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MRCP Flashcards

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1
Q

Conns (primary hyperaldosteronism)

Features

A

High BP
Low K*
Alkalosis

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2
Q

Conns
Investigation

A

Aldosterone/renin ratio
CT Adrenal

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3
Q

Melanoma of pales/soles/nails

African American

A

Acral Lentigous

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4
Q

Gilberts syndrome inheritence

A

Autosomal recessive

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5
Q

Cause of Gilberts Syndrome

A

Deficiency of USP glucuronyl transferase

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6
Q

Features of Gilberts Disease

A

Unconjugated billirubinaemia
Jaundice in illness
Rise in billirubin after prolonged fasting or IV nicotinic acid

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7
Q

Benzos MOA

A

GABA inhibitor
By increasing frequency of chloride channels

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8
Q

Dobutamine MOA

A

Beta 1 agonist

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9
Q

Salbutamol MOA

A

Beta 2 agonist

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10
Q

Ligand gate ion channels examples

A

Nicotinic acid
GABA

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11
Q

Tyrosine kinase receptor examples

A

Insulin
Epidermal growth factor
Prolactin EPO

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12
Q

Guanylate cyclase receptors examples

A

ANP
BNP

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13
Q

Polycystic kidney inheritance

A

Autosomal dominant
PKD1

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14
Q

PCP pneumonia features

A

Bilateral interstistial infiltrates
Exercise imduced desaturation
Needs broncheolar lavage
Often leads to pneumothorax

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15
Q

Mytonic dystrophy features

A

Distal weakness
Autosomal dominant
Diabetes
Dysarthria

DDDDDD

Cataracts
Ptosis

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16
Q

Renal transplant matching gene

A

HLA DR

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17
Q

Parvolex MOA

A

Replenishes glutathione which binds with paracetamol to make mercapturic acid
When that stops tries to use P450 so if on other inhibitors then lower threshold for parvolex

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18
Q

Rabies features

A

RNA rhabdovirus
Causes encephalitis
Negri bodies
Needs ABx and booster even if vaccinated

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19
Q

Anion Gap

A

(Na+K) - (Cl+HCO3)
Normal = 10-18

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20
Q

Raised anion gap causes

A

Lactate - shock/hypoxia
Ketones -DKA

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21
Q

Kaposis sarcoma virus

A

Human Herpes Virus 8

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22
Q

Osteomalacia electrolytes

A

Low vit D
High ALP
Low Ca2
Low phos

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23
Q

Serotonin syndrome tx

A

Serotonin antagonists eg cyproheptadine, chlorpromazine

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24
Q

MEN 1

A

3 Ps

Parathyroid
Pituitary tumours
Pancreas (insulinoma)
Common presentation = hypercalcaemia

