PastTest PastPapers Flashcards
(294 cards)
1
Q
Whats Leiner’s Disease ?
A
Chronic Diahorrea
Wasting
Seborrheic Dermatitis
2
Q
Co-existing Pneumonia and Meningitis treatment ?
A
Gram Positive Cocci (Streptococcus Meningitis)
Ceftriaxone with Vancomycin
3
Q
MOA of Osmotic Demyelination Syndrome ?
A
Astrocyte Apoptosis
then …. Oligodendrocyte Apoptosis
4
Q
Brachial Neuritis
- Presentation
- Treatment
A
Pain not relieved by Non-Opiates and
GENERALISED Shoulder Weakness as the Pain Resolves.
Physio
5
Q
Location of Gastinoma’s ?
A
1st Part of Duodenum
PPI - 1st Line but
Keep in Mind
60% have chance to become Malignant so Dudenectomy if within duodenum
6
Q
CeleCoxib
Does it Increase or Decrease Bleeding and GI Ulcers ?
A
DECREASES both
Because COX 1 is
Promote Platelet Coagulation and Produce Mucus in GI lining
So if COX 2 ONLY blocked COX1 is free to protect lining and promote clotting hence
Less Bleeding and Less GI Ulcers in COX2 inhibitors
7
Q
Reason for Hemoptysis in Bronchiectasis
A
Capillary Engorgement
8
Q
Strongest Risk Factor for Osteonecrosis of the Jaw ?
A
Dental Caries
9
Q
Anyone who received Blood Products after 1980 cant donate blood.
A
Remember
10
Q
Treatment for HIV Nephropathy
A
HAART
11
Q
What points toward BACTERIAL Endocarditis ?
A
Fever
12
Q
Rhumatic Heart Disease
Diagnostic Criteria Mnemonic
GABHS OR Anti Streptolysin O
PLUS
2 Major or
1 Major + 2 Minor
A
JONES (Major) CAFE PAL (Minor)
Joint Involvement
O =MyOcarditis
Nodules
Erythema Marginatum
Syndenham Chorea
CRP Elevated
Arthralgia
Fever
ESR Elevated
Prolonged PR
Anamnesis of Rheumatic
Leukocytosis
13
Q
Steven Johnson Syndrome Drugs ?
A
PCP LAPSE
Phenytoin
Carbamazepine
Phenobarbital
Lamotrigine
Allopurinol
Penicillin
Sulfa Drugs
Erythromycin
ABACAVIR
INDAPAMIDE
14
Q
ERV or FVC reduced in Obesity ?
A
ERV !!!!
15
Q
White Lacy Lesions in the Buccal Mucosa ?
A
Lichen Planus - Topical Steroids
Lichen Sclerosis - Genitals
16
Q
Thyroid Hormone receptor found where ?
A
NUCLEUS !!!!
TSH - Gs Coupled !!!!
17
Q
PDE6 found where and if inhibited causes what ?
A
Rods and Cones
Blue Discoloration
18
Q
Dialysis Disequilibrium Syndrome
A
Reverse Osmotic Shift
After Dialysis –> Low Urea in Blood but High Urea in Brain
Water move from Brain to Vessels –> Cerebral Edema
Confusion Headaches etc…
19
Q
Differentiating Vitamin B12 from Folate ?
A
Look for Glossitis in Folate Deficiency
20
Q
When to give dopamine and when to give Trans-Sphenoidal Resection in Prolactinomas
A
IF Macroprolactinoma –> Bromocriptine
IF Non functioning adenomas —> Transsphenoidal Surgery
IF acromegaly its trans-sphenoidal surgery -> somastatin analogue -> dopamine agonist
21
Q
Why some family members with BRCA have the Cancer and Some Dont ?
A
Autosomal Dominant
Reduced Penetrance
22
Q
How does alcohol cause hypoglycemia ?
A
Alcohol diverts the blood from Exocrine to Endocrine and stimulate Insulin Release
Increased Insulin Synthesis
23
Q
Chronic Venous Ulcer associated with Which Cancer ?
A
Squamous Cell Carcinoma !!!!!!
Excise
24
Q
Mixing Studies do not work in which disease
A
Acquired Hemophilia A
FEIBA !!!
25
Contraindication for Lung Transplantation in CF ?
BMI < 15
Active Mycobacterial Infection
26
Which Antiepileptic DOES NOT cause HEART BLOCK
Primidone
27
When to stop ALL Anti - TB Medications
Symptomatic Hepatitis
Bilirubin High
ALT > 5 X upper limit
28
Seminoma vs Non Seminoma Tumor Marker ?
Non Seminoma - AFP
Seminoma - HCG
29
SJS HLA Association
B 1502
30
In Cystic Fibrosis Patients what Anti-Diabetic Medication is given ?
