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MRCP 1 > Misc > Flashcards

Misc Flashcards

1
Q

X ray findings in scurvy

A

Sub periosteal haemorrhages in long bones

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2
Q

X ray findings in osteopetrosis

A

Osteogenic (dense) bony lesions

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3
Q

X ray findings in dietary rickets

A

Widening of the space between the epiphysis and metaphysis and cupping, irregularity and a ragged flaring metaphyseal surface (cupping, splaying and fraying)

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4
Q

Breastfeeding is protective against the development of certain allergies compared to formula T/F

A

T

However no evidence shown supporting it’s exclusive use past 6 months

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5
Q

If breast feeding is not possible in a family with a strong hx of atopic dermatitis evidence supports the use of hydrolysed cows milk T/F

A

True

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6
Q

Incomplete fusion of the choroid fissure in the first trimester can lead to what

A

Coloboma - defective development of the eye in the embryo stage, can be a defect of the iris, retina, optic nerve or eye lide

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7
Q

By how much is successful breast feeding reduced in those who have breast augmentation?

A

25%

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8
Q

Which is more concerning for child abuse in an infant

a parietal crack fracture or a depressed occipital skull fracture?

A

Depressed occipital skull fracture - indicated significant force.

Note: accidental fractures tend to be singular and in the parietal region

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9
Q

Cranial bruit may be heard in a patient with Vein of Galen malformation T/F

A

T - although cranial bruit is not pathognomonic of AVM (may be head in 15% of well children)

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10
Q

Muscle biopsy showing fibrofatty replacement of muscle fibres what disease?

A

Duchenne muscular dystrophy

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11
Q

A smaller proportional degree of force is required to fracture a child’s ribs than an adults T/F

A

F - adults ribs are more brittle than children’s

Note: due to this children can also have significant lung injury without rib fractures

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12
Q

When in a shockable rhythm hypothermia can lead to it being refractory to defibrillation T/F

A

True - should limit to three shocks at temperatures below 30

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13
Q

Any change in administering of drugs in a patient 30-35 degrees during a resus?

A

Interval between drug doses should be doubled (eg adrenaline every 8 minutes instead of every 4)

Note: 32 degrees is the temp a pt should be warmed to before stopping resus. Below 30 degrees resuscitations drugs are CI

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14
Q

Calc for an uncuffed and cuffed ETT

A

Uncuffed: internal diameter - (Age/4) + 4

Cuffed: internal diameter - (Age/4) + 3.5

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15
Q

How much is the risk of SIDS increased by sleeping prone?

A

6x

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16
Q

Which is a more common cause of familial hypophosphataemic rickets X linked or AD

A

X link is 80% - note this is X link AD so affects males and females

AD is 20%

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17
Q

MMR is safe to give to patients with a hx of anaphylaxis to eggs - T/F

A

True - it is grown on chick cells, not the egg white or yolk

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18
Q

Bone pain after alcohol consumption is a rare but characteristic manifestation of what disease?

A

Hodgkin’s lymphoma

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19
Q

Which vaccine is given via intradermal route?

A

BCG

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20
Q

Presentation of Vitamins K def vs Vit C

A

Vit K - impaired coag (easy bruising, mucosal bleeding), no hair changes

Vit C - Petechiae, bruising, gingivitis, impaired wound healing. Also joint pain, lethargy and curly hair

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21
Q

Presentation of Vit A def?

A

Night blindness and complete blindness

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22
Q

Presentation of Cu def?

A 
Fragile and abnormally formed hair
Skin depigmentation
Hepatosplenomegaly
Osteoporosis
Neurological and MSK disturbances
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23
Q

Breath holding spellings in children are assoc with what nutritional deficiency?

A

Fe

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24
Q

Phytomenadione is AKA

A

Vit K

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25
Q

Precursor of prostagladins? What enzyme?

A

Arachidonic acid

Cyclooxygenase

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26
Q

What inhibits prostagladin synthesis?