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25
MEN IIa
Medullary thyroid cancer Parathyroid Phaeocromocytoma
26
MEN IIb
Phaeochromocytoma Marfanoid Neuromas Medullary thyroid cancer
27
Macrolides MOA, SE | (erythromycin, clarithromycin, azithromycin)
Inhibit protein synthesis Prokinetic therefore GI SE CHolestatic jaundice P450 inhibitor
28
Alports syndrome features and inheritance
Inherited X linked Type Iv collagen Renal failure Deafness Renal transplant failure - anti GBM Retinitis pigmentosa
29
Alpha 1 anti trypsin deficiency
Piss homo worse Emphysema Liver cirrohsis TX IV alpha 1 anti trypsyn Lung reduction surgery/transplant
30
Schistosomiasis tx
Praziquantel
31
CREST
Calcinosis Raynauds Esophageal dysmotility Sclerodacttly Telangectasia
32
Anti SCl 70
Diffuse systemic Sclerosis
33
Anti Ds DNA
SLE
34
Anti CCP
Rheumatoid arthritis
35
Anti mitochondrial AMA
PBC
36
Anti centromere
Limited cutaenous sclerosis
37
Penicillins MOA
Inhibit cell wall formation
38
Cephalosporins MOA (cefataxime)
Inhibit cell wall synthesis
39
Aminoglycosides (gentamicin, streptomycin)
Inhibit protein synthesis
40
Churg Strauss triad
Asthma Mononeuritis Esinophilia
41
Rituximab target
CD20
42
Complete heart block post MI location
RCA
43
Graves disease signs
Eye signs - exopthalmos, opthalmoplegia Pretibial myoxedema Thyroid acropathy
44
Most common lung ca in non smokers
Adenocarcinoma
45
Most common lung ca in smokers
Squamous cell
46
Most aggressive lung ca
Small cell
47
Whats does HBsAG positive mean?
Acute infection within 6 months or chronic if \> 6 months
48
Anti HBs positive
Hep b immunity
49
Anti HBc positive
Infection at some point past or current
50
Lateral epicondylsis - painful movement
Wrist extension with flexed elbow
51
Type of renal disease ax with SLE
Diffuse proliferative glomuerulonephritis
52
Features of Steven Johnsons Syndrome
Mucosal involvement Target lesions Fever Arthralgia Vesicles/bullae
53
Drugs causing Steven Johnsons Syndrome
penicillin sulphonamides lamotrigine, carbamazepine, phenytoin allopurinol NSAIDs oral contraceptive pill
54
Primary Hyperparathyroidism
High calcium High/normal PTH Low phos From adenoma
55
JVP c wave
Closure of tricuspid wave
56
Aciclovir MOA
Inhibits DNA polymerase
57
Vitreous haemorrhage presentation
Dark shadows
58
Retinal detachment presentation
Painless loss of vision, dense shadow starts peripheral moving in
59
Wernickes encephalopathy features
Ataxia Opthalmoplegia Confusion
60
Korsakoffs features
Ataxia Opthalmoplegia Confusion Amnesia Confabulation
61
Amoebiasis features and treatment
Bloody diarrhoea Hepatomegaly Trophozoites Tz metronidazole
62
Diabetes diagnostic critera
Fasting glucose 7 or more Random/OGTT glucose 11.1 or more
63
Impaired fasting glucose
6.1-7.0
64
Impaired glucose tolerance
OGTT 7.8-11.1
65
Gullian barré infection + direction
Campylobacter Ascending
66
Miller fischer syndrome
GB + Othalmoplegia Areflexia Ataxia
67
HCOM Inheritance
Autosomal dominant
68
HCOM tissue change
B myosin heavy chain protein/myosinbinding c
69
Testicular seminoma marker
HCG
70
Silicosis CXR
Eggshell calcification upper zones
71
ABx causing prolonged QT
Erythromycin
72
Cyclophosphamide side effects
Haemorrhagic cystitis
73
cANCA
Wegeners
74
pANCA
Churg strauss
75
G6PD Deficiency features
Gallstones Splenomegaly Heinz bodies/blister cells Neonatal jaundice
76
G6PD Deficiency triggers
Anti malarials eg quinines Cipro Flava beans Sulphs
77
Coeliac disease HLA
HLA DQ2
78
Most common bacterial meningitis in adults
Strep pneumoniae Neissera meningitidis
