Past papers Flashcards by Sarah Hoban

Management for ethylene glycol overdose

Fomepizole

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Burkitt’s lymphoma karyotype

T8:14

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What is the mode of inheritance and defect of Alport’s syndrome

X-linked dominant type IV collagen

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Screening for PKD

USS

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47-year-old female with a history of rheumatoid arthritis presents with a painful and red left eye

Scleritis

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Churg-Strauss syndrome serololgy

+ pANCA

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85-year-old lady presents to dermatology clinic complaining of itchy white plaques affecting her vulva and inner thigh

Lichen sclerosus

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Marfan’s syndrome is caused by a mutation in protein?

fibrillin-1

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Angiodysplasia is associated with which murmur?

Aortic stenosis

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Which TB medication can cause lupus?

Isoniazid

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Which organelle is responsible for the catabolism of long chain fatty acids?

Peroxisome

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Dermatitis herpetiformis is associated with

HLA-DR3

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Which cell surface marker is associated with Reed-Sternberg cells?

CD15

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What is the mechanism of cyanide toxicity?

Inhibits the mitochondrial enzyme cytochrome c oxidase

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myocardial territory is most likely to have been affected if heart block develops post MI

inferior

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Which phase in the cycle is influenced by p53 and determines the cell cycle length?

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Congenital adrenal hyperplasia is most commonly due to?

21-hydroxylase deficiency

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What is the first-line long term therapy to reduce the occurrence of sickle cell indicents

Hydroxycarbamide

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Bilateral spastic paresis and loss of pain and temperature sensation, what is affected

Anterior spinal artery syndrome1

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1st line management in aspirin overdose

activated charcoal within 1 hr

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Triangle of safety for chest drain insertion

Superiorly: base of the axilla.
Inferiorly: 5th intercostal space or level of the nipple.
Anteriorly: lateral edge of pectoralis major.
Posteriorly: anterior border of latissimus dorsi.

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Chlamydia psittaci is treated with

tetracyclines

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The fastest conduction velocities in the heart are in the

Purkinje fibres

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Functional residual capacity =

Expiratory reserve volume + Residual volume

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Meningococcal meningitis prophylaxis for contacts

Oral cipro

management to reduce the likelihood of haemorrhagic cystitis in non-Hodgkins pt receiving cyclophosphamide

Hydration + mesna

most common and severe form of renal disease in SLE patients

Diffuse proliferative glomerulonephritis

Where do SGLT-2 inhibitors work?

renal proximal convoluted tubule

Which oncogene is associated with Burkitt's lymphoma?

c-MYC

Management of severe alcoholic hepatitis

Pred

Antidiuretic hormone action

water reabsorption by the insertion of aquaporin-2 channels

28-year-old man painful gential ulcers, diagnosis and asscioated organism

Chancroid Haemophilus ducreyi

How is Cryptosporidium diagnosed

Ziehl-Neelsen staining of stool to reveal red cysts

Local anesthetic toxicity can be treated with

IV 20% lipid emulsion

Pan-systolic murmur which is best heard at the end of inspiration Murmur and associated JVP change

Tricuspid regurg Prominent V waves

Reflux nephropathy investgation

Micturating cystography

calcium, phosphate and PTH unaffected with ALP raised Diagnosis and management

Pagets zoledronate

low calcium and low phosphate with increased ALP and increased PTH. Diagnosis & risk factor

osteomalacia vegetarian

tenosynovitis, migratory polyarthritis, dermatitis Diagnosis

Disseminated gonococcal infectio

Unilateral Flashes + floaters diagnosis

posterior vitreous detachment

Which phase does vincristine act during

metaphase

Which spinal columns are affected in subacute combined degeneration of the spinal cord,

dorsal columns and lateral corticospinal tracts

Which part of the kidney is most affected in nephrogenic DI

Vasopressin receptor

Bisphosphonate action

inhibit osteoclasts

AF on warfarin with ICH, management

Vit K and prothrombin complex

Suspicious freckle on face or scalp of chronically sun-exposed patients pigmented and rapidly changing

