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MY MRCP CARDS > MRCP part 1 (2) > Flashcards

MRCP part 1 (2) Flashcards

1
Q

Mitochondrial diseases

A

Inherited from maternal genes.

MELAS syndrome - Mitochondrial encephalomyelopathy, lactic acidosis and stroke like episodes

MERRF syndrome - Myoclonic epilepsy with ragged red fibres

Sensorineural hearing loss

Kearnes sayre syndrome - <20, external opthalmoplegia, retinitis pigmentosa, ptosis

Leber’s optic atrophy - central scotoma with rapid loss of vision

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2
Q

Treatment of Diarrhea following ileal resection for crohn’s disease

A

Oral cholestyramine

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3
Q

MOA of 5 ASA drugs

A

eg - Sulphasalazin, Mesalazin

act to inhibit local inflammation

Side effects
Sulphasalzine - Oligospermia, rash, headache, megaloblastic anaemia

Mesalazine - Agranulocytosis, Acute pancreatits, GI upset

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4
Q

MOA of Azathioprine

A

Inhibition of purine synthesis -
It is broken down to mecarptopurine which enters DNA to prevent purine synthesis thus inhibiting rapid proliferation of cells.

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5
Q

MOA of Mycophenolate Mofetil

A

Inhibition of Inosine monophosphate dehydrogenase thus inhibiting purine synthesis

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6
Q

Management of Ulcerative colitis

A

INDUCING REMISSION
Mild/moderate disease:
Proctitis - rectal aminosalicylate
Right sided coitis - rectal aminosalicylate
Extensive - rectal aminosalicylate + Oral aminosalicylate

Severe disease
IV steroids / IV ciclosporin

MAINTANING REMISSION
Mild-moderate disease:
Proctits - Topical and/or Oral aminosalicylate
Extensive: - Oral aminosalicylate

Severe disease - Azathioprine/mercaptopurine

Surgery

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7
Q

Management of crohn’s disease

A

Induction of remission
First line - Steroids or 5ASA
2nd line - 5 ASA
Isolated perianal disease - Metronidazole
Associated Fistula - Infliximab

MAINTAINING INDUCTION
Azathiprine / Mecarptopurine

Surgery

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8
Q

Juice and drug interactions

A

Grapefruit juice interacts with Statins

Cranberry juice interacts with Warfarin

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9
Q

Risk factors of steroid induced myopathy

A

Female sex
multisystem disease - DM
Low BMI
Advanced age

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10
Q

Interpretation of DEXA scan

A

T score
> -1 - Normal
-1 to -2.5 - Osteopenia
< -2.5 - Osteoporosis

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11
Q

Commencing Bone protection for steroid induced osteoporosis

A

> 65 years or previous fragility fracture - Start bone protection

If<65yrs - Do a bone density scan
If T score:
0 to -1.5 - repeat scan in 1-3yrs
< -1.5 - Start bone protection

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12
Q

Drug-induced impaired glucose tolerance

A

thiazides, furosemide (less common)
steroids
tacrolimus, ciclosporin
interferon-alpha
nicotinic acid
antipsychotics

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13
Q

Dabigatran reversal agent

A

Idarucizumab

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14
Q

What are the major complications of ignoring subclinical hyperthyroidism

A

Atrial Fibrillation

Osteoporosis

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15
Q

Typical xray finding in Lung diseases

A

Egg shell calcifications of lymph nodes - Silicosis
Bilateral hilar lymphadenopathy - Sarcoidosis, Beryllosis
Mediastinal involvvment - Histoplasmosis

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16
Q

How do you determine the causes of Ascites

A

Use Serum ascites albumin gradient = Serum albumin - Ascitic albumin

If >11g/dl - Ascites is due to portal hypertension
If <11g/dl - due to protein loss, Cancer, TB, Pancreatitis

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17
Q

How do you classify pleural effusion into exudates and transudates

A

If pleural fluid protein is
>30g/L - Exudate

<30g/L - Transudates

18
Q

Causes of false positive non-treponemal (cardiolipin) tests:

A

pregnancy
SLE, anti-phospholipid syndrome
tuberculosis
leprosy
malaria
HIV

19
Q

bilateral hilar lymphadenopathy (BHL) + erythema nodosum + fever + polyarthralgia.

