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MRCP > Part 2 > Flashcards

Part 2 Flashcards

1
Q

Brucellosis tx

A

Doxy and rifampicin 6 weeks

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2
Q

Wellens syndrome ECG

A

T wave inversion or biphasic T waves V2-V3

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3
Q

Wellens syndrome significance

A

Critical LAD stenosis

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4
Q

Wellens syndrome treatment

A

Tx as STEMI

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5
Q

Scleroderma renal crisis tx

A

ACEi Dialysis/transplant

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6
Q

Bleeding with prolonged APPT

A

VWD

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7
Q

Drug to bring out Brugada ECG changes

A

Flecanide

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8
Q

Whipples disease features

A

*Diarrhoea* *Arthralgia* Neuro sx Skin pigmentation/photosensitivity Middle aged men

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9
Q

Chest pain <48hr after MI

A

Pericarditis

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10
Q

Diarrhoea + low B12 + high folate

A

SBBO

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11
Q

Temp post Blood transfusion (TRALI or TACO)

A

TRALI

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12
Q

Blood products more commonly causing TRALI

A

FFP/platelets

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13
Q

What is Plummer Vinson syndrome

A

Esophageal webs Dysphagia IDA

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14
Q

Liver cirrhosis + previously lived abroad

A

Schistosomiasis

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15
Q

Tx for HUS

A

Supportive Plasma exchange Ecuzilumab

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16
Q

What is Nijmegen questionnaire for?

A

hyperventilation syndrome

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17
Q

How to adjust NIV to get rid of more CO2?

A

Increase IPAP

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18
Q

How to adjust NIV to improve oxygenaton?

A

Increase EPAP or 02

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19
Q

What is carcinoid syndrome

A

Tumour secreting serotonin

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20
Q

Features of carcinoid syndrome

A

Valve disease (P or T) Right sided heart failure Chronic diarrhoea Flushing Hypotension

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21
Q

Ix for carcinoid syndrome

A

urinary 5-HIAA plasma chromogranin A y

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22
Q

Tx for HTN in pregnancy

A

labetalol

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23
Q

Fasting BM of >7 in pregnancy management

A

Insulin Aspirin

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24
Q

Esinophilia - Churg Strauss or Wegners?

A

Churg Strauss - esinophilia with polyangitis

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25
Q

TB drug causing arthalgia

A

Pyrazinamide

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26
Q

MI + CCF - what drugs do you need to be on?

A

ACEi beta blocker statin mineralocorticoid receptor antagonist (e.g. eplenerone)

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27
Q

Kleinfelters + can’t smell

A

Kallmans

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28
Q

Anaemia and gallstones =?condition

A

Hereditary spherocytosis

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29
Q

Tx Q fever

A

Doxycycline

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30
Q

Farmer, fever, transamenitis

A

Q fever

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31
Q

Tx botulism

A

Trivalent antitoxin

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32
Q

Muscle weakness “Endomysial lymphocytic infiltrates that invade nonnecrotic muscle fibres”

A

Polymyositis

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33
Q

Muscle weakness “Perimysial inflammation of lymphocytes and parafascicular atrophy “

A

Dermatomyositis

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34
Q

Lupus + loin pain + haematuria

A

Renal vein thrombosis

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35
Q

Drugs causing DRESS syndrome

A

Anti epileptics Allopurinol Chemo

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36
Q

Features of DRESS syndrome

(Drug Reaction With Esinophilia and Systemic Symptoms)

A

Widespread rash

Fever

High lymphocytes

Esinophils

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37
Q

Malignant MCA syndrome

A

Young people have MCA infarct then bleed out, get raised ICP, drop GCS, need craniotomy

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38
Q

How do you calculate anion gap?

A

Sodium - (bicarb + chloride)

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39
Q

Normal anion gap

A

8-12

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40
Q

Poisoning causing acidosis and raised anion gap

A

glycols methanol oxoproline lactate ketones aspirin,

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41
Q

Ix to diagnose MG?

A

Single fibre EMG

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42
Q

Dementia with fluctuating cognition

A

Lewy Body

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43
Q

1st line tx RA

A

Methotrexate and pred

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44
Q

Cluster headache frequency, duration

A

1 every other day - 8x day last 15-180 minutes

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45
Q

Paroxysmal hemicrania

A

>5x/day respond absolutely to indomethacin

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46
Q

Hemicrania continua

A

continuous headache like cluster but never lets but responds to indomethacin

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47
Q

How to reduce eye complications in methanol poisoning

A

Folinic acid

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48
Q

HIV neuro symptoms headache CSF India ink positive

A

Cryptococcal meningitis

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49
Q

Tx for cryptococcal meningitis

A

amphotericin B & flucytosine

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50
Q

Non caseating granulomas (on bronch)

A

Sarcoid

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51
Q

Africa + itchy skin + asthma

A

strongyloides

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52
Q

Strongyloides tx

A

Ivermeticin

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53
Q

Ank spond features (As)

A

Apical fibrosis Anterior uveitis Aortic regurgitation Achilles tendonitis AV node block Amyloidosis

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54
Q

POEMS syndrome

A

paraneoplastic polyneuropathy, organomegaly, endocrinopathy, M-protein band from a plasmocytoma, and skin pigmentation

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55
Q

Young people presenting with PVD symptoms but no vascular risk factors, possibly affecting upper limbs

A

Thrombophlebitis obliterans

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56
Q

“yellow-green colour under Woods lamp”

A

Pityriasis versicolour

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57
Q

Valproate + high ammonia + impaired GCS

A

valproate-associated hyperammonaemic encephalopathy (VHE)

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58
Q

Homozygous FH presentation age

A

<30

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59
Q

Heterozygous FH presentation age

A

>30

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60
Q

Jarisch-Herxheimer reaction

A

syphilis - get fever, rash and tachycardia after B abX started

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61
Q

How to diagnose DeQuervains thyroidits

A

thyroid scintigraphy globally reduced uptake of iodine-131

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62
Q

1st line treatment for T2DM w new HTN (regardless of age or race)

A

ACEi

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63
Q

Monitoring for primary hyperparathyroidism

A

DEXA 1-2 years U+Es Ca2+

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64
Q

Angiod retinal streaks

A

Ehler Danos

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65
Q

Aquaporin-4 +ve

A

Neuromyelitis optica

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66
Q

Polymorphic eruption of pregnancy vs Pemphigoid gestationis

A

PEP - last trimester PG blisters, often starts around umbilicus

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67
Q

Limbic Encephalitis antibody

A

NMDA

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68
Q

Test for SBBO

A

jejeunal aspirate

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69
Q

Councilman antibodies

A

Yellow fever

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70
Q

Features of severe malaria

A

hypoglycaemia acidosis coma convulsions severe anaemia pulmonary oedema

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71
Q

When to Ix anaemia in dialysis

A

Hb <110 or sx of anaemia

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72
Q

Blood test for auto immune pancreatitis

A

IgG4

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73
Q

Tx for high output stoma not responding to loperamide

A

Ocreotide

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74
Q

Antibodies for MG

A

Anti ACh Anti MUSK

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75
Q

Cause of low TSH and low T4 (secondary hypothyroidism)

