03/04/18 Flashcards
1
Q
What is the difference between Ia and Ib Aa fibres?
A
Ia are muscle spindle fibres whereas Ib are golgi tendon organ fibres
2
Q
What is the function of Ab/II fibres?
A
touch,pressure
3
Q
What is the function of Ay fibres?
A
motor to muscle spindles
4
Q
What is the function of Ad III fibres?
A
fast pain; cold and touch
5
Q
What is the function of B fibres?
A
preganglionic sympathetic fibres and visceral afferents
6
Q
What is the function of C (IV) fibres?
A
slow pain; hot; reflex
7
Q
What is the other function of C fibres?
A
postganglionic sympathetics
8
Q
What is type 1 small vessel disease?
A
arteriosclerosis
9
Q
What is type 2 small vessel disease?
A
cerebral amyloid angiopathy
10
Q
what is type 3 small vessel disease?
A
inherited or genetic SVD
11
Q
What is type 4 small vessel disease?
A
inflammatory and immunomediated SVD
12
Q
What is type 5 small vessel disease?
A
venous collagenosis
13
Q
what is type 6 small vessel disease?
A
other SVD
14
Q
Give examples of type 6 small vessel disease?
A
post-radiation angiopathy; non-amyloid microvessel degeneration in Alzheimers
15
Q
What nuclei in the brainstem deals with taste fibres?
A
solitary nucleus
16
Q
What is the secretomotor nucleus of vagus?
A
dorsal nucelus
17
Q
What is a succenturiate lobe?
A
smaller accessory placenta separate to main placental disc
18
Q
What is velamentous insertion
A
umbilical cord inserts into fetal membranes not placenta
19
Q
What is velamentous insertion close to the cervix called?
A
vasa praevia
20
Q
What is the difference between the CO of an 80 year olad and a 20 years old?
A
half
21
Q
What is the average bone loss in women per decade ?
A
5-10%
22
Q
Why may creatinine levels be normal in poor renal function?
A
low muscle mass
23
Q
What is the function of hte appetitive and approach systems?
A
pleasure
24
Q
What neurotransmitter is invovled in the appetitive and approach systems?
A
dopamine
25
What is first line treatment for a simple partial seizure?
lamotrigine or carbamazepine
26
What heart conditions are contraindications for HRT?
active or recent arterial thromboembolic disease- angina or MI
27
What should be measured before starting the COC and why?
BMI and BP as obesity and uncontrolled high BP are CI
28
What is the neurotransmitter change seen in withdrawal from sedative-hypnotic drugs?
reduced GABA
29
Over what Hb are blood transfusions not recommended?
8g/L
30
over what age are mammograms done?
35
31
What is a compulsory treatment order?
allows detention in hospital for 6 months
32
What is a compulsion order?
patients subject to criminal proceedings to receive treatment
33
What are risk factors for NEC?
IUGR; absent end diatolic flow at placenta; prematurity; hypoxic ischaemic insult
34
Why do rapidly contracting muscle fibres produce lactic acid?
need to regenerate NAD+ in order to produce ATP by glycolysis
35
Why is sickle solubility test not as useful as HPLC?
indicates presence of sickle cells but is positive in carriers as well as those with disease
36
What is the function of the infundibulum?
broad end of the uterine tube that receives the oocyte at ovulation
37
What is the isthmus?
where uterin tube narrows to enter the uterus
38
When is a mid-cavity forceps delivery e.g Haig Ferguson done?
position is direct OA and foetal head is below ischial spine
39
When is the typical onset of acute dystonic reactions?
within hours of administration
40
Which antipsychotic has the best evidence for safety and efficacy in pregnant manic patients?
olanzapine
41
Why do ACEi improve survival in heart failure?
chronic up-regulation of the renin system place extra strain on the heart by increasing preload and afterlad
42
What is the apex of the posterior traingle?
union of SCM nad trapezius
43
What is the base of the posterior triangle?
middle third of the clavicle
44
What fascia covers the posterior triangle?
investing layer of fascia
45
Over what BMI is the COC CI?
>39
46
What drugs are associated iwht cervical dystonia?
anticholinergics; phenothiazines; botulinum toxin
47
Which hepatitis types are spread by faeco-oral route?
hep A and E
48
What type of treatments are useful for endometriosis?
any treatment that reduces menstruation e.g COC
49
which type of lymphoma is lymphocytosis seen with?
non-hodgkins
50
What is the treatment for PID if gonorrhea risk is low?
ofloxacin plus metronidazole for 14 days
51
What may be used instead of ofoxacin in PID treatment?
levofloxacin
52
What is the other option for PID without gonorrhea?
ceftriazone IM plus doxy and metronidazole for 14 days
53
When would risk of gonoccal infection be considered high?
partner has gonorrhea; symptoms and signs are severe or has had sexual contact abroad
54
what is the treatment for PID with high risk of gonorrhea?
ceftriaxone IM plus doxy and metronidazole for 14 days
55
What must be given with metronidazole and doxy?
IM ceftriaxone
56
What antibiotics regimens should not be given to women with PID and high risk of gonorrhea?
ofloxacin or azithromycin
57
Which areas of the hands are most frequently missed?
thumb; space between thumb and first finger; in between fingers; nails
58
What drugs should be avoided in delirium?
BZDs
59
What class of drug is effective in treating delirium?
antipsychotics esp. haloperidol
60
When is it necessary to monitor patients on LMWH?
pregnancy or renal impairment
61
What is the MOA of dabigatran?
new oral direct thrombin inhibitor
62
When is dabigatran CI?
GFR <30
63
What bag should used IV drip tubing go into?
orange bag
64
What type of consent is required for a surgical procedure?
written
65
How should consent be obtained in a patient wihtout capacity and who is unlikely to gain capacity in the future?
court of law
66
Why does CNVII lesion cause pain in the posterior triangle of the neck
innervates platysma
67
How many ribs should be visible anteirorly on a CXR?
5-7
68
how many ribs should be visible posteirorly on CXR
10
69
What is normal cardiothoracic ratio?
<0.5
70
What ST elevation in V2-5?
anteiror
71
What is ST elevation in V1-3?
anteroseptal
72
Waht is ST elevation in V4-6; I and aVL?
anterolateral
73
What is reciprocal ST elevation in V1 and 2?
posterior
74
What happens in the embyronic period of lung maturation?
branching to level of lobar bronchi
75
What happens in canalicular period of lung maturation?
respiratory bronchioles and alveolar ducts form
76
Waht happens in the saccular period of lung maturation?
terminal sacs form and capillaries become assocaited with them
77
What happens in the psuedoglandualr stage of lung maturation?
branching gives rise to temrinal bronchioles
78
Waht is the midgut?
GI tract from mid duodenum to 2/3rs along transverse colon plus pancreas
79
What is the difference between balloon adn bougie oesophageal dilatation?
balloon is safer than bougie
80
What is the gold standard for giardia diagnosis?
distal duodenal biopsy
81
Which virus is a common cause of bronchiolitis and was discovered in 2001?
metapneumovirus
82
What is MAP equal to?
diastolic pressure + 1/3(systolic-diastolic)
83
What is the test for small bowel overgrowth syndrome?
glycocholic breath test
84
What disease is early white hair associated with?
autoimmune- pernicious anaemia
85
What is the treatment for pseudomonas pneumonia?
ciprofloxacin
86
What is the best anthropometric predictor of CVS disease?
waist circumference
87
What is the difference on spiromtery between asthma and COPD?
asthma has preserved FVC whereas COPD it isnt
88
What is always true if the FEV/FVC ratio is reduced?
PEF will be reduced
89
Which bone contributes to the base of skull and is an attachment for 2 muscles of mastication?
sphenoid
90
What is the likely diagnosis in a young patient with recurrent malaena, central abdo pain and prev normal gastroscopy?
meckels diverticulum
91
Waht is the most common cause of most congential abnormalities?
unknown
92
When should soap and water be used rather than alcohol rub?
visibly soiled; contact with bodily fluids; patients with c.diff or MRSA; or >5 consequtive uses of alcohol gel
93
What is salmeterol?
LABA
94
What is the commonest cause of renal failure in the <5years?
E.coli 0157
95
What are the paired vessels of the abdo aorta from sup. to inf.?
adrenal; renal and gonadal
96
What do healthy start vitamins contain?
folic acid; vitamin C and D
97
What is pellagra caused by?
niacin deficiency
98
What is niacin?
vitamin B3
99
Where are Merkel endings found?
near border of epidermis
100
Where are Meissners corpuscles found?
dermal papillae
101
What are the two types of intrafusal muscle fibre?
nuclear bag and nuclear chain
102
What are the 2 types of sensory endings associated with intrafusal muscle fibres?
annulospiral and flower spray
103
What is the fibre associated with annulospiral endings?
Ia
104
What is the fibre type associated with flower spray endings ?
II- Ab
105
What is the function of Meissners corpuscles?
fine discriminative touch
106
What is the function of Merkels discs?
touch/pressure
107
What is the function of Pacinian corpuscles?
mechanical distortion esp. vibration
108
What is endoneurium?
connective tissue between individual nerve fibres
109
what is epineuroium?
connective tissue around whole nerve
110
What type of connective tissue is the dura continous with?
epineurium
111
What is the difference between the origins of the anterior and posterior pituitaries?
posterior is neural in origin
112
What is semantic memory?
knowledge of the world
113
What is semantic memory dependent on?
middle and inferior tempral gyri
114
What is episodic memory?
learning and recollection of autobiographical events
115
what is episodic memory dependent on?
hippocampus
116
Where is the primary olfactory cortex?
uncus of the temporal love
117
What does a patent processus vaginalis predispose to?
testicular torsion
118
What is apraxia?
inability to perform voluntary movements
119
Where would a lesion be to cause apraxia?
parietal loe
120
What area of the basal ganglia is affected in huntingtons chorea?
striatum- caudate nucleus
121
What is alexia?
impairment of reading
122
What constitutes the striatum?
caudate nucleus and putamen
123
What constititues the lentiform nucleus?
putamen and globus pallidus
124
What is the function of the nucleus accumbens?
links the basal ganglia and limbic system
125
What anibody is devic's syndrome associated iwth?
