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Yr 2 EOYS ^2 > Quick Facts 7 > Flashcards

Quick Facts 7 Flashcards

1
Q

TCAs are toxic to which part of the body? [1]

A

Cardiotoxic: Blockade of fast sodium channels in myocardial cells slows the action potential and provides a membrane stabilizing effect. The characteristic QRS prolongation seen in TCA overdose occurs secondary to prolongation of phase “0” of the myocardial action potential. T

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2
Q

venlafaxine is what drug class? [1]

A

SNRI

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3
Q

Which drug class are first treatment for moderate-severe depression? [1]

A

SSRIs

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4
Q

How do SSRIs differ in their mechanism to TCAs? [1]

A

SSRIs don’t inhibit noradrenaline reuptake

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5
Q

Which SSRI increases QT intervals? [1]

A

Citalopram

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6
Q

Phentoin is an anti-seizure drug that targets which channel?

GABA-A
NMDA Glutamate
AMPA Glutamate
Na+
CA2+

A

Phentoin is an anti-seizure drug that targets which channel?

GABA-A
NMDA Glutamate
AMPA Glutamate
Na+
CA2+

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7
Q

What pathology is phenytoin used for? [1]

A

Seizures

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8
Q

Name some key side effects of phenytoin acute [2] chronic [3] and idiosynchratic use [1]

A
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9
Q

Name and explain a MSK disease prolonged phenytoin use can cause

A

enhanced vitamin D metabolism causing osteomalacia

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10
Q

Name two uses of amantadine [2]
State MoA [2]

A

Treats: Parkinson’s disease & PVS
NMDA receptor antagonistic effect & block dopaminergic reuptake

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11
Q

What does Agomelatine treat? [1]

A

Depression

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12
Q

State the class of drugs that selegiline belongs to [1]

A

MOA inhibitor

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13
Q

Management of tonic-clonic seizures is with:

First line: []
Second line: [] or []

A

Management of tonic-clonic seizures is with:

First line: sodium valproate
Second line: lamotrigine or carbamazepine

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14
Q

Which drug class has the highest risk for mania if used to treat depression in bipolar patients?

TCAs
SNRIs
MAOIs
SSRIs

A

Which drug class has the highest risk for mania if used to treat depression in bipolar patients?

TCAs
SNRIs
MAOIs
SSRIs

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15
Q

Which is the first line treatment for trigeminal neuraglia? [1]

A

Carbamazepine

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16
Q

Name two indications for Carbamazepine [2]

A

Epiplepsy
Trigeminal neuralgia

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17
Q

Name a common side effect of Carbamazepine use [1]

A

Carbamazepine hypersensitivity: get a rash

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18
Q

What ion flows through the GABA receptor?

Sodium
Chloride
Bicarbonate
Potassium
Calcium

A

What ion flows through the GABA receptor?

Sodium
Chloride
Bicarbonate
Potassium
Calcium

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19
Q

Zolpidem is a drug that causes patients to temporarily leave vegetative state. What is its MoA?

GABA-A antagonist
GABA-A agonist
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist

A

Zolpidem is a drug that causes patients to temporarily leave vegetative state. What is its MoA?

GABA-A antagonist
GABA-A agonist
NMDA Glutamate antagonist
NMDA Glutamate agonist
AMPA Glutamate antagonist

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20
Q

Name two drugs used for seizure prophylaxis [2]

A

A
Phenytoin
Levetiracetam

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21
Q

Which drug inhibits GABA metabolism? [1]

A

Vigabatrin

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22
Q

Risperidone blocks which 5-HT subtype? [1]

A

5-HT2A

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23
Q

Buspirone is an anti-anxiolytic that targets which receptor
5-HT1A
5-HT1B
5-HT2A
5-HT2B
5-HT2C

A

Buspirone is an anti-anxiolytic that targets which receptor
5-HT1A
5-HT1B
5-HT2A
5-HT2B
5-HT2C

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24
Q

Which is the most selective SSRI?

citalopram
sertraline
fluoxetine
paroxetine

A

Which is the most selective SSRI?

citalopram
sertraline
fluoxetine
paroxetine

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25
Q

Phenelzine belongs to which drug class

SNRI
SSRI
MOA (reversible)
TCA
MOA (irreversible)

A

Phenelzine belongs to which drug class

SNRI
SSRI
MOA (reversible)
TCA
MOA (irreversible)

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26
Q

Which of the following is the most cardiotoxic?