A

Pituitary failure

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76
Q

How to diagnose acromegaly

A

Oral glucose tolerance test, IGF, growth hormone

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77
Q

Anti epileptic to avoid in absence seizures and juvenile epilepsy

A

Carbemazepine

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78
Q

Medication for cystine renal stones

A

D pencillamine

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79
Q

HIV med causing psychosis in toxicity

A

Efavirenz

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80
Q

Spirometry measurement for GBS

A

FVC

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81
Q

Medication prophylaxis for altitude sickness

A

Acetozolamide

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82
Q

What type of RTA is nephrocalcinosis

A

1

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83
Q

Migraine prophylaxis for child bearing

A

Propanolol

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84
Q

Definition of bisphosphonate failure

A

two or more fractures on treatment, or one fracture with a reduction in bone density

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85
Q

Treatment of hyperthyroidism in pregnancy

A

Propilthyrourcil in early pregnancy

Carbimazole in late pregnancy

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86
Q

Hypokalaemia + low urine calcium

A

Gittlemans

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87
Q

Missipissi

A

Histoplasmosis

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88
Q

Prolonged high aldosterone on standing

A

Adrenal hyperplasia

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89
Q

PD meds causing loss of control/impulse disorders

A

Pamiprexole

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90
Q

Tx for peritonitis from dialysis

A

intraperitoneal vanc and gent

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91
Q

Goodpastures treatment

A

Pred, cyclophosphamide, plasmapheresis

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92
Q

Dextrocardia ECG findings

A

inverted P wave in lead I, right axis deviation, and loss of R wave progression

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93
Q

R waves in V1-2 MI location

A

posterior

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94
Q

Tx prosethtic valve replacement IE

A

IV vancomycin + rifampicin + low-dose gentamicin

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95
Q

Most common cause of canon ball mets

A

Renal cell carcinoma

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96
Q

Acute 3rd nerve palsy

A

Posterior communicating artery aneurysm

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97
Q

ABx you cant give with methotrexate

A

Trimethoprim/ Co-trimoxazole

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98
Q

Ferritin target in CKD

A

>200

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99
Q

Malodorous sweat infection

A

Brucellosis

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100
Q

Tx for VTE if 7 days pre op

A

IVC filter and LMWH

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101
Q

Hypokalaemia + renal stones

A

RTA 1

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102
Q

Baseline test before starting natalizumab

A

JCV antibody (otherwise can cause progressive multifocal leukoencephalopathy)

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103
Q

Anaemia, weight loss, lymphadenopathy post transplant

A

EBV

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104
Q

Antibody test for drug induced lupus

A

Anti histone antibodies

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105
Q

Heinz bodies

A

GP6D

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106
Q

Underlying condition/deficiency leading to warfarin induced necrosis

A

Protein C deficiency

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107
Q

Vitamin D <30

A

loading dose

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108
Q

Vitamin 30-50

A

maintenance dose

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109
Q

Osteomalacia + Hypokalaemia = RTA?

A

RTA 2

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110
Q

Tx for prognosis pulmonary fibrosis

A

carbon monoxide transfer factor

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111
Q

Auer Rods

A

Acute Promyelitic Leukaemia

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112
Q

Leopard print rash

A

Oncheriasis

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113
Q

Tx crusted scabies

A

Ivermectin

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114
Q

Monitoring for acromegaly tx

A

Insulin like growth factor

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115
Q

Meds to avoid with cocaine

A

beta blockers

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116
Q

No vaccinations + fever + rash + pancytopaenia

A

Parvovirus B19

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117
Q

Hepatitis + ANA +ve + Anti smooth muscle +ve + raised IgG

A

Type 1 auto immune hepatitis

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118
Q

Hepatitis + LKM1 + only kids

A

Type 2 auto immune hepatits

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119
Q

young + episodes of tachycardia + short PR

A

Lown–Ganong–Levine syndrome

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120
Q

Most common inherited thrombophilia

A

Factor V Leiden

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121
Q

Tx for anti GBM/Goodpastures

A

Methylpred Cyclophosphamide Plasma exchange

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122
Q

Amiodarone induced thyrotoxicosis with goitre

ie increased blood flow on thyroid doppler

A

Type 1

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123
Q

Amiodarone induced thyrotoxicosis without goitre

ie reduced blood flow on thyroid doppler

A

Type 2

Tx with steroids

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124
Q

Tx for AIT Type 1 (goitre/ increased blood flow on doppler)

A

carbimazole/potassium perchlorate

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125
Q

Tx for AIT Type 2 (no goitre/ decreased blood flow on doppler)

A

Steroids

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126
Q

Tx for salmonella gastroenteritis

A

If immunosuopressed/over >50/ valve disease - cipro

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127
Q

Most common electrolyte abnormality in alcohol withdrawal

A

Hypophosphataemia

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128
Q

ECG features of HCOM

A

ST depression Deep T wave inversion LVH

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129
Q

ECG features of LVH

A

Deep S waves V1, V2 and tall R waves V5, V6

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130
Q

Fitz Hugh Curtis syndrome

A

PID causing perihepatic adhesions, RUQ pain worse on breathing

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131
Q

Cut off for carotid stenosis

A

>70%, or 50-69% if symptomatic

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132
Q

Tx for myexedemic coma

A

Levothyroxine, liothyronine

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133
Q

Tx of sodium valproate overdose

A

L-cartinine

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134
Q

Bleeding cut off for LP pre thrombolysis

A

7 days

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135
Q

Bleeding cut off for stroke/head injury pre thrombolysis

A

3 months

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136
Q

Bleeding cut off for GI bleed pre thrombolysis

A

3 weeks

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137
Q

NAFLD vs ALFD LFTS

A

NAFLD ALT > AST

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138
Q

Cirrhosis HCC screening

A

USS and AFP every 6 months

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139
Q

Hyper IgM syndrome

A

PCP, hepatitis, diarrhoea

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140
Q

Cancer TTF 1 positive

A

Lung cancer - NSCLC, adenocarcinomas Thyroid cancer

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141
Q

Lacunar infarct presentation

A

Unilateral weakness or pure sensory stroke or ataxic hemiparesis

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142
Q

Posterior circulation infarct

A

cerebellar/brainstem syndrome or LOC or isolated homonymous hemianopia

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143
Q

Tx of NADH methaemoglobinaemia reductase deficiency

A

Ascorbic acid

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144
Q

Isolation for active millary TB

A

negative pressure isolation

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145
Q

Anti epileptic causing pancreatitis

A

Sodium valproate

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146
Q

Tx of ethylene glycol toxicity

A

Fomepizole Alcohol Sodium bicarb

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147
Q

Histoplasmosis tx

A

Itraconazole

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148
Q

Tx for Kallmans infertility/ low FSH +LH

A

Pulsed GNRh

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149
Q

Oculocutaneous albinism Type 1

A

Light everything

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150
Q

Oculocutaneous albinism Type 3

A

Reddish hair, blue eyes

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151
Q

Ascites with raised SAAG

A

related to portal hypertension eg portal vein thrombosis

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152
Q

Cause of hyperglycaemia in malignancy

A

PTH-RP

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153
Q

HIV med causing fat redistribution/diabetes

A

Stavudine

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154
Q

Anti malarial worsening psoriasis

A

Chloroquinine

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155
Q

Vitamin tx in Acute Promyletic Leukaemia DIC

A

Vitamin A/ ATRA

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156
Q

Coeliac —> weight loss, night sweats, raised viscocity

A

Enteropathy associated T cell lymphoma

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157
Q

Abx causing obstructive jaundice

A

Co-amoxiclav

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158
Q

Abx interacting with theophyline

A

Erythromycin

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159
Q

Features of cyanide poisoning

A

HTN and bradycardia Then hypotension, coma, SOB, abdo pain

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160
Q

Receptor involved with familial hypercholesterolaemia

A

LDL receptor

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161
Q

Clicking sound synchronous with heart sounds

A

Left apical pneumothorax

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162
Q

Organism causing endocarditis in farmers

A

Coxiella (can be culture negative)

