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Year 5 Pathology > Past Papers ChemPath > Flashcards

Past Papers ChemPath Flashcards

1
Q

24 y/o asymptomatic man
isolated rise in unconjugated bilirubin
other results (ALT, ALP etc normal)

A

Gilbert’s

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2
Q

22 year old student
two weeks anorexia, fever and malaise – raised ALT
normal/super mildly raised ALP + GGT

A

Viral Hepatitis

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3
Q

Women,colicky abdominal pain.
mildly elevated ALP, ALT, GGT, & Bilirubin.
GGT + Bilirubin most raised

A

Post hepatic cause

  • gallstones/acute cholestasis
  • head of pancreas Ca
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4
Q 
57 y/o man presents 
 hematemesis 
High ALT + GGT
slightly raised ALP
Low Albumin.
A

Alcohol induced hepatitis

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5
Q

elderly man
v high ALP
headache

A

Paget’s

disorder bone remodelling

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6
Q

Increased AST > Increased ALT (2:1)

> Increased GGT + ALP

A

Alcoholic liver disease (aSt wavy - drunk)

NAFLD

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7
Q

Increased ALT > Increased AST (1:<1)

> Increased GGT + ALP

A

Viral hepatitis

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8
Q

Raised Bilirubin - unconjugated

A

haemolysis

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9
Q

Raised Bilirubin - conjugated

A

damage to the liver or the gallbladder/bileduct

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10
Q

high ALP and GGT

raised conj bilirubin

A

cholestasis

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11
Q

Normal GGT + Raised ALP

A

Paget’s

or placenta

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12
Q

Bicarbonate in a pyloric stenosis patient

A

high bicarb

low K, N Na

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13
Q

oral glucose tolerance test

impaired glucose tolerance reading

A

OGTT 7.8 - 11.1

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14
Q

Calculate plasma osmolality

A

2(Na + K) + Urea + Glucose

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15
Q

Normal fasting blood glucose

A

<6.1

and >4

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16
Q

OGTT normal glucose

A

<7.8 (at 2hr reading)

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17
Q

Impaired fasting glucose

A

Fasting glucose 6.1 - 6.9

OGTT 7.8 - 11.1

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18
Q

Diabetes random blood glucose

A

> 11.1

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19
Q

HbA1c:
normal
pre-diabetes
diabetes

A

Normal <6.0%
Prediabetes - 6.0% to 6.4%
Diabetes > 6.5%

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20
Q

Low sodium, all else (K+, CL-) normal

Glucose before OGTT is 4.9, 2 hours later is 10

A

Impaired OGTT

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21
Q

teen
polyuria and polydipsia
wt loss

A

T1DM

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22
Q

high Na
low K
high urine osmolality

A

Conn’s

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23
Q

K in DKA metabolic acidosis

A

high

as no insulin

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24
Q

high sodium
high potassium
plasma osmolality ~400
urine osmolality ~600

A

SIADH

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25
Q

60 y/o

abdominal pain radiating to back, collapses and dies

A

AAA

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26
Q

ex-smoker
hypertension and MI
sudden chest pain which radiates to the neck

A

Descending internal carotid thrombus

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27
Q

50 y/o F,

memory issues/progressive amnesia, hypertension

A

Multiple cerebral/(?cortical) infarcts

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28
Q

man with atrial fibrillation with right flank pain

A

Renal infarct

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29
Q

MI 3 years ago
unwell
sample from pericardial layer -blood

A

Ventricular rupture

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30
Q

Itchiness of the skin more likely in hepatitis or intravascular haemolysis

A

hepatitis

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31
Q

ulcers on mouth following treatment with a drug

A
  • Steven-Johnson Syndrome
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32
Q

which ion low if pt urinating a lot?

A

Na

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33
Q

Na 119 K 4.5
Plasma osmolality 249
Urine Na 54
Urine osmolality 530

Diagnosis?

A

SIADH

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34
Q

Pt hits head, polyuria and polydipsia
Na 130 K 4 U 2.2 Cr 57

Diagnosis?

A

psychogenic polydipsia

diabetes insipidus if high Na (as no ADH to reabsorb water)

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35
Q 
40 y/o renin 6.4 (high)
aldosterone 1200 (high)
A

renal artery stenosis (high renin plus Ald)

NB Conn’s has just high Ald

36
Q

ACEi improve/worsen Creatinine within days of starting?

A

worsen

37
Q

Plasmodium species treated with Primaquine

A

P. vivax

38
Q

Form malaria injected into host

A

Sporozoite

39
Q

First line non-falciparum malaria

A

Chloroquine

40
Q

In multiple myeloma, how would you manage: hypercalcaemia

A

fluid + BISPHOSPHONATES

41
Q

In multiple myeloma, Mx of spinal cord compression

A

Dexamethasone

42
Q

In multiple myeloma, Mx of hyperviscosity

A

Venesection

43
Q

INR of pt with AF

A

INR 2-3

44
Q

Pt with prosthetic valve and AF

A

INR 2.5-3.5

45
Q

Blood monitoring of Old lady who had cancer having aspirin and clopidogrel

A

not needed

46
Q

Which organism?

returning from Afghanistan has a small ulcer on right ring finger that won’t heal and keeps getting bigger

A

Leishmania

47
Q

Liver cyst, travel to South America

A

Entamoeba histolytica

48
Q

HIV, pneumonia

Ground glass CXR

A

PCP

49
Q

Renal transplant CXR halo sign

Organism?

