Paper 2 Flashcards
1
Q
Which molecules do MAO-A + MAO-B deaminate?
A
A -> serotonin + catecholamines (adrenaline and noradrenaline)
B -> dopamine and phenylephrine
2
Q
How does parity affect breast cancer risk?
A
Multiparity is protective against breast cancer
3
Q
Which derm condition can COCP cause?
A
Erythema nodosum
4
Q
Why is good oral hygiene advised when taking bisphosponates?
A
Can cause osteonecrosis of the jaw (plus atypical femoral fractures and osteonecrosis of the external auditory canal)
5
Q
How is ductal carcinoma in situ and no special type breast cancer differentiated?
A
Carcinoma in situ will not have a lump and show calcifications in the breast on imaging.
6
Q
How is laryngeal cancer recurrence monitored after treatment?
A
Flexible laryngoscopy -> 1st year (every 1-2 months), 2nd year (every 2-3 months), 3rd year (every 3-4), 4th year (every 4-6), >5th year (yearly)
7
Q
What is the difference in treatments between glottic and subglottic laryngeal malignancies?
A
Glottic/supraglottic -> single modality
Subglottic -> combination therapy
8
Q
A
9
Q
Which hormone is produced by decidual cells of the placenta?
A
Relaxin -> hormone which acts to loosen up ligaments to prepare body for birth
(hCG from syncytiotrophoblasts)
10
Q
Which Hb do sickle cell disease lack?
A
HbA
11
Q
Why are sickle cell patients given lifelong phenoxymethylpenicillin?
A
If there are repeated episodes of splenic sequestration -> splenic dysfunction and fibrosis -> autosplenectomy -> increased vulnerability to organisms
12
Q
Give the two biologics used for metastatic III melanoma (N + I)
A
Nivolumab (PD-1 Inhibitor)
Ipilimumab (CTLA-4 inhibitor)
13
Q
Give the Garden stages for NoF
A
1 - Incomplete, undisplaced
2 - complete, undisplaced
3 - complete, minimally displaced
4 - complete, displaced
14
Q
What is the criteria for THR + Hemiarthroplasty?
A
Able to live independently previous without significant co-morbidities and can carry out ADLs -> THR (otherwise hemiarthroplasty)
15
Q
Which patients is IM better in?
A
Younger patients
16
Q
Give the isoforms for HbA + HbA2 + HbF
A
HbA -> alpha 2 beta 2
HbA2 -> alpha 2 delta 2
HbF -> alpha 2 gamma 2
17
Q
Menorrhagia -> what is first line hormonal + non-hormonal treatment?
A
Hormonal -> levonorgestrel IUS (min 12M)
Non-hormonal -> Tranexamic acid/NSAID
18
Q
Which syndrome is associated with PDA?
A
Eisenmenger Syndrome
19
Q
Hypopigmented ash leaf macules -> diagnosis?
A
Tuberous sclerosis
20
Q
Bilious vomiting, polyhydramnios, reduced foetal movements, double bubble sign -> diagnosis?
A
Duodenal atresia
21
Q
Give the correct types of RTA:
1) Hyperkalaemia
2) Hypokalaemia, alkalotic urine, normal anion gap metabolic acidosis
3) Hypokalaemia, rickets/osteomalacia
A
1) 4 - associated with hypoaldosteronism +-aldosterone resistance (drugs that affect RAAS -> epleroenone, ramipril) -> hyperkalaemia and acidosis
22
Q
Which score is used for appendicitis?
A
Alvarado
23
Q
What is the O2 threshold for children?
A
<92
24
Q
What is the most common leukaemia in children?
A
ALL - thrombocytopenia, leukocytosis
25
What is the most common cytogenic abnormality in ALL?
t(12;21)
26
Give the electrolyte disturbances for tumour lysis syndrome
Hyperphosphataemia, hyperkalaemia, hypocalcaemia
27
What is first line pancreatic cancer investigation?
Ab US
28
Define Whipple's Procedure
Antrum of stomach, head of pancreas, common bile duct and gallbladder
29
Which protooncogene is mutated in most pancreatic adenocarcinomas?
KRAS
30
Which hormone is produced by the corpus luteum after ovulation? + How does it affect body temperature?
