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166. Episodic eye pain, lacrimation, nasal stuffiness occurring daily - ?diagnos
is 83a
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a 96b
194. Restless leg syndrome - management 97a
195. dopamine agonists such as ropinirole 97b
196. Change to steroid dose in people on long term tx if intercurrent illness? 9
8a
197. Double doses 98b
198. Rheumatoid arthritis - HLA association? 99a
199. DR4 99b
200. HRT: unopposed oestrogen increases risk of? 100a
201. endometrial cancer 100b
202. Bosentan - MoA, uses? 101a
203. endothelin-1 receptor antagonist used if negative response to acute vasodil
ator testing in pulmonary hypertension 101b
204. Pemphigus vulgaris key features? 102a
205. Epidermal, desmoglein 3, involves mucosa, flaccid non-pruritic blisters, yo
unger people 102b
206. Head injury followed by lucid interval? 103a
207. Epidural haematoma 103b
208. Zollinger-Ellison syndrome - CFs 104a
209. epigastric pain and diarrhoea 104b
210. Key contraindication to buproprion? 105a
211. epilepsy 105b
212. Ciclosporin side-effects 106a
213. everything is increased - fluid, BP, K+, hair, gums, glucose 106b
214. Activated protein C resistance = 107a
215. Factor V Leiden, the most common inherited thrombophilia 107b
216. Diabetes diagnosis: 108a
217. fasting > 7.0, random > 11.1 - if asymptomatic need two readings HbA1c of 6
.5% or greater is now diagnostic (WHO 2011)
108b
218. investigation of choice for upper airway compression 109a
219. Flow volume loop 109b
b
328. ESR in polycythaemia rubra vera 164a
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thaemoglobin
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? 169a
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low 164b
Oxygen dissociation curve - shifts Left? 165a
Lower oxygen delivery - Lower acidity, temp, 2-3 DPG - also HbF, carboxy/me
- 165b
Most common lung cancer type in non-smokers? 166a
Lung adenocarcinoma - peripheral lesion 166b
Gallop rhythm (S3) is an early sign of? 167a
LVF 167b
Hodgkin's lymphoma - best prognosis = 168a
lymphocyte predominant 168b
Patients with Sjogren's syndrome have an increased risk of which malignancy
lymphoid malignancies 169b
Rx for Mycoplasma pneumonia 170a
Macrolides. If allergic =doxycycline 170b
Eclampsia - first-line treatment 171a
magnesium sulphate 171b
Sarcoidosis prognosis? 172a
Majority of patients get better without treatment 172b
PTH level in primary hyperparathyroidism 173a
may be normal 173b
TNF-#alpha# inhibitors 174a
may reactivate TB 174b
Choosing prosthetic heart valves 175a
mechanical valves last longer and tend to be given to younger patients 175b
Prolactinoma management -medical or surgical? 176a
medical therapy is almost always first-line 176b
Autosomal recessive conditions tend to be ?? with what exceptions? 177a
Metabolic. Exception = inherited ataxias 177b
Acne rosacea treatment: - 178a
mild/moderate: topical metronidazole - severe/resistant: oral tetracycline
178b
358. Kearns-Sayre syndrome - 179a
359. mitochondrial inheritance - onset < 20-years-old - external ophthalmoplegia
- retinitis pigmentosa 179b
360. Common topical steroids and their potency? 180a
361. moderate: Clobetasone butyrate 0.05% - potent: Betamethasone valerate 0.1%
- very potent: Clobetasol propionate 0.05%
180b
362. Magnesium sulphate - monitoring 181a
363. monitor reflexes + respiratory rate 181b
364. Cetuximab - MoA? 182a
365. monoclonal antibody against the epidermal growth factor receptor 182b
366. Trastuzumab (Herceptin) - 183a
367. monoclonal antibody that acts on the HER2/neu receptor 183b
368. Anorexia features - 184a
369. most things low - G's and C's raised: growth hormone, glucose, salivary gla
nds, cortisol, cholesterol, carotinaemia 184b
370. Rises first following MI? 185a
371. Myoglobin 185b
372. Hypercholesterolaemia rather than hypertriglyceridaemia: 186a
373. nephrotic syndrome, cholestasis, hypothyroidism 186b
374. Signs suggesting TTP rather than HUS? 187a
375. Neuro signs and purpura point towards TTP 187b
376. Motor neuron disease - treatment: 188a
377. NIV is better than riluzole 188b
378. AF treatment: young man, no TIA or risk factors, 189a
379. no treatment is now preferred to aspirin 189b
380. Hodgkin's lymphoma - most common type = 190a
381. nodular sclerosing 190b
tion? 218a
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sarcoidosis 218b
Combined B- and T-cell disorders 219a
SCID WAS ataxic (SCID, Wiskott-Aldrich syndrome, ataxic telangiectasia) 219
Pulsus alternans? 220a
seen in left ventricular failure 220b
HOCM - poor prognostic factor on echo = 221a
septal wall thickness of > 3cm 221b
Detecting occupational asthma? 222a
Serial peak flow measurements at work and at home 222b
Mycoplasma diagnosis 223a
Serology 223b
Dx Addison's disease 224a
short synacthen test 224b
Epilepsy medication: first- line - generalised seizure: 225a
sodium valproate - 225b
Syringomyelia - CFs? 226a
spinothalamic sensory loss (pain and temperature) 226b
Asthma diagnosis - first line investigation in intermediate probability? 22
Spirometry 227b
Paraneoplastic features of lung cancer - squamous cell vs small cell? 228a
457. squamous cell: PTHrp, clubbing, HPOA - small cell: ADH, ACTH, Lambert- Eato
n syndrome 228b
458. Pneumonia following influenza - pathogen? 229a
459. Staphylococcus aureus pneumonia 229b
460. Most common cause of endocarditis if < 2 months post valve surgery 230a
461. Staphylococcus epidermidis 230b
462. Asthma diagnosis - first line investigation in high probability? 231a
463. Start treatment 231b
464. Infective endocarditis - good prognosis 232a
465. streptococcal infection 232b
466. Most common cause of endocarditis 233a
467. Streptococcus viridans 233b
468. Antipsychotics in the elderly -> risk of? 234a
469. stroke and VTE 234b
470. Autosomal dominant conditions tend to be ?? - with what exceptions? 235a
471. Structural. Exceptions = hyperlipidaemia type II, hypokalaemic periodic par
alysis 235b
472. Cluster headache - acute treatment 236a
473. subcutaneous sumatriptan + 100% O2 236b
474. Bullous pemphigoid key features? 237a
475. Subepidermal, hemidesmosomal BP antigens, rarely involves mucosa, tense pru
ritic blisters, older people 237b
476. Diagnosing insulinoma? 238a
477. supervised prolonged fasting 238b
478. Cryptosporidium diarrhoea Rx 239a
479. Supportive therapy 239b
480. Contraindications to lung cancer surgery 240a
481. SVC obstruction, FEV < 1.5, MALIGNANT pleural effusion, and vocal cord para
lysis 240b
482. Reason for ^sweating in acromegaly 241a
483. sweat gland hypertrophy 241b
484. Alcohol withdrawal time to symptoms/signs 242a
485. symptoms: 6-12 hours - seizures: 36 hours - delirium tremens: 72 hours 242b
486. Genital ulcers - painless: 243a
487. syphilis > lymphogranuloma venereum + granuloma inguinale 243b
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e 2 253a
507.
