VIA III Flashcards
1
Q
What bacteria is associated with mesenteric adenitis?
A
yeseria
2
Q
Criteria for Bariatric surgery?
A
BMI 35+ with comorbidity or
BMI 40+
3
Q
What is the acute management of Cluster headache?
And long term?
A
100% o2 for 15min
and sumatriptan in the long term
4
Q
What is a short synacthen test?
A
Stimulation test for deficiency of ACTH - Addison’s disease
5
Q
Hyponatraemic + hyperkalaemic with weight loss, tiredness and nausea?
A
Addison’s disease
6
Q
What is Addison’s disease?
A
Primary Adrenal insufficiency - decreased Cortisol and decreased Aldosterone
7
Q
What is Conn’s syndrome?
A
Primary Hypothyroidism. Increased Aldosterone levels - leading to normal/low Na, increased fluid. The body loses hydrogen and hence the pH goes up.
8
Q
Acute exacerbation of Gout caused by..?
A
90% caused by decreased renal clearance. Other causes include:
9
Q
GORD + Constant heartburn and regurgitation and dysphasia. On gastroscopy you would see….
A
Barrett’s oesophagus
10
Q
30 yo female + Unilateral blurring and acute pain + central scotoma + Right swollen disc
A
Optic Neuritis (MS)
11
Q
Treatment of spontanenous Bacterial peritonitis?
A
Antibiotics - re-tap in 24 hours and neutrophil should have decreased by 50%.
You know its spontaneous bacterial peritonitis because the tap has neutrophils
If the tap didn’t have neutrophils therapeutic paracentesis would be first line.
12
Q
What to avoid in Ventricular tachycardia?
A
Adenosine. Adenosine is given in SVT.
13
Q
45yo man when to Africa two weeks ago - presenting fever, headache and maculopapular rash
A
HIV infection
14
Q
How do you treat PCP ( Pneumocystis jirovecii)?
A
oral Co-trimoxazole
15
Q
HIV is a DNA Virus?
T or F?
A
F - It is a retroviridae - works through reverse RNA transcriptase
16
Q
Mixed upper motor neuron disease and lower motor neuron disease in the upper and lower limb
A
Motor neuron disease
17
Q
Lower motor neuron signs in Upper limbs + Upper motor neuron signs in lower limb
A
Cervical cord compression
18
Q
Signs of progressive bulbar palsy?
A
tongue fasiculations + difficulty swallowing and chewing
19
Q
35 yo woman, two months post partum, 4 week history of joint pain, skin rash and fever. ESR: 40. Diagnosis?
A
SLE
RA wouldn’t have a rash.
20
Q
Differentiating between discoid rash in SLE vs Eczema?
A
SLE would have other symptoms too
21
Q
What is the genes affected by Coeliac?
A
HLA DQ2 and HLA DQ8
22
Q
What do you see on histology with Coeliac?
A
The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened
23
Q
Investigations for Coeliac?
A
anti-tTG, genetics screening, Anti-endomysial antibodies (IgA)
24
Q
When do you transfuse bloods in anaemia?
A
Transfuse blood when iron is less than 70.
25
Woman young, fat with increased intracranial pressure (damage to retina and optic disc swelling)?
Idiopathic (Benign) Intracranial hypertension
26
Why does oral analgesics not work in people that have migraine's whilst having it?
There is gastric stasis and hence orally it is not helpfull.
27
Triggers for Migraine?
CHOCOLATE
Chocolate
H
OCP
28
How to manage migraine?
PREVENTATIVE (avoid triggers) + paracetamol, metachlopramide + aspirin
Migraine diary
triptans (intranasal)??
29
How to differentiate between IgA (can be triggered after sickness) and Post-Streptococcal gN?
IgA is rapid - 24 hrs.
| Post Streptococcus occurs 2 weeks after illness.
30
Abdominal pain + Purpura + GN symptoms
HSP
31
Severe complication of MDMA and Serrotonin syndrome?
Fever
32
Treatment of neuroepeleptical malignant syndrome?
Benzotropine
33
How to treat alcohol withdrawal tremor?
Diazapem
34
Cannabis intoxication?
Dry mouth, increased appetite, conjunctival injection, tachycardia
35
Pupillary constriction with which drug?
Opiod intoxication
36
Signs of neuroepeleptical malignant syndrome?
