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BPT Flashcards > Things I keep forgetting > Flashcards

Things I keep forgetting Flashcards

1
Q

Features of Gitelman’s

A

Low potassium
Metabolic alkalosis
Hypomagnesemia
Hypercalcaemia
Hypocalciuria

AR disorder
Mutation of SLC12A3 gene - encodes thiazide sensitive sodium chloride cotransporter n DCT

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2
Q

Features of Bartter’s

A

Hypochloraemic alkalosis

Normotensive
Hypokalaemia
Hypocalcaemia
Elevated urinary Ca excretion
Elevated urine prostaglandin E

NKCC2, ROMK, CIC-Kb mutation

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3
Q

Features of Gordon’s

A

Hypertensive
Hyperkalaemia
Low renin and aldosterone
Hypocalcaemia

Opposite effect of thiazide
WNK1 and 4 mutation

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4
Q

Features of Liddle’s

A

Salt-sensitive hypertension
High rate or renal sodium uptake
Hypokalaemia
Low renin and aldosterone

Mutation of Na channels –> increased number

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5
Q

Features of Fabry disease

A

X-linked recessive

FABRYC
Foamy urine
a-galactosidase A deficiency/Angiokeratomas
Burning pain in peripheries
Really sweaty/dry
YX genotype (Males)
Cardio-cerebrovascular disease/ceramide trihexoside accumulation

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6
Q

Features of Gaucher disease

A

AR inherited disease
Deficiency of B-glucocerebrosidase

Hepatosplenomegaly
Pancytopenia
Avascular necrosis of femur
Bone crises
Macrophage inclusions - resembles crumpled tissue paper

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7
Q

Features of McArdle disease

A

Generalised muscle weakness
Second wind phenomenon - symptoms of muscle fatigue disappear after period of activity

Rhabdomyolysis and myoglobinuria occurring after demanding physical exercise

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8
Q

Wolfram syndrome features

A

Childhood onset insulin dependent diabetes
Progressive optic atrophy
Diabetes insipidus
Sensorineural hearing loss

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9
Q

The emergence of a pandemic strain of influenza is best explained by which of the following mechanisms?

A

Antigenic shift in H and N proteins of influenza A.

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10
Q

Adverse effects of methotrexate

A

Abnormal LFTs
Liver cirrhosis
Pneumonitis
Pulmonary fibrosis
Mouth ulcers
Alopecia

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11
Q

Adverse effects of tocilizumab

A

Hypertension
Myelosuppression
Dyslipidaemia
GI perforation
Infection
Abnormal LFTs

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12
Q

Adverse effects of TNF inhibitors

A

Injection site reactions
Drug induced lupus
Demyelinating syndrome
Malignancy
Infection
Reactivated TB
Exacerbation of cardiac failure

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13
Q

Adverse effects of tofacitinib

A

Abnormal liver function tests
Myelosuppression
Dyslipidaemia
Reactivated TB
Herpes zoster
VTE

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14
Q

Adverse effects of hydroxychloroquine

A

Photosensitivity
Haemolytic anaeia
Blue-grey skin discolouration
Corneal deposits
Retinal toxicity

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15
Q

Adverse effects of prednisone

A

Adrenal suppression
Diabetes
Hypertension
Osteoporosis
Psychosis
Mania
Delirium
Depression
Insomnia

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16
Q

Adverse effects of sulfasalazine

A

Rash
Haemolytic anaemia
Abnormal LFTs
Nausea
Headache
Oligospermia

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17
Q

Adverse effects of leflunomide

A

Alopecia
Diarrhoea
GIT upset
Hypertension
Pneumonitis
Peripheral neuropathy
Hepatotoxicity

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18
Q

Features of PAN

A

Constitutional symptoms
MSK symptoms
Rash
Subcutaneous nodules
Renal involvement
Epididymo-orchitis

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19
Q

Features of Takayasu

A

Stenotic, occlusive or aneurysmal vessels
Diseases of large and medium sized arteries, with predilection for aorta and branches

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20
Q

Criteria for Takayasu

A

3 or more criteria
- Age of 40 years or younger at disease onset
- Claudication of extremities
- Decreased pulsation of one or both brachial arteries
- Difference of at least 10mmHg in SBP between arms
- Bruit over one or both subclavian arteries or abdominal aorta
- Arteriographic narrowing or occlusion of entire aorta, primary branches, or large arteries in upper or lower extremities not due to other causes

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21
Q

Anti-Scl-70 association

A

Diffuse cutaneous involvement
ILD

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22
Q

Anti-RNA polymerase III association

A

Scleroderma renal crisis
Gastric antral vascular ectasia

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23
Q

Anti-PM/Scl

A

Limited cutaneous involvement
Polymyositis
Dermatomyositis
Better survival rates

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24
Q

Anti Mi-2

A

Specific antibodies for IIM
Predict classic dermatomyositis with good response to treatment

