RACP

Question 1

Crizotinib

Answer 1

EML 4 ALK inhibitorNSCLC

Question 2

Abiratarone

Answer 2

castrate resistant prostate Cablocks tumour androgen productionneed to give w pred to avoid ACTH surge

Question 3

GnRH antagonist

Answer 3

zoladex

Question 4

anti androgen

Answer 4

flutamidecan try to withdraw if castrate resistant prostate Ca - 20% will improve

Question 5

p16

Answer 5

marker for HPV head and neck cancerif present - do better

Question 6

gefitinib

Answer 6

EGFR TKI used in EGFR mutant NSCLC

Question 7

bevacizumab

Answer 7

VEGF inhibitorSE - HTN, proteinuria

Question 8

lambrolizumab

Answer 8

PD1 inhibitor for metastaic melanoma

Question 9

Ipilumimab

Answer 9

CTLA4 blockerused in metastatic melanomaSE - colitis, hepatitis, rash, hypopit (rare)

Question 10

Vemurafenib and dabrafenib

Answer 10

used in BRAF mutant melanomaSE - SCCsphosphoERK – if increased, sign of BRAF inhibitor resistance / disease progression

Question 11

Penatumimab and cetuximab

Answer 11

EGFRmabs used in Kras wild type NSCLC/CRCSE - acne rash (treat w doxy and pred)

Question 12

seminoma treatment

Answer 12

Alpha fetoprotein should NOT be elevatedRtx sensitiveOrchidectomy + active surveillance if early stage

Question 13

non seminoma treatment

Answer 13

AFP is the markerNeed to look for retroperitoneal disease, and if present – retroperitoneal LN dissection Chemotx sensitive

Question 14

SCLC

Answer 14

Chemotx sensitiveIf in one area/field – chemotx + radtx

Question 15

NSCLC

Answer 15

Rtx responsiveIf resectable – removeIf not – stereotactic rtx

Question 16

Rifampicin

Answer 16

inhibits bacterial DNA dependent RNA polymerase preventing transcription of DNA into mRNASE - orange secretions, flu like sx, hepatits

Question 17

Ethambutol

Answer 17

inhibits the enzyme arabinosyl transferase SE - optic neuritis

Question 18

Pyrazinamide

Answer 18

inhibits fatty acid synthase (FAS) ISE - gout / hyperuricaemia, hepatitis

Question 19

Isoniazid

Answer 19

inhibits mycolic acid synthesisSE - peripheral neuropathy (need to give Vitamin B6), hepatitis, agranulocytosis

Question 20

Type I Hypersensitivity

Answer 20

Anaphylactic:antigen reacts with IgE bound to mast cellsanaphylaxis, atopy e.g. asthma, eczema and hayfever

Question 21

Type II Hypersensitivity

Answer 21

Cell bound:IgG or IgM binds to antigen on cell surfaceeg AHA, ITP, Goodpasture’s, acute hemolytic transfusion reactions, bullous pemphigoid, pemphigus vulgaris

Question 22

Type III Hypersensitivity

Answer 22

Immune complex:Free antigen and antibody (IgG, IgA) combineeg serum sickness, SLE, post strep GN

Question 23

Type IV Hypersensitivity

Answer 23

Delayed:T cell mediatedEg - tuberculin skin reaction, GVHD, allergic contact dermatitis, scabies, extrinsic allergic alveolitis (especially chronic phase), MS, Guillain-Barre syndrome

Question 24

Type V Hypersensitivity

Answer 24

Antibodies that recognise and bind to the cell surface receptors, either stimulating them or blocking ligand bindingeg Graves’ disease, myasthenia gravis

Question 25

CEA

Answer 25

CRC maker

Question 26

Ca 125

Answer 26

Ovarian cancer marker

Question 27

Ca 19-9

Answer 27

Pancreatic cancer marker

Question 28

Ca 15-3

Answer 28

Breast cancer marker

Question 29

CLL

Answer 29

B CELL - CD 19Smudge cellshypogammaglobulinaemia leading to recurrent infectionswarm autoimmune haemolytic anaemia in 10-15% of patients

Question 30

drugs than can be haemodialysed

Answer 30

• Barbiturate• Lithium• Alcohol (inc methanol, ethylene glycol)• Salicylates• Theophyllines (charcoal haemoperfusion is preferable)

Question 31

inheritance of haemophilia A and B

Answer 31

X linked recessive

Question 32

where is the lesion?inferior hemanopia

Answer 32

paritel lobe

Question 33

where is the lesion?superior hemanopia

Answer 33

temporal lobe

Question 34

Parietal lobe lesion

Answer 34

• sensory inattention• apraxias• tactile agnosia• inferior homonymous quadrantanopia• Gerstmann's syndrome

Question 35

Gertsman syndrome

Answer 35

lesion of dominant parietal lobealexia, acalculia, finger agnosia and right-left disorientation

Question 36

Occipital lobe lesions

Answer 36

• homonymous hemianopia (with macula sparing)• cortical blindness• visual agnosia

Question 37

Temporal lobe lesion

Answer 37

• Wernicke's aphasia: word substituion, neologisms, speech is fluent• superior homonymous quadrantanopia• auditory agnosia• prosopagnosia (difficulty recognising faces)

Question 38

Frontal lobes lesions

Answer 38

• expressive (Broca's) aphasia: located in the inferior frontal gyrus. Speech is non-fluent, laboured, and halting• disinhibition• perseveration• anosmia• inability to generate a list

Question 39

Cerebellum lesions

Answer 39

• midline lesions: gait and truncal ataxia• hemisphere lesions: intention tremor, past pointing, dysdiadokinesis, nystagmus

Question 40

where is - Wernicke & Korsakoff syndrome generated?

Answer 40

Medial thalamus and mammillary bodies of the hypothalamus

Question 41

where is Hemiballism generated?

Answer 41

Subthalamic nucleus of the basal ganglia

Question 42

where is Huntington chorea generated?

Answer 42

Striatum (caudate nucleus) of the basal ganglia

Question 43

where is parksinons disease generated?

Answer 43

Substantia nigra of the basal ganglia

Question 44

kluver bucy syndrome - hypersexuality, hyperorality, hyperphagia, visual agnosia

Answer 44

amygdala