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AM > Rheumat > Flashcards

Rheumat Flashcards

1
Q

Antibodies corresponding to activity flare in sle

A

AntiC1q anti DS DNA

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2
Q

Antibodies for drug induced lupus

A

Anti histone

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3
Q

Antibodies for drug induced lupus

A

Anti histone

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4
Q

S h i p drugs antihistone related

A

Sulphasalszine
Hydralazine
Isoniazid
Pyrazinamide

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5
Q

Most sensitive entry criteria for s l e

A

A n a anti nuclear antibody

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6
Q

Most specific antibody in SLE

A

Anti SM

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7
Q

Antibodies for CNS lupus

A

Anti neuronal antibody and anti glutamate receptor 2 antibody

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8
Q

Antibody in psychiatric manifestation of SLE

A

Anti ribosomal p

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9
Q

Antibody in mixed connective tissue disorder overlap disorder

A

Anti U1rnp

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10
Q

Antibody for sjogrens

A

Anti ro/ss a
Anti la/ss b

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11
Q

Antibody in congenital heart block and in neonatal lupus

A

Anti ro/ss a

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12
Q

Antibody in anti synthatase syndrome

A

Anti Jo1

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13
Q

Antibody in dermatomyositis

A

Anti M2

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14
Q

Antibody in diffuse scleroderma

A

Anti topoisomerase-1
Anti scl-70

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15
Q

Anti scl 70 antibody for

A

Diffuse scleroderma

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16
Q

Anti topoisomerase 1 antibody for

A

Limited scleroderma / crest

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17
Q

Risk of interstitial lung disease in Limited or diffuse

A

Diffusescleroderma

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18
Q

Risk of Pulmonary arterial hypertension in Limited or diffuse scleroderma

A

Limited crest

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19
Q

Homogenous on fluorescence antibodies

A

Anti dsdna/anti histone

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20
Q

Speckled on fluorescence antibodies

A

Anti ro
Anti la
Anti jo 1
Anti u1rnp

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21
Q

Antibodies peripheral on fluorescence

A

Antismith

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22
Q

Nuclear antibodies on fluorescence

A

Anti topoisomerase/Anti scl 70

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23
Q

Anti TPO Anti bodies in

A

Hashimotos thyroiditis decreased object in r a i u

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24
Q

LATS in

A

Graves

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25
Q

Autoimmune hepatitis antibodies

A

anti sm/anti lkm

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26
Q

Emperipolesis and Interface hepatitis seen in

A
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27
Q

Antibody for primary biliary cirrhosis

A

AMA

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28
Q

History of xanthelesma in young female with pruritus

A

Primary biliary cirrhosis

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29
Q

Osteopenia with fluoride duct lesions seen in

A

Primary biliary cirrhosis

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30
Q

Onion skin fibrosis around bile duct with beading seen in

A

Primary sclerosing cholangitis

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31
Q

p ANCA Seen in

A

1 Microscopic polyangitis
2 Eosinophilic granulomatous with polyangitis Also known as churg strassdisease

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32
Q

cANCA Seen in

A

Wegner’s Granulomatosis also known as granulomatosis with polyangitis

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33
Q

Anti sacchromisis cerviceas antibodies(ASCA) Seen in

A

Crohn’s disease

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34
Q

Most sensitive factor in rheumatoid arthritis is

A

RF

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35
Q

IgM against Fc of IgG is

A

RF

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36
Q

Full House effect seen in

A

Lupus nephritis

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37
Q

Fullhouse effect in lupus nephritis includes

A

IgM IgG IgA C3 C1q

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38
Q

Most common type of lupus nephritis in sle

A

Type four

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39
Q

face Legion in SLE

A

Malar rash

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40
Q

Malar rash includes or spares nasolabial fold

A

spares

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41
Q

Rosacea Includes or spares nasal labial Fold

A

Includes

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42
Q

Type of skin lesion in sle

A

Annular discoidlupus

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43
Q

Arthropathy in S L E erosive or non erosive

A

Non erosive

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44
Q

What type of arthropathy seen in sle

A

Jaccoud’s Arthropathy

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45
Q

jaccoud’s arthropathy Deforming or non deforming

A

Deforming

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46
Q

Criteria for SLE known as

A

new eular/acr

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47
Q

Entry criteria for S L E

A

A NA>1:80

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48
Q

Antibodies in immunologic domain of eular criteria

A

1anticardioloipin
2 anti beta 2 glycoprotien
3 lupus anticoagulant
4 anti dsdna
5 anti sm
6 ANA

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49
Q

APLA domain of regular include antibodies

A

1 anticardiolipin IgG >40
2 anti beta 2 glycoprotien IgG>40
3 lupus anticoagulant

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50
Q

How many points to diagnose SLE from new eular criteria

A

> 10

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51
Q

Scadding grading system for

A

Sarcoidosis

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52
Q

Garland sign lambda sign 123 sign Seen in

A

Sarcoidosis

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53
Q

What form lambda sin in sarcoidosis

A

b/l HiLar Lymph nodes and Right paratrocheal lymph node

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54
Q

A C E increased in which disease

A

Sarcoidosis

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55
Q

Lofgren’s syndrome include

A

Bilateral hila lymphedenopathy erythema nodosum
Arthritis

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56
Q

heerfordt Syndrom Include

A

Bilateral 7th nerve palsy
Anterior uveitis
Parotid gland hypertrophy

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57
Q

Sarcoidosis and uveo parotid involvement

A

mickulicz Syndrome

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58
Q

Bronco alveolar lavag CD4 : CD 8=5:1(>3.5:1)

