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Phase 2a Peer Teaching > Random bits > Flashcards

Random bits Flashcards

1
Q

2 examples of ANCA -ve vasculitis

A

Goodpastures (anti-GBM)

Henoch Schonlein Purpura

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2
Q

diagnosis of febrile neutropenia

A
  • Temperature > 38oc
  • Absolute Neutrophil Count < 1
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3
Q

B12 deficiency can cause

A
  • due to anaemia
    • heart failure
    • angina
  • neuropathy
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4
Q

which drig will enzyme inducers stop working

A

the oral contraceptive pill

so barrier contraception is required

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5
Q

what percentage of patients infected with Hep C will get HCC

A

5%

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6
Q

what are the signs and symptoms of chronic mesenteric ischaemia

A
  • classical triad
    • upper abdo bruit
    • weightloss
    • severe, colicky post-prandial abdo pain
  • bleeding PR
  • malabsorption
  • nausea and vomiting
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7
Q

what are the criteria for diagnosing endocarditis and summarise them

A

Duke’s criteria

for Dx you need 2 major criteria

1 major criteria and 3 minor

or 5 minor criteria

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8
Q

sickle cell disease mutation

A

chromosome 11

glutamic acid replaced by valine

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9
Q

fill in this table

A
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10
Q

Simon, a 57-year-old banker, comes in to the surgery complaining of pain immediately below the ribs. After a taking a history, he tells you the pain is typically worse at night and when he’s hungry but has found that a glass of milk seems to help. He had a MI 3 years ago and takes aspirin daily. What is this history suggestive of?

A

duodenal ulcer

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11
Q

first, second and third line treatments for Crohn’s

A

if mild PO prednisolone

if severe admit for IV fluids and IV methyprednisolone

2nd line is azathioprine

3rd line is infliximab (anti TNF a)

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12
Q

definition of seizure

A

an event of hypersynchronous electrical discharge in the brain that alters behaviour, sensation or movement

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13
Q

4 types of drug for parkinson’s and an example of each

A

Levodopa (with carbidopa in co-careldopa)

MAO-B inhibitors (selegiline)

Dopamine agonists (ropinirole)

COMT inhibitor (tolcapone)

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14
Q

pathogens that cause reactive arthritis

A

STIs and GI

campylobacter

salmonella

shigella

chlamydia trachomatis

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15
Q

which cancer is mainly associated with smoking

A

small cell lung cancer

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16
Q

which HLA type is associated with Type 1 Diabetes

A

HLA-DR3

HLA-DR4

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17
Q

murmur of mitral regurge?

A

pansystolic

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18
Q

fill in this table

A
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19
Q

how much liquid is there normally in a healthy pleural space

A

15ml

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20
Q

where are M3 muscarinic receptors found

A

in the airways

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21
Q

worldwide and UK greatest causes of adrenal insufficiency

A

worldwide: TB

UK: addison’s

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22
Q

what is IC50

A

it is the concentration of an inhibitor that can reduce a dose by half

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23
Q

what is lynch syndrome

A
  • AKA HNPCC
  • causes 1-3% of colon cancers
  • AD inheritance due to mutations in MMR genes
  • 80% lifetime cancer risk
  • also predisposes to ovarian, gastric and endometrial
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24
Q

treatment for grave’s disease (2 things)

A

B blockers and carbimazole

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25
Q

treatment for tumour lysis syndrome

A

allopurinol

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26
Q

how to differentiate mnd and MS

A

no sensory loss in MND

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27
Q

4 abx that can cause C.diff

A

cephalosporins

co-amoxiclav

clindamycin

ciprofloxacin

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28
Q

what are T scores and what are Z scores

A
  • T= Bone density )score/standard deviations away from) compared to a 25 year-old of the same gender
  • Z= bone density compared to the average for their age of the same gender
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29
Q

is asthma worse in the morning or the evening

A

the morning

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30
Q

what is isoprenaline and when is it used

A

it is a B2 adrenoreceptor agonist and it is used in bradycardia and heart block

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31
Q

describe the process of phagocytosis

A
  • Binding of insult e.g bacterium to macrophage
  • Engulfment
  • Phagosome formation
  • Lysosomal fusion and digestion
  • Antigen presentation (MHC II)
  • Secretion of waste products.
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32
Q

definition of malabsorption

A

Inadequate absorption of nutrients/food in/by the small intestines

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33
Q

non smoking causes of lung cancer

A

chromium exposure

radon exposure

coal tar exposure

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34
Q

signs of iron deficiency anaemia

A

angular stomatitis

koilonychia

dry and brittle hair

atrophic glossitis (loss of villae)

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35
Q

long acting M3 receptor antagonists

A

tiotropium

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36
Q

two complications of bronchoscopy

A

pneumonia

pneumothorax

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37
Q

management of GCA

A

PO prednisolone

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38
Q

treatment for c.diff

A

vancomycin and metronidazole

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39
Q

what if you hear an early systolic click on auscultation

A

mitral valve replacement

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40
Q

IBS treatment

A

pain and bloating - buscopan

diarrhoea - loperamide

constipation - senna

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41
Q

Rx for MS

A
  • alemtuzumab (anti-T cell)
  • treating relapses
    • methylprednisolone
  • treating symptoms
    • spasticity: baclofen
    • tremor: botulinum toxin A injection
    • urinary incontinence: self catheterisation
    • fatigue: CBT
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42
Q

causes of SIADH

A

malignancy or drugs

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43
Q

really briefly what happens in pneumoconiosis

A

particle is phagocytosed by macrophage

macrophage releases inflammatory cytokines

infiltrating immune cells damage alveolar epithelium

fibroblasts attempt repair and deposit collagen

causes fibrosis

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44
Q

what is the definition of pulmonary hypertension

A

defined by a mean pulmonary artery pressure ≥25 mmHg at rest

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45
Q

black urine??? what’s your diagnosis

A

malaria

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46
Q

what is the crystal in pseudogout

A

calcium pyrophosphate

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47
Q

how does allopurinol work

A

it inhibits xanthine oxidase and reduces the rate of production uric acid from purines thereby reducing the concentration of circulating uric acid

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48
Q

what is myasthenic crisis and what is the treatment

A

life threatening weakness of resp muscles during relapse - it’s when FVC falls

plasmapheresis to remove the anti-AChR

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49
Q

sterile sites in the body

A

blood

CSF

bone marrow

pleural fluid

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50
Q

when would you see target cells?

A

on a blood film of thalassaemia

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51
Q

treatment for iron deficiency anaemia

A

ferrous sulphate

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52
Q

Patient arrives to hospital with a suspected MI. ECG shows ST elevation. What would you expect to see on the ECG over the next few hours and the next few days?

A
  • Hours = Tall T waves, ST Elevation
  • Days = T inversion, Pathological Q wave
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53
Q

treatment for DI

A

cranial: desmopressin

Nephrogenic: NSAIDs

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54
Q

differences in EF in systolic and diastolic heart failure

name some causes of both .

A
  • EF > 50% in diastolic
    • restricted cardiomyopathy
    • tamponade
    • ventricular hypertrophy
  • EF < 40% in systolic
    • insufficient contraction
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55
Q

what would be reversibility in asthma

A

following salbutamol there’s 400ml increase in FEV1 OR 20% improvement of PEFR

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56
Q

5 steps of osteoarthritis

A

damage

disordered repair

fibrillations

osteophytes

sclerosis

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57
Q

what is atropine and how does it work

A

it is a M2 muscarinic receptor antagonist

is therefore an anticholinergic drug

used to treat heart block and life-threatening bradycardias

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58
Q

how to differentiate mnd from myasthenia gravis

A

mnd never affects the eye movements

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59
Q

where is folate absorbed

A

jejunum

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60
Q

which HLA type is associated with coeliac disease

A

HLA-DQ2

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61
Q

treatment for systemic sclerosis and crest syndrome

A
  • no cure so treat symptoms
  • raynaud’s
    • CCB like nifedipine
  • pulmonary hypertension
    • prostaglandins
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62
Q

immediate treatment of suspected meningitis in hospital

A

IV ceftriaxone

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63
Q

name 3 granulomatous diseases

A

crohn’s

sarcoidosis

TB

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64
Q

fill in this table

A
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65
Q

signs and symptoms of siADH

A

v concentrated urine, confusion, anorexia, nausea

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66
Q

what is Wegener’s Vasculitis

A
  • it is aka granulomatosis with polyangiitis
  • affects arterioles and capillaries
  • is c-ANCA +ve
  • affects
    • sinuses
    • lungs - causing nodules
    • kidney - glomerulonephritis rapidly progressing to CKD
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67
Q

what do PPIs inhibit

A

the K+/H+ ATPase of the stomach

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68
Q

PR interval should be how long

A

0.12-0.2 s

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69
Q

why can granulomatous disease cause hypercalcaemia

A

activated macrophages produce activated vitamin D

there’s bone resorption,

renal reabsorption

and increased absorption in the gut

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70
Q

Tx for crohns

A

oral corticosteroids (prednisolone)

in severe flare ups: IV hydrocortisone

infliximab is 3rd line

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71
Q

what is charcot’s triad and what is reynold’s pentad

A
  • charcot’s triad
    • RUQ pain
    • Jaundice
    • Fever
  • Reynauld’s pendat is charcot’s with:
    • hypotension
    • confusion
  • Reynold’s means the patient is now in shock
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72
Q

what is the definition of hypokalaemia

A

<3.5mmol/L

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73
Q

which antibodies in crest syndrome

A

anti-centromere

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74
Q

treatment of AF

A
  • rate control
    • BB
    • CCB
  • rhythm control
    • amiodarone
  • anticoag with warfarin
    • INR goal is 2-3
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75
Q

sjorgen’s syndrome treatment

A

synthetic tears and saliva

treat arthralgia with NSAIDs

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76
Q

symptoms specific to haemolytic anaemia

A

jaundice

gallstones

signs of underlying disease

splenomegaly

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77
Q

investigations for prostate cancer

A
  • DRE: craggy and enlarged
  • TRUSS and biopsy
  • Gleason grading
  • TNM staging
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78
Q

which substance is responsible for the skin pigmentation in addison’s

A

acth

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79
Q

what is the antibody in vasculitis

A

ANCA

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80
Q

eye signs of graves

A

exopthalmos

dry gritty eyes

lid lag and drag

retro orbital inflammation

photophobia

diplopia

conjunctival oedema

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81
Q

treatment for peripheral arterial disease

A
  • lifestyle: usual suspects
  • clopidogrel
  • percutaneous transluminal angioplasty
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82
Q

Ix following TIA

A

glucose

FBC

carotid doppler

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83
Q

name some bugs often cause ascending cholangitis

A

Escherichia coli,

klebsiela spp.

enterobacter spp.

