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Other Flashcards

1
Q

Enteropathic comma shaped bacteria associated with GBS

A

Campylobacter Jejuni

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2
Q

Biochemical features: High TIBC and Low ferritin

A

Fe deficiency anaemia

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3
Q

Ovarian carcinoma: most common Tumour affecting those < 25y/o

A

Immature teratoma

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4
Q

red, itchy, oozing rash around her neck and fingers

A

Contact dermatitis

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5
Q

Chlamydia serovars D-K

A

Genital chlamydia

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6
Q

Bladder cancer caused by Schistosomiasis

A

Squamous cell carcinoma

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7
Q

Mccune-Albright syndrome triad + associated bone disease

A

Polyostotic dysplasia + cafe au lait spots + precocious puberty (fibrous dysplasia)

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8
Q

Nephrotic syndrome Secondary to HIV and obesity

A

Focal segmental glomerulosclerosis

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9
Q

Soft transillumatory mass in childs posterior triangle of neck

A

cystic hygroma

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10
Q

Ustekinimab - MOA, indications

A

MOA - IL-12 and IL-23 INDICATIONS - psoriasis

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11
Q

Rx warm AIHA

A

Steroids, splenectomy, immunosup

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12
Q

External pathway constituents

A

7, 10

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13
Q

Chlamydia serovars A, B, C

A

Trachoma - eye infection

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14
Q

Ovarian carcinoma: secreting bHCG

A

Choriocarcinoma

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15
Q

Pathological protein in Picks

A

Tau

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16
Q

Example of HIV Drug - prevents attachment/entry

A

maraviROC

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17
Q

TTP pentad

A

1) MAHA 2) fever 3) renal failure 4) neuropsych sx 5) low plt

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18
Q

Pathognominic XR signs of thal

A

Skull bossing, maxillary hypertrophy, hairs on end skull

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19
Q

E. Coli infection in children

A

Enteropathogenic E. Coli (EPEC)

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20
Q

Purine synthesis inhibitor safe in pregnancy

A

AZT - Screen for TPMT before starting

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21
Q

Causes of Warm AIHA

A

Llymphoma, CLL, SLE, methyldopa

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22
Q

Oxazolidinones - example and MOA

A

Linezolid (inhibit protein synthesis)

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23
Q

Brain tumour: Commonest benign tumour in adults. ‘Whorled’ appearence, psammoma boddies. Attached to dura

A

Meningioma

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24
Q

The inactivated vaccine is highly effective in preventing this virus’ potentially devastating paralysing effects. This vaccine is given at 2, 3 and 4 months of age and two further boosters are given, one between 3-5 years of age and one between 13-18 years of age

A

Polio

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25
Q

PCH Abs

A

Donath-landsteiner

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26
Q

Immediate urticaria, wheeze and angioedema following transfusion (background of recurrent respiratory infection)

A

IgA deficiency

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27
Q

Multiple system atrophy: Shy Drager

A

Autonomic dysfunction

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28
Q

Class of drug that inhibits DPP4

A

Gliptins (sitgagliptin)

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29
Q

Investigation for carcinoid syndrome

A

24hr urine 5-HIAA (metabolite of serotonin)

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30
Q

Bleeding disorder, thrombocytopenia, decreased production

A

BM failure

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31
Q

Causes of High MCV anaemia

A

FATRBC: Foetus, Antifolates, Thyroid, Reticulocytosis, B12/Folate, Cirrhosis

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32
Q

HLA association with autoimmune hepatitis

A

HLA-DR3

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33
Q

Treatment of nephrogenic DI

A

Thiazide diuretics

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34
Q

Most common amyloidosis

A

AL

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35
Q

What tissue is this?

A

Liver

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36
Q

Neurocutaneous (2)

A

Variegate porphyria, hereditary coprorphyria

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37
Q

Pathological protein in dementia with lewy bodies

A

Alpha-synuclein, ubiquitin

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38
Q

Painful genital ulcers

A

Herpes, chancroid

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39
Q

Adalimumab - MOA, indications

A

MOA - anti-TNFa INDICATIONS - RA, Ankylosing Spondylitis, Psoriasis, IBD

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40
Q

Negri bodies

A

RABIES

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41
Q

Mechanism of indirect transplant rejection

A

Recipient APC presenting donor antigen to recipient T cells. LIKE NORMAL INFECTION ⇒ CHRONIC REJECTION

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42
Q

Antibodies associated with T1DM

A

Anti-Glutamate Decarboxylase and pancreatic B cells

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43
Q

Gram +ve anaerobic bacillus

A

clostridium difficile

(listeria and bacillus cereus are aerobic)

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44
Q

Ovarian carcinoma: secreting E2

A

Granulosa-Theca cell tumour

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45
Q

Definition of neutropenic PUO

A

PUO + Neutropenia (<500/uL)

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46
Q

A gram-positive β-haemolytic coccus that can cause pharyngitis, erysipelas and cellulitis.

A

Strep. pyogenes

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47
Q

Susceptible to Mycobacterium and Salmonella infection

A

Cytokine deficiency

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48
Q

Multiple myeloma: blood film feature

A

Rouleaux

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49
Q

Golimumab - MOA, indications

A

MOA - anti-TNFa INDICATIONS - RA, Ankylosing Spondylitis, Psoriasis, IBD

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50
Q

Low platelets, low fibrinogen, high d dimer, long PT

A

DIC

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51
Q

What is the most common malaria subtype?

A

Plasmodium falciparum

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52
Q

Biochemical features: High Fe, Low TIBC, High Ferritin

A

Chronic haemolysis (or haemochromatosis - TIBC may also be normal)

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53
Q

HIV Drug - Protease inhibitor

A

RitoNAVIR

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54
Q

severe respiratory difficulty, light-headedness and a red itchy rash. On examination he has laryngeal oedema, bilateral wheezing across the lung fields and is hypotensive. Recent abx for a chest infection.

A

Anaphylaxis

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55
Q

Malaria that remains dormant in hepatocytes

A

Hypnozoites (hypnotised thus sleeping in hepatocytes)

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56
Q

Tx for nosocomial UTI

A

Co-amoxiclav or cephalexin

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57
Q

Benign renal mass central white scarring, pink cytoplasm

A

oncocytoma

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58
Q

What tissue is this?

A

Alveoli

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59
Q

The vaccine for this virus is a diploid cell vaccine containing the inactivated form. In the later stages of infection with this virus the sight of water induces convulsions and paralysis

A

Rabies

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60
Q

MS histology features

A

MS plaques showing sharp margins of myelin loss. Myelin basic protein and proteo-lipid protein

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61
Q

What type of crystals cause staghorn calculi?

A

Magnesium ammonium phosphate crystals

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62
Q

Gram +ve coccus, catalase -ve, beta-haemolytic, bacitracin sensitive bacteria

A

Streptococcus Pyogenes

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63
Q

Prosthetic joint infection

A

Staph epidermidis

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64
Q

Scoring system for cirrhosis

A

Modified Child-Pugh - ascites, bili, encephalopathy, albumin, PT

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65
Q

Stage IV Hodgkin’s

A

Extranodal sites

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66
Q

Definition of healthcare associated PUO

A

PUO that develops following >24 hours in hospital

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67
Q

Mechanism of hyperacute rejection

A

Preformed Ab to HLA/ABO → complement activation

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68
Q

Features of Fanconi’s syndrome

A

Type II renal tubular acidosis. Phosphaturia, glycosuria, aminoaciduria, proteinuria.

