Notorious P.A.S.T.E.S.T. Flashcards
1
Q
Temporal lobe lesion causes what visual disturbance?
A
Contralateral Superior Quadrantanopia
as temporal lobe contains inferior optic radiation
2
Q
Parietal lobe lesion causes what visual disturbance?
A
Contralateral Inferior Quadrantanopia
as parietal lobe contains superior optic radiation
3
Q
Where would a lesion cause Superior Quadrantanopia?
A
Temporal lobe, contralaterally
carries inferior optic radiation
4
Q
Where would a lesion cause Inferior Quadrantanopia?
A
Parietal lobe, contralaterally
carries superior optic radiation
5
Q
Indication for laparotomy (rather than laparoscopy) for female sterilisation? (3)
A
BMI >30
PID
Recent abdo/ pelvis surgery
6
Q
What effect does female sterilisation typically have on periods?
A
None- only fallopian tube clipped
7
Q
Basophils indicate what in Chronic Myeloid Leukaemia?
A
Accelerated phase of disease
8
Q
What degrades fibrin clots?
A
Plasmin
9
Q
Young person with cerebellar symptoms and psychiatric illness raises suspicion of?
A
Wilson’s Disease (too much copper)
10
Q
Diagnostic tests for Wilson’s disease?
A
24hr urine collection (for Cu level)
Low Serum Ceruloplasmin
11
Q
Treatment of essential thrombocytosis?
A
Hydroxyurea
12
Q
Definitive diagnosis of Down Syndrome in 1st trimester?
A
Chorionic Villus Sampling
13
Q
Definitive diagnosis of Down Syndrome in 2nd trimester?
A
Amniocentesis
14
Q
Treatment for unprovoked vulvodynia?
A
Amitriptyline
15
Q
How long does pain have to go on for to diagnose unprovoked vulvodynia?
A
> 3mo
16
Q
Who gets cervical screening every 3 years?
A
Women 25-49
17
Q
Who gets cervical screening every 5 years?
A
Women 50-64
18
Q
Definitive treatment for menorrhagia due to large fibroid?
A
Hysterectomy
19
Q
Drugs for PTSD? (3)
A
Sertraline (1st Line)
Paroxetine
Venlafaxine
20
Q
What ion is lost in vomiting?
A
H+ in stomach acid
Hence Metabolic Alkalosis
21
Q
Pseudogout is strongly associated with which haematological disease?
A
Haemochromatosis
22
Q
Calcium pyrophosphate crystals are often seen in the joints of sufferers of what haematological disease?
A
Haemochromatosis
associated with pseudogout
23
Q
Which area of the prostate most commonly develops cancer?
A
Peripheral zone
24
Q
Popcorn calcification on bony X-Ray suggests? (2)
A
Chondrocalcinosis
Paget’s Disease
25
Cotton wool calcification on bony X-Ray suggests? (2)
Chondrocalcinosis
| Paget's Disease
26
Sun-ray spiculations on bony X-Ray suggests?
Osteosarcoma
27
Onion-skin periostitis on bony X-Ray suggests?
Ewing's Sarcoma
28
Define Codman Triangle
Subperiosteal overgrowth pushes periosteum away from bone, in triangular shape
Seen in Osteosarcoma & Ewing's Sarcoma
29
In what pathology is Codman's Triangle seen on X-Ray? (2)
Osteosarcoma
| Ewing's Sarcoma
30
Subperiosteal overgrowth pushes periosteum away from bone.
What sign is seen on X-Ray?
Codman Triangle
31
Treatment for Dry ARMD?
Vitamin C and E supplements (this is all that can be done)
32
Amaurosis Fugax is strongly associated with what pathology?
Stroke/ TIA! Alarm bells
33
First line treatment in Ankylosing Spondylitis?
NSAIDs
34
First line treatment for a lot of causes of arthralgia?
NSAIDs
Workhorses innit
35
Anti- dsDNA antibodies are seen in what diagnosis?
SLE
| 'diss' > 'slay'
36
What is the best diagnostic antibody for SLE?
Anti- dsDNA antibodies
| 'diss' > 'slay'
37
Heberden's nodes are seen in what disease?