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25
Q

Anti SRP

A

Specific antibodies for IIM
Predict severe, treatment resistant disease

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26
Q

Causes of secondary AVN

A
  • Systemic corticosteroid use
  • Organ transplant recipients
  • Trauma
  • Alcohol abuse
  • SLE, other connective‐tissue diseases
  • Sickle cell disease
  • Haemophilia A or B
  • Osteoporosis medications (i.e. bisphosphonates, denosumab)
  • Bone disorders (slipped capital femoral epiphysis, congenital dysplasia of the hip)
  • Radiation therapy
  • Malignancy (marrow infiltration, malignant fibrous histiocytoma)
  • Pregnancy
  • Psoriasis
  • Inflammatory bowel disease.
27
Q

Conditions associated with CPPD

A

Hyperparathyroidism
Hypothyroidism
Haemochromatosis
Hypomagnesemia and hypophosphatasia
Familial hypocalciuric hypercalcaemia.

28
Q

Muscle biopsy results of IIM

A

Perifascicular, perimysial or perivascular B cell infiltrates + CD4+ T helper cells

29
Q

Antibodies associated with increased risk of malignancy

A

Anti-TIF-1
Anti-NXP-2

30
Q

Anticholinergic side effects

A

Dry mouth
Drowsiness
Blurred vision
Urinary retention
Constipation
Tachycardia

31
Q

Medications with intended anticholinergic effect

A

Oxybutynin
Loperamide
Bronchodilators - ipratropium, theophylline, tiotropium
Antiparkinsonian medications - beperiden, amantadine, benztropine
Atropine

32
Q

Medications with UNintended anticholinergic effect

A

Antipsychotics (olanzapine, periciazine, chlorpromazine, haloperidol, quetiapine)
Anxiolytic (diazepam, alprazolam)
Anticonvulsants (carbamazepine)
Antidepressants (amitriptyline, bupropion, fluvoxamine, paroxetine, venlafaxine)
Antihistamines
Analgesics
Eye drops

33
Q

Characteristics of azithromycin

A

Binds to 50S ribosomal subunit
Inhibits bacterial quorum-sending, reduces biofilm and mucous production, and has immunomodulatory effects
Long half life
Large volume of distribution

Minimal interaction with warfarin
Rarely causes QT prolongation
Can be used in pregnancy

34
Q

What are biosimilars?

A

Biological medication that emulates bio-originator or innovative biologic

34
Q

Clopidogrel metabolism

A

Prodrug converted to its active metabolite by CYP450 enzymes + CYP2C10 is significant contributor
Active compound then irreversibly binds adenosine diphosphate P2Y12 receptor to decrease platelet aggregation

35
Q

MOA of ticagrelor and prasugrel

A

P2Y12 inhibitors
Ticagrelor - active compound with an active metabolite
Prasugrel - inactive compound requiring activation by CYP3A4 and CYP2B6

36
Q

MOA of memantine

A

NMDA antagonist and dopamine agonist

37
Q

Medications that could induce Addisonian crisis

A

CYP3A4 inducers
- Carbamazepine
- Dexamethasone
- Griseofulvin
- Nevirapine
- Phenytoin
- Rifampin
- St John’s Wort

38
Q

Common drugs that act by competitive enzyme inhibiition

A

6-mercaptopurine –> adenylsuccinate synthetase
5-fluorouracil –> thymidylate synthetase
Acyclovir –> DNA polymerase
Allopurinol –> Xanthine oxidase
Alpha methyldopa –> dopa decarboxylase
Celecoxib –> cyclo-oxygenase-2
Methotrexate –> dihydrofolate reductase
Perindopril –> Angiotensin converting enzyme
Rosuvastatin –> HMG-CoA reductase

39
Q

Features of ethylene glycol poisoning

A

High anion gap severe metabolic acidosis
Typical oxalate crystals
Renal impairment (due to tubular blockage by oxalate crystals)

40
Q

Common causes of high anion gap metabolic acidosis

A

GOLD MARK
Glycols
Oxoproline
L-lactate
D-lactate
Methanol
Aspirin
Renal failure
Ketones

41
Q

Medications associated with gynaecomastia

A

Meds with antiandrogenic properties
- Spironolactone
- Alkylating agents
- Bicalutamide
- Flutamide
- Ketoconazole
- Marijuana
- Metronidazole
- Meds with oestrogenic properties
- GnRH agonists
- Oestrogens or oestrogen agonists
- Anabolic steroids
- Diazepam

