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MRCP > MRCP Word Ax COPY > Flashcards

MRCP Word Ax COPY 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

Leukaemia “ Broad based projections” Dry tap TRAP +ve

A

Hairy Cell Leukaemia

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10
Q

Worse prognosis RA

A

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

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11
Q

Rash with one “herald patch” then spreads

A

Pityrisias Rosea

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12
Q

Lewy Body Dementia

A

EPSs Hallucinations Variable sx/GCS

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13
Q

Most common Lupus Antibodie

A

ANA

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14
Q

Translucent bands bones

A

Osteomalacia

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15
Q

Punched Out Osteolytic Lesions

A

Myeloma

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16
Q

Nephritis postive for everything high C3, C4, IgM, IgG

A

Lupus Nephritis

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17
Q

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

A

Cervical Rib

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18
Q

Polymyositis Antibody

A

Anti Jo

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19
Q

TB Drugs peripheral neuropathy

A

Isoniazid

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20
Q

Wernickes vitamin deficiency

A

Thiamine B1

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21
Q

Feltys Syndrome

A

Triad : Leucopaenia + RA + Splenomegaly (lympadenopathy, leg ulcers, normocytic anaemia)

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22
Q

Tense blistering rash (not affecting rash)

A

Bullous Pemphigoid IgG

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23
Q

Farm, haemolytic anaemia, high billrubin, neurology

A

TTP

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24
Q

Diabetic meds causing hypos

A

Gliclazide

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25
Q

Negatively bifringent crystals joint asp Monosodium Urate Monohydrate

A

Gout

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26
Q

Weakly positive bifringent crystals joint asp Calcium pyrophosphate

A

Pesudogout

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27
Q

Tx Tourettes

A

Risperidone

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28
Q

Palmar crease xanthaoma (pathognomonic)

A

Broad beta disease

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29
Q

Subchondral cysts

A

OA

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30
Q

Periarticular osteopaenia

A

RA

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31
Q

Osteophytes

A

OA

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32
Q

Brown/blue pigmentation

A

Alkaptonuria Homognetistic oxidase deficiency

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33
Q

Cushing K+/pH

A

Hypokalaemia Alkalosis

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34
Q

Conns K+/pH

A

Hypokalaemia Alkalosis

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35
Q

Bloody diarrhoea w/ shistocytes

A

E coli

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36
Q

Main bug causing HUS

A

E coli

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37
Q

Phenylketonuria

A

Seizures Eczema LD Musty

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38
Q

Cancer type most like to cause hypercalcaemia

A

Squamous Cell

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39
Q

Waldenstroms Macroglobulinaemia Ig?

A

IgM kappa paraprotein

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40
Q

Waldenstroms Macroglobulinaemia

A

HYPERVISCOCITY Cryoglobulinaemia/Raynauds Hepatosplenomegaly Lymphadenopathy

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41
Q

Lebers Optic Neuropathy inheritance

A

Mitochondrial

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42
Q

Downs cardiology issues

A

ASD PDA Fallots Tetralogy Endocardial cushion defect

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43
Q

Downs syndrome ax illness

A

Duodenal Atresia Leukaemia Esophageal fistulae Hypothyroid

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44
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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45
Q

Turners syndrome cardiac issues

A

Coarctation aorta Bicupsid aortic valve

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46
Q

Turners hormones

A

High gonadotrophin Low estrogen

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47
Q

Noonans features

A

male turners absence testicles/crypto orchidism

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48
Q

Kleinfelters genetics

A

47 XXY XXXYY XXYY

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49
Q

Kleinfeltoms features

A

Tall, thin, gynaecomastia, infertility High urinary gonadotrophins

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50
Q

Women affected more than male genetics

A

X linked

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51
Q

Mitochondrial inheritance

A

Maternal transmission V rare Leber optic neuropathy

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52
Q

Li Fraumeni Syndrome

A

Loss of p53 cancer syndrome Breast, brain, sarcoma

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53
Q

FAP chromosome

A

Bowel cancer deletion 5q21

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54
Q

Colorectal carcinoma chromosome

A

18q deletion

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55
Q

Haemochromatosis HLA

A

HLA A3

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56
Q

Behcets HLA

A

B5

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57
Q

HLA B27

A

Ank spod Reiters Psoriatic arthritis Anterior uveitis

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58
Q

HLA DR2

A

MS Pernicious anaemia Nacrolepsy Juvenile diabetes

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59
Q

HLA DR3

A

Coeliac Sjogens Hepatitis Addisons SLE Graves, Hashimotos IDDM MG

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60
Q

RA HLA

A

HLA DR4

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61
Q

Coeliac HLA

A

HLA DR5, DR7

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62
Q

Gram positive rods

A

Bacillus Clostridium Listeria

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63
Q

Gram positive cocci

A

Strep Staph

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64
Q

Gram negative rods

A

Klebsiella Enterobacter Salmonella Shigella Legionella Campylobacter Pseudomonas

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65
Q

Gram negative cocci

A

Neisseria

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66
Q

Q fever bug

A

C burnetti

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67
Q

Most common transmission Hep C

A

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

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68
Q

Chronic complications Hep C

A

Cirrhosis Hepatocellular carcinoma

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69
Q

Dengue features

A

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

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70
Q

HIV genetics

A

single stranded RNA

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71
Q

Immune changes in HIV

A

decreased CD4, CD8 hypergammaglobulinaemia decreased macrophage

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72
Q

Virus causing T Cell leukaemia

A

HTLV 1

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73
Q

Virus causing Kaposis sarcoma

A

HHV 8

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74
Q

HBsAg

A

Surface antigen = current disease (or carrier)

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75
Q

Anti Hbs

A

Immune

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76
Q

Anti Hbc

A

Current or previous infection

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77
Q

HIV test method

A

ELISA Western blot

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78
Q

Causes of false positive treponomal tests

A

Genital herpes Psoriasis RA SLE

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79
Q

Egg vaccines

A

Flu, yellow fever

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80
Q

Live vaccines

A

MMR Polio Chicken pox Yellow Fever Typhoid

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81
Q

Von Willebrands Rx

A

DDAPV, TXA

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82
Q

Gauchers disease

A

Jewish hepatosplenomegaly, anaemia, osteopaenia

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83
Q

Type I cryoglobulin

A

Waldenstroms

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84
Q

Type II cryoglobulin

A

Hep C, HIV

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85
Q

Type Iii cryoglobulin

A

Sjorgens

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86
Q

OD causing respiratory alkalosis

A

Aspirin, Theophyllines

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87
Q

C1 Inhibitor deficiency

A

Hereditary angioedema

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88
Q

C2, C4 deficiency (classic pathway)