Osteoarthritis
| nodes over Distal Interphalangeal Joints
38
Bouchard's nodes are seen in what diseases? (2)
```
Osteoarthritis
Rheumatoid Arthritis (rare)
```
(nodes over Proximal Interphalangeal Joints)
39
Nodes over Distal Interphalangeal Joints are seen in what disease?
Osteoarthritis
these are Heberden's nodes
(NOT Rheumatoid)
40
Nodes over Proximal Interphalangeal Joints are seen in what disease?
Osteoarthritis
Rheumatoid Arthritis
these are Bouchard's nodes
41
When is Biologic Therapy indicated for Rheumatoid Arthritis? (2)
Active disease
2 DMARDs have been trialled for >6 months
One of the DMARDs should be methotrexate
42
Difference between dry and wet ARMD mechanisms
Dry- drusen grow between choroid and retina
Wet- New vessels grow and leak
43
What is more common- Dry or Wet ARMD?
Dry (90% of cases)
44
Which cells secrete Androgen-Binding Protein?
Sertoli Cells in the seminiferous tubules
45
Treat developed chicken pox in pregnancy? (2)
Acyclovir
| Symptomatic Tx
46
Treat pregnant woman exposed to Varicella Zoster (shingles/chicken pox)?
Varicella Zoster Immunoglobin (VZIG)
47
What is Kleihauer test for?
Check if foetal cells are in maternal circulation
48
What is the test to check volume of foetal blood cells in maternal circulation?
Kleihauer test
49
What does Indirect Coombs test determine?
Presence of of Antibodies against RBC surface antigens
50
When is Indirect Coombs test performed? (2)
Prenatally
Before blood transfusion
(do it before something happens, kind of indirect way of doing things)
51
What does Direct Coombs test determine?
Detects presence of Antibodies or Complement proteins on the surface of RBCs
52
What does Direct Coombs positive suggest?
Haemolytic Anaemia is due to immune cause
53
When do Haemophilia A and B present?
<1 year old in 90% of affected babies
54
What type of anaemia is seen in SLE?
Autoimmune Haemolytic Anaemia (AIHA)
55
When should diagnosis of Parkinson's Plus syndromes be considered?
No response to Levodopa
Rapid dementia progression
Early gait disturbance
56
Parkinsonism with the following:
No response to Levodopa
Rapid dementia progression
Early gait disturbance
Suggests what diagnosis?
Parkinson's plus syndromes
57
Parkinsonism with eye involvement suggests what?
Progressive supranuclear palsy
58
Commonest cause of secondary hypopituitarism?
Pituitary surgery
59
How long does it take for TSH to correct after adjusting thyroxine dose?
6-8 weeks
60
What class is Tamoxifen?
Selective oestrogen receptor blocker
61
First line Tx for Menorrhagia?
Mirena IUS
62
What is produced by Leydig cells?
Testosterone
63
Which cells produce Testosterone?
Leydig
64
Offer test of cure for chlamydia?
Not routinely
65
In whom should you suspect Listeria Monocytogenes infection? (4)
Elderly
Immunocompromised
Alcoholics
<3 years old
66
At what point is a septic patient said to be in Septic Shock?
When they don't respond to fluid challenge
67
Emergency medical treatment of ruptured oesophageal varices?
Terlipressin
| while you wait for endoscopy/ surgery
68
What is the Cerebello-Pontine Angle?
Wedge shaped space between cerebellum and brainstem
69
What is the name for the wedge shaped space between cerebellum and brainstem
Cerebello-Pontine Angle (CPA)
70
What runs in the Cerebello-Pontine Angle (CPA)?
Anterior Inferior cerebellar artery
CNVIII Vestibulocochlear Nerve
CNVII Facial Nerve
71
In which hemisphere are the language centres usually found?
Left (in 80%)
72
Infective causes of Bulbar Palsy?
Poliomyelitis
| Neurosyphilis
73
Which nerve innervates the 1st and 2nd webspaces of the foot?
Deep fibular (deep peroneal)
74
Which cells produce CSF?
Ependymal cells
75
Ependymal cells produce what?
CSF
76
What genetic disorder is associated with recurrent bilateral acoustic neuromas?
Neurofibromatosis type 2
77
Loss of corneal reflex. What should be considered early?
Acoustic neuroma
78
Anti-PLA2r antibody positive is highly suspicious for what renal disease?
