Passtest Flashcards by Tim Mathew

IE Rx 4-6 weeks

Native valve - Amoxicillin + Gentamicin ( Streptococcus pyogenes) , unless staphylococcus is suspected
Prosthetic valve- Vancomycin + Gentamicin + Rifampicin
Staphylococcus aureus - Flucloxaciliin
HACEK - Amoxicillin + Gentamicin

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Mepolizumab

Anti Interleukin 5 Monoclonal Ab , used in eosinophilic asthma , resistant to conventional treatment

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Rizankizumab

Anti IL 23 MAb , psoriasis

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Anti TNF Mab

IBD, RA, Psoriasis

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Canakinumab

Anti IL 1 Mab , Familial Mediterranean Fever, Juvenile arthritis

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MLH -1 gene

Lynch syndrome , Colonic cancer (HNPCC) , Uterine cancer

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BRCA 1

Ovarian cancer , Breast cancer , Prostate ca in men

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Li Fraumeni syndrome

P53 tumour suppressor gene mutation
Sarcoma , Breast , Acute leukemia, Adrenocortical tumors

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RET oncogene

Receptor tyrosine kinase , gain of function mutation- Medullary Thyroid ca
Loss of function mutation - Hircshprung disease

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VIP Oma

Metabolic acidosis , Diarrhoea and Facial flushing

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Somatostatin Oma

Fatty stools and diarrhoea + gallstones and hyperglycemia

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Glucaganoma

Chronic diarrhoea, wt loss and hyperglycemia + Necrolytic migratory erythema

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Severs disease

Inflammation of calcaneus appophysis in children and adult , bilateral heel pain , made worse by exercise

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Omalizumab

Anti IgE Mab , Asthma , not responding to conventional rx

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Benralizumab

Anti IL5 Mab , Asthma not responding to conventional Rx

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Rofulimast

PDE4 inhibitor , increase in cAMP in Copd , not responding to conventional Rx and FEV1 < 50%

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IgG2 deficiency

Risk of meningococcal and pneumococcal infections, polysaccharide coated bacteria’s
Vaccination is important

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Bronchiectasis surgery referral

FEV1 < 30 , age <65 , recurrent exacerbations , ICU admissions

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Drugs exacerbating myasthenia

Beta blockers
Macroides
Quinolones
Statins

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EBV - When Rx with amoxicillin, cause a erythemopapular rash 48 hrs after starting Rx

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Reversed fixed splitting of 2nd heart sound

Aortic stenosis, outflow tract obstruction, LBBB

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Focal laser therapy

Used in maculapathy dangerous to sight

Anti VEGF next in line pegatanib, bevacizumab, Ranibizumab

Pan retinal photo coagulation is used in diffuse retinopathy

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Syphillis Rx

Rx - benzathin penicillin
2nd line doxycycline

Azithromycin - treatment failure

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HLA DR1

Seronegative RA , penicillamine induced myasthenia, schizophrenia

HLA DR2

Anti GBM, multiple sclerosis, SLE

HLA DR3

Type 1 DM , T cell mediated coeliac disease

Cellulitis Rx

Augmentin - diabetic Flucloxacillin - 1st line if non diabetic Clindamycin - penicillin allergy , PO , 90 percent tissue penetrance.

HGPRT deficiency

Lesh nyhan syndrome, X linked recessive disorder , renal failure , acute gouty arthritis, self mutilating, behaviour

Alpha galactosidase deficiency

Fabrys disease , renal impairment, heart failure , pins and needles in extremities

MYH7 , myosin heavy chain 7 ,

Most common gene mutation in HOCM + MYPC3 myosin binding protein c 3 together makes up 50 percent of inherited cause of HOCM

Pregabalin

Gabapentinoid , results in inhibition of voltage gated calcium channels , it is GABA analogue , leads to increased gaba synthesis

GABA b agonist

Baclofen

In mediastinal non seminomatous GCT , will have (1 in 17 ) hematological malignancy like

AML

Cutaneous leishmaniasis Ix

Punch biopsy from the edge of the ulcer - 85 percent of time , identify leishmania PCR - specialists labs and higher costs

Clotting factor 1

Fibrin - involved in stabilisation of the clot ,produced by the liver

Factor 3

Thyrotropin receptor ab

Stimulates thyroid hormone production

Thyroid peroxidase Ab

Involved in decreased production of thyroxine - Hypothyroid , by interfering with iodination

Pregabalin is an under recognised reason for pedal edema

Other common drugs Calcium channel blockers (dyhidropyridine) Alpha blockers

Common variable immunodeficiency

Loss of IgA and IgG leading to recurrent respiratory infections

Most common organism causing SBP

E. coli Streptococcus viridans - 2 nd

Leptospirosis gold standard test

Microscopic agglutination test

Imfliximab and etanercept

TNF agents used in 2nd line in psoriatic arthritis Screening of latent TB and viral Hepatitis to be done before starting Rx

5HT2 Antagonist

Risperidone and olanzapine , atypical antipsychotics

5HT3 antagonist

Ondansetron , Granisetron

Sterile pyuria

NSAIDS, Corticosteroids, PPI

Liddles syndrome

Hypokalemic metabolic alkalosis + HTN

Bartter syndrome

Na and Cl wasting → hypokalemic metabolic alkalosis and normotension/low BP

Hyporenemic hyperaldosteronism

Hypokalemic metabolic alkalosis + Hypertension , Cause adrenal hyperplasia/tumor

Obliterative bronchiolitis

Obstructive lung disease , associated with autoimmune disease like RA

Hemicrania continua

Unilateral continuous headache, with ipsilateral autonomic symptoms, Exclusively responds to indomethacin

Antithrombin 3 deficiency

Is seen in nephrotic syndrome , clotting factors leak into urine

Constrictive pericarditis Rx

Anakinra Steroids

HOCM genes

Myosin binding protein C and beta myosin heavy chain 7 mutations

Exon skipping

Muscular dystrophy

Genomic imprinting

Two copies of the same gene taken from parents , with one not working , Angelman syndrome

Nintedanib

Tyrosine kinase inhibitor, used for IP Fibrosis

Elimination half life of digoxin

30-40 hrs in a person with normal renal function

In Lewy body dementia use of D agonist

Can worsen visual hallucinations and confusion Donepezil, rivastigmine are recommended for memory loss

Candida chorioretinitis

Neutropenic sepsis +multiple Retina yellow/white ball like lesions on fundoscopy Rx Voriconazole

Heyde syndrome

Small bowel angiodysplasia + Aortic stenosis

Indwelling catheter , infection

Staph aureus and staph epidermis , Rx Vancomycin

Uroporphyrinogen 3 synthase deficiency

Congenital erythropoietin porphyria

Uroporphyrinogen decarboxylase deficiency

Porphyria cutaneous tardaa

Corproporphyria oxidase

Hereditary coproporphyria , cutaneous and psychiatric features, AD inheritance

Protoporphyrinogen oxidase deficiency

Porphyria varigata , AD , Mixed Neuro and cutaneous

Patients requiring irradiated blood to prevent graft vs host disease

Hodgkins lymphoma Stem cell transplant Fludaribin therapy Haematological malignancy Taking alemtuzumab Post CAR T therapy in the first three months