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Matt's Path COPY > Last Minute > Flashcards

Last Minute Flashcards

1
Q

Ankylosing Spondylitis Monoclonal

A

Etanercept

TNF-alpha inhibitor

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2
Q

Psoriasis Monoclonal

A

Ustekinumab

IL-12/IL-23

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3
Q

anti-­‐proteinase 3

A

Wegner’s

Granulomatosis with polyangiitis

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4
Q

Felty’s

A

Rheumatoid arthritis + hepatosplenomegaly –> Neutropenia

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5
Q

How to monitor the activity of SLE?

A

C3
C4
Anti-dsDNA

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6
Q

Antibody useful to diagnose someone with systemic sclerosis?

A

Anti-Scl-70

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7
Q

Tocilizumab

A

Rheumatoid Arthritis

IL-6R

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8
Q

Denosumab

A

Osteoporosis

RANKL

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9
Q

IFN-gamma

A

Chronic granulomatous disease

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10
Q

Treating Wegner’s

A

Cyclophosphamide

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11
Q

Treatment of hereditary angioedema

A

IV C1 inhibitor

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12
Q

Treatment of oral allergy syndrome

A

Wash out mouth

oral antihistamines

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13
Q

Utricaria

A

H1-antagonist.

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14
Q

Neutralizing antibody in HIV

A

gp120

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15
Q

NON-Neutralizing antibody in HIV

A

p24

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16
Q

Co-receptor for entry of HIV

A

CCR5

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17
Q

Enzyme targeted by HIV treatment

A

protease

reverse transcriptase

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18
Q

C7 complement deficiency

A

Meningitis

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19
Q

CD40L deficiency

A

Hyper IgM syndrome

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20
Q

Asplenic patient vaccines

A

Pneumovax

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21
Q

Vaccine against viral haemagglutinin

A

Influenza

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22
Q

Yellow fever, MMR and BCG

A

Live vaccines

Avoid in immunocomprimised

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23
Q

Live Vaccines

A

Small Yellow Typhoid Chicken BOY MMR

Smallpox

Yellow fever

Typhoid

Chickenpox

BCG

Oral polio

Yellow fever

MMR

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24
Q

Patient gets recurrent infections with negative NBT and dihdrorrhadamine tests

A

Chronic granulomatous disease

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25
Q

Atypical granulomatous infection in previously healthy patien

A

IFN-y receptor deficiency

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26
Q

Serum sickness

A

Type III

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27
Q

Eczema

A

Type I

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28
Q

vaccinia

A

Small pox vaccine

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29
Q

Treatment of temporal arteritis

A

prednisolone

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30
Q

Azathioprine resistant Crohn’s

A

Anti-TNF alpha (Infliximab)

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31
Q

Cytokine responsible for promoting antibody synthesis

A

Ig4?

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32
Q

Promoting eosinophil growth

A

IL-5

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33
Q

AIRE gene causes

A

Auto-immune polyendocrine syndrome type 1 (APS1)

Auto-immune polyendocrinopathy-candidiasis-ectodermal dystrophy syndrome / APECED

Antibodies vs parathyroid and adrenal glands Hypoparathyroidism and Addison’s

Antibodies vs IL17 and IL22
Candidiasis

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34
Q

HIV: Uses this receptor on the cell wall to facilitate entry

A

gp120

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35
Q

b. What travel vaccine don’t you give to a person who has ankylosing spondylitis and on TNF alpha inhibitor?

A

Yellow fever

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36
Q

What vaccine do you give to girls at 12-13y?

A

HPV

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37
Q

Vaccine you give every 5 years for splenectomised patients

A

Pneumococcal (Pneumovax)

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38
Q

What is in the routine immunization programme but not given to immunocompromised children?

