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MRCP > MRCP Word Ax > Flashcards

MRCP Word Ax Flashcards

1
Q

Chemo peripheral neuropathy

A

Vincristine
Cisplatin

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2
Q

Chemo cardiomyopathy

A

Doxorubicin

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3
Q

Chemo pulmonary fibrosis

A

Methotrexate

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4
Q

Chemo haemorrhagic cystitis

A

Cyclophosamide

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5
Q

Anti epileptics safe in pregnancy

A

Levetiracetam
Lamotrigine

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6
Q

Cereberal Toxoplasmosis Tx

A

Sulfadiazine, Pyrimethamine

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7
Q

Histology Barretts Esophagus

A

Columnar metaplasia

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8
Q

Electrolyte abnormality worsening digoxin toxicity

A

Hypokalaemia

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9
Q

Hormone that stimulates hunger

A

Grehlin

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10
Q

Hormone that suppresses hunger

A

Leptin

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11
Q

Leukaemia “ Broad based projections”
Dry tap
TRAP +ve

A

Hairy Cell Leukaemia

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12
Q

Worse prognosis RA

A

Female
Anaemia 3 months
Gradual onset
+ve IgM RF
+ve CCP

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13
Q

Rash with one “herald patch” then spreads

A

Pityrisias Rosea

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14
Q

Lewy Body Dementia

A

EPSs
Hallucinations
Variable sx/GCS

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15
Q

Most common Lupus Antibodie

A

ANA

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16
Q

Translucent bands bones

A

Osteomalacia

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17
Q

Punched Out Osteolytic Lesions

A

Myeloma

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18
Q

Nephritis postive for everything
C3, C4, IgM, IgG

A

Lupus Nephritis

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19
Q

Neck + shoulder pain, weakness abductor pollicis brevis, pin and needles

A

Cervical Rib

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20
Q

Polymyositis Antibody

A

Anti Jo

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21
Q

TB Drugs peripheral neuropathy

A

Isoniazid

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22
Q

Wernickes vitamin deficiency

A

Thiamine B1

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23
Q

Feltys Syndrome

A

Triad : Leucopaenia + RA + Splenomegaly

(lympadenopathy, leg ulcers, normocytic anaemia)

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24
Q

Tense blistering rash (not affecting rash)

A

Bullous Pemphigoid
IgG

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25
Q

Farm, haemolytic anaemia, high billrubin, neurology

A

TTP

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26
Q

Diabetic meds causing hypos

A

Gliclazide

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27
Q

Negatively bifringent crystals joint asp
Monosodium Urate Monohydrate

A

Gout

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28
Q

Weakly positive bifringent crystals joint asp
Calcium pyrophosphate

A

Pesudogout

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29
Q

Tx Tourettes

A

Risperidone

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30
Q

Palmar crease xanthaoma (pathognomonic)

A

Broad beta disease

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31
Q

Subchondral cysts

A

OA

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32
Q

Periarticular osteopaenia

A

RA

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33
Q

Osteophytes

A

OA

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34
Q

Allopurinol on INR

A

High

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35
Q

St Johns Wort on INR

A

Low

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36
Q

Carbemazepine on INR

A

Low

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37
Q

Phenytoin on INR

A

Low

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38
Q

Rifampicin on INR

A

Low

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39
Q

Brown/blue pigmentation

A

Alkaptonuria
Homognetistic oxidase deficiency

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40
Q

Williams Syndrome

A

Friendly
Short
Neonatal hypercalcaemia
Supravalvular aortic stenosis

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41
Q

Isoniazid on INR

A

High

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42
Q

Cipro/erthryo on INR

A

High

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43
Q

SSRI on INR

A

High

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44
Q

Fluconazole on INR

A

High

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45
Q

Cushing K+/pH

A

Hypokalaemia Alkalosis

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46
Q

Conns K+/pH

A

Hypokalaemia Alkalosis

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47
Q

Bloody diarrhoea w/ shistocytes

A

E coli

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48
Q

Main bug causing HUS

A

E coli

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49
Q

Phenylketonuria

A

Seizures
Eczema
LD
Musty

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50
Q

Burkitts lymphoma oncogene and chromosome

A

c MYC
t8:14

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51
Q

Neuroblastoma oncogene

A

n MYC

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52
Q

Cancer type most like to cause hypercalcaemia

A

Squamous Cell

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53
Q

Waldenstroms Macroglobulinaemia Ig?

A

IgM kappa paraprotein

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54
Q

Waldenstroms Macroglobulinaemia

A

HYPERVISCOCITY
Cryoglobulinaemia/Raynauds
Hepatosplenomegaly
Lymphadenopathy

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55
Q

Lebers Optic Neuropathy inheritance

A

Mitochondrial

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56
Q

Downs syndrome genetics

A

Trisomy 21

  • non dysjunctional mainly
  • moasicm (less severe)
  • Robertonism (parental issue)
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57
Q

Downs cardiology issues

A

ASD
PDA
Fallots Tetralogy
Endocardial cushion defect

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58
Q

Downs syndrome ax illness

A

Duodenal Atresia
Leukaemia
Esophageal fistulae
Hypothyroid

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59
Q

Edwards syndrome genetics

A

Trisomy 18

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60
Q

Edwards syndrome features

A

Retardation, craniofacial abnormalities (prominent occiput, low-set
ears, micrognathia).
‘Rocker bottom’ feet
Cardiac abnormalities.

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61
Q

Pataus syndrome features

A

Mircopthalmia
Cleft palate
Polydactly
Mental retardation

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62
Q

Cri du chat features

A

Retardation
High pitched cry
Epicanthal folds
Low set ears
Spasticity

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63
Q

Cri du chat genetics

A

Chromosome 5 deletion

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64
Q

Prader Willi Genetics

A

microDeletion chromosome 15-11-13

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65
Q

Prader Willi features

A

P WILLIS
Paternal inheritance

Weight increased
LD
Low muscle tone
Infertility/hypogonadism
Short stature

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66
Q

Angelman syndrome features

A

Maternal inheritance
Hypertonia
Prominent jaw
Deep set eyes
Absent speech
Retardation

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67
Q

What is Philadephia chromosome

A

Due to deletion of long arm 22, usually on 9
Prognosis worse without it
Also myelofiborosis, polycythaemia vubra vera

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68
Q

Turners syndrome genetics

A

45 XO
Non disj/moacism

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69
Q

Turners syndrome cardiac issues

A

Coarctation aorta
Bicupsid aortic valve

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70
Q

Turners hormones

A

High gonadotrophin
Low estrogen

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71
Q

Noonans syndrome genetics

A

45 XY

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72
Q

Noonans features

A

male turners
absence testicles/crypto orchidism

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73
Q

Kleinfelters genetics

A

47 XXY XXXYY XXYY

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74
Q

Kleinfeltoms features

A

Tall, thin, gynaecomastia, infertility
High urinary gonadotrophins

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75
Q

Fragile X genetics

A

X linked dominant
expansion CGC
Long arm X

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76
Q

Fragile X features

A

Retardation - severe in males, less in females

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77
Q

Triple X Syndrome

A

47 XXX
Only slight intelligence impairment
Fertility normal

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78
Q

Women affected more than male genetics

A

X linked

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79
Q

Mitochondrial inheritance

A

Maternal transmission
V rare
Leber optic neuropathy

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80
Q

Trinucleotide repeat disorders

A

Huntingtons, MD, Freidreichs, Fragile X

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81
Q

FH inheritance

A

Autosomal Dominant

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82
Q

MD Inheritance

A

Autosomal Dominant

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83
Q

Marfans inheritance

A

Autosomal Dominant

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84
Q

Alpha 1 antitrypsin inheritance

A

Autosomal recessive

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85
Q

Wilsons inheritance

A

Autosomal recessive

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86
Q

Duchenne dystrophy inheritance

A

X linked recessive

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87
Q

Li Fraumeni Syndrome

A

Loss of p53 cancer syndrome
Breast, brain, sarcoma

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88
Q

Retinoblastoma chromosome and inheritance

A

Autosomal dominant
13q14

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89
Q

FAP chromosome

A

Bowel cancer
deletion 5q21

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90
Q

Colorectal carcinoma chromosome

A

18q deletion

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91
Q

Haemochromatosis HLA

A

HLA A3

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92
Q

Behcets HLA

A

B5

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93
Q

HLA B27

A

Ank spod
Reiters
Psoriatic arthritis
Anterior uveitis

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94
Q

HLA DR2

A

MS
Pernicious anaemia
Nacrolepsy
Juvenile diabetes

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95
Q

HLA DR3

A

Coeliac
Sjogens
Hepatitis
Addisons
SLE
Graves, Hashimotos
IDDM
MG

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96
Q

RA HLA

A

HLA DR4

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97
Q

Coeliac HLA

A

HLA DR5, DR7

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98
Q

Gram positive rods

A

Bacillus
Clostridium
Listeria

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99
Q

Gram positive cocci

A

Strep
Staph

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100
Q

Gram negative rods

A

Klebsiella
Enterobacter
Salmonella
Shigella
Legionella
Campylobacter
Pseudomonas

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101
Q

Gram negative cocci

A

Neisseria

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102
Q

Q fever bug

A

C burnetti

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103
Q

Most common transmission Hep C

A

Contaminated blood transfusion
IVDU
(also sex, vertical)
NO VACCINE

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104
Q

Chronic complications Hep C

A

Cirrhosis
Hepatocellular carcinoma

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105
Q

Dengue features

A

fever
headache
retro orbital pain
back ache
rash
mucosal haemorrhage, shcok

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106
Q

HIV genetics

A

single stranded RNA

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107
Q

Immune changes in HIV

A

decreased CD4, CD8
hypergammaglobulinaemia
decreased macrophage

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108
Q

Virus causing T Cell leukaemia

A

HTLV 1

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109
Q

Virus causing Kaposis sarcoma

A

HHV 8

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110
Q

HBsAg

A

Surface antigen = current disease (or carrier)

