Past paper Flashcards

1
Q

Man has an MI 3 years ago. Now comes into hospital feeling very unwell. Is having a sample taken from their pericardial layer and you find blood is aspirated from the pericardium

A

Left ventricular rupture

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2
Q

IV antibiotic for Group A Strep pharyngitis/Strep Throat?

A

Benzylpenicillin

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3
Q

Vitamin deficiency: C (ascorbate)

A

Scurvy

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4
Q

Vitamin deficiency: B6 (pyridoxine)

A

Dermatitis, anaemia, neuropathy

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5
Q

Rate limiting step in haem biosynthesis pathway:

A

ALA synthase (aminolevulinic acid)

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6
Q

MEN2b associations:

A

Phaeo, medullary thyroid, mucocutaneous syndromes, marfans

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7
Q

Which/What cell is increased in cases of a parasitic infection

A

Eosinophils

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8
Q

57 year old man presents following hematemesis and is found to have: High ALT + GGT, and slightly raised ALP. Low Albumin

A

Alcohol induced hepatitis

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9
Q

Pneumonia: transplant patient on immunosuppressive. Halo sign on X-ray

A

Aspergillus

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10
Q

Autoimmune and auto-inflammatory disease: MEFV gene, abdominal pain and ascites

A

Familial Mediterranean Fever

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11
Q

SBA: drug can be used to treat some malignancies and affects T cell activity

A

Pembrolizumab (treat inoperable or metastatic melanoma, metastatic NSCLC)

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12
Q

Bicarbonate in a pyloric stenosis patient

A

High

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13
Q

A man after a road traffic accident (Man vs Car) requires a 6 unit transfusion, and then becomes acutely breathless/SOB, with a fever and tachycardia

A

TRALI

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14
Q

Management of acute angioedema:

A

IM adrenaline 0.5ml of 1:1000

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15
Q

Meningitis: gram positive diplococci

A

Strep pneumoniae

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16
Q

Pancreatic mass + hypoglycaemia

A

Pancreatic insulinoma (Islet cell tumour)

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17
Q

Vitamin deficiency: Folate

A

Macrocytic anaemia, neural tube defects

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18
Q

Liver Function Tests: Woman with colicky abdo pain, raised ALP

A

Gallstones

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19
Q

SBA: Characteristic of ALL

A

Anaemia, thrombocytopenia and neutropenia

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20
Q

AI disease markers: anti-centromere antibody

A

Limited cutaneous scleroderma (CREST syndrome)

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21
Q

German woman with recurrent URTIs + UTIs. She has low neutrophils.

A

Chronic idiopathic neutropenia

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22
Q

Gram positive rod causing meningitis in a 72-year-old?

A

Listeria

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23
Q

AI disease markers: Anti-endomysial

A

Coeliac disease

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24
Q

Drowsy teenage girl with CSF: raised protein + raised lymphocytes

A

Viral meningitis

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25
Q

Man with weakness in the gym and ptosis

A

MG. Anti-ACh receptor

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26
Q

A smoker is found to have a Gram Positive diplococci causing meningitis. Which microorganism is the most likely cause?

A

Streptococcus pneumoniae

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27
Q

Autoimmune and auto-inflammatory disease: due to mutations in the FAS pathway

A

Autoimmune lymphoproliferative syndrome (ALPS)

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28
Q

What lab test would you use for: diagnosing temporal arteritis

A

Initally ESR then temporal artery biopsy

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29
Q

Obstetric haematology: slightly reduced platelet count in 3rd trimester (100 x 10^9)

A

Gestational thrombocytopenia

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30
Q

Sodium handling: patient with lung cancer. High sodium, low potassium

A

Ectopic ACTH secretion, due to lung cancer

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31
Q

Lump that moves around

A

Fibroadenoma

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32
Q

Mab Used to treat Lymphoma and RA

A

Rituximab (anti-CD20)

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33
Q

SBA: Middle aged lady, loss of bile ducts and granulomas present

A

Primary Biliary cirrhosis

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34
Q

Woman presents with aches all over, (diffuse swelling), and joint stiffness?

A

Rheumatoid arthritis. Anti-CCP

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35
Q

VSA: Name an infectious microorganism which is a common cause of meningitis in 3 months or older new-borns?

A

Strep. pneumonia

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36
Q

VSA: infectious microorganism which is a common cause of sepsis in newborns

A

GBS (E.coli)

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37
Q

Meningitis: gram negative diplococcus

A

Neisseria meningitides

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38
Q

A German lady who is asymptomatic, has low neutrophils, but no abnormal cells on film

A

Chronic idiopathic neutropenia

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39
Q

Define impaired glucose tolerance (After 2hr OGTT)

A

BG: 7.8 – 11.1mmol/LImpaired fasting glucose = 6.1-7

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40
Q

Hyperuricaemia/uric acid excess is caused by:

A

Xanthine oxidase

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41
Q

Vaccine for splenectomised patients:

A

Pneumococcal vaccine

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42
Q

Treatment for Listeria meningitis

A

Amoxicillin

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43
Q

STI causing neonatal conjunctivitis

A

Gonorrhoea, chlamydia

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44
Q

Causes of hydrops fetalis < 20 weeks gestation

A

Parvovirus B19 (erythrovirus), CMV, HSV, toxoplasma gondii, treponema pallidum

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45
Q

Woman with UTI: gram positive cocci in clusters

A

Staph saprophyticus

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46
Q

SBA: Most likely cause of HAP?