Insulin
31
Fibrates MOA
Evanicumab MOA ?
PPAR
Angiotensin like Protein 3 Inhibitor
32
What % does Smoking contribute to Lung Cancer ?
85%
33
Which Tumour Marker for Colon Cancer Recurrence ?
CEA ----> Also for Mets
34
Hydatid Disease of the Liver Treatment ?
Echinococcus
Albendazole
35
What medication should be used cautiously in Severe Aortic Stenosis Patients because of the Outflow Gradient ?
BB - if you slow the heart down the blood might not be able to leave
36
Which Anti-TB drug increases Hydrocortisone Requirement ?
Rifampicin
37
How is Pyrazinamide metabolized ?
By Amidase in Liver to Pyrazinoic Acid
38
TPN Requirements daily
25-35 kcal/kg
39
Drug used in Anterior Uveitis?
Cycloplegic Drugs -
Cyclopentolate - Paralyze the Ciliary Body and Prevent Iris sticking to Lens
Topical Steroids
40
Liraglutide Indication ?
BMI 35 (or 32.5 in Ethnic Minority)
Pre-Diabetic
High Risk of Metabolic Syndrome - Dyslipidemia, HTN
41
Clozapine MOA ?
Dopamine Agonist at
1 3 4 5HT2A
Weak at 2
42
How are Reticulocytes identified vs Erythrocytes ?
Reticular Pattern of Ribosomal RNA on Methyl Blue Staining
Normoblast (with Nucleus) ----> Reticulocytes (without Nucleus)
So Nucleus Extruded
43
Colchicine MOA ?
Febuxostat MOA ?
Urate 1 Transporter Inhibitor ?
Tubulin Polymerase Inhibitor
Non Purine Xanthine Oxidase Inhibitor
Benzbromarone
44
Cardiac Myxomas Common in Left or Right Atrium ?
Left Atrium
45
Ring of Small Papules in Dorsum of Hand
What is it ?
Granuloma Annulare
Type 4 HSN
46
Drug of Choice for Lupus Nephritis ?
Mycophenolate
47
Pseudoxanthoma Elasticum Features and Gene
Plucked Chicken Skin
Retinal Streaks
CVD
ATP binding cassette protein - Family C Number 6 Mutation
48
Classical Ehler Danlos Mutation
Collagen Type V Alpha
49
What receptors does Nicotine Bind to ?
Ach
50
How to reduced the Left Ventricular Outflow Obstruction in HOCM ?
BB
DHP CCB - Verapamil
51
Mebendazole MOA ?
Inhibit Tubulin Polymerization
52
Baclofen MOA ?
Barbiturates / Topiramate and Propofol MOA ?
GABA B Agonist
GABA A Agonist
53
In Women with UTI if eGFR < 45 then what's 1st line ?
1st line Pivmecillinam
2nd Line Fosfomycin
54
DMARD advised for AS ?
Adalimumab / Golimumab / Etanercept
55
Treatment for Carcinoid Syndrome ?
Octreotide ---> Telotristat (Tryptophan Hydrolase Inhibitor)
56
Why does Hepatorenal Syndrome Occur ?
Raised Endothelin 1
57
Which Anti-Depressant has the leads impact on Sexual Function ?
Mirtazepine
Alpha 2 Blocker
5HT2/3 Blocker
58
Denosumab MOA ?
Nuclear Factor Kappa B Ligand blocker
59
Hep B Management
1st Line
Pegylated Interferon 2 Alpha for 48 weeks
Entacavir -
2nd Line or 1st line if High Viral Load with Immunosuppression
60
if PCM OD whats the biggest Risk Factor for Acute Liver Failure ?
Low BMI !!!!
61
Esophageal Ulcers in HIV patient
Whats the Causative Pathogen ?
CMV
Treat with Valganciclovir
62
Monitoring for Myotonic Dystrophy ?
Repeat ECG's for Heart Block
63
Which drug causes Leg Swelling ? due to peripheral vasodilation
Diltiazem doesn't
Alpha Blocker
64
Which Artery is Responsible for Lateral Medullary Syndrome ?
Vetebral (MCC) ---> PICA (2nd most Common) !!!
65
Cyclophosphamide MOA ?
Canakinumab MOA ?
Inhibit B and T cells
IL1 Antagonist
66
Which Tumor Marker for what ?
1. Seminoma
2. Non Seminoma
3. Mets from Seminoma
1. HCG
2. AFP
3. LDH (higher in higher tumor burden) although not specific to Seminoma like HCG !!!!
67
Non Cardiogenic Pulmonary Edema Treatment of Choice ?
CPAP
68
What determines Prognostic Factor in Melanoma ?
Breslow Thickness of Lesion
69
If HELLP what do you do ?
FIRSTLY ---> Load 4g IV MgSO4 - Control BP and buy time
DELIVER !!!