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69
Q

Management of essential thrombocythaemia

A

Anagrelide, aspirin and hydroxycarbamide

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70
Q

Effector memory cells

A

CD8 predominante - found in liver/lungs/gut, CCR7-ve & low CD62L, produce perforin and IFN-gamma

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71
Q

Obervation on the blood film and associated underlying conditions?

A

Sphercytes

Associated conditions:

Hereditary spherocytosis

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72
Q

Causes of MAHA

A

HUS, TTP, DIC, PET/Eclampsia

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73
Q

Acute intermittent porphyria

A

HMB synthase (Hydroxymethylbilane synthase)

PBG deaminase (protoporhobilinogen deaminase)

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74
Q

Complications of CMV

A

RCHEP - retinitis, colitis, hepatitis, encephalitis, pneumonitis

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75
Q

Antibodies associated with hashimoto’s

A

Anti thyroglobulin and thyroperoxidase

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76
Q

Cardinal urinary features of diuretic use/ inherited channelopathy

A

RAISED urinary chloride and RAISED urinary sodium

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77
Q

Antibodies associated with Autoimmune hepatitis

A

Anti-SM antibody, Anti Liver Kidney microsomal-1 (anti-LKM-1). Anti Soluble Liver antigen (anti-SLA)

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78
Q

Sources of folate

A

Green veg, nuts, yeast and liver

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79
Q

3 tumour markers of a testicular teratoma?

A

AFP, HCG and LDH

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80
Q

What tissue is this?

A

Adrenal

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81
Q

HIV Drug - NuceloTide reverse transcriptase inhibitor

A

Tenofovir (T FOR TENOFOVIR)

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82
Q

Measures extrinsic pathway function

A

PT

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83
Q

Bone lesion: O-ring sign on x-ray

A

Enchondroma

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84
Q

Anaemia, erythroid dysplasia with >15% ringed sideroblasts

A

Refractory anaemia with ringed sideroblasts

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85
Q

Susceptible to infection by encapsulated bacteria (Streptococcus, neisseria and haemophilus)

A

Complement deficiencies (alternative or C3 and C5-C9)

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86
Q

MSSA IE treatment

A

Flucoxacillin

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87
Q

Gram +ve aerobic bacillus

A

Listeria or bacillus

(probably)

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88
Q

Congenital CMV infection features

A

PINT: Pneumonia, IUGR, Neurological (Hearing, epilepsy and CP) and Thrombocytopenia (petechiae)

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89
Q

Which malaria subtype causes a Quartan fever (swinging fever every 4 days)

A

Plasmodium malariae

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90
Q

Condition caused by a genetic defect in myofilament formation leading to large myocytes

A

Hypertrophic obstructive Cardiomyopathy (HOCM)

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91
Q

Gene associated with Hirschsprung’s

A

RET proto-oncogene Cr10+ (Remember Hirschsprung’s associated with Down’s)

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92
Q

ALA-dehydratase porphyria (Plumbo’s)

A

ALA-dehydratase or PBG synthase (same enzyme)

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93
Q

Pneumonia, -ve cocco-bacilli, assocted with smoking, COP

A

Haemophilus influenza

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94
Q

BK virus Rx

A

Cidofovir

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95
Q

Looser’s zones

A

Osteomalacia

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96
Q

Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel.

A

Acarbose

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97
Q

Definition of PUO

A

Fever (>38.3) persisting for >3 weeks without a diagnosis despite intensive investigation

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98
Q

A patient presents with undulating fever constipation and has rose spots on examination of the abdomen. Observations demonstrate a relative bradycardia

A

Salmonella typhi

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99
Q

Breast: Pre-malignant. Unilateral and unifocal

A

Ductal carcinoma in situ

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100
Q

Hisotological Alzheimer’s features

A

Generalised atrophy of the brain, widened sulci, narrowed gyri, enlarged ventricles, senile plaques of beta amyloid protein and neurofibrillary tangles of tau protein

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101
Q

What is this and when do you get it?

A

Casal’s Sign in Vitamin B3 deficiency - distinctive erythematous, pigmented rash in the necklace distribution

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102
Q

What tissue is this?

A

Skeletal muscle

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103
Q

Pathological protein in corticobasal degeneration

A

Tau

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104
Q

Stage I Hodgkin’s

A

One LN region

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105
Q

Mutation associated with JAK2

A

Essential thrombocythaemia and polycythaemia rubra vera

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106
Q

HIV Drug - Nucleoside reverse transcriptase inhibitor (NRTI)

A

ZidovudINE, emtricitabINE

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107
Q

Bone tumour: CD99 +ve and T(11:22)

A

Ewing’s sarcoma

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108
Q

Derm: Naevus cells located in the superficial and deep portions of the dermis

A

Intradermal naevus

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109
Q

Features of B12 deficiency

A

Mouth (glossitis, angular chelosis), neurospych - lability, depression, psychosis, neuro - numbness, PNs, SACD

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110
Q

Defect in HS

A

Spectrin or ankyrin

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111
Q

Presence of HBeAg

A

Virus replicating (infectious) acute or chronic

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112
Q

Causes of Low MCV anaemia

A

FAST: Fe deficiency anaemia, Anaemia of chronic disease, Sideroblastic anaemia and Thalassaemia

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113
Q

Multiple system atrophy: Olivopontocerebellar

A

Difficulty with balance and coordination

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114
Q

Symptoms of IPEX

A

Eczema, nail dystrophy, alopecia, bullous pemphigoid

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115
Q

Method used to prevent relapse of Wegener’s

A

Co-Trimoxazole can be used to prevent infections which can exacerbate Wegener’s

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116
Q

A 23 year old male, who has just commenced treatment with penicillin, presents with confusion, weakness and seizures. On examination you notice that he is pale, bruised and breathing deeply

A

Acute Tubulointerstitial Nephritis

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117
Q

Schwachman-Diamond syndrome

A

Neutropenia (path-guide is wrong), skeletal abnormalities, endocrine and pancreatic dysfunction

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118
Q

What type of hypersensitivity is acute Rheumatic Fever?

A

Type 2 (antigenic mimicry of M proteins on GAS)

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119
Q

Most important prognostic factor in melanoma

A

Breslow thickness

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120
Q

Stage III Hodgkin’s

A

Two or more LN regions on the opposite sides of the diaphragm

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121
Q

Obervation on the blood film and associated underlying conditions?

