mrcp part 1 Flashcards
(283 cards)
1
Q
quinolones mechanism of action
A
inhibit topoisomerase II (DNA gyrase) and topoisomerase IV
2
Q
most common cause of viral meningitis
A
human enteroviruses- coxsackievirus/ echovirus
3
Q
specificity
A
people who DO NOT have the disease and test NEGATIVE
TN/ (TN + FP)
4
Q
sensitivity
A
people who HAVE the disease and test POSITIVE
TP/ (TP + FN)
5
Q
mechanism of action of cisplatin
A
can cause cross linking in DNA
( CC- Ciplatin= Crosslinking)
5
Q
Mechanism of action of vincristine
A
inhibits microtubules formation
6
Q
positive predictive value
A
the chance the person has the disease if the test is positive
PPV= TP/ (TP +FP)
7
Q
negative predictive value
A
the chance the person DOES NOT have the disease if the test is NEGATIVE
NPV= TN/ (TN + FN)
8
Q
Burkitts lymphoma gene
A
c-myc gene translocation
normallt t(8;14)
9
Q
receptor for EBV
A
CD21
(21 year olds can get EBV)
10
Q
treatment for widened QRS in tricyclic overdose
A
IV sodium bicarb
11
Q
Loffler’s syndrome
A
Transient respiratory illness (fever, cough, night sweats) causing blood eosinophilia and CXR shadowing.
Can be caused by parasites
12
Q
Treatment for acute eosinophilic pneumonia
A
highly responsive to steroids
13
Q
secondary messenger system stimulated by NO
A
cGMP
14
Q
Action of proteasome
A
Degredation of polypeptides through breaking polypeptide bonds
Found in nucleus and cytoplasm
15
Q
Von Hippel-Lindau method of inheritence and location of gene
A
Autosomal dominant
VHL gene on chromosome 3 (VHL=3letters= chromosome 3)
16
Q
Von Hippel-Lindau associated tumours
A
cerebellar haemangiomas–> subarachnoid haemorrhages
retinal haemangiomas–> vitreous haemorrhage
renal cysts (premalignant)
phaeochromocytoma
extra-renal cysts: epididymal, pancreatic, hepatic
endolymphatic sac tumours
clear-cell renal cell carcinoma
17
Q
Cancer associated with Hashimotos
A
MALT tumours
can present without typical B featuresf
18
Q
CLL treatment regime
A
FCR
Fludarabine cyclophosphamide rituximab
19
Q
Non Hodgkins lymphoma treatment
A
RCHOP
Rituximab doxorubicin cyclophosphamide vincristine
20
Q
Gene defect in AIP Acute intermittent Porphyria
A
Porphobilinogen deaminase
Aip- porphobilinogen deAminase
21
Q
Gene defect in PCT porphyria cutanea tarda
A
uroporphinogen decarboxylase
pCt= uroporphinogen deCarboxylase
22
Q
investigation for betathalasaemia trait
A
haemoglobin electrophoresis
23
Q
causes of upper zone fibrosis
A
C - Coal worker’s pneumoconiosis
H - Histiocytosis/ hypersensitivity pneumonitis
A - Ankylosing spondylitis
R - Radiation
T - Tuberculosis
S - Silicosis/sarcoidosis
Think up in the charts
24
cause of soft S2
aortic stenosis
25
LBBB heart sound
reversed (left) split S2
26
RBBB heart sound
widely split (right) S2
27
cause of loud S2
hypertension
28
widely split S2 causes
RBBB
pulmonary stenosis
severe mitral regurg
deep inspiration
29
reverse split S2 causes
LBBB
patent ductus arteriosus
R ventricular pacing
severe AS
WPW syndrome type B
30
syphillis serology
Positive non-treponemal test and positive treponemal test
active syphillis infection
31
syphillis serology
Positive non-treponemal test + negative treponemal test
false positive
(e.g. SLE, RA, malaria, HIV, antiphospholipid syndrome, TB, leprosy)
32
syphillis serology
Negative non-treponemal test + positive treponemal test
previously treated syphillis
33
Fabry's disease
X linked disorder
deficiency in alpha galactosidase--> causes progressive lysosomal depositiion of Gb3 in various tissues causing multiorgan dysfunction
34
Budd Chiari symtoms
ascites, abdominal pain, and hepatomegaly
(thrombosis of the hepatic vein)
35
when to suspect a diagnosis of MODY
