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MRCP Own Deck > MRCP Part 1 > Flashcards

MRCP Part 1 Flashcards

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1
Q

Pathology of Turner’s Syndrome?

A

Coarctation of Aorta
Missing gene BAC
Bicuspid valve
Aortic root dilated
coarct Aorta

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2
Q

TB medications and side effects

A

Isoniazid= Ice causes numbness on the skin = peripheral neuropathy
Ethambutol = Eye = optic neuritis
Rifampicin = Red/orange body secretions
Pyrazinamide= P looks like a big toe = big painful toe bcz of hyperuricemia = Gout

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3
Q

Features and treatment of Leptospirosis

A

Spirocheate
Feats:
fever, malaise, deranged renal function, meningism
Sewers, farmers, abattoir, returning traveler
Tx:
doxy/penicillin

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4
Q

SBP criteria

A

Paracentesis with Neuts >250

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5
Q

Antiemetics MoA
cyclizine
Ondansetron
metoclopramide
promethazine

A

cyclizine NS AH
Ondansetron - 5-HT3
metoclopramide - D2 Ant
promethazine - sed AH

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6
Q

VHL Von Hippel Lindau

A

Many cancers
AD
neoplasias
retinal haemorrhages
renal cysts/Renal cell carcinoma
pheo

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7
Q

Malarias and cycles

A

Know Forty Five Malaria
Knowlesi - 24
Falc/Ovale/vivax - 48
Malariae - 72

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8
Q

LESCH:
Lesch-Nyhan syndrome

A

Lip biting and fingernail biting
Excessive uric acid production
Self-mutilation
Choreoatheosis
HGPRT deficiency

  • Hyperuricaemia, Gout, pissed off behaviour, retarded, tremor - chorea
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9
Q

A-H X-linked recessive conditions

A

A - Androgen insensitivity syndrome
B - Beckers/Duchenes
C - colourblindness
D - DI (nephrogenic)
E - eyes (retinitis pigmentosa)
F - Fabry
G - G6PD deficiency
H - haemophilia A/B, Hunter’s

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10
Q

Long QT Causes
A-E hypo

A

A: anArrhythmic: ie Amiodrone
B: anBiotics: Macrolides, Quinolone
C: pCychotics: Haloperidol
D: antDepressant: SSRI, TCA
E: antEmetics: Ondansetron

Hypo ( hypokalemia, hypomagnesaemia, hypocalcemia)

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11
Q

Causes of LAD and RAD

A

LAD:
LBBB, L ant Hemiblock, obesity, ostium ASD, inferior MI, hyperK, WPW

RAD:
Right sided HF, R hypertrophy, PE, COPD - Cor pulmonale, L post hemiblock, secundum ASD

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12
Q

Combined B and T cell disorders

A

WASH
Wiscot-aldrich
Ataxia telangiectasia
SCID
Hyper IgM

SCID was ataxic

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13
Q

B cell disorders

A

ABD or ABC - IgA/ Brutons/CVID

IgA def
Bruton’s
CVID

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14
Q

T cell disorders

A

DiGeorge

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15
Q

Neutrophil disorders

A

GHL
granulomatous disorder
chediak-Higashi
leukocyte adhesion def

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16
Q

Pellagra

A

Niacin B3
dementia, diarrhoea, dermatitis

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17
Q

Beriberi

A

Thiamine B1
Wet - cardiomyopathy
Dry - peripheral neuropathy

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18
Q

Causes of Hypokalaemic alkalosis

A

alphabetical:
Barters - Loop NKCC2 defect - LOTS of Drinks (polyuria and polydipsia)

Gitlemans - DCT thiazide sensitive Na/Cl co transporter

Liddle’s - collecting duct Epithelial sodium channels (hypertensive)

liquorish

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19
Q

Seminoma bloods

A

Seminoma –> Semen –> pregnancy and rise in HCG alone

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20
Q

Lung cancer RFs

A

NARCOS
Nickel
Arsenic / asbestos
Radon
Cryptogenic FA / chromate
Omitt
Smoking

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21
Q

Seizure treatment

Most M needs Valp, F lame/keppra apart from absence FL ethosux

A

Gen T-C
Male - valp
F - lamotrigine/keppra

Absence
FL: ethosuxamide
SL: M valp, F lamotrigine/Keppra

Focal
FL: lamotrigine/Keppra
SL: carbamazepine/oxcarbazepine/zonisamide

Myoclonic
M valp, F Keppra

Tonic/Atonic
M valp, F lamotrigine

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22
Q

Molecular biology techniques:
Western Blot
Northern
Southern
Eastern

A

Western - proteins
Northern - RNA
Southern - DNA
Eastern -post tranlational protein mods

