MSRA LATEST
how long can someone not drive for after an episode of unexplained
syncope?
banned for 6 months
How is dumping syndrome post gastrectomy diagnosed?
Prologed glucose tolerance test
what is the investigation of choice for someone overdosing on
insulin?
Insulin and C peptide levels
there will be high insulin levels of hypoglycaemia but low C-peptide
levels, indicating suppression of endogenous insuline secretion
12 yo boy presents with a 4h history of nausea, vomiting and
testicular pain. On examination, he has extreme point tenderness of
the right upper pole of his left testis. A small point of blue
discoloration can be seen through the scrotal skin?
Tored Hydatid of Morgagni
management is expectant if diagnosis is clear but pain can be resolved
more quickly if surgically excised
testicular torsion presents similar so urgent urological/surgical opinion is
needed.
what is bernard soulier syndrome?
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PAGE
1
, MSRA LATEST
autosomal recessive
platelets larger than normal
normaly platelets less than normal (thrombocytopenia)
presents as:
- bleeding
- nose bleeds
- bleeding gums
diagnosed with blood tests such as platelet aggregation and flow
cytometry
26 year old asian lady complains of back pain and tenderness in her
thighs. She also mentions she finds it difficult to climb stairs. She
has never smoked and does not drink alcohol. ALP is 250 (normaal
40125) and plasma Ca is low. Whats the most likely diagnosis and
what features would you see on pelvic radiograph?
Osteomalacia (vitamin D deficiency)
you will see transluscent bands (also described as pseudofractures) on
xray
also known as rickets in children
what does the biochemistry look like in osteoporosis and osteopenia?
normal ca, P04 and ALP
what does bone expansion and sun-ray appearance of xray suggest?
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PAGE
2
, MSRA LATEST
Fast growing osteosarcoma
most common bone cancer in teenagers and young adults
tends to affect the distal femur or proximal tibia
other common affected areas include: hip, jaw and shoulder
what is the most likely cause of unconjugated hyperbilirubinaemia
12h after birth?
ABO incompatability
a well newborn develops progressive conjugated
hyperbilirubinaemia with pale stools and dark urine. whats the most
likely dx?
Biliary atresia
dark urine and pale stools indicate an obstructive jaundice
what is the first line investigation for acute intersitial nephritis?
FBC, UE's
then maybe you would do a renal biopsy which is most diagnostic
What is Creutzfeldt-Jakob disease?
characterized by rapidly progressive dementia associated with:
- long tract signs
- myoclonic jerks
END OF
PAGE
3
, MSRA LATEST
- severe rigidity
- abnormal EEG in 90% of cases (shows periodic sharp wave
complexes)
what is the most definitive step in diagnosis of CML?
Genotype study
How does a hydatidiform mole present in pregnancy?
exagerated symptoms of pregnancy
elevated Beta HCG
severe hyperemesis
first trimester pre-eclampsia
vaginal bleeding
What antibodies are associated with Limited cutaneous systemic
sclerosis (CREST syndrome)?
Anti-centromer antibodies (ACAs) + Anti-topiosomerase-1 antibodies
(Anti-SCL-70( and anti-RNA polymerase antibodies)
RF present in 30%
ANA present in 95%
40 yo man presents with a 6 week history of abdo pain and rectal
bleeding. He is noted to have pigmented macules on his lips. Whats
the most likely dx?
Peutz-Jeghers syndrome.
autosomal dominant condition associated with the development of
END OF
PAGE
4
how long can someone not drive for after an episode of unexplained
syncope?
banned for 6 months
How is dumping syndrome post gastrectomy diagnosed?
Prologed glucose tolerance test
what is the investigation of choice for someone overdosing on
insulin?
Insulin and C peptide levels
there will be high insulin levels of hypoglycaemia but low C-peptide
levels, indicating suppression of endogenous insuline secretion
12 yo boy presents with a 4h history of nausea, vomiting and
testicular pain. On examination, he has extreme point tenderness of
the right upper pole of his left testis. A small point of blue
discoloration can be seen through the scrotal skin?
Tored Hydatid of Morgagni
management is expectant if diagnosis is clear but pain can be resolved
more quickly if surgically excised
testicular torsion presents similar so urgent urological/surgical opinion is
needed.
what is bernard soulier syndrome?
END OF
PAGE
1
, MSRA LATEST
autosomal recessive
platelets larger than normal
normaly platelets less than normal (thrombocytopenia)
presents as:
- bleeding
- nose bleeds
- bleeding gums
diagnosed with blood tests such as platelet aggregation and flow
cytometry
26 year old asian lady complains of back pain and tenderness in her
thighs. She also mentions she finds it difficult to climb stairs. She
has never smoked and does not drink alcohol. ALP is 250 (normaal
40125) and plasma Ca is low. Whats the most likely diagnosis and
what features would you see on pelvic radiograph?
Osteomalacia (vitamin D deficiency)
you will see transluscent bands (also described as pseudofractures) on
xray
also known as rickets in children
what does the biochemistry look like in osteoporosis and osteopenia?
normal ca, P04 and ALP
what does bone expansion and sun-ray appearance of xray suggest?
END OF
PAGE
2
, MSRA LATEST
Fast growing osteosarcoma
most common bone cancer in teenagers and young adults
tends to affect the distal femur or proximal tibia
other common affected areas include: hip, jaw and shoulder
what is the most likely cause of unconjugated hyperbilirubinaemia
12h after birth?
ABO incompatability
a well newborn develops progressive conjugated
hyperbilirubinaemia with pale stools and dark urine. whats the most
likely dx?
Biliary atresia
dark urine and pale stools indicate an obstructive jaundice
what is the first line investigation for acute intersitial nephritis?
FBC, UE's
then maybe you would do a renal biopsy which is most diagnostic
What is Creutzfeldt-Jakob disease?
characterized by rapidly progressive dementia associated with:
- long tract signs
- myoclonic jerks
END OF
PAGE
3
, MSRA LATEST
- severe rigidity
- abnormal EEG in 90% of cases (shows periodic sharp wave
complexes)
what is the most definitive step in diagnosis of CML?
Genotype study
How does a hydatidiform mole present in pregnancy?
exagerated symptoms of pregnancy
elevated Beta HCG
severe hyperemesis
first trimester pre-eclampsia
vaginal bleeding
What antibodies are associated with Limited cutaneous systemic
sclerosis (CREST syndrome)?
Anti-centromer antibodies (ACAs) + Anti-topiosomerase-1 antibodies
(Anti-SCL-70( and anti-RNA polymerase antibodies)
RF present in 30%
ANA present in 95%
40 yo man presents with a 6 week history of abdo pain and rectal
bleeding. He is noted to have pigmented macules on his lips. Whats
the most likely dx?
Peutz-Jeghers syndrome.
autosomal dominant condition associated with the development of
END OF
PAGE
4
