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MRCP Passmed bits Flashcards

1
Q

Dithranol

A

Topical use in psoriasis

Anthracene derivative
Slows cell division in psoriatic plaques

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2
Q

Vitamin D analogues
(for psoriasis)

A

Include:
- calcipotriol (Dovonex)
- calcitriol
- tacalcitol

Work by reducing cell division and differentiation

May be used long-term

Reduce scale and thickness of plaques but not erythema

Avoid in pregnancy

Maximum weekly amount for adults is 100g

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3
Q

Zinc deficiency

A

Zinc deficiency:

-Perioral dermatitis
-acrodermatitis
-alopecia
-short stature
-hypogonadism
-hepatosplenomegaly
-geophagia (ingesting clay/soil)
-cognitive impairment

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4
Q

Gastric cancer associations

A

-H. pylori infection
-blood group A: gAstric cAncer
-gastric adenomatous polyps
-pernicious anaemia
-smoking
-diet: salty, spicy, nitrates
-may be negatively associated with duodenal ulcer

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5
Q

HLA-A3

A

Haemochromatosis

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6
Q

HLA-B51

A

Behcet’s disease

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7
Q

HLA-B27

A
  • Ankylosing spondylitis
  • Reiter’s syndrome
  • Acute anterior uveitis
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8
Q

HLA-DQ2/DQ8

A

coeliac disease

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9
Q

HLA-DR2

A

-Narcolepsy
-Multiple sclerosis
-SLE
-Goodpasture’s

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10
Q

HLA-DR3

A

-Dermatitis herpetiformis
-Sjogren’s syndrome
-Primary biliary cirrhosis

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11
Q

HLA-DR4

A

-Type 1 diabetes mellitis (also with HLA-DR3 to a lesser degree)

-Rheumatoid arthritis - in particular DRB1 (DRB104:01 and DRB104:04)

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12
Q

CD1

A

MHC molecule - presents lipids

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13
Q

CD2

A

Thymocytes, T cells, NK cells

Ligand for CD58 and CD59

Cell signalling and cell adhesion

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14
Q

CD3

A

Signalling component of TCR complex

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15
Q

CD4

A

Helper T cells.
Co-receptor for MHC II
Used by HIV to enter T cells

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16
Q

CD5

A

Mantle-cell lymphoma

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17
Q

CD8

A

Cytotoxic T cells.

Co-receptor for MHC I

(Also on myeloid dendritic cells)

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18
Q

CD14

A

Marker for macrophages

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19
Q

CD15

A

Expressed on Reed-Sternberg cells (along with CD30)

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20
Q

CD16

A

Binds to Fc portion of IgG

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21
Q

CD21

A

EBV receptor

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22
Q

CD28

A

Interacts with B7 on APCs as costimulation signal

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23
Q

CD45

A

Protein tyrosine phosphatase

All leucocytes

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24
Q

CD56

A

Unique to NK cells

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25
Q

CD95

A

FAS receptor in apoptosis

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26
Q

Cell surface markers: Haematopoeietic stem cells

A

CD34

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27
Q

Cell surface markers: Helper T cell

A

CD4, TCR, CD3, CD28

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28
Q

Cell surface markers: Cytotoxic T cell

A

CD8, TCR, CD3, CD28

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29
Q

Cell surface markers: Regulatory T cell

A

CD4, CD25, TCR, CD3, CD28

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30
Q

Cell surface markers: B cell

A

CD19, CD20, CD40, MHC II, B7

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31
Q

Cell surface markers: Macrophage

A

CD14, CD40, MHC II, B7

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32
Q

Cell surface markers: Natural killer cell

A

CD16, CD56

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33
Q

Inheritence of Hereditary Haemorrhagic Telagiectasia

A

Autosomal Dominant

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34
Q

Oncogenes (gain of function > cancer)

A

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

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35
Q

Tumour suppressor genes (loss of function > cancer)

A

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

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36
Q

Abnormal protein in Marfan’s syndrome

A

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

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37
Q

Site of origin of circulating B-type natriuretic peptide in patients with chronic heart failure

A

L ventricular myocardium

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38
Q

TNF

A

From macrophages.

