PastTest Facts Flashcards
1
Q
Schistosoma Mansoni Features
A
S. mansoni (Africa + parts of South America, the Caribbean and the Middle East while S. japonicum is endemic in China, Indonesia and parts of the Philippines.
- Egg Morphology: In stool microscopy examination, S. mansoni eggs appear ovoid with a lateral spine whereas S. japonicum eggs are round with a small rudimentary spine which may not be visible.
- Host Snail Species: The intermediate host snail species differ between the two; Biomphalaria spp for S. mansoni and Oncomelania spp for S.japonicum.
2
Q
Schistosomiasis Manconi Features
A
Nephrotic Syndrome
Liver Cirrhosis –> Varices / Cor Pulmonale
3
Q
First Sign of Puberty in Girls ?
A
Breast Bud Development
4
Q
How often to Follow-Up DUKE A CRC ?
A
Colonoscopy - annually for 2 years —> 3 yearly
FOB –> 6 monthly for 4 years –> Annually
CEA —> Monitor Recurrence
5
Q
DIC and Clotting Screen
A
6
Q
If Refractory to Medical Therapy with
- Young
- Ongoing Respiratory Sx
Consider what ?
A
Laparoscopic fundoplication
Nissen > Toupet
7
Q
Creatinine Kinase is Normal or Elevated in Polymyalgia Rheumatica ?
A
Normal in Polymyalgia Rheumatica
Elevated in Polymyositis
8
Q
Which Nerve Roots Supply which Reflexes ?
A
C5 C6 - Bicep and Brachioradialis
C7 C8 - Tricep
L3 L4 - Knee
S1 S2 - Ankle
C8-T1 - Ulnar
C6-T1 - Median
C5 - T1 - Radian
9
Q
Wallerian Degeneration
Neurotemesis
Axotomy
A
10
Q
Contraindication for Thrombolysis ?
A
Known Intracranial Tumor
Ischemic Stroke < 3 months
Any Hx of Hemorrhagic Stroke
Suspected Dissection
Traumatic CPR in last 3 weeks
11
Q
Type 1 RTA Causes
A
RA / Sjogren / Amphotericin Toxicity / Cirrhosis
12
Q
Risk factor for HCC ?
A
Alpha 1 Antitrypsin
13
Q
Nephrotic Syndrome Serum Electrophoresis
A
- Increased Alpha 1 and Alpha 2 Globulins
- Decreased Albumin
14
Q
What is Reflex Autonomic Dystrophy or Sudek’s Syndrome ?
A
Complex Regional Pain Syndrome
Disproportionate Pain to Signs
Cool Scaly Skin
Swollen Limb
15
Q
WPW Type A and B
A
Type A (Left Sided Pathway) - Dominant R wave in V1 + Right Axis Deviation
Type B (Right Sided Pathway) - No R wave in V1 + Left Axis Deviation
16
Q
Neurogenic Syncope Best Ix ?
A
Tilt Table Test
17
Q
What intolerance is seen commonly after a Giardia Infection ?
A
Lactose
Diahorrea after treatment with Tinidazole
Omit Lactose Containing Food
18
Q
Which Immunosuppressant post renal transplant gives a Chron’s like picture ?
A
MMF
19
Q
Anaphylaxis highest in which group of Anesthetic Drug ?
A
Vecuronium
20
Q
Glucagonoma Features
A
Angular Stomatitis
Necrolytic Migratory Erythema
Normocytic Normochromic Anemia
21
Q
Which Electrolyte Abnormality is most serious in Refeeding Syndrome ?
A
Hypophosphatemia
22
Q
Acutely Urate Levels Low or High in Gout ?
A
Low
23
Q
SD vs SE ?
A
SD: Spread of individual data points.
SE: Spread of sample MEAN if you repeated the experiment many times.
24
Q
MODY 2 vs MODY 3
How to differentiate
A
MODY 2 (Glukokinase Defect)
Glucokinase is what detects the BM and releases Insulin
So if defect then BASELINE FASTING GLUCOSE will be HIGHER but the OGTT rise will be LESS.
+
Family History in Questions would have no Complications which makes MODY2>3
25
Chlamydia Psittaci
Horder's Spots + Exposure to an ill bird = Pathognomic
Not Responding to Penicillin based Abx + Organomegaly
26
Waldenstrom Macroglobulinemia is IgM or IgG rise ?