A

Heinz Bodies

Associated conditions:

G6PD deficiency

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122
Q

CML: translocation, fusion gene

A

(9;22), BCR-ABL

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123
Q

Breast: Risk of subsequent breast carcinoma, can be bilateral and multifocal. Occurs in pre-menopausal women

A

Lobular carcinoma in situ

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124
Q

Brain tumour associated with NF2

A

Meningioma (schwannomas and ependymoma)

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125
Q

Gardner syndrome

A

GI polyps (FAP) + osteomas of the skull + epidermoid cysts

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126
Q

ALPS mutation

A

TNFRSF6 gene → FAS pathway defects → splenomegaly and lymphoma

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127
Q

MRSA IE treatment

A

Vancomycin + Gentamycin/Rifampicin

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128
Q

Which clotting factor cross links ribrin

A

XIIIa

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129
Q

Loss of podocyte foot processes and subepithelial deposits (spikey)

A

Membranous glomerular disease

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130
Q

IgG/IgA >30g/l; >10% clonal plasma cells, no symptoms

A

Smouldering MM

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131
Q

Breast: Benign cause of bloody nipple discharge

A

Intraductal papilloma

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132
Q

Indication and target of: Terbinafine

A

Indication: Moulds, Target: cell membrane integrity

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133
Q

Sacral rediculomyeltis

A

Urinary retention in genital herpes

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134
Q

A 25 year old male notices blood in his urine. Light microscopy detects mesangial cell proliferation

A

Mesangiocapillary Glomerulonephritis

aka - Membranoproliferative glomerulonephritis

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135
Q

Brain: ventricular tumour + hydrocephalus

A

Ependymoma

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136
Q

How does TFPI work?

A

Inhibits FXa and TF-VIIa complex

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137
Q

HCV Rx

A

OLD - PegINF alpha 2b/2a, ribavarin, NEW - Sofosbuvir

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138
Q

list B-cell lymphomas in order of aggressiveness

A

Burkitt’s (very aggressive), DLBCL (aggressive), mantle cell (aggressive), follicular (indolent), marginal (indolent), small lymphocytic. “Burkitt’s Doesn’t Make Fat Men Skinny.”

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139
Q

Wickam striae

A

Lichen planus

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140
Q

When shoukld you measure G6PD levels

A

2-3M post haemolytic event

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141
Q

HIV Drug - Non-NRTI (NNRTI)

A

Efavirenz, nevirapine

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142
Q

TTP Pentad

A

Fever, MAHA, Thrombocytopenia, CNS effects and reduced renal function

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143
Q

Biochemical features: High Iron, Normal TIBC and High Ferritin

A

Sideroblastic anaemia

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144
Q

Abx Aspiration pneumonia

A

Cefuroxime + metronidazole

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145
Q

Anticoagulant duration: 1st VTE with known cause

A

3 months

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146
Q

Lung Ca: k-ras

A

Smoker’s adenocarcinoma

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147
Q

What causes restrictive (diastolic) heart failure?

A

Sarcoidosis, amyloidosis, radiation induced damage

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148
Q

Rx Waldenstrom’s

A

Plasmaphresis, chlorambucil, cyclophosphamide

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149
Q

Most common cause of infective endocarditis in prosthetic heart valves?

A

Staph Epidermidis

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150
Q

S.E pyrazinamide

A

Hyperuricaemia, hepatotoxicity

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151
Q

Bleeding disorder, reduced platelet function, Congenital

A

Storage pool disease, thrombasthenia

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152
Q

Rx for pyelonephritis

A

IV Co-amox +/- gent, cefuroxime +/- gent

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153
Q

CLL: bad prognostic factors

A

LDH raised, CD38 +ve, 11q23 deletion

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154
Q

Treatment for Ab mediated rejection

A

Plasmaphoresis, Steroids, Alemtuzumab

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155
Q

General marrow findings of myelodysplastic syndrome

A

Hypercellular marrow <20% blasts

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156
Q

Breast: Phyllodes vs Fibroadenoma

A

Larger, >40 y/o and malignant

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157
Q

Features of plummer vinson syndrome

A

Dysphagia, oesphageal webs, IDA squamous cell CA and other stuff

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158
Q

Commonest vessel affected in stroke victims?

A

MCA

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159
Q

Nephrotic syndrome in elderly caused by NSAIDs

A

Minimal change disease

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160
Q

Causes of Micronodular cirrhosis (<3mm)

A

Alcoholic hepatitis and biliary tract disease

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161
Q

Neutralising HIV antibodies

A

Anti-GP120 and anti-GP41

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162
Q

Sezary syndrome

A

Cutaneous T-cell lymphoma → erythroderma, HSPmegaly, LNopathy, keratoderma

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163
Q

What tissue is this?

A

Skeletal muscle

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164
Q

Bladder cancer arising from extensive intestinal metaplasia

A

Adenocarcinoma

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165
Q

South East asian ovalocytosis inheritance

A

AR

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166
Q

Porphyria cutanea tarda

A

UROD (Uroporphyrinogen decarboxylase). Most common.

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167
Q

Causes of sideroblastic anaemia

A

Myelodysplastic disorders, chemotherapy, alcohol excess, myeloproliferative disease

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168
Q

Flu peaks

A

INfluenza A H1 - jan influenza A H1N1 - dec influenza B - march

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169
Q

Drug causes of G6PD

A

primaquine , sulfonamides, aspirin

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170
Q

Mechanism behind Sideroblastic anaemia

A

Ineffective erythropoiesis leads to iron loading causing hemosiderosis (endocrine, liver and cardiac damage due to iron deposition)

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171
Q

Management of aplastic anaemia

A

Supportive (transfusion), Oxymethalone (androgen), immunosuppressants (?AI aetiology), SCT/BMT definitive

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172
Q

Causes of bloody diarrhoea

A

CHESS (Campylobacter, Haemorhagic E. Coli, Entamoeba Histolytics, Salmonella, Shigella)

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173
Q

HBV Rx

A

entecavir , PegINF alpha 2a, tenofovir

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174
Q

Obervation on the blood film and associated underlying conditions?

A

Cabot ring

Associated conditions:

Pernicious anaemia, Lead poisoning

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175
Q

Tx for severe community acquired ammonia

A

Co-amoxiclav and clarithromycin

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176
Q

Most common cause of febrile Conv

A

HHV6

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177
Q

An unfortunate chap has a giant MI and dies. An autopsy is conducted by that fat man who did the lecture. Histologically you see necrosis, loss of nuclei and infiltration of polymorphs and macrophages. With lots of cellular debris. How long ago did he die?

A

1-4d

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178
Q

Features of Chronic myelomonocytic anaemia

A

<20% blasts, monocytosis (>1x10^9)

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179
Q

HLA association with Goodpastures

A

HLA-DRB15

(HLA-DRB1-1501)

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180
Q

Erythropoetic protoporphyria

A

Ferrochelatase (non-blistering skin rash in children)

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181
Q

Diagnostic criteria for SIADH

A

EXCLUSION DIAGNOSIS:

1) LOW serum osmolarity
2) Euvolaemia
3) Hyponatraemia
4) Urine osmo >100
5) Urine Na >20
6) Normal TFTs
7) Normal adrenal function

RULE OF THUMB: URINE OSMO > PLASMA OSMO

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182
Q

Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4)

A

Gliptins e.g. alogliptin, sitagliptin

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183
Q

Monoclonal used in Castleman’s disease

A

Tocilizumab

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184
Q

Features of congenital rubella syndrome?

