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MSRA Flashcards

1
Q

Features of William’s syndrome?

A

Short stature
Learning difficulties
Friendly, extrovert personality
Transient neonatal hypercalcaemia
Supravalvular aortic stenosis

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2
Q

Features of Cri Du Chat Syndrome?

A

Characteristic cry (hence the name) due to larynx and neurological problems
Feeding difficulties and poor weight gain
Learning difficulties
Microcephaly and micrognathism
Hypertelorism

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3
Q

What is the genetic alteration which causes Cri Du Chat syndrome?

A

Chromosome 5p deletion

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4
Q

Features of Prader- Willi Syndrome?

A

Hypotonia
Hypogonadism
Obesity

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5
Q

Features of Pierre- Robin Syndrome?

A

Micrognathia
Posterior displacement of the tongue (may result in upper airway obstruction)
Cleft palate

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6
Q

Features of Noonan Syndrome?

A

Webbed neck
Pectus excavatum
Short stature
Pulmonary stenosis

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7
Q

Features of Fragile X Syndrome?

A

Learning difficulties
Macrocephaly
Long face
Large ears
Macro-orchidism

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8
Q

Features of Edward’s syndrome

A

Trisomy 18
Micrognathia
Low-set ears
Rocker bottom feet
Overlapping of fingers

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9
Q

Features of Patau Syndrome?

A

Trisomy 13
Microcephalic, small eyes
Cleft lip/palate
Polydactyly
Scalp lesions

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10
Q

What is a common complication of small cell lung cancer?

A

SIADH

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11
Q

Which type of lung cancer is the most common in non smokers?

A

Adenocarcinoma

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12
Q

What is carcinoid syndrome?

A

Carcinoid syndrome is characterised by flushing, diarrhoea, and bronchospasm due to the release of serotonin and other vasoactive substances. It is a complication of lung carcinoma which is a large and slow growing neuroendocrine tumour

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13
Q

Which endocrine abnormality can you get in squamous cell carcinoma of the lung?

A

Hypercalcaemia due to parathyroid hormone related peptide secretion

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14
Q

What is the science of SIADH?

A

which leads to water retention, volume expansion, and dilutional hyponatraemia
ADH is produced by the hypothalamus and stored in the posterior pituitary gland. Its primary function is to regulate the body’s water balance
It does this by increasing water reabsorption in the collecting ducts of the kidneys, thereby decreasing the volume of urine produced
In SIADH, there is an inappropriate and continuous release of ADH that is not inhibited by normal physiological mechanisms, such as adequate or excess body fluid levels
As a result, the kidneys reabsorb more water, leading to decreased urine output, and expansion of extracellular fluid volume.
Importantly, this increase in body fluid volume does not lead to the expected signs of fluid overload, such as oedema or hypertension, because the excess fluid is uniformly distributed throughout all body fluid compartments.

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15
Q

Which portions of the bowel are most effected in coeliac disease?

A

Jejunum and duodenum

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16
Q

Which test is used to diagnose Chlamydia?

A

nucleic acid amplification test (NAAT)

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17
Q

What are the Chlamydia partner identification rules?

A

Chlamydia - partner notification:
symptomatic men: all partners from the 4 weeks prior to the onset of symptoms
women + asymptomatic men: all partners from the last 6 months or the most recent sexual partner

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18
Q

What are the FBC/ Coag findings for antiphospholipid syndrome?

A

Low platelets and high APTT

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19
Q

Which other condition is antiphospholipid syndrome often secondary to?

A

SLE

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20
Q

What is the management of antiphospholipid syndrome?

A

Primary thromboprophylaxis (aspirin) or secondary (DOAC vs Warfarin)

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21
Q

What are the rules for anti-coagulation for VTE?

A

3 months of anticoagulation if there is a cause such as surgery, 6 months if unprovoked

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22
Q

What is the diagnostic tool for lyme disease?

A

ELISA test

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23
Q

What is the antibiotic management for lyme disease

A

Doxycyline

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24
Q

Which classes of drugs can be used to prevent angina attacks?

