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Year 2 > Last Minute toughies > Flashcards

Last Minute toughies Flashcards

1
Q

What can cause pseudo-obstruction in GI

A
  1. DIFFUSE SCLERODERMA

2. Parkinson’s

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2
Q

What mediators activate fibroblasts in Scleroderma

A
  1. IL-1
  2. IL-4
  3. IL-6
  4. IL-8
  5. TGF-B
  6. PDGF
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3
Q

What viruses can cause Polymyositis

A
  1. Coxsackie
  2. Rubella
  3. Influenza
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4
Q

What encodes HLA B27 gene

A

MHC on chromosome 6

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5
Q

What is raised in Myositis

A
  1. CRP

2. ESR is NOT raised

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6
Q

Specific autoantibody found in RA

A

Anti-CCP

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7
Q

Specific autoantibody found in Polymyositis/Dermatomyositisi

A
  1. Anti Jo-1

2. Anti-Mi-2

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8
Q

Specific autoantibody found in Scleroderma

A
  1. Anti-Scl70 (diffuse)
  2. Anti-Ro
  3. Anti Centromere (limited)
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9
Q

What antigen is Sjogren Syndrome associated with

A

HLA-B8/DR3

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10
Q

What condition can Sjogren’s syndrome lead to

A

Non-Hodgkin’s Lymphoma:

Diffuse large B-cell lymphoma
Marginal zone lymphoma

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11
Q

What antigen is APS associated with

A

DR7

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12
Q

What genes are responsible for peak bone mass

A
  1. Collagen type 1A1
  2. Vit D recpetor
  3. Oestrogen receptor gene
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13
Q

Blood test results for SLE

A
  1. Raised ESR
  2. Normal CRP
  3. Anaemia of chronic disease
  4. Urea and creatinine raised
  5. C3/C4 reduced
  6. Anti-Ro
  7. Anti-La
  8. Anti-Smith
  9. Anti-dsDNA
  10. Rheumatoid Factor
  11. Anti-ANA
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14
Q

Blood tests seen in all Vasculitis

A
  1. ANCA negative
  2. Serum alkaline phosphatase raised
  3. Normochromic normocytic anaemia
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15
Q

What disease is PAN associated with

A

Hep B

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16
Q

How do kidney defects cause gout

A
  1. Defective gene for URAT1
  2. High insulin (lowers rate of excretion)
  3. Diuretics impair uric acid excretion (thiazides)
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17
Q

What diseases can cause gout

A
  1. Polycythaemia vera
  2. Leukaemia
  3. Surgery
  4. Psoriasis
  5. Carcinoma
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18
Q

What conditions does Gout increase incidence of

A
  1. CVD
  2. Hypertension of kidneys
  3. Diabetes Mellitus II
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19
Q

What FBC content is used to distinguish between polymyalgia rheumatic and myositis

A

Creatinine kinase levels normal in PR

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20
Q

What people are effected by pseudo gout

A
  1. Oteoarthritis
  2. Obesity
  3. Haemochromatosis
  4. Hyperparathyroidism
  5. Diabetes
  6. Old Age
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21
Q

What is the problem with isotope bone scans in Paget’s

A

Unable to distinguish between Paget’s and sclerotic metastatic carcnioma

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22
Q

Where do osteosarcomas metastasise to

A

the LUNG

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23
Q

Why do we look at creatinine levels for kidney function

A

Can only be excreted by the kidneys (made by the muscles)

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24
Q

At what eGFR is anaemia seen in

A

<30

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25
Q

What is the MAP that drives filtration in the Bowman’s capsule

A

60-70mmHg

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26
Q

What causes Falconi Syndrome

A
  1. Cystinosis
  2. Wilson’s
  3. Tenofovir
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27
Q

What molecules does angiotensin II upreuglate (polycystic kidney disease)

A
  1. TGF-beta

2. PAI-1

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28
Q

If I find eosinophils in my urine, what can this indicate

A

Cholesterol Emboli or allergic tubulointerstitial nephrotis

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29
Q

When does ADPKD arise

A

In males - adulthood

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30
Q

CVD effects of anaemia

A
  1. Pericarditis

2. Pericardial effusion

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31
Q

What condition is associated with minimal change disease

A
  1. Hodgkin’s lymphoma
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32
Q

Clinical Presentation of Lacunar strokes

A
  1. Pure sensory loss
  2. Ataxic hemiparesis
  3. Unilateral weakness

ONE OF THREE

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33
Q

How long is the time frame for thrombolysis

A

4.5 hours max

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34
Q

What diseases can predispose you to aneurysms

A
  1. Polycystic kidney disease
  2. Ehlers Danlos Syndrome
  3. Coarctation of the aorta
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35
Q

