Misc

Question 1

thumb printing on AXR

Answer 1

intestinal oedema/ haemorrhage

– ischaemic colitis

Question 2

Cinchonism

Answer 2

Quinine toxicity
Quinine is an antimalarial drug also used for leg cramps

features of toxicity: cardiac arrhythmias, nausea, vomiting and tinnitus, VISUAL disturbance

Question 3

drugs that can be cleared by haemodialysis

Answer 3

Drugs that can be cleared with haemodialysis - mnemonic: BLAST
Barbiturate
Lithium
Alcohol (inc methanol, ethylene glycol)
Salicylates
Theophyllines (charcoal haemoperfusion is preferable)

Question 4

what is a normal ABPI value and what value suggests arterial disease?

Answer 4

a ‘normal’ ABPI may be regarded as between 0.9 - 1.2. Values below 0.9 indicate arterial disease.

Question 5

what do ABPI values above 1.3 suggest?

Answer 5

values above 1.3 may also indicate arterial disease, in the form of false-negative results secondary to arterial calcification

Question 6

Proteasome function

Answer 6

Along with the lysosome pathway involved in degradation of protein molecules that have been tagged with ubiquitin

Question 7

Peroxisome function

Answer 7

Catabolism of very long chain fatty acids and amino acids
Results in the formation of hydrogen peroxide

Question 8

Li-Fraumeni syndrome

Answer 8

A mutation in the P53 gene can cause Li-Fraumeni syndrome which can present with soft tissue sarcomas, breast carcinoma, glioblastoma, lymphoma and leukaemia. It is a rare autosomal dominant disorder.

Question 9

stopping of anti-epileptic drugs (AED)

Answer 9

Can be considered if seizure free for > 2 years, with AEDs being stopped over 2-3 months
37%

Question 10

Paget’s disease urine test

Answer 10

• increased serum and urine levels of hydroxyproline

Question 11

what CD marker Found on cytotoxic T cells is a Co-receptor for MHC class I

Answer 11

CD8

Question 12

The main ECG abnormality seen with hypercalcaemia is

Answer 12

shortening of the QT interval

Question 13

large volumes of 0.9% Sodium Chloride for fluid therapy risks what metabolic change?

Answer 13

hyperchloraemic metabolic acidosis

Question 14

Motion sickness treatment

Answer 14

hyoscine > cyclizine > promethazine

Question 15

Hepatorenal syndrome is primarily caused by

Answer 15

splanchnic vasodilation

This occurs due to the release of vasodilatory substances such as nitric oxide and prostaglandins in response to portal hypertension.

The resultant splanchnic vasodilation leads to a decrease in effective arterial blood volume, which in turn triggers activation of the renin-angiotensin-aldosterone system (RAAS) and antidiuretic hormone (ADH) secretion. These compensatory mechanisms cause renal vasoconstriction and sodium retention, leading to worsening renal function.

Question 16

Behcet’s syndrome, HLA association

Answer 16

HLA B51

Question 17

biochemical changes with adrenaline infusion

Answer 17

Adrenaline induces hyperglycemia, hyperlactatemia and hypokalaemia

Question 18

treatment of choice for essential tremor

Answer 18

Propranolol

Question 19

Marfan’s syndrome + lower back pain associated with neurological problems such as bladder and bowel dysfunction - what manifetation?

Answer 19

dural ectasia (ballooning of the dural sac at the lumbosacral level)

Question 20

the most appropriate test to check for latent tuberculosis?

Answer 20

Mantoux test

2. interferon gamma

Question 21

Which blood marker is first to appear during acute hepatitis B infection?

Answer 21

HBsAg

Question 22

rascburicase vs allopurinol mechanism of action

Answer 22

Rasburicase - a recombinant version of urate oxidase, an enzyme that metabolizes uric acid to allantoin

allopurinol - xanthine oxidase inhibitor so less uric acid formed

Question 23

urine dip, UTI and bacteria link

Answer 23

Gram negative organisms test positive on the nitrite test as they convert nitrates to nitrites for energy. Gram positive organisms are unable to reduce nitrate to nitrite and therefore, test negative.

Question 24

examples of live attenuated vaccines

Answer 24

BCG
measles, mumps, rubella (MMR)
influenza (intranasal)
oral rotavirus
oral polio
yellow fever
oral typhoid

do not give to immunocompromised

Question 25

Infertility in PCOS

Answer 25

• clomifene is typically used first-line

metformin is second line

Question 26

Down’s syndrome risk

Answer 26

1/1,000 at 30 years then divide by 3 for every 5 years

Question 27

adrenaline doses

Answer 27

anaphylaxis: 0.5mg - 0.5ml 1:1,000 IM

cardiac arrest: 1mg - 10ml 1:10,000 IV
or 1ml of 1:1000 IV

Question 28

mitochondrial disease unifying finding on muscle biopsy

Answer 28

muscle biopsy classically shows ‘red, ragged fibres’ due to increased number of mitochondria

Question 29

muscle biopsy classically shows ‘red, ragged fibres’ due to increased number of mitochondria

Answer 29

mitochondrial disease

Question 30

Bisphosphonates MOA

Answer 30

inhibit osteoclasts

Question 31

the most common bacterial cause of pharyngitis (sore throat) in children and young adults.

Answer 31

Streptococcus pyogenes. This organism, also known as Group A Streptococcus (GAS), is

Question 32

people who are allergic to latex can also be allergic to which fruits

Answer 32

Latex-fruit syndrome

banana, pineapple, avocado, chestnut, kiwi fruit, mango, passion fruit and strawberry.

Question 33

vitamin B and C deficiency

Answer 33

Vitamin B1(thiamine) deficiency can cause Wernicke-Korsakoff syndrome, cardiomyopathy and peripheral neuropathy. It is not particularly associated with angular cheilitis.

Vitamin B3(niacin) deficiency causes pellagra. This constitutes diarrhoea, dermatitis and dementia. While dermatitis may manifest as angular cheilitis, there is no mention of diarrhoea in the question stem so this answer is incorrect.

Vitamin B6(pyridoxine) deficiency causes sideroblastic anaemia and peripheral neuropathy. It is mainly caused by medications such as isoniazid.

Vitamin C(ascorbic acid) deficiency causes gingivitis, bruising and poor wound healing.

Question 34

which phase determine the length of the cell cycle:

Answer 34

G1

Question 35

Yellow nail syndrome (YNS)

Answer 35

1. yellow discolouration of the nails
2. lymphoedema
3. respiratory manifestations.

Question 36

A common complication of plasma exchange is

Answer 36

hypocalcaemia

which occurs as calcium is chelated by sodium citrate, the agent used as an anticoagulant during the procedure.

Question 37

Torticollis is caused by

Answer 37

contracture of the ipsilateral sternocleidomastoid muscle which leads to the chin being pushed to the opposite side.

Question 38

wilsons disease
inheritance and pathogenesis

Answer 38

Autosomal recessive
abnormal copper accumulation
low caeruloplasmin

Wilson’s disease, absence of ATP7B, also known as the Wilson’s disease protein, means caeruloplasmin cannot be correctly synthesised in hepatocytes, resulting in an effective absence in serum. copper accumulates in tissues