70
Mild Diahorrea + Right Iliac Fossa Pain + Gran Negative Rod ?
Yersinia Enterocolitica
Undercooked Pork !!!!
71
What is Positively Skewed ?
Mean > Median > Mode - Positive Skew
Mode > Median > Mean - Negatively Skew
72
Benefit of Raloxifene ?
Reduce Risk of Breast Cancer
73
Antibiotics for Erysipelas ?
Co-Amoxiclav
74
Is Bosentan Teratogenic ?
Yes
75
Diabetic Maculopathy Treatment ?
Focal Laser Therapy
Pan Retinal Photocoagulation is in Diabetic Retinopathy with or without Neovascularization
76
Diabetic Maculopathy in Pregnancy ?
IV Trimacinine
77
Immune Cells with Memory for Vaccine ?
Apparently T cells !!!1
78
When to use Single Chamber Pacemaker ?
When the AV blockade is temporary and reversible
79
Where do the Dual Leads go in Pacemakers ?
Atrial Appendage and Coronary Sinus
80
Which Vein drains the Upper 2/3rd of Esophagus ?
Azygous Vein
81
Treatment for RLS ?
Gabapentin
82
Bad Side Effect of Flumazenil
Decrease Seizure Threshold
83
Lichen Planus Treatment for Oral Lesions ?
Topical Beclomethasone
84
Investigation of Choice for IDA in CKD ?
Blood Film for Hypochromic Cells
85
In CKD Renal Disease
1st Line is Phosphate Binders
Now which one ?
Calcium Acetate IF CALCIUM LOW NORMAL
if Calcium AND /OR PHOSPHATE High give Lanthanum
86
Types of Brugada Syndrome
Type 1 - > 2mm ST Elevation in V1/V2
Type 2 - Saddle ST Elevation in V1/V2
Type 3 - <2mm ST Elevation of Types 1 or 2
87
Clostridium Perfringens Infection Treatment
Gas Gangrene
Clindamycin and Metronidazole
88
If Wagener's and Anti GBM as a query then check what ?
ESR
89
Function of microRNA ?
Silencing of mRNA
90
Inflammatory Arthritis = Left / Lateral Non Weight Bearing
Osteoarthritis - Weight Bearing Medial Side
91
Most Common Antibody in SS ?
ANA
Anti Scl70 is Diffuse
Anti Centromere is Limited
Anti RNA Polymerase III - Rapid Scleroderma Renal Crisis
92
if HOCM before ICD what do we do ?
Ambulatory ECG Monitoring
93
Black People with HTN What's 1st Line ?
Amlodipine --> ARBs
94
Benefit of Combining Chemotherapeutic Agents ?
Reduce Drug Resistance
95
When to give HCO3- in Severe Acidosis ?
pH < 7.2
96
What is Pathagnomic is Rotator Cuff Injury ?
Abduct till 90 Passively and Let go
Quickly Fall
First 90 Painful
97
Distal Left Descending vs Proximal Left Descending Occlusion
ST Elevation in V1-V2
vs
ST Elevation in V5-V6
98
Waldenstrom Macroglobunemia Chemotherapy of Choice
Betamustidine + Fludarabine
Alemtuzumab if Reactivation of CMV and Relapses
Ibrutinib - If one therapy failed
99
Non Dominant Temporal Lobe
Non Verbal Memory
100
Kluver Bucy Syndrome
Visual Agnosia + Binging + Hypersexuality
101
CVID Most Common Infection ?
Giardiasis
102
HIV + CD4 < 100 + Diahorrea - Investigation of Choice
Ileal Intubation
103
GH Deficiency Test of Choice ?
Also Insulin Growth Factor 1
104
Mitral Valve Stenosis Treatment in Pregnancy ?
Nitrates and Furosemide for Heart Failure
BB for Heart Rate
Percutaneous Valve Commissure
105
Antibiotic for Chlamydia in Pregnancy ?
1st line - Azithromycin and Test of Cure 3 weeks after
2nd Line - Erythromycin
106
Which TNF Alpha Inhibitors endorsed for AS by NICE ?
Golimumab / Adalimumab / Etanercept
107
Tacrolimus MOA
IL2 Inhibitor
108
Risk Factor for Gastric Cancer ?
Smoking
NSAIDs Protective Factor
109
Chancroid Organism ?
Hemophilus Ducreyi
Single Azithromycin
or
IM Ceftriaxone
110
Treatment for Acute Mania ?
If BZD or Haloperidol
Then Risperidone
111
Bullous Impetigo
Bullous Phemigoid
Phemigus Vulgaris
Staphyl Aureus
Flaccid Bulle
Straw Colored
Mupirocin
and Fusidic Acid
Hemidesmosomes
Tense Bullae
Itchy
Immunofluorescence: Linear IgG/C3 at dermoepidermal junction
Autoantibodies to desmoglein 3 ± 1 (desmosomes)
Immunofluorescence: Intraepidermal “chicken wire” IgG
112
Diabetic and Osteomyelitis Antibiotic of Choice ?