Progesterone -> increases
31
serotonin syndrome -> presented within 1 hour
Activated charcoal, IV benzo, fluids, serotonin antagonists (chlorpromazine)
32
What are the side effects of SSRI? + What can be given prophylactically if the patient is taking NSAIDs?
Stomach upset, PPI to protect from stomach ulcers
33
Which artery does Volkmann's contracture involve?
Brachial artery -> ischaemic necrosis of forearm flexors -> permanent claw hand
34
Which part of the colon is most commonly affected by Hirschsprung's?
Rectosigmoid
35
Which fracture is associated with ACL tear?
Segond fracture
36
Give PAIR for seronegative pathologies
Psoriatic arthritis
AS
IBD
Reactive arthritis (Reiters)
37
Which nodules are NF1 associated with?
Lisch nodules -> astrocytoma
38
Which renal pathology shows spikes in GBM?
Glomerulonephritis
39
Which blood test is used for antiphospholipid syndrome?
Lupus anticoagulant
40
Give 1st + 2nd + 3rd line for psoriatic arthritis
Naproxen + Methotrexate + Sulfasalazine
41
What is first line therapy for pregnant with antiphospholipid syndrome?
LMWH and aspirin
42
Smooth tongue, macrocytic anaemia, cognitive decline, ataxia -> which blood test?
Vitamin B12 and folate
43
In Sjogrens, which biopsy is used to test for focal lymphocytic chronic sialadenitis?
Labial biopsy
44
Which subluxation is a complication of RA that can make it difficult to intubate a patient?
Atlanto-Occipital
45
Which antibody is associated with dermatomyositis?
Anti-jo1
46
What is Gottron's papule associated with?
Dermatomyositis
47
Which part of the brain + ear area do vestibular schwannomas arise?
Cerebellopontine angle + internal auditory canal
48
What is first line for Behcets?
Colchicine
49
What is second line after allopurinol for gout? (F)
Febuxostat
50
What is first line for tumour lysis syndrome?
Rasburicase
51
If painless foot drop is present, other than common fibular nerve palsy -> which other pathology should be considered?
CES
52
Which classification is used for open fractures?
Gustilo and Anderson
53
Which bloods should be monitored for rhabdomyolysis?
Myoglobin is nephrotoxic -> monitor U+Es and serum CK
54
Which contracture is seen post-compartment syndrome + Which grading is used?
Volkmann's Contracture
Tsuge:
Mild - finger flexor
Moderate - wrist and finger flexors
Severe - extensors
55
Which movement can illicit pain in anterior compartment syndrome?
Plantarflexion -> stretches muscles of anterior compartmente
56
Define delta P in ACS
Diastolic pressure - compartment pressure <30mmHg = ACS
Absolute compartment pressure >40mmHg
57
Multiple fractures with different stages of healing, elevated ALP -> which bone pathology?
Paget's
58
What is the most common clinical sign of multiple myeloma?
Pallor
59
How does omeprazole affect clopidogrel?
Omeprazole inhibits CYP2C19 (P450) which usually activates clopidogrel -> decreases clopidogrel action
60
Microcytic, hypochromic -> normal/high serum ferritin -> what's next test + give 3 results
DAGT
1) Cold autoantibody -> CHAD (Cold Haemagluttinin Disease)
2) Warm -> autoimmune, drugs, CLL
3) Alloantibody -> transfusion reaction
61
Haemosiderin deposition, oedema, eczema -> which type of ulcer?
Venous
62
In pathologies with ANA+ve -> Which complement is increased to counteract damage?
Complement C3
63
Fever, ab pain, foul smelling lochia -> diagnosis? + Organism?
Post partum infection (GBS)
Strep agalactiase
64
Bone spicule pigmentation in peripheral retina -> diagnosis?
Retinitis pigmentosa -> loss of night vision and peripheral field vision
65
Which WBC abnormality can sudden withdrawal of lithium cause?
Agranulocytosis
66
Trauma to breast area previously, associated tethering, irregular mass -> diagnosis?
Fat necrosis -> dead adipose tissue on biopsy
67
Give the curative treatment after failed medical management in hip osteoarthritis
THR
68
Bone pain, CNVIII involvement, FH -> diagnosis?
