Week 3 bb revision Flashcards
1
Q
Monoclonal
Immunoglobulin light chain
urine or serum
A
Bence-Jones protein
2
Q
Bence-Jones found in what conditions
A
Multiple Myeloma
Waldenstrom’s macroglobulinaemia
Amyloidosis
3
Q
Blood serum paraprotein GREATER than 30
A
Multiple Myeloma
4
Q
Amyloid in myeloma-associated amyloidosis
A
AL amyloid
5
Q
Initial multiple myeloma chemo pre-autologous stem cell transplant
A
Lenalidomide + dexamethasone
6
Q
proteasome inhibitor used for multiple myeloma
A
Bortezomib
7
Q
Old patient with multiple myeloma not eligible for transplant. What treatment do they get?
A
melphalan and prednisolone
with either thalidomide or bortezomib
8
Q
Which immunoglobulin is raised in macroglobulinaemia?
A
IgM
9
Q
The most common paraprotein in multiple myeloma
A
IgG
10
Q
Raised beta2-microglobulin
A
Poor prognosis in multiple myeloma
11
Q
Weight loss and IgM paraprotein on electrophoresis
A
Waldenstrom’s macroglobulinaemia
12
Q
tartrate-resistant acid phosphatase
A
Hairy-cell leukaemia
Gaucher’s disease
13
Q
Haemolytic anaemia refractory to corticosteroids, next line treatment?
A
Splenectomy and rituximab
14
Q
Chemo options for CLL?
A
FCR = Fludarabine, cyclophosphamide, Rituximab
CHOP = Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone
15
Q
Antiproliferative used in polycythaemia vera
A
Hydroxyurea
16
Q
Anagrelide
A
Reduces platelets in thrombocythaemia
17
Q
Lecuovorin
A
Methotrexate rescue drug
18
Q
Solid organ transplant, MS, NHL
Reduces B lymphocytes more than T
A
Rituximab
19
Q
Treatment of hodgkins
A
ABVD (Doxorubicin, Bleomycin, Vinblastine, Decarbazine) +/- radiotherapy
20
Q
Raised ESR
History of temporal arteritis
A
Polymyalgia rheumatica
21
Q
Schistocytes
anaemia
A
Microangiopathic haemolytic anaemia
22
Q
Gram-negative monocytosis, urease positive
A
Brucella
Urease negative = salmonella
23
Q
C1 inhibitor deficiency aka…
A
hereditary angioedema
24
Q
Bubonic plague
A
Yersinia pestis
25
Dodgy water source
| Profuse, non-bloody diarrhoea
Cryptosporidium parvum
26
Rat bite fever
| sodoku
Spirillium minus
27
Cat-scratch disease
Bartonella henselae or Bartonella quintana
28
Epidemic typhus
Rickettsia prowazekii
29
Hunter who has been skinning animals
Tularemia
30
Erythema chronicum migrans
Lyme disease
31
A form of brucella ...
Mediterranean
Goats
Easy culture
Brucella melitensis
'm' for mediterranean
Brucella abortus is more common in cows
32
Ulceration
Black and necrotic
Gram positive rods
Respond to penicillin
Bacillus anthracis
33
Trichophyton rubrum
Tinea pedis
34
Epidermophyton floccosum
Tinea pedis
35
Tichophyton interdigitale
Tinea pedis
36
Fungus associated with hepatocellular carcinoma
Aspergilllus flavus
37
Malassezia furfur
Pityriasis versicolor
38
Malassezia restricta
Seborrhoeic dermatitis
39
Malassezia globosa
Sebrrhoeic dermatitis
40
Woods lamp exam - yellow or orange
Pityriasis versicolor
41
Woods lamp exam - red pink fluorescence
Porphyria cutanea tarda
42
India ink with halo around the cell
Cryptoccus neoformans
43
Swollen and painful limb near a boil
Staphylococcal osteomyelitis
44
Female
Macular rash
Pain in wrists and hands
No respiratory symptoms
Rubella
This is common for women, more than men
45
Clutton's joints
symmetrical joint swelling with congenital syphillis
46
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Radiography:
Oval, elliptical or serpentine
sclerosis
granulation
nidus
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Brodie's abscess - subacute osteomyelitis
47
RANK ligand is involved with the differentiation of which bone product?
osteoclast differentiation and activation
48
This type of bone is 80-90% calcified and has mostly mechanical and protective functions
Cortical
49
bone which is haphazard in its organisation of collagen fibers and is mechanically weak
Woven/fibrous bone
50
Bone which has a regular parallel allignment of collagen into sheets and is mechanically strong
lamellar bone
51
These star shaped cells are important in the regulation of bone formation and are the most commonly found tissue in the bone marrow.
osteocytes
52
This part of bones has fibrous and cambium layers which are involved in fibroblast and osteoblast formation.
Periosteum
53
This type of bone is found towards the ends of long bones near the joints and has trabeculae aligned towards the mechanical load distribution.