Medications that induce hyperprolactinaemia
- Haloperidol
- Metoclopramide

Medications with unclear mechanism
- Amiodarone
- Ca channel blockers
- ACE inhibitors
- Finasteride
- Antidepressants
- Minoxidil

42
Q

Extrarenal manifestations of PCKD

A

Multiple benign hepatic cysts
Cysts in pancreas, spleen, ovary and testicles
Cerebral berry aneurysms
Cardiovascular - arterial hypertension, MV prolapse, LVH
Colon diverticula, abdominal or inguinal hernias

43
Q

EIM that parallels course of IBD

A

Peripheral arthropathy
Erythema nodosum
Sweet’s syndrome
Oral aphthous ulcers
Episcleritis

44
Q

EIM that has separate course of IBD

A

Axial arthropathy
Peripheral arthropathy

45
Q

EIM that may or may not parallel disease activity of IBD

A

Pyoderma gangrenosum
Uveitis
PSC

46
Q

High risk groups of HCC

A

Patients with cirrhosis, Child Pugh class A and B
Patients with cirrhosis, Child Pugh C, if awaiting liver transplant
Non-cirrhotic patients with HBV and following characteristics:
- Active hepatitis
- Family history of HCC
- Africans and African Americans
- Asian males > 40 years
- Asian females > 50 years

47
Q

Right heart catherisation findings for post-capillary pulmonary HTN

A

mPAP > 20
PCWP > 15
PVR variable
BOTH ARE HIGH
Suggestive of LVEF

48
Q

Right heart catherisation findings for pre-capillary pulmonary HTN

A

mPAP > 20
PCWP < 15

49
Q

First line management for idiopathic PAH

A

Ca channel blockers

50
Q

High risk features of thyroid nodules

A

Solid hypoechoic nodule or solid hypoechoic component with at least one of following:
- Irregular margins
- Taller-than-wide shape
- Microcalcifications
- Rim calcifications with extruding tissue
- Extrathyroidal extension

51
Q

Low risk features of thyroid nodule

A

Isoechoic or hyperechoic solid nodule
Cystic nodule with eccentric solid component

52
Q

Very low risk features of thyroid nodule

A

Partially cystic nodule
Spongiform nodule

53
Q

Benign features of thyroid nodule

A

Cystic nodules (anechoic) without solid component

54
Q

Indications for FNAC of thyroid nodules

A
  • Solid hypoechoic nodules >/ 1cm with/without additional sonographic signs of thyroid cancer
  • Consider for solid hypoechoic nodules < 1cm if any of following are present:
    –> extrathyroidal growth
    –> cervical lymphadenopathy
    –> symptoms suggestive of distant metastases
    –> pt preference for FNAC over observation
  • partly cystic, isoechoic and hyperechoic nodules >/ 1.5cm
  • consider in spongiform or partly cystic nodule >/ 2cm
55
Q

Bethesda system for thyroid cytopathology

A

I - nondiagnostic or unsatisfactory
II - benign
III - atypia or follicular lesion of undetermined significance
IV - follicular neoplasm or suspicious for follicular neoplasm
V - suspicious for malignancy
VI - malignant

56
Q

Major criteria for modified Dukes criteria

A
  • Positive blood culture
  • Typical microorganisms from two separate blood cultures
  • Microorganisms consistent with infective endocarditis from persistently positive blood cultures
  • Single positive BC for coxiella burnetti or phase I IgG antibody titer > 1:800
  • Positive echo
  • Vegetation, abscess, or new partial dehiscence of prosthetic valve
  • New valvular regurgitation
57
Q

Minor criteria for modified Duke’s crtieria

A
  • Presence of predisposing cardiac condition of IV drug use
  • Temperature > 38
  • Vascular phenomena
  • Immunologic phenomena
  • Positive blood cultures that don’t meet major criteria or serologic evidence of active infection
58
Q

Mechanism of actions of polyenes

A

E.g. amphotericin B
Binds to cell membrane ergosterol
Forms artificial pores permitting potassium efflux and cell death

59
Q

Mechanism of action of pyrimidine analogues

A

E.g. 5-fluorocytosine
Binds to fungal cytosine permease, which imports it into the cell, and is converted to fluorouracil and impairs nucleic acid synthesis

60
Q

Mechanism of action of azoles

A

Inhibits C14-a-sterol demethylase
Leads to accumulation of sterol precursors and reduction of ergosterol

61
Q

Mechanism of echinocandins

A

e.g. capsofungin, anidulafungin
Inhibits fungal cell wall polysaccharide B-1,3 glucan synthesis

62
Q
A

BPT Flashcards (32 decks)

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