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Cross reference - year 5 > MedGEMS > Flashcards

MedGEMS Flashcards

1
Q

what does probenecid do?

A

increase FEUA

reduce urate in non-acute gout

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2
Q

what is Fanconi syndrome?

A

failure of PCR in kidneys to resorb molecules

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3
Q

causes of Fanconi syndrome

A 
congenital
Wilson's
tetracyclines
MM
lead poisnoning
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4
Q

what is the anti-PCSK9 Ab?

A

Evolocumab

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5
Q

what causes familial hypercholesterolaemia?

A

LDLR mutations = increase LDL

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6
Q

what is the MoA of lomitapine?

A
  • inhibits microsomal triglyceride transfer protein (MTP)
    = blocks release of VLDL from liver = lower LDL levels
    used in treatment of familial hypercholesterolaemia
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7
Q

what is the job of human apolipoprotein E (ApoE)?

A

crucial role in cholesterol and lipid metabolism

3 major isoforms: ApoE2, ApoE3, ApoE4

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8
Q

thinks to remember about ApoE3, ApoE3, ApoE2

A 
ApoE3 = most common
ApoE4 = Alzheimer's link
ApoE2 = Type 3 hyperlipoproteinemia (inc total cholesterol + TGs)
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9
Q

MoA of ezetimibe

A

NPC1L1 inhibitor

= sterol absorption inhibitor

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10
Q

cause of Tangier disease

A

ABC A1 gene mutation = dec HDL levels
prevents release of cholesterol/lipids from cells = accumulates in organs (hepatomegaly, splenomegaly, orange tonsils in children)

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11
Q

what enzyme is involved in the formation of bile acids from cholesterol in classical pathway?

A

cholesterol 7 alpha hydroxylase

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12
Q

causes of normal anion gap metabolic acidosis (ABCD)

A
  1. Addison’s disease
  2. Bicarbonate loss (diarrhoea, laxative abuse, RTA)
  3. Chloride gain (NaCl 0.9% infusion)
  4. Drugs (Acetazolamide)
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13
Q

inheritance of MEN

A

AD

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14
Q

cytoplasm in SCC

A

eosinophillic cytoplasm

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15
Q

gold standard diagnostic for Leishmaniasis

A

splenic aspirate

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16
Q

how is leishmaniasis spread? where do they mutiply?

A

spread by sandflies

multiply inside macrophaghes

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17
Q

what are the fungal antigen tests?

A
  • cryptococcus: CXM
  • aspergillus: Galactomannan
  • candida/asper/pcp: Beta-D-Glucan
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18
Q

treatment of visceral leishmaniasis

A

amphotericin B

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19
Q

HSV that causes encephalitis

A

1

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20
Q

what is the most common cause of diarrhoea in returning traveller?

A

E. coli

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21
Q

cause of Q fever

A

Coxiella Burnetti

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22
Q

medium for mycobacterium tuberculosis

A

Lowenstein-Jenson medium

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23
Q

side effect of pyraxinamde

A

hyperuricaemia

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24
Q

features of cutaenous leishmaniasis

A

ulcerative lesion

long time to heal

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25
Q

microscopy for the fungi

A
  • cryptococcus (India Ink)
  • candida (periodic acid-schiff stain, methenamine silver stain)
  • aspergillus (methenamine silver stain, PAS stain)
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26
Q

beef tapeworm

A

Taenia saginata

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27
Q

what is a decent diagnostic test for tinea/trycophyton?

A

potassium hydroxide

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28
Q

how does pityriasis versicolor appear under wood lamp?

A

orange

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29
Q

reaction in response to syphillis treatment

A

Jarisch Herxheimer reaction

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30
Q

treatment of sinusitis

A

phenoxymethylpenicillin

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31
Q

anti-IL17

A

secukinumab

used in psoriatic arthritis, AS

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32
Q

one sign of LAD

A

delayed sloughing of umbilical cord

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33
Q

RSV prophylaxis

A

palivizumab

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34
Q

Ab in ITP

A

anti-glyoprotein 2b/3a

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35
Q

what happens if there is anti-Ro in pregnancy?

