MRCP Word Ax Flashcards
(777 cards)
1
Q
Chemo peripheral neuropathy
A
Vincristine
Cisplatin
2
Q
Chemo cardiomyopathy
A
Doxorubicin
3
Q
Chemo pulmonary fibrosis
A
Methotrexate
4
Q
Chemo haemorrhagic cystitis
A
Cyclophosamide
5
Q
Anti epileptics safe in pregnancy
A
Levetiracetam
Lamotrigine
6
Q
Cereberal Toxoplasmosis Tx
A
Sulfadiazine, Pyrimethamine
7
Q
Histology Barretts Esophagus
A
Columnar metaplasia
8
Q
Electrolyte abnormality worsening digoxin toxicity
A
Hypokalaemia
9
Q
Hormone that stimulates hunger
A
Grehlin
10
Q
Hormone that suppresses hunger
A
Leptin
11
Q
Leukaemia “ Broad based projections”
Dry tap
TRAP +ve
A
Hairy Cell Leukaemia
12
Q
Worse prognosis RA
A
Female
Anaemia 3 months
Gradual onset
+ve IgM RF
+ve CCP
13
Q
Rash with one “herald patch” then spreads
A
Pityrisias Rosea
14
Q
Lewy Body Dementia
A
EPSs
Hallucinations
Variable sx/GCS
15
Q
Most common Lupus Antibodie
A
ANA
16
Q
Translucent bands bones
A
Osteomalacia
17
Q
Punched Out Osteolytic Lesions
A
Myeloma
18
Q
Nephritis postive for everything
C3, C4, IgM, IgG
A
Lupus Nephritis
19
Q
Neck + shoulder pain, weakness abductor pollicis brevis, pin and needles
A
Cervical Rib
20
Q
Polymyositis Antibody
A
Anti Jo
21
Q
TB Drugs peripheral neuropathy
A
Isoniazid
22
Q
Wernickes vitamin deficiency
A
Thiamine B1
23
Q
Feltys Syndrome
A
Triad : Leucopaenia + RA + Splenomegaly
(lympadenopathy, leg ulcers, normocytic anaemia)
24
Q
Tense blistering rash (not affecting rash)
A
Bullous Pemphigoid
IgG
25
Farm, haemolytic anaemia, high billrubin, neurology
TTP
26
Diabetic meds causing hypos
Gliclazide
27
Negatively bifringent crystals joint asp
Monosodium Urate Monohydrate
Gout
28
Weakly positive bifringent crystals joint asp
Calcium pyrophosphate
Pesudogout
29
Tx Tourettes
Risperidone
30
Palmar crease xanthaoma (pathognomonic)
Broad beta disease
31
Subchondral cysts
OA
32
Periarticular osteopaenia
RA
33
Osteophytes
OA
34
Allopurinol on INR
High
35
St Johns Wort on INR
Low
36
Carbemazepine on INR
Low
37
Phenytoin on INR
Low
38
Rifampicin on INR
Low
39
Brown/blue pigmentation
Alkaptonuria
Homognetistic oxidase deficiency
40
Williams Syndrome
Friendly
Short
Neonatal hypercalcaemia
Supravalvular aortic stenosis
41
Isoniazid on INR
High
42
Cipro/erthryo on INR
High
43
SSRI on INR
High
44
Fluconazole on INR
High
45
Cushing K+/pH
Hypokalaemia Alkalosis
46
Conns K+/pH
Hypokalaemia Alkalosis
47
Bloody diarrhoea w/ shistocytes
E coli
48
Main bug causing HUS
E coli
49
Phenylketonuria
Seizures
Eczema
LD
Musty
50
Burkitts lymphoma oncogene and chromosome
c MYC
t8:14
51
Neuroblastoma oncogene
n MYC
52
Cancer type most like to cause hypercalcaemia
Squamous Cell
53
Waldenstroms Macroglobulinaemia Ig?
IgM kappa paraprotein
54
Waldenstroms Macroglobulinaemia
HYPERVISCOCITY
Cryoglobulinaemia/Raynauds
Hepatosplenomegaly
Lymphadenopathy
55
Lebers Optic Neuropathy inheritance
Mitochondrial
56
Downs syndrome genetics
Trisomy 21
- non dysjunctional mainly
- moasicm (less severe)
- Robertonism (parental issue)
57
Downs cardiology issues
ASD
PDA
Fallots Tetralogy
Endocardial cushion defect
58
Downs syndrome ax illness
Duodenal Atresia
Leukaemia
Esophageal fistulae
Hypothyroid
59
Edwards syndrome genetics
Trisomy 18
60
Edwards syndrome features
Retardation, craniofacial abnormalities (prominent occiput, low-set
ears, micrognathia).
'Rocker bottom' feet
Cardiac abnormalities.
61
Pataus syndrome features
Mircopthalmia
Cleft palate
Polydactly
Mental retardation
62
Cri du chat features
Retardation
High pitched cry
Epicanthal folds
Low set ears
Spasticity
63
Cri du chat genetics
Chromosome 5 deletion
64
Prader Willi Genetics
microDeletion chromosome 15-11-13
65
Prader Willi features
P WILLIS
Paternal inheritance
Weight increased
LD
Low muscle tone
Infertility/hypogonadism
Short stature
66
Angelman syndrome features
Maternal inheritance
Hypertonia
Prominent jaw
Deep set eyes
Absent speech
Retardation
67
What is Philadephia chromosome
Due to deletion of long arm 22, usually on 9
Prognosis worse without it
Also myelofiborosis, polycythaemia vubra vera
68
Turners syndrome genetics
45 XO
Non disj/moacism
69
Turners syndrome cardiac issues
Coarctation aorta
Bicupsid aortic valve
70
Turners hormones
High gonadotrophin
Low estrogen
71
Noonans syndrome genetics
45 XY
72
Noonans features
male turners
absence testicles/crypto orchidism
73
Kleinfelters genetics
47 XXY XXXYY XXYY
74
Kleinfeltoms features
Tall, thin, gynaecomastia, infertility
High urinary gonadotrophins
75
Fragile X genetics
X linked dominant
expansion CGC
Long arm X
76
Fragile X features
Retardation - severe in males, less in females
77
Triple X Syndrome
47 XXX
Only slight intelligence impairment
Fertility normal
78
Women affected more than male genetics
X linked
79
Mitochondrial inheritance
Maternal transmission
V rare
Leber optic neuropathy
80
Trinucleotide repeat disorders
Huntingtons, MD, Freidreichs, Fragile X
81
FH inheritance
Autosomal Dominant
82
MD Inheritance
Autosomal Dominant
83
Marfans inheritance
Autosomal Dominant
84
Alpha 1 antitrypsin inheritance
Autosomal recessive
85
Wilsons inheritance
Autosomal recessive
86
Duchenne dystrophy inheritance
X linked recessive
87
Li Fraumeni Syndrome
Loss of p53 cancer syndrome
Breast, brain, sarcoma
88
Retinoblastoma chromosome and inheritance
Autosomal dominant
13q14
89
FAP chromosome
Bowel cancer
deletion 5q21
90
Colorectal carcinoma chromosome
18q deletion
91
Haemochromatosis HLA
HLA A3
92
Behcets HLA
B5
93
HLA B27
Ank spod
Reiters
Psoriatic arthritis
Anterior uveitis
94
HLA DR2
MS
Pernicious anaemia
Nacrolepsy
Juvenile diabetes
95
HLA DR3
Coeliac
Sjogens
Hepatitis
Addisons
SLE
Graves, Hashimotos
IDDM
MG
96
RA HLA
HLA DR4
97
Coeliac HLA
HLA DR5, DR7
98
Gram positive rods
Bacillus
Clostridium
Listeria
99
Gram positive cocci
Strep
Staph
100
Gram negative rods
Klebsiella
Enterobacter
Salmonella
Shigella
Legionella
Campylobacter
Pseudomonas
101
Gram negative cocci
Neisseria
102
Q fever bug
C burnetti
103
Most common transmission Hep C
Contaminated blood transfusion
IVDU
(also sex, vertical)
NO VACCINE
104
Chronic complications Hep C
Cirrhosis
Hepatocellular carcinoma
105
Dengue features
fever
headache
retro orbital pain
back ache
rash
mucosal haemorrhage, shcok
106
HIV genetics
single stranded RNA
107
Immune changes in HIV
decreased CD4, CD8
hypergammaglobulinaemia
decreased macrophage
108
Virus causing T Cell leukaemia
