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Past papers Flashcards

1
Q

What are post-authorisation safety studies?

A

Observational studies conducted after clinical trials

Look at adverse effects in patients not studied e.g. pregnant women, children, liver and renal impairment

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2
Q

What is seen on renal biopsy in HSP (IgA vasculitis)?

A

Mesangial deposition of IgA

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3
Q

What is the difference in serology between acute hepatitis B and false positive hepatitis B?

A

Acute - core IgM antibody

False positive - core IgG antibody

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4
Q

What blood tests are seen in Wilson’s disease?

A

Low caeruloplasmin

High serum, hepatic, and urinary copper

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5
Q

What are the characteristics of alopecia areata?

A

Non scaly discrete patches of hair loss

Increased association with atopic eczema

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6
Q

If urinary calcium is not high enough for thiazide diuretic therapy to prevent renal calculi, what is used?

A

Potassium citrate

Forms complexes with calcium ions

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7
Q

What is a risk of starting statins whilst patients are hypothyroid?

A

Increased risk of myalgia

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8
Q

What is the most common thyroid malignancy?

A

Papillary

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9
Q

What is an adverse effect of urate-lowering therapy?

A

Acute gout attacks

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10
Q

What is the source of bleeding in haemoptysis?

A

Bronchial artery in 90%

Pulmonary artery in 5%

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11
Q

When is serum C-peptide not useful?

A

In the absence of true hypoglycaemia

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12
Q

Define delayed haemolytic transfusion reaction

A

Occurs at least 24 hours after transfusion

Clinically evident by 2 weeks post transfusion

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13
Q

Why is flecainide avoided in LVSD or IHD?

A

Negatively inotropic

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14
Q

How is septic arthritis post joint injection diagnosed?

A

Blood cultures (more sensitive than synovial fluid culture)

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15
Q

What are the effects of cocaine?

A 
Hyperthermia
Chest pain
Hypertension
Agitation
Arrhythmias
Rhabdomyolysis
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16
Q

Where is the ulnar nerve commonly entraped?

A

At the elbow - medial epicondyle

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17
Q

Why is ABPI required in venous ulcers?

A

Compression bandaging is contra-indicated if there is insufficient arterial blood supply of the foot

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18
Q

What are the effects of systemic sclerosis on the bowel?

A

Small bowel bacterial overgrowth from reduced peristalsis and dilatation

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19
Q

Which drugs can cause lithium toxicity?

A

ACEIs
ARBs
Diuretics

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20
Q

What should be performed before CT scan in acute ulcerative colitis?

A

AXR to exclude toxic megacolon

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21
Q

What antibody is involved in hyperacute organ rejection?

A

IgG - as it is from pre-existing humoral immunity

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22
Q

What is the treatment of restless leg syndrome?

A

Mild: quinine

Mod-severe: ropinirole, pramiprexol, rotigotine

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23
Q

Describe the pupil of acute angle glaucome

A

Dilated

Non-reactive

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24
Q

What is the triad of Miller-Fisher syndrome?

A

Ataxia
Internal and external ophthalmoplegia
Arreflexia

Associated with antibodies to GQ1b

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25
Q

What happens to the RAAS system in CCF?

A

Pathologically activated due to decreased renal perfusion pressure
Leading to high levels of aldosterone, angiotensin, renin

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26
Q

What are the joint crystals in gout and pseudo gout?

A

Gout: needle shaped, negative birefringence
Pseudo: rhomboid shaped, positive birefringence

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27
Q

What organism colonises indwelling lines?

A

Staph epidermis

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28
Q

What is a side effect of quinolones?

A

Tendon rupture

29
Q

What investigation is diagnostic of acromegaly?

A

Growth hormone suppression test

30
Q

How do thiazide diuretics cause hypokalaemia?

A

Increased loss in the distal tubule

Sodium ions are exchanged for potassium and H+ ions

31
Q

How many anti-retroviral drugs are used for PEP?

A

3

32
Q

What is the most common cause of viral gastroenteritis?

A

Norovirus

33
Q

What does BRCA code for?

A

DNA repair protein (tumour suppressor gene)

34
Q

What is a common method of analysis in RCTs?

A

Intention to treat

35
Q

What is the most common cause of myocardial infarction in pregnancy?

