path from past papers Flashcards
most common cause of constrictive pericarditis with calcifications
TB
Prostate scoring system
Gleason
Steroid given in Covid-19 with low O2
Dexamethasone
Flower nuclei
Adult T-cell lymphoma
<30g/L but increased IgG lambda, normal kappa lambda ration
smouldering
H pylori eradication therapy
PPI + amoxicillin + erythromycin
Cavitating lesion, bloody phlegm
Mycobacterium tuberculosis
Virus that doesn’t normally become chronic but dangerous in pregnancy
Hep E
Hirschsprung biopsy
Absence of ganglion cells in the submucosal and myenteric plexuses
Low CH50, Low AP50, purpuric rash and fever
N meningitidis - C7 deficiency
Hypoglycaemia drug
Quinine
lung peripheries cancer, high ADH
small cell lung cancer
skin prick testing
95% negative predictive value
Unprovoked DVT - long term prophylaxis after LMWH
DOAC
HIV, low CD4 count, diarrhoea, alcohol and acid fast bacilli
Mycobacterium avium complex
Covid antiviral
remsedivir
Acute pancreatitis: causative type of hyperlipidaemia
triglycerides
Multiple pulmonary emboli consequence
pulmonary HTN
rank narrow to broad: pip taz, meropenem, cef, fluclox, co-amox
fluclox
co-amox
ceftriaxone
pip taz
meropenem
osteomyelitis: s aureus, e coli, brucella melitensis, s anginosus, pseudomonas aeruginosa
- s aureus
- strep anginosus
- e coli
- pseudomonas aeruginosa
5.brucella melitensis
coeliac disease and macrocytosis
folate deficiency
Waldenstrom’s macroglobulinaemia aka
lymphoplasmacytic lymphoma
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
adult t cell lymphoma
food poisoning + timeline
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)
Diarrhoea (before 12 hours)
staph aureus or bacillus cereus
Diarrhoea (before 12 hours) + Rice or Chinese
bacillus cereus
diarrhoea after 12 hours or day after meal
salmonella
diarrhoea 2-3 days post meal
campylobacter
diarrhoea > 7 days after meal
giardiasis
bloody diarrhoea + e coli
salmonella
bloody diarrhoea + campylobacter presentation
shigella
bloody diarrhoea + giardiasis presentation
entamoeba histolytica
Diarrhoea + (context of question e.g. Travel to Southeast Asia)
cholera
diarrhoea + travel from bangladesh
typhoid
Diarrhoea + Sex Worker or IV Drug user or Homeless
HIV apparently
low or moderate severity community acquired pneumonia
oral amox + macrolide if in hosp
high severity community acquired pneumonia
iv co-amoxiclav + clarithromycin
OR
cefuroxime + clarithromycin
OR
cefotaxime + clarithromycin
if anyone has a penicillin allergy…
don’t treat with cephalosporins or amoxicillin
pharyngitis: if IV?
benzylpenicillin
pharyngitis + penicillin allergy
mild: clarithromycin
mod-severe: clindamycin
severe strep throat
IV penicillin & clindamycin
if spain mentioned in question for pneumonia?
legionella
clarithromycin > erythromycin
normal random, fasting, and OGTT glucose
random: 4-<7.8
fasting: 4-<6.1
OGTT: 4-<7.8
impaired fasting glucose
6.1-6.99
fasting glucose suggestive of diabetes
> 7
what next are impaired or diabetes-suggestive fasting glucose?
oral glucose tolerance test
impaired glucose tolerance test
7.8-11.0999
isolation OGTT > 11.1
suggestive but not diagnostic
Which/What cell sits in (it’s immature form in) the periphery, and when it matures, goes to present things to T cells?
dendritic cells
inhibited by presence of MHC 1
Natural killer cells
Which/What cell undergoes positive and negative selection in the thymus.
