Past papers 2 Flashcards
1
Q
If have gout in knee, poisoning with what leads to it
A
Lead
2
Q
Which enzyme is the rate limiting step in de novo purine synthesis?
A
PAT
3
Q
Which anticoagulant would you use in a patient with DVT and renal failure?
A
Warfarin
4
Q
Name the first line treatment for Wilson’s Disease.
A
Zinc
5
Q
What might cause a mildly elevated ALT?
A
Fatty liver
6
Q
Which protein is defective in Polycystic Kidney Disease?
A
Polycystein-1
7
Q
Which cause of nephrotic syndrome doesn’t respond to high dose steroids?
A
Membranous
8
Q
Which cytokine is predominantly responsible for T cell proliferation and survival?
A
IL-2
9
Q
What infection associated with mixed cryoglobulinaemia
A
Hep C
10
Q
What is evans syndrome
A
Type II HS seen mainly in CLL
AIHA and ITP
11
Q
Difference between NF1 and NF2
A
NF 1- astrocytomas, neurofibromas and optic gliomas
NF2 - vestibular schwannomas, meningiomas, ependymomas and astrocytomas
12
Q
Which syndrome presents with parkinsonism, dystonia, apraxia and ‘alien limbs’ phenomenon?
A
Corticobasal
13
Q
Which Parkinson Plus Syndrome presents with early autonomic dysfunction?
A
Multiple system atrophy
14
Q
Which Parkinson Plus syndrome is associated with early falls, axial rigidity, akinesia, dysarthria and dysphagia?
A
Progressive supranuclear palsy
15
Q
Which tumour is ventricular, and associated with hydrocephalus?
A
Ependyoma
16
Q
Which brain tumour is soft, gelatinous and calcified?
A
Oligodendroma
17
Q
Which bacteria is caught through reheated meats, causes diarrhoea and cramps and may cause gas gangrene?
A
Clostridium perfringens
18
Q
Which lysosomal disorder occurs due to a defect in Hexoaminidase A, and leads to lipid accumulation, nervous damage and death at a young age?
A
Tay-sachs
19
Q
Which group of disorders cause hypoglycaemia, lactic acidosis, hepatomegaly and developmental delay?
A
Glycogen storage
20
Q
Name two examples of aminoacidopathies, which present with mental retardation, blue eyes and fair hair/skin
A
PKU
Maple syrup disease
21
Q
How does the mannose binding pathway work?
A
MBL binds to microbial cell surface carbohydrates, which stimulates C2/4 of the classical pathway
22
Q
Which pathways do CH50 and AP50 reflect
A
CH50- common pathway
AP50- alternative pathway
23
Q
What do you do to assess allergies if a patient cannot stop anti-histamines or has a history of anaphylaxis?
A
RAST
24
Q
Which cells may have potential to be utilised as cancer vaccines?
A
Dendritic
25
For which disease might you use Interferon Beta?
Behcets
26
Give an example of a passive vaccination
Varicella Zoster Ig
27
v
Help neutrophils
28
Which immunohisto stain targets epithelial cells?
Cytokeratin
29
Which leukaemia most commonly causes pancytopaenias?
Hairy cell
30
Main complication of hereditary elliptocytosis
Hydrops fetalis
31
In which condition are target cells commonly seen?
SCD
32
What do you do if a patient on warfarin presents with an INR of 6?
Withhold doses until below 5
33
An immunocompromised patient presents with disseminated TB. What is the most likely diagnosis?
Mycobacterium Avium
34
A man from Australia presents with painless nodules which are beginning to ulcer, scar and contract. What is the most likely diagnosis?
Mycobacterium ulcerans
35
Name a gram negative cocci that can cause typical Pneumonia
Moraxella cattarrhalis
36
What are the gram negative cocci
Neisseria species
Moraxalla species
37
What can cause painful inguinal buboes and genital elephantosis?