Paget's
69
Give first line for CML + genetic mutation
Imatinib (tyrosine kinase inhibitor
t(9:22) Philadelphia chromosome
70
What is the most common presentation of a child with Wilm's tumour?
Asymptomatic abdominal mass
71
What is the second most common sickle cell disease phenotype?
HbSC (after HbSS)
72
If there is a complete miscarriage with TVUS empty uterus and no ectopic, positive beta-hCG -> what are next steps?
Repeat urine bhCG in 3 weeks time
73
What is seen on blood film in HELLP?
Schistocytes
74
Hemiparesis after epileptic seizure -> diagnosis?
Todd's paresis
75
Which prophylaxis can be used in third stage of labour to prevent PPH?
Prophylactic uterotonics
Oxytocin 10 iu
76
What does fibrillation potentials on EMG suggest?
ALS -> spontaneous potentials from denervation
77
What is the only medication recommended in ALS?
Riluzole
78
Which condition do genes SOD1 and C9ORF72 cause?
ALS
79
Inguinal lymphadenopathy, chlamydia patient, painless pustule -> diagnosis?
lymphogranuloma venereum
80
Keratoderma blenorrhagica is associated with which arthritis?
Reactive
81
What is the investigation for optic neuritis?
MRI orbit
82
No wet nappies for >12h is an indication for what?
NG feeding
83
What is the SADQ-C questionnaire used for?
Alcohol dependence
84
Which genetic mutation is associated with HNPCC/Lynch?
MLH1
MSH2
85
Which agent can be given in methotrexate toxicity?
Leucovorin
86
Give the effects of premature ovarian failure on oestradiol, FSH, LH
Decreased estradiol production -> negative feedback -> increased FSH, LH
87
Give the effect of rifampicin on P450 enzymes + COCP
P450 inducer -> increases metabolism of COCP -> caution use if trying to prevent pregnancy
88
Give the risk of recurrent ectopic after one episode
5-20%
(>30% if >2 previous episodes)
89
Give investigation for Kawasaki + treatment
Echo -> coronary artery aneurysm
IVIG, aspirin for prevention of coronary artery aneurysm
90
What is the difference between critical and acute limb ischaemia
Critical >2w chronic
91
What are Heberden's nodes caused by?
Osteophyte formation at DIPJ
92
Give the vitamin K dependent clotting factors
II, VII, IX, X, Protein C/S
93
Increased APTT with positive lupus serology -> diagnosis
Antiphospholipid Syndrome
94
What is the most common germ cell tumour in children?
Yolk Sac Tumour
95
What is IM pethidine used for?
Long labour without epidural after trying co-codamol and entonox
96
Rash on hands, feet and face, thrombocytopenia, anaemia and hepatic dysfunction after transplant -> diagnosis?
GVHD
97
Which newborn head bump crosses suture lines?
Caput succaedum (scalp oedema)
Cephalohaematoma (subperiosteal bleeding, doesn't cross)
98
What is the mechanism of mefenamic acid + tranexamic acid?
M -> NSAID, can affect fertility (use tran)
T -> antibrinolytic, inhibits plasminogen to plasmin
99
Which investigation is used for vWD?
Risocetin cofactor activity
100
Previous PID presenting with RUQ
Fitz-Hugh-Curtis Syndrome
101
What is the management for INR >8 and no bleeding?
Stop warfarin and wait until <5, start again at reduced rate
102
Which syndrome is 47 XXY?
Klinefelter Syndrome
103
Which biologic is second line after NSAID in AS?
TNF-alpha inhibitor (e.g. adalimumab)
104
Which screening is used in PCOS diabetics who are overweight or non-caucasian?
OGTT every 1-3 years
105
Immunocompromised, ear pain, night pain -> diagnosis?
Necrotising OE
106
Give an important complication of OM
Mastoiditis
107
What is an important warning given for glandular fever?
Splenomegaly -> avoid contact sports to prevent splenic rupture
108
Chest pain, subcutaneous emphysema, vomiting -> which triad + syndrome?
Mackler's Triad
Boerrhave Syndrome (spontaneous oesophageal rupture)
109
Which score is used for MW tear? + Which score requires inpatient endoscopy?