IgM
27
MOA of Fomepizole
Competitive Inhibitor of Alcohol Dehydrogenase
28
Milk kept outside
What bug grows and what Toxin ?
Staphylococcus Aureus
Heat Stable Endotoxin OR TSST1 Superantigen
Toxins would be PREFORMED in the milk at time of consumption
29
Gene for Alport Syndrome ?
COL4A5
30
Before starting Treatment for GBS what test must be done ?
measure IgA and if IgA deficiency then likely anaphylaxis when giving IVIG
31
Renal Extraction Ratio Meaning ?
Decline in the concentration of Drug from Arterial to Venous Side
32
Anti Thyroglobulin Antibodies and Anti Microsomal Antibodies seen where ?
Hashimoto's Thyroiditis
33
Whats the best Modality to Screen Siblings who want to donate for ADPKD sibling?
Genetic not Abdo USS
34
Drug that causes Intracranial HTN and hence 6th CN Palsy ?
Tetracycline
Amiodarone
OCP
35
GLUT1 -
Insulin Independent
RBC Brain
GLUT2
Insulin Independent
2 Kidneys
2 Organs - Liver and Small Intestines
High Affinity and High Km
GLUT3
Nerves
Placenta
GLUT4
INSULIN DEPENDANT
Skeletal Muscles and Adipose
GLUT5
Hepatocytes
Seminiferous Tubules
GIT
36
Which drugs cause Cholestasis > Hepatitis ?
Chlorpromazine
Co-Amoxiclav
Erythromycin Estolate (rare
Nitrofurantoin
37
Conducting Zone in Bronchial Tree ?
First 16 branches
38
Gas exchange happens in which branches of the Bronchial Tree ?
17-23
Last 7 branches
39
Which Receptor in Eosinophilic Apoptosis ?
P1
40
Beta Blocker with Greatest Distribution or Most Lipophilic
Metaprolol
41
Which 2 drugs are Protein Bound ?
Wafarin and Phenytoin
42
Commonly misdiagnosed as MS
X linked ADL
Has Myelopathy + Peripheral Neuropathy WITH or WITHOUT Adrenal Failure
43
Which Ig is associated with Periodic Fever ?
IgD
44
Which Ig activate which Complement Pathway ?
IgG and IgM - Classical
IgA - Alternate
45
Anatomical Landmark for Oblique Fissure ?
Medical Scapula Border when Arms Abducted
46
Inferior Alveolar Branch of the Mandibular Division of Trigeminal Nerve Supplies what ?
Lower Lip
47
Methotrexate Absorbed at Kidney Via ?
Organic Anion Transporter 1 (OAT1)
Probenecid inhibits OAT1
48
Which Drugs use MDAC ?
Phenobarbital
Quinine
Dapsone
Theophylline
Carbamazepine
49
Azathioprine MOA ?
Purine Synthesis Inhibitor
Reduce Lymphocyte Number and Function
50
Theophylline Toxicity
(Metabolic Acidosis + Hypokalemia) is caused by which drugs ?
Allopurinol
51
Traztuzumab causing Dilated Cardiopathy via what Reception Inhibition
Erb-b2 Receptor
52
Leptin in addition to promoting satiety also does what ?
Increase GnRH
53
Ethylene Glycol Toxicity has what metabolic picture ?
HypoCalcemia
54
SLE Complement
C1q r s C4
55
Drugs causing Pancytopenia ?
ACS
Antibiotics: Trimethoprim, Chloramphenicol.
AED: Carbamazepine
Anti-rheumatoid: Penicillamine, Gold
Carbimazole
Cytotoxics
Sulfonylureas: Tolbutamide
56
What channels cause Rapid Repolarization in Cardiac Membranes ?
Closure of L type Calcium > Opening of K+
57
Hep B or C in Polyclonal Cryoglobunemia ?
Hep CCCCCCCCCC
For Exam
Type 1 and Type 2 have Rheumatoid Sensitivity so dont be put off if Rh Factor +
58
Wisktott Aldrich Syndrome (X linked)
Ezcema + Thrombocytopenia + Recurrent B/V/F
1/3 rd develop cancers !!!!
T cell Deficiency !!!
