Random PassMed Facts

Question 1

BRCA 1 is carried on which chromosome?

Answer 1

BRCA 1 is carried on chromosome 17

Question 2

BRCA 2 is carried on which chromosome?

Answer 2

BRCA 2 is carried on chromosome 13

Question 3

BRCA 1 & 2 are linked to developing breast cancer (60%) and which other cancer(s)?

Answer 3

Females:
- Risk of developing ovarian cancer (55% BRCA 1; 25% BRCA 2)

Males:
- BRCA 2 is associated with prostate cancer

Question 4

Lynch Syndrome is:

A) Autosomal dominant
B) Autosomal recessive
C) X-linked dominant
D) X-linked recessive

Answer 4

A) Autosomal dominant

Question 5

What conditions are associated with Lynch Syndrome?

Answer 5

Colonic cancer and endometrial cancer.

Question 6

What proportion of affected individuals will get colonic and/or endometrial cancer with Lynch syndrome?

Answer 6

80% of affected individuals will get colonic and/ or endometrial cancer

Question 7

What scoring system can be used to identify individuals at high risk of Lynch syndrome?

Answer 7

Amsterdam criteria

• Three or more family members with a confirmed diagnosis of colorectal cancer, one of whom is a first degree (parent, child, sibling) relative of the other two.
• Two successive affected generations.
• One or more colon cancers diagnosed under age 50 years.
• Familial adenomatous polyposis (FAP) has been excluded.

Question 8

What is Gardner’s syndrome?

Answer 8

Familial colorectal polyposis.

Autosomal dominant mutation of APC gene located on chromosome 5.

Question 9

What is the most likely cause of the following presentation:

Persistent shortness of breath, swelling of face and neck, headache, difficulty with vision. Visibly very red and prominent neck and face veins.

A) Aortic aneurysm
B) Leukaemia
C) Lung cancer
D) Spinal cord compression
E) Vertebral artery rupture

Answer 9

C) Lung cancer

Small cell lung cancer is the most common cause of SVCO.

The presentation above is superior vena cava obstruction (SVCO). The most common cause of that is lung cancer (most commonly small cell lung cancer, especially in the right upper lobe).

Question 10

Why might a patient with known anorexia nervosa present with tiredness and unexpected weight gain?

Answer 10

Anorexia can cause hypothyroidism.

Question 11

What is the first-line treatment of anorexia nervosa in children and young people?

Answer 11

Focused family therapy

Question 12

____ is the presence of delusion of a famous person being in love with them in the absence of other psychotic symptoms.

Answer 12

Erotomania

Question 13

True or false: Antidepressant medication should be stopped before ECT treatment.

Answer 13

False.

Antidepressant medication should be reduced but not stopped when a patient is about to commence ECT treatment.

Question 14

What is the risk of taking sertraline in the first trimester of pregnancy?

Answer 14

SSRI use in first trimester - small increased chance of congenital heart defects.

Must weigh risks v benefits.

Question 15

What type of incontinence is associated with tricyclic antidepressants?

Answer 15

Overflow incontinence due to anticholinergic effect.

Question 16

Which of the following side effects is most associated with olanzapine?

A) Hypernatraemia
B) Hypercholesterolaemia
C) Hyperkalaemia
D) Hypoprolactinaemia
E) Hyperparathyroidism

Answer 16

B) Hypercholesterolaemia

Metabolic side effects of antipsychotics include dysglycaemia, dyslipidaemia, and diabetes mellitus.

Olanzapine (and other antipsychotics) causes metabolic side-effects primarily including hyperlipidemia, hypercholesterolemia, hyperglycemia and weight gain.

Anti-psychotics are dopamine antagonists so would cause hyperprolactinemia as dopamine is a prolactin antagonist.

They do not affect the parathyroid hormones or electrolytes.

Question 17

If a patient is on phenelzine, why should you not prescribe an SSRI?

Answer 17

Phenelzine is a MAOI. Both increase levels of serotonin. SSRIs and MAOIs should never be combined as there is a risk of serotonin syndrome.

Question 18

If a patient is already on an SSRI for generalised anxiety disorder, what is the second line treatment?

Answer 18

Another SSRI or an SNRI.

If a first line SSRI such as sertraline is ineffective or not tolerated, try another SSRI or an SNRI for GAD.

Duloxetine and venlafaxine are examples of SRNIs.

Question 19

A patient with suspected spinal cord compression should initially be started on which drug at what dose?

Answer 19

High-dose oral dexamethasone, 8 mg bd

Question 20

What is the SSRI of choice in children and adolescents?

Answer 20

Fluoxetine

Question 21

You decide to amend a patient’s lithium dose. When should you next re-check her lithium levels?

Answer 21

A week later.

After a change in dose, lithium levels should be taken a week later and weekly until the levels are stable