A

HSP Glomerulonephritis SLE Strep Staph

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89
Q

C3-C9 deficiency

A

Recurrent bacterial infection e.g Neisseria

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90
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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91
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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92
Q

Raised IgG in liver disease

A

hepatitis, cryptogenic cirrhosis

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93
Q

Raised IgM in liver disease

A

biliary/alcoholic cirrhosis

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94
Q

Raised IgA in liver disease

A

alcoholic cirrhosis

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95
Q

Anti smooth muscle +ve

A

Hepatits PBS Cirrhosis Viral infection

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96
Q

Anti mitochondrial +ve

A

PBC Hepatitis Cirroshsi

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97
Q

Gastric parietal cell antibody +ve

A

Pernicious anaemia Atrophic gastrisi Autoimmune thyroid disease

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98
Q

Thyroid autoantibodies

A

Hashimotos Graves Hypothyroidism Pernicious Anaemia

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99
Q

ANA +ve

A

Sjorgens Lupus RA MG Hashimotos UC

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100
Q

cANCA

A

Wegeners granulomatosis Microscopic polangitis

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101
Q

pANCA

A

Idiopathic crescentic glomerulonephritis Microscopic polyangitis Churg Strauss

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102
Q

Hyperacute organ rejection presentation

A

Hours Complemented mediated Vascular spasm, occlusion, failed organ perfusion

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103
Q

Acute organ rejection

A

Days to weeks HLA incompatibility T cell/CD4

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104
Q

Chronic organ rejection

A

months-years T Cells

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105
Q

What cells mediate graft versus host disease

A

T cells

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106
Q

Causes of +ve Coombs test

A

haemolytic anaemia/tranfusion reactions LSE, lymphoma, leukaemia Methyldopa

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107
Q

Loss of forearm pronation Weak wrist flexion Thenar wasting

A

Median nerve palsy

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108
Q

Wasting hand muscles, hypothenar Claw hand Radial deviation

A

Ulnar nerve

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109
Q

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

A

Sciatic nerve palsy

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110
Q

What controls motor function

A

Basal ganglia

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111
Q

Anterior Cerebral Artery Occlusion

A

weak, numb contralateral leg mild arm signs face spare

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112
Q

Middle Cerebral Artery Occlusion

A

Contralateral hemiplegia sensory loss face dyphasia/dyspraxia contralateral homonynmous hemianopia

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113
Q

Vertebrobasilar artery occlusion

A

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

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114
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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115
Q

Brocas dysphasia

A

Inferolateral frontal lobe non fluent speech comprehension intact

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116
Q

Wernickes dysphasia

A

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

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117
Q

Fanconi syndrome

A

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

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118
Q

What do Th1 Helper cells secrete?

A

Cell mediated immunity IFN gamma IL2, IL3

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118
Q

What do Th2 helper cells secrete?

A

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

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119
Q

Nacrolepsy HLA

A

HLA DR2

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120
Q

Nicotinic Acetylcholine what type of Receptor

A

Ligand gated

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121
Q

Whats the usual outcome measure of a cohort study?

A

Relative risk

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122
Q

Fabry disease

A

Angiokeratomas “corneal whirl” Proteinurias Early MI/stroke

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123
Q

Shistocytes in blood smears

A

DIC

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124
Q

What type of receptor is ANP

A

Guanylate cyclase

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125
Q

Chi squared test

A

Comparing 2 percentages/proprotions

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126
Q

Mechanism of doxy

A

Inhibits 30s unit ribosomes

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127
Q

Achondroplasia mutation

A

FGFR3 fibroplast growth receptor

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128
Q

Achondroplasia inheritance

A

autosomal dominant

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129
Q

Features of achondroplasia

A

short arms and legs, short, flat nose

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130
Q

Bartters syndrome

A

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

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131
Q

Tay Sachs disease

A

lysosomal storage cherry red spot macula no hepatospelnomegaly developmental delay

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132
Q

Mcardles disease

A

glycogen storage myalgia myoglobinuria

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133
Q

Homocystinuria features

A

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

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134
Q

Pathophysiology of homocystinuria

A

cystathionine beta synthase

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135
Q

Tetralogy of Fallot

A

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

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136
Q

Goodpasture HLA

A

HLA DRB1*15:01

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137
Q

Ank spond renal disease

A

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

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138
Q

UC Vs Crohns Transmural inflammation

A

Crohns

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139
Q

UC Vs Crohns Fissuring ulcers

A

Crohns

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140
Q

UC Vs Crohns Lymphoid/neutrophil aggregates

A

Crohns

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141
Q

UC Vs Crohns Mucosa/submucosa only

A

UC

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142
Q

UC Vs Crohns Crypt Abcesses

A

UC

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143
Q

UC Vs Crohns Skip lesions

A

Crohns

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144
Q

UC Vs Crohns Continous inflammation

A

UC

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145
Q

UC Vs Crohns Transmural/all layers inflammation

A

Crohns

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146
Q

Few polyps and fhx of cancer

A

HNPCC

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147
Q

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

A

FAP

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148
Q

HIV nephropathy histology

A

Microcystictubular dilatation Collapsing FSGS

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149
Q

CMV Tx

A

Gancliclovir

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150
Q

Which antibodies cross the placenta

A

IgG

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151
Q

Initial therapy for phaeochromocytoma SVT

A

Phenoxybenzamine

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152
Q

Philadelphia chromosome in ALL good/bad prognosis?

A

Bad

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153
Q

Weber syndrome

A

Midbrain stroke THIRD NERVE PALSY SAME SIDE Contralateral hemiparesis and hemiparkinsonism

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154
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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155
Q

MOA/enzyme glitazone

A

CYP2C8

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156
Q

SVT in pregnancy tx

A

Beta blocker

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157
Q

Hyperlipoproteinaemia IB mutation

A

Apolipoprotein CII (APO CII)

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158
Q

Red spots with bluish white centre

A

Koplik spots Measles

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159
Q

Sheep, lymphadenopathy Fever Sweats Weight loss

A

Brucellosis

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160
Q

Tx for cholera

A

Doxy

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161
Q

Which immunoglobulins are responsible for haemolytic blood transfusion reactions?

