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M R C P > Pastest mocks > Flashcards

Pastest mocks Flashcards

1
Q

in multiple drug overdose - what substance concentration is screened for

A

paraquat– helpful in aiding diagnosis and whether palliative tx needed
also helpful to determine what overdose was taken eg which med

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2
Q

renal artery stenosis signs

A

asymmetrical sized kidneys
rec episodes pulm oedema
HTN
raised creatinine

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3
Q

angiodysplasia

A

vascular deformity of GI tract

causes:
bleeding, IDA, AORTIC STENOSIS

Tx cautery, tranexamic acid

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4
Q

how is fluconazole excreted

how should it be dosed

A

it is renally excreted

so if a pt is having dialysis- give fluconazole AFTER the session

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5
Q

avoid which vaccine in egg allergy

A

influenza and yellow feverf

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6
Q

meta analysis graph =

A

forest plot

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7
Q

plots / graphs to input data from meta analysis

A

forest or funnel

funnel to show pub bias

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8
Q

carpal tunnel pain worse when

A

worse at night

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9
Q

which type of neuropathy nn is commonest in DM

A

femoral neuropathy

CFs
mm wasting and weakness- quadriceps
Loss of sensation medial thigh

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10
Q

hepatorenal syndrome causes?

A

splanchnic vasoDILATION

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11
Q

which p450 enzyme inhibits warfarin

A

2c9

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12
Q

how to tell if insulin abuse

A

low c peptide during proven episode of hypoglycaemia

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13
Q

radiotherapy site for mesolithioma

A

to thoracoscopy tract site

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14
Q

androgen insensitivity syndrome main CFS

A

no pubic or axillary hair

x linked recessive

46XY

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15
Q

LOW POTASSIUM== ALWAYS GIVE WHICH ANTI HTN

A

SPIRONOLACTONE

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16
Q

PERIARTICULAR osteoporosis= ?

A

RA

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17
Q

phaeochroocytoma Tx

A

phenoxybenzamine = non selective alpha antagonist

adrenal mass

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18
Q

sedation in the elderly

A

HALOPERIDOL ONLY TO reduce risk of CV event

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19
Q

how does gentamicin cause nephrotoxicity

A

proximal tubular dysfunction

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20
Q

byssinosis

A

cotton mills, symptoms similar to occupationa asthma

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21
Q

human genome

A

methylation suppresses gene transcription

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22
Q

GTN MOA

A

dilate systemic veins

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23
Q

klebsiella Abx treatment=

A

tazocin

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24
Q

pH 7.0 = H?
pH 7.4 = H?

A

pH 7.0 = H 100
pH 7.4 =H 40

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25
Q

hypercalcaemia + multivitamin supplements +indigestion:

A

milk alkali syndrome

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26
Q

which heart med causes mouth ulcers

A

nicorandil

nico likes k and this gives him ulcers

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27
Q

which drug target governs hayflick limit

A

telomeres

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28
Q

mesenteric colitis/ischaemia vessel affected

A

superior mesenteric artery

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29
Q

PVL staph aureus treatment
first n second like

A
  1. fluclox
  2. clindamycin
  3. po linezolid
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30
Q

primary cause of ketonuria

A

lipolysis

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31
Q

treatment essential thromboytosis

A

hydroxyurea

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32
Q

which part of antibody binds to phagocyte surface

A

Fc portion

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33
Q

how to confirm if goitre is causing breathlessness

A

flow loop spirometry

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34
Q

how does alcohol cauase hypoglycaemia in DM patient

A

increased first phase insulin response

increased insulin secretion

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35
Q

duchenne and beckers dystrophy cause of mm weakness

A

telomere shorteningq

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36
Q

sjogrens antibody

A

anti ro

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37
Q

behcet syndrome treatment

A

prednisolone

second line azathioprine

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38
Q

what pain relief increases serotonin syndrome likelihood

A

tramadol

ecstasy
amphetamines also affect

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39
Q

Tx CRAO

A

acetazolomide
vasodilators
ocular massage

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40
Q

human bite abx Tx

A

co amoxiclav

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41
Q

platelet transfusion bacterial contamiation organism

A

Staph epidermis

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42
Q

in hyperkalemia= how does insulin dextrose help

A

insulin drives K from extracellular into intracellular space

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43
Q

TB test to show active, infectious TB

A

multiple sputum smears and cultures

ALL other investigations (mantoux, IFGamma, TB PCR== latent tb)

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44
Q

marfans heart murmur

A

Pulmonary regurg== gives diastolic murmur
AORTIc REGURG most commonly seen
MITRAL VALVE PROLAPSE 75%

FIBRILLIN

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45
Q

eczema herpeticum causative org

A

herpes simplex virus 1

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46
Q

IgG1 deficiency symptoms

A

hypogammaglobulinaemia
recurren infections, resp infections, sinusitis
Tx is vaccines are essential

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47
Q

post SAH treated with coiling- pt has headache, CN6 palsy== cause?
neuro signs, papillodema

A

hydrocephalus- common SAH complication

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48
Q

RA HLA ??

