MIscellaneous Flashcards
What are the 2 high-risk HPV subtypes that cause about 70% of cervical cancers?
HPV 16 and HPV 18
What is the screening program for cervical cancer?
Women aged 25-65 invited for screening every 3-5 years
Sample sent for cytology and examined for cervical intraepithelial neoplasia (CIN)
What are the 3 HLA subtypes used for tissue typing?
HLA A, B and DR
What are the 2 mechanisms of graft rejection?
- T-cell mediated
2. Antibody-mediated
What is the cardinal feature of antibody-mediated graft rejection?
Presence of antibodies and inflammatory infiltrate in microvasculature of graft organ
Treating acute rejection: T cell mediated and antibody-mediated. For which do you use:
- Steroids
- IVIG, plasma exchange?
T cell mediated: steroids + T cell depleting agents
Antibody-mediated:
What is the time period for early onset sepsis in the neonate? What are the top 2 causative organisms?
Within 48h after birth. Group B Strep (S. agalactiae) is by far the most common, from the vaginal canal, followed by E. coli.
What is the time period for late onset sepsis in the neonate? What are the top 2 causative organisms?
After 72h after birth. Top is Staph aureus followed by Group B strep.
What is the current pathogen screening for pregnant women?
Hep B
HIV
Rubella
Syphillis
What is the classic triad for rubella of the newborn?
Deafness, eye problems (cataracts, micropthalmia), cardiac problems (PDA, pulm artery stenosis)
What are the three classes of selective targets for antibiotics?
- Peptidoglycan cell wall
- Ribosomal subunits
- DNA gyrase
What are the 2 classes of antibiotic that target peptidoglycan synthesis?
- Beta-lactams (penicillins, cephalosporins, carbapenems)
2. Glycopeptides
What is the preferred penicillin for S. aureus and why?
S. aureus produces beta-lactamase. Flucloxacillin is stable to S. aureus-produced beta-lactamase and is thus used first-line.
What is Virchow’s triad?
- Haemostasis / turbulent blood flow
- Endothelial damage
- Hypercoagulability
What cancer is associated with EGFR mutations? And what are the tyrosine kinase inhibitors used to treat it?
Adenocarcinoma of the lung (esp in non-smokers). Erlotinib and gefitinib.
Which 2 lung cancers are strongly associated with smoking?
Small cell lung cancer and squamous cell carcinoma
Why do defects in the synthesis of α and β globin chains present at different ages?
α-globin is synthesised early in the fetus, so presents earlier; β globin is synthesised later, and presents later after HbF is reduced.
Management of sickle-cell anaemia?
Vaccination (pneumococcus, meningococcus, H. influenzae)
Prophylactic penicillin
Folate supplementation
Why are females less likely to have G6PD deficiency?
X-linked
What is the immediate treatment of anaphylactic shock?
Stabilise airway: oxygen, bronchodilators
IM adrenaline
IV: antihistamine (chlorphen), corticosteroids, fluids
What specific immunological defect is associated with recurrent meningococcal / pneumococcal / H. influenzae infections? What specific investigations would you do?
Complement deficiency, especially in alternative and common pathways.
Specific investigations: Serum C3 / C4 levels, CH50 (common pathway), AP50 (alternative pathway)
What 3 tests are used to assess SLE disease activity?
Complement (C3 and C4) levels
ESR
Anti-dsDNA Ig levels
Which is the most specific blood test for rheumatoid arthritis?
Anti-CCP antibodies (95% specific) Rheumatoid factor (anti-IgM) is only 70% specific.
Note that both are only 60-70% sensitive.
Typical microscopy indicative of gout
Needle-shaped crystals (of urate) that are negatively birefringent under polarised light`
