Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Path > Past papers > Flashcards

Past papers Flashcards

1
Q

What scan do for bony metastases

A

Technetium bisphsophonate scan
Also see activity where fractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What scan do for meabolically active metastases

A

FDG PET scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Septic arthritis with gram negative intracellular diplococci

A

Neisseria gonorrhoea
Get primary gonorrhoea then a few weeks later get septic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common cause of septic monoarthritis in someone aged 19-30

A

Neisseria gonorrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Gram negative intracellular diplococci causing meningitis

A

Neisseria meningitidis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

6 year old with gram negative rods on lumbar puncture

A

Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Neonate or premature with gram negative rods on lumbar puncture

A

E coli
Only causes meningitis in neonates and premature babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Gram positive diplococci on blood culture

A

Step pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Gram positive in clusters

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Mild fever PUO, cultures come back gram positive cocci

A

Strep viridans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What malignancy is lambert eaton associated with

A

Small cell lung cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which coagulation factor decreases quickest after warfarin

A

VII

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does a normal osmolality with hyponatraemia suggest

A

Pseudohyponatraemia
Caused by hyperlipidaemia or paraproteinaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is needed for a true hyponatraemia

A

A low osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How to differentiate between causes of hypovolaemic hyponatraemia

A

Look at urinary sodium
- if over 20 then renal cause (drugs, salt losing nephropathy)
- if under 20 diarrhoea etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypokalaemia with hypoglycaemia

A

Insulin OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What causes hypokalaemia, hypotension and hypercalciuria

A

Bartter syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hyperkalaemia with a low aldosterone

A

ACEi
Reduced production of aldosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the types of renal tubular acidosis and their affect on potassium handling

A

Type 1 (distal tubule)- hypokalaemia
Type 2 (proximal tubule)- hypokalaemia
Type 3 (both DCT and PCT)- hypokalaemia
Type 4 (adrenals) - hyperkalaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is used to differentiate causes of metabolic acidosis

A

Anion gap (NR 10-18)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Brittle hair and developmental delay

A

Homocysteinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Cherry red spot
Developmental delay
Deafness and blindness

A

Fabrys disease (lysosomal disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Encephalopathy- hypotonia, lethargy, poor feeding
Sweet odour and sweaty feet

A

Maple syrup disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How to tell difference between primary and tertiary hyperparathyroidism

A

Can be very difficult to tell difference biochemically however presence of CKD shows is tertiary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

If ischaemia causing a hyerkalaemia what is cause of the hyperkalaemia

A

Can either be due to metabolic acidosis or tissue injury
Tissue injury releases K and metabolic acidosis would cause hyperkalaemia to correct acidosis
If acidosis corrected is tissue injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What does normal base excess show

A

Whether a resp acidosis or alkalosis is being corrected
If between -2 and 2 is not compensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is osmolarity calculated

A

2(Na+K)+ glucose+urea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is rash like in pellagra

A

Casals necklace- erythematous an dpigmented rash in neklace distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is ALP in myeloma

A

Normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How many half lifes does it take for a drug to reach a steady state

A

4-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is best measure of confirming a reinfarction a couple days after first MI

A

CK MB as returns to normal a couple days after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is best measure of MI in terms of sensitivity and specificity

A

Troponin I

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are differences between cold and warm AIHA

A

Warm
- haemolysis occurs in spleen
- IgG
- occurs at 37C in DAT

Cold
- intravascular peripheral haemolysis
- IgM
- occurs at lower temperatures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Causes of warm AIHA

A

Drugs
CLL
SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Causes of cold AIHA

A

Mycoplasma
EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are howell-jolly bodies

A

Nuclear remnants in RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is anisocytosis

A

Variety in size of RBC- seen in IDA, beta thalassaemia, megaloblastic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are cabot rings and what are they seen in

A

Looped structures found within RBC
B12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is pental for TTP

A

MAHA
Renal failure
Thrombocytopenia
Fever
Neuro signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is definitive test for TTP

A

ADAM-ST13 enzyme assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What leukaemia is caused by HTLV-1 infection in japanese women commonly

A

Adult T-cell leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What presents with centrocytes and centroblasts on histology

A

Follicular NHL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What lymphoma is seen in HIV

A

Diffuse large cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What can cause hyposplenism

A

Trauma
Planned splenectomy
Physiological hyposplenism- coeliac, UC, SCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Conditions where splenectomy helpful

A

The PIIES
Thalassaemia
PK deficiency
Immune haemolytic anaemia
Idiopathic TTP
Elliptocytosis
Spherocytosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How does beta thalassaemia trait present

A

Normally picked up on routine blood test
Have slightly microcytic anaemia
Slightly increased HbA2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is normal proportion of HbA2

A

1.5-3.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Presentation of beta thalassaemia major

A

Failure to thrive
Severe microcytic anaemia
Hepatosplenomegaly
Bossing of forehead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are donath-landsteiner antibodies seen in

A

Paroxysmal cold haemoglobinuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How to remember symptoms of paroxysmal nocturnal haemoglobinuria

A

Pancytopenia
New thrombus
Haemolytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is most sensitive antibody for pernicious anaemia

A

Anti-parietal cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are blood findings of haemochromatosis

A

High ferritin
Low TIBC
High transferrin saturation
High iron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Presentation of hereditary haemochromatosis

A
  • the liver (hepatomegaly, deranged LFTs)
  • joints (arthralgia, chondrocalcinosis)
  • pancreas (diabetes)
  • heart (dilated cardiomyopathy)
  • pituitary gland (hypogonadism and impotence)
  • adrenals (adrenal insufficiency)
  • skin (slate grey skin pigmentation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Management of TTP

A

Plasma exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How do packed red cells and FFP transfusions cause thrombocytopenia

A

They contain very few platelets and have diluting effect on the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Physiologically what causes an increased ESR

A

Fibrinogen
Acute phase proteins
Immunoglobulins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What causes combined polycythaemia

A

Chronic smoking
Smoking contains CO which displaces O from Haemogoblin causing raised EPO. Furthermore it is a risk factor for COPD which causes polycythaemia too
Presence of COPD shows is combined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is difference between splenomegaly and hypersplenism

A

Splenomegaly is when spleen enlarged- in some cases this can become hypersplenism
Hypersplenism is when get splenomegaly with a reduction in a cell line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is red cell mass

A

Essentially is a better measure of HCT as HCT can be increased if the patient is dehydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is an absolute versus a relative erythrocytosis

A

Relative erythrocytosis is caused by dehydration whereas absolute is polycythaemia
Red cell mass proves this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What happens to red cell mass in true polycythaemia

A

Increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is glanzmanns thrombasthenia

A

Inherited lack of Glp11b/111a leading to defective platelet aggregration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

