MedGEMS Flashcards
1
Q
what does probenecid do?
A
increase FEUA
reduce urate in non-acute gout
2
Q
what is Fanconi syndrome?
A
failure of PCR in kidneys to resorb molecules
3
Q
causes of Fanconi syndrome
A
congenital Wilson's tetracyclines MM lead poisnoning
4
Q
what is the anti-PCSK9 Ab?
A
Evolocumab
5
Q
what causes familial hypercholesterolaemia?
A
LDLR mutations = increase LDL
6
Q
what is the MoA of lomitapine?
A
- inhibits microsomal triglyceride transfer protein (MTP)
= blocks release of VLDL from liver = lower LDL levels
used in treatment of familial hypercholesterolaemia
7
Q
what is the job of human apolipoprotein E (ApoE)?
A
crucial role in cholesterol and lipid metabolism
3 major isoforms: ApoE2, ApoE3, ApoE4
8
Q
thinks to remember about ApoE3, ApoE3, ApoE2
A
ApoE3 = most common ApoE4 = Alzheimer's link ApoE2 = Type 3 hyperlipoproteinemia (inc total cholesterol + TGs)
9
Q
MoA of ezetimibe
A
NPC1L1 inhibitor
= sterol absorption inhibitor
10
Q
cause of Tangier disease
A
ABC A1 gene mutation = dec HDL levels
prevents release of cholesterol/lipids from cells = accumulates in organs (hepatomegaly, splenomegaly, orange tonsils in children)
11
Q
what enzyme is involved in the formation of bile acids from cholesterol in classical pathway?
A
cholesterol 7 alpha hydroxylase
12
Q
causes of normal anion gap metabolic acidosis (ABCD)
A
- Addison’s disease
- Bicarbonate loss (diarrhoea, laxative abuse, RTA)
- Chloride gain (NaCl 0.9% infusion)
- Drugs (Acetazolamide)
13
Q
inheritance of MEN
A
AD
14
Q
cytoplasm in SCC
A
eosinophillic cytoplasm
15
Q
gold standard diagnostic for Leishmaniasis
A
splenic aspirate
16
Q
how is leishmaniasis spread? where do they mutiply?
A
spread by sandflies
multiply inside macrophaghes
17
Q
what are the fungal antigen tests?
A
- cryptococcus: CXM
- aspergillus: Galactomannan
- candida/asper/pcp: Beta-D-Glucan
18
Q
treatment of visceral leishmaniasis
A
amphotericin B
19
Q
HSV that causes encephalitis
A
1
20
Q
what is the most common cause of diarrhoea in returning traveller?
A
E. coli
21
Q
cause of Q fever
A
Coxiella Burnetti
22
Q
medium for mycobacterium tuberculosis
A
Lowenstein-Jenson medium
23
Q
side effect of pyraxinamde
A
hyperuricaemia
24
Q
features of cutaenous leishmaniasis
A
ulcerative lesion
long time to heal
25
microscopy for the fungi
- cryptococcus (India Ink)
- candida (periodic acid-schiff stain, methenamine silver stain)
- aspergillus (methenamine silver stain, PAS stain)
26
beef tapeworm
Taenia saginata
27
what is a decent diagnostic test for tinea/trycophyton?
potassium hydroxide
28
how does pityriasis versicolor appear under wood lamp?
orange
29
reaction in response to syphillis treatment
Jarisch Herxheimer reaction
30
treatment of sinusitis
phenoxymethylpenicillin
31
anti-IL17
secukinumab
| used in psoriatic arthritis, AS
32
one sign of LAD
delayed sloughing of umbilical cord
33
RSV prophylaxis
palivizumab
34
Ab in ITP
anti-glyoprotein 2b/3a
35
what happens if there is anti-Ro in pregnancy?
baby at risk of congenital heart block
36
features of X-linked SCID
absent T cells
elevated B cells
eczema like rash
37
xenograft
between different species
38
problem in X-linked SCID
defective common gamma chain
39
Muromonab
monoclonal Ab targets CD3 (all T cells)
40
isograft
genetically identical
41
what does CH50 actually assess?
patient ability to lyse sheep erythrocytes coated with rabbit and anti-sheep Ab
42
problem in CGD
NAPDH oxidade fef
43
what does Natalizumab target?
alpha 4 integrin
| MS
44
role of IL2
promotes T cell activation
45
Ustekinumab
Ab targets IL-23, IL-12
| in psoriasis and psoriatic arthritis
46
what is protein losing enteropathy?
loss of protein from blood
state of immunodeficiency
diagnosed with faecal alpha 1 antitrypsin
47
patch testing for which type of reactions
type 4
48
gold standard test for food allergy
double blind oral food challenge
49
antibody in RA
anti-CCP
50
what is radioallergosorbent test?
detection of allergen specific IgE in blood
51
order of tests in TB
1. mantoux test
| 2. IGRA
52
what is neutralisation?
target molecule is covered in ABs so that it can bind to its receptors
53
what molecules are involved in the initial binding of CD4 in HIV?
gp120 and CCR5
54
what does binding of gp120 do?
expose gp41
55
what is CD14 found on?
monocytes
56
what is the main Ab in breast milk?
IgA
57
what is latex food allergy syndrome?