SNOW (South - NOrth - West)
DROP (DNA - RNA - Protein)

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23
Q

Anticoagulant / DOAC targets
apixaban
dabigatran
Abciximab
daltaparin

A

Target Xa
apiXaban - Xa

Target both Xa +thrombin -= PARIN
Dalteparin

Target IIa (thromBin)
DaBigatran

Abciximab
Glycoprotein IIB/IIIA

Clopi
ADP receptor inhibitors

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24
Q

CYP Inducers

A

CRAP GPS
Carbemaz
Rif
chronic alcohol
phenobarb
Grisfulvin
Phenytoin
smoking, St John

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25
CYP Inhibitors
SICKFACES.COM SSRI , isoniazid, clari, erythro, fluconazole/ketoconazole, acute alcohol, allopurinol/amioderone, sodium valp, cimetidine, omeprazole, metronidazole Ritonavir
26
Translocation abnormalities (haem) t(8:14) t(9:22) t(11:14) t(14:18) t(15:17)
8urkitts - t(8:14) 9hiladel9hia - t(9:22) 11antle - t(11:14) Four-licular Lymphoma - t(14:18) Acute Promyelocytic Leukaemia - t(15:17) ALL - 12:21 - L as number is 1 and there are 2 of the acute promyelocytic = the M3 subtype of AML (5 words, 17 letters for t(15:17)) = RARA Gene (Rare, Auer rods, Relatively young (for AML), All trans retinoic acid sensitive (treatment) NB AML with Ch 5, 7 is BAD
27
Ways to remember stat significance tests
(Mann-)Whitney Houston can sing many scales. You learnt normal distribution as a school student - t tests Wilcoxon - theres an 'o' before and after the 'x' speaRman's (non-Para) or Pearson (para) = coRRellation Chi squared = proportions/percentages
28
Rifampicin MoA
inhibits RNA synthesis
29
Antibiotics MoA
● Buy AT 30 Aminoglycosides Tetracyclines CELL for 50 Clindamycin Erythromycin Linezolid ● Cell wall - my favourite - penicillin and cephalosporins Protein synthesis --> Core Medical Trainee is Forever Alone - Chorampenicol - Macrolide - Tetracycline - Fusidic acid - Aminoglycosides R*NA synthesis - R*ifampicin DNA synthesis - Miss cutie (MS QT) - Metro - Sulphonamide - Quinolone - Trimethopri (Copied)
30
Ix into systemic mastocytosis?
Urinary histamines
31
Quick manifestations of W-A syndrome Friederich's ataxia AIP
Wiskott Aldrich syndrome triad small thrombocytopenia plus eczema plus Repeated infections Friedreich ataxia lower limb neurological loss motor and reflexes Acute intermittent porphyria 4ps painful abdomen, polyneuropathy, psyciatric symptoms, port wine urine
32
Rickettsia diseases Coxiella Burnetti Rickettsia Rickettsi Rickettsia typhi Rickettsia prowzekeii
C(Q)oxiella burnetti = Q fever. Rickettsia rickettsii = Rocky Mountain spotted fever. Rickettsia typhi = endemic typhus. Rickettsia prowazekii = epidemic typhus. Ehrlichia = ehrlichiosis.
33
ALS adrenaline doses
ALS 1ml 1:1000 OR 10ml 1:10000 Anaphylaxis 0.5ml 1:1000
34
Interferon treatments
INF= Alpha=A=V VIRAL=HEP B C HHV8 Beta= B=m ms Gamma= GMA= GranoloMA MACROPHAGE
35
MoA paracetamol OD and liver injury
paracetamol OD metab produced toxic NAPQI to hepatocytes. Normally glutathione detoxifies but this to mercapturic acid. But gets depleted in OD. NAC replenishes glutathione.
36
androgen receptor blockers / prostate Ca tx
Goserelin==> GnRH agonist Androgen: A==>B==>C First Sythensis Blocker, then Receptor Bloker A==> Abiraterone==> Synthesis blocker B==>Bicalutamide==>Receptor blocker C==>Cyproterone==> Receptor blocker N.B. any terone, means Steroidal, so CyproTerone==> Steroidal Bicalutamide==> Non-steroidal
37
Pulmonary Arterial Hypertension management
Depends on if responsive to CCB - vasodilary CCB if responsive If not: - Anything with 'prost' in the name = prostacyclin analogues - Anything with 'ent' in the name = endothelin-1 receptor antagonist - PDE4 inhibitor - sildafenil
