Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MRCP Part 1 > Mock Exam Notes > Flashcards

Mock Exam Notes Flashcards

1
Q

tear drop poikilocytes

A

myelofibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

chlamydia treatment

A

doxycycline is preferable to azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

management of stroke and TIA

A

clopidogrel
carotid endarterectomy only if stenosis >50 or 70% depending on guideline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ethylene glycol toxicity management

A

fomepizole
also ethanol
and haemodialysis if metabolic acidosis has developed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

testing for haemochromatosis

A

general population - transferrin saturation > ferritin
family member of affected = HFE genetic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

why would coeliac testing be negative if all symptoms correlate

A

selective IgA deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

CML translocation

A

t(9:22)(q34:q11). BCR-ABL gene
poor prognosis in ALL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Burkitts translocation

A

t8:14
MYC oncogene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mantle cell translocation

A

t11:24, cyclin D1 (BCL1) gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Follicular lymphoma translocation

A

t14:18

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

APML translocation

A

t15:17
fusion of PML and RAR-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Beta blocker overdose

A

atropine, IV glucagon in resistant cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

renal transplant + infection

A

?CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

loud S1 in

A

mitral stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

soft S2 in

A

aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

S3 heard if

A

LVF (dilated cardiomyopathy) - gallop rhythm
constrictive pericarditis (pericardial knock)
mitral regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

S4 heard when

A

aortic stenosis
HOCM (double apical impulse)
HTN

coincides with p wave on ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

P450 inducers
(ie lowered INR)

A

SCRAP GPS

sulfonylureas
carbamazepine
rifampin
alcohol (CHRONIC)
phenobarbital

griseofulvin
phenytoin
st johns wort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

P450 inhibitors
(ie raised INR)

A

SICKFACESCOM

sulfonamides
isoniazid
cimetidine
ketoconazole
fluconazole
alcohol (ACUTE)
ciprofloxacin
erythromycin
sodium valproate

chloramphenicol
omeprazole
metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Barrter’s syndrome

A

autosomal recessive
severe hypokalaemia
defect in NKCC2 in asc LOH
normotension
presents with failure to thrive, polyuria and polydipsia and weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Alport’s syndrome

A

x linked dominant
defect in gene for T4 collagen leading to abnormal GBM
more severe in males

failing renal transplant

presents with-
microscopic haematuria
progressive renal failure
bilateral sensorineural deafness
lenticonus
retinitis pigmentosa
splitting of lamina densa on electron microscopy

diagnosis - molecular genetic testing

renal biospy - basket-weave appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

screening test for ADPKD

A

USS abdo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

causes of upper zone fibrosis

A

CHARTS

coal workers pneumoconiosis
histiocytosis/hypersensitivity pneumonitis
ank spond
radiation
TB
sarcoid/silicosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

causes of lower zone fibrosis

A

IPF
CTD
Drug - amiodarone, bleomycin, methotrexate
Asbestosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

normal ABPI

A

0.9-1.2 (<0.9 = arterial disease, also >1.2 in diabetics with calcification)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Churg-strauss stages of presentation

A

1) allergy - asthma, allergic rhinitis -> nasal polyps
2) eosinophilia
3) vasculitis -> kidneys, lungs, heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Marfan’s is due to a defect in

A

fibrillin-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

COPD Mx

A

1st line = SABA/SAMA

asthmatic features?

N = LABA+LAMA
Y = LABA+ICS -> +LAMA

theophyllines only after ^ if cannot have inhaled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Heyde’s syndrome

A

aortic stenosis and colonic angiodysplasia

reduction in vWF as blood passes through narrow valve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

idiopathic membranous glomerulonephritis

A

antiphospholipase A2 antibodies

MGN - spike and dome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

fixed and dilated pupil with down and out eye, following history of traumaa

A

raised ICP -> third nerve palsy due to uncal or trans-tentorial herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

GPA presentation

A

upper respiratory tract signs, haemoptysis, epistaxis/earache, crusting, sinusitis, hearing loss, blocked/runny nose

ENT + RESP + KIDNEY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

drug-induced lupus causes

A

procainamide
hydralazine

isoniazid
minocycline
phenytoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

which organelle is responsible for the catabolism of long chain fatty acids

A

peroxisome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

HLA A3

A

haemochromatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

HLA B51

A

Behcets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

HLA B27

A

Ank spond
reactive arthritis
acute anterior uveitis
psoriatic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

HLA DQ2/DQ8

A

coeliac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

HLA DR2

A

narcolepsy
Goodpastures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

HLA DR3

A

dermatitis herpetiformis
Sjogrens
PBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

HLA DR4

A

T1DM
RA - DRB1 gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

which cytokine activates macrophages

A

IFN gamma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

IL2 is secreted from

A

macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

IL3 stimulates

A

proliferation and differentiation of myeloid progenitor cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

IL4 is responsible for

A

proliferation of B cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

TNF alpha is responsible for

A

acute fevers and neutrophil chemotaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

CD 15 is found on

A

Reed-Sternberg cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

CD1 is

A

MHC molecule that presents lipid molecules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

CD4

A

found on helper T cells
co-receptor for MHC class 2
used by HIV to enter T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

CD5

A

mantle cell lymphomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

CD8

A

found on cytotoxic T cells
co-receptor for MHC class 1
myeloid dendritis cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

CD14

A

cell surface marker for macrophages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

CD16

A

binds to Fc portion of IgG antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

CD21

A

receptor for EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

CD28

A

interacts with B7 on antigen presenting cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

CD56

A

marker for NK cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

CD95

A

FAS receptor, apoptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MI secondary to cocaine should be given

A

IV benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

mechanism of cyanide toxicity

A

inhibits mitochondrial enzyme cytochrome c oxidsae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

depletion of glutathione stores

A

paracetamol toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Cushing reflex

A

hypertension and bradycardia

attempt to increase MAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Waldenstrom’s

A

organomegaly with no bone lesions
no bone pain - instead hyperviscosity pain eg headaches
can still have bence jones protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

first line investigation for stable chest pain of suspected CAD aetiology

A

contrast enhanced coronary CT angiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

paralysis of all intrinsic hand muscles

A

C8-T1 nerve root damage
Klumpke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Erb’s palsy

A

C5-6
loss of sensation in arm and paralysis of deltoid, biceps and brachialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Lateral medullary syndrome

A

facial and contralateral body loss of pain sensation along with nystagmus and ataxia
PICA stroke

AICA - same but with same side face weakness and loss of hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

C5-9 deficiency

A

predisposes to neisseria meningitidis infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

C1q, C1rs, C2, C4 deficiency (classic pathway components)

A

predisposes to SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

C5 deficiency

A

Leiner disease - diarrhoea, wasting, seborrhoeic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

C1 inh deficiency

A

hereditary angioedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

C3 deficiency

A

recurrent bacterial infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

cataracts - drug cause

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

corneal opacities - drug cause

A

amiodarone, indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

optic neuritis - drug cause

A

ethambutol
amiodarone
metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

sildenafile eye ADR

A

blue discolouration
non-arteritic anterior ischaemic neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

inverted champagne bottle legs and clumsiness

A

CMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Gastrin

A

G cells in antrum of stomach

distension of stomach, vagus nerves

inhibited by low pH, somatostatin

increases acid secretion by gastric parietal cells, pepsinogen and IF secretion, increases gastric motility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

CCK

A

I cells in upper small intestine

Increases secretion of enzyme-rich fluid from pancreas, contraction of gallbladder and relaxation of sphincter of Oddi, decreases gastric emptying, trophic effect on pancreatic acinar cells, induces satiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

secretin

A

S cells in upper small intestine

Increases secretion of bicarbonate-rich fluid from pancreas and hepatic duct cells, decreases gastric acid secretion, trophic effect on pancreatic acinar cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

VIP

A

small intestine, pancreas

Stimulates secretion by pancreas and intestines, inhibits acid secretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Somatostatin

A

D cells in pancreas and stomach

Decreases acid and pepsin secretion, decreases gastrin secretion, decreases pancreatic enzyme secretion, decreases insulin and glucagon secretion
inhibits trophic effects of gastrin, stimulates gastric mucous production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

AV block can occur following

A

inferior MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

cell cycle

A

G0 - resting, quiescent cells (hepatocytes, neurons)

G1 - cells increase in size, determines length of cell cycle, influence p53

S - synthesis of DNA, RNA, histone; centrosome duplication

G2 - cells continue to increase in size

M - mitosis, cell division, shortest phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Jarisch herxheimer

