Past Papers Flashcards
(206 cards)
1
Q
Womanly man, small balls, libido lacking?
Any mention of male with sparse pubic hair, gynaecomastia and small testes also
A
Kleinfelters
2
Q
Acute MI after stenting and stopping clopidogrel? Re-stenosis or in-stent thrombosis?
A
In-stent thrombosis
Re-stenosis takes much longer
3
Q
Sounds like cauda equina with lower limb weakness but INCREASED tone?
A
Conus medularis syndrome
4
Q
Concurrent single genital ulcer with lymphadenopathy?
A
LV
(Shyphilis lymphadenopathy presents later)
5
Q
Antibiotic preference in legionella
A
Modern quinolone e.g. levofloxacin
Macrolides are an alternative
6
Q
Side effects of retinal photocoagulation?
A
Tunnel vision, colour loss
7
Q
Acute onset AF, no heart disease?
A
Flecanaide
8
Q
Earliest helpful investigation in RA (imaging)
A
Colour doppler
9
Q
Where is phosphate reabsorbed?
A
Proximal tubule
10
Q
PPH poor prognostic factors
A
Raised BNP
Arrhythmia
RHF/hypertrophy
11
Q
Largest component of bile?
A
Bile salts
12
Q
Which part of the kidney is impermeable to water?
A
Ascending loop of henle
13
Q
Long term bronchiectasis/chronic inflammatory condition and then develops kidney failure?
A
Think amyloid
14
Q
Blistering skin condition in the sun in an alcoholic, often with raised AST/ALT and ferritin?
A
PCT
15
Q
Thyroid cancer much higher risk in hashimotos patients?
A
Lymphoma
16
Q
First line for schitstosomiasis?
A
Praziquentel
17
Q
Best treatment of worsening lupus nephritis?
A
MFM
18
Q
TB drug most commonly assoc with eye disease?
A
Ethambutol
19
Q
Mild genotype in A1AT?
A
MZ
20
Q
Therapy of choice in anti-GMB renal disease?
A
Cyclophosphamide
21
Q
Where is the ostium of the coronary sinus?
A
RA
22
Q
Small bowel angiodysplasia and heart murmur?
A
Heyde’s disease - AS
23
Q
Frontal lobe stroke symptoms?
A
Distal anterior cerebral artery
24
Q
Fluconazole and verapamil together and constipation
A
FLuconazole may have increased serum verapamil and caused it
25
Vomiting 7-8hrs post rice?
Bacillus ceres
26
Occular tumour in VHL?
Hemangioblastoma
27
Ciclosporin action?
Anti-IL-2
28
Hormone under constant feedback?
Prolactin
29
Schistosoma mansoni and haematobium, which assoc with bladder Ca and which with hepatic fibrosis?
Haematobium bladder Ca - (bladder Ca bleeds (haem))
30
Pupil in syphilis?
Argyll Robertson
usually bilateral
31
Mention of shawl-like distribution of sensory loss?
Syringomyelia
32
What time is cortisol lowest?
0000
33
First line treatment for WPW (non-acutely)
Ablation
34
Massive uric acid levels despite either allopurinol or fexobustat?
Add benzbromarone
35
Cyclophosphamide action
Anti-Tcell
36
Ambrisentan mechanism?
Endothelin B antagonist
37
What can be added in psoriatic arthritis after MTX and another DMARD?
ANti-TNF e.g. golimumab/infliximab/adalimumab/etanercept
38
Renal biopsy in GPA?
Pauci immune!
39
Hasnt tried continuous HRT, or is within 2 years of last period?
Sequential HRT
40
Hyperkalaemic metabolic acidosis with worsening of potassium on ACEi?
RTA type 4
41
Gonorrhoea and penicillin allergy?
High dose azithromycin once off
42
Neglect mentioned? Which lobe affected and which side
Contralateral parietal lobe
43
How do you prevent stones in someone with medullary sponge kidney?
Large fluid intake
44
What is a 7th nerve palsy? Treatment?
