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Path 1 Flashcards

1
Q

Inc GGT+ALP > inc AST+ALT

A

Obstructive picture

i.e. gallstones, malignancy

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2
Q

Inc AST+ALT

A

Hepatocyte damage - ALT more sensitive
2AST:1ALT = ETOH
1>AST:1ALT = Viral

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3
Q

Elevated GGT

A

Chronic ETOH use (confirms hepatic source of ALP)

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4
Q

Gilbert’s

A

Reduced conjugation of bili.

Biochem normal apart from inc bili

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5
Q

Ax - autoimmune antiglycoprotein IIb-IIIa Ab leading to thrombocytopenia (chronic)/ virus coated plts (acute)
Px - plt disorder so superficial bleeding (gums), low plts, proceeds infx, in children (acute, chronic differs slightly)
Mx - self limiting (acute)/steroids + splenectomy (chronic)

A

Autoimmune thrombocytopenic purpura

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6
Q

Ax - FVIII deficiency, X-linked recessive,
Px - prolonged bleeding after surgery
Mx - FVIII concentrates lifelong

A

Haemophilia A

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7
Q

Ax - FIX def, X-linked recessive
Px - like Haemophilia A
Mx - FIX concentrates lifelong

A

Haemophilia B/Christmas disease

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8
Q

Ax - plt microthrombi causing MAHA
Px - Renal failure, low plts, fever, neuor signs (headache, stroke)
Mx - plasma exchange

A

(Idiopathic) Thrombotic thrombocytopenic purpura

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9
Q

Ax - E.coli toxin leads to RBC damage

Px - D, renal failure, children and elfderly

A

Haemolytic uraemic syndrome (HUS)

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10
Q

Ax - widespread activation of coagulation due to malignancy/sepsis/trauma/placental abruption/amniotic fluid embolus
Px - Clotting F’s + Plts consumed=bleeding, low Plts, low fibrinogen, renal failure, shock

A

Disseminated intravascular coagulation (DIC)

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11
Q

Ax - vWF def, autosomal dominant, (low production of FVIII)

Px - Gum bleeding, epistaxis, prolonged bleeding after surgery

A

Von Willebrand disease

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12
Q

Ax - autosomal dominant

Px - telangiectasia on skin and mucous membranes

A

Osler-Webber-Rendu/hereditary haemorrhagic telangiectasia

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13
Q

Rheumatoid Arthritis AutoAb

A

Anti-CCP, rheumatoid F

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14
Q

Autoimmune hepatitis autoAb

A

Anti-smooth muscle, anti-liver kidney microsomal-1 (anti-LKM1), anti-soluble liver antigen (anti-SLA)

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15
Q

Dermatomyositis autoAb

A

Anti-Jo1

Px - heliotrope rash around eyes, Gottron’s papules, proximal limb weakness

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16
Q

Systemic scleroderma/CREST syndrome

A

Ax - anti-centromere Ab

Px - Calcinosis, Reynaud’s, Oesophageal dysmotility, Sclerodactyly, Telangectasia

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17
Q

Diffuse cutaneous scleroderma autoAb

A

Anti-topoisomerase

Px - similar to CREST but more aggressive

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18
Q

Churg-Strauss syndrome/Eosinophilic granulomatosis with polyangiitis

A

pANCA

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19
Q

SLE

A

Ax - anti-dsDNA

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20
Q

Pernicious anaemia

A

Ax - anti-parietal cell Abs

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21
Q

Graves

A

Ax - anti-TSH Abs

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22
Q

Coeliac’s autoAb

A

anti-TTG, anti-endomysial Abs

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23
Q

Myasthenia Gravis AutoAb

A

Anti-Ach receptor

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24
Q

Primary biliary cirrhosis AutoAb

A

Anti-mitochondrial Ab

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25
Q

T1DM AutoAb

A

Anti-glutamate decarboxylase, Anti-pancreatic beta cells

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26
Q

Wegener’s Granulomatosis/Granulomatosis with PolyAngitis (GPA)

