast

298
Q

Duct ectasia

Benign

A

Dilated ducts
Periductal inflammation
Filled with secretions

299
Q

Mastitis

A

Neutrophils (trinucleate cells)
Acute inflammation
+/- abscess

300
Q

Fat necrosis

Later fibrosis and calcification

A

Degenerative fat
Foamy macrophages
Giant cells

301
Q

Fibrocytsic change

A

Apocrine metaplasia
Adenosis
Epithelial and stromal hyperplasia

302
Q

Phyllodes tumour

Benign

A

Overlapping cells
Excess glandular and stromal proliferation
Leaf-like fonds

303
Q

Intraductal papilloma

Benign

A

Branching papillary groups
Papillary mass within duct lined by epithelium
Fibrovascular core

304
Q

Radial scar

Benign

A

Central zone of scarring
Radiating zone of proliferating glandular tissue
Stellate mass

305
Q

DCIS

A

Ducts filled with atypical epithelial cells

306
Q

Invasive breast carcinoma

A

Infiltrating atypical epithelial cells

307
Q

Invasive ductal

A

Most common breast cancer

308
Q

DCIS

A

Cancer staged into low grade, intermediate, high grade

309
Q

phylloides tumour

A

Proliferation of fibroepithelium and stromal tissue

310
Q

LCIS

A

Loss of E.cadherin

311
Q

High grade DCIS

A

HR PR negative

312
Q

Mitral valve

A

Rheumatic valvular disease

313
Q

Hypertrophic cardiomyopathy

A

Condition caused by a genetic defect in myofilament formation leading to large myocytes

314
Q

Dilated heart failure

A

Conditions caused by progressive loss of myocytes

315
Q

Aortic stenosis

A

Condition of structural calcification causing onset of a murmur late in life

316
Q

Strep Pneumonia

A

35 yr old male presented with a 1 week history of hoarse voice, cough, headache and mild fever. His symptoms were getting worse and he was finding it harder to breathe. He also developed sinus pain.

317
Q

Strep pneumonia

A

A 75 year old male non-smoker presented with a cough productive of sputum and fever. He was short of breath and felt a ‘catching’ chest pain upon breathing in. Chest X-ray showed consolidation in the right lower lobe.

318
Q

Mycoplasma pneumonia

A

An otherwise healthy 25 year old female complained of ‘flu like’ symptoms following return from Mexico. She had a headache, weakness and joint pains and had developed a dry cough. Tests detected the presence of cold agglutins.

319
Q

TB

A
  1. 25 year HIV positive man presented with a 2 week history of a bloody cough and night sweats. He had lost weight and had a fever. 3 weeks ago he had travelled to Africa to visit family. Chest xray revealed hilar lymphadenopathy and left sided upper lobe shadowing.
320
Q

Legionella

A

A 45 year old business man was previously well. One week after staying in a hotel he developed diarrhoea, nausea and weakness. He had a headache and on examination was confused and pyrexial. Tests revealed lymphopaenia and hyponatraemia.

321
Q

Cardiac failure

A

A 69yr old male smoker is rushed into hospital complaining of severe breathlessness when walking upstairs. He is tachycardic with a reduced pulse volume and you also note that his ankles are considerably swollen.

322
Q

Staph Aureus

A

A 26yr old known I.V. drug user presents with fever, weakness, lassitude and night sweats. On examination you discover a heart murmur

323
Q

Rheumatic fever

A

A 7yr old girl complains of a rash on her chest and painful joints. On further questioning you discover she had recovered from a sore throat a fortnight ago

324
Q

Hypertrophic cardiomyopathy

A

A young fit 22yr old is rushed into A&E after complaining of a severe chest pain and breathlessness. A loud fourth heart sound is heard.

325
Q

Pericarditis

A

A 55yr old male presents to A&E with a sharp centralised chest pain which is relieved by sitting forwards. A pericardial rub is heard at the left sternal edge.

326
Q

Clostridium perfringens

A

A gram positive bacillus that produces alpha-toxin causing gas gangrene in infected wounds

327
Q

Anaerobes

A

A man punches someone in a pub brawl. The recipient then bites his hand. Later the bite wound becomes infected, with lots of pus and a foul smell. The most likely pathogen is?

328
Q

Strep pyogenes

A

A gram positive B haemolytic coccus that can cause pharyngitis, erysipelas and cellulitis.

329
Q

Polycythaemia rubra vera

A

A 65yr old male is found to have an Hb of 19g/dl on a routine blood test, EPO levels were normal. On examination he is found to have splenomegaly and engorgement of the retinal vein. Bone marrow histology showed increased cellularity of erythroid cells. What is the most likely diagnosis?

330
Q

Essential thrombocythemia

A

A 30yr old female was found to have platelets>600x109/L on 3 separate occasions. Her CRP and ESR were within the normal range. She suffered a DVT 3 months ago. What is the likely diagnosis?

331
Q

Anagrolide

A

Which drug aids in the reduction of platelet number and can cause palpitations and flushing?

332
Q

Myelofibrosis

A

A peripheral blood film of a patient with polycythaemia vera shows a leucoerythroblastic picture with tear drop poikilocytes. What is the likely diagnosis?

333
Q

Chronic granulocytic leukaemia

A

Imatinib can be used in the treatment for which leukaemia?

