MRCP Passmed bits Flashcards

Question

CD95

Answer 1

FAS receptor in apoptosis

Answer 2

CD4, TCR, CD3, CD28

Answer 3

CD8, TCR, CD3, CD28

Answer 4

CD4, CD25, TCR, CD3, CD28

Answer 5

CD19, CD20, CD40, MHC II, B7

Answer 6

CD14, CD40, MHC II, B7

Answer 7

CD16, CD56

Answer 8

Autosomal Dominant

Answer 9

ABL c-MYC n-MYC BCL-2 RET RAS erb-B2 (HER2/neu)

Answer 10

p53 APC BRCA1 BRCA2 NF1 Rb WT1 MTS 1, p16 (multiple tumor suppressor 1)

Answer 11

Fibrillin-1 Due to defect in FBN1 gene on chromosome 15. Autosomal dominant.

Answer 12

L ventricular myocardium

Answer 13

From macrophages. Activates macrophages and neutrophils, Co-stimulator for T cell activation

Answer 14

Examples anti-Ro: Sjogren's syndrome, SLE, congenital heart block anti-La: Sjogren's syndrome anti-Jo 1: polymyositis anti-scl-70: diffuse cutaneous systemic sclerosis anti-centromere: limited cutaneous systemic sclerosis

Answer 15

DMARD used in rheumatoid arthritis. Long half-life and teratogenic. Monitor FBC/LFT and blood pressure

Answer 16

ANA most common anti-Mi-2 most specific

Answer 17

Metabolised to mercaptopurine, a purine analogue that inihibits purine synthesis. TPMT test to check for azathioprine toxicity.

Answer 18

Fleicanide blocks the Nav1.5 sodium channels in the heart Slows the upstroke of cardiac action potential

Answer 19

-vasoconstriction -relaxation of GI smooth muscle -salivary secretion -hepatic glycogenolysis alpha-1:activate phospholipase C → IP3 → DAG

Answer 20

Mainly presynaptic: inhibition of transmitter release (inc NA, Ach from autonomic nerves) -inhibits insulin -platelet aggregation alpha-2: inhibit adenylate cyclase

Answer 21

mainly located in the heart increase heart rate + force beta-1: stimulate adenylate cyclase

Answer 22

-vasodilation -bronchodilation -relaxation of GI smooth muscle beta-2: stimulate adenylate cyclase

Answer 23

lipolysis beta-3: stimulate adenylate cyclase

Answer 24

Monoclonal antibody against the HER2/neu receptor. Used in metastatic breast cancer and some with early disease. S/E: -Flu-like symptoms & diarrhoea -Cardiotoxocity (esp if anthracyclines have been used)

Answer 25

Alpha-1 agonists -phenylephrine Alpha-2 agonists -clonidine Beta-1 agonists -dobutamine Beta-2 agonists -salbutamol Beta-3 agonists -being developed, may have a role in preventing obesity (stimulation causes lipolysis)

Answer 26

Peptidoglycan cross-linking: -penicillins -cephalosporins -carbopenems Peptidoglycan synthesis: -glycopeptides (e.g. vancomycin)

Answer 27

50S subunit: - Macrolides (clarithromycin, azithromycin, erythromycin) - Chloramphenicol - Clindamycin - Linezolid - Streptogrammins 30S subunit: - aminoglycosides - tetracyclines

Answer 28

quinolones (eg ciprofloxacin)

Answer 29

metronidazole

Answer 30

sulphonamides trimethoprim

Answer 31

rifampicin

Answer 32

Long-acting analogue of somatostatin Uses: - acute variceal haemorrhage - acromegaly - carcinoid syndrome - prevent complications following pancreatic surgery - VIPomas - refractory diarrhoea Adverse effects: -gallstones (secondary to biliary stasis)

Answer 33

Release from D cells of pancreas Inhibits release of growth hormone, glucagon and insulin

Answer 34

infliximab = anti-TNF used in rheumatoid arthritis and Crohn's

Answer 35

rituximab = anti-CD20 used in non-Hodgkin's lymphoma and rheumatoid arthritis

Answer 36

cetuximab = epidermal growth factor receptor antagonist used in metastatic colorectal cancer & head and neck cancer

Answer 37

alemtuzumab = anti-CD52 used in chronic lymphocytic leukaemia

Answer 38

abciximab = glycoprotein IIb/IIIa receptor antagonist prevention of ischaemic events in patients undergoing percutaneous coronary interventions