Bells
Steroids
45
Single thyroid nodule (symptomatic) in woman with completed family and older children?
Radioiodine
46
Paget's treatment
IV!!! bisphosphonates
47
Soil contamination wound?
Clindamycin
48
Eye changes in NFM?
Lisch nodules
49
What do microRNAs do?
Silence mRNA
50
What often drops with IV quinine treatment for malaria?
Glucose
51
Schistosomiasis treatment?
Praziquantel
52
Short fourth and fifth metacarpals?
Pseudohypoparathyroidism
53
Herceptin (trastuzumab) major adverse effect?
Cardiac failure
54
Deletions assoc with poor prognosis in CLL?
17q
p53
55
Genetic features assoc with better prognosis in CLL?
13q
Trisomy 12
56
Treatment for Waldenstrom's?
Rituximab-containing chemo regime
(if you see a chemo plus rituximab it's that)
57
Most sensitive area in response to hypoxia?
Carotid body
58
Earliest detectable test for HIV infection?
RNA
59
Osmolality equation?
(2 x Na) + (2 x K) + urea + glucose
60
Bacteria often found in dog bites
Pasturella
61
Endovascular coil or neurosurgical clipping preferred in intracranial aneurysm?
Coil
62
Live vaccines?
Yellow fever
BCG
MMR
Influenza
VZV
63
Long term prevention for cluster headaches?
Verapamil
64
Thinking pathway for AV replacement?
If fit, either mechanical or bioprosthetic valve. If a contraindication to anticoagulation - bioprosthetic.
If not fit for surgery - TAVI.
65
Treatment for cyclosporidium?
Co-trim
66
Antibiotic treatment in culture negative peritonitis?
Intraperitoneal vanc plus oral cipro
67
What can you give to protect the bones in a Turners patient?
HRT
68
First line preventative measure in congenital long QT?
BB
69
First and second line for reactive arthritis?
NSAIDs
Then steroids
70
What to add to SU in MODY if needs further intervention?
Insulin, usually long acting in first instance
71
Aspirin mechanism?
COX 1 AND COX 2
72
Immunotherapy in Grave's eye disease?
Tocilizumab
73
APML gene?
15:17
74
MODY with renal cysts?
MODY-5
75
First line in JME?
When might you want to use something else and what would you use?
Valproate
Older girls - risk to a foetus. Leviteracitam istead
76
Prominent x and y descents?
Restrictive disease
77
Most prone side of the heart for healthy individuals?
Left side (high pressure)
Right side in IVDU
78
Young man with progressive unilateral optic neuropathy, eventually other eye involvement, +/- proximal muscle features and increased tone?
Leber's hereditary optic myopathy
79
How long off driving after ICD shock?
6 months
80
When to check lithium level after starting?
5-7 days
81
Where most affected in Wilson's?
Basal ganglia
82
von Willebrand chromosome?
12
83
Depression with significant somnolence?
Venlafaxine
84
Main treatment for ank spon?
Adalibumab
85
Antifreeze antidote?
Fomepizole
86
Most common GI cause of GBS?
Campylobacter
87
Vaginal flora mostly made up of?
Lactobacilli
88
Crossed neurological signs after stroke? Lesion must be in the ...
Brainstem
89
Best test of respiratory muscle weakness in GBS?
FVC
90
Dense fibrous tissue replacing the thyroid?
Riedel's
91
HIV nephropathy type
COLLAPSING (like the immune system)
92
Gallop rhythm an early sign of?
LVH
93
SGLT2 location of action?
Early proximal tubule
94
Most specific finding in pericarditis?
PR depression
95
AML good prognosis genetic finding?
t15:17 (APML)
96
Negative predictive value equation?
TN / (TN + FN)
(think all the negatives, comparing the actual negatives with all the negative results)
97
Most common endocarditis organism? What if within 2 months of replacement?
Staph aureus
Staph epidermis
98
Goodspastures and ANCA GNs, which type?