A

fever, rash, tachycardia after the first dose of antibiotic

in contrast to anaphylaxis, there is no wheeze or hypotension
it is thought to be due to the release of endotoxins following bacterial death and typically occurs within a few hours of treatment
no treatment is needed other than antipyretics if required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

in which stage of mitosis does vincristine act

A

metaphase

taxanes - metaphase
antimetabolites - S phase
anthracyclines - S phase
topoisomerases - mitosis and meiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

pathogenesis of Fanconi syndrome

A

generalised disorder affecting tubular resorption in the PCT

There is increased excretion of nearly all amino acids, glucose, bicarbonate, phosphates, uric acid and potassium. Features include polyuria, polydipsia, rickets, hypokalaemia, hypophosphatemia, growth failure and acidosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Liddle’s syndrome mutation

A

inability to degrade epithelial sodium channels located at the DCT

Classically patients may experience hypertension, hypokalaemia and metabolic alkalosis. Amiloride counters this by selectively blocking the epithelial sodium transport channels in the DCT and collecting duct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Gitelman syndrome

A

rare autosomal recessive disorder which occurs due to a mutation causing a resorptive defect of the sodium chloride co-transporter. It is characterised by hypokalemia-hypomagnesemia and alkaline urine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

bilateral spastic paresis and loss of pain and temperature sensation

A

anterior spinal artery occlusion

The anterior spinal artery supplies the anterior portion of the spinal cord. This leads to bilateral motor and sensory paralysis below the level of the infarct. There is sparing of the dorsal column medial lemniscal pathway preserving proprioception. As well as this autonomic dysfunction inferior to the level of the lesion is seen. This condition is most commonly due to atherosclerosis, risk factors include diabetes, hypertension and anything else causing a hypercoagulable state.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

ECG abnormalities associated with hypercalcaemia

A

shortening of the QT interval. Osborne (J) waves may also be seen in more severe cases. If the hypercalcaemia is not corrected, ventricular arrhythmias like Ventricular Fibrillation can develop.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

dexamethasone suppression test

A

Cushing’s disease (ACTH secreting pituitary adenoma), cortisol is not suppressed by low-dose dexamethasone but is suppressed by high-dose dexamethasone

exogenous steroid use, the plasma ACTH would be decreased

With ectopic ACTH from small cell lung cancer, cortisol would not be suppressed by low dose or high-dose dexamethasone.

With cortisol secretion from an adrenal adenoma, cortisol would not be suppressed by low-dose or high-dose dexamethasone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

salicylate overdose mx

A

general (ABC, charcoal (within an hour of OD))

urinary alkalinization with intravenous sodium bicarbonate - enhances elimination of aspirin in the urine

haemodialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

triangle of safety for chest drain

A

base of the axilla, lateral edge pectoralis major, 5th intercostal space and the anterior border of latissimus dorsi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

eczema herpeticum cause

A

HSV1
coxsackie

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

first hormone secreted in response to hypoglycaemia

A

glucagon -> GH and cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

coved ST-segment elevation in leads V1-V3 with T wave inversion, gene mutation

A

SCN5A

CASQ2 is a gene for cardiac calsequestrin, a calcium-binding protein that plays a key role in cardiac regulation. Mutations in this gene lead to catecholaminergic polymorphic ventricular tachycardia (CPVT).

KCNQ1 and KCNH2 are both genes encoding for potassium channels. Defects in these can lead to long-QT syndrome (Romano-Ward) or short-QT syndrome.

RYR2 encodes for the ryanodine receptor found in cardiac muscle. Mutations in RYR2 are associated with catecholaminergic polymorphic ventricular tachycardia (CPVT) and arrhythmogenic right ventricular dysplasia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

widening of wrist joints

A

rickets, due to excess non-mineralised osteoid at growth plate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

microtubule function

A

guide movement during intracellular transport and help bind internal organelles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

what can reduce absorption of levothyroxine

A

iron
calcium carbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

chlamydia psittaci treatment

A

tetracyclines
macrolides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

fastest conduction velocities in the heart

A

Purkinje fibres

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

lung volumes

A

Tidal volume (TV)
volume inspired or expired with each breath at rest
500ml in males, 350ml in females

Inspiratory reserve volume (IRV) = 2-3 L
maximum volume of air that can be inspired at the end of a normal tidal inspiration
inspiratory capacity = TV + IRV

Expiratory reserve volume (ERV) = 750ml
maximum volume of air that can be expired at the end of a normal tidal expiration
significantly reduced in obesity (increased abdominal fat mass pushes up against the diaphragm, reducing the volume of air that can be expelled)

Residual volume (RV) = 1.2L
volume of air remaining after maximal expiration
increases with age
RV = FRC - ERV

Functional residual capacity (FRC)
the volume in the lungs at the end-expiratory position
FRC = ERV + RV

Vital capacity (VC) = 5L
maximum volume of air that can be expired after a maximal inspiration
4,500ml in males, 3,500 mls in females
decreases with age
VC = inspiratory capacity + ERV

Total lung capacity (TLC) is the sum of the vital capacity + residual volume

Physiological dead space (VD)
VD = tidal volume * (PaCO2 - PeCO2) / PaCO2
where PeCO2 = expired air CO2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

thyroid scans

A

The combination of hyperthyroid symptoms, blood results, and patchy uptake on nuclear scintigraphy point towards a diagnosis of toxic multinodular goitre.

In Graves disease, scintigraphy would show diffuse enlargement of both thyroid lobes, with uniform uptake throughout.

A solitary adenoma would present similarly to toxic multinodular goitre, but you would expect nuclear scintigraphy to show a small focus of uptake.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

tricyclic overdose management

A

IV bicarbonate
first-line therapy for hypotension or arrhythmias
indications include widening of the QRS interval >100 msec or a ventricular arrhythmia

other drugs for arrhythmias

+ class 1a (e.g. quinidine) and class Ic antiarrhythmics (e.g. Flecainide) are contraindicated as they prolong depolarisation
class III drugs such as amiodarone should also be avoided as they prolong the QT interval
response to lignocaine is variable and it should be emphasized that correction of acidosis is the first line in the management of tricyclic-induced arrhythmias

intravenous lipid emulsion is increasingly used to bind free drug and reduce toxicity

dialysis is ineffective in removing tricyclics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

ITP bone marrow exam

A

increased megakaryocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

metastatic bone pain mx

A

analgesia
bisphosphonates
radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

prophylaxis for contacts of patients with meningococcal meningitis

A

oral ciprofloxacin or rifampicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

most common and severe form of renal disease in SLE patients

A

diffuse proliferative GN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

renal tubular acidosis causes metabolic acidosis with

A

normal anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

painful third nerve palsy

A

PCA aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

CLL investigation of choice

A

immunophenotyping (will demonstrate Bcells CD19 positive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Flecainide MOA

A

blocking the Nav1.5 sodium channels in the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

SGLT2 inhibitors site of action

A

early PCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

most specific ECG finding in acute pericarditis

A

PR depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

nephrotic syndrome + malignancy

A

membranous glomerulonephritis

lymphomas cause MCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

AML good prognosis

A

t15:17 APML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

NAFLD, next investigation

A

enhanced liver fibrosis blood test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

causes of rapidly progressive glomerulonephritis

A

Goodpastures
ANCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

MEN2B

A

medullary cancer, phaeo, marfan

When differentiating between MEN 2A and 2B, it is worth remembering that MEN 2B has similar characteristics as MEN 2A (Thyroid carcinoma’s, Adrenal tumours, Parathyroid hyperplasia) but in addition typically have a Marfanoid appearance and mucosal neuromas, as well as the absence of hyperparathyroidism.

