phase 4 set 1

Question 1

In which type of lymphoma would you find reed sternberg cells?

Answer 1

hodgkin

Question 2

what is the critical diagnostic investigation in lymphoma?

Answer 2

lymph node biopsy

Question 3

What is the lugano classification used to stage?

Answer 3

lymphoma
stage 1: confined to one node or group of nodes
stage 2: in more than one group of nodes but on the same side of the diaphragm
stage 3: affects nodes both above and below the diaphragm
stage 4: widespread involvement including non lymphatic organs

Question 4

What causes dengue fever?

Answer 4

the dengue virus

Question 5

What type of antiemetic is cyclizine ?

Answer 5

H1 antihitamine

Question 6

What type of antiemetics are metoclopramide and domperidone?

Answer 6

dopamine antagonist

Question 7

What type of antiemetic is ondansetron?

Answer 7

5HT3 receptor antagonist

Question 8

What medication might you offer for chemotherapy induced nausea and vomiting?

Answer 8

ondansetron

Question 9

which type of lymphoma is a common cause of tumour lysis syndrome?

Answer 9

Burkitts

Question 10

which type of lymphoma has a starry sky appearance on lymph node biopsy?

Answer 10

Burkitts lymphoma

Question 11

In which type of leukaemia is the philadelphia translocation seen in?

Answer 11

chronic myeloid leukemia (CML)

Question 12

CA 15-3 is a tumour marker associated with which type of cancer?

Answer 12

breast

Question 13

Which tumour marker is associated with ovarian cancer?

Answer 13

CA125

Question 14

What medication do you give if neoplastic spinal cord compression is suspected?

Answer 14

oral dexamethasone

Question 15

describe the rash seen in meningococcal septicaemia

Answer 15

non- blanching purpuric rash

Question 16

What would we give in suspected bacterial meningitis?

Answer 16

IV ceftriaxone
in patients over 65 give amoxicillin to cover listeria

Question 17

What type of antibiotic is ceftriaxone?

Answer 17

cephalosporin

Question 18

what is the antibiotic of choice for prophylaxis for close contacts of a patient with meningococcal meningtis?

Answer 18

ciprofloxacin 500mg orally

Question 19

what is an important investigation to send off in cases of suspected malaria?

Answer 19

three sets of thick and thin blood film

Question 20

In malaria, how should we treat patients with parasitaemia of greater than 2%

Answer 20

IV artesunate

Question 21

What are the different components of the CURB 65 score?

Answer 21

c- confusion
u- urea
R- resp rate
B- blood pressure
65- age

Question 22

what does a curb 65 score of 1 mean?

Answer 22

low risk manage at home

Question 23

what does the respiratory rate have to be to score for the RR section of the curb65 score?

Answer 23

30 or more

Question 24

What is the most common cause of community acquired pneumonia in adults?

Answer 24

streptococcus pneumoniae

Question 25

A patient has had symptoms of pneumonia for 1 week and you suspect legionella pneumophila is the pathogen- what should we test the urine for ?

Answer 25

legionella antigen (nb this is only present in first two weeks of infection)

Question 26

What is first line for CAP in a patient with a CURB 65 score of 0-1?

Answer 26

amoxicillin

Question 27

What is first line for CAP in a patient with a CURB65 score of 3-5?

Answer 27

IV co-amoxiclav and PO/IV clarithromysin

Question 28

what is the incubation period of ingested staphylococcus aureus?

Answer 28

less than 6 hours as the toxin is already in the food

Question 29

what is the problematic bacteria in reheated rice?

Answer 29

bacillus cereus

Question 30

what would you expect the diarrhoea to be like in someone who has ingested reheated rice?

Answer 30

watery

Question 31

what is the most common causative organism of gastroenteritis?

Answer 31

campylobacter jejuni

Question 32

what organism would you suspect in a patient with bloody diarrhoea and no fever who ingested ground beef 3 days ago?