Amitriptyline
Nortriptyline
Citalopram
Sertraline
Fluoxetine

A

Which of the following is the most cardiotoxic?

Amitriptyline
Nortriptyline
Citalopram
Sertraline
Fluoxetine

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27
Q

Which dopamine pathway is involved in reward and addiction? [1]

Exam Q

A

Mesolimbic

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28
Q

Describe MoA of ketamine [1]

A

NMDA glutamate receptor antagonist

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29
Q

Which cortical region is thought to be most involved in affactive and emotional behaviour [1]

Exam Q

A

Cingulate gyrus

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30
Q

Propofol; Thiopental; Etomidate are examples of what drug class? [1]

A

Intravenous anaesthetics:

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31
Q

Enflurane and Halothane are what type of drug class? [1]

A

Inhaled anaesthetics

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32
Q

Which drugs can you use to start seizure prophylaxis? [2]

A

phenytoin/levetiracetam

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33
Q

Which drugs can you use to induce coma? [2]

A

Sedation/Induce coma with propofol or benzodiazepines

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34
Q

Foetal malformations represent a main unwanted effect of an antiepileptic drug. Name this drug [1]

A

Phenytoin

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35
Q

The patient has some concerns as he is aware that codeine is an opioid medication.

What side effect is likely to continue to affect the patient, even with long-term use?

Constipation
Dry mouth
Peptic ulceration
Respiratory depression
Sedation

A

The patient has some concerns as he is aware that codeine is an opioid medication.

What side effect is likely to continue to affect the patient, even with long-term use?

Constipation
Constipation All side effects of opioids tend to abate with long-term use, except for constipation

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36
Q

Which anti-epileptic treatment works by bind to synaptic vesicle protein SV2A causing a reduction in neurones

Sodium Valproate
Ethosuximide
Lamotrigine
Levetiracetam
Lorazepam

A

Which anti-epileptic treatment works by bind to synaptic vesicle protein SV2A causing a reduction in neurones

Sodium Valproate
Ethosuximide
Lamotrigine
Levetiracetam
Lorazepam

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37
Q

A 27-year-old female is recently started on olanzapine following a diagnosis of schizophrenia. Shortly after the initiation of the drugs she becomes restless and her mother states that she seems to be staring blankly. On examination you note an upward deviation of both eyes.

What is the cause of this?

Brain tumour

Neuroleptic malignant syndrome

Oculogyric-crisis

Cranial nerve III palsy

A

Oculogyric-crisis

Oculogyric crisis is a dystonic reaction that occurs shortly after initiation of anti-psychotics, most commonly with the older typical anti-psychotics. Treatment involves drug cessation and anti-muscarinic administration.

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38
Q

Which of the following inhibits GABA transaminase to prevent GABA breakdown

Vigabatrin
Levetiracetam
Phenobarbitone
Tiagabine

A

Which of the following inhibits GABA transaminase to prevent GABA breakdown

Vigabatrin
Levetiracetam
Phenobarbitone
Tiagabine

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39
Q

Name a drug that used for epilepsy that has recent use for insomnia [1]

A

A
Pregabalin

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40
Q

Name a tricyclic antidepressant that is used to treaet neuropathic and cancer pain [1]

A

Amitriptyline

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41
Q

[] is an effective pharmacotherapy to aid smoking cessation

A

Bupropion is an effective pharmacotherapy to aid smoking cessation

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42
Q

Which anti-epileptic drugs are safe in pregnancy? [2]

A

Lamotrigine and levetiracetam

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43
Q

What are the first three firstline drug classes recommended for neuropathic pain? [3]

A

SNRIs (duloxetine)
tricyclic antidepressants (amitrypyline)
calcium channel blockers(gabapentin, pregabalin)

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44
Q

What type of family of antidepressants are clomipramine, imipramine, desipramine, amitriptyline, nortriptyline and protriptyline? [1]

A

TRICYCLIC ANTIDEPRESSANTS (TCAs)

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45
Q

Explain the three phases of antidepressant treatment [3]

A
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46
Q

Focal Seizures Treatment:

First line: [] or []
Second line: [] or []

A

First line: carbamazepine or lamotrigine
Second line: sodium valproate or levetiracetam

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47
Q

A 28-year-old patient with schizophrenia presents to the general practice. On two occasions he has noticed discharge on his shirt, when inspecting he noticed a milky fluid was coming from his nipples. He remembers the psychiatrist mentioning something similar to this could occur with his medication.

