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)
2
Q
induction vs inhibition time scale
A
longer term exposure vs short
3
Q
dose of bicarbonate in salicylate overdose
A
50-100mL of 8.4% with target pH 7.45-55
4
Q
when is prednisolone indicated for treatment of IgA nephropathy
A
significant proteinuria where steroids have been proven to slow progression of disease
5
Q
initial intervention of choice for primary thrombocytosis
A
hydroxyurea
6
Q
achalasia treatment
A
balloon dilatation
Heller’s myotomy
7
Q
Behcet’s disease treatment
A
eye involvement -> systemic therapy with corticosteroids
cyclophosphamide, azathioprine and etanercept
8
Q
presentation of ASD
A
syncopal episodes, pAF, ankle swelling, fixed split S2, mid-systolic murmur (with L to R shunt)
9
Q
hereditary angioedema inheritance
A
AD
10
Q
SBP most common pathogen
A
E coli
cefotaxime 2g IV TDS
11
Q
Whipple’s disease treatment
A
2 weeks ceftriaxone
up to a year of cotrim
12
Q
what do peripheral chemoreceptors do in CO poisoning
A
have no effect on ventilation
13
Q
ventricular tachycardia on BG of recent AMI and limited ST elevation with no chest pain and no elevation
A
LV aneurysm
14
Q
erysipelas treatment
A
oral co-amox
15
Q
oral to SC morphine
A
divide by 2
16
Q
atlantoaxial subluxation from RA
A
C spine XR
17
Q
pregnant and on bosentan
A
stop - endothelin antagonists are teratogenic
18
Q
evolocumab
A
reduces LDL
recommended where LDL persistently >4 despite max lipid-lowering therapy
19
Q
immune memory and long-term protection from vaccination
A
T cells
20
Q
Kallmann syndrome inheritance
A
XLR
21
Q
CF inheritance if both partners have siblings with CF
A
1/9
22
Q
treatment for nephrogenic diabetes insipidus
A
low solute diet and thiazides
23
Q
most risk for pressure sores
A
BMI >25
24
Q
benzo OD
A
flumaz
seizure -> intubate and ventilate
25
dermatomyositis treatment
prednisolone
azathioprine
26
baclofen MOA
inhibits glutamate release
27
what does the R recurrent laryngeal nerve lie close to
bifurcation of the R inferior thyroid artery
28
ankylosing spondylitis treatment
trial of 2 NSAIDs
anti TNF agent - adalimumab or etanercept
29
chronic renal failure with low Ca and marked elevation in serum phosphate
use calcium acetate to reduce serum phosphate
30
raloxifene vs teriparatide
advantage in patients with FHx of breast
vs
T -3.5, 2+ fractures and >65
31
pulmonary and renal haemorrhage, with renal failure, haematuria and proteinuria, with normal ESR
anti GBM disease
32
high risk of OP with AED
phenytoin
33
renal stones in patients with small bowel resection or active small bowel and terminal ileal inflammation eg Crohns
oxalate
34
ezetimibe receptor
NPC1L1
35
colectomy in acute severe colitis
not responded to 7 days rescue therapy (ciclosporin or infliximab)
or deterioration/complications eg toxic megacolon, severe haemorrhage or perforation
36
investigation of choice for anaemia associated with CKD
percentage of hypochromic red cells
37
measles transmission
airborne
38
most appropriate investigation to establish the origin of the bacteria in infective endocarditis
orthopantomogram
39
ticagrelor moa
P2Y12 inhibitor
40
giardiasis treatment
metronidazole 7d tinidazole
intermittent diarrhoea, abdominal bloating and anorexia
41
asthma with worsening symptoms, eosinophilia, inflammatory changes on CXR and positive Asp
ABPA
oral steroids and itraconazole
42
microcytic anaemia with abnormal LFTs and liver mets on USS ->
colonoscopy
43
polymyositis antibody
anti-jo1
44
grumbling epigastric pain, fever, epigastric mass
modest elevation in amylase
pancreatic pseudocyst
45
antibodies in pemphigus
desmoglein 3 and 1
46
inheritance of hereditary spherocytosis
AD
47
on hcq for SLE, tired and renal involvement
MMF and cyclophosphamide for nephritis
former - african and hispanic
latter - avoid in young patients particularly childbearing potential
48
cause of thyrotoxicosis in Graves disease
long acting thyroid stimulating antibodies
49
Ebstein's anomaly ECG
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
50
what is Kallman's syndrome due to
hypogonadotrophic hypopituitarism
51
TAVI is only indicated where
the patient is not able to undergo surgical valve replacement because of their pre-morbid condition
52
most common complication of TIPS
HE
risk factors - hyponatraemia, sarcopenia, increased age, prior hx, >10mm shunt diameter
53
human bite pathogen
strep anginosus
54
septic arthritis treatment
IV fluclox
IV ceftriax - if gonococcal or gram-negative
IV vanc - if MRSA
55
referral for parathyroidectomy if
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
most important marker of UC severity according to Montreal classification
stool frequency
57
cyclospora infection treatment
co-trimoxazole
58
peritoneal dialysis - bacterial peritonitis treatment
oral cipro and intraperitoneal vanc (if no organism or mixed growth)
59
Turner syndrome OP prevention
early HRT
60
pregnancy thyroid levels
increase in oestrogen leads to increase in thyroid binding globulin initially -> increase in overall levels of TH although free stays the same
61
which antibodies are the cause of hyperthyroidism in Graves
anti-thyroid-stimulation hormone receptor (stimulating)
62
Waldenstrom's macroglobulinaemia treatment
rituximab based chemo
63
detection of measles
early - oral fluid measles RNA