individuals with persistent, asymptomatic hyperglycemia detected before the age of 25, without the typical features of Type 1 or Type 2 diabetes
36
MODY 2 treatment
no specific treatment required
37
MODY 3 treatment
low dose sulphonylurea
38
cyclosporin side effects
nephrotoxicity and hepatotoxicity
fluid retention
hypertension
hyperkalaemia
hypertrichosis
gingival hyperplasia
tremor
impaired glucose tolerance and hyperlipidaemia
increased susceptibility to severe infection
(everything is increased)
39
symptoms of Pendred's disease
autosomal recessive disorder found on chromosome 7 causing a defect in the organification of iodine
bilateral sensorineural deafness
mild hypothyroid
goitre
40
causes of normal ion gap acidosis
ABCD
Addisons
Bicarb loss (diarrhoea or renal tubular acidosis)
Chloride excess
Diuretics
41
causes of high ion gap acidosis
lactate- sepsis
Ketones- DKA
renal failure
toxins
42
main constituent of pulmonary surfactant
phospholipids, proteins and carbohydrates- dipalmitoyl phosphatidylcholine
=DPPC
43
treatment of magnesium sulphate induced respiratory depression
calcium gluconate
44
What are Forrest plots/ blobbograms used for?
Blobbograms are used to display the results of all the constituent studies included in a meta-analysis.
Conventionally, each study is represented with a data point showing the odds ratio (e.g. of death in placebo vs control) with error bars representing a 95% confidence interval.
45
What are funnel plots used to show?
Publication bias in meta-analyses
46
What are box plots used for
Used to show quantitative results
Can show the means and range etc as well as positive or negative skew
47
What does a histogram show
Type of bar chart that shows how many times a variable occurs within a set range.
e.g. the number of myocardial infarctions on the y-axis against patient age by decade on the x-axis
48
what does a symmetrical inverted funnel plot indicate?
publication bias is unlikely
49
Which class of antibodies mediate hyperacute organ rejection
IgG
pre-exsiting IgG antibodies against HLA antigens
50
3 reasons for hypertension in patients with neurofibromatosis
essential hypertension
phaeochromocytoma
renal vascular stenosis from fibromusculardysplasia
51
causative organism for bilateral pneumonia with cavitating lung lesions following a viral illness?
staph aureus
52
which type of bacteria is listeria
gram positive bacillus
53
therapy indicated for heart failure patients with a LVEF < 35% who are still symptomatic on ACE-inhibitors & beta-blockers
sacubitril-valsartan
54
therapy for adrenaline induced ischaemia
phentolamine
55
drugs which may cause an acute attack of AIP
barbiturates
halothane
benzodiazepines
alcohol
oral contraceptive pill
sulphonamides
56
diagnostic criteria for patients with suspected COPD
FEV1/FVC less than 70% predicted and symptoms suggestive of COPD
57
treatment for facial hirsutism
topical eflornithine
58
Treatment for GuillianBarre Syndrome
IV IG
(helps neutralise the antibodies which cause GBS)
59
severe hypokalaemia ECG changes
U waves
small or absent T waves (occasionally inversion)
prolong PR interval
ST depression
long QT
(U have no Pot and no T but a long PR and a long QT)
60
Holmes Adie pupil
once the pupil has constricted it remains small for an abnormally long time
slowly reactive to accommodation but very poorly (if at all) to light
61
McArdles disease symptoms
muscle pain and stiffness following exercise
muscle cramps
myoglobinuria
low lactate levels during exercise
62
test used to investigate hypopituitarism
insulin stress test
Give IV insulin and measure GH and cortisol
63
spinal cord compression above level of L1 symptoms
upper motor neuron signs and a sensory level
64