A

Sarcoidosis

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59
Q

Normal Bronco alveolar lavag CD4:CD8=

A

2:1

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60
Q

kweim’s test For

A

Sarcoidosis

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61
Q

ACE raised >3.5 in

A

Sarcoidosis

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62
Q

Calcium increased in sarcoidosis due to

A

Granulomas increases 1 alpha hydroxylase
Active vit D

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63
Q

Antibodies against A C E Seen in

A

Sarcoidosis

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64
Q

Panda sign seen on

A

Gallium scan

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65
Q

Panda sign seen in

A

sarcoidosis

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66
Q

Panda sign same due to involvement of

A

Paroted glands nasopharyngeal glands

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67
Q

Most common ocular manifestation in sarcoidosis

A

Anterior uveitis

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68
Q

Eggshell calcification in lymph nodes seen in

A

Post radiotherapy lymph nodes Silicosis Sarcoidosis

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69
Q

What type of hypersensitivity in sarcoidosis

A

Type four

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70
Q

Crest syndrome include

A

Calcinosis cutis
Renaud’s phenomena
EsophagealDisorders Barrett’s GERD
Sclerodactyly
Telengiectasia

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71
Q

Flea e bitten kidney Seen in diffuse or limited sleoderma

A

Diffuse

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72
Q

Nail fold capillary scopy Done in

A

Scleroderma

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73
Q

Reynauds phenomena progression

A

w-b-r

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74
Q

Phallenges involvement in scleroderma

A

acroosteolysis
Dita challenges involvement

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75
Q

Schermer’s test used in

A

Dry eye sjogrens

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76
Q

Rose Bengal dye used in

A

Dry eye sjogrens

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77
Q

Systemic drugs for increasing secretions in sJogren’s

A

Oralpilocarpine 5mg tds
Cevimeline 30mg tds

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78
Q

Which anaemia is part of criteria for diagnosis of S L E

A

Autoimmune anaemia hemolitic

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79
Q

Which class of lupus nephritis gives 10 points in criteria for sle

A

Class three and four

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80
Q

Points in criteria for sle for lupus nephritis class two and five

A

Eight

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81
Q

Diagnosis of sJogren’s done by

A

Biopsy of lips for minor salivary glands showing lymphoplastic infiltration

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82
Q

Extra glandular manifestations of sJogren’s

A

Arthritis Reynolds phenomena vasculitis renal tubular acidosis lymphoma

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83
Q

What cell lymphoma seen in sjogrins

A

B cells

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84
Q

RTA which type seen in sJogrins

A

Type one

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85
Q

Management of arthritis in sJogrins

A

HCQ 200-400 mg/d
Methotrexate 0.2-0.3 mg/kg
Prednisolone<10 mg daily

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86
Q

Management of lymphoma in sJogrens

A

CHOP and Rituximab

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87
Q

Glandular manifestation of sJogren’s

A

dry eye Parotid enlargement dry mouth

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88
Q

Local stimulation of Secretions in sJogrens

A

camp
Cyclosporin
Castor/olive oil

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89
Q

Management of RTA in sjogren’s

A

Bicarbonates

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90
Q

Sausage shaped pancreas On CT seen in

A

IgG4 related disease

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91
Q

Lympho sclerosing Infiltrate disorder also known as

A

IgG4a RD

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92
Q

Only reversible type of pancreatitis seen in igG 4a

A

Auto immune pancreatitis

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93
Q

Triad of histopathology in I gG 4a

A

1 lymphoplasmocytic infiltration
2 Story from Fibrosis Basket Weave appearance
3 Obliterative phlebitis

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94
Q

Mayo clinic criteria for

A

IgG4a rd

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95
Q

Mayo clinic criteria includes

A

History
imaging
serology IgG4 >135
other organ involvement
biliary strictures
Retro peritonal fibrosis
Thyroid
Salivary glands
Orbital
response to steroids within 48 hours

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96
Q

Myopathies

A

1 Polymyalgia rheumatica
2 Inflammatory myopathies
3 Steroid induced myopathy
4 Statin induced myopathy
5 Hypothyroidism

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97
Q

Inflammatory myopathies

A

1 Dermato myositis
2 Polymyositis
3 Immune mediated necrotising myositis
4 Anti synthetase syndrome
5 Inclusion body myositis

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98
Q

Myopathies with raised esr

A

Polymyalgia rheumatica Inflammatory myopathy

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99
Q

Myopathy’s with raised CK

A

Inflammatory myopathies
Statin induced myopathy Hypothyroidism

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100
Q

Proximal weakness no pain normal esr normal ck history of drug intake

A

Steroid induced myopathy

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101
Q

Morning stiffness raised esr raised crp normal ck Shoulder hip pain

A

polymyalgia Rheumatica

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102
Q

Proximal pain and weakness raised esr raised ck

A

Inflammatory myopathies

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103
Q

Inflammatory myopathy with normal c k

A

Inclusion body myopathy

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104
Q

Pain no weakness raised c K Normal esr

A

Statin induced myopathy

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105
Q

Proximal pain and weakness delayed reflexes

A

Hypothyroidism

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106
Q

CD8 involvement in which inflammatory myositis

A

Polymyositis and inclusion body Myositis

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107
Q

CD4 involvement in which inflammatory myositis

A

Dermatomyositis and
anti synthetase syndrome

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108
Q

Rimmed Vacuoles Seen in which myopathy

A

Inclusion body myositis type of inflammatory myopathy

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109
Q

Endomysial Perivascular involvement in which myocytis

A

Polymyositis and inclusion body myositis

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110
Q

Perimysial and perivascular involvement in which myocytis

A

Dermatomyositis and anti synthetas esyndrome

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111
Q

Perifacicular atrophy

A

Dermatomyositis type of inflammatory myopathy

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112
Q

Heliotrope rash scene in

A

Dermatomyositis

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113
Q

Gottronn papules scene where

A

Knuckles

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114
Q

Gottron papules Scene in which disease

A

Dermato myositis

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115
Q

shawl sign sene wherell sign scene where

A

V sign on back of neck
Seen in Dermatomyositis

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116
Q

Hallmark of juvenile dermatomyocytes

A

gottron’s papules

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117
Q

FAIRMM Seen in

A

Anti synthetase syndrome

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118
Q

Features of anti synthetase syndrome are

A

Fever
arthritis
ILD
Reynolds phenomena
proximal muscle weakness
Mechanical hands
Anti amino acyl TRNA synthesase (anti Jo1antibody)