A

MESH: mental retardation, eye problems (cataracts), sensorineural deafness and Heart defects (PDA, VSD, ASD)

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185
Q

Antibodies associated with congenital heart block in infants of mothers with SLE

A

Anti-Ro

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186
Q

Nephritic syndrome – Linear deposition of IgG in GBM

A

Goodpastures (Type 1 nephritic syndrome)

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187
Q

Diffuse glomerular basement membrane thickening

A

Membranous glomerular disease

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188
Q

Osteopetrosis

A

‘marble’ bone disease - inheritied condition causing brittle hardening and increased propensity to #

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189
Q

Koebner’s Phenomenon

A

Psoriasis in previous scar

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190
Q

Dacrocytes (tear drop cells) and dry tap on BM biopsy

A

Myleofibrosis

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191
Q

Target INR: 2.5 (2-3)

A

1st episode DVT or PE, AF, cardiomyopathy, symptomatic inherited thrombophilia, mural thrombus, cardioversion

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192
Q

Obervation on the blood film and associated underlying conditions?

A

Schistocytes

Associated conditions:

MAHA (DIC, HUS, TTP)

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193
Q

Cause of magnesium ammonium phosphate crystals (triple stones)

A

Infection (proteus) à urease production

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194
Q

Causes of a non-megaloblastic macrocytosis

A

Alcohol (most common if no concomitant anaemia) liver disease , hypothyroidism and pregnancy

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195
Q

Ovarian mass - lipid and spindle cells present

A

Thecoma

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196
Q

Lines of therapy for CMV

A

Ganciclovir (nucleoside analogue), foscarnet, cidofovir (retinitis)

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197
Q

Meningitis vs encephalitis

A

Encephalitis: Altered mental state +/- seizures

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198
Q

Antibodies associated with mixed connective tissue disease

A

Anti-U1RNP (speckled pattern)

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199
Q

Clinical Signs/symptoms of rickets

A

Bone pain, bowing tibia, rachitic rosary, frontal bossing, pigeon chest, delayed walking

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200
Q

Brown tumour

A

1ry HPT - aka osteitis fibrosa cystica

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201
Q

Immunostimulatory adjuvant. Activates TLRs on APCs stimulating expression of costimulatory molecules

A

Unmethylated CpG dinucleotides

–> maturation of dendritic cells, upregulation of MHC class II leading to production of Th1 cytokines and triggering B-cell proliferation

202
Q

Abx Legionella

A

Macrolide + rifampicin

203
Q

Heparin antidote

A

Protamine sulphate

204
Q

What tissue is this?

A

Prostate

205
Q

Anaplastic large cell lymphoma

A

“Epithelioid lymphocytes” t(2;5)

206
Q

Breast histology: atrtichoke like

A

Phyllodes

207
Q

Nephrotic syndrome Secondary to SLE, Infection (Syphilis, malaria, Hep B/C)

A

Membranous glomerular disease

208
Q

What is the typical growth pattern of melanomas?

A

Initially horizontally (radial growth phase) then vertically (vertical growth phase) producing BUCKSHOT appearance (=Pagetoid cells)

209
Q

Pathological hallmarks of chronic organ rejeciton

A

Fibrosis, GNs, vasculopathy, bronchiolitis obliterans (lungs)

210
Q

What does IPEX stand for? And what causes it?

A

Immune dysregulation, polyendocrinopathy, enteropathy and X-linked inheritance

FOXP3 KO

211
Q

Treatment for iron overload

A

Desferrioxamine

212
Q

Bug causing gas gangrene

A

Clostridium Perfringes

213
Q

Treatment for pernicious anaemia

A

IM hydroxycobalamin (B12)

214
Q

Prognostic factor in HCV

A

Viral genotype: 4,5,6 – bad 2,3 – good

215
Q

What tissue is this?

A

Prostate

216
Q

Causes of hypovolaemic hyponatraemia. How can you differentiate between them

A

RENAL loss (ARF/diuresis) RAISED urinary sodium (>20). EXTRARENAL loss (diarrhoea and vomiting) REDUCED urinary sodium (<20).

217
Q

Mutations in a-thal

A

Deletions on Ch16

218
Q

Neurovisceral (2)

A

ALA-Dehydratase Porphyria, Acute intermittent porphyria

219
Q

Causes of pseudohyponatraemia

A

Hyperlipidaemia, hyperglycaemia

220
Q

Sirolimus - MOA, indications

A

MOA - blocks clonal proliferation of T-cells INDICATIONS - transplantation

221
Q

persistent itchy wheels for the last 2 months. she also has a fever and feels generally unwell. After an acute attack, she has bruising and post-inflammatory residual pigmentation at the site of the itching

A

Urticarial vasculitis

222
Q

Anticoagulant duration: 1st VTE in thrombophilic patient

A

3 months, possibly lifelong

223
Q

The recombinant protein vaccine for this virus is given to at risk individuals. This virus can cause jaundice

A

Hepatitis B

224
Q

Melanoma on the palms, soles and subungual areas

A

Acral lentiginous melanoma (skin cancer that killed Bob Marley)

225
Q

Brain tumour: S-100 positive. Acoustic neuroma

A

Schwannoma

226
Q

When to treat HBV

A

Serum HBV > 2000, serum AST > N, mod/sev inflammation on biopsy

227
Q

A patient presents with urticarial rash following transfusion

A

Mild allergic reaction

228
Q

Warm AIHA

A

IgG

229
Q

CD99 +ve, 11:22 translocation

A

Ewing’s

230
Q

Ovarian carcinoma: secreting AFP

A

(Immature) Teratoma and yolk sac tumour

231
Q

Clinical condition a/w cold agglutinin disease

A

Raynaud’s

232
Q

Apremilast - MOA, indications

A

MOA - PDE4 inhibitor INDICATIONS - psoriasis

233
Q

How long is Osteltamivir effective for after flu infection first starts?

A

48hrs

234
Q

Indication and target of: Azole (e.g. Fluconazole)

A

Indication: Yeasts, Target: cell membrane Synthesis

235
Q

Breast: Risk of subsequent breast carcinoma. No microcalcifications or stromal reactions

A

Lobular carcinoma in situ

236
Q

Mutations associated with small cell carcinoma

A

ANS: P53 & RB1 INFO: Paraneoplastic associations, smoking relaetd

237
Q

Form of malaria that infects hepatocytes

A

Sporozoites

238
Q

Munro’s microabscess

A

Psoriasis

239
Q

Ix for PCH

A

Ham’s test & immunophenotyping - NB DAT -ve

240
Q

HLA-DR15

A

Goodpastures

241
Q

Live vaccines

A

Polio (sabin, oral), MMR, chicken pox, BCG, yellow fever, typhoid,

242
Q

Commonest type of endometrial CA and risk factors

A

Endometrioid - E2 excess: obesity, anovulatory amenorrhoea (e.g. PCOS), nulliparity, early menarche, late menopause, tamoxifen, DM, HTN

243
Q

Protein defect in Marfans

A

Fibrillin

244
Q

Dukes Criteria - diagnosis

A

2mjr + 1mnr, 1 mjr + 3mnr, 5mnr

245
Q

Skin lesion: Tend to grow downwards, deeper into the skin quite quickly. Often very dark brownish black. Found in middle age.

A

Nodular melanoma

246
Q

Obervation on the blood film and associated underlying conditions?

