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MRCP facts I need to know > MRCP Pt 1 > Flashcards

MRCP Pt 1 Flashcards

1
Q

Number needed to treat formula?

A

NNT= 1 / (CRR-EER)

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2
Q

Medication which may exacerbate syncopal episodes in a pt with AS?

A

Bisoprolol - beta blockade means LVF is reduced, but in AS, the heart may just need to work that bit harder to overcome the increased pressure so that it can maintain CO

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3
Q

AntiTb drug that increases hydrocortisone requirements?

A

Rifampicin - because it is a p450 enzyme inducer, including corticosteroid metabolism

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4
Q

Treatment for hypocalcaemia (especially with hungry bone syndrome)

A

IV calcium gluconate

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5
Q

Cause of cortical blindness?

A

B/L occipital lobe infarcts, especially in periods of prolonged hypotension. Often with preservation of pupillary reaction to light

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6
Q

Anton syndrome

A

when patients with cortical blidnness deny their dieases and confabulate visions

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7
Q

large increases in insulin can drive reduction in which electrolytes?

A

phosphate, potassium and magnesium

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8
Q

consequences of hypophosphataemia

A

muscle weakness cardiac failure, neurological dysfunction, including seizures

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9
Q

Anti-smooth muscle antibody is associated with?

A

Autoimmune hepatitis

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10
Q

By what mechanism does lithium cause nephrogenic DI?

A

through decreased aquaporin-2 expression

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11
Q

What kind of bias has the biggest impact on interpretation of meta-analyses?

A

publication bias - tendency to only submit positive trials and for joirnals to favour publication of positive studies

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12
Q

selection vs attrition vs performance bias

A

selection: systematic differences in the baseline characteristic of two groups of subjects entering a study

attrition: systemic differences between groups in withdrawals from a stufy

performance: systematic differences in the care provided to 2 groups of pts in a study

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13
Q

carry-over bias

A

occurs in crossover trials , where the first tx may impact the performance of the 2nd

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14
Q

coag studies in haemophilia A

A

significant prolongation of ATPP

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15
Q

chronic headaches, lethargy, foci of bleeding and increased risk of thrombosis is associated with?

A

essential thrombocythaemia

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16
Q

how many cal/kg does a typical person need per day?

A

25-35/kg

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17
Q

how quickly can hydrocephalus set in after a SAH?

A

as early as 24h after the initial haemorrhage and build slowly over hours to days

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18
Q

headache, seizure, papilloedema, depressed level of consciousness

A

think cerebral venous sinus thrombosis

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19
Q

complication of cerebral venous sinus thrombosis

A

SAH

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20
Q

complication of SAH

A

hydrocephalus, cerebral ischaemia, re-bleed

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21
Q

acutely painful red eye with cloudy anterior chamber is likely?

A

anterior uveitis

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22
Q

Mx of anterior uveitis

A

topical corticosteroids, systemic corticosteroids may be needed if has chronic uveitis

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23
Q

gritty eyes, no loss of vision

A

episcleritis

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24
Q

red eye, pain worse at night and on movement of the eye

A

scleritis

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25
Q

JVP: dominant vs absent a waves

A

dominant: INCREASED atrial contraction ie when there is tricuspid/pulmonary stenosis

absent: MINIMAL atrial contraction , think in AF

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26
Q

JVP: Prominent vs absent X descent

A

X descent: occurs after A wave, corresponds with atrial relaxation and rapid atrial filling due to low pressure

Prominent: cardiac tamponade

Absent: tricuspi stenosis

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27
Q

JVP: Dominant V waves

A

V waves - venous filling of RA when tricupsid valve is closed. Seen in tricuspid regurgitation /ASD

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28
Q

conditions for use of liraglutide for weight loss?