MEN type 1 is characterised by pancreatic neuroendocrine tumours, pituitary adenoma and parathyroid hyperplasia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

ABPA treatment

A

systemic glucocorticoid

oral antifungals adjunct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

disproportionate microcytic anaemia with raised HbA2

A

beta thalassaemia trait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

CLL treatment

A

FCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

PBC

A

IgM
antimitochondrial antibodies, M2 subtypes
middle aged females

sicca syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

prolactin release is

A

inhibited by dopamine
upregulated by TRH and oestrogen

inhibitS GnRH and LH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Brown-sequard syndrome

A

Contralateral loss of temperature, ipsilateral loss of fine touch and vibration, ipsilateral spastic paresis

The spinothalamic tract decussates at the same level the nerve root enters the spinal cord. The corticospinal tract, dorsal column medial lemniscus, and spinocerebellar tracts decussate at the medulla

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

PCT diagnosis

A

urine uroporphyrinogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

serum and urine porphobilinogen

A

AIP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

eosinophilia and mononeuritis multiplex after starting new med for asthma

A

monteleukast can unmask churg-strauss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

management of HACE and HAPE

A

Management of HACE -
descent
dexamethasone

Management of HAPE -
descent
nifedipine, dexamethasone, acetazolamide, phosphodiesterase type V inhibitors*
oxygen if available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

troponin binding

A

I to actin
T to tropomyosin
C to calcium ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

drugs which exhibit zero order kinetics

A

phenytoin
alcohol
salicylates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

FISH

A

uses fluorescent DNA or RNA probe to bind to specific gene site of interest for direct visualisation of chromosomal anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

causes of drug-induced photosensitivity

A

thiazides
tetracyclines, sulphonamides, ciprofloxacin
amiodarone
NSAIDs e.g. piroxicam
psoralens
sulphonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

severe alcoholic hepatitis

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

anal fissure management

A

Management of an acute anal fissure (< 1 week)
soften stool
dietary advice: high-fibre diet with high fluid intake
bulk-forming laxatives are first-line - if not tolerated then lactulose should be tried
lubricants such as petroleum jelly may be tried before defecation
topical anaesthetics
analgesia

Management of a chronic anal fissure
the above techniques should be continued
topical glyceryl trinitrate (GTN) is first-line treatment for a chronic anal fissure
if topical GTN is not effective after 8 weeks then secondary care referral should be considered for surgery (sphincterotomy) or botulinum toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

SIADH underlying mechanism causing hyponatraemia

A

Antidiuretic hormone promotes water reabsorption by the insertion of aquaporin-2 channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

pseudoxanthoma elasticum

A

autosomal recessive

retinal angioid streaks
‘plucked chicken skin’ appearance - small yellow papules on the neck, antecubital fossa and axillae
cardiac: mitral valve prolapse, increased risk of ischaemic heart disease
gastrointestinal haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

cryptosporidium diagnosis

A

Ziehl-neelsen modified staining of stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

evolving pattern of lesions of individual nerves, pain (ful sensory loss)

A

MM

PAN can cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

prominent V waves on JVP

A

tricuspid regurg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

cannon A waves

A

CHB and atrial flutter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

absent A waves

A

atrial fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

slow Y descent

A

tricuspid stenosis or cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

exaggerated X descent

A

constrictive pericarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

prognosis in pancreatitis

A

PANCREAS

PaO2 <8
Age >55
Neutrophilia
Calcium <2
Renal - urea >16
enzymes; LDH and AST
Albumin <32
Sugar - glucose >10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

anti-NMDA receptor encephalitis

A

associated with ovarian teratoma

psychiatric symptoms, seizures, autonomic instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

hepatitis is associated with which cryoglobulinaemia

A

mixed T2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

type 1 cryoglobulinaemia

A

lymphoproliferative disorders with immunology demonstrating presence of monoclonal IgG or M

RAYNAUDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

marbled appearance of bone

A

osteopetrosis
normal Ca, phosph, ALP and PTH

Osteitis fibrosa cystica - replacement of bone mass with fibrosis and development of brown tumours. Patients have raised ALP, raised calcium, raised PTH and low phosphate.

Osteomalacia - low calcium and low phosphate with increased ALP and increased PTH.

Osteogenesis imperfecta type 3 - disorder of collagen formation leading to brittle bone, bone deformities and blue sclera amongst other features.

Osteopetrosis - normal calcium, phosphate, ALP and PTH levels.

Paget’s disease - calcium, phosphate and PTH unaffected with ALP raised.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

disseminated gonococcal infection triad

A

tenosynovitis
migratory polyarthritis
dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

oxygen dissoc curve left shift (lower o2 delivery)

A

Low [H+] (alkali)
Low pCO2
Low 2,3-DPG
Low temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

oxygen dissoc curve R shift (raised O2 delivery)

A

Raised [H+] (acidic)
Raised pCO2
Raised 2,3-DPG
Raised temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

electrolyte imbalance potentiating digoxin toxicity

A

lower potassium levels lead to higher levels of digoxin binding to the ATPase pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

paracetamol overdose occurs when glutathione stores run out leading to

A

an increase in NAPQI (n actely p benzoquinone imine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

whipple’s disease

A

diarrhoea, weight loss, arthralgia, lymphadenopathy, ophthalmoplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

how does alcohol binging lead to polyuria

A

inhibition of posterior pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

subacute combined degeneration of the cord

A

loss of proprioception and vibration sense (dorsal columns) + lateral columns are also affected and would cause spasticity and brisk knee reflexes. Babinski sign is typically positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

genetic cause of nephrogenic DI

A

vasopressin receptor
aquaporin 2 channel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

familial mediterranean fever

A

autosomal recessive, hereditary inflammatory disorder characterised by reoccurring episodes of abdominal pain, fever, arthralgia, and chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

warfarin management of high INR

A

Major bleeding (e.g. variceal haemorrhage, intracranial haemorrhage) -
Stop warfarin
Give intravenous vitamin K 5mg
Prothrombin complex concentrate - if not available then FFP*

INR > 8.0 + Minor bleeding -
Stop warfarin
Give intravenous vitamin K 1-3mg
Repeat dose of vitamin K if INR still too high after 24 hours
Restart warfarin when INR < 5.0

INR > 8.0 + No bleeding -
Stop warfarin
Give vitamin K 1-5mg by mouth, using the intravenous preparation orally
Repeat dose of vitamin K if INR still too high after 24 hours
Restart when INR < 5.0

INR 5.0-8.0 + Minor bleeding -
Stop warfarin
Give intravenous vitamin K 1-3mg
Restart when INR < 5.0

INR 5.0-8.0 + No bleeding -
Withhold 1 or 2 doses of warfarin
Reduce subsequent maintenance dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

de clerambaults

A

famous in love

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

in a patient with hypercalciuria and renal stones

A

give thiazide diuretics

usually cause hypercalc, but not in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

rifampicin MOA

A

inhibits RNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

penicillins, cephalosporins and carbapenems MOA

A

cell wall synthesis - peptidoglycan cross-linking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

glycopeptides (vanc) MOA

A

cell wall synthesis - peptidoglycan synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

quinolones MOA

A

inhibit DNA topoisomerase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

metronidazole MOA

A

damages DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

trimethoprim MOA

A

dihydrofolate reductases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

sulfonamides MOA

A

dihyrdopteroate synthase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

aminoglycosides and tetracyclines MOA

A

protein synthesis - 30S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

macrolides, chloramphenicol, clindamycin, linezolid, streptogrammins MOA

A

protein synthesis - 50S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

tolbutamide drug class

A

sulfonylureas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

hypnagogic jerks occur during

A

nREM1

REM - lucid dreaming and the absence of the normal atonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

metabolic ketoacidosis with normal or low glucose

A

think alcoholic ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

angular cheilitis

A

vitamin B2 riboflavin deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

thyrotoxic storm treatment

A

Bb, PTU and hydrocort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

overuse of NaCl

A

hyperchloraemic metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Budd Chiari syndrome triad

A

abdo pain
ascites -> distension
tender hepatomegaly

USS with doppler flow studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Paget’s disease biochemical marker

A

urine hydroxyproline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

expressivity describes

A

the extent to which a genotype shows its phenotypic expression in an individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

relapsing polychondritis

A

ear problems, nasal chondritis, respiratory tract involvement, arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

blood group A is associated with increased risk of

A

gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

pancreatic cancer sign

A

double duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

LMWH MOA

A

activation of AT3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

Cushings VBG

A

hypokalaemic metabolic alkalosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

Addisons VBG

A

hyperkalaemic metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

aminoglycoside toxicity is secondary to

A

acute tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

what is protective in paracetamol OD

A

acute alcohol intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

adhesive capsulitis which movement most affected

A

ext rot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

SJS vs TEN

A

10% vs >30% of BSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Hashimotos increases risk of development of

A

MALT lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

Horners syndrome

A

First-order - where the lesion is central, occurring anywhere from the hypothalamus, through the midbrain to the synapse at T1.
head, arm, trunk = central lesion: stroke, syringomyelia

Second-order - where the lesion is between the synapse in the spinal cord to the superior cervical ganglion.
just face = pre-ganglionic lesion: Pancoast’s, cervical rib