Vancomycin and Ceftriaxone
But If Klebsiella then go for Tazocin
113
When to chose Sequential vs Continuous HRT ?
If Periods Stopped < 1 year ago - Sequential HRT
114
When to start Steroids in IPF ?
When FVC < 50-80% but STOP if FVC drop further 10%
115
TRALI occurs usually after how many hours of Infusion ?
6
116
Left Sided Neglect Visually so Which Lobe is the Lesion in ?
Right Parietal Lobe
117
Paintbrush Papillae in Renal Pelvis on CT Urogram Pathgnomic for
Medullary Sponge Kidney -
Increase Fluid Intake
118
Drugs causing Nephrogenic DI ?
Ofloxacin
Lithium
Ifosfamide
Amphotericin B
119
If Mixed CNS Stimulant OD then what do we give to calm patients down ?
Haloperidol AND Lorazepam
If CNS Depressants only Haloperidol
120
Why ALT Elevated in Hepatitis
HEPATOCYTE NECROSIS !!!!! not Apoptosis !!!!
121
Investigation of Choice for Cardiac Amyloidosis ?
Cardiac MRI !!!!
122
Which Lung has 3 lobes ?
Right
123
Which Ketone rapidly falls in DKA ?
Beta-Hydroxybutyrate
so Acetoacetate is reason for residual Ketonuria after DKA is reversed
124
What is the New York Criteria for AS
Clinical
1. Low Back Pain for 3 months , Improved with Exercise and Not Relieved by Rest
2. Sagittal and Frontal Plane Limitation
3. Limited Chest Expansion
Radiological + 2 Clinical = AS
125
Latex Allergy Dignostic Ix ?
Skin Prick
126
Early AS X ray or MRI ?
MRI !!!
127
Which HLAs associated with AS ?
HLA B60
HLA B39
128
Most Common Way IgA Nephropathy presents ?
Microscopic Hematuria with or without hematuria
129
If Stroke pick the Distal Portion Occlusion cuz of Collateral Supply
130
VHL Vision Issue due to ?
Hemangioblastoma
Optic Nerve Glioma in NF 1
131
What predisposes one to Lithium Toxicity ?
Decrease in Lean Mass
132
What Antibody in AntiGBM ?
Anti PR3
133
S. Haemobicum Associateed with What Cancer ?
Bladder
134
S Mansoni associated with what pathology ?
Hepatic Fibrosis
135
Graves Ophthalmopathy Worsened by ?
Radioiodine
Use Block and Replace to reduce worsening
136
BRCA 1 and BRCA 2 which Cancers Common ?
BRCA 1 -
Ovarian and Breast
BRCA 2 -
Pancreas and Prostate
137
When does GvH Disease happen after transfusion ?
4th and 30th day Post Transfusion
138
Alcoholic Diabetics having Hypoglycemia Why ?
The Alcohol makes the Pancreatic Endocrine Function shifted to Exocrine and
Increased 1st phase insulin secretion
139
Becker's and Duchenne's Dystrophy Pathophysiology on why muscles breakdown and cant regenerate ?
Telomere Shortening
140
Bechet's Syndrome Treatment ?
Prednisolone
Azathioprine
TNF Alpha Inhibitors
Cyclophosphamide if Posterior Uveitis
141
Serotonin Syndrome if SSRI + ______ (Analgesia) ?
Tramadol
142
Distal vs Proximal Median Nerve Involvement ?
If Thenar SENSORY Loss then --> Proximal
If Thenar SENSORY preserved --> Distal
143
Anti Ro and Anti La
Which is more specific to Sjogren and Which is more common in SLE ?
La (SSB) in Sjogren
Ro (SSA) in SLE
144
Imiquimod MOA
acts as a toll-like receptor-7 agonist and activates macrophages and other immune cells
145
If BCC then Imiquimod if Limbs and Trunk
Surgery with a 4 mm margin recommended
146
Bacteria in Platelet Contamination is ?
Staphylococcus Epididymitis
147
Noonan Syndrome
(Triangular Facies , Skeletal Abnormalities in Rib Cage and Cardiac Defects) Inheritance ?
Autosomal Dominant
148
2nd Left ICS Diastolic Murmur ?
vs
3rd Left ICS Diastolic Murmur ?