A

c-ANCA

saddle shaped nose, epistaxis, haemoptysis, haematuria, glomerulonephritis

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27
Q

Chlamydia trachomatis

A

Grm -ve obligate
Px:
Chlamydiosis - dysparenuia, dysuria, vaginal/penile discharge
Lymphogranuloma venerum - painless papule/ulcer, LA

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28
Q

Treponema pallidum

A

Syphilis
primary - painless genital ulcer
Secondary - bacteriaemic, rash, LA
Tertiary - multiple organs, neuro signs, pupils

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29
Q

Haemophlus ducreyi

A

Grm -ve coccobacillus, cultured on chocolate agar

Px -tropical ulcer diseas, painful genital ulcer

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30
Q

Neiserria gonorrhoeae

A

Grm -ve diplococcus
Px - urethritis, dysuria, purulent discharge
Thayer-Martin VCN medium

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31
Q

Bacterial vaginosis

A

Ax - bacterial imbalance
Px - fishy smelling, white cream discharge
Ix - pH >4.5, clue cells

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32
Q

Trichomonas vaginalis

A

flagellated protozoan

Ix - wet prep microscopy

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33
Q

Klebsiella granulomatis

A

Grm +ve rod
Px - donovanosis, ulcerating STI
Ix - giemsa stain=donovan bodies

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34
Q

Herpes simplex virus 2

A

Px - genital herpes, fluid filled painful blisters

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35
Q

Addison’s disease

A

Def - Adrenal insufficiency
Px - fatigue, orthostatic hypotension, hyponatraemia, hyperkalaemia
Ix - synACTHen test

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36
Q

Conn’s syndrome

A

Def: primary hyperaldosteronism

Px - HTN, hypernatraemia, hypokalaemia

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37
Q

Prolactinoma

A

Def: most prevalent pituitary tumour

Px - amenorrhoea, galactorrhoe, gynaecomastia

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38
Q

Grave’s

A

Def: TSH receptor Abs overproduction

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39
Q

Kallman’s

A

Def: hypogonadotrophic hypogonadism

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40
Q

FV leiden

A

Def: FV less easily broken down by protein c = hypercoagulable

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41
Q

Anti phospholipid syndrome

A

Autoimmune: anti-cardiolipin Abs, lupus anticoagulant

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42
Q

Buerger’s disease

A

Vasculitis

Px - Corkscrew angiogram

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43
Q

Protein S deficiency

A

Imparied degradation of FVa + VIIIa

Protein S is an anticoagulant that break down FVa + FVIIIa

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44
Q

Antithrombin deficiency

A

Antithrombin inhibits FIIa (thrombin) and FXa

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45
Q

Sjorgren’s syndrome

A

Anti-ro, anti-la present in 50%
Def: destruction of the epithelial cells of the exocrine glands
Px - dry eyes/mouth, parotid swelling, arthralgia, myalgia

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46
Q

Amoxicillin

A

Beta-lactam Abx

Mild community aqc pneumonia

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47
Q

Flucloxacillin

A

Beta-lactam Abx

S. Aureus

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48
Q

Trimethoprim

A

Folate metabolism inhibitor
Uncomplicated UTI’s
SE: megaloblastic anaemia

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49
Q

Vancomycin

A

Glycopeptide Abx inhiits cell wall synthesis
MRSA
Grm +ve
SE’s need to be monitored

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50
Q

Cefotaxime

A

3rd gen cephalosporin

N.Men/Bacterial meningitis

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51
Q

Doxycycline

A

Tetracycline (30s protein synthesis)

Chlamydia + gonorrhoea, COPD exacerbation

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52
Q

Co-amoxiclav

A

Amox and clavulinic acid (beta-lactamase inhibitor)

Severe community aqc pneumonia, nosocomial UTI

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53
Q

Cirrhosis Histo

A

Fibrosis and nodules

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54
Q

Hameochromatosis

A

Def: autosomal recessive condition due to HFE mutation causing inc Fe
Ix - Perl’s prussian blue stain

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55
Q

Hepatocellular carcinoma

A

Most common primary liver malignancy, commonly secondary to cirrhosis
Aflatoxin

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56
Q

Pagets biochem

A 
Ca: N
PTH: N
ALP: Inc
PO4: N
VitD: N
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57
Q