A

Staphylococcus aureus (closely followed by Pseudomonas)

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47
Q

Cause of Karposi’s sarcoma

A

HHV8

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48
Q

VSA: mixed pattern auto-inflammatory condition has over 90% heritability and effects the sacroiliac joint

A

Ankylosing Spondylitis

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49
Q

Known breast cancer + red/rough nipple

A

Pagets disease of the breast, or DCIS

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50
Q

10 year old with seizures. Low calcium, high phosphate, high PTH

A

Secondary hyperparathyroidism, due to renal osteodystrophy. (Low calcium can cause seizures)

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51
Q

Protozoa causing infection in pregnancy

A

Toxoplasma gondii

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52
Q

A glycopeptide used to treat MRSA

A

Vancomycin or teicoplanin

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53
Q

What is the mass that can for following acute pancreatitis:

A

Pancreatic pseudocyst

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54
Q

Tx for Young women with cystitis and fully sensitive E-Coli.

A

Trimethoprim

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55
Q

Most common type of malignancy in the breast?

A

Invasive ductal carcinoma

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56
Q

VSA: used to measure the turnover of bone, and is raised in people who have Paget’s orOsteomalacia

A

ALP

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57
Q

Which of these options causes DIC (in pregnancy)?

A

Amniotic fluid embolism

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58
Q

Breast Cancer which has a high, medium and low stage to it

A

DCIS

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59
Q

VSA: raised in obstructive jaundice/biliary obstruction

A

ALP

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60
Q

SBA: Which Hepatitis does not lead to/cause Chronic Hepatitis

A

Hepatitis A

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61
Q

By what mechanism does GORD cause cancer?

A

dysplasia

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62
Q

Sodium handling: Patient becomes drowsy after Road traffic accident

A

Cranial Diabetes Insipidus (Due to trauma)

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63
Q

Pneumonia: weight loss, haemoptysis, upper lobe cavitation

A

TB

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64
Q

What is the most common cause of traveller’s diarrhoea?

A

E Coli

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65
Q

SBA: Cancer with transitional cells on histology. Where is the primary?

A

Bladder

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66
Q

What drug do you use to treat influenza A?

A

Oseltamivir

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67
Q

Pathogen found in badly collected urine sample

A

Staph A

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68
Q

Vaccine preventable disease: causes lumps in parotid and neck

A

Mumps

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69
Q

Patient with JAK2 mutation has raised haemoglobin, and gets pruritus following showering.

A

Polycythaemia Rubra Vera

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70
Q

Material seen in the vessel of a burst atheroma in a patient with an MI

A

Atheromatous plaque

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71
Q

SBA: Diarrhoea and weight loss + patchy inflammation and granuloma

A

Crohn’s disease

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72
Q

20 year old rugby player with boils. Rest of his team have them, and so do his family

A

Herpes gladiatorum (Type of HSV-1)

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73
Q

Rash on penis, soles, hands

A

Syphilis

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74
Q

SBA: Gout medication contraindicated with Allopurinol

A

Azothioprine

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75
Q

Requires C-section if mu has outbreak >34 weeks

A

Primary HSV infection

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76
Q

A man with Atrial fibrillation develops fever, nausea, vomiting and pain in his right loin/flank. What is the most likely cause?

A

Renal infarct

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77
Q

AI disease markers: anti-Ro. Patient has dry eyes

A

Sjogrens syndrome

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78
Q

Bloated after drinking milk but not IgE mediated

A

Lactose intolerance

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79
Q

Leukaemia: Middle aged person. t(9:22) present, BCR-ABL. Blood film shows 3% blasts

A

CML

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80
Q

An 18 year old students is found to have Gram Negative diplococci causing meningitis. Which microorganism is the most likely cause?

A

Neisseria meningitides

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81
Q

In Rhabdomyolysis, which biomarker is likely to be raised?

A

Creatinine Kinase

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82
Q

Woman with progressive amnesia dies from bronchopneumonia

A

Dementia (Alzheimers?)

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83
Q

24 year old asymptomatic man with isolated rise in unconjugated bilirubin (all other results (ALT, ALP etc normal)

A

Gilberts

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84
Q

Old woman falls and breaks her hip. What condition does she have?

A

Osteoperosis

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85
Q

Cause of molluscum contagiosum

A

Poxvirus

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86
Q

Elderly man with atrial fibrillation with right flank pain?

A

Renal infarcts

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87
Q

Vitamins: Young patient with bowed legs

A

Vit D deficiency (Ricketts)

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88
Q

ChemPath investigations: Diabetic visiting GP for routine appointment

A

HbA1c

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89
Q

A lady has frank (visible) painless haematuria and a mass palpable on one side. What is the most likely cause?

A

Renal cell carcinoma

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90
Q

VSA: massive splenomegaly, and JAK2 V617F mutation with a leucoerythroblastic picture and tear-drop poikilocytes

A

Myelofibrosis

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91
Q

Metabolic acidosis. High potassium.

A

T1DM

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92
Q

What happens to the body of the stomach in a patient with pernicious anaemia?

A

Atrophic body gastritis

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93
Q

VSA: Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?

A

Psoriasis

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94
Q

Sudden headache, loss of consciousness and meningism

A

Sub-arachnoid haemorrhage

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95
Q

Core biopsy coding: B5

A

B5 = malignant. B5a = DCIS, B5b = invasive carcinoma

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96
Q

Cause of haemorrhagic cystitis post-transplant

A

BK virus

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97
Q

Patient with recurrent pneumococcal infections and meningitis

A

C3 deficiency (or alternative pathway deficiency)

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98
Q

An elderly gentleman has really elevated ALP on it’s own, and the other results are normal. He also reports a history of headaches

A

Paget’s disease

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99
Q

Broad spectrum antibiotic with no pseudomonal activity. Usually given with a beta lactamase inhibitor

A

Amoxicillin (given with clavulanic acid = co-amoxiclav)

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100
Q

High sodium, low potassium, high urine osmolarity

A

Conns syndrome

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101
Q

Carcinoma due to H. Pylori infection

A

Gastric adenocarcinoma

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102
Q

22 year old student with two weeks anorexia, fever and malaise – raised ALT, normal ALP + GGT

A

Viral hepatitis

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103
Q

Patient with high IgG paraprotein – (32 or 40) g/dl, back pain and loss of sensation in legs

A

Multiple myeloma

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104
Q

Most common cause of UTI: in general

A

E. coli

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105
Q

Vitamins: Patient with Pellagra

A

B3 deficiency (3Ds- Dementia, diarrhoea, dermatitis {necklace rash})

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106
Q

SBA: Vector of Trypansoma brucei?