3 days after - IgM
64
intervention of choice for symptomatic hypercalcaemia in sarcoid
pred
65
asymptomatic long QT syndrome treatment
BB
if high risk esp if already arrhythmia - then ICD
66
birch pollen allergy association
apples, cherries, plums, apricots, pears, kiwi, carrot, celery
ragweed - bananas, melons, cucumber, potatoes, courgettes
mugwort - broccoli
timothy grass allergy - watermelon
67
reactive arthritis
analgesia and NSAIDs
short course of steroids
DMARDS if not responding to steroids
68
Li-fraumeni syndrome
TP53 mutation
breast cancer, soft tissue and osteo sarcoma, leukemias, brain cancer and adrenocortical tumours
69
treatment of HNF-1 alpha MODY
sulfonylurea
eventually B cell failure progresses and initiation of insulin is necessary
70
cyclophosphamide moa
DNA alkylation
71
codeine to morphine conversion
divide by 10
72
Alport syndrome proteinuria tx
ACEI to reduce proteinuria and slow renal progression
due to defect in collagen t4
73
pleural fluid pH <7.2
RA
CTD
malignancy
empyema
TB
oesoph rupture
74
aspirin moa
non selective cox inhibition
75
events associated with highest risk of future stroke
ABCD2 score
age
BP
clinical features
duration of TIA
diabetes
76
temporal lobe epilepsy
trial of 2 anti-epileptic agents and still having disabling seizures
anterior temporal lobectomy (preferred option)
can do DBS
77
MCA occlusion symptoms
contralateral hemiparesis, sensory loss and hemianopsia
gaze preference toward side of lesion
agnosia
receptive or expressive aphasia
78
timolol drops moa
reduced formation of aq hum
79
where are adrenergic receptors located
cell membrane
GPCR
80
mumps treatment
supportive
paracetamol and NSAIDs
scrotal support
81
pain from bony mets in prostate ca
strong opioids
bisphosphonates
radiotherapy
82
craniopharyngioma
lower loss
83
drug causes of microscopic colitis
PPIs
NSAIDs
acarbose
ranitidine
84
where is affected in global aphasia
L perisylvian region and thalamus
85
thyroid eye disease
steroids
tocilizumab
orbital radiation
86
complex partial epilepsy treatment
levetiracetam
87
dog bite pathogen
pasteurella
88
medication to reduce risk of colorectal ca in patients with lynch
aspirin 600mg
89
deterioration with evidence of further decrease in pancreatic endocrine function (hyperglycaemia), combined with worsening hypocalcaemia, acidosis and abdominal collection
acute pancreatic necrosis
90
back pain lethargy night sweats
raised globulins
urinary protein consistent with light chain excretion
pain over lumbar spine
malignant myeloma
91
efficacy of hep B vaccine
anti HBs antibody level
92
features on ECG consistent with imminent cardiac arrest
QRS prolongation
high grade AV block with sinus bradycardia or slow AF
sine wave appearance
93
EPO is only indicated for treatment of anaemia associated with CKD in
patients who are iron replete
94
which of the following ig subtypes in RF composed of
IgM
bind to human IgG
95
why do you use irradiated blood
depletion of donor white cells (T lymphocytes) in order to reduce risk of gvhd
96
radio lucent renal stones
urate
xanthine
(cystine are semi opaque)
97
prevention of calcium renal stones
fluids
potassium citrate
thiazides
98
prevention of oxalate stones
cholestyramine and pyridoxine
99
prevention of uric acid stones
allopurinol
alkalisation - eg bicarb
100
where does S4 correspond on ECG
after the P wave
101
features of lateral medullary syndrome - vertebral artery occlusion
vestibular disturbance, Horner's, nystagmus, reduced corneal reflex and palatial paralysis with contralateral sensory loss
102
SLE DMARD of choice
HCQ
103
FRC
volume of air present in the lungs at the end of passive expiration
104
necrobiosis lipoidica diabeticorum treatment
topical corticosteroids with occlusive dressing
later triamcinolone
105
area of heart recognised to be pro-arrhythmogenic
coronary sinus
106
treatment of Whipple's disease
IV ceftriaxone or penicillin
107
diabetics during ramadan
change metformin dosing schedule to 1/3 am 2/3 pm with meal
108
low Ca
low PO4
raised ALP
raised PTH
osteomalacia
109
recurrent vaginal candidiasis
fluconazole 150mg oral every 72hrs
110
docetaxel kidney effect
renal tubular toxicity
111
tocilizumab moa
anti IL6
112
infliximab moa
tnf-a antagonist
113
abatacept moa
CTLA4-Ig
114
nephrogenic DI failed to respond to solute and protein reduction following discontinuation of lithium therapt
hydrochlorthiazide
115
primary mode of killing for neutrophils
phagocytosis
116
dermatomyositis treatment
high dose pred tapering
azathioprine
cyclophosphamide
117
primary syphilis infection with penicillin allergy
doxy (14d 100mg bd)
azithro (stat)
118
pyrazinamide side effect
joint pains
hepatitis
pyrexia
119
% of identical HLA match in sibling
25
120
first choice anti-hypertensive if already on lithium
CCB
BB (impaired glucose tolerance)
121
salmeterol moa
partial agonist of beta 2 receptor
122
fixed flexion deformity of the hip
rectus femoris
123
SGLT2 transporters location
PCT
124
acute optic neuritis investigation
MRI brain and orbits with contrast
125
minor symptoms of haemoptysis in lung ca
oral TXA
126
HHT inheritance
AD
127
Crohn's sx + PG
IV infliximab
128
where do spironolactone and eplerenone work
distal part of the DCT
129
which feature identifies a reticulocyte instead of a normal mature erythrocyte
contains ribosomal RNA
130