HTLV 1
109
Virus causing Kaposis sarcoma
HHV 8
110
HBsAg
Surface antigen = current disease (or carrier)
111
Anti Hbs
Immune
112
Anti Hbc
Current or previous infection
113
HIV test method
ELISA
Western blot
114
Causes of false positive treponomal tests
Genital herpes
Psoriasis
RA
SLE
115
Egg vaccines
Flu, yellow fever
116
Live vaccines
MMR
Polio
Chicken pox
Yellow Fever
Typhoid
117
Von Willebrands Rx
DDAPV, TXA
118
Gauchers disease
Jewish
hepatosplenomegaly, anaemia, osteopaenia
119
Type I cryoglobulin
Waldenstroms
120
Type II cryoglobulin
Hep C, HIV
121
Type Iii cryoglobulin
Sjorgens
122
OD causing respiratory alkalosis
Aspirin, Theophyllines
123
Type I hypersensitivity
| (Anaphylactic)
Anaphylaxis
Atopy
Drug Allergy
124
Type II hypersensitivity
| (Cell Bound)
Goodpastures, anti GBM
MG
ITP
Tranfusion
Thyroid
125
Type III hypersensitivity
| (Immune Complex)
post strep glom
Hep C B
HIV
Syspihilis, Shisto, SLE
Malaria
RA
126
Type IV hypersensitivity
| (Cell mediated/delayed)
TB
Contact dermatitis
Graft rejection
Tumour
scabies
127
C1 Inhibitor deficiency
Hereditary angioedema
128
C2, C4 deficiency (classic pathway)
HSP
Glomerulonephritis
SLE
Strep
Staph
129
C3-C9 deficiency
Recurrent bacterial infection e.g Neisseria
130
Test for Type I Hypersensitivity
IgE/skin prick
131
Test for Type II Hypersensitivity
Coombs Test
132
Test for Type III Hypersensitivity
Antibody levels
133
Test for Type IV Hypersensitivity
Patch
134
Type I Hypersensitivity Ig
IgE
135
Type II Hypersensitivity Ig
IgG IgM
136
Type III Hypersensitivity Ig
IgG IgM
137
What type of hypersensitivity is urticaria?
Type I
138
What type of hypersensitivity is bullous disease?
Type II
139
What type of hypersensitivity is vasculitis?
Type III
140
What type of hypersensitivity is allergic contact dermatitis?
Type IV
141
Ataxic Telangoectasia syndrome
| (inheritance, features, Ig)
autosomal recessive
kids - cerebellar ataxia, oculocutaneous telangiectasia, recurrent sinus/lung infections
Low IgA, IgE
Possible T cell deficiency
142
Wiskott Aldrich syndrome
X linked recessive
Eczema, thrombocytopaenia, recurrent infection
Lymph tumours
Low antibody, IgM high IgE
B and T cell
WASP
143
Raised IgG in liver disease
hepatitis, cryptogenic cirrhosis
144
Raised IgM in liver disease
biliary/alcoholic cirrhosis
145
Raised IgA in liver disease
alcoholic cirrhosis
146
Anti smooth muscle +ve
Hepatits
PBS
Cirrhosis
Viral infection
147
Anti mitochondrial +ve
PBC
Hepatitis
Cirroshsi
148
Gastric parietal cell antibody +ve
Pernicious anaemia
Atrophic gastrisi
Autoimmune thyroid disease
149
Thyroid autoantibodies
Hashimotos
Graves
Hypothyroidism
Pernicious Anaemia
150
ANA +ve
Sjorgens
Lupus
RA
MG
Hashimotos
UC
151
cANCA
Wegeners granulomatosis
Microscopic polangitis
152
pANCA
Idiopathic crescentic glomerulonephritis
Microscopic polyangitis
Churg Strauss
153
Hyperacute organ rejection presentation
Hours
Complemented mediated
Vascular spasm, occlusion, failed organ perfusion
154
Acute organ rejection
Days to weeks
HLA incompatibility
T cell/CD4
155
Chronic organ rejection
months-years
T Cells
156
What cells mediate graft versus host disease
T cells
157
Causes of +ve Coombs test
haemolytic anaemia/tranfusion reactions
LSE, lymphoma, leukaemia
Methyldopa
158
Loss of forearm pronation
Weak wrist flexion
Thenar wasting
Median nerve palsy
159
Wasting hand muscles, hypothenar
Claw hand
Radial deviation
Ulnar nerve
160
Paralysis of knee flexion
Foot drop
Ankle jerk and plantar reflex absent
Sciatic nerve palsy
161
What controls motor function
Basal ganglia
162
Anterior Cerebral Artery Occlusion
weak, numb contralateral leg
mild arm signs
face spare
163
Middle Cerebral Artery Occlusion
Contralateral hemiplegia
sensory loss face
dyphasia/dyspraxia
contralateral homonynmous hemianopia
164
Vertebrobasilar artery occlusion
Hemianopia
Cortical Blindness
Vertigo, nystagmus
hemi/quadraplegia
sensory loss, drop attacks, cerebellar sx
165
Lateral Medullary infarct = Posterior Inferior Cereberal Artery Infarct
vertigo, vomiting, nystagmus TOWARDS lesion
ipsilateral hypotonia
ataxia
horners
soft palate paralysis
166
Brocas dysphasia
Inferolateral frontal lobe
non fluent speech comprehension intact
167
Wernickes dysphasia
posterior superior temporal lobe
Fluent speech but errors
Issues reading, writing, comprehension
168
Fanconi syndrome
cystinuria, phosphaturia, RTA 2, glycosuria, rickets/osteomalacia
169
Cystinosis
cystine crystal deposition
RTA, Fanconi, renal failure, hepatosplenomegaly
170
RCT
Randomly allocated to intervention/control
Limited by ethics
171
Cohort study
Group of people exposed to something and then follow up to see how many develop disease/other outcome
Measured in relative risk
172
Case-control study
People with condition matched with control
Then data collected on past exposure
ODDS RATIO
173
Cross sectional study
Snapshot or prevalence
Not useful for cause/effect
174
Level of evidence: Ia
Meta analysis RCT
175
Level of evidence: Ib
At least one RCT
176
Level of evidence: IIa
At least one well designed control trial (not randomised)
177
Level of evidence: IIb
At least one well designed experimental
178
Level of evidence: III
case, correlation, comparative studies
179
Level of evidence: IV
panel of experts
180
Normal distribution
Mean = median = mode
181
Positively skewed distribution
mean \> median \> mode
182
Negatively skewed
mean \< median\< mode
183
Sensitivity
TP / (TP +FN)
tested +ve/who actually had it
184
Specificity
TN / (TN + FP)
tested -ve/ who actually didnt have it
185
Positive predictive value
| (chance you have it if your test is positive)
TP / (TP + FP)
Had it and tested +ve/tested positive
186
Negative predictive value
| (chance if you're negative you didn't have it)
TN / (TN +FN)
didnt have it and tested negative / everyone who tested negative
187
Likelihood ratio for positive test
sensitivity/ (1-specificity)
188
Likelihood ratio for negative test
(1 - sensitivity) / specificity
189
Relative risk
EER/CER
amount it occurs in experiment group/amount it occurs in control group
190
Penetrance
describes 'how likely' it is that a condition will develop
191
Expressivity
Severity of the phenotype
192
Odds
You do get the outcome/you don't get the outcome
193
Odds ratio
Odds you do with x/ odds you do with placebo
194
Number needed to treat
1 / (EER -CER)
195
What % values lie within 1 SD of mean?
