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Transition Block > 03/04/18 > Flashcards

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

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2
Q

What is the function of Ab/II fibres?

A

touch,pressure

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3
Q

What is the function of Ay fibres?

A

motor to muscle spindles

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4
Q

What is the function of Ad III fibres?

A

fast pain; cold and touch

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5
Q

What is the function of B fibres?

A

preganglionic sympathetic fibres and visceral afferents

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6
Q

What is the function of C (IV) fibres?

A

slow pain; hot; reflex

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7
Q

What is the other function of C fibres?

A

postganglionic sympathetics

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8
Q

What is type 1 small vessel disease?

A

arteriosclerosis

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9
Q

What is type 2 small vessel disease?

A

cerebral amyloid angiopathy

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10
Q

what is type 3 small vessel disease?

A

inherited or genetic SVD

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11
Q

What is type 4 small vessel disease?

A

inflammatory and immunomediated SVD

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12
Q

What is type 5 small vessel disease?

A

venous collagenosis

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13
Q

what is type 6 small vessel disease?

A

other SVD

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14
Q

Give examples of type 6 small vessel disease?

A

post-radiation angiopathy; non-amyloid microvessel degeneration in Alzheimers

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15
Q

What nuclei in the brainstem deals with taste fibres?

A

solitary nucleus

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16
Q

What is the secretomotor nucleus of vagus?

A

dorsal nucelus

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17
Q

What is a succenturiate lobe?

A

smaller accessory placenta separate to main placental disc

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18
Q

What is velamentous insertion

A

umbilical cord inserts into fetal membranes not placenta

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19
Q

What is velamentous insertion close to the cervix called?

A

vasa praevia

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20
Q

What is the difference between the CO of an 80 year olad and a 20 years old?

A

half

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21
Q

What is the average bone loss in women per decade ?

A

5-10%

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22
Q

Why may creatinine levels be normal in poor renal function?

A

low muscle mass

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23
Q

What is the function of hte appetitive and approach systems?

A

pleasure

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24
Q

What neurotransmitter is invovled in the appetitive and approach systems?

A

dopamine

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25
Q

What is first line treatment for a simple partial seizure?

A

lamotrigine or carbamazepine

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26
Q

What heart conditions are contraindications for HRT?

A

active or recent arterial thromboembolic disease- angina or MI

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27
Q

What should be measured before starting the COC and why?

A

BMI and BP as obesity and uncontrolled high BP are CI

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28
Q

What is the neurotransmitter change seen in withdrawal from sedative-hypnotic drugs?

A

reduced GABA

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29
Q

Over what Hb are blood transfusions not recommended?

A

8g/L

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30
Q

over what age are mammograms done?

A

35

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31
Q

What is a compulsory treatment order?

A

allows detention in hospital for 6 months

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32
Q

What is a compulsion order?

A

patients subject to criminal proceedings to receive treatment

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33
Q

What are risk factors for NEC?

A

IUGR; absent end diatolic flow at placenta; prematurity; hypoxic ischaemic insult

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34
Q

Why do rapidly contracting muscle fibres produce lactic acid?

A

need to regenerate NAD+ in order to produce ATP by glycolysis

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35
Q

Why is sickle solubility test not as useful as HPLC?

A

indicates presence of sickle cells but is positive in carriers as well as those with disease

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36
Q

What is the function of the infundibulum?

A

broad end of the uterine tube that receives the oocyte at ovulation

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37
Q

What is the isthmus?

A

where uterin tube narrows to enter the uterus

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38
Q

When is a mid-cavity forceps delivery e.g Haig Ferguson done?

A

position is direct OA and foetal head is below ischial spine

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39
Q

When is the typical onset of acute dystonic reactions?

A

within hours of administration

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40
Q

Which antipsychotic has the best evidence for safety and efficacy in pregnant manic patients?

A

olanzapine

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41
Q

Why do ACEi improve survival in heart failure?

A

chronic up-regulation of the renin system place extra strain on the heart by increasing preload and afterlad

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42
Q

What is the apex of the posterior traingle?

A

union of SCM nad trapezius

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43
Q

What is the base of the posterior triangle?

A

middle third of the clavicle

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44
Q

What fascia covers the posterior triangle?

A

investing layer of fascia

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45
Q

Over what BMI is the COC CI?

A

> 39

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46
Q

What drugs are associated iwht cervical dystonia?

A

anticholinergics; phenothiazines; botulinum toxin

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47
Q

Which hepatitis types are spread by faeco-oral route?

A

hep A and E

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48
Q

What type of treatments are useful for endometriosis?

A

any treatment that reduces menstruation e.g COC

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49
Q

which type of lymphoma is lymphocytosis seen with?

A

non-hodgkins

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50
Q

What is the treatment for PID if gonorrhea risk is low?

