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Formative Revision > Notorious P.A.S.T.E.S.T. > Flashcards

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

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2
Q

Parietal lobe lesion causes what visual disturbance?

A

Contralateral Inferior Quadrantanopia

as parietal lobe contains superior optic radiation

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3
Q

Where would a lesion cause Superior Quadrantanopia?

A

Temporal lobe, contralaterally

carries inferior optic radiation

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4
Q

Where would a lesion cause Inferior Quadrantanopia?

A

Parietal lobe, contralaterally

carries superior optic radiation

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5
Q

Indication for laparotomy (rather than laparoscopy) for female sterilisation? (3)

A

BMI >30
PID
Recent abdo/ pelvis surgery

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6
Q

What effect does female sterilisation typically have on periods?

A

None- only fallopian tube clipped

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7
Q

Basophils indicate what in Chronic Myeloid Leukaemia?

A

Accelerated phase of disease

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8
Q

What degrades fibrin clots?

A

Plasmin

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9
Q

Young person with cerebellar symptoms and psychiatric illness raises suspicion of?

A

Wilson’s Disease (too much copper)

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10
Q

Diagnostic tests for Wilson’s disease?

A

24hr urine collection (for Cu level)

Low Serum Ceruloplasmin

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11
Q

Treatment of essential thrombocytosis?

A

Hydroxyurea

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12
Q

Definitive diagnosis of Down Syndrome in 1st trimester?

A

Chorionic Villus Sampling

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13
Q

Definitive diagnosis of Down Syndrome in 2nd trimester?

A

Amniocentesis

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14
Q

Treatment for unprovoked vulvodynia?

A

Amitriptyline

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15
Q

How long does pain have to go on for to diagnose unprovoked vulvodynia?

A

> 3mo

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16
Q

Who gets cervical screening every 3 years?

A

Women 25-49

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17
Q

Who gets cervical screening every 5 years?

A

Women 50-64

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18
Q

Definitive treatment for menorrhagia due to large fibroid?

A

Hysterectomy

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19
Q

Drugs for PTSD? (3)

A

Sertraline (1st Line)
Paroxetine
Venlafaxine

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20
Q

What ion is lost in vomiting?

A

H+ in stomach acid

Hence Metabolic Alkalosis

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21
Q

Pseudogout is strongly associated with which haematological disease?

A

Haemochromatosis

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22
Q

Calcium pyrophosphate crystals are often seen in the joints of sufferers of what haematological disease?

A

Haemochromatosis

associated with pseudogout

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23
Q

Which area of the prostate most commonly develops cancer?

A

Peripheral zone

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24
Q

Popcorn calcification on bony X-Ray suggests? (2)

A

Chondrocalcinosis

Paget’s Disease

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25
Q

Cotton wool calcification on bony X-Ray suggests? (2)

A

Chondrocalcinosis

Paget’s Disease

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26
Q

Sun-ray spiculations on bony X-Ray suggests?

A

Osteosarcoma

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27
Q

Onion-skin periostitis on bony X-Ray suggests?

A

Ewing’s Sarcoma

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28
Q

Define Codman Triangle

A

Subperiosteal overgrowth pushes periosteum away from bone, in triangular shape

Seen in Osteosarcoma & Ewing’s Sarcoma

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29
Q

In what pathology is Codman’s Triangle seen on X-Ray? (2)

A

Osteosarcoma

Ewing’s Sarcoma

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30
Q

Subperiosteal overgrowth pushes periosteum away from bone.

What sign is seen on X-Ray?

A

Codman Triangle

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31
Q

Treatment for Dry ARMD?

A

Vitamin C and E supplements (this is all that can be done)

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32
Q

Amaurosis Fugax is strongly associated with what pathology?

A

Stroke/ TIA! Alarm bells

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33
Q

First line treatment in Ankylosing Spondylitis?

A

NSAIDs

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34
Q

First line treatment for a lot of causes of arthralgia?