spinal cord compression below the level of L1 symptoms
lower motor nueron signs
increased tendon reflexes above the lesion
absent tendon reflexes at the lesion
65
diagnostic criteria for allergic bronchopulmonary aspergillosis
Major criteria for the diagnosis are:
Clinical features of asthma
Proximal bronchiectasis
Blood eosinophilia
Immediate skin reactivity to Aspergillus antigen
Increased serum IgE (>1000 IU/ml)
Minor criteria:
Fungal elements in sputum
Brown flecks in sputum
Delayed skin reactivity to fungal antigens
66
management for allergic bronchopulmonary aspergillosis
glucocorticoids
itraconazole is second line
67
indicators for severe pancreatitis
hypocalcaemia
hyperglycaemia
age over 55
hypoxia
elevated LDH and AST
neutrophilia
68
treatment of thyroid dysfunction for a patient recently started on amiodarone
continue amiodarone and give thyroid replacement
69
first line treatment for myoclonic seizures in males
sodium valporate
70
drugs which may exacerbate myasthenia gravis
penicillamine
quinidine, procainamide
beta-blockers
lithium
phenytoin
antibiotics: gentamicin, macrolides, quinolones, tetracyclines
71
Miller Fisher syndrome antibodies
Anti-GQ1b
72
Myasthenia gravis antibodies
Anti-MuSK
Anti-AChR
73
Eaton Labert Syndrome antibodies
Anti-VGCC
74
VIP action
stimulates secretion from pancreas and intestines
inhibits gastric acid secretion
75
Gene mutation associated with CADSIL
NOTCH3 mutation
(CADSIL= cerebral autosomal dominant arteriopathy with subcortical infarcts and leukencephalopathy)
76
Fabry disease gene mutation
GLA mutation
77
Examples of anthracyclines
doxorubicin and epirubicin
78
most common histological finding in rheumatic heart disease
Ashcoff bodies
(granulomatous bodies found in rheumatic heart fever)
79
antiphospholipid syndrome clotting screen findings
prolonged APTT
low platelets
80
Leishmaniasis treatment
miltefosine
81
mechanism of renal protective use of ACEi
dilation of EFFERENT arteriole
82
Cancer associated with schistosomiasis infection
Squamous cell bladder cancer
Schisto= Squamous
83
Histological finding associated with gastric adenocarcinoma
Signet cells
(large mucin containing vacuole pushes the nucelus to one side, giving the appearance of a Signet ring)
84
plan for patients admitted with MI on metformin treatment
stop metformin as can cause lactic acidois
85
around 1 in 10 people diagnosed with renal angiomyolipomas are diagnosed with which condition?
tuberous sclerosis
86
action of maltase
breaks down maltose into 2 glucose
87
action of sucrase
breaks down sucrose into glucose and fructose
88
action of lactase
breaks down lactose into glucose and galactose
89
which type of vaccine is yellow fever
live attenuated
90
gentamicin is nephrotoxic as it causes what?
acute tubular necrosis
91
mercury poisoning symptoms
visual field defects, paraesthesias and hearing loss
can also cause hyperchloraemic metabolic acidosis
92
features of cholesterol emboli
renal failure
livedo reticularis
eosinophilila
purpura
92
which layer are melanocytes found in?
stratum germinativum
92
biochemical features associated with anorexia nervosa
HIGH Cs AND Gs
high cholesterol
high cortisol
carotinaemia
high glucose
high GH
high salivary Gland output
92
Dengue symptoms
fever
retro orbital headache
facial flushing
rash
bitten by mosquitos/returning traveller
93
fever
retro orbital headache
rash
thrombocytopenia
facial flushing
dengue
93
Dengue treatment
'
Ipportive with fluids etc
(no anti retrovirals indicated)
94
Dengue investigations
Bloods- thrombocytopenia, leukopenia, raised liver enzymes
NAATS for viral RNA
NS1 antigen
95
testicular seminoma tumour marker
HCG
96
pemphigus vulgaris- antibody is directed against what?