Cancellous aka trabecular aka spongy bone
54
onion-skin on radiograph
Ewing's sarcoma
55
CD99 immunostain
Ewing's sarcoma
56
Bone-in-bone radiological appearance
Osteopetrosis
57
marble bone
osteopetrosis
58
Bone conditions with Codman's triangle
Osteosarcoma
| Ewing's sarcoma
59
Sun burst, moth-eaten, fir-tree appearance on radiograph
Osteosarcoma
60
Hypercalcaemia with hypocalciuria in an otherwise well patient
Familial hypocalciuric hypercalcaemia
61
Condition caused by hyperparathyroidism, may see Brown's tumours on xray
Osteitis Fibrosa cystica
62
Young men
Dull pain in long bone which gets worse at night
Relieved with NSAIDs
Osteoid osteoma
63
Anastomosing bony trabeculae
| Osteoblastic rimming
Osteoid osteoma
64
Hard immobile painless palpable mass that is slowly growing
| Teenager
osteochondroma
65
Cavity in bone filled with yellow fluid which grow next to epiphyseal plate until it fills the entire diaphysis.
Can lead to fractures
Simple bone cyst
66
Glycogen on staining cells from a bone biopsy
Ewing's sarcoma
67
Rings and arcs calcification
Enchondroma
68
Cartilage cyst in bone
Enchondroma
69
Bone tumour that exhibits osteoblastic differentiation and produces malignant osteoid
Osteosarcoma
70
This lung cancer is often found alongside LEMS
Small-cell
71
anti-thyroid peroxidase antibodies
Hashimoto's thyroiditis
72
Initial hyperthyroidism with neck pain
| Returns to normal within a few weeks
De Quervain's
73
This teratoma is often malignant and found in men
Immature
74
This teratoma is often benign and found in women
mature
75
This tumour can present as an ovarian mass. It is multi-lobular with a smooth lining of epithelium. Most often are benign.
Mucinous tumour
76
A neoplasm that produces oestrogen typically
| Spindle cells with moderate pale cytoplasm containing lipid droplets and central nuclei
Thecoma
77
Ovarian neoplasm
| cells surrounded by serous fluid and psammomma bodies
Seroud cystadenocarcinoma
78
mucin-secreting signet-ring cells in the tissue of the ovary
Krukenburg tumour
79
A malignancy in the ovary that has metastasized from a primary site - can show mucin-secreting signet-ring cells in the tissue of the ovary.
Krukenburg tumour
80
Ovarian tumour which has uniform germ cells mixed with lymphocytes
Dysgerminoma
81
Rises in placental alkaline phosphatase, hCG, LDH but not classically alpha fetoprotein
Seminoma
82
Schiller-Duval bodies
Endodermal sinus tumour
83
Neoplasm composed of cytotrophoblast and syncytiotrophoblase cells
Choriocarcinoma
84
Arise from the germinal epithelium of the seminiferous tubules
Seminona
85
This tumour can produce masculinisation in women with raised serum testosterone.
Sertoli-Leydig cell tumour
86
Metaplasia that occurs in the transformation zone which involves which cell-types?
Glandular to squamous epithelium
87
Breast investigation that gives histology
Core biopsy
88
Breast investigation that gives cytology
FNA
89
Common drug used for cardiovascular conditions which affects kidney's ability to excrete uric acid
Aspirin
90
Which drug competes with uric acid for the organic acid transporter in the kidney thereby increasing serum urate
Thiazide diuretics
91
Chvostek's and Trousseau's indicate what biochemical state ...
hypocalcaemia
92
What is PTH-rP?
PTH related peptide - undetectable by usual PTH test . Common cause for malignant hypercalcaemia
93
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Short metacarpals
Rounded facies
Low serum calcium
High phosphate
High PTH
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Pseudohypoparathyroidism aka Albright's hereditary osteodystrophy
94
Bowing of long bones in adults
Paget's
95
IgM spike
Waldenstrom's macroglobulinaemia
96
young COPD patient with worsening LFTs
?Alpha-1 antitrypsin deficiency which can lead to liver cirrhosis
97
Micrognathia
posterior displacement of tongue
upper airway obstruction
clef palate
Pierre-Robin sequence
98
T and B cell lymphocyte infiltration of the islets of Langerhans leading to inflammation and destruction of the beta cells
Insulitis
99
The three hormones used in the combined pituitary function test
Insulin
GnRH
TRH
100
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Overweight with central obesity
Hypertension
Raised triglycerides
PCOS
erectile dysfunction
```
Metabolic syndrome
101
Massive accumulation of chylomicrons in the plasma and severe hypertriglyceridaemia.
The plasma has a creamy appearance.
Lipoprotein lipase deficiency
102
This molecule is formed by the gut post-meal and carries dieatary triglycerides
Chylomicrons
103
The smallest lipoprotein particle which transports cholesterol to the liver
HDL
104
Persistent jaundice from day 1 of life which has been worsening
Crigler-Najjar syndrome
105
Haemoglobinuria ... intra or extra vascular haemolysis?
Intravascular haemolysis
106
Niacin deficiency
Pellagra
107
Delayed motor development
Self-mutilation, e.g. biting
Sand-like crystals in nappies
Lysch-nyhan syndrome
108
The virus that can only propagate in the presence of HBV.
Hepatitis D virus