Answer 39

OKT3 = anti-CD3 used to prevent organ rejection

Answer 40

Contraindicated in structural heart disease

Answer 41

-isoniazid -procainamide -hydralazine -dapsone -sulfasalazine

Answer 42

-amiodarone -indomethacin

Answer 43

-ethambutol -amiodarone -metronidazole

Answer 44

-chloroquine, quinine

Answer 45

-blue discoloration -non-arteritic anterior ischaemic neuropathy

Answer 46

-antiepileptics: phenytoin carbamazepine -barbiturates -rifampicin -St John's Wort -chronic alcohol intake -griseofulvin -smoking

Answer 47

-antibiotics: ciprofloxacin, erythromycin -isoniazid -cimetidine, omeprazole -amiodarone -allopurinol -imidazoles: ketoconazole, fluconazole -SSRIs -ritonavir -sodium valproate -acute alcohol intake -quinipristin

Answer 48

Immunosuppressant. Inhibits calcineurin, which reduces IL-2 release, and therefore decreases clonal proliferation of T cells. Adverse effects: -nephrotoxicity -hepatotoxicity -fluid retention -hyperkalaemia -hypertrochosis -givival hyperplasia

Answer 49

Alpha antagonists: -alpha-1: doxazosin -alpha-1a: tamsulosin - acts mainly on urogenital tract -alpha-2: yohimbine -non-selective: phenoxybenzamine (previously used in peripheral arterial disease) Beta antagonists -beta-1: atenolol -non-selective: propranolol Carvedilol and labetalol are mixed alpha and beta antagonists

Answer 50

Nivolumab (PD-1 inhibitor) "programmed cell death" inhibitor

Answer 51

Inhibits Na+/K+ ATPase pump. Also stimulates vagus nerve. Acts to increase force of contraction Also slows AV conduction

Answer 52

Live attenuated: -BCG -MMR -influenza (intranasal) -oral rotavirus -oral polio -yellow fever -oral typhoid

Answer 53

Inactivated preparations: -rabies -hepatitis A -influenza (intramuscular)

Answer 54

Toxoid (inactivated toxin): -tetanus -diphtheria -pertussis

Answer 55

Subunit = only part of pathogen used to generate immunogenic response. Conjugate = poorly immunogenic bacterial polysaccharides linked to more immunogenic proteins -pneumococcus (conjugate) -haemophilus (conjugate) -meningococcus (conjugate) -hepatitis B -human papillomavirus

Answer 56

IV cefotaxime + amoxicillin

Answer 57

IV cefotaxime

Answer 58

IV cefotaxime + amoxicillin

Answer 59

IV benzylpenicillin or cefotaxime

Answer 60

IV cefotaxime

Answer 61

IV cefotaxime

Answer 62

IV amoxicillin + gentamicin

Answer 63

chloramphenicol

Answer 64

Bactericidal antibiotics: -penicillins -cephalosporins -aminoglycosides -nitrofurantoin -metronidazole -quinolones -rifampicin -isoniazid

Answer 65

Bacteriostatic antibiotics: -chloramphenicol -macrolides -tetracyclines -sulphonamides -trimethoprim

Answer 66

Surface antigen. First maker to appear. Causes production of anti-HBs HBsAg normally implies acute disease ( present 1-6 months) It present >6 months implies chronic disease (ie infective)

Answer 67

Anti-HBs implies immunity (either exposure or immunisation) Negative in chronic disease

Answer 68

Anti-HBc implies previous (or current) infection IgM anti-HBc appears during acute or recent infection and is present for about 6 months. IgG anti-HBc persists

Answer 69

HBeAg results from breakdown of core antigen from infected liver cells - therefor is a marker of infectivity

Answer 70

anti-HBs positive All others negative

Answer 71

anti-HBc positive HBsAg negative

Answer 72

anti-HBc positive, HBsAg positive

Answer 73

Ia: Block sodium channels, Increases AP duration -Quinidine -Pocainamide -Disopyramide

Answer 74

Ib: Block sodium channels, Decreases AP duration -Lidocaine

Answer 75

Ic: Block sodium channels, No effect on AP duration - Fleicanide

Answer 76

II: Beta-adrenoceptor antagonists -Propranolol -Atenolol -Bisporolol -Metoprolol

Answer 77

III: Block potassium channels -Amiodarone -Sotalol

Answer 78

IV: Calcium channel blockers -Verapamil -Diltiazem

Answer 79

-Hepatitis A -Hepatitis B -Haemophilus influenzae B (Hib) -Influenza - parenteral -Japanese encephalitis -Meningococcus-MenC -Meningococcus-PPV23 -Poliomyelitis - parenteral (IPV) -Rabies -Tetanus-Diptheria (Td)

