Revision Questions Flashcards
1
Q
What drug is used to treat gout and what class of drug is it?
A
Allopurinol - Xanthine oxidase inhibitor
2
Q
How does SLE present?
A
Discoid rash, oral ulcers, photosensitivity, arthritis, anti-dsDNA
3
Q
How is rheumatoid arthritis diagnosed?
A
Anaemia, raised CRP/ESR, platelets
Rheumatoid factor
Anti-CCP +ve (anti-cyclic citrullinated peptide), ANA +ve (antinuclear antibodies)
X-ray: soft tissue swelling, reduced joint space, bony erosions
USS/MRI synovitis
4
Q
What does rituximab inhibit?
A
CD 20 receptors on the surface of activated B cells
5
Q
What does toclizumab inhibit?
A
IL-6
6
Q
What does infliximab inhibit?
A
TNF-alpha
7
Q
What organisms can cause UTIs?
A
E.coli, Klebsiella, S.aureus, Enterococcus
8
Q
What drug is used to treat uncomplicated lower tract UTIs?
A
Trimethoprim
9
Q
What drug is used to treat uncomplicated upper tract UTIs?
A
Co-amoxiclav (broad spectrum antibiotics)
10
Q
What hormone is tested for in the diagnosis of testicular carcinoma?
A
betahCG (human chorionic gonadotrophin)
11
Q
How are renal stones diagnosed and managed?
A
Urine dipstick: haematuria
KUBXR
NCCTKUB (non-contrast computerised tomography)
IV diclofenac for pain, cefuroxime, medical expulsion therapy, percutaneous nephrolithotomy
12
Q
What are some differentials for renal colic?
A
Ruptured AAA, diverticulitis, appendicitis, testicular torsion
13
Q
How can renal stones be prevented?
A
Drink 2-3L/day water, diet low in sodium, fat and protein, reduce oxalate rich food
Recurrent calcium stones/ hypercalciuria - thiazide diuretic
14
Q
What are the 3 cardinal signs of nephritic syndrome?
A
Hypertension, haematuria, proteinuria
15
Q
What are the 3 cardinal signs of nephrotic syndrome?
A
Proteinuria, oedema, hypoalbuminaemia
16
Q
What 3 criteria are used to diagnose AKI?
A
Creatinine rise >26micromol/L in 48 hrs
Creatinine rise >50% in 7 days
Urine output <0.5ml/kg/hr for >6 hrs
17
Q
What are the risk factors for AKI?
A
Sepsis, >75, diabetes, cardiac failure
18
Q
What are the symptoms of AKI?
A
Oliguria, nausea, vomiting, confusion, increased heart rate
19
Q
How does hyperkalaemia present on an ECG?
A
Tall T waves, small P waves, prolonged QRS
20
Q
How is AKI diagnosed?
A
Bloods: serum creatinine
NCCT-KUB
Urinalysis: infective organisms
21
Q
How is AKI managed?
A
Stop nephrotoxic drugs
IV fluid, abx for sepsis
22
Q
How is non-urgent and acute hyperkalaemia (medical emergency) managed?
A
Non-urgent - polystyrene sulphonate resin = binds K+ in gut, decreasing uptake
Acute:
Calcium gluconate = decreases VFib risk in heart
Insulin + dextrose = drives K+ into cells
Salbutamol nebulised
Calcium resonium
23
Q
How is CKD diagnosed?
A
Low GFR (<90ml/min/1.73m2), Raised albumin:creatinine ratio, urine dipstick: haematuria/ proteinuria, USS U+E's: raised urea and creatinine, low calcium, raised PTH, raised phosphate and potassium, raised renin Renal biopsy
24
Q
What causes CKD?
A
HTN, diabetic nephropathy, AKI, PKD, NSAIDs
25
What does GGT stand for and when is it raised?
Gamma-glutamyl transpeptidase
| Raised in alcoholic liver disease
26
What does ALP stand for and when is it raised?
