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RACP EXAM CRAM Flashcards

1
Q

What is the mechanism of action of dobutamine?

A

Beta 1-adrenoceptror agonist

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2
Q

What is the most common cause of myocarditis?

A

Enterovirus

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3
Q

Which drug is most effective in improving systolic function in CCF?

A

ACE inhibitor

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4
Q

How do beta blockers help in stable angina?

A

Reduce myocardial oxygen demand

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5
Q

What is the classic cause of an accelerated junctional rhythm?

A

Digoxin toxicity

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6
Q

What rate is a junctional escape rhythm?

A

40-60bpm

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7
Q

Oral morphine to IV/scut morphine?

A

3:1

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8
Q

Treatment of choice for invasive pulmonary aspergillus?

A

Voriconazole

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9
Q

Formula for A-a gradient at sea level

A

713 * FiO2 - 1.25*pCO2 - paO2

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10
Q

Tibial nerve innervates which ankle movement?

A

Inversion

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11
Q

Deep peroneal nerve innervates which ankle movement?

A

Eversion

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12
Q

Which 3 anti-hypertensives will not interfere with aldosterone:renin ratio?

A

Verapamil, hydralazine, prazosin

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13
Q

Addison’s disease is due to a deficiency in which enzyme?

A

21-hydroxylase

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14
Q

If a patient has ACTH-dependent Cushing’s disease, what is the best next test that will differentiate a pituitary tumour from an ectopic tumour?

A

High dose (8 mg) dexamethasone suppression test will suppress ACTH and cortisol with a pituitary, but NOT with an ectopic tumour

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15
Q

In adrenal insufficiency, what prophylaxis should be done during times of stress? What if they are not tolerating PO intake?

A

Double dose of glucocorticoid (or hydrocortisone IV 25mg TDS if not tolerating PO)

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16
Q

Puffy hands, anti-U1RNP positive, dsDNA negative. Diagnosis?

A

Mixed connective tissue disease

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17
Q

Antibody for limited scleroderma?

A

Anti-centromere
[anti-centromere = limited SSc and Pulm HTN]
[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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18
Q

Antibody for ILD in scleroderma?

A

Anti-topisomerase I aka Scl-70.

[anti-centromere = limited SSc and Pulm HTN]

[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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19
Q

Anti-centromere antibodies are associated with which 2 features of scleroderma?

A

Limited SSc. Pulmonary hypertension
[anti-centromere = limited SSc and Pulm HTN]
[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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20
Q

Antibody for pulmonary hypertension in scleroderma?

A

Anti-centromere
[anti-centromere = limited SSc and Pulm HTN]
[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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21
Q

Anti-topoisomerase (aka Scl-70) antibodies are associated with which 2 features of scleroderma?

A

Diffuse SSc + Interstitial lung disease

[anti-centromere = limited SSc and Pulm HTN]

[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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22
Q

Anti-RNA polymerase III antibodies are associated with which 2 features of scleroderma?

A

Diffuse SSc. Severe renal disease

[anti-centromere = limited SSc and Pulm HTN]

[anti-topoisomerase/Scl-70 = Diffuse SSc and ILD]

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23
Q

Which ANCA has a higher relapse rate?

A

c-ANCA / PR-3

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24
Q

Which ANCA has a lower relapse rate?

A

p-ANCA/ MPO

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25
Q

Which antibody is associated with primary Sjogren’s syndrome?

A

Anti-SSA (Ro60) - not Ro53

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26
Q

Anti-SSA (Ro60) is associated with which condition?

A

Primary Sjogren’s

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27
Q

Anti-Jo1 is associated with which condition?

A

Polymyositis

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28
Q

Anti-Mi2 is associated with which condition?

A

Dermatomyositis

29
Q

Some autosomal recessive genetic condition has a carrier frequency of 1 in 50. What is the prevalence?

A

50^2 * 4 = 1 in 10,000
Prevalence = (carrier freq)^2 * 4

30
Q

Some autosomal recessive condition has a prevalence of 1 in 40,000. What is the carrier frequency?

A

In in 100. (40,000 /4 = 10,000. Sqr root of 10,000 = 100)
Carrier freq = Sqr(prevalence/4)

31
Q

AML: worst prognostic cytogenetics?

A

Del 5 or del 7

32
Q

APML cytogenetics?

33
Q

Translocation in Burkitt’s lymphoma

A

t(8;14)
8urkitt’s 14mphoma

34
Q

Translocation in follicular lymphoma?

A

t(14;18)
14mphoma (18 letters in foll lymph)

35
Q

Translocation in mantle cell lymphoma?