Rapidly progressive
99
First line treatment for ABPA?
Steroids
100
What inhibits prolactin?
Dopamine
101
What is contralateral in Brown-Sequard?
pain and temperature loss
102
What's high in PCT?
What about AIP?
Urine UROporphyrinogen
Urine PORphobilinogen
103
What produces IL-1?
Macrophages
104
What does troponin I bind to?
Actin
105
Phenytoin mode of metabolism? What else uses this?
Zero-order
Alcohol, salicylates
106
Most common photosensitivity drug cause?
Thiazides
107
What is inserted in response to ADH?
Aquaporin-2 channels
108
Chancroid microbial
H. ducreyi
109
Cryptosporidium test?
ZN stain on stool
110
TR change in JVP waveform?
Prominent V waves
111
Anti-NMDA cancer assoc?
Ovarian teratoma
112
Type 1 and 2 cryo, assoc with what?
Type 1 - Monoclonal IgG/IgM diseases, lymphoproliferative syndromes
Type 2 - AI disease/ IDs. Polyclonal IgGs/IgM
113
Good stuff for cancer oral pain?
Benzydamine mouthwash
114
Toxin in paracetamol overdose?
NAPQI
115
First line for rosacea?
Topical metronidazole
116
Sensitivity equation?
TP / TP+FN
117
Most commonly affected gene in congenital nephrogenic DI?
Vasopressin
Second most Aquaporin 2
118
Burkitts gene
8:14
119
Tear drop cells?
Myelofibrosis - think of marrow trying to squeeze cells out of dry marrow
120
Earliest XR change in RA?
Juxta-articular osteoporosis/osteopenia
121
Renal transplant + infection, think...
CMV
122
S4 coincides with?
P wave
123
Thinking toxoplasmosis but only one lesion and homogenously enhancing?
CNS lymphoma
124
Barters vs Liddles vs Gitelmans
All hypokalaemic
Liddles causes
Barters HIGH calcium (Big C)
Gitelmans causes LOW calcium (Gone C) and LOW magnesium
125
Alports inheritance?
X-linked dominant
126
Itchy white spots on the vulva of old woman?
Lichen sclerosus
127
Idiopathic MG antibody?
APLA2
128
TB drug induced lupus?
Isoniazid
129
Goodpastures collagen type?
4
130
Dermatitis herpetiformis HLA association?
HLA - DR3
131
CD on Reed-Sternberg cells?
CD15
132
What should you give in cocaine induced MI alongside ACS Rx?
IV benzos
133
Drug causing corneal opacities?
Amiodarone
134
Somatostatin produced where?
D cells
135
Which stage of cell cycle dictates the length? (p53 acts on this part)
G1
136
Most common cause of CAH?
21-hydroxylase def
137
Pityriasis rosea implicated virus?
Herpes 7
138
Whats wrong in Fanconi syndrome?
Global lack of resorptive defect in PROXIMAL tubule
139
Triangle of safety borders?
Lateral pec major
5th intercostal space in axilla
Anterior border of latissimus dorsi
140
Brugada gene?
SCN5A
141
Widening of the wrist joints?
Rickets
142
Microtubule function?
Help guide movement during intracellular transport and also help bind internal organelles
143
Hyperthyroid and patchy gland uptake?
Toxic multinodular goitre
144
Mucopigmentation and polyps/GI cancer?
Peutz-Jeghers
145
Where does RNA splicing happen?
Nucleus
146
ADAMTS13?
TTP
147
Inf STEMI?
RCA
148
Range of inherited heart diseases but the deaths appear while sleeping/overnight?
Brugada
149
Furosemide primarily reduces preload or afterload?
Preload
150
Achondroplasia inheritance?
AD
151
3 steps of haemoglobin metabolism
Haem -> biliverdin -> bilirubin
152
IV therapy in serotonin syndrome?
Cyproheptadine
153
Young woman, perhaps sportsperson, pain swelling of forefoot?