68.3%
196
What % values lie within 2 SD of mean?
95.4%
197
What % values lie within 3 SD of mean?
99.7%
198
Intention to treat analysis
Analysing random group of RCT patient regardless of whether they finished the treatment or not
Limits the effect of drop outs
199
Incidence
incidence is the number of new cases per population in a given time period.
For example, if condition X has caused 40 new cases over the past 12 months per 1,000 of the population the annual incidence is 0.04 or 4%.
200
Prevelance
Cases per population at any one time
201
Funnel plot
to show bias in meta analysis
treatment outcome vs study size vert
202
Standard error of mean
SEM = SD / square root (n)
203
Phase I Clinical Trial
pharmacokinetics and pharmacodynamics and side-effects prior to larger studies
Healthy volunteers
204
Phase II Clinical Trial
Efficacy and dosage
Small number affected by disease
IIA - dosing
IIb - efficacy
205
Phase III Clinical Trial
Assess effectiveness
Lots of people
RCT
Comparing new tx with old one
206
Phase IV Clinical Trial
Post marketing surveillance
Long term side effects and effectiveness
207
What does RER do?
translation/folding proteins
glycosylation
makes lyosomal enzymes
lots in pancreatic, goblet and plasma cells
208
What does SER do?
steroid and lipid synthesis
lots in adrenal, liver, testes, ovaries
209
What does Golgi apparatus do?
O-linked glycosylation
modifies, sorts, packages molecules meant for secretion
210
What does mitochondria do?
aerobic respiration
contains circular DNA
211
What does the nucleus do?
DNA maintenance
RNA transcription/splicing
212
What do lysosomes do?
Break down large molecules like proteins and polysacchrides
213
What does the nucleolus do?
Ribosome production
214
What does the peroxisome do?
Catabolism of v long chain fatty acids and amino acids, makes hydrogen peroxide
215
What does the ribosome do?
Translates RNA into proteins
216
What do proteasomes do?
Breaks down proteins
217
Anderson-Fabry disease
X linked recessive
deficiency of alpha galactosidase A
burning parathesia childhood
angiokeratomas
lens opacities
proteinuria
early CVD
218
Selection Bias
eg sampling biads, volunteer bias, non responder bias
219
Recall bias
People remembering things differently based on how they are now eg having lung ca and thinking you had asbestos
220
Publication bias
Not publishing things that aren't as interesting etc
221
Work up/verification bias
Being reluctant to order gold standard when thats what youre comparing to
222
Expectation bias (pygmalion effect)
People reporting things based on what they think the study wants
223
Hawthorne effect bias
Knowing you're being studied
224
Late-look bias
Getting info at inappropriate time eg years later when subject may have died
225
Procedure bias
People in same group get different treatment
226
Lead-time bias
New test diagnoses something arlier but doesn't have any effect on the disease
227
Hazard ratio
For analysing survival over time
228
Type V Hypersensitivity
Graves disease
MG
229
What do Th1 Helper cells secrete?
Cell mediated immunity
IFN gamma IL2, IL3
230
What do Th2 helper cells secrete?
Humoural immunity
IgE
IL4, IL4, IL6, IL10, IL13
231
Nacrolepsy HLA
HLA DR2
232
Nicotinic Acetylcholine what type of Receptor
Ligand gated
233
Whats the usual outcome measure of a cohort study?
Relative risk
234
Fabry disease
Angiokeratomas “corneal whirl”
Proteinurias
Early MI/stroke
235
Shistocytes in blood smears
DIC
236
What type of receptor is ANP
Guanylate cyclase
237
Chi squared test
Comparing 2 percentages/proprotions
238
Mechanism of doxy
Inhibits 30s unit ribosomes
239
Achondroplasia mutation
FGFR3 fibroplast growth receptor
240
Achondroplasia inheritance
autosomal dominant
241
Features of achondroplasia
short arms and legs, short, flat nose
242
Bartters syndrome
Severe hypokalaemia defective chloride absorption Na+/K/Cl cotransporter loop of henle
243
Tay Sachs disease
lysosomal storage
cherry red spot macula
no hepatospelnomegaly
developmental delay
244
Mcardles disease
glycogen storage
myalgia
myoglobinuria
245
Homocystinuria features
fine, fair hair
Marfanoid
LD
downwards (inferonasal) dislocation of lens
VTE
also malar flush, livedo reticularis
246
Pathophysiology of homocystinuria
cystathionine beta synthase
247
Whats the definition of the p value?
is the probability of obtaining a result by chance at least as extreme as the one that was actually observed, assuming that the null hypothesis is true
248
DiGeorge Syndrome pathophysiology
Primary immunodeficiency
T cell dysfunction
249
DiGeorge Syndrome chromsome
Deletion 222 (22q11.2)
250
DiGeorge Syndrome features
viral/fungal infections
parathyroid gland hypoplasia → hypocalcaemic tetany
thymus hypoplasia
T-lymphocyte deficiency/dysfunction
251
Tetralogy of Fallot
VSD
RVH
right ventricular outflow tract obstruction, pulmonary stenosis
overriding aorta
252
Goodpasture HLA
HLA DRB1\*15:01
253
Ank spond renal disease
AA amyloidosis - apple green +ve bifringence, enlarged kidneys, heavy proteinuria
IgA nephropathy
254
UC Vs Crohns
Transmural inflammation
Crohns
255
UC Vs Crohns
Fissuring ulcers
Crohns
256
UC Vs Crohns
Lymphoid/neutrophil aggregates
Crohns
257
UC Vs Crohns
Mucosa/submucosa only
UC
258
UC Vs Crohns
Crypt Abcesses
UC
259
UC Vs Crohns
Skip lesions
Crohns
260
UC Vs Crohns
Continous inflammation
UC
261
UC Vs Crohns
Transmural/all layers inflammation
Crohns
262
Few polyps and fhx of cancer
HNPCC
263
Loads of polyps (100s-1000s) and fhx of cancer
FAP
264
HIV nephropathy histology
Microcystictubular dilatation
Collapsing FSGS
265
CMV Tx
Gancliclovir
266
Which antibodies cross the placenta
IgG
267
Initial therapy for phaeochromocytoma SVT
Phenoxybenzamine
268
Philadelphia chromosome in ALL good/bad prognosis?
Bad
269
Weber syndrome
Midbrain stroke
THIRD NERVE PALSY SAME SIDE
Contralateral hemiparesis and hemiparkinsonism
270
Wallenberg syndrome
Lateral medullary syndrome
Ipsilateral pharyngeal/ palatal palsy
Ipsi horner syndrome
Ipsi pain/temp loss face
Contra pain/temp loss body
271
MOA/enzyme glitazone
CYP2C8
272
SVT in pregnancy tx
Beta blocker
273
Hyperlipoproteinaemia IB mutation
Apolipoprotein CII (APO CII)
274
Red spots with bluish white centre
Koplik spots
Measles
275
Sheep, lymphadenopathy
Fever
Sweats
Weight loss
Brucellosis
276
Tx for cholera
Doxy
277
Which immunoglobulins are responsible for haemolytic blood transfusion reactions?
