Past papers Flashcards
Management for ethylene glycol overdose
Fomepizole
Burkitt’s lymphoma karyotype
T8:14
What is the mode of inheritance and defect of Alport’s syndrome
X-linked dominant type IV collagen
Screening for PKD
USS
47-year-old female with a history of rheumatoid arthritis presents with a painful and red left eye
Scleritis
Churg-Strauss syndrome serololgy
+ pANCA
85-year-old lady presents to dermatology clinic complaining of itchy white plaques affecting her vulva and inner thigh
Lichen sclerosus
Marfan’s syndrome is caused by a mutation in protein?
fibrillin-1
Angiodysplasia is associated with which murmur?
Aortic stenosis
Which TB medication can cause lupus?
Isoniazid
Which organelle is responsible for the catabolism of long chain fatty acids?
Peroxisome
Dermatitis herpetiformis is associated with
HLA-DR3
Which cell surface marker is associated with Reed-Sternberg cells?
CD15
What is the mechanism of cyanide toxicity?
Inhibits the mitochondrial enzyme cytochrome c oxidase
myocardial territory is most likely to have been affected if heart block develops post MI
inferior
Which phase in the cycle is influenced by p53 and determines the cell cycle length?
G1
Congenital adrenal hyperplasia is most commonly due to?
21-hydroxylase deficiency
What is the first-line long term therapy to reduce the occurrence of sickle cell indicents
Hydroxycarbamide
Bilateral spastic paresis and loss of pain and temperature sensation, what is affected
Anterior spinal artery syndrome1
1st line management in aspirin overdose
activated charcoal within 1 hr
Triangle of safety for chest drain insertion
Superiorly: base of the axilla.
Inferiorly: 5th intercostal space or level of the nipple.
Anteriorly: lateral edge of pectoralis major.
Posteriorly: anterior border of latissimus dorsi.
Chlamydia psittaci is treated with
tetracyclines
The fastest conduction velocities in the heart are in the
Purkinje fibres
Functional residual capacity =
Expiratory reserve volume + Residual volume
Meningococcal meningitis prophylaxis for contacts
Oral cipro
management to reduce the likelihood of haemorrhagic cystitis in non-Hodgkins pt receiving cyclophosphamide
Hydration + mesna
most common and severe form of renal disease in SLE patients
Diffuse proliferative glomerulonephritis
Where do SGLT-2 inhibitors work?
renal proximal convoluted tubule
Which oncogene is associated with Burkitt’s lymphoma?
c-MYC
Management of severe alcoholic hepatitis
Pred
Antidiuretic hormone action
water reabsorption by the insertion of aquaporin-2 channels
28-year-old man painful gential ulcers, diagnosis and asscioated organism
Chancroid
Haemophilus ducreyi
How is Cryptosporidium diagnosed
Ziehl-Neelsen staining of stool to reveal red cysts
Local anesthetic toxicity can be treated with
IV 20% lipid emulsion
Pan-systolic murmur which is best heard at the end of inspiration
Murmur and associated JVP change
Tricuspid regurg
Prominent V waves
Reflux nephropathy investgation
Micturating cystography
calcium, phosphate and PTH unaffected with ALP raised
Diagnosis and management
Pagets
zoledronate
low calcium and low phosphate with increased ALP and increased PTH.
Diagnosis & risk factor
osteomalacia
vegetarian
tenosynovitis, migratory polyarthritis, dermatitis
Diagnosis
Disseminated gonococcal infectio
Unilateral Flashes + floaters
diagnosis
posterior vitreous detachment
Which phase does vincristine act during
metaphase
Which spinal columns are affected in subacute combined degeneration of the spinal cord,
dorsal columns and lateral corticospinal tracts
Which part of the kidney is most affected in nephrogenic DI
Vasopressin receptor
Bisphosphonate action
inhibit osteoclasts
AF on warfarin with ICH, management
Vit K and prothrombin complex
Suspicious freckle on face or scalp of chronically sun-exposed patients
pigmented and rapidly changing
Lentigo maligna melanoma
Thyrotoxic storm management
beta blockers, propylthiouracil and hydrocortisone
How do you differentiate between chronic myeloid leukaemia from leukaemoid reactions
leukocyte alkaline phosphatase score is low in CML, high in leukaemoid reaction
The time taken for an arteriovenous fistula to develop is
6-8 weeks
Cushing’s syndrome VBG
Hypokalaemic metabolic alkalosis
Brain abscess management
IV Cefotaxime and metronidazole
Where is phosphate reabsorbed
proximal tubule
A high vaginal swab is performed and microscopy reveals stippled vaginal epithelial cells and the whiff test is positive.
Diagnosis and organism
BV
Gardnerella vaginalis
worse on resisted wrist extension/suppination whilst elbow extended
Lateral epicondylitis
management of eosinophilic oesophagitis
Dietary modification and topical steroids
Peripheral blood film findings in coeliac
Target cells and Howell-Jolly bodies
Metastatic bone cancer pain management
MST + refer for radiotherapy
Poor prognostic factors in AML
A age more than 60
M myeloblast more than 20% (> 20% blasts after first course of chemo)
L cytogenetic location : deletions of chromosome 5 or 7 (Acute = 5 letters , myeloid = 7 letters )
Thyrotoxicosis with tender goitre
De Quervain’s thyroiditis
Which glomerulonephritis is most associated with Goodpasture’s syndrome?
