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Year 2 > Last Minute toughies > Flashcards

Last Minute toughies Flashcards

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1
Q

What can cause pseudo-obstruction in GI

A
  1. DIFFUSE SCLERODERMA

2. Parkinson’s

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2
Q

What mediators activate fibroblasts in Scleroderma

A
  1. IL-1
  2. IL-4
  3. IL-6
  4. IL-8
  5. TGF-B
  6. PDGF
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3
Q

What viruses can cause Polymyositis

A
  1. Coxsackie
  2. Rubella
  3. Influenza
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4
Q

What encodes HLA B27 gene

A

MHC on chromosome 6

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5
Q

What is raised in Myositis

A
  1. CRP

2. ESR is NOT raised

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6
Q

Specific autoantibody found in RA

A

Anti-CCP

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7
Q

Specific autoantibody found in Polymyositis/Dermatomyositisi

A
  1. Anti Jo-1

2. Anti-Mi-2

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8
Q

Specific autoantibody found in Scleroderma

A
  1. Anti-Scl70 (diffuse)
  2. Anti-Ro
  3. Anti Centromere (limited)
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9
Q

What antigen is Sjogren Syndrome associated with

A

HLA-B8/DR3

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10
Q

What condition can Sjogren’s syndrome lead to

A

Non-Hodgkin’s Lymphoma:

Diffuse large B-cell lymphoma
Marginal zone lymphoma

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11
Q

What antigen is APS associated with

A

DR7

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12
Q

What genes are responsible for peak bone mass

A
  1. Collagen type 1A1
  2. Vit D recpetor
  3. Oestrogen receptor gene
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13
Q

Blood test results for SLE

A
  1. Raised ESR
  2. Normal CRP
  3. Anaemia of chronic disease
  4. Urea and creatinine raised
  5. C3/C4 reduced
  6. Anti-Ro
  7. Anti-La
  8. Anti-Smith
  9. Anti-dsDNA
  10. Rheumatoid Factor
  11. Anti-ANA
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14
Q

Blood tests seen in all Vasculitis

A
  1. ANCA negative
  2. Serum alkaline phosphatase raised
  3. Normochromic normocytic anaemia
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15
Q

What disease is PAN associated with

A

Hep B

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16
Q

How do kidney defects cause gout

A
  1. Defective gene for URAT1
  2. High insulin (lowers rate of excretion)
  3. Diuretics impair uric acid excretion (thiazides)
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17
Q

What diseases can cause gout

A
  1. Polycythaemia vera
  2. Leukaemia
  3. Surgery
  4. Psoriasis
  5. Carcinoma
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18
Q

What conditions does Gout increase incidence of

A
  1. CVD
  2. Hypertension of kidneys
  3. Diabetes Mellitus II
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19
Q

What FBC content is used to distinguish between polymyalgia rheumatic and myositis

A

Creatinine kinase levels normal in PR

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20
Q

What people are effected by pseudo gout

A
  1. Oteoarthritis
  2. Obesity
  3. Haemochromatosis
  4. Hyperparathyroidism
  5. Diabetes
  6. Old Age
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21
Q

What is the problem with isotope bone scans in Paget’s

A

Unable to distinguish between Paget’s and sclerotic metastatic carcnioma

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22
Q

Where do osteosarcomas metastasise to

A

the LUNG

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23
Q

Why do we look at creatinine levels for kidney function

A

Can only be excreted by the kidneys (made by the muscles)

