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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
Anti SRP
Specific antibodies for IIM Predict severe, treatment resistant disease
26
Causes of secondary AVN
- 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
Conditions associated with CPPD
Hyperparathyroidism Hypothyroidism Haemochromatosis Hypomagnesemia and hypophosphatasia Familial hypocalciuric hypercalcaemia.
28
Muscle biopsy results of IIM
Perifascicular, perimysial or perivascular B cell infiltrates + CD4+ T helper cells
29
Antibodies associated with increased risk of malignancy
Anti-TIF-1 Anti-NXP-2
30
Anticholinergic side effects
Dry mouth Drowsiness Blurred vision Urinary retention Constipation Tachycardia
31
Medications with intended anticholinergic effect
Oxybutynin Loperamide Bronchodilators - ipratropium, theophylline, tiotropium Antiparkinsonian medications - beperiden, amantadine, benztropine Atropine
32
Medications with UNintended anticholinergic effect
Antipsychotics (olanzapine, periciazine, chlorpromazine, haloperidol, quetiapine) Anxiolytic (diazepam, alprazolam) Anticonvulsants (carbamazepine) Antidepressants (amitriptyline, bupropion, fluvoxamine, paroxetine, venlafaxine) Antihistamines Analgesics Eye drops
33
Characteristics of azithromycin
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
What are biosimilars?
Biological medication that emulates bio-originator or innovative biologic
34
Clopidogrel metabolism
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
MOA of ticagrelor and prasugrel
P2Y12 inhibitors Ticagrelor - active compound with an active metabolite Prasugrel - inactive compound requiring activation by CYP3A4 and CYP2B6
36
MOA of memantine
NMDA antagonist and dopamine agonist
37
Medications that could induce Addisonian crisis
CYP3A4 inducers - Carbamazepine - Dexamethasone - Griseofulvin - Nevirapine - Phenytoin - Rifampin - St John's Wort
38
Common drugs that act by competitive enzyme inhibiition
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
Features of ethylene glycol poisoning
High anion gap severe metabolic acidosis Typical oxalate crystals Renal impairment (due to tubular blockage by oxalate crystals)
40
Common causes of high anion gap metabolic acidosis
GOLD MARK Glycols Oxoproline L-lactate D-lactate Methanol Aspirin Renal failure Ketones
41
Medications associated with gynaecomastia
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
Extrarenal manifestations of PCKD
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
EIM that parallels course of IBD
Peripheral arthropathy Erythema nodosum Sweet's syndrome Oral aphthous ulcers Episcleritis
44
EIM that has separate course of IBD
Axial arthropathy Peripheral arthropathy
45
EIM that may or may not parallel disease activity of IBD
Pyoderma gangrenosum Uveitis PSC
46
High risk groups of HCC
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
Right heart catherisation findings for post-capillary pulmonary HTN
mPAP > 20 PCWP > 15 PVR variable BOTH ARE HIGH Suggestive of LVEF
48
Right heart catherisation findings for pre-capillary pulmonary HTN
mPAP > 20 PCWP < 15
49
First line management for idiopathic PAH
Ca channel blockers
50
High risk features of thyroid nodules
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
Low risk features of thyroid nodule
Isoechoic or hyperechoic solid nodule Cystic nodule with eccentric solid component
52
Very low risk features of thyroid nodule
Partially cystic nodule Spongiform nodule
53
Benign features of thyroid nodule
Cystic nodules (anechoic) without solid component
54
Indications for FNAC of thyroid nodules
- 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
Bethesda system for thyroid cytopathology
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
Major criteria for modified Dukes criteria
- 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
Minor criteria for modified Duke's crtieria
- 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
Mechanism of actions of polyenes
E.g. amphotericin B Binds to cell membrane ergosterol Forms artificial pores permitting potassium efflux and cell death
59
Mechanism of action of pyrimidine analogues
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
Mechanism of action of azoles
Inhibits C14-a-sterol demethylase Leads to accumulation of sterol precursors and reduction of ergosterol
61
Mechanism of echinocandins
e.g. capsofungin, anidulafungin Inhibits fungal cell wall polysaccharide B-1,3 glucan synthesis
62

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