A

ofloxacin plus metronidazole for 14 days

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51
Q

What may be used instead of ofoxacin in PID treatment?

A

levofloxacin

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52
Q

What is the other option for PID without gonorrhea?

A

ceftriazone IM plus doxy and metronidazole for 14 days

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53
Q

When would risk of gonoccal infection be considered high?

A

partner has gonorrhea; symptoms and signs are severe or has had sexual contact abroad

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54
Q

what is the treatment for PID with high risk of gonorrhea?

A

ceftriaxone IM plus doxy and metronidazole for 14 days

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55
Q

What must be given with metronidazole and doxy?

A

IM ceftriaxone

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56
Q

What antibiotics regimens should not be given to women with PID and high risk of gonorrhea?

A

ofloxacin or azithromycin

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57
Q

Which areas of the hands are most frequently missed?

A

thumb; space between thumb and first finger; in between fingers; nails

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58
Q

What drugs should be avoided in delirium?

A

BZDs

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59
Q

What class of drug is effective in treating delirium?

A

antipsychotics esp. haloperidol

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60
Q

When is it necessary to monitor patients on LMWH?

A

pregnancy or renal impairment

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61
Q

What is the MOA of dabigatran?

A

new oral direct thrombin inhibitor

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62
Q

When is dabigatran CI?

A

GFR <30

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63
Q

What bag should used IV drip tubing go into?

A

orange bag

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64
Q

What type of consent is required for a surgical procedure?

A

written

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65
Q

How should consent be obtained in a patient wihtout capacity and who is unlikely to gain capacity in the future?

A

court of law

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66
Q

Why does CNVII lesion cause pain in the posterior triangle of the neck

A

innervates platysma

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67
Q

How many ribs should be visible anteirorly on a CXR?

A

5-7

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68
Q

how many ribs should be visible posteirorly on CXR

A

10

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69
Q

What is normal cardiothoracic ratio?

A

<0.5

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70
Q

What ST elevation in V2-5?

A

anteiror

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71
Q

What is ST elevation in V1-3?

A

anteroseptal

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72
Q

Waht is ST elevation in V4-6; I and aVL?

A

anterolateral

73
Q

What is reciprocal ST elevation in V1 and 2?

A

posterior

74
Q

What happens in the embyronic period of lung maturation?

A

branching to level of lobar bronchi

75
Q

What happens in canalicular period of lung maturation?

A

respiratory bronchioles and alveolar ducts form

76
Q

Waht happens in the saccular period of lung maturation?

A

terminal sacs form and capillaries become assocaited with them

77
Q

What happens in the psuedoglandualr stage of lung maturation?

A

branching gives rise to temrinal bronchioles

78
Q

Waht is the midgut?

A

GI tract from mid duodenum to 2/3rs along transverse colon plus pancreas

79
Q

What is the difference between balloon adn bougie oesophageal dilatation?

A

balloon is safer than bougie

80
Q

What is the gold standard for giardia diagnosis?

A

distal duodenal biopsy

81
Q

Which virus is a common cause of bronchiolitis and was discovered in 2001?

A

metapneumovirus

82
Q

What is MAP equal to?

A

diastolic pressure + 1/3(systolic-diastolic)

83
Q

What is the test for small bowel overgrowth syndrome?

A

glycocholic breath test

84
Q

What disease is early white hair associated with?

A

autoimmune- pernicious anaemia

85
Q

What is the treatment for pseudomonas pneumonia?

A

ciprofloxacin

86
Q

What is the best anthropometric predictor of CVS disease?

A

waist circumference

87
Q

What is the difference on spiromtery between asthma and COPD?

A

asthma has preserved FVC whereas COPD it isnt

88
Q

What is always true if the FEV/FVC ratio is reduced?

A

PEF will be reduced

89
Q

Which bone contributes to the base of skull and is an attachment for 2 muscles of mastication?

A

sphenoid

90
Q

What is the likely diagnosis in a young patient with recurrent malaena, central abdo pain and prev normal gastroscopy?

A

meckels diverticulum

91
Q

Waht is the most common cause of most congential abnormalities?

A

unknown

92
Q

When should soap and water be used rather than alcohol rub?

A

visibly soiled; contact with bodily fluids; patients with c.diff or MRSA; or >5 consequtive uses of alcohol gel

93
Q

What is salmeterol?

A

LABA

94
Q

What is the commonest cause of renal failure in the <5years?

A

E.coli 0157

95
Q

What are the paired vessels of the abdo aorta from sup. to inf.?

A

adrenal; renal and gonadal

96
Q

What do healthy start vitamins contain?

A

folic acid; vitamin C and D

97
Q

What is pellagra caused by?

A

niacin deficiency

98
Q

What is niacin?

A

vitamin B3

99
Q

Where are Merkel endings found?