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119
Q

Anti amino acyl t rna synthase is
Seen in

A

jo1 Anti synthetase syndrome

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120
Q

Arthritis aspirates with wbc’s 200 to 5000

A

Osteoarthritis

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121
Q

Arthritis aspirants with wbc’s 5000 to 50,000

A

Inflammatory arthritis

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122
Q

Turbid arthritis aspirate with wbc’s more than 50,000

A

Septic arthritis

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123
Q

Rat bite erosion in first meta tarsophalangeal joint Seen in

A

Gout

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124
Q

Martel’s Sign seen in

A

Gout

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125
Q

Martel’s sign Shows

A

Large erosions with overhanging margins

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126
Q

Elderly alcoholic male with acute pain and redness in first Meta tarzo phalangel joint

A

Gout

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127
Q

Calcasinosis of meniscus in knee joint known as

A

Chondro Calcinosis

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128
Q

CHondro calcinosis seen In Gout or pseudo gout

A

Pseudogout

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129
Q

Arthritis aspirate showing needle shaped crystals negatively bifringent On polarised microscopy seen in

A

gout

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130
Q

Needle shaped crystals negatively by fringe on polarised microscopy made of

A

Mono sodium urate

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131
Q

Arthritis aspirate with rhombiide shaped crystals Positively bifringent on polarised microscopy seen in

A

Pseudogout

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132
Q

Rhombi shaped crystals positively bifurgent on polarised microscopy made of

A

Calcium pyrophosphate

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133
Q

Acute Gout Management

A

n s a I D S
Steroids
colchcine

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134
Q

Nssids Not given in AcuteGout

A

Aspirin Decreases uric acid Excretion
paracetamol Very low anti inflammatory effect

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135
Q

Allopurinol given in acute or chronic gout

A

Chronic

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136
Q

xanthine Oxidase Inhibitors

A

Allopurinol and Febuxostat

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137
Q

Anti govt drug given in Kala Azhar

A

Allopurinol

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138
Q

Mechanism of action of xanthine oxidase

A

Inhibit conversion of xanthine to uric acid

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139
Q

Mechanism of action of uricase enzyme

A

Convert uric acid to alantoin Which is soluble and easily excreted

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140
Q

Examples of uricase enzyme

A

Rasburicase
Pegloticase

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141
Q

Colchicine arrests Mitosis in which Phase
By what mechanism

A

Metaphase
Microtubule inhibition

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142
Q

Side effect of colchicine

A

diarrhoea severe
A granular cytosis

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143
Q

Drugs facilitating uric acid excretion(4)

A

probenecid
Sulfinpyrazone
Benxbromarone
Lesinurad

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144
Q

Chronic arthritis are divided into

A

Inflammatory and non inflammatory

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145
Q

Inflammatory chronic arthritis are(3)

A

Rheumatoid arthritis
psoriatic arthropathy
sle

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146
Q

Non inflammatory chronic arthritis are(3)

A

Osteoarthritis
Neuropathic joint Hemolytic arthropathy

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147
Q

Pseudo tumour due to collection of blood squared patella intercondyler notch widening seen in

A

Hemolytic arthropathy

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148
Q

Hemolitic arthropathy seen in what patient

A

x linked recessive boy young

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149
Q

Arthritis that looks bad doesn’t feel bad history of d M disorganisation density destruction debris distinction scene in

A

Neuropathic joint also known as charcot joint

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150
Q

Charcot joint Most common Joint involved

A

Mid tarsal joint

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151
Q

Heberdans nodules scene where
In

A

DIP
Osteoarthritis

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152
Q

Bouchard’s Nodules seen where
In

A

P I p
Osteoarthritis

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153
Q

Most common joint involved in osteoarthritis is

A

First carpometacarpal

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154
Q

Joint space reduction in osteoarthritis seen Most commonly where

A

Medial compartment

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155
Q

Asymmetrical large joints with Jointspace reduction Seen in

A

Osteoarthritis

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156
Q

No erosions but deformity present in joints in which disease

A

SLE
jacoud’s Arthropathy

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157
Q

Most common joint involved DIP and PIP with telescoping of digits marginal erosions with whiskering seen in

A

Psoriatic arthropathy

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158
Q

Most common cause of oligo arthritis

A

Psoriatic arthropathy

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159
Q

Most common joint involved metacarpopharyngeal with sparing of dip seen in

A

Rheumatoid arthritis

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160
Q

HLADR 4 associated with

A

Rheumatoid arthritis

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161
Q

Marginal erosion hallmark of

A

Rheumatoid arthritis

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162
Q

Bamboo spine scene in

A

Ankylosing spondylitis due to fusion of spine

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163
Q

Investigation of choice for ankylosing spondylitis is

A

MRI of SI joint

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164
Q

Most sensitive investigation For ankylosing spondylitis

A

MRI of S I joint

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165
Q

HLAB 27 associated with

A

Ankylosing spondylitis

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166
Q

Pain reduces on rest in inflammatory or noninflammatory arthritis

A

Non inflammatory

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167
Q

pain increases on rest in inflammatory or non inflammatory arthritis

A

Inflammatory increased morning stiffness

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168
Q

In ankylosing spondylitis pain increases on rest or on activity

A

On rest

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169
Q

Bilateral heel pain seen in

A

Ankylosing spondylitis

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170
Q

Bilateral heel pain in ankylosing spondylitis due to

A

Anthecytis Pain where tendon is inserted

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171
Q

3 Fusions
tram track Or dagger sign seen in

A

Ankylosing spondylitis

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172
Q

Ossification of anterior longitudinal ligament Known as
seen in

A

Flowing Ossification Seen in DISH

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173
Q

Arthritis associated with infection of champylobacter or klebsiella
G I Or STD infection