79
Most common meningitis in immunosuppresed
Listeria
80
Causative organism of granuloma inguinale
Klebsiella granulomatis
81
Sulfonylureas SEs (amides)
Hypos Weight gain
82
Heparin MOA
Hinds to antithrombin III (so can’t make thrombin)
83
Thiazilidinediones (plioglitazone) MOA
PPAR gamma agonist - reduce insulin resistance
84
Hypothermia ECG changes
J waves
85
Gene neuroblastoma
N MYC
86
Klebsiella CXR
Upper lobe cavitating lesions
87
Coeliac ax renal disease
IgA Nephropathy
88
RTA 1
Cant excrete uric acid in distal tubule Hypokalaemia Nephrocalcinosis/kidney stones
89
Acromegaly tx
Ocreotide (somatostatin analogue, inhibits GH)
90
ICB with fluctuating conciousness
Subdural
91
Target INR Mechanical Mitral
3.5
92
Target INR Mechanical Aortic
3.0
93
Adenosine contraindicated in...
Asthmatics
94
VTE INR target
2.5
95
Recurrent VTE INR target
3.5
96
AF Target INR
2.5
97
Cluster headache tx
Sc sumatriptan and O2
98
Hyperosmolar Hyperglycaemic State - triad
1) really high BM \>30 2) hyperosmolar 3) hypovolaemic NO KETONES NO ACIDOSIS
99
Background retinopathy features
Micro aneurysm Blot haemorrhage Hard exudates
100
Pre-proliferative retinopathy
cotton wool spots (soft exudates; ischaemic nerve fibres) \> 3 blot haemorrhages venous beading/looping deep/dark cluster
101
Listeria presentation
diarrhoea, flu-like illness pneumonia , meningoencephalitis ataxia and seizures
102
Simvastatin contraindicated in...
Pregnancy
103
Bleeding + anaemia + pulmonary AV malformations
Hereditary Haemorrhagic Telangectasia
104
Mechanism of increased thromboembolic risk in liver failure
Elevated Factor 8
105
Breast Ca Tumour Marker
Ca 15 3
106
Post flu pneumonia organism
Staph A
107
Post splenectomy on pen v - what organism susceptible to?
Hib
108
Prader-Willi Syndrome genetics
15q11/-13 microdeletion Paternal
109
Positive red Congo stain
Amyloidosis
110
Bendroflumethiazide MOA
inhibits sodium reabsorption by blocking the Na+-Cl− symporter at the beginning of the distal convoluted tubule
111
Narcolepsy MOA
Low orexin
112
High urea - pre-renal (AKI) vs Acute Tubular Necrosis
Pre renal = low urine sodium \<20 AVN = high urine sodium \>30
113
Reactive Arthritis Triad
Arthritis + conjunctivitis + urethritis
114
Pioglitazone main side effect
Peripheral edema Weight gain LFTs
115
Turners syndrome Cardiac defect
Bicuspid aortic valve
116
ABx causing MRSA
Cipro, penicillins
117
Rifampacin SE s
Orange bodily fluids, rash, hepatotoxicity, drug interactions
118
Isoniazid SEs
Peripheral neuropathy, psychosis, hepatotoxicity
119
Pyrizanimide SEs
Arthralgia, gout, hepatotoxicity, nausea
120
Ethambutol
Optic Neuritis. Rash
121
Ehler Danos Collagen type
Type 3 Collagen
122
Wiscott Aldrich Syndrome (4 features)
Eczema Thrombocytopaenia Recurrent chest infections Low IgM X linked recessive
123
Live Vaccines
BCG MMR Yellow Fever Oral polio/typhoid
124
Radio opaque renal calculi
Calcium
125
Semi opaque renal calculi
Cistine
126
Radio lucent renal calculi
Xanthine Urate
127
Lyme disease (buls eye/target rash) tx
PO doxy if not disseminated IV cef if systemic
128
Joint aspiration Positively bifringent crystals
Pseudogout
129
calcium pyrophosphate dihydrate on joint aspiration
Pseudogout
130
Factors predisposing to pseudogout
Hypothyroid, HyperPTH, Low Mg, Low Phos, Wilsons, acro, haemochromatosis
131
Glycopeptide MOA (teicoplanin, vancomycin)
Inhibit cell wall synthesis
132
B12 Absorption
Active in terminal ileum
133
Causes of false +ve VLDR
SomeTimes Mistakes Happen SLE, TB, Malaria, HIV
134
Urge Incontinence