desmoglein
(components of desmosomes)
97
normal distribution
mean=mode=median
68% of values under the curve lie within 1 standard deviation of the mean
97
systemic mastocytosis symptoms
urticaria pigmentosa (wheals on rubbing)
flushing
abdo pain
mastocytosis on blood film
98
best imaging modality for osteomyelitis
MRI
99
most common bacterial cause of osteomyelitis in patients with sickle cell disease
salmonella
100
Mantle cell lymphoma gene translocation
t(11:15)
101
Burkitt's lymphoma histology
'starry sky'
lymphocytes sheets with interspersed macrophages containing dead apoptotic tumour cells
102
presents with
flu like illness less than 1 week--> brief period of remission --> jaundice and haematemesis
Yellow fever
103
NICE target after starting statin for 3 months
40% reduction in non-HDL 40% cholesterol in 3 months
104
oseltamivir/ tamiflu mechanism of action
neuraminidase inhibitor
105
mechanism of hypercalcaemia in sarcoidosis
Macrophages in the granulomas cause increased conversion of Vit D to it's active form
106
most important blood test for restless legs syndrome
ferritin
107
mechanism of action of NAC
replenishes glutathione
108
which cancer is most associated with ectopic ACTH production
small cell lung cancer
109
treatment for C diff which does NOT respond to oral vancomycin or fidaxomicin?
oral vancomycin and IV metronidazole
110
tumour marker associated with primary peritoneal cancer
CA 125
111
vaccinations in patients undergoing splenectomy
HiB, pneumococcus, meningococcus types B and C
14 days AFTER splenectomy
112
mycoplasm pnemonia diagnostic test
serology
113
most important ECG change to monitor for in aortic valve endocarditis
PR prolongation
could indicate an aortic root abscess
114
equation for power of a study
1- probability of making type 2 error
115
Howell-Jolly bodies association
hyposplenism
(you're not so jolly without a spleen)
116
serotonin syndrome treatment
cyproheptadine
(H1 and non specific 5HT antagonist)
117
Lofgrens syndrome
acute form of sarcoidosis
polyarthralgia
bihilar lymphodenopathy
erythema nodosum
fever
118
diagnostic test for hereditary spherocytosis
EMA binding test
119
P450 enzyme inducers
CRAP GPS induces rage
Carbamazepine
Rifampicin
Alcohol (chronic)
Phenytoin
Griseofulvin
Phenobarbitone
Sulphoylureas
120
initial treatment for APML (acute promyelocytic myeloid leukaemia)
All-trans retinoic acid
(force immature granulocytes into maturation to resolve a blast crisis prior to more definitive chemotherapy)
121
primary immunodeficiency caused by defect in B cell function
common variable immunodeficiency
122
Wiscott Aldrich syndrome features
bloody diarrhoea
thrombocytopenia (low platelets)
eczema
recurrent bacterial infections
(X linked recessive condition affecting B and T cell signalling)
123
rosacea treatment
mild flushing
--> topical brimonidine
mild to mod with pustules
--> topical ivermectin
(also topical metronidazole/azeliac)
mod to severe
--> topical ivermectin and oral doxycycline
124
SSRI post MI
sertraline
125
Immunoglobulin which activates B cells
IgD
126
most common bateria in neutropenic sepsis
gram positive, coagulase negative
staph epidermidis
127
cause of regular canon waves
AVNRT
128
cause of irregular canon waves
complete heart block
129
stain used to confirm diagnosis of pneumocystis carinii
silver stain
130
sickle cell disease aplastic crisis symptoms
sudden drop in Hb
bone marrow suppression--> reduced reticulocyte count
assocaited with parovirus infection
131
methaemogloblinaemia treatment
methylthioninium chloride
132
SSRI with highest incidence of discontinuation symptoms
paroxetine
(Paroxetine causes Problems when it is dicontinued)
133
drugs associated with photosensitivity
thiazides
tetracyclines
amiodarone
sulphonylureas and sulphonamides
psoralens
134
NNT calculation
1- absolute risk reduction
134
treatment for anthrax
ciprofloxacin
135
pain in hands and feet
angiokeratomas
decreased ability to sweat
GI problems
tinnitus and hearing loss