A

DRB1 04:01

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49
Q

NOS and alcohol worsen what ?

A

b12 deficiency
optic neuritis
loss vibration and priopception
+ upgoing plantars

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50
Q

digoxin MOA

A

Inhibits Na K ATPase membrane pump= increase intracellular sodium

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51
Q

vincristinewhich stage of cell cycle does vincristine act on

A

which stage of cell cycle does vincristine act on
METAPHASE

VINNY from jersey shore is META

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52
Q

legionella pneumonia tx

A

Azithromycin

levofloxacin if macrolide contraindicated

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53
Q

side effects of pan retinal photocoagulation

A

tunnel vision (decreased peripheral vision) , reduced colour vision

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54
Q

smooth enlarged slightly tender goitre and hyperthyroid symptoms==?

A

graves disease
block and replace w carbimazole

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55
Q

diptheria Tx

A

azithromycin

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56
Q

what is intention to treat

A

ITT= eg if 70 ppl dropped out of a study, assume that they had no response to the treatment being invetigated

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57
Q

young pt without structural heart disease in new SVT== treat ?

A

fleicanide

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58
Q

treaatment whipples disease

A

positive PAS test schiff
CO TRIMOXAZOLE

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59
Q

AMAUROSIS FUGAX cfs and causative vessel

A

curtain descending in an eye
causedby ISPSILATERAL ICA

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60
Q

stable HBa1c monitor time

A

6 montly

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61
Q

flexor pollicis longus action and supply

A

thumb flexion- terminal phalanx of thumb
median nerve supply

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62
Q

radial nn actions and supply

A

extensor muscles and abductor pollicis longus

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63
Q

campylobacter Abx treatment

A

erythromycin or azithromycin

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64
Q

best initial investigation for small joint involvemnt in Rheum Arth

A

colour US Doppler

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65
Q

Ix for ?OSA and what it involves

A

polySOMography\

records oximetry, BP, HR and evidence of awakenings

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66
Q

poor prognosis in pulmonary HTN

A

raised BNP, development of AF

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67
Q

what does COCP protect agaisnt and increase risk of

A

protects against: ovarian, endometrial, colorecta ca

INCREASE risk of cervical and breast ca and incr VTE
cervical cancer risk incr the most

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68
Q

primary sclerosing cholangitis IX

A

MRCP

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69
Q

lateral medullary syndrome CFs and which vessel affected

A

PICA
ipsilateral horners
contralateral loss of temp and pain

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70
Q

how does apical pulmonary fibrosis affect KCO

A

increased KCO

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71
Q

largest constituent of bile

A

bile salts

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72
Q

main physiological cause of achalasia

A

failure of dilation of cardiac/lower oesophageal sphincter
disordered motility of LOWER third of oesophagus

Tx botox
dilation myotomy

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73
Q

MALT lymphoma tx

A

H pylori eradication

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74
Q

bloody diarrhoea= giardia or amoeba?

A

amoeba

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75
Q

what is palindromic rheumatism and its treatment

A

rhem joint symptoms that recover between attacks
tx= hydroxychloriquine

small joint polyarthritis, responds well to non steroidal treatment

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76
Q

which part of nephron is impermeable to water

A

ascending LOH

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77
Q

what happens to hepatocytes hep a or hep e infection

A

hepatocyte necrosis

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78
Q

ECG showing VT more likely that SVT with abberant conduction

A

negative concordance across chest leads

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79
Q

why does urine remain ketone positive after DKA treated?

