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
2
Q
Describe the pharmacology of spironolactone
A
Inhibition of aldosterone receptor in the distal tubules
3
Q
What drug class is spironolactone?
A
Aldosterone receptor antagonists
4
Q
What type of valve disorder presents with: pan-systolic murmur at the apex
A
Mitral regurgitation
5
Q
What are the 4 most common ECG changes seen in MI?
A
- ST elevation
- ST depression
- Abnormal Q wave
- T wave inversion
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
7
Q
Which risk score should be used to assess heart attack risk?
A
QRISK2 score
8
Q
Which risk score should be used to assess stroke risk after a TIA?
A
ABCD2 score
9
Q
What are the 3 key aspects of Conn’s syndrome?
A
- hypertension associated with hypokalaemia
- medication- resistant hypertension
- hypertension before 40
10
Q
Which medication stabilises the BP and K+ levels?
A
Spironolactone (potassium sparing diuretic)
11
Q
What do raised renin and aldosterone levels suggest?
A
Secondary hyperaldosteronism (suggest a renin secreting tumour)
12
Q
What value proves diagnostic for a HbA1c test?
A
> 48mmol/mol
13
Q
What is seen on the ECG of someone with hyperkalaemia?
A
- Absent P waves
- Prolonged PR interval
- Tall T waves
- Wide QRS complex
14
Q
What is the classical triad of carcinoid syndrome?
A
- Cardiac involvement
- Diarrhoea
- Flushing
15
Q
What is the gold standard diagnostic test for coeliac disease?
A
Endoscopy and intestinal biopsy
16
Q
Which blood tests would you order for coeliac disease?
A
IgA tissue transglutaminase or IgA endomysial antibody
17
Q
What is the first line treatment of H. Pylori causing peptic ulcers?
A
PPI + amoxicillin + clarithromycin/metronidazole
18
Q
What are the 2 ways to diagnose for H. Pylori?
A
- Carbon-13 urea breath test
2. Stool antigen test
19
Q
Which cells do PPI’s act on?
A
Parietal cells
20
Q
What is the main warning sign for bladder cancer?
A
Painless haematuria
21
Q
What are the common SE of tamsulosin?
A
- Postural hypotension
- Dizziness
- Syncope
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
23
Q
What are the 5 common causes of UTIs?
A
KEEPS
- Klebsiella
- E Coli (most common)
- Enterococcus
- Proteus/pseudomonas
- Staphylococcus saprophytic
24
Q
What is the classic triad of nephrotic syndrome?
A
- Hypoalbuminaemia
- Peripheral oedema
- Proteinurea
25
Which disease presents with the Philadelphia chromosome on investigation?
Chronic myeloid leukaemia
26
Which disease presents with Auer rods on investigation?
Acute myeloid leukaemia
27
Which disease presents with Reed-Steinberg cells on investigation?
Hodgkin's lymphoma
28
Which disease presents with Bence-Jones proteins on investigation?
Myeloma
29
What is pharmokinetics?
The action of the body on the drug
30
What is pharmacodynamics?
The action of the drug on the body
31
What is a phaeochromocytoma?
A tumour of the adrenal medulla
32
What drugs are used to treat pulmonary TB?
RIPE
1. Rifampicin
2. Isoniazid
3. Pyrazinamide
4. Ethambutol
33
Which heart valve is most commonly affected in infective endocarditis?
Tricuspid
34
What does Neisseria spp. look like under Gram stain?
Gram negative diplococcus
35
What does E. coli look like under Gram stain?
Gram negative bacilli (grows on MacConkey)
36
What is the mechanism of clarithromycin/erythromycin?
Inhibit protein synthesis
37
What does CURB-65 stand for?
```
C = confusion
U = urea > 7mmol/L
R = resp rate > 30
B = BP <90/60
- 65 = over 65
```
38
Which disease are Bouchard nodules seen in?
Osteoarthritis
39
What would be seen in a pt with pseudo-gout under light microscopy?
Rhomboid shape and positively bi-fringent
40
What would be seen in a pt with gout under light microscopy?
Needle shape and negatively bi-fringent
41
What is the second line treatment for osteoporosis?
Denusomab (monoclonal antibody)
42
What is the treatment for acute gout?
Colchicine
43
What are the preventative gout drugs?
Allopurinol and febuxostat
44
What is the best investigation to confirm rheumatoid arthritis?
Anti - CCP
45
What is the appearance of osteoarthritis on x-ray?
```
LOSS
L = loss of joint space
O = osteophytes
S = subchondral sclerosis
S = subchondral cysts
```
46
What is the first line management of a pt with septic arthritis?
Aspirate the joint and send off for a blood culture THEN antibiotics!
47
What is the first line treatment for a migraine?
Ibuprofen
48
What headache would you use aspirin to treat?
Tension-type headache
49
What is the first line prophylactic treatment of a migraine?
Topiramate
50
What is the most common cause of meningitis?
Streptococcus pneumonia
51
Which nerve is involved in carpal tunnel syndrome?
Median nerve
52
Which drug treats the jerky movements in Huntington's?
Risperidone
53
What is the first line treatment for a PE?
Start a DOAC such as apixaban
54
What is the treatment for a tension pneumothorax?
Immediate decompression via large bore cannula
55
What is the treatment for a primary spontaneous pneumothorax?
Needle aspiration
56
How can you tell if it is full or partial metabolic compensation?
If bicarb is elevated and pH remained low = partial
| If bicarb elevated and pH corrected itself/returned to normal = full
57
What drug group cause bronchodilation by blocking acetylcholine receptors that normally contract bronchial smooth muscle?
Long-acting muscarinic antagonists
58
Which electrolyte imbalance is a key finding in sarcoidosis?
Hypercalaemia
59
What is the antibody involved in Goodpasture's syndrome?
Anti-glomerular basement membrane
60
What is the calculation for working out units of alcohol?
(% x vol in ml) / 1000
61
What does the 6-in-1 vaccine contain?
Diptheria, tetanus, pertussis, polio, Hib and hep B
62
When is the 6-in-1 vaccine given?
3x when 8, 12, 16 weeks old
63
When is the Meningococcal group B vaccine given?
8 weeks old
64
What are the acronyms to remember the two types of bundle branch blocks?