LGV
38
How do renal tubular acidosis type 1 and 2 cause acidosis
T1- Can't excrete H+
T2- can't reabsorb bicarb
39
When is Urobilinogen raised
Pre-hepatic
40
Which porphyria presents with urine colour change (Port Wine) with abdominal pain?
Acute intermittent porphyria
41
Which Thyroid Disease might display ‘Hurthle Cells’?
Hashimotos
42
What is the most common radiolucent cause of nephrolithiasis?
Uric acid
43
What does Hyxroxycarbimide do?
Increase foetal Hb
44
In which scenario is transfusion a better treatment for iron deficiency than oral iron?
Sepsis and severe infection as oral iron won't absorb well
45
Management of sideroblastic anaemia
Pyridoxine
46
What would you see on iron studies of a pregnant lady?
Pregnancy
47
in which condition might you see a classical ‘hairs on end’ skull X-Ray?
Beta thalassaemia
48
How do you diagnose Paroxysmal Nocturnal haemoglobulinuria?
Hams test
49
When is Vitamin K indicated?
INR over 5 and bleeding
INR over 8 and not bleeding
50
Which T Cell lymphoma is most aggressive?
Anaplastic
51
Which agent can be used in the management of T Cell Lymphomas
Alemtuzumab
52
What does BCG stand for?
Bacille-calmette-guerin
53
Name a gram negative rod that causes typical pneumonia
Klebsiella
54
How is syphylis investigated?
Dark ground microscopy
55
What might cause a urea 10x higher than usual?
Upper GI bleed
56
Which HLA is associated with Haemochromatosis?
A3
57
What is serum sickness?
Type III HS to proteins in penicillin
58
Which hypersensitivity type is Chronic urticaria?
Type 2
59
What is Lynch Syndrome/HNPCC?
Carcinomas in right colon, associated with gynae cancers
60
Pancreatic cancer positive for lipase, trypsin and chymotrypsin
Acinar cell
61
Which stain is used for Alpha-1-antitrypsin deficiency?
Periodic acid schiff
62
In which condition might you see ‘wire-loop capillaries’ and ‘lumpy bumpy granular deposition in the GBM’ on a renal biopsy?
Lupus nephritis
63
Which breast cancer is associated with BRCA?
Basal like carcinoma
64
Which IL-6 Inhibitor can be used in hypoxic COVID?
Toclizumab
65
What is zanamivir used for?
Hep A and Flu in lung disease
66
What enzymes raised in sarcoid
ACE
Alpha 1 hydroxylase
67
What causes osteomyelitis in children?
Haem influenza
Group B strep
68
In which condition are ‘Brown Tumours’ seen?
Primary hyperparathyroid
69
A woman is prescribed a statin. What would be the expected effect on:
a) LDLs
b) HDLs
c) Triglycerides
LDL- reduction
HDL- increase
Triglycerides- slight increase
70
A lady presents with osteomalacia secondary to Vitamin D deficiency. Her medical history is remarkable for one, long term, well controlled condition. Which class of drugs are most likely to have contributed to her deficiency?
Anticonvulsants
71
A patient is found to be in a hyperglycaemic hyperosmolar state. Why must you take care in giving lots of fluids to this patient?
Cerebral oedema
72
If a red blood cell is described as ‘polychromatic’ on blood film, what does this mean.
Bluish appearance due to taking up eosinophilic and basophilic dyes. Occurs due to the presence of reticulocytes.
73
Which cancers are associated with secondary polycythaemias, and why?
Liver
Renal Cell
Ectopic EPO production
74
A patient presents with a rash and coryzal symptoms. They are found to have a basophilia on blood film. Which class of virus are they most likely to be infected with?
Poxvirus
75
A patient presents with a rash and coryzal symptoms. They are found to have a basophilia on blood film. Which class of virus are they most likely to be infected with?
Small cell lymphocytic
76
A lymphoma is shown to be positive for CD15 and CD30. Which histological subtype is it most likely to be?
Classical hodgkins lymphoma
77
A patient presents with a progressive dry cough. His medical history is notable for treated Hodgkin’s Lymphoma. What is the most likely diagnosis?