Which of the following is the most likely cause of his discharge?

Clozapine
Risperidone
Fluoxetine
Olanzapine
Quetiapine

A

A 28-year-old patient with schizophrenia presents to the general practice. On two occasions he has noticed discharge on his shirt, when inspecting he noticed a milky fluid was coming from his nipples. He remembers the psychiatrist mentioning something similar to this could occur with his medication.

Which of the following is the most likely cause of his discharge?

Clozapine
Risperidone
Fluoxetine
Olanzapine
Quetiapine

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48
Q

A man with generalized anxiety disorder is started on buspirone therapy. This drug is thought to interact with which of the following neurotransmitters?

A. Acetylcholine
B. Gamma amino butyric acid
C. Norepinephrine
D. Serotonin (5-HT)

A

A man with generalized anxiety disorder is started on buspirone therapy. This drug is thought to interact with which of the following neurotransmitters?

A. Acetylcholine
B. Gamma amino butyric acid
C. Norepinephrine
D. Serotonin (5-HT) (5HT1A)

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49
Q

A 19-year-old man is brought in by his family. They tell you he has become withdrawn and not left the house for several months and has been acting strangely. They think he is hearing voices and he often refuses to eat as he claims the food it is poisoned. Given the likely diagnosis, what would be the most appropriate first-line treatment?

Clozapine

Olanzapine

Sertraline

Sodium Valproate

Pregabalin

A

A 19-year-old man is brought in by his family. They tell you he has become withdrawn and not left the house for several months and has been acting strangely. They think he is hearing voices and he often refuses to eat as he claims the food it is poisoned. Given the likely diagnosis, what would be the most appropriate first-line treatment?

Clozapine

Olanzapine

Sertraline

Sodium Valproate

Pregabalin

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50
Q

Ponsenti method treats which growth abnormality? [1]

A

Club foot / Tapes equinovarus

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51
Q
A

A: RA
B: OA
C: gout

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52
Q

Which angle is used to detect CDH via ultrasound

What is a normal angle? [1]

alpha-angle
beta-angle
delta-angle
gamma-angle

A

alpha-angle

The alpha angle is formed by the acetabular roof to the vertical cortex of the ilium. This is a similar measurement to that of the acetabular angle (see below). The normal value is greater than or equal to 60º.

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53
Q

What is 3? [1]

A
  1. Synovial fold
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54
Q

Omalizumab is used to treat

Vitiligo
Phemphis vulgaris
Leukocytoclastic vulgaris
Urticaria

A

Omalizumab is used to treat

Vitiligo
Phemphis vulgaris
Leukocytoclastic vulgaris
Urticaria

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55
Q

Which cell makes type 1 collagen?

osteoclasts
osteoblasts
osteocyte
osteoprogenitor

A

Which cell makes type 1 collagen?

osteoclasts
osteoblasts
osteocyte
osteoprogenitor

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56
Q

State an autoimmune disease that can cause AVN block [1]

A

Ankylosing spondylitis

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57
Q

What pathology is depicted here? [1]

A

Trigger finger

Superficial and deep flexor tendons with local tenosynovitis at the metacarpal head subsequently develop localised nodal formation on the tendon, distal to the pulley (Fig. 1). The A1 pulley is the most frequently involved ligament in trigger finger.

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58
Q

Adalimumab is a treatment for OA. Which cytokine does it target?

IL-1
IL-6
TNF-a
IL-17

A

Adalimumab is a treatment for OA. Which cytokine does it target?

IL-1
IL-6
TNF-a
IL-17

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59
Q
A

A: Involucrum: A reactive shell of new bone forms around the sequestrum

B: sequestrum: necrotic bone fragment

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60
Q

Jefferson Fracture occurs at

C1
C2
C3
C4
C5

A

Jefferson Fracture occurs at

C1
C2
C3
C4
C5

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61
Q
A

Boutienne

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62
Q

Erosive OA typically has erosion of cartilage in

Thumb DIP
Index finger PIP
Middle finger DIP
4th finger PIP
Little finger DIP

A

Erosive OA typically has erosion of cartilage in

Thumb DIP
Index finger PIP
Middle finger DIP
4th finger PIP
Little finger DIP

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63
Q

Which of the following antibodies would help confirm the diagnosis?

Anti-Ro
Anti-nuclear
Anti-histone
Anti-U1 RNP
Anti-cyclic citrullinated peptide

A

Which of the following antibodies would help confirm the diagnosis?