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163
Q

T score for osteoporosis

A

less than -2.5 at hip or spine or less -1.5 if on steroids

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164
Q

Tick bite in: Massechuteses Long Island Marthas Vineyard Nantucket NY

A

Babeosis

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165
Q

Diabetes med worsening heart failure

A

Glitazone

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166
Q

Sepsis with black skin lesions

A

Echythma gangrenosum from pseudomonas auerginosa infection

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167
Q

Which part of the kidney does gent damage

A

Proximal tubule

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168
Q

Tx for lewy body dementia

A

Acetyl cholinesterase inhibitors eg Rivastigamine

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169
Q

Flagellate protazoa in stool

A

Giardia

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170
Q

Pneumonia w +ve Coombs test

A

Mycoplasma

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171
Q

Tx for mycoplasma pneumonia

A

Clarithromycin

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172
Q

Tx for calcium channel blocker overdose

A

IV Calcium chloride then insulin dex

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173
Q

Tx for low fibrinogen

A

Cryopreciptate or FFP

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174
Q

STI with multiple painful ulcers and flu like sx

A

Herpes simplex

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175
Q

Tx for long QT

A

Beta blocker

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176
Q

Tx for meningococcal mengiitis

A

IV cef

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177
Q

Tx for Dressler syndrome

A

Aspirin 650mg QDS

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178
Q

Restrictive lung disease with reduced KCO (transfer factor)

A

Sarcoidosis

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179
Q

Worms causing GI bleeding

A

N americanus Ancylostoma duodenale

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180
Q

HIV Itchy rash CD4 <300

A

Eosinophilic folliculitis

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181
Q

Tx for crytosporidium (ooyst cysts)

A

Nitazoxinide

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182
Q

Tx for well Mobitz I

A

Nothing

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183
Q

Tx for Mobitz II

A

Pacemaker

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184
Q

Vasculitis PR3 +ve

A

Granulomatosis with polyangitis

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185
Q

Foreign travel reduced ET walking barefoot abdo and chest sx IDA

A

Hookworm

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186
Q

Hyperviscocity syndrome features

A

Ax with waldenstroms or multiple myeloma Triad : bleeding gums + visual changes + neurological sx

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187
Q

Type 1 HIIT

A

48hr-72hr platelets stay >100 no tx needed

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188
Q

Type 2 HIIT

A

5-10 days platelets drop to <100 Needs tx with danapuroid, lepirudin, argobatran

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189
Q

How does amlodipine OD cause hypotension and tachycardia (mechanism)?

A

L type calcium channel blockade

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190
Q

Post MI 5-10 days New murmur pansystolic LSE SOB/pulmonary edema/hypotension

A

VSD

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191
Q

Sx of aspirin OD

A

tinnitus, vomiting, hyperventilation

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192
Q

Poor school perfomance then seizures and visual deterioration then unresponsiveness/rigidity

A

Subacute sclerosing panecephalitis (from measles)

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193
Q

Diagnostic test for groin ringworn (tinea cruris)

A

KOH-treated skin scrapings

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194
Q

Low Hb Low platelets High PPT Low fibrinogen Shistocytes

A

DIC

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195
Q

ST elevation in I and AVL - MI location

A

High lateral wall MI

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196
Q

Greyish skin pigmentation

A

Haemochromatosis

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197
Q

Tx for strongyloides

A

Ivermectin

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198
Q

Fractures Precocious puberty Cafe au lait

A

McCune Albright Syndrome

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199
Q

Tx for raised INR warafin if really unwell/risk of major bleed

A

Prothrombin complex (beriplex)

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200
Q

Deteriorating vision Pins and needles Muscle weakness Hx of autoimmune

A

hypoparathyroidism (with secondary cataracts)

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201
Q

Legionella rather than mycoplasma

A

Flu like sx Haemoptysis GI sx Middle aged Office/air con Hyponatraemia

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202
Q

Mycoplasma rather than Legionella

A

Rash Younger 2w prodrome Can have normal white cells Neuro Haemolytic anaemia

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203
Q

Surveillance for HNPCC

A

Colonoscopy every 2 years until 40

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204
Q

Primary hyperparathyroidism

A

High PTH causes high Calcium and low phosphate

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205
Q

Secondary Hyperparathyroidism

A

Chronic renal failure causes low calcium and high phosphate

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206
Q

Tertiary hyperparathyroidism

A

Have secondary for ages , so high PTH, high calcium

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207
Q

“wood grain” rash

A

Erythema gyratum repens EGR paraneoplastic, usually from lung ca SCC Bronchus

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208
Q

Lymphocytic meningitis differentials

A

TB or crytpococcal

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209
Q

Ix for cryptococcal meningitis

A

India Ink stain CSF

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210
Q

Tx for latent TB in HIV on HAART

A

Isoniazid for 6-9 months

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211
Q

Drusens spots in young person

A

Malattia levantinese Auto dom No tx

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212
Q

Raised congugated billirubin Normal haptoglobins Dark granule hepatocytes

A

Dubin Johnson sydrome

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213
Q

“Onion skin” periductal fibrosis liver biopsy

A

PSC

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214
Q

Lung cancer causing hypercalcaemia

A

SCC

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215
Q

Lutembacher syndrome

A

mitral stenosis ASD presents as AF and fatigue in 40s

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216
Q

Olaparib MOA

A

poly ADP ribsome inhibitor PARP

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217
Q

Tx of lithium toxicity

A

Haemodialysis

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218
Q

HIV LRTI + visual change/GCS change/deranged LFTS

A

CMV pneumonitis

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219
Q

Haematuria after cyclophosphamide

A

Bladder ca

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220
Q

Foreign travel + lymphedema + eosinophilia + rash

A

Lioasis

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221
Q

Mildly elevated urinary cortisol/early morning post low dose dex cortisol

A

Pseudo cushings

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222
Q

Haemochromatosis + joint pain

A

Pseudogout/ pyrophosphate arthropathy

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223
Q

Tx for listeria meningitis

A

Ampicillin and gent

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224
Q

Tx for pen allergic meningitis

A

Chloramphenicol

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225
Q

Tx for protein C deficiency

A

Lifelong NOAC

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226
Q

ST depression V1-4 which artery?