Answer 80

-MMR -Varicella -Yellow Fever

Answer 81

-Cholera CVD103-HgR -Influenza - intranasal -Poliomyelitis - oral (OPV) - Tuberculosis (BCG)

Answer 82

gram-negative bacterium Burkholderia pseudomallei Diabetes is strongest risk factor Treatment: IV ceftazidime, imipenem or meropenem

Answer 83

Antiviral used in chronic hepatitis B infection. Thymidine nucleoside analogue

Answer 84

Caused by dog tapeworm Echinococcus granulosis Management: albendazole

Answer 85

Caused by Taenia solium (from pork) and Taenia saginata (from beef) Management: niclosamide

Answer 86

Ancylostoma braziliense Strongyloides stercoralis Toxocara canis

Answer 87

Commonest cause of cutaneous larva migrans Central + Southern America

Answer 88

Acquired percutaneously Causes pruritis + llarva currens Management: -Thiabendazole, albendazole -Ivermectin in chronic infection

Answer 89

Dog faeces Commonest cause of visceral larva migrans

Answer 90

2 weeks prior to operation if elective Hib, meningitis A&C Annual influenza vaccination Pneumococcal vaccine every 5 years Penicillin V: at least 2 years/at least until 16yo/lifelong

Answer 91

ABCD L -Actinomyces -Bacillus anthracis -Clostridium -Diptheria (corynebacterium diphteriae) -Listeria monocytogenes

Answer 92

-Neisseria meningitidis -Neisseria gonorrhoeae -Moraxella catarrhalis

Answer 93

Chagas disease Early periorbital oedema. GI and cardiac effects Management: azole/benznidazole or nifurtimox

Answer 94

Sleeping sickness - Ttetse fly Trypanosoma gambiense in West Africa Trypanosomar rhodiuenses in East Africa -Trypanosoma chancre - painless at site of infection -Fever + lymphadenopathy Management: -Early: IV pentamidine or suramin -Later/CNS involvment: IV melarsoprol

Answer 95

Used in non-falciparum malaria to destroy liver hypnozoites and prevent relapse Check for G6PD deficiency prior to administration

Answer 96

Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, Plasmodium knowlesis Management: - Artemisinin-based combination therapy (ACT) -Chloroquine -Ovale + Vivax: Primaquine after acute treatment. Destroys liver hyponozoites and prevent relapse

Answer 97

Triple therapy: Rifampicin, dapsone and clofazimine

Answer 98

IV amoxicillin/ampicillin + gentamicin

Answer 99

Azithromycin (stat) or doxycycline (7 days)

Answer 100

Entamoeba histolytica. Spread by faecal-oral route. Causes Amoebic dysentery or Amoebic liver abscess

Answer 101

'hot stool' miscroscopy may show trophozoites serology Treat invasive amoebiasis with metronidazole. Followed by luminal amoebicide to eradicate cystic stage (diloxanide furoate)

Answer 102

Klebsiella granulomatis

Answer 103

-Group B streptococcus (most common in neonates) -E.coli -Listeria monocytogenes

Answer 104

-Neisseria meningitidis -Strep pneumoniae -Haemophilus influenzae

Answer 105

-Neisseria meningitidis -Streptococcus pneumoniae

Answer 106

-Strep pneumoniae -Neisseria meningitidis -Listeria monocytogenes

Answer 107

-Listeria monocytogenes

Answer 108

Polymicrobial. Most commonly isolated organism is Pasteurella multocida Co-amoxiclav Pen allergic: doxycycline + metronidazole

Answer 109

From sheep or goats Parapox virus Hands/arms: small papule > flat -topped and haemorrhagic

Answer 110

Fungal nail infection. Taken orally. Inhibits fungal enzyme squalene epoxidase. Causing cell death.

