path from past papers Flashcards
1
Q
most common cause of constrictive pericarditis with calcifications
A
TB
2
Q
Prostate scoring system
A
Gleason
3
Q
Steroid given in Covid-19 with low O2
A
Dexamethasone
4
Q
Flower nuclei
A
Adult T-cell lymphoma
5
Q
<30g/L but increased IgG lambda, normal kappa lambda ration
A
smouldering
6
Q
H pylori eradication therapy
A
PPI + amoxicillin + erythromycin
7
Q
Cavitating lesion, bloody phlegm
A
Mycobacterium tuberculosis
8
Q
Virus that doesn’t normally become chronic but dangerous in pregnancy
A
Hep E
9
Q
Hirschsprung biopsy
A
Absence of ganglion cells in the submucosal and myenteric plexuses
10
Q
Low CH50, Low AP50, purpuric rash and fever
A
N meningitidis - C7 deficiency
11
Q
Hypoglycaemia drug
A
Quinine
12
Q
lung peripheries cancer, high ADH
A
small cell lung cancer
13
Q
skin prick testing
A
95% negative predictive value
14
Q
Unprovoked DVT - long term prophylaxis after LMWH
A
DOAC
15
Q
HIV, low CD4 count, diarrhoea, alcohol and acid fast bacilli
A
Mycobacterium avium complex
16
Q
Covid antiviral
A
remsedivir
17
Q
Acute pancreatitis: causative type of hyperlipidaemia
A
triglycerides
18
Q
Multiple pulmonary emboli consequence
A
pulmonary HTN
19
Q
rank narrow to broad: pip taz, meropenem, cef, fluclox, co-amox
A
fluclox
co-amox
ceftriaxone
pip taz
meropenem
20
Q
osteomyelitis: s aureus, e coli, brucella melitensis, s anginosus, pseudomonas aeruginosa
A
- s aureus
- strep anginosus
- e coli
- pseudomonas aeruginosa
5.brucella melitensis
21
Q
coeliac disease and macrocytosis
A
folate deficiency
22
Q
Waldenstrom’s macroglobulinaemia aka
A
lymphoplasmacytic lymphoma
23
Q
If they sound Multiple myeloma-esque but don’t fulfil the CRAB criteria but do have a super high calcium, + have some hint of IV drug use in their history
A
adult t cell lymphoma
24
Q
food poisoning + timeline
A
1-6 hrs: Staphylococcus aureus, Bacillus cereus*
12-48 hrs: Salmonella, Escherichia coli (watery camper)
48-72 hrs: Shigella (bloody), Campylobacter (hayfever campylo (flu prodrome) + (diarrhoea can be bloody))
7 days: Amoebiasis (Bloody), Giardiasis (Non-bloody diarrhoea)
25
Diarrhoea (before 12 hours)
staph aureus or bacillus cereus
26
Diarrhoea (before 12 hours) + Rice or Chinese
bacillus cereus
27
diarrhoea after 12 hours or day after meal
salmonella
28
diarrhoea 2-3 days post meal
campylobacter
29
diarrhoea > 7 days after meal
giardiasis
30
bloody diarrhoea + e coli
salmonella
31
bloody diarrhoea + campylobacter presentation
shigella
32
bloody diarrhoea + giardiasis presentation
entamoeba histolytica
33
Diarrhoea + (context of question e.g. Travel to Southeast Asia)
cholera
34
diarrhoea + travel from bangladesh
typhoid
35
Diarrhoea + Sex Worker or IV Drug user or Homeless
HIV apparently
36
low or moderate severity community acquired pneumonia
oral amox + macrolide if in hosp
37
high severity community acquired pneumonia
iv co-amoxiclav + clarithromycin
OR
cefuroxime + clarithromycin
OR
cefotaxime + clarithromycin
38
if anyone has a penicillin allergy...
don't treat with cephalosporins or amoxicillin
39
pharyngitis: if IV?
benzylpenicillin
40
pharyngitis + penicillin allergy
mild: clarithromycin
mod-severe: clindamycin
41
severe strep throat
IV penicillin & clindamycin
42
if spain mentioned in question for pneumonia?
legionella
clarithromycin > erythromycin
43
normal random, fasting, and OGTT glucose
random: 4-<7.8
fasting: 4-<6.1
OGTT: 4-<7.8
44
impaired fasting glucose
6.1-6.99
45
fasting glucose suggestive of diabetes
>7
46
what next are impaired or diabetes-suggestive fasting glucose?
oral glucose tolerance test
47
impaired glucose tolerance test
7.8-11.0999
48
isolation OGTT > 11.1
suggestive but not diagnostic
49
50
Which/What cell sits in (it’s immature form in) the periphery, and when it matures, goes to present things to T cells?
dendritic cells
51
inhibited by presence of MHC 1
Natural killer cells
52
Which/What cell undergoes positive and negative selection in the thymus.
T lymphocytes
53
Loss of E cadherin breast cancer
Invasive lobular carcinoma
54
Most common type of malignancy in the breast?
invasive ductal carcinoma
55
Presence of E cadherin breast cancer
invasive ductal carcinoma
56
Breast cancer aka non-specfici type
invasive ductal carcinoma
57
Breast cancer w a high medium and low stage to it
ductal carcinoma in situ
58
Fibroepithelial tumour with abundal stromal elements
Phyllodes tumour
59
A 12 year old boy has recurrent chest infections, and has an ear infection. He doesn’t have any B Cells.
Bruton's X-linked agammaglobulinaemia
60
A boy’s father has TB. The same boy develops a mycobacterium infection, following their BCG.
