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Phase 2A > PTS Mock AoW > Flashcards

PTS Mock AoW Flashcards

1
Q

What is the appropriate antiplatelet therapy for pts presenting with MI?

A

Dual platelet therapy - aspirin and clopidogrel/ticagrelor

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2
Q

Describe the pharmacology of spironolactone

A

Inhibition of aldosterone receptor in the distal tubules

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3
Q

What drug class is spironolactone?

A

Aldosterone receptor antagonists

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4
Q

What type of valve disorder presents with: pan-systolic murmur at the apex

A

Mitral regurgitation

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5
Q

What are the 4 most common ECG changes seen in MI?

A
  1. ST elevation
  2. ST depression
  3. Abnormal Q wave
  4. T wave inversion
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6
Q

How does A Fib cause strokes?

A

Blood collects in the atria and forms clots that break off and travel through the circulation to the brain

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7
Q

Which risk score should be used to assess heart attack risk?

A

QRISK2 score

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8
Q

Which risk score should be used to assess stroke risk after a TIA?

A

ABCD2 score

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9
Q

What are the 3 key aspects of Conn’s syndrome?

A
  1. hypertension associated with hypokalaemia
  2. medication- resistant hypertension
  3. hypertension before 40
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10
Q

Which medication stabilises the BP and K+ levels?

A

Spironolactone (potassium sparing diuretic)

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11
Q

What do raised renin and aldosterone levels suggest?

A 
Secondary hyperaldosteronism 
(suggest a renin secreting tumour)
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12
Q

What value proves diagnostic for a HbA1c test?

A

> 48mmol/mol

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13
Q

What is seen on the ECG of someone with hyperkalaemia?

A
  1. Absent P waves
  2. Prolonged PR interval
  3. Tall T waves
  4. Wide QRS complex
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14
Q

What is the classical triad of carcinoid syndrome?

A
  1. Cardiac involvement
  2. Diarrhoea
  3. Flushing
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15
Q

What is the gold standard diagnostic test for coeliac disease?

A

Endoscopy and intestinal biopsy

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16
Q

Which blood tests would you order for coeliac disease?

A

IgA tissue transglutaminase or IgA endomysial antibody

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17
Q

What is the first line treatment of H. Pylori causing peptic ulcers?

A

PPI + amoxicillin + clarithromycin/metronidazole

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18
Q

What are the 2 ways to diagnose for H. Pylori?

A
  1. Carbon-13 urea breath test

2. Stool antigen test

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19
Q

Which cells do PPI’s act on?

A

Parietal cells

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20
Q

What is the main warning sign for bladder cancer?

A

Painless haematuria

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21
Q

What are the common SE of tamsulosin?

A
  1. Postural hypotension
  2. Dizziness
  3. Syncope
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22
Q

Why does tamsulosin cause postural hypotension?

A

It is a selective alpha-1 adrenergic receptor antagonist

Relaxes smooth muscle in bladder neck and prostate allowing increase urinary flow rate and an improvement in symptoms

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23
Q

What are the 5 common causes of UTIs?

A

KEEPS

  1. Klebsiella
  2. E Coli (most common)
  3. Enterococcus
  4. Proteus/pseudomonas
  5. Staphylococcus saprophytic
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24
Q

What is the classic triad of nephrotic syndrome?

A
  1. Hypoalbuminaemia
  2. Peripheral oedema
  3. Proteinurea
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25
Q

Which disease presents with the Philadelphia chromosome on investigation?

A

Chronic myeloid leukaemia

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26
Q

Which disease presents with Auer rods on investigation?

A

Acute myeloid leukaemia

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27
Q

Which disease presents with Reed-Steinberg cells on investigation?

A

Hodgkin’s lymphoma

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28
Q

Which disease presents with Bence-Jones proteins on investigation?

A

Myeloma

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29
Q

What is pharmokinetics?

A

The action of the body on the drug

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30
Q

What is pharmacodynamics?

A

The action of the drug on the body

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31
Q

What is a phaeochromocytoma?

A

A tumour of the adrenal medulla

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32
Q

What drugs are used to treat pulmonary TB?

A

RIPE

  1. Rifampicin
  2. Isoniazid
  3. Pyrazinamide
  4. Ethambutol
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33
Q

Which heart valve is most commonly affected in infective endocarditis?

A

Tricuspid

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34
Q

What does Neisseria spp. look like under Gram stain?

A

Gram negative diplococcus

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35
Q

What does E. coli look like under Gram stain?

A

Gram negative bacilli (grows on MacConkey)

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36
Q

What is the mechanism of clarithromycin/erythromycin?

A

Inhibit protein synthesis

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37
Q

What does CURB-65 stand for?

A 
C = confusion
U = urea > 7mmol/L
R = resp rate > 30 
B = BP <90/60
- 65 = over 65
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38
Q

Which disease are Bouchard nodules seen in?

A

Osteoarthritis

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39
Q

What would be seen in a pt with pseudo-gout under light microscopy?

A

Rhomboid shape and positively bi-fringent

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40
Q

What would be seen in a pt with gout under light microscopy?

A

Needle shape and negatively bi-fringent

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41
Q

What is the second line treatment for osteoporosis?

A

Denusomab (monoclonal antibody)

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42
Q

What is the treatment for acute gout?

A

Colchicine

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43
Q

What are the preventative gout drugs?

A

Allopurinol and febuxostat

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44
Q

What is the best investigation to confirm rheumatoid arthritis?

A

Anti - CCP

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45
Q

What is the appearance of osteoarthritis on x-ray?

A 
LOSS
L = loss of joint space
O = osteophytes
S = subchondral sclerosis
S = subchondral cysts
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46
Q

What is the first line management of a pt with septic arthritis?

A

Aspirate the joint and send off for a blood culture THEN antibiotics!

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47
Q

What is the first line treatment for a migraine?

A

Ibuprofen

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48
Q

What headache would you use aspirin to treat?

A

Tension-type headache

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49
Q

What is the first line prophylactic treatment of a migraine?

A

Topiramate

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50
Q

What is the most common cause of meningitis?

A

Streptococcus pneumonia

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51
Q

Which nerve is involved in carpal tunnel syndrome?

A

Median nerve

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52
Q

Which drug treats the jerky movements in Huntington’s?

A

Risperidone

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53
Q

What is the first line treatment for a PE?

A

Start a DOAC such as apixaban

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54
Q

What is the treatment for a tension pneumothorax?

A

Immediate decompression via large bore cannula

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55
Q

What is the treatment for a primary spontaneous pneumothorax?

A

Needle aspiration

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56
Q

How can you tell if it is full or partial metabolic compensation?

A

If bicarb is elevated and pH remained low = partial

If bicarb elevated and pH corrected itself/returned to normal = full

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57
Q

What drug group cause bronchodilation by blocking acetylcholine receptors that normally contract bronchial smooth muscle?

A

Long-acting muscarinic antagonists

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58
Q

Which electrolyte imbalance is a key finding in sarcoidosis?

A

Hypercalaemia

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59
Q

What is the antibody involved in Goodpasture’s syndrome?

A

Anti-glomerular basement membrane

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60
Q

What is the calculation for working out units of alcohol?

A

(% x vol in ml) / 1000

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61
Q

What does the 6-in-1 vaccine contain?

A

Diptheria, tetanus, pertussis, polio, Hib and hep B

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62
Q

When is the 6-in-1 vaccine given?