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24
Q

At what eGFR is anaemia seen in

A

<30

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25
What is the MAP that drives filtration in the Bowman's capsule
60-70mmHg
26
What causes Falconi Syndrome
1. Cystinosis 2. Wilson's 3. Tenofovir
27
What molecules does angiotensin II upreuglate (polycystic kidney disease)
1. TGF-beta | 2. PAI-1
28
If I find eosinophils in my urine, what can this indicate
Cholesterol Emboli or allergic tubulointerstitial nephrotis
29
When does ADPKD arise
In males - adulthood
30
CVD effects of anaemia
1. Pericarditis | 2. Pericardial effusion
31
What condition is associated with minimal change disease
1. Hodgkin's lymphoma
32
Clinical Presentation of Lacunar strokes
1. Pure sensory loss 2. Ataxic hemiparesis 3. Unilateral weakness ONE OF THREE
33
How long is the time frame for thrombolysis
4.5 hours max
34
What diseases can predispose you to aneurysms
1. Polycystic kidney disease 2. Ehlers Danlos Syndrome 3. Coarctation of the aorta
35
What is lipohyalinosis
1. Vessel wall thickening causing hypertension Results in lacunar infarcts and strokes
36
What causes status epileptics
1. Stopping preventative treatment 2. Alcohol Abuse 3. Poor compliance to therapy
37
What environmental problems can cause Parkinson's
1. Pesticides 2. MPTP - opiates Causes mitochondrial dysfunction + Oxidative stress
38
What are lewy-bodies made of
1. Alpha synuclein | 2. Ubiquitin
39
In what condition is Propranolol contraindicated
Diabetes Mellitus
40
Why dow e avoid Bromocriptine and Cabergoline when treating Parkinson's
Causes cardiac valvulopathy
41
Side-effect of Mao-B inhibitor
1. Postural Hypotension | 2. AF
42
Name two dopamine antagonist
1. Oral Ropinirole | 2. Oral Pramiprexole
43
Why do we get rigidity in Parkinson's
Lesions in the extrapyramidal tract
44
What conditions can cause dementia
1. Alcohol Abuse 2. Liver Failure 3. Creutzfeldt-Jakob disease 4. B12/folate deficiency 5. Huntington's
45
Describe the anatomy of the cervical ICA
1. Posterior and lateral to ECA 2. Anterior and medial to internal jugular vein ANASTOMOSES with basilar artery sometimes
46
Branches of the petrous ICA
1. Caroticotympanic artery | 2. Vivian artery connection to ECA
47
Branches of the cavernous ICA
1. Meaning-hypophyseal artery (posterior pituitary) | 2. Inferolateral Trunk to ECA
48
Branches of the supraclinoid ICA
1. Ophthalmic artery 2. Superior hypophyseal 3. Posterior communicating 4. Anterior choroidal artery
49
What does the lateral lenticulostriate artery supply (M1 - middle cerebral artery)
1. Lentiform nucleus (putamen and globus pallidus) 2. Caudate 3. Internal Capsule
50
What branch of the anterior cerebral artery supplies the corpus callosum
1. Recurrent artery of Heubner
51
What does the posterior inferior cerebellar artery supply
1. Medulla | 2. Inferior cerebellum
52
What does the basilar artery supply
Anterior inferior cerbeellar artery: Cerebellum, CN7 + 8 Bilateral superior cerebellar artery
53
What does the posterior cerebral artery supply
1. Thalamus 2. Geniculate body 3. Cerebral pentacles 4. Tectum
54
Why is ethosuximide only given in petit mal
It only prevents against generalised seizures - not focal and generalised
55
What drugs only stop against focal seizures
1. Carbamazepine | 2. Phenytoin
56
Name the three classes of Calcium-ion channel blockers
1. Dihydropyradines 2. Phenylamines 3. Diphenylalkylamines
57
How do ACEI work other than their effect on RAAS
Stop degradation of Bradykinin Increased production of Prostacyclin and NO = Vasodilation
58
Side-effects of ACEI
1. Hyperkalaemia 2. Renal Artery Stenosis (due to decreased angiotensin levels) - ----Applies to ARBs^^----- 3. Bradykinin-mediated dry cough and angioedema