CVID (20-40)
Low Ig globally + Low Response to Abx
SCID
B and T cell Deficiency
59
Metabolic Syndrome Diagnostic Criteria ?
1. Abdominal Waist Circumference
2. Low HDL
3. High Triglycerides
4. High BP
5. High Glucose
60
Long Term Protease Inhibitor in HIV Side Effect ?
ART insulin Resistance ----> Basically Cushings
61
HHT
Inheritance ?
Defective Protein ?
Alternative Name for the Disease ?
Features
AD
Endoglin
Osle-Weber-Rendu Syndrome
GI Hemorrhage
62
Optic Chiasm = Bitemporal Hemianopia
Optic Nerve = Central Scotoma !!!!!!!!
63
Chances of Having a Baby with Achondroplasia ?
AD
but 80% Germcell Mutation so <1%
64
SNOW DROP yes !!!
but what is used to look at the 3D Structure of Proteins ?
Then what is used to look at the Change in the Confirmational State of Proteins ?
X ray Crystallography
Dual Polarization Inferometry !!!!!
65
Bullous Phemigoid vs Phemigus !!!
Investigation of Choice ?
Bullous - Direct Immunofluorescence of Biopsy
Phemigus - Acantholyis on Biopsy and Antibodies against Desmoglein 1 and 3 !!!!
66
MOA of Metformin ?
Activate AMP Activated Protein Kinase
67
If Ileostomy patients with HypoCalcemia then correct what ?
Hypomagnesemia
68
KRAS
Rb
p16
Ichthyosis and Pancreatic Cancer
Bladder Ca
Pancreatic Cancer
69
Chi Square
Propotion on Patients Alive AT THE SAME TIME for each group
IF follow up at 3 and 5 then if 5 some might not survive till 5 so always compare the same time
70
Neuralgic Amyotrophy Features ?
AKA Brachial Neuritis
Post Vaccination
Axonal Changes in EMG
Winging of Scapula
Weakness across a Dermatome
NO SENSORY CHANGES
71
Listeria Monocytogenes covered in Meningitis with which Antibiotic
Ampicillin
72
Barretts Esophagus Follow up
No Dysplasia - 2-5 yearly f/u
If Low Grade Dysplasia - 6 monthly
If High Grade - 3 monthly
73
Congenital Long QT Syndrome Pathology ?
Slow Delayed Rectifier K Channel Mutation
KCNQ1 - MCC Gene Mutation for Type 1 Long QT Syndrome
Rapid Delayed Rectifier K Channel Mutation - LQT Type 2
Na Channel Mutation - LQT Type 3
Sudden Infant Death Syndrome / SUDS
Ankyrin B - LQT Type 4
Ca 1.2 Sodium Channel Mutation - Type 8
74
If underlying cirrhosis and then SBP from Peritoneal Dialysis
What's the organism ?
E coli
Usually Epidermidis then S. Aureus --> treated with Vaco + Ceftizime added to Peritoneal Fluid
OR
Vanc to Peritoneal Fluid + Oral Cipro
75
Lumbar Spinal Stenosis vs Intermittent Claudication ?
If Stationary Exercises are tolerable like a Peloton then SPINAL STENOSIS
76
5 types of Lacunar Stroke !!!
Pure Motor
Pure Sensory
Sensorimotor Stroke
Ataxic Hemiparesis
Clumsy Hand Dysarthria
77
Naltrexone SE ?
GI so prefer Acamprosate
78
If MM/ Walderstom Macroglobunemia in Options and Patient had Headache Vision Changes and Ischemia
Think what ??
Think Hyperviscosity Syndrome !!!!
79
Sniff Test in a Patient with Left Hemidiaphragm Elevation should show what ?
Paradoxical Hemidiaphragm Elevation
80
Complication of Untreated Hypothyroidism ?
SIADH
81
SSC metastasize via ????
Lymphatics
82
Treatment for Tourette ?
Risperidone
83
SADPERSONS Score Recall and the relevant weightages
Sex Male
Age <19 or >40
Depression (2)
Previous Attempts
Excessive Alcohol
Rational Thinking Loss (2)
Separated/Widowed
Organized (2)
No Social Support
Stated Future Intent (2)
84
EMG Triad for Polymyositis ?
1. Fibrillation at Rest
2. Polyphasic or Short Duration in Voluntary Movement
3. Repetitive Potentials at Mechanical Stimulation
85
Post ileal Resection in Chron's and having watery Diahorrea then Treatment ??????
