Past Paper Questions Flashcards by Emily Deurloo

neutrophils in myelodysplastic syndrome

hypogranulation and hyposegmented neutrophils

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Smear cells on blood film

CLL

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neutrophils in megaloblastic anaemia

hypersegmented neutrophils

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rank cancers as cause of death in men

1 lung
2 prostate
3 colon

(breast least likely)

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5 stages of eosophageal adenocarcinoma progression

Reactive
metaplasia
low grade dysplasia
high grade dysplasia
adenocarcinoma

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Na and K in Conns

(high aldosterone) high sodium low patassium (high BP)

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Evolocumab

PCSK9 antibody reduces LDL

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Dry mouth, dry eyes, anti ro, anti la, speckled pattern

Sjogrens

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JAK2 V617F mutation

Polycythaemia Vera

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Spherocytes on blood film, coombs +ve

Autoimmune haemolytic anaemia

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Which coag factor falls most rapidly after starting warfarin

(CR) 7 > 9 > 10 > 2

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therapeutic anticoagulation during pregnancy

LMWH

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Imatinib

CML - in chronic phase

ALL if 9;22 translocation

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kappa and lambda light chains

Multiple myeloma

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Reed sternberg cells

Hodgkins lymphoma

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temp for platelet storage

room temp

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Venetoclax

BCL2 inhibitor induces apoptosis (used in CLL)

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smear cells CD5 and CD18 +ve

B cell CLL

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commonest primary tumour of the heart

atrial myxoma

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most likely cause of mobile mass in breast

fibroadenoma

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commonest malignant breast cancer

invasive ductal carcinoma

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What type of emphysema is associated with smoking?

centriobular

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what type of emphysema is associated with alpha 1 antitrypsin deficiency

Panacinar

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most common primary cause of nephrotic syndrome in adults

Focal segmental glomerulosclerosis

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most common secondary cause of nephrotic syndrome in adults

diabetes

most common cause of portal vein thrombosis

malignancy

organism causing pneumonia with blood sputum in alcoholic and diabetics

Klebsiella Pneumoniae

male version of ovarian dysgeminoma

Seminoma

most common histological type of oesophageal cancer in UK

adenocarcinoma

goblet cells present in barret's

intestinal metaplasia

goblet cells NOT present in barett's

gastric metaplasia

vascular tumour associated with HHV8 infection

Kaposi Sarcoma

commonest cause of myocarditis

viral infection

raised AMA in what liver disease

Primary Biliary Cirrhosis

temporal encephalitis

Herpes Simplex Virus

most common cause of hypocalcaemia in community

Vit D def

liver enz specifically suggesting obstructive jaundice

ALP

liver enz specifically suggesting hepatic jaundice

AST and ALT

which adrenal zone produces aldosterone?

Zona glomerulosa

which adrenal zone produces cortisol?

zona fasciculata

which adrenal zone produces androgens?

zona reticularis

which adrenal zone produces noradrenaline

medulla

What condition occurs in both MEN1 and MEN2A

Parathyroid hyperplasia

What conditions occur in both MEN2A and MEN2B

Phaeo | Medullary thyroid carcinoma

Conditions in MEN1

PPP Pituitary adenoma Parathyroid hyperplasia Pancreatic tumours

Conditions in MEN2A

PPM Parathyroid hyperplasia Pheaochromocytoma Medullary thyroid carcinoma

Conditions in MEN2B

PMMM Pheaochromocytoma Medullary Thyroid Carcinoma Marfanoid body Mucosal neuromas

what enz does allopurinol inhibit?

Xanathine oxidase

What vit def causes pellagra?

Niacin

What vit def causes anaemia and neuropathy?

Vit E

What vit def causes clotting abnormalities=

Vit K

What vit def causes dermatitis and anaemia?

Vit B6

which hormone increases urinary phosphate excretion?

PTH

confirm pancreatitis

serum lipase

hypercalcaemia in sarcoidosis

1 alpha hydroxylase release by activated macrophages

commonest cause of hypercalcaemia in community

Primary hyperparathyroidism

hormone produced by fat cells with receptors in hypothalamus

leptin

deficiency of what plasma protein in liver disease and mvmnt disorder

Ceruloplasmin

fully differentiated b cell that produces antibodies

Plasma cell

what condition invloves upper and lower airways, kidneys, ANCA positive with cytoplasmic staining for proteinase 3?