HARM
37
Serotonin syndrome? (3)
CAN:
CNS
Autonomic system (temperature),
Neuromuscular excitation`
38
In acidic environment (Stomach) what sort of substance is more easily able to be absorbed?
An acidic substance - because it has to be non-ionised to be absorbed.
39
Episodic impairment of consciousness?
| Fluctuating mental state in old people
Chronic sub-dural haematoma
40
Crescent shaped haemorrhage
Subdural haematoma
41
Lemon shaped haemorrhage?
Epidural haematoma
42
Drugs causing infiltrative lung disease? (BAM)
Bleomycin
Amiodarone
Methotrexate
43
Ground glass appearance/ Honeycomb appearance on CT?
Infiltrative lung disease (pulmonary fibrossi)
44
Young man , 47, with osteoporosis (causing vertebral collapse).. how would you investigate?
Testosterone concentration?
45
ddx for testosterone deficiency?
- Genetic syndorme (Kleinfelter's)
-
-
46
Difference between primary and secondary polycthaemia?
Primary - renal cell carcinoma producing EPo
| Secondary causes - due to a chronic disease
47
How do you check someone's blood group
INDirect coombs test for cross matching to pick up on the antibodies!
48
When do you need FFP?
When coagulopathy problem?
49
How do you manage an asthamtic patient who quickly gets softer breath sounds?
immediate intubation!
50
Most frequent cause of blood stained nipple discharge?
Duct Papilloma
51
What is Paget disease?
DCIS of the nipple
52
Indian filed fashion of the breast
Invasive lobular breast cancer
53
Dengue fever presents with _______
back pain and myalgia and arthralgia
54
Mx of Malaria?
Chloroquinone
55
CA-125 is a marker for _____
Ovarian Cancer
56
CA-19-9 is tumour marker for __________
Pancreatic cancer
57
Organophosphate cause inhibition of ________
Acetylcholinesterase
58
Normal pressure hydrocephalus can occur be either idiopathic or secondary. Secondary is due to?
The secondary type of NPH can be due to a subarachnoid hemorrhage, head trauma, tumor, infection in the central nervous system, or a complication of cranial surgery.[1]
59
Most common cause of polyhydramnios?
Idiopathic polyhydramnios
or Gestational. So look at RF.
60
Severe oligohydramnios and no foetal bladder found
Renal Agenesis
61
How do you manage post menopausal bleeding due to and uterus procidentia?
Vaginal hysterectomy and repair
62
What is the gynaecologist preparing for by inserting ureteric stents before a hysterectomy?
Clamp and ligate uterine arteries
63
What additional steps have to be taken to remove the ovaries compared to a simple TAH
To ligate the infundibulopelvic ligaments
64
Complications in surgery after a women has had C-sections
Sharp dissection of he anterior lead (broad ligament) before reflecting onto the bladder
65
Bout of constipation, dehydration and serum potassium is low
Bartter syndrome
66
Progressively unstable walking. His mother mentions he always suffered from ear infections than his brother.
Ataxic telengectasia
Blood vessels in the ear makes hm more prone
67
Floppy baby with absent tendon reflexes and hypotonia + fasciculation's of his tongue
SMA
68
Inverted champagne bottle legs - progressive distal muscular wasting
Charcot Marie tooth disease
69
Broad wrists and ankles with a large forehead. Which Vitamin is he deficient in?
Vitamin D -
Bones unable to form properly
70
Baby is admitted with potential sepsis. Massive hepatomegaly with no jaundice
Glycogen Storage disease
71
Check ACE-i after ______ starting it
1 weeks
72
Which anti-psychotic causes Bradykinesia?
Haloperidol
73
Sclerotic lesion with a sunburst appearance on the fever
Osteosarcoma
Ewing sarcoma affects the shaft of the bone and is associated with onion sign
74
Most commonly associated with long in-situ (non-invasive) phase
Mesothelioma
75
What statistical test to compare two discrete values (two drugs)?
Chi-Square test
76
What statistical test to compare to continuous values?
Linear regression
77
Discrete X variable and continuous Y variable ....
T-Test
78
Where should you listen for breath sounds from the right middle lobe?
Posteriorly, 5 cm below the mid clavicular line
79
What is the only increased marker in Paget's disease?
ALP
80
What antibiotics do you use for Acute prostatitis?
Quinolone
81
How do you treat Syphillis?
