Cramming Qs Flashcards

Question

Gold standard investigation for coeliac

Answer 1

Duodenal biopsy

Answer 2

Villous atrophy Raised epithelial lymphocytes

Answer 3

Older age Fever Left Lower Quadrant pain Leukocytosis Rectal bleeding

Answer 4

Low fibre diet

Answer 5

Inflammation and fibrosis of intra and extra hepatic bile ducts

Answer 6

All ages Jaundice Itching Pain in RUQ Muscle atrophy & weight loss **Associated with IBD**

Answer 7

- Middle aged - Female - **Not** associated with IBD - Hx of autoimmune disease - Itch - Fatigue - Jaundice

Answer 8

Anti-mitochondrial Ab (AMA)

Answer 9

PSC - conservative. No direct treatment PBC - ursodeoxycholic acid & potential transplant

Answer 10

Upper GI endoscopy

Answer 11

Gastroscopy

Answer 12

- Episodes of forceful retching, vomiting, coughing, straining - Black tarry stools - melaena - Hx alcohol abuse - Haematemesis

Answer 13

Non-specific - Skin pigmentation "more tanned" - Lethargy - Weakness

Answer 14

Bloodletting Iron chelating drugs, eg deferoxamine or deferasirox

Answer 15

- Younger age 10-40 - Dysdiadochokinesis / problems with fine motor movements - Eyes changing colour - Stiff & slow movements

Answer 16

'severe epigastric pain that radiates to the back' - Abdo pain after meal - Steatorrhoea - Alcohol abuse - Diabetes is associated

Answer 17

Transmural inflammation with granulomas and lymphoid aggregates

Answer 18

Crypt abscesses Pseudopolyps

Answer 19

Pernicious anaemia Mild jaundice + anaemia pallor

Answer 20

Hodgkin's lymphoma

Answer 21

Iron deficiency anaemia

Answer 22

IM hydroxycobalamin (B12)

Answer 23

Iron - duodenum Folate - jejenum B12 - terminal ileum

Answer 24

B12 - neuro symptoms, folate does not

Answer 25

GAG → GTG adenine → thymine glutamic acid → valine overall

Answer 26

Philadelphia chromosome t[9:22]

Answer 27

Tyrosine kinase inhibitor = imatinib

Answer 28

- Difficulty swallowing solids - Regurg rather than reflux - Slow oesophageal movement

Answer 29

Anti-tTg antibody - must keep gluten in diet for 6 weeks

Answer 30

Gastric - worse with eating Duodenal - improve after eating

Answer 31

- Achalasia - Barrett's oesophagus - Diverticulitis - FHx - ↑ age - Male - GORD - Alcohol + smoking - Hiatal hernia

Answer 32

Prednisolone

Answer 33

During or after a course of Abx

Answer 34

Polycythaemia rubra vera

Answer 35

Rectal prolapse

Answer 36

Autonomous, abnormal, persistent, new growth

Answer 37

Hb electrophoresis

Answer 38

When RBCs fail to form haem Iron deposits in the mitochondria

Answer 39

Eosinophils, basophils, neutrophils (all derived from myeloid progenitor cells)

Answer 40

A palpable gallbladder in the presence of painless jaundice Rules out gallstones So likley to be an obstructing pancreatic or biliary neoplasm

Answer 41

LOES Loss of joint space Osteopenia Erosion of bone Swelling of soft tissue

Answer 42

Ulnar deviation Swan neck fingers Boutenniere deformity

Answer 43

Herberden's node - distal Bouchard's node - proximal

Answer 44

Type III | (3 letter in SLE = type 3)

Answer 45

Increased fibroblast activity So increased collagen deposition

Answer 46

CREST Calcinosis - calcium deposition in subcutaneous tissue Raynauds Eosophageal dysmotility or strictures Sclerodactyly - local thickening/tightness of skin on fingers/toes Telenagiectasia - spider veins

Answer 47

Inhibits osteoclasts | (1st line treatment in osteoporosis)

Answer 48

Radial nerve

Answer 49

Sacroilitis

Answer 50

All are normal

Answer 51

- Serum calcium = LOW - Serum phosphate = LOW - ALP = HIGH - PTH = HIGH

Answer 52

Salmonella

Answer 53

E.coli or pseudomonas

Answer 54

Long needle-shaped crystals Negatively bifringent under plane polarised light

Answer 55

Rhomboid shaped crystals Positively bifringent under plane polarised light

Answer 56

Localised disorder of bone remodelling Leads to ↑ bone resorption followed by ↑ formation of weaker bone

Answer 57

Older male Bone pain Deafness Skull thickening Fractures Osteosarcoma

Answer 58

Raised ALP

Answer 59

Sensitive = ANA Specific = anti-ds DNA

Answer 60

CRP - normal ESR - raised

Answer 61

Thrombosis and or recurrent miscarriages - Coagulation defects - Thrombocytopenia - Obstetric issues

Answer 62

Lytic bone lesions Onion skin appearance

Answer 63

Sunburst/sunray spiculation

Answer 64

Popcorn calficications Lytic lesions

Answer 65

SHATTERED S - steroid use H - hyperthyroidism & hyperparathyroidism A - alcohol & tobacco T - thin (low BMI) T - Testosterone decrease E - early menopause R - renal or liver failure E - erosive/inflammatory bone disease D - dietary calcium decrease

Answer 66

Irregularly irregular Absent P waves

Answer 67

Saw tooth with F waves between QRS complex

Answer 68

PR interval remains the same length QRS complexes dropped

Answer 69

ECG - saddle shaped ST elevation

Answer 70

Amlodipine

Answer 71

Alcohol abuse Gallstones

Answer 72

Fungal or TB

Answer 73

Reduces level of calcium in the blood

Answer 74

Anti-GBM | (anti-glomerular basement membrane)

Answer 75

Methotrexate

Answer 76

Modify RFs _(or) Pharmacological:_ NSAIDs or Colchicine

Answer 77

Allopurinol

Answer 78

Rickets is osteomalacia in children

Answer 79

Defective mineralisation of newly formed bone matrix or osteoid in adults Due to low phosphate or calcium and ↑ bone resorption

Answer 80

Loading dose of aspirin

Answer 81

Sodium valproate In pregnant women give Imotrigine

Answer 82

Levetiracetam or topiramate

Answer 83

Ethosuximide

Answer 84

Mutation on chromosome 4 leading to repeated CAG

Answer 85

Beta-amyloid plaques Neurofibrillary tangles

Answer 86

Cholinesterase inhibitors

Answer 87

Lewybodies in **occipito-parietal** region

Answer 88

Cholinesterase inhibitors

Answer 89

Excruciating pain - localised around one eye - Watery blood shot eye - Facial flushing - Rhinorrhoea - Miosis/ptosis