A

acetoacetate

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80
Q

what improves ank spon back pain

A

back pain in ank spon improves with exercise
not rest

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81
Q

what genotype of alpha antitrypsin causes no disease if non smoker. can have slightly lowered peak flow

A

PIMZ

can have pimz but no smoking

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82
Q

early ank spon Imaging Ix gold standard

A

MRI lumbosacral spine and pelvis

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83
Q

strong indication for permanent pacemaker insertion

A

right BBBB and left anterior fascicular block - predisposes to complete heart block.
+syncope

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84
Q

where is the ostium of coronary sinus

A

right atrium

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85
Q

COPD venturi mask setting

A

38% o2 via venturi mask

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86
Q

niemann pick disease– cause and what organelle affected

A

lysosomes affected , abnormal processing and transport of lipids
cauases cherry red spot on macula

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87
Q

24yo presents with DKA after alcohol - what type of diabetes does he have

A

type 1-DKA more likely in t1DM

MODY usually presents with skin infections, gradual symptoms
NOT dka

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88
Q

schistoma haematobium = causes. what
schistoma mansii = causes what

A

s haematobium causes bladdder TCC, CKD ALL RENAL
s mansonii causes hepatic fibrosis

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89
Q

pupil difference of 1mm but both pupils react normally==?

A

normal variant

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90
Q

biggest impact on kidney rejection 6 weeks post transplant?

A

HLA matching

HLA DR B a

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91
Q

biggest impact on kidney rejection 6 weeks post transplant?

A

HLA matching

HLA DR 6 months
B 2 years
A

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92
Q

regimental badge numbness = ?

A

axillary nerve
weakness deltoid mm

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93
Q

young ish person, no engagement w medicine,,
presents with short stature, tired ness, hypo PTH symptoms =?

A

congenital hypo parathyroidism

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94
Q

facial nn palsy compression at which anatomical site is common

A

stylomastoid foramen - supplies taste to ant 2 thirds of tongue

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95
Q

long term treatment for WPW syndrome

A

radiofrequency ablation

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96
Q

medication for juvenile myoclonic epilepsy- males and femlaes

A

sodium vlproate
levitiracetam

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97
Q

management of PPULMhypertension if pregnant

A

stop endothelin antag==== teratogenic

start sildenafil
START LMWH

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98
Q

gout- if pt cannot tolerate allopurinol or feboxustat=== try what medication?

A

benzobromarone
MOA= URAT1 inhibitor

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99
Q

when is cortisol highest and lowest

A

lowest at midnight (bed time- rest )
highest in the. morning

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100
Q

what type of cells express MHC HLA DR B class2

A

dendritic cells

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101
Q

ank spon initial and second line treatment

A

NSAID NAPROXEN

infliximab TNF if nsaid does not work

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102
Q

cyclophosphamide moa

A

t cell modulation
B cell depletion

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103
Q

pulmonary HTN can lead to what heart murmur?

A

Tricuspid regurg

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104
Q

fleicanide moa

A

Na fast channel inhibition

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105
Q

granulomatosis and polyangiitis cANCA positive renal biopsy finding?

A

pauci immune crescenteric glomerulonephritis

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106
Q

osteomyelitis abx tx in DIABETES PT

A

vancomycin and ceftriaxone

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107
Q

post PCI punched out ulcers, bluue discolouration? and mx

A

cholesterol embolism,
supportive mx

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108
Q

mediterranean background and Hb== screen for ?

A

screen for beta thallasemia
Hb electrophoresis

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109
Q

nurses holding power section

A

5 (4)
for 6 hours to arrange dr for 5(2) section

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110
Q

IPF medication

A

nintedanib - tyrosine kinase inhibitor
discontinue if disease progression seen

pirfenidone

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111
Q

small VSD during pregnancy mangement

A

reassure and leave
if no eisenmengers syndrome
or severe AS

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112
Q

agitated drug inducedpsychosis == give?

A

IM Haloperidol

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113
Q

UTI pt on trimethoprim has incr creat but normal GFR - likely cause?

A

trimethoprim

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114
Q

healthy 25yo man blood volume

A

75L man
65L woman

neonate 85

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115
Q

delerious old pt needs sedation

A

haloperidol
but avoid in parkinson

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116
Q

nephritic symptoms but no hearling loss /alports symptoms

A

thin basement membrane nephropathy

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117
Q

stroke pt has visual neglect- which lobe

A

parietal most likely

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118
Q

hereditary angiodema caused by

A

c1 inhibitor deficiency
elevated bradykinin

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119
Q

non alc steatohepatitis vs Alcoholic steatohepatitis

A

ALCOHOLIC steato hepatitis :
AST>ALT by 2 times

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120
Q

gangrene

A

subcut air
foul smelling liquid from bullae
dark purple discolouration

soldier, soil contamination

TX. metronidazole and clindamycin

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121
Q

microRNA function

A

splicing of messenger mRNA

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122
Q

dipyridamole MOA

A

ADP uptake inhibitor

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123
Q

IV quinine therapy side effect

A

hypoglycaemia

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124
Q

hypoparathyroid symptoms + short 4th 5th metacarpal + short + obese + LD

A

PSEUDOHYPOPARATHYROIDISM

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125
Q

omeprazole electrolyte disturbance

A

low sodium
low magnesium

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126
Q

In ALL pts with systemic sclerosis (incl limited and diffuse)which antibody is positive