T lymphocytes
Loss of E cadherin breast cancer
Invasive lobular carcinoma
Most common type of malignancy in the breast?
invasive ductal carcinoma
Presence of E cadherin breast cancer
invasive ductal carcinoma
Breast cancer aka non-specfici type
invasive ductal carcinoma
Breast cancer w a high medium and low stage to it
ductal carcinoma in situ
Fibroepithelial tumour with abundal stromal elements
Phyllodes tumour
A 12 year old boy has recurrent chest infections, and has an ear infection. He doesn’t have any B Cells.
Bruton’s X-linked agammaglobulinaemia
A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG.
IFN-gamma receptor deficiency
Signs of CF + Ear infection
X-linked agammaglobulinaemia
Signs of X-linked agammaglobulinaemia + Nose Bleed
Wiskot-Aldrich
60 year old Man with abdominal pain radiating to back, collapses and dies
acute aortic aneurysm
Man, ex-smoker, with history of hypertension and MI, has sudden chest pain which radiates to the neck
descending internal carotid thrombus
50 year old lady with memory issues/progressive amnesia, hypertension (?? + bronchopneumonia??)
Multiple cerebral/(?cortical) infarcts
Elderly man with atrial fibrillation with right flank pain?
renal infarct
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
ventricular rupture
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)
herpes virus
CSF cloudy + high lymphocytes + fibrin web
TB
CSF clear/cloudy + normal glucose + normal/raised protein + raised white cells
viral
CSF cloudy, low glucose, high protein, high white cells
bacterial
pembrolizumab moa
blocks programmed cell-death rpotein 1 receptor (PD1 receptor)
infliximab moa
TNFa blocker - used in psoriasis, Crohn’s, rheumatoid arthritis
There are 5 special drug treatments. Which drug can be used to treat some malignancies and affects T cell activity?
Rituximab – Targets B cells + causes inactivation of T cells:
denosumab
osteoporosis
ustekinumab
psoriasis
follicular lymphoma
diffuse lymphoma
burkitt’s
hairy cell leukaemia
CLL smear cells
most common malignant ovarian tumour
serous cystadenocarcinoma
most common benign ovarian tumour
serous cystadenoma
Trypanosoma brucei rhodesiense vector
tsetse fly
Leishmaniasis vector
sandfly
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)?
chondrocarcinoma
most common primary bone tumour
osteosarcoma
ewing sarcoma on x-ray
onion skin periosteal reaction
Indications for Acute Dialysis
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).”
What does denosumab target?
Receptor activator of nuclear factor kappa-B Ligand
Which enzyme would you expect to be raised in obstructive jaundice/biliary obstruction?
Gamma-glutamyl transpeptidase
What can be used to measure the turnover of bone, and is raised in people who have Paget’s, Osteomalacia / Rickets?
alkaline phosphatase
Subdural
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
Extradural
EXTRA loss of consciousness = Immediate loss of consciousness followed by lucid interval. Followed by EXTRA loss of consciousness several hours later.
Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias
erythromycin
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?
mechanical haemolytic anaemia
Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?
psoriasis
Name the main class of drug used to treat HIV
nucleoside reverse transcriptase inhibitors
Ixodes tick disease
Lyme disease
A DNA synthesis inhibitor used to treat Pseudomonal infections but bad against anaerobes
ciprofloxacin
Target INR for 1st episode DVT or PE
3.5
Target INR for atrial fibrillation
2-3
target INR for cardiomyopathy
2.5
target INR for symptomatic inherited thrombophilia
2.5
target INR for mural thrombus
2.5
Target INR for cardioversion
2.5
Target INR for recurrent DVT or PE
3.5
Target INR for mechanical prosthetic valve
2.5-3.5
Target INR for coronary graft thrombosis
3.5
Target INR for antiphospholipid syndrome
3.5
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.
tumour necrosis factor alpha
anti-IL1
anakinra
anti CD20
rituximab
anti-IL6
tocilizumab
anti T cell co-stimulatory cytokines
Abatacept
secukinumab used for?
psoriasis
influenza A antiviral
Zanamivir
most common primary CNS tumour in children
pilocytic astrocytoma
Mepolizumab - mode and use?
Eosinophilic asthma - IL5
Secukinumab
IL-17
Plaque psoriasis