A

Right circumflex

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227
Q

MOA Entacevir

A

Nucleoside analogue

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228
Q

Tx for bronchopulmonary aspergillosis

A

Steroids and itraconzole

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229
Q

Abx to avoid to ciclosporin

A

Erythromycin/ clarithromycin

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230
Q

Monitoring/management for asymptomatic aortic regurgitation

A

Yearly echo

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231
Q

CD4 cut off for likely PCP

A

200

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232
Q

Drug causing red man syndrome

A

Vanc

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233
Q

Tx red man syndrome

A

Topical steroid

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234
Q

Kallmans MRI findings

A

absent olfactory bulbs

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235
Q

fever myalgia v unwell new york

A

West Nile disease

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236
Q

“brown coloured rash on shins” =

A

pretibial myexedema

237
Q

Nocardia asteroides

A

Sulphadiazine

238
Q

Lofgrens syndrome

A

Acute sarcoidosis

239
Q

Lofflers syndrome

A

Esinophil collection in lungs from parasite

240
Q

Iron test for haemochromatosis

A

Transferrin saturation

241
Q

Tx for hepatorenal syndrome

A

Terlipressin

242
Q

Tx for diarrhoea in bile acid malabsorption

A

Cholestyramine

243
Q

How does rifaximin reduce hepatic encephalopathy

A

Decreases ammonia production

244
Q

Colon IE bugs

A

strep bovis bacteroides fragiles

245
Q

Gardners syndrome

A

Tumours: bone, soft tissue, colon

246
Q

Focal consolidation in HIV organism

A

Strep pneumoniae

247
Q

Diffuse consoldation in HIV organism

A

PCP

248
Q

Tx for bleeding/hyperviscocity in Waldenstroms

A

Plasmapheresis

249
Q

TRAL antibody mediation

A

Anti HLA or Anti granulocyte

250
Q

Mucupurulent cervical discharge

A

Chlamydia

251
Q

Cardioversion for AF if young well and no IHD

A

IV Flecanide

252
Q

Tx for syphilis in pen allergy

A

Doxy

253
Q

Migraine with aura stroke like sx Family hx migraine and early dementia No Vascular risk factors

A

CADASIL

254
Q

HLA for chinese patient taking phenytoin

A

HLA B5102

255
Q

Bright enlarged liver on USS Raised transaminases No ETOH

A

NASH

256
Q

Tx for PCP if pen allergic

A

Pentamidine nebs Clindamycin + pramaquine + pred

257
Q

mass in epigastrium + hard palpable liver

A

gastric carcinoma

258
Q

What type of renal stones do patients with small bowel syndrome get?

A

Oxalate

259
Q

Abdo pain seizures worsening w epileptics neuropathy (mimicking GBS) Low sodium

A

Acute intermittent porphyria

260
Q

Tx for acute intermittent porphyria

A

IV 5% dex saline High carb meal

261
Q

Polyglandular syndrome Type 1

A

2 or more of: Hypoparathyroidism Adrenal insufficiency Mucutocutaeous candidia Hypothyroidism Hypogonadism

262
Q

Polyglandular syndrome Type 2

A

Type 1 diabetes Hypothyroidism Primary adrenal failure

263
Q

Tx for adrenal cortical carcinoma

A

Mitotane

264
Q

Tx for legionella

A

Azithromycin

265
Q

ABx causing blue black pigmentation

A

Minocycline

266
Q

Tx for flare of minimal change disease

A

Steroids

267
Q

Primary versus secondary pulmonary hypertension

A

Secondary is due to pulmonary fibrosis

268
Q

Nuclear pleomorphism and absent mitoses

A

Bronchial carcinoid

269
Q

Tx for absence seizures

A

Sodium valproate

270
Q

Diabetes with proximal pain and weakness femoral nerve

A

Diabetic amyotrophy

271
Q
A
272
Q

Tx for TTP

A

Plasmapharesis

273
Q

Features of chagas

A

VTE

Mega esophagus

Conduction defects eg BBB

274
Q

Mechanism of AIHA with CLL

A

Autoreactive T cell induction

275
Q

Mullerans cells

A

Ovarian ca

276
Q

Drug for diabetic retinopathy

A

Ranibizumab

277
Q

Cause of negative Mantoux in TB

A

HIV

278
Q

Causes of torsades

A

Prolongd QT, AF

Low Mg, Low K, Low Ca2+

Female

Alkalosis

Macrolides, digoxin, sotalol

279
Q

Tx for VTE in Factor V Leiden

A

Anticoagulants at least 3 months

280
Q

Anticoagulation for x2 provoked VTE

A

6 months

281
Q
A
282
Q
A

Necrobiosis lipidecta

Tx with topical steroids

283
Q

?

A

Retinal vein occlusion

(disc swelling, haemorrhages)

284
Q

?

A

Retinal artery occlusion

285
Q

?

A

Optic nerve atrophy

286
Q
A

Papilloedema

287
Q
A

Malignant Hypertension

haemorrhages

cotton wool spoots

optic disc swelling

288
Q
A

Diabetic retinopathy

289
Q
A

Proliferative retinopathy

290
Q
A

AVRNT

Pseudo R waves V1

291
Q

Chest complication of severe pancreatitis, v unwell

A

ARDS

292
Q

When is cardiac resynchronisation therapy indicated?

A

Max dose of meds including Ivabradine

Ventricular dys-synchrony eg LBBB/broad QRS

293
Q

Features and management of Bells Palsy

A

NO FOREHEAD SPARING

Tx - steroids and eye taping

294
Q

Tx for malignant hypertension/hypertensive encephalopathy

A

Sodium nitroprusside

295
Q
A
296
Q

Test to differentiate ?pleural plaques vs ?mesothelioma

A

Pleural biopsy (thorascopy)

297
Q
A

Thoracoplasty

rib resection + loss of lung volume

298
Q

Risk factors for mesothelioma

A

Abestos

Radiation exposure

(smoking increases risk of abestosis causing mesothelioma but doesn’t cause mesothelioma in itself)

299
Q

Ventilator settings indicated in ARDS

(PEEP, TV and RR)

A

High PEEP

Low tidal volume

RR up to 35

300
Q

Travel to Turkey

Deranged LFTs

A

Hepatitis A

301
Q

Hair loss

White patches on mouth and vulva

A

Lichen planopilaris

302
Q

Features of WPW (short PR, delta wave)

Surigcal heart repair in childhood

+- collapse

+- palpitations

A

Ebsteins anomaly

303
Q

Rash over cheeks, chest, back of hands

SOB, chest crackles

Muscle weakness

A

Dermatomyositis

(Crackles are ILD)

304
Q

Abx for CSF leak meningitis (ie Staph aureus meningitis)

A

IV linezolid

305
Q

Tx for methotrexate overdose

A

Calcium folinate

(By passes step folate metabollism step blocked by methotrexate)

306
Q

Response to desmopression test in cranial DI

A

urine osmolality should improve to >660

307
Q

Farmer

Liver cysts/heptomegaly

+- pleural effusion

Deranged LFTs

Eosinophilia

(Dx, Ix, Tx)

A

Hydatid disease

Dx with ELISA testing for echinococcus

Tx with albendazole +- surgical excision

308
Q

Management of obstetric cholestasis

A

Ursodeocyholic acid for sx, rifampicin

If term - deliver baby

309
Q

Dx and Rx

common in IBD

A

Pyoderma gangrenosum

1st line - topical steroids

2nd line - topical DMARD eg tacrolimus

3rd line - systemic biological eg Infliximab

310
Q

Nodular face lesion, sun exposure, most common

A

BCC

311
Q

When to stop NAC

A

INR <1.3

ALT <60/twice upper limit normal

312
Q

Prognostic markers for myeloma

A

B2 microglobulin

Albumin

CA FISH

LDH

313
Q

Diagnosis and management

A

Severe atopic eczema

1st line - topical steroids

2nd line - topical calcineurin inhibitors eg tacrolimus

314
Q

Tx for severe psoriasis

A

Methotrexate

315
Q

Tx for MODY

A

Sulphonylureas initially (eg gliclazide)