Pulmonary Regurgitation
vs
Aortic Regurgitation
149
Functions of
1. IgA
2. IgE
3. IgD
4. IgM
5.IgG
1. Breast Milk , Mucosal Protection
Most Commonly produced Ig in the body
2. Synthesized by Plasma Cells
Least Abundant
3. Activation of B cells
4. First to be release when infection and found in Anti-A/B antibodies
5. Most abundant in serum
IgG2 - Ineffective Response to Bacterial Polysaccarides
IgG1 - Sinopulmonary Infections (MCC)
IgG4 - Diffuse Joint Pain and Fatigue
150
HLA Associations
RA (DRB1 0401 !!!)
HLA A3
Hemochromatosis
HLA B51
Bechet Disease
HLA B27
HLA-DQ2/DQ8
Celiac
HLA-DR2
Narcolepsy
Good Pasture
HLA-DR3
Sjogren
Dermatitis Herpetiform
Primary Biliary Cirrhosis
HLA-DR4
T1DM ,
RA (DRB1 0401 in Whites)
RA DRB1 1301 Europeans)
DRB1 08 - Graves
DR15 / B39 - Chaga Related Cardiomyopathy
B39 / B52 - Takayasu Arteritis
B1507 - Abacavir Sensitivity
151
Conus Medullaris (L1-L5) vs Cauda Equina (T12 to L2)
Conus Medullaris - LMN+ UMN - Symmetrical - Hyperreflexia and Hypertonic
Cauda Equina
LMN - Asymmetrical and Flaccid
152
Vincristine in which Phase of Cell Cycle ?
Metaphase
153
Pan Retinal Photocoagulation -
Tunnel Vision
Loss of Rods and Color Vision
154
Diphtheria Treatment ?
Azithromycin
155
Amaurosis Fugax Embolus originates from where ?
Internal Carotid
156
Interval for Monitoring HbA1c in T2DM ?
6 months
157
Weak Flexion of Terminal Phalanges of Thumb ?
Nerve Injury
Median
How tho ?
158
Camplylobacter Antibiotic of Choice ?
Erythromycin
159
Hyporenemic Hyperaldosteronism
Bilateral Adenoma Hyperplasia and
Unilateral Adrenal Adenoma
160
1st Line Investigation for Small Joint Synovitis in Hand ?RA
Color Doppler
161
Whats common in Bile ?
Bile Salts or Cholesterol ?
Bile Salts
162
Pseudohypoparathyroidism is mutation where ?
G protein coupled receptor
163
What is the Poor Prognostic Factor in PAH ?
Atrial Fibrillation
164
Pulsus Paradox in Cardiac Tamponade
Drop in BP with Inspiration
Same in OCP/Asthma and Croup
Usually Pulse PRESSURE Falls on Expiration !!!!
165
Ivabradine is an I(f) Channel Inhibitor
166
Myotonic Dystrophy Inheritance ,
Features and Associations
Myotonic Dystrophy (Autosomal Dominant - CTG Trinucleotide Repeat)
DM1 - CTG Trinucleotide Repeat at end of DMPK gene on Chromosome 19 (Distal First)
DM2 - Repeat Expansion of ZNF9 gene on Chromosome 3 (Proximal First)
LMN
Distal Muscle Weakness
Loss of Ankle Reflex
Face
Bilateral Ptosis
Mastication Weakness
Frontotemporal Balding
Myotonia
Slow Release Hand Shake
Percussion Myotonia
Slow to Open eyes after Shutting tight
Christmas Tree Cataracts
Hypertrophic Cardiomyopathy & HB
Dysphagia
Testicular Atrophy
3T 3D
- 3T: Toupee (balding), ticker (cardiomyopathy), testicles (atrophy)
- 3D: diabetes, dysarthria, learning disability
167
Hereditary Spastic Paraplegia
Lower Limb Weakness + Foot Drop
168
If Resistant to Anti IL1 in AOSD then what Monoclonal ?
Toclizumab
169
Posterior MI on ECG
Prominent R wave in V1
170
Small Cell Lung Cancer associated with Cerebellar Dysfunction How ?
Anti Yo - Small Cell Lung Cancer - Men !!!!
Anti Hu - Ovarian and Breast Cancer causing Cerebellar Dysfunction
171
Which Muscle is associated with Maintaining Posture when standing ?
Soleus
172
AION vs Non AION
If GCA Sx --> AION
If not ---> NAION
173
Cisplatin Side Effect
Atrial Fibrillation
174
Gonorrhoeic Treatment
IV or IM Ceftriaxone
If not
IM Ceftriaxone + Oral Azithramycin
175
What indicates worsening of Mitral Valve Stenosis
Hemoptysis
176
Treatment for Phemigus
Rituximab
177
178
Drugs causing G6PD !!!
Trimethoprim Safe ?
YES !!!!!
If combined with Co-Trimoxiazole then DONT
178
MMF Side Effect ?
Tremor
179
INO
Demyelination of MLF
Located in Paramedian area of Midbrain and Pons
Features
1. Unable to ADDUCT of the eye on the same side as the lesion
2. Horizontal nystagmus of the ABDUCT TING eye on the contralateral side
Test of Convergence to help INO>Oculomotor Nuclear Palsy
180
In Lyme disease when to start Treatment ?