Oxybutinin (cause inc risk falls/confusion), Darefenacin… Mirabegron if hx of retention
135
Hypokalaemia and high BP
Vomiting, thiazides, Conns, Cushings
136
Non specific urethritis tx
Doxy/azythro
137
Most common site cardiac tumour
Left atrium
138
LTOT for COPD
x2 ABG with O2 \<7.3
139
Multiple stomach ulcers, HyperPTH
MEN I (Zolllinger Ellinson)
140
CADASIL
young strokes NOTCH3 Autosomal dominant
141
Anterior cerebral artery stroke
Contralateral hemiparesis and sensory loss, lower extremity \> upper
142
Middle cerebral artery stroke
Contralateral hemiparesis and sensory loss, upper extremity \> lower Contralateral homonymous hemianopia Aphasia
143
Posterior cerebral artery stroke
Contralateral homonymous hemianopia with macular sparing Visual agnosia
144
Weber's syndrome (branches of the posterior cerebral artery that supply the midbrain) stroke
Ipsilateral CN III palsy Contralateral weakness of upper and lower extremity
145
Posterior inferior cerebellar artery (lateral medullary syndrome, Wallenberg syndrome)
Ipsilateral: facial pain and temperature loss Contralateral: limb/torso pain and temperature loss Ataxia, nystagmus
146
Anterior inferior cerebellar artery (lateral pontine syndrome)
Symptoms are similar to Wallenberg's (see above), but: Ipsilateral: facial paralysis and deafness
147
Retinal/ophthalmic artery clot
Amaurosis fugax
148
Basilar artery
'Locked-in' syndrome
149
TTP Features
Fever Bleeding Haemolysis/renal failure Neuro signs
150
Alpha Thalassaemia Chromosome number
16
151
Hereditary Spherocytosis
Autosomal dominant failure to thrive jaundice, gallstones splenomegaly aplastic crisis precipitated by parvovirus infection MCHC elevated
152
Cause of Aplastic Crisis
Parovirus B19
153
Bromocriptine, ropinirole, cabergoline are examples of...
Dopamine agonists
154
Tear Drop Polikilocytes
Myelofibrosis
155
Myelofibrosis presentation
eelderly person anaemia massive splenomegaly weight loss, night sweats etc
156
Wilsons disease tx
Penicilliamine
157
Wilsons disease genetics
ATP7B gene located on chromosome 13.
158
Wilsons disease features
liver neuro speech, behavioural psych Kayser-Fleischer rings renal tubular acidosis (esp. Fanconi syndrome) haemolysis blue nails
159
Wilsons disease diagnosis
reduced serum caeruloplasmin reduced serum copper increased 24hr urinary copper excretion
160
Syringomyelia
Loss of temp
161
Mixed upper and lower motor neurone with fasciculations
MND/ALS
162
Drugs triggering Churg Strauss
LRA - montelukast
163
Acute Migraine tx
Triptan and NSAID
164
Migraine Prophylaxis
Propanolol, Topiramate (not for child bearing)
165
ABx to avoid with methotrexate
Trimethoprim, Co-trimoxazol
166
Which diabetic meds cause hypos
Sulfonylureas; glimperide, glicaclazide
167
Bence Jones +ve with no boney lesions
Waldenstroms Macroglobulinaemia
168
Rapid onset dementia + myoclonus
Creutzfeldt-Jakob disease
169
Test for lead poisoning
urinary coproporphyrin
170
First line Tx for Phaemochromocytoma
Phenoxybenzamine
171
Courvosiers sign
Palpable gallbladder, painless jaundice - cholangiocarcinoma
172
Myxoedemic coma tx
Hydrocortisone and thyroxine
173
Cryptosporidium tx
nil - self limiting
174
Blood film: bilobed large mononuclear cells
AML
175
Less severe alpha 1 anti trypsin allele
PIMZ
176
More severe alpha 1 anti trypsin allele
PIZZ
177
Cavitating lung ca
squamous cell
178
diabetic meds causing severe pancreatitis
exanetide
179
renal transplant infection
cmv
180
Alvardo Score
Acute Appendicitis
181
Sjorgens syndrome HLA
HLA DR3
182
Indications for steroids in sarcoidosis