CHOLESTYRAMINE
86
If HS then what colour are the gallstones ?
Black
87
Tropical Sprue vs Whipple
Lack of Whipple and also living in an infection prone place
Subtotal Villous Atrophy in Tropical Sprue
88
What Drug reduces Wafarin Absorption ?
Inducers + Cholestyramine
89
Botulinum presents like LEMS ---> Repetitive Stimulation showing Increment Response
90
Nitric Oxide derived from ------------>
L-Arginine
91
Hereditary Angioedema Inheritance
AD
92
Chronic Thromboembolic Pulmonary Hypertension results in ??????
Widening of Alveolar - Arterial gradient on Exercise
93
What type of Colonic Polyps are Premalignant
Serrated
94
Drug induced Lupus More Common in which Population ?
White '
Black Women more in SLE !!!!!
95
Long Term Dialysis Associated with Which Complication ?
Carpal Tunnel Syndrome !!!
96
Tylosis (Palmar Plantar Keratoderma) Associated with Which Cancer ?
Esophageal
97
Doxasosin
For Urinary Incontinence in Spinal Cause Injury !!!!!
98
Penicillamine and Gold Causes what Renal Impairment ?
Nephrotic Syndrome
Associted with HLA DR3
99
In HyperCalcemia what Antiemetic is recommended
Haloperidol then 2nd Line Metoclopramide
1st line for Chemotherapy induced --> Ondansetron
100
Down regulation of Glucokinase in the Liver is an example of _________
Co-Repression
101
Anti GBM Collagen Type ?
Alpha 3 Subunit of Collagen 4
102
What is the Hep C Antibody Status in those with
1. Immunocompromised
2. On Hemodialysis
FALSELY NEGATIVE
so do HCV PCR !!!!
103
Diffuse Proliferative Glomerulonephritis seen in ?
Post Streptococcal and
SLE !!!!
104
Which Medication can Cause First Dose Hypotension ?
ACEi
Especially in combination with Diuretics
105
Calciphylaxis vs PG how to differentiate ?
Unilateral vs Bilateral
Calciphylaxis in ESRD patients not attending Dialysis sessions
106
MOA of Orlistat ?
Pancreatic Lipase Inhibitor
107
When to consider Orlistat ?
Liraglutide when to consider ?
BMI > 28 with RF
BMI > 30
Continued Weight Loss of 5% in 3 months
Initial BMI of ≥30 kg/m² OR ≥27 to <30
(overweight) + 1 RF like
dysglycaemia (pre-diabetes or type 2 diabetes mellitus),
hypertension,
dyslipidaemia or obstructive sleep apnoea'
108
Antiphospholipid vs Activated Protein C Resistance
Shortened APTT and normal platelets in Factor V Leiden
Prolonged APTT + Low Platelets in APLS
109
Investigation of Choice for Bile Acid Malabsorption Post Crohn's Resection ?
SeCHAT Test
110
Porphyria Cutaneous Tardia (Decarboxylase) Deficiency)
Congenital Erythropoietic Porphyria (Urophobilinogen Synthase III)
Variegate Porphyria (Protoporphyrogen Oxidase)
Erythropoietic Protoporphyria
(Ferrochelatase)
Sporadic
Alcohol Users / Long Tern Estrogen Users
Hep C / Hemochromatosis
111
PTU and Carbimazole when to give in Early Pregnancy ?
PTU then Carbimazole later in 3rd Trimester !!!!
112
DAD/MIDD Disease
Diabetes Insipidus
Deafness
Mitochondrial Disease
113
Difference between Thiazide vs Thiazide Like Diuretics
Thiazide Like Has no Dysglycaemia
114
Benzbromarone MOA ?
URAT1 inhibitor
115
Amyloidosis is Beta Pleated Sheets
116
Psoriasis is what HLA ?
HLA CW6
117
Varenicline MOA ?
5HT3 Agonism
118
Gold Standard to Test for PanHypoPituitarism
Insulin Stress Test
But Contraindicated in Seizures/IHD
119
Topiramate Side Effects ?
Weight Loss and Renal Stones
120
121
Bosentan Side Effect ?
Inhibit both ETA and ETB
Dose Dependent Hepatotoxicity