A Anti-Ro
Anti-nuclear (your answer)
Anti-histone (correct answer)
D Anti-U1 RNP
E Anti-cyclic citrullinated peptide

This is not SLE!

One of the hallmarks of drug-induced lupus is the presence of anti-histone autoantibodies, which are found in >95% of cases (formation is drug-specific).

Anti-Ro - seen in Sjögren syndrome.
Anti-CCP - seen in rheumatoid arthritis.
Anti-nuclear - seen in many autoimmune diseases.
Anti-U1 RNP - seen in mixed connective tissue disease

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64
Q

What proportion of patients with systemic lupus erythematous are positive for anti-nuclear antibody?

A 95%
B 75%
C 50%
D 25%
E 1%

A

What proportion of patients with systemic lupus erythematous are positive for anti-nuclear antibody?

A 95%
B 75%
C 50%
D 25%
E 1%

65
Q

Denosumab is a monoclonal antibody that can be used in the treatment of osteoporosis.

Which of the following best describes the mechanism of action of Denosumab?

A TNF-alpha inhibitor
B RANK ligand inhibitor
C IL-23 inhibitor
D IL-1 receptor inhibitor
E IL-12/IL-23 inhibitor

A

Denosumab is a monoclonal antibody that can be used in the treatment of osteoporosis.

Which of the following best describes the mechanism of action of Denosumab?

A TNF-alpha inhibitor
B RANK ligand inhibitor
C IL-23 inhibitor
D IL-1 receptor inhibitor
E IL-12/IL-23 inhibitor

66
Q

This HLA type has been associated with rheumatoid arthritis and type 1 diabetes melllitus? [1]

A

HLA-DR4

67
Q

This HLA type has been associated with coeliac disease [1]

A

HLA-DQ2

68
Q

A culture that that has staphyloxanthin found in it indicates an infection from which pathogen? [1]

A
69
Q

A culture that that has staphyloxanthin found in it indicates an infection from which pathogen? [1]

A
70
Q

Which of the following drug treatment causes dose dependent type 2 atrophy

Statins
Hydroxychloroquine
Corticosteroids
Prednisilone

A

Which of the following drug treatment causes dose dependent type 2 atrophy

Statins
Hydroxychloroquine
Corticosteroids
Prednisilone

71
Q

Farmers often have OA in the

Knee
Spine
Hip
Hands

A

Farmers often have OA in the

Knee
Spine
Hip
Hands

72
Q

Damage occurs from twisting injuries:

Posterior cruciate ligament injury
Menisical injury
Medial collateral ligament injury
Lateral collateral ligament injury

A

Damage occurs from twisting injuries:

Posterior cruciate ligament injury
Menisical injury
Medial collateral ligament injury
Lateral collateral ligament injury

73
Q

Which treatment for RA targets IL-6?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

A

Which treatment for RA targets IL-6?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

74
Q

Belimubab inhibits BAFF (B cell activating factor). It is used to treat

Ankylosing spondylitis
Systemic lupus erythematosus
Dermatomyositis
Scleroderma
Rheumatoid arthritis

A

Belimubab inhibits BAFF (B cell activating factor). It is used to treat

Ankylosing spondylitis
Systemic lupus erythematosus
Dermatomyositis
Scleroderma
Rheumatoid arthritis

75
Q

Granuloma formation is a which type of hypersensitivity reaction?

Type 1
Type 2
Type 3
Type 4

A

Type 4

76
Q

Which layer do chondrocytes die in?

A: tangenitial layer
B: transitional layer
C: radial layer
D: calcified cartilage
E: bone

A

Which layer do chondrocytes die in?

A: tangenitial layer
B: transitional layer
C: radial layer
D: calcified cartilage
E: bone

77
Q

As part of citrullination, which positively charged amino acid is converted into citrulline?

A Tyrosine
B Tryptophan
C Glutamic acid
D Arginine
E Lysine

A

D Arginine

The process of self-citrullination involves alteration of a positively charged arginine amino acid into the neutral citrulline.

78
Q

A 41-year-old is seen by the rheumatology team following a diagnosis of ankylosing spondylitis. He has been suffering from chronic lower back pain and right ankle tenderness. He has no significant medical history. He has been using paracetamol 1g QDS but the pain is ongoing.

What is the most appropriate first-line pharmacological treatment?

