MRCP cont.

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vb406
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249982
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MRCP cont.
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2013-12-13 13:25:09
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MRCP medicine
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  1. Mechanism of action of dipyradimole?
    Phosphodiesterase inhibitor
  2. What should be monitored once a pregnant lady is started on Mg2+ for eclampsia?
    How long should treatment be continued for and why?
    • Resp rate
    • Reflexes
    • O2 sats
    • Urine output

    Continue treatment for 24hrs after last seizure or delivery as 40 % of patients have post-labour seizures.
  3. Features of Shigella and its treatment?
    Bloody diarrhoea

    Treat with ciprofloxacin
  4. C1q. C1rs, C2 and C4 deficiency imply...?
    A deficeincy in the 'classical pathway'

    Predispose to immune-complex diseases, SLE Henoch-choenlien,
  5. C3 defieciency predisposes to?
    Recurrent bacterial infections.
  6. C5 deficiency causes?
    Leiner's disease - reccurrent sebbhoreic dermatitis, wasting and diarrhoea
  7. Treatment of sortic dissections?
    • Type A = ascending aorta = IV labetalol + surgery
    • Type B = descending aorta = Iv Labetalol ONLY

    Keep BP between 100 and 120 systolic.
  8. How often do you perform DOTS for TB?
    3 times a week.
  9. What paraneoplastic process does Anti-Ri cause? What tumors is it asocc with?
    • Opsoclonus-myoclonus.
    • Cause by small cell and breast
  10. What paraneoplastic process does Anti-Yo cause? Which tumors is it Assoc with?
    • Cerebellar syndrome
    • Assoc with ovarian and breast
  11. What paraneoplastic syndrome does Anti-GAD cause? What tumors cause it?
    • Stiff person syndrome.
    • Breast, colorectal and SCLC.
  12. How long does finasteride take to work?
    Up to 6 months!!
  13. Treatment options for Oesophageal varices?
    • Propanalol
    • Endoscopic variceal band ligation.
  14. Burkitt's lymphome?
    MIKE BURKITT!!!

    Assoc with the C-myc translocation of MYC oncogene to an immunoglobulin (8:14)
  15. What causes aplastic crisis in pts with hereditary spherocytosis?
    Parvovirus infection.
  16. Anything to do with cysteine...??
    TEST WITH cyanide-nitroprusside test.
  17. What is familial mediterranean fever? How do you treat it?
    • Disease which affects Arabic, armenian and turkish people.
    • Also called recurrent polyserositis!
    • Abnormality in a protein called pyrin (coded for on MEFV gene) which normally inhibits interlukin 1B, therefore interlukin 1 B goes around causing all the inflam it wants.
    • Causes flares of inlam commonly, abdo, joints, pleura, tunica vaginalis, pericarditis, myalgia, erysipelas and fever on its own.¬†
    • Long term comp = AA amyloidosis

    • Treat with daily colchisine +- anakinra(IL1 antag).
    • These therapies aim to decrease flare frequency.
  18. Causes of LAD?
    • Left ventricular hypertrophy
    • LBBB
    • Left ant hemiblock
    • WPW with right accessory pathway
    • Ostium primum ASD
    • Tricuspid atresia
    • Hyperkalemia
    • Obesity
  19. Treament for Trigeminal neuralgia?
    Carbamazepine.
  20. Contraindications to surgery in Lung cancer?
    • Malignant pleural effusion
    • FEV<1.5
    • Tumor near hilum
    • Evidence of Mets
    • Vocal cord paralysis
    • SVC obx
  21. How is it best to differentiate between neuro toxo and neuro lymphoma in a person with HIV?
    • Toxo: Ring-enhancing, multiple lesions, Thallium SPECT negative
    • Lymphoma: Single lesion, Solid enhancment, Thallium SPECT positive.
  22. Indication for Botox?
    • Hemifacial spasm
    • Blepharospasm
    • Hyperhidrosis of axillae
    • Focal Spasticity including CP and Stroke
    • Spasmodic torticollis
    • Achalasia
  23. Indications for steroids in sarcoid?
    • Eye, heart or neuro involvment
    • Worsening lung function
    • Hypercalcaemia
  24. IgA Nephropathy is assoc with what conditions?
    • Coeliacsdermatitis
    • Alcoholic cirrhosis
    • HSP
  25. Characteristic features of Dengue on bloods?
    • Raised ALT
    • Low Platelets
  26. Which meds for depression after MI?
    Sertraline
  27. What do people on dialysis die of?
    Ischaemic heart disease
  28. What investigations do you do in PE during pregnancy?
    • Everyone gets a CXR
    • Duplex legs could give you indirect evidence and save radiation.
    • CTPA increases risk of breast cancer in mum
    • VQ increase risk of abnorms in baby
  29. Imaging modality of choice in osteomyelitis?
    MRI
  30. Whats the difference between a MUGA and a MIBI?
    • MUGA is for accurate ejection fraction calculation before starting cardiotoxic drugs.
    • MIBI is to assess myocardial perfusion + viability.
  31. Drugs that cause impaired glucose tolerance?
    • Thiazides, furosemide
    • steroids
    • nicotinic acid
    • ciclosporin
    • Olanzapine¬†
    • Interferon alpha
  32. Clinically sig albumin:cr ratio in a non-diabetic?
    >30
  33. Clinically sig albumin:cr ratio in a diabetic?
    • >2.5 in men
    • >3.5 in women
  34. Erythrasma?
    A flat, pinkbrown, asypmtomatic rash generally in the groinaxillae caused by the diptherioid Coryne bacterium minutissimum.