How to differentiate between a reactive neutrophilia and cancer

A

Luekocyte ALP
Low in dyscrasia but normal/high in reactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

MOA of bortezomib

A

Proteosome inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

How is von wilebrand treated

A

Desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is most common cause of death in myelodysplastic syndromes

A

Bacterial infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Increased susceptibility to infection following from diarrhoea

A

Protein-losing enteropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is protein losing enteropathy

A

Crohns and coeliac disease can lead to hypoproteinaemia causing loss of Ig which diminishes adaptive immune response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is defect in CVID

A

Mutation in MHC III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What does presence of anti-Jo suggest about dermatomyositis

A

Lung fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Presentation of PBC

A

Malaise
Itching
Symptoms from lack of absorption of fat soluble vitamins
- Vit A blindness
- Vit K bruising
- vitamin D osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Which antigen is indicated in pathogenesis of AIHA

A

rhesus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Which antigen is indicated in pathogenesis of PAN

A

Hep B surface antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Which antigen is indicated in pathogenesis of MS

A

Myelin basic protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Biopsy of lupus nephritis

A

IgM, IgG and IgA deposition
C3 deposition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is used to diagnose IgA nephropathy

A

Immunofluoresecence showing IgA deposition in the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the kviem test used for

A

Sarcoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is CH50 and what happens to it in SLE

A

An acute phase protein
Raised in SLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Which HLA is coeliac associated with

A

HLA-DQ2 and 8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is the NBT test

A

Nitro blue tetrazolium
Measures ability of neutrophils to produce NADPH
Positive (normal functioning neutrophils) means turning blue
Negative (aberrant function) means stays colourless/yellow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is NBT in the different neutrophil immunodeficiencies

A

Kostmann and leukocyte adhesion deficiency is positive
Negative in chronic granulomatous disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What autoimmune conditions are often seen in selective IgA deficiency

A

RA
SLE
Coelaic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Which cell first encounters an allergen

A

Macrophage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

In rejection due to ABO incompatibility what cell is responsible for reaction

A

B cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What is treatment of a myasthenic crisis

A

Plasmapharesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is a hyperacute organ rejection

A

Occurs within minutes to hours due to preformed antigens on surface of donor organ
Often occurs if mismatch on ABO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What are the 2 monoclonal anti-TNF alpha antibodies and what is difference

A

Infliximab- mouse human chimeric
Adalimumab- human monoclonal antibody

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What T1DM antibody is against tyrosine phosphate

A

Anti-IA-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Which factors suggest type 2 AIH as opposed to type 1

A

Presence of anti liver kidney microsome antibodies
Younger people (children)
Resistance to steroids
Low IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What antIbodies are seen in vitiligo

A

Anti-melanocyte

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What are anti glutamic acid decarboxylase antibodies associated with

A

T1DM
Stiff man syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What antibodies are indicated in GBS

A

Anti-ganglioside LM1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Low IgA in disease with deranged liver function or symptoms

A

Type 2 AIH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What is the stain done for PJP

A

Gomori methenamine silver stain showing flying saucer shaped cysts on microscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

When are moraxella catarrhalis infections common

A

In chronic lung disease often in COPD infective exacerbations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Organism causing gastroenteritis after drinking unpasteurised milk

A

Listeria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Which patients are listeria GI infections seen in

A

Immunocompromised
Neonates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Beta haemolytic anaerobic organism with tumbling motility causing GI infection

A

Listeria monocytogenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

GI infection after swimming in a contaminated lake in UK

A

E coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Severe watery diarrhoea with no leukocytes on microscopy

A

Vibrio cholera as produce enterotoxins which cause water loss but don’t colonise the intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

What type of organism is giardia

A

Pear shaped trophozyte with 4 flagella and 2 nuceli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

In what people should giardia be considered

A

Homosexual men
Hikers
Travellers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Which bacteria causes diarroea by producing exotoxins which act as a superantigen

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are phases to leptospirosis (weils syndrome)

A

Initially get non specific fever, headache and conjunctival haemorrhage
Then haemolytic anaemia, meningitis and renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What organism causes leptospirosis

A

Leptospira interrogans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Gold standard for leptospirosis

A

Microscopic agglutination test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What type of organism is cryptococcus

A

Encapsulated yeast infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Most common cause of viral meningitis

A

Non-polio enteroviruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What are examples of NRTIs

A

Lamivudine and zidovudine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What bacteria causes lyme disease

A

Borrelia burgdorferi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Main brucella complication

A

Granulomatous liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What are examples of NNRTI

A

Efavirenz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Presentation of lyme disease

A

In 3 stages
Local
- rash and constitutional sx

Disseminated
- PEACH
- peripheral neuropathy
- erythem migrans
- arthritis
- cranial nerve palsy
- heart block

Late
- arthritis
- encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Most appropriate and useful test for sporadic CJD

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

How to remember sx of sporadic CJD

A

Demented LAMB
Dementia
LMN signs
Akinetic mutism
Myoclonus
Blindess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Differentiating between the meningitis’ on CSF
- viral
- bacterial
- TB

A

Both viral and TB can have clear CSF and high lymphocytes however they have extremely high protein and low glucose
Bacterial will have high neutrophils and high proteins but always be turbid and also have a low glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What is most significant predictor of clearing the virus in Hep C

A

Genotype as are a few in the UK some of which carry significantly worse prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What is used to diagnose a current Hep C infection

A

Hep C RNA PCR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What are haemosiderin macrophages in the lung seen in

A

LHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Gastric biopsy reveals signet rings and linitis plastica

A

Gastric adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

How are peptic ulcers differentiated from gastric adenocarcinomas

A

Carcinomas have raised and uneven borders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Which cancer is associated with exposure to alfatoxins (from aspergillus)

A

Hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Difference in identification lobular and ductal carcinoma in situ

A

Ductal- unilateral with calcifications
Lobular- bilateral (can have many) and cant be picked up on mammogram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

Breast tumour with artichoke like appearance

A

Phyllodes tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Multiple lytic zones around epiphyses

A

Giant cell tumours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Pains in limbs with shooting pain and SOB too

A

Pagets bone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Recurrent emboli from vegetations on mitral valve where no inflammation and blood cultures negative

A

Non thrombotic endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Colorectal cancers with pigmentation around the mouth

A

Peutz jeughers giving harmartomatous polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

How to differentiate between emphysema and chronic bronchitis

A

Chronic bronchitis produces copious amounts of sputum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What is lung disease associated with burns injuries

A

ARDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

What presents with oral ulcers, malaise and erythema multiforme

A

SJS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What is eosinophiluria indicative of

A

Tubulointerstitial nephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

How is beta thalassaemia diagnosed

A

High performance liquid chromatography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Treatment for spinal chord compression myeloma

A

Steroids
Radiotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What is standard INR target

A

2-3
This for first time DVT/PE, AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

What factors can raise the target INR

A

Prosthetic valve
Second DVT/PE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

If on continuous unfractionated heparin what need monitored

A

aPTT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

If on prophylaxis LMWH for a surgery what monitoring needed

A

None

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What is done to blood donations to reduce risk of TaGvHD in immunosuppressed patients?

