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Year 5 Pathology > Past Papers ChemPath > Flashcards

Past Papers ChemPath Flashcards

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1
Q

24 y/o asymptomatic man
isolated rise in unconjugated bilirubin
other results (ALT, ALP etc normal)

A

Gilbert’s

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2
Q

22 year old student
two weeks anorexia, fever and malaise – raised ALT
normal/super mildly raised ALP + GGT

A

Viral Hepatitis

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3
Q

Women,colicky abdominal pain.
mildly elevated ALP, ALT, GGT, & Bilirubin.
GGT + Bilirubin most raised

A

Post hepatic cause

  • gallstones/acute cholestasis
  • head of pancreas Ca
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4
Q 
57 y/o man presents 
 hematemesis 
High ALT + GGT
slightly raised ALP
Low Albumin.
A

Alcohol induced hepatitis

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5
Q

elderly man
v high ALP
headache

A

Paget’s

disorder bone remodelling

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6
Q

Increased AST > Increased ALT (2:1)

> Increased GGT + ALP

A

Alcoholic liver disease (aSt wavy - drunk)

NAFLD

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7
Q

Increased ALT > Increased AST (1:<1)

> Increased GGT + ALP

A

Viral hepatitis

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8
Q

Raised Bilirubin - unconjugated

A

haemolysis

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9
Q

Raised Bilirubin - conjugated

A

damage to the liver or the gallbladder/bileduct

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10
Q

high ALP and GGT

raised conj bilirubin

A

cholestasis

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11
Q

Normal GGT + Raised ALP

A

Paget’s

or placenta

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12
Q

Bicarbonate in a pyloric stenosis patient

A

high bicarb

low K, N Na

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13
Q

oral glucose tolerance test

impaired glucose tolerance reading

A

OGTT 7.8 - 11.1

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14
Q

Calculate plasma osmolality

A

2(Na + K) + Urea + Glucose

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15
Q

Normal fasting blood glucose

A

<6.1

and >4

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16
Q

OGTT normal glucose

A

<7.8 (at 2hr reading)