If high Suspicion START !!!!
No need Erythema Migrans or Tick Bite !!!
181
If Diabetic Ulcer
IV Co-amoxiclav
Clindamycin
If Gram Negative Suspected --> Add Metro/Cipro
182
Cerebral Abscess Treatment ?
Ceftriaxone and Metronidaole
Linezoid !!!
183
Acyclovir MOA ?
Sofosbuvir MOA ?
DNA Polymerase Inhibitor
RNA Polymerase Inhibitor
184
Antihypertensive in Marfan ?
ARB - Block Transforming Growth Factor - Beta Pathway
BB
185
AIN and ATN Causative
2. Interstitial
AIN - NSAIDs, Sulpha Drugs, PPI, Check Point Inhibitors, Abx, Recurrent Pyelonephritis
3. Tubular
ATN - Ischemia, Aminoglycosides, Crystalluria (Acyclovir, Cisplatin,MTX, Ciprofloxacin)
MM, TLS, Rhabdomyolysis
186
Yersinia Enterocolitica
Ciprofloxacin
187
Which is an Indication for Heart Surgery
Complete Heart Block
188
PPAR Alpha vs PPAR Gamma
Fibrates vs Pioglitazone
189
If Unexplained Anemia what needs to be tested regardless ??
Anti TTG
190
Glucagon MOA ?
Glycogenolysis Initially then --> Gluconeogenesis
191
Buprenorphine MOA
Partial Mu and Kappa
192
Oral Allergy Syndrome Tx
Skin Prick
Avoid
193
MM Chemotherapy
Betamustidine + Prednisolone
If Clinical Neuropathy then add
Thalidomide ----> Bortezomib (Protease Inhibitor and NK Kappa B activator)
194
EBV associated Lymphoma's
Post Transplantation
Nasopharyngeal
Hodgkin
Burkitt
CNS Primary Lymphoma
195
Monoclonals
Belimumab - B Lymphocyte Stimulator Inhibitor - SLE
Omalimuab - IgE - Asthma
Mepolizumab - Anti IL5 which reduces Eosinophil Degranulation - Asthma
Alemtuzumab - Anti CD52
Ocrezumab - MS
Elbasvir MOA - HCV NS5A
Dasabuvir HCV NS5B
Grazoprevir HCV NS3/4A
196
Idiopathic Intracranial Hypertension Ix of Choice ?
MRI Venogram !!!
197
LADA (Anti GAD +) Tx ?
Metformin
198
Cervical Spondylosis Pain
Between Shoulder Blades or Occiput
199
Cerebella Degeneration Autoantibodies
Anti Hu - Small Cell Lung
Anti Yo - Breast
Anti Tr - Hodgkin Lymphoma
Anti ANNA3 - Encephalitis in Hodgkin Lymphoma
200
Stiff Person Syndrome
Exaggerated Lumbar Lordosis
Anti Amphiphysin Antibodies
201
Pregnancy and Herpes
Primary or Recurrent - Start Acyclovir at 36 weeks onwards !!!
202
If Bilateral Renal Atheroma with Rising Creatinine what's the Treatment ?
Amlodipine 10mg
If recurrent Pulmonary Edema or Worsening Creatinine despite Amlodipine --->Bilateral Stents
203
Acute Fatty Liver Disease of Pregnancy vs Intra-Hepatic Cholestasis of Pregnancy
Acute Fatty Liver - After 35th Week
Intrahepatic Cholestasis -
25th Week + Jaundice is RARE !!!!
204
When you stand does Systemic Vascular Resistance Fall or Increase
Increase !!!
Stroke Volume Decrease
Heart Rate Increases
205
Treatment for FTD ?
SSRI (Paroxetine)
206
Side Effect of Febuoxstat ?
Bone Marrow Suppression
207
Graves Eye Disease Treatment ?
Prednisolone then 2nd Line
Give Rituximab/Ciclosporin
208
How to differentiate Eschar from Orientia vs Lyme ?
Orientia in South East - Northern Australia,
Nepal Tibet
+ Pulmonary Involvement !!!
209
If Pregnant and on Anti TNF for RA which is well controlled. What will you do
1. Stop Infliximab at Week 16
2. Switch to Azathioprine
STOP INFLIXIMAB
Anti TNF Alpha are SAFE in Pregnancy BUT in Infliximab stop at 16 especially well controlled
210
If Inappropriately Stored Fish what toxin is responsible ?
Scombroid Toxin
211
Pathophysiology of Holmes Adie's Pupil
Parasympathetic Ciliary Damage
212
Pseudogout is to HH so Gout i to ?
Primary Polycythemia
213
If Severe UC Treatment ?