A

BMI >35, non-diabetic hyperglycaemia, high risk factors of CVD eg HTN/dyslipidaemia

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29
Q

management of psychotic symptoms in PD

A
  1. quetiapine
  2. clozapine (dopamine antagonist) - imporves psyh sx and reduces tremor
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30
Q

for how long must CPAP be used overnight to have an adequate effect for those with OSA

A

> =4 hours

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31
Q

identifying reticulocytes vs erythrocytes

A

reticular staining with methylene blue of ribosomal ribonucleic acid . erythrocytes DNH ribosomal ribonucleic acid

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32
Q

Heinz body vs Howell jolly body

A

Heinz - seen in G6PD deficiency, composed of denature Hb
Howell Jolly - markers of hyposplenism, composed of small inclusions of basophulic nuclear material

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33
Q

lupus is a/w which complement deficiencies

A

C1q, C1r, C2, C4

34
Q

DID YOU KNOW THAT REARRANGED DURING TRANSFECTION is long for the RET proto-oncogene? Anyway what condition is this associated with

A

MEN 2A, MEN 2B, familial medullary thyroid cancer

35
Q

weird proto-oncogenes:
C-KIT
Kirsten rat sarcoma

A

C-KIT - activates mutations for seminomas and gastrointestinal stromal tumours

Kirsten - lung adenocarcinoma, pancreatic ca, colorectal ca

36
Q

conditions associated with wide vs narrow vs reverse splitting of S2

(hint: go from right to left)

A

wide: VSD or RBBB

narrow: pulm HTN

reverse: WPW or HTN heart dx or LBBB

37
Q

aetiology testing for contact dermatitis

A

patch testing
radioallergosorbent test

38
Q

mx for pruritus a/w liver failure

A

cholestyramine - its a bile acid sequestrant. in LF, accumulation of bile acids is what causes the itching.
otherwise may try to use rifampicin if that doesnt work

39
Q

involuntary tics, echolalia, palilalia, coprolalia, difficulty concentrating made worse by periods of stress

A

tourette syndrome

40
Q

Elevated LDH and 1-3 beta -d-glucan in a pt with HIV - what tx options are there

A

thisis pneumocystis jirovecii. Tx is co-trimox, then pentamidine if that doesnt work/severe dx

41
Q

interleukin that drives NK cell activation?

A

IL-12

42
Q

MoA of allopurinol

A

Xanthine oxidase inhibitor - purine analogue. did u know - these kinds of meds may also reduce progression of diabetin nephropathy

43
Q

most common place for a cardiac myxoma

A

LA - around 75-80%

44
Q

rash at the dorsum of the hand, consisting of a ring of papules, each 1-2mm in diameter. NOT ITCHY. dx + tx?

A

granuloma annulare - will self resolve in a few months, but may use intralesional steroids

45
Q

single erythematous nodula lesion. pt works with fish tanks.

A

mycobacterium marinum

46
Q

traveler who stupidly drank local stream water. ongoing sx >1 week. abdo bloating, sulphurous burping, intermitten diarrhoea. dx + tx?

A

giardiasis. 1x dose of tinidazole

47
Q

tx for lupus nephritis vs lupus with more joint features?

A

mycophenalate for nepritis. hydroxychloroquine for joint disease

48
Q

formula for sensitivity

A

sensitivity= true positive/ (true positives + false negatives AKA the total number of positive result from the test)

49
Q

in acute asthma, after back to back nebulised salbutamol what is recommended and what is NOT recommended (2x)?

A

recommended: IV magsulf

NOT recommended: IV aminophylline. WHY? limited additional impact wrt bronchodilation and increases the risk of arrhythmias.
IV hydrocortisone - needs 6hrs to work bruh by that time pt dead

50
Q

anti hypertensives that can cause oedema

A

amlodipine, doxazosin

51
Q

alpha blockers are not recommended in patients with….?

A

reduced ejection fraction, bc it increases the risk of cardiac failure

52
Q

proximal myopathy, raised ALP, borderline low calcium, decreased phosphate

A

think vitamin d deficiency

53
Q

ERB-B2/HER2 inhibitors (eg trastuzumab) increase likelihood of ….?

A

dilative cardiomyopathy. HER2 receptors are thought to be preventative for this condition

54
Q

Patients on trastuzumab therefore require what investigation?