A

Irradiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What is mechanism behind hyperacute organ rejection

A

Preformed antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

What is VTE risk compared to women for men

A

x3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

How is heparin function monitored if have renal impairment

A

Anti-Xa assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Chimeric antigen receptor T-cell therapy against CD19: what type of haematological malignancy does it target?

A

Any B cell lymphoma or leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

Diagnostic test for HS

A

Eosin-5’-maleimide dye test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

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. What is the possible cause?

A

Post thrombotic syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Other than PCV what else can JAK2 mutations occur in

A

Myelofibrosis
Essential thrombocythaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

What are irregularly contracted cells seen in

A

G6PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Haematuria after starting a drug what is diagnosis

A

G6PD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

What is used for treatment of p53 mutation CLL

A

Ibrutinib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What thrombomodulator reduces in pregnancy

A

Protein S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

What is targeted in Graft vs Host disease?

A

HLA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

What drug can allopurinol not be given with

A

Azathioprine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

Which thrombomodulators are antithrombotic

A

Thrombomodulin
Protein S
Protein C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

How does renal artery stenosis cause hyperaldosteronism

A

Reduced perfusion which activates RAAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What is normal response to water deprivavtion test

A

Urine osmolality increases over 600

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
156
Q

What enzyme gets raised if taken cocaine

A

AST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
157
Q

Elderly gentleman with history of headaches and a raised ALP alone

A

Pagets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
158
Q

What enzyme is raised in mumps

A

Amylase-S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
159
Q

If vegan has macrocytic anaemia what is like vitamin deficiency

A

B12 as folate in veggies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
160
Q

What happens to epiphyses and metaphyses in rickets

A

Widened epiphyses
Metaphyses become cupped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
161
Q

Final enzyme in uric acid production

A

Xanthine oxidase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
162
Q

What is raised in rhabdomyolysis

A

CK
Myoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
163
Q

Acute management of gout

A

NSAIDS
Colchicine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
164
Q

Chronic management of gout

A

Allopurinol
Probenecid in some countries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
165
Q

In what condition is there deficiency in HGPRT

A

Lesch nyan syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
166
Q

What is main difference biochemically between osteomalacia and osteodystrophy

A

High phosphate in renal
Low in osteomalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
167
Q

What is calcitonin raised in

A

Medullary thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
168
Q

Whats in MEN1

A

3 ps
Parathyroid
Pancreatic (insulinoma)
Pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
169
Q

What is in MEN2a

A

2Ps 1M
Parathyroid
Phaeo
Medullary thyroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
170
Q

What is in MEN 2b

A

1P 2MS
Phaeo
Medullary thyroid
Mucocutaenous
Associated with Marfans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
171
Q

Interpreting hot uptake on thyroid gland
- diffuse
- multinodular
- single nodule

A

Diffuse- graves
Multinodular- toxic multinodular goitre (plummers)
Single nodule- toxic adenoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
172
Q

Hyperthyroidism with cold uptake globally

A

De quervains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
173
Q

Which molecule takes cholesterol and moves it to liver and steroidogenesis organs?

A

HDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
174
Q

How to interpret urine specific gravity

A

Normal range from 1.005-1.030
If low suggests lots of water in the urine
If high implies very dehydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
175
Q

What is most common type of tumour in appendix

A

Neuroendocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
176
Q

Mass in pancreas after pancreatitis

A

Pseudocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
177
Q

Where does pancreatic cancer most commonly metastasie

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
178
Q

Surgeons notice grey specks on the pancreas

A

Ductal adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
179
Q

Symmetrical joint pain in younger woman

A

RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
180
Q

Which thyroid cancer metastasises to lymph nodes most commonly

A

Papillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
181
Q

Ovarian cancer with signet ring cells

A

Kruckenburg tumour- gastric metastases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
182
Q

Which virus increases risk of nasopharyngeal cancer

A

EBV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
183
Q

Alcoholic with white stripes in oesophagus

A

Candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
184
Q

42 year old woman has a history of intermenstrual bleeding. On examination, a cervical polyp is found. What do you do next?

A

Remove and send for histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
185
Q

What type of section is done intraoperatively if need a diagnosis

A

Intra-operative frozen section

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
186
Q

Cause of HTN in upper body only

A

Aortic coarctation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
187
Q

Most common lung cancer in a non smoker

A

Adeno

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
188
Q

What is method of spread of melanoma

A

Lymphoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
189
Q

What presents with muscles aches all over and joint pain

A

Polymyositis (can also present with joint pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
190
Q

What would you measure in an excacerbation of SLE

A

C3 and C4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
191
Q

Which cells are Foxp3+

A

Treg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
192
Q

Which cell has oxidative and non-oxidative killing methods and dies once job is done

A

Neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
193
Q

What are antibodies for sjogrens

A

ENA
Anti-Ro
Anti-La

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
194
Q

What is associated with increased susceptibility to mycobacterium and the BcG vaccine

A

IFN-gamma deficiency
IL-12 deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
195
Q

Person older than 18 with recurrent infections and evidence of B cell problems

A

CVID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
196
Q

Normal B cells and CD8 but deficient CD4

A

Bare lymphocyte syndrome type II

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
197
Q

Reduced T cell and neutrophil counts but normal B cells

A

X-linked SCID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
198
Q

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

A

Hyper IgM syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
199
Q

What monoclonal antibody used to treat ank spond

A

Etanercept

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
200
Q

What is MOA of etanercept

A

TNF-alpha inhibitor AND TNF-beta unlike infliximab and adalimumab which just alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
201
Q

What antibodies are used to treat melanoma

A

Ipilimumab
Pembrolizumab
Nivolumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
202
Q

MOA of ipilimumab

A

Blocks T cell inhibitory checkpoints by binding to CTLA4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
203
Q

Recurrent episodes of flushed face and breathing problems with hepatomegaly

A

Hereditary angioedema

204
Q

What type of gel and coombs HS reaction is atopic eczema

A

Type I

205
Q

If targetting TNF-alpha doesnt work in ank spnd what can then be used

A

Secukinumab- Anti-IL17

206
Q

Which receptor mutation is associated with better outcomes in HIV

A

CCR5

207
Q

What immunodeficiency is associated with IL2 common gamma chain

A

X-liked SCID

208
Q

What is maxium number of HLA mismatches in a transplant

A

6
Do off HLA class 1 proteins and are 2 of DR, A and B

209
Q

How does nivolumab/pembrolizumab work

A

PD1 on regulator t cells to induce apoptosis
This then in turn means more circulating T cells to destroy cancer cells