IgM
278
Homocystinuria pathophysiology
deficiency of cystathionine beta synthase
279
Homocystinuria features
fine, fair hair
Marfanoid
LD
downwards (inferonasal) dislocation of lens
VTE
also malar flush, livedo reticularis
280
Homocystinuria tx
B6 supplementation
281
Conditions ax with turners
Cystic hygroma
Lymphedema
Hypothyroidism
Horseshoe kidney
Crohns
282
Features CF
short stature
diabetes mellitus
delayed puberty
rectal prolapse
nasal polyps
male infertility, female subfertility
283
Main constituent of pulmonary surfactant
dipalmitoyl phosphatidylcholine (DPPC)
284
Lesch-Nyhan syndrome
X recessive
juvenile gout
absence HGPRT
orange sand stools
285
Liddles syndrome
Hypokalaemia
HTN
286
Wilcoxon signed-rank test -
compares two sets of observations on a single sample eg before/after
287
DiGeorge Mnemonic
'CATCH22
C - Cardiac abnormalities
A - Abnormal facies
T - Thymic aplasia
C - Cleft palate
H - Hypocalcaemia/ hypoparathyroidism
22 - Caused by chromosome 22 deletion
288
Kearns-Sayre syndrome
mitochondrial inheritance
onset \< 20-years-old
external ophthalmoplegia
retinitis pigmentosa
289
Beckwith-Wiedemann syndrome
organomegaly, macroglossia,
abdominal wall defects, Wilm's tumour neonatal hypoglycaemia.
290
Complement Leiner disease
C5
291
Norepinephrine receptor
G protein coupled receptor
292
Dermatitis herpetiformis HLA
HLA D3
293
Ligand gated ion receptors
Nicotinic acetylcholine
Gaba
glutamate
294
Tyrosine kinase receptors
insulin-like growth factor (IGF), epidermal growth factor (EGF)
PIGG(L)ET: Prolactin, Immunomodulators
GH, G-CSF,
Erythropoietin Thromobopoietin
295
Guanylate cyclase receptors
ANP/BNP
296
HLA Psoriasis
HLA CW6
297
T1 RTA
Anion gap
Normal
298
Lactic Acidosis Anion Gap
Raised
299
T1 RTA presentation
hyperchloraemic hypokalaemic metabollic acidosis
300
Linear IgG desposits
anti glomerular basement membrane disease
301
MOA sitagliptin
DPP-IV inhibitor
302
Tx cluster headaches
verapamil
303
Lip smacking seizure - which area of brain
Temporal lobe
304
CXR "mass surrounded by rim of air"
Aspergilloma
305
MODY presentation
diabetes without ketones
antibody negative
autosomal dominant
family hx
306
Latent Autoimmune Diabetes Adult LADA
Presentation
Treated as Type 2 for few years
High BMS
Ketonuria
Hx of auto immune
307
Warm AIHA features
Happens at body temp
Anaemia + jaundice +splenomegaly
Coombs test +ve
308
Cold AIHA features
Worse cold temp
Raynauds/purplish discoloration (acronyansosis)
Coombs test +ve
309
White turbid fluid joint
Acute Gouty Arthritis
310
1st step tx aortic dissection
Labetalol
311
Haemochromatosis inheritance
Autosomal recessive
312
Haemochromatosis pathophysiology
mutation of HFE on chromosome 6
C282Y (80%) AND H63D (20%) cause decreased hepcidin
313
Heinz bodies
GP6D deficiency
314
Howell Jolly bodie
Hyposplenism/splenctomy
315
Rouleax (blood film)
Waldenstroms, myeloma
316
Warm AIHA features
Happens at body temp
Anaemia + jaundice +splenomegaly
317
Cold AIHA features
Worse cold temp
Raynauds/purplish discoloration (acronyansosis)
318
Warm AIHA Ig
IgG
319
Cold AIHA Ig
IgM
320
What infections does Sickle Cell predispose to ?
encapsulated eg strep pneumoniae, salmonella
321
What organism causes aplastic sickle cell crisis?
Parvovirus
| (Causes sudden drop in Hb)
322
"Pulmonary infiltrates" in sickle cell
Acute chest syndrome
323
Acute chest syndrome sickle cell presentation
SOB, chest pain, pulmonary infiltrates, hypoxia
324
Long term tx sickle cell
hydroxyurea
325
Carcinoid tumour features
tachycardia
flushing
bronchoconstriction
haemodynamic instability
diarrhoea
326
"lambda light chain" in kidney
myeloma amyloidosis
327
Tramline spine
Ank spond bamboo spine
328
Rugger Jersey spine
Renal osteodystrophy
329
Trophozites/cysts in stool culture
Giardia
330
Type II RTA
Hypokalaemic hyperchloraemic acidosis with low bicarb (high in urine) and high urine pH
331
Cisplatin side effects
Ototoxicity
nephrotoxicity - hypokal, mag, calc
332
Tx for Hep C
Daclatasvir, sofosbuvir +\_ ribavirin
333
Ciclosporin mechanism
IL2 inhibitor
334
Small testes, delayed puberty, loss of smell
Klamanns syndrome
335
Retinal protein responsible for light perception
rhodopsin
336
Boney lumps DIP
Heberdens nodes OA
337
Boney lumps PIP
Bouchards node RA
338
Von Hippel Lindau
Cysts tumours everywhere
Chromosome 3
RCC common
339
Scheuermanns disease
irregular endplates
loss of disc space height
teenage girls
thoracic smooth lump
340
Hormone change at ovulation
LH surge
341
Net like rash
Cholesterol emboli
342
Sickle cell treatment
Hydroxyurea
343
McArdle disease
Repeated cramping and myoglubinuria (dark drown urine) after exercise
344
Illness where prophylaxis causing haemolytic anaemia
G6PD deficiency
345
Hypersegmented neutrophils
Megaloblastic anaemia
346
Left shift of myeloid cells
Pregnancy, severe infection, CML
347
Blast cells
AML/ALL
348
Auer rods
AML
349
Smear/smudge cells
lymphocytosis usually CLL
350
Primary thrombocytopaenia features
Bleeds/clots
splenic infarcts/atrophy
raised megakaryoctyes
351
Primary thrombocytopaenia tx
hydroxycarbamide, alpha interferon, anagrelide
aspirin
352
Polycythaemia rubra vera features
Clots - headaches, dizziness, VTE, stroke, hepatosplenomegaly
353
Tear drop poikilocytes
Myelobfibrosis
354
What condition often turns into myelofibrosis?
PRV
355
What condition does myleofibrosis often turn into?