Answer 90

Sumatriptan

Answer 91

GD-enhancing plaques

Answer 92

Supportive care Riluzole - delays need for respiratory assistance

Answer 93

Symptom control - reversible ACHesterase inhibitors, eg pyridostigmine Immunosuppression Thymectomy

Answer 94

Tensilon test will be positive A person tests positive for myasthenia gravis if their muscles get stronger after being injected with Tensilon. Tensilon prevents the breakdown of ACh

Answer 95

Antibodies to post-synaptic acetylcholine receptors (anti-ACh)

Answer 96

CT neck scan - thymoma is common in MG patients

Answer 97

Kernig's and Brudzinski's

Answer 98

Positive = resistance to extension of leg while hip is flexed

Answer 99

Flexion of the hips and knees in response to neck flexion

Answer 100

Blood cultures = first line

Answer 101

Campylobacter jejenum

Answer 102

Sudden growing weakness up to 6 weeks after an infection Weakness spreads proximally Glove & stocking distribution

Answer 103

Slow conduction velocities Protein in CSF

Answer 104

FVC - monitor pulmonary function

Answer 105

Antiganglioside antibodies (anti-GM1)

Answer 106

1 - propanolol (not in asthmatic) 2 - topiramate (not in pregnancy) 3 - amitryptilline

Answer 107

Personality change

Answer 108

Non-contrast CT of kidneys, ureter and bladder

Answer 109

1: GFR\>90 2: 60-89 3a: 45-59 3b: 30-44 4: 15-29 5: \<15

Answer 110

- Loin pain - Fever - Pyuria

Answer 111

Ciprofloxacin or co-amoxiclav

Answer 112

- Hypotension - Hypovolaemia - Low cardiac output (ie HF) - Low renal perfusion

Answer 113

- Glomerulonephritis - Vasculitis - Rhabdomyolysis - Acute tubular necrosis

Answer 114

- Stones - BPH - Prostate cancer - Bladder cancer - Blood clots - Urethral stricture

Answer 115

IM ceftriaxone

Answer 116

- **Painless** haematuria - Weight loss - UTI symptoms with bacteriuria

Answer 117

Flexible cystoscopy

Answer 118

IgA nephropathy

Answer 119

Focal segmental glomerulosclerosis

Answer 120

Oxybutynin

Answer 121

Transrectal US guided biopsy

Answer 122

NSAIDs ACEi Aminoglycides ARB Loop diuretics

Answer 123

Slow the progression of the disease * - DM treatment * - HTN treatment Reduce risk of CVD * - Statin Manage complications * - Give vit D * - Treat anaemia

Answer 124

LUTS Haematuria Back pain

Answer 125

IM ceftriaxone

Answer 126

Painless lump Hydrocele Gynacomastia

Answer 127

Generally asymptomatic Microscopic haematuria

Answer 128

Oliguria SOB

Answer 129

Anti-GBM antibodies in blood

Answer 130

- Plasma exchange - Steroids - Cyclophosphamide

Answer 131

- Haematuria - Evidence of strep infection

Answer 132

- Purpuric rash on legs - Nephritic symptoms - haematuria etc - Joint pain

Answer 133

- Steroids - ACEi/ARB

Answer 134

Anti phospholipase A2 receptor antibody

Answer 135

- Haematuria - Flank pain - Palpable abdo mass

Answer 136

- Bloods - polycythaemia - Raised BP - due to renin secretion - US - CT/MRI - CXR - cannonball mets

Answer 137

- Klebsiella - E.coli - Enterococci - Proteus - Staphylococcus coagulase -ve

Answer 138

Mid-stream urine and culture

Answer 139

- Cefalexin - Analgesia

Answer 140

Urine culture & sensitivity

Answer 141

Ciprofloxacin or levofloxacin

Answer 142

Azithromycin 1g dose Doxycycline

Answer 143

- Testicular pain - Dysuria

Answer 144

- Pelvicoureteric junction - Pelvic brim - Vesicouretal junction

Answer 145

Dehydration High salt intake Obesity - lowers bodily pH Oxalate rich diet Gout

Answer 146

Non-contrast CT of KUB

Answer 147

Nucleic acid amplification test (NAAT)

Answer 148

High urea - Pericarditis - Encephalopathy - Renal colic

Answer 149

Chlamydia trachomatis

Answer 150

1. Diet & lifestyle changes 2. Metformin

Answer 151

- Severe dehydration - Decreased level of consciousness - Hyperglycaemia - Hyperosmolality - No ketones in blood or urine - Stupor or coma

Answer 152

- Replace fluid - IV saline - Insulin - low rate of infusion - Restore electrolytes - LMWH

Answer 153

- ABC management - Replace fluid with 0.9% IV saline - IV insulin - Restore electrolytes, eg K+

Answer 154

- Orbital inflammation & swelling of extra-ocular muscles - Eye discomfort - Grittiness - Increased tear production - Diplopia

Answer 155

Aspirin (in v v symptomatic cases give prednisolone)

Answer 156

TSH receptor stimulating antibodies (TSHR-Ab)

Answer 157

Carbimazole

Answer 158

TPO antibody will be present

Answer 159

Thyroid nodules Cervical lymphadenopathy Thyroid gland ↑ in side, is hard or irregular in shape Dysphagia Hoarseness of voice

Answer 160

IGF-1 will be raised

Answer 161

Oral glucose tolerance test - No suppression of glucose - Since normally glucose should inhibit GH release & this isn't happening

Answer 162

- Somatostatin analogue - GH receptor antagonist - Dopamine agonist

Answer 163

Hypertension Hypokalaemia - Weakness/cramps - Paraesthesia - Polyuria - Polydipsia

Answer 164

Spironolactone

Answer 165

Laparoscopic adrenalectomy

Answer 166

- Female - Fatigue - Anorexia & weight loss - Skin more pigmented - Diarrhoea, constipation, abdo pain

Answer 167

U+Es - Hyponatraemia - Hyperkalaemia - Hypoglycaemia

Answer 168

Short synACTHen test Result = low cortisol

Answer 169

1⁰= parathyroid gland produces excess PTH 2⁰= caused by low calcium → excess PTH to compensate 3⁰= autonomous PTH secretion

Answer 170

1⁰ = parathyroid gland failure - autoimmune or idiopathic 2⁰ = following parathyroidectomy or thyroidectomy

Answer 171

Low PTH → low Ca * Convulsions * Arrhythmias * Tetany * Spasms * Hand numbness

Answer 172

Stones, moans, groans etc - Kidney stones - Constipation - Abdo pain - Depression & other psychiatric problems

Answer 173

Hypernatraemia (excess water lost so sodium levels in blood not 'watered down')