Bacteroides fragilis

Enterococcus spp. (group D strep)

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84
Q

how do penicillins work

A

Penicillin prevents peptidoglycan from cross-linking properly in the last stages of bacterial cell wall synthesis

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85
Q

what is ulcerative colitis

A

relapsing remitting inflammatory condition of the colon mucosa

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86
Q

specific signs of iron deficiency anameia

A

koilonychia

angular stomatitis

dry hair and nails

atrophic glossitis

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87
Q

What scoring tool may you use to assess the severity of LUTS in men?

A

IPSS (International prostate scoring system)

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88
Q

empirical treatment of MRSA

A

Vancomycin

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89
Q

treatment for focal seizures

A

carbamazepine

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90
Q

Go through kidney disease staging

A
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91
Q

pyrazinamide side effect

A

gout and rash as well as hepatitis

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92
Q

where do bone marrow biopsies come from

A

Iliac crests

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93
Q

INR target for patients with AF on warfarin

A

2-3

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94
Q

PTT and APTT what do they stand for, what pathway do they measure and which will haemophilia A and B affect

A
  • partial thromboplastin time = PTT
    • extrinsic pathway
  • activated partial thromboplastin time = APTT
    • intrinsic pathway
  • Haemophilia A and b both affect intrinsic pathway so PTT is normal but APTT will be slow
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95
Q

Rx for addison’s

A

hydrocortisone for cortisol

fludrocortisone for aldosterone

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96
Q

what is the scoring system to evaluate risk of PE and what are the components

A
  • well’s criteria
    • clinical signs of DVT
    • previous DVT
    • PE is number one diagnosis or equally likely
    • haemoptysis
    • malignancy with recent treatment
    • HR >100
    • recent surgery or immobilisation
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97
Q

most common bacteria causing meningitis infection in adults

A

Strep pneumoniae

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98
Q

treatment for reactive arthritis

A

Treat underlying cause

NSAIDs

corticosteroids

DMARDS

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99
Q

malignant melanoma presentation

A
  • ABCDE
    • assymetrical
    • border irregularity
    • colour irregularity
    • diameter >6mm
    • evolution
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100
Q

where does transferrin bind iron and where does ferritin bind iron

A

ferritin binds iron intracellularly mainly in the liver, but also in the bone marrow, spleen, and muscles

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101
Q

hoespital acquired pneumonia is normally which microorganism

A

Staphylococcus aureus

think “hospital staff”

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102
Q

what criteria are used to diagnose GCA

A
  • ACR criteria - diagnosed if 3 of these 5 met
    • Age at disease onset 50 years
    • New headache
    • Temporal artery abnormality
    • Elevated erythrocyte sedimentation rate 50 mm/hr
    • Abnormal artery biopsy: biopsy specimen showing vasculitis characterised by a predominance of mononuclear cell infiltration or granulomatous inflammation, usually with multinucleated giant cells
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103
Q

what type of haemorrhage is a lumbar puncture absolutely contraindicated in

A

Extra-dural haemorrhage

they may reduce CSF pressure and speed up herniation

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104
Q

what is normal blood glucose

A

3.5 - 8 mmol/L

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105
Q

hand signs of liver cirrhosis

A

Leuconychia

Terry’s nails

clubbing

dupytren’s contracture

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106
Q

treatment for thalassaemia

A

blood transfusion

desferrioxamine for iron chelation

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107
Q

what does amiodarone do?

A

it prolongs phase 3 of the cardiac action potential and so slows the heart

so it’s used in arrhythmias

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108
Q

risk factors for RA

A

increasing age

female

premenopausal

smoking

stress

infection

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109
Q

small bowel obstruction in adults causes

A

adhesion,

malignancy,

hernia,

crohns

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110
Q

tongue like a sack of worms and quiet horse voice

A

CN 9-12 palsy caused by progressive bulbar palsy

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111
Q

Ix for RA

A
  • rheumatoid factor (+ve in 70%)
  • anti-CCP (anticitrullinated peptide)
  • x ray
  • bloods: high esr and crp
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112
Q

where is iron absorbed

A

in the duodenum

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113
Q

treatment for hyperkalaemia

A

immediate calcium gluconate

insulin infusion with dextrose

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114
Q

name a test for peripheral vascular disease

A
  • Buerger’s test
    • elevating leg (colour goes)
    • hang over side of bed (comes back)
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115
Q

immediate treatment of suspected meningitis in the community

A

IM benzylpenicillin

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116
Q

causes of encephalitis

A

mainly viral like west nile virus, HSV and vericella zoster

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117
Q

who typically gets SLE

A

black women between ages 20 to 40

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118
Q

cardiac enzymes to do in ACS

A

troponin T

myoglobin

CK-MB

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119
Q

4 causes of pernicious anaemia

A

autoimmune

atrophic gastritis

gastrectomy

crohn’s

coeliac

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120
Q

hypercalcaemia clinical features

A

Bones, stones, abdominal groans, thrones and psych overtones

  • bone pain
  • renal calcuil
  • constipation
  • polyuria
  • depression
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121
Q

lucid interval pattern should make you think

A

extradural haemorrhage

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122
Q

how does lidocaine work

A

it inhibits voltage gates Na+ channels and thereby blocks action potentials being sent

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123
Q

when is murphy’s sign typically positive and when is it typically negative

A

positive in cholecystitis,

but negative in choledocholithiasis, pyelonephritis, and ascending cholangitis.

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124
Q

how long after changing levothyroxine dose should you wait to measure their TSH

A

4 weeks

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125
Q

when is desferrioxamine indicated

A

iron chelation in haemochromatosis and if they have thalassamia and need continuous transfusions

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126
Q

what is dressler’s syndrome

A

Dressler’s syndrome is secondary pericarditis caused by an immune system response after damage to heart tissue or to the pericardium, from events such as a heart attack, surgery or traumatic injury.

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127
Q

BRCA1 and BRCA2 lifetime risk of breast cancer

A

BRCA1 - 55-65%

BRCA2 - 45%

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128
Q

what is the Ix for Sjorgen’s

A

Schirmer’s test for conjunctival dryness

also serology for anti-Ro (aka anti-sjorgen’s sydrome related antibody)

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129
Q

acute treatment of gout

A

NSAIDs (like diclofenac)

colchicine if NSAIDS CI (peptic ulcer etc)

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130
Q

Treatment for TTP

A

plasma exchange to remove antibodies and replace ADAMTS13

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131
Q

what is the diagnosis for helicobacter pylori

A

C13 urea breath test

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132
Q

signs of cushing’s

A

buffalo hump

hirsutism

central obesity

bruising

thin skin

osteoporosis

moon face

acne

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133
Q

if a patient is male, old and has myasthenia gravis, what should you be concerned about

A

thymic tumour

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134
Q

what score would you use to predict someone’s likelihood of PE

A

Well’s score

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135
Q

What do NSAIDs inhibit and what is the result?

A

Inhibit Cyclooxygenase enzyme (COX)

Prevents the conversion of arachidonic acid to prostaglandin H2

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136
Q

migraine triggers

A

chocolate

hangovers

oral contraceptive pill

caffeine/cheese

orgasms

lie-ins

alcohol

travel

exercise

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137
Q

what stain would you use on biopsy to diagnose haemochromatosis

A

Perl’s stain identifies iron and will show gross iron staining

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138
Q

what is nephrotic syndrome

A

proteinuria with hypoalbuminaemia and peripheral oedema

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139
Q

immediate medical interventions for DKA

A

ABCDE approach so fluids first

insulin

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140
Q

whats the pneumonia organism if they mention air conditioning

A

Legionella pneumophila

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141
Q

what is retuximab

A

monoclonal antibody against CD20 on the surface of B cells

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142
Q

management of sickle cell crisis

A

high flow O2 and morphine

transfusion

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143
Q

definition of neoplasia

A

lesion resulting from autonomous abnormal growth of cells which persist after the initiating stimulus has been removed

it is never normal

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144
Q

what would you hear on auscultation in pericarditis

A

pericardial friction rub

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145
Q

name 5 cancers that typically metastasise to bone

A

breast

prostate

bronchi

thyroid

kidney

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146
Q

diagnosis of acromegaly

A

don’t do GH test

do glucose response test: it’s Dx if GH doesn’t drop in response to glucose

follow with MRI pituitary fossa

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147
Q

what is a post-ictal state

A

it’s 5-30 mins of drowsiness, confusion, nausea and headache following seizure

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148
Q

5 symptoms of acromegaly

A

acroparaesthesia

loss of libido

sweating

arthralgia

headache

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149
Q

which type of head bleed do you get meningism and positive bradzinski’s

A

SAH

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150
Q

differential diagnoses for being HLA-B27+

A
  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Iriitis/ Acute anterior uveitis
  • Reactive arthritis
  • Enteropathic arthritis
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151
Q

acromegaly signs

A

massive gradual growth of hands and jaw

widely spaced teeth

big tongue

deep voice

darkening skin

puffy lips

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152
Q

short acting M3 antagonists

A

Ipratropium bromide

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153
Q

treatment of acute pseudogout

A

diclofenac or Colchicine if CI

intra articular steroids

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154
Q

when do you do a LP in SAH

A

if CT -ve but history is suggestive

wait 12hrs so it’s yellow not red

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155
Q

non-motor symptoms of parkinson’s

A
  • autonomic dysfunction
    • constipation
    • dribbling
    • urinary frequency and urgency
  • sleep disturbance
  • neuro-psychiatric complications
    • depression
    • dementia
    • psychosis
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156
Q

what are bradycardia and tachycardia

A

bradycardia <60 bpm

tachycardia >100bpm

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157
Q

prevention of gout

A

low dose aspirin

allopurinol titrated up based on serum urate levels

may trigger attack so wait 3 weeks following attack to start allopurinol

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158
Q

what is the definition of erectile dysfunction

A

The inability to gain and maintain an erection long enough to achieve sexual satisfaction