A

Tsetse Fly

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107
Q

What cancer can the Bruton Tyrosine kinase inhibitor ibrutinib be used in?

A

CLL

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108
Q

Sodium handling: HTN, High Na, Low K, high renin

A

Renal artery stenosis (Renin low in Conns)

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109
Q

Meningitis: aseptic (unable to culture), raised lymphocytes, raised protein, normal glucose

A

Viral meningitis

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110
Q

Cell of immune system: differentiated B cell that produces immunoglobulins

A

Plasma B cell

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111
Q

Wegener’s immunotherapy:

A

Cyclophosphamide (+ corticosteroids)

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112
Q

Obstetric haematology: recurrent first trimester miscarriage

A

Antiphospholipid syndrome

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113
Q

ChemPath investigations: Pt can’t fit on shoes or put on wedding ring and has prognathism. Which test to confirm?

A

OGTT (measure GH- should be suppressed) {Can also measure IGF-1 levels}

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114
Q

A man is injured playing sports. He is found to have pancytopenia and immature myeloid cells on blood film. WCC normal.

A

AML

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115
Q

What enzyme regulates the rate limiting step in haem biosynthesis pathway/of the blood?

A

ALA synthase

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116
Q

What lab test would you use for: diagnosing thalassaemia

A

Hb electrophoresis

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117
Q

A (?teenager?) presents with a history of several weeks of increased thirst (polydipsia), increased urination (polyuria) / High urinary output and weight loss:

A

T1DM

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118
Q

Autoimmune and auto-inflammatory disease: associated with Nod2/CARD15

A

Crohn’s disease

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119
Q

INRs and appropriate management: patient with a previous DVT, INR 4

A

Decrease dose of warfarin to aim for target INR of 2.5 (2-3)

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120
Q

Young boy has normal B cells, but no CD4+ or CD8+ cells

A

X-linked Severe combined immunodeficiency

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121
Q

AI disease markers: anti-CCP

A

Rheumatoid arthritis

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122
Q

50 year old lady with memory issues/progressive amnesia, hypertension (?? + bronchopneumonia??)

A

Multiple cerebral infarcts

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123
Q

SBA: Dad and brother of dead individual disagree over having an autopsy. The Dad was the main carer but no mention of Standing order or special status assigned to dad by the dead individual.

A

An autopsy can be done but to settle the disagreement it goes to a special court

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124
Q

Allergy: patient gets allergy symptoms every summer, with a runny nose

A

Allergic rhinitis

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125
Q

Cause of positive NAAT test + PID

A

Chlamydia trachomatis

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126
Q

Vaccine preventable disease: maculopapular rash starts on face. Can cause encephalitis and pneumonitis

A

Measles

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127
Q

Bitten woman in nigeria in with chills

A

Malaria

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128
Q

SBA: Why do the walls of vessels expresses anti-thrombotic factors

A

Thrombomodulin

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129
Q

A girl with a sore throat is given penicillin and develops a rash. She is found to have EBV.

A

Drug reaction

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130
Q

Blood transfusions: woman received a transfusion before her hysterectomy, presents with bleeding gums and rash on her shins on discharge

A

Post-transfusion purpura (presents 5-12 days after transfusion. Associated with thrombocytopenia)

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131
Q

Young man with fever, leucocytosis and petechial rash after URTI

A

Henoch–Schönlein purpura

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132
Q

A 2 year old has a palpable abdominal mass when his mother picks him up. What is the most likely cause?

A

Wilms tumour

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133
Q

SBA: Mouth/lip swelling following a dental procedure with a family history

A

C1 inhibitor deficiency

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134
Q

What lab test would you use for: bone marrow response to haemolytic anaemia

A

Reticulocytes

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135
Q

ChemPath investigations: Cushing-like woman, BP 109/100, thin skin, Overweight, high-normal sodium, low-normal potassium, OGTT (glucose high-normal)

A

Low dose dex suppression

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136
Q

Allergy: itchy mouth after eating certain fruits

A

Food allergy or anaphylaxis or oral allergy syndrome. IgE mediated

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137
Q

Vitamins: Person with Crohn’s and megaloblastic anaemia

A

Folate deficiency

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138
Q

Impaired glucose tolerance in OGTT

A

7.8-11.1

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139
Q

what enzyme is raised in osteomalacia?

A

ALP

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140
Q

Blood transfusions: what is most serious complication of blood transfusion

A

TRALI is the number 1 cause of transfusion mortality

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141
Q

A ward sister gets diarrhoea, and patients on the ward have been ill recently

A

Norovirus

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142
Q

Cell of immune system: responsible for the killing of cancerous cells, and is inhibited by MHC-1

A

NK cell

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143
Q

Which drug do you give to a woman who is infected with herpes simplex/ HSV1 encephalitis?

A

Aciclovir

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144
Q

Patient with raised IgM paraprotein (32)

A

Waldenstroms macroglobinaemia

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145
Q

Macrolide used to treat atypical pneumonias

A

Clarithromycin

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146
Q

VSA: Which clotting factor falls most rapidly after administering warfarin

A

Protein C

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147
Q

VSA: What zoonotic disease does the Ixodes Tick cause

A

Lyme disease (Borelia burgdorferi)

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148
Q

What cell sits in (it’s immature form in) the periphery, and when it matures, goes to present things to T cells?