Answer 174

SABA SABA + ICS SABA + ICS + LTRA SABA + ICS + LABA (+LTRA in adults)

Answer 175

SABA & LABA + LAMA SABA & LABA + LAMA + ICS

Answer 176

SABA or SAMA & LABA + ICS SABA & LABA + LAMA + ICS

Answer 177

- Usually following trauma (or underlying condition) - Young, male, tall, thin - Chest pain - Dyspnoea - Absent breath sounds on auscultation

Answer 178

CXR - area devoid of lung markings periperhal to the edge of the collapsed lung

Answer 179

Aspirate or chest drain

Answer 180

\<1cm = O2 & admit 1-2cm = aspirate \>2cm = chest drain

Answer 181

CXR - upper lobe cavitation

Answer 182

Sputum sample - Ziehl Niehsen stain

Answer 183

RIPE Rifampacin Isonazid Pyrazinamide Ethambutol

Answer 184

Rifampacin - orange urine Isonazid - neuropathy Pyrazinamide - gout Ethambutol - optic neuritis

Answer 185

- Neonatal jaundice - Recurrent chest infections - Steatorrhoea - Malabsorption - DM - Male infertility

Answer 186

- Postural drainage & chest physio - High calorie, high fat diet - Pancreatic supplementation - Minimise contact with other infective patients

Answer 187

- Cystic fibrosis - Post-infection - Lung cancer

Answer 188

- Cough - khaki coloured sputum - Dyspnoea - Haemoptysis - Recurrent chest infections

Answer 189

CXR: dilated bronchi with thickened walls Sputum: H.influenzae most common

Answer 190

- Physical training - Postural drainage - Prophylactic abx - Surgery (localised disease)

Answer 191

Pneumocystitis jiroveci

Answer 192

Legionella - Hx of travel abroad eg to Spain - Dodgy AC - Multiple people from same event with the illness

Answer 193

- SOB - Productive cough - Fever - Pleuritic chest pain - Dull to percus - Increased vocal resonance - Coarse crackles on auscultation

Answer 194

CURB-65 * Confusion * Urea \>7 * RR \>30 * BP\<90 systolic &/or \<60 diastolic * Age ≥ 65yrs

Answer 195

- Abx - O2 - Analgesia - Fluid

Answer 196

- Adenocarcinoma - Squamous cell carcinoma - Large cell & differentiated tumours - Carcinoid tumours

Answer 197

Adenocarcinoma

Answer 198

Cigarette smoking

Answer 199

Epithelial cells in the central bronchus

Answer 200

Breast Bowel Bladder Kidney Prostate

Answer 201

CXR - Opacified lesion - Hilar enlargement - Pleural effusion - Collapse

Answer 202

Usually related to inflammation so local - Lung cancer - Pneumonia - Rheumatoid arthritis - TB

Answer 203

- Congestive HF - Fluid overload - Hypoalbuminaemia (fluid shifting)

Answer 204

- SOB - Cough - Stony dull percussion over effusion - Reduced breath sounds - Tracheal deviation away from effusion

Answer 205

CXR - Blunting of costophrenic angle - Fluid in lung fissures - Meniscus - Tracheal and mediastinal deviation if large effusion

Answer 206

If fluid overload or CHF cause: **diuretic** Infective: **antibiotics** Large effusions: **aspiration or drainage**

Answer 207

- Acute onset SOB - Cough +/- haemoptysis - Pleuritic chest pain - DVT - Hypoxia - Tachycardia - Low grade fever

Answer 208

WELLS score

Answer 209

1st line - Apixaban or rivaroxaban DOAC 2nd line - or LMWH

Answer 210

- Chest pain - Haemoptysis - Dyspnoea - Auscultation - hyperresonant breath sounds

Answer 211

Mid-axillary line of 5th intercostal space - Anterior/lateral edge of latissimus dorsi - Lateral edge of pectoralis major

Answer 212

Increased vocal resonance Coarse crackles Dull to percus

Answer 213

Fine respiratory crackles

Answer 214

High ADH → hyponatraemia High ACTH → Cushing's High PTH → hyperparathyroidism

Answer 215

- cANCA positive - Hearing loss, sinusitis, nose bleeds - Saddle shaped nose due to perforated septum

Answer 216

Anti-LA & Anti-Ro are specific to Sjogren's Schirmer test

Answer 217

* Squaring of vertebral bodies * Subchondral sclerosis and erosions * Syndesmophytes * Ossification of the ligaments, discs and joints * Fusion of the facet, sacroiliac and costovertebral joints

Answer 218

1. DMARD, eg methotrexate or sulfasalazine 2. 2 of the above 3. Methotrexate + biologic (usually anti-TNF) 4. Rituximab

Answer 219

- Felty's syndrome (RA, neutropenia, splenomegaly) - Anaemia of chronic disease - Pulmonary fibrosis - Amyloidosis

Answer 220

RA Neutropenia Splenomegaly → repeated infections

Answer 221

- V high creatinine kinase - Gottron lesions - Photosensitive erythematous rash on back & neck - Purple rash on face & eyelids - Subcutaenous calcinosis - Anti-Jo-1 antibodies

Answer 222

_Dermatomyositis_ - Anti-Jo-1 - Anti-Mi-2 - ANA _Polymyositis_ - Anti-Jo-1

Answer 223

Dermatomyositis is chronic inflammation of the **skin and muscles** Polymyositis = chronic inflammation of the **muscles only**

Answer 224

Rhabdomyolisis

Answer 225

- Low income - Being divorced - Low education status - Depression - Overprotective family **or** lack of support - Middle age

Answer 226

Flucloxacillin

Answer 227

- Hx infection, eg tonsilitis - Conjunctivitis - Urethritis - Enthesitis 'can't see, can't pee, can't climb a tree'

Answer 228

Hereditary retinoblastoma

Answer 229

Osteosarcoma

Answer 230

Ulcerative colitis Cholangiocarcinoma

Answer 231

- Hepatocellular carcinoma - RA (or other autoimmune condition)

Answer 232

Carbamazepine

Answer 233

Dysarthria Dysphagia Nasal regurgitation of fluids and choking LMN lesions of tongue & muscles of talking or swallowing → absent jaw jerk reflex Flaccid fasciculating tongue Change in speech

Answer 234

Drowsy Headache Vomiting

Answer 235

N. gonorrhoeae (S.aureus in whole population)

Answer 236

1st line = USS Gold standard = MRCP

Answer 237

CT abdomen | (US = first line)

Answer 238

Extra-dural

Answer 239

HbA1c (level \>48 indicates dabetes

Answer 240

Increases insulin production: - Binds to K+ channels in ß cells - Increases depolarisation