Lung disease Hypercalcaemia Neuro/cardiac involvement
183
Factor V Leiden mechanisms
Activated protein C resistance
184
Ca 15 3
Breast Ca
185
Alpha fetoprotein tumour marker
Testicular teratoma
186
ABx PCP prophylaxis
Cotrimoxazole
187
CD4 Count for PCP prophylaxis
\<200
188
Haemophilia A clotting
Pt normal APPT prolonged
189
Haemophilia A factor
Factor VIII deficiency
190
Chi squared test
To compare proportions/percentages
191
Renal tubular acidosis ion gap
Normal
192
Metabollic acidosis normal ion gap (hyperchloraemic acidosis) causes
GI losses Renal tubular acidosis Ammonia chloride Addisons
193
Metabollic acidosis raised ion gap
Lactic acid Keto acid Uric acid Poisoning acid
194
Sarcoidosis stage 1 CXR
1 = BHL
195
Sarcoidosis CXR Stage 2
BHL + infiltrates
196
Sarcoidosis CXR stage 3
Infiltrates
197
Sarcoidosis stage 4 CXR
Fibrosis
198
Type of Hodgkins lymphoma with best prognosis
Lymphocyte predominant
199
Type of Hodgkins lymphoma with worst prognosis
Lymphocyte depleted
200
Most common type of hodgkins lymphoma
Nodular scelrosing
201
Med for HER +ve breast ca
Trastuzumab
202
Muddy brown casts
Acute tubular necrosis
203
Charcot's cholangitis triad
Fever + jaundice + RUQ pain
204
Acute Myeloid Leukaemia Good prognostic marker
Translocation 15:17
205
MOA cetuximab | (Colorectal cancer)
Monoclonal antibody against epidermal growth factor
206
What type of lung ca is Lambert Eaton Syndrome ax with?
SCLC
207
Waldenstroms Macroglobulinaemia
IgM Paraprotein Weight loss DVT
208
Most aggresive melanoma
Nodular
209
Haeomolytic uraemic syndrome organism
E coli
210
DIC blood film
Shistocytes
211
Schistosomiasis bladder ca type
Squamous cell
212
Nephrogenic diabetes mutations
ADH AVPR2
213
Pemphigous vulgaris
Desmoglein 3 mutation Mucosal ulceration Flaccid blisters - itchy but not painful Acantholysis on biopsy Nikolskys sign positive
214
Drug induced thrombocytopaenia
Quinine NSAIDS Abx Anti epileptics Heparin
215
Gastroenteritis few hours after eating bug
Staph A
216
Receptor for EBV
CD14
217
What type of hypersensitivity reaction is ITP
II
218
Cardiac abnormality ax with PKD
Mitral valve prolapse
219
Hypo pigmentations + subungual fibromas
Tuberus sclerosis
220
What do atypical lymphocytes suggest?
Glandular fever
221
Cause of pellagra
Niacin B3 deficiency
222
Pneumonia in bird keepers
Chlamydia psittaci
223
Acute migraine rx
Triptan \*NSAID/paracetamol
224
Migraine prophylaxis
Tompirate Propanolol
225
Case control stats
Odds ratio
226
Genital warts HPV
6 and 11
227
Brown Sequard Mechanism
Lateral hemisection of spinal cord
228
Tonsilitis organism
Strep pyogenes
229
What does 3rd heart sound indicate
Constrictive pericarditis
230
Bronchiectasis HLA
HLA DR1
231
SLE HLA
HLA DR2
232
Sjorgen HLA
HLA DR3
233
Autoimmune hepatitis HLA
HLA DR3
234
Cat scratch disease
Bartonella henselae
235
Yellow fever presentation
Flu like illness Then well period Then jaundice + haematemesis
236
Very high WCC leukaemia
Chronic myeloid leukaemia
237
Hashimotoa thryroiditis
Hypothyroidism + goitre + anti TPO
238
MODY gene
HNF 1 alpha
239
Wood grain rash
Erythema gyratum repens
240
Diabetic nephropathy histopathology
Nodular glomerulisclerosishyaline artiosclerosis Kimmelstiel wilson lesions
241
Hepatitis in pregnancy
Hep E
242
LVF pulse
Pulsus alternans
243
Black bone spicule retina
Reinitis pigmentosa
244
Retinitis pigmentosa features
Night blindness + tunnel vision
245
Upper zone fibrosis
Extrinsic allergic alveolitis
246
EAA causes
Bird fanciers Farmers - saccharopolyspora rectivgula Malt workers - aspergillous clavatus Mushroom
