incorrect deck Flashcards
1
Q
FMF description and rx?
A
Familial Mediterranean Fever (FMF) is a genetic disorder characterised by recurrent episodes of painful inflammation in the abdomen, chest, or joints. These episodes are often accompanied by fever - rx with colchicine
2
Q
A patient is started on finasteride for the treatment of benign prostatic hyperplasia. How long should the patient be told that treatment may take to be effective?
A
6M
3
Q
Drugs exhibiting zero-order kinetics?
A
phenytoin
salicylates (e.g. high-dose aspirin)
heparin
ethanol
Please Stop Having Excessive (drinks)
4
Q
Drugs affected by acetylator status?
A
isoniazid
procainamide
hydralazine
dapsone
sulfasalazine
I Pray He Doesn’t Stray
5
Q
Once stable dose has been achieved of lithium how often should levels be checked?
A
3M
6
Q
Miller Fisher triad and antibody?
A
Areflexia, opthalmoplegia, ataxia - anti GQ1B
7
Q
Which measurement is not part of the diagnostic criteria of acute respiratory distress syndrome (ARDS)?
A
RR
8
Q
Mode of action of evolocumab?
A
Prevents PCSK9-mediated LDL receptor degradation
9
Q
Typically presents with proteinuria and is associated with early onset strokes or myocardial infarctions with a typical rash known as angiokeratomas?
A
Fabry disease
10
Q
Extensive skin rash, high fever, and organ involvement?
A
DRESS - eosinophilia
11
Q
Mechanism of mycophenolate?
A
Inosine-5’-monophosphate dehydrogenase inhibitor
12
Q
Examples of calcineurin inhibitors?
A
Tacrolimus and ciclosporin
13
Q
Examples of HMG-CoA reductase inhibitors?
A
Statins
14
Q
Examples of ribonucleotide reductase inhibs?
A
Hydroxycarbamide
15
Q
Can haloperidol be used in Parkinson’s?
A
No
16
Q
Gold standard for GORD dx?
A
24hr oesophageal pH monitoring?
17
Q
Protease and integrase?
A
Avir and gravir
18
Q
First line meds for treating dementia? Second line?
A
Donepezil, rivastig, galanta - 1
Memantine - 2
19
Q
Uncommon feature in visceral leishmaniasis?
A
Diarrhoea
20
Q
What best describes the Bohr effect?
A
Increasing acidity (or PCO2) means oxygen binds less well to Hb
21
Q
Dermatomyositis - most specific, most positive antibody?
A
Specific - anti Mi2
Positive - ANA
22
Q
H Pylori strongest association?
A
Duodenal ulcers
23
Q
Polymyositis antibody?
A
anti Jo1
24
Q
HIV: anti-retrovirals - P450 interaction
A
Inducer - NNRTIs
Inhibitor - protease inhibitors
25
Interferon gamma role?
Activation of macrophages
26
Exo and endotoxin release?
Exotoxins - gram neg
Endotoxins - gram pos
27
Which constellation of signs on examination is the most consistent with a diagnosis of Guillain-Barre Syndrome?
Tachycardia, flaccid paralysis, hyporeflexia
28
Plasmodium vivax/ovale: cyclical fever every ? hours
Plasmodium malariae: cyclical fever every ? hours
48, 72
29
Mixed respiratory alkalosis and metabolic acidosis in a sweaty, confused patient point towards?
Salicylate OD
30
Eculizumab side effect?
C5-9 deficiency - must give neiss meningitis vaccination
31
C1-INH deficiency is associated with?
Hereditary angioedema
32
Deficiency in C1q, C1rs, C2 and C4 predisposes to?
SLE
33
C3 deficiency predisposes patients to?
Recurrent bacterial infections
34
C5 deficiency is seen in?
Leiner disease
35
C5-9 deficiency affects the formation of membrane attack complex (MAC), which is associated with?
Neisseria infections
36
Clostridium tetani and botulinum receptors?
Tetani - GABA and glycine
Bot - Ach
37
cANCA and pANCA associations?
cANCA - GPA
pANCA - eosinophilic granulomatosis with polyangiitis
38
Hyperintense T2 signal extending across the spinal cord, between the levels of T9 and T12 + spastic leg weakness?