A

ANTI NUCLEAR

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127
Q

what electrolyte makes digoxin toxicity worse

A

hypokalemia
long QTc

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128
Q

addisons ix

A

ACTH stim test

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129
Q

which Ig positive in chronic hep b

A

chronic hep b = positive IgG anti Hbc

NO IgM

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130
Q

trastuzumab MOA

A

HER 2
causes cardiac failure

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131
Q

why combo chemo therapy used

A

decrease risk of resistance developing

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132
Q

splentecomy- at risk of ?

A

h influenzae, n meningititis, s pneumoniae

need flu and pnuemococcal 4 weeks before splenectomy
post op= proph penicillin

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133
Q

when to start IV sodium bicarb if patient has low hco3?

A

if pH <7.2 - start IV bicarb

otherwise:
start IV 0.9nacl

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134
Q

latent TB tx

A

3 months R and I

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135
Q

spironolactone Site of action

A

distal tubule cortical collecting duct

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136
Q

ependydyomoa= slow growing

A

symtpoms over months and months

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137
Q

Pulmonary HTN is most associated with what congen heart condition

A

VSD

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138
Q

which organ has most response to hypoxia

A

carotid body

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139
Q

what is the earliest detectable test in HIV

A

HIV RNA

p53 7 days after infection

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140
Q

serium osmolality calculation

A

2Na+2K+urea+glucose

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141
Q

viral herpes encephalitis CFs

A

drowsy, confusion, loss of short term memory, tonic clonic seizure
only small rise in CRP
pyrexic
CSF shows lymphocytosis ,

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142
Q

phaechromocytoma BP tx

A

phenoxybenzamine

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143
Q

ACEi dilate afferent or efferent arteriole ? causing incr creatinine

A

cause efferent arterial renal dilation

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144
Q

common variable immunodeficiency most common type of infection?

A

giardiasis

145
Q

pregnancy and T1DM - which supplement is most important

A

high dose folate 5mg=— incr risk neural tube defect

146
Q

bicep innervation

A

c6

147
Q

pituitary apoplexy== haemorrage from incr pressure
pregnancy

A

Tx= cortisol replacement ASAP

hypotension/hyponatraemia secondary to hypoadrenalism

Investigation
MRI is diagnostic

Management
urgent steroid replacement due to loss of ACTH
careful fluid balance
surgery

CFs pit apoplexy
similar sudden onset headache like SAH
bitemp hemianopia

148
Q

severe hyperkalemia = what ECG finding indiciates imminent cardiac arrest

A

long QRS

149
Q

SIADH treatment

A

fluid restrict if obs stable

demeocycline= reduces the responsiveness of the collecting tubule cells to ADH

correct slowly due to central pontine myelinilysis

150
Q

best way to slow progression of pulmonary fibrosis with asbestosis

A

STOP SMOKING
also getting flu and pneumonia vaccines

TO STLOW IPF== methyl pred and cyclophosphamide

151
Q

Rheumatoid factor made of which Ig?

A

IgM

152
Q

decrease hepatic encephalopathy=

A
  1. lactulose
  2. rifixamin
153
Q

graft vs host disease causes ?

A

deletion of donor white cells
why u need to give irradiated blood

154
Q

4th fourth heart sound HS corrrelates to ?ecg

A

after p wave

155
Q

lateral medullary syndrome cause =

A

vertebral aa more common
PICA sometimes

156
Q

acute psychosis medication

A

risperidone

157
Q

Functional residual capacity FRC=?