247
EAA bloods, broncheolar lavage
No eosinophilia on bloods Lymphcytosis on lavage
248
Non resolving pneumonia w dry cough
Cryptogenic organising pneumonia
249
Abestosis - pleural plaques
Most common Benign
250
Asbestosis
Related to length of exposure 15-30 latent
251
Abestosis fibrosis region
Lower zones
252
Mesothelioma features
Progressive SOB Chest pain Pleural effusion
253
SCLC Paraneoplastic features
ADH (hyponatraemia) ATCH (high bm, htn, low k) Lambert Eaton
254
Lambert eaton - presentation and ax
SCLC Myasthenia sx
255
Squamous Cell Paraneoplastic features
Hyperparathyroidism Hyperthyroid Clubbing Hypertrophic pulmonary osteoarthropathy
256
Lung adenocarcinoma paraneoplastic features
HPOA Gynaecomastia
257
Causes of lung fibrosis CHARTS
Coal workers pneumoconiosis Histiocyotisis/hypersensitivity pneumonitis Ank spond Radiation Tb Silicosis/sarcoid
258
Drug causes of lung fibrosis
Amiodarone Methotrexate Bleomycin
259
What cells does SCLC arise from
APUD
260
When does pleural fluid need chest drain
pH \<7.2 Purulent fluid Positive culture
261
Transudate vs exudate proteins
Exudates \>30 Transudates \<30
262
When to use lights criteria for pleural fluid
Protein 25-30
263
Lights criteria
Exudate = Pleural fluid protein/serum protein \>0.5 Pleural LDH/serum LDH \>0.6 Pleural LDH more than 2/3 of upper limits normal serum LDH
264
Where does mesothelioma metastases to
Other lung Peritoneum
265
Which lung is mesothelioma most commonly in
Right
266
``` Pulmonary Hypertension (\>25mmhg) Group 1 ```
Idiopathic Familial Ax with sickle cell, HIV, congental heart disease w shunt, collagen disease
267
``` Pulmonary Hypertension (\>25mmhg) Group 2 ```
PHTN w left heart disease eg mitral valve or LVSD
268
``` Pulmonary Hypertension (\>25mmhg) Group 3 ```
Secondary to lung disease/hypoxia Eg COPD, ILD, sleep apnoea, altitude
269
``` Pulmonary Hypertension (\>25mmhg) Group 4 ```
Due to thromboembolic disease
270
``` Pulmonary Hypertension (\>25mmhg) Group 5 ```
Miscellaneous eg sarcoid or carcinomatosis
271
Primary pneumothorax \<2cm and not SOB
Discharge
272
Primary pneumothorax \>2cm/SOB
Aspirate If fails chest drain
273
Secondary pneumothorax \<50 1-2cm
Aspirate Admit 24 hr
274
Secondary pneumothorax \>50 \>2cm/SOB
Chest drain
275
Secondary pneumothorax \<1cm
Admit 24 hours O2
276
Heart defect causing stroke/VTE
PFO
277
Loud S2
HTN Hyper dynamic ASD w/o phtn
278
Soft S2
AS
279
Fixed split S2
ASD
280
Reversed split S2
LBBB Severe AS Righr ventricular pacing WPW Tb PDA
281
Widely split S2
Deep inspiration RBBB Pulmonary stenosis Severe MR
282
WPW ECG changes
Short PR Wide QRS with slurred upstroke LAD/RAD
283
WPW type 1 vs Type 2
Type 1 dominant r wave in v1
284
Associated conditions of WPW
HOCM Mitral valve prolapse Ebsteins anomaly Thyrotoxicosis Secundum ASD
285
WPW management
Ablation Sotalol/amiodarone/flecanide
286
Signs tricuspic regurg
Pan systolic murmur Prominenet/ giant V waves JVP Pulsatile hepatomegaly Left parasternal heave
287
Causes tricuspid regurg
RV infarct PHTN Rheumatic heart disease IE Ebateins anomaly Carcinoid syndrome
288
Poor prognostic factors Infective Endocarditis
Staph A Prosthetic valve Culture neg Low complement
289
Indications for surgery infection endocarditis
Severe valve incompetence Aortic abcess Resistant infection Heart failure Recurrent emboli
290
Infective endocarditis - initial blind therapy
Amox and gent
291
Infective endocarditis - initial blind therapy pen allergic
Vanc + gent
292
Infective endocarditis - initial blind therapy prostethic valve
