Meeran's Path Questions for Mocks Flashcards
What is the correct pathological term for a discontinuation in the epithelial surface?
Ulcer
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?
Barrett’s Oesophagus
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?
Fistula
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?
Krukenberg Tumour
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?
Teratoma
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?
Strep Pneumoniae
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?
Legionnaires Disease
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?
Salmonella Typhae
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.
Heliobacter Pylori
Which tumour is caused by Human Herpes virus 8?
Kaposi’s Sarcoma
A 28-year old woman presents with malaise, weight loss, and abdominal pain. Both anti-tissue transglutaminase (tTG) and anti-endomyseal (EMA) antibodies were found in the serum. What is the likely diagnosis?
Coeliac Disease
The same 28-year old woman with anti-tissue transglutaminase (tTG) and anti-endomyseal (EMA) antibodies wanted to know if she needed any further investigations. What gold standard diagnostic test should be undertaken?
Duodenal Biopsy
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)
Di George Syndrome
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?
Anti-centromere
A 32-year old woman is thought to have Graves’ disease. What antibody should you look for?
Anti-TSH Receptor antibodies
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?
Spread to both sides of body and below diaphragm too
Give one feature that would make you add the suffix “B” to the stage of the Hodgkins disease.
Fever, night sweats or 10% weight loss
What type of neutrophil is shown in the middle of this blood film, in this patient known to have pernicious anaemia?
Hypersegmented Neutrophil
A patient is thought to have multiple myeloma. What is found in the urine that will confirm this diagnosis?
Bence Jones protein
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?
MAHA
A 67-year-old woman presented with confusion 2 days after a cholecystectomy. She had experienced some pain postoperatively, largely relieved by analgesia. On examination, she was disoriented, her heart rate was 66 beats per minute and her blood pressure was 162/82 mmHg. She only had minor discomfort of the abdomen. The urine sodium was 90mmol/l (NR 20-200mmol/l depending on hydration of patient).
The figure below shows the colours you would see on the dipstick after it has been dipped in the urine, and it was yellow in colour, consistent with an SG of 1.030.
Investigations:
Haemoglobin 130 g/L (115-165)
MCV 92 fL (80-96)
white cell count and platelet count normal
serum sodium 120 mmol/L (137-144)
serum potassium 3.7 mmol/L (3.5-4.9)
serum urea 3 mmol/L (2.5-7.0)
serum creatinine 90 µmol/L (60-110)
serum albumin 36 g/L (37-49)
random plasma glucose 5 mmol/L
What is the most likely cause of the low sodium
SIADH
A 45 year old woman, presents with increasing pain in her thighs and hips. Blood results : Ca – 2.4 mmol/L (2.2 to 2.6), Phosphate – 0.9 mmol/L (0.8 to 1.4), PTH – 5.0 pmol/L (1.1 to 6.8), ALP 3900 (39-120).What is the likely diagnosis?
Paget’s disease
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?
Metabolic Alkalosis
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.
Acarbose
Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4)
Sitagliptins
What is the condition in which infiltrates show characteristic green staining of the myocardium with Congo Red?
Amyloidosis
A 26 year old known I.V. drug user presents with fever, weakness, lassitude and night sweats.
On examination you discover a heart murmur. What is the diagnosis?
Infective Endocarditis Staph Aureus
A 70 year old known teetotal patient is noted to have a heart murmur and careful examination reveals splenomegaly with an obvious notch and you can’t get above it. There are no visible veins on the anterior abdominal wall, and there is no ascites, so you conclude that there is no portal hypertension. Dipstick of the urine reveals microscopic haematuria. She is found to have a temperature of between 37.5oC and 38.5oC whenever it is checked.
What is the diagnosis?
Infective Endocarditis Strep Viridans
A 7 year old girl complains of a rash on her chest and painful joints. She has some nodules on her elbows and has some difficulty walking and appears clumsy with apparent random arm movements, as if she is trying to dance. On further questioning you discover she had recovered from a sore throat a fortnight ago.
What is the diagnosis?
Rheumatic Fever
A 44 year 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.
What is the diagnosis?
Pericarditis
A 34 year old female presents with breathlessness. Investigations reveal normal renal function, but a calcium of 3.0mM and a suppressed PTH. Chest X-ray reveals bilateral hilar lymphadenopathy.