Membranous Nephropathy
79
How is uveitis confirmed?
Slit lamp (ophthalmologist)
80
Left Testicular cancer metastatic route? (3)
Left Testicular Vein,
Left Renal Vein,
Inferior Vena Cava
81
Right Testicular cancer metastatic route?
Right Testicular Vein,
| Inferior Vena Cava
82
Facial hemiparesis with forehead sparing. UMN or LMN lesion?
UMN
| probably Stroke
83
Facial hemiparesis, forehead affected. UMN or LMN lesion?
LMN
| probably Bell's Palsy
84
Compare facial hemiparesis in Stroke and Bell's Palsy
Stroke- forehead sparing, UMN lesion
Bell's palsy- forehead affected, LMN lesion
85
From where does a Cystic Hygroma arise?
Posterior triangle of neck
86
Is a Cystic Hygroma transilluminable?
Yes, brilliantly
87
Where is the anhidrosis in a Horner's Syndrome due to Pancoast Tumour?
Unilaterally on face only
88
Infant with 'double bubble' on abdominal X-Ray. Diagnosis?
Duodenal atresia
89
What organism causes Slapped Cheek Syndrome?
Parvovirus B19
90
Fractured neck of Femur. Rupture of what artery can cause AVN of femoral head?
Medial circumflex femoral
91
African child with jaundice and painful swollen digits. What's happening?
Sickle cell crisis
92
First investigation for ?rotator cuff tear?
USS shoulder
93
Ischaemi & Necrosis distal to AV fistula?
Ischaemic Steal Syndrome
94
What percentage of Molar Pregnancies go on to become invasive?
15%
95
Define Anticipation in genetics
Phenomenon where inherited conditions present earlier & more severely through generations
96
Inherited conditions present earlier & more severely through generations. Name the genetic phenomenon?
Anticipation
97
Most likely organism to cause an uncomplicated UTI?
E. Coli
98
Why is there hypercalcaemia in Chronic Kidney Disease?
Reduced hydroxylation of Vitamin D
99
First inverstigation in suspected SAH?
Non-contrast CT
100
Who is required to certify brainstem death?
2x doctors registered 5+ years with GMC
| One must be consultant
101
Can you have papilloedema and tension headache?
No, this rules out Tension Headache (diagnosis of exclusion)
102
What brain structures atrophy in Huntington's disease? (2)
Caudate Nucleus
| Putamen
103
Atrophy of Caudate Nucleus implicated in what disease?
Huntington's
104
Butterfly brain atrophy. Think of what diagnosis?
Huntington's
105
Rapid dementia, myoclonus, psych & cerebellar symptoms. Diagnosis?
Creutzfeldt-Jacob Disease (CJD)
106
When can a bus or lorry be driven after a TIA?
12 months
| same as stroke
107
When can a bus or lorry be driven after a Stroke?
12 months
108
Describe Cerebellar speech
Slurred/ staccato
| Struggles with tongue twisters ('West Register Street')
109
Slurred/ staccato speech
| What type of speech?
Cerebellar speech
110
Struggles with tongue twisters ('West Register Street')
| What type of speech?
Cerebellar speech
111
Fluent nonsensical sentences
Unaware they're not making sense
What type of speech?
Wernicke's Receptive Dysphasia
112
Describe Wernicke's Receptive Dysphasia (2)
Fluent nonsensical sentences
| Unaware they're not making sense
113
Non-fluent effortful speech
Struggles finding next word
Comprehension maintained
What type of speech?
Broca's Expressive Dysphasia
Broca- Broken
114
Describe Broca's Expressive Dysphasia (3)
Non-fluent effortful speech
Struggles finding next word
Comprehension maintained
115
Recurrent Laryngeal Nerve is part of what cranial nerve?
Vagus CNX
116
Name the symptoms required to diagnose Total Anterior Circulation Syndrome Stroke (3)
Face & Limb hemiplegia
Speech or higher order deficit
Hemianopia
117
Multi-infarct Dementia is also known as what?
Vascular Dementia
| it's a subtype of this
118
What travels through the Foramen Rotundum?
CNV2, Maxillary Division of Trigeminal Nerve
119
Commonest cause of Viral Encephalitis?
Herpes Simplex Virus
120
Spinal level of Lumbar Puncture?