59
When is Verapamil contraindicated
Beta-blockers
60
What type of arrhythmic drug is Quinidine and procaine amide
1a - prolongs QT intveral
61
When is Quinidine prescribed
1. Atrial arythmias, tachycardias and ectopic beats 1A - Atria Short QT syndrome Brugada Syndrome
62
When is lidocaine given
Ventricular arrythmias Acute MI or Cardioversion
63
When is Procaineamide given
Ventricular Tachycardia Ventricular ectopic beats AF (all supra ventricular arrythmias)
64
Cardioversion for AF
1. Amiodarone or Procainamide
65
When is Tocainide given (1B)
Reduce chances of secondary heart attack
66
What class drug is Flecainide
1C
67
What channel does digoxin inhibit
Na+/K+ ATPase in myocardium
68
What causes Infective Endocarditis
1. IVDU, Diabetes and surgery - S.Aureus 2. Dental - S.viridans 3. Pseudomonas Aerguinosa
69
Clinical presentation of Hypertrophic Cardiomyopathy
1. Double Apical pulsation (forceful atrial contraction causes fourth heart sound) 2. Jerky carotid pulse (rapid ejection + LVOT) 3. Ejection systolic murmur (due to LVOT in systole)
70
Asthma vs COPD in clinical presentation
1. Reduced chest expansion in attacks (barrel chest in COPD) | 2. Nocturnal cough and symptoms in ASTHMA not COPD
71
What should be done if asthmatic attack isn't improving with treatment
CXR for heart failure
72
What inflammatory mediators are released by cigarettes in COPD
IL-1 IL-8 TNF-alpha
73
Genetic cause of asthma
ADAM33
74
What drugs can cause asthma
NSAIDs | Beta-blockers
75
What condition are patents with silicosis susceptible to
1. TB
76
What asbestos fibres cause asbestosis
1. Crocidolite 2. Amosite COMMON - Chrysolite
77
Complication of Idiopathic Pulmonary Fibrosis
Interstitial Pneumonia Pulmonary embolism and Pneumothorax
78
When does pleural effusion cause chest pains
When LYING DOWN
79
What viruses can cause infective diarrhoea
1. Rotavirus 2. Adenovirus 3. Norovirus 4. Astrovirus
80
Risk factors for Hashimoto's thyroiditis
CTLA-4 gene mutation | Down Syndrome
81
What drugs can induce hashimoto's thyroiditis
1. Carbimaxole 2. Lithium 3. Amiodarone (high iodine content stops T3-T4)
82
Complications Hashimoto's thyroiditis
Non-Hodgkin's Lymphoma
83
What are askanazy cells
In hypothyroidism: Cells develop eosinophilic granular cytoplasms due to proliferation of mitochondria.
84
Risks of giving LEVOTHYROXINE
1. AF | 2. Osteoporosis
85
What is myxoedema coma
SEVERE HYPOTHYROIDISM Characterised by lethargy, weakness and confusion
86
How is myxoedema Coma treated
1. IV T3 and Glucose infusion
87
Four ways hypothyroidism is induced
1. Carbimazole 2. Lithium 3. Amiodarone 4. INF
88
Side-effect of SIADH management
1. Central Pontine Myelinolysis
89
What conditions is Addison's associated with
1. Type I diabetes 2. Hashimoto's thyroiditis 3. Coeliac's 4. Vitiligo
90
Risk Factors for Hashimoto's Thyroiditis
1. Gene mutation in CTLA-4 | 2. Down's Syndrome
91
What infections can cause lymphomas
1. HELICOBACTER PYLORI INFECTION | 2. EBV
92
What happens to Hb in renal tubular cells during haemolytic anaemia
Deposited as Haemosiderin into cells
93
Side-effect of erythropoietin treatment in CDA
1. Flu 2. Hypertension 3. Rise in platelet count 4. Thromboembolism
94
Neurological effects of B12 deficiency
1. Paraesthesia of foot and toe 2. Ataxia and weakness 3. Paraplegia 4. Optic atrophy 5. Dementia 6. Hallucination
95
Why can't folate be given without B12
Degeneration of spinal cord
96
What is heard on a stethoscope in Anaemia
1. Systolic flow murmur - due to tachicardia
97
How is t(9;22) diagnosed
1. BCR/ABL dual colour dual-fusion probe
98
What molecules inhibit osteoblasts
HGF | DKK-1
99
What indicates a poor prognosis of myeloma
1. Reduced serum albumin 2. Increased serum betamicroglobulin 3. Increased LDH
100
What compounds activate osteoclasts
1. RANK Ligands | 2. IL-3
101
Where is the G6PD gene located
Chromosome Xq28 on factor VIII gene
102
How does G6PD defend RBCs
Provides NADPH which is used with glutathione to protect from H2O2
103
What causes oxidative crisis
Reduction in glutathione production
104
What induces glutathione reduction
1. Aspirin 2. Antibacterials 3. Dapsone 4. Quinidine
105
How is thalassaemia distinguished form iron deficiency
1. Blood tests | 2. Hb electrophoresis
106
Complications of thalassaemia treatment
1. Iron deposition in liver and spleen = cirrhosis and fibrosis 2 Iron deposition in endocrine glands and heart = diabetes
107
Genetic mutations that cause SCA
1. Single-base mutation of adenine to Thymine which substitutes Valine for Glutamic acid at 6th codon for beta-globin
108
Genetic cause of polycythaemia Vera
1. Point mutation that substitutes phenylalanine for valine at 617th position
109
What enzyme indicates anaemia
Elevated lactate dehydrogenase
110
What part of the prostate over proliferates in BPH
1. Stroma | 2. Glands
111
Clinical Presentation of WILM's TUMOUR
1. Distended abdomen | 2. Haematuria
112
What layer of the prostate has carcinomas arising from it
Peripheral zone of the prostate BPH - Transitional
113
What is Von Hippel Lindau Syndrome
Genetic cause of Renal Cell carcinoma 3q gene mutation - Autosomal Dominant
114
What genes predispose you to prostatic cancer
1. HOXB13 | 2. BRCA2
115
Urine biomarker for prostatic cancer
1. PCA3
116
Name some biomarkers for testicular cancer
1. Alpha-fetoprotein | 2. B-hCG
117
What antigen increases susceptibility to UTIs
HLA-A3
118
What microbes secrete urease against the host
GRAM-POSITIVE: 1. Klebsiella 2. Pseudomonas 3. Proteus GRAM-NEGATIVE: 1. Staphylococcus 2. Mycoplasma
119
Three adhesive features of E.coli
1. Pilli for ascent 2. Aerobactin for Fe acquisition 3. Haemolysin - pore formation
120
Wha virus causes Hep A and how is it excreted
Picornavirus In bile
121
What fungi can cause pericarditis
1. Histoplasmosis | 2. Coccidioplasmosis
122
What is needed in conjunction with ORAL TENOFOVIR
Renal Monitoring
123
What virus is HCV
RNA Flavivirus
124
Hep E virus
RNA
125
HBV virus
DNA
126
What is Mirizzi syndrome
Where stone in cystic duct compresses common bile duct
127
Most common HCV genotypes that infect people
1a and 1b
128
Replacement of colonoscopy
1. Double contrast barium enema
129
What is used to check for rectal cancer in elderly
1. CT colonoscopies No perforation risk
130
What would be found in FBC for prosthetic joint infection
Alpha defensins
131
Symptoms of JIA enthesitis
1. IBD Back pain
132
Main Side-effect of tamsulosin
Postural Hypotension
133
What carcinogens increase risk of bladder cancer
1. Azo Dyes | 2. Beta-Napthylamine
134
How is the value of concentrtaion-dependant killing calculated
Peak conc. / MIC ratio
135
Formula for breakpoint conc.
cmax/et x f x s ``` s = shift factor t = factor to allow for serum elimination half-life e = factor by which cmax should exceed MIC ```
136
How to treat candidaisis
Fluconazole
137
Complications of DKA
1. Cerebral oedema 2. Adult Respiratory Syndrome 3. Thromboembolism 4. Aspiration Pneumonia
138
What is given to a patient before thyroidectomy surgery
Potassium Iodide - reduces vascularity of the thyroid gland Also discontinue antithyroid
139
What blood test would indicate hypothyroidism
1. Normocytic anaemia 2. Raised serum aspartate transferase 3. Increased serum creatinine kinase levels 4. Hypercholesterolaemia 5, Hyponatraemia
140
What is belt-clapper deformity
1. Where testis is not fixed to scrotum completely (free movement)

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