A

baby at risk of congenital heart block

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36
Q

features of X-linked SCID

A

absent T cells
elevated B cells
eczema like rash

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37
Q

xenograft

A

between different species

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38
Q

problem in X-linked SCID

A

defective common gamma chain

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39
Q

Muromonab

A

monoclonal Ab targets CD3 (all T cells)

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40
Q

isograft

A

genetically identical

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41
Q

what does CH50 actually assess?

A

patient ability to lyse sheep erythrocytes coated with rabbit and anti-sheep Ab

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42
Q

problem in CGD

A

NAPDH oxidade fef

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43
Q

what does Natalizumab target?

A

alpha 4 integrin

MS

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44
Q

role of IL2

A

promotes T cell activation

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45
Q

Ustekinumab

A

Ab targets IL-23, IL-12

in psoriasis and psoriatic arthritis

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46
Q

what is protein losing enteropathy?

A

loss of protein from blood
state of immunodeficiency
diagnosed with faecal alpha 1 antitrypsin

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47
Q

patch testing for which type of reactions

A

type 4

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48
Q

gold standard test for food allergy

A

double blind oral food challenge

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49
Q

antibody in RA

A

anti-CCP

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50
Q

what is radioallergosorbent test?

A

detection of allergen specific IgE in blood

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51
Q

order of tests in TB

A
  1. mantoux test

2. IGRA

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52
Q

what is neutralisation?

A

target molecule is covered in ABs so that it can bind to its receptors

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53
Q

what molecules are involved in the initial binding of CD4 in HIV?

A

gp120 and CCR5

54
Q

what does binding of gp120 do?

A

expose gp41

55
Q

what is CD14 found on?

A

monocytes

56
Q

what is the main Ab in breast milk?

A

IgA

57
Q

what is latex food allergy syndrome?

A

IgE mediated

cross reactivity to latex antigens in fruits/seed

58
Q

what kind of organisms are people with CGD at risk of?

A 
catalase +ve
E. coli
Staph. Aureus
Listeria
Klebsiella
Candida
59
Q

what do Basiliximab/Daclizumab target?

A

CD25

60
Q

what does Tofacitinib do?

A

inhibits tyrosine kinase (JAK)

reduces expression of pro-inflammatory cytokines

61
Q

indication?

A

RA
UC
psoriatic arthritis

62
Q

treatment of Kostmann syndrome

A

GCSF injection

63
Q

Tisagenlecleucel

A

chimeric antigen receptor T cell

64
Q

Alemtuzimab

A

anti-CD52

65
Q

affect of haemophillia on bleeding time

A

no effect

66
Q

levels of vWF in vWF deficiency

A

leves of vWF may be normal or low

depends if issue is with function of vWF or lack of production

67
Q

what is the starry sky appearnace?

A

large number of lymphocytes

significant macrophages

68
Q

what is the most common cause of Fe deficiency in developing world?

A

Hookworm

69
Q

reversal of rivaroxaban

A

adexanet alfa

70
Q

what feature does haemophilia increase?

A

increased APTT (defect of intrinsic pathway)

71
Q

treatment of acute promyelocytic leukaemia

A

all-transretinoic acid

72
Q

features of Scwachmann-Diamond

A

neutropenia
pancreatic dysfunction
short stature

73
Q

what is small molecule inhibitor for CLL?

A

ibrutinib

74
Q

what is ventoclax?

A

BCL2 inhibitor for CLL

75
Q

what is the issue is heparin induced thrombocytopaenia?

A

Abs directed against heparin and PLATELET FACTOR 4

  • prothrombotic
  • thrombocytopaenia
  • immune complex formation
76
Q

most common lymphoma in >40 year olds

A

diffuse large B cell lympoma

77
Q

absolute levels of G6PD in acute haemolytic crisis

A

may be normal

78
Q

what is the most common INR target?