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159
Q

which HLA is associated with spondyloarthropathies

A

HLA-B27

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160
Q

what is the gene for alpha-1-antitrypsin deficiency

A

SERPINA1 gene on chromosome 14

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161
Q

treatment for intrinsic bradycardia

A

atropine

Muscarinic antagonist

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162
Q

which antibody is associated with Sjorgen’s

A

Anti-Ro

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163
Q

very briefly what are the different hypersensitivity reactions

A
  • ACID
    • Allergic - anaphylactic
    • Cytotoxic - goodpastures
    • Immune complex - SLE
    • Delayed - mantoux test
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164
Q

Ulcerative colitis Rx

A
  • methotrexate or sulfasalazine
  • corticosteroids
  • azathioprine
  • infliximab
  • surgery can be curative (colectomy)
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165
Q

why might a patient have a hyperparathyroid picture with low parathyroid

A

Parathyroid hormone-related protein (or PTHrP) is a protein member of the parathyroid hormone family. It is occasionally secreted by cancer cells (breast cancer, certain types of lung cancer including squamous cell lung carcinoma)

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166
Q

bilateral hilar node enlargement is seen on CXR of what condition

A

sarcoidosis

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167
Q

causes of sjorgen’s

A

can be primary fibrosis of exocrine glands

or secondary to SLE, RA or systemic sclerosis

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168
Q

3 diseases that cause a low transfer coefficient

A

fibrosing alveolitis

emphysema

anaemia

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169
Q

does UC or Crohn’s confer a higher risk of colon cancer

A

UC confers higher risk

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170
Q

What blood test would you conduct to help diagnose this as heart failure?

A

BNP (Brain natriuretic peptide)

NT-proBNP (N-terminal pro b-ype natriuretic peptide)

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171
Q

diagnosis of migraine

A
  • >5 headaches lasting 4-72hrs with nausea and vomiting or photo/phonophobia plus any two of the following
    • unilateral
    • pulsating
    • impairs or is worsened by usual activity
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172
Q

murmur in aortic stenosis

A

A crescendo-decrescendo ejection systolic murmur

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173
Q

name a medication used to treat eczema

A

tacrolimus

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174
Q

GCA with acute blindness in one eye is called what?

what is the treatment

A

arteritic ischaemic optic neuropathy

this is irreversible vision loss so it’s a medical emergency to save vision in the other eye

treat with immediate IV methylprednisolone

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175
Q

signs of liver cirrhosis

A

terry nail

dupuytren’s contracture

spider naevi

jaundice

xanthelasma

ascites

bruising

palmar erythema

clubbing

leuchonychia

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176
Q

what does FRAX measure and what are the components

A
  • 10 year probability of fracture
    • age
    • sex
    • weight
    • height
    • previous fracture
    • parent fractured hip
    • smoking
    • corticosteroids
    • RA
    • high alcohol consumption
    • secondary osteoporosis
    • BMD
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177
Q

two antibodies found in coeliac

A

anti-EMA (endomysial) and anti-tTG (tissue Transglutaminase)

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178
Q

what is morphine converted to and by what

A

morphine –> morphine-6-glucuronide

converted by CYP2D6

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179
Q

is goodpastures ANCA +ve or -ve

A

ANCA -ve but anti-GBM positive

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180
Q

histological findings in coeliac

A

increased intraepithelial lymphocytes

lamina propria inflammation

villous atrophy

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181
Q

4 signs of glandular fever in mouth and pharynx

A

● Tonsillar enlargement,
● tonsillar exudate,
● uvular oedema,
● palatal petichae

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182
Q

how common is teratology of fallot

A

3-6/100,000 live births

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183
Q

what is the definition of psoriasis and where does it mostly occur

A

chronic inflammatory skin condition due to hyperproliferation of keratinocytes

mostly occurs on lower back, scalp, elbows and knees

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184
Q

what is the crystal in gout

A

monosodium urate crystals

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185
Q

what number CD4+ T cells constitutes a diagnosis of AIDs

A

200/mm3

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186
Q

medication to improve BPH symtoms in men

A

tamsulosin (alpha blocker)

finasteride (5-alpha-reductase inhibitor)

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187
Q

AVNRT example and what is the accessory pathway called

whats BPM

A

wolf parkinson white

bundle of kent

BPM of up to 200

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188
Q

what is the system of classification of PVD - describe it

A

fontaine system

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189
Q

what are the two coeliac antibodies

A
  • IgA Tissue Transglutaminase (tTg)
  • IgA Anti-Endomysial (EMA)
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190
Q

treatment of DIC

A

treat underlying cause

give activated protein C (a clotting factor)

maintain blood volume and tissue perfusion

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191
Q

causes of pleural effusion consisting of exudate

A
  • Malignancy (lung, breast, mesothelioma),
  • Infection (lung, pleural, abdominal),
  • Inflammatory (RA, SLE),
  • Pulmonary embolism,
  • Benign asbestos related,
  • Traumatic (haemothorax/chylothorax),
  • Drug reaction
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192
Q

triggers for SLE

A

UV light

EBV

drugs like isoniazid

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193
Q

treatment for migraines

A
  • acutely
    • triptans such as sumatriptan, NSAIDs and paracetamol
  • propanolol can reduce attack frequency
  • avoid triggers
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194
Q

what is amiloride and where does it act

A

it is a K+ sparing diuretic

it inhibits ENaC which causes Na loss and therefore water loss in the distal convoluted tubule

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195
Q

hypokalaemia symptoms

A

muscle weakness

constipation

bradyarrhythmias

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196
Q

murmer in mitral regurge

A

mid-diastolic murmur heard loudest at the apex.

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197
Q

MRSA treatment

A

vancomycin

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198
Q

medical treatment of osteoarthritis

A

steroid injections intra-articularly

analgeisic ladder

PPI if long term NSAIDs

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199
Q

C.diff treatment

A

vancomycin/metronidazole

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200
Q

gold standard diagnosis for mesothelioma

A

pleural biopsy

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201
Q

initial management for DKA

A

FLUIDS FIRST

then insulin

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202
Q

acute treatment of gout

A

high dose NSAID (diclofenac) or colchicine

oral steroids may also be used

not allopurinol

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203
Q

3 cardinal symptoms of heart failure

A

Shortness of breath

Fatigue

Peripheral oedema

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204
Q

DVT Ix

A

D-dimer

US compression test

Well’s score

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205
Q

triggers for trigeminal neuralgia

A

shaving

washing

eating

talking

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206
Q

define osteoporosis

A

● Decreased bone mass with normal mineralisation

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207
Q

which drug is associated with nephrogenic diabetes insipidus

A
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208
Q

what is the difference between transudate and exudate in pleural effusions and what criteria tests this

A

lights criteria

if Pleural fluid protein / Serum protein >0.5 then it’s exudate

i.e. if the pleural fluid is more than half as proteiny as serum then it’s exudate

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209
Q

what does drugability mean

A

It is the ability of a protein to bind small molecules with high affinity

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210
Q

diagnostic criteria in SLE

A
  • You need 4/11 of MD SOAP BRAIN
    • Malar rash
    • Discoid rash
    • Scleritis
    • Oral ulcers
    • Arthritis
    • Photosensitivity
    • Bloods (anaemia, thrombocytopenia, leukopenia)
    • Renal (proteinuria)
    • ANA
    • Immunologica (dsDNA
    • Neurological (seizures)
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211
Q

what is the mutation in CF say full name

A

cystic fibrosis transmembrane conductance regulator (CFTR) on chromosome 7

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212
Q

what is trigeminal neuralgia and what is the treatment

A

it is paroxysmal intense stabbing pain that lasts seconds and exists in the trigeminal nerve distribution unilaterally

caused by nerve compression

treatment is with carbamazepine

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213
Q

what is pseudohypoparathyroidism and how do you treat it

A

it’s decreased bone response to PTH

low Ca2+ and high PTH

treat with AdCal and calcitriol

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214
Q

dermatitis herpeteformis is associated with which gut disorder

A

coeliac

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215
Q

what is the mutation that is a risk factor for crohn’s

A

NOD2 mutation on chromosome 16

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216
Q

4x possible triggers for exacerbation of asthma

A

cold,

exercise,

menstrual cycle,

pets,

infections,

laughter,

emotion

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217
Q

management of tension pneumothorax

A

large bore needle aspiration

into second intercostal space in mid clavicular line on side of pneumothorax

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218
Q

treatment for hyperosmolar hyperglycaemic state

A

LMWH

fluid

insulin

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219
Q

diagnosis of spontaneous bacterial peritonitis

A

Neutrophils >250/mm3

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220
Q

most common type of MND

A

amyotrophic lateral sclerosis

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221
Q

causes of low calcium

A
  • HAVOC
    • hypoparathyroidism
    • acute pancreatitis
    • vitamin D deficienct
    • osteolamacia
    • CKD
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222
Q