A

NSAIDs

Workhorses innit

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35
Q

Anti- dsDNA antibodies are seen in what diagnosis?

A

SLE

‘diss’ > ‘slay’

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36
Q

What is the best diagnostic antibody for SLE?

A

Anti- dsDNA antibodies

‘diss’ > ‘slay’

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37
Q

Heberden’s nodes are seen in what disease?

A

Osteoarthritis

nodes over Distal Interphalangeal Joints

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38
Q

Bouchard’s nodes are seen in what diseases? (2)

A 
Osteoarthritis
Rheumatoid Arthritis (rare)

(nodes over Proximal Interphalangeal Joints)

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39
Q

Nodes over Distal Interphalangeal Joints are seen in what disease?

A

Osteoarthritis
these are Heberden’s nodes

(NOT Rheumatoid)

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40
Q

Nodes over Proximal Interphalangeal Joints are seen in what disease?

A

Osteoarthritis
Rheumatoid Arthritis

these are Bouchard’s nodes

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41
Q

When is Biologic Therapy indicated for Rheumatoid Arthritis? (2)

A

Active disease
2 DMARDs have been trialled for >6 months

One of the DMARDs should be methotrexate

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42
Q

Difference between dry and wet ARMD mechanisms

A

Dry- drusen grow between choroid and retina

Wet- New vessels grow and leak

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43
Q

What is more common- Dry or Wet ARMD?

A

Dry (90% of cases)

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44
Q

Which cells secrete Androgen-Binding Protein?

A

Sertoli Cells in the seminiferous tubules

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45
Q

Treat developed chicken pox in pregnancy? (2)

A

Acyclovir

Symptomatic Tx

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46
Q

Treat pregnant woman exposed to Varicella Zoster (shingles/chicken pox)?

A

Varicella Zoster Immunoglobin (VZIG)

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47
Q

What is Kleihauer test for?

A

Check if foetal cells are in maternal circulation

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48
Q

What is the test to check volume of foetal blood cells in maternal circulation?

A

Kleihauer test

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49
Q

What does Indirect Coombs test determine?

A

Presence of of Antibodies against RBC surface antigens

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50
Q

When is Indirect Coombs test performed? (2)

A

Prenatally
Before blood transfusion

(do it before something happens, kind of indirect way of doing things)

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51
Q

What does Direct Coombs test determine?

A

Detects presence of Antibodies or Complement proteins on the surface of RBCs

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52
Q

What does Direct Coombs positive suggest?

A

Haemolytic Anaemia is due to immune cause

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53
Q

When do Haemophilia A and B present?

A

<1 year old in 90% of affected babies

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54
Q

What type of anaemia is seen in SLE?

A

Autoimmune Haemolytic Anaemia (AIHA)

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55
Q

When should diagnosis of Parkinson’s Plus syndromes be considered?

A

No response to Levodopa
Rapid dementia progression
Early gait disturbance

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56
Q

Parkinsonism with the following:
No response to Levodopa
Rapid dementia progression
Early gait disturbance

Suggests what diagnosis?

A

Parkinson’s plus syndromes

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57
Q

Parkinsonism with eye involvement suggests what?

A

Progressive supranuclear palsy

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58
Q

Commonest cause of secondary hypopituitarism?

A

Pituitary surgery

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59
Q

How long does it take for TSH to correct after adjusting thyroxine dose?

A

6-8 weeks

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60
Q

What class is Tamoxifen?

A

Selective oestrogen receptor blocker

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61
Q

First line Tx for Menorrhagia?

A

Mirena IUS

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62
Q

What is produced by Leydig cells?

A

Testosterone

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63
Q

Which cells produce Testosterone?

A

Leydig

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64
Q

Offer test of cure for chlamydia?

A

Not routinely

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65
Q

In whom should you suspect Listeria Monocytogenes infection? (4)

A

Elderly
Immunocompromised
Alcoholics
<3 years old

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66
Q

At what point is a septic patient said to be in Septic Shock?