Glasgow-Blatchford
>0
110
What levels is agranulocytosis diagnosed?
Neutrophils <1x10^9
111
What is first line for acute epiglottis?
Ceftriaxone
112
Which imaging is used alongside laryngoscopy to diagnose epiglottis? + Which sign is identified?
Lateral neck radiograph -> Thumb sign
113
Give the gene + inheritance pattern for haemochromatosis
HFE
Autosomal recessive
114
Which side effect can occur if aledronate is not taken properly in the morning before breakfast?
Osteonecrosis of the jaw
115
How is Crigler-Najjar and biliary atresia differentiated?
C-N -> autosomal recessive, elevated indirect bilirubin due to defect in conjugation gene
BA -> direct bilirubin, hepatomegaly, progressive jaundice
116
Give one situation for early referral to breast clinic before 50
If there is a first degree relative with bilateral breast cancer <50
117
Lumpy tender breasts, more painful around menstruation, better mid-cycle, perimenopausal patient -> diagnosis?
Fibrocystic
118
When is mammography used vs US?
US for <40 due to more dense breast tissue
119
Which type of bacteria are S. pyogenes + S. agalactiae?
Pyogenes -> GAS
Agalactiae -> GBS
Both are beta-haemolytic
120
When is amoxicillin given with IV cephalosporins in meningitis?
To cover for listeria, usually in children and elderly
121
Give a classic sign + presentation for hereditary haemorrhagic telegiectasia
Spots on lips
Epistaxis
Autosomal dominant
122
Give the range to differentiate between medical and expectant management in ectopics
<35mm
<5000 hCG
hCG >1500 -> medical (methotrexate)
hCG <1500 -> expectant
123
Is long or short sightedness associated with glaucoma?
Hypermetropia
Causes of pupillary dilation (antimuscarinics, e.g. atropine, and sympathomimetics, e.g. phenylephrine)
124
Give the management for rectal cancer with LBO
Defunctioning loop colostomy
125
Give a protective factor against AOM
Breastfeeding
126
Define the Carhart Notch in audiometry
Dip at 2000Hz due to immobilisation of the stapes plate -> seen in otosclerosis
127
Give the surgical procedure for persistent BPPV
Posterior canal occlusion
128
What is the most common cause of cholesteatoma?
Eustachian tube dysfunction
129
Which part of the brain is an acoustic neuroma found?
Cerebellopontine angle (near facial and trigeminal nerves)
130
What is the most common organism in mastoiditis?
Strep pneumoniae
131
What is first line for organophosphate poisoning?
Atropine and pralodoxine
132
Give the first line + criteria for treatment in whooping cough
Within 21 days
Macrolide (e.g. erythromycin)
133
Give an indication for tacrolimus + class + side effect
Renal transplant (with mycophenolate)
Calcineurin inhibitor
Visible tremors
134
Describe benign Rolandic epilepsy
Nocturnal seizures with orofacial involvement -> self-limiting
135
Which vitamin deficiency are Bitot's spots associated with?
Vitamin A
136
Which test is used to diagnose vitamin A deficiency?
Serum retinol
137
What is the initial management for iron overdose?
Bowel irrigation -> Desferroxamine
138
Which type of acid base disturbance is seen in iron overdose?
High anion gap metabolic acidosis
139
When is IV methylpredinosolone given in GCA?
Where there are visual symptoms
140
Give a complication of GCA other than blindness
Aortic aneurysm -> 2 yearly screening
141
What is retinal whitening associated with?
Posterior uveitis
142
What is a more renal friendly version of morphine?
Oxycodone
143
Give some example of DMARDs
Luflonamide, sulfasalazine, methotrexate
144
Young, healthy patient with prolonged periods of refractory seizures -> what is the most common cause?
Autoimmune encephalitis
145
How is VTE risk reduced post-TKR?
Aspirin 14 days
LMWH 14 days with compression stockings
146
How is VTE risk reduced post-THA?
LMWH 10 days and aspirin for following 28 days
LMWH 28 days with compression stockings
147
What is first line for biliary atresia?
Kasai procedure
148
Which biomarker is elevated in carcinoid tumours?
