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Past papers 2 Flashcards

1
Q

If have gout in knee, poisoning with what leads to it

A

Lead

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2
Q

Which enzyme is the rate limiting step in de novo purine synthesis?

A

PAT

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3
Q

Which anticoagulant would you use in a patient with DVT and renal failure?

A

Warfarin

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4
Q

Name the first line treatment for Wilson’s Disease.

A

Zinc

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5
Q

What might cause a mildly elevated ALT?

A

Fatty liver

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6
Q

Which protein is defective in Polycystic Kidney Disease?

A

Polycystein-1

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7
Q

Which cause of nephrotic syndrome doesn’t respond to high dose steroids?

A

Membranous

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8
Q

Which cytokine is predominantly responsible for T cell proliferation and survival?

A

IL-2

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9
Q

What infection associated with mixed cryoglobulinaemia

A

Hep C

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10
Q

What is evans syndrome

A

Type II HS seen mainly in CLL
AIHA and ITP

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11
Q

Difference between NF1 and NF2

A

NF 1- astrocytomas, neurofibromas and optic gliomas
NF2 - vestibular schwannomas, meningiomas, ependymomas and astrocytomas

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12
Q

Which syndrome presents with parkinsonism, dystonia, apraxia and ‘alien limbs’ phenomenon?

A

Corticobasal

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13
Q

Which Parkinson Plus Syndrome presents with early autonomic dysfunction?

A

Multiple system atrophy

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14
Q

Which Parkinson Plus syndrome is associated with early falls, axial rigidity, akinesia, dysarthria and dysphagia?

A

Progressive supranuclear palsy

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15
Q

Which tumour is ventricular, and associated with hydrocephalus?

A

Ependyoma

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16
Q

Which brain tumour is soft, gelatinous and calcified?

A

Oligodendroma

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17
Q

Which bacteria is caught through reheated meats, causes diarrhoea and cramps and may cause gas gangrene?

A

Clostridium perfringens

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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

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19
Q

Which group of disorders cause hypoglycaemia, lactic acidosis, hepatomegaly and developmental delay?

A

Glycogen storage

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20
Q

Name two examples of aminoacidopathies, which present with mental retardation, blue eyes and fair hair/skin

A

PKU
Maple syrup disease

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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

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22
Q

Which pathways do CH50 and AP50 reflect

A

CH50- common pathway
AP50- alternative pathway

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23
Q

What do you do to assess allergies if a patient cannot stop anti-histamines or has a history of anaphylaxis?

A

RAST

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24
Q

Which cells may have potential to be utilised as cancer vaccines?

A

Dendritic

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25
Q

For which disease might you use Interferon Beta?

A

Behcets

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26
Q

Give an example of a passive vaccination

A

Varicella Zoster Ig

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27
Q

v

A

Help neutrophils

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28
Q

Which immunohisto stain targets epithelial cells?

A

Cytokeratin

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29
Q

Which leukaemia most commonly causes pancytopaenias?

A

Hairy cell

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30
Q

Main complication of hereditary elliptocytosis

A

Hydrops fetalis

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31
Q

In which condition are target cells commonly seen?

A

SCD

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32
Q

What do you do if a patient on warfarin presents with an INR of 6?

A

Withhold doses until below 5

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33
Q

An immunocompromised patient presents with disseminated TB. What is the most likely diagnosis?

A

Mycobacterium Avium

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34
Q

A man from Australia presents with painless nodules which are beginning to ulcer, scar and contract. What is the most likely diagnosis?

A

Mycobacterium ulcerans

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35
Q

Name a gram negative cocci that can cause typical Pneumonia

A

Moraxella cattarrhalis

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36
Q

What are the gram negative cocci

A

Neisseria species
Moraxalla species

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37
Q

What can cause painful inguinal buboes and genital elephantosis?

