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MRCP Part 1 > Pastest PPQ Notes > Flashcards

Pastest PPQ Notes Flashcards

1
Q

criteria for ivabradine vs sacubitril/valsartan

A

ivabradine - low EF and a resting heart rate above 75 bpm

sacubitril valsartan - low EF (1st)

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2
Q

induction vs inhibition time scale

A

longer term exposure vs short

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3
Q

dose of bicarbonate in salicylate overdose

A

50-100mL of 8.4% with target pH 7.45-55

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4
Q

when is prednisolone indicated for treatment of IgA nephropathy

A

significant proteinuria where steroids have been proven to slow progression of disease

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5
Q

initial intervention of choice for primary thrombocytosis

A

hydroxyurea

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6
Q

achalasia treatment

A

balloon dilatation

Heller’s myotomy

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7
Q

Behcet’s disease treatment

A

eye involvement -> systemic therapy with corticosteroids

cyclophosphamide, azathioprine and etanercept

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8
Q

presentation of ASD

A

syncopal episodes, pAF, ankle swelling, fixed split S2, mid-systolic murmur (with L to R shunt)

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9
Q

hereditary angioedema inheritance

A

AD

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10
Q

SBP most common pathogen

A

E coli

cefotaxime 2g IV TDS

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11
Q

Whipple’s disease treatment

A

2 weeks ceftriaxone
up to a year of cotrim

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12
Q

what do peripheral chemoreceptors do in CO poisoning

A

have no effect on ventilation

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13
Q

ventricular tachycardia on BG of recent AMI and limited ST elevation with no chest pain and no elevation

A

LV aneurysm

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14
Q

erysipelas treatment

A

oral co-amox

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15
Q

oral to SC morphine

A

divide by 2

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16
Q

atlantoaxial subluxation from RA

A

C spine XR

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17
Q

pregnant and on bosentan

A

stop - endothelin antagonists are teratogenic

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18
Q

evolocumab

A

reduces LDL

recommended where LDL persistently >4 despite max lipid-lowering therapy

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19
Q

immune memory and long-term protection from vaccination

A

T cells

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20
Q

Kallmann syndrome inheritance

A

XLR

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21
Q

CF inheritance if both partners have siblings with CF

A

1/9

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22
Q

treatment for nephrogenic diabetes insipidus

A

low solute diet and thiazides

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23
Q

most risk for pressure sores

A

BMI >25

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24
Q

benzo OD

A

flumaz
seizure -> intubate and ventilate

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25
Q

dermatomyositis treatment

A

prednisolone
azathioprine

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26
Q

baclofen MOA

A

inhibits glutamate release

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27
Q

what does the R recurrent laryngeal nerve lie close to

A

bifurcation of the R inferior thyroid artery

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28
Q

ankylosing spondylitis treatment

A

trial of 2 NSAIDs

anti TNF agent - adalimumab or etanercept

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29
Q

chronic renal failure with low Ca and marked elevation in serum phosphate

A

use calcium acetate to reduce serum phosphate

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30
Q

raloxifene vs teriparatide

A

advantage in patients with FHx of breast

vs

T -3.5, 2+ fractures and >65

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31
Q

pulmonary and renal haemorrhage, with renal failure, haematuria and proteinuria, with normal ESR

A

anti GBM disease

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32
Q

high risk of OP with AED

A

phenytoin

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33
Q

renal stones in patients with small bowel resection or active small bowel and terminal ileal inflammation eg Crohns

A

oxalate

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34
Q

ezetimibe receptor

A

NPC1L1

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35
Q

colectomy in acute severe colitis

A

not responded to 7 days rescue therapy (ciclosporin or infliximab)
or deterioration/complications eg toxic megacolon, severe haemorrhage or perforation

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36
Q

investigation of choice for anaemia associated with CKD

A

percentage of hypochromic red cells

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37
Q

measles transmission

A

airborne

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38
Q

most appropriate investigation to establish the origin of the bacteria in infective endocarditis

A

orthopantomogram

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39
Q

ticagrelor moa

A

P2Y12 inhibitor

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40
Q

giardiasis treatment

A

metronidazole 7d tinidazole

intermittent diarrhoea, abdominal bloating and anorexia

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41
Q

asthma with worsening symptoms, eosinophilia, inflammatory changes on CXR and positive Asp