Chromogranin A
149
What is first line for vWD? + Second line?
Desmopressin -> IV vW factor
150
What does HHV 6 cause in children?
Roseola infantum
151
How do you differentiate roseola infantum and measles?
RI -> rash after fever subsides (chest spreads to neck)
M -> rash comes with fever and coryza prodrome (maculopapular rash spreading from ears down)
152
What paediatric tumour is an elevation in HMA and VMA associated with?
Neuroblastoma
153
Persistent fever of unknown origin, negative transoesophageal echo, elevated inflammatory markers, back pain -> investigation + diagnosis?
MRI lumbar spine
Discitis
154
Which syndrome is livedo reticularis (netlike rash) associated with?
Antiphospholipid
155
What is first line for antiphospholipid syndrome who have had thrombotic events?
Warfarin INR 2-3
156
What must be done before surgical excision of phaeochromocytoma? + give a complication if part of this is not followed?
Control of BP -> alpha blockade (phenoxybenzamine, phentolamine) + beta blockade
Only beta blockade -> unopposed alpha stimulation -> hypertensive crisis and vasoconstriction
157
Give a specific x-ray finding on X-ray for pseudogout
Chondrocalcinosis
158
Which overdose is associated with tinnitus?
Aspirin
159
Which cells are seen in CLL?
Smudge cells
160
What is the Richter transformation?
CLL -> non-Hodgkins lymphoma
Rapidly progressing cervical lymphadenopathy, B symptoms
161
Which cancer does Sjogren's increase the risk of?
Non-Hodgkin's Lymphoma
162
Give the triad of bloods seen in CML
Neutrophilia, thrombocytosis, anaemia
163
What is seen on blood film in HUS?
Schistocytes
164
What does apple green befireringance on Congo red stain signify?
Amyloidosis
165
What is the follow-up post pregnancy in complete hydatiform mole?
6-8 weeks serum beta-hCG
166
What is first line in low risk choriocarcinoma (following complete hydatiform mole)?
Methotrexate
167
Which drugs are associated with osteomalacia?
Anticonvulsants -> induce P450 -> metabolises vitamin D
168
Alcohol induced cervical lymphadenopathy pain -> which malignancy?
Hodgkins
169
What is first line for tumour lysis syndrome?
Rasburicase -> converts uric acid to inactive form
170
Which histology is pathognomic for Hodgkin's?
Reed Sternberg
171
Which syndrome is associated with psoriatic arthritis?
Metabolic syndrome
172
Give classification for acute limb ischaemia + stage for viable + non-viable + management
Rutherford -> 1,2 = viable (revascularisation), 3 = non-viable (amputation)
173
What is a common complication of revascularisation?
Limb reperfusion injury from increased pressure due to O2 free radicals and inflammatory mediators
174
Which cancer risk increases in mono (EBV)
Nasopharyngeal carcinoma
175
Give a common renal complication of diffuse systemic sclerosis
Renal crisis -> hypertension ,reduced urine output, acute renal failure
176
What does evidence of haemotympanum signify? + what is indicated?
Basal skull fracture (panda eyes, CSF rhinorrhoea, Battle sign) -> immediate CT head
177
What do elevated VMA levels show in children? + which scan confirms diagnosis?
Neuroblastoma
Metaiodobenzylguanidine scan (MIBG)
178
Give the pathophysiology of hypocalcaemia in tumour lysis syndrome
Release of phosphates -> hyperphosphataemia -> phosphates bind with free serum calcium -> hypocalcaemia
179
Why is allopurinol given prophylactically for tumour lysis syndrome?
Prevents rise in uric acid
180
Multiple tender ulcers on preputial skin on penis following sexual intercourse -> diagnosis?
Herpes simplex
181
Exaggerated lumbar lordosis, palpable depression above L5, low back pain that improved with rest -> diagnosis?
Spondylolitheasis
182
How many months should a child be sitting unsupported?
7 months
183
How many months should a child be able to feed themselves and say at least 2 words?
12 months
184
Which fibroid location can cause urinary frequency?
Subserosal fibroids
185
Define red degeneration
Uterine fibroids that grow rapidly during pregnancy causing pain and a low-grade fever due to a surge in sex hormones
186
Which congenital syndrome is associated with ToF?