What is the diagnosis?
Sarcoidosis
Name the disorder of calcium handling most commonly seen in patients with end-stage chronic renal failure, in which the plasma calcium is raised?
A. Hypoparathyroidism B. Primary Hyperparathyroidism C. Pseudohypoparathyroidism D. Secondary Hyperparathyroidism E. Tertiary Hyperparathyroidism
Tertiary Hyperparathyroidism
Name the peptide hormone responsible for increasing plasma calcium in response to reduced calcium levels by stimulating osteoclast activity.
A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Parathyroid Hormone
PTH
Name the form of vitamin D produced following the action of 1alpha hydroxylase on 25-OH D3 in the kidney.
A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Vitamin D3
Calcitirol
Which of the options acts to stimulate 1alpha hydroxylase activity in the kidney to increase the production of vitamin D3?
A. Calcitonin B. Calcitriol C. Cholecalciferol D. Ergocalciferol E. Parathyroid Hormone
PTH
What is the diagnosis in a patient with a plasma calcium concentration of 2.9mmol/L (2.2-2.6),
a normal creatinine, a phosphate concentration of 0.76mmol/L (0.8-1.2), a parathyroid hormone level of 4.2pmol/L (1.1-6.8).
A. Malignant hypercalcaemia B. Primary Hyperparathyroidism C. Pseudohypoparathyroidism D. Secondary Hyperparathyroidism E. Tertiary Hyperparathyroidism
Primary Hyperparathyroidism
A 69 year 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.
What is the diagnosis?
A. Cardiac Failure B. Myocardial Infarction C. Restrictive Cardiomyopathy D. Stable Angina E. Sub-acute Bacterial Endocarditis
Cardiac Failure
A young fit 22 year old is rushed into A&E after complaining of a severe chest pain and breathlessness. A loud fourth heart sound is heard.
What is the diagnosis?
A. Cardiac Failure B. Myocardial Infarction C. Restrictive Cardiomyopathy D. Stable Angina E. Sub-acute Bacterial Endocarditis
Restrictive Cardiomyopathy
A 65 year old male is found to have an Hb of 190g/l 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. Chronic hypoxia B. Chronic lymphocytic leukemia C. Essential thrombocythaemia D. Myeloma E. Polycythaemia Vera
Polycythaemia Vera
A 30yr old female was found to have Hb 130g/l, WC 11.0 x109/L and platelets=690x109/L on three separate occasions. Her CRP and ESR were within the normal range. She suffered a DVT 3 months ago.
What is the likely diagnosis?
A. Chronic lymphocytic leukemia B. Chronic myeloid leukemia C. Essential thrombocythaemia D. Myeloma E. Polycythaemia Vera
Essential thrombocythaemia
Imatinib can be used in the treatment for which of these conditions?
A. Acute lymphoblastic leukaemia B. Acute myeloid leukaemia C. Chronic lymphocytic leukemia D. Chronic myeloid leukemia E. Myeloma
CML
Copper carrying protein with oxidase activity.
A. Alpha-1- antitrypsin B. Alpha-fetoprotein C. Bence-Jones protein D. C1-esterase inhibitor E. C3 F. CA19.9 G. Caeruloplasmin H. Carcinoembryonic antigen I. C-reactive protein J. Immunoglobulin E K. Transferrin
Caeruloplasmin
Low levels are present in Wilson’s disease (hepatolenticular degeneration)
A. Alpha-1- antitrypsin B. Alpha-fetoprotein C. Bence-Jones protein D. C1-esterase inhibitor E. C3 F. CA19.9 G. Caeruloplasmin H. Carcinoembryonic antigen I. C-reactive protein J. Immunoglobulin E K. Transferrin
Caeruloplasmin
A 40 year old man who has never smoked develops severe emphysema. Which protein may be deficient?
A. Alpha-1- antitrypsin B. Alpha-fetoprotein C. Bence-Jones protein D. C1-esterase inhibitor E. C3 F. CA19.9 G. Caeruloplasmin H. Carcinoembryonic antigen I. C-reactive protein J. Immunoglobulin E K. Transferrin
A1AT
Which protein appears in the urine in patients with myeloma?