Lentigo maligna melanoma

Thyrotoxic storm management

beta blockers, propylthiouracil and hydrocortisone

How do you differentiate between chronic myeloid leukaemia from leukaemoid reactions

leukocyte alkaline phosphatase score is low in CML, high in leukaemoid reaction

The time taken for an arteriovenous fistula to develop is

6-8 weeks

Cushing's syndrome VBG

Hypokalaemic metabolic alkalosis

Brain abscess management

IV Cefotaxime and metronidazole

Where is phosphate reabsorbed

proximal tubule

A high vaginal swab is performed and microscopy reveals stippled vaginal epithelial cells and the whiff test is positive. Diagnosis and organism

BV Gardnerella vaginalis

worse on resisted wrist extension/suppination whilst elbow extended

Lateral epicondylitis

management of eosinophilic oesophagitis

Dietary modification and topical steroids

Peripheral blood film findings in coeliac

Target cells and Howell-Jolly bodies

Metastatic bone cancer pain management

MST + refer for radiotherapy

Poor prognostic factors in AML

A age more than 60 M myeloblast more than 20% (> 20% blasts after first course of chemo) L cytogenetic location : deletions of chromosome 5 or 7 (Acute = 5 letters , myeloid = 7 letters )

Thyrotoxicosis with tender goitre

De Quervain's thyroiditis

Which glomerulonephritis is most associated with Goodpasture's syndrome?

Rapidly progressive glomerulonephritis

treatment of choice for allergic bronchopulmonary aspergillosis

PO glucocorticoids

Which meds cause toxicity due to zero order elimination

There is zero order in a HEAP Heparin Ethanol Aspirin Phenytoin

Which group of medications are associated with increased mortality in dementia patients

Anti-psychotics

Which meds cause photosensitive rash

SAT for a PHOTO: Sulphonamides/Sulphonylureas/pSoralens/Siprofloxacin Amiodarone/nsAids Tetracycline/Thiazides

What is raised in acute intermittent porphyria

urinary porphobilinogen

42-year-old woman with pseudoxanthoma elasticum which conditions is she at risk of

mitral valve prolapse and ischaemic heart disease

32-year-old female 3-week history of a mild rash on her face very sensitive to the sunlight two months postpartum Diagnosis and mangement

Acne rosacea Topical metronidazole/PO tetracycline

Which structure may overlie the L renal hilum

Tail of pancreas

Why can alcohol cause hypoglycaemia

Increased first phase insulin response

HOCM inheritance pattern

Autosomal dom

42 female with SLE, presents with dry eyes Diagnosis and +Ve antibodies

Sjorens Anti-Ro and Anti La

27 male, night sweats, weight loss, gential ulcers, arthralgia, red itch eyes diagnosis and management

Bechets (uveitis, oral and gential ulcers) Pred

46 female, HTN, T2DM swollen hands/fingers and increasing size of jaw investigation and diagnosis

IGF1 - raised Glucose tolerance test with GH measurements (GH >1) acromegaly

wasting of thenar eminence , reduced sentation over 2nd and 3rd fingertips nerve affected and condition

distal median nerve carpal tunnel

loss of sensation over dorsal and radial portion of hand, dorsal thumb and dorsal index finger, motor intact nerve affected

distal radial

History of CVD, sudden unilateral deterioration in vision pale retina on fundoscopy

CRAO

Police officer bitten by human, broken skin and blood drawn Management

Co-amox if <72h

Likely organism to colonate platelet transfusion

staph epidermidis

19 male, struggles to form relationships, tall, thin, sparse pubic hair, bilateral gynaecomastia Diagnosis and chromosomes

Klienfelter XXY

18 male, prolonged bleeding following tooth extraction, sister had similar thing Diagnosis and inheritance and prophylaxis