NMO-IgG
126
What is Devic's syndrome also known as?
neuromyleitis optica
127
What is devic's syndrome?
inflammation and demylination of the optic nerve and spinal cord
128
What is Uhthoff's phenomenon?
worsening of vision following rise in body temp
129
What is Uhthoff's phenomenon associated with?
MS
130
What is the relations of the median nerve to the brachial artery going down the arm?
lateral--anterior--medial
131
Where does the brachial artery begin?
lower border of teres major
132
What is the mostcommon cause of primary PPH?
uterine atony
133
What are the 4T's of PPH?
tone; tissue; trauma; thrombosis
134
What is a Chiari malformation?
part of hte brain pushes down into the psinal canal
135
What is a Chiari 1 malformation?
cerebellum extends beyond foramen magnum
136
Where is the sciatic nerve formed?
lower border of piriformis
137
What is the lymphatic drainage of the vocal cords?
have no drainage
138
What should be done for all babies born to Rh neg mothers?
cord blood for FBC; blood group and direct Coombs
139
What is the Kleihauer test?
add acid to maternal blood, fetal cells are resisitant
140
Why are rhesus babies oedematous?
liver devoted to rBC production so reduced albumin
141
What are infected endocervical cells called?
koilocytes
142
What are the features of koilocytes?
enlarged nucleus; irrregular nuclear membraen contous; hyperchromasia; perinuclear halo
143
What is progressive supranuclear palsy?
dysfunction of muscles involved in looking upwards
144
Where are Hassal's corpuscles found?
medulla of the thymus
145
what other name are parafollicular cells of the thyroid known as?
C-cells
146
What is found within the thyroid follicle?
colloid
147
What is seen at the risk with Klumpke's ?
loss of wrist flexors
148
After what structure is the optic radiation?
lateral geniculate body
149
What is the innervation of hte stapedius?
VII
150
What is the effect of the COC on breast, cervical, ovarian and endometrial cancers?
increases breast and cervical but decreases ovarain and endometrial
151
What does the anteiror pituitary develop from?
Rathkes pouch
152
When is DPG generated?
during glycolysis
153
What is the function of MOA-B inhibitors?
prevents breakdown of dopamine
154
What is the difference between an UMN lesion and spinal shock in terms of reflexes?
spinal shock-arefelxia
155
What is the difference between the ebryological origins of the gut and spleen?
gut-endoderm; spleen0mesenchymal
156
When should a woman be referred for colposcopy with mod or severe dyskarysosis?
2 weeks
157
what is CGIN?
pre-invasive adenocarcinoma of the cervix
158
What is the difference between the hemiparesis seen in anterior and middle cerebral artery lesions?
anteiror- lower more than upper; middle- upper more than lower
159
What is seen with basilar aretry lesions?
locked in syndrome
160
Which side of the body does a lesion of the cerebellar vermis cause?
bilateral
161
Where is calcium mostly absorbed?
small bowel
162
What are Barr bodies?
inactivated X chromsomes
163
What cancause barr bodies in males?
klinefelters syndrome
164
When may keratin pearls be seen?
SCC lung cancer
165
Which muscle does the radial nerve lie on as it exits the axilla?
teres major
166
What space of the shoulder does the radial nerve exit the axilla in?
triangular space
167
What structures pass trhough the quadrangular space?
axillary nerve and posterior circumflex humeral artery
168
What accompanies the radial nerve through the traingular space?
profunda brachii artery
169
What does the profunda brachii supply?
triceps
170
Waht is the most superficial fascia of the neck?
investing fascia
171
What happens to the investing fascia around SCM and trapeziuz?
splits into 2 to completely surround the mucsles
172
What is the found in the pretracheal fascia?
infrahyoid muscles; thyroids gland; trachea; oesophagus
173
What is found in the prevertebral fascia?
around the vertebral column
174
What triangle does the prevertebral fascia foudn the base of?
psoterior triangle
175
When should a woman with CIN1 wtih HPV be referred for colposcoy?
6 weeks
176
Who gets ovarian epithelial tumours?
elderly females
177
What is a dysgerminoma?
seminoma in the ovary essentially
178
Waht is the required for diagnosis for teratoma?
need all germ cell layers