Transverse myelitis
39
Causative organism for rocky mountain spotted fever?
Rickettsia ricketsii
40
Biclutanamide action?
Androgen receptor blocker
41
Faecal elastase is a useful test of?
Exocrine function in chronic pancreatits
42
Local anaesthetic toxicity can be treated with?
Lipid emulsion
43
MSH2 gene function?
DNA mismatch repair
44
Fred ataxia inheritance?
Auto recessive
45
X-ray findings - cupping and fraying of metaphyseal region? Disease and mechanism?
Rickett's - excess of non-mineralized osteoid at the growth plate
46
A 45-year-old with a history of untreated HIV presents with a 3-week history of gradual onset headaches and altered mental status. He also complains of nausea but denies fever or visual changes.
On examination, he is slightly disoriented, with mild nuchal rigidity and a Glasgow Coma Scale of 14.
Dx and investigation?
Diagnosis - cryptococcus
Investigation - CSF India Ink
47
Prior to urea breath test how long should abx and PPIs be stopped for?
Abx - 4 weeks
PPI - 2 weeks
48
Bloody diarrhoea in which infections?
Campylo, amoeba, shigella
49
HNPCC associations?
Colorectal and endometrial cancer
50
Drugs precipitating AACG?
TCAs + anticholinergics
51
Escalation of steroids in eczema?
1- hydrocortisone 2- clobethasone 3 - betamethasone 4 - clobetasol
52
AL vs AA Amyloidosis?
AA - RA, bronchiectasis, TB
AL - more common, seen in myeloma and other haem conditions
53
Intracellular proteins tagged with extensive ubiquitination?
Proteasome
54
Ejection fraction calculation?
EF = (EDV-ESV)/EDV
55
Stills disease - blood results?
Neg rheumatoid factor, raised CRP ESR
56
Abx to give with human tetanus immglob?
Metro
57
Virus linked to oropharyngeal cancer?
HPV 16
58
Indications for pacing?
Sinus pause > 3 secs, persistent brady, mobitz type 2, trifasci block
59
Block and replace vs carbimazole regimes - which is shorter?
B + R
60
A family history of breast and ovarian cancer suggests a mutation in which gene?
BRCA
61
Which HLA subtype implicated in hyperacute rejection?
HLA-C
62
Minimal change disease associated with which condition?
Hodgkins
63
Hep B post exposure?
Monthly monitoring of Hep C RNA
64
Listeria rx in over 60s or immsuppressed?
Amox and ceftriaxone
65
Serious ADR of bosentan?
Liver toxicity
66
Cytokine involved in acute phase response?
TNF alpha
67
Bronchial carcinoid markers?
Chromogranin A + neuron specific enolase
68
Standard deviation and variation relationship?
Variance = square of standard deviation
69
Relative risk reduction?
Relative risk reduction = (EER - CER) / CER
70
Standard error of the mean?
Standard error of the mean = standard deviation / square root (number of patients)
71
What can ondansetron cause?
Prolongation of QT => polymorphic VT
72
Difference between pons and cerebrum lesions?
Pons - ipsilateral facial weakness Cerebrum - contralat weakness
73
Ondansetron mechanism?
5 HT3 antagonist
74
Sulphonylureas mechanism?
Closes K ATP on beta cells
75
Patients who are high-risk for contrast-induced nephropathy should have xxxx withheld for xxxx after procedure?
Patients who are high-risk for contrast-induced nephropathy should have metformin withheld for a minimum of 48 hours and until the renal function has been shown to be normal
76
Interferon alpha beta and gamma - produced where and used where and which receptors?
type 1 - alpha beta
type 2 - gamma
alpha - leucocytes, antiviral
beta - fibroblasts, antiviral - used in MS
gamma - natural killer cells/T cells, weak antiviral used to immunomodulate
77
Dendritic corneal ulcer rx?
Topical antiviral
78
Which cells secretes the majority of tumour necrosis factor in humans?