Alkaline phosphatase
| Raised in biliary tree damage or in diseases that cause bone resorption e.g. metastases
27
What do AST/ALT stand for and when are they raised?
Aspartate transaminase/ Alanine aminotransferase
| Raised in hepatocyte damage
28
What drug is used to treat chronic Hep B?
Pegylated interferon-alpha 2a (stimulates immune response)
29
What drug is used to treat chronic Hep C?
Antivirals - ribavirin
30
What drug helps remove excess iron in haemochromatosis and beta thalassaemia major?
Desferrioxamine
31
What is the pathophysiology behind portal hypertension?
Endothelin-1 production is increased in cirrhosis which increases vasoconstriction.
NO production decreases in cirrhosis which decreases vasodilation.
There is now a reduced radius, increasing the resistance and leading to a higher portal pressure in the portal system
32
What are the causes of portal hypertension?
Pre-hepatic: Portal vein thrombosis
Intra-hepatic: Sarcoidosis, primary biliary cirrhosis, Budd-Chiari syndrome, cirrhosis
Post-hepatic: constrictive pericarditis, IVC obstruction, RHF
33
What is the treatment for oesophageal varices?
Beta-blockers - reduce CO, reduce portal pressure
Nitrates reduce portal pressure
Terlipressin - reduce portal pressure
Surgical: Endoscopic banding
34
What are some causes of ascites due to transudate?
Cirrhosis, portal vein thrombosis, constrictive pericarditis, Budd-Chiari syndrome
35
What are some causes of ascites due to exudate?
Inflammation (increased vascular permeability), malignancy, infections, pancreatitis
36
What is the treatment of spontaneous bacterial peritonitis (complication of ascites with cirrhosis)?
Cefotaxime
37
What is the tumour marker?
Raised AFP - alpha-fetoprotein
38
What antibody is tested for primary biliary cirrhosis?
Anti-mitochondrial antibody
39
What antibody is tested for primary sclerosing cholangitis?
Anti-nuclear cytoplasmic antibodies
40
What are the features of Charcot's Triad and Reynold's pentad?
Charcot's - fever, RUQ pain, jaundice
Reynold's - hypotension, confusion
Presentation of Ascending cholangitis
41
What are the signs of late stage acute pancreatitis?
Grey-Turner's sign - bruising flanks
| Cullen's sign - bruising around umbilicus
42
What score is used to measure the severity of LUTS?
International prostate scoring system
43
What are the macroscopic signs of Crohn's disease?
Thickened and narrowed bowel, cobblestone appearance, deep ulcers in the mucosa, skip lesions, fistulae
44
How would a lumbar puncture CSF sample appear a.) 2 hours b.) 15 hours after a subdural haematoma?
a.) bloody b.) xanthochromic (yellow)
45
What chromosome is the causative mutation for Huntington's found on and what is the trinucleotide repeat?
Chromosome 4
| CAG
46
What is the term used to describe when an inherited disorder appears earlier in each generation?
Anticipation
47
What are the signs of a life-threatening asthma attack?
Exhaustion, bradycardia, peak flow <33%, silent chest, cyanosis, PaO2 <8kPa, severe SOB, low oxygen sats, audible wheeze, tachypnoea
48
What is the gold standard diagnostic test for DVT/ PE?
CT pulmonary angiography
49
Name one thing you'd see on an ECG of someone with a PE?
Sinus tachycardia
50
What are the causative organisms of reactive arthritis?
Campylobacter, shigella, salmonella
51
What drugs can cause hyperuricaemia?
Thiazide diuretics, NSAIDs (many more)
| e.g. bendroflumethiazide, furosemide, aspirin
52
What is the diagnostic blood test for heart failure?
Brain natriuretic peptide
53
What are the radiographic signs of heart failure?
