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MRCP PART 1 > PP4 > Flashcards

PP4 Flashcards

1
Q

HTN on CCB and ACE what next? Why not the other one?

A

Thiazide like - indapamide

Thiazide diuretics mess with blood sugars

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2
Q

Why sickle cell have reasonable hba1c despite consistently raised BM?

A

Chronic haemolysis -> Hb has a shorter lifespan -> doesn’t get time to become fully glycosylated

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3
Q

Denosumab vs teriparatide

A

Denosumab usually - only need to give it every 6 months

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4
Q

Proximal vs distal RCA infarction

A

Distal - II, III, AVF

Proximal - Above and v1,v2

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5
Q

Dominant-sounding family history of cardiac death with no murmurs- when might you think brugada rather than Long QT?

A

Brugada - deaths occuring in bed
[get VF while asleep]

QT - during exercise

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6
Q

GCSF also called

A

Filgrastim

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7
Q

how do loop diruetics help heart in failure? B blockers?

A

Reduce preload
Reduce afterload

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8
Q

which lens dislocation in marfan? homocystinuria?

A

Marfan - upwards

Homocys- downwards

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9
Q

Vit D action on osteoclasts and PTH?
T cells?

A

Increase osteoclasts [increase Ca into blood and healthy bone turnover]

Negative PTH - [think PTH usually high in osteomalacia]

Decrease TH1 cell
Increase TH2

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10
Q

Achondroplasia inheritance

A

Dominant

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11
Q

CKD 5. DVT rx

A

Warfarin

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12
Q

Whats in the middle of the process of getting bilirubin from haem

A

Haem -> biliverdin -> bilirubin

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13
Q

Where in the foot gets avascular necrosis

A

2nd metatarsal head

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14
Q

African with FSGN what gene? What is it protective of?

A

APOL1
-Protects against sleeping sickness

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15
Q

Bekker vs duchene presentation? Same gene in each?

A

Bekker less severe - calf hypetrophy in 20s

Duchenne - in a wheelchair by 20s

Dystrophin gene

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16
Q

HIV CD4 50. Presents with acute meningitis and raised ICP.
Rx?

A

Cryptococcus
Amphotericin B

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17
Q

Bar amlodipine what other antihypertensive leads to calf swelling

A

Doxazosin / a blockers

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18
Q

Open-angle glaucoma 1st line rx

A

Topical timolol

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19
Q

What to give for CMV prophylaxis in solid organ transplant

A

Valganciclovir

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20
Q

MEN1 with dyspepsia has

A

Gastrinoma

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21
Q

Gold standard for hereditary spherocytosis

A

Cryohaemolysis and EMA binding

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22
Q

Lateral medullar most common

A

Vertebral artery > PICA

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23
Q

Clean surfaces in c diff outbreak

A

Dilute bleach

[Not chlorhex / alcohol]

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24
Q

CCB bar fluid retention, 2nd most common complaint

A

Headaches

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25
Q

Pulm HTN who wants to stay pregnant on sildenafil needs what medication

A

LMWH - high clot risk

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26
Q

Pulse pressure change as you age

A

Widens over time
[stiff arteries so systolic rises]

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27
Q

Divide population into males / females and then ask do you smoke or not

A

Fishers exact

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28
Q

Restless leg

A

Dopamine agonists Eg ropinorole

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29
Q

Which cells produce IgE

A

B cells

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30
Q

SBP 1st line

A

Cephalosporin

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31
Q

Cholangitis ERCP or Lap coley

A

ERCP first
Then cholecystectomy once stable

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32
Q

Rheum A which joint MOST likely

A

PIP

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33
Q

MS monitoring best way

A

MRI brain with contrast

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34
Q

Cardiac meds used in caution in AS

A

Bisop - as need pressure sufficient to overcome valve
[start with low dose and up titrate - once established positive outcomes]

Furosemide/ loop - might decrease LV filling pressure

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35
Q

How many kcals need per day normal person

A

30kcal/Kg

70kg = 2100

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36
Q

Pulm stenosis on JVP

A

Raised A waves

37
Q

Impaired fasting glucose obese and HTN med?

A

Liraglutide / other GLP-1

38
Q

Psychosis in parkinsons 1st / second line

A

Quetiapine
Clozapine

39
Q

Pneumocystis jirovecii is?

A

Fungus

40
Q

Which IL in
CD2- t helper
NK cells stimulation
Allergy IgE response

A

CD2- t helper - il-4
NK cells stimulation - IL-12
Allergy IgE response - IL-13

41
Q

Ring of 1-2mm papules is describing?