A

Dendritic cell

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149
Q

SBA: Cause of rash in amoxicillin + IM

A

Drug reaction

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150
Q

Which/What enzyme is raised in mumps?

A

Amylase-S

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151
Q

SBA: Which cancer does asbestos cause?

A

Mesothelioma

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152
Q

Liver Function Tests: 20 year old with 2 weeks of anorexia, fever and malaise – raised ALT, normal ALP and GGT

A

Viral Hepatitis

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153
Q

SIADH related cancer

A

Small cell lung cancer

154
Q

Which drug do you use to treat viral syncytial virus (bronchiolitis) in a child?

A

Ribavirin

155
Q

Young girl from Bangladesh is pale and tired. Her blood film shows hypochromic RBCs and pencil cells

A

Pencil cells = IDA

156
Q

Man with vertebral fracture and high paraprotein

A

Multiple myeloma

157
Q

A women with known SLE presents with an exacerbation of her SLE/worsening symptoms. What do you measure?

A

C3, C4 (C4 drops first, then C3 in severe disease)

158
Q

Man with penile discharge + gram negative diplococci

A

Neisseria gonorrhoea

159
Q

SBA: Intermittent mouth and tongue swelling for past 2 years unresponsive to anti-histamines. Taking aspirin and ACEi

A

Drug induced reaction

160
Q

GVHD disease pathophysiology i

A

pre-existing antibodies in the recipientpre-exisiting WBCs & their Abs in the graft i think - ollie

161
Q

Organism in50 year old with septic arthritis

A

Staph aureus (46%), strep (22%), E.coli (rare)

162
Q

Which cancer develops in Barrett’s oesophagus?

A

Oesophageal adenocarcinoma

163
Q

Cancer in Coeliac disease. What would they get if they don’t follow a gluten free diet?

A

Lymphoma (EATL)

164
Q

AI disease markers: anti-dsDNA

A

SLE

165
Q

VSA: African man, with Burkitt’s lymphoma is given Rasburicase. He develops haematuria with irregularly contracted cells. What is the cause?

A

G6PD deficiency

166
Q

Beta Lactam antibiotic with anti-pseudomonas activity

A

Carbapenem e.g. meropenem, enteropenem

167
Q

Women has had some surgery which required antibiotics, and now has profuse watery diarrhoea

A

C. diff

168
Q

Normal B and T cells, high IgM, absence of IgA, IgE and IgG

A

Hyper IgM syndrome

169
Q

Which/What antibiotic would you use for cellulitis with MRSA (question specifies it HAD to be IV).

A

Vancomycin

170
Q

Man has an allergic reaction during surgery and who’s lips becomes swollen/oedematous when blowing up balloons as his daughter’s birthday party

A

Type I / 1 hypersensitivity latex allergy

171
Q

Postassium level in DKA is:

A

Raised (hyperkalaemia)

172
Q

Obstetric haematology: woman has low platelets, schistocytes, headaches and seizures. Her blood pressure is 100/60

A

TTP

173
Q

Craggy, enlarged prostate

A

Prostate adenocarcinoma

174
Q

SBA: most common cause of jaundice + fever in traveller with fever

A

Malaria

175
Q

Cell changes seen in GORD

A

Barret’s oesophagus/ metaplasia

176
Q

What cancer is associated with chronic schistosomiasis

A

Bladder squamous cell carcinoma

177
Q

When there is an infection, this cell is responsible for the production of pus when it dies

A

Neutrophils

178
Q

Calculate osmolarity:

A

2(Na + K) + U + G

179
Q

Boy with abscesses has a positive NBT

A

Myeloperoxidase deficiency if positive NBT (turns blue). Chronic Granulomatous disease if NBT negative (turns yellow)

180
Q

Requires rapid vaccination at birth if mum is infectious

A

Hep B, TB

181
Q

Cause of Neonatal thrombocytopenia?

A

Maternal ITP

182
Q

Transplant complications: mechanism behind antibody mediated rejection

A

B-cell activation: antibody attacks vessels

183
Q

Food poisoning question - after Chinese/rice based dinner

A

Bacillus cereus

184
Q

Transplant complications: mechanism behind cellular reaction

A

CD4 activating a type IV reaction

185
Q

Patient with JAK2 mutation has tear drop poikilocytes on blood film

A

Myelofibrosis

186
Q

Blood transfusions: woman with O Rh+ blood is given A Rh- blood, what happens?

A

ABO immediate haemolytic reaction. Occurs immediately after transfusion. Sx: restlessness, fever, vomiting, loin/chest pain, collapse, haemoglobinuria

187
Q

Pancreatic cancer: cancer is found in head of pancreas

A

Pancreatic ductal adenocarcinoma

188
Q

Cause of genital warts

A

HPV 6 & 11

189
Q

cause of UTI associated with renal calculi:

A

E coli, proteus

190
Q

Vitamin deficiency: B3 (niacin)

A

Pellagra (dementia, diarrhoea, dermatitis – necklace rash)

191
Q

Vaccine preventable disease: virus resides in pharynx & GIT. Can cause encephalitis and destruction of motor neurons

A

Polio

192
Q

INRs and appropriate management: patient with AF, INR: 2.5

A

No change in medication required, target INR is 2.5

193
Q

Neonate with meningitis: gram positive organism in chains

A

GBS

194
Q

SBA: 10 year old Nigerian boy with a neck swelling + Starry sky

A

Burkitt’s lymphoma

195
Q

Cancer due to coeliac disease

A

Enteropathy-associated T-cell lymphoma (EATL)

196
Q

Lady who receives blood transfusion goes home, then develops rash all over and shortness of breath

A

Probably post transfusion purpura - usually presents 5–12 days after transfusion.