A

When they don’t respond to fluid challenge

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67
Q

Emergency medical treatment of ruptured oesophageal varices?

A

Terlipressin

while you wait for endoscopy/ surgery

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68
Q

What is the Cerebello-Pontine Angle?

A

Wedge shaped space between cerebellum and brainstem

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69
Q

What is the name for the wedge shaped space between cerebellum and brainstem

A

Cerebello-Pontine Angle (CPA)

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70
Q

What runs in the Cerebello-Pontine Angle (CPA)?

A

Anterior Inferior cerebellar artery
CNVIII Vestibulocochlear Nerve
CNVII Facial Nerve

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71
Q

In which hemisphere are the language centres usually found?

A

Left (in 80%)

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72
Q

Infective causes of Bulbar Palsy?

A

Poliomyelitis

Neurosyphilis

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73
Q

Which nerve innervates the 1st and 2nd webspaces of the foot?

A

Deep fibular (deep peroneal)

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74
Q

Which cells produce CSF?

A

Ependymal cells

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75
Q

Ependymal cells produce what?

A

CSF

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76
Q

What genetic disorder is associated with recurrent bilateral acoustic neuromas?

A

Neurofibromatosis type 2

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77
Q

Loss of corneal reflex. What should be considered early?

A

Acoustic neuroma

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78
Q

Anti-PLA2r antibody positive is highly suspicious for what renal disease?

A

Membranous Nephropathy

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79
Q

How is uveitis confirmed?

A

Slit lamp (ophthalmologist)

80
Q

Left Testicular cancer metastatic route? (3)

A

Left Testicular Vein,
Left Renal Vein,
Inferior Vena Cava

81
Q

Right Testicular cancer metastatic route?

A

Right Testicular Vein,

Inferior Vena Cava

82
Q

Facial hemiparesis with forehead sparing. UMN or LMN lesion?

A

UMN

probably Stroke

83
Q

Facial hemiparesis, forehead affected. UMN or LMN lesion?

A

LMN

probably Bell’s Palsy

84
Q

Compare facial hemiparesis in Stroke and Bell’s Palsy

A

Stroke- forehead sparing, UMN lesion

Bell’s palsy- forehead affected, LMN lesion

85
Q

From where does a Cystic Hygroma arise?

A

Posterior triangle of neck

86
Q

Is a Cystic Hygroma transilluminable?

A

Yes, brilliantly

87
Q

Where is the anhidrosis in a Horner’s Syndrome due to Pancoast Tumour?

A

Unilaterally on face only

88
Q

Infant with ‘double bubble’ on abdominal X-Ray. Diagnosis?

A

Duodenal atresia

89
Q

What organism causes Slapped Cheek Syndrome?

A

Parvovirus B19

90
Q

Fractured neck of Femur. Rupture of what artery can cause AVN of femoral head?

A

Medial circumflex femoral

91
Q

African child with jaundice and painful swollen digits. What’s happening?

A

Sickle cell crisis

92
Q

First investigation for ?rotator cuff tear?

A

USS shoulder

93
Q

Ischaemi & Necrosis distal to AV fistula?

A

Ischaemic Steal Syndrome

94
Q

What percentage of Molar Pregnancies go on to become invasive?

A

15%

95
Q

Define Anticipation in genetics

A

Phenomenon where inherited conditions present earlier & more severely through generations

96
Q

Inherited conditions present earlier & more severely through generations. Name the genetic phenomenon?

A

Anticipation

97
Q

Most likely organism to cause an uncomplicated UTI?

A

E. Coli

98
Q

Why is there hypercalcaemia in Chronic Kidney Disease?

A

Reduced hydroxylation of Vitamin D

99
Q

First inverstigation in suspected SAH?

A

Non-contrast CT

100
Q

Who is required to certify brainstem death?

A

2x doctors registered 5+ years with GMC

One must be consultant

101
Q

Can you have papilloedema and tension headache?