Answer 111

Serological tests include: Cardiolipin tests (not treponeme specific) Treponemal-specific antibody tests

Answer 112

VDRL and RPR Insensitive in late syphilis Become negative after treatment

Answer 113

TPHA (Treponema palidum HaemAgglutinin test) Remains positive after treatment

Answer 114

-pregnancy -SLE, anti-phospholipid syndrome -TB -leprosy -malaria -HIV

Answer 115

Nevirapine (NNRTI) - induces P450 Protease inhibitors - inhibit P450

Answer 116

Oral ciprofloxacin or rifampicin

Answer 117

co-amoxiclav or cefuroxime

Answer 118

piperacillin with tazobactam OR broad-spectrum cephalosporin (ceftazidime) OR quinolone (ciprofloxacin)

Answer 119

-maraviroc -enfurvitide

Answer 120

-zidovudine -didanosine -lamivudine -tenofovir

Answer 121

-nevirapine -efavirenze

Answer 122

-indinavir -nelfinavir -ritonavir -saquinavir

Answer 123

-raltegravir

Answer 124

single oral dose of praziquantel

Answer 125

Initial phase - 2 months of RIPE Continuation phase - 4 months f Rifampicin and Isoniazide

Answer 126

3 months of isoniazid (with pyridoxine) and rifampicin OR 6 months of isoniazid (with pyridoxine)

Answer 127

Animals and unpasteurised diary. Fluctuating fever, transient arthralgia, hyperhydrosis with wet hay smell. Treat: Doxycycline and streptomycin

Answer 128

Strep pneumoniae Haemophilus influenzae Neisseria gonorrhoeae

Answer 129

Strep pyogenes

Answer 130

Haemophilus influenzae

Answer 131

Corynebacterium diptheriae

Answer 132

Bacillus anthracis Clostridium perfringens Clostridium tetani

Answer 133

Clostridium perfringens

Answer 134

Bacillus anthracis

Answer 135

Listeria monicytogenes

Answer 136

power = 1 - the probability of a type II error

Answer 137

The null hypothesis is rejected when it is true

Answer 138

The null hypothesis is accepted when it is false

Answer 139

-angiotensin II -ADH -hypoxia -mechanical shearing force

Answer 140

-nitric oxide -prostacyclin

Answer 141

Autosomal dominant

Answer 142

Nematode (roundworm) Cestodes (tapeworms) Trematodes (flukes)

Answer 143

Strongyloides stercoralis Enterobius vermicularis Hookworm (Ancylosoma duodenale, Necator americanus) Loa loa Trichinella spiralis Onchocerca volvulus Wuchereria bancrofti Toxocara canis (dog roundworm) Ascaris lumbricoides (giant roundworm)

Answer 144

Echinococcus granulosus Taenia solium

Answer 145

Schistoma haematobium Paragonimus westermani Clonorchis sinensis Fasciola hepatica (liver fluke)

Answer 146

Disease caused by Taenia solium. Undercooked pork. Swiss cheese appearance brain lesions Bendazoles

Answer 147

Autosomal dominant Fibroblast growth factor receptor 3 gene (FGFR-3). Abnormal cartilage

Answer 148

X-linked recessive

Answer 149

Neonates and small children

Answer 150

Children or adults 30-50kg (up to 20ml air in cuff)

Answer 151

adults 50-70kg (up to 30ml of air in the cuff)

Answer 152

adults 70-100kg (up to 40ml of air in the cuff)

Answer 153

PPV = True Positive / (True Positive + False Positive)

Answer 154

Non-parametric test Unpaired data

Answer 155

Non-parametric test Correlation

Answer 156

Non-parametric test Compares wo sets of observations on a signle sample

Answer 157

Non-parametric test Used to compare proportions of percentages

Answer 158

Student's t-test: paired on unpaired Pearson's product-moment coefficient - correlation

Answer 159

-heredirary angioedema -C1-INH = serine protease inhibitor=likely due to bradykinin release

Answer 160

(classical pathway components) -predisposes to immune complex disease -SLE, HSP

Answer 161

Recurrent bacterial infections

Answer 162

-predisposes to Leiner disease -recurrent diarrhoea, wasting and seborrhoeic dermatitis

Answer 163

-encodes MAC -prone to Neisseria meningitis infection

Answer 164

NNT = 1 / Absolute Risk Reduction ARR = Experimental event RATE - control event RATE (or vice versa if outcome of study is undesirable) (Risk = event asked about, eg can be survival)

Answer 165

SEM = standard deviation / square root (number of patients)

Answer 166

Anaphylaxis Atopy Antigen reacts with IgE bound to mast cells

Answer 167

Cell bound IgG or IgM binds to antigen on cell surface -Autoimmune haemolytic anaemia -IT -Goodpasture's -Pernicious aneamia -Acute haemlytic transfusion reactions -Rheumatic fever -Phemphgus vulgaris/bullous pemphigoid