TNF 268b
Nitric oxide - key effects 269a
Vasodilation - mainly venodilation Inhibits platelet aggregation 269b
Superiority vs equivalence vs non-inferiority. What sample sizes? 270a
Superiority trial --> large sample size needed. 270b
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e. 301b
604. 1.5 cm difference btwn kidneys 302a
605. Renal artery stenosis ? Magnetic resonance angiogram. 302b
606. Temporal tenderness 303a
607. temporal arteritis ? steroids > 90% ischemic neuropathy, 10% retinal art o
cclusion. 303b
608. cluster headache. 304a
609. Severe retroorbital, daily headache, lacrimation 304b
610. Diagnosis of polyuria 305a
611. water deprivation test, then DDAVP 305b
612. Causes of villous atrophy 306a
613. coeliac (lymphocytic infiltrate), Whipples , dec Ig, lymphoma, trop sprue (
Rx tetracycline). 306b
614. Hepatitis B with general deterioration 307a
615. hepaocellular carcinoma 307b
616. Albumin normal, total protein high 308a
617. myeloma (hypercalcemia, electrophoresis). 308b
618. HBsAg positive, HB DNA not detectable 309a
619. chornic carirer 309b
620. Aortic Stenosis 310a
621. s2 paradoxical split, length proportional to severity 310b
622. Loud S1 311a
623. MS, hyperdynamic, short PR 311b
624. Soft S1 312a
625. immobile MS, MR. 312b
626. Loud S2 313a
627. hypertension, AS 313b
628. Fixed split 314a
629. ASD 314b
630. Opening snap 315a
631. MOBILE MS, severe near S2 315b
632. HOCM/MVP 316a
633. inc by standing,valsalva, dec by squating (# all others) 316b
634. HOCM 317a
635. Sudden death athlete, FH, Rx. Amiodarone, ICD 317b
636. Guillan Barre syndrome 318a
637. check VITAL CAPACITY. 318b
638. Horners 319a
639. sweating lost in upper face only - lesion proximal to common carotid artery
. 319b
640. Internuclear opthalmoplegia 320a
641. medial longitudinal fasciculus connects CN nucleus 3-4. 320b
695. renal vein thrombosis. Causes: nephrotic syndrome, RCC, amyloid, acute pyel
onephritis, SLE ,atiphospholipid syndrome 347b
696. Anemia in the elderly assume 348a
697. GI malignancy 348b
698. Diptheria 349a
699. exudative pharyngitis, lymphadenopathy, cardio and neuro toxicity. 349b
700. Indurated plaques on cheeks, scarring alopecia, hyperkeratosis over hair fo
llicles 350a
701. Discoid LUPUS 350b
702. Wt loss, malabsoption, inc ALP 351a
703. pancreatic cancer 351b
704. Wt loss, anemia (macro/micro), no obvious cause 352a
705. coeliac (diarrhea does NOT have to be present) 352b
706. Hematuria, proteinuria, best investigation 353a
707. if glomerulonephritis suspected ? renal biopsy 353b
708. Venous ulcer treatment 354a
709. exclude arteriopathy (eg ABPI), control edema, prevent infection, compressi
on bandaging. 354b
710. Fever, lymphadenopathy, lymphocytosis, pharygitis 355a
711. EBV ? heterophile antibodies 355b
712. GI bleed after endovascular AAA Surgery 356a
713. aortoenteric fistula 356b
714. Functional hypogonadotrophic hypogonadism 357a
715. amennorhea. LH and FSH both low. All other hormones are usually normal. Fer
ritin low. 357b
716. Vitiligo - commonest assoctions 358a
717. pernicious anemia type 1 DM , autoimmune addisons, autoimmune thyoid 358b
718. Peripheral neuropathy 359a
719. a) B12 - rapid, dorsal columns (joint pos, vibration), sensory ataxia, pseu
doathetosis of upperlimbs b) diabetic - slow,
spinothalamic (p
ain, temp?) c)alcohol - slow progressive, spinothalamic d) Pb - motor upper limb
s 359b
720. CNS abnormalities in HIV 360a
721. toxoplaasmosis (multiple ring enhancing), lymphoma (solitary lesion). HIV e
ncephalopathy, progressive multifocal
leucoencephalopathy (PML
- demylination in advanced HIV, low attenuation lesions) 360b
722. Travellers diarrohea 361a
723. chronic (>2 WEEKS) giardia (incidious onset rx. Metronidazole), SALMONELLA
(serious systemic illness), E.coli (rx.
Ciprofloxacin) ,
Shigella 361b
724. If you see blood on urinalysis forget about 362a
725. RAS 362b
726. Fasciculations 363a
727. Motor neurone diease 363b
728. Silvery white scale 364a
729. PSORIASIS 364b
730. Hypopigmented 365a
731. vitiligo/pityriasis versicolor 365b
732. Pretibial myxedema 366a
733. Graves 366b
734. R. Arthritis with nephritic syndrome 367a
735. looks for amyloidosis, even by rectal biopsy. 367b
736. Your valuable comments are highly appreciated. 368a
737. Thank You 368b