A

IgM

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162
Q

Homocystinuria pathophysiology

A

deficiency of cystathionine beta synthase

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163
Q

Homocystinuria features

A

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

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164
Q

Homocystinuria tx

A

B6 supplementation

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165
Q

Conditions ax with turners

A

Cystic hygroma Lymphedema Hypothyroidism Horseshoe kidney Crohns

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166
Q

Features CF

A

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

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167
Q

Main constituent of pulmonary surfactant

A

dipalmitoyl phosphatidylcholine (DPPC)

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168
Q

Lesch-Nyhan syndrome

A

X recessive juvenile gout absence HGPRT orange sand stools

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169
Q

Liddles syndrome

A

Hypokalaemia HTN

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170
Q

Wilcoxon signed-rank test -

A

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

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171
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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172
Q

Kearns-Sayre syndrome

A

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

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173
Q

Beckwith-Wiedemann syndrome

A

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

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174
Q

Complement Leiner disease

A

C5

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175
Q

Norepinephrine receptor

A

G protein coupled receptor

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176
Q

Dermatitis herpetiformis HLA

A

HLA D3

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177
Q

Ligand gated ion receptors

A

Nicotinic acetylcholine Gaba glutamate

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178
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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179
Q

Guanylate cyclase receptors

A

ANP/BNP

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180
Q

HLA Psoriasis

A

HLA CW6

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181
Q

T1 RTA Anion gap

A

Normal

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182
Q

Lactic Acidosis Anion Gap

A

Raised

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183
Q

T1 RTA presentation

A

hyperchloraemic hypokalaemic metabollic acidosis

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184
Q

Linear IgG desposits

A

anti glomerular basement membrane disease

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185
Q

MOA sitagliptin

A

DPP-IV inhibitor

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186
Q

Tx cluster headaches

A

verapamil

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187
Q

Lip smacking seizure - which area of brain

A

Temporal lobe

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188
Q

CXR “mass surrounded by rim of air”

A

Aspergilloma

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189
Q

MODY presentation

A

diabetes without ketones antibody negative autosomal dominant family hx

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190
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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191
Q

Warm AIHA features

A

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

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192
Q

Cold AIHA features

A

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

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193
Q

White turbid fluid joint

A

Acute Gouty Arthritis

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194
Q

1st step tx aortic dissection

A

Labetalol

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195
Q

Haemochromatosis inheritance

A

Autosomal recessive

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196
Q

Haemochromatosis pathophysiology

A

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

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197
Q

Heinz bodies

A

GP6D deficiency

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198
Q

Howell Jolly bodie

A

Hyposplenism/splenctomy

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199
Q

Rouleax (blood film)

A

Waldenstroms, myeloma

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200
Q

Warm AIHA features

A

Happens at body temp Anaemia + jaundice +splenomegaly

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201
Q

Cold AIHA features

A

Worse cold temp Raynauds/purplish discoloration (acronyansosis)

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202
Q

Warm AIHA Ig

A

IgG

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203
Q

Cold AIHA Ig

A

IgM

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204
Q

What infections does Sickle Cell predispose to ?

A

encapsulated eg strep pneumoniae, salmonella

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205
Q

What organism causes aplastic sickle cell crisis?

A

Parvovirus (Causes sudden drop in Hb)

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206
Q

“Pulmonary infiltrates” in sickle cell

A

Acute chest syndrome

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207
Q

Acute chest syndrome sickle cell presentation

A

SOB, chest pain, pulmonary infiltrates, hypoxia

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208
Q

Long term tx sickle cell

A

hydroxyurea

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209
Q

Carcinoid tumour features

A

tachycardia flushing bronchoconstriction haemodynamic instability diarrhoea

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210
Q

“lambda light chain” in kidney

A

myeloma amyloidosis

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211
Q

Tramline spine

A

Ank spond bamboo spine

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212
Q

Rugger Jersey spine

A

Renal osteodystrophy

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213
Q

Trophozites/cysts in stool culture

A

Giardia

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214
Q

Type II RTA

A

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

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215
Q

Cisplatin side effects

A

Ototoxicity nephrotoxicity - hypokal, mag, calc

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216
Q

Tx for Hep C

A

Daclatasvir, sofosbuvir +_ ribavirin

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217
Q

Ciclosporin mechanism

A

IL2 inhibitor

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218
Q

Small testes, delayed puberty, loss of smell

A

Klamanns syndrome

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219
Q

Retinal protein responsible for light perception

A

rhodopsin

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220
Q

Boney lumps DIP

A

Heberdens nodes OA

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221
Q

Boney lumps PIP

A

Bouchards node RA

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222
Q

Von Hippel Lindau

A

Cysts tumours everywhere Chromosome 3 RCC common

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223
Q

Scheuermanns disease

A

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

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224
Q

Hormone change at ovulation

A

LH surge

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225
Q

Net like rash

A

Cholesterol emboli

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226
Q

Sickle cell treatment

A

Hydroxyurea

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227
Q

McArdle disease

A

Repeated cramping and myoglubinuria (dark drown urine) after exercise

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228
Q

Illness where prophylaxis causing haemolytic anaemia

A

G6PD deficiency

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229
Q

Hypersegmented neutrophils

A

Megaloblastic anaemia

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230
Q

Left shift of myeloid cells

A

Pregnancy, severe infection, CML

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231
Q

Blast cells

A

AML/ALL

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232
Q

Auer rods

A

AML

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233
Q

Smear/smudge cells

A

lymphocytosis usually CLL

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234
Q

Primary thrombocytopaenia features

A

Bleeds/clots splenic infarcts/atrophy raised megakaryoctyes

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235
Q

Primary thrombocytopaenia tx

A

hydroxycarbamide, alpha interferon, anagrelide aspirin

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236
Q

Polycythaemia rubra vera features

A

Clots - headaches, dizziness, VTE, stroke, hepatosplenomegaly

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237
Q

Tear drop poikilocytes

A

Myelobfibrosis

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238
Q

What condition often turns into myelofibrosis?

A

PRV

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239
Q

What condition does myleofibrosis often turn into?

