MRCP cont.

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MRCP cont.
2013-12-13 13:25:09
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?

    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?
  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?
  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?
  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?
  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?
  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?
  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?

    • 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