A

ABPA

oral steroids and itraconazole

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42
Q

microcytic anaemia with abnormal LFTs and liver mets on USS ->

A

colonoscopy

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43
Q

polymyositis antibody

A

anti-jo1

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44
Q

grumbling epigastric pain, fever, epigastric mass
modest elevation in amylase

A

pancreatic pseudocyst

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45
Q

antibodies in pemphigus

A

desmoglein 3 and 1

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46
Q

inheritance of hereditary spherocytosis

A

AD

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47
Q

on hcq for SLE, tired and renal involvement

A

MMF and cyclophosphamide for nephritis

former - african and hispanic
latter - avoid in young patients particularly childbearing potential

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48
Q

cause of thyrotoxicosis in Graves disease

A

long acting thyroid stimulating antibodies

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49
Q

Ebstein’s anomaly ECG

A

RBBB, broad and tall P waves, R waves small in leads V1 and 2, abnormalities of the terminal QRS pattern

susceptible to paroxysmal SVT

early surgery

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50
Q

what is Kallman’s syndrome due to

A

hypogonadotrophic hypopituitarism

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51
Q

TAVI is only indicated where

A

the patient is not able to undergo surgical valve replacement because of their pre-morbid condition

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52
Q

most common complication of TIPS

A

HE

risk factors - hyponatraemia, sarcopenia, increased age, prior hx, >10mm shunt diameter

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53
Q

human bite pathogen

A

strep anginosus

54
Q

septic arthritis treatment

A

IV fluclox

IV ceftriax - if gonococcal or gram-negative

IV vanc - if MRSA

55
Q

referral for parathyroidectomy if

A

symptoms of hypercalcaemia (thirst, urine, constip) or end organ disease (renal stones, fractures), or >2.85

cinacalcet only for end-stage disease in refractory 2y HPT

56
Q

most important marker of UC severity according to Montreal classification

A

stool frequency

57
Q

cyclospora infection treatment

A

co-trimoxazole

58
Q

peritoneal dialysis - bacterial peritonitis treatment

A

oral cipro and intraperitoneal vanc (if no organism or mixed growth)

59
Q

Turner syndrome OP prevention

A

early HRT

60
Q

pregnancy thyroid levels

A

increase in oestrogen leads to increase in thyroid binding globulin initially -> increase in overall levels of TH although free stays the same

61
Q

which antibodies are the cause of hyperthyroidism in Graves

A

anti-thyroid-stimulation hormone receptor (stimulating)

62
Q

Waldenstrom’s macroglobulinaemia treatment

A

rituximab based chemo

63
Q

detection of measles

A

early - oral fluid measles RNA
3 days after - IgM

64
Q

intervention of choice for symptomatic hypercalcaemia in sarcoid

A

pred

65
Q

asymptomatic long QT syndrome treatment

A

BB

if high risk esp if already arrhythmia - then ICD

66
Q

birch pollen allergy association

A

apples, cherries, plums, apricots, pears, kiwi, carrot, celery

ragweed - bananas, melons, cucumber, potatoes, courgettes

mugwort - broccoli

timothy grass allergy - watermelon

67
Q

reactive arthritis

A

analgesia and NSAIDs
short course of steroids
DMARDS if not responding to steroids

68
Q

Li-fraumeni syndrome

A

TP53 mutation

breast cancer, soft tissue and osteo sarcoma, leukemias, brain cancer and adrenocortical tumours

69
Q

treatment of HNF-1 alpha MODY

A

sulfonylurea

eventually B cell failure progresses and initiation of insulin is necessary

70
Q

cyclophosphamide moa

A

DNA alkylation

71
Q

codeine to morphine conversion

A

divide by 10

72
Q

Alport syndrome proteinuria tx

A

ACEI to reduce proteinuria and slow renal progression

due to defect in collagen t4

73
Q

pleural fluid pH <7.2

A

RA
CTD
malignancy
empyema
TB
oesoph rupture

74
Q

aspirin moa

A

non selective cox inhibition

75
Q

events associated with highest risk of future stroke

A

ABCD2 score
age
BP
clinical features
duration of TIA
diabetes

76
Q

temporal lobe epilepsy

A

trial of 2 anti-epileptic agents and still having disabling seizures

anterior temporal lobectomy (preferred option)

can do DBS

77
Q

MCA occlusion symptoms

A

contralateral hemiparesis, sensory loss and hemianopsia
gaze preference toward side of lesion
agnosia
receptive or expressive aphasia

