metabolic medicine/palliative/oncology/immuno

Question 1

Key features of hypocalcaemia

Answer 1

perioral paraesthesia, cramps, tetany and convulsions

Question 2

criteria for familial hypercholesterolaemia

Answer 2

presence of tendon xanthomata and cholesterol levels meet the diagnostic

Question 3

ECG changes seen in hyperkalaemia ..?…

Answer 3

tall-tented T waves, small P waves, widened QRS leading to a sinusoidal pattern and asystole

Question 4

QRISK2 CVD risk assessment
for who?

Answer 4

aged 40 over

Question 5

first-line management in patients with hypercalcaemia

Answer 5

iv fluids 0.9%

Question 6

Hypocalcaemia:
clincal features?

ecg changes?
tx?

Answer 6

Hypocalcaemia: prolonged QT interval is an indication for urgent IV calcium gluconate

Question 7

cancer associated with syndrome of inappropriate ADH

Answer 7

small cell lung cancer

Question 8

During the acute phase response the liver decreases the production of proteins..?

Answer 8

ALBUMIN

Question 9

relative contraindication to donepezil prescription?

Answer 9

resting bradycardia

Question 10

mechanism of action of memantine?

Answer 10

Memantine - NMDA receptor antagonist

Question 11

Cyclophosphamide mOA adverse effcts?:

Answer 11

Alkylating agent - causes cross-linking in DNA  
Adverse effects: Haemorrhagic cystitis, myelosuppression, transitional cell carcinoma

Question 12

Bleomycin: moa, s/e?

Answer 12

Bleomycin:
Degrades preformed DNA
Lung fibrosis

Question 13

Fluorouracil (5-FU)

Answer 13

Fluorouracil (5-FU)
Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase)    
Myelosuppression, mucositis, dermatitis

Question 14

Vincristine, vinblastine     

s/e?

moa?

Answer 14

Vincristine, vinblastine      
Inhibits formation of microtubules  

Vincristine: Peripheral neuropathy (reversible) , paralytic ileus

Vinblastine: myelosuppression

Question 15

Breast cancer
pancreatic

tumor marker association

Answer 15

BREAST CA 15 -3

PANCREATIC 19 9

Question 16

Alpha-feto protein (AFP):

Answer 16

Alpha-feto protein (AFP): Hepatocellular carcinoma, teratoma

Question 17

S-100: TUMOR MARKER?

Answer 17

Melanoma, schwannomas

Question 18

Beta HCG

Answer 18

non seminomintous testicular cancer

Question 19

least inherited
CANCER

Answer 19

GASTRIC CANCER

Question 20

Calcitonin- cancer?

Answer 20

Calcitonin- mediullay carcinoma

Question 21

From To Conversion factor
Oral morphine Subcutaneous morphine?

Oral morphine Subcutaneous diamorphine ?

Oral oxycodone Subcutaneous diamorphine ?

Answer 21

Oral morphine Subcutaneous morphine Divide by 2
Oral morphine Subcutaneous diamorphine Divide by 3
Oral oxycodone Subcutaneous diamorphine Divide by 1.5

Question 22

palliative care- tx for confusion?

Answer 22

first choice: haloperidol
other options: chlorpromazine, levomepromazine

Question 23

In the terminal phase of the illness then agitation or restlessness is best treated with ?

Answer 23

midazolam

Question 24

Palliative care prescribing: hiccups

Answer 24

chlorpromazine

Question 25

palliative care

preferred opioids in patients with chronic kidney disease.

Answer 25

Alfentanil, buprenorphine and fentanyl

Question 26

Anaphylaxis - ..?….rise following an acute episode

Answer 26

serum tryptase levels

Question 27

Useful test for contact dermatitis.

Answer 27

SKIN PATCH TEST

Question 28

Radioallergosorbent test (RAST) GOOD FOR?

Answer 28

Determines the amount of IgE that reacts specifically with suspected or known allergens, for example IgE to egg protein. Results are given in grades from 0 (negative) to 6 (strongly positive)

Useful for food allergies, inhaled allergens (e.g. Pollen) and wasp/bee venom