334
Q

ULCER

A

What is the correct pathological term for a discontinuation in the epithelial surface?

335
Q

Barrett’s oesophagus.

A

A 65 year old male with a long history of epigastric pain. Endoscopy reveals 3.2cm of columnar metaplasia in the lower oesophagus. What does this suggest?

336
Q

Fistula

A

What is the technical term for a connection between two epithelial surfaces, as occurs in Crohns disease where for example there might be a connection between the bladder and the bowel?

337
Q

Krukenberg tumour

A

A 46-year old Japanese female is found to have bilateral ovarian masses on imaging of the abdomen and had both ovaries removed. Histology revealed malignant signet ring cells containing mucin in both ovaries. What is the diagnosis?

338
Q

Dermoid cyst or Cystic Teratoma

A

A 50 year-old female was found to have an ovarian mass. On its removal, histology revealed several cell types, including thyroid follicles, hair and teeth. What is the likely diagnosis?

339
Q

Streptococcus pneumoniae

A

A 40 year-old female non-smoker presents with a one week history of fever, shortness of breath and a cough productive of rusty coloured sputum. Microscopy of the sputum is shown (Gram positive diplococci). What is the organism?

340
Q

Legionnaires disease or Legionella Pneumophila

A

A 37 year-old man presents with a headache, myalgia and a cough. He is also suffering with nausea, diarrhoea and abdominal pain. On examination he is tachypnoeic and has a pyrexia of 39ºC. Blood tests reveal lymphopenia and hyponatraemia. A gram stain from the patients sputum is shown here (Gram negative rods). CXR shows lobar consolidation. Cold agglutinins are negative. What is the organism?

341
Q

Salmonella Typhae or Typhoid fever.

A

A 40 year-old woman presents with malaise, muscular pains and diarrhoea with mucus and blood. On examination she has a fever and several distinctive spots on her abdomen (Rose spots). Blood cultures are positive and grow gram negative rods. What is the likely organism?

342
Q

Helicobacter pylori.

A

genus of spiral flagellated Gram negative bacteria. Found in the stomach within the mucosa layer. It occurs in the majority of middle-aged people and causes progressive gastritis. Invariably present in duodenal ulceration and usually in gastric ulceration. What is the organism?

343
Q

Di George syndrome or 22q11.2 deletion syndrome.

A

A 4 year old girl presents to the A&E with a recurrent chest infection that will not clear. On examination, the house officer notices that she has low set ears, a cleft palate and a murmur. Investigations reveal:

Calcium 1.9 mM (NR 2.2 to 2.6);
Phosphate 1.4 mM (NR 0.8 to 1.4)
PTH 1.1 pM (NR 1.1 to 6.8)

What is the likely diagnosis?

344
Q

Anti-centromere

A

A 40-year old lady complains of tight fingers and dysphagia, and is thought to have a syndrome associated with Raynaud’s phenomenon, and telangiectasia. What antibody should we measure to confirm this possible diagnosis?

345
Q

Acarbose

A

Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel.

346
Q

Gliptins such as alogliptin or sitagliptin

A

Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4).

347
Q

Metabolic acidosis

A

A patient presents with weakness and is found to have a potassium of 2.4mM (NR 3.5 to 5.0). What is the likely acid-base abnormality if you check the patients arterial blood gas?

348
Q

SIADH

A

A 67-year-old woman presented with confusion 2 days after a cholecystectomy. She had experienced some pain postoperatively, largely relieved by analgesia.

349
Q

MAHA

A

A 51-year old man is having investigations for palliative surgery due to gastric adenocarcinoma. He is found to be anaemic, with high a reticulocyte count and fragmented red blood cells on blood smear. What is this anaemia known as?

350
Q

Disease above AND below the diaphragm.

A

In a patient with Hodgkins Lymphoma, the stage of disease is given by the amount of spread, with stage 1 disease involving only one group of nodes, and stage IV disease involving extra nodal spread. What would stage III Hodgkins disease suggest?

351
Q

Brain abscess

A

A 56 year-old male presents with fever, vomiting and seizures. Examination reveals a well- established ear infection and there is a ‘ring-enhancing’ lesion on the MRI of his brain.

352
Q

Neisseria gonorrhoeae

A

A 27 year old patient has a knee effusion drained. The gram stain reveals Gram negative intracellular diplococci. What is the likely organism?

353
Q

Eosinophilic Granulomatosis with Polyangiitis. (EGPA)

A

A 40 year old man presents with weight loss, muscle aches and abdominal pain. On examination he has high BP and urine dipstick reveals blood + and protein +. The patient is thought to have a vasculitis and is p-ANCA positive.

354
Q

Anti glomerular basement membrane.

A

A patient presents with haemoptysis and haematuria. She is thought to have Goodpastures syndrome. What antibody should you look for?

355
Q

Henoch Schonlein purpura

A

A four-year-old boy presents with a purpuric rash across the legs and buttocks. Two weeks previously you had seen the child about a chest infection. Further examination reveals abdominal pain and haematuria. Serum IgA levels are raised. What is the likely diagnosis?

356
Q

Auto-immune haemolytic anaemia

A

A patient is found to have a positive Coombes (anti-globulin) test. What is the likely diagnosis?

Matt's Path REVERSE (18 decks)

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