Possibly GVHD - usually fever, rash which progresses to T.E.N., also D & V.

Possibly allergic/anaphylaxis reaction.

197
Q

Patient with IgM paraprotein and visual disturbances

A

Waldenstroms gammaglobulinaemia (lymphoblastic lymphoma)

198
Q

Vitamin deficiency: B2 (riboflavin)

A

Glossitis, normocytic anaemia, dry mucous membranes

199
Q

Potassium DKA

A

High

200
Q

VSA: An elderly man has a fall, and doesn’t become unconscious/lose consciousness, and presents two days later with a confusion, where is the likely site of bleeding

A

Subdural haemotoma

201
Q

SBA: True positive/Total with disease

A

Sensitivity

202
Q

Young girl has been on holiday. She has low platelets, profound anaemia, oliguria. Blood film shows bite cells and schistocytes

A

G6PD deficiency or HUS

203
Q

Vitamin deficiency: D (cholecalciferol)

A

Rickets, osteomalacia

204
Q

Pneumonia: young patient with lower lobe consolidation

A

Strep pneumoniae

205
Q

SBA: 50 y/o with Midshaft femur fracture. What most likely type of cancer?

A

Chondrosarcoma?

206
Q

Which cancer is associated is E-cadherin positive?

A

Invasive ductal carcinoma

(Negative is invasive lobular Ca)

207
Q

Subtypes of thyroid cancer:

A

· 60% Papillary – young. Psammoma bodies, 25% Follicular – middle age. 5% Medullary – MEN2, 5% Lymphoma – MALT origin, Anaplastic

208
Q

Cell of immune system: expresses Foxp3 and CD25

A

T-reg cell

209
Q

VSA: Name the main class of drug used to treat HIV

A

Nucleoside Reverse transcriptase inhibitors

210
Q

What is deposited in the kidneys in multiple myeloma?

A

AL amyloid protein

211
Q

SBA: Most specific marker for RA

A

Anti-cyclic citrullinated protein

212
Q

Leukaemia: blood film shows smear cells

A

CLL

213
Q

VSA: What type of amyloid is deposited in multiple myeloma

A

AL amyloidosis

214
Q

Gram Negative diplocci - meningitis

A

Neiserria meningitidis

215
Q

SBA: Woman found at home unresponsive with needles. Dies on way to hospital and they find next of kin, her brother. What do you do next?

A

Refer to coroner (for advice) as cause of death is unknown

216
Q

A patient with well controlled HIV, who is currently on HAART. What would you measure?

A

Lymphocyte subsets. CD4

217
Q

Sodium handling: patient with polyuria and polydipsia. Low sodium low potassium, low plasma and urine osmolarity

A

Psychogenic polydipsia

218
Q

Normal change in pregnancy

A

rise in fibrinogen + F(VII, VIII, X), decreased fibrinolysis

219
Q

MEN2a associations:

A

Parathyroid, phaeo, medullary thyroid

220
Q

VSA: Denosumab target

A

RankL inhibitor

221
Q

guy develops foul-smelling diarrhoea and cramping pain 5 days after eating chicken at a barbeque

A

Campylobacter

222
Q

Vitamins: Patient with high PTH

A

Vit D deficiency (osteomalacia)

223
Q

STI that can pass through placenta

A

Syphilis, HIV

224
Q

High sodium, plasma osmolality 400, urine osmolality 600

A

Dehydration

225
Q

Which enzyme if low, leads to hyperuricemia?

A

HGPRT in juvenile gout (lesch-nyhan syndrome)

226
Q

Gram + rod (bacilli) that can pass through placenta

A

Listeria monocytogenes

227
Q

A man has spherocytes, polychromasia and reticulocytosis on blood film

A

Hereditary spherocytosis

228
Q

Mab Used to treat Ankylosing spondylitis

A

Etanercept (anti-TNF receptor antibody) or Secukinumab (anti-IL-17a antibody)

229
Q

VSA: Histology of Lung CA in non-smoker

A

Mucin

230
Q

Management of contact hypersensitivity:

A

nothing

231
Q

DNA synthesis inhibitor used to treat pseudomonas infections, but not effective against anaerobes

A

Ciprofloxacin

232
Q

Patient had an appendectomy a week ago. What would you see in their scar?

A

Granulation tissue

233
Q

Vaccine preventable disease: develops a grey film over the epiglottis

A

Diptheria

234
Q

What cell in the body is likely to bind to MHC1 presenting cells:

A

CD8+

235
Q

VSA: high Na+, low K+, and low renin

A

Conn’ syndrome

236
Q

Meningitis: old lady with gram positive bacilli

A

Listeria monocytogenes

237
Q

Man has an MI 2-3 weeks ago. Now he comes into hospital and blood is aspirated from the pericardium

A

Left ventricular rupture

238
Q

Blood transfusions: sickle cell patient has pain in his joints, dark urine, fever and headache. They have a blood transfusion. What complication of a blood transfusion should you screen for?

A

Iron overload

239
Q

VSA: Which vasculitis cases a Disease in which a branch of the external carotid is affected

A

GCA

240
Q

Man with bowed legs becomes deaf

A

Paget’s disease

241
Q

SBA: Ulcers on mouth following treatment with a drug

A

Steven-Johnson Syndrome

242
Q

An African lady’s doctor requests a sickle cell solubility test, [?after blood tests show low Hb and normal MCV?]. The test comes back positive with some clouding of the tested blood. What is the diagnosis?

A

Sickle cell trait

243
Q

Calculate anion gap:

A

(Na + K) – (Cl + HCO3)

244
Q

SBA: Reason for immediate dialysis

A

Uraemia

245
Q

Management of hay fever:

A

PO antihistamine

246
Q

VSA: Both mother and grandmother had medullary thyroid carcinoma, and have tested positive for MEN2. What [biomarker/protein] would be raised in the blood to confirm medullary thyroid cancer?