Singular IM injection of Benzathine penicillin
82
How do you treat gingivitis (acute necrotising ulcerative)
Metronidazole
83
5 Xray signs for Acute Pulmonary oedema?
| ABCDE
```
Alveolar oedema (Bat wing appearance)
B Kerley lines
Cardiomegaly
Dilated upper lobe vessels
Effusions (Pleural)
```
84
How do you manage APO?
LMNOP
```
Lasix
Morphine +/- Metoclopromide
Nitrogen
Oxygen
Positive pressure/Position
```
85
Fluid retention in heart failure is a combination of 2 things..
1. Reduced GFR
| 2. Activation of RAAS and sympathetic system
86
A patient is symptomatic with CHF only on moderate extertion - what NYHA category does he fall in?
NYHA Class II
NYHA - Class I - Asymptomatic
NYHA Class III - Symptomatic with minimal extertion
NYHA Class IV - Symptomatic at rest
87
Nephrotic syndrome related to Hep B?
Membranous
88
Anit-Smith antibodies seen in _______-
Lupus nephritis
89
Pleuritic Chest pain + Pyrexia after a previous MI
Dressler's syndrome
90
Haemolytic Uraemic syndrome is Gastro caused by which bug?
E. Coli
91
Three common ECG changes seen with Hypokalaemia:
U waves
Flattened T waves
And ST depression
and prolonged PR interval!
92
Alport has all of the following except:
| CKD, Presentation in childhood, Loss of smell, Microscopic haematuria, Lenticonus
Loss of smell! It presents with sensorineural hearing loss
93
You should cease Ace-I in a CKD patient if the eGFR is less than ____% or Rise of creatinine more than ____%
eGFR is less than 25% or Rise of creatinine more than 30%
94
Which of the following is false for Haemolytic Uraemic syndrome?
- Presence of Fragmented red blood cells
- Raised Serum Haptoglobin
- Decreased Platelets
You get DECREASED Haptoglobin.
| All with anaemia and and AKI
95
Three common drugs that cause P450 inducers and affect contraception use:
Carbamazepine (whilst use and 4 weeks after), Phenytoin (whilst and 4 weeks after) and Rifampicin (whilst and 8 weeks after)
96
The optimum sub-bandage pressure for healing venous ulcers has been shown to be ___ mm Hg at the ankle graduating to____mm Hg at the knee
The optimum sub-bandage pressure for healing venous ulcers has been shown to be 40 mm Hg at the ankle graduating to 17mm Hg at the knee
97
Which asthma medication is competitive selective phosphodiesterase inhibitor?
Aminophylline
98
Which tumour excretes large levels of Serotonin?
| And what symptoms does this lead to?
Carcinoid
Flushing, Diarrhea, Wheezing, Abdominal cramping
99
Dysgraphia, Dyscalculi, Finger Agnosia + Left right orientation syndrome. Stroke affecting
Pareital Lobe
100
What medication helps with Raynauds and Htn?
CCB - Dihydropyridine: amolodipine/Nifedipine
101
Common causes of decreased middle ear mobility?
Middle ear fluid (OME). Other causes are increased stiffness of the eardrum (from scarring), tympanosclerosis (the formation of dense connective tissue around the auditory ossicles), cholesteatoma, or middle ear tumor
102
Amitriptylline can cause ______
Bowel obstruction
103
Which ulcer is painful - Syphillis or HSV?
HSV
104
Sexually active male - Rash on palms and soles. What is it?
Syphillis
105
Hypersegmented neutrophils:
B12 def
106
How do you manage Vulval warts?
Imiquimod or Podophyllotoxin
107
Which part of the nephron absorbs glucose?
PCT
108
Carbimazole acts to reduce T3/T4 production by inhibiting _______
iodination
109
Dendritic cells act to .....
initiate primary immune response
110
Natural Killer cells induce apoptosis of infected cells which is triggered by the absence of ______ on target cells
MHC I
111
CD3 cells?
T Cells
112
CD4 Cells?
Helper T cells
113
CD8 Cells?
Killer T Cells
114
CD19/CD20 Cells?
B Cells
115
BCL - 2 oncogene on Chromosome 14/18
Follicular lymphoma
116
Myc activation on chromosome 18?
Burkitt's lymphoma
117
Clopidogrel acts to block ______ receptors on ____
Blocks ADP receptors on platelets
118
Hypocellular bone marrow with increased fat spaces?
Aplastic anaemia
119
Heinz Bodies?