sickle cell mutation

A

chromosome 11, glutamic acid becomes a valine on B globin gene

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223
Q

causes of diabetes insipidus

A
  • cranial: head trauma, pituitary tumour
  • nephrogenic: lithium
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224
Q

who is a blue bloater and who is a pink puffer

A

emphysema = pink puffer

chronic bronchitis = blue bloater

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225
Q

two conditions associated with asthma

A

eczema and hayfever

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226
Q

what is the name of the criteria used to diagnose MS

A

MacDonald criteria

227
Q

what is the surgical treatment of BPH

A

TURP

transurethral resection of prostate

228
Q

gout Ix

A
  • joint aspirate and polarised light microscopy
    • would show -vely birefringent needle shaped monosodium urate crystals
229
Q

name a treatment for myasthenia gravis

A

pyridostigmine

230
Q

red flags for back pain

A

Thoracic pain

Fever and unexplained weight loss

Bladder or bowel dysfunction

History of carcinoma

Ill health or presence of other medical illness

Progressive neurological deficit

Disturbed gait, saddle anaesthesia

Age of onset <20 years or >55 years

231
Q

causes of secondary osteoporosis

A
  • SHATTERRED
    • Steroid use
    • Hyperparathyroidism or pseudo
    • Alcohol/smoking
    • Thin
    • Testosterone/oestrogen low
    • Early menopause
    • Renal disease
    • Relatives (family history)
    • Erosive bone disease (myeloma or RA)
    • Dietary calcium low
232
Q

what is the diagnostic test for the epstein barr virus

A

Monospot test

Paul-bunnel test

233
Q

treatment of SIADH

A

treat underlying cause

restrict fluid

vasopressin receptor antagonists: vaptans

234
Q

hyperkalaemia symptoms

A

cramping

flaccid paralysis

arrhythmias and arrest

235
Q

what is DIC

A
  • disseminated intravascular coagulation
  • generation of fibrin within blood vessels
  • consumption of platelets and clotting factors
  • initial thrombosis followed by bleeding tendancy
236
Q

4 secondary causes of hypertension

A

Conn’s

Coarctation of the aorta

CKD

Pregnancy

237
Q

what tool would you use to know someone’s risk of stroke following a TIA

A
  • ABCD2
    • Age > 60 +1
    • BP > 140/90 +1
    • Clinical features of the TIA
      • unilateral weakness +2
      • speech disturbances +1
    • Diabetes +1
238
Q

what is eczema herpeticum

A

it’s a rare but severe disseminated infection that generally occurs at sites of skin damage produced by, for example, atopic dermatitis, burns, long term usage of topical steroids or eczema

caused by herpes simplex virus

239
Q

3 things that make future pandemics more likely

A

increased travel

increased world pop

increased intensive farming

240
Q

causes of bone marrow failure

A

chemo

malignant infiltration

congenital

aplastic anaemia (acquired)

241
Q

what should you give someone with alcoholic hepatitis

A

pabrinex

242
Q

what antibody is found in antiphospholipid syndrome

A

anti-cardiolipin antibody

243
Q

in which age group do 50% new HIV infections occur in

A

19-24

244
Q

what cardiac enzymes should you test for in suspected MI

A

troponin T

myoglobin

CK-MB

245
Q

hypercalcaemia is basically always due to one of two things what are they

what does this mean for investigating hypercalcaemia

A

cancer

hyperparathyroidism

check corrected calcium and PTH levels

if the hypercalcaemia is due to cancer then the PTH levels will be low

246
Q

secondary causes of polycythaemia are due to _______ and include:

A

due to increased circulating EPO

include chronic hypoxia

EPO releasing tumours

Abnormal RBC structure

247
Q

what is required for diagnosis of ra

A
  • 4 of the following 7:
    • morning stiffness
    • rheumatoid nodules
    • symmetrical
    • hand arthritis
    • arthritis of >3 joints
    • radiographic changes
    • rheumatoid factor +ve
248
Q

what type of jaundice in malaria

A
  • Pre-Hepatic Jaundice
  • Urine Normal /Yellow /Clear
  • Stool Normal / Brown
249
Q

what is rheumatoid arthritis

A

it is a systemic auto-inflammatory disorder that leads to immune complex deposition in joints which causes symmetrical deformin polyarthritis

250
Q

what is the ECG of AF

A

irregularly irregular QRS complexes

absent P waves

251
Q

how do you decide if you should give Abx for a sore throat

A
  • CENTOR Criteria give Abx if 3 or more
    • C - cough absent
    • E - exudate on tonsils
    • N - nodes tender and enlarged
    • T - temperature above 38 C
252
Q

duration of a migraine

A

4-72hrs

253
Q

antibodies in UC

A

70% have anti-neutrophil cytoplasmic antibodies (ANCA)

254
Q

what is the treatment for CML

A

imatinib which is a tyrosine kinase inhibitor

255
Q

treatment for hypoglycaemia in DMT1

A

glucose and glucagon

256
Q

two organisms that cause cellulitis

A

Staphylococcus Aureus,

Streptococcus pyogenes

257
Q

where does insulin resistance occur in DMT2

A

post receptor

258
Q

what is the most common non-small cell lung cancer

A

adenocarcenoma

259
Q

management of pseudogout

A
  • acute attacks:
    • cool packs
    • aspiration
    • intra articular steroids
  • NSAIDs and Colchicine may prevent attacks
260
Q

name three sickle cell precipitants

A

cold

infection

hypoxia

261
Q

treatment for prostate cancer

A
  • localised
    • prostatectomy
  • if spread
    • androgen deprivation therapy
    • chemo
262
Q

will back pain go with rest?

A

mechanical will but inflammatory won’t

263
Q

which ethnic group has an increased risk of prostate cancer

A

Afro-Caribbean

264
Q

4 features of horner’s syndrome

A

Ptosis, miosis, enopthalmosis, hydrosis

265
Q

two structural changes that may cause epilepsy

A

scarring due to trauma

stroke

266
Q

what are the symptoms and signs of cushing’s disease

A
  • CUSHING
    • cateracts
    • ulcers
    • skin striae
    • hypertension
    • infections
    • necrosis
    • glucosuria
  • buffalo hump
  • hirsutism
  • central obesity
  • acne
  • moon face
267
Q

what is a very important syndrome that is a complication of SLE

A

anti-phospholipid syndrome

268
Q

prevention of gout

A

allopurinol (xanthine oxidase inhibitor)

269
Q

definition of cellulitis

A

infection of the dermis and the sub cut tissue

270
Q

when would you see bite and blister cells

A

on a blood film in glucose-6-phosphate dehydrogenase deficiency

271
Q

what is the definition of CKD

A

abnormalities of kidney function lasting >3 months with implications for health

272
Q

what is the empirical antibiotic for suspected meningitis

A

IV ceftriaxone

consider IV amoxicillin if >60 or immunocompromised

273
Q

what is thrombotic thrombocytopaenic purpura

A

deficiency in ADAMTS13 which normally cleaves vWF

large vWF aggregates cause platelet aggregation and fibrin deposition in small vessels

this leads to multi-system thrombotic microangiopathy which is an EMERGENCY

274
Q

thalassaemia inheritance pattern

A

autosomal recessive

275
Q

how is IBS diagnosed

A

with rome criteria which includes recurrent abdominal pain, on average, at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

Related to defecation

Associated with a change in frequency of stool

Associated with a change in form (appearance) of stool.

276
Q

emphysema definition

A

enlarged air spaces distal to terminal bronchioles

277
Q

name a parasite that causes infective diarrhoea

A

giardia lamblia

278
Q

what is the treatment for hypothyroidism

A

synthetic levothyroxine

279
Q

namee 5 side effects of long term steroid therapy

A
  • Weight Gain (1)
  • Decreased Density of Bone / Osteoporosis (1)
  • Increased risk of infection / Immunosuppression (1)
  • Hyperglycaemia (1) / Link to causing DM+ HTN (1)
  • Effects growth (caution use in younger people) (1)
  • Skin Thinning (1)
  • Fluid Retention / Oedema (1)
280
Q

treatment for primary polycythaemia

A

blood letting and aspirin

281
Q

if over 50, male and have renal colic what must you exclude

A

AAA rupture or dissection

282
Q

management for chronic pseudogout

A

methotrexate or sulfasalazine

283
Q

treatment for hepatitis C

A

pegylated interferon and ribavirin for 6 months

1 yr if it’s type 1

284
Q

CLL is malignancy of what kind of cell

A

B cells

285
Q

Dx if cushing’s

A

failure of dexamethasone to suppress cortisol levels over 24hr period

dexamethasone suppression test

286
Q

if they have AF and acute abdo pain what should you always think of?