A

Reiter syndrome

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174
Q

Arthritis with circinate and keratoderma bleenorhagium

A

Reiter syndrome

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175
Q

Felty syndrome

A

Neutropenia RA splenomegaly

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176
Q

Specific dislocation in rheumatoid arthritis

A

atlanto axial

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177
Q

Most common ocular manifestation in rheumatoid arthritis is

A

keratoconjunctivitis sicca
Episcleritis
Scleritis complicated as scleromalacia perforance(bluish)

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178
Q

PneumocoNeosis With rheumatoid arthritis

A

Caplan syndrome

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179
Q

Management of acute flare of ra

A

Intra Lesional or intraarticular injection steroids l

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180
Q

Chronic R a management

A

1 dmards(triple therapy)
2 Biologicals

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181
Q

triple therapy in R A

A

Methotrexate Sulfasalazine Hydroxychloroquine

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182
Q

not given in pregnant female with R A

A

Methotrexate

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183
Q

Less than 16 year old oligo asymmetrical arthritis with uveitis

A

Juvenile idiopathic arthritis

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184
Q

what is stil’s disease

A

Systemic juvenile idiopathic arthritis With rash hepatosplenomegaly lymphedenopathy and uvitis

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185
Q

Are dmards given in ankylosing spondylitis

A

no

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186
Q

Are steroids given in ankylosing spondylitis

A

no

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187
Q

Drugs given in ankylosing spondylitis

A

Nsaids and biologicals

188
Q

Drugs given in scleroderma

A

Methotrexate
and microphenolate moffatill

189
Q

Scleroderma renal crisis management

A

ACE 1 inhibitors

190
Q

Endothelin inhibitors given in

A

P a h

191
Q

Ambricentan

A

Endothelin inhibitor

192
Q

Acute management of Gout

A

nsaid=indomethacin
colchicine(s/e)
steroids

193
Q

tophi/stones/>2 attacks per year

A

chronic gout

194
Q

allupurinol to be avoided with hla

A

hla b 5 *801

195
Q

allopurinol to be avoided with drugs=

A

azathioprine
6 mercaptopurine

196
Q

drug to be avoided with hla b*701

A

abacavir

197
Q

s/e hcq

A

irreversible retinal damage
blood dyscracias

198
Q

male infertility/oligospermia by which dmard

A

sulfasalazine

199
Q

Category X drugs in DMARDS

A

Methotrexate and leflunomide

200
Q

IGRA TEST is

A

Quantifier

201
Q

TB screening for which drugs

A

TNF Alpha inhibitors JAK inhibitors abatacept
Anakinra
1L 6 Inhibitors

202
Q

Citinib drugs are

A

JAK Inhibitors

203
Q

Co stimulation Inhibitor /CTLA 4 inhibitor is

A

Abatacept

204
Q

B cell depleter/CD20

A

rituximab

205
Q

IL 1r Antagonist

A

anakinra

206
Q

etanercept forms

A

Fusion protein between TNF Alpha and IgG Fc(ra factor against this)

207
Q

etenercept
Adalimu
Certolizu
Inflixi
Golimu are

A

TNF Alpha Inhibitors DMARD S

208
Q

tocilizuman
Sarilizumab are

A

IL6 Inhibitors

209
Q

Hepatitis B reactivation caused by which dmards

A

rituximab CD20 inhibitor

210
Q

How many classes of lupus nephritis

A

6

211
Q

Class of minimal Mesengial lupus nephritis

A

1

212
Q

Class of minimal proliferative lupus nephritis

A

2

213
Q

Class of focal lupus nephritis

A

3

214
Q

Class of diffused lupus nephritis

A

4

215
Q

Class of membranous lupus nephritis

A

5

216
Q

Glass of advanced sclerosing lupus nephritis or ckd like

A

6

217
Q

Wire loop lesion scene in which lupus nephritis

A

4 Defuse Lupus nephritis

218
Q

Renal replacement required in which class of lupus nephritis

A

6

219
Q

Management of sle Class 3 4 and 5 glupus nephritis

A

High doseglucocorticoids
Mycophenolate muffetal Or myophytic acid
Cyclophosphamide
Calcineurin inhibitor like tacrolimus then B lympho stimulator inhibitor belimumab
Rituximab

220
Q

High Dose of Prednisolone in sle lupus nephritis

A

1MG / KG/ day

221
Q

low dose Of glucocorticoid or prednisolone in sle lupus nephritis

A

0.3 mg/kg/d

222
Q

Full House effect in which class of lupus nephritis

A

4

223
Q

Sleep Dysfunction with tension headache with fatigue normal esr

A

Fibromyalgia

224
Q

Anterior trigger points in fibromyalgia

A

Knee
Lat epicondyl
Low cervical vertebra
Second ribs

225
Q

Posterior trigger points in fibromyalgia

A

Muscle insertion below back of head Supraspinatus Trapezius Hip

226
Q

Treatment of choice in fibromyalgia

A

Blood transfusion

227
Q

What type of hypersensitivity are vasculitis

A

Type four

228
Q

C anca Seen in

A

Wagner’s or gpa

229
Q

Vasculitis with granulomas(4)

A

Giant cell Arthritis or temporal arteritis
taka Yasu
Wagner’s or gpa
EGPA or churg strass