A

ECHO before and during therapy

55
Q

what is oxoliplatin commonly administered with for colorectal carcinoma?

A

folinic acid and fluorouracil

56
Q

what is the common adverse effect for patients receiving oxoliplatin?

A

sensory polyneuropathy. Also ototoxicity, myelosuppresiona nd GI toxicity

57
Q

agoraphobia vs social phobia

A

agoraphobia - fear of places where you cannot freely escape

58
Q

l’illusion des sosies

A

an illusion of seeing doubles IE thinking someone close to you is an imposter

59
Q

Which ssri’s are suitable for panic disorders?

A

paroxetine and citalopram

60
Q

HPV is associated with what cancers?

A

anal cancer and cervical cancer

61
Q

incubation period of hep b vs hep a

A

hep b - upto 4 months. hep a - 2-6 weeks

62
Q

characteristic symptoms of leptospirosis

A

headache, fever, mylagia, SUBCONJUNCTIVAL effusions, jaundice (liver failure). Bleeding is not as prominent as in hantavirus infection

63
Q

where is yellow fever endemic?

A

africa and south &central americs

64
Q

typical illness course of yellow fever

A

flu-like illness with severe fever –> gets better –> fever again but also jaundiced and bleeding bc hepatomegaly

65
Q

weil disease???

A

severe form of leptospirosis, presentsw after the initial illness seems to have resolved. a/w with meningitis, hepatic failure, kidney injury

66
Q

congenital vzv infection vs congenital cmv infection

A

vzv: shingles, low birth weight, eye abnormalities
cmv: jaundice, pneumonia, seizures, microcephaly

67
Q

associated bloodwork results of antiphospholipid

A

anti cardiolipin, anti lupus anticoagulant
+ve VDRL (fals positive)
normal PT, prolonged aptt
thrombocytopaenia

68
Q

what is the mechanism of tranexamic acid

A

antifibrinolytic. competitive inhibitor to the enzyme converting plasminogen to plasmin

69
Q

retinitis pigmentosa

A

characterised by gradual loss of night and peripheral vision. pigmented bone-spicules in the mid periphery

70
Q

central retinal VEIN occlusion vs central retinal ARTERY occlusion

A

BOTH: sudden, painless loss of vision in one eye
VEIN: torturous veins, retinal haemorrhages in all 4 quadrants of the eye
ARTERY: pale retina due to iscahemia, cherry red spot on the macula

71
Q

which murmur is diminished in pregnant women?

A

aortic regurg, due to decrease in diastolic pressure, therefore difference in aortic and LV pressure is lower

72
Q

management of choice for torsades de pointes

A

magnesium

73
Q

character of pulse in PDA?

A

collapsing

74
Q

ddx of acute pulm oedema

A

severe LVD, paroxysmal arrhythmias, 3 vessel or left mainstem coronary artery disease

75
Q

skin signs associated with type iii hyperlipoproteinamia

A

palmar xanthomata and tuboeruptive xanthomata

76
Q

skin sign associated with type ii hyperlipoproteinamia

A

xanthoma tendinosum

77
Q

which hyperlipoproteinamia is associated with glucose intolerance and hyperuricaemia

A

type v

78
Q

what are some of the complications of type i hyperlipoproteinamia

A

occlusion of retinal vein, acute pancreatitis, steatosis, organomegaly and lipaemia retinalis

79
Q

systolic-click murmur syndrome

A

mid-systolic mitral valve prolapse with recurrent non-coronary artery chest pains –> leads to excessive stress on the heart and ischaemia. The systolic click improves with standing

80
Q

what ecg changes may be seen in patients with aortic dissection?

A

st changes in inferior leads (ii iii avf) as a backward tear can disrupt flow in the RCA

81
Q

causes of a split second heart sound

A

ASD, right heart failure, pulmonary hypertension

82
Q

what is the criteria for thrombolysis for coronary events

A

1mm st elevation in limb leads or 2mm elevation in chest leads….within 2? 3? hours

MRCP facts I need to know (2 decks)

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