Alveolar oedema, Kerley B lines, Cardiomegaly, Dilated upper lobe vessels, pleural Effusion
(ABCDE)
54
What murmur would be heard in aortic stenosis and where would you hear it?
Ejection systolic murmur
| Right sternal edge, 2nd intercostal space
55
What are the side effects of long term steroid use?
Weight gain, osteoporosis, immunosuppression, oedema, effects growth, hypokalaemia, hypertension
56
Name an example of a proton pump inhibitor
Omeprazole
57
What antibodies are tested for in coeliac's disease?
IgA Tissue transglutaminase, IgA Anti-Endomysial
58
What is tumour lysis syndrome and how is it managed?
Complication of cancer treatment - large amounts of tumor cells are killed off (lysed) at the same time by the treatment, releasing their contents into the bloodstream.
Replacement of electrolyte balance and IV fluids
59
What are the 2 diagnostic features of febrile neutropenia?
Temp >38C, absolute neutrophil count <1
60
What is Kernig's sign and what condition is it a sign for?
Not being able to extend the knee when hip is flexed at 90degrees
Meningitis
61
What diagnostic tests would you do for a patient you suspect has meningitis?
Lumbar puncture, FBC, WBC count, GCS, Head CT, Throat swabs, Pneumococcal and Meningococcal PCR
62
How do you treat bacterial meningitis?
Urgent antibiotics, IV cefotaxime, consider amoxillicin if immunocompromised (listeria cover)
63
What are the features of Parkinson's?
Shuffling gait, resting tremor, bradykinesia, increased tone, stooped posture, decreased arm swing
64
What specific part of the brain does Parkinson's affect and which neurotransmitter?
Loss of dopamine in the substantia nigra of the pars compacta
65
What are the red flag symptoms for headaches?
New headache with Hx of cancer, cluster headache, seizure, altered consciousness/memory/ confusion, papilloedema
66
What drug decreases ICP?
MANNITOL
67
What are the complications of DM separated into microvascular/ macrovascular?
Micro - retinopathy, neuropathy
| Macro - CVD, cerebrovascular disease, peripheral artery disease
68
What thyroid autoantibodies are tested for in hyperthyroidism?
Thyroglobulin and anti-thyroid peroxidase antibodies
69
How is hyperthyroidism treated?
Carbimazole, beta blockers e.g. propranolol, radioiodine therapy, thyroidectomy
70
What are the side effects fo ACEi?
Dry cough, headache, diarrhoea
71
How do STEMIs present on an ECG over a few hours then a few days?
Hours: Tall T waves, ST elevation
Days: T wave inversion, pathological Q waves
72
What are the 3 cardinal symptoms of heart failure?
SOB
Fatigue
Peripheral oedema
73
What condition is characterised with a concave-upwards (saddle-shaped) ST elevation?
Pericarditis
74
How does atrial fibrillation present on an ECG?
F waves, no P waves, QRS irregularly irregular
75
What are the clinical features of aortic dissection?
```
Sudden tearing chest pain, may radiate to the back
Unequal arm pulses and BP
Acute limb ischaemia
Paraplegia
Anuria
```
76
What are the 4 stages of chronic limb ischaemia?
1. Asymptomatic
2. Intermittent claudication
3. Rest pain/ nocturnal pain
4. Necrosis/ gangrene
77
What are the secondary causes of hypertension?
CKD, PKD, renal artery stenosis, Cushing's, Conn's, coarctation of the aorta, pregnancy, COCP
78
What are the complications of aneurysms?
Rupture, thrombosis, embolism, excess pressure on other structures
79
What are the radiographic signs of pulmonary hypertension?
Enlargement of the pulmonary arteries, lucent lung fields, enlarged right atrium, elevated cardiac apex due to right ventricular hypertrophy
80
What are the side effects of chemo?
Alopecia, nausea and vomiting, peripheral neuropathy, constipation/diarrhoea, mucositis, rash, bone marrow suppression (anaemia, fatigue, anaphylaxis)
81
What are the causes of pleural effusion consisting of exudate?