A

Coronary artery dissection

36
Q

What parameters does the waterlow score use?

A 
Continence
Age
Sex
Body weight
Nutritional status
Skin type
Mobility
37
Q

What is the initial treatment of erythrodermic psoriasis?

A

White soft paraffin

Until systemic treatment is initiated

38
Q

What drug can precipitate generalised pustular psoriasis?

A

Prednisolone

39
Q

What does the SMA supply?

A

Distal duodenum to 2/3 the way across transverse colon

40
Q

How does intense exercise cause amenorrhoea?

A

Hypothalamus secretes less GnRH

41
Q

What is anacrotic pulse?

A

Slow rising pulse seen in aortic stenosis

42
Q

What kind of pulse is found in cardiac tamponade?

A

Pulsus paradoxus

43
Q

What are the risk factors for completed suicide?

A

Older age
Male
Use of alcohol (to a lesser extent)

44
Q

In patients taking morphine with renal impairment, what accumulates?

A

Morphine 6-glucuronide

45
Q

What is the mechanism of action of isosorbide mononitrate?

A

Increases cGMP - nitric oxide donor

Mediates the vasodilatory effects of nitrates

46
Q

What blood test results suggest autoimmune hepatitis?

A

Raised IgG

ALT>AST >1 (favours autoimmune/viral over alcoholic)

47
Q

What is seen in posterior MI?

A

ST depression and dominant R wave V1-V3

48
Q

What supplies the posterior surface of the heart?

A

85% - posterior descending

15% - circumflex (left dominant circulation)

49
Q

What would occlusion in the first septal branch of the LAD lead to?

A

STE in I and aVL alone

50
Q

What is the treatment of toxic thyroid adenoma?

A

Radioiodine

51
Q

When is prednisolone indicated in hyperthyroidism?

A

Thyroiditis

52
Q

How to calculate serum osmolality?

A

2Na + 2K + glucose + urea

53
Q

What is the treatment of overactive bladder?

A

Anti-muscarinic drug such as oxybutynin or solifenacin

54
Q

When are hydralazine and isosorbide mononitrate started in heart failure?

A

3rd line - often started together
Hydralazine - arterial vasodilator, isosorbide - venodilator
Often if BP is high

55
Q

What are the indications of ivabradine in heart failure?

A

Often IHD
EF<35%
HR >75bpm

56
Q

What is the mechanism of action of haloperidol?

A

D2 receptor antagonist

Binds to receptors in area postrema (medullary structure controlling vomiting)

57
Q

Anaphylactic allergy to penicillin means avoidance of which antibiotics?

A

Beta-lactams

Includes penicillins, meropenem, cephalosporins

58
Q

What is the mechanism of hypophosphataemia in refeeding syndrome?

A

Intracellular shift

59
Q

What cardiac diseases are important in pregnancy?

A

Stenotic valvular lesions (regurgitant lesions well tolerated)
Pulmonary hypertension
R to L cardiac shunt

60
Q

What is the cause of torticollis?

A

Contracture of the contralateral sternocleidomastoid muscle

61
Q

What is the most common cause of epiglottitis?

A

Haemophilus influenzae

62
Q

Which infection can mimic Crohn’s disease/appendicitis by causing mesenteric adenitis?

A

Yersinia enterocolitica

63
Q

How are bone marrow metastases diagnosed?

A

Pancytopenia

Blood film shows leukoerythroblastic infiltration e.g. nucleated red blood cells, myelocytes, metamyelocytes

64
Q

Where are the site of lesions causing a fixed eye palsy?

A

Frontal lobe

Eyes look towards lesion

65
Q

Which drugs characteristically cause tremor?

A 
Lithium
Valproate
Tacrolimus/ciclosporin
Thalidomide/cytarabine
Theophylline
66
Q

What is aneuploidy?

A

Abnormal number of chromosomes

67
Q

What type of biopsy is done in Hodgkin lymphoma?

A

Excision

Fine needle likely to yield insufficient material

68
Q

What isotype of ANA are associated with lupus?

A

IgG

69
Q

What is meningococcal meningitis prophylaxis for close contacts?

A

Ciprofloxacin

MRCP (17 decks)

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