A

vol of air left in lungs at the end of passive expiration

158
Q

where is pacing wire inserted in the heart

A

coronary sinus= right atrium

159
Q

stat test to identify disease that is crucial is identified

A

sensitivity

160
Q

whipples disease tx

A

co trimoxazole
or
? tetracycline

161
Q

malaria prophylaxis

A

atovaquone/proguanil== FIRST LINE
mefloquine (psych SEs)

162
Q

how does docetaxel cause reduced renal function

A

renal tubular toxicity

163
Q

tocilizumab MOA

A

anti IL6

164
Q

IgA nephropathy Tx

A

common post resp infection
Tx PREDNISOLONE

165
Q

nephrogenic DI treatment

A

thiazide eg hydrochlorthiazide== decreases urine output

166
Q

syphilis Tx

A

azithromycin

167
Q

plucked yellow papules chicken skin + polyp and hiatus herinia

A

pseudoxanthoma elasticum aut rec

168
Q

which TB abx causes arthralgia and gout

A

P= pyrizinamine

169
Q

sibling % of being HLA match for transplant

A

25%

170
Q

Anti HTN medicine for lithium

A

amlodipine

171
Q

salmeterol = ?

A

partial agonist of beta 2 receptor

172
Q

optic neuritis Ix

A

MRI orbit and brain with contrast

173
Q

If a pt has uncontrolled crohns causing pyoderma gangrenosum= start what treatment?

A

IV infliximab= bc their crohns is not being controlled adequately

174
Q

bleeding duodenal ulcer = which vessel

A

gastroduodenal aa

175
Q

psych + parkinsons = seeing things but knows they are not real = ?

A

hallucinations

176
Q

primary progressive MS tx

A

ocrelizumab

177
Q

eplerenone MOA and site of action

A

distal distal convoluted tubule (distal x 2)
both spironolactone and eplerenone act here

178
Q

Parkinsons Tx :

with signif motor symptoms

without motor symptoms

A

WITH motor symptoms affecting QOL: LEVODOPA

without any motor symptoms: ropinirole

179
Q

SE PPI omeprazole

A

low electrolytes
low sodium
low magnesium
OSTEOPOROSIS

180
Q

Tx graves opthalmopathy

A

iv methylpred

severe= tocilizumab

181
Q

difference between a reticulocyte and normal mature erythrocyte

A

reticulocyte containts RNA

182
Q

what causes hypoxia on o2 sats in pneumonia

A

intrapulmonary shunting

183
Q

what is ebsteins anomaly

A

large atrium, small ventricle (low tricuspid valve)

malformation of tricuspid valve and right ventricle

184
Q

female primary amenorrhoea, no axillary hair, sparse pubic hair, NO SMELL == ?

A

kallmans
hypogonadotrophic hypopituitarism

185
Q

SEVERE AS: if patient is well and fit for surgery= ?

A

biprosthetic valve replacement surgery if relatively fit

TAVI if old and frail and unsuitable for surgery

186
Q

drainage of aqueous humour?

A

canal of schlemm

187
Q

stroke timeframe for thrombolysis

A

4.5 hrs
do not give 300mg aspirin if going for thrombolysis or thrombectomy

188
Q

human bite bacteria

A

human bite: sanguinis (bacteria found in mouth)

INFECTED human bite= s aureus

dog bite= pasteurella (gram negative bacillic), p acnes,

189
Q

graves disease treatment

A

BLOCK AND REPLACE

severe= tociluzumab

190
Q

CYCLOspora Abx

A

co trimoxazole

191
Q

SBP treatment

A

e coli
iv cefotaxime
ciprofloxacin (covers gram neg)
vancomycin/ taz

192
Q

turners syndrome = low oestrogen so how to prevent osteoporosis

A

HRT

193
Q

normal thyroid change in pregnancy

A

free thyroxine= same
increase total t4

due to incr in thyroid binding globulin

194
Q

early detection of measles test

A

oral fluid measles RNA

195
Q

prolonged QT syndrome Tx

A

eg qt 490 (>450)
positive family history
DEFECT in POTASSIUM K channel alpha subunit
AVOID ICD== life threatening

Treatment = beta blocker, stellate ganglionectomy

196
Q

reactive arthritis Tx

A

NSAID naproxen

prednisolong 2nd line

197
Q

MODY= once sulfonylurea stops working ?tx

A

long acting insulin

198
Q

alports syndrome initial Tx

A

ACE i to slow proteinuria

199
Q

rheumatoid arthritis pleural effusion

A

pH <7.2

200
Q

most important factors for re=stroke

A

duration>60 mins and
unilateral weakness

201
Q

chronic co2 retention on VBg =?