230
Q

p acne Seen in(2)

A

Microscopic polyangitis
EGPA/css

231
Q

Reno pulmonary syndrome seen in which vasculitis

A

Microscopic polyangitis
EGPA/css

232
Q

Immune complex in vasculitis seen in(4)

A

Henok sholien Purpura(hsp)
Sle
Polyarteritis nodosa Associated with Hepatitis B
Cryoglobinemia associated with Hepatitis C

233
Q

Most common vasculitis in adults(2)

A

Indiopathic cutaneous vasculitis giant cell arteritis/temporal

234
Q

Most common vasculitis in children overall
And in Asia

A

Henock sholein purpura
Kawasaki (anti endothelial cell antibody)

235
Q

Jaw Claudication Cord like superior temporal artery

A

Giant cell arteritis
Temporal arteritis

236
Q

Elastic degradation seen in which vasculitis

A

GCA or temporal

237
Q

Management of gca

A

Start steroids immediately to avoid anterior ischemic optic neuropathy

238
Q

Gold standard for diagnosis of GCA vasculitis

A

Biopsy of more than 1CM due to skip lesions

239
Q

Less than 40 year old female with bp difference between upper limb hypertension Vasculitis

A

taka Yasu Or Aorctic Arch syndrome

240
Q

Most common vessel involved in Takayasu

A

Left Subclavian artery

241
Q

Modify Sharma classification

A

Takayasu aortic arch syndrome

242
Q

In Takayasu left subclavian artery narrowing scene on

A

DSA

243
Q

Less than 35 year old smoker with limb pain

A

Thrombophlebitis obliterans

244
Q

Arteries affected in thrombophlebitis obliteran

A

Radial/ tibial

245
Q

Medium Vessel Vasculitis involving arteries vanes and nerves and lymphatics

A

Thrombophlebitis obliterance

246
Q

What cells are seen in Microapses in biopsy in thrombophlebitis obliterance

A

Neutrophils

247
Q

Corkscrew collateral scene in dsa

A

Thrombophlebitis obliterance

248
Q

Fibrinoid necrosis History of hypertension and Hepatitis B infection

A

Poly arteritisnodusa

249
Q

Pulmonary artery and glomeruli not involved in which vasculitis

A

PAN

250
Q

URTI /LRTI /kidneys involvement seen in which vasculitis

A

Wagner’s G P A

251
Q

I GA Mediated vasculitis

A

henock sholein purpura

252
Q

Saddle nose /strawberry gingiva/ Cavitatri lesions on hrct rpgn in kidney in which vasculitis

A

Wagner’s G P A

253
Q

Vasculitis associated with intusueception

A

HSP

254
Q

Non thrombocytopenic perpura with abdominal pain nephritis leukoclastic vasculitis seen in

A

H s p

255
Q

Oral genital ulcers
uveitis
patergy test
Seen in

A

Bechet’s disease

256
Q

Antibody against Alpha enolase seen in which vasculitis

A

bachet’s disease

257
Q

becet’sdisease associated with HL a

A

B51

258
Q

Spikes on Basel Electrical Rhythm Cause

A

Contraction in G I

259
Q

B E R Basel Electrical Rhythm causes or does not causes contraction

A

Not causing contraction

260
Q

Pacemaker cells of GI

A

Interstitial cells of cajal

261
Q

Minimum to maximum contraction rate in GI

A

Caecum 2 stomach 4 Sigmoid 6 Ilium 8 jejunam 11 Duodenum 12

262
Q

Migratory motor complexes seen in Fed state or hunger

A

Hunger also known as housekeeping

263
Q

Migratory motor complex caused by hormone

A

Motilin

264
Q

Motilin secreted by

A

M0 cells

265
Q

Function of segmentation and peristalsis

A

Segmentation for mixing terrestrial forward movement

266
Q

Contraction behind peristalsis caused by

A

Substance P acetylcholine

267
Q

Relaxation in front of bolus is caused by

A

VIP and NO

268
Q

Sweeping cleaning rate of intestine mmc

A

5 centimetre per minute

269
Q

Antimicrobial Causing increase in Motilin

A

macrolides

270
Q

enterogastric reflex is

A

inhibition of stomach by distenstion of intestine

271
Q

Enterogastric increases

A

CCK Secretin peptide y
Fat>carb>protein
Acidity
Osmolarity

272
Q

colonic contraction on gastric distension

A

Gastrocolic reflex seen in babies

273
Q

Most common colon nvolved in gastrocolic reflex is

A

Sigmoid

274
Q

Relaxation of ileocal valve due to gastric distinction

A

gastroel reflex

275
Q

G I reflexes seen in babies

A

gastrocolic and gastro illiel

276
Q

Hormone increasing gastric acid secretion or gastric motility

A

Gastrin

277
Q

Hormones decreasing gastric acid secretion or gastric motility or gastric emptying(4)

A

Somatostatin decreasing acid
CCK decreases emptying
secreten decreases acid and emptying
glp decreases acid and emptying

278
Q

Hormone increasing satiety

A

Glucose dependent insulinotropic peptide glp

279
Q

Hormone increasing hunger appetite

A

Grhelin

280
Q

Hormone increasing intestinal electrolyte and water secretion and relaxing smooth muscles and Sphincters

A

VIP Vaso active intestinal polypeptide

281
Q

Hormone increasing pancreatic bicarbonate secretion

A

secritin

282
Q

Hormone increasing insulin secretion from pancreas

A

GLP and C C K

283
Q

Hormone increasing board by carbonate and hormones and Enzymes Secretion from pancreas