DiGeorge (22q11 deletion) - CATCH22
187
Give a temporary measure for ToF whilst awaiting surgery
Blalock Shunt -> connects pulmonary and subclavian artery to ensure perfusion to pulmonary circulation
188
What is the definitive management for Hirschprung?
Ano-rectal pull through
189
Which leukaemia shows gum hyperplasia?
AML
190
What is the reversal agent for factor Xa inhibitors (DOACs)?
Adexanet alfa
190
Give a subtype of AML with t(15;17) and is associated with DIC
Acute promyelocytic leukaemia
191
What secondary malignancy is associated with retinoblastoma?
Osteosarcoma
192
Why does total IgA need to be taken for coeliac?
Some patients are IgA deficient
193
How does dopamine affect renal artery flow?
Renal artery vasodilator
194
Clonal B cell population, ATM mutation, Del(13q14) -> which leukaemia?
CLL
195
What is the main cause of cramps in haemodialysis?
Fluid depletion leading to reduced perfusion of muscles
196
Which hormone is protective against endometrial cancer?
Progesterone
197
Give the management for endometrial hyperplasia without cellular atypia
6 month surveillance
then trial progesterone (IUS Mirena)
198
Which scan should be considered in children with recurrent UTIs?
DMSA scan for renal scarring due to recurrent UTIs
199
Which antibiotic classes block 30s subunit?
Tetracyclines
Aminoglycosides
200
What should be given alongside potassium replacement in hypokalaemia?
Hypomagnesaemia can be a culprit -> magnesium aspartate to retain potassium
201
What is given for menopausal symptoms with no uterus?
Oestrogen-only HRT
202
How to differentiate between sequential and continuous combined HRT?
<12 months symptoms -> sequential
203
How do you differentiate myelodysplasia and AML?
Bone marrow biopsy <20% blast cells
204
Which SSRI can be stopped immediately?
Fluoxetine due to long half life
205
Which drug class increases the risk of serotonin syndrome with SSRI?
Sumatriptan
206
What can CML transform into?
ALL, AML -> check blood cell count for blast cells
207
Which genetic mutation is myelofibrosis associated with?
JAK2
208
How is primary and secondary PCV differentiated?
Primary -> decreased erythropoietin
Secondary -> increased
209
What is the first line for PCV?
Aspirin
Weekly phlebotomy
210
What is a prognostic marker for Ewings?
LDH
211
What is given first line for antiphopholipid syndrome during pregnancy?
Aspirin
LMWH
212
When is oral olseltamavir given for influenza A?
At risk groups presenting within 48h of symptom onset
213
Give a first line prophylaxis for Menieres
Betahistine
214
Which ENT cancer is HPV associated with?
SCC oropharynx
215
What is first line for finger flexion deformity?
Physio
Finger splint to allow tendon to heal
216
What is first line for classical Hogkin's?
Chemotherapy
217
What is a hallmark marker in tumour lysis syndrome?
Urate
218
Lymphocytosis, thrombocytopenia, normocytic anaemia, reduced reticulocyte -> which diagnosis?
ALL
219
What is given long term for hereditary spherocytosis?
Folic acid
220
Which organism is associated with aplastic crisis after splenectomy?
Parvovirus B19
221
What is seen on ECG in West Syndrome (Saalam attacks, head, neck and trunk contractions)?
Hypsarrythmia
222
What is seen on histology for both DIC and TTP?
Schistocytes
223
Which type of hypersensitivity reaction is hyper acute rejection?
Type 2
224
Most important HLA alleles to match in transplant?
HLA-A, HLA-B, HLA-DR
225
Why does
226
How is scleritis and episcleritis differentiated?
Topical phenylphrine
227
What is the most common causative organism in lichen planus? + what can it change to?
Longstanding cases can change into SCC
228
When is jaundice always pathological in newborns?
Within 24h -> sepsis, severe haemolysis
229
Give 2 causes of physiological jaundice (enzyme + blood)
1. Reduced activity of UGT -> decreased efficiency of bilirubin conjugation
2. Foetal RBC have shorter half life
230
How is thalassaemia and iron deficiency anaemia differentiated in bloods?
