Other Path Flashcards
What is the main mechanism behind HSV resistance to antivirals?
Thymidine Kinase mutation
What is the main mechanism behind CMV resistance to antivirals?
Protein Kinase mutation
Which virus is most commonly implicated in infection post-transplant in paediatric populations?
Adenovirus
How is post-transplant adenovirus treated?
Brincidofovir
How is RSV infection treated?
Ribavarin
Which virus is implicated in post-transplant lymphoproliferative disease?
EBV
When would you not give Ganciclovir to treat CMV?
Post HCST, use Foscarnet
A patient who has recently been on a cruise in Japan, where they ate lots of raw seafood, presents with diarrhoea. What is the most likely causative organism?
Vibrio parahaemolyiticus
Give an example of an antibiotic class that is affected by altered target resistance.
Macrolides
Give an example of an antibiotic that is affected by bypass resistance.
Trimethoprim
What is a fungal eye infection most commonly found to be?
Candida endopthalmitis
How would you treat Candida spp. infections not caused by Candida albicans?
Echinocandin
Which Cryptococcus species infects immunocompetent hosts?
Cryptococcus gattii
Which Cryptococcus species infects immunosuppressed hosts?
Cryptococcus neoformans
A patient with pneumonia has a CXR, which shows a bat wing appearance. What is the most likely causative organism?
Pneumocystis jirovecii
How is Hepatitis C treated?
Interferon
Ribavarin
How are infected prosthetic joints managed?
Removal and debridement before Abx
A patient returns from a city break in Bangkok complaining of a new, sunburn like rash, a retro-orbital headache and myalgia. What is the most likely diagnosis?
Dengue Fever
In which infectious disease are ‘Purple eyelids’ a common feature?
Chagas Disease
In which infectious disease are ‘Negri Bodies’ seen?
Rabies
Name two classes of drug which may be used to treat Benign prostatic Hyperplasia.
5-alpha reductase inhibitor
Alpha Blocker
In which disease might there be a mutation affecting Superoxide Dismutase 1?
Motor Neurone Disease
How would you manage a Pseudomonas aeruginosa infection?
Gentamicin
Ceftazadine
Which disease’s severity would be assessed using the Breslow Score?
Melanoma
Which organism is the most common cause of bronchopneumonia?
Haemophilus influenzae
Which organism is the most common cause of CNS infections overall?
Coxsackie virus
Which organism most commonly causes lung disease in patients with Cystic Fibrosis?
Pseudomonas aeruginosa
Which tapeworm species is found in pigs?
Taenia solium
Which tapeworm species is found in cows?
Taenia saginata
Which type of worm’s life cycle involves migrating from the skin to the bowel, laying eggs, hatching as rhabitiform larvae and maturing into filariform larvae?
Strongyloide (Pinworm), type of Nematode (soil-based)
Which type of worm’s life cycle involves being eaten, living in the intestines, forming a cyst and the cyst releasing a tapeworm, which grows and releases more eggs?
Cestodes (Tapeworm)
Which type of worm’s life cycle involves cercariae invading the skin after being released by freshwater snails, worms developing in the liver, migrating to the mesenteric venules/venous plexus of bladder, laying eggs which become miricidia and reinfecting freshwater snails?
Trematode (Schistosomiasis)
How would you treat strongyloide infection?
Ivermectin
Which medication is most widely used for parasitic infection?
Praziquantel
The centre of a granuloma being diffuse red indicates what?
Necrosis
Caseation
At what level must skin damage be to leave a scar?
Dermis
Where is the dermis in relation to the basement membrane?
Sits below it
Which virus is associated with Nasopharyngeal Carcinoma?
EBV
Which toxins are associated with Hepatocellular Carcinoma?
Aflatoxins
What is the role of stellate cells in the liver?
Vitamin A stores
Activate to myofibroblasts to lay down collagen
What does ‘Grade’ mean with regards to Chronic Hepatits?
Severity of inflammation
What does ‘Stage’ mean with regards to Chronic Hepatitis?