corneal opacity or corneal verticillata
Fabry disease
136
markers used to monitor haemochromatosis
transferrin saturations
ferritin
137
cancer associated with CA15-3 tumour marker
breast cancer
138
most common cardiac defect associated with Marfans syndrome
dilation of aortic sinuses
139
mixed alpha and beta receptor antagonist
carvedilol
140
management of stress incontinence
1. pelvic floor exercises
2. duloxetine
3. retropubic midurethral tape procedures
141
management of urge incontinence
1. bladder retraining
2. oxybutynin (avoid in frail and elderly- use mirabegron instead)
tolterodine
142
mechanism of action of duloextine in stress incontinence
increases the concentration of serotonin and noradrenaline in the presynaptic cleft of the pudendal nerve--->increased contraction of urethral sphincter muscles
143
legionella treatment
macrolide e.g. clarithromycin
144
autoantibody associated with polyarteritis nodosa
no antibody is likely to be positive
145
common complication of PCP
pneumothorax
146
DEXA scan result of -1.0 to -2.5
osteopenia
147
DEXA scan result of less than -2.5
osteoporosis
148
sarcoid CXR changes stages
stage 1: BHL
stage 2: BHL and infiltrates
stage 3: infiltrates
stage 4: fibrosis
149
tumour lysis blood levels
high urate
high potassium
high phosphate
LOW CALCIUM
(high phosphate will chelate calcium in the blood)
(PUKE Calcium= Phosphate Urate Kpotassium Elevated. Calcium low)
150
ethylene glycol antidote and mechanism of action
fomepizole
(competitive inhibitor of alcohol dehydrogenase)
151
most common type of Hodgkins lymphoma
nodular sclerosing
(associated with Reed Sternberg cells)
152
What is the use of leukocyte alanine phosphatase levels
LAP is found in mature WBC
Low LAP levels are associated with conditions with high immature WBC -e.g. CML
high LAP levels are associated with conditions with mature WBC e.g. myelofibrosis
153
how is cryptosporidium diagnosed?
stool sample- turns red on acid fast staining
154
Features of Parkinsons malignant syndrome
presents like neuroleptic malginant syndrome with hyperthermia, confusion, rigidity and increased RR HR BP
caused by abrupt withdrawal of Parkinsons meds
treatment= BROMOCRIPTINE
155
primary immunodeficiency disorders involving both T and B cells
SCID
Wiscott Aldrich Syndrome
Ataxic telangiectasia
SCID WAS ATAXIC
156
first line treatment for lichen planus
POTENT topical steroids
157
autoantibodies most specific for dermatomyositis
anti-Mi2
158
causes of predominantly sensory neuropathy
uraemia
alcoholism
B12 deficiency
leprosy
amyloidosis
diabetes
159
causes of predominantly motor neuropathy
Guillian Barre
Charcot Marie Tooth
porphyria
lead poisoning
diptheria
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
160
When is a Wilcoxon signed rank test used?
To compare a before and after following an intervention on the same group
(compares 2 sets of observations on a single sample)
161
mechanism of action of amphotericin B
binds with ergosterol
(component of fungal cell membranes-->forms pores-->cell wall lysis--> fungal death)
162
most common cardiac complication in myotonic dystrophy
1st degree heart block
163
treatment for severe symptomatic mitral stenosis
percutaneous mital commissurotomy
164
most common cause of congenital adrenal hyperplasia
21-hydroxylase deficiency
165
TTP symptoms
thrombocytopenia
neurological symptoms
renal failure
fever
anaemia
166
autoantibodies associated with idiopathic membranous glomerulonephritis
anti phospholipase A2
167
mechanism of action of vassopression in von Willebrands disease
induces release of von Willebrand factor from endothelial cells
168
mechanism of action of tetanus toxin
inhibits GABA release
169
absolute risk reduction
Control event rate - experimental event rate
170
Number needed to treat
NNT= 1- absolute risk reduction
(absolute risk reduction= control event rate - experimental event rate)
171
type of motor neurone disease with the worse prognosis
progressive bulbar palsy
172
Why are ACEi contraindicated in HOCM?