Thalassaemia -> Low Hb, low MCV, normal RBC
Iron deificiency anaemia -> low all three
231
How is vWD differentiated with clotting screen?
vWD (platelet adhesion and VIII activity) has normal clotting screen
232
What is seen on blood smear in AML vs ALL?
AML -> blast cells
+ leukocytosis, thrombocytopenia
233
How do you differentiate physiological jaundice and breast milk jaundice?
Physiological -> few days
Breast milk -> few weeks
234
How to differentiate TRALI and TACO?
TRALI only has respiratory distress
TACO -> fluid overload symptoms
235
What is the pathophysiology of haemolytic transfusion reaction + febrile + allergic reaction?
Haemolytic -> immune against donor RBC, ABO incompatibility
Febrile -> Antibiodies against donor leukocytes
Allergic -> Plasma proteins
236
Which 2 diseases is pyoderma gangrenosum associated with?
IBD
RA
237
When is 6 in 1 vaccine given?
8, 12, 16 weeks
238
Which type of anaesthetics is malignant hyperthermia associated with?
Inhaled
239
What is first line for fibroids without surgery?
Selective progesterone receptor modulator (e.g. ulipristal acetate)
240
What is required pre-intubation in OSA and obesity?
Pre-oxygenation 100%
241
Which condition is scleritis associated with?
RA
242
What is the first line antihypertensive agent in pregnancy?
Nifedipine
243
Which two blood tests are required before starting lithium?
U+Es
TFTs
244
Palliative analgesia with renal impairment -> which analgesia?
Oxycodone (hepatic excretion)
245
Pes planus, PMP22 gene mutation -> diagnosis?
Charcot Marie Tooth disease -> hereditary motor and sensory neuropathy
246
Give the weeks for the closure of the anterior + posterior fontanelles
Anterior - 7-18 months
Posterior - within 2 months
247
Which 2 syndromes are port wine stains associated with?
Sturge-Weber -> too many capillaries in meninges
Klippel-Trenauney -> limb hypertrophy,
248
What is the newborn hearing test? + Second line?
Otoacoustic emission test
Auditory Brainstem response test
249
Which type of hypersensitivity is ITP?
Type 2 -> IgG against platelets
250
Hair on end, Howell Jolly body, target cell -> diagnosis?
beta-thalassaemia
251
What is the gold standard for beta thalassamia major?
Hb electrophoresis
252
What is the only curative option for beta thalassaemia major?
Stem cell transplant
253
Which supplement is given with blood transfusion?
Folate
254
What is given with blood transfusion to prevent haemochromatosis?
Desferroxamine
255
What is SPINK1 + MYH-7 associated with?
SPINK1 -> acute pancreatitis
MYH-1 -> HOCM
256
How long for chronic suppurative OM?
>2 weeks
257
What is the long term risk for depo-vera contraception?
BMD loss
258
psoriasis -> later develops synovitis -> next step?
Urgent referral to rheum
259
Which STI is tabes dorsalis associated with?
Syphilis
260
What is the newborn chest compression ratio?
3:1
261
What is the advice for impetigo in terms of contamination?
48h of AB
Crusted over
262
What is the incubation of chickenpox? + advice for school?
21 days
Off school until last lesion has crusted over
263
What prophylaxis is given for CF?
Flucloxacillin for staph aureus
264
For palliative nausea with raised ICP -> which antiemetic is used?
Cyclizine plus steroids
265
Which antiemetic post op?
Ondansetron
266
How is EDD calculated?
LMP 1st day + 1 year, 7 days - minus 3 months
267
What is a common side effect of cisplatin?
Peripheral neuropathy
268
What is the ratio for oral:SC morphine?
2:1
269
How do you calculate breakthrough after converting to SC morphine?
1/6 of 24h requirement
270
Baby has SVT arrhythmia -> what is first step?
Ice water submersion
271
Which anaemia is associated with basophilic granules?
Sideroblastic anaemia
272
What blood result can linezolid cause?
Thrombocytopenia
273
Which investigation is used to diagnose PE in sickle cell disease?
V/Q Scan
274
What investigation to check before starting ondansetron?
ECG (prolongs QT)
275