1. MaRRoW
| 2. WiLLiaM
65
What would be seen on an ECG of someone with RBBB?
1. R wave in lead 1 (M shape)
| 2. Slurred S wave in lead 6 (W shape)
66
What would be seen on an ECG of someone with LBBB?
1. Slurred S wave in lead 1 (W shape)
| 2. R wave in lead 6 (M shape)
67
What are the 6 P's of critical ischaemia?
1. Pain
2. Pallor
3. Paralysis
4. Parasthesia
5. Perishingly cold
6. Pulselessness
68
4 key features of tetralogy of fallot?
1. Ventricular septal defect
2. Pulmonary stenosis
3. Overriding aorta
4. Hypertrophy of RV
69
What are the 3 stages of hypertension?
Stage 1 = >140/90
Stage 2 = >160/100
Severe = >180/110
70
What are the distinctive signs of infective endocarditis?
1. Splinter haemorrhages
2. Olser's nodes
3. Janeway lesions
4. Roth spots
5. Fever
71
What is achalasia?
Muscles of oesophageal sphincter don't relax, so food cannot reach the stomach
72
First line treatment for GORD:
Omeprazole - a PPI
73
How does mucosal ischaemia cause peptic ulcers?
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
74
How do NSAIDs cause peptic ulcers?
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
75
What is the first line investigation for a large bowel obstruction?
Abdominal x-ray
76
When do duodenal ulcers cause pain?
Pain several hours after eating and pain gets better while eating
77
What is the gold standard investigation for bowel cancer?
Colonoscopy
78
What is the most common location for colon cancers?
Distal colon
79
What is the most common cause of AKI's?
Acute tubular necrosis
80
How does prostatic hyperplasia cause post-renal AKI?
1. Urinary tract is obstructed
2. Increases intra-tubular pressure
3. Decreases GFR
4. Increases urea and creatinine remaining in the blood
81
What are the different stages of CKD?
```
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
```
82
What is the most common cause of pyelonephritis?
E. Coli - from the patients own bowel flora cause the infection
83
Can trimethoprim be used in pregnancy for UTI?
NO- it is teratogenic in the first trimester as it inhibits folate synthesis
84
What is the first line antibiotic for UTI in pregnant women?
Nitrofurantoin
85
When would you find Auer rods on bone marrow biopsy?
Acute myeloid leukaemia
86
What is the urgent gold standard treatment for someone with TTP?
Plasma exchange
87
How would you treat a post-op hip replacement pt with a risk of VTE?
Dalteparin acutely and then maintenance treatment with apixaban
88
What is the protein target of Rituximab?
CD20
89
What is the ideal first line treatment for severe/complicated malaria?
IV artesunate
90
What are the 5 signs of acute inflammation?
1. rubor (redness)
2. dolor (pain)
3. calor (heat)
4. tumor (swelling)
5. loss of function
91
What metaplastic change occurs in Barrett's oesophagus?
Stratified squamous -> simple columnar
92
What is the 1st line pharmacological treatment for paracetamol overdose?
N-acetyl cysteine
93
What are the causes of pancreatitis?
```
GET SMASHED
G = gallstones
E = ethanol excess
T = trauma
S = steroids
M = mumps
A = autoimmune
S = scorpion venom
H = hyperlipidaemia
E = emboli
D = drugs
```
94
1st line alcohol withdrawal treatment for seizures:
Chlordiazepoxide
95
What vitamin deficiency causes Wernicke's encephalopathy?
Vitamin B1 (thiamine)
96
What type of drug is alendronic acid?
Bisphosphonate
97
What is a common side affect of bisphosphonates?
Oesophagitis
98
What test is used for the diagnosis of Sjogren's syndrome?
Schirmer test
99
What sign is commonly seen on an x-ray of a pt with psoriatic arthritis?
Pencil in a cup
100
What X-ray sign is commonly seen if a pt has ankylosing spondylitis?
Bamboo spine
101
What X-ray sign is commonly seen if a pt has gout?
Periarticular erosions
102
What is the first line management of ankylosing spondylitis?
NSAIDs like ibuprofen
103
What is the typical presentation of pseudogout?
Acute onset of mono arthritis - often in the knee, and potentially with a fever
104
What can cause pseudo gout?
Anything that can derange calcium levels (parathyroidectomy or IV fluids)
105
What is the typical presentation of gout?
Acute onset of mono arthritis in the toe which is precipitated by an event such as overindulgent meals or new medications
106
What is the typical presentation of reactive arthritis?
Usually following a GI or GU infection
107
What is the typical presentation of septic arthritis?
Often in the knee but pt is systemically unwell with sub-acute onset over a week or so
108
What does a T score of -1 to -2.5 suggest?
Osteopenia
109
What does a T score of under -2.5 suggest?
Osteoporosis
110
What is osteomalacia?
Adult version of rickets - bones become soft due to calcium or vitamin D deficiency
111
What is amaurosis fugax?
A symptom of a TIA where a person cannot see out of one/both eyes due to lack of blood flow
112
What is the first line treatment for generalised seizures?
Sodium valproate
113
When is rivastigmine used and what is it?
Used in the treatment of Alzheimers and is an Ach-esterase inhibitor
114
What is the treatment for giant cell arteritis?
Oral steroids such as prednisolone
115
Pt with acute stoke should receive alteplase treatment within what time after onset of symptoms?
<4.5hrs
116
What is the most common cause of infective exacerbation in COPD?
Haemophilus influenzae
117
What are the classic symptoms of PE?
1. Pleuritic chest pain
2. SoB
3. Haemoptysis
118
What investigation confirms Addison's disease?
SynACTHen test
119
What are the symptoms of Addison's disease?
1. Lose weight
2. Lose appetite
3. Lightheaded
4. Darkened skin in creases
5. Scars darkening
120
What electrolyte finding would you expect to see in SIADH?
Hyponatraemia
121
What asthma medication can cause hypokalaemia?
Regular nebuliser salbutamol
122
What electrolyte imbalance can ramipril cause?
Hyperkalaemia
123
What is the first line investigation for acromegaly?
Serum IGF-1
124
What is the second line investigation for acromegaly?
OGTT - oral glucose tolerance test
125
What would you find from the OGTT if a pt had acromegaly?
No suppression of GH and may show impaired glucose tolerance
126
What is the first line investigation of Conn's Syndrome/primary hyperaldosteronism?