VWD autosomal dom desmopression prior to procedures

Test for infectious TB

Multiple sputum smear and culture

Marfans Murmur

pulmonary regurg

Lyme disease management

doxy

19 male atopic eczema, admitted with multiple itchy pustules, fever Diagnosis and management

eczema herpaticum IV aciclovir

DRB1 *04:01 *04:04 *10 *01:10

Loss of proprioception and vibration, upgoing plantars, optic neuritis

Vit B12 def

smoker bilateral lower limb weakness with increased tone and hyperreflexia

Conus medallaris

Digoxin MOA

Intracellular Na accumulation - inhibits sodium potassium exchange pump

male, unprotected sex in India, single painless ulcer on penis + lymphadenopathy Diagnosis and management

Lymphogranuloma Venereum Doxy

60 male returning from convention in Portugal, fever, joint/muscle pain, diarrhoea Diagnosis and managment

Legionnaires disease Levo

Diabetic retinopathy, has received full scatter pan-retinal photocoagulation, which visual defects may he have

tunnel vision reduced colour impaired contract sensitivity

45 returned from Russia, coryzal symptoms followed by fever , severe sore throat and nose bleeds. grey/white membrane over pharyngeal tissue diagnosis and management

Diptheria azithromycin

20 male, no PMH, sudden onset palps whilst drinking ECHO normal ECG shows new AF Haemodynamically stable Management

Flecanide

Amaurosis fugax artery affected

internal carotid

How frequently should you monitor bloods in stable diabetic

6 months

Poor prognostic factors in PPH

Elevated BNP Developing AF

70 male sudden onset vomiting, vertigo and R sided Horners , L sided loss of pain/temp in torso and limbs Diagnosis

R PICA

Phosphate reabsorption

prox tubule

Management of persistent ascites in liver pts

spiro

19 female, syncope, muscle cramps and tiredness hypokalaemia high bicarb high urine calcium diagnosis and management

Bartter syndrome K+ replacement

Calcium oxelate stone managemetn

thiazide diuretic

Abnormal resp test in obesity

exp reserve volume

25, UC rapidly growing ulcerated lesion on shin with necrotic centre diagnosis and management

pyoderma gangrenosum PO pred

61 female, HTN, DM sore throat, rash and mouth ulcers, conjunctivitis diagnosis

Steven Johnson syndrome

Acute promyelocytic leukaemia management

all-trans retinoic acid

Blood test following acute allergic reaction

trypase

Gene associated with breast, prostate and pancreatic ca

BRCA2

45 male weight gain, HTN, acne, elevated fasting glucose diagnosis and investigation

24h cortisol Cushings

Causes of exudate and transudate effusion

exudate: malig and infection transudate: failures

Which human leukocyte antigen is associated with psoriasis

B27

management of rocacea

1st: top metrondiazole top azeliac acid PO doxy

23 T1DM syncope, N&V, hyponatraemia, hypoglycaemia Investigations and diagnosis

synacthen test ?adrenal insuf

Neck spasm and fixed gaze following metaclopramide diagnosis and management

oculogyric crisis benztropine (anticholingeric)

Which cancers is HPV 16 associated with?

Cervical Oropharnygeal anal penile

mid systolic click followed by late systolic murmur, loudest at apex

mitral valve prolapse

Neuro consequence of Nitrous oxide use

low b12 -> subacute combined degen of spinal cord impared motor, proprio, fine touch

Pathophysio of haemoptysis in bronchiectasis

capillary engorgement

Which deficiency causes loose teeth and gum disease in alcoholics

Vit C

Most likely site of gastrin producing tumour

pancreas

What is the reason for transfusing irridated blood?

avoid graft versus host disease

Blood film: neutrophils with bilobed nucleia

hereditary pelger huet

Antibodies seen in primary biliary cholangitis?

anti-mitochondrial

amitriptylline OD GCS 10, short runs of VT QRS 115 Initial management

Sodium bicarb

meningitis, gram + diplococci management

strep pneumoniae ceftriaxone and vanc

meningitis gram -ve diplococci Organism and management

Neisseria ceftriaxone

Where are the cells affected by gent toxicity located?

