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MRCP > Recall > Flashcards

Recall Flashcards

1
Q

Zieve syndrome?

A

Seen in severe ETOH excess
- haemolytic anaemia + jaundice + deranged LFTs + deranged lipids

Tx: alcohol abstinence

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2
Q

What medications may lead to Li toxicity by reducing urinary clearance?

A

NSAIDs, thiazides, ACEi

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3
Q

Type of seizures associated with epigastric aura and early oral automatism?

A

Temporal lobe seizures

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4
Q

2nd line management for migraine prophylaxis? (If pt unable to take propranolol or anitriptyline)

A

Candesartan

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5
Q

SLE treatment?

A

Hydroxychloroquine

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6
Q

Effect of haemodialysis on HbA1c?

A

May falsely lower bc of reduced red cell life span with HD

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7
Q

Loffler syndrome?

A

Eosinophilic pneumonia 2’ ascaris lumbricoides

> tropical areas such as Central America
generally self limiting and resolves within 2/52 of onset

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8
Q

Weight gain + painful hepatomegaly + ascites + jaundice within 12 days of haematopoietic stem cell transplant?

A

veno-occlusive syndrome (aka sinusoidal obstructive syndrome)

> usually low Plt, high transaminases, imaging of liver showing hepatic venous congestion (nutmeg liver)

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9
Q

Diagnosis of veno-occlusive syndrome (aka sinusoidal obstructive syndrome)?

A

Liver biopsy

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10
Q

Ix of lambert Eaton syndrome assoc w malignancy?

A

Anti VGCC ab
Nerve conduction studies: variation of muscle action potentials

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11
Q

Atypical pneumonia + farmer + transaminitis + blood culture negative endocarditis?

A

Q fever
- coxiella burnetii

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12
Q

Management of Q fever?

A

Doxycycline

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13
Q

What antibiotic may lead to theophylline toxicity (n+v, palpitations, acidosis with hypok)?

A

Ciprofloxacin
> CYP1A2 inhibitor > causing increased theophylline levels

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14
Q

Empirical management of infective endocarditis in IVDU?

A

Flucloxacillin
> because most likely organism is staph aureus

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15
Q

Empirical management of infective endocarditis in IVDU?

A

Flucloxacillin
> because most likely organism is staph aureus

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16
Q

Difference between stage 3 and 4 diabetic nephropathy?

A

Stage 3: microalbuminuria (3-300mg/ day)

Stage 4: significant proteinuria with urine dip positive proteinuria. >300mg/day

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17
Q

Family history of renal stones + radioopaque stones?

A

Cystinuria

Tx: hydration + urinary alkalinisation

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18
Q

Functional B12 deficiency 2’ illicit drug use (NO inhalation)?

A

B12 levels may be normal -> still have SACD

-> serum methylmalonic acid and homocysteine levels high

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19
Q

Management of poly myalgia rheumatica?

A

Prednisolone

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20
Q

What is WPW?

A

AVRT
- re entry via accessory pathway not the AV node
So it’s a atrioventricular re-entry tachycardia

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21
Q

Common drug causes of transaminitis?

A

Sodium valproate
Methotrexate
Amiodarone
Statins
Paracetamol

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22
Q

Common drug causes of bullous pemphigoid?

A

Furosemide
Captopril
Penicillamine and other penicillin derivatives

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23
Q

Management of severe leptospirosis?

A

IV penicillin

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24
Q

management of cannabis induced psychosis?

A

atypical antipsychotic e.g. risperidone

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25
Q

management of severe bleeding while on warfarin?

A

PCC

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26
Q

management of a solitary hot nodule if no features of malignancy e.g. thyroid adenoma?

A

radioiodine
> high level of effectiveness + does not carry the morbidity assoc w partial thyroidectomy

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27
Q

management of psychosis in Parkinson’s patients?

A

clozapine or quetiapine
- usually ppl use quetiapine first because clozapine would require FBC monitoring

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28
Q

1st line mx of Guillain barre?

A

IVIG

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29
Q

cause of bronchiectasis + very low levels of nasal nitric acid (<250 ppb)

A

Primary ciliary dyskinesia

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30
Q

what medication can you use for Restless legs syndrome if you do not want to use ropinirole because of Parkinson’s disease?

A

gabapentin

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31
Q

management of cystine stones?

A

can use penicillamine
- urinary alkalisation
+ potassium citrate

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32
Q

management of aortic root dilation in Marfans when elective surgery is recommended (>50mm)?

A

valve-sparing aortic root replacement

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33
Q

management of lewy body dementia ?

A

donepezil

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34
Q

how to diagnose non classical CAH?

A

ACTH stimulation test

  • levels of 17OH progesterone will rise > 10
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35
Q

do you test for resolution of h pylori if symptoms have resolved?

A

no

36
Q

first line mx of SLE with lupus nephritis?

A

mycophenolate mofetil

37
Q

management of intractable nausea and vomiting, or agitation and distress in a pt in last few days of life?

A

levomepromazine

38
Q

raised AFP and testicular tumour?

A

teratoma

39
Q

what may precipitate scleroderma renal crisis?

A

steroids

39
Q

what may precipitate scleroderma renal crisis?

A

steroids

40
Q

HLA assoc w TEN?

A

HLA B1502

41
Q

what may give rise to pacemaker induced VT?

