Past Papers etc

Question 1

Biggest risk factor for colonic carcinoma:

1) Crohn’s
2) Diverticular disease
3) IBS
4) Peutz-Jeghers
5) UC

Answer 1

UC

Question 2

In which condition would you choose allogeneic BMT over autologous?

1) Acute leukaemia
2) BM failure
3) Chronic leukaemia
4) Myeloma
5) Lymphoma

Answer 2

BM

Question 3

Name 3 mixed pattern autoinflammatory conditions.

Answer 3

Behcet’s
Psoriatic arthritis
Axial spondyloarthritis

Question 4

MOA of corticosteroids?

Answer 4

Inhibits phospholipase A2

Question 5

By which mechanism does sarcoidosis cause hypercalcaemia?

Answer 5

Ectopic expression of 1 alpha hydroxylase

Question 6

Abx for pseudomonas aeruginosa lung infection?

Answer 6

Gentamicin

Question 7

What inhibits thromboxane a2?

Answer 7

Aspirin

Question 8

Most sensitive marker of liver damage?

Answer 8

PT

Question 9

Superoxide dismutase 1 is a misfolded protein associated with which condition?

Answer 9

Motor neurone disease

Question 10

Name 2 organisms which cause bronchopneumonia.

Answer 10

HiB and Klebsiella pneumoniae

Question 11

What are some causes of interstitial pneumonia?

Answer 11

Mycoplasma and viruses

Question 12

Most common cause of CNS infections?

Answer 12

Coxsackie group B

Question 13

What does aseptic meningitis mean?

Answer 13

Viral

Question 14

Name an intracellar gram -ve coccus.

Answer 14

Neisseria

Question 15

Condition which causes failure to produce neutrophils?

Answer 15

Kostmann syndrome

Question 16

Rank these in terms of highest to lowest calcium.
Parathyroid carcinoma 
1o hyperparathyroidism 
2o hyperparathyroidism
Osteoporosis 
Osteomalacia

Answer 16

Parathyroid carcinoma 
1o hyperparathyroidism 
Osteoporosis 
2o hyperparathyroidism
Osteomalacia

Question 17

Which would have a higher plasma osmolality: pneumonia or DI?

Answer 17

DI has higher osmolality than pneumonia

Question 18

What is the function of gastrin? What stimulates its release?

Answer 18

Gastrin enhances HCl secretion

Vagus nerve controls both HCl production and gastrin release

Question 19

What is zollinger ellison syndrome?

Answer 19

Tumour of islet cells of pancreas that increase HCl production

Question 20

Which condition has higher gastrin production: H pylori infection or Zollinger Ellison syndrome?

Answer 20

H pylori has higher gastrin release than ZES

Question 21

What is thyroxine bound to in order?

Answer 21

Thyroxine binding globulin
Thyroxine binding pre-albumin
Albumin
Free

Question 22

Name 2 most common causes of PUO.

Answer 22

Malaria
Dengue
(then: diarrhoea, UTI, VHF)

Question 23

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

Answer 23

Staph aureus 
TB
Strep pneumo
E coli 
Psuedomonas

Question 24

What is nemaline rod deficiency?

Answer 24

hereditary neuromuscular disorder with many symptoms that can occur such as muscle weakness, hypoventilation, swallowing dysfunction, and impaired speech ability

Question 25

``` 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 ```

Answer 25

``` FBC CXR Echo ECG U&E ```

Question 26

``` 56yo woman presents with hepatosplenomegaly and generalised lymphadenopathy. Rank from most to least likely: Hodgkin's CML CLL PMF ALL ```

Answer 26

``` CLL Hodgkin's CML ALL PMF ```

Question 27

Where on the body are traumatic blisters unlikely to be found?

Answer 27

Flexural surfaces

Question 28

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?

Answer 28

Subacute bacterial endocarditis

Question 29

Name the disorder of calcium handling most commonly seen in patients with end-stage chronic renal failure, in which the plasma calcium is raised

Answer 29

tertiary hyperparathyroidism

Question 30

What is the function of calcitonin?

Answer 30

Decrease calcium levels, released by the thyroid

Question 31

Name the form of vitamin D produced following the action of 1alpha hydroxylase on 25-OH D3 in the kidney.

Answer 31

Calcitriol

Question 32

Antibodies to phospholipase A2 receptor are associated with what form of glomerulonephritis?

Answer 32

Membranous

Question 33

``` Which of these is most likely to CAUSE bronchiectasis? A. E-coli B. Pseudomonas Aeruginosa C. Staph aureus D. Strep pneumoniae E. Strep pyogenes ```

Answer 33

Staph aureus

Question 34

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?

Answer 34

Fistula

Question 35

What is struma ovarii?

Answer 35

Rare ovarian tumour that expresses thyroid tissue

Question 36

Name a spiral flagellated Gram negative bacteria

Answer 36

H pylori

Question 37

A patient is found to be anaemic, with high a reticulocyte count and fragmented red blood cells on blood smear. What is this anaemia?

Answer 37

MAHA

Question 38

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?

Answer 38

Metabolic alkalosis - hypokalaemic alkalosis go together ...hypokalaemia causing alkalosis and alkalosis causing hypokalaemia

Question 39

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

Answer 39

Acarbose --> undigested sugar in bowel

Question 40

. Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4).

Answer 40

Sitagliptin

Question 41

Where do sulfonylureas act?

Answer 41

GLT2 transporter in pancreatic beta cells

Question 42

Give examples of sulfonylureas.

Answer 42

1st gen = tolbutamide | 2nd = glipizide/glyburide

Question 43

Give an example of a meglitinide?

Answer 43

Repaglinide

Question 44

Give an example of an incretin.

Answer 44

GLP1R agonists e.g. exenaTIDE, liragluTIDE

Question 45

Give an example of a DDP4 inhibitor.

Answer 45

SitaGLIPTIN

Question 46

What is the cause of a ring enhancing lesion on MRI after ear infection?

Answer 46

Cerebral abscess - centre of abscess does not enhance because it has dead cells and pus

Question 47

Cheese + gram +ve rods = ?

Answer 47

Listeria

Question 48

Cheese + gram -ve rods = ?

Answer 48

Brucella

Question 49

Cause of hyper-segmented neutrophils?

Answer 49

B12/folate deficiency

Question 50

Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4)

Answer 50

Vitamin D deficiency or osteomalacia --> secondary hyperparathyroidism.

Question 51

Name a non-neoplastic polyp.

Answer 51

Hyperplastic Inflammatory (pseudopolyps) Hamartomatous (juvenile/Peutz Jeghers)

Question 52

Name 3 neoplastic polyps.

Answer 52

Villous adenoma Tubulovillous adenoma Tubular adenoma

Question 53

What size polyp is risky?

Answer 53

4cm

Question 54

Inheritance and gene associated with FAP?

Answer 54

APC gene, AD

Question 55

Which polyp syndrome is associated with supernumerary teeth?

Answer 55

Gardner's FAP