A

MMR

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39
Q

Ground glass appearance

A

PCP

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40
Q

Guy has urethritis, arthritis and eye problems

A

Reiter’s syndrome

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41
Q

Gram positive that gives LUT symptoms in women

A

Staphylococcus Saprophyticuss

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42
Q

Gram neg rod UTI

A

E.Coli

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43
Q

Flagellate protozoan that can cross placenta

A

Toxoplasmosis

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44
Q

STI that can cross placenta in third trimester

A

Syphilis

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45
Q

Squamous cells on microscopy

A

=Contamination of sample

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46
Q

Coliform organisms

A

Nitrites

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47
Q

Stone associated infetcion

A

Proteus

Struvite stones

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48
Q

Gas gangrene

A

Clostridium perfringens

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49
Q

Urine antigen detection

A

Legionella

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50
Q

Rust coloured sputum

A

Strep pneumonia

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51
Q

HIV: Enzyme that copies with errors

A

Reverse transcriptase

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52
Q

What is the chemokine that inhibits HIV entry into cells

A

Aminooxypentane (AOP)-MIP-1α

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53
Q

Molluscum contagiosum

A

pox virus

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54
Q

Kaposi’s sarcoma

A

HHV8

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55
Q

gram positive rod

A

Listeria

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56
Q

N. meningitis

A

gram negative cocci

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57
Q

Smoker – gram positive cocci

A

Strep pneumonia

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58
Q

Meningitis, normal glucose, raised lymphocytes, slightly raised protein

A

Herpes

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59
Q

neonatorum ophthalmia

A

Chlamydia trachomatis

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60
Q

What causes hemorrhagic cystitis in kids

A

Adenovirus

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61
Q

Mum had skin infection with a son with a sore throat

A

Strep pyogenes

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62
Q

Guy came back from afganistan with ulcer on his ring finger

A

cutaneous leishmaniasis

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63
Q

Kid had red erythemous, oedematous rash, first on face and crosses the nasal bridge and spread really quickly –

A

N.Meningitis

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64
Q

Livery cyst

A

antamoeba histolytica

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65
Q

Angular stomatitis

A

Folate deficiency /B12

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66
Q

You suspect Acute Intermittent Porphyria. What test?

A

Urine PBG

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67
Q

Jaundiced baby no dysmorphic features

A

Urine amino acids

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68
Q

hypoglycaemic neonate

A

Urine reducing substances

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69
Q

Wet Beri Beri

A

Pulmonary oedema

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70
Q

Dry Beri Beri

A

Neurological symptoms

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71
Q

Bicarb in pyloric stenosis

A

High

> 30

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72
Q

Woman with hypothyroidism, T1DM, adrenal failure

A

Polyendocrinopathy

–> B12 def (pernicious anaemia)

73
Q

Enzymes - rate-limiting enzyme in haem synthesis?

A

ALA synthase

first enzyme

74
Q

Deficiency leads to high urate

A

HGPRT

Leysch-Nyhan syndrome

75
Q

How to diagnose B Thal trait

A

Raised HbA2

76
Q

Raised amylase

A

Mumps

77
Q

Impaired glucose tolerance

A
  1. 1-6.9 FASTING

7. 8-11.0 OGTT 2 hours

78
Q

Diabetes cut-off

A

> 7.0 Fasting

> 11.1 OGTT 2 hours

HbA1c > 6.5% (48mmol/mol)

79
Q

One that causes hepatic cirrhosis and portal hypertension in some and cardiomyopathy in others?

A

Haemochromatosis

80
Q

CAH

A

Hyperkalaemia

+ salt losing crisis

81
Q

Adult T-­‐cell lymphoma

A

JC virus

82
Q

INR Someone with AF?

A

2.0-3.0

83
Q

INR: Someone with a prosthetic valve.

A

3.0-4.0

84
Q

Monitoring: Someone on unfractionated heparin.

A

APTT

85
Q

Normal Hb - positive sickle solubility test

A

Sickle trait

86
Q

Low Hb - positive sickle test

A

Sickle cell disease

87
Q

polychromasia and spherocytes

A

Hereditary spherocytosis

88
Q

Raised ESR

A

Temporal arteritis

89
Q

Thalassaemia patient looks tanned and has diabetes

A

Transfusion haemosiderosis

90
Q

Patient has prolonged APTT, normal PT and normal bleeding time

A

Haemophilia A

91
Q

Patient has menorrhagia, prolonged APTT, normal PT and prolonged bleeding time. Her mother had similar problems

A

vWF

92
Q

Elderly Patient is asymptomatic and has generalised lymphadenopathy, with abnormal bloods

A

CLL

93
Q

Elderly patient presents with MASSIVE splenomegaly with low platelets, red cells and normal white cells

A

Myelofibrosis

94
Q

Pelger Huet cells, hyposegmented neutrophil

A

Myelodyplastic syndrome

95
Q

Breast Mass. Aspirated. Brown ‘fluid’

A

Galactocele

96
Q

Halo-sign on x-ray

A

Aspergillosis

97
Q

CD19+
CD5+
B cells

A

CLL

98
Q

Ritcher’s transformation

A

CLL
Hairy cell
—> DLBC

99
Q

Smear Cells

A

CLL

100
Q

CD5+

A

CLL

Or could be a mantle cell lymphoma!