Pulmonary fibrosis
78
What is staginf for CLL
Rai and binet
79
What is mutation in reticular dysgenesis
Adenylate kinase 2
80
How would you test function of the alternative complement pathway?
AP50
81
A patient undergoing chemotherapy presents with recurrent infections and low neutrophil counts. They never experienced similar issues before starting chemotherapy. What is the most likely diagnosis?
Mannose binding leptin
82
A patient is found to be anaemic, and has lots of variation in the size and shape of erythrocytes on blood film. What is this sign called, and what is the likely cause of their anaemia?
Anisopoikilocytosis
Iron Deficiency Anaemia
83
An infant is found to have very low T Cells, very low B Cells and very low NK Cells?
Adenosine deaminase
84
A man presents with non-bloody loose stools. He does not have a fever. He recently ate some chicken. Culture grows Gram Negative Rods. What is the likely causative organism?
Salmonella enteritidis
85
Which enteric bacterium has the lowest infective dose?
Shigella
86
A patient presents with descending paralysis. he reports visiting a farm recently and trying their honey. What is the most likely causative organism?
Clostridium botulinum
87
Treatment for entamoeba histolytica
Metronidazole
88
What type of drug is lopinavir?
Protease inhibitor
89
What is the most common cause of hospital-acquired pneumonia?
Enterobacteriaciae (E.Coli, Klebsiella)
90
A patient presents with a chronic productive cough. Biopsy shows dilatation of the airways, goblet cell hyperplasia and hypertrophy of mucous glands. What is the most likely diagnosis?
Chronic bronchitis
91
A child presents with episodes of cough and wheeze, with associated dyspnoea. They have a history of eczema. Histology shows whorls of shed epithelium, eosinophils and Charcot-Leyden Crystals. What is the most likely diagnosis?
Asthma
92
A patient presents with dyspnoea and cough. Histology shows loss of the alveolar parenchyma distal to the terminal bronchiole. What is the most likely diagnosis?
Emphysema
93
What is the most common cause of a non-anaemic macrocytosis?
Alcohol
94
What is the most common oestrogen-secreting tumour?
Mucinous cystadenoma
95
What is the most common malignancy in Equatorial Africa?
Burkitts lymphoma
96
What is the most common cause of Cerebral Infarction?
Cerebral atherosclerosis
97
What is the most common cause of Nephrotic Syndrome in Afro-Caribbean people?
FSGS
98
Most common benign tumour of the bone
Osteochondroma
99
What is the most common Neuroepithelial Tumour?
Astrocytoma
100
What is the most common location for an undescended testis?
Inguinal canal
101
What is the treatment for aspiration pneumonia?
Tazocin and metronidazole
102
What is the second line management for Minimal Change Disease?
Ciclosporin
103
How is Salmonella treated?
Ceftriazone
104
How is Campylobacter treated?
Erythomycin/ciprofloxacin
105
How would you manage someone with Vitamin K Deficiency who is acutely haemorrhaging?
FFP
106
How might Myasthenia Gravis be treated?
Neostigmine
107
How is Burkitt’s Lymphoma treated?
Rituximab
108
How is Haemochromatosis treated?
Desferrioxamine
Venesection
109
How to differentiate between TRALI and TACO
TRALI has hypotension
110
Patient with thymoma and proximal muscle weakness
Myasthenia gravis
111
Neutropenic sepsis most common cause
Staph epidermis- coagulase negative
112
What is fastest growing known tumour
Burkitts lymphoma
113
Which bone tumour metastasises rapidly to the lungs
Osteosarcoma
114
What do ewings sarcoma vs osteosarcomas form
Osteosarcomas- bone
Ewings sarcoma- mesenchymal tissue
115
Which inherited disorder of metabolism can lead to recurrent E coli infections
Galactossaemia
116
Which infection does C3 infection predominantly predispose to
N meningitidis
117
What is CSF finding of neurosyphyllis
High lymphocytes
High protein
118
What does Alk-1 mean in anaplastic lymphoma
Good prognosis