Probably needs insulin later

316
Q

CKD or recent contrast scan

Skin tightening

“Woody plaques”

Pulmonary fibrosis/ cardiomyopathy/ pulmonary HTN

A
317
Q

Intermittent wheeze, flushing and diarrhoea

A

Carcinoid syndrome

Ix urinary HIAA

318
Q

Knuckles, trunk

A

Diseemenated granuloma annulaire

Lymphoma/HIV

Should resolve over years, otherwise systemic immunosuppression/HAART

319
Q

Tx for aspirin OD

A

Activated charcoal

Correction of K+

Urinary alkylisation

320
Q

Leukaemia

High lymphocytes

abberhent expression of T-cell marker CD5

A

CLL

321
Q

Problems releasing grip/ opening closely eyes quickly

Distal weakness

Inherited

Worse in cold weather

A

Myotonic dystrophy Type 1

322
Q

Meningitis

Lymphocytic pleocytosis

Ependymal enhacement MRI

CSF: raised protein, low glucose, clear

A

CMV meningoencephalitis

323
Q

Bartter Vs Gitelman

A

Both cause hypokalaemia

Bartters presents profound hypotension childhood,

Gitelman young adults

Gitelman has reduced urinary calcium excretion

324
Q

Skin abcesses/other infection

Descending paralysis

Bilateral ptsosis

Hypoventilating

A

Botulism

325
Q

Indications for specialist liver referral in paracetamol OD

A

pH <7.3

PT >100

Cr >300

Hepatic encephalopathy III or IV

326
Q

Sudan black +ve

Myeloperoxidase +ve

Auer rods

Non specific esterase ++

A

Acute monocytotic leukaemia

327
Q

Jamaican

Skin nodules

Ulcers

VRDL +ve

A

Yaws

328
Q

Chest infection and hepatomegaly from Sri Lanka

(diagnosis and tx)

A

Amboeiasis - entamoeba histoltyca

Tx with co-amoxiclav, clarithromycin, metronidazole

329
Q

Vocalisation episodes

Worse at night

Mild post ictal phase

A

Frontal lobe seizures

330
Q

Melanosis coli on colonoscopy

Laxative abuse

A

Senna abuse

331
Q

Congenital adrenal hyperplasia

enzyme/test

A

21 hydroxylase deficiency

(also 17 alpha hydroxylase but much less common)

332
Q

IgA nephropathy (ie mesangioproliferative glomeluronephritis) vs post strep glomeurlonephritis

A

IgA is within 2-3 days of sore throat

Post strep is weeks after

333
Q

Goodpastures treatment

A

High dose pred and cyclophosphamide

334
Q

Edema

Asthma

Eosinophils

Deteriorating renal function

A

Esinophilic granulomatosis with polyangitis

pANCA +ve

Tx IV steroids

+- biologics

335
Q

Best indicator of severity of liver failure in paracetamol OD

A

PT

336
Q

Chronic inflammatory condition

+hepatosplenomegaly

+malabsorption

+cardiac disease

+proteinuria

+waxy skin plaques

A

Amyloidosis

337
Q

Pink skin papules

+travel Asia

+ abdo pain

+headache

+GI upset

A

Typhoid

Tx with cef

338
Q

Breast Ca drug causing heart failure

A

Trastuzumab

339
Q
A

Hypokalaemia

U waves

340
Q

“Hot and dry skin”

OD

widened QRS

dilated pupils

A

TCA

341
Q

Features of amiodaraone toxicity lungs

A

B/L infiltrates

Pneumonitis

Pleural effusion

Pleuritic chest pain

Cough

Pulmonary fibrosis

342
Q
A

Pericardial calcification

eg constrictive pericarditis

343
Q

“High intensity echo signal around the heart”

on echo

A

Constrictive pericarditis

344
Q

Meningitis:

young well person

elevated CSF pressure

high lympocytes

slightly high protein

A

Viral meningitis

345
Q

Where is the lesion:

  • reduced sensation all 3 branches of trigeminal
  • Lateral rectuc is paretic
A

Left petrous temporal

e.g schwannoma, meningioma, mets, nasophryngeal carcinoma

346
Q

Anterolateral MI vessel

A

LAD + circumflex

347
Q

Diagnostic test for CJD

A

RT1uIC and 14.3.3 protein analysis in CSF

348
Q

Drugs worsening psoriasis

A

Lithium, anti malarials, NSAIDs, beta blockers

349
Q

Tx for neuroleptic malignant syndrome

A

Aggressive IV fluids (for rhabdo)

Bromocriptine/dantrolene can be used but not much evidence

350
Q

renal failure w chest sx

“cresenteric glomerulonephritis with IgG staining on immunofluorescence”

A

anti GBM

351
Q

Young person

seizures after waking/myoclonic jerks in the morning

+- generalised seizures

+- absence seizures

A

Juvenile myoclonic epilepsy

352
Q

Erectile dysfunction

Tremor

Rigidity

Incomplete voiding

Ataxia

A

Multi systems atrophy

(if mentions erectile dysfunction, postrual hypotension, urinary frequency or urgency etc - MSA)

Plus parkinsonian symptoms that don’t respond well to tx

353
Q
A

LBBB

(M shaped QRS in aVL, notched R lead I, monophasic R wave V6)

354
Q

Tx for Lambert Eaton Syndrome

A

3, 4-diaminopyridine

355
Q
A
356
Q

How to diagnosis for IgA nephropathy

A

Renal biopsy

(blood levels IgA will be raised but are non specific)

357
Q

What type of creature spread Dengue?

A

Aedes mosquito

358
Q

Fever

Macular rash

“bone breaking” muscle and joint pain

Worst headache ever

Vomiting

Travel

A

Dengue

359
Q

Post pancreatitis:

Abdo pain

Mass

Fever

Persistently raised amylase

A

Pancreatitic pseudocyst

360
Q

How do you diagnosis Whipples disease?

A

Jejunal biopsy

shows macrophages +ve PAS (periodic acid schiff staining)

361
Q

Pale conjunctivae

Blue lines on gums

(Dx and Tx)

A

Lead poisoning

Dimercaptosuccinic acid

362
Q
A

Erythema nodosum

Painful, red tender nodules

Ax with throat infections, sarcoid, IBD TB, leprosy

363
Q

Tx for bifasicular block with pauses

A

PPM

364
Q

STI with rash on soles of feet

A

Keratoderma Blennorrhagcia

Ax with chlamydia

(often ax with reiters syndrome)

365
Q

Increase in total T3/ T4

Normal free hormones

A

Pregnancy

366
Q
A

Gastric ulcer

367
Q

Tx for carbon monixde poisoning

A

100% O2

can consider hyperbaric O2

ventilation only if comatose

368
Q

Ataxia

Deafness

Epilepsy

DM

Eye movement problems

Maternal inheritance

A

Mitochondrial disorder

369
Q

Live vaccines

A

Mumps/MMR

BCG

Typhoid

Yellow Fever

Chicken pox

370
Q

Recommended vaccines for HIV

A

Pneumococcal

Flu

Hep A, Hep B

371
Q

Management of Barrets

A

Low grade dysplasia - repeat OGD 6 months

High grade dysplasia - consider endoscopic ablation therapy

372
Q

Management of Melanoma

A

Exicison with at least 1cm margin

373
Q

Abdo pain

Ascites

Hepatomegaly

Prolonged PTT

A

Budd Chiari

(from clot from lupus)

374
Q
A

Veil sign

Loss of left heart border

Left sign white than right

Shows LUL collapse

375
Q

Tx and prophylaxis of cluster headaches

A

Tx - high flow O2 and triptans

Prophylaxis - verapamil

376
Q

Drug tx for prolactinoma

A

Bromocriptine

(can also use ropinerole)

377
Q

Tx for depression with psychotic features in PD

A

Clozapine

378
Q

Treatment for premature ventricular ectopics

A

Beta blockers

379
Q

Precordial heave

Wide split second heart sound

Pulmonary flow murmur

RBBB

Prominent pulmonary arteries

A

ASD

Needs echo and right heart catherisation ?suitable for closure

380
Q

MEN I

A

3 P’s

Parathyroid

Pituitary

Pancreatic

381
Q

MEN IIA

A

2 P’s, 1 M

Phaechromocytoma

Parathyroid

Medullary thyroid cancer

382
Q

MEN IIB

A

Medullary Thyroid Cancer

Phaeochromocytoma

Marfans/neuromas

383
Q

Management when unable to wean steroids after 12 months PMR

A

Add tocluzimab

384
Q

Cancers ax dermatomyositis

A

Bronchial carcinoma

Esophageal carcinoma

385
Q

Tx for Crohns flare in pregnancy

A

Steroids

386
Q

How to differentiate between Progressive multi focal leukoencephalopathy and HIV encephalopathy

A

PML will be JC virus +ve

387
Q

How do you differentiate between cervical myelopathy and MND

A

Cervical will have primarily sensory sx, MND sensation is intact

388
Q
A

Buccal pigmentation - suggests adrenal insufficiency/Addisons

389
Q

“absent erythropoesis” on bone marrow

A

Pure red call aplasia

390
Q

Intrahepatic cholestasis of pregnancy Vs Acute fatty liver of pregnancy

A

Cholestasis: v high ALP (obstructive LFTS), prolonged PT, malaise, pruritis

AFLP: all transaminases raised, more unwell - abdo pain, encephalopathy, DIC, raised WCC

391
Q

What counts as a positive Schirmers test?

A

<5mm wetting per 5 mins

392
Q

Diabetic

Worsening glycaemic control

weight loss

Loose stools

Pruritis skin rash

A

Glucagonoma syndrome

393
Q

Features of glucagonoma syndrome

(4 Ds)

A

Dermatitis (necrolytic migratory erythema)

Depression

DVT

Diabetes

394
Q

Which is Epley and Dix Hallpike

A

Dix Hallpike - diagnostic

Epley - manouevre

395
Q

Young person (usually woman)

Flash pulmonary edema

HTN

A

Fibromuscular dysplasia

396
Q

Immunoglobulin raised in ABPA

A

IgE

397
Q

What is fenofibrate for?

A

Hypertriglyceridaemia

NOT HIGH CHOLESTEROL

398
Q

Name and ax condition

A

Granuloma annulare

Diabetes

399
Q
A

Dermatomyositis

Gottrons papules

400
Q

Bug indentified at revision of prosthetic joint but not causing any issues or symptoms

A

Propionibacterium acnes

401
Q

Initial LOC then recovers, then drops GCS again

Head injury

A

Extradural haematoma

402
Q

Ventilation settings for COPD

A

PEEP no more than 12

403
Q

Causes of lymphocytosis meningitis

A

EBV

TB

404
Q

Weight loss

Night sweats

Haematuria

Variocele

A

Renal cell carcinoma

405
Q

Features of androgen insensitivity syndrome

A

Normal external genitalia

No internal female organs

B/L undescended testes which present as BL inguinal hernias few weeks after birth

Absent or reduced pubic hair

XY karyotype

406
Q

RTA 1 features

A

(all are hyperchloraemic metabollic acidosis)

Hypokalaemia

Nephrocalcinosis

Hypercalciuria, ax with auto immune

unable to generate acid in distal tubule

407
Q

RTA 2 Features

A

Ax with Fanconi syndrome, myeloma or acetozolamide/sulfonamides, Wilsons

Increased urinary excretion of: glucose, uric acid, phosphate, amino acids, citrate, calcium, K+, protein

can’t reabsorb bicarb

causes osteomalacia

Tx with citrate and K+ supplementation

408
Q

RTA 4 features

A

Deficienct aldosterone action on distal tubule

caused by diabetic nephropathy or chronic interstitial nephritis

Hyperkalaemia

Can be precipitated by ACEi or mineralocorticoid receptor antagonists

409
Q
A

Failure of ventricular capture

410
Q

Most likely organism for endocarditis in native valve and dental procedure

A

Strep viridans

411
Q

Deranged LFTs with no/only slight raise in ALP

AMA +ve

(Dx and Tx)

A

Auto immune hepatitis

Prednisolone

412
Q

Tx for familial transthyretin amyloidosis

A

Tafamidis

413
Q

Mechanism of promthrombotic state in nephrotic syndrome

A

Decreased anti thrombin III

(is lost in urine with the albumin)

414
Q

Left sided abdo pain

bloody diarrhoea

Travel/day care/hostel

(Dx and Tx)

A

Shigella

Tx with azithro

415
Q
A

Normal pressure hydrocephalus

416
Q
A

Failed ventricular capture

(ie pacing spike doesn’t transmit to ventricles, pacing spikes without QRS or then with weird broad QRS)

417
Q

“Owl eye” on MRI spine

A

Spinal infarct

418
Q

Antibody for systemic sclerosis

A

Anti-scl70

419
Q

Hypoxia + pulmonary edema + pulmonary haemorrhage

Recently ventilated and extubated

Obese/airway obstruction

Blood stained fluid from chest suction

A

Haemorrhage pulmonary edema

420
Q

Cameroon

A

Drancunculus (guinea worm)

from unfiltered water

blister with worm track under the skin

421
Q
A

Esophaegeal malignancy

Similar to achalasia but achalasia would be smooth below narrowing (plus not have red flag sx)

422
Q
A

Biltaeral hydronephrosis - ureteral dilatation

423
Q

Whats the mechanism of VT in:

a) pacemaker
b) temporary pacing wire

A

pacemaker - undersensing of atrail and ventricular signals

pacing wire - lead displacement

424
Q
A

Cirrhosis

425
Q

Tx for Pelvic Inflammatory Disease with chlamydia

A

IM cef

+

14 days doxy BD

+

14 days metronidazole BD

426
Q

Impaired fasting glucose tolerance definition

A

6.1-6.9

427
Q

Fasting glucose level diagnostic of diabetes

A

>7

428
Q

Impaired glucose tolerance definition

A

7.8-11.1 after food or 2 hour OGTT

429
Q
A

Vesitubular schwannoma

430
Q

Tx for diabetic retinopathy

A

Ranibizumab (anti VEGF)

Focal photocoagulation

431
Q

KUB malignancy causing polymyalgia type syndrome

A

Renal adenocarcinoma

432
Q

mechanism of ACEi induced angio edema

A

Increased bradykinin

433
Q

Management for adrenal insufficiency in labour

A

100mg IV hydrocortisone evey 6 hours

434
Q

Tx for methanol/ethylene glycolFome overdose

A

Fomepizole

435
Q

Tx for hydatid disease

A

Albendazole

436
Q

Tx for sx of PBC/hyperbillirubinaemia

A

1) Ursodeoxycholic acid
2) if end stage disease of pregnant - colestryamine

437
Q

Bullous pemphigoid biopsy findings

A

Linear IgG deposits at dermal-epidermal junction

438
Q

Pemphigus vulgaris biopIgGsy findings

A

IgG deposition throughout dermis

439
Q

Hilar mass causing Cushings syndrome

A

Small cell carcinoma of bronchus

440
Q

Obese

Pitting edema to knee

Erythema

Eczema

Hyperpigmentation medial ankles

Normal pulses

(Dx and Tx)

A

Stasis dermatitis

Tx with compression bandaging

441
Q

Felty syndrome triad

A

RA +Splenomegaly +neutropaenia

+anaemia

skin ulcers

leg pigmentation

442
Q
A

Globally increased uptake, likely Graves

443
Q

Palpitations and preisyncope in myotonic dystrophy

A

Atrial tachycardia - like pAF

444
Q
A

Branch retinal vein occlusion - flames are only over one half

445
Q

Bug causing painful cervical lymphadenopathy in HIV

A

Mycobacterium avium

446
Q

Compression bandaging ABPI cut off

A

>0.8 triple layer bandaging

0.5-0.8 lesser bandaging

<0.5 not suitable

447
Q
A

HCOM

448
Q
A

Auer rods

AML

449
Q
A

Insulinoma

450
Q

Direct antiglobulin test in AIHA

A

+VE

451
Q

Direct antiglobulin test in G6PD

A

-ve

452
Q
A
453
Q
A
454
Q
A

Left atrail myxoma

455
Q

Travel (Colombia)

Began as erythematous plaque

Developed into painless ulcer

A

Cuteanous leishmaniasis

456
Q

Flu like symptoms

Painful thyroid

Hyperthyroidism

A

Subacute thyroiditis

Don’t treat

457
Q
A

Neuropathic ulcer

Callus edge

Clean base

458
Q

Indications for DigiFab

A

Haemodynamic instablity

Life threatening arrythmia

K+ >5

plasma digon >13

ingestion >10mg adults or >4mg kids

recurrent bradycardia

459
Q

Tx for dermatitis herpetiformis

A

Gluten free diet

Dapsone

Sulfapyridine PO - risks of agranulocytosis

460
Q

Neurofibromatomas features

A

Cafe au lait spots

axially or inguinal freckles

Neurofibroma

Optic nerve glioma

(2 or more) Iris haemartomas

Sphenoid dysplasia or long bone abnormalities

461
Q

Electrolyte disturbance with cisplatin

A

Hypomagnesaemia

462
Q

Tx for thyrotoxicosis in pregnancy

A

Propylthioraci 1st 3 months

Carbimazole after that

463
Q

TB med causing:

confusion

seborrheic dermatitis

stomatisis

peripheral neuropathy

A

Pyridoxine deficiency from Isoniazid

(replacement worsens PD symptoms)

464
Q
A

Cicatrical alopecia

465
Q

Telogen effluvium

A

Non scarring hair loss due to stress

466
Q

Alopecia areata

A

Non scarring

pruritis or burning sensation

Broken hairs - exclamation points

467
Q

E HISTOLYTICA TREATMENT

A

METRONIDAZOLE

468
Q
A

Delta sign

Saggital sinus thrombosis

469
Q
A

Multi ring enhancing lesions

Toxoplasmosis

470
Q

Parkinsonism

Postural hypotension

Hallucinations

Low Mood

A

Lewy Body Dementia

471
Q

Meds then —>

worsening renal function

white cells, protein and blood on urine dip

K+ high

eosinophilia

rash

A

Acute interstitial nephritis

472
Q

Causes of acute interstitial nephritis

A

Mycoplasma

NSAIDS

Penicillin

Diuretics

Cephalosporins

473
Q

K+ >5.5 pre renal transplant surgery

A

Do extra dialsysis

474
Q
A

Stanford A aortic dissection

Ascending aorta

475
Q
A

Stanford B aortic dissection

Descending aorta

476
Q

What ODs can you use activated charcoal in?

A

Carbemazipine

Dapsone

Phenobarbital

Digoxin

Theophylline

Quinine

477
Q

Biologics for psoriasis

A

Etanercept

Infliximab

Adalimumab

Ustekinumab

478
Q

Tumour with:

  • raised HCG
  • normal AFP
  • normal CEA
A

Testicular choriocarcinoma

479
Q

Painful eye with perilimbal injection

photophobia

pain on eye movement

blurred vision

A

Anterior uveitis

ax with sarcoid

480
Q

Painful eye with gritty feeling

A

Episcleritis

481
Q

Painful eye with

severe eye pain which deteriorates with movement, possibly affecting vision

A

Scleritis

482
Q

Features of theophyline toxicity

A

Tachycardia

Vomiting

Hypokalaemia

Hyperglycaemia

Mild acidosis

483
Q

Type of hepatitis transferred with unscreened blood transfusions eg Haemophiliiacs from other countries

A

Hep C

484
Q

Treatment for Lewy Body Dementia

A

Rivastigmine

485
Q

Bandage for pressure sores

A

Calcium alginate

Then hydrocolloid

486
Q
A

Silicosis

487
Q

CKD + pericardial rub

A

Uraemic pericarditis

Risk of cardiac tamponade

Needs urgent dialysis

488
Q

Mechanism of steroids causing osteoporosis

A

Alteration of parathyroid hormone

489
Q

Tx of multi focal atrial tachycardia in COPD

A

Verapamil

490
Q
A
491
Q

Is MND upper or lower motor neuron?

A

Both

492
Q

Muscle weakness - quadriceps and finger flexors

Mild CK rise

A

Inclusion body myositis

493
Q

Causes of absent ankle reflexes and upgoing plantars

A

Syringomylia

Fredreichs Ataxia

Conus medullaris

MND

Subacute combined degeneration of the cord

Taboparesis (teriary neurosyphilis)

494
Q

What is sick euthyroid syndrome?

A

Due to illness

Low T3, T4

Normal TSH

Don’t treat will self resolve

495
Q

Subclinical hypo/hyperthyroidism

A

TSH is off but T4/T3 fine

496
Q

Cat scratch disease

A

Bartonella

Self resolves or azithro for severe lymphadenopathy

497
Q

Tx for gonorrhea

A

IM cef

Or Azithro if pen allergic

498
Q

Anti psychotics causing weight gain/T2DM

A

Olanzapine

Clozapine

499
Q

VIPoma

A

vasoactive peptide secreting tumour of pancreas

flushing, diarrhoea, hypokalaemia, acidosis

half are malignant

500
Q

Tx for typhoid

A

Ceftriaxone

501
Q

Rash worse on hands and nipples

A

Scabies

502
Q

Pearly nodule with overlying telangectasia

A

BBC

503
Q

Pulsatile tinnitus

X, XI, XII

+- flushing, sweating, headache

A

paraganglionoma

504
Q

dysphagia woserning as you eat,

improves after regurgitation

A

pharyngeal pouch

505
Q

Hunter criteria serotonin syndrome

A

Spontaenous clonus

Inducible clonus with tremor/sweating

Ocular clonus plus agitation or sweating

tremor with hyperreflexia

hypertonia and temp >38

506
Q

Rash after cipro and sun exposure

A

Phototoxic reaction

507
Q
A

Campylobacter

508
Q

Sx of vertebral artery dissection

A

Dizziness, vertigo, nausea

(can be ax with infarct of posterior inferior cerebellar artery)

509
Q

Basilart artery stroke

A

Locked in syndrome

510
Q

Reticular rash

Gangrene/ulcers/necrosis

VTE

ax w SLE/ Hep C/RA/ Sjorgens

A

Cryoglobulinaemia

511
Q

Polyarteritis Nodosa

A

Hep B

Mononeuritis

Weight loss

Livedo reticularis

Renal impairment

512
Q

Giant a waves

A

Pulmonary/tricupsid stenosis

513
Q

Smudge/smear cells

A

CLL

514
Q

Blast cells

A

ALL

515
Q
A
516
Q

Most common renal disease in adults

A

Focal segmental glomerulonephritis

517
Q

Overweight

Raised AST, ALT

Normal ALP

A

Steato hepatitis - NASH or alcoholic

518
Q

Grey/white membranes on tonsils

A

Diptheria

1st tes is PCR for dipetheria toxin

Then culture and Elek testing

519
Q
A
520
Q

Freidrichs ataxia

A

Progressive ataxia

cerebellar ataxia

progressive LL weakness

can have pes cavus/scolisos

eye/hearing problems

521
Q

Tx for RA in pregnancy

A

Sulphasalazine

2nd line azothioprine

Can give TNF alpha in early pregnancy but not ideal

522
Q

Main ABx to avoid in myasthenia

A

Gent, clarithromycin. erythromycin

523
Q

Effect of diabetes on cholesterol

A

Low HDL

High tryglycerides

524
Q

Mediterrean or African

Recent meds (Abx)/food —>

Jaundice, abdo pain

Low Hb

High LDH

Urobilligen +

Heinz bodies, Bite cells

A

G6PD Deficiency

525
Q

Oculogyric crisis

A

Dopamine blockade at basal ganglia from eg Metoclopermide

Tx with procyclidine or trihyxphenidyl (benzhexol)

526
Q

Signification of calcified diaphragm

A

Abestosis

527
Q

Questionnaire for social anxiety

A

Mini Spin

GAD

528
Q

Tx for restless legs

A

Pramiprexole

529
Q

Tx for Shigella

A

Azithro

530
Q

First cardiac marker to be elevated

A

Myoglobin

531
Q

Rx of keloid scars

A

1st line - intralesion triamcinolone

2nd line - intra lesional 5 fluorouracil

3rd - radiotherapy and surgery

532
Q
A

brain met

533
Q

Liddles syndrome

A

Hypokalaemia metabollic alkalosis

Hypertension in adolesence

534
Q

Mononeuritis

Vasuculitis

SOB

Esinophilia

pANCA +ve

A

Esinophilic granulomatosis with polyangitis

535
Q

Inclusion bodies on colon biopsy

A

CMV infection

tx with ganciclovir

536
Q
A

Trifsacicular block

Needs PPM

537
Q

Meningitis with SIADH

B/L VI nerve palsies

A

TB

538
Q

INR 5-8 no bleeding

A

stop warfarin

539
Q

INR >5 with minor bleeding

A

IV Vit K

540
Q

INR > 8 no bleeding

A

IV vit K PO (IV prep PO)

541
Q

Diarrhoea

immunocomprised

cysts

Acid fast +ve

A

Cryptosporidium

542
Q

Deranged LFTs after high risk sex

A

Hep B

543
Q

Hormone secreted by MEN parathyroid cancer

A

Calcitonin

544
Q

Thickened gallbladder and pericholecystic fluid

No gallstones

ITU/burns

A

Acalculous cholecystitis

545
Q

How to differentiate between hyperaldosteronism due to Conns vs due to fibromusclar dysplasia

A

Conns has supressed plasma renin

fibromusclar dysplasia has elevated plasma renin

546
Q

Anti MPO +ve

A

microscopic polyangitis

(or other small vessel vasculitis eg rheuamtoid vasculitis)

547
Q
A

Lichen planus

548
Q

LIF pain and temp

A

Diverticulitis

549
Q

Vasculitis with nasal sx

A

Granulomatosis with polyangitis

550
Q

Succession splash

A

Gastroparesis

551
Q

Nephropathy improving quickly with steroids

A

Minimal change

552
Q

Rapidly growing keratotic lesion

Immunosuppressed

Sun exposed area

A

SCC

Needs excision

553
Q
A

Pityriasis versicolour

554
Q

Management of CLL

A

Usually nothing

if; fever, weight loss, night sweat, bone marrow suppresion - can give biologics

555
Q

Bug if meningitis from ear infection

A

Strep pneumoniae

556
Q
A

Subarachnoid haemorrhage

557
Q
A

Extra dural haemorrhage

558
Q
A

Subdural haemorrhage

559
Q
A

Meningoma

560
Q
A

Glioblastoma

561
Q
A

HSV Encephalitis

562
Q

What does bicalutamide do?

A

Reduces tumour flare w goserelin

563
Q

How to diagnose sarcoid with BHL

A

Transbronchial needle aspiration

564
Q

Test for post strep glomerulonephritis

A

Anti streptolysin O titre

565
Q

Spike and dome renal biopsy

A

Membranous glomerulonephritis

566
Q

Alternative to eGFR if you’re dead muscley

A

C Cystatin

567
Q

Haematuria in sickle cell

A

Papillary necrosis

568
Q

Meningitis bacteria if neurosurgery

A

Staph epidermis

569
Q

Tx for nacrolepsy

A

Modafinil

570
Q

Tx for nacrolepsy/cataplexy

A

Oxybate

571
Q

Tx of aortic root dilatation in Marfans

A

Bets blockers

572
Q
A

Toxoplasmosis Retinits

573
Q
A

Retinal detachment

574
Q

AKI + eosinophilia

A

Acute interstitial nephritis

575
Q
A

HPOA

NSCLC

Periosteitis

576
Q

Tx for cyanide poissning (polyuerthane)

A

Dicobalt edetate

577
Q

PR3 +ve

A

Granulomatosis with polyangitis

578
Q
A

Erythema multiforme

579
Q
A

Drusen spots

580
Q

Tx for Wilsons

A

Trietine

581
Q

Antibody for auto immune hepatitis

A

Anti smooth muscle

Anti nuclear antibody

582
Q

Tx of hyperparathyroidism in renal disease

A

Alfacalcidol

Cinacalcet if on dialysis and not fit for surgery

583
Q

Aortic dissection management

A

Type A (involving ascending aorta) - surgery

Type B - IV labetolol

584
Q

Medicines worsening.causing gallstones

A

Fenofibrate

585
Q

Tx for organophosphate poisoning

A

Atropine

Pralidoxime

586
Q

Tx for myasthenia if sx not resolving with pyridostigmine

A

IV immunoglobulin

587
Q

Treatement threshold of kappa IgG paraprotein in myasthenia

A

>30

588
Q

Pressure sore dressing (exudate vs no exudate)

A

No exduate - hydrocolloid

Exduate - alignate

MRCP (5 decks)

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