Vanc + gent + rifampicin
293
Infective endocarditis - native valve staph
Fluclox
294
Infective endocarditis - prostethic valve staph
Fluclox (or vanc if pen allergic) + gent + rifampicin
295
Infective endocarditis caused by strep
Ben pen + gent if not fully sensitive Switch benpen to vanc if pen allergic
296
Features of severe AS
Narrow pulse pressure Slow rising pulse Soft/absent S2 Thrill LVH Fourth heart sound
297
Causes of AS
Calcification Bicuspid aortic valve Williams syndrome Post rheumatic disease HOCM
298
Management AS
If symptomatic or gradient \>40 + LVSD replace Balloon valvuloplasty if not fit for replacement
299
Cannon waves JVP
``` Regular = VT, AVRNT Irregular = complete heart block ```
300
Pulsus parodoxus
Severe asthma Cardiac tamponade
301
Slow rising pulse
AS
302
Collapsing pulse
Aortic regurg PDA hyperkinetic
303
Pulsus alternans
Severe LVF
304
Jerky pulse
LVSD
305
VT management
Drugs - amiodarone, lidocaine, procainamide, magnesium Shock/ICD
306
DVLA HTN
Fine unless unacceptable side effects Group 2 not if 180/100
307
DVLA angioplasty
Week off
308
DVLA CANG
4 weeks off
309
DVLA ACS
4 weeks off or 1 week if successful angio
310
DVLA Angina
Cant drive if sx at rest
311
DVLA pace maker inserted
1 week off
312
DVLA ICD
Prophylactic 1 month, if not 6 Total ban for Group 2
313
DVLA Catheter ablation
2 days
314
DVLA Aortic aneurysms
\>6 notify DVLA \>6.5 cant drive
315
Target BP \<80
140/90 or ABPM/HPBM 135/85
316
Target BP \>80
150/90 or ABPM HBPM 145/85
317
Coeliac HLA
HLA DQ2 HLA DQ8
318
HLA DQ2/DQ8
Coeliac
319
Coeliac complications
Anaemia Hyposplenism Osteoporosis/malacia Lactose intolerance Enteropathy ax t cell lymphoma Subfertility
320
Eczema herpticium features
Kinds who already have atopy life threatening HSV 1 acyclovir puncted out lesions monomorphic blisters
321
Coeliac HLA
HLA DQ2
322
Klebsiella pneumonia
Diabetics, alcoholics, aspiration upper lobe
323
DiGeorge syndrome
C - Cardiac abnormalities A - Abnormal facies T - Thymic aplasia C - Cleft palate H - Hypocalcaemia/ hypoparathyroidism 22 - Caused by chromosome 22 deletion
324
erysipelas organism
strep pyogenes
325
Peritonitis from dialysis organism
staph epidermis
326
Hypothermia ecg
long qt
327
Howell-Jolly bodies and pencil cells
coeliac Post splenectomy
328
extra dural haemorrhage vessel
MMA
329
causes of prolonged qt
amiodarone, sotalol, class 1a antiarrhythmic drugs TCA, SSRIs methadone chloroquine terfenadine\*\* erythromycin haloperidol ondanestron
330
stag horn calculi composition
struvite
331
prosthetic valve endocarditis abx
rifampicin + vanc + gent
332
Terlipressin - method of action
constriction of the splanchnic vessels
333
anti jo 1 antibodies
polymyositis
334
Lofgren's syndrom
acute form sarcoidosis characterised by bilateral hilar lymphadenopathy (BHL), erythema nodosum, fever and polyarthralgia.
335
muscle cramp and brown urine after exercise
mcardle syndrome
336
Lateral medullary syndrome
PICA lesion - cerebellar signs, contralateral sensory loss & ipsilateral Horner's
337
Complications of pancreatitis
Necrosis Pseudocysts/fluid Abcess Haemorrhage ARDS
338
Budd Chiari triad
Abdo pain ascites tender hepatosplenomegaly
339
Causes of Budd Chiari
Polycythaemia rubra vera Thrombophilia OCP Pregnancy
340
Peutz Jegers
Pigmented lesions on palms, soles, mouth Hamartous polyps High risk of developing another cancer Intusuception/obstruction/GI bleed
341
Philadephia Chromsome
CML | (causes BCR ABL increased tyrosine kinase)
342
CML Chromosome translocation
t9:22 q34:11
343
t(15:17)
Acute Promyelotic leukaemia