Third-order - where the lesion is post-ganglionic occurring anywhere above the superior cervical ganglion.
absent = post-ganglionic lesion: carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

where is phosphate reabsorbed

A

proximal tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

Fabry’s disease inheritance

A

XLR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

what class of receptors does adrenaline work on

A

GPCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

pilocarpine drug class

A

musc agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

microscopic colitis

A

chronic diarrhoea

colonoscopy and biopsy

Microscopic colitis typically presents with persistent watery diarrhoea. Colonoscopy plus random colonic biopsies are essential for the definitive diagnosis of microscopic colitis. The colon often appears macroscopically normal, with biopsies showing a mononuclear cell infiltration of the lamina propria with either a thickened subepithelial collagen band (in collagenous colitis) or intraepithelial cell lymphocytosis (in lymphocytic colitis). Proton-pump inhibitors, and in particular, lansoprazole, are associated with the development of microscopic colitis, making this the best answer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

systemic mastocytosis

A

abdo pain, flushing, urticaria pigmentosa - urinary histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

myoclonic seizures

A

valproate first line for males
females - levetiracetam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

methaemoglobinaemia treatment

A

if congenital - IV ascorbic acid

if not - methylene blue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

which molecule is added to the enzyme by the golgi apparatus to tag it for transport to the lysosome

A

mannose 6-phosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

SJS drug causes

A

lamotrigine
phenytoin
carbamazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

publication bias diagram

A

funnel plots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
204
Q

when starting SSRI in someone on NSAID

A

give PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
205
Q

liver transplant criteria

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
206
Q

which blood tests monitor haemochromatosis

A

ferritin and transferrin saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
207
Q

causes of restrictive lung disease

A

Pulmonary fibrosis
Asbestosis
Sarcoidosis
Acute respiratory distress syndrome
Infant respiratory distress syndrome
Kyphoscoliosis e.g. ankylosing spondylitis
Neuromuscular disorders
Severe obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
208
Q

causes of obstructive lung disease

A

asthma
COPD
bronchiectasis
bronchiolitis obliterans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
209
Q

alpha 1 antitrypsin genotypes

A

normal: PiMM
heterozygous: PiMZ
evidence base is conflicting re: risk of emphsema
however, if non-smoker low risk of developing emphsema but may pass on A1AT gene to children
homozygous PiSS: 50% normal A1AT levels
homozygous PiZZ: 10% normal A1AT levels (MANIFEST DISEASE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
210
Q

bone pain, tenderness and proximal myopathy (waddline gait)

A

osteomalacia
D3 supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
211
Q

NIV works in range

A

7.25-35

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
212
Q

pentad of TTP

A

fever
neurological dysfunction
evidence of haemolysis on blood film
renal injury
thrombocytopaenia

An acquired inhibition of ADAMTS13, preventing the cleavage of von Willebrand Factor multimers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
213
Q

prolapsed disc

A

L3 nerve root compression -
Sensory loss over anterior thigh
Weak hip flexion, knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

L4 nerve root compression -
Sensory loss anterior aspect of knee and medial malleolus
Weak knee extension and hip adduction
Reduced knee reflex
Positive femoral stretch test

L5 nerve root compression -
Sensory loss dorsum of foot
Weakness in foot and big toe dorsiflexion
Reflexes intact
Positive sciatic nerve stretch test

S1 nerve root compression -
Sensory loss posterolateral aspect of leg and lateral aspect of foot
Weakness in plantar flexion of foot
Reduced ankle reflex
Positive sciatic nerve stretch test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
214
Q

terbinafine MOA

A

inhibits squalene epoxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
215
Q

griseofulvin MOA

A

interacts with microtubulues to disrupt mitotic spindle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
216
Q

amphoB MOA

A

binds with ergosterol forming a transmembrane channel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
217
Q

flucytosine MOA

A

converted by cytosine deaminase to 5-fluorouracil, which inhibits thymidylate synthase and disrupts fungal protein synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
218
Q

caspofungin MOA

A

inhibits synthesis of beta-glucan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
219
Q

metformin MOA

A

activation of AMPK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
220
Q

PSC choice investigation

A

ERCP/MRCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
221
Q

syringomyelia affects which spinal cord structure

A

compression of the spinothalamic tract fibres decussating in the anterior white commissure of the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
222
Q

Japanese encephalitis

A

Clinical features of Japanese encephalitis are headache, fever, seizures. Parkinsonian features indicate basal ganglia involvement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
223
Q

common complication of plasma exchange

A

hypocalcaemia
due to citrate use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
224
Q

cisplatin electrolyte disturbance

A

hypomagnesaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
225
Q

polychromatic macrocytes what type of cell

A

reticulocytes

have a mesh-like (reticular) network of ribosomal RNA that is visible when stained. This is not present in mature erythrocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
226
Q

matching HLA in transplant, importance

A

DR > B > A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
227
Q

tolvaptan drug class

A

VP receptor 2 antagonist

used for ADPKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
228
Q

Hodgkins lymphoma receive which blood product

A

irradiated packed red cells - avoid gvhd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
229
Q

PBC management

A

first-line: ursodeoxycholic acid
slows disease progression and improves symptoms
pruritus: cholestyramine
fat-soluble vitamin supplementation
liver transplantation
e.g. if bilirubin > 100 (PBC is a major indication)
recurrence in graft can occur but is not usually a problem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
230
Q

campylobacter treatment

A

clarithromycin
cipro 2nd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
231
Q

majority of glucose reabsorption in the nephron occurs within

A

PCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
232
Q

in gestational diabetes if already on metformin

A

add insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
233
Q

codeine to morphine conversion

A

divide by 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
234
Q

organophosphate poisoning

A

Medical management of organophosphate poisoning involves resuscitation, critical care and airway maintenance, and administration of atropine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
235
Q

dermatomyositis antibodies

A

ANA most common
anti mi 2 most specific

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
236
Q

polymyositis antibodies

A

anti jo1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
237
Q

atherosclerosis stages

A

(1) Endothelial dysfunction is the initial stage - triggered by risk factors - resulting in a pro-inflammatory, pro-oxidant, proliferative state.

(2) This allows for the fatty infiltration of the subendothelial space by low-density lipoprotein (LDL) particles.

(3) Leukocytes are recruited to the site of development due proinflammatory cytokines, which are partly maintained by LDL.

(4) Over time, these phagocytose LDLs and other lipoproteins, becoming foam cells which contribute to the overall structure of the plaque.

(5) Smooth muscle cell proliferation and migration is the final step in the formation of atheroma, leading to the development of a fibrous capsule over the fatty plaque.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
238
Q

Marfanoid features, learning difficulties, downward lens dislocation, myopia, malar flush

A

homocystinuria
treatment is pyridoxine - vitamin B6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
239
Q

lithium desensitises the kidney’s ability to respond to ADH in the

A

collecting ducts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
240
Q

drug causes of urticaria

A

aspirin
penicillins
NSAIDs
opiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
241
Q

sulfonylureas MOA

A

Binds to and shuts pancreatic beta cell ATP-dependent K+ channels, causing membrane depolarisation and increased insulin exocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
242
Q

mixed connective tissue disease antibody

A

anti-ribonuclear protein antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
243
Q

strongyloides treatment

A

ivermectin and bendazoles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
244
Q

levothyroxine acts via

A

nuclear receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
245
Q

why does haptoglobin fall in G6PD

A

binds to free Hb

246
Q

variable intensity of S1 is caused by

A

CHB

247
Q

screening for hereditary angioedema BETWEEN attacks

A

C4

248
Q

coved ST elevation followed by negative T wave

A

Brugada

249
Q

if ICD causing ventricular arrhythmias in Brugada

A

quinidine

250
Q

unmasking ECG abnormalities of Brugada

A

flecainide

251
Q

angiodysplasia with aortic stenosis cause

A

acquired VWD
angiodysplasia due to alteration in the pulse waveform and hypoxia

252
Q

gas gangrene due to clostridium perfringens infection

A

clindamycin and metronidazole

253
Q

mixed respiratory and metabolic acidosis

A

CO2 raised
bicarb below the lower limit of normal
acidosis

254
Q

posterior cerebral artery stroke visual

A

contralateral homonymous hemianopia (usually with macular sparing)