Primary hyperparathyroidism

A 
Ca: Inc
PTH: Inc/N
ALP: Inc/N
PO4: Dec
VitD: N
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58
Q

Osteomalacia

A 
Ca: Dec
PTH: Inc
ALP: Inc
PO4: Dec
VitD: Dec
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59
Q

Primary hypoparathyroidism

A 
Ca: Dec
PTH: Dec
ALP: Dec/N
PO4: Inc
VitD: N
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60
Q

Graft vs host disease

A

Ax - transfer of donor lymphocytes in immsupressed

Px - D, macpap rash, skin necrosis

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61
Q

Transfusion related lung injury

A

w/in 6hrs

px - dry cough dyspnoea and fever

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62
Q

Immediate haemolytic transfusion reaction

A

Ax - ABO incompatibility

Px - Abdo pain, loin pain, vomiting, flushing, HbUria

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63
Q

Goodpasture’s

A

Type IV collagen T2 hypersensitivity reaction

Px - cough, haemoptysis, HbUria

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64
Q

Hepatitis B

A

dsDNA virus prevelant in sub-Saharan Africa
IP 2-6mnths Acute<6 mnths
20% become chronic

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65
Q

Hepatitis C

A

ssRNA

80% become chronic

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66
Q

EBV

A

Associated with glandular fever/infectious mononucleosis

Monospot test+ve, atypical lymphocytes

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67
Q

Influenza

A

Binds to sialic acid receptor

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68
Q

Chronic myeloid leukaemia

A

Def: Myeloproliferative disorder
Epid: 40-60
Ax - Phili chromosome 9;22 = BCR-Abl
Px - often asymptomatic picked up on routine blds, splenomegaly massive
Ix - Ph+ve, BM biopsy shows hypercellula BM
Chronic, accelerated and blast phase
Tx - tyrosine kinase inhibitor, BMT

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69
Q

Hairy cell leukaemia

A

CLL subtype, B lymphocyte malignancy
Diagnosis - tartrate-resistant acid phosphatase
Px - pancytopenia, HepSplenMeg

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70
Q

Acute myeloid leukaemia

A

Neoplastic process of BM, immature blast cells>20% of BM
Auer rods on blood film
Px - HepSplenMeg, LA, Gum hypertrophy
Ix - morphology, immunophenotyping, cytogenetics
Tx - Chemo

71
Q

Adult T cell leukaemia

A

Ax - human T-cell leukaemia virus Type 1.
Japan Caribbean
Px - HyperCa, LA, HepSplenMeg

72
Q

Chronic lymphocytic leukaemia

A

B cell neoplasm lymphocyte count >4000
Epx- 65-70 males smudge cells
Px - non specific, LA

73
Q

Acute lymphoblastic leukaemia

A

Most common paediatric Ca

74
Q

Multiple sclerosis

A

Myelin basic protein + proteolipid protein implicated in pathogenesis of MS
Def: demyelinating disease
Ax - TIV hypersens reaction cytotixic T cells
Px - optic neuritis, urinary/bowel incontinence, weakness, dysphagia

75
Q

Oral allergy syndrome

A

Type 1 hypersens reaction

IgE cross reacts with food substance (stony fruit)

76
Q

Zidovudine

A

Nucleoside reverse transcriptase inhibitor (NRTI)

AIDS/HIV

77
Q

Interferon-alpha

A

Immune system potentiation JAK-STAT pathway

HepB

78
Q

Oseltamivir

A

Neuramidase inhibitor

Influenza

79
Q

Gancyclovir

A

2-deoxyguanosine analogue

CMV

80
Q

Lamivudine

A

Nucleoside reverse transcriptase inhibitor (NRTI)

81
Q

Efavirenz

82
Q

Ritonavir

A

Protease inhibitor

HIV

83
Q

Amantidine

A

M2 ion channel inhibitor

84
Q

Pemphigoid

A

Fluid filled blisters

Ax - autoimmune

85
Q

Actinic keratosis

A

Brown-red-warty lesion w/ rough consistency

Hist - solar elastosis, focal parakeratosis, premalignant

86
Q

Lichen planus

A

7 p’s - pruritic, purple, polygonal, planar, popular, plaques, pearl sheen.

