Mock Exam

Question 1

What to measure in Paget’s disease of bone?

Answer 1

alkaline phosphatase

Answer 2

plain x-ray
?? bsiphosphonate san

Question 3

what kind of deafness does Pagets disease of bone cause?

Answer 3

conduction (paget’s disease of the osscicles) and nerve deafness (compression of 8th nerve)

test with tuning fork

Question 4

what kind of clinical test should you perform in patients with pagets disease in finals?

Answer 4

Weber and Rinne

Question 5

What blood marker is increased in osteomalacia?

Answer 5

alkaline phostphatase

Question 6

What is osteomalacia

Answer 6

lack of vitamin D -> secondary hyperparathyroidism?

Question 7

what is increased after myocardial infarction?

Answer 7

Troponins
CK (MB)
AST
LDH

they will have a low potassium at presentation because the adrenaline causes it to drop

Question 8

What is raised in a patient with Addisons disease?

Answer 8

potassium

Question 9

What is raised in a patient with jaundice due to gall stone?

Answer 9

alkaline phosphatatse

Question 10

why are the patterns

Answer 10

different enzymes in different zones of the portal triad

different released in the different types of damage

Question 11

liver on histology

Answer 11

hexagon
portal vein
portal triad
duct with duct cells

Question 12

Which LFT is mainly raised in viral hepatitis?

Answer 12

alanine aminotransferase (ALT)

Question 13

which LFT is most increased in a patient with chronic alcoholic cirrhosis?

Answer 13

AST =

lots of cells die, nodules, won’t have the nice anatomy

Question 14

which marker is increased in prostate cancer?

Answer 14

acid phosphatase = prostate specific antigen

Question 15

what is acid phosphatase?

Answer 15

prostate specific antigen

Question 16

what is another name for PSA?

Answer 16

acid phosphatase

Question 17

What is low in primary hyperparathyroidism?

Answer 17

vitamin D

because it is consumed, PTH activates vitamin D

alk phos goes up

Question 18

What is measured when vitamin D levels are measured?

Answer 18

xx

Question 19

What rises most accurately in acute renal failure where the cause is dehydration?

Answer 19

Urea

(goes up very quickly in a dehydrated patient)

Question 20

what rises most in chronic renal failure caused by a fall in GFR?

Answer 20

creatinine

Question 21

What is a good marker of glucose control over the last 3 w?

Answer 21

fructosamine

=> useful in patients with a rapidly changing glucose.

HbA1c would be over the last 3 months

Question 22

PTH in primary hyperparathyroidism

Answer 22

normal or high

if a calcium is high the PTH should be V low, if it is not -> primary hyperparaathyroiidisim

Question 23

What is Lesch Nyhan syndoem?

Question 24

What occurs in Lesch Nyham syndrome? (rheum)

Answer 24

Gout

Question 25

What parathryroid finding occurs in osteomalacia?

Answer 25

secondary hyperparathyroidism

Question 26

causes of isolate hypernatraemia in the context of polydipsia and polyuria

Answer 26

diabetes insipidus / VP deficiency

Question 27

Leptospirosis presentation

Question 28

What is the full name for rodent ulcer

Answer 28

basal cell carcinoma

Question 29

thyroid histology

Question 30

liver histology

Answer 30

central vein portal triad many dance cells with visible nuclei

Question 31

histology of kidneys

Answer 31

glomeruli tubules

Question 32

Adrenal histology lecture

Answer 32

medulla in the middle xxx

Question 33

SIADH

Answer 33

high urine osmolality low blood osmolality xxx

Question 34

psychogenic polydipsia

Question 35

sodium in cranial diabetes insipidus?

Answer 35

sodium would be high in cranial diabetes insipidus like 150 and 160

Question 36

Renin in Conn's

Answer 36

suppressed!!!

Question 37

hypertension and hyperkalaemia causes with high aldosterone

Answer 37

RAS (normal renin) Conn's (renin suppressed)

Question 38

What controls renin?

Question 39

causes of RAS

Answer 39

1. paeds ??? 2. high cholesterol ??

Question 40

RAS vs Conn's

Answer 40

renin is suppressed in Conn's syndrome good discriminator

Question 41

ACE inhibitors in patients with diabtest

Answer 41

initially worsens creatinine xxx

Question 42

ACE inhibitors in diabetes patients - why?

Answer 42

mamicroalbuminuria disappears b/c the pressure is lower

Question 43

which drugs protect kidneys in diabetes?

Answer 43

ACEi SGLT2 inhibitors

Question 44

Should you stop ACEi when creatinine rises after starting it in diabetes?

Answer 44

usually no - in most cases it makes the creatinine rise a bit in severe cases e.g. if someone comes to the hospital with sepsis you don't also don't give ACEi in RAS

Question 45

what BP med is contraindicated in RAS?

Answer 45

ACEi

Question 46

deadly malaria

Answer 46

P. falciparum (kills many patients by obstructing blood flow)

Question 47

P. vivax - what additional treatment?

Answer 47

primaquine 30mg because of the parasites in the liver

Question 48

what are thick and thin films for?

Answer 48

thick - is there malaria? thin - what type of malaria is it and what species is it?

Question 49

45yo female with itchy skin, anti-mitochondrial antibodies

Answer 49

Primary biliary cirrhosis

Question 50

Kayser Fleischer rings - dx?

Answer 50

Wilsons disease

Question 51

20 yo male with jaundice and malaise, high ALT and recent travel to India

Answer 51

hepatitis A

Question 52

45 yo male with leucocytosis, high bilirubin, low albumin, folate and b12. prolonged PT. Dx?

Answer 52

alcoholic liver disease

Question 53

radiological finding in PSC?

Answer 53

beaded appearance on ERCP