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

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39
Q

Extractable nuclear antigens

A

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

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40
Q

Leflunomide

A

DMARD used in rheumatoid arthritis.

Long half-life and teratogenic.

Monitor FBC/LFT and blood pressure

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41
Q

Dermatomyositis antibodies

A

ANA most common

anti-Mi-2 most specific

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42
Q

Azathioprine: mechanism of action

A

Metabolised to mercaptopurine, a purine analogue that inihibits purine synthesis.

TPMT test to check for azathioprine toxicity.

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43
Q

Fleicanide mechanism of action

A

Fleicanide blocks the Nav1.5 sodium channels in the heart

Slows the upstroke of cardiac action potential

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44
Q

Alpha-1 adrenoceptor effects

A

-vasoconstriction
-relaxation of GI smooth muscle
-salivary secretion
-hepatic glycogenolysis

alpha-1:activate phospholipase C → IP3 → DAG

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45
Q

Alpha-2 adrenoceptor

A

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

alpha-2: inhibit adenylate cyclase

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46
Q

Beta-1 adrenoceptor

A

mainly located in the heart
increase heart rate + force

beta-1: stimulate adenylate cyclase

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47
Q

Beta-2 adrenoceptor

A

-vasodilation
-bronchodilation
-relaxation of GI smooth muscle

beta-2: stimulate adenylate cyclase

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48
Q

Beta-3 adrenoceptor

A

lipolysis

beta-3: stimulate adenylate cyclase

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49
Q

Trastuzumab (Herceptin)

A

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)

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50
Q

Examples of adrenoceptor AGONISTs

A

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)

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51
Q

Inhibits cell wall formation

A

Peptidoglycan cross-linking:
-penicillins
-cephalosporins
-carbopenems

Peptidoglycan synthesis:
-glycopeptides (e.g. vancomycin)

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52
Q

Inhibits protein synthesis (by acting on the ribosome)

A

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

30S subunit:
- aminoglycosides
- tetracyclines

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53
Q

Inhibits DNA synthesis

A

quinolones (eg ciprofloxacin)

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54
Q

Damages DNA

A

metronidazole

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55
Q

Inhibits folic acid formation

A

sulphonamides

trimethoprim

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56
Q

Inhibits RNA synthesis

A

rifampicin

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57
Q

Octreotide
What is it?
Uses?
Adverse effects?

A

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)

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58
Q

Somatostatin:
Released from?
Actions?

A

Release from D cells of pancreas

Inhibits release of growth hormone, glucagon and insulin

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59
Q

infliximab

A

infliximab = anti-TNF

used in rheumatoid arthritis and Crohn’s

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60
Q

rituximab

A

rituximab = anti-CD20

used in non-Hodgkin’s lymphoma and rheumatoid arthritis

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61
Q

cetuximab

A

cetuximab = epidermal growth factor receptor antagonist

used in metastatic colorectal cancer & head and neck cancer

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62
Q

alemtuzumab

A

alemtuzumab = anti-CD52

used in chronic lymphocytic leukaemia

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63
Q

abciximab

A

abciximab = glycoprotein IIb/IIIa receptor antagonist

prevention of ischaemic events in patients undergoing percutaneous coronary interventions

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64
Q

OKT3

A

OKT3 = anti-CD3

used to prevent organ rejection

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65
Q

Fleicanide

A

Contraindicated in structural heart disease

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66
Q

Drugs affected by acetylator status (deficiency in N-acetyltransferase)

A

-isoniazid
-procainamide
-hydralazine
-dapsone
-sulfasalazine

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67
Q

Drugs causing corneal opacities

A

-amiodarone
-indomethacin

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68
Q

Drugs causing optic neuritis

A

-ethambutol
-amiodarone
-metronidazole

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69
Q

Drugs causing retinopathy

A

-chloroquine, quinine

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70
Q

Drugs causing cataracts

A

steroids

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71
Q

Sildenafil eye effects

A

-blue discoloration
-non-arteritic anterior ischaemic neuropathy

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72
Q

P450 inducers

A

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

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73
Q

P450 inhibitors

A

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

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74
Q

Ciclosporin: moa + side effects

A

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

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75
Q

Examples of adrenoceptor ANTAGONISTS

A

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

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76
Q

Nivolumab

A

Nivolumab (PD-1 inhibitor)
“programmed cell death” inhibitor

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77
Q

Digoxin

A

Inhibits Na+/K+ ATPase pump.
Also stimulates vagus nerve.