Severity of Fibrosis
What is the most common form of carcinoma that arises from CIN changes?
Squamous Cell Carcinoma
In which breast cancer are large, pleomorphic cells seen?
Invasive Ductal
In which breast cancer are Indian Files seen?
Invasive Lobular
In which breast cancer are Elongated Tubules seen?
Invasive Tubular
In which breast cancer are Empty Spaces seen?
Invasive Mucinous
What is the most important prognostic factor for Breast Cancer?
Spread to axillary lymph nodes
Which stain is used to distinguish Squamous Cell Carcinomas from Adenocarcinomas?
P40
In which condition would you see ‘Soap Bubble Osteolysis’ on x-ray, with ‘Chinese Letters and Shepherd’s Crook’ Signs?
Fibrous Dysplasia
In which syndrome would you see polyostotic fibrous dysplasia and rough border Cafe au Lait spots?
McCune Albright Syndrome
Which benign bone tumour typically affects teenage boys and occurs at the end of long bones?
Osteochondroma
Which benign bone tumour occurs in hands and feet and shows ‘popcorn calcification’ on x ray?
Enchondroma
Which benign bone tumour mainly affects young women and occurs at the epiphyses of long bones? On histology, there are osteoclasts on a background of spindle/ovoid cells.
Giant Cell tumour
What is the most common bone sarcoma?
Osteosarcoma
Which malignant bone tumour shows ‘Codman’s Triangle and a sunburst appearance’ on x-ray and malignant mesenchymal cells on histology?
Osteosarcoma
Which malignant bone tumour produces cartilage, and on histology shows ‘Malignant chondrocytes with or without chondroid matrix’?
Chondrosarcoma
Which malignant bone tumour shows ‘onion skinning of the periosteum’ on x-ray, and ‘sheets of small round cells’ on histology?
Ewing’s Sarcoma
Which tumour is associated with t(11;22)(q24;q12)?
Ewing’s Sarcoma
How are cytopathological samples of Breast cancers graded?
C1-5
1: Inadequate
2: benign
3: Atypia, probably benign
4: Atypia, probably malignant
5: malignant
Which disease shows proteinaceous material and neutrophils on cytology, and duct distension with proteinaceous material and ‘foamy macrophages’ on histology?
Duct Ectasia
Which breast disease shows neutrophils on cytology, and is usually caused by Staphylococcus aureus?
Acute Mastitis
Which breast disease shows ‘fat cells surrounded by macrophages’ on cytology?
Fat Necrosis
Which breast disease shows ‘dilated, calcified ducts’ on histology.
Fibrocystic Disease
Which breast disease shows ‘glandular and stromal cells’ on histology, and presents as a mobile, well circumscribed lump?
Fibroadenoma
Which breast condition shows ‘overlapping cells’ on histology, and is benign? It is sometimes described as having a ‘leaf-like’ appearance.
Phyllode’s Tumour
Which benign breast tumour may present with bloody nipple discharge?
Central Intraductal Papilloma
Which breast condition shows:
Cytology: Clusters of cells
Histology: Dilated ducts, polypoid mass in the middle
?
Intraductal Papilloma
Which breast condition may show ‘a central stellate area’ and a ‘proliferation of ducts and acini’ on histology?
Radial Scar
List 3 types of proliferative breast disease.
Usual Epithelial Hyperplasia
Flat Epithelial Atypia/Ductal Carcinoma
In situ lobular neoplasia
Which breast condition shows ‘cribiform, punched out;’ appearance on histology, with compact lumens, calcification and overlapping cells?
Low grade Ductal carcinoma in situ
Which breast condition shows a ‘central lumen of necrotic tissue’ with large cells, pleiomorphic cells which occlude a duct, and few lumens?
High grade ductal carcinoma in situ
Which breast cancer shows ‘pleiomorphic cells with large nuclei’ on histology and is E-cadherin +ve?
Invasive Ductal Carcinoma
Which breast cancer shows a ‘linear, Indian File pattern’ on histology, with a monomorphic appearance?
Invasive Lobular Carcinoma
Which breast cancer shows ‘elongated tubules invading the stroma’ on histology?