A

2.5

79
Q

high risk e.g. metallic valve INR target

A

3.5

80
Q

factor with shortest half life

A

7

81
Q

anticoag treatment in cancer

A

DOAC

82
Q

bronchiectasis appearance on CT

A

bronchial wall thickening

+ve signet ring sign

83
Q

score system for HIT

A

4 Ts

84
Q

cancer with highest mortality

A

lung cancer

85
Q

inheritance of SCD

A

AD

86
Q

what does Fanconi anaemia increase chance of?

A

MDS

AML

87
Q

most sensitive marker for IDA

A

low ferritin

88
Q

anticoagulant in renal failure

A

warfarin

89
Q

what is a dacrocyte

A

poikilocyte erythrocyte

90
Q

Idarucizumab

A

reversal agent of dabigatran

91
Q

what proteins require Vit K?

A

protein C and protein S seasoning

92
Q

appearance of basophil

A

deep blue granules
bilobed nucleus
x3 larger than erythrocyte

93
Q

appearance of eosinophil

A

reddish purple granules
bilobed nucleus
x3 larger than erythrocyte

94
Q

follicular lymphoma translocation

A

14;18

95
Q

what is high/low in TLS?

A

increase K, P, urate

decrease Ca

96
Q

Diamond Black fan

A
  • anaemia
  • elevated fetal Hb
  • craniofacial malformation (e.g. cleft palate/cardiac defect)
97
Q

appearance of a lymphocyte

A

small
giant nucleus
no granules
thin blue cytoplasm

98
Q

what is a poor prognostic marker in ALL?

A

philidelphia chromosome (9;22)

99
Q

enzyme that warfarin inhibits

A

Vit K epoxide reductase

100
Q

treatment of HIT

A
  • stop heparin

- rapid anticoagulation with direct thrombin inhibitor

101
Q

gene mutation in Burkitts

A

c-myc (oncogene)

102
Q

appearance of monocyte

A

large
kidney bean shaped nucleus
relatively common

103
Q

bicalutamide

A

androgen antagonist

prostate cancer

104
Q

pancreatic chemo

A

FOLFIRINOX

105
Q

benign familial haematuria

A

microscopic haematuria
otherwise well
AD

106
Q

what damage causes mitral regurg?

A

papillary muscle damage

107
Q

what valve affected in drug users endocarditis?

A

Tricuspid

108
Q

HSV encephalitis affects the?

A

temporal lobe

109
Q

H&E stain

A

Haematoxylin and Eosin stain

110
Q

inheritance of MODY

A

AD

111
Q

Men 1

A

3Ps
Pituitary
Parathyroid
Pancreatic

112
Q

Men 2a

A

2P’s 1M
Parathyroid
Phaeo
Medullary thyroid

113
Q

Men 2b

A

1P 2M’s
Marfanoid
Medullary
Phaeo

114
Q

what is the misfolded protein in MND?

A

superoxide dismutase

115
Q

what are the features of Alport syndrome?

A
  • nephritic syndrome
  • cataracts
  • sensorineural deafness
116
Q

prostate cancer chemo

A

docetaxel

117
Q

what protein is defective in PCKD

A

polycystin 1

118
Q

Courvoisier’s sign

A
119
Q

casts in CKD

A

waxy

120
Q

what type of cancer does schistosomasis case?

A

SCC of bladder

121
Q

what are the weak points that allow diverticular to form?

A

taenia coli

122
Q

nodules on renal biopsy in Diabetes

A

Kimmelstiel wilson nodules

123
Q

most common type of lung cancer

A

Adenocarcinoma

124
Q

hepatobilliary disease associated with p-ANCA

A

PSC

125
Q

bronchiectasis key sign

A

tram track opacity

126
Q

A1AT inheritance pattern

A

autosomal co-dominant

127
Q

A1AT clinical spirometry and CXR

A

obstructive

CXR = hyperinflation

128
Q

what is acantholysis?

A

lost intracellular connections between neighbouring cells

129
Q

V1 and V2 area

A

septal region

130
Q

tumour associated with zollinger ellison

A

gastrinoma

Cross reference - year 5 (22 decks)

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