A. Alpha-1- antitrypsin B. Alpha-fetoprotein C. Bence-Jones protein D. C1-esterase inhibitor E. C3 F. CA19.9 G. Caeruloplasmin H. Carcinoembryonic antigen I. C-reactive protein J. Immunoglobulin E K. Transferrin
Bence-Jones
Tumour marker associated with colorectal cancer.
A. Alpha-1- antitrypsin B. Alpha-fetoprotein C. Bence-Jones protein D. C1-esterase inhibitor E. C3 F. CA19.9 G. Caeruloplasmin H. Carcinoembryonic antigen I. C-reactive protein J. Immunoglobulin E K. Transferrin
CEA
15 year old male with cystic fibrosis has a chronic productive cough with green sputum. What is the likely organism?
A. Chlamydia pneumoniae B. Chlamydia psittaci C. Klebsiella pneumoniae D. Legionella pneumophila E. Mycobacterium tuberculosis F. Mycoplasma pneumoniae G. Pneumocystis carinii pneumonia H. Pseudomonas aeruginosa I. Staph aureus J. Strep. Pneumonia
H
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. Chlamydia pneumoniae B. Chlamydia psittaci C. Klebsiella pneumoniae D. Legionella pneumophila E. Mycobacterium tuberculosis F. Mycoplasma pneumoniae G. Pneumocystis carinii pneumonia H. Pseudomonas aeruginosa I. Staph aureus J. Strep. Pneumonia
J
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. Chlamydia pneumoniae B. Chlamydia psittaci C. Klebsiella pneumoniae D. Legionella pneumophila E. Mycobacterium tuberculosis F. Mycoplasma pneumoniae G. Pneumocystis carinii pneumonia H. Pseudomonas aeruginosa I. Staph aureus J. Strep. Pneumonia
F
A 25 year old HIV positive man presented with a two week history of a bloody cough and night sweats. He had lost weight and had a fever. Chest X-Ray revealed hilar lymphadenopathy and left sided upper lobe shadowing.
A. Chlamydia pneumoniae B. Chlamydia psittaci C. Klebsiella pneumoniae D. Legionella pneumophila E. Mycobacterium tuberculosis F. Mycoplasma pneumoniae G. Pneumocystis carinii pneumonia H. Pseudomonas aeruginosa I. Staph aureus J. Strep. Pneumonia
E
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. Chlamydia pneumoniae B. Chlamydia psittaci C. Klebsiella pneumoniae D. Legionella pneumophila E. Mycobacterium tuberculosis F. Mycoplasma pneumoniae G. Pneumocystis carinii pneumonia H. Pseudomonas aeruginosa I. Staph aureus J. Strep. Pneumonia
D
If an unvaccinated pregnant woman became infected with this virus the baby can be born with a congenital syndrome. Features of this syndrome include mental retardation, cataracts, deafness and heart defects.
A. Cholera B. Diphtheria C. Haemophilus influenzae type B D. Hepatitis B E. Hepatitis C F. Measles G. Meningitis C H. Mumps I. Pertussis J. Polio K. Rabies L. Rubella M. Tetanus N. Tuberculosis O. Typhoid P. Varicella-zoster
L
The inactivated vaccine is highly effective in preventing this virus’ potentially devastating paralysing effects. This vaccine is given at 2, 3 and 4 months of age and two further boosters are given, one between 3-5 years of age and one between 13-18 years of age.
A. Cholera B. Diphtheria C. Haemophilus influenzae type B D. Hepatitis B E. Hepatitis C F. Measles G. Meningitis C H. Mumps I. Pertussis J. Polio K. Rabies L. Rubella M. Tetanus N. Tuberculosis O. Typhoid P. Varicella-zoster
J
The recombinant protein vaccine for this virus is given to at risk individuals. This virus can cause jaundice.
A. Cholera B. Diphtheria C. Haemophilus influenzae type B D. Hepatitis B E. Hepatitis C F. Measles G. Meningitis C H. Mumps I. Pertussis J. Polio K. Rabies L. Rubella M. Tetanus N. Tuberculosis O. Typhoid P. Varicella-zoster
D
Vaccination has reduced the incidence of meningitis caused by this organism in five year olds over the last 10 years.