Answer 241

Exogenous steroids

Answer 242

- Rebound tenderness - Shoulder tip pain - Localised guarding - Rigidity

Answer 243

Spontaneous bacterial peritonitis

Answer 244

Haemachromatosis 1. Venesection Gold = liver transplant

Answer 245

Gentamicin

Answer 246

Augmented - predictable, dose dependent, common Bizarre - not predictable and not dose dependent Chronic - due to a cumulative dose, time-related Delayed - become apparent a while after using the medication End of use - occur after abrupt drug withdrawal

Answer 247

Morphine & constipation (eg predictable)

Answer 248

Not predictable and not dose dependent eg anaphylaxis & penicillin

Answer 249

Osteoporosis and steroids

Answer 250

Thalidomide and limb abnormalities in babies

Answer 251

Opiate withdrawal syndrome

Answer 252

Peripheral zone

Answer 253

Transitional zone

Answer 254

Squamous cell carcinoma

Answer 255

Urothelial carcinoma

Answer 256

Older age Alcoholism Hx of recurrent head trauma

Answer 257

CT head Lumbar puncture

Answer 258

Xanthrochromic (straw coloured due to breakdown of bilirubin in RBCs)

Answer 259

Ptosis (drooping upper eyelid) Miosis (pupil constriction) Anhidrosis (ipsilateral loss of sweating)

Answer 260

Inhaled corticosteroid

Answer 261

- Signet-ring sign = prominent dilated airway compared to accompanying vessel

Answer 262

Away from the affected lung

Answer 263

Pulmonary embolism COPD Obstructive sleep apnea Obesity CVD

Answer 264

- Chest pain - Signs of cor pulmonale, eg oedema, hepatomegaly - Lethargy - Fatigue - Exertional dyspnoea

Answer 265

- Young, black female - Dry cough - SOB - Erythema nodosum - Fever - Fatigue - Weight loss - Polyarthralgia _Lofgren's triad = bilateral hilar lymphadenopathy, erythema nodosum, polyarthralgia_

Answer 266

US guided biopsy of mediastinal lymph nodes - Non-caseating granulomas with epithelioid cells

Answer 267

1st line = no treatment 2nd line = steroids (if treatment required) 3rd = methotrexate Final: lung transplant

Answer 268

- Flattened hemidiaphragm - Hyperinflation - Bullae

Answer 269

Mesothelioma

Answer 270

Intrapulmonary * idiopathic pulmonary fibrosis * extrinsic allergic alveolitis * coal worker's pneumoconiosis/progressive massive fibrosis * silicosis * sarcoidosis * drug-induced fibrosis: amiodarone, bleomycin, methotrexate * asbestosis Extrapulmonary * neuromuscular disease: polio, myasthenia gravis * obesity * scoliosis

Answer 271

Immunological memory to something causing an immediate and often severe allergic response

Answer 272

Hayfever Anaphylaxis

Answer 273

Cytotoxic, antibody dependent Immunoglobulins bound to surface antigens on a target cell which is actually a host cell

Answer 274

Goodpasture's

Answer 275

Immune complex disease Antibodies bind to soluble antigen forming a circulating immune complex Little lumps get deposited in skin, lung etc activating immunity → local inflammation

Answer 276

Delayed T cell mediated TH cells activated by APC When antigen appears again, macrophages are activated → inflammatory response

Answer 277

Exposure to poison ivy → contact dermatitis

Answer 278

If ≤1, first line = quantative D-dimer If ≥2, first line = proximal leg vein USS

Answer 279

If score ≤4, first line =quantative D-dimer test If score \>4, first line = immediate CT pulmonary angiogram

Answer 280

Mesothelioma Ovarian carcinoma

Answer 281

Bone and soft tissue tumours

Answer 282

* Melanoma * Breast * Lung * GI tumours

Answer 283

Ipatropium

Answer 284

Tiotropium

Answer 285

Kernig's sign

Answer 286

Brudzinski's neck sign

Answer 287

- Head CT - Throat swabs - Bloods: FBC, CRP - Pneumococcal and meningiococcal PCR

Answer 288

Neisseria meningitidis

Answer 289

Urgent cefotaxime IV Consider amoxicillin if pt immunocompromoised or over 55

Answer 290

Benzylpenicillin

Answer 291

Act to stop the breakdown of dopamine clearance, increases dopamine available

Answer 292

- Contralateral motor weakness of upper limbs - Contralateral sensory loss of upper limbs - Hemianopia - Face drop - Aphasia - Dysphasia

Answer 293

- Contralateral weakness and sensory loss of the lower limb - Incontinence - Drowsiness - Truncal ataxia - drunken sailor gait

Answer 294

- Loss of peripheral vision - Cortical blindness - eye healthy, but vision lost - Prosopagnosia - cannot see faces - Unilateral headache

Answer 295

- New headache with hx cancer - Cluster headache - Seizure - Altered: consciousness, memory, co-ordination, confusion

Answer 296

Decreased tone/flaccid Decreased reflexes Muscle wasting Fasciculations

Answer 297

- Increased tone - Brisk reflexes - Minimal muscle atrophy - Babinski's sign

Answer 298

Occurs after the sole of the foot has been firmly stroked. Big toe moves upwards in a positive result Can indicate * UMN lesion * Stroke * Brain injury or tumour * MS * Meningitis * Spinal cord tumour or injury

Answer 299

Median nerve

Answer 300

Herniated disc

Answer 301

Reversible AChsterase inhibitors (usually pyridostigmine) Immunosuppression (prednisolone) Thymectomy

Answer 302

Reversible acetylcholinesterase inhibitor - Increases amount of ACh in NMJ - Improves symptoms of MG

Answer 303

No treatment option to slow or stop disease progression * Speech & language therapy * Genetic counselling Symptom relief: * Antipsychotics * Benzodiazepines * Dopamine depleting agents

Answer 304

* IV immunoglobulins * Plasma exchange * Supportive care * Venous thromboembolism prophylaxis

Answer 305

Small cell lung cancer

Answer 306

Autonomic dysfunction is not caused by MG, but is caused by LEMS Presence of acetylcholine receptor (AChR) antibodies strongly suggests MG

Answer 307

Amifampridine Investigate for SCLC

Answer 308

Amifampridine - Allows more ACh to be released in the NMJ synapses - Prolongs depolarisation of cell membranes - Improves symptoms in LEMS

Answer 309

Inherited mutations Typically affect Schwann cells & myelin → demyelination

Answer 310

- High foot arches - Distal muscle wasting - Weakness in lower legs → ankle dorsiflexion - Weakness in the hands - Reduced tendon reflexes - Reduced muscle tone - Peripheral sensory loss

Answer 311

Deficiency of thiamine

Answer 312

Suggests muscular dystrophy Children with proximal muscle weakness use a specific technique to stand up from a lying position: * They get onto their hands and knees * Then push their hips up and backwards like the “downward dog” yoga pose. * They then shift their weight backwards and transfer their hands to their knees. * Whilst keeping their legs mostly straight they walk their hands up their legs to get their upper body erect.