A Tramadol 50 mg PO QDS
B Naproxen 500 mg PO BD
C Methotrexate 7.5 mg PO once a week
D Infliximab infusion regimen
E Rituximab infusion regimen

A

A 41-year-old is seen by the rheumatology team following a diagnosis of ankylosing spondylitis. He has been suffering from chronic lower back pain and right ankle tenderness. He has no significant medical history. He has been using paracetamol 1g QDS but the pain is ongoing.

What is the most appropriate first-line pharmacological treatment?

A Tramadol 50 mg PO QDS
B Naproxen 500 mg PO BD
C Methotrexate 7.5 mg PO once a week
D Infliximab infusion regimen
E Rituximab infusion regimen

E: Anti-TNF biologic agents would be the first-line option in patients with ankylosing spondylitis if required.

79
Q

What is the most likely diagnosis?

Secondary syphilis
Atopic eczema
Hand, foot and mouth disease
Reactive arthritis
Necrotising fasciitis

A

What is the most likely diagnosis?

Secondary syphilis
Atopic eczema
Hand, foot and mouth disease
Reactive arthritis
Necrotising fasciitis

The image shows evidence of keratoderma blennorrhagica, which describes the thickening of the soles and palms that may be seen in reactive arthritis.

80
Q

This person with a tattoo has an adverse reaction. This occurs due to

Mast cell-mediated inflammation
Antibody-mediated inflammation
Immune complex mediated inflammation
Delayed hypersensitivity
Automimmunity

A

Immune complex mediated inflammation

81
Q
A

Radial layer

82
Q

This histological slide supports a diagnosis of

Body inclusion myositis
Duchenne MD (early)
Duchenne MD (late)
Myositis
Infantile myopathy
Fibromyalgia

A

Myositis

83
Q

The acromioclavicular joint is which type of joint

saddle
plane
hinge
condyloid

A

The acromioclavicular joint is which type of joint

saddle
plane
hinge
condyloid

84
Q

Vincular arteries supply

Ligaments
Enthesis
Tendons
Perimysium

A

Tendons

85
Q

Which treatment for RA leads to decreased T-cell proliferation and cytokine production?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

A

Which treatment for RA leads to decreased T-cell proliferation and cytokine production?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

86
Q

This histological slide is suggestive of

Gout
Osteoarthritis (OA)
Hydroxyapatite deposition disease (HADD)
Septic arthritis
Pseudo-gout

A

Gout

87
Q

Which area of articular cartilage does OA initiate in?

A: tangenitial layer / superifical layer
B: transitional layer
C: radial layer
D: calcified cartilage
E: bone

A

Which area of articular cartilage does OA initiate in?

A: tangenitial layer / superifical layer
B: transitional layer
C: radial layer
D: calcified cartilage
E: bone

88
Q

Which cells characteristically infiltrate muscle cells in myositis? [1]

A

CD8+

89
Q

Describe the characterisitcs of blounts disease

A

Infantile Blount’s disease is progressive pathologic genu varum centered at the tibia in children 2 to 5 years of age.

90
Q
A

Annular ligament

91
Q

What type of NSAID is indomethacin

Acetic acid derivative
Propoinic acid derivative
Selective COX-2 inhibitros
Salicylates

A

What type of NSAID is indomethacin

Acetic acid derivative
Propoinic acid derivative
Selective COX-2 inhibitros
Salicylates

92
Q

Gout
Pseudogout
Osteoarthritis
Rheumatoid arthritis
Patella tendinitis

A

Pseudogout

The knee x-ray shows evidence of cartilage calcification, previously termed chondrocalcinosis, which is typical of pseudogout.

In hyaline cartilage, cartilage calcification will appear as a thin opaque line. **The knee is the most common joint to see pseudogout. **Another common place cartilage calcification occurs is the triangular fibrocartilage complex (TFCC) of the wrist.

93
Q

Which joints are most commonly affected in rheumatoid arthritis (RA)?

A Metacarpohalangeal (MCP) joints
B Metatarsophalangeal (MTP) joints
C Temporomandibular joints
D Cervical spine
E Elbows

A

Which joints are most commonly affected in rheumatoid arthritis (RA)?

A Metacarpohalangeal (MCP) joints
B Metatarsophalangeal (MTP) joints
C Temporomandibular joints
D Cervical spine
E Elbows

94
Q

A DEXA scan most commonly assess the bone mineral density of which two bones?