Answer 168

Free antigen and antibody combine - Serum sickness -SLE -Post-streptococcal glomerulonephritis -EEA (acute phase)

Answer 169

T-cell mediated -TB/tuberculin skin reaction -GVHD -Allergic contact dermatitis -Scabies -EEA (chronic phase) -MS -Guillain-Barre syndrome

Answer 170

Antibodies recognise and bind to cell surface receptors. Stimulate receptors or block ligand binding -Graves' disease -Myasthenia gravis

Answer 171

(C5 - C7) Elbow flexion (supplies biceps brachii) Supination

Answer 172

(C5, C6) Should abduction (deltoid muscle)

Answer 173

(C5 - C8) Extension: forearm, wrist, fingers, thumb

Answer 174

(C6, C8, T1) LOAF muscles Wrist lesion > paralysis of thenar muscles, opponens pollicis Elbow lesion > loss of pronation and weak wrist flexion

Answer 175

(C8, T1) Intrinsic hand muscles except LOAF Wrist flexion

Answer 176

(C5 - C7) Serratus anterior

Answer 177

68.3% of values within 1 SD of the mean 95.4% of values within 2 SD of the mean 99.7% of values within 3 SD of the mean Within 1.96 SD of the mean lie 95% of sample values

Answer 178

Gram-negative obligate itracellular parasites. Rickettsia Ricketsii - Rocky Mountain spotted fever Coxiella burnetti - Q fever Rickettsia typhi - Endemic typhus Rickettsia prowazekii - Epidemic typhus Ehrlichia - Ehrlichliosis

Answer 179

Rickettsia ricketsii Tick-borne East coast of US Headache, fever and rash spreading centrally from peripheries.

Answer 180

Coxiella burnetti No vector Pneumonia, no rash.

Answer 181

Rickettsia typhi. Spread by flea. Rash starts centrally then spread to peripheries.

Answer 182

Rickettsia prowazekii Via human body louse

Answer 183

Ehrlichia Tick-borne

Answer 184

Metabolic conditions Exceptions: inherited ataxias

Answer 185

Structural conditions Exceptions: - Gilbert's -hyperlipidaemia type II

Answer 186

Mitochondrial inheritance -Onset < 20 years old -external opthalmoplegia -retinits pigmentosa

Answer 187

The chance that the patient has the condition if the diagnostic test is positive TP / (TP + FP)

Answer 188

The chance that the patient does not have the condition if the test is negative TN / (TN + FN)

Answer 189

Proportion of patients with the condition who have a positive test result TP / (TP + FN)

Answer 190

Proportion of patients without the condition who have a negative test result TN / (TN + FP)

Answer 191

How much the odds of the disease increase when a test is positive sensitivity / (1 - specificity)

Answer 192

How much the odds of the disease decrease when a test is negative (1 - sensitivity) / specificity

Answer 193

Lysosomal storage disease Hexosaminidase A -developmental delay -cherry red spots on macula -without hepatosplenomegaly

Answer 194

Lysosomal storage disease Defect in Beta-glucocerebrosidase -hepatosplenomegaly -aseptic necrosis of the femur

Answer 195

Lysosomal storage disease defect in Sphingomyelinase -hepatosplenomegaly -cherry red spot on macula

Answer 196

Lysosomal storage disease alpha-galactosidase A -angiokeratomas -peripheral neuropathy of extremeties -renal failure

Answer 197

Lysosomal storage disease galactocerebrosidase -peripheral neuropathy -optic atrophy -globoid cells

Answer 198

Lysosomal storage disease Arylsulfatase A -demyelination of CNS + PNS

Answer 199

Mucopolysaccharidosis type 1 alpha-1-idurnidase -gargoylism -hepatosplenomegaly -corneal clouding

Answer 200

Mucopolysaccharidosis type 1 iduronate sulfatase -course facial features -learning difficulty -short stature -no corneal clouding

Answer 201

Glycogen storage disease type I Glucose-6-phosphatase Hypoglycaemia Lactic acidosis Hepatomegaly

Answer 202

Glycogen storage disease type II Lysosomal alpha-1,4-glucosidase Cardiomegaly

Answer 203

Glycogen storage disease type III Alpha-1,6-glucosidase Muscle hypotonia

Answer 204

Glycogen storage disease type III Glycogen phosphorylase Myalgia Myoglobinuria with exercise

Answer 205

- bone marrow depression - nausea/vomiting - pancreatitis - increased risk non-melanoma skin cnacer