Past Papers etc Flashcards
Biggest risk factor for colonic carcinoma:
1) Crohn’s
2) Diverticular disease
3) IBS
4) Peutz-Jeghers
5) UC
UC
In which condition would you choose allogeneic BMT over autologous?
1) Acute leukaemia
2) BM failure
3) Chronic leukaemia
4) Myeloma
5) Lymphoma
BM
Name 3 mixed pattern autoinflammatory conditions.
Behcet’s
Psoriatic arthritis
Axial spondyloarthritis
MOA of corticosteroids?
Inhibits phospholipase A2
By which mechanism does sarcoidosis cause hypercalcaemia?
Ectopic expression of 1 alpha hydroxylase
Abx for pseudomonas aeruginosa lung infection?
Gentamicin
What inhibits thromboxane a2?
Aspirin
Most sensitive marker of liver damage?
PT
Superoxide dismutase 1 is a misfolded protein associated with which condition?
Motor neurone disease
Name 2 organisms which cause bronchopneumonia.
HiB and Klebsiella pneumoniae
What are some causes of interstitial pneumonia?
Mycoplasma and viruses
Most common cause of CNS infections?
Coxsackie group B
What does aseptic meningitis mean?
Viral
Name an intracellar gram -ve coccus.
Neisseria
Condition which causes failure to produce neutrophils?
Kostmann syndrome
Rank these in terms of highest to lowest calcium. Parathyroid carcinoma 1o hyperparathyroidism 2o hyperparathyroidism Osteoporosis Osteomalacia
Parathyroid carcinoma 1o hyperparathyroidism Osteoporosis 2o hyperparathyroidism Osteomalacia
Which would have a higher plasma osmolality: pneumonia or DI?
DI has higher osmolality than pneumonia
What is the function of gastrin? What stimulates its release?
Gastrin enhances HCl secretion
Vagus nerve controls both HCl production and gastrin release
What is zollinger ellison syndrome?
Tumour of islet cells of pancreas that increase HCl production
Which condition has higher gastrin production: H pylori infection or Zollinger Ellison syndrome?
H pylori has higher gastrin release than ZES
What is thyroxine bound to in order?
Thyroxine binding globulin
Thyroxine binding pre-albumin
Albumin
Free
Name 2 most common causes of PUO.
Malaria
Dengue
(then: diarrhoea, UTI, VHF)
Rank these in terms of the most likely cause of a collection around T12 in a IVDU: Staph aureus Pseudomonas Strep pneumo TB E coli
Staph aureus TB Strep pneumo E coli Psuedomonas
What is nemaline rod deficiency?
hereditary neuromuscular disorder with many symptoms that can occur such as muscle weakness, hypoventilation, swallowing dysfunction, and impaired speech ability
40yo woman with diabetes and heavy periods complains of breathlessness. Bibasal crackles OE. Rank in order of likelihood that the investigation will be useful. Echo U&E CXR ECG FBC
FBC CXR Echo ECG U&E
56yo woman presents with hepatosplenomegaly and generalised lymphadenopathy. Rank from most to least likely: Hodgkin's CML CLL PMF ALL
CLL Hodgkin's CML ALL PMF
Where on the body are traumatic blisters unlikely to be found?
Flexural surfaces
A 70 year old known teetotal patient is noted to have a heart murmur and careful examination reveals splenomegaly with an obvious notch and you can’t get above it. There are no visible veins on the anterior abdominal wall, and there is no ascites, so you conclude that there is no portal hypertension. Dipstick of the urine reveals microscopic haematuria. She is found to have a temperature of between 37.5oC and 38.5oC whenever it is checked.
What is the diagnosis?
Subacute bacterial endocarditis
Name the disorder of calcium handling most commonly seen in patients with end-stage chronic renal failure, in which the plasma calcium is raised
tertiary hyperparathyroidism
What is the function of calcitonin?
Decrease calcium levels, released by the thyroid
Name the form of vitamin D produced following the action of 1alpha hydroxylase on 25-OH D3 in the kidney.
Calcitriol
Antibodies to phospholipase A2 receptor are associated with what form of glomerulonephritis?
Membranous
Which of these is most likely to CAUSE bronchiectasis? A. E-coli B. Pseudomonas Aeruginosa C. Staph aureus D. Strep pneumoniae E. Strep pyogenes
Staph aureus
What is the technical term for a connection between two epithelial surfaces, as occurs in Crohns disease where for example there might be a connection between the bladder and the bowel?
Fistula
What is struma ovarii?
Rare ovarian tumour that expresses thyroid tissue
Name a spiral flagellated Gram negative bacteria
H pylori
A patient is found to be anaemic, with high a reticulocyte count and fragmented red blood cells on blood smear. What is this anaemia?
MAHA
A patient presents with weakness and is found to have a potassium of 2.4mM (NR 3.5 to 5.0). What is the likely acid-base abnormality if you check the patients arterial blood gas?
Metabolic alkalosis - hypokalaemic alkalosis go together …hypokalaemia causing alkalosis and alkalosis causing hypokalaemia
Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel
Acarbose –> undigested sugar in bowel
. Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4).
Sitagliptin
Where do sulfonylureas act?
GLT2 transporter in pancreatic beta cells
Give examples of sulfonylureas.
1st gen = tolbutamide
2nd = glipizide/glyburide
Give an example of a meglitinide?
Repaglinide
Give an example of an incretin.
GLP1R agonists e.g. exenaTIDE, liragluTIDE
Give an example of a DDP4 inhibitor.
SitaGLIPTIN
What is the cause of a ring enhancing lesion on MRI after ear infection?
Cerebral abscess - centre of abscess does not enhance because it has dead cells and pus
Cheese + gram +ve rods = ?
Listeria
Cheese + gram -ve rods = ?
Brucella
Cause of hyper-segmented neutrophils?
B12/folate deficiency
Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4)
Vitamin D deficiency or osteomalacia –> secondary hyperparathyroidism.
Name a non-neoplastic polyp.
Hyperplastic
Inflammatory (pseudopolyps)
Hamartomatous (juvenile/Peutz Jeghers)
Name 3 neoplastic polyps.
Villous adenoma
Tubulovillous adenoma
Tubular adenoma
What size polyp is risky?
4cm
Inheritance and gene associated with FAP?
APC gene, AD
Which polyp syndrome is associated with supernumerary teeth?
Gardner’s FAP