38
TYPES OF COLLAGEN - PATHOLOGY:
Type 1 = O1 (Osteogenesis 1mperfecta). Type 2 = chondrodysplasias Type 3 = 3hlers-Danlos syndrome (E and 3 are mirror images). Type 4 = Good4asture syndrome, 4lport's syndrome (4 does look like an A and a P). Type 5 = Variant form of Ehlers-Danlos syndrome (5 = V).
39
Child-Pugh scoring and Tx for HCC
Child-Pugh A cirrhosis: * No Portal HTN * Single lesions <2cm = Surgical resection. Child-Pugh A and B cirrhosis: * 2-3 tumours <= 3 cm / 1 tumour <=5 cm * No Vascular / Extrahepatic spread = Liver transplantation (bridge - TACE or RFA) Child-Pugh A or B cirrhosis: * Good performance status, * Vascular, Lymphatic / Extrahepatic spread = Tyrosine Kinase inhibitor, Sorafenib, Child-Pugh C cirrhosis: * End-stage liver disease * Poor candidates for therapy = Symptomatically
40
Acute intermittent porphyria vs Porphyria cutanea tardia
AIP - porphobilinogen deAminase; PCT - uroporphyrinogen deCarboxylase - UDC
41
UL pathologies Lat Epi Med Epi De Quevarian (lat epi)
Lateral epi ( ext & supination) Like Radial tunnil but here ext & pronation and pain distal Medial epi ( flex & pronation) pain localize to epicondile Looks like cubital tunnil but ithink pain here not localized. Deqrevan base of thumb Olocranon post aspect of elbow.
42
Collagen abnormalities I II III IV V
type I - Osteogenesis imperfecta II - cartciLLage = chondrodysplasias III - reticular fibres = E-D IV - Basement membrane eg alport/goodpastures V - cell/hair - Classic variant E-D
43
Modified Duke's Criteria Major Minor 2 major 5 minor 1 major 3 minor
Major 1.B lood culture positive for IE / molecular assays 2.E ndocardial involvement 3.F ever 4.I mmunologic phenomena 5.V ascular phenomena 6. D rug abuse (or with Previous Heart conditions) ''FIVE BD
44
Congenital diseases
Congenital toxoplasmosis - Eyes, brain - all the Cs - cats, Chorioretinitis, cerebrocalcification, hydroceph Congenital rubella - Eyes, ears, heart Congenital CMV - Ears, rash
45
Parkinsonisms
Parkinsonism+ cognitive impairment +visual hallucination [Lewy body dementia] Parkinsonism+ cognitive impairment +Urinary incontinence [ Normal pressure hydrocephalus] Parkinsonism+ cognitive impairment +Vertical gaze impairment [progressive supranuclear palsy] Parkinsonism +Autonomic disturbance + cerebellar signs [ Multiple system atrophy].
46
cytotoxic agents MoA Cyclophosphamide, Ciclosporin, Cispltin Bleomycin Topotecan, Irenotecan HydroxyuRea docetaxel
Cyclophosphamide, Ciclosporin, Cispltin = Cross linking Bleomycin = blows DNA = degrades formed DNA Topotecan, Irenotecan = Topoisomerase inhibition HydroxyuRea = Ribonucleotide Reductase inhibition doceTaxel = microTubule disassembly inhibition
47
Vestibular neuronitis vs viral labyrinthitis?
viraL = hearing LOSS
48
A1AT classification
M = Normal S = slow Z = Very slow PiMM = normal PiMZ = heterozygous PiSS = 50% PiZZ = 10%
49
Live Vaccines MY PITT
MMR, yellow, polio, influenza, TB, Typhoid, (rotavirus)
50
HIV / antiviral drug classes
- Navir - = protease inhibitors (never tease a pro) - Tegra - = inTegrase inhibitors - VIR - = NNRTI Roc / tide = fusion inhibitor Others = NRTIs NRTIs end in 'ine' Pis: end in 'vir' NNRTIs: nevirapine, efavirenz
51
MEN types 1 2a 2b
1 = PPP - para, pituitary, panc 2a = PPM - para, pheo, Med thyroid 2b = PMN - pheo, Marfan, NeuromaC, Med thyroid
52
Cryoblobinaemia
Igs preceipitae at 4 degrees reversible when warmed - T1- raynauds/myeloma (primary raynauds = 1?) - T2 - RA/Hep C/lymphoma/sjogrens - T3 RA
