quesmed Flashcards
A 17-year-old boy presents to the GP as he is yet to start puberty. On examination, he is taller than average but has gynaecomastia and small firm testicles, with no secondary sexual characteristics.
What is the most likely diagnosis?
Klinefelter’s
Genotyping result for Gilbert’s?
Homozygous UGT1A1 gene with mutated promoter region
MODY gene affected?
Hepatocyte nuclear factor (HNF)-1 alpha gene
Transdermal fentanyl 12 µg patch = approximately x mg oral morphine
Transdermal buprenorphine 10 µg patch = approximately y mg oral morphine
x - 30mg
y - 24mg
Commonest Hodgkin’s in young adults?
Nodular sclerosing
Origins of CNs?
Cerebrum (x2) - Olfactory (I) + Optic (II)
Midbrain (x2) - Oculomotor (III) + Trochlear (IV)
Pons (x4) - Trigeminal (CN V), Abducens (VI), Facial (VII) + Vestibulocochlear (VIII)
Medulla oblongata (x4) - Glossopharyngeal (IX), Vagus (X), Accessory (XI) + Hypoglossal (XII)
Normal platelets; prolonged bleeding time; prolonged APTT, normal PT and TT
Von Wille’s disease
High calcium, low phosphate, high ALP, normal PTH
Primary hyperparathyroidism
2nd line rx if bisphosp not tolerated?
Denosumab
Which antibody can cross placenta?
IgG is the only class of antibody that can cross the placenta and enter the fetal circulation
Why HBA1c is unreliable in pregnancy?
Decreased erythrocyte lifespan
Auer rods associated with which pathology?
AML
Rx post stroke?
Start Aspirin 300mg OD for 2 weeks, then switch to Clopidogrel 75mg OD
Carcinoid syndrome associations?
Heart valve defects most frequently associated with the carcinoid syndrome can be memorised using the acronym TIPS = Tricuspid Insufficiency, Pulmonary Stenosis
Vasculature of stomach?
Lesser: left and right gastric arteries
Greater curvature: left gastroepiploic artery
Posterior stomach: splenic artery
Second part of the duodenum: inferior pancreaticoduodenal artery
Posterior duodenum: gastroduodenal artery
Oxybutinin side effects?
Dry mouth, constipation, dilated pupils, tachycardia
Carcinoid syndrome associated murmur?
Pulmonary stenosis
Purely sensory loss in stroke?
Lacunar stroke - thalamus affected
Full thickness keratinocyte atypia within epidermis?
Bowen’s disease
How does alcohol cause hypoglycemia?
Inhibits gluconeogenesis
Unsafe vaccines in HIV?
Yellow fever, BCG, MMR, typhoid
Chromosome 6 - mutation?
Chromosome 16 - mutation?
6 - haemochromatosis
16 - ADPKD
Anti-smooth muscle antibodies - ?
Anti-liver/kidney microsomal antibodies - ?
Autoimmune hepatitis 1
Autoimmune hepatitis 2
Raised LDH, raised bilirubin, low haptoglobin?
Hereditary spherocytosis
Capture beats?
VT
Drugs worsening psoriasis?
Drugs: Beta blockers, Anti-malarials, Lithium, Indomethacin/NSAIDs (useful mnemonic - BALI)
Mechanism of action of abx?
Rifamp -
Ciproflox -
Aminoglycosides -
Penicillins and cephalosporins -
Rifamp - inhibits RNA synthesis
Ciproflox - inhibits DNA synthesis
Aminoglycosides - inhibits protein synthesis
Penicillins and cephalosporins - inhibits cell wall synthesis
Daptomycin - disrupts the cell membrane
The Koebner phenomenon describes skin lesions that appear at the site of injury. It is seen in?
Psoriasis, vitiligo, warts, lichen sclerosus and planus, molluscum
Pigmented -
Struvite -
Urate -
Cysteine -
Cholesterol -
Pigmented - haemolysis
Struvite -
Urate -
Cysteine -
Cholesterol -
TEN vs SSSS
TEN - preceding infection and drug use, mucosal involvement
SSSS - no mucosal involvement
Which organisms are splenectomy pts most susceptible to?
Streptococcus pneumoniae, Haemophilus influenza and Neisseria meningitidis
Relapses of GCA?
Tocilizumab
Homo hemianopia without macular sparing?
Lateral geniculate body
Painful genital ulcers/painless genital ulcers?
Painful - Herpes , Chlamydia
Painless - Treponema,
IL1, IL4, IL12
IL1 - secreted by macrophages
IL4 - activates T2 cells
IL12 - activates T1 cells