210
Q

What type of hypersensivity reaction is serum sickness

A

III

211
Q

What is adalimumab used in treatment of

A

RA

212
Q

Which anibody confers natural protection against HIV

A

gp120

213
Q

What vaccine cant be given to pregnant women

A

MMR as a live vaccine

214
Q

Which cells bind to MHC1

A

NK
CD8+

215
Q

What is used to treat a child with comorbidities who has RSV

A

Ribavirin

216
Q

When differentiating between CMV and rubella in neonatal infection how to differentiate

A

The eye disease
Cataracts in rubella but CMV has choroidretinitis

217
Q

Most common cause of travellers diarrhoea

A

Entero-toxigenic E coli

218
Q

Even on a ward what is most likely cause of an outbreak of gastroenteritis

A

Norovirus

219
Q

Best antibiotic for pseudomonas

A

Ciprofloxacin

220
Q

Outbreak of boils around someones friendship group

A

S aureus

221
Q

Treatment for typhoid

A

Ceftriaxone

222
Q

What is definition of herd immunity

A

The proportion of immune healthy people needed within a population to stop a pathogen’s spread

223
Q

What are the 3 characteristics of a successful flu outbreak

A

Novel antigenicity
Efficient replication in human airway
Efficient transmission between humans

224
Q

Alcoholic man is on ceftriaxone for meningitis, what organism is he at risk of which this does not cover for?

A

Listeria

225
Q

Has contact with someone with TB, what is the lifetime risk of immunocompetent getting active TB?

A

10%

226
Q

What are snail track oral ulcers seen in

A

Syphyllis

227
Q

What carries borrelia burgdorferi

A

Ixodes tick

228
Q

Which vaccine-preventable organism causes cough, lymph node enlargement and has a potential to occlude the airway?

A

Cornyebacterium diphteria

229
Q

Which hepatitis does not cause chronic hepatitis

A

Hep A and E

230
Q

Most common cause of cellulitis

A

Strep pyogenes

231
Q

What infections cause aplastic anaemia

A

Parvovirus B19
HEPATITIS

232
Q

Most common malignancy in breast

A

Invasive ductal carcinoma

233
Q

MOA of allopurinol

A

Xanthine oxidase inhibitor

234
Q

What is pathophysiology in hyper IgM syndrome

A

Mutation in CD40 on T cells which affect communication between B and T cells

235
Q

Gram positive rods causing meningitis in elderly

A

Listeria

236
Q

Why are under 12 months not able to have honey

A

Risk of infection with clostridium botulinum

237
Q

Which hepatitis virus is associated with more severe disease if acquired in pregnancy potentially leading to fulminant hepatic failure and death?

A

Hep E

238
Q

What can be treated with plasmapharesis

A

Anything with excessive type 2 mediated hypersensitivity
- Myasthenic crisis
- Goodpastures
- Antibody mediated rejection
- cryoglobulinaemia

239
Q

What are the expected number of HLA matches between parent and child

A

3/6
50%

240
Q

What is the likelihood of these matches between 2 siblings
- 0 matches
- 3/6 matches
- 6 matches

A

0/6- 25%
3/6- 50%
6/6- 25%

241
Q

What type of HS reaction is PAN

A

III

242
Q

How to interpret a high prolactin

A

Moderately high (1000-5000)
- microprolactinoma (<10mm)
- non-functioning adenoma compressing stalk supplying dopamine

Extremely high (over 5000)
- macroprolactinoma

243
Q

What happens to urinary bilirubin in haemolytic jaundice

A

There is not bilirubinaemia as uncnoj bilirubin hydrophillic
Get urobilirubinaemia as more urobilirubin absorbed to enterohepatic recycling pathway

244
Q

What happens to HDL if an alcoholic

A

Gets raised

245
Q

Most common skin cancer

A

BCC

246
Q

Brain tumour that occurs near top of brain and often asymptomatic

A

Meningioma

247
Q

Which is the commonest glial cell in the CNS?

A

Astrocytes

248
Q

Most common cause of ARDS in adults

A

Sepsis

249
Q

What is the most common ovarian tumour?

A

Serous cystadenoma

250
Q

Which type of necrosis is associated with a MI?

A

Coagulative necrosis

251
Q

In obstetric practice, the maximum risk of fatal maternal thrombo-embolism occurs at which stage of pregnancy?

A

Post partum

252
Q

Acute GvHD post-allogeneic haematopoietic stem cell transplant is mediated by which cell type?

A

Donor T cells

253
Q

What do MDS progress to

A

AML
As blasts

254
Q

What causes relative polycythaemia

A

Dehydration

255
Q

What is left and right shift with regards to neutrophils and its significance

A

Shifted to left means producing less lobes (reactive neutrophilia)
Shifted to right means more lobes (megaloblastic)

256
Q

What is organism in mumps

A

Mumps virus

257
Q

Which class of antibiotics has concentration dependent killing (i.e. the goal of therapy is to maximise peak > MIC)

A

Aminoglycoside

258
Q

Doctors should measure the level/activity of which enzyme before prescribing azathioprine?

A

Thiopurine methyltransferase

259
Q

What hormone is produced by fat cells, and has receptors in the hypothalamus?

A

Leptin

260
Q

What is the commonest cause of hypercalcaemia in the community?

A

Parathyroid adenoma

261
Q

What active enzyme in sarcoidosis patients causes hypercalcaemia

A

1 alpha hydroxylase

262
Q

Most common cause of hypocalcaemia in the community

A

Hypoalbuminaemia

263
Q

What are adrenal zones and what produce

A

Zona glomerulosa- aldosterone
Zona fasciculata- cortisol
Zona reticularis- sex steroids
Medulla- adrenaline
REMEMBER AS ACS

264
Q

What is the commonest cause of portal vein thrombosis?