A

Calcitonin

247
Q

HIV RNA forms HIV, via which error prone enzyme?

A

Reverse transcriptase

248
Q

Woman with dry eyes and parotid swelling?

A

Sjogren’s syndrome. Anti-La

249
Q

Fibro-epithelial tumour with abundant stromal elements

A

Phyllodes tumour

250
Q

During cholecystectomy, the surgeon notices white spots on the pancreas

A

Pancreatic acinar cell carcinoma (or maybe pancreatic cyst)or Chronic pancreatitis??

251
Q

Endocrine: Raised TSH and prolactin <1000

A

Hypothyroidism

252
Q

Meningitis: gram positive organism in chains

A

Strep pneumoniae

253
Q

Non-healing ulcer Afghanistan

A

Cutaneous leishmaniosis (Leishmania major)

254
Q

SBA: Which ion is most likely to be abnormal in an alkalosis?

A

Potassium

255
Q

What lab test would you use for: polcythaemia monitoring

A

Hb & Hct

256
Q

SBA: Which of these can cause peri/neonatal illness without causing damage to the foetus if the mother is infected antenatally

A

Herpes Simplex Virus

257
Q

Obstetric haematology: patient has pre-eclampsia, low platelets and deranged coagulation

A

DIC

258
Q

Woman with discharge. Infection is diagnosed on wet slide microscopy

A

Bacterial vaginosis (shows clue cells)

259
Q

SBA: Pregnant lady In first trimester with high MCV and low Hb. Has not started taking any multivitamins or supplements.

A

Folate (pernicious anaemia)

260
Q

Young girls has normal B cells, normal CD8+, but zero CD4+ cells

A

Bare lymphocyte syndrome type 2

261
Q

Haemolysis after antimalarials / malaria treatment.

A

G6PD deficiency

262
Q

VSA: aortic valve replaced 3 months ago. They have now come back a few weeks later with jaundice, Hb-urea (haemoglobinuria), and raised reticulocytes

A

Mechanical haemolysis

263
Q

During a nephrectomy procedure, the surgeon notices a mass in the kidney that extends into the renal vessels and into the perineal fat

A

Renal cell carcinoma or renal angiomyolipoma

264
Q

A lady with loin-to-groin pain, haematuria and pain at the end of micturition. What is the most likely cause?

A

Renal calculi

265
Q

Pneumonia: IVDU with ground glass on xray

A

Pneumocystis jirovecci (carinii)

266
Q

Vitamin deficiency: B12 (cobalamine)

A

Pernicious anaemia

267
Q

Which/what cell is inhibited by the presence of MHC1 on cells?

A

NK cells

268
Q

Used for mild CAP (Community acquired pneumonia) caused by Hib (Haemophilus influenza type B)

A

Amoxicillin

269
Q

INRs and appropriate management: patient with a prosthetic valve, INR: 3.5

A

Decrease dose of warfarin to aim for target INR 3 (2.5-3.5)

270
Q

Patient presents with low mood after renal transplant, following longstanding renal disease. Raised calcium, high PTH

A

Tertiary hyperparathyroidism

271
Q

Which of these vaccines must not be given to a pregnant woman:

A

MMR

272
Q

Person is discharged after surgery, who had a bilateral hemianopia, with removal of pituitary adenoma. Consultant says it is alright to discharge them. What do you prescribe the patient on discharge?

A

Glucocorticoid e.g. hydrocortisone

273
Q

Allergy: young child has rash on extensor surfaces. The pathology is IgE mediated

A

Atopic dermatitis (or acute urticaria?)

274
Q

Calcium and bone handling: raised calcium, normal phosphate, low PTH, high ALP. Patient is lethargic

A

Malignancy

275
Q

A Lady with myelodysplastic syndrome requires regular monthly blood transfusions. 10 minutes after another transfusion (her latest transfusion), she becomes tachycardic, has transfusion site pain, and hypotensive, what is the cause?

A

ABO incompatibility

276
Q

Transplant complications: can lead to post-transplant lymphoproliferative disease

A

EBV

277
Q

A girl has recently been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose (on LP)

A

Viral e.g. Herpes

278
Q

A man presents with the symptoms of a UTI and acute onset costovertebral pain. He is found to have pus cells and blood in his urine. What is the most likely cause?

A

Pyelonephritis

279
Q

Hyperuricaemia is caused by deficiency in:

A

Urate oxidase

280
Q

VSA: What drug is used to treat severe falciparum malaria

A

Artensunate

281
Q

SBA: Large mass on right side and has blood in the urine

A

Renal Carcinoma, Wilm’s tumour

282
Q

Gam Positive diplococci - meningitis

A

Strep pneumoniae

283
Q

Management of acute uriticaria:

A

PO antihistamine

284
Q

ChemPath investigations: Patient with low sodium ?normal potassium, low plasma osmolality and urine osmolality of 70

A

SIADH (urine osmolality >100)

285
Q

a cause of UTI in hospitalised/young boys

A

Proteus mirabilis

286
Q

Liver Function Tests: Man following haematemesis with raised GGT and ALT

A

Oesophageal varices

287
Q

SBA: most common Lung CA in a non-smoker

A

Adenocarcinoma

288
Q

SBA: Doctor with needlestick injury and patient refuses blood test. Asks CT1 if lab can test one of old blood samples. What does CT1 say?