A

3x when 8, 12, 16 weeks old

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63
Q

When is the Meningococcal group B vaccine given?

A

8 weeks old

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64
Q

What are the acronyms to remember the two types of bundle branch blocks?

A
  1. MaRRoW

2. WiLLiaM

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65
Q

What would be seen on an ECG of someone with RBBB?

A
  1. R wave in lead 1 (M shape)

2. Slurred S wave in lead 6 (W shape)

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66
Q

What would be seen on an ECG of someone with LBBB?

A
  1. Slurred S wave in lead 1 (W shape)

2. R wave in lead 6 (M shape)

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67
Q

What are the 6 P’s of critical ischaemia?

A
  1. Pain
  2. Pallor
  3. Paralysis
  4. Parasthesia
  5. Perishingly cold
  6. Pulselessness
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68
Q

4 key features of tetralogy of fallot?

A
  1. Ventricular septal defect
  2. Pulmonary stenosis
  3. Overriding aorta
  4. Hypertrophy of RV
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69
Q

What are the 3 stages of hypertension?

A

Stage 1 = >140/90
Stage 2 = >160/100
Severe = >180/110

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70
Q

What are the distinctive signs of infective endocarditis?

A
  1. Splinter haemorrhages
  2. Olser’s nodes
  3. Janeway lesions
  4. Roth spots
  5. Fever
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71
Q

What is achalasia?

A

Muscles of oesophageal sphincter don’t relax, so food cannot reach the stomach

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72
Q

First line treatment for GORD:

A

Omeprazole - a PPI

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73
Q

How does mucosal ischaemia cause peptic ulcers?

A
  1. Stomach cells not supplied with sufficient blood
  2. Cells die off and don’t produce mucin
  3. Gastric acid attacks those cells
  4. Cells die -> formation of ulcer
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74
Q

How do NSAIDs cause peptic ulcers?

A
  1. Mucus secretion stimulated by prostaglandins
  2. COX-1 needed for prostaglandin synthesis
  3. NSAIDs inhibit COX-1 therefore mucus isnt secreted
  4. Reduced mucosal defence -> mucosal damage
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75
Q

What is the first line investigation for a large bowel obstruction?

A

Abdominal x-ray

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76
Q

When do duodenal ulcers cause pain?

A

Pain several hours after eating and pain gets better while eating

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77
Q

What is the gold standard investigation for bowel cancer?

A

Colonoscopy

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78
Q

What is the most common location for colon cancers?

A

Distal colon

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79
Q

What is the most common cause of AKI’s?

A

Acute tubular necrosis

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80
Q

How does prostatic hyperplasia cause post-renal AKI?

A
  1. Urinary tract is obstructed
  2. Increases intra-tubular pressure
  3. Decreases GFR
  4. Increases urea and creatinine remaining in the blood
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81
Q

What are the different stages of CKD?

A 
Stage 1 = >90ml/min with evidence of renal damage
Stage 2 = 60-89ml/min
Stage 3a = 46-59ml/min
Stage 3b = 30-44ml/min
Stage 4 = 15-29ml/min
Stage 5 = <15ml/min
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82
Q

What is the most common cause of pyelonephritis?

A

E. Coli - from the patients own bowel flora cause the infection

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83
Q

Can trimethoprim be used in pregnancy for UTI?

A

NO- it is teratogenic in the first trimester as it inhibits folate synthesis

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84
Q

What is the first line antibiotic for UTI in pregnant women?

A

Nitrofurantoin

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85
Q

When would you find Auer rods on bone marrow biopsy?

A

Acute myeloid leukaemia

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86
Q

What is the urgent gold standard treatment for someone with TTP?

A

Plasma exchange

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87
Q

How would you treat a post-op hip replacement pt with a risk of VTE?

A

Dalteparin acutely and then maintenance treatment with apixaban

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88
Q

What is the protein target of Rituximab?

A

CD20

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89
Q

What is the ideal first line treatment for severe/complicated malaria?

A

IV artesunate

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90
Q

What are the 5 signs of acute inflammation?

A
  1. rubor (redness)
  2. dolor (pain)
  3. calor (heat)
  4. tumor (swelling)
  5. loss of function
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91
Q

What metaplastic change occurs in Barrett’s oesophagus?

A

Stratified squamous -> simple columnar

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92
Q

What is the 1st line pharmacological treatment for paracetamol overdose?

A

N-acetyl cysteine

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93
Q

What are the causes of pancreatitis?

A 
GET SMASHED
G = gallstones
E = ethanol excess
T = trauma
S = steroids
M = mumps
A = autoimmune
S = scorpion venom
H = hyperlipidaemia
E = emboli
D = drugs
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94
Q

1st line alcohol withdrawal treatment for seizures:

A

Chlordiazepoxide

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95
Q

What vitamin deficiency causes Wernicke’s encephalopathy?

A

Vitamin B1 (thiamine)

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96
Q

What type of drug is alendronic acid?

A

Bisphosphonate

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97
Q

What is a common side affect of bisphosphonates?

A

Oesophagitis

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98
Q

What test is used for the diagnosis of Sjogren’s syndrome?

A

Schirmer test

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99
Q

What sign is commonly seen on an x-ray of a pt with psoriatic arthritis?

A

Pencil in a cup

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100
Q

What X-ray sign is commonly seen if a pt has ankylosing spondylitis?

A

Bamboo spine

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101
Q

What X-ray sign is commonly seen if a pt has gout?

A

Periarticular erosions

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102
Q

What is the first line management of ankylosing spondylitis?

A

NSAIDs like ibuprofen

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103
Q

What is the typical presentation of pseudogout?

A

Acute onset of mono arthritis - often in the knee, and potentially with a fever

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104
Q

What can cause pseudo gout?

A

Anything that can derange calcium levels (parathyroidectomy or IV fluids)

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105
Q

What is the typical presentation of gout?

A

Acute onset of mono arthritis in the toe which is precipitated by an event such as overindulgent meals or new medications

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106
Q

What is the typical presentation of reactive arthritis?

A

Usually following a GI or GU infection

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107
Q

What is the typical presentation of septic arthritis?

A

Often in the knee but pt is systemically unwell with sub-acute onset over a week or so

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108
Q

What does a T score of -1 to -2.5 suggest?

A

Osteopenia

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109
Q

What does a T score of under -2.5 suggest?

A

Osteoporosis

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110
Q

What is osteomalacia?

A

Adult version of rickets - bones become soft due to calcium or vitamin D deficiency

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111
Q

What is amaurosis fugax?

A

A symptom of a TIA where a person cannot see out of one/both eyes due to lack of blood flow

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112
Q

What is the first line treatment for generalised seizures?

A

Sodium valproate

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113
Q

When is rivastigmine used and what is it?

A

Used in the treatment of Alzheimers and is an Ach-esterase inhibitor

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114
Q

What is the treatment for giant cell arteritis?

A

Oral steroids such as prednisolone

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115
Q

Pt with acute stoke should receive alteplase treatment within what time after onset of symptoms?

A

<4.5hrs

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116
Q

What is the most common cause of infective exacerbation in COPD?

A

Haemophilus influenzae

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117
Q

What are the classic symptoms of PE?

A
  1. Pleuritic chest pain
  2. SoB
  3. Haemoptysis
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118
Q

What investigation confirms Addison’s disease?

A

SynACTHen test

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119
Q

What are the symptoms of Addison’s disease?

