Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

FRACP Shuyu > Dunedin 2019 > Flashcards

Dunedin 2019 Flashcards

1
Q

How many neurons in Horner’s and where do they synapse from and to

A

Horner’s is a 3 neuron arc

1st order – posterolateral hypothalamus, descend through midbrain and pons, terminate in intermediolateral cell column of the spinal cord at C8-T2 aka ciliospinal centre of Budge

2nd order – originates ciliospinal centre of Budge, exits at T2 and enters cervical sympathetic chain (close proximity to pulmonary apex and subclavian artery), ascend sympathetic chain and synapse in superior cervical ganglion at bifurcation of common carotid artery

3rd order – postganglionic pupillomotor fibres exit superior cervical ganglion and ascend along internal carotid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mifepristone MOA and indication

A

Glucocorticoid receptor antagonist - blocks the effect of cortisol at flucocorticoid receptor

Used to treat hyperglycaemia in Cushing’s syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ambrisentan MOA

A

Endothelin receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Sildenafil MOA

A

Inhibits PDE-5 in smooth muscle of pulmonary vasculature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Riociguat MOA

A

Dual mode of action

  1. Sensitises soluble guanylate cyclase to endogenous NO by stabilising NO-sGC binding
  2. Directly stimulates sGC independent of NO
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Iloprost MOA

A

Prostacyclin analogue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

VRE resistance mechanism

A

Change in cell wall structure from d-ALA d-ALA to d-ALA d-LAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Most specific antibody for RA

A

Anti-CCP 95-98% specificity

RF not specific, but similar sensitivity to anti-CCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Type II error

A

Falsely accepting the null hypothesis = false negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Genetic defect a/w autoimmune polyendocrine syndrome type 1

A

AIRE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Mutation in which gene a/w IPEX

A

FOX P3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Reed Sternberd Cell surface immunophenotype

A

CD15 and CD30 positive

CD45 negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ipilimumab MOA

A

CTLA-4 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Antigen in HIT

A

Platelet factor 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Levetiracetam MOA

A

Binds to synaptic vesicle protein SV2A, altering vesicle fusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ethosuximide MOA

A

Diminishes T-type calcium currents in the thalamic neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Carbamazepine

A

Inhibits voltage gated sodium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Clobazam MOA

A

Binds to GABA receptor and facilitate the attachment of GABA to the receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Signal two in T-cell activation

A

Interaction between CD28 and CD80/86 on APC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Edwards syndrome

A

Trisomy 18 - detectable by karyotype

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PBC management

A

Ursodeoxycholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Uveal melanoma commonly metastasises to which site

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Mechanism of red man syndrome

A

Vancomycin directly causes mast cell degranulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What extraintestinal manifestation of IBD is associated with active GI inflammation