IgE mediated
| cross reactivity to latex antigens in fruits/seed
58
what kind of organisms are people with CGD at risk of?
```
catalase +ve
E. coli
Staph. Aureus
Listeria
Klebsiella
Candida
```
59
what do Basiliximab/Daclizumab target?
CD25
60
what does Tofacitinib do?
inhibits tyrosine kinase (JAK)
| reduces expression of pro-inflammatory cytokines
61
indication?
RA
UC
psoriatic arthritis
62
treatment of Kostmann syndrome
GCSF injection
63
Tisagenlecleucel
chimeric antigen receptor T cell
64
Alemtuzimab
anti-CD52
65
affect of haemophillia on bleeding time
no effect
66
levels of vWF in vWF deficiency
leves of vWF may be normal or low
| depends if issue is with function of vWF or lack of production
67
what is the starry sky appearnace?
large number of lymphocytes
| significant macrophages
68
what is the most common cause of Fe deficiency in developing world?
Hookworm
69
reversal of rivaroxaban
adexanet alfa
70
what feature does haemophilia increase?
increased APTT (defect of intrinsic pathway)
71
treatment of acute promyelocytic leukaemia
all-transretinoic acid
72
features of Scwachmann-Diamond
neutropenia
pancreatic dysfunction
short stature
73
what is small molecule inhibitor for CLL?
ibrutinib
74
what is ventoclax?
BCL2 inhibitor for CLL
75
what is the issue is heparin induced thrombocytopaenia?
Abs directed against heparin and PLATELET FACTOR 4
- prothrombotic
- thrombocytopaenia
- immune complex formation
76
most common lymphoma in >40 year olds
diffuse large B cell lympoma
77
absolute levels of G6PD in acute haemolytic crisis
may be normal
78
what is the most common INR target?
2.5
79
high risk e.g. metallic valve INR target
3.5
80
factor with shortest half life
7
81
anticoag treatment in cancer
DOAC
82
bronchiectasis appearance on CT
bronchial wall thickening
| +ve signet ring sign
83
score system for HIT
4 Ts
84
cancer with highest mortality
lung cancer
85
inheritance of SCD
AD
86
what does Fanconi anaemia increase chance of?
MDS
| AML
87
most sensitive marker for IDA
low ferritin
88
anticoagulant in renal failure
warfarin
89
what is a dacrocyte
poikilocyte erythrocyte
90
Idarucizumab
reversal agent of dabigatran
91
what proteins require Vit K?
protein C and protein S seasoning
92
appearance of basophil
deep blue granules
bilobed nucleus
x3 larger than erythrocyte
93
appearance of eosinophil
reddish purple granules
bilobed nucleus
x3 larger than erythrocyte
94
follicular lymphoma translocation
14;18
95
what is high/low in TLS?
increase K, P, urate
| decrease Ca
96
Diamond Black fan
- anaemia
- elevated fetal Hb
- craniofacial malformation (e.g. cleft palate/cardiac defect)
97
appearance of a lymphocyte
small
giant nucleus
no granules
thin blue cytoplasm
98
what is a poor prognostic marker in ALL?
philidelphia chromosome (9;22)
99
enzyme that warfarin inhibits
Vit K epoxide reductase
100
treatment of HIT
- stop heparin
| - rapid anticoagulation with direct thrombin inhibitor
101
gene mutation in Burkitts
c-myc (oncogene)
102
appearance of monocyte
large
kidney bean shaped nucleus
relatively common
103
bicalutamide
androgen antagonist
| prostate cancer
104
pancreatic chemo
FOLFIRINOX
105
benign familial haematuria
microscopic haematuria
otherwise well
AD
106
what damage causes mitral regurg?
papillary muscle damage
107
what valve affected in drug users endocarditis?
Tricuspid
108
HSV encephalitis affects the?
temporal lobe
109
H&E stain
Haematoxylin and Eosin stain
110
inheritance of MODY
AD
111
Men 1
3Ps
Pituitary
Parathyroid
Pancreatic
112
Men 2a
2P's 1M
Parathyroid
Phaeo
Medullary thyroid
113
Men 2b
1P 2M's
Marfanoid
Medullary
Phaeo
114
what is the misfolded protein in MND?
superoxide dismutase
115
what are the features of Alport syndrome?
- nephritic syndrome
- cataracts
- sensorineural deafness
116
prostate cancer chemo
docetaxel
117
what protein is defective in PCKD
polycystin 1
118
Courvoisier's sign
119
casts in CKD
waxy
120
what type of cancer does schistosomasis case?
SCC of bladder
121
what are the weak points that allow diverticular to form?
taenia coli
122
nodules on renal biopsy in Diabetes
Kimmelstiel wilson nodules
123
most common type of lung cancer
Adenocarcinoma
124
hepatobilliary disease associated with p-ANCA
PSC
125
bronchiectasis key sign
tram track opacity
126
A1AT inheritance pattern
autosomal co-dominant
127
A1AT clinical spirometry and CXR
obstructive
| CXR = hyperinflation
128
what is acantholysis?
lost intracellular connections between neighbouring cells
129
V1 and V2 area
septal region
130
tumour associated with zollinger ellison
gastrinoma