Answer 313

X-linked recessive

Answer 314

- Boys - Aged 3-5 years - Vague symptoms of muscle weakness ?FHx

Answer 315

- Oral steroids can slow progression - Creatine supplementation - OT - Physio - Surgical & medical management of complications eg scoliosis

Answer 316

Herpes simplex virus

Answer 317

- Localised pain in a dermatome - Erythematous maculopapular rash - in affected dermatome - Fever, headache etc

Answer 318

- Reduce pain using analgesics - Aciclovir

Answer 319

Increases them ACEi → reduces aldosterone & ADH so more Na+ lost so more K+ retained

Answer 320

Lowers them

Answer 321

Elevated plasma free metanephrines (made when body breaks down adrenaline & noradrenaline - has longer half life than them)

Answer 322

- Bind to an ATP-dependent K+ channel on the cell membrane of beta cells - Increasing insulin secretion

Answer 323

Glucose - low Sodium - low Potassium - high

Answer 324

Chief cells

Answer 325

Grave's disease

Answer 326

- Bradycardia - Reflexes relax slowly - Ataxia - Dry/thin hair & skin - Yawning, drowsiness, coma - Cold hands - Ascites - Round puffy 'moon' face - Immobile

Answer 327

- Palpitations - Headache - Episodic sweating - Anxiety - HTN

Answer 328

Liver Carcinoid tumour = a rare, slow growing tumour

Answer 329

Lactic acidosis

Answer 330

Frequent hypoglycaemia Weight gain

Answer 331

Bladder cancer (rare)

Answer 332

C5/6-T1 median nerve

Answer 333

Waxy discolouration - 'orange peel' appearance

Answer 334

Ketones \>3mmol/L Glucose \>11mmol/L pH \<7.3

Answer 335

1. Somatostatin analogue 2. Dopamine agonist 3. GH receptor antagonist 4. Radiotherapy

Answer 336

1. Phentolamine 2. Sodium nitroprusside

Answer 337

Developing = iodine deficiency Developed = Hashimoto's

Answer 338

FEV1 percentage of predicted

Answer 339

Pulmonary fibrosis

Answer 340

Pneumonia Asthma Pulmonary embolism COPD

Answer 341

COPD (both T1&T2) Neuromuscular disease

Answer 342

Alpha-feto protein (AFP)

Answer 343

Brain aneurysms → SAH Liver cysts Pregnancy complications Mitral valve prolapse Diverticulitis

Answer 344

Terminal ileum

Answer 345

- Decrease formation of cytokines - Decrease microvascular permeability - Inhibit influx of eosinophils - Reduce bronchial hyper-responsiveness

Answer 346

Left renal vein (so varocele more common on this side)

Answer 347

Inhibit cross-linking of peptidoglycan in bacterial cell walls

Answer 348

Inhibit bacterial protein cell synthesis by binding to the 50S subunit of the ribosome

Answer 349

Right lower lobe

Answer 350

MOCA - Montreal cognitive assessment MMSE - mini mental state exam ACE3 - Addenbrooke's cognitive exam 3

Answer 351

Lining of small intestine

Answer 352

Benzanthine penicillin or azithromycin

Answer 353

Thiazide diuretics Modify RFs - stay hydrated, lose weight, less oxalate in diet (eg red meat)

Answer 354

Angina worse on lying down

Answer 355

Pericarditis about 2-8/12 weeks after an MI

Answer 356

Tricuspid regurgitation

Answer 357

Buerger's test

Answer 358

Tall T waves & short QT interval

Answer 359

IVDU - s.aureus General - S.viridans Prosthetic valves - Staph epidermis

Answer 360

Uric acid = Radiolucent (not visible) Calcium/magensium = radiopaque or radiodense

Answer 361

Less than 2 months old

Answer 362

No. true positives

Answer 363

No. true negatives

Answer 364

No. cases in a given day

Answer 365

No. new cases in a given day

Answer 366

Primary = prevention Secondary = early detection & stop progression (treat) Tertiary = reduce/treat complications

Answer 367

Either a resolved or chronic infection

Answer 368

Acute infection

Answer 369

Ectopic pregnancy Bowel obstruction Peptic ulcer perforation Gastritis from H.pylori

Answer 370

- Ataxia - Opthalmoplegia - Confusion

Answer 371

Sarcoidosis - Fever - Erythema nodosum - Bilateral hilar lymphadenopathy

Answer 372

Pink, waxy, flat

Answer 373

Red, scaly, firm

Answer 374

RA, low WCC, splenomegaly

Answer 375

Brain - seizures Heart - pericarditis Kidneys - kidney failure

Answer 376

Calcitonin & bisphosphonates

Answer 377

B12 or folate deficiency

Answer 378

Group B strep

Answer 379

S. pnuemoniae

Answer 380

N. meningitidis

Answer 381

Listeria monocytogenes

Answer 382

Characterising baseline dyspnoea in patients with resp diseases such as COPD

Answer 383

PVD has no loss of bowel control, cauda equina does

Answer 384

Indicates appendicitis Pain in right abdo on palpating left

Answer 385

Corticosteroids - prednisolone Ciclasporins - in very severe cases 5-ASA - Aspirin Thiopurines - azathioprine Biologics - infliximab, adalimumab

Answer 386

PSC Ankylosing spondylitis Uveitis Erythema nodosum NAFLD

Answer 387

Large & small irregular hypochromic RBCs

Answer 388

Megaloblastic anaemia

Answer 389

Translocation of a gene between chromosome 9&22 → philadelphia chromosome

Answer 390

K+ = high Urate = high Phosphate = high Calcium = low

Answer 391

- IV fluids - Medication to decrease uric acid - Replacement of electrolyte balance

Answer 392

Blast cells \>20%

Answer 393

PKD1 gene on chromosome 16

Answer 394

At least 2 cysts either uni or bilaterally if aged \<30yrs At least 2 cysts in each kidneys age 30-59yrs At least 4 cysts in each kidney age \>60yrs

Answer 395

Goodpasture's - anti-GBM Wegener's - c-ANCA

Answer 396

1. Tumour \<7cm and only in the kidney 2. \>7cm and only in the kidney 3. Tumor is growing into a major vein, eg IVC 4. Tumour is growing beyond Gerota's fascia and might've reached the adrenal gland