A

Liver cirrhosis

265
Q

Most common cause of nephrotic syndrome in adults

A

FSGS

266
Q

Most common cause of constrictive pericarditis in developing world

A

TB

267
Q

Most common primary tumour of heart

A

Myxoma

268
Q

What is a myelocyte

A

A neutrophil precursor

269
Q

What is stain for cryptococcus

A

India ink- see yeast cells surrounded by halos

270
Q

What is stain for chlamydia psittaci

A

Giemsa stain

271
Q

What electrolyte abnormality can quinines cause

A

Hypoglycaemia

272
Q

Indications for nivolumab and pembrolizumab

A

Melanoma
Metastatic renal cancer

273
Q

Which infection does cyclophosphamide make you susceptible to

A

PJP

274
Q

What drug increases excretion of uric acid

A

Probenecid

275
Q

What is main killer in CKD

A

Calcifications and subsequent atherosclerosis

276
Q

How to differentiate between renal artery stenosis and conns as causing hypokalemia, hypernatraemia and hypertension

A

Look at aldosterone renin ratio
- high aldosterone in conns
- high renin in RAS as reduced perfusion

277
Q

Causes of normal anion gap metabolic acidosis

A

ABC
Addisons
Bicarb loss- renal tubular acidosis, diarrhoea, laxatives
Chloride gain- NaCl infusion

278
Q

What is fanconi syndrome

A

Condition where failure of PCT to reabsorb small particles

279
Q

Causes of fanconi syndrome

A

Congenital
Wilsons
Myeloma
Lead poisoning
Tetracyclines

280
Q

Lab results of fanconi syndrome

A

Glucosuria
Hypokalaemia
Metabolic acidosis
Hyperuricosuria
Proteinuria

281
Q

MOA of lomitapide

A

Lomitapide acts by inhibiting Microsomal triglyceride transfer protein (MTP)

282
Q

MOA of colchicine

A

Inhibits tubulin polymerisation to reduce migration of neutrophils

283
Q

Pseudohypoparathyroidism presentation

A

Resistance to PTH
- low calcium
- high phosophate
- high PTH
Short 4th and 5th metacarpals

284
Q

Other name for pseudohypoparathyroidism

A

Albright hereditary osteodystrophy

285
Q

Difference between osmolarity and osmolality

A

Osmolarity is what is estimation of particles in a solution is. Units =units mmol/L
Osmolality is measured particles in a solution done by osmometer. Units= mmol/Kg

286
Q

MOA of ezetimibe

A

Inhibits absorption of cholesterol

287
Q

What is inside of homemade alcohol that can cause hyperuricaemia poisnoing

A

Lead

288
Q

What presents with orange tonsils and very low HDL

A

Tangier disease
Can also present with hepatosplenomegaly

289
Q

Elevated plant sterol

A

Phytosterolaemia

290
Q

Which brain tumour has psammoma bodies in

A

Meningioma

291
Q

What is assocaited with epithelial casts in urine

A

ATN

292
Q

COPD in 20 year old woman what should be investigated

A

Alpha 1 antitrypsin deficiency

293
Q

What sign, which may be visible around the nails, is seen in Graves’ disease and is due to periosteal bone growth in the nail bed?

A

Thyroid acropavhy

294
Q

Which cancer has largest mortality in UK

A

Lung

295
Q

Second and third most common cancer for each sex

A

2nd- lung
3rd- bowel

296
Q

What condition is characterised by microangiopathic haemolytic anaemia, thrombocytopenia and renal failure in children?

A

HUS

297
Q

What protein in PCKD

A

Polycystin-1

298
Q

What is the name given to areas of regenerating mucosa which project into the lumen of the bowel, which may be visualised during a colonoscopy of a patient with ulcerative colitis?

A

Pseudopolyp

299
Q

What structures, present in the large bowel, represent weak points in the bowel wall and allow for the formation of diverticula?

A

Taenia coli

300
Q

What respiratory condition is characterised by airspace enlargement and alveolar wall destruction?

A

Emphysema

301
Q

What condition is the presence of waxy casts in urine associated with?

A

CKD

302
Q

What do delta cells from pancreas produce

A

Somatostatin which reduce secretion of glucagon and insulin

303
Q

Which enzyme, synthesised by the pancreas, is most sensitive for the diagnosis of pancreatitis?

A

Lipase

304
Q

Post TIA what scan do

A

Carotid USS

305
Q

What are buffers in intracellular fluid, extracellular fluid and red blood cells

A

Intra- phosphate
Exta- Bicarbonate
RBC- haemoglobin

306
Q

What is best measure of glucose over last 3 weeks

A

Fructosamine

307
Q

What is broken down to create uric acid

A

Purines

308
Q

Why remove whole thyroid in cancer

A

Thyroglobulin is marker and so can use to monitor if goes above 0

309
Q

Most common cause of AKI in hospital

A

Reduced perfusion

310
Q

What happens to urinary urinobilinogen in obstructive jaundice

A

Is low

311
Q

What are codfish vertebrae, pepper pot skull and looser zones seen in

A

Osteomalacia

312
Q

Why does hyperventilation cause paraesthesia?

A

Hyperventilation increases the pH of the blood, which increases the amount of calcium that binds to albumin in the serum. This essentially causes hypocalcaemia which causes paraesthesia.

313
Q

What are the most common causes of primary and secondary hyperparathyroidism?

A

Primary: A parathyroid adenoma
Secondary: Chronic renal failure

314
Q

Which drugs decrease afferent arteriolar pressure

A

NSAIDS
Calcineurin inhibitors

315
Q

Which drugs decrease efferent arteriolar pressure

A

ACEi
ARBs

316
Q

Proportion of thyroid transported in blood

A

Thyroglobulin binding globulin 75
Thyroxine binding prealbumin 20
Albumin 5
Free 0.03

317
Q

What causes pityraisis versicolor

A

Melassazia

318
Q

If have a high WCC what can it be confused for

A

Reticulocyte count- blood film

319
Q

Most common cause of IDA in world

A

Hookworm

320
Q

What is d-dimer a measure of

A

Fibrinolysis

321
Q

What are cigar cells seen in

A

IDA

322
Q

After a DVT in arm what investigations do

A

Chest x-ray then do doppler

323
Q

Reversal agent for rivaroxaban

A

Andexanet alpha

324
Q

What triggers intrinsic pathway

A

Exposed collagen

325
Q

What is second most common of pancreatic exocrine insufficiency in children inherited

A

Schwachman diamond syndrome

326
Q

Which RBC are polychromatic and stain for presence of RNA

A

Reticulocyte

327
Q

How does heparin induced thrombocytopenia present

A

Pro-thrombotic even though thrombocytopenia as platelets get activated by immune complexes

328
Q

First line for VTE in cancer

A

DOAC

329
Q

What lymphoma originates in the germinal zone

A

Burkitts

330
Q

What do all myeloproliferative conditions carry risk of progressing to

A

AML

331
Q

Which cofactor is required for synthesis of the anticoagulant proteins C and S?

A

Vitamin K

332
Q

A 56 year old man is reviewed by his GP after his blood tests suggested a new microcytic anaemia.

His ferritin and serum iron is low. His full blood count, CRP, renal function, LFTs, B12 and folate are otherwise normal.

A blood film reveals the presence of hypochromic erythrocytes with pencil cells.

