Misc

Question 1

Indications for antivenom

Answer 1

Haemo instability
ECG abnormalities
PERSISTENT hypotension
Marked local tissue swelling extending proximally within four hours of the bite

Question 2

Pt with pseudoxanthoma elasticum may present with

Answer 2

GI haemorrhage (upper or lower)
Peripheral or coronary artery disease
Mitral or aortic regurgitation or aortic dissection

Question 3

Dosage of adrenaline in anaphylaxis

Answer 3

1:1,000 500mcg IM

Question 4

Causes of lipoprotein lipase deficiency

Answer 4

primary: autosomal recessive loss of LPL

secondary to diseases:
Pancreatitis
Alcoholism
Hypothyroidism
Type 1 diabetes
Cushing’s syndrome

Note: secondary is more common

Question 5

Cyclophosphamide causes an increased risk of breast Ca T/F

Answer 5

F

Note: Cyclophosphamide causes premature ovarian failure and infertility in both men and women.

Question 6

Inheritance of Peutz-Jeghers syndrome ?

Answer 6

Autosomal dominant

Note: the mutation is in the STK11 gene

Question 7

Acetazolamide results in what type of acid/base disturance?

Answer 7

Normal anion gap met acidosis

Note:

Question 8

Features of yellow nail syndrome and associations?

Answer 8

Yellow nail syndrome is caused by hypoplastic lymphatics and is characterised by the triad of:

Lymphoedema
Pleural effusions
Yellow discolouration of the nails.
Approximately 40% of patients also have bronchiectasis.

Question 9

First line treatment of cocaine overdose?

Answer 9

Benzo

Note: 2nd line is calcium channel blockers (such as nifedipine). Beta blockers are contraindicated as they can cause unopposed alpha activity and worsen hypertension.

Question 10

IV heparin can interfere with what assay?

Answer 10

Thyroid function test assays (on occasions displacing bound thyroid hormone)

Question 11

Raynaud’s phenomenon
Myositis
Fibrosing alveolitis, and
Typical mechanic’s hands (thickened, cracking, and peeling skin)

What diagnosis?

Answer 11

Anti synthase syndrome

AKA polymyositis or Jo-1 syndrome

Note: also have a raised CK

Question 12

Impregnation of the surface of the CVC with chlorhexidine has been shown to reduce risk of CVC associated infections. T/F

Answer 12

T

Question 13

Familial hypercholesterolaemia AKA?

Answer 13

Type IIa hypercholesterolaemia

Question 14

Triad of retinitis pigmentosa, external ophthalmoplegia, and complete heart block?

Answer 14

Kearns-Sayre-Daroff syndrome

Question 15

Patient with heart failure, cataracts, renal disease and angiokeratomas. Like diagnosis?

Answer 15

Fabry disease

Note: x linked recessive

Question 16

MST 40 mg b.d. is approximately equivalent to a __ µg/hr buprenorphine patch or a __ µg/hr fentanyl patch

Answer 16

35 µg/hr buprenorphine patch or a 25 µg/hr fentanyl patch

Question 17

Dantrolene is used in tx of serotonin syndrome or NMS?

Answer 17

NMS

Question 18

Cyproheptadine is used in tx of serotonin syndrome or NMS?

Answer 18

Serotonin syndrome

Note: can also use methysergide

Question 19

Fomepizole used to treat what toxicity?

Answer 19

Methanol

Note: dilated pupils that do not reaction to light is a clue for methanol toxicity (eg it shows optic nerve toxicity)

Question 20

Serious side effects of cyclosporin?

Answer 20

Hypertension, and renal impairment.

Note: tremor is another side effect (dose dependant)

Question 21

MOA of Anakinra

Answer 21

Anti-IL 1 antibody

Question 22

Mechanism of action of abatacept

Answer 22

CTLA4 homologue

Question 23

MOA golimumab and certolizumab

Answer 23

Anti-TNF alpha agents

Note: as are adalimumab, etanercept, infliximab

Question 24

In hyperthermia, as body temperature increases, what is the earliest biochemical abnormality?

Answer 24

Earliest is hypoK

Note: later can get hyperK (due to rhabdo ) and lactic acidosis

Question 25

When does fat embolism syndrome usually present?

Answer 25

24 - 72 hrs after initial injury

Question 26

Features of phenytoin toxicity?

Answer 26

Typically a cerebellar-like syndrome. Nystagmus is present even in mild toxicity.

Question 27

What biochem abnormality is seen in Paget's disease?

Answer 27

Elevated alk phos

Question 28

3 medications known to increase Troponin I

Answer 28

Adriamycin Herceptin 5-fluorouracil

Question 29

1st and 2nd line tx of neuropathic pain?

Answer 29

Duloxetine Amitriptyline Note: both are CI if hx of glaucoma. If hx glaucoma pregabalin or gabapentin can be considered. However where there is renal impairment, pregabalin is preferable over gabapentin.

Question 30

What is Fitz-Hugh-Curtis syndrome

Answer 30

A perihepatitis associated with Chlamydia trachomatis infection.

Question 31

MOA denosumab?

Answer 31

Decreased osteoclast formation RANK ligand inhibitor

Question 32

Safest antidepressants to prescribe with warfarin?

Answer 32

Sertraline and Citalopram appear to be the safest