Malignancy, infection, inflammation - SLE, PE, traumatic, drug reaction
82
What stain is used for Mycobacterium tuberculosis and what is it grown on?
Ziehl-Neelsen stain
| Lowenstein-Jensen culture
83
What is the action of salbutamol?
Binds to beta-2 adrenoreceptors present In the lungs leading to smooth muscle relaxation and therefore bronchodilation
84
What tests are done to diagnose cystic fibrosis?
Sweat test, genetics, faecal elastase
85
What drug would you use to treat a UTI on a pregnant patient?
Nitrofurantoin
86
How does the catalase test work?
A small amount of the bacteria is added to hydrogen peroxide, if bubbles of oxygen are observed = catalase positive
87
What drug would you give to a patient with a morphine overdose?
Naloxone
88
Where are venous ulcers most likely to occur?
Medial gaiter region
89
What is the result of a random plasma glucose test for a type 2 diabetic?
>11mmol/L
90
How does metformin work?
It increases the cell sensitivity to insulin
91
What drug is used to treat eczema?
Tacrolimus
| Emollient creams to hydrate
92
Name some 'risk score' calculating theories and what they are for
```
Kilip - acute MI
Fontaine - Peripheral vascular disease
Wells score - DVT
Qrisk2 - CV event in next 10 years
CHADS2VASc - stroke with AF
```
93
When is methotrexate contraindicated and why?
Pregnancy - folate antagonist - can cause macrocytic anaemia
94
How would psuedogout appear under polarised light microscopy?
Weakly positive birefringent rhomboid crystals
| Gout = -ve needle crystals
95
What is Lhermitte's sign and what is it a sign of?
A sudden, brief, buzzing sensation like an electric shock that moves down your neck into your spine
MS
96
What are the 3 physiological changes that occur in asthma?
Inflammation of the mucosa
Bronchoconstriction
Increased mucous secretion
97
What is the mechanism of action of prednisolone?
Up-regulate anti-inflammatory genes and down regulate pro-inflammatory genes
98
What are the contraindications for thrombolysis?
Haemorrhage, intracranial bleeds, onset of symptoms over 4.5 Hours ago, time of onset unknown, heparin, BP >185/110, peptic ulcer, low platelets, recent stroke, recent trauma, aneurysms, clotting disorders
99
What are the signs in the hand for RA?
Hot, swollen joints
| Swan neck deformity, Z thumbs, ulnar deviation, muscle weakness, Boutonniere deformity
100
What are the extra-articular effects of RA?
Vasculitis, pulmonary fibrosis, pericarditis, pericardial effusion, lymphadenopathy, neuropathy, anemia
101
Name some differentials for fatigue
Cancer, hypothyroid, diabetes, depression, coeliac disease, chronic fatigue syndrome, anaemia, anxiety, restless leg syndrome, infection, pregnancy
102
Give 2 examples of drugs and their classes that can be used to treat GORD
PPI - omeprazole
| Histamine 2 receptor antagonist - Ranitidine
103
What would be seen on an X-ray of someone with TB?
Consolidation of upper lobe, pleural effusion, cavitation, hilarity lymphadenopathy
104
What test is used to detect latent TB?
Mantoux (t4 HS reaction) / Quantiferon test
105
What are the side effects of the TB drugs?
Rifampicin - red urine
Isoniazid - Peripheral neuropathy
Pyrazinamide - arthralgia
Ethambutol - optic neuritis
106
What are the side effects of sodium valproate?
Cognitive disturbance, heart disease
107
What are the differences between epileptic and non-epileptic seizures?
Epileptic - eyes open, incontinence, tongue biting
| Non-epileptic - hip thrusting, last longer
108
What drugs are used to treat breast cancer?