AML
356
Most common leukaemia adults
AML
357
Philadelphia chromosome in ALL ?prognosis
Poor prognosis
358
CLL presentation
painless lymphadenopathy + anaemia
Smear cells
359
Reed Sternberg cells "owls eye" appearance
Hodgkins lymphoma
360
Most common type of Hodgkins
Nodular sclerosing
women
good prognosis
361
High number Reed Sternbergs ?Hodgkins type
Mixed cellularity
362
Best prognosis Hodgkins
Lymphocyte predominant
363
Worst prognosis Hodgkins
Lymphocyte depleted
364
Poor prognostic factors in AML
\>60
\>20% blasts after 1st chemo
deletion chromosome 5 or 7
365
Acute promyelocytic leukaemia genetics and cells
t15:17
fusion of PML and RAR alpha
Auer rods
366
"Increased granulocytes at different stages of maturation +- thrombocytosis"
CML
367
CML genetics
t9:22
q34:11
BCR-ACL
368
CML treatment
imatinib - tyrosine kinase inhibitors
369
Leukaemia presenting with DIC
APML
370
Good prognostic factors ALL
FAB L1 type
common ALL
Pre-B phenotype
low initial WCC
del 9p
371
Poor prognostic factors ALL
FAB L3 type
T or B cell markers
Philadelphia
\<2 or 10\<
male
CNS involvement
high WCC
not white
Hypodiploidy
372
"monoclonal proliferation well differentiated B lymphocytes"
CLL
373
Ann Arbor Stage I
single region lymph nodes
374
Ann Arbor Stage II
2 sites same side of diaphragm
375
Ann Arbor Stage III
several sites both sides of diaphragm
376
Ann Arbor Stage IV
extralymphatic structures
377
Tumour lysis syndrome
High phos, potassium, uric acid
Low Ca2+
378
Mantle cell lymphoma genetics
CD5+, CD19+, CD22+, CD23-, CD10-
t11:!4
379
Follicular lymphoma genetics
t 14:18
BCL 2
380
TTP antibody
ADAMTS 13
381
What clotting factor does Von Willebrand process
Factor VIII carrier protein
382
What factors doe Haemophilla A affect
Factor VIII
383
What factors doe Haemophilla B affect
IX
384
DIC blood features
prolonged PT, APTT, thrombin clotting
WCC, platelet, fibrinogen low
385
Chemo agent causing low Mg
cisplatin
386
Causes of intravascular haemolysis
Blood transfusion
G6PD
TTP
DIC
HUS
PNH
Cold AIHA
387
Causes of extravascular haemolysis
Sickle cell, thalasaemia
Hereditary sphereocytosis
Haemolytic of newborn
Warm AIHA
388
Haemophilia PT/APTT
PT normal
APPT prolonged
389
Antiphospholipid pregnancy tx
Aspirin and LMWH
390
Prognostic marker for myeloma
B2 microglobulin
391
MOA cisplatin
cross linking DNA
392
Haem issue causing headache, blurred vision
Waldenstroms
393
Causes warm AIHA
SLE
methyldopa
394
Causes cold AIHA
Mycoplasma, EBV
395
Surgical prophylaxis Von Willebrands
Desmo
396
Leukaemiod reaction (rather than leukaemia)
high leucocyte alkaline phosphatase score
Dohle bodies white cells
Left shit neutrophils
397
Von Williebrand PT/APTT
Mildly prolonged APTT
398
CLL poor prognostic markers
male
\>70
lymphocyte \>50
lymphocyte doubling \<12 months
raised LDH
CD38
TP53
del 17
399
CLL good prognosis
del 13
400
Hereditary spherocytosis features
Fhx, gallstones, anaemia
splenomegaly FTT
EMA binding test
401
Glutide main side effects
Hypos
plus pancreatitis, renal imp, nausea and vomiting
402
Ca 125
Ovarian
Peritoneal
403
ECOG 0
Normal
404
ECOG 1
Can't do strenuous stuff, but ok with work
405
ECOG 2
Ambulatory and ADLs but not capable of work
406
ECOG 3
Limited self care, confined to be more than 50% waking
407
Dapaglifozin SGLT2 risks
DKA
Increased cholesterol
408
Med to reduce risk of tumour lysis
rasbicurase
409
JAK 2
Thrombocythaemia
410
Sickle cell HbSC
Mild disease
411
Hereditary spherocytosis tx
Fluids, high dose folic acid
412
Diabetes meds contraindicated in CCF
Pioglitazone
413
G6PD triggers meds
primaquine
cipro
sulphs
414
Test for anaphylaxis post reaction
tryptase
415
Hodgkins poor prognostic markers
weight loss \>10% 6 months
fever \>38
night sweats
416
Acute intermittent porphyria enzyme defect
Uroporphyrinogen decarboxylase
417
Factor V Leiden mechanism
resistance to activated protein C
418
Common cancer tumour lysis syndrome
Burkitts lymphoma
419
Necrosis following warfarin
Protein C deficiency
420
What does polycythaemia vubra vera progress to?
Myelofibrosis, AML
421
Bilobed mononuclear cells
AML
422
Liver transplant criteria paracetamol OD
pH \<7.3
or
INR \>6.5 + grade 3/4 encephalopathy + Cr \>300
423
Hypovolaemia shock post MI
RV infarct
424
Most common thyroid cancer
Papillary, great prognosis
425
Type and MOA pioglitazone, rosiglitazone
PPAR gamma agonist, increase insulin signalling/sensitivity
426
Conns triad
HTN + hypokalaemia + alkalosis
427
Conns causes
RAS
CAH
CCF
Corrhosis
Nephritic syndrome
428
Waterhouse Fredichsen
Septicaemia causing adrenal haemorrhage causing addisons
429
Primary hyperparathyroid
Tumour producing PTH
High PTH
HIgh Ca2
430
Secondary hyperparathyroid
Vit d deficiency
Low/normal ca
High PTH
431
Tertiary hyperparathyroidism
Secondary hyperparathyroidism goes on for ages causing high PTH, causing high Ca2
432
Hyperaemic membranes
TSS
433
Where do SGLT 2 inhibitors glifozins work
Early PCT
434
Glutide main side effects
Hypos
435
Indications for surgery in HPTH
\<50
CA \>0.25 upper lmit
eGFR \<60
renal stones/nephrocalcinosis
osteoporosis
sx
436
Mst common cause primary hyperaldoteronism
Adreanl hyperplasia
437
Pendred syndrome
Deafness and hypothyroid
438
MOA gliptins
DPP 4 inhibitors
439
Dapaglifozin SGLT2 MOA
Stops reabsorption glucose proximal renal tubule
440
Dapaglifozin SGLT2 risks
DKA
441
Normal fasting glucose
\<6.1
442
Post glucose /random glucose
\<7.8
443
Kallmans syndrome
Like kleinfelters but low LH, FSH and crypto orchidism
444
Sulfonylureas MOA
increase insulin secretion B cells and decrease hepatic clearance
445
MODY 3
most common
ax with HNF alpha
inc risk HCC
446
MODY 2 gene
glucokinase
447
MODY 5
rare
cysts
HNF 1 beta
448
Gitelmans syndrome
Defect in Na Cl transporter DCT
Normotension
Hypokalaemia
Hypocalciruia
Hypomagnesaemia
Met alk
449
Target HbA1c T1DM
48
450
Estrogen only HRT risk
Endometrial ca
451
Supressed by high but low dose dex suppresion test
Cushings disease
452
Diabetic meds that dont cause hypos
Metformin
Glitazones
Gliptins
453
Diabetic meds that do cause hypos
Gliclazides
Exanatides
454
Type and MOA gliclazide, glimperide
Sulfonylureas, inhibit K ATPase
455
Type and MOA exanatide, lirglutide
GLP 1
stimulates GLP1 receptor, Ca2+ influx, inc insulin
456
Type and MOA sitagliptin, linagliptin
DDP4 inhibitors
Stops breakdown of GLP1
457
Type and MOA pioglitazone, rosiglitazone
PPAR, increase insulin signalling/sensitivity
458
Type and MOA empagliflozin, dapagliflozin
SGLT 2 inhibitors
inhibit kidney reabsorption of glucose, excretes more in urine
459
Type and MOA acarbose
alpha glucosidase inhibitor
inhibits gut absorption of glucose
460
What are insulin stress tests used for
Cushings vs pseudo cushings
461
Addisons electrolyes/ph
Low Na
High K
Acidotic
462
Hookworm presentation
itchy rash then resp asthma/allergy sx, the GI upset +- anaemia
India
463
Pseudohypoparathyroidism bloods
PTH: high
calcium: low
phosphate: high
464
Pseudohypoparathyroidism features
short fourth and fifth metacarpals
short stature
cognitive impairment
obesity
round face
465
Pseudohypoparathyroidism genetics
G protein mutation
auto dom
466
Well done!
.