A
  1. Lose weight
  2. Lose appetite
  3. Lightheaded
  4. Darkened skin in creases
  5. Scars darkening
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120
Q

What electrolyte finding would you expect to see in SIADH?

A

Hyponatraemia

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121
Q

What asthma medication can cause hypokalaemia?

A

Regular nebuliser salbutamol

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122
Q

What electrolyte imbalance can ramipril cause?

A

Hyperkalaemia

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123
Q

What is the first line investigation for acromegaly?

A

Serum IGF-1

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124
Q

What is the second line investigation for acromegaly?

A

OGTT - oral glucose tolerance test

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125
Q

What would you find from the OGTT if a pt had acromegaly?

A

No suppression of GH and may show impaired glucose tolerance

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126
Q

What is the first line investigation of Conn’s Syndrome/primary hyperaldosteronism?

A

Aldosterone renin ratio

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127
Q

What is the initial management of Cushing’s syndrome?

A

Medication review

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128
Q

What suggests an ACTH independent cause of Cushing’s syndrome?

A

No cortisol suppression with a low ACTH level

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129
Q

What does inappropriately raised serum calcium and normal PTH levels suggest?

A

Primary hyperparathyroidism

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130
Q

What do high levels of plasma catecholamines and metanephrines suggest?

A

Pheochromocytoma

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131
Q

What area produces and secretes corticosteroids such as cortisol?

A

Zona fasciculata

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132
Q

What does the zone glomerulosa produce?

A

Mineralocorticoids like aldosterone

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133
Q

What does the zone reticularis produce?

A

Androgens

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134
Q

What does the adrenal medulla produce?

A

Catecholamines and metanephrines

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135
Q

What cells are in the adrenal medulla and secrete catecholamines?

A

Chromaffin cells

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136
Q

What is the first line management of DKA?

A

IV fluid resuscitation

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137
Q

What is the first line medicinal treatment for DM2?

A

Metformin

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138
Q

What is the gold standard diagnosis for phaeochromocytoma?

A

Elevated plasma free metanephrine

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139
Q

What nerve damage would be indicated by presence of the claw hand and pain in the elbow?

A

Ulnar nerve damage

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140
Q

What is the first line medication for trigeminal neuralgia?

A

Carbamazepine

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141
Q

What is the prophylactic treatment for cluster headaches?

A

Verapamil

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142
Q

What antibody would you find if a pt has Granulomatosis with polyangiitis?

A

cANCA

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143
Q

What are the 4 routine investigations for suspected dementia?

A
  1. MMSE (mini mental state examination)
  2. MRI
  3. CSF analysis
  4. Confusion screen
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144
Q

What type of dementia is characterised by a stepwise like progression of stability and then deterioration?

A

Vascular dementia

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145
Q

What are the characteristics of Alzheimer’s?

A
  1. Tau tangles
  2. Beta-amyloid plaques
  3. Cortical atrophy
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146
Q

What are the characteristics of dementia with Lewy bodies?

A
  1. Parkinsonism’s
  2. Sleep disturbances
  3. Visual hallucinations
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147
Q

What are the characteristics of fronto-temporal dementia?

A
  1. Frontal and temporal lobe atrophy

2. TDP-43 positive inclusions

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148
Q

What are the main signs of Huntington’s disease?

A
  1. Hyperkinesia
  2. Chorea (irregular, involuntary, jerky movements)
  3. Depression
  4. Possible dementia
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149
Q

What are the main signs of Parkinson’s disease?

A
  1. Bradykinesia
  2. Depression
  3. Dementia
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150
Q

What would a stroke in the anterior cerebral artery cause?

A

Contralateral lower limb weakness

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151
Q

What would a stroke in the middle cerebral artery cause?

A
  1. Hemiparesis of lower contralateral face
  2. Speech impairment
  3. Contralateral weakness
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152
Q

What would a stroke in the posterior cerebral artery cause?

A
  1. Acute vision loss

2. Memory loss

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153
Q

What cells are targeted in MS?

A

Oligodendrocytes

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154
Q

What symptoms would you expect with a temporal lobe seizure?

A
  1. Lip smacking
  2. Chewing
  3. Fiddling
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155
Q

What symptoms would you expect with a frontal lobe seizure?

A

Motor features

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156
Q

What is the difference between a complex partial and simple partial seizures?

A

Complex = awareness affected and is confused after

Simple = do not affect awareness and no post-ictal symptoms

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157
Q

What is involved in progressive bulbar palsy?

A

Lower motor neurone involvement of CN9, 10, 11, 12

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158
Q

Which nerve would be affected if a pt cannot open his fist or extend his wrist?

A

Radial nerve

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159
Q

What would happen if the ulnar nerve is damaged?

A
  1. Claw sign

2. Pt cannot cross fingers to make a ‘good luck’ sign

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160
Q

What would happen if the axillary nerve was damaged?

A

Weakness in shoulder abduction

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161
Q

What would happen if the median nerve was damaged?

A
  1. Wasting of the thenar eminence
  2. Sensory loss
  3. Weakness of abductor pollicis brevis
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162
Q

Which tumour marker is raised in testicular cancer?

A

Alpha feto-protein (AFP)

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163
Q

What non-specific tumour marker is raised in ovarian cancer and other conditions?

A

Cancer antigen 125 (Ca125)

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164
Q

What tumour marker is raised in bladder cancer?

A

Fibrin

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165
Q

What is the gold standard investigation for bladder cancer?

A

Cystoscopy

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166
Q

What is the staging system used for prostate cancer?

A

Gleason Scoring

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167
Q

What is the staging system used for colorectal cancer?

A

Dukes system

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168
Q

What type of haemorrhage is associated with autosomal dominant polycystic kidney disease?

A

Sub arachnoid haemorrhage

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169
Q

What hormone is released by the kidneys in response to hypovolaemia?

A

Renin

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170
Q

What is released by the kidneys in response to tissue hypoxia?

A

Erythropoietin

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171
Q

Which type of glomerular syndrome would cause haematuria?

A

Nephritic syndrome

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172
Q

What is the criteria for AKI stage 1?

A
  1. Increased serum creatinine to 150-200% over baseline

2. Urine production <0.5ml/kg/hr for >6hrs

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173
Q

What is the criteria for AKI stage 2?

A
  1. Increased serum creatinine to 200-300% over baseline

2. Urine production <0.5ml/kg/hr for >12hrs

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174
Q

What is the antibody in Goodpasture’s Syndrome?

A

Anti-glomerular basement membrane

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175
Q

What does the ANA antibody suggest?

A
  1. SLE
  2. Scleroderma
  3. Sjogrens
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176
Q

What does dsDNA antibody suggest?

A

Lupus

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177
Q

Who does minimal change disease usually affect?

A

Mainly children and young adults

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178
Q

What does minimal change disease present with?

A

Nephrotic syndrome

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179
Q

What can prolonged NSAIDs cause?

A

Acute tubulointerstitial disease - damage to the kidney tubules

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180
Q

Who would be classed as a complicated UTI?

A
  1. Pregnant females
  2. Males
  3. Children
  4. Recurrent UTI’s
  5. Elderly people
  6. Pt w abnormal urinary tract/disease affecting kidneys
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181
Q

What medication would be given to treat Chlamydia trachomatis?

A

Azithromycin or doxycyline

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182
Q

What medication would be given to treat Neisseria Gonorrhoeae?

A

Azithromycin or ceftriaxone

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183
Q

What is the first line treatment for BPH?