Pre-menopause: Tamoxifen
| Post-menopause: Anastrozole
109
What is a monoclonal paraprotein?
One immunoglobulin which is excessively produced
110
What makes LABAs longer acting in the tissues than SABAs?
They are lipophilic
111
How does an epidural haemorrhage appear on a CT scan?
Midline shift, adjacent to skull, hyper dense (white) haematoma, biconvex (lemon-shaped)
112
What can happen if beta-2-agonists are used at high conc in badly controlled asthma?
B2-receptor desensitisation
113
What are the characteristic heart sounds of mitral stenosis?
Diastolic murmur, loud opening S1 snap
114
Why is acne more common during puberty?
Androgen and progesterone production is increased so sebum production is increased
115
What is the 1st line treatment for acne?
Keratolytics - benzyl perozide
| Topical erythromycin
116
What is the first line treatment for cellulitis?
Flucloxacillin
117
What is the treatment for psoriasis?
1st line - Emollient creams
| 2nd line - Topical calcipotriol
118
What is necrotising fasciitis?
Rapid deep fascia infection = necrosis of subcutaneous tissue
Pain, erythema, systemic toxicity
119
What is the first line treatment for necrotising fasciitis?
Benzylpenicillin and surgical debridement
120
What CD4 cell count is diagnostic of AIDS?
<200/mm3
121
What is a common AIDS defining illness and why is it not normally found in other people?
Pneumocystis pneumonia
| Opportunistic pathogen - can only can cause disease in those that are immunocompromised
122
What are the treatments for hyper/hypoparathyroidism?
Hyper - Treat cause, bisphosphonates (alendronic acid)
| Hypo - Calcium supplements, calcitriol, synthetic PTH
123
What is the first line treatment for type 2 diabetes?
Lifestyle advice
124
What is the first medication you would prescribe to a T2DM patient, what is its action and side effects?
Metformin - increases insulin sensitivity
| SE: nausea, weight loss, diarrhoea
125
What is the dual therapy for T2DM and what HbA1c would you start it on?
HbA1c >53mmol/mol
Metformin + DDP4 inhibitor e.g. Sitagliptin
OR
Metformin + sulphonylurea e.g. Gliclazide
126
What is the action of DDP4 inhibitors?
Stimulate insulin secretion
127
What is the action of sulfonylurea?
Stimulates B cells to secrete insulin
128
What is the triple therapy for T2DM and what HbA1c would you start it on?
HbA1c >58mmol/mol
Metformin + DDP4 inhibitor e.g. Sitagliptan + sulfonylurea e.g. Gliclazide
Insulin based therapy is last resort
129
What are 3 diabetic emergencies and how would each present?
DKA - insufficient insulin - fruity breath, dehydration, Kussmaul breathing
Hypo - too much insulin - aggression, sweating, seizures
HHS - hyperglycaemia - signs of dehydration
130
What is the diagnostic test for adrenal insufficiency?
Short ACTH stimulation test: give ACTH, measure cortisol - levels should remain low if AI
131
What is Eisenmenger's complex?
ASD - shunt reversed due to development of pulmonary hypertension = cyanosis and organ damage
132
What abnormal heart sounds would you hear in a ventricular septal defect or coarctation of the aorta?
VSD: pan-systolic murmur. Smaller the hole = louder the murmur
CoA: Systolic murmur over left scapula (scapular bruit)
133
What is the gold standard diagnostic test for angina?
CT angiography - shows luminal narrowing
134
What are the SIGNS of an MI?
Clammy and pale, 4th heart sound, pan systolic murmur, may later develop pulmonary oedema
135
Give some differentials of Chest pain
ACS, pericarditis, pneumonia, PE, rib fracture, chest trauma, GORD, anxiety/panic attack
136
What is the EF for diastolic and systolic heart failure and what can cause each?
Diastolic - EF >50%, constrictive pericarditis, hypertension, cardiac tamponade
Systolic - EF <40%, IHD, MI, CM
137
What are the compensatory changes that occur in heart failure?