A

No, this rules out Tension Headache (diagnosis of exclusion)

102
Q

What brain structures atrophy in Huntington’s disease? (2)

A

Caudate Nucleus

Putamen

103
Q

Atrophy of Caudate Nucleus implicated in what disease?

A

Huntington’s

104
Q

Butterfly brain atrophy. Think of what diagnosis?

A

Huntington’s

105
Q

Rapid dementia, myoclonus, psych & cerebellar symptoms. Diagnosis?

A

Creutzfeldt-Jacob Disease (CJD)

106
Q

When can a bus or lorry be driven after a TIA?

A

12 months

same as stroke

107
Q

When can a bus or lorry be driven after a Stroke?

A

12 months

108
Q

Describe Cerebellar speech

A

Slurred/ staccato

Struggles with tongue twisters (‘West Register Street’)

109
Q

Slurred/ staccato speech

What type of speech?

A

Cerebellar speech

110
Q

Struggles with tongue twisters (‘West Register Street’)

What type of speech?

A

Cerebellar speech

111
Q

Fluent nonsensical sentences
Unaware they’re not making sense
What type of speech?

A

Wernicke’s Receptive Dysphasia

112
Q

Describe Wernicke’s Receptive Dysphasia (2)

A

Fluent nonsensical sentences

Unaware they’re not making sense

113
Q

Non-fluent effortful speech
Struggles finding next word
Comprehension maintained
What type of speech?

A

Broca’s Expressive Dysphasia

Broca- Broken

114
Q

Describe Broca’s Expressive Dysphasia (3)

A

Non-fluent effortful speech
Struggles finding next word
Comprehension maintained

115
Q

Recurrent Laryngeal Nerve is part of what cranial nerve?

A

Vagus CNX

116
Q

Name the symptoms required to diagnose Total Anterior Circulation Syndrome Stroke (3)

A

Face & Limb hemiplegia
Speech or higher order deficit
Hemianopia

117
Q

Multi-infarct Dementia is also known as what?

A

Vascular Dementia

it’s a subtype of this

118
Q

What travels through the Foramen Rotundum?

A

CNV2, Maxillary Division of Trigeminal Nerve

119
Q

Commonest cause of Viral Encephalitis?

A

Herpes Simplex Virus

120
Q

Spinal level of Lumbar Puncture?

A

L3/L4

Line between Posterior Iliac Crests

121
Q

Depth of Lumbar Puncture anatomically?

A

Subarachnoid space

122
Q

Is there CSF present in the Subarachnoid space?

A

Yes

Take Lumbar Puncture sample here L3/L4

123
Q

Is there CSF present in the Subdural space?

A

No

124
Q

Progression/ Life expectancy of Creutzfeldt-Jacob Disease?

A

6-12months

125
Q

Progression/ Life expectancy of Huntington’s Disease?

A

10-30 years

126
Q

What are the 4Ts?

reversible causes of cardiac arrest

A

Thrombosis
Tension pneumothorax
Toxin
Tamponade

(Throw Ten Toxic Tampons)

127
Q

What are the 4Hs?

A

Hypoxia
Hypovolaemia
Hypokalaemia/ Hyperkalaemia
Hypothermia

128
Q

Treatment for pulseless VT/ VF

A

Amiodarone

DC Cardioversion

129
Q

Most common gynaecological problem in prepubertal age group?

A

Vulvovaginitis

130
Q

Excessive vaginal discharge without other symptoms in COCP user. Diagnosis?

A

Cervical ectropion

Secretory columnar epithelium spreads beyond transition zone

131
Q

Causes of cervical ectropion? (2)

A

COCP

Pregnancy

132
Q

What happens to haemoglobin levels in pregnancy?

A

Fall

133
Q

Antepartum haemorrhage with Maternal/ Foetal compromise. Treat?