Answer 397

Transitional cell carcinoma

Answer 398

Aromatic amines found in dyes, rubber, cigarette smoe

Answer 399

Royal Marsden Staging System

Answer 400

Female, sexual activity, pregnancy, DM, menopause, catheterisation

Answer 401

10^5 per ml

Answer 402

1st/2nd trimester = nitrofurantoin 3rd = amoxicillin/cefalexin

Answer 403

Blood cultures Urine output Fluid Abx Lactate Oxygen

Answer 404

More than 2mmol/L

Answer 405

International prostate scoring system (IPSS)

Answer 406

Reducible Separate to testis Bowel sounds present

Answer 407

Renal cell carcinoma - Should usually disappear on lying down so if it doesn't there is likely a blockage in the renal vein → ?cancer

Answer 408

Both - fresh red blood & chronic constipation Fissures only - sharp anal pain on defaecation, haemorrhoids are painful all of the time

Answer 409

Contrast CT colonography

Answer 410

Weight loss Cervical lymphadenopathy Anorexia Vomiting

Answer 411

Abnormal thickening of the skin in the palm of your hand and at the base of your fingers → one or more fingers curl/contract - sign of chronic liver disease

Answer 412

Livver cirrhosis

Answer 413

- Infectious - Secretory - Osmotic - Dysentry - Exudative

Answer 414

Bristol stool chart

Answer 415

Dilated jejenum or ileum Absence of gas in bowel distal to the obstruction

Answer 416

- Nil by mouth - Insert NG tube to decompress the bowel - Analgesia - IV fluids & correct electrolytes - Urinary catheter - Suitable anti-emetics

Answer 417

Ischaemia or strangulation

Answer 418

- Helicobacter pylori infection - NSAIDs - Alcohol abuse

Answer 419

Internal: painless covered in mucus, can also prolapse External: form at the anal opening, painful, covered with skin

Answer 420

- Weight loss - Healthy eating - Smoking cessation - Eat smaller meals - Eat evening meals 3-4 hours before going to bed - Reduce alcohol consumption - Raise the head of the bed/use more pillows

Answer 421

Macroscopic: skip lesions, mouth to anus, cobblestone mucosa Microscopic: transmural, granuloma, goblet cells, fewer crypt abscesses than UC GALS:Granuloma; All; Layers and Levels; Skip lesions

Answer 422

Urea breath test Stool antigen test Blood IgG antibody detection

Answer 423

- Large bowel perforation - Fistual formation - LBO - Bleeding - Mucosal inflammation

Answer 424

IV terlipressin IV somatostatin

Answer 425

- Crohn's - Ectopic pregnancy - UTI - Diverticulitis - Perforated ulcer - Food poisoning

Answer 426

Mental changes Sepsis (plus RUQ pain, jaundice & fever)

Answer 427

Amoxicillin - Clarithromycin - Omeprazole

Answer 428

Haemachromatosis

Answer 429

Hours after: tall T waves, ST elevation Days after: T wave inversion, pathological Q waves

Answer 430

1. Asymptomatic 2. Intermittent claudication 3. Rest pain/nocturnal pain 4. Necrosis

Answer 431

Stenosis → reduced renal perfusion → ↑ renin → ↑ RAAS = higher BP

Answer 432

* Severe crushing chest pain that radiates to left arm & shoulder * Nausea & vomiting * Sweating * Pallor * SOB * Dizzy

Answer 433

Infarction = death of **heart** muscles cells due to a reduced or absent blood supply Ischaemia = restriction in blood supply to tissues causing a shortage of oxygen that is needed for cell function

Answer 434

Cardiogenic Hypovolaemic Anaphylactic Septic Neurogenic

Answer 435

Cardiogenic - heart problems Hypovolaemic - too little blood volume Anaphylactic - allergic reaction Septic - infection Neurogenic - damage to NS

Answer 436

Neurogenic

Answer 437

- Tachycardia - Mydriasis - Dry mouth - Hypohidrosis - Constipation - Urinary retention

Answer 438

Upper GI bleed → high urea level

Answer 439

- Vit D deficiency - Renal failure - Inherited - Liver disease

Answer 440

Schober's test

Answer 441

1. Xanthine oxidase inhibitor 2. So xanthine is not metabolised into uric acid 3. Inhibiting XO lowers plasma uric acid 4. And precipitation of uric acid in joints/kidneys

Answer 442

Lytic: excessive osteoclast resorption Mixed: excessive osteoclast resorption and formation of disorganised bone Blastic: osteoblasts lay down excess disorganised weak bone

Answer 443

a. Buttocks = lower aorta or iliac b. Thigh = iliac or common femoral c. Upper 2/3 calf = superficial femoral d. Lower 1/3 = popliteal e. Foot = tibial or peroneal artery

Answer 444

Primary - inherited/genetic muation Secondary - PKD, hydronephrosis, fanconi syndrome, renal amyloidosis, hypercalcaemia, HIV infection, iatrogenic

Answer 445

Glucose - normal Sodium - high Potassium - low Serum osmolality - high

Answer 446

- Raised intraepithelial lymphocytes - Crypt hyperplasia - Villous atrophy

Answer 447

* Acute renal failure - due to dehydration!! * Sepsis * ARDs * Pancreatic abscess * Ascites * Enteric fistula * Chronic pancreatitis * Abdo compartment syndrome

Answer 448

I GET SMASHED * Idiopathic * Gallstones * Ethanol * Trauma * Scorpion venom * Mumps/malignancy * Autoimmune * Steroids * Hyperlipidaemia * ERCP * Drugs = NSAIDs + diuretics + steroids

Answer 449

* Gottron lesions (scaly erythematous patches) on the knuckles, elbows and knees * Photosensitive erythematous rash on the back, shoulders and neck * Purple rash on the face and eyelids * Periorbital oedema (swelling around the eyes) * Subcutaneous calcinosis (calcium deposits in the subcutaneous tissue)

Answer 450

- Creatine kinase - Electromyography - Muscle biopsy = gold standard - Autoantibodies - Spirometry

Answer 451

Seen in patients with MS - Dysarthria - Nystagmus - Inattention tremor

Answer 452

- Ghon complex - Ghon focus - Dense homogenous opacity - Hilar lymphadenopathy - Pleural effusion

Answer 453

Caseating granuloma

Answer 454

- Mucus secretion/production - Smooth muscle contraction - Thickening of airways

Answer 455

Non-caseating granuloma

Answer 456

- Cystic fibrosis - Infection, eg whooping cough, TB - Immunodeficiency - Airway obstruction - Idiopathic

Answer 457

- Coarse crackles heard in early inspiration - Wheeze - Clubbing

Answer 458

- Repeated infection & deteriorating lung function - Empyema - Lung abscess - Pneumothorax from repeated coughing - Life-threatening haemoptysis - Respiratory failure