A. Cholera B. Diphtheria C. Haemophilus influenzae type B D. Hepatitis B E. Hepatitis C F. Measles G. Meningitis C H. Mumps I. Pertussis J. Polio K. Rabies L. Rubella M. Tetanus N. Tuberculosis O. Typhoid P. Varicella-zoster
C
The vaccine for this virus is a diploid cell vaccine containing the inactivated form. In the later stages of infection with this virus the sight of water induces convulsions and paralysis.
A. Cholera B. Diphtheria C. Haemophilus influenzae type B D. Hepatitis B E. Hepatitis C F. Measles G. Meningitis C H. Mumps I. Pertussis J. Polio K. Rabies L. Rubella M. Tetanus N. Tuberculosis O. Typhoid P. Varicella-zoster
K
A 23 year old male, who has just commenced treatment with penicillin, presents with confusion, weakness and seizures. On examination you notice that he is pale, bruised and breathing deeply.
A. Acute Tubular Necrosis B. Acute Tubulointerstitial Nephritis C. Chronic Tubulointerstitial Nephritis D. Diabetic Retinopathy E. Focal Segmental Glomerulosclerosis F. Goodpasture's Syndrome G. Hypertensive Renal Damage H. IgA Nephropathy I. Membranous Glomerulonephritis J. Mesangiocapillary Glomerulonephritis K. Minimal Change Glomerulonephritis L. Pyelonephritis M. SLE Nephritis N. Wegener’s Granulomatosis
B
A 45 year old female presents with swelling of the ankles and abdomen. Urine dipstick shows proteinuria +++ but no blood. Light microscopy detects a thickening of the glomerular basement membrane.
A. Acute Tubular Necrosis B. Acute Tubulointerstitial Nephritis C. Chronic Tubulointerstitial Nephritis D. Diabetic Retinopathy E. Focal Segmental Glomerulosclerosis F. Goodpasture's Syndrome G. Hypertensive Renal Damage H. IgA Nephropathy I. Membranous Glomerulonephritis J. Mesangiocapillary Glomerulonephritis K. Minimal Change Glomerulonephritis L. Pyelonephritis M. SLE Nephritis N. Wegener’s Granulomatosis
I
A 7 year old boy presents with swelling of the legs and sacrum. Urine dipstick shows no haematuria but two ++ of proteinuria ++.
A. Acute Tubular Necrosis B. Acute Tubulointerstitial Nephritis C. Chronic Tubulointerstitial Nephritis D. Diabetic Retinopathy E. Focal Segmental Glomerulosclerosis F. Goodpasture's Syndrome G. Hypertensive Renal Damage H. IgA Nephropathy I. Membranous Glomerulonephritis J. Mesangiocapillary Glomerulonephritis K. Minimal Change Glomerulonephritis L. Pyelonephritis M. SLE Nephritis N. Wegener’s Granulomatosis
K
A 25 year old male notices blood in his urine. Light microscopy detects mesangial cell proliferation.
A. Acute Tubular Necrosis B. Acute Tubulointerstitial Nephritis C. Chronic Tubulointerstitial Nephritis D. Diabetic Retinopathy E. Focal Segmental Glomerulosclerosis F. Goodpasture's Syndrome G. Hypertensive Renal Damage H. IgA Nephropathy I. Membranous Glomerulonephritis J. Mesangiocapillary Glomerulonephritis K. Minimal Change Glomerulonephritis L. Pyelonephritis M. SLE Nephritis N. Wegener’s Granulomatosis
J
A 45 year old female presents with swelling of the ankles and abdomen. Urine dipstick shows proteinuria +++ but no blood. Light microscopy detects segmental scarring of the glomeruli.
A. Acute Tubular Necrosis B. Acute Tubulointerstitial Nephritis C. Chronic Tubulointerstitial Nephritis D. Diabetic Retinopathy E. Focal Segmental Glomerulosclerosis F. Goodpasture's Syndrome G. Hypertensive Renal Damage H. IgA Nephropathy I. Membranous Glomerulonephritis J. Mesangiocapillary Glomerulonephritis K. Minimal Change Glomerulonephritis L. Pyelonephritis M. SLE Nephritis N. Wegener’s Granulomatosis
E
Condition caused by progressive loss of myocytes.