Sympathetic stimulation: Peripheral vasoconstriction causing increased after load
RAAS: salt and water retention. Increased afterload and preload
Ventricular dilatation, myocyte hypertrophy
138
What is the treatment for acute heart failure?
100% O2, nitrates - GTN spray, IV opiates - diamorphine, IV furosemide (loop diuretics), consider inotropic drug
139
What is the treatment for chronic heart failure?
```
ABCD
ACEi e.g. ramipril / ARB e.g candesartan
Beta blockers e.g. atenolol
CCB e.g. amlodipine
Diuretics and digoxin
```
140
What would an ECG of atrial fibrillation look like?
Irregularly irregular (pulse), no clear P waves, F waves, rapid and irregular QRS
141
What murmur would be heard in aortic stenosis?
Ejection-systolic, crescendo-decrescendo character
142
What are the 4 types of shock and their causes?
Septic - infection with any organism - acute vasodilation from inflammatory cytokines
Anaphylactic - Type-1 IgE mediated hypersensitivity, release of histamine
Neurogenic - spinal cord injury, epidural, spinal anaesthesia
Hypovolaemic - bleeding, trauma, ruptured aortic aneurysm, GI bleed
143
What are the signs of septic shock?
Temp >38C/ <36C
Tachycardia
Resp rate >20per min
WBC > 12x10^9/L
144
What would be heard through a stethoscope on a patient with acute pericarditis?
Pericardial friction rub (scratching sound)
145
What would spirometry of a COPD patient show?
FEV1/FVC <70, normal FVC, FEV1 < 80
146
What is screened for in a cystic fibrosis screening?
Immunoreactive trypsinogen
147
What are the complications of lung cancer?
SVC obstruction, Addison's disease, bone pain, recurrent laryngeal nerve palsy
148
What would pleural effusion sound like when percussed?
Stony dull percussion
149
Where would you do a needle aspiration or a chest drain tube?
Needle aspiration - 2nd intercostal space, midclav line
| Chest drain tube - 4-6th intercostal space midaxil line
150
What is an example of a mucolytic?
Dornase alfa
151
How is a life threatening asthma attack managed?
```
OSHIT
Oxygen to 94-98%
Salbutamol (neb 5mg)
Hydrocortisone IV
Ipratropium 0.5mg/6h to nebulisers
Theophylline IV
```
152
What drug is used to treat diarrhoea?
Loperamide
153
How is Crohn's managed?
Oral corticosteroids, IV hydrocortisone in severe flare ups
Add anti-TNF antibodies if no improvement (infliximab)
If frequent exacerbations - methotrexate to stay in remission
154
What antibody is tested for in ulcerative colitis?
pANCA - perinuclear anti-neutrophil cytoplasmic antibodies
155
What drugs can be used for the symptoms of IBS?
Pain/bloating - buscopan
Constipation - laxative e.g. Senna
Diarrhoea - loperamide
156
What causes peritonitis?
AEIOU
| Appendicitis, ectopic pregnancy, infection with TB, Obstruction, Ulcer
157
How is pancreatitis diagnosed?
High amylase, high lipase, CT chest/abdo
| AXR shows no psoas shadow
158
What chromosomes are BRCA1 and BRCA2 found on?
1 - Chromosome 17
2- Chromosome 13
Tumour suppressor genes
159
How does breast cancer present?
Axillary lump, breast lump with/without pain, nipple changes of concern e.g. discharge and retraction, skin changes e.g. tethering
Mets - bone pain, jaundice, SOB, headache
160
What dose of paracetamol can be fatal for the average adult and the malnourished?
Adult - 150mg/kg
| Malnourished - 75mg/kg
161
What is the treatment for paracetamol overdose?
IV N-acetylcysteine
162
What is the characteristic feature of amyloidosis and how is it treated?