Acts to increase force of contraction

Also slows AV conduction

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78
Q

Live attenuated vaccines

A

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

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79
Q

Inactivated vaccines

A

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

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80
Q

Toxoid (inactivated toxin) vaccines

A

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

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81
Q

Subunit/comjugate vaccines

A

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

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82
Q

Meningitis initial empirical therapy aged <3 months?

A

IV cefotaxime + amoxicillin

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83
Q

Meningitis - initial empirical therapy aged 3 months - 50 years?

A

IV cefotaxime

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84
Q

Meningitis - initial empirical therapy aged > 50 years?

A

IV cefotaxime + amoxicillin

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85
Q

Meningococcal meningitis - therapy?

A

IV benzylpenicillin or cefotaxime

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86
Q

Pneumococcal meningitis - therapy?

A

IV cefotaxime

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87
Q

Meningitis caused by Haemophilus influenzae - therapy?

A

IV cefotaxime

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88
Q

Meningitis caused by Listeria - therapy?

A

IV amoxicillin + gentamicin

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89
Q

Meningitis - patient with allergy to penicillin/cephalosporins?

A

chloramphenicol

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90
Q

Bactericidal antibiotics

A

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

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91
Q

Bacteriostatic antibiotics

A

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

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92
Q

HBsAg

A

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)

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93
Q

Anti-HBs

A

Anti-HBs implies immunity (either exposure or immunisation)

Negative in chronic disease

94
Q

Anti-HBc

A

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

95
Q

HBeAg

A

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

96
Q

Serology previous Hep B immunisation

A

anti-HBs positive

All others negative

97
Q

Serology pervious Hep B > 6 months ago, not a carrier

A

anti-HBc positive

HBsAg negative

98
Q

Serology Previous hepatitis B, now a carries

A

anti-HBc positive,
HBsAg positive

99
Q

Vaughan Williams Ia

A

Ia: Block sodium channels, Increases AP duration

-Quinidine
-Pocainamide
-Disopyramide

100
Q

Vaughan Williams Ib

A

Ib: Block sodium channels, Decreases AP duration

-Lidocaine

101
Q

Vaughan Williams Ic

A

Ic: Block sodium channels, No effect on AP duration

  • Fleicanide
102
Q

Vaughan Williams II

A

II: Beta-adrenoceptor antagonists

-Propranolol
-Atenolol
-Bisporolol
-Metoprolol

103
Q

Vaughan Williams III

A

III: Block potassium channels

-Amiodarone
-Sotalol

104
Q

Vaughan Williams IV

A

IV: Calcium channel blockers

-Verapamil
-Diltiazem

105
Q

Vaccines that can be used in all HIV-infected adults

A

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

106
Q

Vaccines that can be used in HIV if CD4 > 200

A

-MMR
-Varicella
-Yellow Fever

107
Q

Vaccines contraindicated in HIV-infected adults

A

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

108
Q

Meliodosis (Whitmore’s Disease)

A

gram-negative bacterium Burkholderia pseudomallei

Diabetes is strongest risk factor

Treatment:
IV ceftazidime, imipenem or meropenem

109
Q

Telbivudine

A

Antiviral used in chronic hepatitis B infection.

Thymidine nucleoside analogue

110
Q

Hydatid disease

A

Caused by dog tapeworm Echinococcus granulosis

Management: albendazole

111
Q

Cystercosis

A

Caused by Taenia solium (from pork) and Taenia saginata (from beef)

Management: niclosamide

112
Q

Nematodes

A

Ancylostoma braziliense

Strongyloides stercoralis

Toxocara canis

113
Q

Acylostoma braziliense

A

Commonest cause of cutaneous larva migrans

Central + Southern America

114
Q

Strongyloides stercoralis

A

Acquired percutaneously

Causes pruritis + llarva currens

Management:
-Thiabendazole, albendazole
-Ivermectin in chronic infection

115
Q

Toxicara canis

A

Dog faeces

Commonest cause of visceral larva migrans

116
Q

Splenectomy vaccination

A

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

117
Q

Gram positive bacilli

A

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

118
Q

Gram-negative cocci

A

-Neisseria meningitidis
-Neisseria gonorrhoeae
-Moraxella catarrhalis

119
Q

American trypanosomiasis

A

Chagas disease

Early periorbital oedema.
GI and cardiac effects

Management: azole/benznidazole or nifurtimox

120
Q

African Trypanosomiasis

A

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

121
Q

Primaquine

A

Used in non-falciparum malaria to destroy liver hypnozoites and prevent relapse

Check for G6PD deficiency prior to administration

122
Q

Non-falciparum Malaria

A

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

123
Q

Leprosy treatment

A

Triple therapy:
Rifampicin, dapsone and clofazimine

124
Q

Listeria meningitis treatment

A

IV amoxicillin/ampicillin + gentamicin

125
Q

Chlamydia treatment

A

Azithromycin (stat) or doxycycline (7 days)

126
Q

Amoebiasis

A

Entamoeba histolytica.

Spread by faecal-oral route.

Causes Amoebic dysentery or Amoebic liver abscess

127
Q

Amoebiasis diagnosis and treatment

A

‘hot stool’ miscroscopy may show trophozoites

serology

Treat invasive amoebiasis with metronidazole.

Followed by luminal amoebicide to eradicate cystic stage (diloxanide furoate)

128
Q

granuloma inguinale causative organism

A

Klebsiella granulomatis

129
Q

Meningitis causes 0-3 months

A

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

130
Q

Meningitis causes 3 months - 6 years

A

-Neisseria meningitidis
-Strep pneumoniae
-Haemophilus influenzae

131
Q

Meningitis causes 6 years - 6- years

A

-Neisseria meningitidis
-Streptococcus pneumoniae

132
Q

Meningitis causes > 60 years

A

-Strep pneumoniae
-Neisseria meningitidis
-Listeria monocytogenes

133
Q

Meningitis causes in immunosuppressed

A

-Listeria monocytogenes

134
Q

Animal bites

A

Polymicrobial.
Most commonly isolated organism is Pasteurella multocida

Co-amoxiclav
Pen allergic: doxycycline + metronidazole

135
Q

Orf

A

From sheep or goats

Parapox virus

Hands/arms: small papule > flat -topped and haemorrhagic

136
Q

Terbinafine

A

Fungal nail infection. Taken orally.

Inhibits fungal enzyme squalene epoxidase. Causing cell death.

137
Q

Syphilis testing

A

Serological tests include:

Cardiolipin tests (not treponeme specific)

Treponemal-specific antibody tests

138
Q

Syphilis cardiolipin tests

A

VDRL and RPR

Insensitive in late syphilis

Become negative after treatment

139
Q

Treponemal specific antibiody tests

A

TPHA (Treponema palidum HaemAgglutinin test)

Remains positive after treatment

140
Q

Causes of false positive cardiolipin tests

A

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

141
Q

HIV anti-retrovirals which interact with P450

A

Nevirapine (NNRTI) - induces P450

Protease inhibitors - inhibit P450

142
Q

Meningococcal meningitis contact management

A

Oral ciprofloxacin or rifampicin

143
Q

Hospital acquired pneumonia < 5 days since admission

A

co-amoxiclav or cefuroxime

144
Q

Hospital acquired pneumonia > 5 days since admission

A

piperacillin with tazobactam

OR broad-spectrum cephalosporin (ceftazidime)

OR quinolone (ciprofloxacin)

145
Q

entry inhibitors

A

-maraviroc
-enfurvitide

146
Q

NRTIs

A

-zidovudine
-didanosine
-lamivudine
-tenofovir

147
Q

NNRTIs

A

-nevirapine
-efavirenze

148
Q

PIs

A

-indinavir
-nelfinavir
-ritonavir
-saquinavir

149
Q

Integrase inhibitors

A

-raltegravir

150
Q

Schistosoma haematobium treatment

A

single oral dose of praziquantel

151
Q

Treatment of active tuberculosis

A

Initial phase - 2 months of RIPE

Continuation phase - 4 months f Rifampicin and Isoniazide

152
Q

Treatment for latent tuberculosis

A

3 months of isoniazid (with pyridoxine) and rifampicin

OR

6 months of isoniazid (with pyridoxine)

153
Q

Brucellosis

A

Animals and unpasteurised diary.

Fluctuating fever, transient arthralgia, hyperhydrosis with wet hay smell.

Treat: Doxycycline and streptomycin

154
Q

Organisms with IgA protease

A

Strep pneumoniae
Haemophilus influenzae
Neisseria gonorrhoeae

155
Q

Organisms with M Protein

A

Strep pyogenes

156
Q

Organisms with Polyribosyl ribitol phosphate capsule

A

Haemophilus influenzae

157
Q

Organisms with bacteriophage

A

Corynebacterium diptheriae

158
Q

Organisms with spore formation

A

Bacillus anthracis
Clostridium perfringens
Clostridium tetani

159
Q

Lecithinase alpha toxin

A

Clostridium perfringens

160
Q

D-glutamate polypeptide capsule

A

Bacillus anthracis

161
Q

Actin rockets

A

Listeria monicytogenes

162
Q

Power of a study

A

power = 1 - the probability of a type II error

163
Q

Type I error

A

The null hypothesis is rejected when it is true

164
Q

Type II error

A

The null hypothesis is accepted when it is false

165
Q

Promote release of endothelin

A

-angiotensin II
-ADH
-hypoxia
-mechanical shearing force

166
Q

Inhibit release of endothelin

A

-nitric oxide
-prostacyclin

167
Q

Familial hypercholesterolaemia

A

Autosomal dominant

168
Q

Types of helminth

A

Nematode (roundworm)

Cestodes (tapeworms)

Trematodes (flukes)

169
Q

Nematodes

A

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)

170
Q

Tapeworms

A

Echinococcus granulosus

Taenia solium

171
Q

Flukes

A

Schistoma haematobium

Paragonimus westermani

Clonorchis sinensis

Fasciola hepatica (liver fluke)

172
Q

Cystercosis

A

Disease caused by Taenia solium.

Undercooked pork.

Swiss cheese appearance brain lesions

Bendazoles

173
Q

Achondroplasia

A

Autosomal dominant

Fibroblast growth factor receptor 3 gene (FGFR-3).

Abnormal cartilage

174
Q

G6PD deficiency

A

X-linked recessive

175
Q

LMA size 1 and 2

A

Neonates and small children

176
Q

LMA size 3

A

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

177
Q

LMA size 4

A

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

178
Q

LMA size 5

A

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

179
Q

Positive predictive value

A

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

180
Q

Mann-Whitney U test

A

Non-parametric test
Unpaired data

181
Q

Spearman, Kendall rank

A

Non-parametric test
Correlation

182
Q

Wilcoxon signed-rank test

A

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

183
Q

Chi-squared test

A

Non-parametric test
Used to compare proportions of percentages

184
Q

Parametric tests

A

Student’s t-test: paired on unpaired

Pearson’s product-moment coefficient - correlation

185
Q

C1 inhibitor protein deficiency

A

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

186
Q

C1q, C1rs, C2, C4 deficiency

A

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

187
Q

C3 deficiency

A

Recurrent bacterial infections

188
Q

C5 deficiency

A

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

189
Q

C5-9 deficiency

A

-encodes MAC
-prone to Neisseria meningitis infection

190
Q

Number need to treat

A

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)

191
Q

Standard error of the mean

A

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

192
Q

Relative risk

193
Q

Type I hypersensitivity

A

Anaphylaxis
Atopy

Antigen reacts with IgE bound to mast cells

194
Q

Type II hypersensitivity

A

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

195
Q

Type III hypersensitivity

A

Free antigen and antibody combine

  • Serum sickness
    -SLE
    -Post-streptococcal glomerulonephritis
    -EEA (acute phase)
196
Q

Type IV hypersensitivity

A

T-cell mediated

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

197
Q

Type V hypersensitivity

A

Antibodies recognise and bind to cell surface receptors.
Stimulate receptors or block ligand binding

-Graves’ disease
-Myasthenia gravis

198
Q

Musculocutaneous nerve
(Motor)

A

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

Supination

199
Q

Axillary nerve
(Motor)

A

(C5, C6)
Should abduction (deltoid muscle)

200
Q

Radial nerve (motor)

A

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

201
Q

Median nerve (motor)

A

(C6, C8, T1)
LOAF muscles

Wrist lesion > paralysis of thenar muscles, opponens pollicis

Elbow lesion > loss of pronation and weak wrist flexion

202
Q

Ulnar nerve (motor)

A

(C8, T1)
Intrinsic hand muscles except LOAF

Wrist flexion

203
Q

Long thoracic nerve (motor)

A

(C5 - C7)
Serratus anterior

204
Q

Normal distribution and SD

A

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

205
Q

Rickettsiae

A

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

206
Q

Rocky mountain spotted fever

A

Rickettsia ricketsii

Tick-borne
East coast of US

Headache, fever and rash spreading centrally from peripheries.

207
Q

Q fever

A

Coxiella burnetti

No vector

Pneumonia, no rash.

208
Q

Endemic typhus

A

Rickettsia typhi.

Spread by flea.

Rash starts centrally then spread to peripheries.

209
Q

Epidemic typhus

A

Rickettsia prowazekii

Via human body louse

210
Q

Ehrlichliosis

A

Ehrlichia

Tick-borne

211
Q

Autosomal recessive conditions

A

Metabolic conditions

Exceptions: inherited ataxias

212
Q

Autosomal dominant conditions

A

Structural conditions

Exceptions:
- Gilbert’s
-hyperlipidaemia type II

213
Q

Kearns-Sayre syndrome

A

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

214
Q

Positive predictive value

A

The chance that the patient has the condition if the diagnostic test is positive

TP / (TP + FP)

215
Q

Negative predictive value

A

The chance that the patient does not have the condition if the test is negative

TN / (TN + FN)

216
Q

Sensitivity

A

Proportion of patients with the condition who have a positive test result

TP / (TP + FN)

217
Q

Specificity

A

Proportion of patients without the condition who have a negative test result

TN / (TN + FP)

218
Q

Likelihood ratio for a positive test result

A

How much the odds of the disease increase when a test is positive

sensitivity / (1 - specificity)

219
Q

Likelihood ratio for a negative test result

A

How much the odds of the disease decrease when a test is negative

(1 - sensitivity) / specificity

220
Q

Tay-Sachs

A

Lysosomal storage disease

Hexosaminidase A

-developmental delay
-cherry red spots on macula
-without hepatosplenomegaly

221
Q

Gaucher’s disease

A

Lysosomal storage disease

Defect in Beta-glucocerebrosidase

-hepatosplenomegaly
-aseptic necrosis of the femur

222
Q

Niemann-Pick disease

A

Lysosomal storage disease

defect in Sphingomyelinase

-hepatosplenomegaly
-cherry red spot on macula

223
Q

Fabry disease

A

Lysosomal storage disease

alpha-galactosidase A

-angiokeratomas
-peripheral neuropathy of extremeties
-renal failure

224
Q

Krabbe’s disease

A

Lysosomal storage disease

galactocerebrosidase

-peripheral neuropathy
-optic atrophy
-globoid cells

225
Q

Metachromatic leukodystrophy

A

Lysosomal storage disease

Arylsulfatase A

-demyelination of CNS + PNS

226
Q

Hurler syndrome

A

Mucopolysaccharidosis type 1

alpha-1-idurnidase

-gargoylism
-hepatosplenomegaly
-corneal clouding

227
Q

Hunter syndrome

A

Mucopolysaccharidosis type 1

iduronate sulfatase

-course facial features
-learning difficulty
-short stature
-no corneal clouding

228
Q

Von Gierke’s disease

A

Glycogen storage disease type I

Glucose-6-phosphatase

Hypoglycaemia
Lactic acidosis
Hepatomegaly

229
Q

Pompe’s disease

A

Glycogen storage disease type II

Lysosomal alpha-1,4-glucosidase

Cardiomegaly

230
Q

Cori disease

A

Glycogen storage disease type III

Alpha-1,6-glucosidase

Muscle hypotonia

231
Q

McArdle’s disease

A

Glycogen storage disease type III

Glycogen phosphorylase

Myalgia
Myoglobinuria with exercise

232
Q

Azathioprine side effects

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

**Bank (74 decks)

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