A

Granuloma annulare

42
Q

What type of receptor in brain nicotine binds to

A

Acetylcholine

43
Q

HOCM - how to reduce LV outflow tract gradient

A

B blockers
[Then surg]

44
Q

How do the Azoles work againts helminths

A

Inhibition of tubulin [polymerisation]

[Little tubular worms we gotta kill]

45
Q

inhibit 30s ribosomal subunit in which Abx

A

Tetracyclines - Eg doxy

46
Q

WHO performance status 0-4

A

0 - Fully active
1 - Can carry out light work
2 - Moves about >50% of day
3 - Less than 50%
4 - Cant perform any self care

47
Q

Baclofen mechanism

A

GABA-B agonist

48
Q

UTI rx in women with eGFR <45

A

Pivmecillinam

49
Q

Recurrent laryngeal which vessel closest

A

Inferior thyroid

50
Q

Carcinoid diarrhoea resistant to ocretitde Rx?

A

Telotristat

51
Q

which vasoconstrictor raised in hepatorenal syndrome [ excluding RASS]?

A

Endothelin 1

52
Q

Stopping smoking in preg rx

A

Nicotine replacement therapy

53
Q

HNPCC mutations

A

MSH2 - 60%
MLH1 - 30%

54
Q

Keeps birds gets pneumonia 1st line rx

A

Doxy - chlamydia

55
Q

antidepressant in a man that still wants to shag

A

Mirtazapine

56
Q

Acute hepB without significant dysfunction rx

A

Observe and repeat PCR in couple months
[90% clear if fit an healthy]

57
Q

HIV low CD4 - Ulcers on oesophagus =

A

CMV
Valganciclovir

58
Q

Central venous thromobosis Rx

A

lmwh

59
Q

Myotonic dystrophy monitoring

A

ECGs

60
Q

1L 0.9% Nacl
how much stays intravascular

A

200mls

0.45% = 100mls

61
Q

Idiopathic membranous nephropathy rx

A

Rituximab

[pred + cyclophosphamide considered if rapid worsening]

62
Q

ramipril vs bisop 1st line heart failure

A

Ramipril if pulse <75

63
Q

Which vaccine always has egg

A

Yellow [yolk] fever

64
Q

pH pf stomach

A

1.5-3.5

65
Q

Which shisto most likely causes katayama fever if from east/SE asia

A

S Japonicum

66
Q

MEN 1 tumours

A

Pituitary
[Parathyroid 4 gland hyperplasia]
Pancreas - Gastinoma > Insulinoma

67
Q

Homocystinuria initial Rx

A

Pyridoxine

68
Q

Prev peptic ulcer + Previous coronary stenting. Chronic leg pain on paracetamol. Which NSAID? Why not celecoxib?

A

Naprox + ppi

celo- increase CV risk

69
Q

Post MI. Syncopal episodes and bifasicular block with reduced EF rx?

A

Cardiac resynchronisation therapy
[pacemaker]

70
Q

CF which cells in inflamed airways most in men

A

Neutrophils

[eosin / mast / T cells in women]

71
Q

Weber syndrome vessel

A

Posterior cerebral

72
Q

Barter gene
Giltemans gene
Liddle

A

SCL12A1
SCL12A3
SCNN1B

73
Q

How long for keratinocytes to transform into anucleate corneocytes? In psoriasis?

A

30 days

3 days in psoriasis

74
Q

Acute vs chronic CKD single blood test

A

PTH

75
Q

New guidelines for prolactinoma

A

Carbegoline first line NOT surgery

76
Q

Why clots in factor V leiden

A

Protein c resistance

77
Q

MND key Ix

A

EMG

78
Q

rasburicase mechanism

A

Urate oxidation

79
Q

ebv how long before contact sports

A

8 weeks

80
Q

Statin liver enzyme

A

CYP3A4

81
Q

Worse outcomes post MI in

A

reduced EF <30%

82
Q

gout don’t tolerate allopurinol and have MI history

A

Low dose colchicine

83
Q

Listeria meningitis

A

Amox + gent

84
Q

OSA lung function tests

A

NORMAL

85
Q

Antigen presenting cells - name 3

A

Macrophage, dendritic, B cells
Basophils, eosinophils

86
Q

hepatotoxicity with valproate due to

A

Mitochondrial dysfunction

87
Q

ATAT inheritance

A

CO-dominant

88
Q

Vietnamese Why do they have HCC

A

alfatoxin exposure

MRCP PART 1 (22 decks)

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