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1
Q

most common cause of constrictive pericarditis with calcifications

A

TB

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2
Q

Prostate scoring system

A

Gleason

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3
Q

Steroid given in Covid-19 with low O2

A

Dexamethasone

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4
Q

Flower nuclei

A

Adult T-cell lymphoma

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5
Q

<30g/L but increased IgG lambda, normal kappa lambda ration

A

smouldering

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6
Q

H pylori eradication therapy

A

PPI + amoxicillin + erythromycin

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7
Q

Cavitating lesion, bloody phlegm

A

Mycobacterium tuberculosis

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8
Q

Virus that doesn’t normally become chronic but dangerous in pregnancy

A

Hep E

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9
Q

Hirschsprung biopsy

A

Absence of ganglion cells in the submucosal and myenteric plexuses

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10
Q

Low CH50, Low AP50, purpuric rash and fever

A

N meningitidis - C7 deficiency

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11
Q

Hypoglycaemia drug

A

Quinine

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12
Q

lung peripheries cancer, high ADH

A

small cell lung cancer

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13
Q

skin prick testing

A

95% negative predictive value

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14
Q

Unprovoked DVT - long term prophylaxis after LMWH

A

DOAC

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15
Q

HIV, low CD4 count, diarrhoea, alcohol and acid fast bacilli

A

Mycobacterium avium complex

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16
Q

Covid antiviral

A

remsedivir

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17
Q

Acute pancreatitis: causative type of hyperlipidaemia

A

triglycerides

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18
Q

Multiple pulmonary emboli consequence

A

pulmonary HTN

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19
Q

rank narrow to broad: pip taz, meropenem, cef, fluclox, co-amox

A

fluclox
co-amox
ceftriaxone
pip taz
meropenem

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20
Q

osteomyelitis: s aureus, e coli, brucella melitensis, s anginosus, pseudomonas aeruginosa

A
  1. s aureus
  2. strep anginosus
  3. e coli
  4. pseudomonas aeruginosa
    5.brucella melitensis
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21
Q

coeliac disease and macrocytosis

A

folate deficiency

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22
Q

Waldenstrom’s macroglobulinaemia aka

A

lymphoplasmacytic lymphoma

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23
Q

If they sound Multiple myeloma-esque but don’t fulfil the CRAB criteria but do have a super high calcium, + have some hint of IV drug use in their history

A

adult t cell lymphoma

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24
Q

food poisoning + timeline

A

1-6 hrs: Staphylococcus aureus, Bacillus cereus*

12-48 hrs: Salmonella, Escherichia coli (watery camper)

48-72 hrs: Shigella (bloody), Campylobacter (hayfever campylo (flu prodrome) + (diarrhoea can be bloody))

7 days: Amoebiasis (Bloody), Giardiasis (Non-bloody diarrhoea)

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25
Q

Diarrhoea (before 12 hours)

A

staph aureus or bacillus cereus

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26
Q

Diarrhoea (before 12 hours) + Rice or Chinese

A

bacillus cereus

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27
Q

diarrhoea after 12 hours or day after meal

A

salmonella

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28
Q

diarrhoea 2-3 days post meal

A

campylobacter

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29
Q

diarrhoea > 7 days after meal

A

giardiasis

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30
Q

bloody diarrhoea + e coli

A

salmonella

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31
Q

bloody diarrhoea + campylobacter presentation

A

shigella

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32
Q

bloody diarrhoea + giardiasis presentation

A

entamoeba histolytica

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33
Q

Diarrhoea + (context of question e.g. Travel to Southeast Asia)

A

cholera

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34
Q

diarrhoea + travel from bangladesh

A

typhoid

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35
Q

Diarrhoea + Sex Worker or IV Drug user or Homeless

A

HIV apparently

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36
Q

low or moderate severity community acquired pneumonia

A

oral amox + macrolide if in hosp

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37
Q

high severity community acquired pneumonia

A

iv co-amoxiclav + clarithromycin
OR
cefuroxime + clarithromycin
OR
cefotaxime + clarithromycin

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38
Q

if anyone has a penicillin allergy…

A

don’t treat with cephalosporins or amoxicillin

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39
Q

pharyngitis: if IV?