Wegener's Granulomatosis (GPA)

ANCA positive with perinuclear staining for myeloperoxidase

Microscopic Polyangitis

reactivation of human polyoma virus t (john cunningham virus)

Progressive Multifocal Leukoencephalopathy

MEFV gene mutation

Familial mediteranian fever

measure what before azathioprine use?

Thiopurine Methyltransferase (TPMT)

neutrophils fail to oxidise dihydrorhodamine (DHR)

Chronic granulomatous disease

antibody isotype for food allergy

IgE

antibody isotype in secretions

IgA

Antibody isotype in primary response

IgM

Antibody isotype in secondary response

IgG

IL2RG mutation encoding IL2 common gamma chain

X linked SCID

CAR-T cell for what cancer cell type?

B cells

Bare lymphocyte syndrome affecting HLA class II - what def?

CD4+ T cells (T helper cells)

Bare lymphocyte syndrome affecting HLA class I - what def?

CD8+ T cells (cytotoxic T cells)

mutation of CD40 ligand

Hyper IgM syndrome

Denosumab

monoclonal antibody for RANKL used to treat Osteoporosis

IgA specific for TTG

coeliac

class of abx - conc dependent killing

aminoglycosides

gram -ve bacilli causing fever and abdo pain after trip to india, Malaria neg, what abx?

Salmonella? Ceftriaxone

gram +ve rods in CSF of elderly woman

Listeria monocytogenes

which human herpes virus is associated with post transplant lymphoproliferative disorder ?

EBV (Human herpes virus 4)

yeasts in CSF of HIV patient

cryptococcus neoformans

Rice water stool

Vibrio Cholera

which virus in first 20 weeks of pregnancy causes hydrops fetalis

Parvovirus B19 (slapped cheek)

mucomycosis antifungal therapy

amphotericin B

4 year old with bloody diarrhoea and HUS

E coli 0157:H7

what is the cause of beta thalassaemia major

decreased production of beta globin chains

auer rods on blood film

AML

left shift

increase of immature cells

toxic granulation

bacterial infection

factors in cryprecipitate

8 ,13 and vWF

factos in FFP

Fibrinogen and all coag factors

young girl with leg pains, palor, bruising, lymphadenopathy and blood film shows 80% blast cells

ALL

smoker with high Hb, normal RBC mass, low plasma volume

relative polycythemia

neutropenic sepsis secondary to myelodysplasia presents with pancytopenia, and blood film with numerous large primitive cells

Progression to myelofibrosis

DOAC monitoring

none

LMWH monitoring

none

Warfarin monitoring

INR

Unfractionated heparin monitoring

APTT or Anti Xa assay

acute graft v host disease mediated by which cell type

donor t cells

symptoms of multiple myeloma

CRAB Calcium Renal failure Anaemia Bone lesions

therapy for CML with philadelphia translocationin chronic phase

imatinib (ABL1 tyrosine kinase inhibitor)