```
Periorbital purpura (really bad black eyes)
IV melphalan
```
163
How do you treat reactive arthritis?
No cure. Splint joints
NSAIDs, local steroid injections
Methotrexate if >6months
164
Give 2 examples of drugs and their classes that can be used to treat BPH?
Alpha blocker - tamsulosin
| 5-alpha-reductase inhibitor - finasteride
165
Give 3 side effects of NSAIDs
Diarrhoea, dizziness, nausea
166
Give 3 side effects of bisphosphonates
Alopecia, anaemia, constipation, headache
167
Give 3 side effects of methotrexate
Fever, anaemia, fatigue, diarrhoea
168
Give 3 side effects of hydroxychloroquine
Abdo pain, diarrhoea, headache
169
What are the complications of bronchiectasis?
Amyloidosis, pneumothorax, pulmonary hypertension and RVF
170
What are the differentials for a wheeze?
Asthma, COPD, Bronchiectasis, Cystic fibrosis
171
What are the differentials for haemopytsis?
Bronchiectasis, lung cancer, pneumonia, Goodpasture's syndrome, Wegener's granulomatosis
172
What are the differentials for a cough?
COPD, asthma, bronchiectasis, cystic fibrosis, lung cancer, TB, pneumonia, pulmonary fibrosis, sarcoidosis, hypersensitivity pneumonitis, Wegener's granulomatosis
173
What is Post-ictal Todd's Palsy?
Paralysis of the limbs involved in a seizure for several hours
174
What is the treatment for Parkinson's?
1st line - Dopamine receptor agonists - ropinirole
2nd line - monoamine oxidase-B inhibitor - Selegiline
Co-careldopa (L-dopa) late - causes dyskinesias
Amantadine - anticholinergic drug to manage tremors
175
How is Huntington's treated?
Chorea and aggression - antipsychotics - risperidone
| Depression - selective serotonin reuptake inhibitors (SSRI) - sertraline
176
What are the causes of tension headaches?
MC SCOLD - missed meals, conflict, stress, clenched jaw, overexertion, lack of sleep, depression
177
What is the 1st line treatment for MS?
Beta interferon and glatiramer acetate
| Acute attacks: IV methylprednisolone
178
What is the treatment for myasthenia graves?
Acetylcholinesterase inhibitor - Pyridostigmine
179
What is sciatica?
L5/S1 nerve lesion - S1 nerve root compression
| Sensory loss/pain down back of leg
180
How does clopidogrel work (anti-platelet)?
Inhibits P2Y12 ADP receptor on platelets
181
How do statins work (e.g. simvastatin)?
Inhibit HMG CoA, reducing cholesterol synthesis
182
How is peripheral artery disease diagnosed?
CT angiography - stenosis, Ankle-brachial pressure index, colour duplex USS - shows vessels and blood flow
183
What makes up conventional chemotherapy?
TI-CE
| Topoisomerase, ifosamide, Etoposide, cisplatin
184
Give the treatment for different types of anaemia
```
Iron def - ferrous sulfate
Chronic dis - erythropoietin to raise Hb
Sidero- pyroxidine, repeat transfusions
Folate def - folic acid
Pernicious - hydroxocobalamin (vit B12)
Aplastic - bone marrow transplant
```
185
How is polycythaemia treated?
Keep haematocrit <0.45 to decrease risk of thrombosis
Young - venesection
>60 - hydroxycarbamide
Low dose aspirin
186
What monoclonal antibody can be found in urine of a myelomas patient?
Bence Jones protein
187
How is malaria treated?
Quinine + doxycycline
188
What are the signs of iron deficiency anaemia?
Brittle hair and nails, atrophic glossitis, kolionychia, angular stomatitis
189
What is the main side effect of ferrous sulphate?
```
Black stools
(Also: constipation/ diarrhoea, nausea, upset, epigastric abdo pain)
```