What is the next most appropriate blood test to request, prior to an OGD and colonoscopy?

A

Anti-TTG

333
Q

What is lymphoma in a young person

A

Burkitts

334
Q

In a young person non child what is likely lymohoma

A

Hodgkins

335
Q

How to quickly raise plateltes in ITP

A

IVIG

336
Q

What are negri bodies pathognomic for

A

Rabies

337
Q

What presents with fever worse in evening

A

Brucellosis

338
Q

What presents with black lesions and lung problems

A

Anthrax

339
Q

What presents with areas of hypopigmentation which under woods lamp appears orange

A

Pityriasis versicolor

340
Q

Gold standard for leishmaniasis

A

Splenic aspirate

341
Q

Normal B cells and CD4 cells but absent CD8

A

BLS I

342
Q

How diagnose coxiella

A

Serology

343
Q

What stains can be used for aspergillus and candida

A

Methanamine silver

344
Q

What can be used to quickly diagnose nail infections

A

Potassium hydroxide test

345
Q

What gram positive organism is associated with tumbling motility and rockets?

A

Listeria

346
Q

Gets bitten by fish and then nodules arise

A

Mycobacterium marinum

347
Q

How are streptoccus infections split up

A

Into alpha or beta haemolytic
Incubate on blood agar
- partial haemolysis is alpha (green)
- complete haemolysis is beta (clear)
Beta haemolytic then split into lancefield groups based off antigens on cell membrane

348
Q

What are 2 main alpha haemolytic strep

A

Strep viridans and pneumoniae

349
Q

Lancefield strep groups

A

A- no antigens (strep viridans and pneumoniae)
B- (strep agalactiae)
D- enterococcus

350
Q

What is growth medium for differnetiating strep

A

Blood agar

351
Q

A 34 year old man has severe Crohn’s disease. His gastroenterologist wishes to start a biologic drug, infliximab. What infection should be ruled out before commencing the drug?

A

TB- mantoux test

352
Q

What antigen is injected intradermally as part of the mantoux screening test for tuberculosis?

A

Tuberculin

353
Q

What is main metabolite of azathioprine

A

6-mercatopurine

354
Q

How does reticular dysgenesis present

A

Severe life threatening infections
Profound sensorineural deafness

355
Q

Blood findings of reticular dysgenesis

A

Deficiency of the myeloid and lymphoid cell lineages

356
Q

Inheritance of reticular dysgenesis

A

Autosomal recessive

357
Q

What immune cell releases granzyme and perforin when activated?

A

Killer T cells

358
Q

What viral enzyme is predominantly responsible for the high mutation rate of HIV and other RNA viruses?

A

Reverse transcriptase

359
Q

In skin prick testing, what is used as a positive control?

A

Histamine

360
Q

Which cytokine is important in the pathogenesis of rheumatoid arthritis, anyklosing spondylitis and inflammatory bowel disease?

A

TNF-alpha

361
Q

How long before skin prick testing must antihistamines be stopped to allow for accurate interpretation?

A

48 hours

362
Q

A neutrophil releases preformed myeloperoxidase, defensins and neutrophil elastase. What is this process known as?

A

Degranulation

363
Q

Which joints in the hand are classically not affected by rheumatoid arthritis?

A

Distal interphalangeal

364
Q

What HLA allele is associated with Graves disease?

A

DR3

365
Q

A 5 year old girl is seen by her GP. Her mother says she is unable to sleep at night as her knees, elbows and shoulders are very red and painful, especially to touch. Her mother has also noticed small bumps under her skin. She is currently pyrexic, but the mother says she is still recovering from a bad sore throat two weeks ago.

What is the likely diagnosis?

A

Rheumatic fever

366
Q

How is Latex Food Syndrome diagnosed?

A

Skin prick

367
Q

HIV infected CD4+ cells are killed by the immune system. What cell type is responsible for this?

A

T killer cells

368
Q

Swan neck deformity which corrects itself when putting hans together

A

SLE

369
Q

A 31 year old accountant reports an itchy rash over the trunk and back that has been present for the last 7 weeks. On examination, there are smooth erythematous papules with evidence of excoriation. She reports no association with food, time and has changed her washing powder to a “Non-Bio” formulation.

What condition is she suffering from?

A

Chronic urticaria

370
Q

Woman with coeliac develops low albumin and immunoglobulins, what is diagnosis

A

Protein losing enteropathy

371
Q

How to differentiate between goodpastures and microscopic polyangiitis

A

Goodpastures has systemic symptoms like fever and joint pain

372
Q

What cell of immune systme would identify a lack of MHC on the surface and destroy it

A

NK cells

373
Q

Which interleukins are responisble for fever

A

IL-1 and 6

374
Q

Which antibody is associated with homogenous ANA staining

A

Ant-dsDNA

375
Q

What gel and coombs is mantoux test

A

4

376
Q

What is main immunoglobulin in breast milk

A

IgA

377
Q

A severe asthmatic presents to their GP for the third time in three years complaining of blocked sinuses. However, over the last 6 months, she has also had unintentional weight loss and reports intermittent fevers. She also has an indistinct erythematous macular rash on both her ankles.
A Full Blood Count reveals an eosinophilia (>10% of white blood cells). What rare immunological condition may be responsible for her symptoms?

A

Eosinophillic granulomatosis

378
Q

What cell stains with CD14

A

Monocyte

379
Q

What is the name given to the immunological process that must have occurred prior to a hyperacute transplant rejection?

A

Sensitisation

380
Q

Immunoglobulins may bind to multiple pathogens at once in order to enhance phagocytosis. What is this process known as

A

Neutralisation

381
Q

What is the name given to a substance that increases the effectiveness of an immune reponse to a vaccination without altering the specificity of the response?

A

Adjuvant

382
Q

What test can be used to measure the levels of serum IgE directed against brazil nut antigens?