A

Caesarean section & resus

134
Q

Why does abdominal laparoscopic surgery cause shoulder pain? (3)

A

Abdo cavity inflated with CO2
Sensed by C345 in diaphragm
Pain referred to shoulder

135
Q

Treat Genital Herpes Simplex infection in pregnancy?

A

Oral acyclovir until it abates

Resume acyclovir from 36 weeks

136
Q

What is Placenta Percreta?

A

Where placenta goes completely through the uterine wall

On the accreta scale

137
Q

What is Placenta Increta?

A

Where placenta adheres to middle of myometrium, more deeply than placenta accreta

138
Q

First line treatment for Uterine Atony is uterine massage. What’s second line?

A

Uterine balloon tamponade

139
Q

Why is an USS performed early in a pregnant woman with Hyperemesis Gravidarum?

A

High risk trophoblastic disease

140
Q

Hard contracted uterus rules out what cause of PPH?

A

Uterine Atony

it’s hard and can contract i.e. has tone

141
Q

How to best manage irregular periods?

A

COCP

142
Q

Investigation for suspected cervical cancer?

A

Punch biopsy

143
Q

What Arrhythmias can result from Long QT Syndrome? (2)

A

Torsades des pointes

Ventricular Fibrillation

144
Q

What class of drug is anastrozole?

A

Aromatase inhibitor

145
Q

Muscle implicated in Winged Scapula?

A

Serratus Anterior

146
Q

Nerve implicated in Winged Scapula?

A

Long Thoracic

147
Q

Cord-like structure under breast skin. Pain decreases over time. Diagnosis?

A

Mondor’s disease

thrombophlebitis of subcutaneous veins

148
Q

What skeletal muscle enzymes are raised in Polymyositis? (2)

A

Creatine Phosphokinase

Aldolase

149
Q

What is Tietze Syndrome?

A

Costochondritis of upper sternal ribs

150
Q

Psammoma body with neck swelling. Diagnosis?

A

Papillary Thyroid Cancer

151
Q

Is Carbimazole safe in pregnancy?

A 
Not in 1st trimester 
Propylthiouracil better (but liver SEs)
152
Q

What do Sulphonylureas stimulate?

A

Insulin release from B Cells in pancreas

Hence Hypoglycaemia & weight gain

153
Q

What hormone stimulates pancreas to produce extra insulin? Hormone released when food is in GI tract.

A

GLP-1

154
Q

Drugs ending in -enatide or -glutide are of what class?

A

GLP-1 receptor agonists

Increase insulin release

155
Q

What is the mechanism of -gliptin drugs?

A

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
Q

What class are -glitazone drugs?

A

TZD

157
Q

What treatment is used to reverse vitiligo?

A

Topical corticosteroids

158
Q

‘Crazy paving’ rash is a buzzword description for what?

A

Asteototic eczema

159
Q

Where does Lichen Sclerosus affect?

A

Vulva

‘Sus’- vulva

160
Q

Where does Lichen Planus affect?

A

Body and limbs

Not specifically vulva like Lichen Sclerosus

Planus, plain, nowhere exciting

161
Q

Polygonal purple papules is a common description of what diagnosis?

A

Lichen Planus

Planus Purple Polygonal

162
Q

What colour is Lichen Sclerosus?

A

White

163
Q

What is the commonest form of MODY?

A

MODY3

Associated with Hepatocellular carcinoma

164
Q

What type of diabetes is associated with Hepatocellular Carcinoma?

A

MODY3

165
Q

Layers of the Adrenal Cortex

A

Zona Glomerulosa
Zona Fasciculata
Zona Reticularis

GFR- out to in

166
Q

What does the Adrenal Medulla secrete?

A

Catecholamines

167
Q

What does the Zona Glomerulosa secrete?

A

Mineralocorticoids (salt hormones)

G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets

168
Q

What does the Zona Fasciculata secrete?

A

Glucocorticoids (sugar hormones)

G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets

169
Q

What does the Zona Reticularis secrete?

