key notes Flashcards
1
Q
investigation in GORD
A
24hr oesophageal pH monitoring is gold standard
2
Q
Goodpasture’s syndrome
depostis?
A
IgG deposits on renal biopsy
anti-GBM antibodies
3
Q
Acute angle closure glaucoma is associated with …?.. where as primary open-angle glaucoma is associated with ..?…..
A
hypermetropia,
myopia
4
Q
Addison’s disease metabolic inbalance?
A
metabolic acidoosis
5
Q
Acute myeloid leukaemia - good prognosis translocation
A
15:17
6
Q
adenosine- what increases effect?
decreases effect?
A
dipyridamole enhances effect
aminophylline reduces effect
7
Q
s/e phentolamine?
A
Adrenaline induced ischaemia
8
Q
ADH site of action
A
collecting ducts
9
Q
Bartter’s syndrome is associated with …regarding BP…
A
normotension
10
Q
Bosentan moa?
A
endothelin-1 receptor antagonist
11
Q
Burkitt’s lymphoma - gene translocation
A
c-myc
12
Q
CLL - ? is investigation of choice
A
immunophenotyping
13
Q
Chorea is caused by damage to the
A
basal ganglia, in particular the Caudate nucleus
14
Q
H. pylori eradication:
A
PPI + amoxicillin + clarithromycin, or
PPI + metronidazole + clarithromycin
15
Q
Acute myeloid leukaemia - poor prognosis:
A
deletion of chromosome 5 or 7
16
Q
Amiodarone - MOA:
A
blocks potassium channels
17
Q
Angiodysplasia is associated with
A
aortic stenosis
18
Q
Anti-ribonuclear protein (anti-RNP) =
A
mixed connective tissue disease
19
Q
Antipsychotics in the elderly - increased risk of
A
stroke and VTE
20
Q
Aortic stenosis -?…marker of severity
A
S4
21
Q
Aspergillus clavatus causes
A
malt workers’ lung, a type of EAA Extrinsic allergic alveolitis
22
Q
Bendroflumethiazide - mechanism of hypokalaemia:
A
increased sodium reaching the collecting ducts
activation of the renin-angiotensin-aldosterone
23
Q
Benzodiazepines enhance the effect of
A
GABA, the main inhibitory neurotransmitter
24
Q
Beta-blocker overdose management:
A
atropine + glucagon
25
most common cause of primary hyperaldosteronism
Bilateral idiopathic adrenal hyperplasia
26
Bitemporal hemianopia
lesion of
upper quadrant defect > lower quadrant defect - tumor?
lower quadrant defect > upper quadrant defect - tumor?
optic chiasm
inferior chiasmal compression, commonly a pituitary
tumour
superior chiasmal compression, commonly a
craniopharyngioma
27
Brush border enzymes:
maltase:
sucrase:
lactase:
maltase: glucose + glucose
sucrase: glucose + fructose
lactase: glucose + galactose
28
cancer? common cause of tumour lysis syndrome
Burkitt's lymphoma
29
CLL - treatment:
Fludarabine, Cyclophosphamide and Rituximab (FCR)
30
CLL is caused by
a monoclonal proliferation of B-cell lymphocytes
31
CML - Philadelphia chromosome -
t(9:22)
32
Causes of villous atrophy (other than coeliacs):
tropical sprue, Whipple's, lymphoma, hypogammaglobulinaemia
33
Cetuximab - moa?
monoclonal antibody against the epidermal growth factor receptor
34
Chronic myeloid leukaemia tx? moa?
imatinib = tyrosine kinase inhibitor
35
cisplatin- s/e electorlyte inlabance/
hypomagnesemia, peripheral neuopthy
36
Clopidogrel moa?
inhibits ADP binding to platelet receptors
37
Collapse + ARF → dx? tx?
rhabdomyolysis - treat with IV fluids
38
Complete heart block following an inferior MI vs anterior MI... whihc can pace?
inferior is NOT an indication for pacing, unlike with an anterior MI
39
Congenital toxoplasmosis
features?
cerebral calcification
chorioretinitis
40
Contraindications to lung cancer surgery include
SVC obstruction, FEV < 1.5, MALIGNANT pleural effusion, and vocal cord paralysis
41
Cyclophosphamide -
s/e and how to prevent it?
haemorrhagic cystitis - prevent with mesna
42
most common and important viral infection in solid organ transplant recipients
CMV
43
DVLA cant drive until
ANIOPLASTY
TIA
POST MI
MULTIPLE TIA
ANIOPLASTY 1 week
TIA 1 month
POST MI 1 month
MULTIPLE TIA 3 months
44
Deletion of chromosome 15
what 2 genetic conditions?