A

Radioallergosorbent test

383
Q

What does RAST stand for

A

Radioallergosorbent tets

384
Q

What is crucial enzyme in salvage pathway for purines

A

HGPRT

385
Q

Rate limiting enzyme for purine metabolism

A

PAT

386
Q

How to tell if something is positively birefringent or not

A

If positively birefringent
When aligned with light filter goes blue
When light filter perpendicular it goes yellow/whiteish

387
Q

Which renal stone is ethylene glycol associated with

A

Calcium oxalate as ethylene glycol broken into oxal acid

388
Q

What are hyperlobated nuclei (flower cells) seen in

A

Adult T cell lymphoma

389
Q

What does siderosis mean

A

Iron accumulation

390
Q

How does starry sky actually appear

A

Macrophages filled with apoptotic remains on a background of lymphoblasts

391
Q

What are auer rods

A

Azurophillic crystal found in neutrophils

392
Q

What technique is used to identify genetic feature of CML

A

FISH

393
Q

Most common inherited coagulopathy

A

Factor 5 Leiden- normally only increased risk in presence of other RF like COCP

394
Q

What clotting factor is contraindicatedlly raised in pregnancy

A

11

395
Q

Where and in who does does bullous pemphigoid occur

A

Elderly
Flexural surfaces

396
Q

What is centromere pattern immunofluorescence associated with

A

CREST

397
Q

What is nucleolar pattern immunofluorescence associated with

A

Diffuse systemic sclerosis

398
Q

What is wire loop appearance in kidney associated with

A

SLE

399
Q

What thyroid cancer arises from parafollicular c-cells

A

Medullary

400
Q

2 most common pituitary adenomas

A

Prolatinoma 1st
Non-functioning 2nd

401
Q

What is somatotrophin

A

GH

402
Q

When is only time screening for cervical cancer may extend 64

A

If not had since 50 or recent abnormal results

403
Q

What is most significant independant RF for CVD

A

Family history

404
Q

If have femoral artery stenosis what change happens to skeletal muscle in legs

A

Atrophy

405
Q

What is most damamging pathology to myocardium

A

Ischaemia as toxic waste products accumulate which cant be drained efficiently

406
Q

What is process whereby in slowed flow, white cells are drawn to vessels walls

A

Margination- drawing cells to walls

407
Q

How are macrophages described in granulomas

A

Epithelioid as develop intracellular organelle growth

408
Q

Penetration through which layer of skin will lead to formation of scar

A

Basement membrane

409
Q

If severe autoimmune haemolysis removal of which organ may help syomptoms

A

Spleen

410
Q

Deficiency in what cell leads to recurrent viral infections

A

Classic NK deficiency

411
Q

What is role of follicular t helper cells

A

Promoting germinal centre reactions and differentiation of B cells into IgG and IgA secreting plasma cells

412
Q

Person with multiple autoimmune conditions presents with muscle weakness what could be cause

A

Myasthenia gravis

413
Q

What organisms are very likely to cause bronchiectasis

A

Pertussis
Staph aureus

414
Q

What is most specific finding for IDA

A

Pencil cells

415
Q

Rank these as cause of HAI

A. Skin and soft tissue
B. Surgical site
C. Urinary tract
D. Hospital acquired pneumonia
E. Gastrointestinal system

A

1 - E. Gastrointestinal system
2 - C. Urinary tract
3 - D. Pneumonia/ LRTI
4 - B. Surgical site
5 - A. Skin and soft tissue

416
Q

Rank as cause of PUO
A. Dengue
B. Viral haemorrhagic fever
C. Malaria
D. UTIs
E. Bacterial diarrhoea

A

1 - C. Malaria
2 - A. Dengue
3 - E. Bacterial diarrhoea
4 - D. UTIs
5 - B. Viral haemorrhagic fever

417
Q

Rank as cause of anaphylaxis
A. Eggs
B. Penicillin
C. Banana
D. Gliadin
E. Peanut

A

1 - E. Peanut
2 - B. Penicillin
3 - A. Eggs
4 - D. Gliadin
5 - C. Banana

418
Q

Rank from narrow to broad spectrum
A. Meropenem
B. Benzylpenicillin
C. Co-amoxiclav
D. Tazocin
E. Amoxicillin

A

1 - B. Benzylpenicillin
2 - E. Amoxicillin
3 - C. Co-amoxiclav
4 - D. Tazocin
5 - A. Meropenem

419
Q

Superoxide dismutase 1 is a misfolded protein associated with which condition?

A

MND

420
Q

Best treatments for pseudomonas

A

Aminoglycosides are best narrow spectrum
Can also give broad spectrum beta lactams like ceftazidime

421
Q

Meningitis with high opening pressure

A

Cryptococcus

422
Q

Flu like illness a few weeks after contracting HIV

A

HIV seroconversion illness

423
Q

What infection is likely to cause positive result on heterophile test aswell as well as EBV

A

CMV

424
Q

Most appropriate test for EBV

A

EBV IgM as heterophile test can also be positive in CMV

425
Q

What test do before intiating a quinine

A

G6PD test

426
Q

4 causes of massive splenomegaly

A

Certain haematological malignancies (e.g. myelofibrosis, CML, hairy cell leukaemia)
Chronic malaria
Leishmaniasis
Gaucher disease

427
Q

What infection are immunosuppressed kids especially at risk of

A

Adenovirus

428
Q

Most common cause of infectious congenital hearing loss

A

CMV

429
Q

Which causes of diarrhoea have lowest infective dose

A

Noroviris
Shigella

430
Q

Why does the influenza virus only cause respiratory disease?

A

The influenza virus requires activation by host cell proteases that are only expressed in the respiratory tract

431
Q

What is the vector for Trypsanoma brucei rhodesiense?

A

Tsete fly

432
Q

What is the most common cause of late onset sepsis in neonate?

A

Staph epidermis

433
Q

What stain is used to screen TB

A

Auramine

434
Q

What drug is given with cidofovir

A

Probenecid

435
Q

What is rate limiting step in haem synthesis

A

ALA synthase

436
Q

What can denosumab be used to treat other than osteoprosis

A

Giant cell tumours
Metastases

437
Q

Which test would be used to confirm a diagnosis of Cushing’s Syndrome?

A

High dose dexamethasone

438
Q

How would you manage renal failure in a patient with Myeloma?

A

Haemodialysis

439
Q

How would you manage spinal cord compression in a patient with myeloma?

A

Radiotherapy and dexamethasone

440
Q

A man has spherocytes, polychromasia and reticulocytosis on blood film, what is the most likely diagnosis?

A

Hereditary spherocytosis

441
Q

Which viruses are screened for in platelet donations intended for pregnant women?

A

HIV
HBV
CMV

442
Q

How do proteasome inhibitors, such as Bortezomib, work

A

Inhibited protein degradation leads to amino acid build up, shortage and cell death

443
Q

What is the first line biological treatment for Ankylosing Spondylitis?

A

Anti-TNF alpha

444
Q

What would be the most likely diagnosis in a teenage girl who develops an erythematous rash after running in winter?

A

Cold urticaria

445
Q

An HIV patient with a low CD4+ count presents with meningitis. What is the most likely causative organism?

A

Cryptococcus neoformans

446
Q

A lady returns from a holiday in America, where she stayed in Arizona. She presents with systemic symptoms, including a fever. What is the most likely diagnosis and causative organism?

A

Valley fever

Coccidioides

447
Q

Which congenital initially presents asymptomatically

A

CMV

448
Q

Which virus resides in the pharynx and gastrointestinal tract, causes encephalitis in 1/100, and destruction of motor neurones in 1/1000?