A

AML

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240
Q

Most common leukaemia adults

A

AML

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241
Q

Philadelphia chromosome in ALL ?prognosis

A

Poor prognosis

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242
Q

CLL presentation

A

painless lymphadenopathy + anaemia Smear cells

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243
Q

Reed Sternberg cells “owls eye” appearance

A

Hodgkins lymphoma

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244
Q

Most common type of Hodgkins

A

Nodular sclerosing women good prognosis

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245
Q

High number Reed Sternbergs ?Hodgkins type

A

Mixed cellularity

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246
Q

Best prognosis Hodgkins

A

Lymphocyte predominant

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247
Q

Worst prognosis Hodgkins

A

Lymphocyte depleted

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248
Q

Poor prognostic factors in AML

A

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

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249
Q

Acute promyelocytic leukaemia genetics and cells

A

t15:17 fusion of PML and RAR alpha Auer rods

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250
Q

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

A

CML

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251
Q

CML genetics

A

t9:22 q34:11 BCR-ACL

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252
Q

CML treatment

A

imatinib - tyrosine kinase inhibitors

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253
Q

Leukaemia presenting with DIC

A

APML

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254
Q

Good prognostic factors ALL

A

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

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255
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

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256
Q

“monoclonal proliferation well differentiated B lymphocytes”

A

CLL

257
Q

Ann Arbor Stage I

A

single region lymph nodes

258
Q

Ann Arbor Stage II

A

2 sites same side of diaphragm

259
Q

Ann Arbor Stage III

A

several sites both sides of diaphragm

260
Q

Ann Arbor Stage IV

A

extralymphatic structures

261
Q

Tumour lysis syndrome

A

High phos, potassium, uric acid Low Ca2+

262
Q

Mantle cell lymphoma genetics

A

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

263
Q

Follicular lymphoma genetics

A

t 14:18 BCL 2

264
Q

TTP antibody

A

ADAMTS 13

265
Q

What clotting factor does Von Willebrand process

A

Factor VIII carrier protein

266
Q

What factors doe Haemophilla A affect

A

Factor VIII

267
Q

What factors doe Haemophilla B affect

A

IX

268
Q

DIC blood features

A

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

269
Q

Chemo agent causing low Mg

A

cisplatin

270
Q

Causes of intravascular haemolysis

A

Blood transfusion G6PD TTP DIC HUS PNH Cold AIHA

271
Q

Causes of extravascular haemolysis

A

Sickle cell, thalasaemia Hereditary sphereocytosis Haemolytic of newborn Warm AIHA

272
Q

Haemophilia PT/APTT

A

PT normal APPT prolonged

273
Q

Antiphospholipid pregnancy tx

A

Aspirin and LMWH

274
Q

Prognostic marker for myeloma

A

B2 microglobulin

275
Q

MOA cisplatin

A

cross linking DNA

276
Q

Haem issue causing headache, blurred vision

A

Waldenstroms

277
Q

Causes warm AIHA

A

SLE methyldopa

278
Q

Causes cold AIHA

A

Mycoplasma, EBV

279
Q

Surgical prophylaxis Von Willebrands

A

Desmo

280
Q

Leukaemiod reaction (rather than leukaemia)

A

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

281
Q

Von Williebrand PT/APTT

A

Mildly prolonged APTT

282
Q

CLL poor prognostic markers

A

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

283
Q

CLL good prognosis

A

del 13

284
Q

Hereditary spherocytosis features

A

Fhx, gallstones, anaemia splenomegaly FTT EMA binding test

285
Q

Glutide main side effects

A

Hypos plus pancreatitis, renal imp, nausea and vomiting

286
Q

Ca 125

A

Ovarian Peritoneal

287
Q

ECOG 0

A

Normal

288
Q

ECOG 1

A

Can’t do strenuous stuff, but ok with work

289
Q

ECOG 2

A

Ambulatory and ADLs but not capable of work

290
Q

ECOG 3

A

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

291
Q

Dapaglifozin SGLT2 risks

A

DKA Increased cholesterol

292
Q

Med to reduce risk of tumour lysis

A

rasbicurase

293
Q

JAK 2

A

Thrombocythaemia

294
Q

Sickle cell HbSC

A

Mild disease

295
Q

Hereditary spherocytosis tx

A

Fluids, high dose folic acid

296
Q

Diabetes meds contraindicated in CCF

A

Pioglitazone

297
Q

G6PD triggers meds

A

primaquine cipro sulphs

298
Q

Test for anaphylaxis post reaction

A

tryptase

299
Q

Hodgkins poor prognostic markers

A

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

300
Q

Acute intermittent porphyria enzyme defect

A

Uroporphyrinogen decarboxylase

301
Q

Factor V Leiden mechanism

A

resistance to activated protein C

302
Q

Common cancer tumour lysis syndrome

A

Burkitts lymphoma

303
Q

Necrosis following warfarin

A

Protein C deficiency

304
Q

What does polycythaemia vubra vera progress to?