A

high bicarb

202
Q

where is beta adrenergic receptor

A

g protein in cell membrane

203
Q

orchitis from mumps tx

A

NSAIDS= supportive
no need for abx

204
Q

global aphaasia which part of brain

A

left perisylvian region and thalamus

205
Q

t1dm antibody

A

anti GAD65

206
Q

how to assess hep b immunity level

A

Hbs level

anti hep b surface antibody

207
Q

anaphylactic blood transfusion reactions caused by which Ig?

A

IgA deficiency causes blood transufsion analphylaxis

208
Q

which sudden death cardiac conditions associated w exercise

A

exercise - familial long QT and HOCM

dead in bed and also familial= brugada

209
Q

furosemide MOA

A

reduce preload
ascending LOH naKCL

210
Q

both trigylcerides and cholesterol raised in young ish person =

A

familial combined hyperlipideamia

if chol >7= heterozygous (norma triglyc)

211
Q

acute pancreatitis drug causes

A

sodium vaproate
FUROSEMIDE

212
Q

brucellosis

A

sheep cattle
rifampicin and doxyclcyine treatment
fever, neutropenia
joint pains

213
Q

oculomotor nerve palsy which aa?

A

CN3 = PCA artery

214
Q

DVT but pt needs anticoag with CKD5

A

warfarin - oral

215
Q

bilirubin precursor

A

bilverdin

216
Q

serotonin syndrome Tx

A

cyproheptadine

217
Q

vomiting VBG

A

hypochloraemic metabolic alkalosis

218
Q

drug induced lupus antibody

A

antihistone

219
Q

irinotectan MOA

A

DNA topoisomerase 1 inhibitor

220
Q

which parkinsons med increases gambling behaviour

A

procyclidine

221
Q

which heart medicine excacerbates syncope in AS

A

beta blocker

222
Q

eyes appear responsive but pt is blind

A

occipital lesions

223
Q

most specific RA

A

anti ccp

224
Q

nephrogenic DI cause

A

defect aquaporin 2 channels

225
Q

calculate cals needed / day

A

25-25 x kg

226
Q

psychosis in parkinsons treatment

A

clozapine ( no worseing of movememnt disorder)

227
Q

which IL in natural killer cell activation

A

IL12

228
Q

where are cardiac myxomas most common

A

LA

229
Q

measure asthma progression

A

FEV1

230
Q

mebendazole moa

A

inhibit tubulin polymerisation

231
Q

baclofen MOA

A

gaba B agonist

232
Q

first line Abx UTI GFR <45

A

pivmecillamanenm

233
Q

which aa closest to recurrent laryngeal nn

A

Inferior thyroid artery

234
Q

pagets Tx

A

iv zolendronate

only denosumab if pt cannot tolerate

235
Q

carcinoid tx

A

ocreotide

telotristat

236
Q

pathogenesis of raised creatinine in liver alcoholics

A

raised endothelin

237
Q

smoking cessation in pregnancy

A
  1. NIcotine replacement therapy
238
Q

HNPCC gene mutation

A

MSH

30% MLH

239
Q

bird fanciers chlamydia pittsaci, brady cardia

A

doxy

240
Q

Acute hep b tx

A

wait and see
repeat pcr

241
Q

HIV and oesophageal ulcers

A

Tx= valganciclovir

242
Q

venous thrombosis Tx

A

LMWH

243
Q

skin condition name in lyme disease

A

erythema chronicum migrans

244
Q

frontal balding, myotonia, prox weakness = and ix

A

dystrophhy
need REPEAT ECGS

245
Q

CNS TB treatment time

A

12 months

246
Q

heart med anti htn causes ankle swelling

A

ACEi: due to incr bradykinin

doxasozin

247
Q

post MI what is common

A

Mitral regurg SOB hypotensive but no chest pain

248
Q

how does prednisolone help asthma

A

reduce transcription of inflammatory genes

249
Q

bilateral central scotoma, cupping, raised intraocular pressure

A

open angle glaucoma

first line tx= timolol

250
Q

foot plantar flexion

A

gastroscnemius

251
Q

pneumothorax

A

chest wall to peripheral lung at hilum

252
Q

true measurement of risk benefit for a new drug = ?