A

CCK

284
Q

Hormones increasing bile acid secretions

A

CCK and Secretin

285
Q

Prader Villa syndrome increases with hormone in G I

A

ghrelin

286
Q

gastrin secreted by

A

G cells in stomach and Deodenum

287
Q

SomatoStatin secreted by

A

D cells Pancreatic islet Cells

288
Q

C C K produced from which cells

A

Icells in stomach duodenum jejunum

289
Q

Secretin secreted by

A

S sells In Duodenum

290
Q

G L P secreted by

A

K cells
Duod jejumun

291
Q

VIP secreted by

A

Parasympathetic ganglion

292
Q

Grelin secreted by

A

Stomach

293
Q

Maximum potassium secreted in which

A

Saliva

294
Q

Maximum concentration of potassium secreted in Which gi fluid

A

Colon

295
Q

Increasing sodium flow rate in which GI fluid

A

Saliva

296
Q

Increasing HCL in which G Ifluid

A

Stomach

297
Q

Maximum bicarbonate secreted in which G I fluid

A

pancreas

298
Q

Most alkaline secretion in G I

A

Bruner’s gland in Duodenum

299
Q

ACH acting on which receptors to increase acid secretion in stomach

A

M receptors

300
Q

gastrin acts on which cells to increase hcl secretion

A

ECL
C C K receptors

301
Q

Vegas now increase gastron roof G cells by acting on

A

GRP

302
Q

CCK receptors and M1 receptors increase hcl through gs or gq

A

GQ

303
Q

His stumbling is released in GI by

A

Ecl cells

304
Q

Histamine to increase HCL secretion acts on H 1 receptors or H2 receptors

A

H2 receptors

305
Q

h two receptors at via G S or G Q to increase hcl secretion

A

G S

306
Q

G I activated by somato statin and prostaglandin causes what in stomach on H C L

A

Inhibition of HCL Secretion by inhibition of proton pump

307
Q

Atropine increases or decreases hcl secretion

A

Inhibits ACH so decreases

308
Q

What causes milk alkali syndrome

A

Calcium carbonate

309
Q

Antacid aluminium hydroxide and magnesium hydroxide used together

A

Magnesium hydroxide causes diarrhoea and aluminium hydroxide causes constipation

310
Q

Hit and run mechanism in antacids

A

Ppi’s blog for 24 hours

311
Q

Allergic interstitial nephritis is a side effect of witch antacid

A

ppi

312
Q

C defficle infection

A

PPI

313
Q

Increased fracture risk by which antacids

A
314
Q

B twelve deficiency by which antacids

A

PPI’s

315
Q

UlceroProtective coat are formed by which two drugs

A

Bismuth
Sucralfate

316
Q

Rustic land in analogue for decreasing hcl production

A

Nsaids Induced peptic ulcer

317
Q

Triple drug therapy in peptic ulcers

A

CAP clarithromycinamoxicillin ppi

318
Q

Iron absorption in

A

duodenum

319
Q

Trefoil peptide secreted by

A

Mucus cells for stability of bicarbonate

320
Q

Conversion of ferric to Ferrous on Luminal side

A

Duodenal
cytochrome B

321
Q

Absorption of ferrous by

A

DMT 1

322
Q

Conversion of ferrous to ferric on Capillary side in intestine bye

A

hephastin

323
Q

Absorption of ferrous on capillary side by

A

feroportin 1

324
Q

Ferroportin 1 inhibited by

A

hepcidin

325
Q

Ferric travels in blood by

A

transferrin

326
Q

What is affected in anaemia of chronic disease

A

Increase hepcidin

327
Q

In which form is iron stored in bone marrow and liver

A

Ferric/ferritin

328
Q

Heptocorrin secreted by
Protects in
digested in

A

Saliva stomach intestine

329
Q

Intrinsic factor produced in combines in
absorbs in

A

Stomach
small intestine
ileum

330
Q

Ferrous absorption decreases by what food products

A

Phytic acid
tannic acid
milk due to competition with calcium

331
Q

Ferrous absorption increases by what food products

A

HCL Vitamin C amino acids

332
Q

CYP inhibitor antacidcausing gynecomastia

A

Cemetidine
H2 blocker

333
Q

Famotidine nizatidine

A

H2 Blockers

334
Q

Drugof choice for peptic Ulcer

A

P P I

335
Q

What opioid receptor causes Constipation

A

Mu

336
Q

Racecodotril causes

A

Inhibition of opioid metabolism by inhibiting enkephalinase

337
Q

enkephalinase inhibitor

A

rececodotril

338
Q

mu agonist for diarrhoea

A

Loperamide

339
Q

Bulk forming substance for constipation

A

Methylcellulose

340
Q

Osmotic substance used for constipation

A

Lactulose
PEG

341
Q

bisacodyl acts by

A

bowel movement stimulation

342
Q

senna acts by

A

Bowel movement stimulation

343
Q

Lubiprostone Acts by Used in

A

Chloride channel activator

344
Q

Linaclotide Acts by Used in

A

cGMP agonism Used inConstipation

345
Q

pLecanatide Acts by used in

A

cGMP agonist Used in constipation

346
Q

prucalopride acts by
Used in

A

5 HT 4 agonist used in constipation

347
Q

Tenapenor Act by Used in

A

Sodium hydrogen exchanger Used in constipation

348
Q

For post of ilieus drugs used are

A

Peripheral opioid inhibitors
avlimopam
Naloxegol
Methylnaltrexone

349
Q

Central opioid inhibitors can block

A

Respiration

350
Q

Melanosis coli or pigmentation of colon caused by

A

senna

351
Q

Main receptors in brain stem for vomiting centre are

A

5HT3/D2

352
Q

Stimulator of 5 HT 3 and D 2

A

area postrea/ctz

353
Q

5HT3 D2Inhibitors are

A

Ondensatron Gransatron

354
Q

Drug of choice for Early onset post op post rt post chemo vomiting

A

Ondensatron Gransatron

355
Q

Ondensatron Gransatron Side effects

A

Headache QT prolongation constipation

356
Q

Drug of choice for delayed vomiting in cisplatin

A

NK Substance P inhibitors
Aprepitant

357
Q

Aprepitant is

A

Substance P NK Inhibitors

358
Q

Drug of choice for morning sickness

A

doxilamine+B6

359
Q

Drug of choice for mountain sickness

A

Acedazolamide

360
Q

Drug of choice for sea sickness

A

Antihistamine meslizine

361
Q

Drug of choice for motion sickness

A

hyoscine

362
Q

Metoclopramide acts by(2)