A

LGV

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38
Q

How do renal tubular acidosis type 1 and 2 cause acidosis

A

T1- Can’t excrete H+
T2- can’t reabsorb bicarb

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39
Q

When is Urobilinogen raised

A

Pre-hepatic

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40
Q

Which porphyria presents with urine colour change (Port Wine) with abdominal pain?

A

Acute intermittent porphyria

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41
Q

Which Thyroid Disease might display ‘Hurthle Cells’?

A

Hashimotos

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42
Q

What is the most common radiolucent cause of nephrolithiasis?

A

Uric acid

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43
Q

What does Hyxroxycarbimide do?

A

Increase foetal Hb

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44
Q

In which scenario is transfusion a better treatment for iron deficiency than oral iron?

A

Sepsis and severe infection as oral iron won’t absorb well

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45
Q

Management of sideroblastic anaemia

A

Pyridoxine

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46
Q

What would you see on iron studies of a pregnant lady?

A

Pregnancy

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47
Q

in which condition might you see a classical ‘hairs on end’ skull X-Ray?

A

Beta thalassaemia

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48
Q

How do you diagnose Paroxysmal Nocturnal haemoglobulinuria?

A

Hams test

49
Q

When is Vitamin K indicated?

A

INR over 5 and bleeding
INR over 8 and not bleeding

50
Q

Which T Cell lymphoma is most aggressive?

A

Anaplastic

51
Q

Which agent can be used in the management of T Cell Lymphomas

A

Alemtuzumab

52
Q

What does BCG stand for?

A

Bacille-calmette-guerin

53
Q

Name a gram negative rod that causes typical pneumonia

A

Klebsiella

54
Q

How is syphylis investigated?

A

Dark ground microscopy

55
Q

What might cause a urea 10x higher than usual?

A

Upper GI bleed

56
Q

Which HLA is associated with Haemochromatosis?

A

A3

57
Q

What is serum sickness?

A

Type III HS to proteins in penicillin

58
Q

Which hypersensitivity type is Chronic urticaria?

A

Type 2

59
Q

What is Lynch Syndrome/HNPCC?

A

Carcinomas in right colon, associated with gynae cancers

60
Q

Pancreatic cancer positive for lipase, trypsin and chymotrypsin

A

Acinar cell

61
Q

Which stain is used for Alpha-1-antitrypsin deficiency?

A

Periodic acid schiff

62
Q

In which condition might you see ‘wire-loop capillaries’ and ‘lumpy bumpy granular deposition in the GBM’ on a renal biopsy?

A

Lupus nephritis

63
Q

Which breast cancer is associated with BRCA?

A

Basal like carcinoma

64
Q

Which IL-6 Inhibitor can be used in hypoxic COVID?

A

Toclizumab

65
Q

What is zanamivir used for?

A

Hep A and Flu in lung disease

66
Q

What enzymes raised in sarcoid

A

ACE
Alpha 1 hydroxylase

67
Q

What causes osteomyelitis in children?

A

Haem influenza
Group B strep

68
Q

In which condition are ‘Brown Tumours’ seen?

A

Primary hyperparathyroid

69
Q

A woman is prescribed a statin. What would be the expected effect on:

a) LDLs
b) HDLs
c) Triglycerides

A

LDL- reduction
HDL- increase
Triglycerides- slight increase

70
Q

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?

A

Anticonvulsants

71
Q

A patient is found to be in a hyperglycaemic hyperosmolar state. Why must you take care in giving lots of fluids to this patient?

A

Cerebral oedema

72
Q

If a red blood cell is described as ‘polychromatic’ on blood film, what does this mean.

A

Bluish appearance due to taking up eosinophilic and basophilic dyes. Occurs due to the presence of reticulocytes.

73
Q

Which cancers are associated with secondary polycythaemias, and why?

A

Liver
Renal Cell
Ectopic EPO production

74
Q

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?

A

Poxvirus

75
Q

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?