467
Impaired glucose tolerance
7.8-11.1
468
How to test for Zollinger Ellison
Serum gastrin
Ocreotide scan
469
Impaired fasting glucose
6.1-7
470
Impaired glucose tolerance
7.8-11.1
471
Tx Listeria meningitis
aciclovir, cef, ampicillin
472
Painless solitary genital ulcer
Syphillis
473
Painless genital ulcer painful lymphadenopathy
Lymphogranuloma verenum
474
Painful ulcer Painful lymphadenopathy
Chancroid (Haemophilis ducrei)
475
What does ezetimibe do
redcues intestinal cholesterol absoprtion
476
CSF TB Meningitis
very low glucose
477
Enterovirus meningitis
cold, diarrhoea preceding
resp/faeco-oral spread
creche
478
Necrotising pneumonia
predeing viral illness
empyema/abcess
Staph aureus
479
Adult Stills Disease
Fluctuating salmon Pink rash
Arhtralgia
Hepatosplenomegaly
Fever
480
Azothiaprine eznyme
TPMT thiopurine methyltranferase
481
Intracranial bleed with cranial nerves, hyponatraemia, hypokalaemia
Pituitary apoplexy
482
Cholestrymine on INR
Lower
483
Abx worsening SE of statin
clarithromycin
484
SHBG in PCOS
Low
485
Intoxicated, high BP, high HR, low K+
amphetamines
486
Muscle weakness in medial epicondylitis/ulnar nerve palsy
adductor pollicis
487
Hookworm presentation
Rash then resp asthma/allergy sx, the GI upset +- anaemia
India
488
definitive test myotonic dystrophy
Genetic testing
489
APML tx
all trans retinotic acid ATRA
490
Reasons to stop stress test
\>250/115
2mm ST depression lateral leads
491
What age to continue HRT to in early menopause
51
492
Exogenous insulin on C peptide
supresses
493
How to test for Zollinger Ellison
Serum gastrin
494
Tx for chlamydia pneumonia
Erythromycin
495
physiological pred dose for 75kg man
7.5mg
496
1st line tx OCD
CBT, ERP
497
Thrombolysis window stroke
4.5 hours
498
Vitamin supplement in CF
Vitamin A
499
Hormone pattern PCOS
High LH, normal FSH, normal estradiol, high testosterone
500
Right sided stroke, DVT ?cause
PFO
501
Choroid neovascularisation
Dye stain leaking at macula
?diagnosis
Age related macular degeneration
Tx anti VEGF
502
SE/caution of tevinor/truvada (HIV med)
renal impairment
503
Painless transient visual loss
Curtain descending
?diagnosis
amaurosis fugax
504
Amaurosis fugax tx
Clopidogrel
505
Ulcers ax with RA
Pyoderma gangrenosum
506
Photosensitive blistering rash
Ax with alcohol, HIV, hep, estrogen
Porphyrea cutanea tarda
507
Intestinal Bacterial Overgrowth
E coli/bacteroides
Presents diarrhoea, B12 deficiency
tx with metro
508
Prolactinoma medical management
Cabergoline (dopamine agonist)
509
Which anti malarials are contra indicated in epilepsy
mefloquine
chloroquine
510
Malaria prophylaxis in pregnancy
chloroquine
folate supplements
511
TV definition
volume inspired or expired with each breath at rest
512
Inspiratory reserve volume 2-3 L Definition
maximum volume of air that can be inspired at the end of a normal tidal inspiration
inspiratory capacity = TV + IRV
513
Expiratory reserve volume (ERV) = 750ml
maximum volume of air that can be expired at the end of a normal tidal expiration
514
Residual volume (RV) = 1.2L
volume of air remaining after maximal expiration
515
Functional residual capacity (FRC)
the volume in the lungs at the end-expiratory position
516
Vital capacity (VC) = 5L
maximum volume of air that can be expired after a maximal inspiration
517
Total lung capacity (TLC)
sum of the vital capacity + residual volume
518
Physiological dead space (VD)
VD = tidal volume \* (PaCO2 - PeCO2) / PaCO2
519
Causes of raised transfer factor
Asthma
Pulmonary haemorrhage
Weg/goodp
L to R shunt
polycythaemia
hyperkinetic
male
exercise
age
520
Causes of low TLCO
Pulmonary fiborsis
pneumonoa
PE
pulmonary edema
emphysema
anaemia
Low cardiac output
521
Primary Sclerosing cholangitis features
Cholestatis
pANCA
male
jaundice, pruritis, fatigue
522
PMR symptoms
raised ESR, CRP
Weight loss/anorexia
Normal CK
523
Anastrazole mechanism
blocks peripheral tissue conversion of androgen to estrogen
524
Pneumonectomy eligibility criteria
FEV \>2L
FEV \>50% of FVC
Normal PaC02 at rest
525
When do you use CEA for colorectal ca
post op surveilance
526
Rhomboid shaped crystals on joint aspiration
pseudogout - pyrophosphate arthritis/chondrocalcinosis
527
Rash "concentric rings varying colours"
Erythema multiforme
528
Hep E endemic region
North Africa
529
Trauma -\> muscle wasting of whole hand
T1 nerve root damage
530
Other antibodies ax with anti phospholipid
anti b2 glycoprotein
anti cardiolipin
531
Dig toxicity
Complete heart block
Nausea/vom
Yellow vision
Brady/hypo
532
Complete heart block post MI ?which vessel
Posterior interventricular artery
533
1st line for acne and hirstutism in PCOS
Dianette Co-cyprindol
534
What causes in renal impairment in rhadomyolysis
Myoglobin
535
Botulin vs tetanus
Tetanus is rigid paralysis, botulin is flaccid
536
VTE and nephrotic syndrome
Anti thrombin III deficiency
537
PPAR drugs
fenofibrate
538
Immunoglobulin well person, allergic reaction blood
IgA
539
Familial primary pulmonary HTN sx
SOB, faitgue, angina
raised JVP
Left parasternal heave
pansystolic mrumur
S4
peripheral edema
540
Acanthosis nigricans ax illness
gastric adenocarcinoma, endometrial carcinoma
541
Cyanotic but not hypoxic
methaemoglobinaemia
sulfonamide exposure
tx methylene blue
542
Pneumonia:
Young person
out of keeping radiology
muscle ache
cold agglutins
Mycoplasma
543
Pontine haemorrhage stroke ?Vessel
Basilar artery
544
Malignant otitis externa
Otitis externa spreading to temporal bone/skull
Facial nerve involvement
Caused by pseudomonas aeruginosa
545
Trigeminal neuralgia sx with sensory loss
Tumour
546
Tx for recurrent renal stones with hypercalciruia
Thiazide diruetic
547
Indications for pacemaker
persistent symptomatic bradycardia
Trifasicular block
mobitz type 2 AV block
sinus pause \>3s
548
Anterior MI v1-v6
LAD
549
Septal M1 V1-V4
LAD septal branches
550
Lateral MI I, aVL, V5, V6
Left circumflex
551
Inferior MI II, III aVF
Right coronary artery (80%) or Right circumflex (20%)
552
Posterior MI V7, V8, V9
RCA
553
Right ventricle MI VI, V4R
RCA
554
Thoracic Outlet Syndrome
Pulse disappears when arm raised above head
pain, parathesia, numb arm
Ix doppler
555
Lipaemic sample pancreatitis
Triglycerides/chylomicrons
556
Power of study definition
probability of rejecting null hypothesis when its false
557
Cancer PSC progresses to
cholangiocarcinoma
558
Digital ischaemia tx
phentolamine
559
Gabapentin mechanism
binds to alpha 2 delta on voltage gated calcium
560
Skin plaques and acid fast bacilli
Leprosy
561
Pramaquine MOA
Removes hypnozites from liver
562
Somatostatin effect
Reduces gastrin secretion
Reduces gastric motility
563
Modified glasgow pancreatitis criteria
Age
O2
WCC
Ca
ALT
LDH
Glucose
Urea
Albumin
564
2nd line for animal bite
doxy and metro
565
T2DM med to avoid in gastroparesis
GLPT 1 glutides
566
Visual change with benign ICH
Enlarged blind spot
Constriction visual field
567
Yellow fever
Flavivirus
flu, epigastric pain, bruising, bleeding gums, fever
568
Doxasoin SE
worsens CCF
peripheral edema
palpitations
569
Pseudohypoparathryoidism mechanism
loss of function G protein linked to PTH receptor