ACEi reduce afterload which can worsen the LVOT (LV outflow tract obstruction) gradient
**nitrates and ionotropes should also be avoided
173
Features of Familial Mediterranean Fever
Autosomal recessive
Attacks which normally last 3 days of:
Fevers
Abdominal pain (peritonitis)
Pleurisy
pericarditis
erysipeloid rash on lower limbs
arthritis
treat with CHOLCHICINE
174
cardiac marker used to look for reinfarction after MI
CK-MB
175
markers of bone turnover which would be rasied in Pagets disease
hydroxyproline
urinary N telopeptide
serum C telopeptide
Procollagen type 1 N terminal propeptide
176
severe LVF pulse
pulsus alterans
177
flu like illness-->brief remission--> jaundice and haematemesis
Yellow fever
178
investigation of choice for bile acid malabsorption
SeHCAT test
(patient ingests Selenium-75-labelled homocholic acid taurine and then gets a whole body gamma scan 7 days after. Low retention- think bile acid malabsorption)
179
tumour associated with high levels of bombesin
small cell lung cancer
180
contents of cryoprecipitate
vWF Factor VIII and fibrinogen
181
most important factor to consider when deciding whether to give cryoprecipitate
give if low fibrinogen levels (to help clot formation)
(normally used in DIC, liver failure, after massive transfusion)
182
antibody associated with idiopathic membraneous glomerulonephitis
anti phospholipase A2
183
rare causes of papilloedema
vitamin A toxicity
hypocalcaemia and hypoparathyroid
184
mechanism of action of bicalutamide
androgen receptor blocker
(used in prostate cancer)
185
anti Yo antibodies
related to paraneoplastic cerebellar degeneration
(assoc with gynaecological cancers such as ovarian and breast)
186
anti Hu antibodies
related to paraneoplastic neurological symptoms e.g. painful sensory neuropathies
(assoc with small cell lung cancer)
187
conditions assoc with Eisenmenger's syndrome
Atrial septal defect
Ventricular septal defect
PDA
188
Condition associated with tear shaped piokilocytes
myelofibrosis
(myeloCRYbrosis)
189
Function of peroxisomes
catabolism of long chain fatty acids
190
first line agent for treatment of multifocal atrial tachycardia
verapamil
191
testing for haemochromatosis
Screening: transferrin saturations> ferritin
Family members: HFE gene analysis
192
renal transplant (mostly over 4 weeks ago) and new infectious symptoms likely cause?
CMV
193
HIV, neurological symptoms and SINGLE homogenous ring-enhancing lesion on CTB
CNS Lymphoma
194
Most common cause of brain lesions in HIV?
toxoplasmosis
195
Conversion disorder symptoms
Functional neurological disorder usually acute loss of sensory or motor function
196
most common symptoms of drug induced lupus
arthralgia
myalgia
skin (e.g. malar rash) and pulmonary involvement (e.g. pleurisy) are common
ANA positive in 100%, dsDNA negative
anti-histone antibodies are found in 80-90%
anti-Ro, anti-Smith positive in around 5%
(normally resolves on stopping the drug)
197
cavernous sinus thrombosis symptoms
headache
proptosis
unilateral facial oedema
photophobia
palsies of cranial nerves which pass through (CN III, IV, V, VI)
198
treatment of Paget's disease of the bone
IV bisphosphonates
198
treatment options for metastatic bone pain
opioids
bisphosphonates
RT
198
most common and severe form of renal disease in SLE patients
diffuse proliferative glomerulonephritis
199
what must be excluded in a patient with a third nerve palsy and headache?