A

Small cell lymphocytic

76
Q

A lymphoma is shown to be positive for CD15 and CD30. Which histological subtype is it most likely to be?

A

Classical hodgkins lymphoma

77
Q

A patient presents with a progressive dry cough. His medical history is notable for treated Hodgkin’s Lymphoma. What is the most likely diagnosis?

A

Pulmonary fibrosis

78
Q

What is staginf for CLL

A

Rai and binet

79
Q

What is mutation in reticular dysgenesis

A

Adenylate kinase 2

80
Q

How would you test function of the alternative complement pathway?

A

AP50

81
Q

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?

A

Mannose binding leptin

82
Q

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?

A

Anisopoikilocytosis
Iron Deficiency Anaemia

83
Q

An infant is found to have very low T Cells, very low B Cells and very low NK Cells?

A

Adenosine deaminase

84
Q

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?

A

Salmonella enteritidis

85
Q

Which enteric bacterium has the lowest infective dose?

A

Shigella

86
Q

A patient presents with descending paralysis. he reports visiting a farm recently and trying their honey. What is the most likely causative organism?

A

Clostridium botulinum

87
Q

Treatment for entamoeba histolytica

A

Metronidazole

88
Q

What type of drug is lopinavir?

A

Protease inhibitor

89
Q

What is the most common cause of hospital-acquired pneumonia?

A

Enterobacteriaciae (E.Coli, Klebsiella)

90
Q

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?

A

Chronic bronchitis

91
Q

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?

A

Asthma

92
Q

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?

A

Emphysema

93
Q

What is the most common cause of a non-anaemic macrocytosis?

A

Alcohol

94
Q

What is the most common oestrogen-secreting tumour?

A

Mucinous cystadenoma

95
Q

What is the most common malignancy in Equatorial Africa?

A

Burkitts lymphoma

96
Q

What is the most common cause of Cerebral Infarction?

A

Cerebral atherosclerosis

97
Q

What is the most common cause of Nephrotic Syndrome in Afro-Caribbean people?

A

FSGS

98
Q

Most common benign tumour of the bone

A

Osteochondroma

99
Q

What is the most common Neuroepithelial Tumour?

A

Astrocytoma

100
Q

What is the most common location for an undescended testis?

A

Inguinal canal

101
Q

What is the treatment for aspiration pneumonia?

A

Tazocin and metronidazole

102
Q

What is the second line management for Minimal Change Disease?

A

Ciclosporin

103
Q

How is Salmonella treated?

A

Ceftriazone

104
Q

How is Campylobacter treated?

A

Erythomycin/ciprofloxacin

105
Q

How would you manage someone with Vitamin K Deficiency who is acutely haemorrhaging?

A

FFP

106
Q

How might Myasthenia Gravis be treated?

A

Neostigmine

107
Q

How is Burkitt’s Lymphoma treated?

A

Rituximab

108
Q

How is Haemochromatosis treated?

A

Desferrioxamine
Venesection

109
Q

How to differentiate between TRALI and TACO

A

TRALI has hypotension

110
Q

Patient with thymoma and proximal muscle weakness

A

Myasthenia gravis

111
Q

Neutropenic sepsis most common cause

A

Staph epidermis- coagulase negative

112
Q

What is fastest growing known tumour

A

Burkitts lymphoma

113
Q

Which bone tumour metastasises rapidly to the lungs

A

Osteosarcoma

114
Q

What do ewings sarcoma vs osteosarcomas form

A

Osteosarcomas- bone
Ewings sarcoma- mesenchymal tissue

115
Q

Which inherited disorder of metabolism can lead to recurrent E coli infections

A

Galactossaemia

116
Q

Which infection does C3 infection predominantly predispose to

A

N meningitidis

117
Q

What is CSF finding of neurosyphyllis

A

High lymphocytes
High protein

118
Q

What does Alk-1 mean in anaplastic lymphoma

A

Good prognosis

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