A

D2 Blocker
5HT4 agonist Used in gastroparesis

363
Q

Mechanism of action of Dom Peridon

A

D2 blocker

364
Q

Does metaclopramide crosses blood brain barrier

A

yes Extra pyramidal side effects present causes prolactinemia

365
Q

Does domperidone crosses blood brain barrier

A

No

366
Q

Hyperventilation on altitude causes metabolic alkalosis or metabolic acidosis

A

Metabolic alkalosis due to washout of CO2

366
Q

Drug of choice for Levodopa induced vomiting

A

domperidone

367
Q

Saag stands for

A

Serum ascites albumin gradient

368
Q

S a A G relation to portal hypertension

A

Directly proportional

369
Q

When S AA G< 1.1g/dl Portal hypertension present or not

A

no

370
Q

S AA G< 1.1g/dl Frothy urine

A

Nephrotic syndrome

371
Q

S AA G< 1.1g/dl Fever weight loss

A

TB Ascetic albumin increased

372
Q

S AA G< 1.1g/dl Elderly weight loss

A

Malignancy

373
Q

Acute pain S AA G< 1.1g/dl

A

Pancreatitis

374
Q

S A A G >1.1 g/dl Portal hypertension present or not

A

Present

375
Q

S A A G >1.1 g/dl
ascetic protein >2.5g/dl(3)

A

bud chiari Syndrome( I V C blocked)
Constructive pericarditis
restrictive cardiomyopathy

376
Q

S A A G >1.1 g/dl
Asitic protein. <2.5g/dl

A

cirrhosis

377
Q

Volume of asitis visible on usg

A

50ML to 100ML on E fast

378
Q

Shifting dullness in ascitis seen In volume

A

500ML

379
Q

Fluid thrill in asitis seen in volume

A

1500 ml

380
Q

only usg Detection Mild Ascitis Management

A

Salt restriction

381
Q

Moderate asitis with usg detection and abdominal Distension management

A

First line furosemide spironolactone eplerenone

382
Q

Spironolactone side effect

A

Gynecomastia Refractive

383
Q

Severe acsitis with respiratory distress Management

A

High volume paracentesis >2.5l
Album and supplementation for 6 to 8 g/L Fluid removed

384
Q

Less than two weeks of diarrhoea is acute or sub acute

A

Acute diarrhoea

385
Q

Acute diarrhoea less than 6 hours history of Chinese food

A

B Ceres

386
Q

Acute diarrhoea less than six hours history of dairy product

A

s aureus

387
Q

diarrhoea more than six hours history of travel

A

ETEC

388
Q

Rice water diarrhoea more than six hours

A

Vibrio cholera

389
Q

diarrhoea more than six hours history of shellfish eating

A

Vibrio parahemolyticus

390
Q

diarrhoea more than six hours history of camping persistent diarrhoea malabsorption

A

giardia

391
Q

Acute right iliac fosa pain diarrhoea more than six hours

A

yersinia pesudoappendicitis

392
Q

NTS Pharyngeal stimulation by

A

9th nurve

393
Q

NTS Stimulation by gastric mucosa by

A

Tenth n

394
Q

More than six hours of diarrhoea history of antibiotic intake

A

c.defficle

395
Q

Bloody diarrhoea history of Poultryand egg

A

Salmonella

396
Q

Bloody diarrhoea history of severe dehydration and febrile seizures

A

Shigela

397
Q

Bloody diarrhoea associated with GB S Or retire syndrome

A

campylobacter

398
Q

Hot campfire skirrow’s associated with

A

Campylobacter

399
Q

Bloody diarrhoea associated with anaemia uremia

A

hemoliticuramic syndrome by EHEC

400
Q

Bloody diarrhoea associated with flask shaped ulcers

A

Entamoeba Histolytica

401
Q

Bloody diarrhoea with longitudinal ulcers

A

Typhoid

402
Q

Bloody diarrhoea with transverse ulcers

A

TB

403
Q

Diagnostic form of giardia

A

trophozoit

404
Q

Infective form of giardia

A

Cyst form

405
Q

Chronic diarrhoea more than how many weeks

A

4weeks

406
Q

Stool osmotic gap Formula

A

290-2×[stool Na +stool K]

407
Q

If stool osmotic gap more than fifty what type of diarrhoea

A

Osmotic

408
Q

If stool osmotic gap less than 50 then what type of diarrhoea

A

Secretory

409
Q

Causes of chronic Secretary diarrhoea

A

Z E S Carcinoid syndrome

410
Q

Osmotic diarrhoea with stool osmotic gap more than 50 and positive hydrogen breath test

A

Lactose intolerance

411
Q

Stool osmotic gap Decreases Or increases on fasting

A

Decreases

412
Q

Next step for osmotic diarrhoea after hydrogen breath test

A

stool fat Content

413
Q

In osmotic diarrhoea if stool fat percent more than seven Next step

A

d xylose test

414
Q

what is d xylose test

A

Ring radioactive D xylose
If proper absorption excreted in urine

415
Q

Osmoticdiarrhoea with stool fat more than 7% d xylose test normal

A

Pancreatitis where only fat absorption reduced

416
Q

Asthmatic diarrhoea stool fat more than 7% be xylose test abnormal differentials(2)