255
Q

pulmonary haemorrhage + renal impairment

A

anti GBM disease

plasma exchange is intervention of choice

256
Q

phase 0 of cardiac action potential

phase 2

A

sodium ion influx

L and T type calcium channels

phase 3 - potassium efflux

257
Q

Barrett’s with low grade dysplasia for the first time

A

surveillance endoscopy with 6 month repeat

if seen again -> RFA

258
Q

HF with symptoms and persistent increased pulse rate

A

ivabradine

259
Q

primary function of microRNAs

A

silencing of messenger RNA preventing ribosomal binding and protein translation

260
Q

dipyridamole moa

A

adenosine uptake inhibitor

261
Q

LVF with low ejection fraction and episodes of recurrent VT

A

ICD - due to significant arrest risk

262
Q

IV quinine therapy SE

A

hypoglycaemia

malaria -> hyperkalaemia, hypocalcaemia, hyponatraemia

263
Q

short QT interval

A

hypercalcaemia
hyperkalaemia
hyperthermia
metabolic acidosis

264
Q

Katayama fever tx

A

corticosteroids

265
Q

pseudohypoparathyroidism

A

borderline low serum Ca and phosphate at upper limit of normal

GPCR mutation -> parathyroid hormone resistance

266
Q

omeprazole electrolyte disturbance

A

hypomagnesaemia

267
Q

most likely ab to be positive in systemic sclerosis

A

ANA

268
Q

benzbromarone moa

A

URAT-1 inhibitor -> increases excretion of uric acid by blocking reabsorption

269
Q

COL4A3/4/5

A

Alport

270
Q

HNF1a/b

A

MODY3/5

271
Q

PNPLA3

A

NASH

272
Q

latent tb rx

A

3 months of iso+rif or 6 months of iso with pyridoxine

273
Q

painful arc

A

subacromial impingement

274
Q

posterior MI

A

most often PDA (90% of patients)

275
Q

del(13q) vs (17q)

A

good prog vs poor in CLL

276
Q

slow growing brain tumour - months of raised ICP

A

ependymoma

277
Q

Waldenstroms mx

A

rituximab based chemo (eg with bendamustine)

278
Q

evidence of pulmonary htn, RHF and increase in O2 sat between the RA and the RV

A

VSD

279
Q

which organ drives most of the response to hypoxia

A

carotid body

280
Q

injury to dominant temporal lobe causes

A

receptive aphasia, dyslexia, impaired verbal memory and word agnosia, complex hallucinations and contralateral homonymous upper quadrantanopia

281
Q

how does aspirin prevent platelet aggregation

A

reduced production of TXA2

is a COX1 inhibitor

282
Q

what drives the initial generation of an action potential within muscle cells

A

sodium influx

283
Q

why does ACEI cause rise in creatinine

A

efferent renal arteriolar dilatation

284
Q

which infections occur with much greater frequency in CVID

A

giardiasis

prone to Hib, s pneum, morax, s aureus, PCP, myco

285
Q

progressive IgA nephropathy despite controlled BP, full dose ACEI and high dose oral pred

A

cyclophosphamide and azathioprine

286
Q

proximal myopathy, abdominal adiposity

A

IGF1 - GH deficiency

287
Q

medial medullary syndrome - vertebral artery occlusion

A

R limb weakness and loss of fine touch and proprio
facial sens normal (trigeminal nucleus spared)

288
Q

pituitary apoplexy most important hormone to replace first

A

cortisol

289
Q

small bowel diarrhoea - large volume watery in HIV

A

microsporidia or salmonella

colonoscopy with ileal intubation

290
Q

delta waves on ECG

A

WPW

291
Q

hereditary spherocytosis with RUQ pain

A

haemolysis (spectrin and ankyrin deficiency) -> gallstones

292
Q

dull RUQ pain + portal htn + ascites

A

Budd Chiari syndrome

293
Q

JME mx

A

levetiracetam

294
Q

in pregnancy switch bosentan for

A

sildenafil

295
Q

tx of sight threatening macular oedema

A

focal photocoagulation

296
Q

lowest level of cortisol

A

0000

297
Q

myocardial ischaemia on bg of chronic cocaine abuse

ST depression -> coronary artery spasm

A

GTN infusion or CCB

298
Q

AF in pregnancy

A

avoid thiazide diuretics
metoprolol over bisoprolol
nitrates are vasodilator of choice, as ACEI/ARB teratogenic
if murmur + AF + HF -> PMV

299
Q

which cells express MHC class 2 antigens

A

dendritic cells

300
Q

chlamydia in pregnancy

A

azithromycin 1g

301
Q

primary mode of action of cyclophosphamide

A

T cell modulation

302
Q

adalimumab moa

A

TNF inhibitor

303
Q

denosumab
teriparatide

A

6 monthly SC injection
daily injection

304
Q

non-parametric 2 independent groups of samples

A

WRS

305
Q

ambrisentan vs bosentan

A

endothelin A only
vs both (non-sel)

306
Q

MODY abs?

HNF1a

A

none

very sensitive to sulfonylureas

307
Q

failure of 2 DMARDs in psoriatic arthropathy

A

TNF antagonist - golimumab

ustekinumab IL12/23 after

MTX first as DMARD

308
Q

flaccid bullae leaking straw-coloured fluid and healing with erythematous base

A

bullous impetigo - Staph Aureus
mupirocin and fusidic acid

309
Q

PSM
pulsatile hepatomegaly
heave

A

TR

310
Q

UGT1A1 gene

A

Gilberts syndrome

311
Q

chlamydia tx

A

doxy BD 7d

312
Q

GN in GPA

A

pauci-immune crescentic glomerulonephritis

313
Q

crescentic glomerulonephritis with linear IgG deposition

A

antiGBM

314
Q

osteomyelitis due to mixed organism (hx of diabetes mellitus)

A

vanc + ceft 4-6 weeks

315
Q

post angiography skin changes, eosinophilia, raised CRP and acute renal failure

A

cholesterol emboli
supportive therapy only

316
Q

Turners karyotype

A

XO

317
Q

Klinefelter karyotype

A

XXY

318
Q

AIS

A

XY karyotype

319
Q

sequential vs continuous combined HRT

A

if < year -> sequential

320
Q

diagnosis of polymyositis

A

EMG and muscle biopsy

steroids -> mx

321
Q

confirmation of B thal trait

A

Hb electrophoresis

322
Q

hyperkalaemic metabolic acidosis worsened with introduction of ACEI

A

RTA t4 (deficiency of aldosterone action) caused by DM, SLE, amyloid, chronic tubulointerstitial disease

323
Q

section 5.2

A

doctor to detain 72 hours

324
Q

5.4

A

psych nurse to detain for 6 hours

325
Q

section 2

A

compulsory detain for assessment

326
Q

section 3

A

admission for treatment

327
Q

section 7

A

guardianship

328
Q

when does gvhd happen in transfusion

A

when non irradiated transfusions are given to pt with underlying haematological malignancy

329
Q

ST elev in leads 2,3,avf

A

RCA

330
Q

gonorrhoea with penicillin allergy

A

single high dose 2g azithro

331
Q

Legionella

A

levofloxacin or azithromycin

332
Q

JAK2 V617F is present in 45-68% of patients with

A

myelofibrosis

333
Q

creatinine rise with trimethoprim

A

reversibly inhibits renal tubular secretion of creatinine - independent of gfr which remains same

334
Q

pubic lice

A

malation/permethrin

335
Q

CYP3A4 inhibitors which can increase tacrolimus levels leading to toxicity

A

fluconazole

336
Q

TBMN

A

AD due to collagen formation defect
familial haematuria

337
Q

LGV treatment

A

doxy bd for 21d

338
Q

recurrent microscopic haematuria
renal impairment
renal colic
multiple areas of medullary calcification on AXR

A

medullary sponge kidney
increase fluid intake -> citrate

339
Q
A
340
Q

single thyroid nodule hot

A

tx dose radioiodine

341
Q

polyuria
polydipsia
postural drop in BP on standing
low osm and elevated urine sodium excretion

A

nephrogen DI drug induced

ofloxacin

342
Q

agitated with a CNS stimulant

A

IM lorazepam and haloperidol

343
Q

chemo for MALToma

A

imatinib and rituximab

344
Q

TZD site of action

A

DCT

345
Q

ipsilateral Horners and nystagmus in affected direction
contralateral loss of pain and temp sensation in limbs

A

PICA

346
Q

nephron normally impermeable to water

A

ascending limb of LOH

347
Q

increased transaminases in hep A or E

A

hepatocyte necrosis

348
Q

systemic amyloidosis in bronchiectasis

A

related to chronic inflammation

progressive protein leak in kidneys and peripheral oedema

cardiac? MRI

349
Q

asthma sinusitis mononeuritis and eosinophilia

A

EGPA

350
Q

AF during a period of ischaemia

A

aspirin, clopi, apixaban

351
Q

blister heals with hyperpigmentation and hypertrichosis
elevated transaminase and ferritin

A

PCT

352
Q

which features on ECG are supportive of VT compared to SVT with aberrant conduction

A

negative concordance across chest leads

RSR with taller L R wave

extreme axis deviation (northwest)

absence of typical R or L BBB

broad QRS >160

353
Q

2 main ketones produced by the liver

A

acetoacetate -> falls slowly
BHB

354
Q

SLE renal failure despite hcq

A

MMF
safer than cyclopshoph due to lower risk of ovarian failure
then cyclo then aza

355
Q

likely DVT, low Sats, possible PE + symptoms of an acute stroke

A

paradoxical embolism as cause of stroke

due to undiagnosed PFO

bubble contrast echo!