A

Aspirin

Glucocorticoids

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27
Q

Lipoxygenase are involved in the synthesis of?

A

Leukotrienes

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28
Q

In mechanical ventilation what should tidal volumes be targeted?

A

4-6ml/kg

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29
Q

Induration at the site of BCG vaccine is seen in 50% of children with what disease?

A

Kawasaki

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30
Q

The use of pillows increased the risk of SIDS by how much?

A

x2.5

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31
Q

According to APLS at what blood sugar level is an IV glucose bolus indicated?

A

< 2.6mmol/l

32
Q

Features of zn deficiency?

A

Chronic diarrhoea
Perianal and perioral rash
Reddish hair and alopecia
Ocular changes ( blepharitis, conjunctivitis, photophobia and corneal dystrophy)
Can also have associated candida infections

33
Q

According to NICE guidelines below what level of 25OH vit D should supplementation be given?

A

Less than 25nmol/L

Note: 25 - 50 can advise nutrition and lifestyle

34
Q

What treatment for Kawasaki disease has been shown to decrease the prevalence of coronary artery abnormalities?

A

IV IG

Note: aspirin is used in the tx but does not seem to have any effect on coronary artery abnormalities.

35
Q

What is the treatment of Wilson’s disease?

A

Penicillamine (Cu binder) + vit B6 (to avoid neuropathy) + low Cu diet (avoid excessive chocolate, shellfish and liver)

36
Q

Baseline urinary Cu and blood ceruloplasmin are the best ways to diagnosis Wilson’s disease T/F

A

F- overall diagnosis is challenging, baseline Cu is unreliable with low sensitivity and specificity.

Do check blood ceruloplasmin, can also do a pencillamine challenge ( if + will show raised urinary Cu > 25umol/24 hour after penicillamine) and raised hepatic Cu on biopsy. Note: serum Cu levels are not helpful.

37
Q

It is rare for patient’s with Wilsons disease to present with neuro/psych symptoms. T/F

A

F - 50% will have these symptoms at presentation

38
Q

In patients with rickets when do features of hypoCa usually present?

A

In adolescents (ie not seen in younger children with rickets)

Note: other features craniotabes (softening of the skull with delayed fontanelle closure), rachitic rosary, bowed legs (in weight bearing children) delayed dentition.

39
Q

Aphonic cry is characteristic of what vit deficiency?

A

Thiamine def (B1)

Other features: lethargy, restlessness, emesis, tachypnea, cyanosis. Late stage - peripheral neuritis and decreased reflexes.
VitB1 is neutralised by boiling

40
Q

What is Marcus Gunn syndrome also known as ?

A

“Jaw winking syndrome” - eyelid with ptosis opens wider when pt opens their mouth

41
Q

Is idiopathic scoliosis more common in males or females?

A

Females

Note: typically do surgery when curvature is greater than 40 - 50 degrees in otherwise well children. Surgery is done sooner in those with DMD usually around 20 -30 degrees

42
Q

Initial investigations in a 2 yr old presenting with concern for rickets?

A

Labs: Ca, alk phos, phos, vit D, PTH

Xrays

43
Q

Ca, alk phos, phos, vit D, PTH labs findings in nutritional rickets?

A

Ca, phos: low or normal
Vit D: low
Alk phos, PTH: high

44
Q

What labs values differentiate hypophosphataemic rickets from other types?

A

PTH and bicarb will be normal

Note: prox tubular acidosis can also cause hypophos rickets but the bicarb will be low

45
Q

Obesity in children is defined as BMI > 25 T/F

A

F - do not use BMI number for obesity def in children. It is BMI > 95% for age and height

46
Q

Formula for calculation of additional fluid replacement based on % body burns

A

% burn x weight (kg) x 3

47
Q

Lead poisoning is assoc with antisocial behaviour T/F

A

T

Other assoc: 
Nausea, abdo pain, constipation
Blue discolouration of gums, anaemia and pallor
Motor neuropathy
neuropsych problems, impaired cognition
48
Q

Symptoms of hydrogen sulphide exposure?