A

If they decline to consent and have capacity then you cannot do the test

289
Q

Man, ex-smoker, with history of hypertension and MI, has sudden chest pain which radiates to the neck

A

Anterior MI (blockage of LAD)

290
Q

SBA: common finding in someone who has portal hypertension

A

Splenomegaly

291
Q

60 year old Man with abdominal pain radiating to back, collapses and dies

A

AAA

292
Q

A teenage girl who when she goes cross country running gets an erythematous rash on her legs. It is well controlled by antihistamines

A

Cold urticaria? Or allergy. Not sure

293
Q

Radiosensitive cancer of the testicle in a young man with a white smooth appearance

A

Seminoma

294
Q

Women with colicky abdominal pain. Elevated ALP, ALT, GGT, & Bilirubin

A

Acute cholestasis

295
Q

Vitamin deficiency: A (retinol)

A

Colour blindness

296
Q

What cancer does H. Pylori cause?

A

MALT

297
Q

Allergy: hypertensive and diabetic, with angioedema

A

Angioedema (possible caused by ACE inhibitors)

298
Q

20 year old man with leukaemia: t(9:22). BCR-ABL present. TdT was expressed on cells. Blood film shows 70% blasts

A

ALL (TdT is an immature marker)

(note, you can get t(9:22) in ALL, and CML also)

299
Q

Transplant complications: mechanism behind GVHD

A

Donor cells attack host cells (APC mediated destruction,)

300
Q

What changes do you get in the lymph nodes with sarcoidosis?

A

Granuoma

301
Q

After a lady receives a blood transfusion and platelets, she goes home and develops a rash all over

A

Post transfusion purpura, usually presents 5–12 days after transfusion

Possibly GVHD - usually fever, rash which progresses to T.E.N., also D & V.

302
Q

Malignancy due to longstanding reflux. Endoscopy shows a mass 30cm down

A

Oesophageal adenocarcinoma

303
Q

SBA: A man presents with history of heart disease, left ventricular hypertrophy, has a facial basal cell carcinoma and type 2 diabetes. Investigations from one year ago showed critical aortic stenosis, with poor ejection fraction. Current (Investigations/ECHO) shows (severe/critical) aortic stenosis. They suddenly die. List the order for the coroners / How should you fill out the MCCD (Medical Certificate of Causes of Death)?

A

1a = Aortic Stenosis

304
Q

What lab test would you use for: testing whether a haemolytic anaemia is autoimmune in origin

A

DAT test

305
Q

INRs and appropriate management: patient with a previous DVT, INR 1.5

A

Increase dose of warfarin to aim for target INR of 3.5 (2.5-3.5)

306
Q

Which breast cancer is also known as non-specific type?

A

Invasive ductal carcinoma

307
Q

Most common cause of UTI: catheter

A
  1. E Coli, 2. Staph saprophyticus 3. klebsiella
308
Q

Which drug do you give to a woman who is infected with herpes zoster in pregnancy?

A

Aciclovir

309
Q

Cell of immune system: monocytes resident in peripheral skin cells

A

Langerhans cells

310
Q

An overweight individual with diabetes has longstanding bone/back pain. They are found to have paraprotein IgA ~8g/dl, and GFR 55mls/min/1.73m^2. FBC normal and albumin normal

A

MGUS

311
Q

Pneumonia: hyponatraemia, confusion

A

Legionella pneumophillia

312
Q

Breast: blood, discharge, benign change

A

Duct Papilloma

313
Q

Low sodium, all else (K+, CL-?) normal. Glucose before OGTT is 4.9, 2 hours later is 10 ish

A

Impaired glucose tolerance

314
Q

Alcoholic has an AAA repair, and several days later develops a fever, with low Hb, and jaundice

A

Delayed haemolytic transfusion reaction

315
Q

Mab Used to treat osteoporosis

A

Denosummab (anti-RANK ligand antibody)

316
Q

Causes cataracts, sensoneural deafness, hepatomegaly, thrombocytopenia

A

CMV

317
Q

SBA: Diagnosis of Cushing disease

A

Head scan (MRI)

318
Q

SBA: Nephrotic syndrome in child

A

Minimal change disease

319
Q

Vitamins: Vegan with megaloblastic anaemia

A

B12 deficiency

320
Q

Transplant complications: causes progressive multifocal leukoencephalopathy

A

JC virus

321
Q

Vitamin deficiency: E (tocopherol)

A

Haeolytic anaemia, SCD, neuropathy

322
Q

If taking infliximab and travelling to Africa/ S. America:

A

Can’t have live vaccine: e.g. BCG, typhoid, polio, yellow fever, MMR, varicella, influenza

323
Q

Autoimmune and auto-inflammatory disease: associated with HLA-DR4 and cyclic citrullinated peptide (CCP)

A

Rheumatoid arthritis

324
Q

What drug do you give to treat a Neonate with Cytomegalovirus Retinitis?

A

Ganciclovir

325
Q

VSA: Person who had negative direct coombs test but who has anaemia (low Hb), and jaundice

A

MAHA, haemoglobinopathy, mechanical haemolysis

326
Q

20-year-old man with a lytic lesion in the diaphysis of his leg, which is relieved by aspirin

A

Osteoid osteoma

327
Q

Which/What cell undergoes positive and negative selection in the thymus

A

T-cells

328
Q

A 12 year old boy has recurrent chest infections, and has an ear infection. He doesn’t have any B Cells

A

Bruton’s

329
Q

Pyloric stenosis bicarb is:

A

Raised (metabolic alkalosis)

330
Q

Baby with seizures. Low Ca, Low PTH

A

Hypoparathyroidism. May be due to DeGeorge syndrome.

331
Q

Appendix that is full of neutrophils and is enlarged, touching the peritoneum

A

Inflammation?

332
Q

Allergy: lady has flushed face, difficulty breathing and an enlarged liver. This has happened to her several times

A

Hereditary angioedema (C1 esterase inhibitor deficiency)

333
Q

VSA: Signs of hyperthyroidism. Bloods show low TSH and high thyroxine. Does not have good uptake on technetium scan.