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111
Q

Anti Hbs

A

Immune

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112
Q

Anti Hbc

A

Current or previous infection

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113
Q

HIV test method

A

ELISA
Western blot

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114
Q

Causes of false positive treponomal tests

A

Genital herpes
Psoriasis
RA
SLE

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115
Q

Egg vaccines

A

Flu, yellow fever

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116
Q

Live vaccines

A

MMR
Polio
Chicken pox
Yellow Fever
Typhoid

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117
Q

Von Willebrands Rx

A

DDAPV, TXA

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118
Q

Gauchers disease

A

Jewish
hepatosplenomegaly, anaemia, osteopaenia

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119
Q

Type I cryoglobulin

A

Waldenstroms

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120
Q

Type II cryoglobulin

A

Hep C, HIV

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121
Q

Type Iii cryoglobulin

A

Sjorgens

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122
Q

OD causing respiratory alkalosis

A

Aspirin, Theophyllines

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123
Q

Type I hypersensitivity

(Anaphylactic)

A

Anaphylaxis
Atopy
Drug Allergy

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124
Q

Type II hypersensitivity

(Cell Bound)

A

Goodpastures, anti GBM
MG
ITP
Tranfusion
Thyroid

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125
Q

Type III hypersensitivity

(Immune Complex)

A

post strep glom
Hep C B
HIV
Syspihilis, Shisto, SLE
Malaria
RA

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126
Q

Type IV hypersensitivity

(Cell mediated/delayed)

A

TB
Contact dermatitis
Graft rejection
Tumour
scabies

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127
Q

C1 Inhibitor deficiency

A

Hereditary angioedema

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128
Q

C2, C4 deficiency (classic pathway)

A

HSP
Glomerulonephritis
SLE
Strep
Staph

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129
Q

C3-C9 deficiency

A

Recurrent bacterial infection e.g Neisseria

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130
Q

Test for Type I Hypersensitivity

A

IgE/skin prick

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131
Q

Test for Type II Hypersensitivity

A

Coombs Test

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132
Q

Test for Type III Hypersensitivity

A

Antibody levels

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133
Q

Test for Type IV Hypersensitivity

A

Patch

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134
Q

Type I Hypersensitivity Ig

A

IgE

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135
Q

Type II Hypersensitivity Ig

A

IgG IgM

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136
Q

Type III Hypersensitivity Ig

A

IgG IgM

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137
Q

What type of hypersensitivity is urticaria?

A

Type I

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138
Q

What type of hypersensitivity is bullous disease?

A

Type II

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139
Q

What type of hypersensitivity is vasculitis?

A

Type III

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140
Q

What type of hypersensitivity is allergic contact dermatitis?

A

Type IV

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141
Q

Ataxic Telangoectasia syndrome

(inheritance, features, Ig)

A

autosomal recessive
kids - cerebellar ataxia, oculocutaneous telangiectasia, recurrent sinus/lung infections
Low IgA, IgE
Possible T cell deficiency

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142
Q

Wiskott Aldrich syndrome

A

X linked recessive
Eczema, thrombocytopaenia, recurrent infection
Lymph tumours
Low antibody, IgM high IgE
B and T cell
WASP

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143
Q

Raised IgG in liver disease

A

hepatitis, cryptogenic cirrhosis

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144
Q

Raised IgM in liver disease

A

biliary/alcoholic cirrhosis

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145
Q

Raised IgA in liver disease

A

alcoholic cirrhosis

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146
Q

Anti smooth muscle +ve

A

Hepatits
PBS
Cirrhosis
Viral infection

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147
Q

Anti mitochondrial +ve

A

PBC
Hepatitis
Cirroshsi

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148
Q

Gastric parietal cell antibody +ve

A

Pernicious anaemia
Atrophic gastrisi
Autoimmune thyroid disease

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149
Q

Thyroid autoantibodies

A

Hashimotos
Graves
Hypothyroidism
Pernicious Anaemia

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150
Q

ANA +ve

A

Sjorgens
Lupus
RA
MG
Hashimotos
UC

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151
Q

cANCA

A

Wegeners granulomatosis
Microscopic polangitis

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152
Q

pANCA

A

Idiopathic crescentic glomerulonephritis
Microscopic polyangitis
Churg Strauss

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153
Q

Hyperacute organ rejection presentation

A

Hours
Complemented mediated
Vascular spasm, occlusion, failed organ perfusion

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154
Q

Acute organ rejection

A

Days to weeks
HLA incompatibility
T cell/CD4

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155
Q

Chronic organ rejection

A

months-years
T Cells

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156
Q

What cells mediate graft versus host disease

A

T cells

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157
Q

Causes of +ve Coombs test

A

haemolytic anaemia/tranfusion reactions
LSE, lymphoma, leukaemia
Methyldopa

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158
Q

Loss of forearm pronation
Weak wrist flexion
Thenar wasting

A

Median nerve palsy

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159
Q

Wasting hand muscles, hypothenar
Claw hand
Radial deviation

A

Ulnar nerve

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160
Q

Paralysis of knee flexion
Foot drop
Ankle jerk and plantar reflex absent

A

Sciatic nerve palsy

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161
Q

What controls motor function

A

Basal ganglia

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162
Q

Anterior Cerebral Artery Occlusion

A

weak, numb contralateral leg
mild arm signs
face spare

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163
Q

Middle Cerebral Artery Occlusion

A

Contralateral hemiplegia
sensory loss face
dyphasia/dyspraxia
contralateral homonynmous hemianopia

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164
Q

Vertebrobasilar artery occlusion

A

Hemianopia
Cortical Blindness
Vertigo, nystagmus
hemi/quadraplegia
sensory loss, drop attacks, cerebellar sx

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165
Q

Lateral Medullary infarct = Posterior Inferior Cereberal Artery Infarct

A

vertigo, vomiting, nystagmus TOWARDS lesion
ipsilateral hypotonia
ataxia
horners
soft palate paralysis

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166
Q

Brocas dysphasia

A

Inferolateral frontal lobe
non fluent speech comprehension intact

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167
Q

Wernickes dysphasia

A

posterior superior temporal lobe
Fluent speech but errors
Issues reading, writing, comprehension

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168
Q

Fanconi syndrome

A

cystinuria, phosphaturia, RTA 2, glycosuria, rickets/osteomalacia

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169
Q

Cystinosis

A

cystine crystal deposition
RTA, Fanconi, renal failure, hepatosplenomegaly

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170
Q

RCT

A

Randomly allocated to intervention/control
Limited by ethics

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171
Q

Cohort study

A

Group of people exposed to something and then follow up to see how many develop disease/other outcome
Measured in relative risk

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172
Q

Case-control study

A

People with condition matched with control
Then data collected on past exposure
ODDS RATIO

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173
Q

Cross sectional study

A

Snapshot or prevalence
Not useful for cause/effect

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174
Q

Level of evidence: Ia

A

Meta analysis RCT

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175
Q

Level of evidence: Ib

A

At least one RCT

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176
Q

Level of evidence: IIa

A

At least one well designed control trial (not randomised)

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177
Q

Level of evidence: IIb

A

At least one well designed experimental

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178
Q

Level of evidence: III

A

case, correlation, comparative studies

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179
Q

Level of evidence: IV

A

panel of experts

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180
Q

Normal distribution

A

Mean = median = mode

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181
Q

Positively skewed distribution

A

mean > median > mode

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182
Q

Negatively skewed

A

mean < median< mode

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183
Q

Sensitivity

A

TP / (TP +FN)
tested +ve/who actually had it

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184
Q

Specificity

A

TN / (TN + FP)
tested -ve/ who actually didnt have it

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185
Q

Positive predictive value

(chance you have it if your test is positive)

A

TP / (TP + FP)
Had it and tested +ve/tested positive

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186
Q

Negative predictive value

(chance if you’re negative you didn’t have it)

A

TN / (TN +FN)
didnt have it and tested negative / everyone who tested negative

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187
Q

Likelihood ratio for positive test

A

sensitivity/ (1-specificity)

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188
Q

Likelihood ratio for negative test

A

(1 - sensitivity) / specificity

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189
Q

Relative risk

A

EER/CER
amount it occurs in experiment group/amount it occurs in control group

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190
Q

Penetrance

A

describes ‘how likely’ it is that a condition will develop

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191
Q

Expressivity

A

Severity of the phenotype

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192
Q

Odds

A

You do get the outcome/you don’t get the outcome

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193
Q

Odds ratio

A

Odds you do with x/ odds you do with placebo

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194
Q

Number needed to treat

A

1 / (EER -CER)

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195
Q

What % values lie within 1 SD of mean?

A

68.3%

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196
Q

What % values lie within 2 SD of mean?

A

95.4%

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197
Q

What % values lie within 3 SD of mean?

A

99.7%

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198
Q

Intention to treat analysis

A

Analysing random group of RCT patient regardless of whether they finished the treatment or not
Limits the effect of drop outs

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199
Q

Incidence

A

incidence is the number of new cases per population in a given time period.

For example, if condition X has caused 40 new cases over the past 12 months per 1,000 of the population the annual incidence is 0.04 or 4%.

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200
Q

Prevelance

A

Cases per population at any one time

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201
Q

Funnel plot

A

to show bias in meta analysis
treatment outcome vs study size vert

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202
Q

Standard error of mean

A

SEM = SD / square root (n)

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203
Q

Phase I Clinical Trial

A

pharmacokinetics and pharmacodynamics and side-effects prior to larger studies
Healthy volunteers

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204
Q

Phase II Clinical Trial

A

Efficacy and dosage
Small number affected by disease
IIA - dosing
IIb - efficacy

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205
Q

Phase III Clinical Trial

A

Assess effectiveness
Lots of people
RCT
Comparing new tx with old one

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206
Q

Phase IV Clinical Trial

A

Post marketing surveillance
Long term side effects and effectiveness

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207
Q

What does RER do?

A

translation/folding proteins
glycosylation
makes lyosomal enzymes
lots in pancreatic, goblet and plasma cells

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208
Q

What does SER do?

A

steroid and lipid synthesis
lots in adrenal, liver, testes, ovaries

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209
Q

What does Golgi apparatus do?

A

O-linked glycosylation
modifies, sorts, packages molecules meant for secretion

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210
Q

What does mitochondria do?

A

aerobic respiration
contains circular DNA

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211
Q

What does the nucleus do?

A

DNA maintenance
RNA transcription/splicing

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212
Q

What do lysosomes do?

A

Break down large molecules like proteins and polysacchrides

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213
Q

What does the nucleolus do?

A

Ribosome production

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214
Q

What does the peroxisome do?

A

Catabolism of v long chain fatty acids and amino acids, makes hydrogen peroxide

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215
Q

What does the ribosome do?

A

Translates RNA into proteins

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216
Q

What do proteasomes do?

A

Breaks down proteins

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217
Q

Anderson-Fabry disease

A

X linked recessive
deficiency of alpha galactosidase A
burning parathesia childhood
angiokeratomas
lens opacities
proteinuria
early CVD

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218
Q

Selection Bias

A

eg sampling biads, volunteer bias, non responder bias

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219
Q

Recall bias

A

People remembering things differently based on how they are now eg having lung ca and thinking you had asbestos

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220
Q

Publication bias

A

Not publishing things that aren’t as interesting etc

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221
Q

Work up/verification bias

A

Being reluctant to order gold standard when thats what youre comparing to

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222
Q

Expectation bias (pygmalion effect)

A

People reporting things based on what they think the study wants

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223
Q

Hawthorne effect bias

A

Knowing you’re being studied

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224
Q

Late-look bias

A

Getting info at inappropriate time eg years later when subject may have died

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225
Q

Procedure bias

A

People in same group get different treatment

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226
Q

Lead-time bias

A

New test diagnoses something arlier but doesn’t have any effect on the disease

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227
Q

Hazard ratio

A

For analysing survival over time

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228
Q

Type V Hypersensitivity

A

Graves disease
MG

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229
Q

What do Th1 Helper cells secrete?

A

Cell mediated immunity
IFN gamma IL2, IL3

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230
Q

What do Th2 helper cells secrete?

A

Humoural immunity
IgE
IL4, IL4, IL6, IL10, IL13

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231
Q

Nacrolepsy HLA

A

HLA DR2

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232
Q

Nicotinic Acetylcholine what type of Receptor

A

Ligand gated

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233
Q

Whats the usual outcome measure of a cohort study?

A

Relative risk

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234
Q

Fabry disease

A

Angiokeratomas “corneal whirl”
Proteinurias
Early MI/stroke

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235
Q

Shistocytes in blood smears

A

DIC

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236
Q

What type of receptor is ANP

A

Guanylate cyclase

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237
Q

Chi squared test

A

Comparing 2 percentages/proprotions

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238
Q

Mechanism of doxy

A

Inhibits 30s unit ribosomes

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239
Q

Achondroplasia mutation

A

FGFR3 fibroplast growth receptor

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240
Q

Achondroplasia inheritance

A

autosomal dominant

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241
Q

Features of achondroplasia

A

short arms and legs, short, flat nose

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242
Q

Bartters syndrome

A

Severe hypokalaemia defective chloride absorption Na+/K/Cl cotransporter loop of henle

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243
Q

Tay Sachs disease

A

lysosomal storage
cherry red spot macula
no hepatospelnomegaly
developmental delay

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244
Q

Mcardles disease

A

glycogen storage
myalgia
myoglobinuria

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245
Q

Homocystinuria features

A

fine, fair hair
Marfanoid
LD
downwards (inferonasal) dislocation of lens
VTE
also malar flush, livedo reticularis

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246
Q

Pathophysiology of homocystinuria

A

cystathionine beta synthase

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247
Q

Whats the definition of the p value?

A

is the probability of obtaining a result by chance at least as extreme as the one that was actually observed, assuming that the null hypothesis is true

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248
Q

DiGeorge Syndrome pathophysiology

A

Primary immunodeficiency
T cell dysfunction

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249
Q

DiGeorge Syndrome chromsome

A

Deletion 222 (22q11.2)

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250
Q

DiGeorge Syndrome features

A

viral/fungal infections
parathyroid gland hypoplasia → hypocalcaemic tetany
thymus hypoplasia
T-lymphocyte deficiency/dysfunction

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251
Q

Tetralogy of Fallot

A

VSD
RVH
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta

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252
Q

Goodpasture HLA

A

HLA DRB1*15:01

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253
Q

Ank spond renal disease

A

AA amyloidosis - apple green +ve bifringence, enlarged kidneys, heavy proteinuria
IgA nephropathy

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254
Q

UC Vs Crohns
Transmural inflammation

A

Crohns

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255
Q

UC Vs Crohns
Fissuring ulcers

A

Crohns

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256
Q

UC Vs Crohns
Lymphoid/neutrophil aggregates

A

Crohns

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257
Q

UC Vs Crohns
Mucosa/submucosa only

A

UC

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258
Q

UC Vs Crohns
Crypt Abcesses

A

UC

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259
Q

UC Vs Crohns
Skip lesions

A

Crohns

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260
Q

UC Vs Crohns
Continous inflammation

A

UC

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261
Q

UC Vs Crohns
Transmural/all layers inflammation

A

Crohns

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262
Q

Few polyps and fhx of cancer

A

HNPCC

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263
Q

Loads of polyps (100s-1000s) and fhx of cancer

A

FAP

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264
Q

HIV nephropathy histology

A

Microcystictubular dilatation
Collapsing FSGS

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265
Q

CMV Tx

A

Gancliclovir

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266
Q

Which antibodies cross the placenta

A

IgG

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267
Q

Initial therapy for phaeochromocytoma SVT

A

Phenoxybenzamine

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268
Q

Philadelphia chromosome in ALL good/bad prognosis?

A

Bad

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269
Q

Weber syndrome

A

Midbrain stroke
THIRD NERVE PALSY SAME SIDE
Contralateral hemiparesis and hemiparkinsonism

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270
Q

Wallenberg syndrome

A

Lateral medullary syndrome
Ipsilateral pharyngeal/ palatal palsy
Ipsi horner syndrome
Ipsi pain/temp loss face
Contra pain/temp loss body

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271
Q

MOA/enzyme glitazone

A

CYP2C8

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272
Q

SVT in pregnancy tx

A

Beta blocker

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273
Q

Hyperlipoproteinaemia IB mutation

A

Apolipoprotein CII (APO CII)

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274
Q

Red spots with bluish white centre

A

Koplik spots
Measles

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275
Q

Sheep, lymphadenopathy
Fever
Sweats
Weight loss

A

Brucellosis

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276
Q

Tx for cholera

A

Doxy

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277
Q

Which immunoglobulins are responsible for haemolytic blood transfusion reactions?

A

IgM

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278
Q

Homocystinuria pathophysiology

A

deficiency of cystathionine beta synthase

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279
Q

Homocystinuria features

A

fine, fair hair
Marfanoid
LD
downwards (inferonasal) dislocation of lens
VTE
also malar flush, livedo reticularis

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280
Q

Homocystinuria tx

A

B6 supplementation

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281
Q

Conditions ax with turners

A

Cystic hygroma
Lymphedema
Hypothyroidism
Horseshoe kidney
Crohns

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282
Q

Features CF

A

short stature
diabetes mellitus
delayed puberty
rectal prolapse
nasal polyps
male infertility, female subfertility

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283
Q

Main constituent of pulmonary surfactant

A

dipalmitoyl phosphatidylcholine (DPPC)

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284
Q

Lesch-Nyhan syndrome

A

X recessive
juvenile gout
absence HGPRT
orange sand stools

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285
Q

Liddles syndrome

A

Hypokalaemia
HTN

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286
Q

Wilcoxon signed-rank test -

A

compares two sets of observations on a single sample eg before/after

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287
Q

DiGeorge Mnemonic

A

‘CATCH22
C - Cardiac abnormalities
A - Abnormal facies
T - Thymic aplasia
C - Cleft palate
H - Hypocalcaemia/ hypoparathyroidism
22 - Caused by chromosome 22 deletion

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288
Q

Kearns-Sayre syndrome

A

mitochondrial inheritance
onset < 20-years-old
external ophthalmoplegia
retinitis pigmentosa

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289
Q

Beckwith-Wiedemann syndrome

A

organomegaly, macroglossia,
abdominal wall defects, Wilm’s tumour neonatal hypoglycaemia.

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290
Q

Complement Leiner disease

A

C5

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291
Q

Norepinephrine receptor

A

G protein coupled receptor

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292
Q

Dermatitis herpetiformis HLA

A

HLA D3

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293
Q

Ligand gated ion receptors

A

Nicotinic acetylcholine
Gaba
glutamate

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294
Q

Tyrosine kinase receptors

A

insulin-like growth factor (IGF), epidermal growth factor (EGF)
PIGG(L)ET: Prolactin, Immunomodulators
GH, G-CSF,
Erythropoietin Thromobopoietin

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295
Q

Guanylate cyclase receptors

A

ANP/BNP

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296
Q

HLA Psoriasis

A

HLA CW6

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297
Q

T1 RTA
Anion gap

A

Normal

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298
Q

Lactic Acidosis Anion Gap

A

Raised

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299
Q

T1 RTA presentation

A

hyperchloraemic hypokalaemic metabollic acidosis

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300
Q

Linear IgG desposits

A

anti glomerular basement membrane disease

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301
Q

MOA sitagliptin

A

DPP-IV inhibitor

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302
Q

Tx cluster headaches

A

verapamil

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303
Q

Lip smacking seizure - which area of brain

A

Temporal lobe

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304
Q

CXR “mass surrounded by rim of air”

A

Aspergilloma

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305
Q

MODY presentation

A

diabetes without ketones
antibody negative
autosomal dominant
family hx

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306
Q

Latent Autoimmune Diabetes Adult LADA
Presentation

A

Treated as Type 2 for few years
High BMS
Ketonuria
Hx of auto immune

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307
Q

Warm AIHA features

A

Happens at body temp
Anaemia + jaundice +splenomegaly
Coombs test +ve

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308
Q

Cold AIHA features

A

Worse cold temp
Raynauds/purplish discoloration (acronyansosis)
Coombs test +ve

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309
Q

White turbid fluid joint

A

Acute Gouty Arthritis

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310
Q

1st step tx aortic dissection

A

Labetalol

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311
Q

Haemochromatosis inheritance

A

Autosomal recessive

312
Q

Haemochromatosis pathophysiology

A

mutation of HFE on chromosome 6
C282Y (80%) AND H63D (20%) cause decreased hepcidin

313
Q

Heinz bodies

A

GP6D deficiency

314
Q

Howell Jolly bodie

A

Hyposplenism/splenctomy

315
Q

Rouleax (blood film)

A

Waldenstroms, myeloma

316
Q

Warm AIHA features

A

Happens at body temp
Anaemia + jaundice +splenomegaly

317
Q

Cold AIHA features

A

Worse cold temp
Raynauds/purplish discoloration (acronyansosis)

318
Q

Warm AIHA Ig

A

IgG

319
Q

Cold AIHA Ig

A

IgM

320
Q

What infections does Sickle Cell predispose to ?

A

encapsulated eg strep pneumoniae, salmonella

321
Q

What organism causes aplastic sickle cell crisis?

A

Parvovirus

(Causes sudden drop in Hb)

322
Q

“Pulmonary infiltrates” in sickle cell

A

Acute chest syndrome

323
Q

Acute chest syndrome sickle cell presentation

A

SOB, chest pain, pulmonary infiltrates, hypoxia

324
Q

Long term tx sickle cell

A

hydroxyurea

325
Q

Carcinoid tumour features

A

tachycardia
flushing
bronchoconstriction
haemodynamic instability
diarrhoea

326
Q

“lambda light chain” in kidney

A

myeloma amyloidosis

327
Q

Tramline spine

A

Ank spond bamboo spine

328
Q

Rugger Jersey spine

A

Renal osteodystrophy

329
Q

Trophozites/cysts in stool culture

A

Giardia

330
Q

Type II RTA

A

Hypokalaemic hyperchloraemic acidosis with low bicarb (high in urine) and high urine pH

331
Q

Cisplatin side effects

A

Ototoxicity
nephrotoxicity - hypokal, mag, calc

332
Q

Tx for Hep C

A

Daclatasvir, sofosbuvir +_ ribavirin

333
Q

Ciclosporin mechanism

A

IL2 inhibitor

334
Q

Small testes, delayed puberty, loss of smell

A

Klamanns syndrome

335
Q

Retinal protein responsible for light perception

A

rhodopsin

336
Q

Boney lumps DIP

A

Heberdens nodes OA

337
Q

Boney lumps PIP

A

Bouchards node RA

338
Q

Von Hippel Lindau

A

Cysts tumours everywhere
Chromosome 3
RCC common

339
Q

Scheuermanns disease

A

irregular endplates
loss of disc space height
teenage girls
thoracic smooth lump

340
Q

Hormone change at ovulation

A

LH surge

341
Q

Net like rash

A

Cholesterol emboli

342
Q

Sickle cell treatment

A

Hydroxyurea

343
Q

McArdle disease

A

Repeated cramping and myoglubinuria (dark drown urine) after exercise

344
Q

Illness where prophylaxis causing haemolytic anaemia

A

G6PD deficiency

345
Q

Hypersegmented neutrophils

A

Megaloblastic anaemia

346
Q

Left shift of myeloid cells

A

Pregnancy, severe infection, CML

347
Q

Blast cells

A

AML/ALL

348
Q

Auer rods

A

AML

349
Q

Smear/smudge cells

A

lymphocytosis usually CLL

350
Q

Primary thrombocytopaenia features

A

Bleeds/clots
splenic infarcts/atrophy
raised megakaryoctyes

351
Q

Primary thrombocytopaenia tx

A

hydroxycarbamide, alpha interferon, anagrelide
aspirin

352
Q

Polycythaemia rubra vera features

A

Clots - headaches, dizziness, VTE, stroke, hepatosplenomegaly

353
Q

Tear drop poikilocytes

A

Myelobfibrosis

354
Q

What condition often turns into myelofibrosis?

A

PRV

355
Q

What condition does myleofibrosis often turn into?

A

AML

356
Q

Most common leukaemia adults

A

AML

357
Q

Philadelphia chromosome in ALL ?prognosis

A

Poor prognosis

358
Q

CLL presentation

A

painless lymphadenopathy + anaemia
Smear cells

359
Q

Reed Sternberg cells “owls eye” appearance

A

Hodgkins lymphoma

360
Q

Most common type of Hodgkins

A

Nodular sclerosing
women
good prognosis

361
Q

High number Reed Sternbergs ?Hodgkins type

A

Mixed cellularity

362
Q

Best prognosis Hodgkins

A

Lymphocyte predominant

363
Q

Worst prognosis Hodgkins

A

Lymphocyte depleted

364
Q

Poor prognostic factors in AML

A

>60
>20% blasts after 1st chemo
deletion chromosome 5 or 7

365
Q

Acute promyelocytic leukaemia genetics and cells

A

t15:17
fusion of PML and RAR alpha
Auer rods

366
Q

“Increased granulocytes at different stages of maturation +- thrombocytosis”

A

CML

367
Q

CML genetics

A

t9:22
q34:11
BCR-ACL

368
Q

CML treatment

A

imatinib - tyrosine kinase inhibitors

369
Q

Leukaemia presenting with DIC

A

APML

370
Q

Good prognostic factors ALL

A

FAB L1 type
common ALL
Pre-B phenotype
low initial WCC
del 9p

371
Q

Poor prognostic factors ALL

A

FAB L3 type
T or B cell markers
Philadelphia
<2 or 10<
male
CNS involvement
high WCC
not white
Hypodiploidy

372
Q

“monoclonal proliferation well differentiated B lymphocytes”

A

CLL

373
Q

Ann Arbor Stage I

A

single region lymph nodes

374
Q

Ann Arbor Stage II

A

2 sites same side of diaphragm

375
Q

Ann Arbor Stage III

A

several sites both sides of diaphragm

376
Q

Ann Arbor Stage IV

A

extralymphatic structures

377
Q

Tumour lysis syndrome

A

High phos, potassium, uric acid
Low Ca2+

378
Q

Mantle cell lymphoma genetics

A

CD5+, CD19+, CD22+, CD23-, CD10-
t11:!4

379
Q

Follicular lymphoma genetics

A

t 14:18
BCL 2

380
Q

TTP antibody

A

ADAMTS 13

381
Q

What clotting factor does Von Willebrand process

A

Factor VIII carrier protein

382
Q

What factors doe Haemophilla A affect

A

Factor VIII

383
Q

What factors doe Haemophilla B affect

A

IX

384
Q

DIC blood features

A

prolonged PT, APTT, thrombin clotting
WCC, platelet, fibrinogen low

385
Q

Chemo agent causing low Mg

A

cisplatin

386
Q

Causes of intravascular haemolysis

A

Blood transfusion
G6PD
TTP
DIC
HUS
PNH
Cold AIHA

387
Q

Causes of extravascular haemolysis

A

Sickle cell, thalasaemia
Hereditary sphereocytosis
Haemolytic of newborn
Warm AIHA

388
Q

Haemophilia PT/APTT

A

PT normal
APPT prolonged

389
Q

Antiphospholipid pregnancy tx

A

Aspirin and LMWH

390
Q

Prognostic marker for myeloma

A

B2 microglobulin

391
Q

MOA cisplatin

A

cross linking DNA

392
Q

Haem issue causing headache, blurred vision

A

Waldenstroms

393
Q

Causes warm AIHA

A

SLE
methyldopa

394
Q

Causes cold AIHA

A

Mycoplasma, EBV

395
Q

Surgical prophylaxis Von Willebrands

A

Desmo

396
Q

Leukaemiod reaction (rather than leukaemia)

A

high leucocyte alkaline phosphatase score
Dohle bodies white cells
Left shit neutrophils

397
Q

Von Williebrand PT/APTT

A

Mildly prolonged APTT

398
Q

CLL poor prognostic markers

A

male
>70
lymphocyte >50
lymphocyte doubling <12 months
raised LDH
CD38
TP53
del 17

399
Q

CLL good prognosis

A

del 13

400
Q

Hereditary spherocytosis features

A

Fhx, gallstones, anaemia
splenomegaly FTT
EMA binding test

401
Q

Glutide main side effects

A

Hypos
plus pancreatitis, renal imp, nausea and vomiting

402
Q

Ca 125

A

Ovarian
Peritoneal

403
Q

ECOG 0

A

Normal

404
Q

ECOG 1

A

Can’t do strenuous stuff, but ok with work

405
Q

ECOG 2

A

Ambulatory and ADLs but not capable of work

406
Q

ECOG 3

A

Limited self care, confined to be more than 50% waking

407
Q

Dapaglifozin SGLT2 risks

A

DKA
Increased cholesterol

408
Q

Med to reduce risk of tumour lysis

A

rasbicurase

409
Q

JAK 2

A

Thrombocythaemia

410
Q

Sickle cell HbSC

A

Mild disease

411
Q

Hereditary spherocytosis tx

A

Fluids, high dose folic acid

412
Q

Diabetes meds contraindicated in CCF

A

Pioglitazone

413
Q

G6PD triggers meds

A

primaquine
cipro
sulphs

414
Q

Test for anaphylaxis post reaction

A

tryptase

415
Q

Hodgkins poor prognostic markers

A

weight loss >10% 6 months
fever >38
night sweats

416
Q

Acute intermittent porphyria enzyme defect

A

Uroporphyrinogen decarboxylase

417
Q

Factor V Leiden mechanism

A

resistance to activated protein C

418
Q

Common cancer tumour lysis syndrome

A

Burkitts lymphoma

419
Q

Necrosis following warfarin

A

Protein C deficiency

420
Q

What does polycythaemia vubra vera progress to?

A

Myelofibrosis, AML

421
Q

Bilobed mononuclear cells

A

AML

422
Q

Liver transplant criteria paracetamol OD

A

pH <7.3

or
INR >6.5 + grade 3/4 encephalopathy + Cr >300

423
Q

Hypovolaemia shock post MI

A

RV infarct

424
Q

Most common thyroid cancer

A

Papillary, great prognosis

425
Q

Type and MOA pioglitazone, rosiglitazone

A

PPAR gamma agonist, increase insulin signalling/sensitivity

426
Q

Conns triad

A

HTN + hypokalaemia + alkalosis

427
Q

Conns causes

A

RAS
CAH
CCF
Corrhosis
Nephritic syndrome

428
Q

Waterhouse Fredichsen

A

Septicaemia causing adrenal haemorrhage causing addisons

429
Q

Primary hyperparathyroid

A

Tumour producing PTH
High PTH
HIgh Ca2

430
Q

Secondary hyperparathyroid

A

Vit d deficiency
Low/normal ca
High PTH

431
Q

Tertiary hyperparathyroidism

A

Secondary hyperparathyroidism goes on for ages causing high PTH, causing high Ca2

432
Q

Hyperaemic membranes

A

TSS

433
Q

Where do SGLT 2 inhibitors glifozins work

A

Early PCT

434
Q

Glutide main side effects

A

Hypos

435
Q

Indications for surgery in HPTH

A

<50
CA >0.25 upper lmit
eGFR <60
renal stones/nephrocalcinosis
osteoporosis
sx

436
Q

Mst common cause primary hyperaldoteronism

A

Adreanl hyperplasia

437
Q

Pendred syndrome

A

Deafness and hypothyroid

438
Q

MOA gliptins

A

DPP 4 inhibitors

439
Q

Dapaglifozin SGLT2 MOA

A

Stops reabsorption glucose proximal renal tubule

440
Q

Dapaglifozin SGLT2 risks

A

DKA

441
Q

Normal fasting glucose

A

<6.1

442
Q

Post glucose /random glucose

A

<7.8

443
Q

Kallmans syndrome

A

Like kleinfelters but low LH, FSH and crypto orchidism

444
Q

Sulfonylureas MOA

A

increase insulin secretion B cells and decrease hepatic clearance

445
Q

MODY 3

A

most common
ax with HNF alpha
inc risk HCC

446
Q

MODY 2 gene

A

glucokinase

447
Q

MODY 5

A

rare
cysts
HNF 1 beta

448
Q

Gitelmans syndrome

A

Defect in Na Cl transporter DCT
Normotension
Hypokalaemia
Hypocalciruia
Hypomagnesaemia
Met alk

449
Q

Target HbA1c T1DM

A

48

450
Q

Estrogen only HRT risk

A

Endometrial ca

451
Q

Supressed by high but low dose dex suppresion test

A

Cushings disease

452
Q

Diabetic meds that dont cause hypos

A

Metformin
Glitazones
Gliptins

453
Q

Diabetic meds that do cause hypos

A

Gliclazides
Exanatides

454
Q

Type and MOA gliclazide, glimperide

A

Sulfonylureas, inhibit K ATPase

455
Q

Type and MOA exanatide, lirglutide

A

GLP 1
stimulates GLP1 receptor, Ca2+ influx, inc insulin

456
Q

Type and MOA sitagliptin, linagliptin

A

DDP4 inhibitors
Stops breakdown of GLP1

457
Q

Type and MOA pioglitazone, rosiglitazone

A

PPAR, increase insulin signalling/sensitivity

458
Q

Type and MOA empagliflozin, dapagliflozin

A

SGLT 2 inhibitors
inhibit kidney reabsorption of glucose, excretes more in urine

459
Q

Type and MOA acarbose

A

alpha glucosidase inhibitor
inhibits gut absorption of glucose

460
Q

What are insulin stress tests used for

A

Cushings vs pseudo cushings

461
Q

Addisons electrolyes/ph

A

Low Na
High K
Acidotic

462
Q

Hookworm presentation

A

itchy rash then resp asthma/allergy sx, the GI upset +- anaemia
India

463
Q

Pseudohypoparathyroidism bloods

A

PTH: high

calcium: low
phosphate: high

464
Q

Pseudohypoparathyroidism features

A

short fourth and fifth metacarpals
short stature
cognitive impairment
obesity
round face

465
Q

Pseudohypoparathyroidism genetics

A

G protein mutation
auto dom

466
Q

Well done!

A

.