Macrophages
79
Which diuretic to reduce calcium? Opposite effect?
Indapamide, furosemide
80
What is important in PCR?
A thermostable DNA polymerase is required
81
His GP would like to commence him on a medication that does not cause weight gain or hypoglycaemia.
What is the likely mechanism of action of this drug?
DPP4 inhibitor - gliptin
Reduces breakdown of incretins
82
Osteomalacia?
Low ca and po4, raised ALP + PTH
83
In ITP which molecule are autoantibodies targetting?
Glycoprotein
84
Diarrhoea and hypokalemia in context of colon pathology?
Villous adenoma
85
Blockage of calcium 1.2 channels?
Verapamil/diltiazem
86
Blockage of calcium 2.3 channels?
R type channels
87
Blockage of K 1.11 channels?
Amiodarone
88
Vitamin B2 def can cause?
Riboflavin - angular chelitis
89
Basket weave appearance on microscopy, haematuria, proteinuria?
Alport's syndrome
90
Horner's syndrome - anhydrosis determines site of lesion:
head, arm, trunk? face? absent?
head, arm, trunk = central lesion: stroke, syringomyelia
just face = pre-ganglionic lesion: Pancoast's, cervical rib
absent = post-ganglionic lesion: carotid artery
91
Brush border enzymes:
maltase?
sucrase?
lactase?
glucose + glucose
glucose + fructose
glucose + galactose
92
First-order neuron?
Second-order neuron?
Third-order neuron?
First-order neuron: Detects the stimulus and transmits the signal to the spinal cord or brainstem.
Second-order neuron: Relays the signal within the spinal cord or brainstem and often crosses over to the opposite side.
Third-order neuron: Transmits the signal from the thalamus to the brain's sensory cortex for processing and awareness.
93
Stroke - UMN or LMN, Bells - UMN or LMN?
Stroke - UMN - spares the forehead
Bells - LMN
94
Auditory agnosia in which lobe?
Temporal lobe
95
Hereditary haemorrhagic telangiectasia inheritance?
Autosomal dominant with age related penetrance
96
Is WPW an indication for ICD?
No
97
A 35-year-old male presents to the clinic with bilateral pitting oedema, lower limb pain and tingling in both arms. On examination, tiny, painless papules were noticed on his abdomen and a whorl-like corneal pattern of cream-coloured lines in the patient's cornea. He has no significant past medical history. Diagnosis?
Fabry's disease
98
Early LVF sign?
S3 gallop
99
Where are Dohle bodies found?
Leukaemoid reaction
100
Indinavir association?
Kidney stones
101
Cyclophosphamide mechanism and ADRs?
Cross linking DNA, haemorrhagic cystitis, TCC, myelosuppression
102
Bleomycin mechanism and ADRs?
Blasts preformed DNA, lung fibrosis
103
Doxorubicin mechanism and ADRs?
Stabilises complex and inhibits DNA + RNA synthesis, cardiomyopathy
104
Methotrexate ADRs?
Myelosuppresion, mucositis, liver and lung fibrosis
105
5-FU mechanism and ADRs?
Pyrimidine analogue inducing cell cycle arrest and apoptosis by blocking thymidylate synthase (works during S phase), myelosuppression, mucositis, dermatitis
106
6-mercaptopurine mechanism and ADRs?
Purine analogue, myelosuppression
107
Cytarabine mechanism and ADRs?
Pyrimidine antagonist, myelosuppression
108
Vincristine mechanism and ADRs?
Inhibits formation of microtubes, peripheral neuropathy and paralytic ileus
109
Docetaxel mechanism and ADRs?
Prevents microtubes depolymerisation, neutropenia
110
Irinotecan mechanism and ADRs?
Inhibits topoisomerase I, myelosupp
111
Cisplatin and hydroxyurea mechanism and ADRs?
Cisplatin - cross linking, nephro and ototox, peripheral neuropathy, hypomag
Hydroxyurea - inhibits ribonucleotide reductase, myelosupp
112
When does CIN develop - contrast nephropathy?
2-3 days later
113
PH positive and neg response?
Pos - nifedipine
Neg - bosentan