A

Androgens (sex hormones)

G- Salt (Mineralocorticoids)
F- Sugar (Glucocorticoids)
R- Sex (Androgens)
The deeper you go the sweeter it gets

170
Q

Why not give overweight patient Sulphonylurea?

A

Weight gain a common side effect

as increases insulin release

171
Q

Name the layers of the Adrenal Cortex and what they secrete

A

Glomerulosa- Salt (Mineralocorticoids)
Fasciculata- Sugar (Glucocorticoids)
Reticularis- Sex (Androgens)
The deeper you go the sweeter it gets

172
Q

Investigation for GH deficiency in adult?

A

Insulin tolerance test

Induce severe hypoglycaemia, body should release GH to compensate

173
Q

Compare electrolytes in Primary Hyperparathyroidism and Bony Mets?

A

Both present with ↑Ca ↑ALP

Bony Mets show normal Phosphate
Hyperparathyroidism shows ↓ Phosphate

174
Q

Testosterone therapy is actually associated with reduced fertility in men. Why? (3)

A

Testosterone-> ↓GnRH release

↓GnRH release-> ↓LH ↓FSH release

↓LH ↓FSH release-> ↓sperm production

175
Q

Which hormone triggers Sertoli cells to produce sperm?

A

FSH

176
Q

Which hormone triggers Leydig cells to produce Testosterone?

A

LH

177
Q

What effect does Testosterone have on GnRH secretion?

A

Inhibits it, negative feedback loop

178
Q

Treatment for Renal Artery Stenosis?

A

Renal angioplasty

179
Q

Difficult to control HTN
Flash Pulmonary Oedema
No history of MI

Diagnosis?

A

Renal Artery Stenosis

180
Q

Most important factor to control for long term outcome in Polycystic Kidney Disease Patients?

A

Control of blood pressure

181
Q

Renal Artery Stenosis symptoms? (2)

A

Difficult to control HTN

Flash Pulmonary Oedema

182
Q

Who gets Fibromuscular Dysplasia?

A

Women, 20-30

183
Q

Chronic asymptomatic hyperkalaemia in renal failure. Drug treatment?

A

Calcium Polystyrene Sulfonate

sometimes called Calcium Resonium

184
Q

What type of dialysis is used in emergencies?

A

Haemodialysis

185
Q

Describe the oedema in Hypoalbuminaemia

A

Generalised- face limbs abdomen

186
Q

Describe the oedema in Inferior Vena Cava Obstruction

A

Lower limb

Dilated umbilical vessels

187
Q

Classic Symptoms of Graft-versus-Host Disease?

A

Watery diarrhoea
Rash
Raised Bilirubin

After an organ transplant

188
Q

Commonest type of Renal Cell Carcinoma?

A

Clear Cell

189
Q

Renal Artery Stenosis leads to an increase in Renin release. Why?

A

↓GFR (as in hypovolaemia)

Homeostatic response is to ↑ Renin

This RAASes blood pressure x

190
Q

What does Aldosterone do to ions?

A

Na+ reabsorption (↑BP)
K+ excretion
H+ excretion (↑Bicarb, ↑pH)

191
Q

Low GFR means what gets released physiologically?

A

Renin

192
Q

How does low GFR lead to low potassium and high bicarbonate?

A

↓GFR- ↑Renin

↑Renin- RAAS- ↑Aldosterone

↑Aldosterone- ↑Excretion of K+ and H+, ↑Reabsorption Na+

193
Q

Polycystic Kidney Disease is due to mutation on what chromosome?

A

16

Polycystic Kidney has 16 letters

194
Q

Primary Biliary Cholangitis is associated with what antibody?

A

Anti-Mitochondrial Antibody

195
Q

First line Phosphate binder in renal failure?

A

Calcium Acetate

196
Q

Name main indications for emergency dialysis in renal failure (3)

A 
Severe Hyperkalaemia (>7)
Pulmonary oedema (resistant)
Severe Metabolic Acidosis

Formative Revision (50 decks)

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