A

bowel/mesentry ischaemia

287
Q

what is the RX for nephrolithiasis >10mm

A

percutaneous nephrolithotomy

288
Q

outline DMT2 treatmnet

A
  1. lifestyle
  2. metformin (biguanide)
  3. dual therapy (metformin + DPP4 inhibitor, glitazone or gliclazide)
  4. triple therapy
  5. insulin
289
Q

who does CLL typically affect

A
  • chronic lymphocytic leukaemia
  • incidence increases with age
  • M>F
  • White>black
290
Q

secondary prevention following TIA or stroke

A

control risk factors

2 weeks aspirin

long term anti-platelet like clopidogrel

291
Q

three treatments for guillain barre syndrome

A

IV Ig

infliximab (anti-TNF-alpha)

plasma exchange

292
Q

which congenital disease is associated with berry aneurysms

A

autosomal dominant polycystic kidney disease

293
Q

name the surgical treatment of GORD

A

fundoplication

294
Q

how many genotypes of Hep C are there and which is the hardest to treat

A

there are 6 and 1 is the hardest to treat

295
Q

what is systemic sclerosis and CREST syndrome

A
  • ANA and ACA +ve
  • 4 central features
    • Calcinosis
    • Raynaud’s
    • Eosophageal dysmotility
    • Sclerodactyly
    • Telangiectasia
  • CREST
    • skin features limited to hands, face and feet
    • fatal hypertension
  • Diffuse
    • all skin and multi-organ fibrosis
296
Q

how will transferrin and TIBC be in haemochromatosis

A

In iron overload, such as in haemochromatosis, iron and transferrin saturation will be high and TIBC will be low or normal.

297
Q

chronic complications of sickle cell

A

renal impairment

pulmonary hypertension

joint damage

298
Q

3 stages of malaria infection

A

exo-erythrocytic

endo-erythrocytic

dormant: P.vivax and P.ovale

299
Q

criteria for diagnosing MS

A

McDonald criteria

300
Q

three things to check in hypertension

A
  • eye problems
    • papilloedema
  • end organ damage
    • urinalysis
    • 12 lead ECG
  • CVD risk
    • fasting glucose and QRISK
301
Q

side effects of chemotherapy

A

Alopecia,

Nausea and Vomiting,

Peripheral neuropathy,

Constipation or Diarrhoea,

Mucositis,

Bone Marrow Suppression –> Anaemia,

Fatigue,

Anaphylaxis

302
Q

signs and symptoms of bone marrow failure

A

bruising

bleeding from nose and gums

susceptibility to infections

303
Q

SAH incidence

A

9/100,000/yr

304
Q

3 types of necrosis

A

coagulative

caseous

liquifactive

305
Q

malaria treatment

A

quinine and doxycycline

306
Q

how long does syncope last

A

5-30 seconds with a recovery of 30 seconds

307
Q

4x things you’d ask in the history to support diagnosis of allergic asthma

A

Diurnal variation, provoking factors, other features of atopy (hayfever, eczmema,
food allergy), reversability/episodic nature, wheeziness.

308
Q

diff between direct and indirect inguinal hernia

A

direct = medial to inferior epigastric vessels

indirect = lateral to inferior epigastric vessels

309
Q

in liver disease how will TIBC and transferrin be?

A

Because transferrin is made in the liver, TIBC and transferrin will also be low with liver disease.

310
Q

Dx of diabetes insipidus

A
  • water deprivation test
    • restrict fluid and urine osmolality remains low in DI
  • then give desmopressin to differentiate nephrogenic and cranial
311
Q

What 4 questions would you ask during a GP consultation to assess whether a patient’s
asthma is poorly controlled?

A

● In the last 4 weeks has your asthma caused nocturnal waking?
● In the last 4 weeks has your asthma caused you to get less done than
usual/interfered with ADLs?
● In the last 4 weeks how many times have you used your blue inhaler?
● In the last 4 weeks how often have you had shortness of breath/symptoms of
asthma?

312
Q

where are M2 muscarinic receptors found

A

heart

313
Q

what is the triad for critical limb ischaemia

A

gangrene

pain

arterial insufficiency ulcers

314
Q

what is the gold standard Ix for renal colic

A

NCCT - KUB

315
Q

how do you diagnose bronchiectasis

A

high res CT chest

316
Q

why does cholera cause so much watery diarrhoea

A

causes high cAMP

leads to massive excretion of Cl- by CFTR

draws out fluid

317
Q

migraines risk factors

A

obesity and family history

318
Q

what does HAS-BLED estimate and what are the components

A
  • assesses 1-year risk of major bleeding in patients taking anticoagulants with atrial fibrillation.
    • Hypertension
    • Abnormal renal or liver function
    • Stroke
    • Bleeding
    • Labile INR
    • Elderly
    • Drugs or alcohol
319
Q

Clinical features of acute mesenteric ischaemia

A

severe abdo pain out of proportion with signs

can lead to rapid hypovolaemia and shock

metabolic acidosis due to high lactate

320
Q

4 stages of acute inflammation

A

changes of vessel calibre

fluid exudate

cellular exudate

chemotaxis

321
Q

Dx of GCA

A
  • ESR high
  • temporal artery biopsy is gold standard
    • necrotising arteritis
322
Q

how do you diagnose ALL

A

>20% blast cells on blood film

323
Q

What’s first line treatment is given for an acute flare of Crohn’s?

A

IV methyl prednisolone

324
Q

treatment for cholestatic itch

A

cholestyramine

325
Q

G-6-PD deficiency: what is the danger

A
  • oxidative chrisis which is brought on by precipitants
    • henna and nitrofurantoin
  • there’s rapid haemolysis, jaundice and anaemia
326
Q

treatment for minimal change disease

A

corticosteroids

327
Q

SAH Tx

A

surgical clipping of aneurysm

maintain BP

328
Q

what is the FRAX scrore for calculating

A

Risk of developing a fracture in the next 10 years

329
Q

cell count where AIDS symptoms occur

A

500-200 cells/mm3

330
Q

Tx for acute attack of cluster headache

A

Sumatriptan and 100% oxygen

331
Q

draw the diagram of epidemiological studies

A
332
Q

is haemophilia A more or less common than haemophilia B

A

A is more common

333
Q

what scoring system evaluates risk of stroke with AF and what are the components

A
  • CHA2DS2VASc
    • CHF +1
    • Hypertension +1
    • Age >75 +2
    • Diabetes +1
    • Stroke, TIA or thromboembolis +2
    • Vascular disease (PAD, MI etc) +1
    • Age 65-74 +1
    • Sex category (female +1)
334
Q

Name a risk assessment tool designed to improve the prediction of short-term stroke risk after a transient ischemic attack (TIA)

describe the peramiters

A
335
Q

name the three non-metformin diabetes drug types, give an example and say how they work and whether they cause weight gain

A
  • sulfonyl-urea (e.g. gliclazide)
    • stimulates B cells to secrete insulin
    • causes weight gain
  • DPP4 inhibitor (e.g. sitagliptin)
    • inhibits inhibitor of incretins
    • incretins increase insulin
    • doesn’t cause weight gain
  • Glitazone (e.g. pioglitazone)
    • stimulates body to make more fat from circulating glucose
    • causes weight gain
336
Q

CXR of pulmonary HTN

A

enlarged proximal pulmonary vessels

337
Q

polycythaemia signs and symptoms

A

headache

dizziness

fatigue

bleeding/bruising

leads to greater risk of thromboembolism

338
Q

which TLR recognises LPS

A

TLR 4

339
Q

where does furosemide act

A

inhibits NKCC cotransporter in thick ascending limb

causes K+, CL- and Na_ loss

340
Q

which virus causes kaposi’s sarcoma

A

human herpes virus 8

341
Q

AF ecg

A

F waves, no P waves, QRS irregularly irregular

342
Q

cause of coeliac

A

inappropriate immune response to the gut flora in genetically susceptible individuals

343
Q

define cellulitis

A

Inflammation involving dermis and epidermis

344
Q

two broad reasons IM adrenaline works in anaphylaxis§

A
  • B2 adrenergic receptor activity
    • bronchial dilation
    • myocardial contraction increased
    • decreased mast cell acrivation
  • alpha adrenergic receptor activity
    • peripheral vasoconstriction
    • reduction of oedema
345
Q

what is impaired glucose tolerance

A

2hr post oral glucose test is >7.8 but <11mmol/L

346
Q

what are the dukes stages

A
  • for colon cancer staging
  • A - limited to muscularis mucosae
  • B - extended beyond muscularis mucosae
  • C - involvement of regional lymph nodes
  • D - distant mets
347
Q

how common is penicillin allergy

A

2% population have it

348
Q

Rx for nephrolithiasis >5mm but <10mm

A

medical expulsive therapy with tamsulosin

349
Q

What is the sequence of events that take place for metastasis to occur?

A

invasion

intravasation

evasion

adherance

extravasation

angiogenesis

350
Q

where is iron absorbed

A

duodenum

351
Q

what does TLR 5 recognise

A

flagellin

352
Q

CT of SAH

A

hyperdense crescent

353
Q

name six red flags from headaches

A

first and worst headache - SAH

unilateral and eye pain - cluster headache

associated with fever or neck stiffness - meningitis

scalp tenderness in over 50s - GCA

headache when coughing/straining - raised ICP

unilateral headache with ipsilateral symptoms - space occupying lesion

354
Q

3 causes of small bowel obstruction

A

Adhesions, Crohn’s, Volvulus, Herniation, Neoplasia, Foreign bodies

355
Q

how do methylxanthines work

A

they are used in asthma and they increase cAMP levels

cAMP leads to bronchodilation AND mast cell stabilisation

356
Q

what do you see on blood film of someone with Multiple myeloma

A

Rouleaux formation

357
Q

treatment for myeloma

A

bisphosphonates

chemotherapy

radiotherapy

358
Q

acute complications of sickle cell

A

painful crisis

sickle cell chest crisis

mesenteric ischaemia

359
Q

antibodies in crohns?