Answer 32

E.coli

Question 33

what type of pneumonia might you see in a person with HIV who does not take their medication?

Answer 33

pneumocystis jirovecii

Question 34

which antibiotic is used to treat pneomocystis jirovecii pneumoniae?

Answer 34

co trimoxazole

Question 35

what does NRTI stand for?

Answer 35

nucleoside reverse transcriptase inhibitor

Question 36

how is hepatitis A usually spread?

Answer 36

faecal oral route

Question 37

For hepatitis D to cause disease, what must a person already be infected by?

Answer 37

hep B

Question 38

Describe vertical transmission of hep B?

Answer 38

Infected mother to baby

Question 39

Describe horizontal transmission of hep B?

Answer 39

sexual, needles and sharps, sharing razors and toothbrushes, blood transfusion

Question 40

which test is a diagnostic confirmation of current hep B infection?

Answer 40

HBsAg

Question 41

In what percentage of patients does HBV spontaneously resolve?

Answer 41

95%

Question 42

what are the complications of chronic HBV infection?

Answer 42

hepatocellular carcinoma cirrhosis

Question 43

what is the classic diagnostic triad in infective endocarditis?

Answer 43

persistent fever new/changing heart murmur embolic phenomenon

Question 44

What are the peripheral stigmata of infective endocarditis?

Answer 44

janeway lesions, osler nodes, roth spots, splinter haemorrhages

Question 45

on which part of the body would you find roth spots?

Answer 45

the retina

Question 46

on which part of the body would you find janeway lesions?

Answer 46

palms of the hands

Question 47

where would you typically find osler nodes?

Answer 47

distal fingers

Question 48

How many sets of blood cultures should be taken in infective endocarditis?

Answer 48

3 sets at 30 minute intervals

Question 49

what is the first line imaging in infective endocarditis?

Answer 49

transthoracic echocardiogram

Question 50

what criteria can be used to help support a diagnosis of infective endocarditis?

Answer 50

modified Duke criteria

Question 51

which type of endocarditis is a well known complication of IV drug use?

Answer 51

staphylococcus aureus endocarditis

Question 52

what is the tuberculin skin test also known as?

Answer 52

mantoux test

Question 53

what is a more specific test for TB than the mantoux test?

Answer 53

interferon gamma release assays e.g t spot test

Question 54

what might you see on chest x ray in active TB?

Answer 54

apical lobe consolidation hilar lymph nodes cavities

Question 55

consuming what drink can put someone at risk of catching TB?

Answer 55

unpastutised cows milk

Question 56

which is more sensitive- tuberculin skin test or interferon gamma release assay?

Answer 56

tuberculin skin test

Question 57

which is more specifc- tuberculin skin test or interferon gamma release assay?

Answer 57

interferon gamma release assay

Question 58

what percentage of people with latent TB never go on to develop active TB?

Answer 58

90%

Question 59

what are the drug options for a person with latent TB for prophlaxis of active TB development?

Answer 59

6 months isoniazid or 3 months of rifampicin and isoniazid

Question 60

which TB drug interacts with hormonal contraception ?

Answer 60

rifampicin

Question 61

which TB drug can cause red urine ?

Answer 61

rifampicin

Question 62

which TB drug can cause peripheral neuropathy?

Answer 62

isoniazid

Question 63

what type of antibiotic is doxycyline?

Answer 63

tetracycline

Question 64

what would streptococcus pneumonia look like on gram staining?

Answer 64

gram positive cocci (lancet shaped diplococci in chains)

Question 65

which organism is classically associated with a pneumonia that causes rust coloured sputum?

Answer 65

streptococcus pneumoniae

Question 66

what colour do gram negative bacteria stain?

Answer 66

pink

Question 67

what class of antibiotic is gentamicin?

Answer 67

aminoglycoside

Question 68

how does gentamicin work?

Answer 68

inhibits protein synthesis

Question 69

what class of antibiotic is erythromycin?

Answer 69

macrolide