570
Sx constrictive pericarditis
Raised JVP steep Y descent
pusatile liver
Right heart failure
571
Kidney disease ax with syphilis
Rapidly porgressive glomerulonephritis
572
Worst alpha 1 anti trypsin phenotype
PIZZ
573
Best alpha 1 anti trypsin phenotype
PISS
574
CYsticerosis
tapeworm
lump + seizure
575
Headache better lying flat
Intracranial hypotension
576
Tx PHT with multi focal atrial tachcardia
verapamil
577
MOA propylthiouracil
inhibits conversion thyroxine to tri iodothyonine
578
Acute pain
Small irregular oval pupil
photophobia
red eye, lacrimation
CILLARY FLUSH, hypopyon
Anterior uveitis
579
Anterior uveitis tx
atropine, cyclopentolate
steroid eye drops
580
Hutchinsons sign
HZO
Rash on tip or side of nose
nasocillary involvement, strong risk factor ocular involvement
581
HZO tx
PO anti virals 7-10 days
can use topical steroids for any inflammation
582
Severe pain
Decreased visual acuity
semi dilated pupil
Hazy cornea, halos
Acute angle closure glaucoma
583
Acute onset
pain
blurred vision photophobia
small, fixed, oval pupil, ciliary flush
Anterior uveitis
584
Visual loss following surgery
Red eye
pain
Endopthalmitis
585
Pathophysiology thyroid eye disease
glycosaminoglycan and collagen deposition in the muscles
586
Management thyroid eye disease
Lubricants
Steroids
radiotherapy
surgery
587
Red flags thyroid eye disease
deterioration in vision
change in color
eye pops out
corneal opacity
cornea visible when eyes closed
disc swelling
588
Bilateral
gritty/discomfort
sticky eyes in morning
red eyelid margins
+- swollen eyelids, styles, chalazions
Blepharitis
589
Blepharitis tx
Hot compress
Lid hygiene
artificial tears
590
Reduced vision
faded colour
glare
halos
defect in red reflex
Cataracts
591
Cataracts risk factors
smoking, DM, alcohol, trauma
long term steroids
radiation
myotonic dystrophy
hypocalcaemia
592
Complications of cataract surgery
posterior capsule opacification
retinal detachment
endophthalmitis
593
Keratitis organisms
bacterial - staph a, pseudomonas aeruginosa contact lens
funga
amoebic keratitis (soil/contaminated water)
parasitic onchocercal river blindness
HSV
exposure
594
Red eye
photophobia
foreign body/gritty
hypopyon
Keratitis
595
Management keratitis
topical abx
cycloplegic for pain
596
Complications of keratitis
corneal scarring
perforation
endopthlamitis
visual loss
597
Redness/swelling
severe ocular pain
visual disturbance
proptosis
pain/opthalmoplegia on eye movements
eyelid edema/ptosis
Orbital cellulitis
598
Orbital cellulitis vs preseptal cellulitis
reduced visual acuity, proptosis, pain/opthalmoplegia on eye movements = orbital cellulitis
599
Floaters
Flashers
blurred vision
Cobwebs across vision
dark curtin descending
Weiss ring
Posterior vitreous detachment
600
Posterior vitreous detachment tx
should self resolve
if retina tear will need treatment
601
Risk factors for vitreous detachment
Age
Myopia
602
Cupping of disc
glaucoma
603
Tx glaucoma
prostaglandin analogue eye drops
2nd line beta blocker, carbonic anhydrase / sympathomimetic
604
Prostaglandin analogue eye drops
increases uveoscleral outflow
brown pigmentation eye, increases eye lash length
605
Beta block eye drops
avoid in asthmatics or heart block
606
Sympathomimetics e.g brimonidine
Reduces aqueous production and increased outflow
Avoid if taking MAOI or TCA, causes hyperaemia
607
Carbonic anhydrase inhibitor eyedrops eg Dorzolamide
Reduces aqueous production, sulphonamide like reactions
608
Miotic eye drops e.g pilocarpine
increase outflow
SE constricted pupil, headache, blurred vision
609
Dry macular degeneration
90% of all
Drusen spots - yellow spots in bruchs membrane
610
Wet macular degeneration
choroidal neovascularisation
eudative
worst prognosis
611
ARMD sx
decreased visual acuity (near)
poor dark vision
fluctuating visual disturbance
photopsia/glare
distortion of ines Amsler grid
red patches/drusen spots
612
Supplements for dry ARMD
Vit A, C, E and zinc
no beta carotene for smokers
613
Angioid retinal streaks
dark red streaks on fundoscopy
caused by breaks in bruchs membrane
ax pseudoxanthoma elasticum, ehler danlos, pagets, sickle cell, acromegaly
614
"plucked chicken" skin
psuedoxanthoma elasticum
615
Treatment of acute glaucoma
acetazolamide + pilocarpine
616
What is a Holmes Adie pupil
Dilated and slow to react pupil
little/no response to light
absent/poor tendon reflexes
617
"Pale well demarcated disc" on fundoscopy
Optic atrophy
618
Acquired causes optic atrophy
MS
Papilloedema
raised IOP
Retinal damage
ischaemia
toxins
nutrition B1, B2, B6 , B12
619
Cogenital causes optic atrophy
Friedreich ataxia
Mitochondrial disorders
DIDMOAD (DI, DM optic neuropathy, deafness)
620
Most common RA eye disease
keratoconjunctivitis sicca
621
RA red eye painless no itch
episcleritis
622
RA dry, itchy
sicca
623
RA red painful eye
scleritis
624
Causes of tunnel vision
papilloedema
glaucoma
retinitis pigmentosa
choroidoretinitis
optic atrophy
hysteria
625
Argyll Robertson pupil
accommodate but dont react
tertiary syphilis
626
HZO tx
PO aciclovir
627
Ramsay hunt
HVV FACIAL nerve (HZO is TRIGEMINAL)
628
Sudden loss of vision + severe retinal haemorrhages on fundoscopy
Central Retinal Vein Occlusion
629
Cherry red spot on pale retina
Central retinal artery occlusion
630
Night blindness + tunnel vision
Retinitis pigmentosa
631
Confusion and papilloedema
Vit A toxicity
632
Causes of RAPD
Retina detachment
Optic neuritis
MS
633
RAPD (Marcus gunn)
light shone into affected eye both eyes dilate
634
Kidney disease ax retinitis pigmentosa
Alports syndrome
635
Visual loss - dense shadow starting peripherally moving inwards
Retinal detachment
636
Enlarging dark spots in vision
Vitreous haemorrhage
637
Stage I hypertensive retinopathy
Arteriolar narrowing, tortusoity
Increased light reflex, silver wiring
638
Stage II hypertensive retinopathy
AV nipping
639
Stage III hypertensive retinopathy
Cotton wool eudates
Flame blots haemorrhages
640
Stage IV hypertensive retinopathy
Papilloedema
641
Mild NPDR
1 or more microaneurysm
642
Moderate NPDR
Microaneurysms
blot haemorrhage
hard excudates
cotton wool spots
venous beading/lopping
643
Severe NPDR
blot haemorrhages and microaneurysms 4 quadrants
venous beading 2 quadrants
IRMA 1 quad
644
Diabetic Proliferative retinopathy
neovascularisation
fibrous tissue ant to disc
645
Diabetic Maculopathy
hard exudates
646
Friedrichs ataxia
cerebellar sx
L and UMN
pes cavus
normal IQ
optic atrophy pale disc
647
intracranial bleed causing fluctuating confusion over time
subdural
648
Tx neuroleptic malignant sydrome
dantrolene
649
Cancers ax with von hippel lindau
clear cell renal
hemangiomas
650
PD vs drug induced parkinsons
```
PD = rigid, resting tremor
DIP = bilateral sx
```
651
Huntingtons genetics
trinucloetide repeat CAG
auto dom
652
MS tx
beta inteferon
653
GBS paralysis
flaccid
hyporefflexia, tachycardia
654
Miller Fisher syndrome
areflexia, ataxia opthalmoplegia
variant of GBS
655
NF1
Cafe au lait
Axillary/groin freckles
Peripheral neurofibromas
Lisch nodules
scolisos
phaeochromcytoma
656
NF2
Bilateral vestibular schwannomas
meningomas
ependynomas