467
Q

Impaired glucose tolerance

A

7.8-11.1

468
Q

How to test for Zollinger Ellison

A

Serum gastrin
Ocreotide scan

469
Q

Impaired fasting glucose

A

6.1-7

470
Q

Impaired glucose tolerance

A

7.8-11.1

471
Q

Tx Listeria meningitis

A

aciclovir, cef, ampicillin

472
Q

Painless solitary genital ulcer

A

Syphillis

473
Q

Painless genital ulcer painful lymphadenopathy

A

Lymphogranuloma verenum

474
Q

Painful ulcer Painful lymphadenopathy

A

Chancroid (Haemophilis ducrei)

475
Q

What does ezetimibe do

A

redcues intestinal cholesterol absoprtion

476
Q

CSF TB Meningitis

A

very low glucose

477
Q

Enterovirus meningitis

A

cold, diarrhoea preceding
resp/faeco-oral spread
creche

478
Q

Necrotising pneumonia
predeing viral illness
empyema/abcess

A

Staph aureus

479
Q

Adult Stills Disease

A

Fluctuating salmon Pink rash
Arhtralgia
Hepatosplenomegaly
Fever

480
Q

Azothiaprine eznyme

A

TPMT thiopurine methyltranferase

481
Q

Intracranial bleed with cranial nerves, hyponatraemia, hypokalaemia

A

Pituitary apoplexy

482
Q

Cholestrymine on INR

A

Lower

483
Q

Abx worsening SE of statin

A

clarithromycin

484
Q

SHBG in PCOS

A

Low

485
Q

Intoxicated, high BP, high HR, low K+

A

amphetamines

486
Q

Muscle weakness in medial epicondylitis/ulnar nerve palsy

A

adductor pollicis

487
Q

Hookworm presentation

A

Rash then resp asthma/allergy sx, the GI upset +- anaemia
India

488
Q

definitive test myotonic dystrophy

A

Genetic testing

489
Q

APML tx

A

all trans retinotic acid ATRA

490
Q

Reasons to stop stress test

A

>250/115
2mm ST depression lateral leads

491
Q

What age to continue HRT to in early menopause

A

51

492
Q

Exogenous insulin on C peptide

A

supresses

493
Q

How to test for Zollinger Ellison

A

Serum gastrin

494
Q

Tx for chlamydia pneumonia

A

Erythromycin

495
Q

physiological pred dose for 75kg man

A

7.5mg

496
Q

1st line tx OCD

A

CBT, ERP

497
Q

Thrombolysis window stroke

A

4.5 hours

498
Q

Vitamin supplement in CF

A

Vitamin A

499
Q

Hormone pattern PCOS

A

High LH, normal FSH, normal estradiol, high testosterone

500
Q

Right sided stroke, DVT ?cause

A

PFO

501
Q

Choroid neovascularisation
Dye stain leaking at macula
?diagnosis

A

Age related macular degeneration
Tx anti VEGF

502
Q

SE/caution of tevinor/truvada (HIV med)

A

renal impairment

503
Q

Painless transient visual loss
Curtain descending
?diagnosis

A

amaurosis fugax

504
Q

Amaurosis fugax tx

A

Clopidogrel

505
Q

Ulcers ax with RA

A

Pyoderma gangrenosum

506
Q

Photosensitive blistering rash
Ax with alcohol, HIV, hep, estrogen

A

Porphyrea cutanea tarda

507
Q

Intestinal Bacterial Overgrowth

A

E coli/bacteroides
Presents diarrhoea, B12 deficiency
tx with metro

508
Q

Prolactinoma medical management

A

Cabergoline (dopamine agonist)

509
Q

Which anti malarials are contra indicated in epilepsy

A

mefloquine
chloroquine

510
Q

Malaria prophylaxis in pregnancy

A

chloroquine
folate supplements

511
Q

TV definition

A

volume inspired or expired with each breath at rest

512
Q

Inspiratory reserve volume 2-3 L Definition

A

maximum volume of air that can be inspired at the end of a normal tidal inspiration
inspiratory capacity = TV + IRV

513
Q

Expiratory reserve volume (ERV) = 750ml

A

maximum volume of air that can be expired at the end of a normal tidal expiration

514
Q

Residual volume (RV) = 1.2L

A

volume of air remaining after maximal expiration

515
Q

Functional residual capacity (FRC)

A

the volume in the lungs at the end-expiratory position

516
Q

Vital capacity (VC) = 5L

A

maximum volume of air that can be expired after a maximal inspiration

517
Q

Total lung capacity (TLC)

A

sum of the vital capacity + residual volume

518
Q

Physiological dead space (VD)

A

VD = tidal volume * (PaCO2 - PeCO2) / PaCO2

519
Q

Causes of raised transfer factor

A

Asthma
Pulmonary haemorrhage
Weg/goodp
L to R shunt
polycythaemia
hyperkinetic
male
exercise
age

520
Q

Causes of low TLCO

A

Pulmonary fiborsis
pneumonoa
PE
pulmonary edema
emphysema
anaemia
Low cardiac output

521
Q

Primary Sclerosing cholangitis features

A

Cholestatis
pANCA
male
jaundice, pruritis, fatigue

522
Q

PMR symptoms

A

raised ESR, CRP
Weight loss/anorexia
Normal CK

523
Q

Anastrazole mechanism

A

blocks peripheral tissue conversion of androgen to estrogen

524
Q

Pneumonectomy eligibility criteria

A

FEV >2L
FEV >50% of FVC
Normal PaC02 at rest

525
Q

When do you use CEA for colorectal ca

A

post op surveilance

526
Q

Rhomboid shaped crystals on joint aspiration

A

pseudogout - pyrophosphate arthritis/chondrocalcinosis

527
Q

Rash “concentric rings varying colours”

A

Erythema multiforme

528
Q

Hep E endemic region

A

North Africa

529
Q

Trauma -> muscle wasting of whole hand

A

T1 nerve root damage

530
Q

Other antibodies ax with anti phospholipid

A

anti b2 glycoprotein
anti cardiolipin

531
Q

Dig toxicity

A

Complete heart block
Nausea/vom
Yellow vision
Brady/hypo

532
Q

Complete heart block post MI ?which vessel

A

Posterior interventricular artery

533
Q

1st line for acne and hirstutism in PCOS

A

Dianette Co-cyprindol

534
Q

What causes in renal impairment in rhadomyolysis

A

Myoglobin

535
Q

Botulin vs tetanus

A

Tetanus is rigid paralysis, botulin is flaccid

536
Q

VTE and nephrotic syndrome

A

Anti thrombin III deficiency

537
Q

PPAR drugs

A

fenofibrate

538
Q

Immunoglobulin well person, allergic reaction blood

A

IgA

539
Q

Familial primary pulmonary HTN sx

A

SOB, faitgue, angina
raised JVP
Left parasternal heave
pansystolic mrumur
S4
peripheral edema

540
Q

Acanthosis nigricans ax illness

A

gastric adenocarcinoma, endometrial carcinoma

541
Q

Cyanotic but not hypoxic

A

methaemoglobinaemia
sulfonamide exposure
tx methylene blue

542
Q

Pneumonia:
Young person
out of keeping radiology
muscle ache
cold agglutins

A

Mycoplasma

543
Q

Pontine haemorrhage stroke ?Vessel

A

Basilar artery

544
Q

Malignant otitis externa

A

Otitis externa spreading to temporal bone/skull
Facial nerve involvement
Caused by pseudomonas aeruginosa

545
Q

Trigeminal neuralgia sx with sensory loss

A

Tumour

546
Q

Tx for recurrent renal stones with hypercalciruia

A

Thiazide diruetic

547
Q

Indications for pacemaker

A

persistent symptomatic bradycardia
Trifasicular block
mobitz type 2 AV block
sinus pause >3s

548
Q

Anterior MI v1-v6

A

LAD

549
Q

Septal M1 V1-V4

A

LAD septal branches

550
Q

Lateral MI I, aVL, V5, V6

A

Left circumflex

551
Q

Inferior MI II, III aVF

A

Right coronary artery (80%) or Right circumflex (20%)

552
Q

Posterior MI V7, V8, V9

A

RCA

553
Q

Right ventricle MI VI, V4R

A

RCA

554
Q

Thoracic Outlet Syndrome

A

Pulse disappears when arm raised above head
pain, parathesia, numb arm
Ix doppler

555
Q

Lipaemic sample pancreatitis

A

Triglycerides/chylomicrons

556
Q

Power of study definition

A

probability of rejecting null hypothesis when its false

557
Q

Cancer PSC progresses to

A

cholangiocarcinoma

558
Q

Digital ischaemia tx

A

phentolamine

559
Q

Gabapentin mechanism

A

binds to alpha 2 delta on voltage gated calcium

560
Q

Skin plaques and acid fast bacilli

A

Leprosy

561
Q

Pramaquine MOA

A

Removes hypnozites from liver

562
Q

Somatostatin effect

A

Reduces gastrin secretion
Reduces gastric motility

563
Q

Modified glasgow pancreatitis criteria

A

Age
O2
WCC
Ca
ALT
LDH
Glucose
Urea
Albumin

564
Q

2nd line for animal bite

A

doxy and metro

565
Q

T2DM med to avoid in gastroparesis

A

GLPT 1 glutides

566
Q

Visual change with benign ICH

A

Enlarged blind spot
Constriction visual field

567
Q

Yellow fever

A

Flavivirus
flu, epigastric pain, bruising, bleeding gums, fever

568
Q

Doxasoin SE

A

worsens CCF
peripheral edema
palpitations

569
Q

Pseudohypoparathryoidism mechanism

A

loss of function G protein linked to PTH receptor

570
Q

Sx constrictive pericarditis

A

Raised JVP steep Y descent
pusatile liver
Right heart failure

571
Q

Kidney disease ax with syphilis

A

Rapidly porgressive glomerulonephritis

572
Q

Worst alpha 1 anti trypsin phenotype

A

PIZZ

573
Q

Best alpha 1 anti trypsin phenotype

A

PISS

574
Q

CYsticerosis

A

tapeworm
lump + seizure

575
Q

Headache better lying flat

A

Intracranial hypotension

576
Q

Tx PHT with multi focal atrial tachcardia

A

verapamil

577
Q

MOA propylthiouracil

A

inhibits conversion thyroxine to tri iodothyonine

578
Q

Acute pain
Small irregular oval pupil
photophobia
red eye, lacrimation
CILLARY FLUSH, hypopyon