A

70% have Anti-Saccharomyces cerevisiae antibodies (ASCA)

360
Q

you should do a lumbar puncture in suspected meningitis unless

A

evidence of shock

petychial rash

raised ICP

abnormal clotting

361
Q

which antibody is present in lupus

A

anti-dsDNA which is a type of ANA

362
Q

Rx for nephrolithiasis <5mm

A

watch and wait

363
Q

how do corticosteroids work

A

they bind zinc fingers that increase transcription of genes that are anti-inflammatory and decrease transcription of genes that are pro inflammatory

364
Q

urine analysis results that suggest infection

A

presence of nitrites

leukocytes

haematuria

365
Q

what is CLL, what are the symptoms and what are the treatment

A
  • chronic lymphocytic leukaemia
  • symptoms are lymphadenopathy, splenomegaly and infections
  • 50% findings incidental though
  • it’s chronic and incurable - patients die with rather than from
366
Q

which cytokine is released after MHC-antigen complex binds CD4?

A

IL-2

it has a possitive feedback effect on production of more CD4+ T cells

367
Q

HLA types for diabetes mellitus

A

HLA-DR3-DQ2

HLA-DR4-DQ8

368
Q

different adverse drug reactions and an example of each

A
  • Type A: Augmented pharmacological (morphine and constipation)
  • Type B: Bizarre (penicillin allergy)
  • Type C: Chronic (colonic dysfunction after laxative therapy)
  • Type D: Delayed (malignancies and immunosuppression)
  • Type E: End of treatment (opiate withdrawal)
  • Type F: Failure (OCP with enzyme inducers)
369
Q

most common bacteria causing meningitis infection in neonates

A

Strep agalactiae (group B strep)

370
Q

name a drug you could use for overactive bladder

A

Oxybutynin which is an anti-cholinergic

371
Q

what is GCA

A

granulomatous arteritis of the aorta and larger vessels like the extracranial branches of the carotid artery

372
Q

what are the antibodies in grave’s disease

A
  • Thyroid stimulating immunoglobulin (TSI) presence is diagnostic
  • Thyroid stimulating hormone receptor antibody (TRAb)
    *
373
Q

what are buserelin and goserelin and how do they work

A
  • They are GnRH agonists for prostate cancer
    • they initially increase LH production and therefore testosterone production
    • so tumour initially grows
    • then overwhelms body’s natural rhythm and LH and testosterone levels drop off
374
Q

why do you get hyperlipidaemia in nephrotic syndrome

A

the liver produces more lipid in response to the hypoalbuminaemia

375
Q

name 3 sites where you might see a hernia?

A

Inguinal (direct/indirect),

Femoral,

Umbilical,

Incisional (site of previous surgical incision)

376
Q

treatment for Legionella pneumophilia pneumonia

A

Erythromicin or or doxycycline

377
Q

morning stiffness in osteoarthritis lasts how long?

A

30 minutes

378
Q

where are NKCC cotransporters found

A

in the ascending limb of the loop of henle

379
Q

renal causes of AKI

A

Glomerulonephritis

SLE

Acute tubular necrosis caused by ACEi or NSAIDs

380
Q

how do you differentiate salmonella and shigella

A

Do serotyping (API strip) to confirm Salmonella vs Shigella

381
Q

why does glandular fever sometimes cause splenomegaly

A

congestion and macrophage activation within the red pulp

red pulp is infiltrated by immunoblasts and
plasmablasts. In infectious mononucleosis, the spleen enlarges
rapidly, increasing capsular tension, and has a soft consistency,
making it very susceptible to rupture

382
Q

causes of disseminated intravascular coagulation

A

septicaemia

malignancy

trauma

infection

haemolytic transfusion reaction

383
Q

painless ulcer with granulating base - what type of ulcer

A

neuropathic ulcer

384
Q

where is the pain in uc

A

lower left quadrant

385
Q

Dx of malaria

A

rapid diagnostic test detects plasmodium antigens in blood

386
Q

symptoms and signs of addison’s

A

tanned, tired, toned and tearful

  • Look: lean and pigmented
  • Mood: depressed and tearful
  • GI: N&V abdo pain
387
Q

definition of AIDS

A

CD4+ T cell count below 200 cells/mm3

388
Q

how long do epileptic seizures normally last?

A

30-120 seconds

389
Q

qt interval should be how long

A

0.4-0.43s

390
Q

what will TIBC/transferrin be in iron deficiency anaemia

A

High in iron deficiency (more is available to bind)

391
Q

hyperlipidaemia and hypoalbuminaemia are in nephritic syndrome or nephrotic syndrome

A

these are both only present in nephrotic syndrome

despite the fact that there may be a small amount of proteinuria in nephritic syndrome - this is not enough to cause hypoalbuminaemia

392
Q

whats the name of the tool used to assess for acute appendicitis

A

alvarado or mantrels

393
Q

what sort of drug for IBS diarrhoea

A

loperamide which is anti-motility

394
Q

what is the triad in reactive arthritis

A
  • reiter’s triad
    • conjunctivitis
    • urethritis
    • arthritis
395
Q

complications from ACS

A
  • DARTH VADER:
  • Death
  • Arrhythmias
  • Ruptured septum
  • Tamponade
  • Heart failure
  • Valve disease
  • Aneurysm of the ventricle
  • Dressler’s syndrome
  • Embolism
  • Reoccurrence of ACS
396
Q

what is the last resort treatment for migraines

A

botulinum toxin A injections

397
Q

give three measurements and values that would warrent a diagnosis of type 2 diabetes mellitus

A

fasting glucose > 7mmol/L

random glucose >11mmo/L

HbA1c > 6.5% or 48mmol/mol

398
Q

4 criteria for allergy to a drug

A

no linear relationship with dose

disappears with cessation

re-appears on re-exposure

occurs in the minority of patients on a drug

399
Q

treatment for huntingon’s chorea

A

benzodiazepines like lorazepam

400
Q

how do you diagnose osteoporosis

A

-2.5 T score on DEXA (dual energy x-ray absorbtiometry)

401
Q

6 secondary causes of hypertension

A

Conn’s syndrome

Cushing’s syndrome

CKD
Phaeochromocytoma

Steroids

Acromegaly

402
Q

which meningitis is a notifiable disease

A

Neisseria meningitidis

403
Q

HLA type associated with grave’s

A

HLA-BO8

404
Q

what is polymyalgia rheumatica and what should you treat it with

A

often coexists with GCA

pain in muscles of shoulders, neck and hips

high CRP and ESR

treat with prednisolone

405
Q

early and late symptoms of huntingtons

A
  • early
    • irritability
    • depression
    • incoordination
  • late
    • chorea
    • seizures
    • death
406
Q

3 viruses that cause meningitis

A

Vericella Zoster virus

Enterovirus

Herpes simplex virus

407
Q

difference between Th1 qnd Th2 response

A
  • Th1 recruit macrophages
  • Th2 recruit eosinophils
  • Th1 cause IgG production via B cells
  • Th2 cause IgE production via B cells
  • Th1 produce anti-viral or anti-parasitic cytokines
  • Th2 produce anti-parasitic cytokines
408
Q

how does warfarin work

A

it inhibits the enzyme that activates vitamin K so it leads to a fall in factor 7, 2, 9, and 10

antidote is vitamin K

409
Q

what is anti-phospholipid syndrome and what are 4 important signs

A
  • it is a hypercoagulable state caused by anti-phospholipid antibodies such as anti-cardiolipin
  • CLOT
    • Coagulation defects
    • Levido reticularis
    • Obstetric - miscarriage
    • Thrombocytopaenia
410
Q

which abx for S. aureus skin infection

A

oral flucloxacillin

411
Q

three types of inherited causes of haemolytic anaemia

A

enzymopathies

membranopathies

haemoglobinopathies

412
Q

what % people suffer with migraines

A

15%

413
Q

radiographic changes in RA

A

Loss of joint space

erosions (periarticular)

soft bones

soft tissue swelling

414
Q

Ix for spherocytosis

A

osmotic fragility test

RBCs are fragile in hypotonic solutions

415
Q

gold standard for PE diagnosis

A

CT pulmonary angiography

416
Q

organisms that commonly cause cellulitis

and which of these commonly causes a dangerous complication

A

S.aureus and S.pyogenes

S.pyogenes is commonly the cause of necrotising fasciitis which is a complication of cellulitis - infection of deep fascia

417
Q

clinical features of myeloma

A
  • CRAB
    • Ca2+ high
    • Renal failure (precipitation of light chains in nephrons)
    • Anaemia
    • Bone lytic lesions
418
Q

pre renal causes of aki

A
  • volume depletion
    • D&V
    • Haemorrhage
  • Hypotension
    • Sepsis
  • Renal artery occlusion
419
Q

treatment for status epilepticus

A
  • IV Lorazepam
  • Assess drug and metabolite levels
  • If continues IV phenytoin
  • if continues >60-90 mins then propofol infusion for paralysis
420
Q

what is the management for anti-phospholipid syndrome

A

aspirin

warfarin or LMWH (dalteparin) if trying to conceive

421
Q

how long do cluster headaches last and how often do people get them

A

each one last 15-120mins

1-2 per day and they are commonly nocturnal

clusters are 4-6 weeks long

422
Q

SDH treatment

A

craniotomy or burr hole washout

urgently address clotting abnormalities

423
Q

R-R interval should be how long

A

0.6-1 second

424
Q

6 extra articular manifestations of RA

A

xreopthalmia

sjorgens

weight loss

pulmonary fibrosis

scleritis

pericarditis

pulmonary fibrosis

Raynauds

425
Q

what are the two signs you can examine for in meningitis

A
426
Q

what is the cause of peripheral oedema in COPD

A

cor-pulmonale

427
Q

what scoring system do you use to assess the severity of community acquired pneumonia, what are the components and what do the different scores mean

A
  • CURB654: one point for each
    • Confusion
    • Urea >7mmol/L
    • Resp rate >30
    • BP <90/60
    • Age > 65
  • score 0-1 = outpatient treatment with PO amoxicillin
  • score 2 = inpatient treatment with amoxicillin and clarithromycin
  • score 3 = inpatient treatment with co-amoxiclav and clarithromycin
428
Q

Tx for Ulcerative colitis

A
  • sulfasalazine
  • oral prednisolone
  • infliximab (anti-TNF alpha)
  • colectomy if intractable
429
Q

what are the polymorphonuclear leukocytes

A

Neutrophil, Basophil, Eosinophil

430
Q

muscle groups commonly affected by myasthenia gravis

A

limb girdle

face

bulbar muscles

extra ocular muscles

neck

431
Q

treatment for psoriasis

A

topical corticosteroids and vitamin D analogues

2nd line would be DMARDs like methotrexate

432
Q

what is the mutation in polycythaemia rubra vera and why does it cause its effect

A

JAK2

causes RBC proliferation in absence of EPO

433
Q

which chromosome is huntington’s mutation

A

4

434
Q

what is the mainstay of remission induction/maintenance in Ulcerative colitis?