IFN-gamma receptor deficiency
61
Signs of CF + Ear infection
X-linked agammaglobulinaemia
62
Signs of X-linked agammaglobulinaemia + Nose Bleed
Wiskot-Aldrich
63
60 year old Man with abdominal pain radiating to back, collapses and dies
acute aortic aneurysm
64
Man, ex-smoker, with history of hypertension and MI, has sudden chest pain which radiates to the neck
descending internal carotid thrombus
65
50 year old lady with memory issues/progressive amnesia, hypertension (?? + bronchopneumonia??)
Multiple cerebral/(?cortical) infarcts
66
Elderly man with atrial fibrillation with right flank pain?
renal infarct
67
Man has an MI 3 years ago. Now comes into hospital feeling very unwell. Is having a sample taken from their pericardial layer and you find blood is aspirated from the pericardium
ventricular rupture
68
A girl has recently been noted by her parents to be acting strange lately. A Lumbar puncture is performed and the CSF shows high lymphocytes and a raised protein, but normal glucose (on LP)
herpes virus
69
CSF cloudy + high lymphocytes + fibrin web
TB
70
CSF clear/cloudy + normal glucose + normal/raised protein + raised white cells
viral
71
CSF cloudy, low glucose, high protein, high white cells
bacterial
72
pembrolizumab moa
blocks programmed cell-death rpotein 1 receptor (PD1 receptor)
73
infliximab moa
TNFa blocker - used in psoriasis, Crohn's, rheumatoid arthritis
74
There are 5 special drug treatments. Which drug can be used to treat some malignancies and affects T cell activity?
Rituximab – Targets B cells + causes inactivation of T cells:
75
denosumab
osteoporosis
76
ustekinumab
psoriasis
77
follicular lymphoma
78
diffuse lymphoma
79
burkitt's
80
hairy cell leukaemia
81
CLL smear cells
82
most common malignant ovarian tumour
serous cystadenocarcinoma
83
most common benign ovarian tumour
serous cystadenoma
84
Trypanosoma brucei rhodesiense vector
tsetse fly
85
Leishmaniasis vector
sandfly
86
50 year old man with Midshaft femur fracture – what would you find at the site of the break/fracture (or rather, which/what type of cancer does he have)?
chondrocarcinoma
87
most common primary bone tumour
osteosarcoma
88
ewing sarcoma on x-ray
onion skin periosteal reaction
89
Indications for Acute Dialysis
AEIOU
"A"- intractable acidosis
"E"- electrolyte disarray ( K+, Na+, Ca++)
"I" - intoxicants (methanol ethylene glycol, Li, ASA)
"O"- intractable fluid overload
"U"- uremic symptoms (nausea, seizure, pericarditis, bleeding)."
90
What does denosumab target?
Receptor activator of nuclear factor kappa-B Ligand
91
Which enzyme would you expect to be raised in obstructive jaundice/biliary obstruction?
Gamma-glutamyl transpeptidase
92
What can be used to measure the turnover of bone, and is raised in people who have Paget’s, Osteomalacia / Rickets?
alkaline phosphatase
93
Subdural
Super Secret Submarine (there’s no warning before it strikes) = No loss of consciousness following initial head injury and then suddenly hours later lose consciousness
94
Extradural
EXTRA loss of consciousness = Immediate loss of consciousness followed by lucid interval. Followed by EXTRA loss of consciousness several hours later.
95
Abx of the Macrolide/lincosamide/streptogrammin group used to treat some atypical pneumonias
erythromycin
96
A patient required an aortic valve replaced 3 months ago. They have now come back a few weeks later with jaundice, Hb-urea (haemoglobinuria), and raised reticulocytes. What is the cause?
mechanical haemolytic anaemia
97
Which common condition can be treated with drugs that target with TNF, IL-17 and IL-12/23?
psoriasis
98
Name the main class of drug used to treat HIV
nucleoside reverse transcriptase inhibitors
99
Ixodes tick disease
Lyme disease
100
A DNA synthesis inhibitor used to treat Pseudomonal infections but bad against anaerobes
ciprofloxacin
101
Target INR for 1st episode DVT or PE
3.5
102
Target INR for atrial fibrillation
2-3
103
target INR for cardiomyopathy
2.5
104
target INR for symptomatic inherited thrombophilia
2.5
105
target INR for mural thrombus
2.5
106
Target INR for cardioversion
2.5
107
Target INR for recurrent DVT or PE
3.5
108
Target INR for mechanical prosthetic valve
2.5-3.5
109
Target INR for coronary graft thrombosis
3.5
110
Target INR for antiphospholipid syndrome
3.5
111
A 25 year old man has a 10 year history of low back pain and stiffness, with symptoms being worse at night and in the early mornings. An MRI scan has shown bone marrow oedema at the sacroiliac joints. Blood tests confirm an acute phase response with C- reactive protein 18 mg/L (<5). He has shown a partial response to NSAIDS. Which cytokine could be targeted to improve disease control.
tumour necrosis factor alpha
112
anti-IL1
anakinra
113
anti CD20
rituximab
114
anti-IL6
tocilizumab
115
anti T cell co-stimulatory cytokines
Abatacept
116
secukinumab used for?
psoriasis
117
118
influenza A antiviral
Zanamivir
119
most common primary CNS tumour in children
pilocytic astrocytoma
120
Mepolizumab - mode and use?
Eosinophilic asthma - IL5
121
Secukinumab
IL-17
Plaque psoriasis