What is lipohyalinosis

A
  1. Vessel wall thickening causing hypertension

Results in lacunar infarcts and strokes

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36
Q

What causes status epileptics

A
  1. Stopping preventative treatment
  2. Alcohol Abuse
  3. Poor compliance to therapy
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37
Q

What environmental problems can cause Parkinson’s

A
  1. Pesticides
  2. MPTP - opiates

Causes mitochondrial dysfunction + Oxidative stress

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38
Q

What are lewy-bodies made of

A
  1. Alpha synuclein

2. Ubiquitin

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39
Q

In what condition is Propranolol contraindicated

A

Diabetes Mellitus

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40
Q

Why dow e avoid Bromocriptine and Cabergoline when treating Parkinson’s

A

Causes cardiac valvulopathy

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41
Q

Side-effect of Mao-B inhibitor

A
  1. Postural Hypotension

2. AF

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42
Q

Name two dopamine antagonist

A
  1. Oral Ropinirole

2. Oral Pramiprexole

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43
Q

Why do we get rigidity in Parkinson’s

A

Lesions in the extrapyramidal tract

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44
Q

What conditions can cause dementia

A
  1. Alcohol Abuse
  2. Liver Failure
  3. Creutzfeldt-Jakob disease
  4. B12/folate deficiency
  5. Huntington’s
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45
Q

Describe the anatomy of the cervical ICA

A
  1. Posterior and lateral to ECA
  2. Anterior and medial to internal jugular vein

ANASTOMOSES with basilar artery sometimes

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46
Q

Branches of the petrous ICA

A
  1. Caroticotympanic artery

2. Vivian artery connection to ECA

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47
Q

Branches of the cavernous ICA

A
  1. Meaning-hypophyseal artery (posterior pituitary)

2. Inferolateral Trunk to ECA

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48
Q

Branches of the supraclinoid ICA

A
  1. Ophthalmic artery
  2. Superior hypophyseal
  3. Posterior communicating
  4. Anterior choroidal artery
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49
Q

What does the lateral lenticulostriate artery supply (M1 - middle cerebral artery)

A
  1. Lentiform nucleus (putamen and globus pallidus)
  2. Caudate
  3. Internal Capsule
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50
Q

What branch of the anterior cerebral artery supplies the corpus callosum

A
  1. Recurrent artery of Heubner
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51
Q

What does the posterior inferior cerebellar artery supply

A
  1. Medulla

2. Inferior cerebellum

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52
Q

What does the basilar artery supply

A

Anterior inferior cerbeellar artery: Cerebellum, CN7 + 8

Bilateral superior cerebellar artery

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53
Q

What does the posterior cerebral artery supply

A
  1. Thalamus
  2. Geniculate body
  3. Cerebral pentacles
  4. Tectum
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54
Q

Why is ethosuximide only given in petit mal

A

It only prevents against generalised seizures - not focal and generalised

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55
Q

What drugs only stop against focal seizures

A
  1. Carbamazepine

2. Phenytoin

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56
Q

Name the three classes of Calcium-ion channel blockers

A
  1. Dihydropyradines
  2. Phenylamines
  3. Diphenylalkylamines
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57
Q

How do ACEI work other than their effect on RAAS

A

Stop degradation of Bradykinin

Increased production of Prostacyclin and NO = Vasodilation

58
Q

Side-effects of ACEI

A
  1. Hyperkalaemia
  2. Renal Artery Stenosis (due to decreased angiotensin levels)
    - —-Applies to ARBs^^—–
  3. Bradykinin-mediated dry cough and angioedema
59
Q

When is Verapamil contraindicated

A

Beta-blockers

60
Q

What type of arrhythmic drug is Quinidine and procaine amide

A

1a - prolongs QT intveral

61
Q

When is Quinidine prescribed

A
  1. Atrial arythmias, tachycardias and ectopic beats

1A - Atria

Short QT syndrome
Brugada Syndrome

62
Q

When is lidocaine given

A

Ventricular arrythmias

Acute MI or Cardioversion

63
Q

When is Procaineamide given

A

Ventricular Tachycardia
Ventricular ectopic beats

AF (all supra ventricular arrythmias)

64
Q

Cardioversion for AF

A
  1. Amiodarone or Procainamide
65
Q

When is Tocainide given (1B)