A

Hip and spine

95
Q

Seropostive (ACPA positive) RA is more likely in people with which HLA

HLA DRB1 alleles
HLA DRB2 alleles
HLA DRB3 alleles
HLA DRB4 alleles

A

Seropostive (ACPA positive) RA is more likely in people with which HLA

HLA DRB1 alleles
HLA DRB2 alleles
HLA DRB3 alleles
HLA DRB4 alleles

96
Q

Osteomalacia

Rheumatoid arthritis

Pseudogout

Osteoporosis

Gout

A

Pseudogout

Pseudogout is a type of arthritis in which a layer of calcification can be seen between articulating surfaces.

97
Q

Ruxolitinib is a JAK inhibitor used to treat

Vitiligo
Phemphis vulgaris
Leukocytoclastic vulgaris
Urticaria

A

Ruxolitinib is a JAK inhibitor used to treat

Vitiligo
Phemphis vulgaris
Leukocytoclastic vulgaris
Urticaria

98
Q

Gout is a disorder in which deposits of uric acid crystals accumulate in the joints because of high blood levels of uric acid. Which of the following is the most common cause of high blood levels of uric acid?

Consumption of too much alcohol

Inadequate elimination of uric acid via the kidneys

Infection causing build-up of uric acid

Production of too much uric acid in the body

A

Gout is a disorder in which deposits of uric acid crystals accumulate in the joints because of high blood levels of uric acid. Which of the following is the most common cause of high blood levels of uric acid?

Consumption of too much alcohol

Inadequate elimination of uric acid via the kidneys

Infection causing build-up of uric acid

Production of too much uric acid in the body

99
Q

Q
Which treatment for RA leads to decreased T-cell proliferation and cytokine production?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

A

Q
Which treatment for RA leads to decreased T-cell proliferation and cytokine production?

Etanercept
Adalimumab
Anakinra
Rituximab
Abatacept
Tolizumab

100
Q

Name this sign [1]

A

The Galeazzi sign is elicited by placing the child supine with both hips and knees flexed (Figure 3). An inequality in the height of the knees is a positive Galeazzi sign and usually is caused by hip dislocation or congenital femoral shortening.

101
Q

Platelet rich plasma (PRP) is a novel treatment process for

Osteoporosis
Osteomalacia
Osteoarthritis
Rheumatoid arthritis

A

Platelet rich plasma (PRP) is a novel treatment process for

Osteoporosis
Osteomalacia
Osteoarthritis
Rheumatoid arthritis

102
Q

Allergic contact dermatitis is caused by which type of response

Th1
Th2
Th17
Th5

A

Allergic contact dermatitis is caused by which type of response

Th1
Th2
Th17
Th5

103
Q

This imaging supports a diagnosis of

Body inclusion myositis
Duchenne MD
Myositis
Sarcopenia
Fibromyalgia

A

This imaging supports a diagnosis of

Body inclusion myositis
Duchenne MD
Myositis
Sarcopenia
Fibromyalgia

104
Q

Which of the following is a fibrous ligament

achilles ligament
deltoid ligament
spring ligament
patella ligament

A

Which of the following is a fibrous ligament

achilles ligament
deltoid ligament
spring ligament
patella ligament

105
Q

Which of the following commonly affects the MCP and PIP joints?

Paget’s disease
Osteoathritis
Osteoporosis
Osteomalacia
Rheumatoid arthritis

A

Which of the following commonly affects the MCP and PIP joints?

Paget’s disease
Osteoathritis
Osteoporosis
Osteomalacia
Rheumatoid arthritis

106
Q

Name this apparatus being used [1]

What pathology is it treating? [1]

What ages would this be used for? [1]

A

Von Rosen splint: CDH between newborn - 6 months

107
Q

Omalizumab works by reducing which molecule? [1]

A

IgE

108
Q

Which prostaglandin causes the most bronchoconstriction in asthma patients?

PGE2
PGD2
PGI2
PGF2α
TXA2

A

Which prostaglandin causes the most bronchoconstriction in asthma patients?

