RNS Flashcards
Tumour marker - neuron specific enolase
Neuron-specific enolase (NSE) is an acidic protease unique to neurons and neuroendocrine cells. It is a sensitive indicator for assessing the severity of nerve cell damage and prognosis. It is also specific markers for tumors such as NEUROBLASTOMA and SMALL CELL LUNG CANCER
What do you have to be wary of in a patient with right ventricular infarction?
Nitrates can cause profound hypotension and cardiogenic shock
A 67 year old lady presents with stiffness and swelling of her hands. Which of the following features is most suggestive of Osteoarthritis over Rheumatoid Arthritis?
A. Involvement of the 1st carpometacarpal joint
B. Involvement of the proximal interphalangeal joints
C. Her age
D. Involvement of the distal interphalangeal joints
E. Asymmetry in presentation
A. Involvement of the 1st carpometacarpal joint
Artery involved in amaurosis fugax
- Form of TIA leading to transient monocular vision loss lasting seconds to minutes
- Retinal ischaemia
- IPSILATERAL SEVERE INTERNAL CAROTID ARTERY STENOSIS
Ophthalmic artery
Refeeding syndrome symptoms
Symptoms
- Muscle weakness
- Peripheral neuropathy
- Neurological impairment
- Myocardial depression
Drop in phosphate (most prominent), magnesium, potassium and fluid accumulation which in combination can lead to cardiac failure
Which antiretroviral has been associated with neural tube defects in fetuses of women taking the drug? A. Raltegravir B. Darunavir C. Atazanavir D. Dolutegravir E. Efavirenz
D. Dolutegravir
Which of the following conditions will NOT reduce the specificity of PET scans for the detection of malignancies? A. Adrenal hyperplasia B. Infection C. Insufficiency fracture D. Hyperglycaemia E. Sarcoidosis
D. Hyperglycaemia
- Will increase false negative and decrease sensitivity
- Tumour uptake of FDG is reduced in the presence of hyperglycaemia as glucose competes with FDG for uptake by the membrane transporter proteins.
- In order to prevent false negative, will need to fast for 4-6 hours prior to procedure
A 75-year-old man presents with back pain and weight loss. He reports recent weight loss of 12 kilograms in 4 weeks and poor appetite.
On examination, he is a thin man with no focal neurological deficits. He has point tenderness over his thoracic vertebrae.
A CT scan of his spine reveals widespread bony metastatic disease. There are expansile lesions in multiple thoracic vertebrae. There is no current radiological evidence of spinal cord impingement. Further imaging, shows a locally invasive tumour in the pelvis and a diagnosis of metastatic prostate cancer is made. He has a serum prostate specific antigen level of 467ng/mL (normal < 5.5).
Which of the following is the most appropriate first-line therapy?
A. Flutamide (anti-androgen)
B. Goserelin (GNRH agonist)
C. Zoledronic acid
D. Mitoxantrone-based chemotherapy
E. Taxane based chemotherapy
A. Flutamide (anti-androgen)
As patient has bony disease, need to use anti-androgen first before GnRH to prevent flare
60 year old man’s echocardiogram shows a dilated left ventricular (LV) cavity with the remainder of the other chamber sizes normal.
Which of the following is the most likely diagnosis?
A. Aortic regurgitation (AR)
B. Aortic stenosis (AS)
C. Hypertensive heart disease
D. Mitral regurgitation (MR)
E. Mitral stenosis (MS)
A. Aortic regurgitation (AR)
AR = dilated left ventricle
MR/AS/HTN = hypertrophy and smaller LV cavity
What artery do you think of if there is a 3rd nerve palsy?
Posterior communicating artery aneurysm
A 39-year-old woman presents to the emergency department with chest pain and ECG changes suggestive of an anterior myocardial infarction. She is transferred for primary angiography, and appearances are consistent with spontaneous coronary artery dissection (SCAD). Which of the following is CORRECT regarding SCAD?
A. SCAD is more common in men
B. The most common presenting symptom with SCAD is back pain
C. Evidence indicates that medical therapies should be given to SCAD patients as per STEMI guidelines, regardless of the presence of atheroma
D. Percutaneous coronary intervention (PCI) has less than 50% reported success rate with SCAD treatment
E. SCAD is not associated with recurrent cardiovascular events
D. Percutaneous coronary intervention (PCI) has less than 50% reported success rate with SCAD treatment
CPAP (Continuous Positive Airways Pressure) in Obstructive Sleep Apnoea has been to shown to improve all of the following parameters EXCEPT: A. Reduction in cardiovascular events B. Cognitive function C. Depression D. Hypertension E. Blood glucose control
A. Reduction in cardiovascular events
Onset of action for hypercalcaemia treatment
IV fluids: during infusion Bisphosphates: 24-72 hours Calcitonin: 4-6 hours Cinacalcet: 2-3 days Steroids: 2-5 days
QUESTION 4 Tacrolimus is commonly used as part of the immunosuppressive regimen for transplant recipients. Which of these is NOT a side effect of this medication? A. Hypertension B. Diabetes mellitus C. Diarrhoea D. Hypercholesterolaemia E. Venous thrombosis
E. Venous thrombosis
Which of these haematological disorders is not associated with a paraproteinemia? A. Chronic lymphocytic leukaemia B. Lymphoplasmacytic lymphoma C. Primary amyloidosis D. Chronic myeloid leukaemia E. Multiple myeloma
D. Chronic myeloid leukaemia