A

Reduce chances of secondary heart attack

66
Q

What class drug is Flecainide

A

1C

67
Q

What channel does digoxin inhibit

A

Na+/K+ ATPase in myocardium

68
Q

What causes Infective Endocarditis

A
  1. IVDU, Diabetes and surgery - S.Aureus
  2. Dental - S.viridans
  3. Pseudomonas Aerguinosa
69
Q

Clinical presentation of Hypertrophic Cardiomyopathy

A
  1. Double Apical pulsation (forceful atrial contraction causes fourth heart sound)
  2. Jerky carotid pulse (rapid ejection + LVOT)
  3. Ejection systolic murmur (due to LVOT in systole)
70
Q

Asthma vs COPD in clinical presentation

A
  1. Reduced chest expansion in attacks (barrel chest in COPD)

2. Nocturnal cough and symptoms in ASTHMA not COPD

71
Q

What should be done if asthmatic attack isn’t improving with treatment

A

CXR for heart failure

72
Q

What inflammatory mediators are released by cigarettes in COPD

A

IL-1
IL-8
TNF-alpha

73
Q

Genetic cause of asthma

A

ADAM33

74
Q

What drugs can cause asthma

A

NSAIDs

Beta-blockers

75
Q

What condition are patents with silicosis susceptible to

A
  1. TB
76
Q

What asbestos fibres cause asbestosis

A
  1. Crocidolite
  2. Amosite

COMMON - Chrysolite

77
Q

Complication of Idiopathic Pulmonary Fibrosis

A

Interstitial Pneumonia

Pulmonary embolism and Pneumothorax

78
Q

When does pleural effusion cause chest pains

A

When LYING DOWN

79
Q

What viruses can cause infective diarrhoea

A
  1. Rotavirus
  2. Adenovirus
  3. Norovirus
  4. Astrovirus
80
Q

Risk factors for Hashimoto’s thyroiditis

A

CTLA-4 gene mutation

Down Syndrome

81
Q

What drugs can induce hashimoto’s thyroiditis

A
  1. Carbimaxole
  2. Lithium
  3. Amiodarone (high iodine content stops T3-T4)
82
Q

Complications Hashimoto’s thyroiditis

A

Non-Hodgkin’s Lymphoma

83
Q

What are askanazy cells

A

In hypothyroidism: Cells develop eosinophilic granular cytoplasms due to proliferation of mitochondria.

84
Q

Risks of giving LEVOTHYROXINE

A
  1. AF

2. Osteoporosis

85
Q

What is myxoedema coma

A

SEVERE HYPOTHYROIDISM

Characterised by lethargy, weakness and confusion

86
Q

How is myxoedema Coma treated

A
  1. IV T3 and Glucose infusion
87
Q

Four ways hypothyroidism is induced

A
  1. Carbimazole
  2. Lithium
  3. Amiodarone
  4. INF
88
Q

Side-effect of SIADH management

A
  1. Central Pontine Myelinolysis
89
Q

What conditions is Addison’s associated with

A
  1. Type I diabetes
  2. Hashimoto’s thyroiditis
  3. Coeliac’s
  4. Vitiligo
90
Q

Risk Factors for Hashimoto’s Thyroiditis

A
  1. Gene mutation in CTLA-4

2. Down’s Syndrome

91
Q

What infections can cause lymphomas

A
  1. HELICOBACTER PYLORI INFECTION

2. EBV

92
Q

What happens to Hb in renal tubular cells during haemolytic anaemia

A

Deposited as Haemosiderin into cells

93
Q

Side-effect of erythropoietin treatment in CDA

A
  1. Flu
  2. Hypertension
  3. Rise in platelet count
  4. Thromboembolism
94
Q

Neurological effects of B12 deficiency

A
  1. Paraesthesia of foot and toe
  2. Ataxia and weakness
  3. Paraplegia
  4. Optic atrophy
  5. Dementia
  6. Hallucination
95
Q

Why can’t folate be given without B12

A

Degeneration of spinal cord

96
Q

What is heard on a stethoscope in Anaemia

A
  1. Systolic flow murmur - due to tachicardia
97
Q

How is t(9;22) diagnosed

A
  1. BCR/ABL dual colour dual-fusion probe
98
Q

What molecules inhibit osteoblasts

A

HGF

DKK-1

99
Q

What indicates a poor prognosis of myeloma

A
  1. Reduced serum albumin
  2. Increased serum betamicroglobulin
  3. Increased LDH
100
Q