A

Alpha blockers

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184
Q

Which test can confirm a diagnosis of ankylosing spondylitis?

A

Shober’s test - assesses mobility of the spine

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185
Q

What is the most common cause of osteomyelitis?

A

Staphylococcus aureus

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186
Q

What is the most common cause of osteomyelitis in a pt w sickle cell anaemia?

A

Salmonella

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187
Q

What x-ray findings would indicate Ewing’s sarcoma?

A
  1. Onion skin appearance of periosteum

2. Lytic lesions

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188
Q

What x-ray findings would indicate osteosarcoma?

A
  1. Sunray/burst appearance

2. Codman’s triangle - lesion lifts periosteum away from bone

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189
Q

What x-ray findings would indicate chondrosarcoma?

A
  1. Popcorn calcifications
  2. Lytic lesions
  3. Endosteal scalloping
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190
Q

What would the ESR and CRP be in SLE?

A

Raised ESR and normal/slightly raised CRP

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191
Q

What would be seen in an x-ray of a pt w rheumatoid arthritis?

A 
LESS
L = loss of articular space
E = erosion
S = soft tissue swelling
S = soft bones (osteopenia)
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192
Q

What are the risk factors for developing osteoporosis?

A 
SHATTERED
S = steroids
H = hyperthyroidism/hyperparathyroidism
A = alcohol/smoking
T = thin - low BMI
T = testosterone decrease
E = early menopause
R = renal failure
E = erosive/inflammatory bone disease
D = dietary calcium decrease/DM1
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193
Q

What is Paget’s disease?

A

Increased uncontrolled bone turnover

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194
Q

What does Paget’s disease typically affect?

A
  1. Skull
  2. Spine
  3. Pelvis
  4. Femur
  5. Tibia
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195
Q

What conditions are associated with pANCA?

A
  1. Microscopic polyangiitis

2. Eoisinophilic polyangiitis

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196
Q

What antibody is most sensitive for lupus?

A

ANA

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197
Q

What are the main aspects of anti-phospholipid syndrome?

A 
CLOT
C = coagulopathy (raised APTT) 
L = Livedo reticularis
O = obstetric emergencies (recurrent miscarriages) 
T = thrombocytopenia
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198
Q

What does fibromyalgia present with?

A
  1. Pain all over
  2. Over a year
  3. Headaches
  4. Poor concentration
  5. Sleep disturbances
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199
Q

What is the first line treatment for neuropathic pain?

A

Amitriptyline

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200
Q

What type of anaemia does folate deficiency cause?

A

Macrocytic megaloblastic anaemia

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201
Q

What is the MCV in microcytic anaemia?

A

<80 fL

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202
Q

What is the MCV in normocytic anaemia?

A

80-100 fL

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203
Q

What is the MCV in macrocytic anaemia?

A

> 100 fL

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204
Q

What is the mechanism of absorption of vitamin B12?

A

B12 binds to intrinsic factor produced by the parietal cells of the stomach

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205
Q

What happens in pernicious anaemia?

A

Parietal cells of the stomach attacked by immune system resulting in atrophic gastritis and loss of intrinsic factor production

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206
Q

What is the management for hereditary spherocytosis?

A

Splenectomy

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207
Q

What describes the appearance of a blood film of a pt w beta thlassaemia major?

A

Large and small irregular hypo chromic RBCs

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208
Q

What would you see on a blood film of a patient with multiple myeloma?

A

Rouleaux formation

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209
Q

What is complicated malaria characterised by?

A

Vascular occlusion

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210
Q

What is the most common type of blood cancer in children?

A

Acute lymphoblastic leukaemia

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211
Q

What is the treatment for chronic myeloid leukaemia?

A

Imatinib and chemotherapy

212
Q

What is the treatment for chronic lymphocytic leukaemia?

A

Rituximab and chemo

213
Q

Which cancer is dexamethasone used as part of the treatment therapy?

A

Multiple myeloma

214
Q

How is beta thalassaemia diagnosed?

A

Blood film

215
Q

What does ITP affect?

A

Platelet aggregation

216
Q

What is the mutated gene in cystic fibrosis?

A

Transmembrane conductance regulator gene (CFTR)

217
Q

Which TB drug causes red sweat/tears/saliva?

A

Rifampicin

218
Q

Which TB drug causes fever, jaundice and nausea?

A

Isonizaid

219
Q

Which TB drug causes hyperuricaemia and gout?

A

Pyrazinamide

220
Q

Which TB drug causes optic neuritis/eye symptoms

A

Ethambutol

221
Q

Whats the most common type of lung cancer?

A

Squamous cell cancer

222
Q

What’s the common CT finding for a pt w bronchiectasis?

A

Signet ring sign

223
Q

What does a ‘tree-in-bud’ CT sign suggest?

A
  1. Aspiration pneumonitis
  2. Bronchiolitis
  3. Atypical pneumonia
224
Q

What does the ‘bronchus’ sign on CT suggest?

A

Lung nodule or mass = bronchogenic cancer

225
Q

What does the ‘polo mint’ sign on CT suggest?

A

PE

226
Q

Is TB restrictive or obstructive?

A

Restrictive

227
Q

Is bronchiectasis restrictive or obstructive?

A

Obstructive

228
Q

Is bronchiolitis restrictive or obstructive?

A

Obstructive

229
Q

What are the ABG findings of type 1 resp failure?

A

Low O2 and normal/low CO2

230
Q

What are the ABG findings of type 2 resp failure?

A

Low O2 and high CO2

231
Q

What are some common causes of type 1 resp failure?

A
  1. Asthma
  2. PE
  3. COVID
232
Q

What are some common causes of type 2 resp failure?

A
  1. COPD exacerbation
  2. Pneumonia
  3. Rib fractures
  4. MND
  5. Opiates
233
Q

What is the most common cause of hospital acquired pneumonia within 4 days of admission?

A

Likely the same as CAP - S pneumoniae/aureus

234
Q

What is the most common cause of hospital acquired pneumonia after 5 days of admission?

A

Pseudomonas aeruginosa or MRSA

235
Q

What is the most appropriate site for a needle thoracotomy for a tension pneumothorax?

A

2nd intercostal space, mid-clavicular line on the same side as the pneumothorax

236
Q

What is the first line investigation for suspected pancreatitis?

A

Serum amylase

237
Q

How is hepatitis A spread?

A

Faeco-oral spread

238
Q

What does Hep A present with?

A
  1. Itching

2. Yellowing of eyes

239
Q

What are the symptoms of Hep C?

A

Asymptomatic

240
Q

How does Hep B present?

A

Often with jaundice

241
Q

What is the first line treatment of autoimmune hepatitis?

A

Prednisolone

242
Q

What is the gold standard treatment of autoimmune hepatitis?

A

Prednisolone with added azathioprine - added after pred started

243
Q

What is a common cause of spontaneous bacterial peritonitis?

A

Staph aureus

244
Q

What is the pathology of primary sclerosing cholangitis?

A

Fibrosis destroying the intrahepatic and extra hepatic ducts

245
Q

What cancer is associated with primary sclerosing cholangitis?

A

Cholangiocarcinoma

246
Q

What does primary sclerosing cholangitis present with?

A
  1. Jaundice
  2. Pruritus
  3. Fatigue
  4. IBS symptoms
247
Q

What colour stool and urine does pre-hepatic jaundice cause?

A

Normal urine and dark stools

248
Q

What colour urine does hepatic jaundice cause?

