MRCP 4

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  1. What happens to TfTs during times of acute illness?
    Sick euthyroid. So you're TSH is normal but your t3 and t4 are low.
  2. Fragmented red cells. Uremia. Low platelets. Febrile. High wcc. Confusion. in a pregnant pregnant woman. Diagnosis?
    TTP

    overlaps with HuS
  3. Autoimmune poly glandular syndrome type 1?
    Rarer form of APS

    • hypoparathyroidism
    • mucocutaneous candidiasis
    • Addison's
    • vitiligo
  4. Autoimmune poly glandular syndrome type 2?
    • T1DM
    • Autoimmune thyroid disease
    • vitiligo
  5. What can PCV transform into?
    • Myelofibrosis and 
    • AML
  6. Drugs that cause pancreatitis?
    • Steroids
    • valproate
    • azathioprine and mesalazine
    • furo and bendro
  7. Causes of a raised protein in CSF?
    • tuberculous, bacterial and fungal meningitis
    • viral encephalitis
    • GBS
    • Spinal block
  8. Drug causes of a long QT?
    • Amiodarone, sotalol, class 1a
    • antipsychotics
    • tricyclics
    • Chloroquine
    • erythromycin
    • Terfenadine
  9. What causes downbeat nystagmus?
    Foramen magnum lesion - Arnold chiari malformation
  10. Upbeat nystagmus?
    Cerebellum vermis lesion
  11. Drugs for motion sickness?
    Hyoscine>cyclizine>promethazine
  12. Raised ALP and normal bone chemistry =?
    Pagets disease
  13. In hypothyroidism what's the first thing you do is some ones hyperlipidemic?
    Give them thyroxine and control their TSH adequately.
  14. What happens to serum caeruloplasmin in Wilson's?
    Low baby!
  15. What's the most appropriate investigation in someone with a chronic venous ulcer?
    ABPIs cus you're going to stocking them and you need to work out whether it's mixed or not.
  16. What drugs precipitate lithium toxicity?
    • ACE inhibs
    • ARBs
    • Thiazides
  17. What drug improves prognosis in stable angina?
    Aspirin
  18. When is it best to give the pneumococcal vaccine to a pt due to have splenectomy?
    1 month before op.
  19. A normal PaCO2 during an acute asthma attack?
    Life-threatening. Shud always be low.
  20. What is PEP?
    3 drugs for 1 month.
  21. Murmur in HoCM?
    Ejection systolic. Louder on Valsalva. Quieter on squatting.
  22. What drugs precipitate AACG?
    Anticholinergics.
  23. Met common side effect of progestogen only pill?
    Irregular periods
  24. Treatment options fir aplastic anaemia?
    • Supportive with blood products
    • avoiding infection

    Antithymocyte globulin or anti lymphocyte globulin.

    stem cell transplantation - allo grafts have 80% success rate.
  25. How does toxic multinodular goitre present?
    what doe investigations show
    what is the treatment of choice?
    • Thyrotoxic with irregular nodular goitre.
    • patchy uptake on scintigraphy
    • best rx is radioiodine
  26. Amiodarone induced thyrotoxicosis type 1?
    Excess iodine uptake.

    Goitre

    carbimazole or potassium perchlorate. + stop amiodarone (unlike AIH)
  27. Amiodarone induced thyrotoxicosis type 2?
    Destructive thyroiditis

    No goitre

    treat with corticosteroids + stop amiodarone (unlike AIH)
  28. Commonest site for an atrial myxoma?
    Fossa ovalis border in the Left atrium.
  29. Dentistry in warfarin patients?
    Check INR 72 hrs before. If less than 4.0 Then continue.
  30. Feature of cholesterol embolisation?
    • Eosinophilia
    • purpura
    • livedo reticularis
    • Renal failure
  31. V for vigabagrin?
    V for visual field defects.

    irreversible

    check fields every 6 months
  32. Vitamin d resistant rickets?
    X linked dominant presents as failure to thrive

    problem with reabsorbing phosphate in the kidney.

    low serum phosphate, normal calcium, raised ALP,

    cupped metaphysis and widening epiphysis
  33. When do you start ARV in a pregnant woman with HIV?
    20-32 weeks
  34. What drugs do you avoid in HOCM?
    Nitrates, ace inhibitor, inotropes.
  35. Pendred's syndrome?
    • Sensorineural deafness
    • goitre
    • euthyroid or mild hypothyroid
  36. Adding progesterone to HRT?
    • Increased risk of breast cancer
    • decreased risk of endometrial cancer
    • Increased risk of venous thromboembolism
  37. Discoid lupus treatment?
    Topical steroids then oral hydroxychloroquine
  38. Treatment of pulmonary hypertension?
    All dependent on acute vasodilator testing.

    if positive then calcium channel blockers

    if negative then prostacyclin analogues, phosphodiesterase inhibitors and endothelin receptor antagonists.
  39. Causes of a warm AIHA?
    Features on investigation?
    What do you treat with?
    • Neoplasia eg lymphoma and CLL
    • autoimmune eg SLE
    • drugs eg Methyldopa

    IgG, extravascular, haemolytic in the spleen.

    steroids, immunosuppresion, splenectomy.
  40. Causes of a cold AIHA? Features on investigation?
    • Neoplasia eg lymphoma
    • infections eg mycoplasma and EBV

    IgM, intravascular, can cause Raynaud's and acrocyanosis.
  41. Fibrosis affecting the lower zones?
    ACDC baby!

    • Cryptogenic
    • drugs
    • asbestosis
    • Connective tissue disorders except AS
  42. Causes of tricuspid regurg?
    • Right vent dilation
    • cor pulmonale
    • rheumaric heart disease
    • IE assoc with IVDU
    • Carcinoid
    • ebsteins anomaly
  43. Causes of predominant hypercholesterolaemia?
    • Cholestasis
    • nephrotic syndrome
    • hypothyroidism

    everything else causes hypertriglyceridaemia.
  44. Target BP in hypertension?
    • Age              Clinic BP   ABPM / HBPM 
    • < 80 years.   140/90.   135/85
    •  
    • > 80 years.   150/90    145/85

Card Set Information

Author:
 vb406
ID:
 255169
Filename:
 MRCP 4
Updated:
2014-01-08 22:22:04
Tags:
Medicine
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