A

Large joint arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Positive predictive value formula
sensitivity x prevalence ---------------------------------------------- [sensitivity x prev] + [(1-spec) x (1xprev)]
26
Negative predictive value formula
specificity x (1-prevalence) ------------------------------------------------- [(1-sensitivity) x prev] + [spec x (1-prev)]
27
Unfractionated heparin MOA
Binds to antithrombin III -\> enhanced ability to inhibit factor Xa and IIa Also inactivates thrombin and other proteases
28
Ticagrelor side effects
Resp: dyspnoea CVS: ventricular pause on ECG, presyncope, syncope CNS: dizziness, LOC GI: nausea Haem: haemorrhage - major and minor Renal: increased serum Cr (transient)
29
Liddle's syndrome
Dysregulation of epithelial ENaC channels in renal collecting ducts
30
PML treatment
IV hydrocortisone Stop offending drug
31
What size adrenal incidentaloma would require adrenalectomy
\>=4cm
32
Next step in management in adrenal incidentaloma \<4cm
Hormonal testing - PAC/PRA; plasma-free metanephrines and normetanephrines; overnight 1mg dexamethasone suppression test If hormonally active then adrenalectomy
33
Precautions for VZV pneumonitis
Negative pressure isolation for disseminated zoster Negative pressure isolation for immunocompromised pt with dermatomal zoster
34
A-a gradient
PAO2 - PaO2 PAO2 = FiO2 (Patm - PH2O) - PCO2/0.8
35
Standard Mx for ARDS
Low tidal volume ventilation and PEEP
36
MGUS Dx
Monoclonal protein spike \<3g/dL Plasma cells \<10% of bone marrow No CRAB features
37
Smouldering MM diagnosis
Monoclonal protein spike \>3g/dL PC \>10% of bone marrow No CRAB features
38
Multiple myeloma diagnosis
Monoclonal spike PC \>10% or plasmacytoma CRAB features Or PC \>60% or SFLC \>100 Or more than one focal lesion on MRI
39
PR3-ANCA association
GPA (in 80-90% of cases)
40
How does fluconazole affect metabolism of some other drugs
Inhibits CYP450
41
Multiple cystic changes through bilateral lung fields
LAM - Associated with tuberous sclerosis
42
Creutzfeldt-Jakob disease
Rapid onset dementia over months Behavioural change, myoclonus EEG - generalised periodic sharp wave pattern MRI - cortical ribboning, caudate and putamen T2 hyperintensity and diffusion restriction on DWI/ADC
43
Difference between NMS and serotonin syndrome
NMS - lead pipe rigidity, reduced reflexes, onset over days Serotonin syndrome - increase tone ++, increased reflexes and clonus, onset over hours
44
What is the only proven benefit of IV pre-endoscopic PPI in acute UGIB
Reduced endoscopic intervention No reduction in mortality or rebleeding rate
45
What bacteria in reactive arthritis are HLA-B27 associated
Chlamydia trachomatis Clostridium difficile Salmonella Shigella Campylobacter Yersinia Intravesical BCG
46
What type of SpA would you use conventional DMARDs in?
Peripheral SpA No role in axial SpA Sulfasalazine or MTX
47
What TNFi do you use in SpA if pt has uveitis or IBD
Infliximab or adalimumab NOT etanercept
48
Secukinumab MOA + indication
IL-17A inhibitor - also ixekizumab Used in axial SpA and psoriatic arthritis Similar efficacy to TNFi
49
Ustekinumab MOA and indication
IL-12/IL-23 monoclonal antibody Effective for enthesitis and psoriasis Not useful for axial SpA
50
What management reduces mortality in COPD
Long-term oxygen therapy in pts with PaO2 \<55mmHg
51
What benefits does pulmonary rehab give in COPD pts
Reduction in symptoms (dyspnoea + fatigue), anxiety and depresseion, exercise capacity, peripheral muscle function Reduces exacerbations requiring hospitalisation NO improvement in mortality
52
King's College Criteris for liver transplant in paracetamol-induced liver failure
Arterial pH \<7.3 OR Grade III or IV encephalopathy AND prothrombin time \>100s AND serum Cr \>301micromol/L
53
King's College Criteria for liver transplant in non-paracetamol induced liver failure
Prothrombin time \>100s (INR \>6.5) OR Any 3 of the following: 1. Age \<10 years or \>40 years 2. Non hep A or B viral hepatitis, halothane hepatitis, idiosyncratic drug reactions 3. Duration of jaundice before encephalopathy \>7 days 4. PT \>50s 5. Bili \>18mg/dL (308micromol/L)
54
Dermatomyositis antibodies
Anti-mi2 TIF-1gamma - associated with malignancy MDA-5 - cutaneous ulceration overlying Gottron papules, mechanic's hands - a/w rapidly progressive ILD MJ
55
Reason for giving anti-androgen treatment with goserelin (GnRH agonist) for prostate cancer
Reduce flare symptoms related to increase in LH production
56
Measles incubation period
6-21 days
57
Cerebral venous sinus thrombosis management
LMWH or UFH Presence of haemorrhage NOT contraindications for anticoagulation Long term anticoagulation - wafarin or dabigatran
58
Tacrolimus ADR
Hyperglycaemia, diabetes Diarrhoea headache tremor nausea Alopecia, hirsutism Nephrotoxicity - dose-related in acute, can be irreversible in chronic Metabolised by CYP 3A4
59
ECG findings of ARVD
V1-5 T wave inversion and epsilon waves Exercise or stress can precipitate CT
60
Define extensively drug-resistant TB
MDR TB + resistance to moxifloxacin and amikacin
61
Hummingbird sign
PSP
62
Hot cross bun sign MRI
MSA - cerebellar type
63
What features are seen in atypical parkinsonism rather than idiopathic PD
Rapid progression of gait impairment \<5 years No response to high-dose levodopa despite mod severity of disease Severe autonomic failure in first 5 years Recurrent falls from imbalance within 3 years Absence of common non-motor features of PD despite 5 years of disease Early bulbar dysfunction Inspiratory respiratory dysfunction
64

FRACP Shuyu (65 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions