Questions from pastest Flashcards by Adam Temple

What antibiotic is contraindicated with statins?

Clarithromycin

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Treatment for subacute degeneration of cord?

As caused by b12 deficiency

Give IM hydroxycobalamin on alternate days until neurological deficit has reached plataeu

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When do symptoms present in staph aureus food poisoning?

Few hours after ingestion

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What is the viral cause of Kaposi’s sarcoma?

HHV 8

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Treatment of MRSA +ve UTI?

Non severe - doxycycline or trimethoprim

Severe - IV vancomycin

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What is the cause of recurrent infection in CLL?

hypogammaglobulinaemia

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What are the features of Alport’s syndrome?

Sensorineural
Microscopic haemturia / renal impairment

X linked disorder (males affected worse)

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Major complication of bleomycin?

Pulmonary toxicity

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Major complication of cisplatin

Nephrotoxic

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Treatment of essential tremor

Propranolol

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treatment of metastatic spinal cord compression

IV dex

then RTx

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Nicorandil indication

Stable angina

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Multiple myeloma treatment

THALIDOMIDE

Then –> Bortezomib

COMMON QUESTION

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What leukaemia is auer rods seen in / what translocation?

AML

t(15;17)

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What cancer is ataxic telangiectasia associated with?

breast cancer

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What to measure to assess disease activity in SLE?

C3 levels

will fall in active disease

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Type 1 autoimmune hepatitis antibodies

Anti smooth muscle

Anti nuclear

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Type 2 autoimmune hepatitis antibodies

Anti LKM1 (liver-kidney-muscle 1)

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In SLE if a patient has thrombocytopaenia what treatment should you use??

Hydroxychlorquine (COMMON IN EXAMS)

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how to distinguish IgA nephropathy from post strep glomerulonephritis

Timing

IgA nephropathy - <5 days after infection

PSGN develops 1-2 weeks after strep infection

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What causes gynaecomastia in chronic liver disease?

Decreased androstenedione catabolism

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Gitalman syndrome features

Hypomagnasaemia
hypoKalaemia
Metabolic alkalosis

Resembles thiazide diuretic

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Bartter’s syndrome

Affects NKC co transporter ascending loop (like loop diuretic)

hypokalaemic metabolic alkalosis (like gitalman)

Differentiate from gitalman: - Mg normal (not low)

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In acute severe UC if IV hydrocortisone not working - what next?

Medical: IV ciclosporin or infliximab

Surgical

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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?

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