L3/L4
| Line between Posterior Iliac Crests
121
Depth of Lumbar Puncture anatomically?
Subarachnoid space
122
Is there CSF present in the Subarachnoid space?
Yes
Take Lumbar Puncture sample here L3/L4
123
Is there CSF present in the Subdural space?
No
124
Progression/ Life expectancy of Creutzfeldt-Jacob Disease?
6-12months
125
Progression/ Life expectancy of Huntington's Disease?
10-30 years
126
What are the 4Ts?
| reversible causes of cardiac arrest
Thrombosis
Tension pneumothorax
Toxin
Tamponade
(Throw Ten Toxic Tampons)
127
What are the 4Hs?
Hypoxia
Hypovolaemia
Hypokalaemia/ Hyperkalaemia
Hypothermia
128
Treatment for pulseless VT/ VF
Amiodarone
| DC Cardioversion
129
Most common gynaecological problem in prepubertal age group?
Vulvovaginitis
130
Excessive vaginal discharge without other symptoms in COCP user. Diagnosis?
Cervical ectropion
Secretory columnar epithelium spreads beyond transition zone
131
Causes of cervical ectropion? (2)
COCP
| Pregnancy
132
What happens to haemoglobin levels in pregnancy?
Fall
133
Antepartum haemorrhage with Maternal/ Foetal compromise. Treat?
Caesarean section & resus
134
Why does abdominal laparoscopic surgery cause shoulder pain? (3)
Abdo cavity inflated with CO2
Sensed by C345 in diaphragm
Pain referred to shoulder
135
Treat Genital Herpes Simplex infection in pregnancy?
Oral acyclovir until it abates
| Resume acyclovir from 36 weeks
136
What is Placenta Percreta?
Where placenta goes completely through the uterine wall
On the accreta scale
137
What is Placenta Increta?
Where placenta adheres to middle of myometrium, more deeply than placenta accreta
138
First line treatment for Uterine Atony is uterine massage. What's second line?
Uterine balloon tamponade
139
Why is an USS performed early in a pregnant woman with Hyperemesis Gravidarum?
High risk trophoblastic disease
140
Hard contracted uterus rules out what cause of PPH?
Uterine Atony
| it's hard and can contract i.e. has tone
141
How to best manage irregular periods?
COCP
142
Investigation for suspected cervical cancer?
Punch biopsy
143
What Arrhythmias can result from Long QT Syndrome? (2)
Torsades des pointes
| Ventricular Fibrillation
144
What class of drug is anastrozole?
Aromatase inhibitor
145
Muscle implicated in Winged Scapula?
Serratus Anterior
146
Nerve implicated in Winged Scapula?
Long Thoracic
147
Cord-like structure under breast skin. Pain decreases over time. Diagnosis?
Mondor's disease
| thrombophlebitis of subcutaneous veins
148
What skeletal muscle enzymes are raised in Polymyositis? (2)
Creatine Phosphokinase
| Aldolase
149
What is Tietze Syndrome?
Costochondritis of upper sternal ribs
150
Psammoma body with neck swelling. Diagnosis?
Papillary Thyroid Cancer
151
Is Carbimazole safe in pregnancy?
```
Not in 1st trimester
Propylthiouracil better (but liver SEs)
```
152
What do Sulphonylureas stimulate?
Insulin release from B Cells in pancreas
Hence Hypoglycaemia & weight gain
153
What hormone stimulates pancreas to produce extra insulin? Hormone released when food is in GI tract.
GLP-1
154
Drugs ending in -enatide or -glutide are of what class?
GLP-1 receptor agonists
Increase insulin release
155
What is the mechanism of -gliptin drugs?
Inhibit DPP4, which degrades GLP-1
Gliptins allow GLP-1 to exist longer and release more insulin
Stop giving me 'lip' or you'll get no 'D'inner
156
What class are -glitazone drugs?
TZD
157
What treatment is used to reverse vitiligo?
Topical corticosteroids
158
'Crazy paving' rash is a buzzword description for what?
Asteototic eczema
159
Where does Lichen Sclerosus affect?
Vulva
'Sus'- vulva
160
Where does Lichen Planus affect?
Body and limbs
Not specifically vulva like Lichen Sclerosus
Planus, plain, nowhere exciting
161
Polygonal purple papules is a common description of what diagnosis?