Aldosterone renin ratio
127
What is the initial management of Cushing's syndrome?
Medication review
128
What suggests an ACTH independent cause of Cushing's syndrome?
No cortisol suppression with a low ACTH level
129
What does inappropriately raised serum calcium and normal PTH levels suggest?
Primary hyperparathyroidism
130
What do high levels of plasma catecholamines and metanephrines suggest?
Pheochromocytoma
131
What area produces and secretes corticosteroids such as cortisol?
Zona fasciculata
132
What does the zone glomerulosa produce?
Mineralocorticoids like aldosterone
133
What does the zone reticularis produce?
Androgens
134
What does the adrenal medulla produce?
Catecholamines and metanephrines
135
What cells are in the adrenal medulla and secrete catecholamines?
Chromaffin cells
136
What is the first line management of DKA?
IV fluid resuscitation
137
What is the first line medicinal treatment for DM2?
Metformin
138
What is the gold standard diagnosis for phaeochromocytoma?
Elevated plasma free metanephrine
139
What nerve damage would be indicated by presence of the claw hand and pain in the elbow?
Ulnar nerve damage
140
What is the first line medication for trigeminal neuralgia?
Carbamazepine
141
What is the prophylactic treatment for cluster headaches?
Verapamil
142
What antibody would you find if a pt has Granulomatosis with polyangiitis?
cANCA
143
What are the 4 routine investigations for suspected dementia?
1. MMSE (mini mental state examination)
2. MRI
3. CSF analysis
4. Confusion screen
144
What type of dementia is characterised by a stepwise like progression of stability and then deterioration?
Vascular dementia
145
What are the characteristics of Alzheimer's?
1. Tau tangles
2. Beta-amyloid plaques
3. Cortical atrophy
146
What are the characteristics of dementia with Lewy bodies?
1. Parkinsonism's
2. Sleep disturbances
3. Visual hallucinations
147
What are the characteristics of fronto-temporal dementia?
1. Frontal and temporal lobe atrophy
| 2. TDP-43 positive inclusions
148
What are the main signs of Huntington's disease?
1. Hyperkinesia
2. Chorea (irregular, involuntary, jerky movements)
3. Depression
4. Possible dementia
149
What are the main signs of Parkinson's disease?
1. Bradykinesia
2. Depression
3. Dementia
150
What would a stroke in the anterior cerebral artery cause?
Contralateral lower limb weakness
151
What would a stroke in the middle cerebral artery cause?
1. Hemiparesis of lower contralateral face
2. Speech impairment
3. Contralateral weakness
152
What would a stroke in the posterior cerebral artery cause?
1. Acute vision loss
| 2. Memory loss
153
What cells are targeted in MS?
Oligodendrocytes
154
What symptoms would you expect with a temporal lobe seizure?
1. Lip smacking
2. Chewing
3. Fiddling
155
What symptoms would you expect with a frontal lobe seizure?
Motor features
156
What is the difference between a complex partial and simple partial seizures?
Complex = awareness affected and is confused after
Simple = do not affect awareness and no post-ictal symptoms
157
What is involved in progressive bulbar palsy?
Lower motor neurone involvement of CN9, 10, 11, 12
158
Which nerve would be affected if a pt cannot open his fist or extend his wrist?
Radial nerve
159
What would happen if the ulnar nerve is damaged?
1. Claw sign
| 2. Pt cannot cross fingers to make a 'good luck' sign
160
What would happen if the axillary nerve was damaged?
Weakness in shoulder abduction
161
What would happen if the median nerve was damaged?
1. Wasting of the thenar eminence
2. Sensory loss
3. Weakness of abductor pollicis brevis
162
Which tumour marker is raised in testicular cancer?
Alpha feto-protein (AFP)
163
What non-specific tumour marker is raised in ovarian cancer and other conditions?
Cancer antigen 125 (Ca125)
164
What tumour marker is raised in bladder cancer?
Fibrin
165
What is the gold standard investigation for bladder cancer?
Cystoscopy
166
What is the staging system used for prostate cancer?
Gleason Scoring
167
What is the staging system used for colorectal cancer?
Dukes system
168
What type of haemorrhage is associated with autosomal dominant polycystic kidney disease?
Sub arachnoid haemorrhage
169
What hormone is released by the kidneys in response to hypovolaemia?
Renin
170
What is released by the kidneys in response to tissue hypoxia?
Erythropoietin
171
Which type of glomerular syndrome would cause haematuria?
Nephritic syndrome
172
What is the criteria for AKI stage 1?
1. Increased serum creatinine to 150-200% over baseline
| 2. Urine production <0.5ml/kg/hr for >6hrs
173
What is the criteria for AKI stage 2?
1. Increased serum creatinine to 200-300% over baseline
| 2. Urine production <0.5ml/kg/hr for >12hrs
174
What is the antibody in Goodpasture's Syndrome?
Anti-glomerular basement membrane
175
What does the ANA antibody suggest?
1. SLE
2. Scleroderma
3. Sjogrens
176
What does dsDNA antibody suggest?
Lupus
177
Who does minimal change disease usually affect?
Mainly children and young adults
178
What does minimal change disease present with?
Nephrotic syndrome
179
What can prolonged NSAIDs cause?
Acute tubulointerstitial disease - damage to the kidney tubules
180
Who would be classed as a complicated UTI?
1. Pregnant females
2. Males
3. Children
4. Recurrent UTI's
5. Elderly people
6. Pt w abnormal urinary tract/disease affecting kidneys
181
What medication would be given to treat Chlamydia trachomatis?
Azithromycin or doxycyline
182
What medication would be given to treat Neisseria Gonorrhoeae?
Azithromycin or ceftriaxone
183
What is the first line treatment for BPH?
Alpha blockers
184
Which test can confirm a diagnosis of ankylosing spondylitis?
Shober's test - assesses mobility of the spine
185
What is the most common cause of osteomyelitis?
Staphylococcus aureus
186
What is the most common cause of osteomyelitis in a pt w sickle cell anaemia?
Salmonella
187
What x-ray findings would indicate Ewing's sarcoma?
1. Onion skin appearance of periosteum
| 2. Lytic lesions
188
What x-ray findings would indicate osteosarcoma?