Prox tubule

Eczema management

Top corticosteroids or tacrolimus PO ciclosporin, azathioprine, mycophenalate -mab or -nib

which receptor found on biospy determines response trastuzumab

HER2

dilated pupil which doesnt react to light diagnosis

3rd nerve palsy

MODY management

gliclazide (sulphonylureas)

HLA associated with Bechets

B51

HIV pt with lesions in mouth on arms and legs diagnosis and organism

Kaposi sarcoma human herpes virus 8

where is most sodium reabsorbed

PCT and asending loop of henle

male, difficultly forming relationships, no sense of smell, small testes sparse pubic hair diagnosis, management

Kallmann syndrome Testosterone or GnRH

Management of pituitary adenoma

Bromocriptine

1cm ulcerated lesion with necrotic centre diagnosis

SCC

Female with rheumatoid, presents after prolonged nose bleed, ATPP prolonged diagnosis and pathophysiology

acquired haemophilia A, factor VIII inhibition

second heart sound + diastolic murmur

ASD

pins and needles 4th and 5th fingers wasting of muscles in hypothenar eminance

cubital tunnel syndrome

testicular teratoma tumour marker

alpha fetoprotein

45 male, increasing weight, T2DM, HTN ?diagnosis and investigation

24h urinary cortisol ?cushings

Management of diabetes in cystic fibrosis patients

insulin

UC maintenance remission

PO mesalazine

71, itch, raised Hb low erythropoietin, splenomegaly diagnosis and genetics

primary polycythaemia JAK 2 +Ve

LFT raised which would indicate hepatic vs cholestatic condition

2 x ALT - hepatic 2 x ALP - cholestatic

seizure involving tongue chewing, mouth and tongue movements and limb jerking area

parietal lobe

SLE antibodies and which Ig

ANA IgG

PPH murmur

tricuspid regurg

42 female, works on farm, PMH asthma, worsening asthma CXR: bilateral shadowing diagnosis

allergic bronchopulmonary aspergilliosis

23 male, 2 weeks following unprotected sex, dysuria, conjunctivitis, olioarthritis organism and diagnosis

Chlamydia trachomatis - reactive arthritis

Post glandular fever Extreme fatigue, SOBOE, bruising Hb/ WCC/platelets low investigation and diagnosis

Bone marrow aspirate Aplastic anaemia

Elderly patient Large tense blisters on flexor surfaces sparing mucous membranes

Bullous pemphigoid

Mangement of bowel spasms

Mebeverdine

HNPCC increased cancer risk

endometrial

Ank spon murmur

Aortic regurg - early diastolic

Management of listeria meningitis

amox and gent

loss of night and peripheral vision spicules on retina

Retinitis pigmentosa

24 years old HTN and high creatinine and +protein on urine dip Recurrent UTIs as a child US shows scarring on L kidney diagnosis

reflux nephropathy

Lithium overdose management

haemodialysis

HIV test 4 weeks post infection

HIV 1 RNA P24 max specific at 3.5 weeks so could have false -ve

Ank spon imaging and management

MRI adalimumab

Variceal bleed prophylaxis

carvedilol

anti-epileptics safe in pregnancy

lamotrigene and keprra

25 male, HTN, headaches and palpitations investigations and diagnosis

24h urinary catecholamines phaeochromacytosis

Which form of haemaglobin is raised in Beta thalasseamia

HbA2

Idiopathic membranous glomerulonephritis management

rixitumab

Staghorn caniculi

magnesium ammonium phosphate stones

farmer, red papule on finger increasing in size diagnosis and management

parapox virus - orf mostly self limiting but if persist cryotherapy or cidoovir cream