AVN of 2nd metatarsal head (Freibergs)
154
If duchenne and becker both options in the question, how to separate?
DMD far more severe, similar features
155
Impetigo first line?
Topical mupirocin/fucidin
156
Alports what is abnormal?
T4 collagen
157
Bad antibiotic in AIP?
Erythromycin
158
What can you not drink with a statin?
Grapefruit juice
159
Threadworn treatment
Mebendazole
160
Drug-induced lupus autoantibody?
Anti-histone
161
Initial PD therapy if trying to avoid dopamine-agonist SEs e.g. gambling?
Procyclidine
162
Anti-LKM2?
AI hepatitis
Drug-induced hepatitis
163
Calcineurin inhibitors target?
IL-2
164
Chronic psoriasis HLA?
CW6
165
RA treatment and pancytopenia and terrible renal impairment?
d-penicillamine
166
Purely a winging of the scapula, what is injured?
Long thoracic nerve
167
Young person with bad sounding presentation/B symptoms and nephrotic syndrome?
Minimal change
168
Ondansetron mechanism?
5-HT3 antagonist
169
Percentage of patients whose renal function will recover after dialysis for ATN?
95%
170
Biggest type of bias problem in meta-analysis?
Publication
171
Psychotic features in PD? Try
Olanzapine
172
Itching in liver failure?
Cholestyramine
173
HNPCC mutation?
MSH2 (no polyps, just cancer)
174
First line treatment of acute hep B in a well person?
Observe and repeat testing
175
Upper GI ulcers in HIV?
Think CMV - valganciclovir
176
Want to compare outcomes from two groups of decent size and with normal distribution?
Students t-test
177
Ipsilateral CNIII palsy and contralateral hemiplegia? Which artery
Weber syndrome (middle medullary sydrome)
Posterior cerebral artery (leads to midbrain infarcation)
178
Very useful endocrine blood test to differentiate between acute and chronic renal failure?
PTH
Normal implies acute disease with 90% confidence
179
What first before surgery for macroprolactinoma?
Cabergoline
180
What is the resistance in factor V leiden?
Protein C
181
First test for MND?
EMG
182
Rasburicase mechanism?
Recombinant urate oxidase
183
Guideline for contact sports post EBV?
4 weeks
184
Comparing two proportions? Which two tests? Which is more accurate?
Fisher - very complex but significantly more accurate
Chi-squared
185
Comparing two large groups with skewed distribution?
Mann-Whitney
186
ARVT causing anaemia?
Zidovudine
187
Why can ETOH cause hypoglycaemia?
Increased insulin generation
188
Most common SBP organism?
E coli
189
Nasty sounding lesion described at the margin of a chronic venous ulcer?
SCC
190
Description of mixed depressive and schizophrenic-like periods?
Schizoaffective disorder
191
BRCA1 & 2 cancers?
Breast
Ovarian
Pancreas
Prostate
192
Autoimmune disease, triggered bleeding and massively prolonged APTT?
Think acquired haemophilia A
193
AED safe in heart block?
Primidone
194
Travel, unwell, salmon-pink rash?
Typhoid
195
Travel, appalling muscle/bone pains, very high fever?
Dengue
196
Which subunit in most common long QT?
Alpha
197
Testicular teratoma marker?
AFP
198
Anti TB peripheral neuropathy?
Isoniazid
199
Evanicumab
ANGPTL3
200
Good initial intervention for mania?
Risperidone
201
Crossed neurological signs so thinking brainstem lesion, describes lateral rectus (abducens) palsy?
Medial pontine syndrome (medial pons)
202
First line DMARD in eczema/psoriasis?
Ciclosporin
203
What do we like to give for cardioprotection in marfans?
Beta blocker, if not ARB e.g. valsartan
204
Where do foam cells originate?
Neutrophils
205
Haloperidol location of action?
D2-receptor antagonist. It has a central antiemetic action, binding to receptors in the area postrema
206
ISMN actioon?
Cyclic GMP