posterior communicating artery aneurysm
200
investigation of choice for CLL
immunophenotyping
201
most common cause of endocarditis less than 2 months post valve surgery
staph epidermidis
202
most common cause of endocarditis 2 months after valve surgery
staph aureus
203
thyrotoxicosis with tender goitre
de Quervians thyroiditis
204
management of polycythemia rubra vera
aspirin (patients are at a higher risk of CVS events)
venesection
hydroxyurea (chemotherapy)
205
role of IFN-γ
produced by Th1 cells to recruit macrophages
206
oncogene associated with neuroblastoma
n-MYC
(think n for neuroblastoma)
207
which cells mediate hyperacute organ rejection
B cells
208
what is tolvaptan
a V2 receptor antagonist
(it reduces water absorption without sodium loss)
208
Mechanism of action of hydrazine
Acts onsmooth muscle receptors of arterioles causing vasodilation and reduced systemic vascular resistance
209
Mechanism of actionof monoxidine
Centrally acting antihypertensive
Stimulates imidazole receptorsin the brain--> reduced sympathetic outflow--> reduced SVR
210
Metabolic causes of nephrogenic diabetes insipidus
Hypokalaemia
Hypercalcaemia
211
first line treatment for TTP
plasma exchange
212
which treatment for Graves may make thyroid eye disease worse?
radio-iodine
213
Jarisch-Herxheimer reaction
Fever reaction with muscles aches, headache and transient rash which occurs 24 hours after starting abx for conditions suchs as Lyme disease and syphilis
214
Golimumab mechanism of action
TNF alpha antagonist
215
drug used to prevent calcium oxalate renal stones
thiazide diuretics
(increases distal tubular calcium resorption)
216
contraindication for prescribing nicorandil in angina
LV failure
217
Tetralogy of Fallot abnormalities
VSD
over-riding aorta
pulmonary artery stenosis
right ventricular hypertrophy
218
mechanism of action of aciclovir
inhibits DNA polymerase
219
mechanism of latanoprost
reduces uveoscleral outflow
219
mechanism of action of timolol
reduces aqueous production
220
mechanism of action of pilocarpine
muscarinic agonist -->pupil constriction--> increased uveoscleral outflow
221
treatment of severe campylobacter infection
clarithromycin
222
plasmodium species with the shortest erythrocyte replication cycle
p. knowlesi
(the accelerated cycle results in the rapid multiplication of the parasite, leading to notably high parasite counts in a brief timeframe.)
223
long QT syndrome is associated with loss of function of which channels
loss of function/ blockage of K+ channels
224
causes of hypokalaemia and hypertension
11 beta hydroxylase deficiency
Liddles syndrome
Conns syndrome
Cushings syndrome
225
causes of hypokalaemia WITHOUT hypertension
Barters syndrome
Gitelmanns syndrome
diuretics
GI loss
Type 1 and 2 renal tubular acidosis
226
Jervell Lange Nielsen syndrome
inherited long QT syndrome
sensorineural deafness
226
organism associated with bacterial vaginosis
Gardnerella vaginalis
(Gram positive cocco bacilli)
227
relative risk calculation
EER/CER
(experimental event rate/ control event rate)
228
likelihood ratio for a positive test result
sensitivity / (1-specificity)
how much the odds of having the disease increase when the test is positive
229
likelihood ratio for a negative test result
(1-sensitivity)/ specificity
how much the odds of having the disease decrease when the test is negative
230
calculation for standard error of the mean
standard deviation / square root of the number of patients
231
dabigatran mechanism of action
direct thrombin inhibitor
232
MRIB findings associated with Wernickes syndrome
enhancement of mamillary bodies
233
drug used in the management of Familial Mediterranean Fever
cholchicine
234
Leiners disease
severe seborrhoeic dermatitis which begins in infancy
assoc with recurrent infections and diarrhoea
C5 deficiency
235
how to tell if AKI is a pre renal uraemia or ATN
in pre renal uraemia, kidneys hold onto sodium to try to conserve volume
(low urinary sodium, high urine osmolality, raised serum Ur:Cr ratio)
236
treatment of Ramsay Hunt
oral aciclovir and oral steroids
236
teicoplanin mechanism of action
inhibits bacterial cell wall formation
236
treatment for Chagas disease
Benznidazole
(kills the parasite Trypanosoma cruzi in both the acute and chronic phases.)