Prader-Willi - paternal
Angelman syndrome - maternal
45
Dentistry in warfarinised patients -
check INR 72 hours before procedure, proceed if INR < 4.0
46
Dermatomyositis antibodies:
most common?
most specific?
ANA most common
anti-Mi-2 most specific
47
Desmopressiin - moa?
used for cranial diabetes insipidis
induces release of von Willebrand's factor from endothelial cells
48
Diffuse proliferative glomerulonephritis, causes:
post-streptococcal
SLE
49
Discoid lupus erythematous - tx 1st and second line?
topical steroids → oral hydroxychloroquine
50
Disproportionate microcytic anaemia - what condition could it be?
think beta-thalassaemia trait
51
Dosulepin antidepresesent why ito aviod?
dangerious if OD'd
52
Drug metabolism
phase I:
phase II:
Drug metabolism
phase I: oxidation, reduction, hydrolysis
phase II: conjugation
53
EBV: associated malignancies:
Burkitt's lymphoma
Hodgkin's lymphoma
nasopharyngeal carcinoma
54
cancer in association of HNPCC?
1st and 2nd most common
1. colorectal
2.endometrial
55
ch head injury ...lucid interval
Epidural haematoma - lucid interval
56
associated with a good prognosis in sarcoidosis
erythema nodosum
57
Ethylene glycol toxicity management -
fomepizole
58
Exenatide moa?
Glucagon-like peptide-1 (GLP-1) mimetic
59
used to monitor respiratory function in Guillain-Barre syndrome
FVC
60
Factor V Leiden mutation results in
activated protein C resistance
61
...?... is the investigation of choice for upper airway compression
Flow volume loop
62
Fomepizole - used in ethylene glycol and methanol poisoning -
MOA?
competitive inhibitor of alcohol dehydrogenase
63
Funnel plots -
show publication bias in meta-analyses
64
signet ring cells
Gastric adenocarcinoma -
65
Gitelman's syndrome vs Liddle's syndrome
BP? electrolyte?
normotension with hypokalaemia
Liddle's syndrome: hypokalaemia + hypertension
think short man syndrome-always tense
66
HIV - multiple ring enhancing lesions =
toxoplasmosis
67
HOCM - drugs to avoid:
nitrates, ACE-inhibitors, inotropes
68
HOCM - poor prognostic factor on echo =
septal wall thickness of > 3cm
69
HUS or TTP? Neuro signs point towards
TTP Thrombotic Thrombocytopenic Purpura
70
Haemochromatosis is ...GENTIC...?
autosomal recessive
71
Hashimoto's thyroiditis = LOOK FOR WHAT IN BLOODS AND PRESENTAION?
hypothyroidism + goitre + anti-TPO
72
Hemiballism is caused by damage to the
subthalamic nucleus
73
Heparin-induced thrombocytopaenia -
moa?
antibodies form against complexes of platelet factor 4 (PF4) and heparin
74
Hepatorenal syndrome is primarily caused by
splanchnic vasodilation
75
Hereditary angioedema -
deficiency?
screening?
C1-INH deficiency
C4 is the best screening test inbetween attacks
76
Hodgkin's lymphoma -
best prognosis
most common type
lymphocyte predominant
nodular sclerosing
77
Homocystinuria -
caused by a deficiency of ?
give what to correct it?
cystathionine beta synthase
vitamin B6 (pyridoxine)
78
Horner's syndrome - anhydrosis determines site of lesion:
head, arm, trunk =
just face =
absent =
head, arm, trunk = central lesion: stroke, syringomyelia
just face = pre-ganglionic lesion: Pancoast's, cervical rib
absent = post-ganglionic lesion: carotid artery
79
Hypertension - step 4
what level of postassium to add the 4th line options?
Hypertension - step 4
K+ < 4.5 then spironolactone
K+ > 4.5 then higher-dose thiazide-like diuretic
80
means loss of HGV licence, regardless of the circumstances
ICD
81
IgM paraproteinaemia -
Waldenstrom's macroglobulinaemia
82
In the primary prevention of CVD using statins aim for a reduction in non-HDL cholesterol of ...percentage?...