A

Polio

449
Q

What is seen on urine dip of pyelonephritis

A

Leukocyte casts

450
Q

What is renal fibrinoid necrosis seen in

A

Malignant HTN

451
Q

A man with known H.Pylori infection has a stomach biopsy. An abnormal area is seen in the antrum, with mitotic figures and cells with a raised nuclear to cytoplasmic ratio. The mass is not invading the basement membrane. What is the most likely diagnosis?

A

Mucosal associated NHL

452
Q

What would you prescribe a patient post-removal of a pituitary adenoma?

A

Desmopressin

453
Q

A man presents with a midshaft femur fracture without a serious history of trauma. What may have caused this?

A

Chondrosarcoma

454
Q

Which breast malignancy may be described as a ‘Fibro-epithelial Tumour with abundant stromal elements’?

A

Phyllodes tumour

455
Q

What are pus cells seen in

A

Pyelonephritis

456
Q

Which testicular cancer is radiosensitive, and typically has a white/smooth appearance?

A

Seminoma

457
Q

A young man presents with a lytic lesion in the diaphysis of his leg. Night pains are relieved by aspirin. What is the most likely diagnosis?

A

Osteoid Osteoma

458
Q

A man goes deaf, and on examination is noted to have bowed legs. What is the most likely diagnosis?

A

Pagets

459
Q

A patient with HIV presents with signs of raised ICP and new onset epilepsy. What is the most likely diagnosis?

A

Primary CNS lymphoma

460
Q

What is the main mechanism behind CMV resistance to antivirals?

A

Protein Kinase mutation

461
Q

Post transplant in child what virus worried about

A

Adenovirus

462
Q

Post HSCT how is CMV treated

A

Foscarnet as ganiciclovir it suppresses the BM

463
Q

A patient who has recently been on a cruise in Japan, where they ate lots of raw seafood, presents with diarrhoea. What is the most likely causative organism?

A

Vibrio parahaemolyiticus

464
Q

How would you treat Candida spp. infections not caused by Candida albicans?

A

Echinocandins

465
Q

A patient with pneumonia has a CXR, which shows a bat wing appearance. What is the most likely causative organism?

A

PJP

466
Q

How are infected prosthetic joints managed?

A

Removal and debridement before Abx

467
Q

A patient returns from a city break in Bangkok complaining of a new, sunburn like rash, a retro-orbital headache and myalgia. What is the most likely diagnosis?

A

Dengue

468
Q

In which infectious disease are ‘Purple eyelids’ a common feature?

A

Chagas

469
Q

Which organism is the most common cause of CNS infections overall?

A

Cocksackie

470
Q

The centre of a granuloma being diffuse red indicates what?

A

Caseating

471
Q

At what level must skin damage be to leave a scar?

A

Dermis

472
Q

What is the role of stellate cells in the liver?

A

Vitamin A stores
Activate to myofibroblasts to lay down collagen

473
Q

In which breast cancer are Indian Files seen?

A

Invasive Lobular

474
Q

In which breast cancer are Empty Spaces seen?

A

Invasive mucinous

475
Q

Which stain is used to distinguish Squamous Cell Carcinomas from Adenocarcinomas?

A

P40

476
Q

Which breast disease shows ‘dilated, calcified ducts’ on histology

A

Fibrocystic disease

477
Q

Breast tumour with leaf like apperance

A

Phyllodes tumour

478
Q

Q
Which breast condition shows:

Cytology: Clusters of cells

Histology: Dilated ducts, polypoid mass in the middle
?

A

Intraductal papilloma

479
Q

What thyroid condition stains with amyloid

A

Medullary carcinoma as calcitonin broken down to amyloid

480
Q

Name one mutation that is associated with Type I endometrial carcinoma.

A

PTEN

481
Q

In which renal condition might you see ‘shrunken kidneys with granular cortices’ and ‘fibrinoid necrosis’?

A

Hypertensive nephropathy

482
Q

What might it indicate if a lung lobe isn’t black on autopsy?

A

Pneumonia

483
Q

In which IgG mediated skin condition might the outer layer of the stratum shear off?

A

Pemphigus follaceous

484
Q

How does Lichen Planus present:

a) on the wrists/arms
b) in the mouth?

A

Arms- red/purplish rash
Mouth- white lines

485
Q

Early versus late phase of asthma

A

Early- Mast cell degranulation and effects
Late- Tissue damage, mucous production, muscle hypertrophy

486
Q

What are the stages of lobar pneumonia?

A

Congestion
Red Hepatisation
Grey Hepatisation
Resolution

487
Q

What is the key feature of grey hepatisation in pneumonia?

A

Intra-alveolar neutrophils

488
Q

In which bone disease might you see ‘Langerhans-type Giant Cells with horseshoe nuclei’?

A

TB

489
Q

In which condition might you see a proliferative synovitis, with pannus formation and grimley sokoloff cells on histology?

A

RA

490
Q

What is the most common genetic predisposition to brain tumours?

A

Neurofibromatosis

491
Q

What is the most common primary brain cancer in adults?

A

Glioblastoma mutliforme

492
Q

What mutation is associated with pilocytic astrocytoma

A

BRAF

493
Q

Which brain cancer displays ‘round cells with clear cytoplasm’ (fried egg appearance)

A

Oligodendroma

494
Q

Which brain cancer shows ‘small blue round cells’ and ‘Horner-Wright Rosettes’?

A

Medulloblastoma

495
Q

Which cytokine plays a key role in development of TH2 cell responses (and hence allergic responses)?

A

IL-4

496
Q

What do TH1 cells release

A

IL-2 or IFN-gamma

497
Q

What is tofacitinib

A

JAK inhibitor

498
Q

Which immunodeficiency may be implicated in a child presenting with recurrent, severe viral infections?

A

NK deficiency

499
Q

How to differentiate between IDA and beta thalassaemia on blood film

A

Basophillic stippling in beta thalassaemia

500
Q

What are the gram positive bacilli

A

Bacillus
Clostridium
Diphteria
Listeria

501
Q

What are gram negative coco bacilli

A

Haemophilus
Bordatella
Pseudomonas
Chlamydia
Brucella

502
Q

Which pneumonia cause shows ‘glossy colonies’ on agar?

A

Haemophilus influenzae

503
Q

What type of organism is entamoeba histolytica

A

Trophozoite with 4 nuclei
Flask shaped ulcer

504
Q

MOA of ribavirin

A

Nuceloside analogue

505
Q

What haem condition is associated with ADAMTS13 mutations other than TTP

A

MAHA

506
Q

What is used as a marker of stem cells?

A

CD34

507
Q

Which stones does renal tubular acidosis predispose to

A

Calcium oxalate

Path (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions