Questions from pastest Flashcards
What antibiotic is contraindicated with statins?
Clarithromycin
Treatment for subacute degeneration of cord?
As caused by b12 deficiency
Give IM hydroxycobalamin on alternate days until neurological deficit has reached plataeu
When do symptoms present in staph aureus food poisoning?
Few hours after ingestion
What is the viral cause of Kaposi’s sarcoma?
HHV 8
Treatment of MRSA +ve UTI?
Non severe - doxycycline or trimethoprim
Severe - IV vancomycin
What is the cause of recurrent infection in CLL?
hypogammaglobulinaemia
What are the features of Alport’s syndrome?
Sensorineural
Microscopic haemturia / renal impairment
X linked disorder (males affected worse)
Major complication of bleomycin?
Pulmonary toxicity
Major complication of cisplatin
Nephrotoxic
Treatment of essential tremor
Propranolol
treatment of metastatic spinal cord compression
IV dex
then RTx
Nicorandil indication
Stable angina
Multiple myeloma treatment
THALIDOMIDE
Then –> Bortezomib
COMMON QUESTION
What leukaemia is auer rods seen in / what translocation?
AML
t(15;17)
What cancer is ataxic telangiectasia associated with?
breast cancer
What to measure to assess disease activity in SLE?
C3 levels
will fall in active disease
Type 1 autoimmune hepatitis antibodies
Anti smooth muscle
Anti nuclear
Type 2 autoimmune hepatitis antibodies
Anti LKM1 (liver-kidney-muscle 1)
In SLE if a patient has thrombocytopaenia what treatment should you use??
Hydroxychlorquine (COMMON IN EXAMS)
how to distinguish IgA nephropathy from post strep glomerulonephritis
Timing
IgA nephropathy - <5 days after infection
PSGN develops 1-2 weeks after strep infection
What causes gynaecomastia in chronic liver disease?
Decreased androstenedione catabolism
Gitalman syndrome features
Hypomagnasaemia
hypoKalaemia
Metabolic alkalosis
Resembles thiazide diuretic
Bartter’s syndrome
Affects NKC co transporter ascending loop (like loop diuretic)
hypokalaemic metabolic alkalosis (like gitalman)
Differentiate from gitalman: - Mg normal (not low)
In acute severe UC if IV hydrocortisone not working - what next?
Medical: IV ciclosporin or infliximab
Surgical
What cancer does aspirin/NSAID reduce the risk of?
Colorectal
Treatment of methanol poisoning?
Fomepizole
How does carbemazapine affect warfarin?
Inducer –> causes fall in INR
Which enzyme is responsible for transporting FFAs wIthin a cell for providing energy?
Carnitine acyltransferase I
What other cardiac defect is coarctation of the aorta associated with?
Bicuspid Aortic valve
What is used to diagnose cerebral toxoplasmosis?
CSF PCR
not IgG toxoplasma titre - as may just have previous exposure
Initial investigation in patient with suspected insulinoma?
Supervised overnight fast with insulin, c peptide and glucose measurement
72 hour fast = gold standard for diagnosis
What can c peptide be used for?
Differentiating enodgenous insulin production vs exogenous production (e.g. injected insulin)
High in endogenous production (e.g. in insulinoma)
Low in exogenous production
What can c peptide be used for?
Differentiating enodgenous insulin production vs exogenous production (e.g. injected insulin)
High in endogenous production (e.g. in insulinoma)
Low in exogenous production
What examination finding favours a common peroneal nerve palsy rather than L5 lesion?
Preserved foot inversion
Treatment of CMV?
Ganciclovir IV or valganciclovir PO first line depending on where
Only treat if immunocompromised
What cells release somatostatin?
D cells
What skin condition is associated with beta blocker use?
psoriasis
What skin condition is associated with psoriasis use?
bisoprolol
What organism has the best outcomes in infective endocarditis?
Streptococcus (NOT staph)
What organism has the best outcomes in infective endocarditis?
Streptococcus (NOT staph)
What a-1 antitripsin deficiency is associated with the most severe lung disease?
ZZ (last)
AF sx’s >48 hours but patient has asthma
verapamil or diltiazim
If AF >48 hours, and decided to electrical cadiovert - how long to wait for anticoagulation to kick in before shocking?
3 weeks
When is febrile neutropenia thought to be highest?
10 days into treatment
MOA vinblastine
Binds to microtubular proteins
MOA Cisplatin
causes DNA cross linking
MOA dobutamine
Beta 1 receptor agonist
Median nerve hand supply
LOAF: Lateral two lumbricals Opponens Abductor pollicis brevis Flexor pollicis
MoA ondansetron?
5ht3 antagonist
What anti-emetic used for people with parkinson’s?
ondansetron
cyclizine
domperidone
don’t use: metoclopramide or prochlorperazine
If someone is allergic to latex what fruits might they allergic to?
Banana
Avocado
Chestnut
Kiwi
What gene is mutated in MODY?
HNF1 BETA
Treatment of threadworms?
Mebendazole (2 doses - one 2 weeks following initital dose)
What is the ketone/ketoacid formed in diabetic ketoacidosis?
Beta-hydroxybutyrate
What type of acid base imbalance does salicylate poisoning (e.g. with aspirin) cause?
Resp alkalosis
+ also metabolic acidosis
In bronchiectasis, what do you find on HRCT?
Tree in bud appearance
Reactive arthritis treatment?
NSAIDs
In neonatal complete heart block caused by SLE, what antibodies cause this?
Anti Ro + La
Major mutation in marfan’s?
FBN1 gene
Cause and treatment of cat scratch disease?
Cause: Bartonella Henselae
Treatment: if immunocompetent - paracetamol + ibuprofen
How many people lie between 2 standard deviations (-2 - +2)
95%
Isoniazid MoA
Inhibits fatty acid synthase
Gitelman’s syndrome nephron region?
Distal convoluted tubule
Usually presents early adulthood
Bartter’s syndrome nephron region?
Loop of henle
Usually presents early childhood
Where is actin found in cardiac muscle cell?
As a component of the thin filaments
What cancer is nigricans acanthosis associated with?
Gastric cancer
First and second line for acute gout
NSAID
Colchicine
Treatment of acute flare of pseudogout
Colchicine (like gout)
What monoclonal can be used in allergic asthma?
Omalizumab
anti-IgE
Cause of kaposi’s
HHV 8
What TB drug causes gout?
Pyrazinamide
Which life cycle stage occurs in P vivax but not P falciparum?
Hypnozoites / dormant liver stage
Liver
INR >2 or PT >14 Renal impairment Systolic BP <80 Hypoglycaemia Metabolic acidosis
Treatment of pseudomonas in CF?
Inhaled tobramycin
If someone is allergic to raw apples, what are they also likely to be allergic to?
birch pollen
What is the treatment of suspected fungal in cancer patients?
Amphotericin B
What is considered a good prognosis in IE?
Streptococcus viridans (NOT staph epidermidis)
What alpha 1 anti trypsin deficiency is associated with severe lung diaease?
ZZ
Which interleukin does ciclosporin AND tacrolimus reduce?
IL 2
What is the reason for vaccination failure in coeliac disease patients?
HLA type
ANCA in polyarteritis nodosum
p-ANCA
What antihypetensives should you avoid in myaesthenia gravis?
Beta blockers and CCBs
Treatment of cat scratch disease (if immunocompetent)
Reassurance !!! + NSAIDs
When should you use sodium bicarbonate in metabolic acidosis (e.g. in overdose)?
If there is QRS widening on ECG (>100)
What does the retina look like in CRAO?
Pale retina with cherry red spot in macula
What does the retina look like in CRVO?
Dot/blot and flame haemorrhages
What is the risk of bromocriptine/cabergoline (dopamine agonists)?
Pulmonary / cardiac fibrosis
Diabetes insipidus osmolalities
serum osmolality >295
Urine osmolality (<700) - dilute
NICE guidance: recommendation of test to confirm eradication of H pylori? (Common exam Q)
Urea breath test
stool antigen is for initial diagnosis
MoA of donepezil
Acetylcholinesterase inhibitor
Causes of high anion gap metabolic acidosis
CAT MUDPILES
Carbon monoxide, Cyanide, CHF
Aminoglycosides
Teophylline, Toluene (Glue-sniffing)
Methanol
Uremia
Diabetic ketoacidosis, Alcoholic ketoacidosis, Starvation ketoacidosis
Paracetamol/Acetaminophen, Phenformin, Paraldehyde
Iron, Isoniazid, Inborn errors of metabolism
Lactic acidosis
Ethanol (due to lactic acidosis), Ethylene glycol
Salicylates/ASA/Aspirin
Treatment of methalaenoglobinaemia?
Methylene blue