PGE2
PGD2
PGI2
PGF2α
TXA2

109
Q

SUFE is which type of Salter-Harris fracture

Type 1
Type 2
Type 3
Type 4

A

Type 1

110
Q

This histological slide supports a diagnosis of

Body inclusion myositis
Duchenne MD (early)
Duchenne MD (late)
Myositis
Infantile myopathy
Fibromyalgia

A

This histological slide supports a diagnosis of

Duchenne MD (early)

  • Fibre size variability
  • Endomysial fibrosis
  • Degenerating muscle fibres undergoing myophagocytosis
111
Q
A

Pavlik harness: treats CDH for newborns - 6 months

112
Q

This imaging supports a diagnosis of

Body inclusion myositis
Duchenne MD
Myositis
Sarcopenia
Fibromyalgia

A

This imaging supports a diagnosis of

Body inclusion myositis
Duchenne MD
Myositis
Sarcopenia
Fibromyalgia

113
Q

Oral steroids; mycophenolate mofetil or azathioprine and / or Rituximab would be used to treat which skin condition? [1]

A

Pemphis vulgaris

114
Q

What is this skin pathology? [1]

A

Leukocytoclastic Vasculitis

Fibrin deposition can be identified within the vessel wall

The perivascular inflammatory infiltrate is comprised predominantly of neutrophils but eosinophils are also present.

115
Q

Mast cell-mediated inflammation
Antibody-mediated inflammation
Immune complex mediated inflammation
Delayed hypersensitivity
Automimmunity

A

Mast cell-mediated inflammation

116
Q

Molluscum contagiosum
Herpes Zoster
Human papillomavirus
Cellulitis
Impetigo
Folliculitis

A

Molluscum contagiosum
Herpes Zoster
Human papillomavirus
Cellulitis
Impetigo
Folliculitis

117
Q

This symptom is a result of?

Mast cell-mediated inflammation
Antibody-mediated inflammation
Immune complex mediated inflammation
Delayed hypersensitivity
Automimmunity

A

This symptom is a result of?

Antibody-mediated inflammation: Pemphigus Vulgaris

118
Q

What skin pathology is depicted? [1]

A

HPV (viral warts / verucca)

119
Q

Molluscum contagiosum
Herpes Zoster
Human papillomavirus
Cellulitis
Impetigo
Folliculitis

A

Molluscum contagiosum
Herpes Zoster
Human papillomavirus
Cellulitis
Impetigo
Folliculitis

120
Q

This flower would cause

Mast cell-mediated inflammation
Antibody-mediated inflammation
Immune complex mediated inflammation
Delayed hypersensitivity
Automimmunity

A

This flower would cause

Mast cell-mediated inflammation
Antibody-mediated inflammation
Immune complex mediated inflammation
Delayed hypersensitivity
Automimmunity

121
Q

Scalded skin syndrome
Necrotising fasciitis
Pemphigus Vulgaris
Leukocytoclastic Vasculitis
Neisseria meningitidis

A

Scalded skin syndrome
Necrotising fasciitis
Pemphigus Vulgaris
Leukocytoclastic Vasculitis
Neisseria meningitidis

122
Q

Molluscum contagiosum

[] bodies that contain virus particles are typical of histological slide

A

Henderson-Patterson bodies that contain virus particles.

123
Q
A

Pityriasis versicolour

124
Q

What skin pathology is depicted? [1]

A

Scabies

125
Q

What pathogen is causing this slide? [1]

A

Mycobacterium leprae or mycobacterium lepromatosis

126
Q

What is the pathogen causing this disease? [1]

What is the name for this presentation? p1[

A

Scrofuloderma follows the direct invasion of the skin from tuberculosis in an underlying lymph node or bone, often in association with pulmonary TB.

127
Q

Scrofuloderma is a skin pathology due to invasion of a lymph node to which pathogen? [1]

A

TB

128
Q

What is this skin pathology depicted? [1]

A

Cellulitis: Infection of the dermis and subcutaneous fat

129
Q

Which drug can be used to determine how mineralised bone is? [1]

A

Tetracycline can be used to see how mineralised bone is. Tetracycline gets taken up on the calcium ions, and becomes deposited here and auto-fluoresces

130
Q

This slide of bone is dyed with tetracyline. What is A? [1]

A

Trabecula bone

131
Q

Describe MoA of Abatacept

A

Blocks T cell activation which thus means macrophages and B cells cannot be activated.

Competes with CD28 binding to CD80/86 by upregulating CTLA-4, which switches T cell off

Reduces production of TH17 cells
Thus reducing inflammation

132
Q

Which drug competes with CD28 by binding to CD80/86 and upregulating CTLA-4?