Invasive tubular carcinoma
Which breast cancer shows ‘empty spaces with lots of mucin’ on histology?
Invasive mucinous carcinoma
Which breast cancer shows ‘sheets of markedly atypical cells, with prominent lymphocytic infiltrates and central necrosis’ on histology?
Basal-Like Carcinoma
Which gene mutation is a poor prognostic indicator for breast cancer?
Her2
Which gene mutation is a good prognostic indicator for breast cancer?
ER/PR
In which thyroid condition might you see calcifications (psammoma bodies) and clear nuclei (Orphan’s Annie Eyes)?
Papillary Thyroid Cancer
In which thyroid condition might you see amyloid deposition with Congo Red staining, and why?
Medullary Carcinoma
Calcitonin breaks down to Amyloid
What effect does PTH have?
1-alpha Hydroxylase activation
Osteoclast activation
Renal calcium resorption
Renal potassium excretion
What is secreted in the Zona Glomerulosa?
Aldosterone
What is secreted in the Zona Fasciculata?
Glucocorticoids
What is secreted in the Zona Reticularis?
Androgens & Glucocorticoids
What is secreted in the Zona Medulla?
Noradrenaline
Adrenaline
What is Waterhouse Friederichson Syndrome?
Haemorrhage into adrenals due to septic DIC = acute adrenal insufficiency
Non-infective endocarditis caused by SLE?
Libman-Sacks Endocarditis
Which vasculitis characteristically shows a ‘rosary beads’ appearance on angiogram due to multiple aneurysms?
Polyarteritis Nodosa
What is c-ANCA directed against?
Proteinase 3
What is p-ANCA directed against?
Myeloperoxidase
Which vasculitis shows ‘narrowing of the lumen and lymphocytic infiltration of the tunica media’ on biopsy?
Temporal Arteritis
Which staging system is used for Cervical Cancer?
FIGO
Name one mutation that is associated with Type I endometrial carcinoma.
PTEN
Which mutation is associated with serous endometrial carcinoma?
p53
Which cancer is most strongly associated with endometriosis?
Ovarian clear cell carcinoma
How does an artheroma form?
Endothelial Injury -> LDL Aggregation
Monocyte Adhesion
Monocyte migration into intima
Platelet Adhesion
Lipid Accumulation
What does MI histology show in the first 6 hours?
Normal
What does MI histology show between 6-24 hours?
Coagulative Necrosis
Loss of Nuclei
Striations
What does MI histology show 1-4 days?
Infiltration of neutrophils & macrophages
What does MI histology show 5-10 days?
Macrophages
What does MI histology show 10-14 days?
Granulation, Angiogenesis, Collagen Synthesis
Myofibroblasts, Macrophages, Angioblasts
What is the most common cause of aortic stenosis?
Calcification
Which disease in children shows ‘effacement of foot processes’ on electron microscopy?
Minimal Change Disease
Which renal disease shows ‘partially scarred glomeruli’ and ‘thickened GBM’?
Focal Segmental Glomerulosclerosis
Which renal disease shows immune deposits on the outside of the glomerular basement membrane and thickening of the BM?
Membranous Glomerulonephritis
Which antibody is associated with membranous glomerulonephritis?
Anti-phospholipase A2 type M receptor
How is Alport’s Syndrome inherited, and what does the mutation affect?
X-linked dominant
alpha 5 subunit of type iv collagen
In which renal condition might you see ‘shrunken kidneys with granular cortices’ and ‘fibrinoid necrosis’?
Hypertensive Nephropathy
Poisoning with which chemical may predispose to Calcium Oxalate crystal formation?
Ethylene Glycol
In which syndrome might you see Renal Oncocytomas?
Birt-Hogg-Dube Syndrome
Which benign renal tumour is epithelial in origin and composed of papules and tubules?
Papillary Adenoma
Which benign renal tumour is epithelial in origin and composed of oncocytic cells?
Renal Oncocytoma
Which benign renal tumour is mesenchymal in origin and composed of thick walled blood vessels, smooth muscle and fat?
Angiomyolipoma
Which malignant renal tumour appears grossly as a ‘golden yellow tumour’ with ‘haemorrhagic areas’?
Clear Cell Carcinoma
Which malignant renal tumour is associated with long-term dialysis and appears as a ‘fragile, friable, brown tumour’?
Papillary Renal Cell Carcinoma
Which malignant kidney tumour appears as a well circumscribed solid brown tumour?
Chromophobe Renal Cell Carcinoma
Which renal tumour appears as ‘small, round, blue cells’ on histology?
Nephroblastoma
How is prognosis for Prostatic Adenocarcinoma calculated?
Gleason Score
What might it indicate if a lung lobe isn’t black on autopsy?
Pneumonia
When would you refer a death to the coroner?
Unknown COD Sudden death (<24h in hospital) Suspicious Self-Neglect/Suicide Related to detainment/Medical care Related to job
Which antibody is implicated in Bullous Pemphigoid?
Anti-Hemidesmosome, attacking basememnt membrane
Where is the site of disease in Pemphigus Vulgaris?
Dermal-epidermal junction
IgG attacks between keratin layers
In which IgG mediated skin condition might the outer layer of the stratum shear off?
Pemphigus follaceous
Which skin condition is characterised pathologically by thickened epidermis, parakeratosis layers, disappeared stratum granulosum and Munro’s microabscesses?
Psoriasis
How does Lichen Planus present:
a) on the wrists/arms
b) in the mouth?
a) Purplish/red rash
b) White Lines (Wickham Striae)
In which condition might you see ‘horn cysts’, which are areas where the epidermis entraps keratin?
Seborrhoeic Dermatitis
What occurs in the immediate phase of asthma?
Mast cell degranulation and effects
What occurs in the late phase of asthma?
Tissue damage, mucous production, muscle hypertrophy
In which lung condition might you find ‘iron-laden macrophages’ on histology?
Pulmonary Oedema
From the heart
What are the stages of lobar pneumonia?
Congestion
Red Hepatisation
Grey Hepatisation
Resolution
What is the key feature of grey hepatisation in pneumonia?
Intra-alveolar neutrophils
What are the stages of fracture repair?
Haematoma
Fibrocartilaginous callus
Mineralisation of callus
Remodelling
In which bone disease might you see ‘Langerhans-type Giant Cells with horseshoe nuclei’?
TB
In which condition might you see a proliferative synovitis, with pannus formation and grimley sokoloff cells on histology?
Rheumatoid Arthritis
Which cells are present in MALTomas related to H Pylori?
B Cells
Which cells are present in Duodenal Lymphomas?
T Cells
What is the most common genetic predisposition to brain tumours?
Neurofibromatosis
What is the most common paediatric brain cancer?
Pilocytic Astrocytoma
Which brain tumour is cerebellar and well circumscribed on MRI, and shows hairy piloid cells and rosenthal fibres on histology?
Pilocytic Astrocytoma
Which mutation is associated with Pilocytic Astrocytoma?
BRAF mutation
What is the most common primary brain cancer in adults?
Glioblastoma Multiforme
How do astrocytomas progress?
Become Glioblastomas
Which brain cancers are associated with IDH1/2 mutations?
Diffuse Astrocytoma
Oligodendroglioma
Which brain cancer displays ‘round cells with clear cytoplasm’ (fried egg appearance)
Oligodendroglioma
Which brain cancer shows ‘small blue round cells’ and ‘Horner-Wright Rosettes’?
Medulloblastoma
How is tau spread staged in Alzheimer’s?
Braak Staging
Which three enzymes are involved in oxidative killing by granulocytes?
NADPH Oxidase
Superoxide Dismutase
Myeloperoxidase
Which antigen is found on all T Cells?
CD3
Which T Cells play a key role in germinal centre reactions and Plasma Cell class switching?
T Follicular Helper Cells
Which T Cells express FoxP3 and CD25?
T Regulatory
Which T Cells express CD4 and secrete IFN-y and IL-2
T Helper 1
Which chemokines help direct dendritic cells to lymph nodes?
CCL19 CCL21
ligands for CCR7
Which agent used in FMF binds to tubulin in neutrophils?
Colchicine
Which HLA is seen in Goodpasture’s Syndrome?
HLA DR15
Which cytokine plays a key role in development of TH2 cell responses (and hence allergic responses)?
IL-4
Which cell type does Azathioprine target?
T
Which cell type does Cyclophosphamide target?
B
Which cell type does mycophenolate motefil target?
T
Which enzyme’s activity must be checked before starting Azathioprine?
TPMT
Name a JAK inhibitor.
Tofacitinab
What does Secukinumab target?
IL-17
What does Guselkumab target?
IL-23
What does Ustekinumab target?
IL12 IL23
What does Abatacept target?
CTLA4-Ig fusion gene
RA if Anti-tnf alpha ineffective
What is the max number of HLA mismatches between a parent and child?
3
What is the max number of mismatches between siblings?
3
What are the 3 phases of antibody mediated transplant rejection?
1: exposure to antigen
2: B Cell proliferation and maturation
3: Effector = antibodies bind to graft epithelium
What are the phases of T cell-mediated graft rejection?
1: Activate alloreactive T Cells
2: Normal T Cell functions vs graft
Effector: T cells tether graft endothelium and attack tubular epithelium.
What are the histological features of T-cell mediated graft rejection?
Lymphocytic interstitial infiltration
Ruptured tubular basement membrane
Tubulitis
Macrophages
What are the cardinal features of antibody-mediated rejection?
Capillaritis
Inflammatory cells in the capillaries
What is there a deficiency of in Leukocyte Adhesion Deficiency?
CD18
Which immunodeficiency may be implicated in a child presenting with recurrent, severe viral infections?
NK Deficiency
A patient has: Low/Absent T Low/Absent NK Normal/High B Low Ig What is the likely cause?
X-linked SCID
A patient has: Low/Absent T Low/Absent NK Low/Absent B Low Ig Normal Neutrophils What is the likely cause?
ADA Deficiency
A patient has: Low CD4 Normal CD8 Normal B Low IgG/IgA What is the likely cuase?
Bare Lymphocyte Syndrome II
How might you differentiate between IDA and Beta Thalassaemia trait on blood film?
Basophilic Stippling = BT
How is anaphylaxis managed?
ABC Mask O2 IM Adrenaline IV Antihistamine Nebulised Bronchodilators IV Corticosteroids IV Fluids
What does normal levels of C3/4, but absent CH50/AP50 represent?
Deficiency in common pathway
Which Staph is coagulase positive?
Staph aureus
Which Staph is coagulase negative?
epidermidis
Which bacteria are gram positive bacilli?
ABCDL Actinomyces Bacillus Clostridium Diptheria Listeria
Which bacteria are gram negative cocci?
Neisseria spp
Moraxella
Which bacteria are gram negative cocobacilli?
Haemophilus Bordatella Pseudomonas Chlamydia Brucella
Which antibiotics are considered broad-spectrum?
'These meds can cover' Tazocin Meropenem Co-amoxicvlax Ciprofloxacin
Which pneumonia cause shows ‘glossy colonies’ on agar?
Haemophilus influenzae
Which cause of pneumonia is cold agglutinin +ve?
Mycoplasma pneumoniae
Trophozoite with 4 nuclei, flask-shaped ulcer?
Entamoeba Histolytica
Trophozoite with 2 nuclei, pear-shaped ulcer?
Giardia Lamblia
What is the mechanism of action of aciclovir and ribavarin?
Nucleoside Analogue
Which disease is transmitted by the Tsetse Fly?
Trypanasoma
Which disease is transmitted by the Sand Fly?
Lesihmania
Which mutation is associated with MAHA and TTP?
ADAMTS13 = VWF cleaving protease deficiency
What are the three main causes of MAHA?
Adenocarcinoma
HUS
TTP
What effect does Protein C have?
Anti-thrombotic
What is the mechanism of action of warfarin?
Vitamin K epoxide reductase inhibitor
How is warfarin monitored?
INR
How is LMWH monitored in patients with renal failure/extremes of weight?
Anti-Xa assay
In which order do factors drop after commencing warfarin?
7, C, 9, 10, 2
Which type of patient might benefit most from long term anticoagulation after a DVT?
M>F
Idiopathic
Which factor falls in pregnancy?
S
Rank B-Cell NHLs from most to least aggressive.
Burkitt's Mantle Diffuse large B Cell Marginal Zone Small Lymphocytic Follicular
Which diagnostic markers are used for Hodgkin’s Lymphoma?
CD30
CD15
Which cancer is likely to be present if B Cells expressing CD5 but not CD19 are found in the peripheral blood?
CLL
When would you treat CLL?
Progressive disease
Massive splenomegaly
Massive Lymphadenopathy
B Symptoms
What might cause psuedopolycythaemia?
Alcohol
Obesity
Diuretics
What might cause a polycythaemia with an appropriately high EPO?
Altitude
Hypoxic Lung Disease
What might cause a polycythaemia with an inappropriately high EPO?
Renal Disease
Which pharmacological agent might be used in the treatment of polycythaemia vera?
Hydroxycarbimide
A patient presents with an isolated mild thrombocythaemia. They regularly suffer from headaches, What is the most likely diagnosis?
Essential thrombocythaemia
A man with CML is found to have between 10-19% blasts on blood film. Which stage of disease is he said to be in?
Accelerated Phase
A man with CML is found to have over 20% blasts on blood film. Which stage of disease is he said to be in?
Blast Crisis
In which group of conditions might you see ringed sideroblasts and bi-lobed neutrophils?
Myelodysplastic Syndromes
How might you treat myelodysplastic syndromes?
Allogenic Stem cell Transplant
Chemo
How do people with myelodysplastic syndrome die?
Third each
Infection
Bleeding
Acute Leukaemia
What is the most common cause of Aplastic Anaemia?
Idiopathic
What might cause congenital Aplastic Anaemia?
Fanconi Anaemia
Dyskeratosis Congenita
What is aplastic anaemia?
Failure of pleuipotent stem cells -> Pancytopaenia
What does the bone marrow look like in aplastic anaemia?
Hypocellular
Fatty
What shortens in dyskeratosis congenita?
Telomere
When is a red cell transplant indicated?
If >30% blood lost
Hb below 70 peri-operatively
Symptomatically
When might you transfuse washed cells?
If patients have severe allergic reactions to blood products
What does blood irradiation do?
Destroys donor lymphocytes to prevent GvHD in immunosuppressed people
When is fresh frozen plasma indicated?
Massive blood loss (>150ml/min)
DIC with bleeding
Liver disease with PT 1.5x normal
A patient develops chills, rigors and fever of 37.8 degrees during a blood transfusion. Your consultant says a reaction has taken place due to the release of cytokines by white cells in blood storage. Which reaction has taken place?
Febrile non-haemolytic transfusion reaction
A patient develops a mild itchy rash and a wheeze during a fresh frozen plasma transfusion. What is the likely diagnosis?
Allergic reaction
A patient develops pulmonary oedema shortly after undergoing a blood transfusion. What is the most likely diagnosis?
Transfusion-associated circulatory overload
A patient develops SOB, low sats and tachycardia 4 hours after undergoing a transfusion. CXR shows pulmonary infiltrates. What is the most likely diagnosis?
Transfusion-associated acute lung injury
A patient who regularly undergoes blood transfusions for Beta-Thalassaemia becomes jaundiced and anaemic 2 days after their most recent treatment. They also notice dark urine. What is the most likely diagnosis?
Delayed Haemolytic Transfusion Reaction
What is the mechanism behind delayed haemolytic transfusion reactions?
Develop new antibodies vs RBCs (Alloimunisation)
What is the prognosis of GVHD?
Mostly fatal
What is used as a marker of stem cells?
CD34
How does chronic GVHD present?
Similarly to Sjogren’s
What disease causes HbSC?
Sickle Cell/Haemoglobin C disease, which causes milder sickling than HbSS
Which disease might cause anaemia via a glycolytic pathway enzyme deficiency?
Pyruvate Kinase Deficiency
In which leukaemia might you see an abundance of promyelocytes with auer rods on blood film?
Acute Promyelocytic Leukaemia
How would you conclusively distinguish between acute leukaemias?
Immunophenotyping
What is the normal range for potassium?
3.5-5.5 mmol/L
What is the normal range for sodium?
135-145 mmol/L
What is the normal range for haemoglobin in men?
130-180 g/L
What is the normal range for haemoglobin in women?
115-160 g/L
What is the normal range for calcium?
2.2-2.6 mmol/L
A patient presents with metabolic acidosis, an isolated hypokalaemia and renal stones. What is the likely diagnosis?
Type 1 Renal Tubular Acidosis
Which drug, used in chronic management of gout, increases the fractional excretion of uric acid?
Probenecid
What causes a raised anion gap metabolic acidosis?
GOLDMARK Glycols Oxoproline L-lactate D-lactate Methanol Aspirin Renal Failure Ketoacidosis
What condition describes inadequate function of the proximal renal tubules of the kidney and is associated with glucosuria, hypophosphataemia and hyperuricosuria?
Fanconi Syndrome
Which enzyme converts Cholesterol into Cholesterol ester?
ACAT
Which agent is best at reducing LDL levels in the blood?
Evolocumab
What may cause a gout attack in the knee?
Saturnine Gout - Lead Poisoning
Which condition might cause hypocholesterolaemia and orange tonsils in children?
Tangier Disease
How might you distinguish between true and pseudo hyponatraemias?
Serum osmolality - should be low
Which sign, often seen in hypocalcaemia, involves tapping the facial nerve and visualising ipsilateral contraction of the facial muscles?
Chvostek’s Sign
What might cause an unexplained metabolic acidosis with both a raised anion gap and osmolar gap?
Glycol, Ethanol, Mannitol, Methanol Poisoning
Which enzyme is the rate limiting step in de novo purine synthesis?
PAT
Which autosomal recessive disorder leads to an increase in blood plant sterols?
Phytosterolaemia
What might cause a normal anion gap metabolic acidosis?
Addisons
Bicarbonate Loss
NaCl infusion
Drugs
What might cause a false lymphocytosis to show on FBC?
Presence of reticulocytes
What might cause p-wave flattening, hyperacute t waves and a broad QRS in a patient undergoing chemotherapy?
Hyperkalaemia due to tumour lysis syndrome
Does haemophilia affect the bleeding time?
No
Which blood film finding is caused by paraproteinaemia in MM?
Rouleaux formation
What complication are patients with essential thrombocytosis at risk of?
Stroke
Which syndrome is characterised by neutropenia, pancreatic dysfunction and short stature?
Shwachmann Diamond Syndrome
Which bone marrow failure syndrome is characterised by an isolated failure of red cell production, presenting as a macrocytic anaemia and low reticulocytes?
Diamond-Blackfan Syndrome
What is the most sensitive marker for iron deficiency anaemia?
Low Serum Ferritin
Which anticoagulant would you use in a patient with DVT and renal failure?
Warfarin
Which medication may be used as prophylaxis for tumour lysis syndrome?
Rasburicase
Which drug can be used to treat M3 AML (Acute promyeloytic leukaemia)?
All Trans Retinoic Acid
Which condition causes progressively falling platelet counts in a patient started on heparin (enoxaparin)?
Heparin induced Thrombocytopaenia
Why does tumour lysis syndrome cause hypocalcaemia?
Released phosphate binds free calcium in the serum
In which cell type are auer rods seen?
Neutrophil
Which oncogene is found in Burkitt’s, and is formed by a t(8;14) mutation?
C-MYC
Which lobe is most commonly affected in HSV encephalitis?
Temporal
Which cancer shows ‘oat-shaped cells’ on biopsy?
Small cell lung cancer
How many stages of CKD are there?
5