G6PD
120
Basophilic stippling
Thalassaemia
121
Schistocytes
haemolysis
122
X-linked haemarthrosis, prolonged APTT
Haemophilia A
123
Heavy periods, bleeding after dental work , mildly prolonged APTT
vWillebrands factor
124
Rouleax stacks?
Multiple Myeloma
125
Reed-Sternberg cells
Hodgkin
126
Burr cells
Uraemia
127
What is the Cisterna Chyli?
It is the most inferior part of the thoracic duct
128
The thoracic duct travels behind the aorta and drains into the ___________.
left subclavian vein
129
The recurrent laryngeal nerves are a branch from _______
vagus nerve
130
The ______ nerve goes below the aortic arch
Left recurrent laryngeal
131
Which lobe is Broca's located in ?
Frontal!
132
Where is Wernicke's lobe located?
Located in the posterior section of the superior temporal gyrus
133
We get triglyceride breakdown and fatty acid export in ____
DM-1
134
The sympathetic neurons provide a motor output in nerves ____
T1-L2
135
The recurrent larygneal nerve is associated with which artery?
Inferior thyroid artery
136
For dental surgery you need an ________ nerve block and ____ nerve
inferior alveolar nerve block and linguinal nerve block
137
Three sites where kidney stones get stuck?
1. Ureteric junction of pelvic (Pelvic ureteric junction)
2. Where ureter crosses over the pelvic vessels (bifurcation)
3. Where the ureter enter the bladder (VUJ)
138
The common iliac artery forms at about nerve root (__) and bifurcates infront of the ________ into the internal and external branches.
Nerve root - L4. And bifurcates infront of the pelvic brim into the internal and external branches.
139
Whilst sleeping __________ helps maintain glucose levels.
Gluconeogenesis whilst sleeping. Adipose tissue when at rest
140
Muscle Glycogenolysis can occur during the flight or fight response but requires which enzymes?
Glucose-6-Phosphate. This is release by myocytes when under stress
141
Chylomicrons transport lipids from _____ to ____, ___ and ____. They transport mainly Triglycerides
Transport lipids absorbed from the intestine to adipose, cardiac, and skeletal muscle tissue, where their triglyceride components are hydrolyzed by the activity of the lipoprotein lipase, allowing the released free fatty acids to be absorbed by the tissues
142
LDL's transport cholestrol from the liver to _______, which attracts ___ and leads to _____
Liver to artery walls - which attracts macrophages and leads to artherosclerosis
143
Efficient phagocytosis requires ______ by complement or bacteria
Oponisation
144
Osler's nodes occur on the palms or fingertips? Pain/painless?
Generally fingertips and are generally tender
145
Sally has been taught that if she pee's in her pants then she will get a smacking. And if she doesnt pee in her pants she gets a Lolly. What sort of conditioning is this?
Operant conditioning
146
Right before Mary Peed her pants She saw a pink dog. Now whenever she sees a pink dog she pees her pants!
Classical conditioning
147
Ankle swelling (oedema) occurs due to ________
increased Venous pressure
148
Treatment for H. Pylori?
Omeprazole, Clarithromycin and Amoxiciliin
149
Fear is sensed by which part of the brain?
The amygdala
150
Do pupils dilate or constrict in flight or fight response?
They Dilate!
151
Difference between disinfecting and sterilising?
Disinfectant removes the most viable microorganism. Sterilisation removes ALL of them!
152
Gram positive bacteria have a thick/thin peptidoglycan wall? And hence on gram stain are purple/pink?
THICK WALL and hence PURPLE.
153
Spinal cord ends at what level?
L1-L2
154
Tongue Deviates to stronger or weaker side?
Towards weaker side
155
Heparin works on ______
Anti-thrombin III - makes it more active.
156
Eversion of foot is done by _______ nerve
Superficial perineal nerve
157
Dorsiflexion specifically is done by
Deep perineal nerve
158
Ascending limb has low or high permeability to water? (Nephron)
Low
159
Hcl and intrinsic factor is produced by which stomach cells?
Pareital cells!
160
Chief cells of the stomach produce:
Pepsinogen!
161
Azygous veins drains into _____
SVC
162
What artery is ligated in nose bleeds?
Anterior ethmoidal artery
163
Alcohol increases/decreases NADh/NAD+ ratio?
Increases
164
Bisphosphonates inhibit the activity of _____
osteoclasts