A

Dark urine

249
Q

What colour urine and stools does post-hepatic jaundice cause?

A

Dark urine and pale stools

250
Q

What is the most common cause of liver cirrhosis?

A

Chronic alcohol abuse

251
Q

What is the typical pain presentation of gallstones?

A

Pain worse after eating

252
Q

What part of the heart is affected if there’s ST elevation in leads V3/V4?

A

Anterior - LAD artery

253
Q

Abnormalities in leads 2, 3 and aVF indicate which artery involvement?

A

Right coronary artery

254
Q

What blood investigation is done for suspected heart failure?

A

B-type natriuretic peptide

255
Q

What is the management of acute SVT?

A

Valsalva manœuvre

256
Q

What is the first line treatment for hypertension if the pt is over 55 or black?

A

CCB - amlodipine

257
Q

What is the first line treatment for hypertension if the pt is under 55 or DM2?

A

ACEi or ARB

258
Q

What is the most appropriate investigation for aortic stenosis?

A

ECHO

259
Q

What is the treatment for a STEMI if within 2hrs of onset?

A

PCI

260
Q

What is the treatment for a STEMI if after 2hrs of onset?

A

Fibrinolysis with IV tenecteplase

261
Q

What is the 1st line investigation for heart failure?

A

BNP levels

262
Q

What is the gold standard for heart failure?

A

ECHO

263
Q

What ECG finding would be seen in atrial flutter?

A

Sawtooth flutter waves

264
Q

What ECG findings would be seen in atrial fibrillation?

A
  1. Absent P waves
  2. Narrow QRS
  3. Irregularly irregular ventricular rhythm
265
Q

What ECG changes would be seen in Wolff-Parkinson-White syndrome?

A

Delta waves

266
Q

What ECG changes would be seen in acute pericarditis?

A

Saddle-shaped ST segment elevation

267
Q

What kind of cardiomyopathy is associated with FHx of young cardiac death?

A

Hypertrophic cardiomyopathy

268
Q

What would be the second-line HTN medication for Afro-Caribbeans/>55y?

A

Add ACEi or ARB alongside the CCB

269
Q

What is the BP drop needed to diagnose postural hypotension?

A

Systolic drop >20mmHg

270
Q

What type of shock is bradycardia a classical sign of?

A

Cardiogenic shock

271
Q

What type of shock is a bounding pulse a classical sign of?

A

Septic shock

272
Q

What are some causes of hypovolaemic shock?

A
  1. GI bleeding
  2. Severe diarrhoea/vomiting
  3. Burns
  4. Pancreatitis
273
Q

What is the most important investigation for potential AAA?

A

USS

274
Q

What is the gold standard test for acromegaly?

A

Oral glucose tolerance test

275
Q

What is the main cause of secondary hypoadrenalism?

A

Long term corticosteroid use

276
Q

What is the management of SIADH?

A
  1. Restrict fluid intake

2. ADH inhibitors - demeclocycline

277
Q

What are 2 signs seen in hypocalcaemia?

A
  1. Troussau’s - wrist flexion following inflation of BP cuff

2. Chevosteks - tapping the facial nerve in the parotid gland causes ipsilateral facial muscle twitching

278
Q

What are the PTH, calcium and phosphate levels in primary hyperparathyroidism?

A

High PTH
High calcium
Low phosphate

279
Q

What is the most common cause of small bowel obstruction?

A

Surgical adhesions

280
Q

What is the most common cause of large bowel obstruction?

A

Malignant tumours

281
Q

What type of cancer is an enlarged Virchow’s node?

A

Gastric cancer

282
Q

What drug is the first line treatment for mild UC?

A

Mesalazine

283
Q

What type of anaemia is chronic disease associated with?

A

Normocytic or microcytic

284
Q

What is the most common form of anaemia?

A

Iron deficiency anaemia

285
Q

What is polycythaemia rubra vera?

A

Bone marrow over produces blood cells caused by JAK2 mutation (95%)

286
Q

What would red blood cells look like on a blood film if a pt had iron-deficiency anaemia?

A

Pale, small and abnormal shaped as do not have sufficient haemoglobin

287
Q

When is Kussmaul breathing seen?

A

In pts with DKA

288
Q

What type of cancer is benzene exposure a risk factor for?

A

Renal cell carcinoma

289
Q

What is the gold standard investigation to diagnose Wilson’s disease?

A

Liver biopsy

290
Q

What is the inheritance pattern of A1- antitrypsin deficiency?

A

Autosomal recessive

291
Q

What is cholera characterised by?

A

Rice water stools

292
Q

What is the treatment of cholera?

A

Rehydration with IV fluids

293
Q

What is the most likely cause of non-bloody diarrhoea in children?

A

Rotavirus

294
Q

What is the most likely cause of non-bloody diarrhoea in elderly/care homes?

A

Norovirus

295
Q

What disease can cause ‘bronze skin’?

A

Haemochromatosis

296
Q

What is Legionnaire’s disease?

A

A severe form of pneumonia caused by Legionella pneumophila - found in water sources/unclean air conditioners and usually in Spain

297
Q

What is the most common cause of UTI?

A

E. coli

298
Q

What type of atypical pneumonia is characterised by contact with birds?

A

Chlamydophila psittacia

299
Q

What is the immediate treatment for meningococcal septicaemia?

A

Benzylpenicillin

300
Q

What is the characteristic presentation of meningococcal septicaemia?

A
  1. Septic appearance - pale, mottled, floppy

2. Non-blanching petechial rash

301
Q

How do you differentiate between staph and strep?

A

Catalase test
+ve = staph
-ve = strep

302
Q

How do you differentiate between types of strep bacteria?

A

Haemolysis test

303
Q

What are the 3 results from the haemolysis test and what colour are they?

A 
Alpha = dark green 
Beta = pale yellow and transparent
Non = agar unchanged
304
Q

Examples of alpha haemolytic bacteria:

A
  1. S. pneumoniae

2. S. viridians

305
Q

Example of beta haemolytic bacteria:

A

S pyogenes

306
Q

How do you differentiate between S pneumoniae and S viridians?

A

Optochin test viridians = resistant pneumoniae = sensitive

307
Q

What nutrient agar is used to grow Mycobacterium Tuberculosis?

A

Lowenstein-Jensen

308
Q

What nutrient agar is used to grow campylobacter jejuni?

A

Charcoal agar

309
Q

What nutrient agar is used to grow strep. pneumoniae?

A

Chocolate agar

310
Q

What nutrient agar is used to grow gram negative bacilli?

A

MacConkey agar

311
Q

Which of the following bacteria is the most common cause of infective endocarditis in adults?

A

Strep. viridians

312
Q

What is the coagulase test used for?

A

To distinguish between staph. aureus and staph. epidermis
+ve = aureus
-ve = epidermis

313
Q

What is the oxidase test used for?

A

Differentiate between pseudomonas and coliform (shigella, salmonella, proteus)
+ve = pseudomonas
-ve = coliforms

314
Q

What does stage 2 MRC dyspnoea scale indicate?

A

Short of breath when hurrying or when walking up hill

315
Q

What does stage 4 MRC dyspnoea scale indicate?

A

Stops for breath after walking 100m on the flat

316
Q

What is the first line investigation for suspected lung cancer?

A

CXR

317
Q

What is a common complication of pneumonia?

A

Pleural effusions

318
Q

What is a characteristic presentation of pleural effusion?