IV Methylprednisolone then
IV Ciclosporin then
Colectomy
214
Diabetics with Yellow Brown Plaque with Telangiectatic Base
Necrobiosis Lipoidica
Topical Steroids
215
Hypokalemia Treatment 1st thing you give ?
K+ Supplementation not Calcium Gluconate
216
Prophylaxis for Malaria ?
Atovaquone and Proguanil
217
How to confirm Active AS ?
Do MRI SPINE STIR Protocol
You will see Osteitis (Bone Marrow Edema)
or
Fat Suppression in T2
218
Vaginal Candidiasis Treatment ?
Fluconazole 150mg every 72 hours for 3 days
219
Psuedoxanthoma Elasticum
Curvilinear Bands from Optic Disc - Retinal Angloid Streaks
Plucked Chicken Skin on Neck
Associated with GI Bleed and MVP in the Long Run
220
Chance of Siblings HLA matching with yours for Organ Tranplant ?
25%
221
Which muscle causes Fixed Flexion Deformity in Lower Limbs to which Botox can be injected ?
Rectus Femoris
222
Membranous Nephropathy Tx for Proteinuria ?
ACEi --> Furosemide
223
Treatment for Pyoderma Gangrenosum Ulcers ?
IV Infliximab
Intralesional Triamcleoone Maybe depending on
site (not peristomal PG)
But Prednisolone for PG
224
MS Preventing Relapses
Relapsing and Relapsing MS Active - Fingolimod
Relapsing and Remitting MS NOT ACTIVE - Dimethyl Fumarate
Primary Progressive MS - Ocrelizumab - Anti CD20
225
226
Cold AIHA
1. Causes
2. IgG or IgM associated
3. What type of Hypersensitivity ?
4. What's Evan's Syndrome ?
5. Treatment
1. Primary (Cold Agglutinin Disease)
Secondary -
EBV, CMV, Mycoplasma
NON HODGKIN Lymphoma, Wladenstrom's
Drugs - Lenalidomide
IgM
COMPLEMENT AND MAC ?????
227
Apomorphine MOA ?
D1/D2 Receptor Agonist
228
5HT2a Antagonist Example
Trazadone
229
Aphasia and Locations
Wernicke's - Word Salad - Superior Temporal Gyrus - Brodmann Areas 22
Comprehension IMPAIRED
Inferior Branch of L MCA
Broca's - Inferior Frontal Gyrus - Brodmann Area 44 and 45
Comprehension PRESERVED
Superior Branch of L MCA
Transcortical -
Temporoparietal Area
Broca's but with normal repetition
Conduction -
Arcuate Fasciculus or Subcortical Lesion
Anomia
Cant Repeat but Comprehension PRESERVED
230
Hypothalamus Parts and Functions
All the nuclei of the hypothalamus along with their functions:
Suprachiasmatic - Circadian rhythm
Anterior - Cooling
Posterior - Heating
Ventrolateral - Secretes orexin => wakefulness and feeding
Medial - Satiety
Arcuate - Satiety
Paraventricular - Oxytocin
Supraoptic - ADH
Preoptic - VL => Sleep; VM => GnRH
Mamillary - Memory
Dorsomedial - Behavior
231
Before putting the patient on an insulin pump what must be done ?
72 hour continuous glucose monitoring
232
Factors Predictive of Another MI ?
Involvement of 2 Carotid Beds
DM / Smoking / Low BMI / AF / Cardiac Failure
233
Location to Insert a Subclavian Catheter ?
1cm inferior to the junction of the middle and medial third of clavicle
234
Post Anti VEGF what Infection to consider ?
Bacterial Endophthalmitis
235
What's the best way to measure Factor Xa Inhibitor Activity
PT
236
Most Common Cause of Erythema Multiforme ?
HSV
237
Surgical 3rd Nerve Palsy apart from Posterior Communicating Artery Aneurysm where else ?
Internal Carotid Artery Aneurysm
238
Lamotrigine Metabolized by ?
Uridine Di Phospho
239
Magnesium in Asthma MOA
Decrease Histamine Release
Inhibit ACh release
240
Ninetanib MOA ?
Tyrosine Kinase Inhibitor
241
Triamcinolone MOA ?
Inhibit phospholipase A2 on cell membranes,
preventing breakdown of lysosomal membranes leukocytes,
prevent the formation of arachidonic acid,
decrease expression of cyclooxygenase and lipoxygenase,
inhibiting synthesis of prostaglandins and leukotrienes.
242
What is used to determine Prognostication in MND ?
SNIP Test
243
Diagnostic Investigation for Rabies ?
Skin Biopsy from Nape of Neck
244
Mitral Stenosis causing Pleural Effusion ?
Unilateral usually left
Transudative
Everything Normal
245
Which Cancer is Hashimoto's associated with ?
