session_8_cpq3_flashcards
A 76yo man presents with symptomatic anaemia, undergoes a bone marrow examination, and a diagnosis of myelodysplastic syndrome is made. With respect to the Revised International prognostic scoring system, rank the following findings in order of poor prognostic significance (worse prognostic marker scores 1, least bad prognostic marker scores 5):
1) Bone marrow blast cell count of 17%
2) An intermediate karyotype/cytogenetics (eg. deletion of long arm of 7th chromosome)
3) A blood platelet count of 80 x 109/L
4) Haemoglobin concentration of 112 g/L
5) Known history of diabetes
1) Bone marrow blast cell count of 17%, 2) An intermediate karyotype/cytogenetics (eg. deletion of long arm of 7th chromosome), 3) A blood platelet count of 80 x 109/L, 4) Haemoglobin concentration of 112 g/L, 5) Known history of diabetes
An 80yo woman presents with tense fluid filled flexural bullae. Rank the following in order of most likely diagnosis:
1) Bullous pemphigoid
2) Pemphigus vulgaris
3) Pemphigus foliaceus
4) Traumatic blisters
5) Pemphigoid gestationis
1) Bullous pemphigoid, 2) Pemphigus vulgaris, 3) Pemphigus foliaceus, 4) Traumatic blisters, 5) Pemphigoid gestationis
A 26yo woman presents with facial swelling, and fixed elevation of the external jugular vein. She has a persistent cough and a 4 month history of drenching night sweat. This histology report from a mediastinal mass biopsy is most likely to show which of the following? Rank in order of likelihood:
1) Hodgkin lymphoma
2) T cell lymphoblastic lymphoma
3) Diffuse large B cell Non Hodgkin lymphoma
4) Acute myeloid leukaemia
5) Mycosis fungoides
1) Hodgkin lymphoma, 2) T cell lymphoblastic lymphoma, 3) Diffuse large B cell Non Hodgkin lymphoma, 4) Acute myeloid leukaemia, 5) Mycosis fungoides
A 56yo woman presents with hepatosplenomegaly and generalised lymphadenopathy. Rank the following in order of likelihood of being the final diagnosis:
1) CLL
2) Hodgkin lymphoma
3) CML
4) ALL
5) Primary myelofibrosis
1) CLL, 2) Hodgkin lymphoma, 3) CML, 4) ALL, 5) Primary myelofibrosis
A 49yo man presents with haemoptysis. On imaging, he has a mediastinal lymphadenopathy and is referred for EBUS-TBNA of the lymph nodes. List the sequence of events in order as they would occur:
1) Rapid on site evaluation by cytopathologist of endoscopic sample
2) Adenocarcinoma diagnosed
3) Sample processed and cell block made
4) EGFR mutation detected
5) Targeted chemotherapy commenced
1) Rapid on site evaluation by cytopathologist of endoscopic sample, 2) Adenocarcinoma diagnosed, 3) Sample processed and cell block made, 4) EGFR mutation detected, 5) Targeted chemotherapy commenced
A previously healthy 65yo patient develops a painful vesicular rash with a T8 dermatomal distribution. Rank in order of appropriateness (in terms of cost and efficacy according to NICE) which antiviral treatments are indicated:
1) Aciclovir po, 800mg 5x daily
2) Valaciclovir po, 1g 3x daily
3) Aciclovir iv 10mg/kg 3x daily
4) Foscarnet iv infusion, 60mg/kg every 8 hours
5) Oseltamivir po, 75mg 2x daily
1) Aciclovir po, 800mg 5x daily, 2) Valaciclovir po, 1g 3x daily, 3) Aciclovir iv 10mg/kg 3x daily, 4) Foscarnet iv infusion, 60mg/kg every 8 hours, 5) Oseltamivir po, 75mg 2x daily
A 14 year old boy complains of pain and swelling around the knee. The X-ray show as single lesion that is worrying for malignancy. Rank the following diagnoses in order of likelihood with 1 being the most likely:
1) Osteosarcoma
2) Ewing’s sarcoma
3) Metastatic neuroblastoma
4) Osteomyelitis
5) Metastatic lung cancer
1) Osteosarcoma, 2) Ewing’s sarcoma, 3) Metastatic neuroblastoma, 4) Osteomyelitis, 5) Metastatic lung cancer
Rank the following Beta-lactam antibiotics in order of spectrum of activity from narrow (1) to broad (5):
1) Benzylpenicillin
2) Amoxicillin
3) Co-amoxiclav
4) Piperacillin / tazobactam
5) Meropenem
1) Benzylpenicillin, 2) Amoxicillin, 3) Co-amoxiclav, 4) Piperacillin / tazobactam, 5) Meropenem
Rank the following in order of likelihood of being followed by further recurrent thromboses:
1) Male with idiopathic thrombosis with no clear precipitant
2) Female with idiopathic thrombosis with no clear precipitant
3) Thrombosis following 4 hour flight
4) Thrombosis whilst taking COCP (and then discontinuing)
5) Thrombosis following surgery
1) Male with idiopathic thrombosis with no clear precipitant, 2) Female with idiopathic thrombosis with no clear precipitant, 3) Thrombosis following 4 hour flight, 4) Thrombosis whilst taking COCP (and then discontinuing), 5) Thrombosis following surgery
A 40yo woman with diabetes and heavy periods complains of breathlessness. Examination bibasal creps. Rank in order of likelihood that the investigation will be useful:
1) FBC
2) CXR
3) Echocardiogram
4) ECG
5) Urea, electrolytes, and creatinine
1) FBC, 2) CXR, 3) Echocardiogram, 4) ECG, 5) Urea, electrolytes, and creatinine