53
AD polycystic Kidney Disease Genes
Type 1 = chr 16 Type 2 = Chr 4 16 letters in polycystic kidney
54
Kallman's vs kleinfelter's
hypogonadism, delayed puberty, infertility, tall ish, low testosterone KaLLmans = LOW FSH/LH
55
Bohr and Haldane effect
BOHR=Binding of O2 with Hb is Reduced in acidic environment. Haldane effect = High O2 --> Down CO2 binding to Hb
56
HLA associations
HLA-B27 = reactive arthritis, Ank Spond HLA-A3 = hereditAry hAemachromAtosis HLA-B51 = Bechet's HLA-DQ2/DQ8 = cOEliac, HLA-DR2 = gOOdpastures, narcOlepsy, SLE (T2 reaction) HLA-DR3 = 3jogren3, PBC (3), dermatitis herpeteformi3, SLE HLA-DR4 = T1DM, RA (4) HLA CW6 / B13/17= psoriasis
57
Lung paraneoplastic Issues
Small Cell = head - ACTH, ADH, AntiVGCaC lambert-eaton Squamous cell = neck - PTH, TSH Adenocarcinoma = body - gynaecomastia/OA
58
Lymphoma and CLL treatment acronyms
FCR - CLL AVBD - Hodgkins R-CHOP - Non-Hodgkins Shortest number of letter to longest matches
59
CDJ - Creutzfeldt-Jakob disease cardinal features
C cerebellar signs J jerks (myoclonus) D dementia
60
Vit B deficiences
work down B1thiamine - brain - wernickes / beri beri B2 riboflavin - mouth B3 niacin - diarrhoea - pellagra B6 pyridoxine - peripheral neuropathy (think of feet)
61
Pupils: Holmes Adie Argyl-Robertson RAPD Third nerve
Holmes - ADILATED Argyl-rob - small irregular, prostitute (accommodates and does not react), syph RAPD - dilates when light shot to eye - marcus Gunn Third nerve - dilated
62
Drugs that can be cleared with haemodialysis - mnemonic: BLAST
B - barbiturates L - lithium A - alcohol (ethylene glycol) S - salicylates T - theophylline
63
Molecular Biology techniques
SNOW (South - NOrth - West) DROP (DNA - RNA - Protein)
64
STI Ulcers and LN Syph Chancroid - ducerii LGV
Inguinal Lymphadenopathy is present in Syphilis, LGV and Chancroid 1. Painless IL plus Painless ulcer - SyphiliS painleSS 2. Painful IL plus Painless ulcer - LGV - LN 3. Painful IL plus Painful ulcer - Chancroid - SHANK
65
Adreno Receptors GPCR
A agonists vs antag A1- SM/arteries A2 - presynaptic B agonists vs antag B1 - heart B2 - bronchial SM / vasodilation / relax GI B3 - mirabegron (bladder) / lipolysis
66
Vitamin Defs
work down B1 - brain- thiamine - wernickes, beri beri B2 - mouth - riboflavin -> angular stomatitis B3 - diarrhoea/dermatitis/dementia niacin- pellagra B6 - neuropathy (think of feet)
67
Acetylator status
Acetylators travelled with ship to relax after stablization Sulfunmides Hydrlazine Izonizid Procainamide
68
Syphillis tests
Trep (TPHA) and non-trep (VDRL) VDRL tests for antigen TP*HA is antibodies - remains P*OS after tx
69
Pemphigoid Pemphigus
oid - deep - no oral inv - IgG and C3 at the dermoepidermal junction Pemphigus - oral - antibodies directed against desmoglein 3
70
Steroid strengths
Mineralocorticoid Activity: Fludrocortisone > Hydrocortisone > Prednisolone > Dexamethasone Glucocorticoid Activity: Dexamethasone > Prednisolone > Hydrocortisone > Fludrocortisone Dex = sugar = Glucocorticoid activity
71
MGUS vs SM vs MM
Monoclonal Gammopathy of Uncertain Significance (MGUS): ▪︎M protein <30 g/l ▪︎BM plasma cells <10% ▪︎No CRAB features Smoldering Multiple Myeloma: ▪︎M protein > 30 g/l ▪︎BM plasma cells 10-60% ▪︎No CRAB features ▪︎Rx: Observe + monitor Multiple myeloma: ▪︎M protein >30g/l ▪︎BM plasma cells >30% ▪︎CRAB features
72
Light's Criteria for pleural effusions
1. Pleural fluid protein / Serum protein >0.5 2. Pleural fluid LDH / Serum LDH >0.6 3. Pleural fluid LDH > 2/3 * Serum LDH upper limit of normal
73

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