A

t(11;14)
Mantle ce11 14mphoma

36
Q

Translocation in Ewing’s sarcoma?

A

t(11;22)
Patrick Ewing 11 + 12 = 33

37
Q

Translocation in Philadelphia chromosome?

A

t(9;22)
9hiladelphia (22 letters in Phil Chr)

38
Q

Translocation in AML?

39
Q

Defining clinical characteristics of MEN 1, MEN2a and 2b?

A
  1. Parathyroid adenoma (pituitary adenoma +/- pancreas/GI adenoma)
    2a. Medullary thyroid cancer
    2b. Marfanoid
40
Q

Genes for MEN 1, 2a and 2b

A

MEN 1. MENIN or MEN1

MEN2a and 2b. RET oncogene

41
Q

Complement deficiency disposes to which bacteria?

A

Meningococcus

42
Q

Most common bacterial cause of IECOPD?

43
Q

Which bacteria in UTI won’t produce nitrites?

A

Enterococcus

44
Q

Which receptor does clopidogrel target?

A

P2Y12

(P for plavix)

45
Q

Autoimmune hepatitis antibody?

A

ASMA

Anti smooth muscle Ab

46
Q

ASMA suggests which condition?

A

Autoimmune hepatitis

47
Q

Antibody in primary biliary cholangitis?

A

AMA

Anti mitochondrial antibody

48
Q

AMA antibodies suggest which condition?

A

PBC

Primary biliary cholangitis

49
Q

Which antibody is associated with primary sclerosis cholangitis?

50
Q

When is pacing indicated in syncope?

A

CardioinhibItory (HR goes down with tilt)or mixed carotid sinus syndrome

51
Q

Causes of loud S1

A

Mitral stenosis, PS, tachycardia

52
Q

Causes of soft S1

A

MR, PR prolongation, LBBB

53
Q

Causes of loud S2

54
Q

Causes of soft S2

A

Aortic stenosis, aortic regurgitation

55
Q

Causes of S3

A

LV failure, MR, constrictive pericarditis, physiological

56
Q

Causes of S4

A

AS, HOCM, HTN, pHTN

57
Q

Fanconi syndrome triad

A

Skeletal lesions of hypophosphatemia (rickets or osteomalacia), renal aminoaciduria, and renal glycosuria

58
Q

Thyroid cancers: Most to least common and best to worse prognosis

A

Papillary, follicular, medullary, anaplastic

Please fuck my arse.

59
Q

Most significant CYP inducers?

A

St John’s wart. Phenytoin. Carbamazepine. Rifampacin. Modafanil. Aprepitant. Ritonavir. Enzalutamide.

There was a CAR, a PREPurchase MODified tRITON. In the ENZ, a ST JOHNS ambulance TOWed it up a RAMP

60
Q

Most significant CYP inhibitors?

A

Amiodarone. Azoles. Duloxetine. Diltiazem. Fluoxetine. Clarithromycin.
Imatinib. COCP. Verapamil. Plavix. Ciclosporin. Paroxetine.

Am I da one dill with clarity? I’m a tiny cock in a deluxe asshole. Vera will play vixen in a cycle of flux and paradox

61
Q

Vd(L) =

A

Vd (L) =

dose (mg)

[plasma] (mg/L)

62
Q

Loading dose =

A

Loading dose = volume of distribution x desired plasma concentration

Dose (mg) = Vd (L) x [plasma] (mg/L)

63
Q

t 1/2 =

A

t 1/2 = .693 x Vd/ Cl

t 1/2 (hr) = .693 x Vd (L) / Cl (L/hr)

64
Q

For a continuous IV infusion

Infusion rate =

A

Desired concentration (mg/L) x clearance (L/hr)

65
Q

For a continuous IV infusion,

Concentration =

A

Concentration = infusion rate/ clearance

[plasma] (mg/L) = infusion rate (mg/hr)/ clearance (L/hr)

66
Q

For intermittent dosing,

Concentration =

A

Steady state concentration =

[dose x bioavailability]

[clearance x dose interval]

[steady state] (mg/L) =

dose (mg) x bioavailability

cl (L/hr) x interval (HR)

67
Q

Definition of pulmonary arterial hypertension?

A

Mean pulmonary arterial pressure >/= 20mmHg and

Pulmonary capillary wedge pressure <15mmHg

68
Q

Indications for mitral valve replacement in MR?

A

60/60

LVEF <60% or LVEDD >60mm

69
Q

Indications for intervention in aortic regurgitation?

A

55/55

Before LVEF <55% and before LVEDD >55mm

BPT written exam (14 decks)

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