Abatacept
Denosumab

A
133
Q

Denosumab treats which disease? [1]

A

Osteoporosis

134
Q

RA treatment:
The most important biologics to remember are the TNF inhibitors …. [3]

A

The most important biologics to remember are the TNF inhibitors adalimumab, infliximab and etanercept

135
Q

Teriparatide treats which disease? [1]

A

Osteoporosis

136
Q

State the role of sulfasalazine after it has been converted to the 5-asa PRODUG IN THE LAMINIA PROPRIA OF THE LARGE INSTESTINE [3]

A

Supresses generation of superoxide radicals and cytokine production by inflammatory cells

IL8 decreased in synovial fluid and decreased production of IgM and IgG, and decreased angiogenesis

Inhibits IL-1 and TNF-a

137
Q

Which antibiotics would you give for chronic osteomyelitis [1]

A

vancomycin cement beads

138
Q

A 48-year-old male discusses his secondary prophylaxis medications after suffering from a myocardial infarction last week. Aspirin is included in the several drugs but he is hesitant due to suffering from multiple bouts of acid reflux despite gastric protection. Celecoxib another COX (cyclooxygenase) inhibitor is prescribed instead.

What best describes the mechanism of action of this drug?

Reversible COX-1 inhibitor
Reversible COX-2 inhibitor
Non-reversible COX-1 inhibitor
Non-reversible COX-2 inhibitor
Non-reversible COX-1 and 2 inhibitor

A

A 48-year-old male discusses his secondary prophylaxis medications after suffering from a myocardial infarction last week. Aspirin is included in the several drugs but he is hesitant due to suffering from multiple bouts of acid reflux despite gastric protection. Celecoxib another COX (cyclooxygenase) inhibitor is prescribed instead.

What best describes the mechanism of action of this drug?

Reversible COX-1 inhibitor
Reversible COX-2 inhibitor
Non-reversible COX-1 inhibitor
Non-reversible COX-2 inhibitor
Non-reversible COX-1 and 2 inhibitor

139
Q

Hydroxychloroquine blocks TL9. What effect does this have? [1]

A

decreases activation of dendritic cells: less autoantobodies produced

140
Q

State two side effects of chronic methotraxate use [2]

A

Pulmonary fibrosis
Hepatic cirrhosis

141
Q

State some side effects of acute methotrexate use [3]

A

GI upset (naus/ vom)
Mouthulcers and sores
Hair loss

142
Q

Name two roles of DOACs [2]

A

VTE
AF

143
Q

State an advantage of using DOACS over heparin for VTE [1]

A

taken orally

144
Q

Tocilizumab targets which IL? [1]

A

IL-6

145
Q

Which IL1 biologicals can be used to treat acute gout? [3]

A

Rilonacept, canakinumab, anakinra

146
Q

Treatment for HPV: viral warts and veruccas? [5]

A

Topical salicylic acid
Fluorouracil cream
Cryosurgery
Surgical curettage
Laser treatment (CO2 laser 582nm)

147
Q

Describe two biological DMARDs for SLE? [2]

A

Belimubab: inhibits BAFF (B cell activating factor)
Rituximab: CD20 blocker

148
Q

Name a bisphosphinate used to treat OA [1]

A

Alendronate

149
Q

Describe treatment regime of dermatomyositis [4]

A

Prednisilone (type of corticosteroid):
* 1 mg / kg per day until creatine kinase normal

Azthioprine

Methotrexate

Rituximab

150
Q

Treatment for leprosy? [3]

A

Rifampicin, dapsone and clofazimine

151
Q

How long does Rituximab take before positive effect? [1]

A

3 months after infusions

152
Q

Describe the MoA of Denosumab [2]

A

Denosumab is a an osteoprotegrin artificial antibody & acts as a monoclonal antibody to RANK:

Denosumab: human monoclonal antibody that inhibits RANKL and helps regulate turnover in healthy bone. Denosumab binds with high specificity and affinity to the cytokine RANKL, inhibiting its action; as a result, osteoclast recruitment, maturation and action are inhibited, and bone resorption slows

153
Q

Retinoic acid & Vit. A alongside oral antibiotics would be used to treat? [1]

A

Folliculitis

154
Q

Retinoic acid & Vit. A alongside oral antibiotics would be used to treat? [1]

A

Folliculitis

155
Q

State why biologicals, despire their efficacy are not used straight away for RA treatment? [2]

A

Due to the develop of anti-drug antibodies that will develop no matter what - decrease efficacy

156
Q

Methotrexate may cause an increase in which liver marker? [1]

A

ALT: causes hepatoxcity

157
Q

What drug class is the first oral biological? [1]

A

JAAK inhibitor

158
Q

Two potential AEs of JAK inhibitors? [2]

A

Thromboembolic events
Cancer related events

Yr 2 EOYS ^2 (42 decks)

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