A

Aspergillosis

50
Q

mechanism in the oesophagus as a result of reflux (GORD) that takes place and leads to cancer?

A

dysplasia

51
Q

mucous producing cancer in lungs

A

Mucinous adenocarcinoma

52
Q

NOD2/CARD15, what is it found in?

A

Crohn’s

53
Q

Immunodeficiency with common gamma chain problem?

A

X-linked SCID

54
Q

Swollen joint, needle-shaped aspirate with negative birefringence, what is the enzyme responsible

A

Xanthine Oxidase

55
Q

Long term Tx for gout

A

Colchicine

56
Q

JC virus cause?

A

Progressive Multifocal Leukoencephalopathy

57
Q

Reactivation of a virus following a transplant

A

Epstein Barr Virus

58
Q

Most common virus causing aseptic meningitis

A

Coxsackie or echovirus

59
Q

Smear cells

A

Chronic LYMPHOCYTIC leukaemia

60
Q

15 yo with brain tumour extends outwards from cerebellum and invading subarachnoid space. Signs of ataxia

A

medulloblastoma

cerebral low grade /commonest in kids = pilocytic astrocytoma

61
Q

Diabetes, fatty stools, weight loss, ‘slate grey skin’ and joint pains

A

Haemachromatosis (joint pain, skin changes, pancreatitis, liver deposition

62
Q

5yr old, tetany, bone pain. Widened epiphyses + ‘Cupping’ of metaphysis shown on x-ray. What is the cause?

A

Rickets

63
Q

minimum amount of time to treat a VTE?

A

3 months

64
Q

Mother is a donor for kidney to a child, what is the max number of mismatches possible with HLA class I?

A

3 out of 6

65
Q
  1. Ovarian tumour with hair. No immature cells seen
A

Mature teratoma

66
Q

liver enzyme is raised in MI

A

AST Aspartate aminotransferase

67
Q

Old man who fell over, been on floor for days. Severely dehydrated. Dark urine. Not blood on microscopy. What causes the dark urine?

A

Myoglobin

Creatine Kinase MM will be HIGH

68
Q

Multiple myeloma and restrictive cardiomyopathy. What will you see on heart biopsy?

A

Amyloid depositions AL (light chain)

69
Q

macrocytic anaemia, atrophy of body of stomach. What substance are they deficient in that leads to B12 malabsorption?

A

Intrinsic Factor

70
Q

IVDU man is given Rituximab - CHOP treatment for Non-Hodgkin’s lymphoma. He later 8 months later develops fulminant liver failure and dies. Why?

A

Hep B reactivation

71
Q

coagulation factor is decreased first on administration of warfarin?

A

Factor VII

72
Q

White things on the oesophagus seen in OGD of an alcoholic man with recurrent bleeding varices.

A

Oesophageal Candidiasis

73
Q

Mexico and ate unpasteurized dairy + diarrhoea?

A

Brucellosis

74
Q

apthous ulcers

A

Crohn’s

75
Q

Which type of cell does Rituximab target?

A

Mature B cells

76
Q

How does HepA spread

A

Faeco oral

77
Q

CLL with p53 mutation Tx

A

Ibrutinib (TK mutation)

less aggressive CLL (no p53 mutation) = watch and wait

78
Q

Prophylaxis for allograft rejection

A

BASILIXIMAB (anti-CD25)

Tacrolimus/Cyclosporin (calcineurin inhibitor)

79
Q 
Which allergy is more likely to present in child than adult? 
•	OAS 
•	Egg
•	Bee
•	Pollen
A

Egg

80
Q

natural antibody that confers protective immunity against HIV

A

gp120 and anti gp41 +

81
Q

Common cause of cellulitis

A

Staph Aureus

B haemolytic Strep - Strep PYOGENES

82
Q

Ion raised in red cell lysis

A

Potassium

83
Q

HTLV1 Virus lymphoma

A

Adult t cell lymphoma/leukaemia

84
Q

Lower in pregnancy

A

Protein S

Factor XI

Plt, Hct, Hb all lower too

85
Q

How does melanoma spread?

A

LN

86
Q

Metabolic disturbance of CAH

A

No Aldosterone - LOW Na, HIGH K

No Cortisol - low Glucose

87
Q

Causes DIC in pregnancy

A

Amniotic fluid embolism
placental abruption
retained dead fetus
pre-eclampsia (severe)

Year 5 Pathology (13 decks)

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