A

Myelofibrosis, AML

305
Q

Bilobed mononuclear cells

A

AML

306
Q

Liver transplant criteria paracetamol OD

A

pH <7.3 or INR >6.5 + grade 3/4 encephalopathy + Cr >300

307
Q

Hypovolaemia shock post MI

A

RV infarct

308
Q

Most common thyroid cancer

A

Papillary, great prognosis

309
Q

Type and MOA pioglitazone, rosiglitazone

A

PPAR gamma agonist, increase insulin signalling/sensitivity

310
Q

Conns triad

A

HTN + hypokalaemia + alkalosis

311
Q

Conns causes

A

RAS CAH CCF Corrhosis Nephritic syndrome

312
Q

Waterhouse Fredichsen

A

Septicaemia causing adrenal haemorrhage causing addisons

313
Q

Primary hyperparathyroid

A

Tumour producing PTH High PTH HIgh Ca2

314
Q

Secondary hyperparathyroid

A

Vit d deficiency Low/normal ca High PTH

315
Q

Tertiary hyperparathyroidism

A

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

316
Q

Hyperaemic membranes

A

TSS

317
Q

Where do SGLT 2 inhibitors glifozins work

A

Early PCT

318
Q

Glutide main side effects

A

Hypos

319
Q

Indications for surgery in HPTH

A

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

320
Q

Mst common cause primary hyperaldoteronism

A

Adreanl hyperplasia

321
Q

Pendred syndrome

A

Deafness and hypothyroid

322
Q

MOA gliptins

A

DPP 4 inhibitors

323
Q

Dapaglifozin SGLT2 MOA

A

Stops reabsorption glucose proximal renal tubule

324
Q

Dapaglifozin SGLT2 risks

A

DKA

325
Q

Normal fasting glucose

A

<6.1

326
Q

Post glucose /random glucose

A

<7.8

327
Q

Kallmans syndrome

A

Like kleinfelters but low LH, FSH and crypto orchidism

328
Q

Sulfonylureas MOA

A

increase insulin secretion B cells and decrease hepatic clearance

329
Q

MODY 3

A

most common ax with HNF alpha inc risk HCC

330
Q

MODY 2 gene

A

glucokinase

331
Q

MODY 5

A

rare cysts HNF 1 beta

332
Q

Gitelmans syndrome

A

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

333
Q

Target HbA1c T1DM

A

48

334
Q

Estrogen only HRT risk

A

Endometrial ca

335
Q

Supressed by high but low dose dex suppresion test

A

Cushings disease

336
Q

Diabetic meds that dont cause hypos

A

Metformin Glitazones Gliptins

337
Q

Diabetic meds that do cause hypos

A

Gliclazides Exanatides

338
Q

Type and MOA gliclazide, glimperide

A

Sulfonylureas, inhibit K ATPase

339
Q

Type and MOA exanatide, lirglutide

A

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

340
Q

Type and MOA sitagliptin, linagliptin

A

DDP4 inhibitors Stops breakdown of GLP1

341
Q

Type and MOA pioglitazone, rosiglitazone

A

PPAR, increase insulin signalling/sensitivity

342
Q

Type and MOA empagliflozin, dapagliflozin

A

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

343
Q

Type and MOA acarbose

A

alpha glucosidase inhibitor inhibits gut absorption of glucose

344
Q

What are insulin stress tests used for

A

Cushings vs pseudo cushings

345
Q

Addisons electrolyes/ph

A

Low Na High K Acidotic

346
Q

Hookworm presentation

A

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

347
Q

Pseudohypoparathyroidism bloods

A

PTH: high calcium: low phosphate: high

348
Q

Pseudohypoparathyroidism features

A

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

349
Q

Pseudohypoparathyroidism genetics

A

G protein mutation auto dom

350
Q

Well done!

A

.

351
Q

Impaired glucose tolerance

A

7.8-11.1

352
Q

How to test for Zollinger Ellison

A

Serum gastrin Ocreotide scan

353
Q

Impaired fasting glucose

A

6.1-7

354
Q

Impaired glucose tolerance

A

7.8-11.1

355
Q

Tx Listeria meningitis

A

aciclovir, cef, ampicillin

356
Q

Painless solitary genital ulcer

A

Syphillis

357
Q

Painless genital ulcer painful lymphadenopathy

A

Lymphogranuloma verenum

358
Q

Painful ulcer Painful lymphadenopathy

A

Chancroid (Haemophilis ducrei)

359
Q

What does ezetimibe do

A

redcues intestinal cholesterol absoprtion

360
Q

CSF TB Meningitis

A

very low glucose

361
Q

Enterovirus meningitis

A

cold, diarrhoea preceding resp/faeco-oral spread creche

362
Q

Necrotising pneumonia predeing viral illness empyema/abcess

A

Staph aureus

363
Q

Adult Stills Disease

A

Fluctuating salmon Pink rash Arhtralgia Hepatosplenomegaly Fever

364
Q

Azothiaprine eznyme

A

TPMT thiopurine methyltranferase

365
Q

Intracranial bleed with cranial nerves, hyponatraemia, hypokalaemia

A

Pituitary apoplexy

366
Q

Cholestrymine on INR

A

Lower

367
Q

Abx worsening SE of statin

A

clarithromycin

368
Q

SHBG in PCOS

A

Low

369
Q

Intoxicated, high BP, high HR, low K+

A

amphetamines

370
Q

Muscle weakness in medial epicondylitis/ulnar nerve palsy

A

adductor pollicis

371
Q

Hookworm presentation

A

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

372
Q

definitive test myotonic dystrophy

A

Genetic testing

373
Q

APML tx

A

all trans retinotic acid ATRA

374
Q

Reasons to stop stress test

A

>250/115 2mm ST depression lateral leads

375
Q

What age to continue HRT to in early menopause

A

51

376
Q

Exogenous insulin on C peptide

A

supresses

377
Q

How to test for Zollinger Ellison

A

Serum gastrin

378
Q

Tx for chlamydia pneumonia

A

Erythromycin

379
Q

physiological pred dose for 75kg man

A

7.5mg

380
Q

1st line tx OCD

A

CBT, ERP

381
Q

Thrombolysis window stroke

A

4.5 hours

382
Q

Vitamin supplement in CF

A

Vitamin A

383
Q

Hormone pattern PCOS

A

High LH, normal FSH, normal estradiol, high testosterone

384
Q

Right sided stroke, DVT ?cause

A

PFO

385
Q

Choroid neovascularisation Dye stain leaking at macula ?diagnosis

A

Age related macular degeneration Tx anti VEGF

386
Q

SE/caution of tevinor/truvada (HIV med)

A

renal impairment

387
Q

Painless transient visual loss Curtain descending ?diagnosis

A

amaurosis fugax

388
Q

Amaurosis fugax tx

A

Clopidogrel

389
Q

Ulcers ax with RA

A

Pyoderma gangrenosum

390
Q

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

A

Porphyrea cutanea tarda

391
Q

Intestinal Bacterial Overgrowth

A

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

392
Q

Prolactinoma medical management

A

Cabergoline (dopamine agonist)

393
Q

Which anti malarials are contra indicated in epilepsy

A

mefloquine chloroquine

394
Q

Malaria prophylaxis in pregnancy

A

chloroquine folate supplements

395
Q

Causes of raised transfer factor

A

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

396
Q

Causes of low TLCO

A

Pulmonary fiborsis pneumonoa PE pulmonary edema emphysema anaemia Low cardiac output