Answer 459

- COPD - Genetics - Smoking - Trauma - Previous pneumothorax - Resus patients

Answer 460

- SOB - Chest pain - Haemoptysis - Sweating - Anxiety - Dizziness - Palpitations - Arrythmias

Answer 461

Pneumothorax = **hyperresonant** on percussion Pleural effusion = **dull** to percus

Answer 462

Pleural effusion – slower onset, PMH including congestive heart failure, cancer, pneumonia and PE Pneumothorax – rapid onset, history of trauma, family history of pneumothorax, smoking

Answer 463

BACAS **B**eta blocker **A**CEi **C**lopidogrel **A**spirin **S**tatins (+RF management)

Answer 464

1st = NT-pro-B-type natriuretic peptide Gold = echo

Answer 465

\>2000ng/l

Answer 466

1st - ACEi or beta blocker 2nd - aldosterone antagonist 3rd - sacubitril valsartan or digoxin

Answer 467

Fontaine classification

Answer 468

Circulating failure resulting in inadequate organ perfusion

Answer 469

Complication for ASD & VSD Reversal of L→R to R→L

Answer 470

Continuous machinery murmur

Answer 471

A small volume and slow rising pulse

Answer 472

Elevates TSH Inhibits T3&T4

Answer 473

Ischaemia of cerebral neurones

Answer 474

Occurs when a female has a single X chromosome

Answer 475

IV Prothrombin complex concentrate IV Vitamin K

Answer 476

Plasma cells

Answer 477

RF management Antiplatelet, eg clopidogrel Intervention, eg percutaenous transluminal angioplasty bypass

Answer 478

Hyponatraemia = most common | (also see ↓glucose & ↑K+)

Answer 479

Vaso-occlusive crisis → swelling of hands and feet Splenic sequestration → blood flow in spleen is compromised → acute splenomegaly & pain. Pooling of blood which can lead to anaemia & circulatory collapse → hypovolaemic shock

Answer 480

Adrenaline and noradrenaline

Answer 481

Bacterial: granulocytes, eg neutrophils, eosinophils, basophils Viral: B&T lymphocytes

Answer 482

Secreted into mucous, tears, saliva and colostrum

Answer 483

Antibody of allergens and antiparasitic activity

Answer 484

Made at the beginning of infection - Involved in primary infection response

Answer 485

B cell receptor

Answer 486

Highly specific molecules targeting single 'epitopes'. Primary immunoglobulin

Answer 487

A rare syndrome caused by the metastasis of carcinoid tumours that secrete high levels of serotonin

Answer 488

- Cutaenous flushing - Recurrent diarrhoea - Abdo cramps - Asthma-like wheezing

Answer 489

Surgical resection or octreotide

Answer 490

Chvostek’s sign * Facial twitch on tapping the facial nerve Trousseau’s sign * Positive when a carpopedal spasm of the hand and wrist occurs after an individual wears a blood pressure cuff inflated over their systolic blood pressure a few minutes.

Answer 491

KDIGO staging ## Footnote CK 1.5-1.9x baseline. Urine: \<0.5ml/kg/h for 6-12hrs CK 2.0-2.9x baseline. Urine: \<0.5ml/kg/h 12hrs CK 3.0x baseline. Urine: \<0.5ml/kg/h for 24hrs or no urine for \>12hrs

Answer 492

Fluoxetine

Answer 493

Aspirin + P2Y12 inhibitor eg clopidogrel

Answer 494

Clinical: 140/90 Home: 135/85

Answer 495

Low * Home = 135/85 - 150/95 * Clinical = 140/90 - 160/100 High * Home \>150/95 * Clinical \> 160/100 Severe * Clinical systolic \>180 or diastolic \>110

Answer 496

* Parietal = gastric acid & intrinsic factor * Mucous neck = mucous & bicarb * ECL = histamine * Chief = pepsin & gastric lipase * D = somatostatin * G = gastrin

Answer 497

Phenoxybenzamine - During the surgery, it is possible for large amounts of catecholamine release → refractory HTN - So pre-blocks α receptors to prevent this

Answer 498

Pseudomembranous colitis

Answer 499

E.coli (enteric bacteria)

Answer 500

Risperidone

Answer 501

Haloperidol

Answer 502

Hypercalcaemia

Answer 503

Children under 1 year

Answer 504

Cullen's = blue/purple discolouration around the umbilicus Grey Turner's = flank discolouration

Answer 505

Replenishes the supply of glutathione that conjugates NAPQI to non-toxic compoounds

Answer 506

If ALT\>AST = chronic liver disease If AST\>ALT = cirrhosis and acute alcoholic hepatitis

Answer 507

ABCDE - Ascites - Bleeding - Caput medusae = cluster of swollen veins in abdo - Diminished liver function - Enlarged spleen

Answer 508

Octreotide or terlipressin

Answer 509

Diagnostic aspiration

Answer 510

- Salt restrict - Diuretics

Answer 511

- Mallory bodies - Neutrophil infiltrates

Answer 512

CAGE Cut down? Ever thought you should? Annoyed? Do you get annoyed at others commenting on your drinking? Guilty? Ever feel guilty about drinking? Eye opener? Ever drink in the morning to help your hangover/nerves?

Answer 513

Indicates Wernicke's encephalopathy - Confusion - Ataxia - Encephalopathy

Answer 514

C282Y HFE gene mutation on chromosome 6

Answer 515

- Alpha feto-protein = hepatocellular carcinoma - CA1909 = cholangiocarcinoma

Answer 516

Indicates past infection IgG - immunity Negative HBs-Ag so not current infection

Answer 517

Cholesterol & bile pigment Cholesterol is more common

Answer 518

- Stool culture - Faecal calprotectin - Faecal occult blood

Answer 519

Common peroneal nerve palsy | (L5 radiculopathy if INversion is weak)

Answer 520

Aortic regurgitation - Early diastolic decrescendo murmur

Answer 521

- Mid diastolic rumble

Answer 522

Both are ejection systolic Aortic stenosis = crescendo decrescendo loudest on **expiration** Pulmonary stenosis = loudest on **inspiration**

Answer 523

Cholesterol deposits in the skin & eyes Seen in PBC

Answer 524

- H.pylori - Increased stomach acid production - Recurrent NSAID use - Mucosal ischaemia

Answer 525

Distal colon

Answer 526

- Low fibre diet - Obesity - NSAIDs - Smoking

Answer 527

Reactive arthritis - Conjunctivitis - Urethritis - Arthritis

Answer 528

Plasma exchange asap

Answer 529

IV artesunate

Answer 530

An aggregate of epithelioid histiocytes

Answer 531

- Also known as liver flap = flapping of the hand due to abnormal liver function

Answer 532

Oesophagitis

Answer 533

'pencil in cup' - only in severe cases

Answer 534

Haemophilus influenzae

Answer 535

1. Endothelial dysfunction 2. Fatty streak formation 3. Migration of leukocytes & smooth muscle 4. Foam cell formation 5. Degradation of extracellular matrix