87
Q

Vit B12 def

A

Pernicious anaemia, assoc w/ graves, megaloblastic anaemia

88
Q

Vit C def

A

Bleeding gums, poor dentition

89
Q

Vit E def

A

poor coordination, areflexia

90
Q

B1/Thiamine

A

Alcholics, wernicke’s encephalopathy,

91
Q

Burkitt’s

A

Starry sky

92
Q

Hodgkin’s lymphoma

A

Reed-Sternberg, pain after ETOH

93
Q

Mantle cell lymphoma

A

Translocation 11;14 (BCL-1 locus +cyclin D1)

94
Q

Follicular lymphoma

A

Centrocytes+centroblasts, translocation 14;18, BCL-2

95
Q

Diffuse large B-cell lymphoma

A

Large B-cells +ve for EBV (or HHV8), HIV

96
Q

Angiocentric lymphoma

A

NK-cell markers and EBV infx

97
Q

Cyclophosphamide

A

Alkylating agent

SLE, Wegeners/GPA

98
Q

Abatacept

A

CTA4-Ig

RA resistant to methotrexate

99
Q

Mycophenolate mofetil

A

prevents guanine synth

Pre-transplant immsup

100
Q

Infliximab

A

TNF-alpha antagonist

101
Q

Denosumab

A

Ab against RANK

Osteoporosis

102
Q

Basiliximab

A

Ab against IL-2alpha receptor

103
Q

Rituximab

A

CD20 monoclonal Ab

Lymphoma, RA, SLE

104
Q

Candida albicans

A

Oral - creamy white patches, Tx - nystatin

Vaginal - cottage cheese like clumps

105
Q

Cryptococcus neoformans

A

India ink CSF analysis = yeast cells with halos
Immcomp pts
Subacute/chronic meningitis