Non Hodgkin
246
If Gastric Bypass Surgery then What Supplement is to be taken ?
Zinc
Zinc overload can lead to copper deficiency
247
Protein 14-3-3 Testing is done for ?
Sporadic CJD
248
PTEN Mutation and Cowden Syndrome
249
Most Common Heart Defect in Noonan Syndrome ?
Pulmonary Stenosis
250
CYP34A - Clarithromycin
CYP2C19 - Omeprazole
251
Tourette Syndrome Treatment ?
Psychoeducation
Clonidine
Risperidone
252
Drug for Coronary Artery Vasospasm ?
Amlodipine
253
Avascular Necrosis Initial Treatment ?
Core Decompression with Bone Graft
254
Antiemetic for Nausea and Vomiting in End of Life Patient from Bowel Obstruction ?
Haloperidol
255
Fear of Germs
Mysophobia
256
Contraindication for Surgical Removal of Lung Cancer ?
Vocal Cord Palsy
257
Amoebic Cyst vs
Hydatid Cyst
Simple Liver Cyst with wall Thickening + Rim of Edema of Cyst
vs
Peripheral Calcifications
258
Adrenal Failure Autoimmune
Home Hemodialysis
259
Adrenal Failure Autoimmune What will you find in Bloods ?
Elevated ACTH > Low Aldosterone
260
Albendazole or Mebendazole for Threadworms ?
Mebendazole
261
Mebendazole Mechanism of Action
Inhibits Microtubules by binding to Colchicine Binding Site of Micro tubulins
262
Biggest Risk Factor for Future Diabetic Ulcers ?
Previous Ulcer
263
Prognostic Marker for Cardiac Tamponade ?
Degree of Pulsus Paradoxus
264
How does C4 injury present ?
SOB on lying down
Paralysis of the Diaphragm
265
Which Vitamin is associated with Colon Cancer ?
Vitamin D
266
Pityriasis Versicolor
Young Patient after a Sunny Holiday
hyperpigmented Macules with Very Fine Scaling
267
When to use Telofivir in NS3/4A Serine Protease Inhibitor
268
Meningioma vs Epidermoid Tumor on Imaging ?
Calcifications vs Non Enhancing + Early Age
269
Breast Cancer > Lung Cancer for Bone Mets
270
When taking Pethidine in Epileptic Patients why does Seizures happen ?
Accumulation of Norpethidine
271
Anti Ma associated with ?
Testicular Cancer
272
Why does Isoniazid Induced Peripheral Neuropathy Occur ?
N Acetyl Transferase Type 2
NAT1 - Colorectal Cancer
273
Pre Patellar Bursitis Treatment ?
Aspirate
274
Post Partum Thyroiditis when Hyperthyroid and when Hypothyroid ?
2-8 weeks Hyperthyroid
6 months of Hypothyroidism
275
Thoracic Outlet Syndrome
Positional
CT with Arm in Neutral and Abducted
276
What is C3 Nephritic Factor ?
Anti C3bBb Antibody
277
Causes of Chylothorax ?
Trauma and Lymphoma
Yellow Nail Syndrome
LAM
Filiaris
278
Why does Chronic Stroke cause Hypothermia ?
Impaired Catecholamine Release
279
What antibodies for HIT ?
Anti PF4
280
If Cellulitis not responding to Flucloxacillin then go for ?
Clarithromycin
281
Cerebral Edema from Hyponatremia Correction
Gain of Water in to the Cells
282
Cholesterol Embolism has traditionally
Eosinophilia
Renal Impairment
283
Hypercalcemia in Thyrotoxicosis !!!
284
If allergic to Penicillin in Syphilis then ?
Doxycycline 100mg BD for 14 days
285
In HOCM
Left Atrial Enlargement = Risk of
Atrial Fibrillation
286
Liddle vs Conn How to Differentiate ?
Liddle Made worse by Stress !!!!!
287
Vaccinations to stop how many weeks before Transplantation?
4 weeks
Give VZV Vaccination to RECIPIENT before 4 weeks of Tranplantation
VZV Antibodies only provide short term immunity
288
Alopecia Acreta Treatment
Exclamation Hairs
Intralesional Corticosteroids
289
Androgen Insensitivity Genotype ?
Primary Amenorrhea
Normal Breasts
Ambiguous Genatalia
Sparse Pubic Hair
46XY !!!!!
290
ACE i cause an Increase in Renin and Decrease in Aldosterone
291
Brain Stem Stroke with Sudden Deterioration in GCS ?
Compression of 4th Ventricle --> Raised ICP ---> Decrease GCS
292
PAH Blood Gas Picture
Normal HCO3- , PaCO2 but SLIGHTLY LOW PO2
293
If Post Chemotherapy and IV Antibiotics not working --> Start Anti Fungal Therapy
