Deck 1

Question 1

PTLD occurrence
highest in?
lowest in?

Answer 1

Highest = intestinal/ multi-organ transplant

Lowest = HSCT/ renal transplant

Question 2

Mnx of PTLD?

Answer 2

1st line = Lower the immunosuppressant dose

2nd line = Rituximab

Question 3

Gene responsible for EARLY onset Alzheimers?

Gene responsible for late onset Alzheimers?

Gene reduces risk of Alzheimers most?

Answer 3

early = APP gene - amyloid precursor protein

late = APOE

protective =APOE e2

Question 4

What drugs inhibit glucuronidation?

Answer 4

Valproate

The rest all induce glucoronidation!

Question 5

How is F8 released from vWF?

Answer 5

Thrombin activity

Question 6

When do you start Desmopressin?

Answer 6

NA > 145
+
Urine output > 300 mls/hr for 3 hours

Question 7

Metastatic Head and neck cancer - 1st line treatment? and 2nd line treatment?

Answer 7

1st line - 5-fluorouracil + Cisplatin

2nd line - nivolumab!

Question 8

NUDT15 mutation causes increased side effects of what drug?

Answer 8

Azathiopurine

Question 9

TH17 producing IL17 can be involve in what bone process?

Answer 9

Bone formation and erosion

Question 10

2nd line therapy for ankylosing spondylitis for both Axial and peripheral Ankylosing spondylitis?

Answer 10

TNFa inhibitor and IL7 blocker

( Adalimumab, Secukinumab) -must continue for 2 years!

Question 11

What IL promotes entheseal (enthesitis) inflammation?

What IL promotes osteoproliferation?

Answer 11

Enthesitis = IL-23

Osteoproliferation = IL-22

Question 12

Reactive arthritis associated with what causes more severe chronic disease?

Answer 12

HLA-B27

Question 13

When treat aortic aneurysm? electively

When license is removed in AAA?

Answer 13

AAA > 5 cm in female, > 5.5 cm in male

when AAA > 5.5cm

Question 14

Low hepatic extraction ratio drugs?

Answer 14

NCAIDS

N- NSAIDS
CA- Carbamazepine
DI - Diazepam
S - S-warfarin ( commonest type of warfarin)

Question 15

What protein binds to acid drug?

What protein binds to alkaline drug?

Answer 15

Albumin = Acid

Alkaline/basic = Alpha-1-Glycoprotein

Question 16

Classes for prescribing drugs in pregnancy and means?

Answer 16

A = Good
B1 = Limited woman taking drugs - but no animal studies or data showing it's bad

B2 = animals studies inadequate/lacking

B3 = animals studies shows damage, but unknown in human

C = Causing reversible damage in fetus

D = Damage irreversible

X = Death/lethal

Question 17

Acamprosate mechanism of action?

Indication

Answer 17

NMDA/GABA modulator

Indication - alcohol dependence = maintain abstinence
non-addictive

Question 18

Baclofen mechanism of action?

Answer 18

GABA-B Agonist

Question 19

Disulfiram mechanism of action?

Answer 19

inhibit aldehyde dehydrogenase - more side effects of alcohol

Question 20

Methadone mechanism of action?

Answer 20

mu opioid receptor agonist

K channel blocker - causes prolonged QTc

Question 21

Amitriptyline toxicity - what to give?

Answer 21

Sodium bicarbonate

Question 22

Commonest reason drug remove from market?

Answer 22

Drug induced liver injury - DILI

Question 23

Morphine act on what receptor?

Answer 23

G-coupled protein receptor ( mu receptor)

Question 24

diazepam mechanism of action?

Answer 24

GABA agonist - Voltage gated CI channel

Question 25

Base excess high in the positives means? | amount of acid needed to restore PH to normal value

Answer 25

Metabolic alkalosis attacking compensating primary respiratory acidosis ( HCO will go up) Cushing's HCI loss via vomiting

Question 26

Sweet syndrome diagnosis | Major and minor criteria?

Answer 26

Major 1. Abrupt onset of tender nodules/plaques 2. Dense neutrophilic infiltrate Minor ( 2 of 4) 1. Fever 2. After GI/fever/malignancy/DRUG INDUCED - abx 3. Elevated CRP/ESR 4. Steroids responsive!

Question 27

when consider Ponticelli treatment in Membranous nephropathy?

Answer 27

(Prednisolone + chlorambucil) -severe proteinuria > 8g + significant renal dysfunction Otherwise CYP

Question 28

Tamoxifen in DCIS?

Answer 28

Reduce recurrence of CONTRALATERAL DCIS

Question 29

Intention to treat analysis always affect treatment in what ways?

Answer 29

Underestimate it

Question 30

H.pylori confirmation of eradication test Abx must stop how many weeks prior to test? PPI must stop how many weeks prior to test?

Answer 30

ABX - 4 weeks | PPI - 2 weeks