which blood stuff decrease in pregnancy

``` Hb Hct Plt Factor 2 Protein S ```

Ann arbor stage 1

hodgkins one LN region

Ann arbor stage 2

Hodgkins 2 or more LN on same sid eof diaphragm

Ann arbor stage 3

hodgkins 2 or more LN on either side of diaphragm

Ann arbor stage 4

hodgkins 2 or more LN on either side of diaphragm and organ mets

what type of necrosis is associated with MI?

coagulative necrosis

most common ovarian tumour

serous cystadenoma

most common testicular cancer

germ cell testicular cancer (seminoma)

extradural haemorrhage blood vessel

middle meningeal artery

subdural haemorrhage blood vessel

bridging veins

subarachnoid haemorrhage blood vessel

berry aneurysm at carotid bifurcation

virus associated with nasopharyngeal carcinoma

EBV

pulmonary oedema due to liver disease

decreased osmotic pressure (low albumin)

commonest cause of ARDS in adults

sepsis

commonest glial cell in CNS

astrocytes

commonest cause of mitral valve stenosis

Rheumatic heart disease

inheritance of haemochromatosis

autosomal recessive

inheritance of Wilsons

Autosomal recessive

Inheritance of alpha 1 antitrypsin deficicency

Autosomal dominant

commonest cause of pancreatitis

gallstones

brain tumor at surface asymptomatic

meningioma

commonest skin cancer

basal cell carcinoma

low Na, high K, low bicarb,, lowish glucose

addisons --> renal loss of Na causing H retention --> metabolic acidosis

AST:ALT alcoholic cirrhosis

2:1

AST:ALT viral hep

1:1

Quinine glucose effect

hypoglycaemia

glucagon

release glucose into blood

clinical features of hypercalcaemia

Stones Bones Groans Moans

macro vs micros pit adenoma

micro <10mm | Macro >10mm

mild prolactin elevation | <1000

``` stress recent breast exam vaginal exam hypothyroidism PCOS ```

moderate prolactin elevation >1000 <5000

``` hypothalamic tumour non-functioning pituitary adenoma microprolactinoma PCOS drugs ```

extreme prolactin elevation | >5000

macroprolactinoma

PPH low pit hormones

Sheehan syndrome (hypopituitarism)

Obstructive jaundice

incr conj bili red urobili pale stool dark urine

haemolytic jaundice

raised LDH red haptoglobin raised urobili raised unconj bili

what binds receptors in adrenal and stimulates aldosterone release

Ang II

what convertes Ang I to ang II

ACE produced by lungs

what converts angiotensinogen to ang I

Renin

where is angiotensinogen produced

liver

in ab mediated rejection of renal allograft where is inflmmatory infiltrate seen?

Capilaries

cells infected by HIV

CD4 t cells

HIV gp120

initial binding

HIV gp41

conformational change

conjugate vaccines

N meningitidis H influenzae Strep pneumonia

high ANA, +ve dsDNA antibody, low C3 and C4

SLE

gastric parietl cell abs

pernicious anaemia

coombs type 1 hypersensitivity rxn

igE mediated mast cell histamine release

coombs type 2 hypersensitivity rxn

igG/IgM to cell/matrix antigen

coombs type 3 hypersensitivity rxn

igG/IgM to soluble antigen

coombs type 4 hypersensitivity rxn

T cell mediated

failure to regulate cryopyrin driven activation of neutrophils

Familial mediteranean fever

Pembrolizumab (anti-PD1)

Keytruda enhances T-cell immunity and used in mx of some cancers (NSCLC, melanoma, bladder cancer, Hodgkins lymphoma)

Rituximab (anti-CD20)

depletes mature B-cells

b-DMARD for RA mx

Adalimumab (anti-TNFalpha)

standard immunosuppressive regimen for transplant pts

CNI + MMF/aza +/- steroid

CNI

Tacrolimus | Cyclosporin

MMF

Mycophenolate mofetil blocks T>B cell prolif via blocking nucleotide synthesis

Azathioprine

prevents T>Bcell activation/prolif via blocking purine synthesis measure TPMT before starting

what chemokine receptor promotes dendritic cell migration to LNs

CCR7

Plasmapheresis

severe type 2 disease Goodpastures (anti GBM) Myasthenia Gravis (anti AchR) Vascular rejection Ab mediated rejection

close contact with TB - what is lifetime risk?

10%

what % of world have TB

33%

Legionella abx

Macrolides (Azithromycin) | Quinolones (ciprofloxacin)

hep worse in pregnancy

Hep E

seroogical test for candida

Beta-D-glucan

serological test for aspergillus

galactomannan

serological test for syphilis

TPPA (treponema pallidum particle agglutination)

Widal test

typhoid paratyphoid

food poisoning organism in honey or canned beans

clostridium botulinim

enteric fever constipation and rose spots

salmonella typhi

undercooked chicken and bloody diarrhoea

campylobacter jejuni

severe malaria tx

IV artesunate

mild malaria tx

Riamet = artemether + lumefantrine

Hep B antiviral

tenofovir

Rat bite fever

Streptobacillis moniliformis

Q fever

coxiella burnetti

syphilis

treponema pallidum

Lyme disease

borrelia birgdoferi

bacillary angiomatosis

bartonella henselae

commonest form of prion disease

sporadic CJD

refer to coroner if

unknown cause of death not seen by dr in last illness or last 28 days death in custody detained under MHA

hierarchy of consent (family)