106
Q

Pityriasis versicolour

A

Hypo/Hyper pigmentation

Spaghetti and meatball appearance

107
Q

Aspergillus

A

Pneumonia, spherical opacity aspergilloma, immcomp

108
Q

Sporothrix schenckii

A

Rose gardener’s disease

109
Q

Tinea corporis

110
Q

Tinea capitis

A

expanding ring on scalp

111
Q

Nephritic syndrome

A

Haematuria, red cell casts, white cell casts

112
Q

Goodpasture’s

A

Anti-glomerular basement mebrane Ab
Crescent morphology
Haemoptysis+haematuria

113
Q

Acute tubular necrosis

A

Muddy casts

114
Q

IgA nephropathy/Berger’s disease

A

1-4 days after resp/gastro infx

Frank/microscopichaematuria 50:50

115
Q

Homocystinuria

A

Fair skin brittle hair

Dev delay+convulsions

116
Q

Phenylketonuria

A

Musty smell

Developmental delay low IQ

117
Q

Von Gierke’s

A

Floppy, Hypoglycaemia, HepMeg, Renomeg

118
Q

Maple syrup urine disease

A

Sweet odour+sweaty feet

119
Q

Fabry’s

A

Cherry red spot

120
Q

Essential thombocythaemia

A

+++Plts >600

Px - burning sensation in extremities, DVT,

121
Q

Myelofibrosis

A

Dry tap on BM aspirate, tear drop cells

122
Q

Multiple myeloma

A

Bence-Jones proteins in urine, lytic lesions on XR, rouleaux

123
Q

Chronic myelo-monocytic leukaemia

A

Elderly, monocytosis >1000/mm3, myeloblasts <20% peripheral bld

124
Q

Polycythaemia ruba vera

A

JAK2 mutation, pruritus after hot baths, low erythropoietin

125
Q

Refractory anaemia w/ excess blasts

A

<5% myeloblasts in BM w/ >15%erythrocyte precursors

126
Q

Refractory anaemia

A

<5% myeloblasts in BM

127
Q

Post streptococcal glomerulonephritis

A

preceeding GAS pharyngitis, anti-streptolysin raised

128
Q

Rapidly progressive glomerulonephritis

A

ESRF in days, needing transplant,

129
Q

Minimal change

A

Commonest cause of nephrotic syndrome, triggered by recent allergic reaction

130
Q

Brucellosis

A

Unpasturized dairy products, farm animals, castaneda medium

131
Q

Lyme disease

A

Borrelia burgdorferi, ixodes ticks

132
Q

Leptospirosis

A

Microscopic agglutination, drinking water

133
Q

Duct ectasia

A

green discharge from nipple

134
Q

Fibroadenoma

A

Soft, mobile, breast mouse, fluctuates cyclically

135
Q

Ductal carcinoma in situ

A

Calcification

136
Q

Phylloides tumour

A

Artichoke like appearance

137
Q

Intraductal carcinoma

A

Invasive, peau d’orange

138
Q

Mastitis

A

Breast feeding mothers

139
Q

Phenytoin

A

Antiepileptic

SE: hypotension, heart block, vent arrhythmias, ataxia

140
Q

Lithium

A 
Tx of bipolar 
Monitoring essential (12hrs post dose) due to toxicity i.e. D+V, coarse tremor, dysarthria
141
Q

Gentamicin toxicity

A

Ringing in ears - ototoxic and nephrotoxic

Aminoglycoside Abx

142
Q

Digoxin toxicity

A

Prolonged PR interval and brady

143
Q

Theophylline

A

Tx of asthma + COPD

Severe toxicity may lead to seizures

144
Q

Methotrexate

A

Antifolate drug

Toxicity - leukocytopenia, ulcerative stomatitis

145
Q

Carbemazepine

A

Anti-convulsant

Toxicity - headaches, ataxia, abdo pain

146
Q

Cyclosporine

A

Immsuppressant

Toxicity - AKI

147
Q

Anaemia of chronic disease

A

Ax - RA

His - microcytic hypochromic anaemia, inc ferritin

148
Q

Temporal arthritis

149
Q

Secondary polycythaemia

A

Ax - Chronic hypoxia, renal disease, solid tumours (renal+liver)
Raised Hb, erthyrocyte, erthyropoeitin

150
Q

Eosinophilia

A

Parasitic infection i.e. schistosomiasis

151
Q

Haem effects ‘Acute pancreatitis’

A

Neutrophilia

152
Q

Haem effects ‘EBV’

A

Reactive lymphocytosis

153
Q

Western blot

154
Q

Kveim test

A

Sarcoidosis

155
Q

Direct antiglobulin test (DAT)/direct Coombes test

A

Autoimmune haemolytic anaemia (AIHA)

Ax - SLE, lymphoproliferative disorders, drugs

156
Q

Skin prick test

A

T1 hypersens reactions i.e. allergic to food, inhalants or specific materials

157
Q

Patch testing

A

Allergen in contact dermatitis

158
Q

Immunofluorescence

A

Henoch-Schonlein purpura

159
Q

Histocompatibility testing

A

Pre transplant test to assess compatibility

160
Q

Mumps

A

Parotitis, amylase inc, orchitis,

161
Q

Listeria

A

Meningitis <3mnths, grm +ve rod

162
Q

Measles

A

Koplik’s spots, rash behind ears, prodrome

163
Q

Haemophilus influenzae

A

Meningitis >3mnths, grm -ve rod

164
Q

Rubella

A

sub occipital+post-aruicular LN’s

Congenital rubella syndrome - sensorineural deafness, eye abnormalities, congenital heart disease

165
Q

Syphilis

A

HepSplenMeg, rash, Saddle shape nose, neuro involvement (neurosyphilis)

166
Q

Cafe-au-lait Spots

A

Fibrous dysplasia (McCune-Albright syndrome)

167
Q

Pseudo-fractures/looser zones

A

Osteomalacia

168
Q

DEXA<2.5

A

Osteoporosis

169
Q

Recurrent chest infx, low T cells+non-functioning b cells

170
Q

Low Neutrophil count

A

Kostmann’s

171
Q

Low IgA/M/G levels

A

Bruton’s

172
Q

Cardiac abnormalities, abnormal facies, thymus aplasia,, cleft palate, hypocalcaemia, 22q11.2 deletion

173
Q

Gomori’s methanamine silver stain ‘flying saucer’

A

Pneumocystis jirovecii

Path (8 decks)

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