> 40%
83
Insulinoma is diagnosed
with supervised prolonged fasting
84
Iron reduces the absorption of
thyroxine
85
are the most common cause of occupational asthma
Isocyanates
86
JVP:
C wave
giant v waves
x descent
y descent
C wave - closure of the tricuspid valve
giant v waves in tricuspid regurgitation
x descent = fall in atrial pressure during ventricular systole
y descent = opening of tricuspid valve
87
Kearns-Sayre syndrome
mitochondrial inheritance
onset < 20-years-old
external ophthalmoplegia
retinitis pigmentosa
88
Keloid scars are most common on the
sternum
89
Klinefelter's vs Kallman's - LH & FSH
Klinefelter's - LH & FSH raised
Kallman's - LH & FSH low-normal
90
L5 lesion features =
loss of foot/big toe dorsiflexion + sensory loss dorsum of the foot
91
LH surge causes
ovulation
92
Lateral medullary syndrome
PICA lesion - cerebellar signs, contralateral sensory loss & ipsilateral Horner's
93
Leptin is secreted by
adipose tissue
94
Leptospirosis - give abx?
penicillin or doxycycline
95
Likelihood ratio for a positive test result
= sensitivity / (1 - specificity)
96
the safest TCA in overdosage
Lofepramine -
97
Long QT syndrome - usually due
to loss-of-function/blockage of K+ channels
98
Lung adenocarcinoma
most common in ?
location?
Lung adenocarcinoma
most common type in non-smokers
peripheral lesion
99
Magnesium sulphate - monitor ..?...
reflexes + respiratory rate
100
Massive PE + hypotension tx?
thrombolyse
101
Mechanical valves - target INR:
aortic:
mitral:
Mechanical valves - target INR:
aortic: 3.0
mitral: 3.5
102
Melanoma: single most important prognostic factor
the invasion depth of the tumour is the
103
Metastatic bone pain may respond to
NSAIDs, bisphosphonates or radiotherapy
104
Mitochondrial diseases follow ..?...inheritance pattern
a maternal
105
Most common cause of endocarditis:
Staphylococcus aureus
Staphylococcus epidermidis if < 2 months post valve surgery
106
Motion sickness - TX?
hyoscine > cyclizine > promethazine
107
Motor neuron disease - tx?
which is a better option
riluzole
NIV better
108
Mucocutaneous ulceration following travel?
Leishmania brasiliensis
basces in the mouth
109
Mycoplasma pneumonia if allergic/intolerant to macrolides -
doxycycline
110
Mycoplasma dx? -
serology is diagnostic
111
rises first following a myocardial infarction
Myoglobin
112
???.. required to diagnose dementia
Neuroimaging is
113
Nitric oxide - moa?
vasodilation + inhibits platelet aggregation
114
po2 level, sats level... characteristic of methaemoglobinaemia
Normal pO2 but decreased oxygen saturation is characteristic of methaemoglobinaemia
115
ethambutol eye s/e
OPTIC NURITIS
116
Osteoarthritis - first-line MX?
paracetamol + topical NSAIDs (if knee/hand)
117
Osteomyelitis: the imaging modality of choice
MRI
118
Painful third nerve palsy =
posterior communicating artery aneurysm
119
Paradoxical embolus -
common cuase?
dx?
PFO most common cause - do TOE
Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart.
120
Paraneoplastic features of lung cancer
squamous cell:
small cell:
Paraneoplastic features of lung cancer
squamous cell: PTHrp, clubbing, HPOA
small cell: ADH, ACTH, Lambert-Eaton syndrome
121
Patients with Sjogren's syndrome have an increased risk of ..?..malignancies
lymphoid
122
Phaeochromocytoma: dx?
do 24 hr urinary metanephrines,
123
Philadelphia translocation, t(9;22) - good prognosis in ..?..
poor prognosis in..?..
CML,
AML + ALL
124
Pneumocystis jiroveci pneumonia - ..?.. common complication
pneumothorax
125
Polycythaemia rubra vera is associated with a low ..inflammaroty marker..?