A. Acute Myocardial Infarction B. Aortic Stenosis C. Atherosclerosis D. Dilated Heart Failure E. Hypertrophic obstructive Cardiomyopathy (HOCM) F. Hypothyroidism G. Infective Endocarditis H. Marfan's Syndrome I. Pericardial Effusion J. Rheumatic Valve Disease K. Ventricular Septal Defect
D
Long-standing result of previous acute inflammation of the heart.
A. Acute Myocardial Infarction B. Aortic Stenosis C. Atherosclerosis D. Dilated Heart Failure E. Hypertrophic obstructive Cardiomyopathy (HOCM) F. Hypothyroidism G. Infective Endocarditis H. Marfan's Syndrome I. Pericardial Effusion J. Rheumatic Valve Disease K. Ventricular Septal Defect
J
Condition caused by a genetic defect in myofilament formation leading to large myocytes.
A. Acute Myocardial Infarction B. Aortic Stenosis C. Atherosclerosis D. Dilated Heart Failure E. Hypertrophic obstructive Cardiomyopathy (HOCM) F. Hypothyroidism G. Infective Endocarditis H. Marfan's Syndrome I. Pericardial Effusion J. Rheumatic Valve Disease K. Ventricular Septal Defect
E
Condition of structural calcification causing onset of a murmur late in life
A. Acute Myocardial Infarction B. Aortic Stenosis C. Atherosclerosis D. Dilated Heart Failure E. Hypertrophic obstructive Cardiomyopathy (HOCM) F. Hypothyroidism G. Infective Endocarditis H. Marfan's Syndrome I. Pericardial Effusion J. Rheumatic Valve Disease K. Ventricular Septal Defect
B
Condition in which a patient develops splinter haemorrhages in the nail beds.
A. Acute Myocardial Infarction B. Aortic Stenosis C. Atherosclerosis D. Dilated Heart Failure E. Hypertrophic obstructive Cardiomyopathy (HOCM) F. Hypothyroidism G. Infective Endocarditis H. Marfan's Syndrome I. Pericardial Effusion J. Rheumatic Valve Disease K. Ventricular Septal Defect
G
The most appropriate treatment for a surgical wound from which MRSA is isolated.
A. Anaerobic bacteria B. Benzyl penicillin C. Cephalosporin D. Clostridium perfringens E. Clostridium tetanae F. Flucloxacillin G. Metronidazole H. Mycobacterium tuberculosis I. Neisseria meningitidis J. Pasterulla multocida K. Salmonella L. Shigella M. Staph. Aureus N. Strep. pyogenes O. Vancomycin
O
A gram positive bacillus that produces α-toxin causing gas gangrene in infected wounds.
A. Anaerobic bacteria B. Benzyl penicillin C. Cephalosporin D. Clostridium perfringens E. Clostridium tetanae F. Flucloxacillin G. Metronidazole H. Mycobacterium tuberculosis I. Neisseria meningitidis J. Pasterulla multocida K. Salmonella L. Shigella M. Staph. Aureus N. Strep. pyogenes O. Vancomycin
D
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. Anaerobic bacteria B. Benzyl penicillin C. Cephalosporin D. Clostridium perfringens E. Clostridium tetanae F. Flucloxacillin G. Metronidazole H. Mycobacterium tuberculosis I. Neisseria meningitidis J. Pasterulla multocida K. Salmonella L. Shigella M. Staph. Aureus N. Strep. pyogenes O. Vancomycin
A
The most appropriate treatment for the man in case the last case who punched 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 appropriate treatment is?
A. Anaerobic bacteria B. Benzyl penicillin C. Cephalosporin D. Clostridium perfringens E. Clostridium tetanae F. Flucloxacillin G. Metronidazole H. Mycobacterium tuberculosis I. Neisseria meningitidis J. Pasterulla multocida K. Salmonella L. Shigella M. Staph. Aureus N. Strep. pyogenes O. Vancomycin
G
A gram-positive β-haemolytic coccus that can cause pharyngitis, erysipelas and cellulitis.
A. Anaerobic bacteria B. Benzyl penicillin C. Cephalosporin D. Clostridium perfringens E. Clostridium tetanae F. Flucloxacillin G. Metronidazole H. Mycobacterium tuberculosis I. Neisseria meningitidis J. Pasterulla multocida K. Salmonella L. Shigella M. Staph. Aureus N. Strep. pyogenes O. Vancomycin
N
Lichen planus is an example of which type of inflammatory reaction pattern.
Lichenoid
Where in the epidermis does the bullae in pemphigus vulgaris form?
Within the epidermis
White/silvery plaques on the extensor surface are seen in which clinical dermatological condition?
Psoriasis
Which common skin cancer does NOT metastasize?
Basal cell carcinoma
A liver biopsy histology is reported as showing “Caseating granulomata”. What is the most likely diagnosis?
TB
A liver biopsy histology is reported as showing “NON Caseating granulomata”. What is the most likely diagnosis?
Sarcoidosis
A liver biopsy histology is reported as showing “A “nutmeg” appearance”. What is the most likely diagnosis?
Heart failure
When stained with a Rhodanine stain a liver biopsy reveals a golden brown colour against the blue counterstain. What is the most likely diagnosis?
Wilson’s disease
What is a rhodamine stain used for
Acid fast bacilli
What is the correct term for a ‘rodent ulcer’?
BCC
Blood biochemistry reveals: Na+ 119 mmol/l K+ 4.5 mmol/l Cl- 84 mmol/l HCO3- 25 mmol/l Urea 3.2 mmol/l Creatinine 97 micromol/l Plasma osmolality 249 mmol/kg Urine biochemistry reveals: Na+ 57 mmol/l K+ 26 mmol/l Urine osmolality 530 mmol/kg What is the most likely diagnosis? a. Conn’s syndrome b. Cushing’s syndrome c. Addison’s disease d. Cranial diabetes insipidus e. Nephregenic diabetes insipidus f. Bartter’s sundrome g. Gitelman’s syndrome h. SIADH i. Renal artery stenosis j. Psychogenic polydipsia
H
A 25-year old medical student trips and hits her head hard on the table. Shortly afterwards she finds that she is very thirsty and drinking several litres of water because she has gone more thirsty. She also wakes at night to pass urine and drinks more water whenever she awakes. Na+ 130, K+ 4, U 2.2, Cr 57 What is the diagnosis? a. Conn’s syndrome b. Cushing’s syndrome c. Addison’s disease d. Cranial diabetes insipidus e. Nephregenic diabetes insipidus f. Bartter’s sundrome g. Gitelman’s syndrome h. SIADH i. Renal artery stenosis j. Psychogenic polydipsia
J
A 40-year old man has hypertension and hypokalaemia. Renin: 6.4 (2.7-4.5) Aldosterone 1200 (140-450 pM) a. Conn’s syndrome b. Cushing’s syndrome c. Addison’s disease d. Cranial diabetes insipidus e. Nephregenic diabetes insipidus f. Bartter’s sundrome g. Gitelman’s syndrome h. SIADH i. Renal artery stenosis j. Psychogenic polydipsia
I Renal Artery Stenosis
cos renin is high
A 40-year old man has hypertension and hypokalaemia. Renin 0.4 (2.7-4.5) Aldosterone: 1300 (140-450 pM) a. Conn’s syndrome b. Cushing’s syndrome c. Addison’s disease d. Cranial diabetes insipidus e. Nephregenic diabetes insipidus f. Bartter’s sundrome g. Gitelman’s syndrome h. SIADH i. Renal artery stenosis j. Psychogenic polydipsia
A
A tired patient has the following results: Na+ 119, K+ 6.2, glucose 3.7 a. Conn’s syndrome b. Cushing’s syndrome c. Addison’s disease d. Cranial diabetes insipidus e. Nephregenic diabetes insipidus f. Bartter’s sundrome g. Gitelman’s syndrome h. SIADH i. Renal artery stenosis j. Psychogenic polydipsia
c
Regarding ACE inhibitors in patients with diabetes:
a. ACE inhibitors cause an improvement in the creatinine within days of starting
b. ACE inhibitors cause an increase (worsening) of the creatinine within days of starting
c. ACE inhibitors increase microalbuminuria
b
Regarding ACE inhibitors in patients with diabetes:
a. ACE inhibitors are useful in patients with diabetes and resultant renal artery stenosis
b. ACE inhibitors increase microalbuminuria
c. ACE inhibitors prevent end stage renal failure
d. ACE inhibitors cause hypokalaemia
c