A

Pelger Huet cells

Associated with:

Myelodysplastic syndromes

247
Q

Richter’s transformation

A

CLL -> DLBC

248
Q

A gram positive bacillus that produces α-toxin causing gas gangrene in infected wounds

A

Clostridium perfringens

249
Q

Most common target of c-ANCA

A

Proteinase 3

250
Q

Diaminopyrimidines - example and MOA

A

Trimethoprim (inhibit folate metabolism)

251
Q

Causes of Macronodular cirrhosis (>3mm)

A

Viral hepatitis, Wilson’s disease and a1 antitrypsin

252
Q

Most common target of p-ANCA

A

Myeloperoxidase

253
Q

PCH DAT status

A

+ve

254
Q

Tx of cryptococcal meningitis + invasive fungal infection

A

Amphotericin B

255
Q

APS1/APECED gene defect?

A

AIRE → self reactive T-cells → parathryoid/adrenal damage

256
Q

PT: normal, APTT: increased, bleeding time: normal

A

Haemophilia

257
Q

Rx aspergillus

A

Voriconazole

258
Q

Young’s Syndrome

A

1) Rhinosinusitis, 2) azoospermia 3) bronchiectasis

259
Q

Features of Mycobacterium intracellulare complex

A

Children- pharyngitis, cervical adenitis

Adults - AIDS defining TB-like infection (CD4<100/50)

260
Q

worsening swelling of the hands and feet and abdominal pain. similar milder episodes have occurred preciously

A

C1 inhibitor deficiency

261
Q

Pneumonia, -ve coccus, associated with smoking

A

Moraxella catarrhalis

262
Q

Variegate porphyria

A

Proto ox (protoporphyrinogen oxidase)

263
Q

Gram +ve coccus, catalase +ve, coagulase -ve, novobiocin sensitive

A

Staphlococcus Epidermidis

264
Q

Congenital erythropoetic porphyria

A

UROS (Uroproporphyrinogen synthase)

265
Q

2 hours after receiving a transfusion a young lad complains of fever and rigors.

A

Febrile non-haemolytic transfusion reaction

266
Q

Rx for acute promyelocytic leukaemia

A

ATRA

(and arsenic trioxide)

267
Q

C3 and C4 normal but CH50 and AP50 low

A

C5-C9 deficiency

268
Q

Alemtuzumab - MOA, indications

A

MOA - Anti CD52 (lymphocyte depletion), INDICATIONS - CLL, MS

269
Q

Carcinoid syndrome: Cause and symptoms?

A

Caused by: 5HT secreting tumour. Symptoms include: Bronchoconstriction, flushing, diarrhoea

270
Q

ABx atypical CAP

A

Macrolide/tetracycline

271
Q

Gene for Haemochromatosis

A

HFE on Chr 6

272
Q

Donovanosis causative organism

A

Klebsiella granulomatis, gram-ve bacillus

273
Q

Auer rods

A

AML

274
Q

Whats this?

A

HbSC crystal

275
Q

Rx for PCH

A

Eculizumab (c5 inhib) - was world’s most expensive drug

276
Q

Obervation on the blood film and associated underlying conditions?

A

Howell-Jolly Bodies

Associated with:

Post-Splenectomy or Hyposplenism (e.g. SCD, Coeliac disease, UC/Crohns, Amyloid), Megaloblasic anaemia

277
Q

Churg-Strauss symptoms

A

Allergy leading to asthma leading to systemic disease

278
Q

Gram +ve coccus, catalase +ve, coagulase -ve, novobiocin resistant

A

Staphlococcus saprophyticus

Staph epi is novobiocin sensitive

279
Q

Obervation on the blood film and associated underlying conditions?

A

Acanthocytes

Associated with: Abetalipoproteinaemia, Liver disease, hyposplenism and alpha-thal

280
Q

Name of system and criteria necessary to diagnose IE

A

Duke, 2mjr OR 1mjr + 3mnr OR 5mnr

281
Q

Causes of secondary polycythaemia

A

INCREASED EPO (reactive): RCC, high altitude and chronic hypoxia

282
Q

Culture negative IE causes

A

1) Post Abx 2) Aspergillus 3) HACEK organisms - haemophilus, aggregatibacter, actinobacillus, fikenella, kingella

283
Q

Cytokines involved in anaemia of chronic disease

A

IFN,TNF and LPS lead to reduced EPO receptor. IL-6 and LPS lead to increased hepcidin which decreases iron absorption from gut

284
Q

What is the correct pathological term for a discontinuation in the epithelial surface?

A

Ulcer

285
Q

Salmonella TyphiMicrobiological characteristics

A

Gram negative anaerobic bacillus, enteric fever (food and water)

286
Q

What is the definition of PHTN

A

Pulmonary wedge pressure >25mmHg at rest

287
Q

What is the commonest cause of travellers diarrhoea

A

Enterotoxigenic E. Coli (ETEC)

288
Q

Drugs for MS

A

Steroids and IFN-beta

289
Q

Hereditary elliptocytosis inheritance

A

AD

290
Q

Layers of infection post surgery - superficial to deep

A

Skin and sub cut, fascial and muscle, organ and space

291
Q

Ovarian carcinoma: AFP screting with Schiller-Duval boddies

A

Yolk sac tumour

292
Q

Cutaneous T-cell lymphoma

A

Mycosis fungoides. Can develop Sezary syndrome.

293
Q

Transfusion reaction, raised JVP with significant shortness of breath.

A

Transfusion associated cardiac overload

294
Q

Mutation associated with lung adenocarcinoma

A

ANS: EGFR +ve INFO: women, peripheral tumours, good surgical candidates, less smoking associated

295
Q

CF, resp infections

A

Pseudomonas aeruginosa, burkholderia cepacia

296
Q

Features of Fanconi’s Anaemia

A

Pancytopenia. Skeletal abnormalities (thumbs), micropthalmia. Autosomal recessive.

297
Q

HUS triad

A

1) MAHA 2) low PLT 3) AKI

298
Q

Heberden’s, Bouchard’s nodes

A

Osteoarthritis

299
Q

Pyruvate kinase deficiency - inheritance and features

A

AR - neonatal jaundice, splenomegaly, haemolyitc anaemia

300
Q

Cyclic lipopeptide - example and MOA

A

Daptomycin (cell membrane toxin)

301
Q

Multiple system atrophy: Striatonigral

A

Difficulty with movement

302
Q

Presence of anti-HBs and anti-HBc

A

Previous infection and immune

303
Q

CSF interpretation: High lymphocytes (mononuclear cells) and normal glucose

A

Viral

304
Q

CLL: good prognostic factors

A

Hypermutated Ig gene, low ZAP-70 expression, 13q14 deletion

305
Q

Treatment for acute cellular rejection

A

T-cell immunosup - AZT, mycophenolate mofetil etc

306
Q

Tofacitinib - MOA, indications

A

MOA - JAK inhibitor INDICATIONS - RA

307
Q

Antibodies associated with Autoimmune Thrombocytopenic purpura

A

Anti-Glp IIb/IIIa or Ib-IX

308
Q

Complications of PCH

A

Budd-chiari (hepatic vein thrombosis)

309
Q

Anaemia, erythroid dysplasia (<5% blasts)

A

Refractory anaemia

310
Q

Marginal (MALToma)

A

Chronic antigen stimulation (H. pylori, sjorgens

311
Q

Deposition of beta 2 microglobulin

A

Haemodialysis associated amyloidosis

312
Q

AML subtype: M3

A

Acute promyelocytic leukaemia- prone to DIC

313
Q

Form of malaria that infects erythrocytes

A

Merozoites

314
Q

Which prion disease has proceeding psychiatric changes before neurodegeneration occurs?