A

Bacterial overgrowth syndrome or small intestine bacterial over growth(BOGS/SIBO)
Mucosal disease like tropical sprue celiac disease or abetalipoproteinemia

417
Q

In case of D xylos test abnormal In osmotic diarrhoea with 7% stool fat next step

A

Rifaximin for 7 days

418
Q

Rifaximin for 7 days results in normal absorption diagnosis

A

BOGS/SIBO

419
Q

Rifaximin For seven days results in abnormal absorption again diagnosis

A

Mucosal disease like tropical sprue celiac disease a bitter lipoproteinemia next step biopsy

420
Q

HLADQ 2 associated with

A

Celiac sprue

421
Q

Most affected part of intestine in celiac sprue to be biopsied

A

Duodenum

422
Q

Antibody in celiac sprue against

A

gliadin/gluten form

423
Q

Enteropathy Associated T cell lymphoma seen

A

celiac sprue

424
Q

Celiac sprue involvement of CD4 or CD8

A

CD8

425
Q

Dermatitis herpetiformis associated with

A

celiac sprue

426
Q

Which immunoglobulin involved in celiac sprue cutaneous form

A

IgA

427
Q

what to avoid in celiac sprue

A

Barely rye oat wheat

428
Q

PAS positive diastase resistance Foamy macrophages cardiac Manifestation Arthralgia neurological manifestations(CAN)

A

Trichopherma whepelli

429
Q

Pass the can of Foamy whipped cream

A

t.whepelli

430
Q

Foamy macrophages on electron microscope in GI with acid fast basili

A

TB

431
Q

Transmural involvement in ulcerative colitis or Crohn’s disease

A

Crohn’s disease

432
Q

Skip legions present in ulcerative colitis or Crohn’s disease

A

Crohn’s disease

433
Q

Structures commonly present in Ulcerativecolitis or Crohn’s disease

A

Crohn’s disease

434
Q

p anca present I Ulcerative colitis or Crohn’s disease

A

Ulcerative colitis

435
Q

ASCA Present in ulcerative colitis or Crohn’s disease

A

Crohn’s disease

436
Q

Hustrations gone on Barium Swallow lead pipe appearance seen in ulcerative colitis or Crohn’s disease

A

Ulcerative colitis

437
Q

Cobblestone appearance aphthous Ulcers seen in ulcerative colitis or Crohn’s disease

A

Crohn’s disease

438
Q

Crypt abscess are hallmark of Ulcerative colitis or Crohn’s disease

A

Ulcerative colitis

439
Q

Non casseating granulomas and can have Crypt abscess

A

in Crohn’s disease

440
Q

True love wit classification for

A

Ulcerative colitis

441
Q

Montreal classification

A

Crohn’s disease

442
Q

Management of Crohn’s disease

A

First steroids second biologicals 3rd surgery not usually done as skip lesions present

443
Q

Management of ulcerative colitis

A

1st 5 as a sulfasalazine osalazine have azo bond
Second steroids
3rd surgery total proctocolectomy Followed by illian pouch anal anastomosis

444
Q

Most common side of Crohn’s disease involvement

A

Terminal ileum

445
Q

Most common site of involvement in ulcerative colitis start

A

Rectum

446
Q

Mucusel granularity on barium swallow seen

A

Ulcerativecolitis

447
Q

Pseudo polyps seen in ulcerative colitis or Crohn’s disease

A

Ulcerative colitis

448
Q

String sign of Cantor seen in

A

Crohn’s disease
Terminal ileus structure

449
Q

comb sign Is
Seen in

A

Increased inflammation vasarecta opens up
Seen in Crohn’s disease

450
Q

Extra particular manifestation of I B D that responds to treatment of I B D

A

Peripheral arthritis
erythema nodosum
Episcleritis

451
Q

Extraarticular manifestation of I B D that does not respond to IBD treatment

A

Axial arthritis Pyoderma Gangrenosum necrotic neutrophilic
Primary Sclerosingcholangitis
Uveitis

452
Q

Fluoride lesion around duct mrcp normal young female pruritis xenthelasma osteopenia

A

Primary biliary cirrhosis

453
Q

Onion skin lesion around duct beaded appearance on MRCP elderly male IBD ulcerative colitis or Crohn’s disease present with jaundice

A

Primary Sclerosing cholangitis

454
Q

Alcoholic AST>ALT(twicw=AST/ALT=2)
mallory denk bodies
CK 8/18
Intermediate filaments

A

Alcoholic hepatitis

455
Q

councilman bodies apoptotic bodies portal track expansion
A LT raised more than AST

A

HCV infection

456
Q

What value of Maddry Discriminant function should steroids be started

A

> 32

457
Q

emperipolisis Interface Hepatitis AntiSM antibody Anti LKM1 antibody

A

Autoimmune hepatitis

458
Q

Anti LKM1 antibody Associated with

A

Autoimmune hepatitis

459
Q

Saag>1.1 + Neutrophil>250/mm3

A

Spontaneous bacterial peritonitis

460
Q

drug of choice for spontaneous bacterial peritonitis

A

Cefotaxime

461
Q

Antimitochondrial antibody Seen in

A

Primary billiary cirrhosis

462
Q

CK8/18
Intermediate filaments involved in

A

Alcoholic hepatitis

463
Q

Mallory denk in bodies seen in

A

Alcoholic Hepatitis and Indian child cirrhosis

464
Q

Transamination reactions
co Factor

A

AST/ SGOT = Aspartate to oxaloacetate
ALT /SGPT= alanin to pyruvate
PyridoxineB6

465
Q
A

AM (12 decks)

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