A

Stony dull percussion

319
Q

What is the antibody used to identify rheumatoid arthritis?

A

Anti-CCP

320
Q

What is a key investigation finding of sarcoidosis?

A

Bilateral hilar lymphadenopathy

321
Q

What spirometry finding indicates an obstructive defect?

A

FEV1/FVC<0.7

322
Q

What are some causes of bronchiectasis?

A
  1. Bronchogenic carcinoma
  2. Cystic fibrosis
  3. Immotile ciliary syndrome
323
Q

What is the second line management of COPD?

A

Add a long-acting beta-2 agonist inhaler to the salbutamol (SABA)

324
Q

What is the diagnostic investigation for sarcoidosis?

A

Tissue biopsy

325
Q

What does a tissue biopsy show if a pt has sarcoidosis?

A

Non-caseating granuloma

326
Q

What type of hypersensitivity reaction is hypersensitivity pneumonitis?

A

Type 3

327
Q

What often precedes Goodpastures syndrome?

A

Upper resp tract infection

328
Q

Why can subarachnoid haemorrhage present with signs of meningism?

A

Blood irritates the meninges

329
Q

What is the classic triad of symptoms in Parkinson’s disease?

A
  1. Bradykinesia
  2. Rigidity
  3. Tremor
330
Q

What would a parietal lobe seizure present with?

A

Paraesthesia

331
Q

What would an occipital lobe seizure present with?

A

Floaters/flashes

332
Q

What is the immediate medical management of a TIA?

A

Aspirin 300mg daily

333
Q

What does cauda equina syndrome present with?

A
  1. LMN signs only
  2. Sphincter disturbance
  3. Impotence
  4. Saddle paraesthesia
  5. Decreased anal tone
334
Q

What is Brown-Sequard syndrome?

A

Lateral hemisection of the spinal cord

335
Q

What does Brown-Sequard syndrome present with?

A
  1. Ipsilateral weakness below lesion
  2. Ipsilateral loss of proprioception + vibration
  3. Contralateral loss of pain + temperature
336
Q

What stain identifies TB?

A

Ziehl-Neelsen

337
Q

What stain studies bone growth?

A

Silver nitrate stain

338
Q

What is a rhabdomyoma?

A

Benign tumour of striated muscle

339
Q

What is a leiomyosarcoma?

A

Malignant tumour of smooth muscle cells

340
Q

What does arterial thrombosis present with?

A

Cold and pale limb

341
Q

What does vasculitis present with?

A

Skin lesion (like purpura or petechiae)

342
Q

What are CD4 cells?

A

T helper cells

343
Q

What are CD8 cells?

A

Cytotoxic T cells

344
Q

What are some examples of Gell and Coombs Classification Type 1?

A
  1. Hayfever

2. Anaphylaxis

345
Q

What are some examples of Gell and Coombs Classification Type 2?

A
  1. Transfusion reactions

2. Autoimmune conditions

346
Q

What are some examples of Gell and Coombs Classification Type 3?

A
  1. SLE

2. Vasculitis

347
Q

What is an example of Gell and Coombs Classification Type 4?

A
  1. TB
348
Q

What is the most significant risk factor for developing atherosclerosis?

A

Hypercholesterolaemia

349
Q

What is the mechanism of aspirin?

A

It irreversibly inhibits the COX enzyme, accelerating the breakdown of arachidonic acid into prostaglandin H2

350
Q

What does the posterior pituitary secrete?

A
  1. ADH

2. Oxytocin

351
Q

What is the first line treatment for hypocalcaemia?

A

IV calcium gluconate over 30 mins

352
Q

How would you treat a hypotensive Addison’s patient?

A

IV saline and hydrocortisone

353
Q

What are the 3 immediate treatment steps for DKA?

A
  1. Fluids
  2. Potassium
  3. Insulin
354
Q

How do diagnose giant cell arteritis?

A

Temporal artery biopsy

355
Q

What is the most common cause of septic arthritis?

A

Staph aureus

356
Q

What HLA complex is ankylosing spondylitis associated with?

A

HLA-B27

357
Q

What is the gold standard treatment for rheumatoid arthritis?

A

Methotrexate

358
Q

What is the genetic defect of the Philadelphia chromosome?

A

Translocation t(9,22)

359
Q

What type of lung cancer is associated with paraneoplastic syndromes?

A

Small cell lung cancer

360
Q

What ABG results suggest a respiratory problem?

A

High pCO2 and low pO2

361
Q

What would suggest metabolic compensation?

A

Abnormal bicarbonate

362
Q

Examples of causes of exudative pleural effusion:

A
  1. Malignancy

2. Rheumatoid arthritis

363
Q

Examples of causes of transudative pleural effusion:

A
  1. Heart failure
  2. Hypothyroidism
  3. Nephrotic syndrome
  4. Liver cirrhosis
364
Q

What is the most common cause of nephrotic syndrome?

A

Minimal change disease

365
Q

What is the management of a pt presenting w testicular torsion?

A

Urgent surgical exploration

366
Q

Examples of causes of hypokalaemia?

A
  1. Cushing’s disease
  2. Conn’s syndrome
  3. Ectopic ACTH-secreting tumour
  4. Furosemide
367
Q

What K+ imbalance does Addison’s disease cause?

A

Hyperkalaemia

368
Q

What Na+ imbalance does diabetes insipidus cause?

A

Hypernatraemia

369
Q

Examples of causes of hyponatraemia:

A
  1. Loop diuretic use
  2. Addison’s disease
  3. Primary hypothyroidism
370
Q

What is used to treat nephrogenic diabetes insipidus?

A

Bendroflurmethiazide

371
Q

What is the treatment for acute MI?

A 
MOANA
M = morphine
O = oxygen
A = atenolol
N = nitrate (GTN)
A = aspirin
372
Q

Example of a medication associated with upper GI bleeds:

A

Aspirin

373
Q

What score is used to assess risk of DVT?

A

Wells score

374
Q

What is koilonychia and what disease is it seen in?

A

Spooning of the nails seen in iron-deficiency anaemia

375
Q

What is leukonychia and what disease is it seen in?

A

Whitening of the nail seen in chronic liver disease

376
Q

What are some signs of chronic liver disease?

A
  1. Testicular atrophy
  2. Gynaecomastia
  3. Caput medusae
  4. Asterixis
377
Q

What are the features of Reynold’s pentad?

A
  1. Fever
  2. RUQ pain
  3. Jaundice
  4. Confusion
  5. Hypotension
378
Q

What is Reynold’s pentad a sign of?

A

Ascending cholangitis

379
Q

What is the gold standard investigation for a bowel obstruction?

A

CT abdomen

380
Q

What will biliary colic present with?

A

Colicky RUQ pain

381
Q

What will cholecystitis present with?

A

RUQ pain and fever

382
Q

What is the gold standard investigation for cholangitis?

A

ERCP - endoscope and x-rays of bile duct

383
Q

What is the first line investigation of cholangitis?

A

US abdomen

384
Q

What is the most common viral hepatitis worldwide?

A

Hep A

385
Q

What does hep A present with?

A
  1. N&V
  2. Anorexia
  3. Jaundice
386
Q

What is the management of hep A?

A

Simple analgesia as should resolve spontaneously

387
Q

What viral hep has a vaccine?

A

Hep A

388
Q

What antibody type is inherited from parent to child?

A

IgG

389
Q

What is the treatment of an opioid overdose?