78
Q

timolol drops moa

A

reduced formation of aq hum

79
Q

where are adrenergic receptors located

A

cell membrane
GPCR

80
Q

mumps treatment

A

supportive
paracetamol and NSAIDs
scrotal support

81
Q

pain from bony mets in prostate ca

A

strong opioids

bisphosphonates

radiotherapy

82
Q

craniopharyngioma

A

lower loss

83
Q

drug causes of microscopic colitis

A

PPIs
NSAIDs
acarbose
ranitidine

84
Q

where is affected in global aphasia

A

L perisylvian region and thalamus

85
Q

thyroid eye disease

A

steroids
tocilizumab
orbital radiation

86
Q

complex partial epilepsy treatment

A

levetiracetam

87
Q

dog bite pathogen

A

pasteurella

88
Q

medication to reduce risk of colorectal ca in patients with lynch

A

aspirin 600mg

89
Q

deterioration with evidence of further decrease in pancreatic endocrine function (hyperglycaemia), combined with worsening hypocalcaemia, acidosis and abdominal collection

A

acute pancreatic necrosis

90
Q

back pain lethargy night sweats
raised globulins
urinary protein consistent with light chain excretion
pain over lumbar spine

A

malignant myeloma

91
Q

efficacy of hep B vaccine

A

anti HBs antibody level

92
Q

features on ECG consistent with imminent cardiac arrest

A

QRS prolongation
high grade AV block with sinus bradycardia or slow AF
sine wave appearance

93
Q

EPO is only indicated for treatment of anaemia associated with CKD in

A

patients who are iron replete

94
Q

which of the following ig subtypes in RF composed of

A

IgM

bind to human IgG

95
Q

why do you use irradiated blood

A

depletion of donor white cells (T lymphocytes) in order to reduce risk of gvhd

96
Q

radio lucent renal stones

A

urate
xanthine
(cystine are semi opaque)

97
Q

prevention of calcium renal stones

A

fluids
potassium citrate
thiazides

98
Q

prevention of oxalate stones

A

cholestyramine and pyridoxine

99
Q

prevention of uric acid stones

A

allopurinol
alkalisation - eg bicarb

100
Q

where does S4 correspond on ECG

A

after the P wave

101
Q

features of lateral medullary syndrome - vertebral artery occlusion

A

vestibular disturbance, Horner’s, nystagmus, reduced corneal reflex and palatial paralysis with contralateral sensory loss

102
Q

SLE DMARD of choice

A

HCQ

103
Q

FRC

A

volume of air present in the lungs at the end of passive expiration

104
Q

necrobiosis lipoidica diabeticorum treatment

A

topical corticosteroids with occlusive dressing

later triamcinolone

105
Q

area of heart recognised to be pro-arrhythmogenic

A

coronary sinus

106
Q

treatment of Whipple’s disease

A

IV ceftriaxone or penicillin

107
Q

diabetics during ramadan

A

change metformin dosing schedule to 1/3 am 2/3 pm with meal

108
Q

low Ca
low PO4
raised ALP
raised PTH

A

osteomalacia

109
Q

recurrent vaginal candidiasis

A

fluconazole 150mg oral every 72hrs

110
Q

docetaxel kidney effect

A

renal tubular toxicity

111
Q

tocilizumab moa

A

anti IL6

112
Q

infliximab moa

A

tnf-a antagonist

113
Q

abatacept moa

A

CTLA4-Ig

114
Q

nephrogenic DI failed to respond to solute and protein reduction following discontinuation of lithium therapt

A

hydrochlorthiazide

115
Q

primary mode of killing for neutrophils

A

phagocytosis

116
Q

dermatomyositis treatment

A

high dose pred tapering

azathioprine

cyclophosphamide

117
Q

primary syphilis infection with penicillin allergy

A

doxy (14d 100mg bd)
azithro (stat)

118
Q

pyrazinamide side effect

A

joint pains
hepatitis
pyrexia

119
Q

% of identical HLA match in sibling

A

25

120
Q

first choice anti-hypertensive if already on lithium

A

CCB
BB (impaired glucose tolerance)

121
Q

salmeterol moa

A

partial agonist of beta 2 receptor

122
Q

fixed flexion deformity of the hip

A

rectus femoris

123
Q

SGLT2 transporters location

A

PCT

124
Q

acute optic neuritis investigation

A

MRI brain and orbits with contrast

125
Q

minor symptoms of haemoptysis in lung ca

A

oral TXA

126
Q

HHT inheritance

A

AD

127
Q

Crohn’s sx + PG

A

IV infliximab

128
Q

where do spironolactone and eplerenone work

A

distal part of the DCT

129
Q

which feature identifies a reticulocyte instead of a normal mature erythrocyte

A

contains ribosomal RNA

130
Q
A

MRCP Part 1 (5 decks)

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