+++ exposure to TB +ve patient testing

Mantoux test

dilated pupil that reacts slowly to light but brisk to accomodation

Holmes Addie

vaccine CI with egg allergy

yellow fever

29 female, prolactin secreting tumour and hyperparathyroidism, sister and dad have the same diagnosis and other ca at risk

MEN type 1 gastrinoma

19 jaundice sclera, splenomegaly, brother has anaemia anaemia with spherocytes on film investigation and diagnosis

cryohaemolysis and eosin-5-maleimide binding tests hereditary spherocytosis

HIV patient seizure multiple ring enhancing lesions on MRI

CNS toxoplasmosis

Sudden onset right hemiplegia and 3rd nerve palsy

posterior cerebral artery infarct

signs of cardiac tamponade

SOB tachycardia elevated JVP

45 male, increasing falls, upper limp weakness, weakness in hands, increased tone in hands, fasciculations investigation and diagnosis

MRI Whole spine ?MND

How long to avoid contact sport following EBV with splenomegaly

4 weeks

MRI: atrophy of temporal and parietal lobes diagnosis and management

Alzheimers Donepenzil

Common mets to bone primary

-breast -prostate -lung

What cardiac med should be use with caution in severe aortic stenosis

beta blockers

Which antibody is most specific for rheumatoid arthritis

anti CCP

cals required

25-35/kg/day

severe pulmonary stenosis on JVP

increased a waves

obesity management

- lifestyle - liraglutide - gastric band

psychotic symptoms in parkinsons disease

clozapine

LBBB signs

reverse splitting of s2

GI symptoms after drinking water on holiday

Giardiasis

Diabetic med with increased risk of hypoglycaemia

gliclazide

Carconoid syndrome mangement

Ocetrotide telotristat

Smoking cessation safe in pregnany

NRT

HIV +ve pain when swallowing, ulcers in lower and middle third of oesophagus diagnosis and management

CMV infection valganciclovir

cerebral venous thrombosis mangement

LMWH

N&V 3 hours after eating out, likely organism

staph aureus

3 days post MI SOB, hypotensive bilateral crackles likely diagnosis

acute MR

Initial investigation in ?CLL

Immunophenotyping

1st line glaucoma management

IOP >24 : laser otherwise lantoprost timolol - pilocarpine

Peripheral sensory and motor neuropathy in pt with macrocytic anaemia

B12 def

Findings on US with diabetic nephropathy

GBM thickening mesangial expansion arteriolar hyalinosis

Urinary Na in SIADH

>20

cat scratch organism

bartonella henselae

Cervical HPV association

HPA 18

restless leg syndrome management

ropinirole

Cell type that produce IgE

B cells

SBP management

IV Cef

72 male, short term memory loss, visual hallucinations, shuffling gate, increased tone left side, bilateral tremor L>R Diagnosis and management

Lewy Body dementia Donepezil

31 male, ex heroin addict, arthralgia, rash with palpable purpura pain in fingers/toes and blue discolouration for 3 months diagnosis

hep C

34 female, laughing inappropriately, difficulty finding words, missing words when speaking diagnosis

lesion in dominant frontal lobe - Brocas area

55 admitted with fever and rash, recent course of co-amox reduction in renal function

interstitual nephritis

liver transplant on tacrolimus, given clari for infection expected symptoms and why

N&V, low Hb, platelets, high Cr and K+ clari is CYP3A4 inhib and tacro is metabolised by CYP3A4 = accumulation of tacro

melanocyte pigmentation around mouth, multiple hamartomatous polps on colonoscopy Mum and sister have breast ca

Peutz Jeghers syndrome

Hypotension and bradycardia post PCI to LAD STE with ventricular escape rhythm mangement

CHB atropine pacing

Anaphylaxis to blood product deficiency and measures to be taken in future transfusions