A

Lofgren’s syndrome - form of sarcoidosis

20
Q

Heertford syndrome

A

A form of Uveoparotid sarcoidosis
parotid enlargement + fever + uveitis

21
Q

fever, deranged transaminases, leukopenia and thrombocytopenia in a post-transplant patient

A

Cytomegalovirus infection

22
Q

Causes of false negative Tuberculin test

A

miliary TB
sarcoidosis
HIV
lymphoma
very young age (e.g. < 6 months)

All Immunosuppressive states

23
Q

Warfarin induced skin necrosis

A

Seen in Protein deficiency. Prevented by having a bridging course of heparin

24
Q

bilateral vitreous haemorrhage and progressive ataxia in a young patient

A

Von Hippel Lindau syndrome -
Autosomal dominant Syndrome of multiple tumors - Retinal and cerebellar hemangioblastoma

Caused by affected VHL gene on chromosome 3

25
Excess Calcitonin
Think Medullary thyroid cancer
26
Tennis shaped Bierbeck granules seen on electron microscope
Langerhan cells histiocytosis
27
Aortic Dissection associations
hypertension: the most important risk factor trauma bicuspid aortic valve collagens: Marfan's syndrome, Ehlers-Danlos syndrome Turner's and Noonan's syndrome pregnancy syphilis
28
Extra-renal features of ADPKD
Liver cysts Mitraal valve prolapse Berry aneurysms Cyts in other organs
29
Cardiac abnormality associated with angiodysplasia
Aortic stenosis
30
Monoclonal antibodies and their uses
infliximab (anti-TNF): used in rheumatoid arthritis and Crohn's rituximab (anti-CD20): used in non-Hodgkin's lymphoma and rheumatoid arthritis cetuximab (epidermal growth factor receptor antagonist): used in metastatic colorectal cancer and head and neck cancer trastuzumab (HER2/neu receptor antagonist): used in metastatic breast cancer alemtuzumab (anti-CD52): used in chronic lymphocytic leukaemia abciximab (glycoprotein IIb/IIIa receptor antagonist): prevention of ischaemic events in patients undergoing percutaneous coronary interventions OKT3 (anti-CD3): used to prevent organ rejection
31
William Syndrome
Caused by microdeletion of chromosome 7
32
Difference between Primary aldosteronism and bilateral renal artery stenosis
Check the renin levels Bilateral Renal artery stenosis - High aldosterone and high renin levels Primary hyperaldosteronism - High aldosterone and Low renin
33
Oncoviruses
Epstein-Barr virus - Burkitt's lymphoma Hodgkin's lymphoma Post transplant lymphoma Nasopharyngeal carcinoma Human papillomavirus 16/18 - Cervical cancer Anal cancer Penile cancer Vulval cancer Oropharyngeal cancer Human herpes virus 8 - Kaposi's sarcoma Hepatitis B virus - Hepatocellular carcinoma Hepatitis C virus - Hepatocellular carcinoma Human T-lymphotropic virus 1 - Tropical spastic paraparesis Adult T cell leukaemia
34
Genital ulcers
Painful: Herpes - HSV Chancroid - Haemophilus ducreyi Painless: Chancre - Syphillis (Treponema Pallidum) Lymphogranulom venerum) - Chlamydia trachomatis Granuloma inguinale - Klebsiella Granulomatis
35
Disseminated gonococcal infection
tenosynovitis migratory polyarthritis dermatitis
36
MOA of immunosuppressive drugs following renal transplant
Ciclosporin - Inhibits Calcineurin causing inhibition of T cell activation Mycophenolate mofetil - Inhibits proliferation of B and T cells by inhibiting Purine synthesis Sirolimus - Inhibits T cell proliferation by blocking IL-2 receptor. Selective IL-2 inhibitors - Monoclonal antibodies eg Basilximab, Daclizumab
37
DRESS syndrome
Drug reaction with Eosinophilia and Systemic Symptoms - Unexpected severe reaction to medication. It is a triad of Extensive rash, Fever and organ involvement.
38
Kallman's syndrome
X linked disorder causing hypogonadotropic hypogonadism. This is due to failure of migration of GnRH neurons to hypothalamus characterized by Anosmia, undescended testis, delayed puberty. Low FSH and LH. Low Testosterone Treated with Testosterone supplementation and Gonadotropin supplementation
39
Klinfelter syndrome
Karyotype: 47 XXY Features: - often taller than average lack of secondary sexual characteristics - small, firm testes infertile - gynaecomastia - increased incidence of breast cancer - elevated gonadotrophin levels but low testosterone
40
Predominantely motor peripheral neuropathy
- Guillain-Barre syndrome - porphyria - lead poisoning - hereditary sensorimotor neuropathies (HSMN) - Charcot-Marie-Tooth - chronic inflammatory demyelinating polyneuropathy (CIDP) - diphtheria
41
Predominantely sensory neuropathy
- Diabetic neuropathy - Uraemic neuropathy - Alcoholic neuropathy - Leprosy - Vit B12 deficiency - Amyloidosis

MY MRCP CARDS (7 decks)

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