Answer 536

- Nausea - Vomiting - Confusion - Pain/discomfort in RUQ - Jaundiced skin

Answer 537

Azithromycin

Answer 538

_Moderate_ PEFR more than 50-75% best or predicted. _Acute severe_ PEFR 33-50% best or predicted _Life-threatening_ PEFR less than 33% best or predicted

Answer 539

Azathioprine

Answer 540

A PIE SAC * Ankylosing spondylitis * Pyoderma gangrenosum * Iritis * Erythema nodosum * Sclerosing cholangitis (PSC) * Apthous ulcers * Clubbing

Answer 541

5-aminosalicyclic acid (then steroids & then biologics) eg sulfasalazine

Answer 542

Inadequate blood flow through mesenteric vessels → ischaemia Due to thrombosis

Answer 543

- Acute severe abdo pain - No abdo signs on exam - Hypovolaemic shock

Answer 544

- Fluid resus - IV heparin to reduce clot - ABx - metronidazole

Answer 545

1st part of duodenum - duodenal cap

Answer 546

Adhesions from recent surgery

Answer 547

Trauma Paralytic ileus (following surgery)

Answer 548

True - diverticula contains all layers of the gut False - only mucosa and submucosa

Answer 549

Indicates stomach cancer Found near L subclavian vein

Answer 550

Red meat UC FHx Age Alcohol Polyps

Answer 551

- Weight loss - Night sweats - Dysphasia - Unexplained vomiting - Haematemesis

Answer 552

If within 2 hours - PCI If within 12 hours - thrombolysis (alteplase) and then consider PCI

Answer 553

Coronary angiogram

Answer 554

GTN spray & either ß blocker or CCB

Answer 555

- Uveitiis - IBD - Apical lung fibrosis - Aortic regurgitation - Amyloidosis

Answer 556

SABA Steroids Consider O2

Answer 557

SABA Steroids Consider O2 & Mg sulphate

Answer 558

ITU SABA on O2 Steroids Consider O2 Magnesium sulfate Aminophylline Abx Mechanical ventilation

Answer 559

- No nighttime symptoms - Inhaler used no more than 3 times per week - No breathing difficulties, cough or wheeze on most days - Able to exercise without symptoms - Normal lung function test

Answer 560

Symptoms that precede the onset of a disease/illness Typical in migraine

Answer 561

Oral sumitriptan = best (or paracetamol or ibruprofen)

Answer 562

Stimulation/agonist of beta adrenergic receptors

Answer 563

Bone fractures Depression & mood changes HTN Infections Diabetes

Answer 564

Risk of stroke following TIA * Age \>60 = 1 point * BP\>140/90 = 1 point * Clinical features: * speech disturbance without weakness = 1 * unilateral weakness = 2 * Duration of symptoms * 10-59mins = 1 point * 60mins = 2 points * DM in PMH = 1 point 0-3 = low risk, 4-5 = moderate, 6-7 = high risk

Answer 565

- Abscess - Empyema - Resp failure - Septicaemia - Pericarditis

Answer 566

Ciprofloxacin

Answer 567

The proportion of patients who test positive who have the condition

Answer 568

Macrocytic

Answer 569

Clear cell

Answer 570

GnRH - goserelin

Answer 571

- Wide QRS - Short PR - Delta wave

Answer 572

Risk of bleeding in patients on anticoagulants

Answer 573

El Escorial criteria - Definite = signs in 3+ regions - Probable = signs in 2+ regions

Answer 574

Excessive bone remodelling → fusion

Answer 575

New York criteria

Answer 576

FEV1 \<0.8 FEV1/FVC \<0.7

Answer 577

ESR & CRP levels

Answer 578

* Nodules * Vasulitis * Sjogren’s * Pleuritis * Glomerulonephritis * Peripheral neuropathy * Pericarditis * MI

Answer 579

Glasgow Blatchford Score

Answer 580

Calcification of aortic valve Cardiomegaly Dilated ascending aorta Pulmonary oedema

Answer 581

Fever Rigors Night sweats Weight loss Anaemia Splenomegaly Clubbing

Answer 582

Vitamin B1/thiamine Wernicke Korsakoff

Answer 583

Alcohol withdrawal * Acute confusion * Severe agitation * Delusions & hallucinations * Tremor * Tachycardia * HTN * Hyperthermia * Ataxia * Arrhytmias

Answer 584

- Pallor - Koilonychias - Angular chelitis - Atrophic glossitis - Tachycardia

Answer 585

Chromosome 11 | (glutamic acid → valine)

Answer 586

Death Arrhythmias Ruptured septum Tamponade Heart failure Valve disease Aneurysm of ventricles Dressler's syndrome Embolism Reoccurence of ASC

Answer 587

- Dry brittle nails - Hair loss - Atrophic skin - Absent pulses - Intermittent claudication

Answer 588

2nd intercostal space **Left** sternal border

Answer 589

X-linked recessive

Answer 590

A RASH POINts MD * ANA positive (in 90% of patients) * Renal nephritis * Arthritis * Serositis (pleuritis, pericarditis, myocarditis) * Hematological eg anemia, leukopenia, thombrocytopenia * Photosensitivity * Oral/mucosal ulcers * Immunology eg ANA, RHf, Anti-dsDNA (most specific) * Neurological symptoms (eg psychosis, depression, anxiety, siexures) * Malar rash * Discoid rash

Answer 591

Hodgkin's lymphoma

Answer 592

Do not notify the DVLA, but no driving for 1 month

Answer 593

Block reabsorption of glucose in the kidneys

Answer 594

Osteosarcoma

Answer 595

Gram negative bacilli

Answer 596

When collapsed or fluid filled air sacs in the lungs open when you breath Caused by: inflammation, fluid or infection in air sacs in the lung, eg pulmonary oedema

Answer 597

β-lactams, gentamicin, tetracycline and erythromycin

Answer 598

Hyperkalaemia Fluid overload, heart failure and pulmonary oedema Metabolic acidosis Uraemia (high urea) can lead to encephalopathy or pericarditis

Answer 599

T1 hypersensitivity. ## Footnote (IgE) stimulates mast cells to rapidly release histamine and other pro-inflammatory chemicals. This is called mast cell degranulation. This causes a rapid onset of symptoms, with airway, breathing and/or circulation compromise.

Answer 600

Measure mast cell tryptase within 6 hours

Answer 601

Richter's syndrome - transformation of CLL to aggressive lymphoma

Cramming Qs Flashcards

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