344
t(8:14)
Burkitts lymphoma MYC oncogene
345
t(11:14)
Mantle cell lymphoma
346
t(14:18)
follicular lymphoma BCL 2
347
Leucocyte ALP raised conditions
Myelofibrosis Leukaemia reactions polycythaemia rubra vera Infections Cushings Pregnancy/COCP
348
Leucocyte ALP low conditions
CML Pernicious anaemia Paroxysmal nocturnal haemoglobuinuria Infectious mononucleosis
349
Features of lead poisoning
Abdo pain Peripheral neuropathy fatigue constipation blue lines on gum Microcytic anaemia
350
Hereditary Spherocytosis inhertiance
autosomal dominant Northern European
351
Hereditary Spherocytosis presentation
FTT Jaundice/gallstones Splenomegaly Aplastic crisis w parvovirus High MCHC Spherocytes EMA binding test
352
G6PD Deficiency inheritance
Male ( X linked recessive) African/mediterrean
353
G6PD Deficiency mechanism
Low G6PD --\> Low glutathione --\> increased red cell susceptibility to ox stress
354
Sickle cell thrombotics/vaso occlusive crises
painful trigerred by infection/dehydration/hypoxia infarcts in lots of organs
355
Sickle cell Sequestration crises
Sickling within organs causing pooling of blood with worsening anaemia
356
Sickle Cell Acute Chest syndrome
dyspnoea, chest apin, pulmonary infiltrates, low o2
357
Sickle Cell Aplastic crises
Triggered by parvovirus Sudden fall in haemoglbin
358
Sickle Cell Haemolytic crises
Fall in Hb due to increased rate haemolysis
359
Warm AIHA
+ve coombs IgG autoimmune/neoplasia/drugs methyldopa central sites responds well to steroids/splenectomy
360
Cold AIHA
IgM Raynauds/acrocyanosis neoplasic eg lymphoma or infection eg mycoplasma/EBV
361
Hereditary angioedema complement
Low C1-INH during attacks Low c2 and C4 between attacks
362
Hereditary angioedema symptoms
painful macular rash paniless swelling subcut/submucosal tissues not usually itching
363
Hereditary angioedema management
C1 inhibitor concentrate FFP prophylactic steroids
364
Polycythaemia vera features
hyperviscosity Prurutis Splenomegaly
365
Polycythaemia vera management
aspirin venesection Hydroxyurea Phosphorus 32
366
Leukaemoid reaction features
High leucocyte ALP Toxic granulation (dohle bodies) Left shift of neutrophils
367
Sickle Cell HbAA
Normal
368
Sickle Cell HbAS
Trait, usually asymptomatic
369
Sickle Cell HS SC/SB
Moderate disease
370
Sickle Cell Hb SS/SBO
Severe disease
371
Ann Arbor Hogdkins lymphoma
1 - single lymph node 2 - 2 lns same side diaphragm 3 lns both sides 4 distant spread to organs A - no systemic sx except pruritic B - weight loss, night sweats, fever
372
How to diagnose CML
Immunophenotyping
373
Smudge/smear cells
CML
374
Congenital Adrenal Hyperplasia - hormone deficieny
21 hydroxylase (or rarer 17)
375
Cushings syndrome - ATCH dependant causes
pituitary secreting ATCH or SCLC secreting ATCH
376
Features of metabollic syndrome
High waist circumference High triglycerides Reduced HDL Raised BP Raised fasting glucose
377
Associated conditions of metabollic syndrome
PCOS Raised uric acid NAFLD
378
What is MODY
T2DM in under 25 yr old
379
MODY 3
60% of cases defect in the HNF-1 alpha gene increased risk of HCC
380
MODY 2
20% of cases defect in the glucokinase gene
381
MODY 5
rare defect in the HNF-1 beta gene liver and renal cysts
382
MODY Features
\< 25 years a family history of early onset diabetes no ketosis presentation very sensitive to sulfonylureas insulin is not usually necessary
383
Diabetes meds - GLP-1 meds eg
exanetide, liruglutide
384
Diabeties meds DDP4 Inhibitors eg
gliptins

MRCP (5 decks)

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