236
antibiotic used to treat cholera
doxycycline
237
mechanism of action of elvitegravir
anti-retroviral - blocks the enzyme which allows integration of viral genome into the host DNA
(-GRAvirs prevent inteGRAtion)
238
pleural fluid with low glucose is suggestive of
rhematoid arthritis
tuberculosis
239
pleural fluid with raised amylase is suggestive of
pancreatitis
oesophageal perforation
240
pleural fluid with heavy blood staining is suggestive of
mesothelioma
PE
TB
241
All patients with a pleural effusion assoc with sepsis or pneumonia should have pleural fluid sampled. What is the criteria for drainage?
If fluid is cloudy or turbid
pH less than 7.2
242
indications for permanent pacemaker insertion in patients with bradycardia
symptomatic bradycardia
trifascicular block
sinus pause of over 3 seconds
mobitz type 2 HB
243
Treatment of Legionella pneumonia
erythromycinor clarithromycin
(abx needs to penetrate the plasma membrane of alveolar macrophages where Legionella hides)
244
immunosuppresive drug used in renal transplant associated with hyperkalaemia
tacrolimus
245
mycobacterium avium treatment
rifampicin
ethambutol
clarithromycin
(Presents similar to mycobacterium TB but causes marked hepatomegaly compared to focal liver lesions seen in TB- it RECs the whole liver)
246
Clinical findings of C8/T1 paralysis/ Klumpkes paralysis
loss of sensation medial hand and forearm
Flexed fingers
Supinated forearm
Wrist extension
May have forearm and intrinsic hand muscle atrophy
247
most common cause of biliary disease in HIV patients
sclerosing cholangitis
most commonly caused by infections such as CMV cryptosporidium and microsporidia
248
phenytoin mechanism of action
binds to Na channels and increases their refractory period
249
Definition of SNP- single nucleotide pleomorphism
substitution of one nucelotide for another
(most commonly found in non-coding DNA, but can be clinically significant in coding DNA)
250
serum osmolality concentration
(2x Na) + (2x K) + Glucose + Urea
251
cisplatin toxicity
nephrotoxicity
neurotoxicity- neuropathy and hearing loss
252
site of action of haloperidol
area postrema- an area of the medulla
253
ropinerole mechanism of action
dopamine receptor agonist
254
muscle responsible for torticollis
ipsilateral sternocleidomastoid muscle contraction (causes chin to deviate to the opposite side)
255
aneuploid definition
abnormal number of chromosomes
256
lung cancer most associated with cavitating lung lesions
squamous cell carcinoma
257
drugs associated with lithium toxicity
thiazide diuretics
ACEi/ ARBs
NSAIDS
metronidazole
258
Chvostek's sign
test for HYPOCALCAEMIA
Facial muscle twitching when tapping over the area of the facial nerve
(Chvostek's sign is more sensitive and specific for hypocalcaemia than Trousseau's sign)
259
Trousseau's sign
test for HYPOCALCAEMIA
Inflate the BP cuff above systolic pressure for 2-3mins --> induces carpal spasm
260
coronary artery and ECG changes assoc with anterolateral MI
proximal LAD
aVL I V1-V6
261
coronary artery and ECG changes assoc with inferior MI
RCA
II III aVF
262
coronary artery and ECG changes assoc with posterior MI
Left circumflex (but can also be RCA)
V1-V3 changes
-horizontal ST depression
-tall broad R waves
-upright T waves
-dominant R wave V2
ST evelation in V7-V9
263
Coronary artery and ECG changes assoc with lateral MI
Left circumflex
I aVL V5 V6
264
Pharmacological treatment for bulimia not responding to CBT
high dose fluoxetine
265
treatment for neuroleptic malignant syndrome
dantrolene
266
marker used to assess prognosis in myeloma
B2 microglobulin
267
CXR staging for sarcoidosis
stage 1: BHL
stage 2: BHL + infiltrates
stage 3: infiltrates
stage 4: fibrosis
268