356
Q

a1at heterozygote

A

PiMZ

357
Q

GBM immunosuppressant of choice

A

cyclophosphamide

358
Q

which ECG finding is the strongest indication for PPM insertion

A

RBBB and LAFB

359
Q

where does ostium of coronary sinus drain

A

R atrium

360
Q

asthma - acidosis with CO2 retention and hypoxia, pH >7.26 and acidotic despite one hour of therapy

A

NIPPV

361
Q

distal vs proximal segment of the ACA

A

proximal less likely to result on neuro seq due to collateral

362
Q

common peroneal nerve palsy in RA

A

due to nerve entrapment due to deformity

363
Q

glycogen storage disorders

A

Von Gierke’s - G6P - hepatic glycogen accumulation - hypoglycaemia, lactic acidosis, hepatomegaly

Pompe’s disease - LA14G - cardiomegaly

Cori disease - A16G - muscle hypotonia

McArdles - GP (myophosphorylase) - myalgia, myoglobinuria with exercise

364
Q

lysosomal storage disease

A

Gauchers - GB - commonest - hsmeg, aseptic femur necrosis

Tay-Sachs - hexosaminidase A - GM2 ganglioside - developmental delay, cherry red spot of the macula, liver and spleen normal

NPD - sphingo - hsmeg ^ else same

Fabry - AGA - agiokeratomas, peripheral neuropathy, renal failure

Krabbe’s disease - galactocerebrosidase - per neur, optic atrophy, globoid cells

metachromatic leukodystrophy - demyelination of central and peripheral ns

365
Q

mucopolysaccharidoses

A

Hurler - gargoylism, hsmeg, corneal clouding

Hunter - coarse facial features, behavioural problems, corneal clouding

366
Q

verapamil + fluconazole

A

constipation and relative bradycardia

367
Q

gastroenteritis incubation

A

1-6 hrs: Staphylococcus aureus (vomiting), Bacillus cereus (vomiting within 6 hrs, diarrhoea after)*
12-48 hrs: Salmonella, Escherichia coli
48-72 hrs: Shigella, Campylobacter
> 7 days: Giardiasis, Amoebiasis

bloody - shigella, amoebiasis, campy

368
Q

VHL

A

haemangioblastoma
phaeo
renal cysts/ca

369
Q

choroidal haemangioma assoc with

A

sturge weber syndrome

370
Q

ciclosporin moa

A

IL2 production inhibition

371
Q

which pituitary hormone is under constant inhibition

A

prolactin from dopamine

ACTH is pulsatile with half life 10 minutes - control of CRH - under negative feedback

ADH - secretion increases in response to hypovolaemia and/or increased osmolality

LH - cyclical

TSH - circadian and pulsatile

372
Q

anti-PR3 antibodies

A

GPA

373
Q

S mansoni

A

hepatic fibrosis

374
Q

low platelets
low fibrinogen
elevated PT and APTT
elevated D dimer

A

DIC

375
Q

short stature
chronic muscle pain and weakness
normal renal function
hypocalcaemia
hyperphosph
low PTH

A

congenital hypoparathyroidism

376
Q

anaemia
low albumin
low calcium
diarrhoea
previous surgical procedures

A

short bowel syndrome

377
Q

7th nerve palsy with loss of sensation - where is lesion

A

before emerges from stylomastoid foramen

378
Q

chronic hypoxia compensatory changes

A

increased haematocrit
positive dip is from running - march haemolysis

379
Q

mitral stenosis with AF in pregnancy

A

BB such as bisop

380
Q

how does alcohol cause hypoglycaemia

A

increased first phase insulin response

381
Q

slowly progressive heart failure and AF, gradual proximal muscle weakness

A

telomere shortening in muscle stem cells - Duchenne/Beckers - inability to regenerate new muscle

382
Q

Behcets mx

A

pred
azathioprine

colchicine an option if unable to take pred and severe genital ulcer
cyclophosphamide only in large artery vasc or posterior uveitis

383
Q

drugs causing serotonin syndrome

A

MAOI
SSRI
ecstasy
amphetamines

384
Q

referral for parathyroidectomy

A

no other chronic illness

385
Q

platelet infections

A

staph epidermidis
bacillus cereus

386
Q

in stent thrombosis

A

first 30 days
ST elevation in same territory after stopping clopi

387
Q

tall and thin with a soft diastolic murmur in the L upper sternal edge, pitting oedema ankles

A

pulmonary regurg

388
Q

IgG defiency

A

G1 - hypogammaglobulinaemia
makes up 2/3rds of total IgG
vaccination essential

G4 - joint pain and fatigue
G2 - Neisseria, strep and haemophilus

389
Q

false positive quantiferon with negative tuberculin

A

latent TB need to rule out

390
Q

nitrous oxide causes deficiency of

A

B12

bilateral loss of vibration and position, upgoing plantars, R optic disc pallor

391
Q

which is the 1y mode of action of digoxin

A

intracellular sodium accumulation

392
Q

MCD - previous response to high dose pred

A

pred again
ACEI?

393
Q

diphtheria tx

A

macrolides and penicillins

394
Q

amaurosis fugax occlusion

A

atheroma within ipsilateral internal carotid

395
Q

weakness of flexion of terminal phalanx of the thumb

A

median nerve

396
Q

campylobacter

A

macrolides

397
Q

best initial investigation for detecting early rheumatoid joint changes

A

colour doppler ultrasound

398
Q

APL abs

A

cardiolipin

399
Q

best marker for assessing disease activity

A

complement C3 levels

400
Q

poor prognosis in PPH

A

elevated BNP
reduced RV EF
SV arrhythmias
elevated hepatoma derived GF
male
elevated R atrial pressure
development of AFib

401
Q

after 5 shocks and pulseless VT

A

amiodarone 150
if 300 given after 3rd shock

402
Q

PSC most appropriate ix

A

MRCP as non invasive

403
Q

phosphate reabsorption

A

PCT

404
Q

acute rejection timing

A

<6 mo

405
Q

leading cause of ESRF in developed countries

A

diabetic nephropathy

406
Q

osmosis definition

A

passage of solvent towards a higher concentration of solute across a semi-permeable membrane

407
Q

CLL fludarabine presenting with worsening anaemia symptomatic

A

AIHA, due to increased imbalance in Treg function from fludarabine. Tx with pred

408
Q

T1 lesion

A

weakness and wasting of the intrinsic muscles of the hand and the interossei, areas of sensory loss corresponding to the T1 dermatome

409
Q

systemic vascular resistance on standing

A

increases

SV decreases
CVP falls
HR increases
venous compliance decreases

410
Q

amphetamine psychosis tx

A

benzos

411
Q

frontotemporal dementia tx

A

SSRIs

412
Q

SO4LR6

A

cn

413
Q

bacterial sepsis and neutropenia (related to carbimazole)

A

GCSF 4-10microgram/kg/d

414
Q

ramipril in pregnancy

A

stop - switch to labetalol or methyldopa

415
Q

cytokines produced by th2 cells

A

IL4

416
Q

renal impairment + haemolytic anaemia working on a farm

A

E coli - HUS
antiplatelets, FFP, anticoag, eculizumab

417
Q

azathioprine and gout

A

avoid xanthine oxidase inhibitors - eg febuxostat -> BM supp

418
Q

HLA for takayasu

A

B52

419
Q

Tourette tx

A

risperidone

420
Q

chlorthalidone site of action

A

DCT

421
Q

low GCS, low BP, sinus tachy and BL pupil dilatation

ECG - QRS widening with 110ms duration
pH 7.21

A

TCA overdose - QRS>100 -> sodium bicarb reverses the Na channel blockade

422
Q

strongy tx

A

ivermectin/albendazole

423
Q

idiopathic membranous nephropathy with worsening proteinuria and renal function + pitting oedema