397
Q

Primary Sclerosing cholangitis features

A

Cholestatis pANCA male jaundice, pruritis, fatigue

398
Q

PMR symptoms

A

raised ESR, CRP Weight loss/anorexia Normal CK

399
Q

Anastrazole mechanism

A

blocks peripheral tissue conversion of androgen to estrogen

400
Q

Pneumonectomy eligibility criteria

A

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

401
Q

When do you use CEA for colorectal ca

A

post op surveilance

402
Q

Rhomboid shaped crystals on joint aspiration

A

pseudogout - pyrophosphate arthritis/chondrocalcinosis

403
Q

Rash “concentric rings varying colours”

A

Erythema multiforme

404
Q

Hep E endemic region

A

North Africa

405
Q

Trauma -> muscle wasting of whole hand

A

T1 nerve root damage

406
Q

Other antibodies ax with anti phospholipid

A

anti b2 glycoprotein anti cardiolipin

407
Q

Dig toxicity

A

Complete heart block Nausea/vom Yellow vision Brady/hypo

408
Q

Complete heart block post MI ?which vessel

A

Posterior interventricular artery

409
Q

1st line for acne and hirstutism in PCOS

A

Dianette Co-cyprindol

410
Q

What causes in renal impairment in rhadomyolysis

A

Myoglobin

411
Q

Botulin vs tetanus

A

Tetanus is rigid paralysis, botulin is flaccid

412
Q

VTE and nephrotic syndrome

A

Anti thrombin III deficiency

413
Q

PPAR drugs

A

fenofibrate

414
Q

Immunoglobulin well person, allergic reaction blood

A

IgA

415
Q

Familial primary pulmonary HTN sx

A

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

416
Q

Acanthosis nigricans ax illness

A

gastric adenocarcinoma, endometrial carcinoma

417
Q

Cyanotic but not hypoxic

A

methaemoglobinaemia sulfonamide exposure tx methylene blue

418
Q

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

A

Mycoplasma

419
Q

Pontine haemorrhage stroke ?Vessel

A

Basilar artery

420
Q

Malignant otitis externa

A

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

421
Q

Trigeminal neuralgia sx with sensory loss

A

Tumour

422
Q

Tx for recurrent renal stones with hypercalciruia

A

Thiazide diruetic

423
Q

Indications for pacemaker

A

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

424
Q

Anterior MI v1-v6

A

LAD

425
Q

Septal M1 V1-V4

A

LAD septal branches

426
Q

Lateral MI I, aVL, V5, V6

A

Left circumflex

427
Q

Inferior MI II, III aVF

A

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

428
Q

Posterior MI V7, V8, V9

A

RCA

429
Q

Right ventricle MI VI, V4R

A

RCA

430
Q

Thoracic Outlet Syndrome

A

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

431
Q

Lipaemic sample pancreatitis

A

Triglycerides/chylomicrons

432
Q

Power of study definition

A

probability of rejecting null hypothesis when its false

433
Q

Cancer PSC progresses to

A

cholangiocarcinoma

434
Q

Digital ischaemia tx

A

phentolamine

435
Q

Gabapentin mechanism

A

binds to alpha 2 delta on voltage gated calcium

436
Q

Skin plaques and acid fast bacilli

A

Leprosy

437
Q

Pramaquine MOA

A

Removes hypnozites from liver

438
Q

Somatostatin effect

A

Reduces gastrin secretion Reduces gastric motility

439
Q

Modified glasgow pancreatitis criteria

A

Age O2 WCC Ca ALT LDH Glucose Urea Albumin

440
Q

2nd line for animal bite

A

doxy and metro

441
Q

T2DM med to avoid in gastroparesis

A

GLPT 1 glutides

442
Q

Visual change with benign ICH

A

Enlarged blind spot Constriction visual field

443
Q

Yellow fever

A

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

444
Q

Doxasoin SE

A

worsens CCF peripheral edema palpitations

445
Q

Pseudohypoparathryoidism mechanism

A

loss of function G protein linked to PTH receptor

446
Q

Sx constrictive pericarditis

A

Raised JVP steep Y descent pusatile liver Right heart failure

447
Q

Kidney disease ax with syphilis

A

Rapidly porgressive glomerulonephritis

448
Q

Worst alpha 1 anti trypsin phenotype

A

PIZZ

449
Q

Best alpha 1 anti trypsin phenotype

A

PISS

450
Q

CYsticerosis

A

tapeworm lump + seizure

451
Q

Headache better lying flat

A

Intracranial hypotension

452
Q

Tx PHT with multi focal atrial tachcardia

A

verapamil

453
Q

MOA propylthiouracil

A

inhibits conversion thyroxine to tri iodothyonine

454
Q

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

A

Anterior uveitis

455
Q

Anterior uveitis tx

A

atropine, cyclopentolate steroid eye drops

456
Q

Hutchinsons sign HZO

A

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

457
Q

HZO tx

A

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

458
Q

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

A

Acute angle closure glaucoma

459
Q

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

A

Anterior uveitis

460
Q

Visual loss following surgery Red eye pain

A

Endopthalmitis

461
Q

Pathophysiology thyroid eye disease

A

glycosaminoglycan and collagen deposition in the muscles

462
Q

Management thyroid eye disease

A

Lubricants Steroids radiotherapy surgery

463
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

464
Q

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

A

Blepharitis

465
Q

Blepharitis tx

A

Hot compress Lid hygiene artificial tears

466
Q

Reduced vision faded colour glare halos defect in red reflex

A

Cataracts

467
Q

Cataracts risk factors

A

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

468
Q

Complications of cataract surgery

A

posterior capsule opacification retinal detachment endophthalmitis

469
Q

Keratitis organisms

A

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

470
Q

Red eye photophobia foreign body/gritty hypopyon

A

Keratitis

471
Q

Management keratitis

A

topical abx cycloplegic for pain

472
Q

Complications of keratitis

A

corneal scarring perforation endopthlamitis visual loss

473
Q

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

A

Orbital cellulitis

474
Q

Orbital cellulitis vs preseptal cellulitis

A

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

475
Q

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

A

Posterior vitreous detachment

476
Q

Posterior vitreous detachment tx

A

should self resolve if retina tear will need treatment

477
Q

Risk factors for vitreous detachment

A

Age Myopia

478
Q

Cupping of disc

A

glaucoma

479
Q

Tx glaucoma

A

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

480
Q

Prostaglandin analogue eye drops

A

increases uveoscleral outflow brown pigmentation eye, increases eye lash length

481
Q

Beta block eye drops

A

avoid in asthmatics or heart block

482
Q

Sympathomimetics e.g brimonidine

A

Reduces aqueous production and increased outflow Avoid if taking MAOI or TCA, causes hyperaemia

