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Flashcards in RACP 2020 Deck (37)
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1
Q

PARP inhibitors MOA and example

A

Inhibits PA-CRP1. PARP1 usually repairs single stranded breaks in DNA. By not repairing these single stranded breaks, they turn into double stranded breaks and inhibits cancerous growth

E.g olaparib

2
Q

What receptor does frusemide act at

A

Na-K-Cl co-transporter at ascending loop of henle

3
Q

Most common mutation in HFE gene causing hereditary haemochromatosis

A

C282Y. H63D less common than C282Y

4
Q

Most common CF mutation

A

F508del

5
Q

BK nephropathy Mx

A

Mainstay is to reduce immunosuppression
- If pt is on tac (calcineurin inhibitor), MMF (anti-metabolite) + pred, would reduce MMF first by half, then cease if no decrease in viral load
- Could also reduce calcineurin inhibitor followed by anti-metabolite
No antiviral agents avail for treatment

6
Q

Accumulation of which substance in ACEi induced angioedema

A

Bradykinin

7
Q

What is agnosia

A

Inability to recognise objects, people, smells, sounds

8
Q

What is apraxia

A

Inability to perform learned movements

9
Q

What is abulia

A

Lack of initiative, will, drive for action, speech, thought

10
Q

Which cranial nerves carry parasympathetic outflow fibers through outside the cranium

A

CN III, VII, IX, X

11
Q

Tranexamic acid MOA

A

Binds lysine binding site on plasminogen

12
Q

In a box plot what does the line in the middle of the box represent

A

Median of the IQR

13
Q

Mechanism of emphysema in alpha-1-antitrypsin

A

Imbalance between neutrophil elastase and elastase inhibitor AAT

14
Q

Denosumab MOA

A

Monoclonal antibody that binds to RANKL

Blocks osteoclast maturation, function and survival

15
Q

Which co-receptor binds with CD4 in early HIV infection

A

CCR5 in early

CXCR5 in later HIV infection

16
Q

What antidepressant has the most anti-cholinergic effect

A

TCA

17
Q

Which immunological structure is beta-2-microglobulin a part of

A

MHC class I

18
Q

How to prevent dialysis related amyloidosis

A

High flux membranes
Beta-2 globulin absorber
Preservation of residual kidney function
Early kidney transplant

19
Q

What vitamin deficiency do you get with metformin

A

Vitamin B12 deficiency

20
Q

What happens to B cells in germinal centres?

A

Antigen-activated B cells diversify their immunoglobulins by somatic hypermutation to generate high-affinity immunoglobulins

21
Q

Toxic metabolite of paracetamol

A

NAPQI

22
Q

How does NAC work in paracetamol poisoning

A

Acts as a glutathione donor to prevent NAPQI accumulation

23
Q

Amyloidosis cardiac and renal involvement

A

AA - kidneys
AL - kidneys and restrictive cardiomyopathy
ATTR - cardiac

24
Q

What type of breast cancer derives most benefit from CDK inhibitors

A

Hormone positive, HER negative

25
Q

Fulvestrant MOA

A

Selective oestrogen down regulator

Use in metastatic hormone positive postmenopausal pts in combo with AI or CDK inhibitor

26
Q

Population attributable fraction

A

PAF = { F(RR-1) / [1 + F(RR-1)] } x 100

F is the prevalence or exposure in the population

27
Q

Type B nerve fibres function

A

Visceral afferent fibres
Preganglionic nerve fibres of autonomic nervous system

Moderately myelinated - less myelinated than type A nerve fibres

28
Q

Type A motor nerve fibres function

A

Alpha - skeletal muscle fibre innervation

Gamma - intrafusal muscle fibre innervation

29
Q

Type A sensory nerve fibres function

A

Ia - proprioception
Ib - golgi tendon organ
II - secondary receptors of muscle spindle, cutanoues mechanoreceptors
III - touch and pressure, nociceptors of neospinothalamic tract, cold thermoreceptors
IV - nociceptors of paleospinothalamic tract, warm receptors

30
Q

Type C nerve fibres

A

Unmyelinated, small diameter, low conduction velocity

Responsible for burning pain, warmth, itch

31
Q

Metaraminol MOA

A

Stimulates alpha-1 receptors to cause peripheral vasoconstriction and increase BP

32
Q

Terlipressin MOA

A

Splanchnic and extrarenal vasoconstriction by stimulating V1 receptors (found in smooth muscle of splanchnic arteries)

33
Q

Sulfasalazine in which type of SpA

A

Good for peripheral SpA, not for axial

Applies for MTX as welll

34
Q

Carbapenamase MOA

A

Hydrolysis beta-lactam ring

35
Q

By what mechanism does clozapine cause myocarditis

A

Myocytes shows eosinophilic infiltration suggesting IgE mediated acute hypersensitivity reaction

36
Q

Cytokines that drive Familial Mediterranean Fever

A

IL-1 and IL-18

37
Q

What non-malignant cause increases CEA

A
Smoking
Infections
IBD
Pancreatitis
Liver cirrhosis