A

Anterior uveitis

579
Q

Anterior uveitis tx

A

atropine, cyclopentolate
steroid eye drops

580
Q

Hutchinsons sign
HZO

A

Rash on tip or side of nose
nasocillary involvement, strong risk factor ocular involvement

581
Q

HZO tx

A

PO anti virals 7-10 days
can use topical steroids for any inflammation

582
Q

Severe pain
Decreased visual acuity
semi dilated pupil
Hazy cornea, halos

A

Acute angle closure glaucoma

583
Q

Acute onset
pain
blurred vision photophobia
small, fixed, oval pupil, ciliary flush

A

Anterior uveitis

584
Q

Visual loss following surgery
Red eye
pain

A

Endopthalmitis

585
Q

Pathophysiology thyroid eye disease

A

glycosaminoglycan and collagen deposition in the muscles

586
Q

Management thyroid eye disease

A

Lubricants
Steroids
radiotherapy
surgery

587
Q

Red flags thyroid eye disease

A

deterioration in vision
change in color
eye pops out
corneal opacity
cornea visible when eyes closed
disc swelling

588
Q

Bilateral
gritty/discomfort
sticky eyes in morning
red eyelid margins
+- swollen eyelids, styles, chalazions

A

Blepharitis

589
Q

Blepharitis tx

A

Hot compress
Lid hygiene
artificial tears

590
Q

Reduced vision
faded colour
glare
halos
defect in red reflex

A

Cataracts

591
Q

Cataracts risk factors

A

smoking, DM, alcohol, trauma
long term steroids
radiation
myotonic dystrophy
hypocalcaemia

592
Q

Complications of cataract surgery

A

posterior capsule opacification
retinal detachment
endophthalmitis

593
Q

Keratitis organisms

A

bacterial - staph a, pseudomonas aeruginosa contact lens
funga
amoebic keratitis (soil/contaminated water)
parasitic onchocercal river blindness
HSV
exposure

594
Q

Red eye
photophobia
foreign body/gritty
hypopyon

A

Keratitis

595
Q

Management keratitis

A

topical abx
cycloplegic for pain

596
Q

Complications of keratitis

A

corneal scarring
perforation
endopthlamitis
visual loss

597
Q

Redness/swelling
severe ocular pain
visual disturbance
proptosis
pain/opthalmoplegia on eye movements
eyelid edema/ptosis

A

Orbital cellulitis

598
Q

Orbital cellulitis vs preseptal cellulitis

A

reduced visual acuity, proptosis, pain/opthalmoplegia on eye movements = orbital cellulitis

599
Q

Floaters
Flashers
blurred vision
Cobwebs across vision
dark curtin descending
Weiss ring

A

Posterior vitreous detachment

600
Q

Posterior vitreous detachment tx

A

should self resolve
if retina tear will need treatment

601
Q

Risk factors for vitreous detachment

A

Age
Myopia

602
Q

Cupping of disc

A

glaucoma

603
Q

Tx glaucoma

A

prostaglandin analogue eye drops
2nd line beta blocker, carbonic anhydrase / sympathomimetic

604
Q

Prostaglandin analogue eye drops

A

increases uveoscleral outflow

brown pigmentation eye, increases eye lash length

605
Q

Beta block eye drops

A

avoid in asthmatics or heart block

606
Q

Sympathomimetics e.g brimonidine

A

Reduces aqueous production and increased outflow

Avoid if taking MAOI or TCA, causes hyperaemia

607
Q

Carbonic anhydrase inhibitor eyedrops eg Dorzolamide

A

Reduces aqueous production, sulphonamide like reactions

608
Q

Miotic eye drops e.g pilocarpine

A

increase outflow

SE constricted pupil, headache, blurred vision

609
Q

Dry macular degeneration

A

90% of all
Drusen spots - yellow spots in bruchs membrane

610
Q

Wet macular degeneration

A

choroidal neovascularisation
eudative
worst prognosis

611
Q

ARMD sx

A

decreased visual acuity (near)
poor dark vision
fluctuating visual disturbance
photopsia/glare
distortion of ines Amsler grid
red patches/drusen spots

612
Q

Supplements for dry ARMD

A

Vit A, C, E and zinc
no beta carotene for smokers

613
Q

Angioid retinal streaks

A

dark red streaks on fundoscopy
caused by breaks in bruchs membrane
ax pseudoxanthoma elasticum, ehler danlos, pagets, sickle cell, acromegaly

614
Q

“plucked chicken” skin

A

psuedoxanthoma elasticum

615
Q

Treatment of acute glaucoma

A

acetazolamide + pilocarpine

616
Q

What is a Holmes Adie pupil

A

Dilated and slow to react pupil
little/no response to light
absent/poor tendon reflexes

617
Q

“Pale well demarcated disc” on fundoscopy

A

Optic atrophy

618
Q

Acquired causes optic atrophy

A

MS
Papilloedema
raised IOP
Retinal damage
ischaemia
toxins
nutrition B1, B2, B6 , B12

619
Q

Cogenital causes optic atrophy

A

Friedreich ataxia
Mitochondrial disorders
DIDMOAD (DI, DM optic neuropathy, deafness)

620
Q

Most common RA eye disease

A

keratoconjunctivitis sicca

621
Q

RA red eye painless no itch

A

episcleritis

622
Q

RA dry, itchy

A

sicca

623
Q

RA red painful eye

A

scleritis

624
Q

Causes of tunnel vision

A

papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy
hysteria

625
Q

Argyll Robertson pupil

A

accommodate but dont react
tertiary syphilis

626
Q

HZO tx

A

PO aciclovir

627
Q

Ramsay hunt

A

HVV FACIAL nerve (HZO is TRIGEMINAL)

628
Q

Sudden loss of vision + severe retinal haemorrhages on fundoscopy

A

Central Retinal Vein Occlusion

629
Q

Cherry red spot on pale retina

A

Central retinal artery occlusion

630
Q

Night blindness + tunnel vision

A

Retinitis pigmentosa

631
Q

Confusion and papilloedema

A

Vit A toxicity

632
Q

Causes of RAPD

A

Retina detachment
Optic neuritis
MS

633
Q

RAPD (Marcus gunn)

A

light shone into affected eye both eyes dilate

634
Q

Kidney disease ax retinitis pigmentosa

A

Alports syndrome

635
Q

Visual loss - dense shadow starting peripherally moving inwards

A

Retinal detachment

636
Q

Enlarging dark spots in vision

A

Vitreous haemorrhage

637
Q

Stage I hypertensive retinopathy

A

Arteriolar narrowing, tortusoity
Increased light reflex, silver wiring

638
Q

Stage II hypertensive retinopathy

A

AV nipping

639
Q

Stage III hypertensive retinopathy

A

Cotton wool eudates
Flame blots haemorrhages

640
Q

Stage IV hypertensive retinopathy

A

Papilloedema

641
Q

Mild NPDR

A

1 or more microaneurysm

642
Q

Moderate NPDR

A

Microaneurysms
blot haemorrhage
hard excudates
cotton wool spots
venous beading/lopping

643
Q

Severe NPDR

A

blot haemorrhages and microaneurysms 4 quadrants
venous beading 2 quadrants
IRMA 1 quad

644
Q

Diabetic Proliferative retinopathy

A

neovascularisation
fibrous tissue ant to disc

645
Q

Diabetic Maculopathy

A

hard exudates

646
Q

Friedrichs ataxia

A

cerebellar sx
L and UMN
pes cavus
normal IQ
optic atrophy pale disc

647
Q

intracranial bleed causing fluctuating confusion over time

A

subdural

648
Q

Tx neuroleptic malignant sydrome

A

dantrolene

649
Q

Cancers ax with von hippel lindau

A

clear cell renal
hemangiomas

650
Q

PD vs drug induced parkinsons

A 
PD = rigid, resting tremor 
DIP = bilateral sx
651
Q

Huntingtons genetics

A

trinucloetide repeat CAG
auto dom

652
Q

MS tx

A

beta inteferon

653
Q

GBS paralysis

A

flaccid
hyporefflexia, tachycardia

654
Q

Miller Fisher syndrome

A

areflexia, ataxia opthalmoplegia
variant of GBS

655
Q

NF1

A

Cafe au lait
Axillary/groin freckles
Peripheral neurofibromas
Lisch nodules
scolisos
phaeochromcytoma

656
Q

NF2

A

Bilateral vestibular schwannomas
meningomas
ependynomas
intracranial schawnommas

657
Q

Tuberous sclerosis

A

Ash leaf spots
adenoma sebaceum
shagreen patches
subungal fibroms
epilepsy
develpmental delay
retinal haematomas

658
Q

Migraine acute tx

A

triptan

659
Q

Migraine prophylaxis

A

tompiramate, propanolol

660
Q

Tx for drug induced PD

A

benzhexol

661
Q

“slow relaxing grip”