A

benzylpenicillin

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40
Q

pharyngitis + penicillin allergy

A

mild: clarithromycin
mod-severe: clindamycin

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41
Q

severe strep throat

A

IV penicillin & clindamycin

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42
Q

if spain mentioned in question for pneumonia?

A

legionella
clarithromycin > erythromycin

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43
Q

normal random, fasting, and OGTT glucose

A

random: 4-<7.8
fasting: 4-<6.1
OGTT: 4-<7.8

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44
Q

impaired fasting glucose

A

6.1-6.99

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45
Q

fasting glucose suggestive of diabetes

A

> 7

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46
Q

what next are impaired or diabetes-suggestive fasting glucose?

A

oral glucose tolerance test

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47
Q

impaired glucose tolerance test

A

7.8-11.0999

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48
Q

isolation OGTT > 11.1

A

suggestive but not diagnostic

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49
Q
A
50
Q

Which/What cell sits in (it’s immature form in) the periphery, and when it matures, goes to present things to T cells?

A

dendritic cells

51
Q

inhibited by presence of MHC 1

A

Natural killer cells

52
Q

Which/What cell undergoes positive and negative selection in the thymus.

A

T lymphocytes

53
Q

Loss of E cadherin breast cancer

A

Invasive lobular carcinoma

54
Q

Most common type of malignancy in the breast?

A

invasive ductal carcinoma

55
Q

Presence of E cadherin breast cancer

A

invasive ductal carcinoma

56
Q

Breast cancer aka non-specfici type

A

invasive ductal carcinoma

57
Q

Breast cancer w a high medium and low stage to it

A

ductal carcinoma in situ

58
Q

Fibroepithelial tumour with abundal stromal elements

A

Phyllodes tumour

59
Q

A 12 year old boy has recurrent chest infections, and has an ear infection. He doesn’t have any B Cells.

A

Bruton’s X-linked agammaglobulinaemia

60
Q

A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG.

A

IFN-gamma receptor deficiency

61
Q

Signs of CF + Ear infection

A

X-linked agammaglobulinaemia

62
Q

Signs of X-linked agammaglobulinaemia + Nose Bleed

A

Wiskot-Aldrich

63
Q

60 year old Man with abdominal pain radiating to back, collapses and dies

A

acute aortic aneurysm

64
Q

Man, ex-smoker, with history of hypertension and MI, has sudden chest pain which radiates to the neck

A

descending internal carotid thrombus

65
Q

50 year old lady with memory issues/progressive amnesia, hypertension (?? + bronchopneumonia??)

A

Multiple cerebral/(?cortical) infarcts

66
Q

Elderly man with atrial fibrillation with right flank pain?

A

renal infarct

67
Q

Man has an MI 3 years ago. Now comes into hospital feeling very unwell. Is having a sample taken from their pericardial layer and you find blood is aspirated from the pericardium

A

ventricular rupture

68
Q

A girl has recently been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose (on LP)

A

herpes virus

69
Q

CSF cloudy + high lymphocytes + fibrin web

A

TB

70
Q

CSF clear/cloudy + normal glucose + normal/raised protein + raised white cells

A

viral

71
Q

CSF cloudy, low glucose, high protein, high white cells

A

bacterial

72
Q

pembrolizumab moa

A

blocks programmed cell-death rpotein 1 receptor (PD1 receptor)

73
Q

infliximab moa

A

TNFa blocker - used in psoriasis, Crohn’s, rheumatoid arthritis

74
Q

There are 5 special drug treatments. Which drug can be used to treat some malignancies and affects T cell activity?