A

Variant

315
Q

Histo features in alcoholic hepatitis

A

Mallory-Denk bodies and hepatocyte ballooning

316
Q

Panacinar COPD

A

A1AT

317
Q

Durie Salmon staging

A

Multiple myeloma

318
Q

Gram +ve coccus, catalase -ve, alpha-haemolytic, optochin sensitive

A

Streptococcus pneumoniae

319
Q

Treatment for Staph. Aures colitis

A

Supportive

320
Q

Drug causes of SLE

A

HIP: Hydralazine (anti-sickness), Isoniazid, procainamide (antiarrhythmic)

321
Q

Derm: Naevus cells at the dermo-epidermal junction confined to the epidermis

A

Junctional naevus

322
Q

Czapek dox agar

A

Aspergillus - remeber - you can buy this medium in your local…

323
Q

Hypocellular marrow and anaemia/pancytopenia

A

Aplastic anaemia

324
Q

Basiliximab - MOA, indications

A

MOA - CD25 INDICATIONS - Transplantation

325
Q

Tx of BPH

A

1st line - 5-alpha reductase inhibitors

2nd line - alpha blocker (doxazocin)

Surgical - TURP

326
Q

Stages of pneumonic process

A

1) Consolidation 2) Red hepatisation (neutrophilia) 3) Grey hepatisation (fibrosis) 4) resolution

327
Q

ABx HAP 1st line

A

Ciprofloxacin +/- Vancomycin

328
Q

What tissue is this?

A

Skeletal muscle

329
Q

Dilated (Systolic) cardiomyopathy is associated with what added sound?

A

3rd heart sound

330
Q

Inhibitors of the clotting cascade

A

TFPI, protein C and S, AT III

331
Q

Nephrotic syndrome with no changes on light microscopy

A

Minimal change disease

332
Q

Brain tumour: Frontal lobe, ‘fried egg’ appearance

A

Oligodendroma

333
Q

Fractures in osteoporosis

A

NOF, vertebrae, wrists- Colles’

334
Q

IgG against FcϵR1 or IgG against IgE

A

Chronic urticaria

335
Q

What are Schuffner’s dots?

A

RBC granulations associated with plasmodium vivax and ovale

336
Q

ID a/w neutrophil and macrophage accumulation + granuloma formation + lyphadenopathy/hepatosplenomegaly

A

Chronic Granulomatous disease

337
Q

Antibody associated with Dermatomyositis

A

Anti-Jo1

338
Q

Causes of B12 deficiency

A

veGANism, malabsorptive (pernicious, CD, backwash ileitis), tropical sprue, tapeworms

339
Q

Histology of sarcoidosis

A

Non-caseating granulomas, Schaumann and asteroid bodies (inclusions of of protein and calcium)

340
Q

Gardener’s Syndrome

A

1) FAP 2) osteomas 3) teratomas 4) Epidermoid cysts 5) Dental caries

341
Q

EATL

A

Enteropathy associated. Coeliac.

342
Q

Low CD4 and CD8 + Low IgG

A

SCID or DiGeorge

343
Q

Symptoms and diagnostic tests in serum sickness

A

Symptoms: Rashes, itching, arthalgia, LNopathy, fever and malaise. Diagnosis - low C3. Rx - remove cause, steroids

344
Q

AIHA antibody target

A

Anti Rh antigen

345
Q

What tissue is this?

A

Kidney

346
Q

Heart condition caused by progressive loss of myocytes

A

Dilated Heart Failure

347
Q

What causes dilated (systolic) heart failure?

A

Idiopathic, ALCOHOL, peripartum, sarcoid, HFE, myocarditis

348
Q

Target of Abs in GBS post campylobacter

A

ganglioside LM1

349
Q

Centrilobular COPD

A

Smoking

350
Q

Urinary features in renal failure

A

RAISED urinary sodium (>20)

351
Q

Breast: Thick, white/green nipple secretions

A

Duct ectasia

352
Q

Kimmelstiel Wilson nodules

A

Diabetic nephrotic syndrome (Mesangial matrix nodules)

353
Q

Lung enzyme that cleaves influenza HA

A

Clara Tryptase = enzyme. Extended trophism for HA + H7

354
Q

Mixed Essential Cryoglobulinaemia

A

TIII hypersensitivity disorder - IgM against IgG. Symptoms include: joint pain, splenomegaly, skin, nerve and kidney involvement. Associated with Hep C

355
Q

Gel coombs classification of and antigen in serum Sickness

A

TIII. Foreign animal proteins in serum - often a/w penicillin

356
Q

Cytopenia in multiple cell lines with dysplasia in >10% of cells across multiple cell lines on BM biopsy and ringed sideroblasts

A

Refractory cytopenia with multilineage dysplasia with ringed sideroblasts

357
Q

what two Abx are linked to theophylline OD

A

Ciprofloxacin and erythromycin

358
Q

CSF interpretation: High lymphocytes and Low glucose

A

TB (duration best indicator)

359
Q

Biochemical markers of haemolysis

A

Bili & urobilinogen, LDH, Rtics (raised MCV and polychromatic), pigment stones

360
Q

What tissue is this?

A

Small Bowel

361
Q

Rifamycin - example and MOA

A

”” (RNA synth inhibitor)

362
Q

PT: normal, APTT: increased, bleeding time: increased

A

VWD

363
Q

Tri-nucleotide repeat disorders

A

1) Fragile X (CGG) 2) Huntington’s (CAG) 3) myotonic dystrophy (CTG) 4) Freidrich’s ataxia

364
Q

Organs affected in sideroblastic anaemia

A

endocrine, liver and cardiac damage due to iron deposition

365
Q

How does unfractionated heparin work?

A

Xa + direct AT potentiation

366
Q

Descending paralysis following consumption of honey/ canned foods

A

Clostridium botulinum

367
Q

Obervation on the blood film and associated underlying conditions?

A

Rouleaux formation (due to increased plasma proteins)

Associated conditions:

Myeloma

368
Q

Pulvinar sign (posterior thalamus highlighted on MRI)

A

Variant CJD

369
Q

Adult T-cell lymphoma

A

HTLV-1 infection. Japan and Carribean.

370
Q

Features of acute ITP: peak age, duration, remission

A

Children (2-6), duration (2-6 weeks), spontaneous remission (common, self limiting)

371
Q

Enterococcal endocarditis

A

Ampicillin and Gentamycin

372
Q

Evan’s syndrome

A

AIHA, ITP associated with CLL

373
Q

Cause of osteomyelitis in children and most common site

A

H.influenzae, GBS - Long bones (metaphysis) {salmonella if Sickle cell disease)

374
Q

Causes of SIADH

A

CNS, Lung, Tumours (Breast), Drugs (SSRI, TCA, opiates, PPi, Carbamazepine), surgery

375
Q

Acute hypoxia, shortness of breath and a non-productive cough immediately after transfusion. JVP is not raised.