A

intention to treat

253
Q

acromegaly test

A
  1. IGF 1 (not any other number)

or

glucose tolerance with GH measurement

254
Q

CMV pre renal prophylaxis

A

gancivlovir/ valganciclovir

255
Q

gastrinoma or insulinoma more common in MEN1

A

GASTRINOMA much more common

256
Q

why can meds be removed by dialysis

A

high water solubility

257
Q

diabetic nephropathy findings on EM

A

mesangial expansion
basement thickening
arteriolarhyalinosis

258
Q

parietal lobe aa supple=

A

ant cerebral aa

259
Q

c diff cleaning

A

dilute bleach solution

260
Q

SIADH = high urinary sodium

A

eg over 20

urinary sodium 30 = SIADH

261
Q

PMR prednisolone dose

A

approx 15mg / day

high high steroid doises eg 40mg/day for temp arteritis

262
Q

OLUgyric crisis anti emetic anti sicknesS

A

metoclopramide- DA antagonist

263
Q

worseing SLE C3

A

if worsening SLE + nephiritis= REDUCED C3

264
Q

aplastic anaemia

A

CFs
post EBV

low hb, low platelets

Tx= imm supp

Ix= bone marrow and trephine biopsy

265
Q

amastigote= tx?

A

visceral leishmanosis
Tx= miltefosine

266
Q

compare outcomes of 2 groups on 2 different interventions

A

chi squared

267
Q

worst prognosis outcome post MI

A

EF<30

268
Q

uncomplicated falcium malaria tx
and complicatd

A

<1% parasitaemia= PO arthemether and lufemantrine

5% parasitaemia= severe = IV artenusate

269
Q

widespread listeria Abx=

A

amox and gentamicin

270
Q

OSA lung function

A

is normal

271
Q

lateral rectus moa

A

abduction

272
Q

specialised antigen presenting cell

A

macrophage

273
Q

over flow diarrhoea tx

A
  1. glyc supp
  2. phos enema
274
Q

how does sodium valp cauase liver dysfunc

A

mitochondrial disturbace

275
Q

diffuse systemic sclerosis antibodies and difference

A

diffuse= lung disease involvement

anti scl
and anti topoisomerase

276
Q

liraglutide MOA

A

GLP1 agonist

277
Q

alpha antitryp 1 def inheritance

A

co dominant

278
Q

signet ring sign on cxr

A

bronchiectasis

279
Q

NASH treatment to aid weight loss

A

liraglutide

GLP1 agonis

280
Q

rapid onsent symptoms, incr blast cells , low platelets = ?

A

AML == Ix = BM

281
Q

initial Ix for close TB contacts screening

A

mantoux test
if wheal ?5cm== screen for active infection
IFGamma assay

282
Q

systolic or diaastolic increase as ages

A

incr in systolic BP

pulse pressure widens

283
Q

in testicular seminoma= which marker to check

A

LDH

if teratoma= AFP

choriocarcinoma= HCG

284
Q

impaired glucose tolerance caused by

A

hepatic insulin resistance

285
Q

terminal ileum aa supple

A

ileocolic

286
Q

ngt correct ph

A

pH1.5-3.5

287
Q

homocystinuria tx

A

pyridoxine

288
Q

migraine

A

unilateral

289
Q

ige prod

A

b cels

290
Q

winging of scapula

A

long thoracic nn

291
Q

primary villiary cirrhosis ix

A

mrcp as well

292
Q

yersinia tx

A

gentamicin

mimics appendicitis

293
Q

what type of cells release tryptase in anaphylaxis

A

MAST CELLS

294
Q

cystic fibrosis increase in which cell causing inflamm

A

neutrophils

295
Q

post bypass surgery what will be deficient

A

IRON deficient post roux en y

296
Q

Nephrogenic DI continues after stopping lithium Tx

A

thiazide like diuretic (indapamide) and NSAID

297
Q

well circumscribed hair loss, exclamation hairs=

A

alopecia areata
Tx= high dose topical steroids

298
Q

rasburicase MOA

A

urate oxidation

299
Q

post HSP splenic rupture time

A

one month (4weeks)

