SBAs

Question 1

Which cancer can the Bruton Tyrosine kinase inhibitor ibrutinib be used in?

a. Bruton’s
b. Chronic myeloid leukaemia (CML)
c. Acute myeloid leukaemia (AML)
d. Acute lymphoblastic leukaemia (ALL)
e. Chronic lymphoblastic leukaemia (CLL)

Answer 1

CLL

Bruton’s is not a cancer!!

Question 2

A Rhesus D negative woman is having a Haematopoietic stem cell transplant (HSCT) and is CMV IgG negative. What is the most important thing to ensure in the transplant?

a. HLA of donor and recipient identical
b. Related to recipient and HLA identical
c. HLA haploidentical
d. CMV IgG negative
e. Donor not Rhesus match

Answer 2

CMV IgG negative

Question 3

Mechanism of Graft vs Host disease

Answer 3

Lymphocytes from donor blood attack host tissues.

Question 4

HIV RNA forms HIV, via which error prone enzyme?

a. RNA polymerase
b. DNA polymerase
c. RNA transcriptase
d. Reverse transcriptase

Answer 4

Reverse transcriptase

Question 5

Which vaccine must not be given to a pregnant woman

Answer 5

MMR - contains live rubella vaccine

Question 6

Which cell in the body binds to MHC1 presenting cells

Answer 6

CD8+ cells (aka Killer T cells, T-killer cells, cytotoxic cells, CD8+ T cells)

Question 7

which biologic treatment can be used to treat some malignancies and affects T cell activity?

Answer 7

Rituximab - targets B cells and causes inactivation of T cells

Question 8

10 yo Nigerian boy with a neck swelling. Staining shows a starry sky appearance

Answer 8

Burkitt’s lymphoma

Question 9

Which of these is a common finding in someone who has portal hypertension?

a. Splenomegaly
b. Hepatomegaly
c. Spider Naevi in distribution of Superior vena cava (SVC)
d. Hand flapping
e. Jaundice

Answer 9

Splenomegaly - blood gets backed up into spleen due to cirrhosis

Question 10

Which cancer does asbestos cause?

Answer 10

Mesothelioma

Question 11

Recurrent mouth/lip swelling following dental procedures. Doesn’t get better with antihistamines. Is on ACE inhibitors.

Answer 11

C1 inhibitor deficiency - hereditary angioedema

Question 12

Where do transitional cell cancers metastasise from?

Answer 12

Bladder

Question 13

Most specific marker for Rheumatoid arthritis

Answer 13

Anti-cyclic citrullinated protein

Question 14

Most common benign ovarian tumour in those over 25

Answer 14

Serous cystadenoma

Question 15

Most common malignant tumour in those over 25

Answer 15

Serous carcinoma

Question 16

Most common benign ovarian tumour in those under 25

Answer 16

Teratoma / dermoid cyst

Question 17

Anti thrombotic factor secreted by the wall of vessels

Answer 17

Thrombomodulin

Question 18

Best investigation to confirm suspected Cushing’s

Answer 18

High dose dexamethasone suppression test

Question 19

Vector for Trypanosoma brucei rhodesiense (African sleeping sickness)

Answer 19

Tsetse fly

Question 20

Number of true positives divided by total number of those who have the disease

Answer 20

Sensitivity

Question 21

non-chronic hepatitis

Answer 21

Hepatitis A

Question 22

Anti-coagulation used in pregnancy

Answer 22

Low Molecular Weight Heparin

Question 23

Can cause peri/neonatal illness without causing damage to the foetus if mother is infected antenatally

Answer 23

Enterovirus

Question 24

Child/infant with nephrotic syndrome

Answer 24

minimal change disease

Question 25

Someone of African American or Hispanic ethnicity with nephrotic syndrome

Answer 25

Focal segmental glomerulonephritis

Question 26

child presents with cola-coloured urine and periorbital swelling. They had a throat infection 2 weeks ago

Answer 26

post-streptococcal glomerulonephritis

Question 27

haematuria, oiliguria and low GFR. Light micrscopy shows a crescent shape in the glomeruli.

Answer 27

Rapidly progressive glomerulonephritis

Question 28

50 yo man with a midshaft femur fracture - what cancer has caused this?

Answer 28

chondrosarcoma

if young person them osteosarcoma (sunburst appearance on xray) or ewing’s if malignant (“onion-skin” appearance on xray)

Question 29

most common cause of hospital acquired pneumonia

Answer 29

Pseudomonas aregenosa

Question 30

Most common cause of jaundice and fever in the returning traveller

Answer 30

malaria

Question 31

liver biopsy reveals portal hepatitis and granulomatous destruction of the bile ducts

Answer 31

Primary biliary cholangitis (anti-mitrochondrial antibodies)

Question 32

smudge cells

Answer 32

CLL