A

Transfusion associated lung injury (TRALI)

376
Q

Treatment of polycythaemia rubra vera

A

Venesection and hydroxycarbamide

377
Q

What tissue is this?

A

Kidney

378
Q

C3, C4 and CH50 low, AP50 normal

A

SLE (severe)

379
Q

Rx cryptococcus

A

Amphotericin B +/- flucytosine

380
Q

HLA protective for ankylosing spondylitis

A

HLA B21 - <50% of genetic risk

381
Q

Syndromes associated with Enchondroma and features

A

Ollier’s syndrome = multiple enchondromas, Maffuci’s syndrome = multiple enchondromas and haemangiomas

382
Q

Carcinoid crisis

A

Life threatening vasodilatation, Hypotension, Tachycardia, Bronchoconstriction, Hyperglycaemia

383
Q

Clinical progression of Sporadic CJD

A

Rapid dementia and death within 6 months. Most common type.

384
Q

Order of importance in HLA matching

A

DR > B > A

385
Q

Investigations in sarcoidosis

A

Calcium (increased), ESR (increased), ACE (increased), transbronchial biopsy, Kveim test (intradermal injection of sarcoid splenic tissue)

386
Q

Wes Hoolahan/Rudy Gestede drops dead in a training session? What is the gene defect and mode of inheritance associated with this disease?

A

HOCM: Beta-MHC gene & autosomal dominant

387
Q

What tissue is this?

A

Breast

388
Q

Commonest cause of prosthetic valve endocarditis

A

Staph. Epidermidis (coagulase negative staphylococci)

389
Q

Management of complicated Plasmodium Falciparum

A

Artesunate (artemisinin-based combination therapies)

390
Q

Askanazy cells

A

Hashimoto’s thyroiditis

391
Q

Asymptomatic haematuria

A

Thin basement membrane disease, IgA nephropathy, Alport syndrome

392
Q

What is the principal inhibitor of coagulation?

A

Antithrombin - serpin → inactivation of clotting factors

393
Q

Obervation on the blood film and associated underlying conditions?

A

Basophilic RBC stippling

Associated with:

Lead poisoning, Megaloblasic anaemia, myelodysplasia, liver disease, haemoglobinopathy (Thal)

394
Q

Mantle cell

A

t(11;14), cyclin D1 (mental to cycle in london) “angular nuclei”

395
Q

Vector for malaria

A

FEMALE anopheles mosquito

396
Q

Protective factors for endometrial CA

A

E2 exposure, COCP, SMOKING

397
Q

Gold standard TB Ix

A

Lowstein Jensen medium

398
Q

Inactivated vaccines

A

Polio (salk), anthrax, cholera, bubonic plague, Hep A, Rabies, Pertussis

399
Q

Ig raised in Waldenstrom’s

A

IgM

400
Q

Sulfonamides - example and MOA

A

Sulfonamides (inhibit folate metabolism)

Sulphamethoxazole (Co-trimoxazole when combined with trimethoprim)

401
Q

Biochemical features: Low Fe, low TIBC high Ferritin

A

Anaemia of chronic disease

402
Q

SCD mutation

A

GAG → GTG of codon 6: glu → val

403
Q

Herpangina

A

Coxsackie

(herpangina = mouth blisters)

404
Q

Indication and target of: Polyene (e.g. Amphotericin)

A

Indication: Yeasts, Target: cell membrane integrity

405
Q

Features of mycobacterum marinarum

A

Single or clusters of papules/plaques. Swimming pool or aquarium owners

406
Q

VIN associated virus

A

HPV 16 (and 18)

407
Q

How does protein S work?

A

Cofactor for TFPI

408
Q

Treatment for Salmonella Typhi

A

Ceftriaxone/ Ciprofloxacin

409
Q

What is fibrinous pericarditis?

A

Epicardial infarct post MI

410
Q

Malignant bone tumour: older women and knee involvement

A

Giant cell

Other featuers: Lytic lesions, multinucleate giant cells, soap bubble osteolysis

411
Q

Features of diabetes insipidus

A

Euvolaemic hypernatraemia. Reduced urinary osmolality. Water deprivation test to investigate. Concentrates in cranial (give DDAVP), fails to concentrate in nephrogenic

412
Q

Management of C. Diff

A

PO Metronidazole (14/7). PO Vancomycin (14/7)

413
Q

Primary adjuvant used in humans, Activates Gr1+ cells to produce IL-4. Helps to prime naive B cells

A

Alum

414
Q

CSF interpretation: High neutrophils and decreased glucose

A

Bacterial meningitis

415
Q

Triad of features in Wilson’s

A

Hepatic disease (hepatitis, failure or cirrhosis) Neuro (parkinsonism, psychosis, dementia), Kayser Fleischer rings

416
Q

What molecule initiates coagulation

A

Tissue factor

417
Q

Main Hepatitis C nephropathy

A

Membranoproliferative glomerulonephritis (not to be confused with membranous glomerular disease)

418
Q

Brain: Indolent childhood tumour. GFAP positive, Rosenthal fibres (eosinophillic astrocytic processes)

A

Pilocytic astrocytoma

419
Q

Anaemia. BM biopsy demonstrated megakaryocytes with hypolobated nuclei and <5% blasts

A

MDS 5q deletion (long arm deletion)

420
Q

Cause of left atrial hypertrophy with no change in left ventricle?

A

Mitral stenosis

421
Q

Mechanism of direct transplant rejection

A

APC presenting Ag/MHC to recipient T-cells. A/W ACUTE REJECTION.

422
Q

Low CD4 and normal CD8 + Low IgG and Low IgA

A

Bare lymphocyte syndrome (usually unwell by 3m and FHx of early death)

423
Q

Cause of Ca oxalate crystals

A

Absorptive hypercalciuria (absorption from the gut)

424
Q

Breast: Increase in size during pregnancy and calcify after menopause

A

Fibroadenoma

425
Q

Bleeding disorder, reduced platelet function, acquired

A

Aspirin, uraemia, cardiopulmonary bypass

426
Q

Gram +ve coccus, catalase -ve, alpha-haemolytic, optochin resistant

A

Streptococcus viridans

427
Q

What tissue is this?