101
Q

Binet staging

A

CLL

Stage 1 <3 lymph nodes
Stage 2 >3 lymph nodes
Stage 3 >3 lymph nodes Hb<100

102
Q

Protein C

A

Inactivates VIIa and V

103
Q

Antithrombin III

A

Inactivates thrombin

Inactivates IX, X and XI

104
Q

Tissue factor pathway inhibitor

A

Inhibits factor Xa and TF:VIIa complex

105
Q

When the integrity of the BBB is disrupted the resultant oedema is described as

A

Vasogenic Oedema

106
Q

Which of the following types of herniation do not involve cortex?

A

Tonsillar

107
Q

What percentage of patents who experience a TIA will get a significant infarct within 5 years?

A

33%

108
Q

What is the most common cause of non-traumatic intraparenchymal haemorrhages?

A

Hypertension

109
Q

Krukenberg tumours

A

Secondary ovarian tumour

Bilateral metastases composed of mucin producing signet ring cells

most often of gastric origin or breast

110
Q

HNPCC associated ovarian tumour

A

Mucinous

111
Q

BRCA associated ovarian tumour

A

Serous cystadenocarcinoma

112
Q

Most common ovarian cancer

A

Serous cystadenocarcinoma

113
Q

Type I Ovarian Tumours

A

Low grade, relatively indolent, arise from well characterised precursors (BOT) and endometriosis

Usually present as large stage I tumours

Mutations in K-ras, BRAF, PI3KCA and HER2, PTEN and beta–catenin

Usually have precursors

Include low grade serous, low grade endometrioid, mucinous and tentatively CCC.

114
Q

Type II Ovarian Tumours

A

High grade mostly of serous type
Aggressive
More than 75% have p53 mutations
No precursor lesions

115
Q

Type I Endometrial Cancer

A

Type I: 80-85%

Endometrioid, mucinous and secretory adenocarcinomas
Younger age
Are oestrogen dependent
Often associated with atypical endometrial hyperplasia
Low grade tumours, superficially invasive

116
Q

Type II Endometrial Cancer

A

Type II: 10-15%

Serous and clear cell carcinomas
Older, postmenopausal
Less oestrogen dependent
Arise in atrophic endometrium
High grade, deeper invasion, higher stage
117
Q

Most common endometrial cancer

A

adenocarcinomas

118
Q

C2 breast

A

Benign

119
Q

C5 breast

A

Malignant

120
Q

Dilated ducts
Periductal inflammation
Filled with secretions

A

Duct ectasia

Benign

121
Q

Neutrophils (trinucleate cells)
Acute inflammation
+/- abscess

A

Mastitis

122
Q

Degenerative fat
Foamy macrophages
Giant cells

A

Fat necrosis

Later fibrosis and calcification

123
Q

Apocrine metaplasia
Adenosis
Epithelial and stromal hyperplasia

A

Fibrocytsic change

124
Q

Overlapping cells
Excess glandular and stromal proliferation
Leaf-like fonds

A

Phyllodes tumour

Benign

125
Q

Branching papillary groups
Papillary mass within duct lined by epithelium
Fibrovascular core

A

Intraductal papilloma

Benign

126
Q

Central zone of scarring
Radiating zone of proliferating glandular tissue
Stellate mass

A

Radial scar

Benign

127
Q

Ducts filled with atypical epithelial cells

A

DCIS

128
Q

Infiltrating atypical epithelial cells

A

Invasive breast carcinoma

129
Q

Most common breast cancer

A

Invasive ductal

130
Q

Cancer staged into low grade, intermediate, high grade

A

DCIS

131
Q

Proliferation of fibroepithelium and stromal tissue

A

phylloides tumour

132
Q

Loss of E.cadherin

A

LCIS

133
Q

HR PR negative

A

High grade DCIS

134
Q

Rheumatic valvular disease

A

Mitral valve

135
Q

Condition caused by a genetic defect in myofilament formation leading to large myocytes

A

Hypertrophic cardiomyopathy

136
Q

Conditions caused by progressive loss of myocytes

A

Dilated heart failure

137
Q

Condition of structural calcification causing onset of a murmur late in life

A

Aortic stenosis

138
Q

35 yr old male presented with a 1 week history of hoarse voice, cough, headache and mild fever. His symptoms were getting worse and he was finding it harder to breathe. He also developed sinus pain.