A

De Quervain’s thyroiditis

334
Q

SBA: Most common Ovarian CA (<25)

A

Teratoma

335
Q

A Girl is found to have no CD4 cells, but CD8 cells and B cells are present

A

Bare lymphocyte syndrome Type 2

336
Q

Which/What antibiotic would you use to treat/prescribe someone who has cellulitis with a Methicillin SENSITIVE strain of Staphylococcus aureus?

A

Flucloxacillin

337
Q

Gram negative rod - meningitis

A

E. coli

338
Q

Man has abdominal pain radiating to the back. He then collapses and dies

A

Abdominal aortic aneurysm

339
Q

SBA: Most common Ovarian CA (>25)

A

Serous adenoma

340
Q

A Rhesus D negative woman is having a Haematopoietic stem cell transplant (HSCT) and is CMV IgG negative. What is the most important thing to ensure in the transplant?

A

HLA of donor and recipient identical

341
Q

INRs and appropriate management: patient with a prosthetic valve, INR: 2.5

A

Increase dose of warfarin to aim for target INR 3 (2.5-3.5)

342
Q

Gram negative rod causing sepsis in a neonate?

A

E. Coli

343
Q

What happens to the body of the stomach in a patient with pernicious anaemia?

A

Atrophy

344
Q

Obstetric haematology: dad is on warfarin, and sister had a DVT

A

Antitrhrombin deficiency

345
Q

Raised in rhadommyolysis:

A

Creatine Kinase (CK)

346
Q

72 year old with headache. Raised calcium, normal phosphate, normal PTH, high ALP

A

Primary hyperparathyroidism

347
Q

Liver Function Tests: Raised unconjugated bilirubin with normal LFTs

A

Gilbert’s syndrome

348
Q

A Man has) beta thalassemia since 13 months of age. He presents to an outpatient clinic with malaise and erectile dysfunction

A

Transfusion associated haemosiderosis

349
Q

An African child is found to be anaemic with a low Hb and normal MCV. The doctor in the hospital has the child’s blood tested by Electrophoresis to confirm the suspected diagnosis. Results show very high HbS and low HbF. What is the diagnosis?

A

Sickle cell anaemia

350
Q

Best marker of UTI on urine dip

A

Nitrites

351
Q

A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG

A

IFN gamma receptor deficiency

352
Q

Recurrent episodes of weakness and paraesthesia that spontaneously resolve

A

Relapsing-remitting MS

353
Q

Autoimmune and auto-inflammatory disease: associated with HLA-B27

A

Ankylosing spondylitis

354
Q

Cell of immune system: immature form is responsible for phagocytosis, mature form is an APC

A

Dendritic cell

355
Q

Child with recurrent episodes of jaundice and anaemia. Blood film shows spherocytosis without central pallor

A

Hereditary spherocytosis

356
Q

Girl with coeliac disease, refuses to stick with a gluten free diet and now has macrocytosis. Why has this happened?

A

B12 deficiency

357
Q

Vitamin deficiency: B1 (thiamine)

A

Wernicke’s encephalopathy, Beri-Beri neuropathy

358
Q

VSA: Person who had a DVT many years ago (or recurrent DVTs), presents with recurrent dark bruising, and swelling over the course of 5 years, and now had pain in their leg.

A

Superficial thrombophlebitis

359
Q

Cause of post-transplant lymphoproliferative disease

A

EBV

360
Q

Man can eat apple pie. But if he eats fresh apples and pears, he gets inflamed lips

A

Oral allergy syndrome

361
Q

Management of anaphylaxis:

A

IM adrenaline 0.5ml of 1:1000

362
Q

What is the most common cause of thrombocytopenia in Pregnancy

A

Gestational thrombocytopenia

363
Q

Child from western Africa with low Hb. Blood film shows elliptocytes

A

Hereditary elliptocytosis

364
Q

Patient with paraprotein, back pain and loss of sensation in legs

A

Multiple myeloma (raised IgG, IgA, light chains or IgD paraprotein)

365
Q

Alzheimer’s pathology

A

Atrophy of brain & neuronal loss, widened sulci, narrowed gyri, enlarged ventricles, plaques of beta-amyloid protein, neurofibrillary tangles of tau protein

366
Q

Increased risk of mycobacterial or salmonella infections e.g. fracture due to TB?

A

Cytokine deficiency e.g. IL12, IL12 receptor, IL-gamma, IL-gamma receptor

367
Q

Cause of progressive multifocal leukoencephalopathy

A

JC virus

368
Q

MEN1 associations:

A

Pituitary, pancreas, parathyroid

369
Q

Painless indurated ulcer. Grown on dark ground microscopy medium. Spiral shaped bacterium

A

Treponema pallidium (syphilis)

370
Q

ChemPath investigations: Pt with low sodium, high potassium and postural hypotension

A

Short SynACTHen test

371
Q

Define impaired fasting glucose

A

BG: 6.1 – 6.9 mmol/L

372
Q

VSA: What cancer is present if keratin and intercellular bridges are present

A

Squamous cell carcinoma

373
Q

SBA: Anti-coagulation in pregnant woman

A

LMW heparin

374
Q

Young man with severe pain in testicle following horse riding

A

Testicular torsion

375
Q

Blood disorder seen in HELLP

A

MAHA

376
Q

VSA: A Turkish man has a fever (and has a history of recurrent chest infections). Tests show a mutation in the MEFV gene.

A

Familial Mediterranean Fever

377
Q

Patient with HIV, raised ICP and new onset epilepsy

A

HIV encephalitis?

378
Q

Man has an MI 3 years ago. Now he comes into hospital and blood is aspirated from the pericardium

A

Cardiac tamponade

379
Q

Vitamin deficiency: K (phytomenadione)

A

Defective clotting

380
Q

Vaccine preventable disease: lockjaw

A

Clostridium tetani (tetanus)

381
Q

Flip this card

A

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