Rapidly progressive glomerulonephritis
treatment of choice for allergic bronchopulmonary aspergillosis
PO glucocorticoids
Which meds cause toxicity due to zero order elimination
There is zero order in a HEAP
Heparin
Ethanol
Aspirin
Phenytoin
Which group of medications are associated with increased mortality in dementia patients
Anti-psychotics
Which meds cause photosensitive rash
SAT for a PHOTO:
Sulphonamides/Sulphonylureas/pSoralens/Siprofloxacin
Amiodarone/nsAids
Tetracycline/Thiazides
What is raised in acute intermittent porphyria
urinary porphobilinogen
42-year-old woman with pseudoxanthoma elasticum which conditions is she at risk of
mitral valve prolapse and ischaemic heart disease
32-year-old female 3-week history of a mild rash on her face very sensitive to the sunlight two months postpartum
Diagnosis and mangement
Acne rosacea
Topical metronidazole/PO tetracycline
Which structure may overlie the L renal hilum
Tail of pancreas
Why can alcohol cause hypoglycaemia
Increased first phase insulin response
HOCM inheritance pattern
Autosomal dom
42 female with SLE, presents with dry eyes
Diagnosis and +Ve antibodies
Sjorens
Anti-Ro and Anti La
27 male, night sweats, weight loss, gential ulcers, arthralgia, red itch eyes
diagnosis and management
Bechets (uveitis, oral and gential ulcers)
Pred
46 female, HTN, T2DM
swollen hands/fingers and increasing size of jaw
investigation and diagnosis
IGF1 - raised
Glucose tolerance test with GH measurements (GH >1)
acromegaly
wasting of thenar eminence , reduced sentation over 2nd and 3rd fingertips
nerve affected and condition
distal median nerve
carpal tunnel
loss of sensation over dorsal and radial portion of hand, dorsal thumb and dorsal index finger, motor intact
nerve affected
distal radial
History of CVD, sudden unilateral deterioration in vision
pale retina on fundoscopy
CRAO
Police officer bitten by human, broken skin and blood drawn
Management
Co-amox if <72h
Likely organism to colonate platelet transfusion
staph epidermidis
19 male, struggles to form relationships, tall, thin, sparse pubic hair, bilateral gynaecomastia
Diagnosis and chromosomes
Klienfelter
XXY
18 male, prolonged bleeding following tooth extraction, sister had similar thing
Diagnosis and inheritance and prophylaxis
VWD
autosomal dom
desmopression prior to procedures
Test for infectious TB
Multiple sputum smear and culture
Marfans Murmur
pulmonary regurg
Lyme disease management
doxy
19 male
atopic eczema, admitted with multiple itchy pustules, fever
Diagnosis and management
eczema herpaticum
IV aciclovir
DRB1 *04:01 *04:04 *10 *01:10
RA
Loss of proprioception and vibration, upgoing plantars, optic neuritis
Vit B12 def
smoker
bilateral lower limb weakness with increased tone and hyperreflexia
Conus medallaris
Digoxin MOA
Intracellular Na accumulation - inhibits sodium potassium exchange pump
male, unprotected sex in India, single painless ulcer on penis + lymphadenopathy
Diagnosis and management
Lymphogranuloma Venereum
Doxy
60 male returning from convention in Portugal, fever, joint/muscle pain, diarrhoea
Diagnosis and managment
Legionnaires disease
Levo
Diabetic retinopathy, has received full scatter pan-retinal photocoagulation, which visual defects may he have
tunnel vision
reduced colour
impaired contract sensitivity
45 returned from Russia, coryzal symptoms followed by fever , severe sore throat and nose bleeds. grey/white membrane over pharyngeal tissue
diagnosis and management
Diptheria
azithromycin
20 male, no PMH, sudden onset palps whilst drinking
ECHO normal
ECG shows new AF
Haemodynamically stable
Management
Flecanide
Amaurosis fugax artery affected
internal carotid
How frequently should you monitor bloods in stable diabetic
6 months
Poor prognostic factors in PPH
Elevated BNP
Developing AF
70 male sudden onset vomiting, vertigo and R sided Horners , L sided loss of pain/temp in torso and limbs
Diagnosis
R PICA
Phosphate reabsorption
prox tubule
Management of persistent ascites in liver pts
spiro
19 female, syncope, muscle cramps and tiredness
hypokalaemia
high bicarb
high urine calcium
diagnosis and management
Bartter syndrome
K+ replacement
Calcium oxelate stone managemetn
thiazide diuretic
Abnormal resp test in obesity
exp reserve volume
25, UC
rapidly growing ulcerated lesion on shin with necrotic centre
diagnosis and management
pyoderma gangrenosum
PO pred
61 female, HTN, DM
sore throat, rash and mouth ulcers, conjunctivitis
diagnosis
Steven Johnson syndrome