A

myotonic dystrophy

662
Q

Loss of corneal reflex

A

acoustic neuroma

663
Q

Dementia and myoclonus

A

CJD

664
Q

Autonomic dysfunction +PD/cerebellar signs

A

multi systems atrophy

665
Q

Long term prophylaxis cluster headaches

A

Verapamil

666
Q

Patchy haemoorahgic change on MRI Head

A

HSV encephalitis

667
Q

Thrombectomy window

A

6 hours

668
Q

Intracranial bleed - hypodense not confied to suture lines

A

chronic subdural

669
Q

Epsilon sign

A

Right ventricular dysplasia

670
Q

Test for acute Hep C

A

HCV RNA

671
Q

Kussmaul sign

A

insp inc venous pressure, steep y jvp - perocarditis

672
Q

tx broad beta

A

fibrate

673
Q

NMS vs serotonin

A 
serotonin = myoclonus, hyperreflexic, tremor 
NMS = rigid
674
Q

loose bodies in joint

A

osteochondritis dissecans

675
Q

onion peel bone

A

ewings sarcoma

676
Q

Thailand
Subcut nodule pus
gram neg bacellie

A

meliodosis

677
Q

Main clinicl sign of left ventircular dysfunction

A

4th heart sound

678
Q

amitriptyline OD with VT tx

A

bicarb

679
Q

Bone mets with breast ca pain relief

A

Bisphosphonates

680
Q

Raised ALP, cortical thickening, trabceular pattern

A

Pagets

681
Q

PD tx

A

interfering - levodopa
not intefering - dopamine receptor agonist eg ropinrole

682
Q

Test for 2 catgeories eg men/women

A

1 sample proprotion test

683
Q

Test for 2 categorical variables eg child/adult, man/woman

A

chi squared

684
Q

Test for numeric value eg height

A

T test

685
Q

Test for 1 numeric and 1 categorical eg height men/women

A

T-test/ANOVA

686
Q

Test for 2 numerical values eg height/weight

A

Corelation test

687
Q

What level of evidence is RCT

A

Ib

688
Q

Test to compare 2 percentages

A

Chi squared

689
Q

Testing for correlation between two variables eg is there correlation between height and FVC

A

Linear regression
Spearman ranked

690
Q

Paired v unpaired T test

A

Paired = same group of people before/after
Unpaired - 2 groups of people

691
Q

Parametric tests

A

Students t
Pearson product-moment

692
Q

Ascending cholangitis

A

Charcot triad - jaundice, RUQ, Fever
Gallstones
E coli

693
Q

Ascending cholangtiis vs cholecystitis

A

Cholan - charcot triad
chole - murphys

694
Q

Diethylene glycol tox/OD tx

A

IV ethanol
haemodialysis

695
Q

Tropical med, non specific sx, eosinophilia

A

helminth/hookworm

696
Q

Biventricular hypertrophy on ECG

A

VSD

697
Q

What type of renal disease is Churg strauss and wegeners

A

focal segmental glomerulonephritis

698
Q

MRI: increased signal in pulvinar of thalamus

A

CJD

699
Q

Hyperoxaluria/uric oxalate renal stones tx

A

calcium supplemements

700
Q

Impaired memory/planning
inappropriate behaviour
diminishing speech

A

fronto temporal dementia

701
Q

Etanacerpt

A

anti TNF alpha
CI in MS. TB

702
Q

MS CF

A

oligoclonal bans
raised IgG

703
Q

TB drug course length

A

TB meningitis 12 months
everything else 6 months

704
Q

Signet ring cells

A

adenocarcinoma

705
Q

MOA bupropion

A

Noradrenaline dopamine reuptake inhibitor

706
Q

Topiramate side effects

A

weight loss, renal stones, behaviour change

707
Q

Amiodarone induced thyrotoxicosis tx

A

Anti thyroid drug and cortico steroids

708
Q

mechanism of pedal edema in ccf

A

increased renin

709
Q

Bronchial carcinoma tumour marker

A

Chromogranin A

710
Q

Recurrent infections
spanish
immunoglobuin deficiency

A

IgD deficiency

711
Q

Kearn sayre syndrome

A

sensineural hearing loss
mitochondrial
atazia
stroke
retinitis pgimentose
cardiomypathy
diabetes

712
Q

Usher syndrome

A

retinitis pigmentose, hearing loss

713
Q

What des BCR ABL code for

A

tyrosine kinase

714
Q

Meds causing torticollis or acute dystonia

A

Prochloperazine, metocloperamide

715
Q

Nerve root - weakness of thumb, numbness first web space

A

Radial nerve

716
Q

NMS tx

A

dantrolene

717
Q

Tx paraneoplastic pemphigous

A

steroids

718
Q

SE carbimazole

A

rash
pruritis
arthalgia
alopecia
agranucytosis
jaundice

719
Q

Lyme disease test

A

Borrelia IgG

720
Q

Irregular plauqe like lesion
chronic progressive
indurated
foreign

A

Lupus vulgaris

721
Q

Annular rimmed lesion with punched out hypopigmented centre

A

Borderline leprosy

722
Q

Gold standard bronchiectasis diagnosis

A

HRCT

723
Q

ECGs sign of impending cardiac arrest hyperkalaemia

A

prolonged QRS

724
Q

Tx Neisseria mengitis

A

Ceftriaxone

725
Q

RF Ig?

A

IgM

726
Q

Why do people with CLL need irradiated blood?

A

Depletion of donor white cells

727
Q

Where does 4th heart sounds sit on ECG

A

After P wave

728
Q

Night sweats, lethargy, penumonia sx, hypercalcaemia

A

pulmonary sarcoid

729
Q

Tx for lupus

A

hydroxchloroquine
life threatening: cyclophosphamide
lupus nephritis: mycophenolate mofteil

730
Q

Tx necrobiosis lipoidica

A

Topical corticosteroids

731
Q

Goes into VT whilst pacemaker - where had been touched?

A

coronary sinus

732
Q

Tx Whipples disease

A

IV cef

733
Q

mucosa appeared yellowed externally with erythematous erosions

A

Whipples

734
Q

Dx ank spond if active sx

A

MRI sacro iliac

735
Q

Pericarditis ECG

A

Saddle shaped ST most leads

736
Q

Bone issue:
High ALP
low phos
Lowish Ca
High PTH

A

Osteomalacia

737
Q

Pagets disease bloods

A

isolated ALP rise

738
Q

Docetaxel renal impairment toxicity

A

renal tubular toxicity

739
Q

MOZ tocilizumab

A

Anti IL 6

740
Q

Tx for nephrogenic DI

A

hydrochlorthiazide

741
Q

MOA baclofen

A

GABA agonist

742
Q

Antibodies causing neonatal heart block

A

Anti RO, anti La

743
Q

Tx syphilis

A

penicillin, doxy, azithro

744
Q

Diabetic med good for heart failure/ CV health

A

dapagliflozin

745
Q

SE pyrazinamide

A

joint pain
hepatitis
fever

746
Q

SE rifampicin

A

thrombocytopaenia, nausea, vom

747
Q

Cahnce of sibling being a HLA match

A

25%

748
Q

Best anti hypertensives if on lithium

A

Ca channel blockers

749
Q

2st step DKA tx

A

fluids

750
Q

Scale for assessing ALDs

A

Barthel

751
Q

Muscle causing fixed flexion deformity

A

rectus femoris

752
Q

Virus causing anal cancer

A

HPV

753
Q

Tx for Crohns skin/stoma ulcers

A

SC infliximab

754
Q

Eplenerone site kidney

A

Distal PCT

755
Q

1st line tx urgent thryoid eye disease

A

IV methylpred

756
Q

Toxin causing heptaocellular carcinoma

A

aflatoxin

757
Q

Positive urine nitroprusside
hexagon shaped crystals on urine analysis

A

cystine stones

758
Q

Boil breaking down to large painful ulcers

A

pyoderma gangrenosum

759
Q

Mechanisms of haemolysis in G6PD

A

Reduced NADPH

760
Q

When is 3rd nerve palsy likely compressive

A

pupil inovolvement

761
Q

Porphyrias skin AND abdo

A

variegate porphyria

762
Q

How long after increasing phenytoin should you check levels

A

2 weeks

763
Q

MOA etanercept

A

TNF alpha

764
Q

headache, fever myalgia, rash with black centre

A

mediterrean spotted fever

765
Q

Can’t sit still

A

Akthasia

766
Q

Chiari 1

A

herniation of cerellbar tonsils
older

767
Q

Chiari 2

A

Arnold chiari
happens when younger

768
Q

Antidote to beta blocker overdose

A

IV glucagon

769
Q

dehydration, sthen seizure, then focal neurology

A

saggital sinus thrombosis

770
Q

Study type that has biggest issue with recall bias

A

case-control

771
Q

Palm/sole melanoma

A

acral lentigous

772
Q

Sun exposed area melanoma

A

Lentigo maligna

773
Q

Which polyarteritis isnt ANCA +ve

A

polyarteritis nodosa

774
Q

Tropical med + raised Right hemidiaphragmm

A

amoebic liver abcess

775
Q

Life threatening warfarin bleed tx

A

Prothrmobin complex and vit K

776
Q

Renal disease caused by NSAID

A

Interstitial nephritis

777
Q

Pneumonia causing haemolytic anaemia

A

Mycoplasma

MRCP (5 decks)

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