A

mesalazine PO or PR

it’s a 5-ASA

435
Q

In an average 70Kg male this constitutes 42 L of water. Approximately how many liters of water would you expect to find in the following compartments of this patient: Intracellular, Extracellular, Plasma?

A

Intracellular ~ 28L (2/3),

Extracellular~ 14L (1/3).

Plasma ~3 L (a component of the extracellular compartment)

436
Q

characteristic X ray finding of psoriatic arthritis

A

pencil in a cup erosion

437
Q

Giardia, Entamoeba histolytica treatment

A

metronidazole

438
Q

what is normal ABPI

what is peripheral arterial disease

A

1-1.2

0.5-0.9

439
Q

what happens once salbutamol binds its receptor

A
  • it binds B2 adrenergic receptor on smooth muscle cell
  • it is a g protein coupled receptor
  • itracellular cascade leads to adenylate cyclase producing more cAMP from ATP
  • this leads to bronchodilation
  • AND cAMP also leads to stabilisation of mast cells
440
Q

what are some of the clinical and biochemical findings needed to diagnose shock

A

● Hypotension (systolic <90mmHg) despite adequate fluid resus
● Tachycardic (HR>90bpm)
● Oliguria (<400 mL/day or 15mL/h)
● Prolonged capillary refill (>2seconds)
● Tachypnoea (>20 cycles/min)
● Raised blood lactate

441
Q

gold standard Ix for angina pectoris

A

CT angiography of coronary arteries

442
Q

primary causes of polycythaemia are due to _______

they include _______ and ______

A

increased sensitivity of bone marrow to EPO

polycythaemia rubra vera (JAK2 mutation)

primary familial congenital polycythaemia (EPOR mutation)

443
Q

3 causes of macrocytic anaemia

A

B12/Folate Deficiency

  • Alcohol excess/liver disease
  • Hypothyroidism
444
Q

2 examples of ANCA +ve vasculitis

A

Churg-Strauss Syndrome

Wegener’s Vasculitis

445
Q

4x pneumonia signs on auscultation

A

● Crackles,
● pleural rub,
● increased vocal resonance,
● bronchial breathing

446
Q

treatment for generalised seizures

A

Sodium valproate

Lamotrigine

447
Q

what is the 1st and 2nd line Rx for osteoporosis

A

AdCal

Bisphosphonates like alendronate

2nd line is add another bisophosphonate like risendronate

448
Q

blood in diarrhoea means what if it’s infectious?

A

means its likely bacterial

449
Q

what’s required to diagose SLE

A
  • 4 of the following 11 are required (MD SOAP BRAIN)
    • Malar rash
    • Discoid rash
    • Serositis
    • Oral ulcers
    • Arthritis
    • Photosensitivity
    • Blood (all low, anaemia, leukopenia, thrombocytopenia)
    • Renal dysfunction (proteinuria)
    • ANA +ve
    • Immune dysfunction (ds-DNA)
    • Neurological symptoms (seizures)
450
Q

components of first pass metabolism

A

Enzymes of GI lumen

Enzymes of gut wall

Enzymes from bacteria

Enzymes of liver

451
Q

bloods in psoriatic arthritis

A

Anaemia

High ESR

RF -ve

452
Q

Rx for acromegaly

A

transphenoidal surgery to remove adenoma

PEGVISOMAT = GH antagonist

453
Q

crohns most commonly affects which part of the gut

A

terminal ileum

454
Q

parkinsonism:

A

hypertonia

bradykinesia

resting tremor

455
Q

define anaemia

A

Low Hb Concentration due to reduced cell mass or increased plasma volume

456
Q

Name 3 drug targets.

A

Receptors,

enzymes,

transporters,

ion channels

457
Q

hypocalcaemia clinical features

A

CATS

convulsions

arrhythmias

tetany

spasms and stridor

458
Q

4 signs of pulmonary hypertension on an X ray

A

Enlargement of the pulmonary arteries,

  • Lucent lung fields,
  • Enlarged right atrium,
  • Elevated cardiac apex due to right ventricular hypertrophy
459
Q

Hep B treatment

A

alpha interferon

tenofovir (nucleoside analogue)

460
Q

which HLA type is associated with SLE

A

HLA-DR2

461
Q

what are the criteria for AKI

A
  • increase in serum creatinine >26micromol/L in the last 48hrs
  • increase in serum creatinine >50% baseline in the last 7 days
  • urine output of <0.5ml/kg/hr for >6 consecutive hrs
462
Q

where does lung cancer commonly metastasise

A

bones

adrenals

liver

brain

463
Q

why does thalassaemia cause anaemia

A

precipitation of globin chains in precursors causes reduced erythropoiesis (Reticulocyte count will be high)

precipitation in mature RBCs causes increased destruction (microcytic hypochromic anaemia)

464
Q

You explain to the patient her children may demonstrate symptoms earlier in their life than she. What is this known as?

A

anticipation

465
Q

what is the antibody in addison’s

A

21 hydroxylase adrenal autoantibodies

466
Q

how long is driving prohibited following TIA

A

1 month

467
Q

Rx for encephalitis

A

IV acyclovir

468
Q

when is treatment for HTN indicated

A

when they have BP >160/100 or if they have >140/90 and they also have other risk factors for cardiovascular disease such as diabetes

469
Q

GCA diagnosis requires what

A
  • 3 of these 5
    • Age > 50
    • Temporal artery tenderness
    • New headache
    • ESR > 50
    • Abnormal artery biopsy
470
Q

any old person with new back pain is what until proven otherwise?

A

multiple myeloma

471
Q

opioid side effects

A
  • Royal Society for Nautical Communications Is Immortal and Everlasting
    • Respiratory depression
    • Sedation
    • Nausea and vomiting
    • Constipation
    • Itching
    • Immune suppression
472
Q

what does tobacco smoke do to alpha-1-antitrypsin and what is the effect

A

it inhibits it

alpha-1-antitrypsin inhibits proteases

therefore there’s uncontrolled protease activity in the lungs

this leads to degradation of elastin, formation of bullae and emphysema

473
Q

as well as hepatitis what can pyrazinamide cause

A

arthralgia

474
Q

Pericarditis ecg

A

saddle shaped ST elevation and PR depression

475
Q

qrs complex should be how long

A

0.08 - 0.11 s

476
Q

what condition do you see a beak like nose and microstomia

A

systemic sclerosis and CREST syndrome

477
Q

what is it called when MS is worse in hot

A

Uhtoff’s phenomenon

478
Q

how much higher is mortality in the epileptic population than gen pop

A

3x

479
Q

chronic management of sickle cell

A

hydroxycarbamide if frequent crises (increases HbF)

Abx prophylaxis and vaccination (they’re immunocompromised due to splenic infartion)

480
Q

differences between venous ulcer and arterial ulcer (can you draw the table?)

A
481
Q

pyelonephritis treatment

A

Co-amoxiclav and gentamycin

482
Q

neutropenic sepsis definition

A

fever > 38 C and N count < 0.5 x 109/L

483
Q

example of low molecular weight heparin

A

dalteparin

484
Q

two bacteria that can cause rapid onset (<6hrs) food poisoning

A

Bacillus cereus

Staphylococcus aureus

485
Q

4 differentials for TIA

A

migraine

hypo/hyperglycaemia

migraine

focal epilepsy

486
Q

why are those with nephrotic syndrome at risk of embolism

A

they have lost all their anti-coagulation factors in their urine

so you need to give them warfarin or LMWH like dalteparin

487
Q

prevention of cluster headaches

A

avoid triggers

verapamil may help

488
Q

definition of atherosclerosis

A
  • accumulation of
    • lipid
    • macrophages (foam cells)
    • smooth muscle cells
  • in intimal plaques of large and medium sized vessels
489
Q

where is vitamin B12 absorbed

A

in the terminal ileum with intrinsic factor

490
Q

what is it when they get a hand spasm when you raise the sphygmomanometer above systolic pressure

A

trousseau’s sign of hypocalcaemia

491
Q

what is the treatment for gonorrhoea

A

single dose oral ceftriaxone

492
Q

how does methotrexate work

A

it is a folate antagonist so it can cause macrocytic anaemia

493
Q

when do you see schistocytes

A

on blood film of haemolytic anaemia

494
Q

what are the Ix of epilepsy

A
  • to look for a provoking cause
    • metabolite levels
    • drug levels
    • LP (infection suspeted)
    • MRI for structural lesions
  • EEG (electroencephalogram)
495
Q

what size is microcytic, normocytic and macrocytic anaemia

A

●MCV<80 = MICROCYTIC

●MCV 80-100 = NORMOCYTIC

●MCV >100 = MACROCYTIC

496
Q

where is vitamin B12 absorbed?