1. Sunray/burst appearance
| 2. Codman's triangle - lesion lifts periosteum away from bone
189
What x-ray findings would indicate chondrosarcoma?
1. Popcorn calcifications
2. Lytic lesions
3. Endosteal scalloping
190
What would the ESR and CRP be in SLE?
Raised ESR and normal/slightly raised CRP
191
What would be seen in an x-ray of a pt w rheumatoid arthritis?
```
LESS
L = loss of articular space
E = erosion
S = soft tissue swelling
S = soft bones (osteopenia)
```
192
What are the risk factors for developing osteoporosis?
```
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
```
193
What is Paget's disease?
Increased uncontrolled bone turnover
194
What does Paget's disease typically affect?
1. Skull
2. Spine
3. Pelvis
4. Femur
5. Tibia
195
What conditions are associated with pANCA?
1. Microscopic polyangiitis
| 2. Eoisinophilic polyangiitis
196
What antibody is most sensitive for lupus?
ANA
197
What are the main aspects of anti-phospholipid syndrome?
```
CLOT
C = coagulopathy (raised APTT)
L = Livedo reticularis
O = obstetric emergencies (recurrent miscarriages)
T = thrombocytopenia
```
198
What does fibromyalgia present with?
1. Pain all over
2. Over a year
3. Headaches
4. Poor concentration
5. Sleep disturbances
199
What is the first line treatment for neuropathic pain?
Amitriptyline
200
What type of anaemia does folate deficiency cause?
Macrocytic megaloblastic anaemia
201
What is the MCV in microcytic anaemia?
<80 fL
202
What is the MCV in normocytic anaemia?
80-100 fL
203
What is the MCV in macrocytic anaemia?
>100 fL
204
What is the mechanism of absorption of vitamin B12?
B12 binds to intrinsic factor produced by the parietal cells of the stomach
205
What happens in pernicious anaemia?
Parietal cells of the stomach attacked by immune system resulting in atrophic gastritis and loss of intrinsic factor production
206
What is the management for hereditary spherocytosis?
Splenectomy
207
What describes the appearance of a blood film of a pt w beta thlassaemia major?
Large and small irregular hypo chromic RBCs
208
What would you see on a blood film of a patient with multiple myeloma?
Rouleaux formation
209
What is complicated malaria characterised by?
Vascular occlusion
210
What is the most common type of blood cancer in children?
Acute lymphoblastic leukaemia
211
What is the treatment for chronic myeloid leukaemia?
Imatinib and chemotherapy
212
What is the treatment for chronic lymphocytic leukaemia?
Rituximab and chemo
213
Which cancer is dexamethasone used as part of the treatment therapy?
Multiple myeloma
214
How is beta thalassaemia diagnosed?
Blood film
215
What does ITP affect?
Platelet aggregation
216
What is the mutated gene in cystic fibrosis?
Transmembrane conductance regulator gene (CFTR)
217
Which TB drug causes red sweat/tears/saliva?
Rifampicin
218
Which TB drug causes fever, jaundice and nausea?
Isonizaid
219
Which TB drug causes hyperuricaemia and gout?
Pyrazinamide
220
Which TB drug causes optic neuritis/eye symptoms
Ethambutol
221
Whats the most common type of lung cancer?
Squamous cell cancer
222
What's the common CT finding for a pt w bronchiectasis?
Signet ring sign
223
What does a 'tree-in-bud' CT sign suggest?
1. Aspiration pneumonitis
2. Bronchiolitis
3. Atypical pneumonia
224
What does the 'bronchus' sign on CT suggest?
Lung nodule or mass = bronchogenic cancer
225
What does the 'polo mint' sign on CT suggest?
PE
226
Is TB restrictive or obstructive?
Restrictive
227
Is bronchiectasis restrictive or obstructive?
Obstructive
228
Is bronchiolitis restrictive or obstructive?
Obstructive
229
What are the ABG findings of type 1 resp failure?
Low O2 and normal/low CO2
230
What are the ABG findings of type 2 resp failure?
Low O2 and high CO2
231
What are some common causes of type 1 resp failure?
1. Asthma
2. PE
3. COVID
232
What are some common causes of type 2 resp failure?
1. COPD exacerbation
2. Pneumonia
3. Rib fractures
4. MND
5. Opiates
233
What is the most common cause of hospital acquired pneumonia within 4 days of admission?
Likely the same as CAP - S pneumoniae/aureus
234
What is the most common cause of hospital acquired pneumonia after 5 days of admission?
Pseudomonas aeruginosa or MRSA
235
What is the most appropriate site for a needle thoracotomy for a tension pneumothorax?
2nd intercostal space, mid-clavicular line on the same side as the pneumothorax
236
What is the first line investigation for suspected pancreatitis?
Serum amylase
237
How is hepatitis A spread?
Faeco-oral spread
238
What does Hep A present with?
1. Itching
| 2. Yellowing of eyes
239
What are the symptoms of Hep C?
Asymptomatic
240
How does Hep B present?
Often with jaundice
241
What is the first line treatment of autoimmune hepatitis?
Prednisolone
242
What is the gold standard treatment of autoimmune hepatitis?
Prednisolone with added azathioprine - added after pred started
243
What is a common cause of spontaneous bacterial peritonitis?
Staph aureus
244
What is the pathology of primary sclerosing cholangitis?
Fibrosis destroying the intrahepatic and extra hepatic ducts
245
What cancer is associated with primary sclerosing cholangitis?
Cholangiocarcinoma
246
What does primary sclerosing cholangitis present with?
1. Jaundice
2. Pruritus
3. Fatigue
4. IBS symptoms
247
What colour stool and urine does pre-hepatic jaundice cause?
Normal urine and dark stools
248
What colour urine does hepatic jaundice cause?
Dark urine
249
What colour urine and stools does post-hepatic jaundice cause?
Dark urine and pale stools
250
What is the most common cause of liver cirrhosis?
Chronic alcohol abuse
251
What is the typical pain presentation of gallstones?
Pain worse after eating
252
What part of the heart is affected if there's ST elevation in leads V3/V4?
Anterior - LAD artery
253
Abnormalities in leads 2, 3 and aVF indicate which artery involvement?
Right coronary artery
254
What blood investigation is done for suspected heart failure?
B-type natriuretic peptide
255
What is the management of acute SVT?
Valsalva manœuvre
256
What is the first line treatment for hypertension if the pt is over 55 or black?
CCB - amlodipine
257
What is the first line treatment for hypertension if the pt is under 55 or DM2?
ACEi or ARB
258
What is the most appropriate investigation for aortic stenosis?
ECHO
259
What is the treatment for a STEMI if within 2hrs of onset?
PCI
260
What is the treatment for a STEMI if after 2hrs of onset?
Fibrinolysis with IV tenecteplase
261
What is the 1st line investigation for heart failure?
BNP levels
262
What is the gold standard for heart failure?
ECHO
263
What ECG finding would be seen in atrial flutter?
Sawtooth flutter waves
264
What ECG findings would be seen in atrial fibrillation?
1. Absent P waves
2. Narrow QRS
3. Irregularly irregular ventricular rhythm
265
What ECG changes would be seen in Wolff-Parkinson-White syndrome?
Delta waves
266
What ECG changes would be seen in acute pericarditis?
Saddle-shaped ST segment elevation
267
What kind of cardiomyopathy is associated with FHx of young cardiac death?
Hypertrophic cardiomyopathy
268
What would be the second-line HTN medication for Afro-Caribbeans/>55y?
Add ACEi or ARB alongside the CCB
269
What is the BP drop needed to diagnose postural hypotension?
Systolic drop >20mmHg
270
What type of shock is bradycardia a classical sign of?
Cardiogenic shock
271
What type of shock is a bounding pulse a classical sign of?
Septic shock
272
What are some causes of hypovolaemic shock?
1. GI bleeding
2. Severe diarrhoea/vomiting
3. Burns
4. Pancreatitis
273
What is the most important investigation for potential AAA?
USS
274
What is the gold standard test for acromegaly?
Oral glucose tolerance test
275
What is the main cause of secondary hypoadrenalism?
Long term corticosteroid use
276
What is the management of SIADH?
1. Restrict fluid intake
| 2. ADH inhibitors - demeclocycline
277
What are 2 signs seen in hypocalcaemia?
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
What are the PTH, calcium and phosphate levels in primary hyperparathyroidism?
High PTH
High calcium
Low phosphate
279
What is the most common cause of small bowel obstruction?
Surgical adhesions
280
What is the most common cause of large bowel obstruction?
Malignant tumours
281
What type of cancer is an enlarged Virchow's node?
Gastric cancer
282
What drug is the first line treatment for mild UC?
Mesalazine
283
What type of anaemia is chronic disease associated with?
Normocytic or microcytic
284
What is the most common form of anaemia?
Iron deficiency anaemia
285
What is polycythaemia rubra vera?
Bone marrow over produces blood cells caused by JAK2 mutation (95%)
286
What would red blood cells look like on a blood film if a pt had iron-deficiency anaemia?
Pale, small and abnormal shaped as do not have sufficient haemoglobin
287
When is Kussmaul breathing seen?
In pts with DKA
288
What type of cancer is benzene exposure a risk factor for?
Renal cell carcinoma
289
What is the gold standard investigation to diagnose Wilson's disease?
Liver biopsy
290
What is the inheritance pattern of A1- antitrypsin deficiency?
Autosomal recessive
291
What is cholera characterised by?
Rice water stools
292
What is the treatment of cholera?
Rehydration with IV fluids
293
What is the most likely cause of non-bloody diarrhoea in children?
Rotavirus
294
What is the most likely cause of non-bloody diarrhoea in elderly/care homes?
Norovirus
295
What disease can cause 'bronze skin'?
Haemochromatosis
296
What is Legionnaire's disease?
A severe form of pneumonia caused by Legionella pneumophila - found in water sources/unclean air conditioners and usually in Spain
297
What is the most common cause of UTI?
E. coli
298
What type of atypical pneumonia is characterised by contact with birds?
Chlamydophila psittacia
299
What is the immediate treatment for meningococcal septicaemia?
Benzylpenicillin
300
What is the characteristic presentation of meningococcal septicaemia?
1. Septic appearance - pale, mottled, floppy
| 2. Non-blanching petechial rash
301
How do you differentiate between staph and strep?
Catalase test
+ve = staph
-ve = strep
302
How do you differentiate between types of strep bacteria?
Haemolysis test
303
What are the 3 results from the haemolysis test and what colour are they?
```
Alpha = dark green
Beta = pale yellow and transparent
Non = agar unchanged
```
304
Examples of alpha haemolytic bacteria:
1. S. pneumoniae
| 2. S. viridians
305
Example of beta haemolytic bacteria:
S pyogenes
306
How do you differentiate between S pneumoniae and S viridians?
Optochin test viridians = resistant pneumoniae = sensitive
307
What nutrient agar is used to grow Mycobacterium Tuberculosis?
Lowenstein-Jensen
308
What nutrient agar is used to grow campylobacter jejuni?
Charcoal agar
309
What nutrient agar is used to grow strep. pneumoniae?
Chocolate agar
310
What nutrient agar is used to grow gram negative bacilli?
MacConkey agar
311
Which of the following bacteria is the most common cause of infective endocarditis in adults?
Strep. viridians
312
What is the coagulase test used for?
To distinguish between staph. aureus and staph. epidermis
+ve = aureus
-ve = epidermis
313
What is the oxidase test used for?
Differentiate between pseudomonas and coliform (shigella, salmonella, proteus)
+ve = pseudomonas
-ve = coliforms
314
What does stage 2 MRC dyspnoea scale indicate?
Short of breath when hurrying or when walking up hill
315
What does stage 4 MRC dyspnoea scale indicate?
Stops for breath after walking 100m on the flat
316
What is the first line investigation for suspected lung cancer?
CXR
317
What is a common complication of pneumonia?
Pleural effusions
318
What is a characteristic presentation of pleural effusion?
Stony dull percussion
319
What is the antibody used to identify rheumatoid arthritis?
Anti-CCP
320
What is a key investigation finding of sarcoidosis?
Bilateral hilar lymphadenopathy
321
What spirometry finding indicates an obstructive defect?
FEV1/FVC<0.7
322
What are some causes of bronchiectasis?
1. Bronchogenic carcinoma
2. Cystic fibrosis
3. Immotile ciliary syndrome
323
What is the second line management of COPD?
Add a long-acting beta-2 agonist inhaler to the salbutamol (SABA)
324
What is the diagnostic investigation for sarcoidosis?
Tissue biopsy
325
What does a tissue biopsy show if a pt has sarcoidosis?
Non-caseating granuloma
326
What type of hypersensitivity reaction is hypersensitivity pneumonitis?
Type 3
327
What often precedes Goodpastures syndrome?
Upper resp tract infection
328
Why can subarachnoid haemorrhage present with signs of meningism?
Blood irritates the meninges
329
What is the classic triad of symptoms in Parkinson's disease?
1. Bradykinesia
2. Rigidity
3. Tremor
330
What would a parietal lobe seizure present with?
Paraesthesia
331
What would an occipital lobe seizure present with?
Floaters/flashes
332
What is the immediate medical management of a TIA?
Aspirin 300mg daily
333
What does cauda equina syndrome present with?
1. LMN signs only
2. Sphincter disturbance
3. Impotence
4. Saddle paraesthesia
5. Decreased anal tone
334
What is Brown-Sequard syndrome?
Lateral hemisection of the spinal cord
335
What does Brown-Sequard syndrome present with?
1. Ipsilateral weakness below lesion
2. Ipsilateral loss of proprioception + vibration
3. Contralateral loss of pain + temperature
336
What stain identifies TB?
Ziehl-Neelsen
337
What stain studies bone growth?
Silver nitrate stain
338
What is a rhabdomyoma?
Benign tumour of striated muscle
339
What is a leiomyosarcoma?
Malignant tumour of smooth muscle cells
340
What does arterial thrombosis present with?
Cold and pale limb
341
What does vasculitis present with?
Skin lesion (like purpura or petechiae)
342
What are CD4 cells?
T helper cells
343
What are CD8 cells?
Cytotoxic T cells
344
What are some examples of Gell and Coombs Classification Type 1?
1. Hayfever
| 2. Anaphylaxis
345
What are some examples of Gell and Coombs Classification Type 2?
1. Transfusion reactions
| 2. Autoimmune conditions
346
What are some examples of Gell and Coombs Classification Type 3?
1. SLE
| 2. Vasculitis
347
What is an example of Gell and Coombs Classification Type 4?
1. TB
348
What is the most significant risk factor for developing atherosclerosis?
Hypercholesterolaemia
349
What is the mechanism of aspirin?
It irreversibly inhibits the COX enzyme, accelerating the breakdown of arachidonic acid into prostaglandin H2
350
What does the posterior pituitary secrete?
1. ADH
| 2. Oxytocin
351
What is the first line treatment for hypocalcaemia?
IV calcium gluconate over 30 mins
352
How would you treat a hypotensive Addison's patient?
IV saline and hydrocortisone
353
What are the 3 immediate treatment steps for DKA?
1. Fluids
2. Potassium
3. Insulin
354
How do diagnose giant cell arteritis?
Temporal artery biopsy
355
What is the most common cause of septic arthritis?
Staph aureus
356
What HLA complex is ankylosing spondylitis associated with?
HLA-B27
357
What is the gold standard treatment for rheumatoid arthritis?
Methotrexate
358
What is the genetic defect of the Philadelphia chromosome?
Translocation t(9,22)
359
What type of lung cancer is associated with paraneoplastic syndromes?
Small cell lung cancer
360
What ABG results suggest a respiratory problem?
High pCO2 and low pO2
361
What would suggest metabolic compensation?
Abnormal bicarbonate
362
Examples of causes of exudative pleural effusion:
1. Malignancy
| 2. Rheumatoid arthritis
363
Examples of causes of transudative pleural effusion:
1. Heart failure
2. Hypothyroidism
3. Nephrotic syndrome
4. Liver cirrhosis
364
What is the most common cause of nephrotic syndrome?
Minimal change disease
365
What is the management of a pt presenting w testicular torsion?
Urgent surgical exploration
366
Examples of causes of hypokalaemia?
1. Cushing's disease
2. Conn's syndrome
3. Ectopic ACTH-secreting tumour
4. Furosemide
367
What K+ imbalance does Addison's disease cause?
Hyperkalaemia
368
What Na+ imbalance does diabetes insipidus cause?
Hypernatraemia
369
Examples of causes of hyponatraemia:
1. Loop diuretic use
2. Addison's disease
3. Primary hypothyroidism
370
What is used to treat nephrogenic diabetes insipidus?
Bendroflurmethiazide
371
What is the treatment for acute MI?
```
MOANA
M = morphine
O = oxygen
A = atenolol
N = nitrate (GTN)
A = aspirin
```
372
Example of a medication associated with upper GI bleeds:
Aspirin
373
What score is used to assess risk of DVT?
Wells score
374
What is koilonychia and what disease is it seen in?
Spooning of the nails seen in iron-deficiency anaemia
375
What is leukonychia and what disease is it seen in?
Whitening of the nail seen in chronic liver disease
376
What are some signs of chronic liver disease?
1. Testicular atrophy
2. Gynaecomastia
3. Caput medusae
4. Asterixis
377
What are the features of Reynold's pentad?
1. Fever
2. RUQ pain
3. Jaundice
4. Confusion
5. Hypotension
378
What is Reynold's pentad a sign of?
Ascending cholangitis
379
What is the gold standard investigation for a bowel obstruction?
CT abdomen
380
What will biliary colic present with?
Colicky RUQ pain
381
What will cholecystitis present with?
RUQ pain and fever
382
What is the gold standard investigation for cholangitis?
ERCP - endoscope and x-rays of bile duct
383
What is the first line investigation of cholangitis?
US abdomen
384
What is the most common viral hepatitis worldwide?
Hep A
385
What does hep A present with?
1. N&V
2. Anorexia
3. Jaundice
386
What is the management of hep A?
Simple analgesia as should resolve spontaneously
387
What viral hep has a vaccine?
Hep A
388
What antibody type is inherited from parent to child?
IgG
389
What is the treatment of an opioid overdose?
IV naloxone
390
What is the initial treatment for polymyalgia rheumatica?
Oral prednisolone
391
What can polymyalgia rheumatica lead to if left untreated?
Giant cell arteritis
392
What area of the brain would cause a seizure with auditory hallucinations and automatisms?
Temporal lobe
393
What is the presentation of Brown-Sequard syndrome?
1. Contralateral loss of pain and temperature
| 2. Ipsilateral loss of motor, vibration and proprioception
394
What spirometry results would you expect in someone with obstructive disease?
FEV1/FVC < 0.7
| FEV<80%
395
What breath sounds would you hear in a pt with acute asthma?
Hyper-resonant breath sounds
396
What is the order of medications prescribed in asthma?
1. SABA
2. Low ICS
3. LTRA
4. LABA
5. MART
6. Mod ICS
7. High ICS
397
What type of lung cancer is associated with asbestos exposure?
Adenocarcinoma
398
Where are common sites of lung metastases?
1. Adrenal glands
2. Bone
3. Brain
4. Liver
5. Lymph nodes
399
Examples of bacteria causing atypical pneumonia:
1. Mycoplasma pneumonia
2. Chlamydophila pneumonia
3. Legionella pneumonia
400
What is the most common CAP?
Strep pneumoniae
401
What is the most common HAP?
Staph aureus
402
What is the most common cause of pneumonia in COPD patients?
Haemophilus influenzae
403
What chromosome is affected in CF?
7
404
What is the 1st line treatment for syphilis?
Benzathine penicillin
405
What is the choice of drug for chemoprophylaxis for suspected meningococcal meningitis pt contacts?
Ciprofloxacin or rifampicin
406
What type of meningitis presents with a non-blanching purpura rash?
Meningococcal meningitis
407
What group of conditions are the most common cause of work-related ill health in the UK workforce?
Stress, anxiety and depression
408
What is the definition of sensitivity?
The proportion of patients who have the disease and test positive
409
What is the definition of specificity?
The proportion of patients who don't have the disease and test negative
410
What is the positive predicted value?
The proportion of patients who test positive who have the condition
411
What would a cerebellar stroke present with?
1. Ataxia
2. Headache
3. Vertigo
4. Vomiting
412
What is the first course of action if a pt presents with stroke symptoms?
Order a head CT within the hr to determine whether ischaemic or haemorrhagic
413
What is Charcot-Marie-Tooth syndrome?
Group of inherited disorders that damage peripheral nerves
414
What can temporal/giant cell arteritis be brought on by?
1. Change in temperature
2. Shaving
3. Combing hair
4. Eating
415
What is the origin of the median nerve?
C5-T1
416
What would a tonic seizure present with?
Sudden stiffness of the limbs
417
What is the mode of action of NSAIDs?
Non-selective inhibitors of COX1 + COX2 enzymes
418
What is MCH a measure of?
Haemoglobin present in RBC's
419
What is the most common cause of hepatitis in travellers?
Hep A
420
What is the management of an inguinal hernia which is symptomatic and irreducible?
Urgent referral to secondary care due to risk of strangulation
421
What are the risk factors for gallstones?
1. Female
2. Fertile
3. 40
4. Fat
5. Fair (Western world)
422
What is the first line investigation for gallstones?
US of gallbladder
423
What is the treatment of pernicious anaemia?
Vitamin B12 injections
424
What is pernicious anaemia?
Autoimmune condition preventing uptake of vitamin B12/folate in the bowel
425
What would pernicious anaemia present with?
1. Classic anaemia symptoms
2. Peripheral neuropathy (pins and needles)
3. Mouth ulcers
4. Lemon tinged skin
5. Depression
6. Dementia
426
What clotting factor is deficient in Haemophilia B?
Factor 9
427
What clotting factor is deficient in Haemophilia A?
Factor 8
428
What is polycythaemia?
Increase in RBC production
429
What can secondary polycythaemia be caused by?
Hypoxia - as a result of lung disease or smoking
430
How can myeloma be managed?
1. Chemotherapy
2. Steroids
3. Thalidomide
431
What is the diagnostic investigation for kidney stones?
Non-contrast CT KUB
432
What is the presentation of kidney stones?
1. Severe intermittent abdo pain
| 2. Present on the side and in testicles
433
What is the most common type of of renal cell carcinoma?
Clear cell
434
What type of drug is Goserelin and what is it used for?
A GnRH agonist used for prostate cancer
435
What would the PTH, Ca+ and phosphate levels be in an individual with secondary hyperparathyroidism?
High PTH
Low calcium
Low phosphate
436
What are some complications of long-term steroid use?
1. Skin thinning
2. Easy bruising
4. DM
5. Immunosuppression
6. Osteoporosis
7. Proximal muscle weakness
437
What would be seen on an ECG of Wolff-Parkinson-White syndrome?
1. Wide QRS
2. Short PR
3. Delta wave
438
What type of arrhythmia is WPW?
Atrioventricular re-entry tachycardia - it is a type of supraventricular tachycardia causing the AV re-entry
439
What are the CXR signs of HF?
```
ABCDE
A = Alveolar oedema
B = Kerley B lines
C = Cardiomegaly
D = Dilated pulmonary vessels
E = Pleural effusion
```
440
What are the appropriate first line medications for HF?
B blocker and ACE inhibitor
441
Which part of the kidney does furosemide act on?
Ascending loop of Henle
442
Which area of the heart is affected if there's ST elevation in leads V1-6, aVL and I?
Anterolateral
443
What is clopidogrel and how does it work?
An anti platelet that prevents platelet aggregation by binding to the P2Y12 receptor
444
What is warfarin?
A vitamin K antagonist
445
What is the medication for ongoing IBS diarrhoea?
Loperamide
446
What is the presentation of pulmonary fibrosis?
1. Dry cough
2. Increasing breathlessness
3. Smoker
4. Clubbing
5. End-inspiratory crackles
447
What disease is primary biliary cirrhosis associated with?
Sjogrens Syndrome
448
What is the presentation of myasthenia gravis?
Motor weakness with spontaneous recovery after a period of time
449
What is the tensilon test used for?
Myasthenia gravis
450
What is the best diagnostic investigation for HF?
ECHO
451
What would a foot drop with normal inversion, sensation and ankle jerk indicate?
Common perineal nerve palsy
452
What would a lumbar radiculopathy present with?
1. Sharp pain in back to foot
2. Numbness or weakness in leg
3. Sensation or reflex changes
453
What causes wasting of the small muscles in the hand?