ESR
126
Post-exposure prophylaxis for HIV:
oral antiretroviral therapy for 4 weeks
127
Prinzmetal angina - treatment =
dihydropyridine calcium channel blocker
128
Progressive supranuclear palsy: what condition>
parkinsonism, impairment of vertical gaze
129
Psoriasis: common triggers are
beta-blockers and lithium
130
Pulmonary surfactant - main constituent is
dipalmitoyl phosphatidylcholine (DPPC)
131
Pulsus alternans - seen i
n left ventricular failure
132
Recommend Adult Life Support (ALS) adrenaline doses
anaphylaxis: cardiac arrest:
Recommend Adult Life Support (ALS) adrenaline doses
anaphylaxis: 0.5ml 1:1,000 IM
cardiac arrest: 10ml 1:10,000 IV or 1ml of 1:1000 IV
133
Refeeding syndrome causes ...electrolyte inblance?
Refeeding syndrome causes hypophosphataemia
134
Renal stones on x-ray
cystine stones:
urate + xanthine stones:
Renal stones on x-ray
cystine stones: semi-opaque
urate + xanthine stones: radio-lucent
135
Renal tubular acidosis causes a ..?.. anion gap
normal
136
Restless leg syndrome - management includes
dopamine agonists such as ropinirole
137
Rheumatoid arthritis - HLA ?
key in pathophysiology ?
HLA DR4
TNF is key in pathophysiology
138
Rituximab - moa?
Rituximab - monoclonal antibody against CD20
139
SLE: markers
sensitive ?
specific ?
ANA is 99% sensitive
anti-Sm & anti-dsDNA are 99% specific
140
Schistosoma haematobium causes?
Schistosoma haematobium causes haematuria
141
Screening for haemochromatosis
general population:
family members:
Screening for haemochromatosis
general population: transferrin saturation > ferritin
family members: HFE genetic testing
142
..?...is the investigation of choice for bile acid malabsorption
SeHCAT
143
Second heart sound (S2)
loud:
soft:
fixed split:
reversed split:
Second heart sound (S2)
loud: hypertension
soft: AS
fixed split: ASD
reversed split: LBBB
144
Severe falciparum malaria - tx
intravenous artesunate
145
Statins and what abx? an important and common interaction
+ erythromycin/clarithromycin -
146
..?... treatment in Cryptosporidium diarrhoea
Supportive therapy
147
Symptom control in non-CF bronchiectasis -
inspiratory muscle training + postural drainage
148
Syringomyelia - presentaion?
spinothalamic sensory loss (pain and temperature)
149
TTP - first-line tx?
plasma exchange
150
Tear-drop poikilocytes =
myelofibrosis
151
diagnostic test for acromegaly
is an oral glucose tolerance with growth hormone measurements
152
what component in co-trimoxazole causes haemolysis in G6PD
sulfamethoxazole
153
Topical steroids
moderate:
potent:
very potent:
moderate: Clobetasone butyrate 0.05%
potent: Betamethasone valerate 0.1%
very potent: Clobetasol propionate 0.05%
154
Trastuzumab (Herceptin) - ??..?..toxicity is common
cardiac
155
Trimethoprim may cause ...to do with blood cells..?
pantcytopaenia
156
Urinary histamine is used to diagnose
systemic mastocytosis
too many mast cells in body
157
normal pressure hydrocephalus
presentation?
Urinary incontinence + gait abnormality + dementia
158
Vincristine - s/e
peripheral neuropathy
159
Visual field defects:
left homonymous hemianopia?
homonymous quadrantanopias: ?
incongruous defects ?
congruous defects?
Visual field defects:
left homonymous hemianopia means visual field defect to the left, i.e. lesion of right optic tract
homonymous quadrantanopias: PITS (Parietal-Inferior, Temporal-Superior)
incongruous defects = optic tract lesion;
congruous defects= optic radiation lesion or occipital cortex
160
Vitamin B12 is actively absorbed in the
terminal ileum
161
Warfarin - clotting factors affected mnemonic -
1972 (10, 9, 7, 2)
162
used to identify patients at risk of pressure sores
Waterlow score -
163
Wiskott-Aldrich syndrome
triad?
recurrent bacterial infections (e.g. Chest)
eczema
thrombocytopaenia
164
X-linked recessive conditions - transmission?
no male-to-male transmission
Affected males can only have unaffected sons and carrier daughters.
165
Zero-order (saturation) kinetics
drugs?
phenytoin
alcohol
166
tia managemnt long term
clopedogil only after the 300mg aspirin
167
tca overdose?
IV bicarb
168
Hirschsprung's disease presentation?
a 10-day-old
abdominal distension and vomiting. He first passed meconium at 72 hours and has not opened is bowels since. An abdominal x-ray shows a dilated colon
169
omphalomesenteric band
mikels diverticulum