A

undersensing of ventricular and atrial beats
- may result in a stimulus being given when ventricular ectopic is also present
> could precipitate VT

42
Q

first line rate control for AF even if they have COPD?

A

bisoprolol
- no evidence that BBs make COPD worse

43
Q
A

Pacemaker: failure to capture

44
Q
A

Failure to pace

45
Q
A

failure to sense/ underspending

46
Q

what may cause palpitations in myotonic dystrophy?

A

atrial tachyarrhythmias
e.g. AF

47
Q

management of Transthyretin (TTR) amyloidosis?

A

tafamidis

> stabilises amyloid tetramers, reduces progression to cardiomyopathy and neuropathy

48
Q

what may be given to reduce size of tumour prior to acromegaly surgery?

A

octreotide
- somatostatin analogue

48
Q

what may be given to reduce size of tumour prior to acromegaly surgery?

A

octreotide
- somatostatin analogue

49
Q

management of Addisons disease during labour?

A

convert steroids to IV hydrocortisone 100mg Q6H

50
Q

choice of blood sugar control in NASH?

A

GLP1 agonists e.g. liraglutide/ semaglutide
- can help w weight loss
- has been shown in trials to slow NASH progression

51
Q

best investigation to assess for iron deficiency anaemia?

A

percentage of hypo chromic red cells
- >6% indicating IDA

52
Q

management of poly myalgia rheumatica like symptoms 2’ renal cell carcinoma? (these usually do not respond to steroids)

A

nephrectomy

53
Q

management of diabetic macular oedema?
- usually can see circle of hard exudates

A

anti-VEGF
e.g. ranibizumab, aflibercept, bevacizumab

2nd line: focal laser photocoagulation

53
Q

management of diabetic macular oedema?
- usually can see circle of hard exudates

A

anti-VEGF
e.g. ranibizumab, aflibercept, bevacizumab

2nd line: focal laser photocoagulation

54
Q

best test to differentiate between ectopic and pituitary ACTH?

A

high dose dexamethasone test
- would usually suppress pituitary ACTH not ectopic

55
Q

first line mx for invasive aspergillosis infection in immunocompromised pt?

A

voriconazole

2nd line: amphotericin

56
Q

transverse femoral fracture + long time on bisphosphonate?

A

remember risk of atypical femoral fracture with prolonged use of bisphosphonate

57
Q

how can you test for sulfonylurea abuse?

A

urinary sulfonylurea testing

58
Q

management of paracetamol OD if also had anaphylaxis to NAC?

A

restart NAC at slower dose and cover with steroids/ antihistamines

59
Q

mx of CLL related AIHA?

A

steroids

60
Q

recent SAH + new NPH?

A

post SAH aqueduct obstruction

61
Q

first line medication to give pregnant people for constipation?

A

bulk forming laxative e.g ispaghula husk

62
Q

management of systemic sclerosis ILD?

A

mycophenolate mofetil

63
Q

choice of pacemaker in AV node block without AF?

A

DDDR (dual chamber rate modulated pacing)
> record both atrial and ventricular rates and can pace either PRN

64
Q

management of erythrodermic psoriasis?

A

ciclosporin +/- systemic steroids for rapid relief

65
Q

Chronic allograft rejection causing obstructive picture in lung transplant?

A

bronchiolitis obliterans

> tx w azithromycin first

66
Q

oral abx option to cover for hospital acquired pseudomonas infection?

A

oral levofloxacin

67
Q

delayed prosthetic joint infection + gram positive bacteria?

A

propionibacterium acnes

68
Q

what common medications cause cholestatic joundice?

A

augmentin, clarithromycin, flucloxacillin, trimethoprim

69
Q

mx of choice of legionella pneumonia?

A

levofloxacin, azithromycin

70
Q

bats/ caves : infective diseases?

A

Marburg virus
Histoplasmosis: mild (itraconazole), severe (hypoxia/ SOB- Amphotericin)

71
Q

Theophylline OD within last few hrs?

A

Activated charcoal!!

71
Q

Theophylline OD within last few hrs?

A

Activated charcoal!!

72
Q

continuous murmur following pregnancy

A

mammary souffle
> flow murmur from increased flow through internal mammary artery

73
Q

initial treatment of Lambert eaton myasthenic syndrome?

A

3,4-diaminopyridine

74
Q

what monoclonal antibody can you use in advanced metastatic melanoma?

A

pembrolizumab (PD1 receptor)

75
Q

what antibiotic do you also use in tetanus infection after giving tetanus Ig?

A

metronidazole

76
Q

most effective management of achalasia?

A

`heller’s laparoscopic myotomy
- for patients with good functional status. symptom relief in up to 90%

77
Q

small bowel pneumotasis in coeliac disease?

A

inflammation of small bowel mucosa with passage of intraluminal gas into small bowel wall
`. can be normal + no need to do anything

78
Q

mx of methamphetamine psychosis?

A

BZD e.g. diazepam

79
Q

Ciprofloxacin inhibits?

A

CYP 1A2

80
Q

what structure implicated in hidradenitis suppurativa?

A

apocrine glands

81
Q

management of duodenal ulcer on endoscopy + H pylori positive?

A

H pylori eradication + re test for h pylori at 4-8 wks

82
Q

high grade dysplasia + Barrett’s oesophagus mx?

A

refer for oseophagectomy

MRCP (21 decks)

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