Involvement of the T1 nerve root
454
What is the pathology finding of cytomegalovirus infection?
'Owls eye' intranuclear inclusions
455
What blood test confirms Paget's disease?
Serum alkaline phosphatase
456
What does an itchy rash in the antecubital and popliteal fossae indicate?
Atopic eczema
457
What drug type is amiodarone?
Anti-arrythmic
458
What disease shows 'abnormal' monocytes on blood film?
Epstein-Barr virus
459
What treatment would be given for low platelets and easy bleeding?
Prednisolone
460
What is the recommended duration of moderate exercise a week?
150 mins
461
What kind of prevention does the COVID vaccination programme offer?
Primary prevention
462
What class of medication is allopurinol?
Xanthine oxidase inhibitor
463
Which hormone is tested for testicular carcinoma diagnosis?
Beta human chorionic gonadotrophin
464
What is anticipation?
A genetic inheritance pattern where the symptoms start earlier in later generations
465
What is salmeterol?
A LABA
466
What receptor does salmeterol act on?
B2 adrenergic receptors
467
What does a head CT with a lentiform area of opacity indicate?
Extradural haematoma
468
What immunoglobulin is prominent in anaphylaxis?
IgE
469
What antibiotic is used for cellulitis?
Flucloxacillin
470
What is the main cause of bacterial pneumonia?
Streptococcus pneumoniae
471
What is the target INR range?
2-3
472
What are some UMN lesion signs?
1. Muscle weakness
2. Overactive reflexes
3. Tight muscles
4. Positive Babinsky sign
473
What are some LMN lesion signs?
1. Muscle atrophy
2. Fasciculations
3. Decreased reflexes
4. Decreased tone
5. Negative Babinsky sign
474
What class of drug is alendronic acid?
Bisphosphonate
475
What is the pattern of blood volume and sodium levels in SIADH?
Normovolaemic, hyponatraemic
476
Which study design is of the highest quality?
Systematic review
477
What screening tool is used to determine depression severity?
PHQ-9
478
What week should the baby check happen?
6-8 weeks
479
What is De Quervain's thyroiditis?
Transient patchy inflammation of the thyroid gland with granuloma formation
480
What do the letters stand for in ABCD2?
```
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
What antibody is associated with GPA?
c-ANCA
482
What is the mechanism of unfractionated heparin?
Activation of antithrombin (factor 3) which deactivates Xa and IIa in the clotting cascade
483
What is an example fo a LTRA?
Montelukast
484
What is another name for the bony spurs developing at synovial margins of a joint?
Osteophytes
485
What is the most common CXR sign of aortic dissection?
Widening of the mediastinum
486
What value would you base the warfarin dose off?
INR value
487
What are the differences between appendicitis and a perforated appendix?
Symptoms of sepsis - confusion etc
488
What would hyperprolactinaemia cause?
1. Menstrual disturbances
2. Reduces libido
3. Galactorrhoea
489
How can you identify silicosis?
1. Egg-shell calcification of hilar nodes
| 2. Diffuse nodular pattern in upper and mid-zones of lung
490
What are some key features of sarcoidosis?
1. Resp symptoms
2. Lymphadenopathy
3. Hepatosplenomegaly
4. Eye symptoms
5. Erythema nodosum
491
What is the first-line treatment for moderate/severe migraines?
Triptans like sumatriptan
492
What would indicate a UTI on a urine dipstick?
1. +ve nitrite
2. +ve leukocyte
3. +ve RBC
493
What would you treat a pneumonia with a CURB score of 0?
Amoxicillin
494
What would you treat a pneumonia with a CURB score of 1-2?
Amoxicillin with clarithromycin
495
What would you treat a pneumonia with a CURB score of 3-5?
Co-amoxiclav with clarithromycin
496
What is the first line treatment for oesophageal varices?
Octeotride/ terlipressin
497
What findings would indicate CLL?
Smudge/basket cells
498
What type of bacteria is N. meningitides?
A gram negative diplococci
499
What is the most common cause of iron deficiency anaemia worldwide?
Hookworm
500
What is the mechanism of DPP-4 inhibitors?
Oral glucose lowering agents that primarily inhibit the breakdown of glucagon-like peptide 1
501
What is the most common nerve injury to a fracture of the fibular head?
Common fibular nerve
502
What does AST measure?
It is an enzyme used to monitor hepatocellular damage
503
When would GGT be raised?
1. Liver and biliary disease
| 2. High alcohol intake
504
What causes jaundice and why?
Bilirubin - it is a breakdown product of RBC
505
What type of bacteria is clostridium difficile?
Gram positive bacilli
506
What antihypertensives can cause nephrotoxicity/intrarenal AKI?
1. ACEi
| 2. ARB
507
What is the acute management of supra ventricular tachycardias?
1. Vagal manoeuvres
| 2. IV adenosine
508
What is the treatment of Paget's disease?
1. Analgesia
| 2. Bisphosphonates
509
What happens to K+ in DKA?
It becomes elevated as glucose cannot help transport it into cells
510
Which artery is stenosed if there is ST-elevation in V2-4?
Left anterior descending
511
What happens if the Well's score is 1 or less?
DVT unlikely so D-dimer test
512
What happens if the Well's score is 2 or more?
Proximal leg vein USS
513
How can you differentiate between epididymo-orchitis rather than torsion?
Pain partially relieved on elevation of testis = epididymo-orchitis
514
What happens if the Well's score is 4 or more?
CTPA
515
Where would liquefactive necrosis be seen?
In the brain as a consequence of ischaemic injury
516
Where would fat necrosis be seen?
1. Breast
| 2. Pancreas
517
What is Kaposi sarcoma associated with?
Human herpes virus 8
518
What would Kaposi sarcoma present with?
Reddish, purple skin lesions
519
What age does AAA screening begin?
65
520
How would you treat severe bacterial cellulitis?
IV benzylpenicillin and flucloxacillin
521
How do you differentiate between meningitis and encephalitis?
Signs of meningism + confusion = encephalitis
522
What is the most common cause of encephalitis?
Herpes simplex virus
523
What is the function of cytotoxic T cells?
Present antigens
524
What do cytotoxic T cells express and why?
CD8 so they can recognise peptides presented by MHC 1
525
Which cell type does M. Tuberculosis reside in?
Macrophages