``` Partner/spouse Parent/child Sibling Grandparent/grandchild Nephew/neice step parent half sibling friend of long standing ```

p ANCA anti myeloperoxidase

Microscopic polyangitis

c ANCA anti proteinase 3

Granulomatosis with Polyangitis

routine test shows raised WCC, Neutrophils and Basophils

CML

Carbimazole side effect

agranulocytosis

Spleen in Ann Arbor staging for hodgkins lymphoma

= Lymphoid (so if theres mets then still considered stage 3)

hypogranular hypolobulated neutrophils

myelodysplastic syndrome

raised Hb A2

Beta thalassaemia

globins that make up Ab A2

2 alpha and 2 gamma globins

pancytopaenia Tear drop poikilocytes primitive cells

Myelofibrosis

liver mass with raised AFP

hepatocellular carcinoma

lesion with eosinophilic cytoplasm, intercellular bridges, intracellular keratin formation

squamous cell carcinoma

Pt without ABO grouping need plasma of what group?

AB (so no anti A or B abs are present)

villous atrophy, lymphocyte infiltrate, crypt hyperplasia

coeliac disease

haemangioblastomas in cerebellum and retina, renal cell carcinomas, cysts of pancreas and kidneys

Von Hippel Lindau

giant cell astrocytoma; cortical tuber; supependymal nodules and calcifications on CT

Tuberous Sclerosis

Sjögrens salivary gland bx

CD4 +ve T cells

hypoglycaemia tx with no IV access

IM/SC glucagon

asymptomatic hyperbilirubinaemia

Gilberts

Positively birefrinent crystals in knee

Pseuogout

18 yo died with hypertrophy of interventricular septum

hypertrophic obstructive cardiomyopathy

which WBC has granulers with myeloperoxidase and ALP

Neutrophils

clear cell carcinoma origin

Kidney

congo red +ve with apple green birefringence

Amyloid

mouldy grain + hepatocellular carcinoma

Afla toxin from aspergillus flavus

ALP > 500 in bone disease

Osteomalacia, pagets

ALP < 500 in bone disease

cancer

overdose with respiratory alkalosis

Aspirin

low calcium, low phosphate, high PTH

secondary hyperparathyroidism

dihydrorhodamine test

chronic granulomatous disease

congenital adrenal hyperplasia enz deficiency

21 hydroxylase

FMF tx

Colchicine

max number of HLA mismatches in parent to child organ donation

chance of perfect HLA match from sibling donor

25%

chance of HLA mm of 3 from sibling donor

50%

chance of HLA mm of 6 from sibling donor

25%

mutation in hyper IgM

CD40L

low Cd4+ve cells and no class switching

bare lymphocyte syndrome type 2

low Cd8+ve cells and normal IgG levels

bare lymphocyte syndrome type 1

cytokine in ankylosing spondylitis

TNF alpha | IL 17

linear deposits of ab along glomerular basement membrane

goodpastures

immune cell type deficient in DiGeorge

Tcells

CSF test for cryptococcus neoformans

India ink stain

urinary antigen test

legionella | strep pneumoniae

cytokine promoting terminal differentiation of eosinphils

IL5

Meningitis tx with cover

Ceftriazone + ampicillin cover for Listeria +/- acyclovir for encephalitis

2 day old CSF gram -ve bacilli

e coli

CoNs causing UTI

staph saprophyticus

dsDNA virus in transplant pts causing nephritis

BK virus

fever, abdo pain, constipation, gram -ve rod

salmonella typhi

helminth

strongoloidies

fetus exposure -> sensorineural deafness, eye abnormalities, congenital heart disease

rubella

Past Paper Questions Flashcards

(234 cards)