483
Q

Carbonic anhydrase inhibitor eyedrops eg Dorzolamide

A

Reduces aqueous production, sulphonamide like reactions

484
Q

Miotic eye drops e.g pilocarpine

A

increase outflow SE constricted pupil, headache, blurred vision

485
Q

Dry macular degeneration

A

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

486
Q

Wet macular degeneration

A

choroidal neovascularisation eudative worst prognosis

487
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

488
Q

Supplements for dry ARMD

A

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

489
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

490
Q

“plucked chicken” skin

A

psuedoxanthoma elasticum

491
Q

Treatment of acute glaucoma

A

acetazolamide + pilocarpine

492
Q

What is a Holmes Adie pupil

A

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

493
Q

“Pale well demarcated disc” on fundoscopy

A

Optic atrophy

494
Q

Acquired causes optic atrophy

A

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

495
Q

Cogenital causes optic atrophy

A

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

496
Q

Most common RA eye disease

A

keratoconjunctivitis sicca

497
Q

RA red eye painless no itch

A

episcleritis

498
Q

RA dry, itchy

A

sicca

499
Q

RA red painful eye

A

scleritis

500
Q

Causes of tunnel vision

A

papilloedema glaucoma retinitis pigmentosa choroidoretinitis optic atrophy hysteria

501
Q

Argyll Robertson pupil

A

accommodate but dont react tertiary syphilis

502
Q

HZO tx

A

PO aciclovir

503
Q

Ramsay hunt

A

HVV FACIAL nerve (HZO is TRIGEMINAL)

504
Q

Sudden loss of vision + severe retinal haemorrhages on fundoscopy

A

Central Retinal Vein Occlusion

505
Q

Cherry red spot on pale retina

A

Central retinal artery occlusion

506
Q

Night blindness + tunnel vision

A

Retinitis pigmentosa

507
Q

Confusion and papilloedema

A

Vit A toxicity

508
Q

Causes of RAPD

A

Retina detachment Optic neuritis MS

509
Q

RAPD (Marcus gunn)

A

light shone into affected eye both eyes dilate

510
Q

Kidney disease ax retinitis pigmentosa

A

Alports syndrome

511
Q

Visual loss - dense shadow starting peripherally moving inwards

A

Retinal detachment

512
Q

Enlarging dark spots in vision

A

Vitreous haemorrhage

513
Q

Stage I hypertensive retinopathy

A

Arteriolar narrowing, tortusoity Increased light reflex, silver wiring

514
Q

Stage II hypertensive retinopathy

A

AV nipping

515
Q

Stage III hypertensive retinopathy

A

Cotton wool eudates Flame blots haemorrhages

516
Q

Stage IV hypertensive retinopathy

A

Papilloedema

517
Q

Mild NPDR

A

1 or more microaneurysm

518
Q

Moderate NPDR

A

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

519
Q

Severe NPDR

A

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

520
Q

Diabetic Proliferative retinopathy

A

neovascularisation fibrous tissue ant to disc

521
Q

Diabetic Maculopathy

A

hard exudates

522
Q

Friedrichs ataxia

A

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

523
Q

intracranial bleed causing fluctuating confusion over time

A

subdural

524
Q

Tx neuroleptic malignant sydrome

A

dantrolene

525
Q

Cancers ax with von hippel lindau

A

clear cell renal hemangiomas

526
Q

PD vs drug induced parkinsons

A

PD = rigid, resting tremor DIP = bilateral sx

527
Q

Huntingtons genetics

A

trinucloetide repeat CAG auto dom

528
Q

MS tx

A

beta inteferon

529
Q

GBS paralysis

A

flaccid hyporefflexia, tachycardia

530
Q

Miller Fisher syndrome

A

areflexia, ataxia opthalmoplegia variant of GBS

531
Q

NF1

A

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

532
Q

NF2

A

Bilateral vestibular schwannomas meningomas ependynomas intracranial schawnommas

533
Q

Tuberous sclerosis

A

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

534
Q

Migraine acute tx

A

triptan

535
Q

Migraine prophylaxis

A

tompiramate, propanolol

536
Q

Tx for drug induced PD

A

benzhexol

537
Q

“slow relaxing grip”

