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MRCP2 > Nov 2023 > Flashcards

Nov 2023 Flashcards

1
Q

Nodular lesion,
shiny surface,
telangiectasis.
skin cancer ?

A

Basal cell CA

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2
Q

Heart block post-IWMI.
Next step ?

A

observation

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3
Q

Urine - E.Coli while
fever (–)
Pain (–)
Blood markers (–)
next step?

A

observation
(no need to change catheter)

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4
Q

alcohol withdrawl / delirium tremons
Dx ?

A

48 - 72 hrs post admission
low PLT/Anemia
acutely confused, spiders crawling on bed/skin

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5
Q

acute schizophrenia Rx ?

A

Risperidone
(atypical anti-psychotic)

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6
Q

DEXA Scan ?

A

underlying osteoporosis
(back pain after RTA, possible wedge fracture)

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7
Q

CO Poisoning in COPD pts
Rx ?

A

NIPV
(Avoid hyperbaric O2 - worsen COPD)

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8
Q

keratocanthoma ?

A

initially grow rapidly in size, then start to reduce in size
(d/d - squamous cell CA don’t reduce in size)

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9
Q

Gonococcal proctitis.
Rx (non-pregnant vs pregnant)

A

Ceftriaxone 1gm IM stat
(pregnancy - azithro 2gm stat)

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10
Q

Vit B12 deficiency ?

A

nitric oxide inactivate methionine - substrate for THF - DNA synthesis - Vit B12 def

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11
Q

haloperidol use ?

A

Rx acute delirium with psychotic features

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12
Q

Pemphigus Dx ?

A

oral lesion almost always (+) and often appears before skin lesions.

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13
Q

pseudo-thrombocytopenia and PLT clumping. high K+, asymptomatic pt.

A

traumatic venepuncture

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14
Q

acute dystonia Rx ?

A

procyclidine

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15
Q

RTA-1
Pathogenesis ?

A

imapired Distal tubule H+ secretion.

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16
Q

COPD
not managed with
ICS (Fluticasone) + LABA (Salmetrol) + LAMA (Tiotropium).
Next step?

A

roflumilast (PDE4 inhibitor)

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17
Q

necrobios lipoidica
appearance ?

A

DM pt
erythematous plaques below knees
later atrophied with yellowing/thinning

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18
Q

low grade dysplasia with Barrett esophagus. next step?

A

radio frequency ablation
(if only barrette - 2yr surveillance)

19
Q

candida albicans Rx ?

A

Caspofungin
(if not enough - Amphoteracin B)

20
Q

Name of vitamin D in CKD ?

A

Calcitriol

21
Q

DVT prophylaxis in Cancer pt ?

A

dalteparin/enoxaparin (LMWH)
(Apiban - only if DVT while treated with LMWH)

22
Q

Daily fever, oligoarthritis, salman pink rash, raise CRP/Ferritin. RA (–)

A

Adult-onset still’s Dz

23
Q

carbamazepine effect on thyroid metabolism?
what happen when you replace it with levetiracetam?

A

(1) increase production of TBG
(2) increase activity of UGT
thereby catalyze the breakdown of thyroid hormone.
levetiracetam - reduce UGT - increase T4 levels - mild thyrotoxicosis s/s.

24
Q

cause of dysphagia post-chemo for hodgkin’s ?

A

esophageal stricture

25
Q

Needle stick injury (HBV)
but
Anti-HBs titer < 10
next step?

A

HepB Ig (2 doses)
+
HepB vaccine (1 booster)

26
Q

hereditary motor & sensory neuropathy type1
(charcot-marie-tooth disease)
Dx ?
Rx ?

A

distal muscle atrophy
loss of fine touch and vibration
Rx - physiotherapy

27
Q

Roxadustat in CKD ?

A

PO treatment for anemia in CKD where pt have enough Iron.
alternative to EPO

28
Q

peritoneal dialysis fluid leak ?

A

pleural fluid: low glucose, low pH
alongwith R-sided pleural effusion.

29
Q

Valsartan - angioedema ?

A

yes, rarely (10% pts who showed angioedema on ACE-i)

30
Q

hemodynamic stable VT
Rx ?

A

amiodarone

31
Q

31 wk pregnant female, RUQ pain, normal LFTs/CRP. mild increase ALP (due to placenta). no stone in bile duct. plan ?

A

re-assurance

32
Q

syphilis Rx (Penicillin allergic) ?

A

Doxycycline (100mg BD - 2weeks)

33
Q

hyperCa++ (lung CA) ?

A

Squamous cell CA

34
Q

Pt on Apiban - develops ICH. Next step ?

A

andeXanet alpha
(better than PCC)

35
Q

Vaccination C/I in HIV (+) pt? 2 vaccines…

A

Live attenuated influenza vaccination
(note Yellow fever vaccination C/I if CD4 < 200 or age > 60)

36
Q

OSA Rx (besides CPAP) ?

A

Mild Dz (mandibular advancement device)
moderate to severe Dz (uvuloplasty)

37
Q

Acute Gout flare Rx
(pt = CKD + HFrEF)

A

Colchicine (not steroids) upto eGFR of 11.

38
Q

bradycardia/syncope causes ?

A

Donepezil
other cholinesterase inhibitors
Rx alzheimer’s Dz

39
Q

Pt on PPM - Need ventricular lead extraction. Why?

A

(1) dropped ventricular beats with P waves only
(2) frequent Ventricular ectopics
(3) change from LBBB to RBBB

40
Q

Tacrolimus (post-renal transplant) + antifungal/macrolides ?

A

antifungal/macrolides = potent inhibitors of CYP3A4 liver enzyme. this enzyme metabolize tacrolimus/ciclosoprin. leading to toxicity of Tacrolimus.

41
Q

HyperCa++ Management (PTHrP s/t Squamous cell CA) ?

A

zoledronate

42
Q

HyperCa++ Management (s/t Tertiary hyperparathyroidism)

A

Cinacalcet (calcimimetic) - pt not fit for surgery.

43
Q

8 hr threshold below which N-acetylcysteine be stop?

MRCP2 (22 decks)

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