A

pred + cyclophos

424
Q

monoclonal ab for thyroid eye disease

A

rituximab

ciclosporin

425
Q

SIBO tx

A

rifaximin

metro/tetra

426
Q

commonest cause of transfusion related morbidity in the UK

A

TACO

427
Q

when are anti TNF agent stopped in pregnancy

A

16 weeks

428
Q

birch fruit syndrome tx

A

oral antihistamine

429
Q

Holmes Adie pupil where is the damage

A

parasympathetic ciliary ganglion

430
Q

paraffin ointment advice

A

no smoking

431
Q

fulminant UC - to avoid surgery

A

cyclosporine

432
Q

seminomas most likely to be elevated

A

LDH

433
Q

pulsus paradoxus

A

exaggerated fall in BP on inspiration

434
Q

dystrophia myotonica type 1

A

progressive weakness, foot drop, weakness of LPS and temporalis, weak sternocleidomastroics and intrinsic muscles + muscles of forearm + high arched palate

435
Q

HSP

A

lower limb muscle weakness and foot drop

436
Q

DM2

A

neck and finger flexors, difficulty getting up from chair or climbing stairs

437
Q

HSAN

A

1 - peripheral neuropathy, ulceration
2 - same

438
Q

oligoarthritis, intermittent fevers, hepatomegaly with -ve RF

A

adult onset Still’s disease
anakinra (IL1)

439
Q

ST depression in V1-3 with dominant R in V2

A

PDA - RCA

440
Q

paraneoplastic cerebellar degeneration

A

bronchial small cell cancer
anti Hu abs

if women with breast/ovarian then antiYo

441
Q

muscle for standing without falling

A

soleus

442
Q

cisplatin heart

A

AF (due to Mg changes)

443
Q

pemphigus vulgaris non responsive to pred and aza

A

IV rituximab

444
Q

strongest pointer of worsening mitral valve stenosis

A

haemoptysis

445
Q

HHR inheritance

A

XLD

446
Q

what causes hyperphosphataemia in chronic renal failure

A

decreased functioning renal tissue

447
Q

purpuric rash affecting lower limbs, raised Cr and urine +ve for blood and protein

A

Hep C (cryoglob)

448
Q

mycophenolate =

A

tremor

449
Q

INO

A

diplopia in other direction to affect MLF

450
Q

skin infection with pen allergy

A

clindamycin

451
Q

SBP

A

significant - piptaz

452
Q

hereditary amyloidosis

A

TTA

453
Q

metastatic prostate ca resistant to first line anti-androgen therapies

A

enzalutamide

454
Q

familial hypercholesterolaemia on statin and ezetimibe, chol 7.2

A

evolocumab

455
Q

recent stay in hospital with ?staph infection

A

cover MRSA
linezolid

456
Q

aciclovir moa

A

DNA polymerase inhibitor

457
Q

Marfan sx bp management

A

ACEI or BB

458
Q

acute interstitial nephritis - drop in Cr, peripheral eosiniphilia, proteinuria with white and red blood cells

A

aciclovir

459
Q

moderate-severe diabetic foot infection

A

IV co-amox

460
Q

cystinuria mx

A

hydration
D penicillamine

461
Q

strongest indication for surgery in endocarditis

A

episodes of complete heart block

462
Q

low K, high BP despite max ACEI, metabolic alkalosis

A

Conns - hyporeninaemic hyperaldosteronism

463
Q

which is a primary feature of hyperglucagonaemia

A

gluconeogenesis

464
Q

aquaporin type in CD

A

2

465
Q

buprenorphine receptor

A

partial mu opioid agonist

466
Q

Pelger-Huet anomaly

A

bilobed nuclei in neutrophils, skeletal abnormalities

467
Q

pericarditis mx

A

NSAID first
then colchicine

468
Q

dorsal interossei nerve root

A

C8/T1

469
Q

dorsal scapular nerve - weakness of rhomboid and levator scapulae

A

C4/5

470
Q

long thoracic, phrenic, suprascapular and lateral pectoral nerve

A

C5/6

470
Q

C6/7 nerve root injury

A

sensory supply to hand (radial)

471
Q

C7/8 nerve root lesion

A

radial injury

472
Q

hypertension resistant to antihypertensives, low potassium

A

hyporeninaemic hyperaldosteronism

473
Q

GBS mx

A

IVIG/pex

474
Q

anti ampiphysin antibodies

A

stiff person syndrome and encephalomyelitis - breast and lung ca

475
Q

anti zic 4 antibodies

A

cerebellar degeneration, SCLC

476
Q

mab for PMR

A

tocilizumab

477
Q

MODY

A

HNF-1a gene
sulphonylureas

478
Q

greater curvature of stomach primary blood supply

A

L gastroepiploic

479
Q

Factor V Leiden background

A

long term anticoag needed

480
Q

aflibercept

A

VEGF - ARMD

481
Q

denosumab moa

A

RANKL inhibitor - nuclear factor kappa B

482
Q

sildenafil moa

A

PDE5

483
Q

MODY symptoms but pancreatic atrophy and formation of renal cysts

A

HNF-1b instead of a

also epididymal cysts and bicornuate uterus etc

484
Q

tennis elbow muscle pain

A

extensor carpi radialis brevis

485
Q

golfers elbow muscles

A

flexor carpi ulnaris

486
Q

alternative to thalidomide

A

bortezomib

proteasome inhibitor
inhibits proteins which govern cell cycle progression and NF kappa B activation leading to cell cycle arrest and apoptosis

487
Q

ezetimibe moa

A

NPC1L1 inhibitor
sterol transporter
reduces cholesterol absorption from the gut

488
Q

hypophosphataemic rickets inheritance

A

X linked dominant
PHEX gene - regulates FGF-23 which regulates hydroxylation of vit D and renal PO4 reabsorption

489
Q

renovator with acidosis and hypophosphataemia - osteomalacia symptoms and bloods

A

proximal RTA - lead poisoning

490
Q

primary CNS lymphoma assoc infection

A

EBV

491
Q

roflumilast

A

PDE4 inhibitor - if fail to gain control of COPD on triple inhaled therapy

elevated cAMP levels and mitigates COPD related malfunction of leukocytes etc

492
Q

PSC mx

A

UDO

493
Q

recurrent sinopulmonary or gastrointestinal infections

A

IgA deficiency

494
Q

MG not responding to pred or pyridostigmine

A

azathioprine

495
Q

AD inherited T2DM - normal BMI at diagnosis and long-term control with diet alone

A

glucokinase mutation

496
Q

SLE worse despite hcq and steroids

A

belimumab - inhibits BLyS receptor -> downreg B lymphocyte activity

497
Q

IIH with worsening of headache, papilloedema, D dimer raised

A

venous sinus thrombosis
do an MRV
at high risk

498
Q

penicillin allergy gonorrhoea

A

azithromycin

499
Q

abx not recommended in pregnancy

A

ciprofloxacin

500
Q

CRAO treatment

A

intra-arterial thrombolysis

501
Q

bradycardia and complete HB with very low BP

A

transvenous pacing

502
Q

obeticholic acid moa

A

Farnesoid-X-receptor
leads to itching

503
Q

yersinia enterocolitica treatment

A

quinolones
co-trimoxazole
tetracyclines

504
Q

Graves in pregnancy

A

PTU in early preg
carbimazole later
NO block and replace!

505
Q

hypotension/normotension, hypokalaemia, alkalosis, increased renin, low urinary Ca

A

Gitelmans syndrome

506
Q

lack of blinding can affect

A

type 1 error
false positive - incorrectly rejecting the null hypothesis

507
Q

NASH, unable to lose weight

A

liraglutide

508
Q

which medication should be avoided in gout with urate renal stones

A

lesinurad - URAT1 and OAT4 inhibition -> increased excretion of uric acid -> formation of new stones

509
Q

hypotension assoc with MI
reduced urine output
increased creatinine
increased urinary Na

A

ATN

510
Q

herpes in pregnanc

A

prophylactic aciclovir from 36 weeks onwards

511
Q

bilateral renal artery atheroma, with pulmonary oedema

A

amlodipine
stenting reserved for prog inc in Cr despite adequate BP control

512
Q

severe asthma raised eo and not responsive to therapy

A

mepolizumab

513
Q

omalizumab

A

IgE neutralising - SC for very atopic

514
Q

reverse transcriptase moa

A

generates cDNA from an RNA template

515
Q

main effect of 1,25-OH vitamin D

A

increase absorption of Ca from the GIT during periods when it falls

516
Q

pancytopaenia and evidence of DIC

A

t15:17 APML

517
Q

differentiation of high vs low median nerve injury

A

high - both sensory and motor weakness
low - only motor

518
Q

long QT without cardiac arrest

A

beta blocker

519
Q

metformin primary moa

A

reduces hepatic glucose output

520
Q

dizziness during exercise stress test

A

stop
also ataxia or presyncope

521
Q

mushroom farmer fibrosis

A

EAA
avoid allergen exposure
trichophyton vulgaris and micropolyspora faeni

522
Q

anaemia, coeliac, weight loss + reflux resistant to tx

A

upper GI endoscopy
increased risk of SCC of oesophagus

523
Q

which vein connect RA to coronary sinus

A

small cardiac vein

524
Q

warfarin enzyme

A

vitamin KO reductase (epoxide)