Lichen Planus
Planus Purple Polygonal
162
What colour is Lichen Sclerosus?
White
163
What is the commonest form of MODY?
MODY3
Associated with Hepatocellular carcinoma
164
What type of diabetes is associated with Hepatocellular Carcinoma?
MODY3
165
Layers of the Adrenal Cortex
Zona Glomerulosa
Zona Fasciculata
Zona Reticularis
GFR- out to in
166
What does the Adrenal Medulla secrete?
Catecholamines
167
What does the Zona Glomerulosa secrete?
Mineralocorticoids (salt hormones)
G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets
168
What does the Zona Fasciculata secrete?
Glucocorticoids (sugar hormones)
G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets
169
What does the Zona Reticularis secrete?
Androgens (sex hormones)
G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets
170
Why not give overweight patient Sulphonylurea?
Weight gain a common side effect
| as increases insulin release
171
Name the layers of the Adrenal Cortex and what they secrete
Glomerulosa- Salt (Mineralocorticoids)
Fasciculata- Sugar (Glucocorticoids)
Reticularis- Sex (Androgens)
The deeper you go the sweeter it gets
172
Investigation for GH deficiency in adult?
Insulin tolerance test
Induce severe hypoglycaemia, body should release GH to compensate
173
Compare electrolytes in Primary Hyperparathyroidism and Bony Mets?
Both present with ↑Ca ↑ALP
Bony Mets show normal Phosphate
Hyperparathyroidism shows ↓ Phosphate
174
Testosterone therapy is actually associated with reduced fertility in men. Why? (3)
Testosterone-> ↓GnRH release
↓GnRH release-> ↓LH ↓FSH release
↓LH ↓FSH release-> ↓sperm production
175
Which hormone triggers Sertoli cells to produce sperm?
FSH
176
Which hormone triggers Leydig cells to produce Testosterone?
LH
177
What effect does Testosterone have on GnRH secretion?
Inhibits it, negative feedback loop
178
Treatment for Renal Artery Stenosis?
Renal angioplasty
179
Difficult to control HTN
Flash Pulmonary Oedema
No history of MI
Diagnosis?
Renal Artery Stenosis
180
Most important factor to control for long term outcome in Polycystic Kidney Disease Patients?
Control of blood pressure
181
Renal Artery Stenosis symptoms? (2)
Difficult to control HTN
| Flash Pulmonary Oedema
182
Who gets Fibromuscular Dysplasia?
Women, 20-30
183
Chronic asymptomatic hyperkalaemia in renal failure. Drug treatment?
Calcium Polystyrene Sulfonate
| sometimes called Calcium Resonium
184
What type of dialysis is used in emergencies?
Haemodialysis
185
Describe the oedema in Hypoalbuminaemia
Generalised- face limbs abdomen
186
Describe the oedema in Inferior Vena Cava Obstruction
Lower limb
| Dilated umbilical vessels
187
Classic Symptoms of Graft-versus-Host Disease?
Watery diarrhoea
Rash
Raised Bilirubin
After an organ transplant
188
Commonest type of Renal Cell Carcinoma?
Clear Cell
189
Renal Artery Stenosis leads to an increase in Renin release. Why?
↓GFR (as in hypovolaemia)
Homeostatic response is to ↑ Renin
This RAASes blood pressure x
190
What does Aldosterone do to ions?
Na+ reabsorption (↑BP)
K+ excretion
H+ excretion (↑Bicarb, ↑pH)
191
Low GFR means what gets released physiologically?
Renin
192
How does low GFR lead to low potassium and high bicarbonate?
↓GFR- ↑Renin
↑Renin- RAAS- ↑Aldosterone
↑Aldosterone- ↑Excretion of K+ and H+, ↑Reabsorption Na+
193
Polycystic Kidney Disease is due to mutation on what chromosome?
16
Polycystic Kidney has 16 letters
194
Primary Biliary Cholangitis is associated with what antibody?
Anti-Mitochondrial Antibody
195
First line Phosphate binder in renal failure?
Calcium Acetate
196
Name main indications for emergency dialysis in renal failure (3)
```
Severe Hyperkalaemia (>7)
Pulmonary oedema (resistant)
Severe Metabolic Acidosis
```