A

IV naloxone

390
Q

What is the initial treatment for polymyalgia rheumatica?

A

Oral prednisolone

391
Q

What can polymyalgia rheumatica lead to if left untreated?

A

Giant cell arteritis

392
Q

What area of the brain would cause a seizure with auditory hallucinations and automatisms?

A

Temporal lobe

393
Q

What is the presentation of Brown-Sequard syndrome?

A
  1. Contralateral loss of pain and temperature

2. Ipsilateral loss of motor, vibration and proprioception

394
Q

What spirometry results would you expect in someone with obstructive disease?

A

FEV1/FVC < 0.7

FEV<80%

395
Q

What breath sounds would you hear in a pt with acute asthma?

A

Hyper-resonant breath sounds

396
Q

What is the order of medications prescribed in asthma?

A
  1. SABA
  2. Low ICS
  3. LTRA
  4. LABA
  5. MART
  6. Mod ICS
  7. High ICS
397
Q

What type of lung cancer is associated with asbestos exposure?

A

Adenocarcinoma

398
Q

Where are common sites of lung metastases?

A
  1. Adrenal glands
  2. Bone
  3. Brain
  4. Liver
  5. Lymph nodes
399
Q

Examples of bacteria causing atypical pneumonia:

A
  1. Mycoplasma pneumonia
  2. Chlamydophila pneumonia
  3. Legionella pneumonia
400
Q

What is the most common CAP?

A

Strep pneumoniae

401
Q

What is the most common HAP?

A

Staph aureus

402
Q

What is the most common cause of pneumonia in COPD patients?

A

Haemophilus influenzae

403
Q

What chromosome is affected in CF?

A

7

404
Q

What is the 1st line treatment for syphilis?

A

Benzathine penicillin

405
Q

What is the choice of drug for chemoprophylaxis for suspected meningococcal meningitis pt contacts?

A

Ciprofloxacin or rifampicin

406
Q

What type of meningitis presents with a non-blanching purpura rash?

A

Meningococcal meningitis

407
Q

What group of conditions are the most common cause of work-related ill health in the UK workforce?

A

Stress, anxiety and depression

408
Q

What is the definition of sensitivity?

A

The proportion of patients who have the disease and test positive

409
Q

What is the definition of specificity?

A

The proportion of patients who don’t have the disease and test negative

410
Q

What is the positive predicted value?

A

The proportion of patients who test positive who have the condition

411
Q

What would a cerebellar stroke present with?

A
  1. Ataxia
  2. Headache
  3. Vertigo
  4. Vomiting
412
Q

What is the first course of action if a pt presents with stroke symptoms?

A

Order a head CT within the hr to determine whether ischaemic or haemorrhagic

413
Q

What is Charcot-Marie-Tooth syndrome?

A

Group of inherited disorders that damage peripheral nerves

414
Q

What can temporal/giant cell arteritis be brought on by?

A
  1. Change in temperature
  2. Shaving
  3. Combing hair
  4. Eating
415
Q

What is the origin of the median nerve?

A

C5-T1

416
Q

What would a tonic seizure present with?

A

Sudden stiffness of the limbs

417
Q

What is the mode of action of NSAIDs?

A

Non-selective inhibitors of COX1 + COX2 enzymes

418
Q

What is MCH a measure of?

A

Haemoglobin present in RBC’s

419
Q

What is the most common cause of hepatitis in travellers?

A

Hep A

420
Q

What is the management of an inguinal hernia which is symptomatic and irreducible?

A

Urgent referral to secondary care due to risk of strangulation

421
Q

What are the risk factors for gallstones?

A
  1. Female
  2. Fertile
  3. 40
  4. Fat
  5. Fair (Western world)
422
Q

What is the first line investigation for gallstones?

A

US of gallbladder

423
Q

What is the treatment of pernicious anaemia?

A

Vitamin B12 injections

424
Q

What is pernicious anaemia?

A

Autoimmune condition preventing uptake of vitamin B12/folate in the bowel

425
Q

What would pernicious anaemia present with?

A
  1. Classic anaemia symptoms
  2. Peripheral neuropathy (pins and needles)
  3. Mouth ulcers
  4. Lemon tinged skin
  5. Depression
  6. Dementia
426
Q

What clotting factor is deficient in Haemophilia B?

A

Factor 9

427
Q

What clotting factor is deficient in Haemophilia A?

A

Factor 8

428
Q

What is polycythaemia?

A

Increase in RBC production

429
Q

What can secondary polycythaemia be caused by?

A

Hypoxia - as a result of lung disease or smoking

430
Q

How can myeloma be managed?

A
  1. Chemotherapy
  2. Steroids
  3. Thalidomide
431
Q

What is the diagnostic investigation for kidney stones?

A

Non-contrast CT KUB

432
Q

What is the presentation of kidney stones?

A
  1. Severe intermittent abdo pain

2. Present on the side and in testicles

433
Q

What is the most common type of of renal cell carcinoma?

A

Clear cell

434
Q

What type of drug is Goserelin and what is it used for?

A

A GnRH agonist used for prostate cancer

435
Q

What would the PTH, Ca+ and phosphate levels be in an individual with secondary hyperparathyroidism?

A

High PTH
Low calcium
Low phosphate

436
Q

What are some complications of long-term steroid use?

A
  1. Skin thinning
  2. Easy bruising
  3. DM
  4. Immunosuppression
  5. Osteoporosis
  6. Proximal muscle weakness
437
Q

What would be seen on an ECG of Wolff-Parkinson-White syndrome?

A
  1. Wide QRS
  2. Short PR
  3. Delta wave
438
Q

What type of arrhythmia is WPW?

A

Atrioventricular re-entry tachycardia - it is a type of supraventricular tachycardia causing the AV re-entry

439
Q

What are the CXR signs of HF?

A 
ABCDE
A = Alveolar oedema
B = Kerley B lines
C = Cardiomegaly
D = Dilated pulmonary vessels
E = Pleural effusion
440
Q

What are the appropriate first line medications for HF?

A

B blocker and ACE inhibitor

441
Q

Which part of the kidney does furosemide act on?

A

Ascending loop of Henle

442
Q

Which area of the heart is affected if there’s ST elevation in leads V1-6, aVL and I?

A

Anterolateral

443
Q

What is clopidogrel and how does it work?

A

An anti platelet that prevents platelet aggregation by binding to the P2Y12 receptor

444
Q

What is warfarin?

A

A vitamin K antagonist

445
Q

What is the medication for ongoing IBS diarrhoea?

A

Loperamide

446
Q

What is the presentation of pulmonary fibrosis?

A
  1. Dry cough
  2. Increasing breathlessness
  3. Smoker
  4. Clubbing
  5. End-inspiratory crackles
447
Q

What disease is primary biliary cirrhosis associated with?

A

Sjogrens Syndrome

448
Q

What is the presentation of myasthenia gravis?

A

Motor weakness with spontaneous recovery after a period of time

449
Q

What is the tensilon test used for?

A

Myasthenia gravis

450
Q

What is the best diagnostic investigation for HF?

A

ECHO

451
Q

What would a foot drop with normal inversion, sensation and ankle jerk indicate?

A

Common perineal nerve palsy

452
Q

What would a lumbar radiculopathy present with?

A
  1. Sharp pain in back to foot
  2. Numbness or weakness in leg
  3. Sensation or reflex changes
453
Q

What causes wasting of the small muscles in the hand?