A

Cough, dyspnoea and sore throat

49
Q

Smell of garlic what toxin?

A

Selenium

Arsenic

50
Q

Smell of bitter almonds what toxin?

A

Cyanide

51
Q

Smell of wintergreen what toxin?

A

Methylsalicylate

52
Q

Smell of mothballs what toxin?

A

Naphthalene

53
Q

Main feature of naphthalene toxicity?

A

Haemolytic anaemia

54
Q

Main features of arsenic poisoning?

A

GI features - nausea, emesis and diarrhoea

55
Q

Is variegate an acute or chronic porphyria?

A

Acute

Note: there are 4 acute porphyrias, the other 3 are
acute intermittent porphyria
aminolaevulinic acid dehydratase deficiency porphyria
hereditary coporphyria
Only the acute ones cause neuro features

56
Q

Features associated with a poor prognosis in carbon monoxide poisoning?

A

Anaemia
Exposure as a foetus
Pre existing CV disease > resp disease
Acidosis after exposure

57
Q

What is the equation for anion gap?

A

(Na + K) - (Cl + Bicarb)

58
Q

What is the pathology of Osgood Schlatter Disease?

A

An inflammation of the patellar ligament at the tibial tuberosity

59
Q

What does met acidosis in the present of a normal anion gap indicate?

A

Bicarb loss (rather than excess acids)

Note: Routes for loss are gut or kidney

60
Q

What is the main factor that determines the mgmt, treatment and outcome in acute pancreatitis?

A

The severity (scoring systems used to determine this)

61
Q

When does the eye develop into a distinct organ?

A

In the first trimester (by 22 days)

62
Q

There is an association between Bells palsy and what cardiac abnormality?

A

Coarctation of the aorta

63
Q

There is an association between Bells palsy and hypotension T/F

A

F - hypertension

64
Q

Otitis media is a known cause of LMN facial palsy T/F

A

T

65
Q

Complex regional pain syndrome vs Diffuse idiopathic pain syndrome?

A

The are both pain amplification syndromes

  • CRPS: localised to one particular area such as a foot
  • DIPS: diffuse as the name suggests
66
Q

Where is renin produced?

A

Juxtaglomerular apparatus

67
Q

Where does ADH primarily act?

A

Collecting ducts

68
Q

Apolipoprotein CII deficiency will lead to what abnormality on a fasting lipid panel?

A

Elevated TG

Note: normal cholesterol

69
Q

What is the most common porphyria?

A

Acute intermittent

NB: autosomal dominant but only 5% of those who have it ever experience an attack

70
Q

What is the inheritance of porphyria cutanea tarda?

A

Can be inherited in an AD manner BUT most are actually acquired secondary to alcoholic liver disease

71
Q

Red flag symptoms for LNs

A 
Non-tender, firm or hard 
> 2cm
progressively enlarging
supraclavicular lymphadenopathy
Other symptoms such as fever or weight loss
72
Q

Intestinal bacterial overgrowth is a cause of B12 or folate deficiency?

A

Cause of B12 deficiency

Note: folate levels would be normal or high because small bowel bacteria increase the synthesis of folate

73
Q

Presentation and mgmt of incarcerated vs strangulated hernia?

A

Both presents with symptoms of obstruction. Patient with a strangulated hernia will also be toxic

Incarcerated: manual reduction and then surgery in 2-3 days or emergency surgery if patient is too unwell. Abx not routinely used

Strangulated: emergency surgery +/- abx

74
Q

What is the formula for BMI calculation?

A

Weight (kg)/ height (m)2

75
Q

XP Analog LCP formula should be used the treatment of what?

A

PKU

MRCP 1 (21 decks)

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