IgA Washed RBC

D&V multiple people on cruise ship

norovirus

incontinence and increased frequency with enlarged smooth prostate management

finasteride doxazosin

family history cardiac arrest whilst asleep

Brugada

marfans sudden onset blurred vision

upwards lens dislocation

headache and inability to open right eye pupil deviated down and right diagnosis

post comm artery aneurysm

anti-psychotic CI parkinsons

haloperidol

HOCM signs

forceful apex beat late systolic murmur augmented by valsalva

management serotonin syndrome

cyproheptadine

IVDU large groin abscess, face grimace, neck stiffness, muscle spasms diagnosis and management

tetanus human tetanus immunoglobulin

Which cardiac med worsens psoriasis

bisoprolol

Where does indapamide act

distal tubule

erythematous crusting lesions on side of chin satellite areas of erythema, itchy

impetigo top mupirocin

threadworm treatment

mebendazole

infection risks post splenectomy

strep pneumonia h influenza n mening

alcoholic, ataxic gait where is damaged

cerebellar vermis

Which parkinsons meds do not increase gambling risk

procyclidine

CA 125

ovarian

CA 19-9

pancreatic

Ca 15-3

Breast

AFP

teratoma hepatocellular

CEA

colorectal

S-100

melanoma, schawannoma

Bombesin

small cell lung cancer, gastric cancer neuroblastoma

17 male, rash swollen joints, haematuria high cr, normal culture and US KUB diagnosis and expected biopsy result

IgA vasculitis Mesangial deposition of IgA

pupils accommodate but do not react and are typically bilaterally small.

Argyll Robertson

ptosis with ipsilateral small pupil

Horners

ipsilateral ptosis and pupillary enlargement.

3rd cranial nerve palsy

Previous thyroidectomy - elevated Cholesterol, TSH high T4 normal management

Levothyroxine

Most common thyroid malignancy

Papillary thyroid carcinoma

adolescent female has cervical and mediastinal lymphadenopathy

Hodgkins lymphoma

Likely source of bleeding with severe haemoptysis

bronchial and pulmonary arteries

A 47-year-old man presented with a 6-month history of episodic sweating and hunger. He had gained 10 kg in weight and drank 10 units of alcohol per week. borderline low fasting glucose Test and diagnosis

plasma glucose concentration following a prolonged (72-h) fast ?insulinoma

pain in his right elbow and tingling in the medial aspect of his right hand. His job involved using a sledgehammer.

lateral epicondylitis - ulnar nerve

42 male UC cholestatic bloods

primary sclerosing cholangitis

A 50-year-old man presented with a 24-hour history of agitation, confusion and suicidal thoughts. He had started VAD chemotherapy (vincristine, doxorubicin and dexamethasone) 4 days previously, following a diagnosis of multiple myeloma. Diagnosis

corticosteroid psychosis

traumatic hemisection of his spinal cord at T10 level. What is most likely to be present below the level of the lesion 2 months after the injury?

contralateral loss of pain and temperature sensation

Which immunoglobulin is responsible for hyperacute rejection

IgG

Management restless leg syndrome

ropinirole

needlestick injury from recently diagnosed HIV pt. hepatitis C negative and vaccinated against hepatitis B virus What is the most appropriate post-exposure prophylaxis for the doctor?

three-drug antiretroviral treatment for 1 month

What is the normal function of BRCA1?

tumour suppression

CSF high protein, low glucose and lymphocytosis

listeria

CSF very high protein, low glucose and lymphocytosis

CSF high protein, low glucose (<50% plasma), and a very high neutrophil count.

Neisseria meningitides and Streptococcus pneumoniae

22 year old MI post partum

coronary artery dissection

mild left-sided ptosis. Her left pupil was larger than her right and reacted poorly to light (direct and consensual). There was loss of pinprick sensation on her right forehead. What is the most likely site of the lesion?

left cavernous sinus

common SE tacrolimus

tremor

What is the mechanism of action of ropinirole?

dopamine receptor agonist

Past papers Flashcards

(260 cards)