A

Strep Pneumonia

139
Q

A 75 year old male non-smoker presented with a cough productive of sputum and fever. He was short of breath and felt a ‘catching’ chest pain upon breathing in. Chest X-ray showed consolidation in the right lower lobe.

A

Strep pneumonia

140
Q

An otherwise healthy 25 year old female complained of ‘flu like’ symptoms following return from Mexico. She had a headache, weakness and joint pains and had developed a dry cough. Tests detected the presence of cold agglutins.

A

Mycoplasma pneumonia

141
Q
  1. 25 year HIV positive man presented with a 2 week history of a bloody cough and night sweats. He had lost weight and had a fever. 3 weeks ago he had travelled to Africa to visit family. Chest xray revealed hilar lymphadenopathy and left sided upper lobe shadowing.
A

TB

142
Q

A 45 year old business man was previously well. One week after staying in a hotel he developed diarrhoea, nausea and weakness. He had a headache and on examination was confused and pyrexial. Tests revealed lymphopaenia and hyponatraemia.

A

Legionella

143
Q

A 69yr old male smoker is rushed into hospital complaining of severe breathlessness when walking upstairs. He is tachycardic with a reduced pulse volume and you also note that his ankles are considerably swollen.

A

Cardiac failure

144
Q

A 26yr old known I.V. drug user presents with fever, weakness, lassitude and night sweats. On examination you discover a heart murmur

A

Staph Aureus

145
Q

A 7yr old girl complains of a rash on her chest and painful joints. On further questioning you discover she had recovered from a sore throat a fortnight ago

A

Rheumatic fever

146
Q

A young fit 22yr old is rushed into A&E after complaining of a severe chest pain and breathlessness. A loud fourth heart sound is heard.

A

Hypertrophic cardiomyopathy

147
Q

A 55yr old male presents to A&E with a sharp centralised chest pain which is relieved by sitting forwards. A pericardial rub is heard at the left sternal edge.

A

Pericarditis

148
Q

A gram positive bacillus that produces alpha-toxin causing gas gangrene in infected wounds

A

Clostridium perfringens

149
Q

A man punches someone in a pub brawl. The recipient then bites his hand. Later the bite wound becomes infected, with lots of pus and a foul smell. The most likely pathogen is?

A

Anaerobes

150
Q

A gram positive B haemolytic coccus that can cause pharyngitis, erysipelas and cellulitis.

A

Strep pyogenes

151
Q

A 65yr old male is found to have an Hb of 19g/dl on a routine blood test, EPO levels were normal. On examination he is found to have splenomegaly and engorgement of the retinal vein. Bone marrow histology showed increased cellularity of erythroid cells. What is the most likely diagnosis?

A

Polycythaemia rubra vera

152
Q

A 30yr old female was found to have platelets>600x109/L on 3 separate occasions. Her CRP and ESR were within the normal range. She suffered a DVT 3 months ago. What is the likely diagnosis?

A

Essential thrombocythemia

153
Q

Which drug aids in the reduction of platelet number and can cause palpitations and flushing?

A

Anagrolide

154
Q

A peripheral blood film of a patient with polycythaemia vera shows a leucoerythroblastic picture with tear drop poikilocytes. What is the likely diagnosis?

A

Myelofibrosis

155
Q

Imatinib can be used in the treatment for which leukaemia?

A

Chronic granulocytic leukaemia

156
Q

What is the correct pathological term for a discontinuation in the epithelial surface?

A

ULCER

157
Q

A 65 year old male with a long history of epigastric pain. Endoscopy reveals 3.2cm of columnar metaplasia in the lower oesophagus. What does this suggest?

A

Barrett’s oesophagus.

158
Q

What is the technical term for a connection between two epithelial surfaces, as occurs in Crohns disease where for example there might be a connection between the bladder and the bowel?

A

Fistula

159
Q

A 46-year old Japanese female is found to have bilateral ovarian masses on imaging of the abdomen and had both ovaries removed. Histology revealed malignant signet ring cells containing mucin in both ovaries. What is the diagnosis?

A

Krukenberg tumour

160
Q

A 50 year-old female was found to have an ovarian mass. On its removal, histology revealed several cell types, including thyroid follicles, hair and teeth. What is the likely diagnosis?

A

Dermoid cyst or Cystic Teratoma

161
Q

A 40 year-old female non-smoker presents with a one week history of fever, shortness of breath and a cough productive of rusty coloured sputum. Microscopy of the sputum is shown (Gram positive diplococci). What is the organism?