What compounds activate osteoclasts

A
  1. RANK Ligands

2. IL-3

101
Q

Where is the G6PD gene located

A

Chromosome Xq28 on factor VIII gene

102
Q

How does G6PD defend RBCs

A

Provides NADPH which is used with glutathione to protect from H2O2

103
Q

What causes oxidative crisis

A

Reduction in glutathione production

104
Q

What induces glutathione reduction

A
  1. Aspirin
  2. Antibacterials
  3. Dapsone
  4. Quinidine
105
Q

How is thalassaemia distinguished form iron deficiency

A
  1. Blood tests

2. Hb electrophoresis

106
Q

Complications of thalassaemia treatment

A
  1. Iron deposition in liver and spleen = cirrhosis and fibrosis
    2 Iron deposition in endocrine glands and heart = diabetes
107
Q

Genetic mutations that cause SCA

A
  1. Single-base mutation of adenine to Thymine which substitutes Valine for Glutamic acid at 6th codon for beta-globin
108
Q

Genetic cause of polycythaemia Vera

A
  1. Point mutation that substitutes phenylalanine for valine at 617th position
109
Q

What enzyme indicates anaemia

A

Elevated lactate dehydrogenase

110
Q

What part of the prostate over proliferates in BPH

A
  1. Stroma

2. Glands

111
Q

Clinical Presentation of WILM’s TUMOUR

A
  1. Distended abdomen

2. Haematuria

112
Q

What layer of the prostate has carcinomas arising from it

A

Peripheral zone of the prostate

BPH - Transitional

113
Q

What is Von Hippel Lindau Syndrome

A

Genetic cause of Renal Cell carcinoma

3q gene mutation - Autosomal Dominant

114
Q

What genes predispose you to prostatic cancer

A
  1. HOXB13

2. BRCA2

115
Q

Urine biomarker for prostatic cancer

A
  1. PCA3
116
Q

Name some biomarkers for testicular cancer

A
  1. Alpha-fetoprotein

2. B-hCG

117
Q

What antigen increases susceptibility to UTIs

A

HLA-A3

118
Q

What microbes secrete urease against the host

A

GRAM-POSITIVE:

  1. Klebsiella
  2. Pseudomonas
  3. Proteus

GRAM-NEGATIVE:

  1. Staphylococcus
  2. Mycoplasma
119
Q

Three adhesive features of E.coli

A
  1. Pilli for ascent
  2. Aerobactin for Fe acquisition
  3. Haemolysin - pore formation
120
Q

Wha virus causes Hep A and how is it excreted

A

Picornavirus

In bile

121
Q

What fungi can cause pericarditis

A
  1. Histoplasmosis

2. Coccidioplasmosis

122
Q

What is needed in conjunction with ORAL TENOFOVIR

A

Renal Monitoring

123
Q

What virus is HCV

A

RNA Flavivirus

124
Q

Hep E virus

A

RNA

125
Q

HBV virus

A

DNA

126
Q

What is Mirizzi syndrome

A

Where stone in cystic duct compresses common bile duct

127
Q

Most common HCV genotypes that infect people

A

1a and 1b

128
Q

Replacement of colonoscopy

A
  1. Double contrast barium enema
129
Q

What is used to check for rectal cancer in elderly

A
  1. CT colonoscopies

No perforation risk

130
Q

What would be found in FBC for prosthetic joint infection

A

Alpha defensins

131
Q

Symptoms of JIA enthesitis

A
  1. IBD

Back pain

132
Q

Main Side-effect of tamsulosin

A

Postural Hypotension

133
Q

What carcinogens increase risk of bladder cancer

A
  1. Azo Dyes

2. Beta-Napthylamine

134
Q

How is the value of concentrtaion-dependant killing calculated

A

Peak conc. / MIC ratio

135
Q

Formula for breakpoint conc.

A

cmax/et x f x s

s = shift factor
t = factor to allow for serum elimination half-life
e = factor by which cmax should exceed MIC
136
Q

How to treat candidaisis

A

Fluconazole

137
Q

Complications of DKA

A
  1. Cerebral oedema
  2. Adult Respiratory Syndrome
  3. Thromboembolism
  4. Aspiration Pneumonia
138
Q

What is given to a patient before thyroidectomy surgery

A

Potassium Iodide - reduces vascularity of the thyroid gland

Also discontinue antithyroid

139
Q

What blood test would indicate hypothyroidism

A
  1. Normocytic anaemia
  2. Raised serum aspartate transferase
  3. Increased serum creatinine kinase levels
  4. Hypercholesterolaemia
    5, Hyponatraemia
140
Q

What is belt-clapper deformity

A
  1. Where testis is not fixed to scrotum completely (free movement)

Year 2 (155 decks)

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