A

Adrenal

428
Q

Skin lesion: Irregular borders + variation in colour. Tend to grow outwards rather than downwards into the skin

A

Superficial spreading malignant melanoma

429
Q

Painless genital ulcers

A

Syphilis, lymphogranuloma venereum, granuloma inguinale

430
Q

Anaemia with BM dysplasia and 5-9% blasts

A

RAEB-I

431
Q

Urinary features in cardiac/liver failure

A

REDUCED urinary sodium (<20) as tubular function maintained

432
Q

Ovarian carcinoma: secreting androgens

A

Sertoli-Leydig

433
Q

PTPN22 polymorphism

A

RA, SLE, T1DM

434
Q

Anticoagulant duration: 1st VTE unknown cause

A

3-6 months, possibly lifelong

435
Q

Burkitt’s

A

t(8;14), c-myc, starry sky, endemic (EBV, jaw), sporadic and immunodeficiency subtypes

436
Q

AML subtype: M4 + 5

A

monoblasts/monocytes: skin/gum infiltration + hypokalemia

437
Q

HPV pathogenesis

A

Inactivation of TSGs: E6 → P53 E7 → Rb

438
Q

Intrinsic pathway constituents

A

12, 11, 9, 8, 10

439
Q

Normal life-span of RBC

A

120d

440
Q

Renal damage caused by BPH

A

Hydronephrosis, Renal cortical atrophy à chronic renal failure

441
Q

Pathological protein in Alzheimer’s

A

Tau, beta amyloid

442
Q

gamma haemolytic cocci

A

Enterococci

443
Q

Elderly gentleman has a platelet count >600 with large platelets on blood film. BM biopsy demonstrates increased megakaryocytes.

A

Essential thrombocythaemia

444
Q

Biochemical features of SIADH in serum

A

True hyponatraemia (low serum osmolality), hyponatraemia, high urine osmolality (>100)

445
Q

Vector for Lyme disease

A

Ixodes tick

446
Q

Q-fever organism

A

Coxiella Burnetti

447
Q

Fluroquinolones - example and MOA

A

Cipro (inhibit DNA synth)

448
Q

Class of drugs that inhibit SGLT-2

A

Glifozins

449
Q

Gene for Wilson’s disease

A

ATP7B on Chr 13

450
Q

Acute IE in IVDU

A

Staph. Aureus

451
Q

Rx cold AIHA

A

Treat cause, avoid cold, chlorambucil

452
Q

Toxoid vaccines

A

Diptheria, tetanus

453
Q

What immunodeficiency is associated with an Increased risk of connective tissue disease?

A

C3 deficiency (Classical pathway deficiency increases susceptibility to AI disease, especially SLE)

454
Q

Allergies suitable for desensitisation

A

bee/wasp sting, grass pollen, dust mite. DOES NOT WORK FOR FOOD ALLERGIES

455
Q

Hereditary coproporphyria

A

Copro ox (Coproporphyrinogen oxidase)

456
Q

Conjugate vaccines

A

Tetanus, HIB, Meningococcus, Pneumococcus

457
Q

Features of chronic ITP: peak age, duration, remission

A

Adults, duration (long term), spontaneous remission (uncommon, rx: IVIg, steroids)

458
Q

Sources of opportunistic infections post BMT

A

Reactivation, from graft, exogenous

459
Q

Prognostic scoring system in MDS

A

International prognostic scoring system (Blast %, Karyotype and degree of cytopenia)

460
Q

Rx of Leprosy

A

Rifampicin, dapsone, clofazimine

461
Q

Brain tumour: Optic chiasm compression (not pituitary lesion) arrising from Rathke’s pouch

A

Craniopharyngioma

462
Q

Subacute bacterial endocarditis causative organism

A

Viridans Streptococcus

463
Q

Clinical features of familial mediterranean fever

A

Attacks of fever, inflammation of serosal surfaces (pleura, peritoneum, sinovium)

464
Q

Component/subunit vaccines

A

Hep B, HPV, Influenza

465
Q

Cutaneous and visceral Leishmania organisms

A

Cutaneous: L. Major/ L. Tropica, Visceral: L. Donovanni

466
Q

Tx for severe hyponatraemia with seizures or fitting

A

3% saline

467
Q

Most common valves in IE generally

A

Aortic and Mitral

468
Q

A patient receives a transfusion of platelets and packed RBCs following an accident. He immediately develops profound hypotension and tachycardia accompanied by a high fever and rigors. He does not report any pain.

A

Bacterial contamination

469
Q

Presence of only HBsAg

A

Vaccinated against Hep B

470
Q

Natural chemokines protective of HIV

A

MIP-1a, MIP-1b, RANTES

471
Q

Breast: Most common invasive breast carcinoma

A

Invasive ductal

472
Q

Breast: Pre-malignant lacks adhesion protein E-cadherin

A

Lobular carcinoma in situ

473
Q

Anechoic mass found at the angle of the mastoid on a child

A

Branchial cyst

474
Q

Vector for Leishmaniasis

A

Sandlfy

475
Q

Breast: Pre-malignant. Appears as areas of microcalcification

A

Ductal carcinoma in situ

476
Q

Eye manifestations of sarcoidosis

A

Anterior uveitis, posterior uveitis, uveoparotid fever, keratoconjunctivitis, lacrimal gland enlargement

477
Q

Which species of malaria causes the most severe infection?

A

Plasmodium falciparum

478
Q

Renal mass tubular/papillary architecture <5mm

A

Papillary adenoma

479
Q

Antigen involved in Pemphigus Vulgaris

A

Epidermal Cadherin

480
Q

What tissue is this?

A

Skeletal muscle

481
Q

Painless black lesion with rim of oedema

A

Anthrax (Bacillus anthracis)

482
Q

Management of uncomplicated Plasmodium Falciparum

A

Riamet (artemether with lumefantrine) or Malarone

483
Q

Heerfordt’s syndrome

A

Atypical sarcoid - Uveoparotid fever: bilateral uveitis, parotid enlargement, facial nerve palsy

484
Q

Nitroimidazoles - example and MOA

A

Metro (inhibit DNA synth)

485
Q

Mechanism of acute cellular rejection

A

CD4 → Type IV reaction

486
Q

Histology in Diffuse large B-cell lymphoma and common pre-cursor disease

A

Sheets of lymphoid cells, Richter’s transformation from CLL

487
Q

Tx for HAP

A

Amoxicillin and gent or tazocin

488
Q

Bleeding characteristics in coagulation disorders

A

Deep tissues (muscles, joints), delayed, prolonged and severe

489
Q

Principles of ALL chemotherapy

A

Remission induction, consolidation, maintenence

490
Q

Ix of infection post BMT

A

Get tissue Dx, Serology doesnt work

491
Q

Lung CA: Mutations associated with squamous cell CA

A

ANS: P53 and c-myc INFO: male predominate, smoking associated, centrally occuring, chemo-insensitive.

492
Q

Causes of euvolaemic hyponatraemia

A

Hypothyroidism, SIADH, adrenal insufficency

493
Q

Form of malaria once inside of erythrocyte

A

Trophozoite

494
Q

Staining pattern in sjogren’s

A

Speckled

495
Q

Brain tumour: Tumour of the 4th ventricle. Perivascular pseudorossettes on histology

A

Ependymoma

496
Q

Measures intrinsic pathway function

A

APTT

497
Q

A man punches someone in a pub brawl. The recipient then bites his hand. Later the bite wound becomes infected, with lots of pus and a foul smell. The most likely pathogen is?

A

Anaerobic bacteria

498
Q

When is a testicular teratoma regarded as malignant?

A

In the post-pubertal male

499
Q

Causes of pseudopolycythaemia

A

Reduced plasma volume: Smoking, dehydration, burns, diarrhoea

500
Q

Breast: Non-malignant inflammatory condition associated with smoking

A

Periductal mastitis (histo: keratinizing squamous epithelium)

Histo (4 decks)

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