A

Involvement of the T1 nerve root

454
Q

What is the pathology finding of cytomegalovirus infection?

A

‘Owls eye’ intranuclear inclusions

455
Q

What blood test confirms Paget’s disease?

A

Serum alkaline phosphatase

456
Q

What does an itchy rash in the antecubital and popliteal fossae indicate?

A

Atopic eczema

457
Q

What drug type is amiodarone?

A

Anti-arrythmic

458
Q

What disease shows ‘abnormal’ monocytes on blood film?

A

Epstein-Barr virus

459
Q

What treatment would be given for low platelets and easy bleeding?

A

Prednisolone

460
Q

What is the recommended duration of moderate exercise a week?

A

150 mins

461
Q

What kind of prevention does the COVID vaccination programme offer?

A

Primary prevention

462
Q

What class of medication is allopurinol?

A

Xanthine oxidase inhibitor

463
Q

Which hormone is tested for testicular carcinoma diagnosis?

A

Beta human chorionic gonadotrophin

464
Q

What is anticipation?

A

A genetic inheritance pattern where the symptoms start earlier in later generations

465
Q

What is salmeterol?

A

A LABA

466
Q

What receptor does salmeterol act on?

A

B2 adrenergic receptors

467
Q

What does a head CT with a lentiform area of opacity indicate?

A

Extradural haematoma

468
Q

What immunoglobulin is prominent in anaphylaxis?

A

IgE

469
Q

What antibiotic is used for cellulitis?

A

Flucloxacillin

470
Q

What is the main cause of bacterial pneumonia?

A

Streptococcus pneumoniae

471
Q

What is the target INR range?

A

2-3

472
Q

What are some UMN lesion signs?

A
  1. Muscle weakness
  2. Overactive reflexes
  3. Tight muscles
  4. Positive Babinsky sign
473
Q

What are some LMN lesion signs?

A
  1. Muscle atrophy
  2. Fasciculations
  3. Decreased reflexes
  4. Decreased tone
  5. Negative Babinsky sign
474
Q

What class of drug is alendronic acid?

A

Bisphosphonate

475
Q

What is the pattern of blood volume and sodium levels in SIADH?

A

Normovolaemic, hyponatraemic

476
Q

Which study design is of the highest quality?

A

Systematic review

477
Q

What screening tool is used to determine depression severity?

A

PHQ-9

478
Q

What week should the baby check happen?

A

6-8 weeks

479
Q

What is De Quervain’s thyroiditis?

A

Transient patchy inflammation of the thyroid gland with granuloma formation

480
Q

What do the letters stand for in ABCD2?

A 
A = age over 40
B = systolic over 140 or diastolic over 90
C = clinical features (1), (2) for weakness
D = duration of symptoms (1) id under an hour
D2 = diabetes
481
Q

What antibody is associated with GPA?

A

c-ANCA

482
Q

What is the mechanism of unfractionated heparin?

A

Activation of antithrombin (factor 3) which deactivates Xa and IIa in the clotting cascade

483
Q

What is an example fo a LTRA?

A

Montelukast

484
Q

What is another name for the bony spurs developing at synovial margins of a joint?

A

Osteophytes

485
Q

What is the most common CXR sign of aortic dissection?

A

Widening of the mediastinum

486
Q

What value would you base the warfarin dose off?

A

INR value

487
Q

What are the differences between appendicitis and a perforated appendix?

A

Symptoms of sepsis - confusion etc

488
Q

What would hyperprolactinaemia cause?

A
  1. Menstrual disturbances
  2. Reduces libido
  3. Galactorrhoea
489
Q

How can you identify silicosis?

A
  1. Egg-shell calcification of hilar nodes

2. Diffuse nodular pattern in upper and mid-zones of lung

490
Q

What are some key features of sarcoidosis?

A
  1. Resp symptoms
  2. Lymphadenopathy
  3. Hepatosplenomegaly
  4. Eye symptoms
  5. Erythema nodosum
491
Q

What is the first-line treatment for moderate/severe migraines?

A

Triptans like sumatriptan

492
Q

What would indicate a UTI on a urine dipstick?

A
  1. +ve nitrite
  2. +ve leukocyte
  3. +ve RBC
493
Q

What would you treat a pneumonia with a CURB score of 0?

A

Amoxicillin

494
Q

What would you treat a pneumonia with a CURB score of 1-2?

A

Amoxicillin with clarithromycin

495
Q

What would you treat a pneumonia with a CURB score of 3-5?

A

Co-amoxiclav with clarithromycin

496
Q

What is the first line treatment for oesophageal varices?

A

Octeotride/ terlipressin

497
Q

What findings would indicate CLL?

A

Smudge/basket cells

498
Q

What type of bacteria is N. meningitides?

A

A gram negative diplococci

499
Q

What is the most common cause of iron deficiency anaemia worldwide?

A

Hookworm

500
Q

What is the mechanism of DPP-4 inhibitors?

A

Oral glucose lowering agents that primarily inhibit the breakdown of glucagon-like peptide 1

501
Q

What is the most common nerve injury to a fracture of the fibular head?

A

Common fibular nerve

502
Q

What does AST measure?

A

It is an enzyme used to monitor hepatocellular damage

503
Q

When would GGT be raised?

A
  1. Liver and biliary disease

2. High alcohol intake

504
Q

What causes jaundice and why?

A

Bilirubin - it is a breakdown product of RBC

505
Q

What type of bacteria is clostridium difficile?

A

Gram positive bacilli

506
Q

What antihypertensives can cause nephrotoxicity/intrarenal AKI?

A
  1. ACEi

2. ARB

507
Q

What is the acute management of supra ventricular tachycardias?

A
  1. Vagal manoeuvres

2. IV adenosine

508
Q

What is the treatment of Paget’s disease?

A
  1. Analgesia

2. Bisphosphonates

509
Q

What happens to K+ in DKA?

A

It becomes elevated as glucose cannot help transport it into cells

510
Q

Which artery is stenosed if there is ST-elevation in V2-4?

A

Left anterior descending

511
Q

What happens if the Well’s score is 1 or less?

A

DVT unlikely so D-dimer test

512
Q

What happens if the Well’s score is 2 or more?

A

Proximal leg vein USS

513
Q

How can you differentiate between epididymo-orchitis rather than torsion?

A

Pain partially relieved on elevation of testis = epididymo-orchitis

514
Q

What happens if the Well’s score is 4 or more?

A

CTPA

515
Q

Where would liquefactive necrosis be seen?

A

In the brain as a consequence of ischaemic injury

516
Q

Where would fat necrosis be seen?

A
  1. Breast

2. Pancreas

517
Q

What is Kaposi sarcoma associated with?

A

Human herpes virus 8

518
Q

What would Kaposi sarcoma present with?

A

Reddish, purple skin lesions

519
Q

What age does AAA screening begin?

A

65

520
Q

How would you treat severe bacterial cellulitis?

A

IV benzylpenicillin and flucloxacillin

521
Q

How do you differentiate between meningitis and encephalitis?

A

Signs of meningism + confusion = encephalitis

522
Q

What is the most common cause of encephalitis?

A

Herpes simplex virus

523
Q

What is the function of cytotoxic T cells?

A

Present antigens

524
Q

What do cytotoxic T cells express and why?

A

CD8 so they can recognise peptides presented by MHC 1

525
Q

Which cell type does M. Tuberculosis reside in?

A

Macrophages

Phase 2A (3 decks)

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