    Treat with topical miconazole or an antibacterial.

    Examination under UV-A light shows coral red fluoresence.
  35. Most specific ECG marker for pericarditis?
    PR depression.
  36. Weight cut-offs for bariatric surgery?
    • With risk factors (T2DM, HTN etc) = 35
    • Without risk factors = 40
  37. After DC cardio version what is the minimum time you shud cont anticoag for?
    4 weeks
  38. Best way to get yer HDLs up?
    Nicotinic acid
  39. X-linked dominant diseases??
    • Vit d resistant rickets
    • rett's disease
    • alports
  40. Test for Gilbert's disease?
    Nicotine acid
  41. Causes of a respiratory alkalosis?
    • Anxiety
    • cns disorders
    • PE
    • early salicylate poisoning
    • Altitude
    • pregnancy
  42. SSRI + NSAID = ?
    Gi bleeding risk. Start lansoprazole.
  43. What is Capecitabine?
    Orally administered prodrug that is enzymatic ally converted to 5Fu in the tumour.
  44. What's a non drowsy anti histamine?
    Loratadine
  45. Incongruous hemianopias = ?
    tract lesion
  46. Congruous hemianopias = ?
    Radiation or occipital lesion.
  47. Order the steroids in order from most mineral to most glucocorticoid in action
    • fludrocortisone
    • hydrocortisone
    • prednisolone
    • dexamethasone/betmethasone
  48. Management of schizophrenia
    • Oral atypicals
    • +CBT
    • manage CV risk early.
  49. UKMeC 4 conditions =?
    • Migraine with aura
    • uncontrolled hypertension
    • previous thrombosisthrombogenic mutation
    • over the age of 35 and smoking >15/day
    • Breast cancer
    • breast feeding <6 weeks postpartum¬†
    • Stroke
    • Major surgery with prolonged immobilisation
  50. What's the guiding principle in UC management?
    • Induce remission with ASAs or Steroids.
    • maintain it with Asa's or azathioprine.
  51. What drugs cause tinnitus?
    • Aspirin
    • Aminoglycisides
    • loop diuretics
    • quinine
  52. Causes of tinnitus apart from drugs?
    • Acoustic neuroma
    • Menieres
    • otosclerosis
    • hearing loss
    • Impacted cerumen
    • CSOM
  53. Treatment of Solar keratosis?
    • Topical 5FU (followed by topical hydrocortisone to treat redness)
    • imiquimod
    • Topical diclofenac
    • cryo
    • curretage +cautery
  54. Annual incidence of HCC developing in patients with cirrhosis secondary to hep C?
    3-5%
  55. Antibodies for dermatomyositis?
    • ANA most common
    • Anti-mi-2 most specific.
  56. cANCA are antibodies targeted against?
    What are they +ve in?
    • PR3
    • serine proteinase 3

    +ve in Wegner's and microscopic polyangitis.
  57. pAnca are targetted against?
    what are they +ve in?
    • Myeloperoxidase
    • +ve in Microscopic polyangitis, Churg-strauss, PSC
  58. Whats the most common ocular sigin in Wernicke's?
    What could you find on investigation?
    Nystagmus

    • Can find decreased red cell transketolase
    • Can also find haemhorrages into thalamus + mammillary bodies on MRI.
  59. Causes of co-arctation of the aorta?
    • Turner's
    • Bicuspid aorta
    • Beryy aneurysms
    • Neurofibromatosis
  60. Whats interfeon alpha released from?
    Whats it a useful therapy for?
    What are its adverse effects?
    • Released from leucocytes
    • Therapy in Hep B+C, Metastatic renal cell cancer, hairy cell leukemia and kaposi's sarcoma.

    Adverse effects include flu-like symptoms and depression.
  61. IFN beta is released from?
    Is used to treat?
    • Fibroblasts
    • R-R MS
  62. IFN gamma is released from?
    Is used to treat?
    Adverse effects?
    • T-cells and NK cells
    • Granulomatous disease and osteopetrosis.
  63. What is Noonan's syndrome?
    The 'male version of turner's'
  64. Poor prognostic factors following MI?
    • Onset of HF
    • cardiac arrest
    • st segment deviation
    • low systolic bp
    • increase in creatinine
    • killip score

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