525
Q

RA and preg

A

azathioprine

526
Q

tinea cruris

A

jock itch
topical clotrimazole

527
Q

HOCM mutation

A

myosin-binding protein C

528
Q

VHL inheritance

A

AD

529
Q

persistent anaemia and abdo discomfort related to splenic enlargement in hereditary spherocytosis

A

splenectomy

530
Q

fhx of progressive heart failure and neuropathy

A

familial amyloidosis -> restrictive cardiomyopathy -> biventricular heart failure and elevated JVP rising with inspiration

531
Q

pathophysiology of Grave’s orbitopathy

A

inflammatory infiltration of fat and muscles by lymphocytes etc
build up of water and glycosaminoglycans

532
Q

GPA - failure to respond to steroids and cyclophosphamide

A

rituximab

533
Q

central weakness, features of systemic infection and an abscess from injecting

A

wound botulism

metronidazole
penicillin preferred

534
Q

CF diabetes mx

A

basal bolus insulin and high calorie diet

535
Q

sporadic CJD

A

rapid neuro deterioration - short term memory loss, movement disorder, myoclonus with dystonia

signal intensity in caudate and putamen

EEG periodic wave complexes

CSF 14-3-3 protein

new variant - younger age, slower progression, psychiatric disorder before memory loss, thalamus signal

536
Q

what does MLH1 code for

A

DNA mismatch repair gene

537
Q

Hashimoto ab

A

TPO

538
Q

MODY 5

A

hnf1b
pancreatic atrophy and renal cysts

539
Q

ankylosing spondylitis - failed 2 different NSAIDs

A

anti-TNF eg etanercept and adalimumab

540
Q

avoid what in scleroderma renal crisis

A

prednisolone

541
Q

carbimazole moa

A

thyroid peroxidase inhibition

542
Q

how do corticosteroids work in thyroid storm

A

inhibit T4 to T3 conversion

543
Q

long term intervention for MS which is safe in pregnancy

A

dimethylfumarate

544
Q

GPA mx

A

IV methylpred and cyclophosphamide

545
Q

Liddle syndrome

A

AD
distal tubular sodium reabsorption
mutations in genes on chr 16p12 that encode the B and G subunits of the epithelial sodium channel in the collecting duct

546
Q

acute pericarditis viral cause

A

coxsackie B

547
Q

multiple bowel resections -> renal stones

A

short bowel syndrome
calcium oxalate stones

548
Q

licorice hypermineralocorticoid effects

A

11-B-hydroxysteroid dehydrogenase type 2 inhibition

enzyme responsible for inactivating cortisol

549
Q

which is associated with sensescence

A

cessation of mitosis

550
Q

methaemoglobinaemia pathophys

A

oxidation of Fe2 to 3+

551
Q

sacubitril valsartan ihibits

A

neprilysin

552
Q

recurrent respiratory tract infections who has immunoglobulins in normal range

A

IgG subclass deficiency

553
Q

central retinal haemorrhages

A

VEGF
photocoag centrally causes macular scarring

554
Q

what drives delayed hypoglycaemia associated with alcohol consumption

A

reduced gluconeogenesis

555
Q

bitemporal inferior quadrantanopia

A

Rathke’s pouch - suprasellar - craniopharyngioma

556
Q

calorie intake

A

weight * 22-25
moderate activity x1.5

557
Q

AML good prognosis

A

Karnofsky score >60%
8:21, 16:16
NPM1 CEBPA mutations
MDR-1 negative phenotype

558
Q

X linked disorder leading to skin rash, osteoporosis, abdo pain, neurological dysfunction

A

Fabry disease - alpha-galactosidase deficiency

559
Q

ceramidase deficiency

A

Farber’s disease - lysosomal storage

560
Q

galactocerebrocidase deficiency

A

Krabbe disease
sphingolipidosis
progressive neurological function

561
Q

glucocerebrocidase deficiency

A

Gaucher’s disease
splenomegaly, hepatomegaly, hypersplenism, pancytopenia

562
Q

pioglitazone moa

A

increases insulin sensitivity in muscle and fat

563
Q

esomeprazole

A

is the S isomer

564
Q

MRSA resistance mechanism

A

mutated penicillin binding proteins

565
Q

mycobacterium avium complex tx

A

ethambutol, rifampicin, azithro/clarithromycin

566
Q

FAP ->

A

APC gene
up to 1000 polyps by age 20-30

567
Q

imatinib resistance ->

A

dasatinib

568
Q

hypotension
hyponatraemia
low cortisol

A

pituitary apoplexy

569
Q

tricyclic OD

A

sodium bicarb if QRS >100

570
Q

avascular necrosis gold standard

A

MRI

571
Q

BODE index

A

BMI
obstruction (FEV1)
distance walked in 6 mins
dyspnoEa assessment

572
Q

lack of efficacy of GTN on top of regular nitrate dosing

A

tolerance

573
Q

spontaneous bacterial peritonitis with pen allergy

A

cipro and IV vanc

taz or ceft + metro in non allergic

574
Q

metabolic acidosis
osteomalacia
nephrocalcinosis

A

RTA1

575
Q

why does methanol od cause blindness

A

formation of formic acid crystals within optic nerve

acute - hyperaemia

576
Q

where does granisetron work

A

vagal nerve
CTZ in area postrema
nucleus
nucleus tractus solitaris in brainstem

577
Q

blood in urine in IgA nephro

A

worse if microscopic vs macroscopic

578
Q

primary site of action of spironolactone

A

distal portion of distal tubule

579
Q

sickle cell genotypes

A

SS
SC
AC

580
Q

painless slowly progressive lymphadenopathy with peripheral cyanosis

A

more likely NHL

HL would be younger age and chest discomfort would be present

581
Q

thermoregulation and circadian rhythm nucleus

A

anterior hypothalamic

582
Q

lateral preoptic nucleus

A

nREM sleep

583
Q

paraventricular nucleus of the hypothalamus

A

osmotic balance - vasopressin and oxytocin

same as supraoptic nucleus of the hypothalamus

584
Q

suprachiasmatic nucleus of the hypothalamus

A

circadian primary

585
Q

in which population should you increase thyroxine dose slowly

A

elderly

586
Q

main component of Lewy bodies

A

alpha synuclein

587
Q

Waldenstroms tx

A

rituximab based regimen

588
Q

most strongly associated with risk of future CV events

A

evidence of atherosclerosis affecting more than one vascular bed

589
Q

subclavian line insertion site

A

1cm inferior to the junction of the middle and medial third of the clavicle

590
Q

optimal way to measure rivaroxaban compliance

A

PT

591
Q

most common infectious cause of erythema multiforme

A

HSV

592
Q

mitochondrial disease

A

DI
DM
OA
D
DIDMOAD syndrome
Lebers optic atrophy
mitochondrial myopathy
Leigh syndrome

593
Q

evolocumab

A

PCSK9 inhibitor
prevents LDLR degradation

594
Q

aneurysms causing CN3 palsy

A

ICA
PCA

595
Q

C diff tx

A

oral vanc
oral vanc and IV metro
rifaximin

596
Q

bendroflumethiazide hypoNa

A

increased distal tubular sodium loss

597
Q

pneumococcal meningitis

A

vanc and ceftriaxone

598
Q

elbasvir

A

HCV NS5A

NS5B - dasabuvir
NS3/4A protease - grazoprevir

599
Q

branches of subclavian artery

A

vertebral
internal mammary

L common carotid - aorta
Basilar - vertebral

600
Q

benzbromarone inhibits

A

uric acid reabsorption in the kidney

601
Q

SVCO initial tx

A

stenting

602
Q

gout IL

A

IL1
canakinumab

603
Q

varenicline

A

nicotinic receptor partial agonist

604
Q

moa of Mg in asthma

A

decreased histamine release

605
Q

ivabradine receptor

A

If

606
Q

absent gastric bubble on cxr

A

achalasia

607
Q

reactivation of hsv and pneumonia

A

S pneum

608
Q

severe refractory colitis

A

trial of ciclosporin

609
Q

nintedanib moa

A

tyrosine kinase inhibitor

610
Q
A

MRCP Part 1 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions