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MRCP > Passmed deck 3 > Flashcards

Passmed deck 3 Flashcards

1
Q

Abx of choice for meingococcal meningitis with penicillin allergy

A

Chloramphenicol

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2
Q

Chagas disease commonest cause of death

A

Myocarditis

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3
Q

Dissemenated lymes disease rx

A

IV Ceftraxone

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4
Q

What is black water fever

A

Haemolysis, jaundice and AKI with haematuria due to malaria - fatal usually

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5
Q

What is melioidosis and the treatment

A

Bacterial infection caused by burkholderia pseudomallei and common in asia and australlia in flood seasons.

Usually presents with skin ulcers, pneumonia, visceral abscesses.

Difficult to treat but given IV ceftazidime or meropenem

Doxy erradication therapy

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6
Q

Diagnositic test with mycoplasma penumoniae

A

Serology

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7
Q

How does legionella present on a CXR

A

Mid to lower zone patchy bilateral consolidation

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8
Q

What does factor V leiden mutation result in

A

Activated protein C resistance

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9
Q

Test for hereditary spherocytosis

A

EMA binding test

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10
Q

Test for contact dermatitis

A

Skin patch test

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11
Q

How long should a person be monitored for a biphasic anaphylactic reaction

A

6hrs

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12
Q

Treatment given to Von willebrands disease patients to reduced bleeding risk for minor ops

A

Desmopressin for prophylaxis

Tranexamic acid for mild bleeding

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13
Q

How to differentiate a leukmoid reaction (raised lymphocytes due to non-cancer cause e.g. infection) and CML

A

leukocyte alkaline phosphatase score is low in CML, high in leukaemoid reaction

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14
Q

What ethnicity is most at risk of beign ethnic neutropenia

A

African afro-caribbean

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15
Q

Two commonest myeloproliferative causitive genes

A
  1. JAK2
  2. CALR (Calreticulin)
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16
Q

Aromatase inhibitors cause what (anastrazole)

A

Osteoporosis

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17
Q

SERMs like tamoxifen cause what

A

VTE and endometrial cancer

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18
Q

Gene affected in burkitts lymphoma

A

MYC gene

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19
Q

Common electrolyte abnormality with cisplatin

A

Hypomagnesia

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20
Q

What is the diagnosis - dyspnoea, obstructive spirometry pattern and RA

A

Bronchiolitis obliterans - treat with immunosuppression and supportive measures

CT - cetrilobualr nodules and bronchial wall thickening on CT

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21
Q

What work based lung disease exposure can predispose people to TB

A

Silica - impairs macrophages

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22
Q

Where does drug induced lung fibrosis occur

A

Lower zones

Work exposure lung diseases, rheumatoid diseases, TB all cause upper zone

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23
Q

Antibody to check if someone has worsening of asthma symptoms after starting LTRA

A

p-ANCA - Leukotriene receptor antagonists may trigger eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)

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24
Q

How to differentiate early PE and anxiety on blood gas

A

Resp alkalosis + Normal PaO2 is Anxiety

Resp alkalosis + reduced PaO2 is PE

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25
Q

Farmers lung pathogen and presentation

A

Saccaropolyspora reticivugula

Dry, cough, fever, lethargy, dyspnoea (can be acute or chronic)

Mid and upper zone fibrosis on cxr
Bronchoalveolar lavage
NO eosinophilia

Give steroids

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26
Q

Criteria for LTOT

A

pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following:

secondary polycythaemia
peripheral oedema
pulmonary hypertension

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27
Q

What lung cancer causes cavitating lesions

A

Squamous cell lung cancer

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28
Q

Name the condition - an acute form sarcoidosis characterised by bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia.

A

Lofgren’s syndrome

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29
Q

Antibody for esinophilia granulomatosis with polyangitis

A

ANCA

30
Q

Organism that causes malt workers lung

A

Aspergillus clavatus

31
Q

What is acute mountain sickness and how is it treated

A

Acute mountain sickness is generally a self-limiting condition. Develops over 12hrs to a few days.

headache
nausea
fatigue

Correlated to physical fitness
Treat with acetazolamide - it causes a primary metabolic acidosis and compensatory respiratory alkalosis which increases respiratory rate and improves oxygenation

32
Q

What is high altitude pulmonary oedema and how is it treated

A

AMS can lead to HAPE - hypobaric hypoxia causing uneven vasoconstriction to lungs causing increased capillary pressure in areas and inducing pulmonary oedema.

Presents like pulmonary oedema

Rx - oxygen, descent, nifedipine and dexamethasone

33
Q

What is high altitude cerebral oedema (HACE)

A

Cerebral vasodilation and increase blood flow and a leaky BBB causing cerebral oedema

Headache, ataxia, papilloedema

Treat with Descent and dexamethasone

34
Q

One work exposure that does not increase cancer risk

A

Coal dust

35
Q

Treatment for allergic bronchopulmonary aspergillosis

A

Pred

36
Q

Causes of upper zone fibrosis (CHARTS)

A

CHARTS
C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis

37
Q

What should be offered to HF with reduced ejection fraction patients on an ACEi/ARB and a beta blocker if they continue to have HF symptoms

A

Spironolactone

38
Q

What clotting factors are affected by warfarin

A

1972

10
9
7
2

39
Q

Exam findings of pulmonary HT

A

Loud S2
Right ventricular pulse is palpable
Raised JVP
Second heart sound loud over left upper sternal border

40
Q

What is the treatemnt for preventing nitrate tolerance in ISMN use

A

Asymmetric dosing regimes - e.g. 8am and 2pm doses (gives nitrate free period and thus reduces tolerance)

41
Q

What condition presents with TWI in V1 to V3 and epilson waves

A

Arrhythmogenic right ventricular cardiomyopathy is characterised by right ventricular myocardium replaced by fatty and fibrofatty tissue

42
Q

How long is dual antiplatelet therapy given in drug eluting stent for PCI

A

12 months - delay any surgery until after that

43
Q

Antithrombotic therapy for stent types

A

bioprosthetic: aspirin
mechanical: warfarin + aspirin

44
Q

First line management for PHT once confirmed via right heart catheterisation

A

Acute vasodilator testing -
If reversibility -CCB
If non-reversible - prostacyclin analogues

45
Q

What anginal med can cause ulceration anywhere in GI tract

A

Nicorandil

46
Q

Treatment for acute pericarditis

A

NSAIDs
AND
Colchicine

47
Q

What is syndrome X and how does it present

A

Microvascular angina

Has ST depression on exercise stress test but normal coronary arteries

Treat with nitrates.

48
Q

What time of pulse is seen in mixed aortic valve disease

A

Bisferiens pulse -

This pulse is characterized by having two distinct systolic peaks separated by a mid-systolic dip.

49
Q

What do the 4 heart sounds correspond to on an ecg

A

S1> peak of R wave

S2 >T wave

S3 > between t wave and p wave

S4 >p wave

50
Q

What does troponin T bind to

A

Trapomyosin

51
Q

How does papillary muscle rupture present

A

Rupture of the papillary muscle due to a myocardial infarction → acute mitral regurgitation → widespread systolic murmur, hypotension, pulmonary oedema

52
Q

Prinzmetal angina treatment

A

Felodipine

53
Q

What statins are more likely to cause myopathy

A

Simvastatin and atorvastatin

54
Q

Deciding factor for bioprosthetic valve or mechanical valve

A

Give bioprosthetic if young as last longer

55
Q

Mutation in what gene is the cause of HOCM

A

β-myosin heavy chain protein or myosin binding protein C

56
Q

What med should be avoided in HOCM

A

ACEI

57
Q

Persistent ST elevation following recent MI, no chest pain, whats the diagnosis

A

Left ventricular aneurysm

58
Q

Drugs that cause ALT and AST rise

A

SV
Alcohol
Statins
TB drugs
Paracetamol
Phenytoin
Nitrofuratoin

59
Q

Drugs that cause cholestasis +/- hepatitis

A

COCP
Fluclox, co-amox, erythromycin
Sulphonylureas

60
Q

Causes of SAAG >=11

A

LIVER - raised ratio indicates portal hypertesion
Cirrhosis
ALF
Liver mets
Portal vein thrombosis

61
Q

How does a villous adenoma present

A

Hypokalaemia
Mucus diarrhoea
Anaemia

62
Q

What are the different lines of c.diff management for first presentation

A

First episode - oral vanc -> oral fidaxomicin –> oral vanc and IV metronidazole

63
Q

What is the management of recurrent c.diff (within12 weeks)

A

Fidaxomicin

64
Q

What is the treatment for life-threatening C.diff

A

oral vancomycin AND IV metronidazole

65
Q

What is the level checked to check Hep B immunisation

A

Anti-Hbs

66
Q

What are the three constituents of brush border enzymes

A

maltase: glucose + glucose
sucrase: glucose + fructose
lactase: glucose + galactose

67
Q

How is c.diff spread

A

Faecal oral via spores

68
Q

C diff monoclonal antibodiy for prevention of further episodes is?

A

Bezlotoxumab

69
Q

How to prevent Hep B in newborns from positive mum

A

Give baby hep B vaccine and immunoglobulins

70
Q

What blood test is used as a marker for pancreatitis severity

A

CRP
Lipase

71
Q
A

MRCP (3 decks)

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