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17
Q

Impaired fasting glucose

A

Fasting glucose 6.1 - 6.9

OGTT 7.8 - 11.1

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18
Q

Diabetes random blood glucose

A

> 11.1

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19
Q

HbA1c:
normal
pre-diabetes
diabetes

A

Normal <6.0%
Prediabetes - 6.0% to 6.4%
Diabetes > 6.5%

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20
Q

Low sodium, all else (K+, CL-) normal

Glucose before OGTT is 4.9, 2 hours later is 10

A

Impaired OGTT

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21
Q

teen
polyuria and polydipsia
wt loss

A

T1DM

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22
Q

high Na
low K
high urine osmolality

A

Conn’s

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23
Q

K in DKA metabolic acidosis

A

high

as no insulin

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24
Q

high sodium
high potassium
plasma osmolality ~400
urine osmolality ~600

A

SIADH

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25
60 y/o | abdominal pain radiating to back, collapses and dies
AAA
26
ex-smoker hypertension and MI sudden chest pain which radiates to the neck
Descending internal carotid thrombus
27
50 y/o F, | memory issues/progressive amnesia, hypertension
Multiple cerebral/(?cortical) infarcts
28
man with atrial fibrillation with right flank pain
Renal infarct
29
MI 3 years ago unwell sample from pericardial layer -blood
Ventricular rupture
30
Itchiness of the skin more likely in hepatitis or intravascular haemolysis
hepatitis
31
ulcers on mouth following treatment with a drug
- Steven-Johnson Syndrome
32
which ion low if pt urinating a lot?
Na
33
Na 119 K 4.5 Plasma osmolality 249 Urine Na 54 Urine osmolality 530 Diagnosis?
SIADH
34
Pt hits head, polyuria and polydipsia Na 130 K 4 U 2.2 Cr 57 Diagnosis?
psychogenic polydipsia diabetes insipidus if high Na (as no ADH to reabsorb water)
35
``` 40 y/o renin 6.4 (high) aldosterone 1200 (high) ```
renal artery stenosis (high renin plus Ald) NB Conn's has just high Ald
36
ACEi improve/worsen Creatinine within days of starting?
worsen
37
Plasmodium species treated with Primaquine
P. vivax
38
Form malaria injected into host
Sporozoite
39
First line non-falciparum malaria
Chloroquine
40
In multiple myeloma, how would you manage: hypercalcaemia
fluid + BISPHOSPHONATES
41
In multiple myeloma, Mx of spinal cord compression
Dexamethasone
42
In multiple myeloma, Mx of hyperviscosity
Venesection
43
INR of pt with AF
INR 2-3
44
Pt with prosthetic valve and AF
INR 2.5-3.5
45
Blood monitoring of Old lady who had cancer having aspirin and clopidogrel
not needed
46
Which organism? | returning from Afghanistan has a small ulcer on right ring finger that won’t heal and keeps getting bigger
Leishmania
47
Liver cyst, travel to South America
Entamoeba histolytica
48
HIV, pneumonia | Ground glass CXR
PCP
49
Renal transplant CXR halo sign | Organism?
Aspergillosis
50
mechanism in the oesophagus as a result of reflux (GORD) that takes place and leads to cancer?
dysplasia
51
mucous producing cancer in lungs
Mucinous adenocarcinoma
52
NOD2/CARD15, what is it found in?
Crohn's
53
Immunodeficiency with common gamma chain problem?
X-linked SCID
54
Swollen joint, needle-shaped aspirate with negative birefringence, what is the enzyme responsible
Xanthine Oxidase
55
Long term Tx for gout
Colchicine
56
JC virus cause?
Progressive Multifocal Leukoencephalopathy
57
Reactivation of a virus following a transplant
Epstein Barr Virus
58
Most common virus causing aseptic meningitis
Coxsackie or echovirus
59
Smear cells
Chronic LYMPHOCYTIC leukaemia
60
15 yo with brain tumour extends outwards from cerebellum and invading subarachnoid space. Signs of ataxia
medulloblastoma | cerebral low grade /commonest in kids = pilocytic astrocytoma
61
Diabetes, fatty stools, weight loss, ‘slate grey skin’ and joint pains
Haemachromatosis (joint pain, skin changes, pancreatitis, liver deposition
62
5yr old, tetany, bone pain. Widened epiphyses + ‘Cupping’ of metaphysis shown on x-ray. What is the cause?
Rickets
63
minimum amount of time to treat a VTE?
3 months
64
Mother is a donor for kidney to a child, what is the max number of mismatches possible with HLA class I?
3 out of 6
65
21. Ovarian tumour with hair. No immature cells seen
Mature teratoma
66
liver enzyme is raised in MI
AST Aspartate aminotransferase
67
Old man who fell over, been on floor for days. Severely dehydrated. Dark urine. Not blood on microscopy. What causes the dark urine?
Myoglobin Creatine Kinase MM will be HIGH
68
Multiple myeloma and restrictive cardiomyopathy. What will you see on heart biopsy?
Amyloid depositions AL (light chain)
69
macrocytic anaemia, atrophy of body of stomach. What substance are they deficient in that leads to B12 malabsorption?
Intrinsic Factor
70
IVDU man is given Rituximab - CHOP treatment for Non-Hodgkin’s lymphoma. He later 8 months later develops fulminant liver failure and dies. Why?
Hep B reactivation
71
coagulation factor is decreased first on administration of warfarin?
Factor VII
72
White things on the oesophagus seen in OGD of an alcoholic man with recurrent bleeding varices.
Oesophageal Candidiasis
73
Mexico and ate unpasteurized dairy + diarrhoea?
Brucellosis
74
apthous ulcers
Crohn's
75
Which type of cell does Rituximab target?
Mature B cells
76
How does HepA spread
Faeco oral
77
CLL with p53 mutation Tx
Ibrutinib (TK mutation) less aggressive CLL (no p53 mutation) = watch and wait
78
Prophylaxis for allograft rejection
BASILIXIMAB (anti-CD25) Tacrolimus/Cyclosporin (calcineurin inhibitor)
79
``` Which allergy is more likely to present in child than adult? • OAS • Egg • Bee • Pollen ```
Egg
80
natural antibody that confers protective immunity against HIV
gp120 and anti gp41 +
81
Common cause of cellulitis
Staph Aureus B haemolytic Strep - Strep PYOGENES
82
Ion raised in red cell lysis
Potassium
83
HTLV1 Virus lymphoma
Adult t cell lymphoma/leukaemia
84
Lower in pregnancy
Protein S Factor XI Plt, Hct, Hb all lower too
85
How does melanoma spread?
LN
86
Metabolic disturbance of CAH
No Aldosterone - LOW Na, HIGH K | No Cortisol - low Glucose
87
Causes DIC in pregnancy
Amniotic fluid embolism placental abruption retained dead fetus pre-eclampsia (severe)

Year 5 Pathology (13 decks)

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