intracranial schawnommas
657
Tuberous sclerosis
Ash leaf spots
adenoma sebaceum
shagreen patches
subungal fibroms
epilepsy
develpmental delay
retinal haematomas
658
Migraine acute tx
triptan
659
Migraine prophylaxis
tompiramate, propanolol
660
Tx for drug induced PD
benzhexol
661
"slow relaxing grip"
myotonic dystrophy
662
Loss of corneal reflex
acoustic neuroma
663
Dementia and myoclonus
CJD
664
Autonomic dysfunction +PD/cerebellar signs
multi systems atrophy
665
Long term prophylaxis cluster headaches
Verapamil
666
Patchy haemoorahgic change on MRI Head
HSV encephalitis
667
Thrombectomy window
6 hours
668
Intracranial bleed - hypodense not confied to suture lines
chronic subdural
669
Epsilon sign
Right ventricular dysplasia
670
Test for acute Hep C
HCV RNA
671
Kussmaul sign
insp inc venous pressure, steep y jvp - perocarditis
672
tx broad beta
fibrate
673
NMS vs serotonin
```
serotonin = myoclonus, hyperreflexic, tremor
NMS = rigid
```
674
loose bodies in joint
osteochondritis dissecans
675
onion peel bone
ewings sarcoma
676
Thailand
Subcut nodule pus
gram neg bacellie
meliodosis
677
Main clinicl sign of left ventircular dysfunction
4th heart sound
678
amitriptyline OD with VT tx
bicarb
679
Bone mets with breast ca pain relief
Bisphosphonates
680
Raised ALP, cortical thickening, trabceular pattern
Pagets
681
PD tx
interfering - levodopa
not intefering - dopamine receptor agonist eg ropinrole
682
Test for 2 catgeories eg men/women
1 sample proprotion test
683
Test for 2 categorical variables eg child/adult, man/woman
chi squared
684
Test for numeric value eg height
T test
685
Test for 1 numeric and 1 categorical eg height men/women
T-test/ANOVA
686
Test for 2 numerical values eg height/weight
Corelation test
687
What level of evidence is RCT
Ib
688
Test to compare 2 percentages
Chi squared
689
Testing for correlation between two variables eg is there correlation between height and FVC
Linear regression
Spearman ranked
690
Paired v unpaired T test
Paired = same group of people before/after
Unpaired - 2 groups of people
691
Parametric tests
Students t
Pearson product-moment
692
Ascending cholangitis
Charcot triad - jaundice, RUQ, Fever
Gallstones
E coli
693
Ascending cholangtiis vs cholecystitis
Cholan - charcot triad
chole - murphys
694
Diethylene glycol tox/OD tx
IV ethanol
haemodialysis
695
Tropical med, non specific sx, eosinophilia
helminth/hookworm
696
Biventricular hypertrophy on ECG
VSD
697
What type of renal disease is Churg strauss and wegeners
focal segmental glomerulonephritis
698
MRI: increased signal in pulvinar of thalamus
CJD
699
Hyperoxaluria/uric oxalate renal stones tx
calcium supplemements
700
Impaired memory/planning
inappropriate behaviour
diminishing speech
fronto temporal dementia
701
Etanacerpt
anti TNF alpha
CI in MS. TB
702
MS CF
oligoclonal bans
raised IgG
703
TB drug course length
TB meningitis 12 months
everything else 6 months
704
Signet ring cells
adenocarcinoma
705
MOA bupropion
Noradrenaline dopamine reuptake inhibitor
706
Topiramate side effects
weight loss, renal stones, behaviour change
707
Amiodarone induced thyrotoxicosis tx
Anti thyroid drug and cortico steroids
708
mechanism of pedal edema in ccf
increased renin
709
Bronchial carcinoma tumour marker
Chromogranin A
710
Recurrent infections
spanish
immunoglobuin deficiency
IgD deficiency
711
Kearn sayre syndrome
sensineural hearing loss
mitochondrial
atazia
stroke
retinitis pgimentose
cardiomypathy
diabetes
712
Usher syndrome
retinitis pigmentose, hearing loss
713
What des BCR ABL code for
tyrosine kinase
714
Meds causing torticollis or acute dystonia
Prochloperazine, metocloperamide
715
Nerve root - weakness of thumb, numbness first web space
Radial nerve
716
NMS tx
dantrolene
717
Tx paraneoplastic pemphigous
steroids
718
SE carbimazole
rash
pruritis
arthalgia
alopecia
agranucytosis
jaundice
719
Lyme disease test
Borrelia IgG
720
Irregular plauqe like lesion
chronic progressive
indurated
foreign
Lupus vulgaris
721
Annular rimmed lesion with punched out hypopigmented centre
Borderline leprosy
722
Gold standard bronchiectasis diagnosis
HRCT
723
ECGs sign of impending cardiac arrest hyperkalaemia
prolonged QRS
724
Tx Neisseria mengitis
Ceftriaxone
725
RF Ig?
IgM
726
Why do people with CLL need irradiated blood?
Depletion of donor white cells
727
Where does 4th heart sounds sit on ECG
After P wave
728
Night sweats, lethargy, penumonia sx, hypercalcaemia
pulmonary sarcoid
729
Tx for lupus
hydroxchloroquine
life threatening: cyclophosphamide
lupus nephritis: mycophenolate mofteil
730
Tx necrobiosis lipoidica
Topical corticosteroids
731
Goes into VT whilst pacemaker - where had been touched?
coronary sinus
732
Tx Whipples disease
IV cef
733
mucosa appeared yellowed externally with erythematous erosions
Whipples
734
Dx ank spond if active sx
MRI sacro iliac
735
Pericarditis ECG
Saddle shaped ST most leads
736
Bone issue:
High ALP
low phos
Lowish Ca
High PTH
Osteomalacia
737
Pagets disease bloods
isolated ALP rise
738
Docetaxel renal impairment toxicity
renal tubular toxicity
739
MOZ tocilizumab
Anti IL 6
740
Tx for nephrogenic DI
hydrochlorthiazide
741
MOA baclofen
GABA agonist
742
Antibodies causing neonatal heart block
Anti RO, anti La
743
Tx syphilis
penicillin, doxy, azithro
744
Diabetic med good for heart failure/ CV health
dapagliflozin
745
SE pyrazinamide
joint pain
hepatitis
fever
746
SE rifampicin
thrombocytopaenia, nausea, vom
747
Cahnce of sibling being a HLA match
25%
748
Best anti hypertensives if on lithium
Ca channel blockers
749
2st step DKA tx
fluids
750
Scale for assessing ALDs
Barthel
751
Muscle causing fixed flexion deformity
rectus femoris
752
Virus causing anal cancer
HPV
753
Tx for Crohns skin/stoma ulcers
SC infliximab
754
Eplenerone site kidney
Distal PCT
755
1st line tx urgent thryoid eye disease
IV methylpred
756
Toxin causing heptaocellular carcinoma
aflatoxin
757
Positive urine nitroprusside
hexagon shaped crystals on urine analysis
cystine stones
758
Boil breaking down to large painful ulcers
pyoderma gangrenosum
759
Mechanisms of haemolysis in G6PD
Reduced NADPH
760
When is 3rd nerve palsy likely compressive
pupil inovolvement
761
Porphyrias skin AND abdo
variegate porphyria
762
How long after increasing phenytoin should you check levels
2 weeks
763
MOA etanercept
TNF alpha
764
headache, fever myalgia, rash with black centre
mediterrean spotted fever
765
Can't sit still
Akthasia
766
Chiari 1
herniation of cerellbar tonsils
older
767
Chiari 2
Arnold chiari
happens when younger
768
Antidote to beta blocker overdose
IV glucagon
769
dehydration, sthen seizure, then focal neurology
saggital sinus thrombosis
770
Study type that has biggest issue with recall bias
case-control
771
Palm/sole melanoma
acral lentigous
772
Sun exposed area melanoma
Lentigo maligna
773
Which polyarteritis isnt ANCA +ve
polyarteritis nodosa
774
Tropical med + raised Right hemidiaphragmm
amoebic liver abcess
775
Life threatening warfarin bleed tx
Prothrmobin complex and vit K
776
Renal disease caused by NSAID
Interstitial nephritis
777
Pneumonia causing haemolytic anaemia
Mycoplasma