A

Streptococcus pneumoniae

162
Q

A 37 year-old man presents with a headache, myalgia and a cough. He is also suffering with nausea, diarrhoea and abdominal pain. On examination he is tachypnoeic and has a pyrexia of 39ºC. Blood tests reveal lymphopenia and hyponatraemia. A gram stain from the patients sputum is shown here (Gram negative rods). CXR shows lobar consolidation. Cold agglutinins are negative. What is the organism?

A

Legionnaires disease or Legionella Pneumophila

163
Q

A 40 year-old woman presents with malaise, muscular pains and diarrhoea with mucus and blood. On examination she has a fever and several distinctive spots on her abdomen (Rose spots). Blood cultures are positive and grow gram negative rods. What is the likely organism?

A

Salmonella Typhae or Typhoid fever.

164
Q

genus of spiral flagellated Gram negative bacteria. Found in the stomach within the mucosa layer. It occurs in the majority of middle-aged people and causes progressive gastritis. Invariably present in duodenal ulceration and usually in gastric ulceration. What is the organism?

A

Helicobacter pylori.

165
Q

A 4 year old girl presents to the A&E with a recurrent chest infection that will not clear. On examination, the house officer notices that she has low set ears, a cleft palate and a murmur. Investigations reveal:

Calcium 1.9 mM (NR 2.2 to 2.6);
Phosphate 1.4 mM (NR 0.8 to 1.4)
PTH 1.1 pM (NR 1.1 to 6.8)

What is the likely diagnosis?

A

Di George syndrome or 22q11.2 deletion syndrome.

166
Q

A 40-year old lady complains of tight fingers and dysphagia, and is thought to have a syndrome associated with Raynaud’s phenomenon, and telangiectasia. What antibody should we measure to confirm this possible diagnosis?

A

Anti-centromere

167
Q

Name the drug used for patients with type 2 diabetes which inhibits the enzyme alpha glucosidase in the brush border membrane of the small bowel.

A

Acarbose

168
Q

Name an example of a drug that inhibits the enzyme dipeptidyl dipeptidase IV (DPP-4).

A

Gliptins such as alogliptin or sitagliptin

169
Q

A patient presents with weakness and is found to have a potassium of 2.4mM (NR 3.5 to 5.0). What is the likely acid-base abnormality if you check the patients arterial blood gas?

A

Metabolic acidosis

170
Q

A 67-year-old woman presented with confusion 2 days after a cholecystectomy. She had experienced some pain postoperatively, largely relieved by analgesia.

A

SIADH

171
Q

A 51-year old man is having investigations for palliative surgery due to gastric adenocarcinoma. He is found to be anaemic, with high a reticulocyte count and fragmented red blood cells on blood smear. What is this anaemia known as?

A

MAHA

172
Q

In a patient with Hodgkins Lymphoma, the stage of disease is given by the amount of spread, with stage 1 disease involving only one group of nodes, and stage IV disease involving extra nodal spread. What would stage III Hodgkins disease suggest?

A

Disease above AND below the diaphragm.

173
Q

A 56 year-old male presents with fever, vomiting and seizures. Examination reveals a well- established ear infection and there is a ‘ring-enhancing’ lesion on the MRI of his brain.

A

Brain abscess

174
Q

A 27 year old patient has a knee effusion drained. The gram stain reveals Gram negative intracellular diplococci. What is the likely organism?

A

Neisseria gonorrhoeae

175
Q

A 40 year old man presents with weight loss, muscle aches and abdominal pain. On examination he has high BP and urine dipstick reveals blood + and protein +. The patient is thought to have a vasculitis and is p-ANCA positive.

A

Eosinophilic Granulomatosis with Polyangiitis. (EGPA)

176
Q

A patient presents with haemoptysis and haematuria. She is thought to have Goodpastures syndrome. What antibody should you look for?

A

Anti glomerular basement membrane.

177
Q

A four-year-old boy presents with a purpuric rash across the legs and buttocks. Two weeks previously you had seen the child about a chest infection. Further examination reveals abdominal pain and haematuria. Serum IgA levels are raised. What is the likely diagnosis?

A

Henoch Schonlein purpura

178
Q

A patient is found to have a positive Coombes (anti-globulin) test. What is the likely diagnosis?

A

Auto-immune haemolytic anaemia

Matt's Path COPY (18 decks)

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