300
Q

BRCA2 cancers

A

breast ovarian

prostate
pancreas

301
Q

acne rosacea Tx

A
  1. top metronidazole
  2. top azaelic acid
302
Q

RA/CTD prolonged epsiaxis

A

acquired haemophilia A caused by factor 8 inhibity antibody

303
Q

antiepileptic LEAST RISK of heart block

A

primidone== BARBITUATES low risk heart block

304
Q

most common cause of new epilepsy in elderly

A

CVS

305
Q

rusty sputum pneumonia

A

Strep pneumoniae

306
Q

maintain UC remission

A

oral mesalazine

307
Q

primary polycythaemia

A

low EPO
high Hb

308
Q

evinacumab Moa

A

angiopoetic 3 inhibitor

309
Q

bil dilated pupils, t wave inversion, aggression

A

coke overdose

310
Q

small bowel bac overgrowth

A

hydroden breath test

xylose breath test

311
Q

liver cyst hyatid cyst infectious disease

A

albendazole

312
Q

meningococcus transmission

A

respiratory droplet

313
Q

how to check if portal htn or nephrotic syndrome

A

Serum alb- ascitic fluid albumin

if <11= nephrotic

if >11= PORTAL HTN

314
Q

lichen planus resistant lesions tx

A

ciclosporin, azathioprine

315
Q

where is thyroid hormone receptor

A

nucleus

316
Q

what metabolite of morphine causes resp depression

A

morphine 6 glucuronide

317
Q

gentamicin toxicity

A

proximal tubule

318
Q

steroid resistant severe eczema Tx

A
  1. ciclosporin, azathiprine , mycolate mofetil

after that- JAK inhibitors eg baricitinib

319
Q

ambisentran -
bosentan =

A

ambisentran= endothelin A only

bosentan = mixed endothelin A and B

320
Q

hypoglycaemia, jaundice, HoTN, drowsy

A

falciparum malaria

321
Q

dilated pupil non responsive to light

A

partial CN3 palsy
birght lights difficult

322
Q

percentage benefit per year eg
5 years, 15% vs 5%

A

(15-5)/5 years == 2%

323
Q

raynauds

A

nifedipine
sildenafil

324
Q

metoprolol gene

A

ADRB2

325
Q

severe untreated psoriasis

A

ciclosporin
infliximab

326
Q

temporal arteritis

A

vision loss/claudication== iv methrylpred 100mg/sday 3 days

otherwise- 40mg pred PO

327
Q

steroid requirement a day
prednisolone and hydrocortisone

A

hydrocortisone 15-25mg / day

which = 4mg prednisolone a day

328
Q

metformin gfr

A

<30 = stop metformin

30-45= reduce dose

329
Q

monitor removed phaeochromocytoma

A

urinary catecholamines

330
Q

s aureus IE treatment infective endocarditis

A
  1. fluclox, rifampicin, gent

if methicillin resistant=. MSRA= give vanc

331
Q

gilbert syndrome

A

unconjugated bili increase

332
Q

factor 5 leiden test

A

dilute russels viper venom time

333
Q

A post-marketing observational study of a new drug

A

profile of adverse effects

334
Q

HSP =

A

IgA , mesangial deposition

335
Q

ST elevation with Q wVES = ?

A

L VENTRICULAR aneurysm

336
Q

what type of renal problem do NSAIDS cause

A

acute interstitial nephritis

337
Q

cause of steatorrhoea in systemic sclerosis

A

smal bowel bacterial overgrowth

338
Q

IPF which lung func test most important

A

decreased TLCO

339
Q

valsalva causes

A

decreased venous return to heart

340
Q

best anti HTN for lithium

A

amlodipine

341
Q

restless leg tx

A

dopamine agonists ropinirole, pramipexole and rotigotine

342
Q

how does chemo work

A

apoptosis

343
Q

most common finding of pericardial constriction

A

hepatomegaly

344
Q

post delivery post partum, most common

A

Coronary artery dissection

345
Q

triceps

A

c7

346
Q

lipodermatosclerosis

A

hypodermis layer of skin

347
Q

predictor of cardiovascular risk in patients with diabetes mellitus and/or hypertension.

A

albumin:creatinine ratio

348
Q

single nucleotide polymorphism (SNP) genotyping.

A

substitution of a nucleotide for any other nucleotide

349
Q

antipsychotic drugs MOA

A

DA antagonist

350
Q

maintain normal sinus rhythm post AF cardioversion

A

amiodarone

351
Q

isosorbide mononitrate

A

increase cyclic GMP

352
Q

deranged LFTs + back pain+raised IgG=?

A

autoimm hepatitis

353
Q

urge incontinence

A

oxybutinin
solifenacin

354
Q

BNP origin

A

ventricles

355
Q

which type of medicine can cause blocked nose in pts with asthma

A

aspirin

356
Q

penicilin allergy

A

avoid mero, taz, cefs

357
Q

what causes hypocalcaemia in renal ckd

A

activated vit d deficiency

358
Q

how does aciclovir cause renal dysfunc

A

crystaluria

359
Q

foam cells

A

macrophages, monocytes

M R C P (18 decks)

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