A

in the terminal ileum

497
Q

multiple myeloma symptoms

A

CRAB

C = calcium (elevated),

R = renal failure,

A = anemia,

B = bone lesions

498
Q

what is the scoring system for likelihood of DVT. what are the components

A
  • Well’s criteria
    • recently bedridden or recent surgery
    • active cancer
    • calf swelling >3cm more than affected leg
    • visible colateral blood vessels
    • pitting oedema confined to affected leg
    • paralysis, paresis or recent plaster immobilisation of affected limb
    • previous DVT
    • tenderness
    • entire leg swollen
  • and then if there’s another diagnosis that is as likely or more likely then take away two points.
499
Q

what antiviral is used to treat CMV

A

ganciclovir

500
Q

drugs to give post-MI

A

ABCDE
MONA

Anticoagulate with fondaprinux (10a inhibitor)

IV glyceryl trinitrate if pain continues

501
Q

Describe the difference between tolerance and desensitisation?

A

Tolerance - reduction in drug effect over time (continuously repeated high conc)

Desensitisation - receptors become degraded / uncoupled / internalised

502
Q

biomarker for HCC

A

alpha fetoprotein is produced by 50% of HCCs but is very low level in normal adults

503
Q

Ix for MS

A

MRI

CSF electrophoresis (monoclonal Ig band)

Evoked Potentials

you need to do more Ix to confirm if there are fewer lesions and fewer attacks

504
Q

what would you see down a microscope looking at biopsy of minimal change disease

A

podicyte effacement

505
Q

where is folate absorbed

A

in the jejunum

506
Q

describe pain of appendicitis

A

Initially a diffuse pain around the centre of the abdomen/umbilicus then localises to the right iliac fossa

507
Q

triad for DMT1

A

polyuria

polydipsia

weightloss

508
Q

what does CFTR stand for?

A

cystic fibrosis transmembrane conductance regulator

509
Q

Crohn’s treatment

A

azathioprine

Corticosteroids

infliximab

IV hydrocortisone for flare-ups

surgery is not curative

510
Q

classical triad of symptoms for renal cell carcinoma

A
  • Flank pain
  • Haematuria
  • Palpable Mass
511
Q

clinical features of bronchiectasis

A
  • Persistent cough,
  • Purulent sputum (but some patients may have a non-productive cough,
  • Clubbing,
  • Dyspnoea
  • Haemoptysis
  • Recurrent pulmonary infections
512
Q

expect non epileptic seizure if

A
  • gradual onset
  • prolonged duration
  • abrupt termination
  • closed eyes resistant to opening
  • normal:
    • CNS exam
    • CT
    • MRI
    • EEG
513
Q

compare features of severe and life threatening asthma attacks (can you draw the table)

A
514
Q

what is the apparent volume of distribution

A

it is the amount of a drug that must be administered to achieve a certain plasma concentration of the drug

Vd = total amount of drug in body/plasma concentration

515
Q

what is the most common cause of pericarditis

A

cocksackie B virus

516
Q

lifestyle advice for improving LUTS in men

A

drink less carbonated drinks, alcohol, caffeine, and drinks with artificial sweeteners

Drink less in the evening

Double voiding

Bladder training

517
Q

what are the red flags for back pain

A
  • TUNAFISH
    • Trauma/TB
    • Unexplained weightloss
    • Neurological deficit
    • Age <20 or >50
    • Fever
    • IVDU
    • Steroid use/immunocompromised
    • History of cancer
518
Q

complications of hepatic failure

A

coagulopathy

encephalopathy

hypoalbuminaemia

Sepsis

SBP

Hypoglycaemia

Portal hypertension -> oesophageal varices, haemorrhoids, caput medusae

519
Q

organism that causes malaria

A

Plasmodia falciparim

P. ovale

P. vivax

520
Q

why do you get immunocompromised in nephrotic syndrome

A

Ig loss in urine

521
Q

Rx for alzheimers

A

acetylcholinesterase inhibitors like donepezil

antiglutamateric treatment like memantine

522
Q

treatment for vibrio cholarae

A

doxycycline and fluids

523
Q

definition of epilepsy

A

the tendancy to spontaneous episodes of impulse discharge in the brain manifesting in seizures

524
Q

Dx of addison’s

A

cortisol remains low even after synthacthen stimulation test

bloods: low Na+ but high K+

525
Q

post-renal causes of AKI

A

stones

tumour of ureter

other abdo tumour

526
Q

when do you see schistocytes and what are they

A

they are broken down shards seen on blood film in haemolytic anaemia

527
Q

what is abarelix and how does it work

A

it is a GnRH antagonist

it decreases LH and therefore testosterone production

there’s decreased dihydrotestosterone

tumour shrinks

528
Q

in what condition is anti-topoisomerase and anti-centromere antibodies commonly seen

A

systemic sclerosis and CREST syndrome

529
Q

treatment for DVT

A
  • Immediately: LMWH and Warfarin
  • When INR 2-3 then change to just warfarin or a NOAC like rivaroxaban
530
Q

RA Rx

A

NSAIDs and PPI

DMARDs like methotrexat or sulfasalazine

biologics like rituximab (anti-CD20)

531
Q

7 clinical features of alzheimers

A
  • impairment of:
    • visuospatial skill
    • memory
    • verbal abilities
    • executive function
  • anosogosia
  • irritability
  • mood disturbance
  • psychosis
  • agnosia
532
Q

what percentage of adults and children will clear a Hep B infection when they get it

A

90% adults clear it

50% children clear it

533
Q

what biomarker can be used to diagnose heart failure

A

brain natriuretic peptide over >100ng/L

but if raised at all it indicates heart failure over other causes of dyspnoea

534
Q

4 stages of peripheral arterial disease

A
  • Stage I: asymptomatic
  • Stage II: intermittent claudication
  • Stage III: rest pain/nocturnal pain
  • Stage IV: necrosis/gangrene
535
Q

Ix for multiple myeloma are

A

urine electrophoresis - bence jones protein

serum electrophoresis - monoclonal band

536
Q

what is conn’s syndrome

A

hyperaldosteronism and low renin due to solitary adrenal adenoma or hyperplasia

this is 2/3 hyperaldosteronism

537
Q

clinical features of aortic dissection

A
  • Sudden ‘tearing’ chest pain +/- radiates to back
  • Unequal arm pulses and BP
  • Acute limb ischaemia
  • Paraplegia
  • Anuria
538
Q

mast cell degranulation in asthma produces what

A

histamine

cytokines (IL-3, IL-4 and IL-5)

leukotrines

prostaglandin D2

539
Q

what crystals do you see under the microscope in pseudogout

A
  • under polarised light microscopy you see
    • positively birefringent rhomboid calcium pyrophosphate crystals
540
Q

what is addison’s disease

A

it is autoimmune impairment of the adrenal gland and consequent low cortisol and aldosterone

541
Q

why does CKD cause hyperparathyroidism

A

no proper filtering so high phosphate

phosphate binds serum calcium so PTH detects low calcium

also not much vitamin D

542
Q

3 causes of TIA

A

atherothromboembolism (usually of carotid artery)

cardioembolism following MI or AF

Hyperviscosity

543
Q

5 steps of chronic asthma management

A
  1. SABA (salbutamol) for symptom relief
  2. Add inhaled steroid (beclamethasone) daily
  3. LABA (salmetarol)
  4. Increase beclamethasone dose
  5. add daily PO prednisolone
544
Q

5 features of CF

A

salty sweat

reurrent chest infections

failure to thrive

late puberty

infertility in males due to abnormality in Vas Deferens

malnutrition

clubbing

545
Q

ankylosing spondylitis 1st, 2nd and 3rd line treatment

A
  • 1st: exercise and physio
  • 2nd: NSAIDs
  • 3rd: TNF alpha blockers like etenercept
546
Q

organisms that can cause struvite stones

A

Proteus

Klebsiella

Pseudomonas

547
Q

most common bug causing CF pneumonia

A

Pseudomonas aeruginosa

548
Q

signs of myasthenia gravis

A

ptosis

diplopia

voice fades when counting to 50

myasthenic snarl

549
Q

why do you get increased risk of thromboembolism in in nephrotic syndrome

A

they are losing all their anti-thrombotic factors in their urine

550
Q

what is atropine

A

it is an M2 antagonist that works in the heart to treat life threatening bradycardias and heart block

551
Q

treatment for hyperaldosteronism

A

spironolactone

552
Q

what type of anaemia can methotrexate cause

A

macrocytic as it’s anti-folate

553
Q

X-ray findings of osteoarthritis

A

loss of joint space

osteophytes

subchondral sclerosis

subchondral cysts

554
Q

how does heparin work

A

inhibits factot Xa

555
Q

what is the definition of inflammation

A

a local physiological response to injury

556
Q

name and describe the bacteria commonly associated with acne

A

proprionibacterium

gram +ve anaerobic bacillus

557
Q

which antibodies are seen in myasthenia gravis

A

Anti-AChR (very commonly) and Anti-MUSK

558
Q

5 causes of peritonitis (and therefore DDx for what?)

A
  • appendicitis
  • ectopic pregnancy
  • infection
  • obstruction
  • ulcer

ALL are DDx for appendicitis (DO A PREGNANCY TEST)

559
Q

treatment for myasthenia gravis

A

anti-choline esterase

prednisolone

plasmapheresis for myasthenic crisis

560
Q

What’s the first line treatment for a severe acute exacerbation of asthma?

A

O2

back to back salbutamol nebulisers

561
Q

Dx of G-6-PD deficiency

A

enzyme assay

562
Q

why do myeloma patients get confused

A

hyperviscosity and hypercalcaemia

563
Q

what are renal stones usually made of

A

calcium oxalate

Phase 2a Peer Teaching (10 decks)

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