A

Rituximab – Targets B cells + causes inactivation of T cells:

75
Q

denosumab

A

osteoporosis

76
Q

ustekinumab

A

psoriasis

77
Q
A

follicular lymphoma

78
Q
A

diffuse lymphoma

79
Q
A

burkitt’s

80
Q
A

hairy cell leukaemia

81
Q
A

CLL smear cells

82
Q

most common malignant ovarian tumour

A

serous cystadenocarcinoma

83
Q

most common benign ovarian tumour

A

serous cystadenoma

84
Q

Trypanosoma brucei rhodesiense vector

A

tsetse fly

85
Q

Leishmaniasis vector

A

sandfly

86
Q

50 year old man with Midshaft femur fracture – what would you find at the site of the break/fracture (or rather, which/what type of cancer does he have)?

A

chondrocarcinoma

87
Q

most common primary bone tumour

A

osteosarcoma

88
Q

ewing sarcoma on x-ray

A

onion skin periosteal reaction

89
Q

Indications for Acute Dialysis

A

AEIOU
“A”- intractable acidosis
“E”- electrolyte disarray ( K+, Na+, Ca++)
“I” - intoxicants (methanol ethylene glycol, Li, ASA)
“O”- intractable fluid overload
“U”- uremic symptoms (nausea, seizure, pericarditis, bleeding).”

90
Q

What does denosumab target?

A

Receptor activator of nuclear factor kappa-B Ligand

91
Q

Which enzyme would you expect to be raised in obstructive jaundice/biliary obstruction?

A

Gamma-glutamyl transpeptidase

92
Q

What can be used to measure the turnover of bone, and is raised in people who have Paget’s, Osteomalacia / Rickets?

A

alkaline phosphatase

93
Q

Subdural

A

Super Secret Submarine (there’s no warning before it strikes) = No loss of consciousness following initial head injury and then suddenly hours later lose consciousness

94
Q

Extradural

A

EXTRA loss of consciousness = Immediate loss of consciousness followed by lucid interval. Followed by EXTRA loss of consciousness several hours later.

95
Q

Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias

A

erythromycin

96
Q

A patient required an aortic valve replaced 3 months ago. They have now come back a few weeks later with jaundice, Hb-urea (haemoglobinuria), and raised reticulocytes. What is the cause?

A

mechanical haemolytic anaemia

97
Q

Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?

A

psoriasis

98
Q

Name the main class of drug used to treat HIV

A

nucleoside reverse transcriptase inhibitors

99
Q

Ixodes tick disease

A

Lyme disease

100
Q

A DNA synthesis inhibitor used to treat Pseudomonal infections but bad against anaerobes

A

ciprofloxacin

101
Q

Target INR for 1st episode DVT or PE

A

3.5

102
Q

Target INR for atrial fibrillation

A

2-3

103
Q

target INR for cardiomyopathy

A

2.5

104
Q

target INR for symptomatic inherited thrombophilia

A

2.5

105
Q

target INR for mural thrombus

A

2.5

106
Q

Target INR for cardioversion

A

2.5

107
Q

Target INR for recurrent DVT or PE

A

3.5

108
Q

Target INR for mechanical prosthetic valve

A

2.5-3.5

109
Q

Target INR for coronary graft thrombosis

A

3.5

110
Q

Target INR for antiphospholipid syndrome

A

3.5

111
Q

A 25 year old man has a 10 year history of low back pain and stiffness, with symptoms being worse at night and in the early mornings. An MRI scan has shown bone marrow oedema at the sacroiliac joints. Blood tests confirm an acute phase response with C- reactive protein 18 mg/L (<5). He has shown a partial response to NSAIDS. Which cytokine could be targeted to improve disease control.

A

tumour necrosis factor alpha

112
Q

anti-IL1

A

anakinra

113
Q

anti CD20

A

rituximab

114
Q

anti-IL6

A

tocilizumab

115
Q

anti T cell co-stimulatory cytokines

A

Abatacept

116
Q

secukinumab used for?

A

psoriasis

117
Q
A
118
Q

influenza A antiviral

A

Zanamivir

119
Q

most common primary CNS tumour in children

A

pilocytic astrocytoma

120
Q

Mepolizumab - mode and use?

A

Eosinophilic asthma - IL5

121
Q

Secukinumab

A

IL-17
Plaque psoriasis

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