A

Beta blocker or calcium channel blocker (if asthmatic). Must be a rate limiting CCB (such as verapamil or diltiazem) because non rate limiting CCB (such as amlodipine) can cause rebound tachycardia

25
Q

What can happen if verapamil and a beta blocker are prescribed concurrently?

A

Complete heart block

26
Q

How does clomifene work?

A

Anti oestrogen so stimulates ovulation

27
Q

What is a long term consequence of PPIs?

A

Osteoporosis and fractures, c.diff, hyponatraemia and hypomagnesmia

28
Q

What are the symptoms of SSRI discontinuation syndrome?

A

increased mood change
restlessness
difficulty sleeping
unsteadiness
sweating
gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
paraesthesia

29
Q

What is the peak time period for alcohol withdrawal seizures?

A

36 hours

30
Q

What are the symptoms of delirium tremens?

A

coarse tremor, confusion, delusions, auditory and visual hallucinations, fever, tachycardia

31
Q

What is the treatment regime for c.diff?

A

Initial presentation= 10 days of oral vancomycin
Second presentation= oral fidaxomicin

32
Q

What is the biochemical cause of alcohol withdrawal?

A

Decreased inhibitory GABA and increased excitatory NDMA glutamate

33
Q

Where are the ECG changes in an anterior MI?

A

V1-V4

34
Q

Where are the ECG changes in an inferior MI?

A

II, III and AVF

35
Q

Where are the ECG changes in an anterolateral MI?

A

V1-6, I and AVL

36
Q

Where are ECG changes in a lateral ECG?

A

I, AVL +/- V5 and V6

37
Q

Which antibiotic can you not prescribe in someone who is taking a statin and why?

A

Erythromycin- potent inhibitor of CYP3A4 which can cause statin induced myopathy and rhabdomyolysis

38
Q

When do you offer the OGTT in pregnancy?

A

24-28 weeks

39
Q

What are the target BM ranges for women with diabetes?

A

Fasting <5.6
1hr <7.8

(5,6,7,8)

40
Q

Name the causes of raised prolactin?

A

pregnancy
prolactinoma
physiological
polycystic ovarian syndrome
primary hypothyroidism
phenothiazines, metoclopramide, domperidone

41
Q

What is the main side effect to counsel patients about when starting them on hydroxychloroquine?

A

Retinopathy

42
Q

Which drug can be given to reduce the risk of tumour lysis syndrome and how does this work?

A

Allopurinol, reduces serum urate which reduces the risk of tumour lysis

43
Q

When are triptans contraindicated?

A

In ischaemic heart disease

44
Q

What is clergyman’s knee?

A

Infrapatellar bursitis

45
Q

What is housemaid’s knee?

A

Prepatellar bursitis

46
Q

What are the symptoms of Kawasaki’s disease?

A

high-grade fever which lasts for > 5 days. Fever is characteristically resistant to antipyretics
conjunctival injection
bright red, cracked lips
strawberry tongue
cervical lymphadenopathy
red palms of the hands and the soles of the feet which later peel

47
Q

What is the second line drug for DMT2 in people with ischaemic heart disease?

A

SGLT-2 inhibitors such as gliclazide

48
Q

What would you see on fundoscopy in age related macular degeneration?

A

Drusen, yellow deposits beneath the retina

49
Q

Which murmur is associated with Turner’s syndrome and why?

A

Ejection systolic due to a bicuspid aortic valve

50
Q

What is the cushings triad?

A

Hypertension, bradycardia and irregular breathing. Seen in increased ICP

51
Q

management of whooping cough?

A

Clarithromycin if in the first 21 days

52
Q

Management of meningitis in kids?

A

<3 months then IV cefotaxime and amox
>3 months IV ceftriaxone

53
Q

Which enzyme should you measure prior to starting azithothiaprine?

A

TPMT

54
Q

What are the features of HOCM on echo?

A

mitral regurgitation, systolic anterior motion of the anterior mitral valve leaflet, asymmetric hypertrophy.

55
Q

Which way do spider naevi fill?

A

From the centre

56
Q

What is charcot’s triad?

A

Fever, RUQ pain and jaundice
For ascending cholangitis

57
Q

How can orbital lymphoma present?

A

Unilateral conjunctivitis which is resistant to treatment

58
Q
A

MSRA (1 decks)

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