A

myotonic dystrophy

538
Q

Loss of corneal reflex

A

acoustic neuroma

539
Q

Dementia and myoclonus

A

CJD

540
Q

Autonomic dysfunction +PD/cerebellar signs

A

multi systems atrophy

541
Q

Long term prophylaxis cluster headaches

A

Verapamil

542
Q

Patchy haemoorahgic change on MRI Head

A

HSV encephalitis

543
Q

Thrombectomy window

A

6 hours

544
Q

Intracranial bleed - hypodense not confied to suture lines

A

chronic subdural

545
Q

Epsilon sign

A

Right ventricular dysplasia

546
Q

Test for acute Hep C

A

HCV RNA

547
Q

Kussmaul sign

A

insp inc venous pressure, steep y jvp - perocarditis

548
Q

tx broad beta

A

fibrate

549
Q

NMS vs serotonin

A

serotonin = myoclonus, hyperreflexic, tremor NMS = rigid

550
Q

loose bodies in joint

A

osteochondritis dissecans

551
Q

onion peel bone

A

ewings sarcoma

552
Q

Thailand Subcut nodule pus gram neg bacellie

A

meliodosis

553
Q

Main clinicl sign of left ventircular dysfunction

A

4th heart sound

554
Q

amitriptyline OD with VT tx

A

bicarb

555
Q

Bone mets with breast ca pain relief

A

Bisphosphonates

556
Q

Raised ALP, cortical thickening, trabceular pattern

A

Pagets

557
Q

PD tx

A

interfering - levodopa not intefering - dopamine receptor agonist eg ropinrole

558
Q

Ascending cholangitis

A

Charcot triad - jaundice, RUQ, Fever Gallstones E coli

559
Q

Ascending cholangtiis vs cholecystitis

A

Cholan - charcot triad chole - murphys

560
Q

Diethylene glycol tox/OD tx

A

IV ethanol haemodialysis

561
Q

Tropical med, non specific sx, eosinophilia

A

helminth/hookworm

562
Q

Biventricular hypertrophy on ECG

A

VSD

563
Q

What type of renal disease is Churg strauss and wegeners

A

focal segmental glomerulonephritis

564
Q

MRI: increased signal in pulvinar of thalamus

A

CJD

565
Q

Hyperoxaluria/uric oxalate renal stones tx

A

calcium supplemements

566
Q

Impaired memory/planning inappropriate behaviour diminishing speech

A

fronto temporal dementia

567
Q

Etanacerpt

A

anti TNF alpha CI in MS. TB

568
Q

MS CF

A

oligoclonal bans raised IgG

569
Q

TB drug course length

A

TB meningitis 12 months everything else 6 months

570
Q

Signet ring cells

A

adenocarcinoma

571
Q

MOA bupropion

A

Noradrenaline dopamine reuptake inhibitor

572
Q

Topiramate side effects

A

weight loss, renal stones, behaviour change

573
Q

mechanism of pedal edema in ccf

A

increased renin

574
Q

Bronchial carcinoma tumour marker

A

Chromogranin A

575
Q

Recurrent infections spanish immunoglobuin deficiency

A

IgD deficiency

576
Q

Kearn sayre syndrome

A

sensineural hearing loss mitochondrial atazia stroke retinitis pgimentose cardiomypathy diabetes

577
Q

Usher syndrome

A

retinitis pigmentose, hearing loss

578
Q

What des BCR ABL code for

A

tyrosine kinase

579
Q

Meds causing torticollis or acute dystonia

A

Prochloperazine, metocloperamide

580
Q

Nerve root - weakness of thumb, numbness first web space

A

Radial nerve

581
Q

NMS tx

A

dantrolene

582
Q

Tx paraneoplastic pemphigous

A

steroids

583
Q

SE carbimazole

A

rash pruritis arthalgia alopecia agranucytosis jaundice

584
Q

Lyme disease test

A

Borrelia IgG

585
Q

Irregular plauqe like lesion chronic progressive indurated foreign

A

Lupus vulgaris

586
Q

Annular rimmed lesion with punched out hypopigmented centre

A

Borderline leprosy

587
Q

Gold standard bronchiectasis diagnosis

A

HRCT

588
Q

ECGs sign of impending cardiac arrest hyperkalaemia

A

prolonged QRS

589
Q

Tx Neisseria mengitis

A

Ceftriaxone

590
Q

RF Ig?

A

IgM

591
Q

Why do people with CLL need irradiated blood?

A

Depletion of donor white cells

592
Q

Where does 4th heart sounds sit on ECG

A

After P wave

593
Q

Night sweats, lethargy, penumonia sx, hypercalcaemia

A

pulmonary sarcoid

594
Q

Tx for lupus

A

hydroxchloroquine life threatening: cyclophosphamide lupus nephritis: mycophenolate mofteil

595
Q

Tx necrobiosis lipoidica

A

Topical corticosteroids

596
Q

Goes into VT whilst pacemaker - where had been touched?

A

coronary sinus

597
Q

Tx Whipples disease

A

IV cef

598
Q

mucosa appeared yellowed externally with erythematous erosions

A

Whipples

599
Q

Dx ank spond if active sx

A

MRI sacro iliac

600
Q

Pericarditis ECG

A

Saddle shaped ST most leads

601
Q

Bone issue: High ALP low phos Lowish Ca High PTH

A

Osteomalacia

602
Q

Pagets disease bloods

A

isolated ALP rise

603
Q

Docetaxel renal impairment toxicity

A

renal tubular toxicity

604
Q

MOZ tocilizumab

A

Anti IL 6

605
Q

Tx for nephrogenic DI

A

hydrochlorthiazide

606
Q

MOA baclofen

A

GABA agonist

607
Q

Antibodies causing neonatal heart block

A

Anti RO, anti La

608
Q

Tx syphilis

A

penicillin, doxy, azithro

609
Q

Diabetic med good for heart failure/ CV health

A

dapagliflozin

610
Q

SE pyrazinamide

A

joint pain hepatitis fever

611
Q

SE rifampicin

A

thrombocytopaenia, nausea, vom

612
Q

Cahnce of sibling being a HLA match

A

25%

613
Q

Best anti hypertensives if on lithium

A

Ca channel blockers

614
Q

2st step DKA tx

A

fluids

615
Q

Scale for assessing ALDs

A

Barthel

616
Q

Muscle causing fixed flexion deformity

A

rectus femoris

617
Q

Virus causing anal cancer

A

HPV

618
Q

Tx for Crohns skin/stoma ulcers

A

SC infliximab

619
Q

Eplenerone site kidney

A

Distal PCT

620
Q

1st line tx urgent thryoid eye disease

A

IV methylpred

621
Q

Toxin causing heptaocellular carcinoma

A

aflatoxin

622
Q

Positive urine nitroprusside hexagon shaped crystals on urine analysis

A

cystine stones

623
Q

Boil breaking down to large painful ulcers

A

pyoderma gangrenosum

624
Q

Mechanisms of haemolysis in G6PD

A

Reduced NADPH

625
Q

When is 3rd nerve palsy likely compressive

A

pupil inovolvement

626
Q

Porphyrias skin AND abdo

A

variegate porphyria

627
Q

How long after increasing phenytoin should you check levels

A

2 weeks

628
Q

MOA etanercept

A

TNF alpha

629
Q

headache, fever myalgia, rash with black centre

A

mediterrean spotted fever

630
Q

Can’t sit still

A

Akthasia

631
Q

Antidote to beta blocker overdose

A

IV glucagon

632
Q

dehydration, sthen seizure, then focal neurology

A

saggital sinus thrombosis

633
Q

Study type that has biggest issue with recall bias

A

case-control

634
Q

Palm/sole melanoma

A

acral lentigous

635
Q

Sun exposed area melanoma

A

Lentigo maligna

636
Q

Which polyarteritis isnt ANCA +ve

A

polyarteritis nodosa

637
Q

Tropical med + raised Right hemidiaphragmm

A

amoebic liver abcess

638
Q

Life threatening warfarin bleed tx

A

Prothrmobin complex and vit K

639
Q

Renal disease caused by NSAID

A

Interstitial nephritis

640
Q

Pneumonia causing haemolytic anaemia

A

Mycoplasma

MRCP (5 decks)

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