A

near border of epidermis

100
Q

Where are Meissners corpuscles found?

A

dermal papillae

101
Q

What are the two types of intrafusal muscle fibre?

A

nuclear bag and nuclear chain

102
Q

What are the 2 types of sensory endings associated with intrafusal muscle fibres?

A

annulospiral and flower spray

103
Q

What is the fibre associated with annulospiral endings?

A

Ia

104
Q

What is the fibre type associated with flower spray endings ?

A

II- Ab

105
Q

What is the function of Meissners corpuscles?

A

fine discriminative touch

106
Q

What is the function of Merkels discs?

A

touch/pressure

107
Q

What is the function of Pacinian corpuscles?

A

mechanical distortion esp. vibration

108
Q

What is endoneurium?

A

connective tissue between individual nerve fibres

109
Q

what is epineuroium?

A

connective tissue around whole nerve

110
Q

What type of connective tissue is the dura continous with?

A

epineurium

111
Q

What is the difference between the origins of the anterior and posterior pituitaries?

A

posterior is neural in origin

112
Q

What is semantic memory?

A

knowledge of the world

113
Q

What is semantic memory dependent on?

A

middle and inferior tempral gyri

114
Q

What is episodic memory?

A

learning and recollection of autobiographical events

115
Q

what is episodic memory dependent on?

A

hippocampus

116
Q

Where is the primary olfactory cortex?

A

uncus of the temporal love

117
Q

What does a patent processus vaginalis predispose to?

A

testicular torsion

118
Q

What is apraxia?

A

inability to perform voluntary movements

119
Q

Where would a lesion be to cause apraxia?

A

parietal loe

120
Q

What area of the basal ganglia is affected in huntingtons chorea?

A

striatum- caudate nucleus

121
Q

What is alexia?

A

impairment of reading

122
Q

What constitutes the striatum?

A

caudate nucleus and putamen

123
Q

What constititues the lentiform nucleus?

A

putamen and globus pallidus

124
Q

What is the function of the nucleus accumbens?

A

links the basal ganglia and limbic system

125
Q

What anibody is devic’s syndrome associated iwth?

A

NMO-IgG

126
Q

What is Devic’s syndrome also known as?

A

neuromyleitis optica

127
Q

What is devic’s syndrome?

A

inflammation and demylination of the optic nerve and spinal cord

128
Q

What is Uhthoff’s phenomenon?

A

worsening of vision following rise in body temp

129
Q

What is Uhthoff’s phenomenon associated with?

A

MS

130
Q

What is the relations of the median nerve to the brachial artery going down the arm?

A

lateral–anterior–medial

131
Q

Where does the brachial artery begin?

A

lower border of teres major

132
Q

What is the mostcommon cause of primary PPH?

A

uterine atony

133
Q

What are the 4T’s of PPH?

A

tone; tissue; trauma; thrombosis

134
Q

What is a Chiari malformation?

A

part of hte brain pushes down into the psinal canal

135
Q

What is a Chiari 1 malformation?

A

cerebellum extends beyond foramen magnum

136
Q

Where is the sciatic nerve formed?

A

lower border of piriformis

137
Q

What is the lymphatic drainage of the vocal cords?

A

have no drainage

138
Q

What should be done for all babies born to Rh neg mothers?

A

cord blood for FBC; blood group and direct Coombs

139
Q

What is the Kleihauer test?

A

add acid to maternal blood, fetal cells are resisitant

140
Q

Why are rhesus babies oedematous?

A

liver devoted to rBC production so reduced albumin

141
Q

What are infected endocervical cells called?

A

koilocytes

142
Q

What are the features of koilocytes?

A

enlarged nucleus; irrregular nuclear membraen contous; hyperchromasia; perinuclear halo

143
Q

What is progressive supranuclear palsy?

A

dysfunction of muscles involved in looking upwards

144
Q

Where are Hassal’s corpuscles found?

A

medulla of the thymus

145
Q

what other name are parafollicular cells of the thyroid known as?

A

C-cells

146
Q

What is found within the thyroid follicle?

A

colloid

147
Q

What is seen at the risk with Klumpke’s ?

A

loss of wrist flexors

148
Q

After what structure is the optic radiation?

A

lateral geniculate body

149
Q

What is the innervation of hte stapedius?

A

VII

150
Q

What is the effect of the COC on breast, cervical, ovarian and endometrial cancers?

A

increases breast and cervical but decreases ovarain and endometrial

151
Q

What does the anteiror pituitary develop from?

A

Rathkes pouch

152
Q

When is DPG generated?

A

during glycolysis

153
Q

What is the function of MOA-B inhibitors?

A

prevents breakdown of dopamine

154
Q

What is the difference between an UMN lesion and spinal shock in terms of reflexes?

A

spinal shock-arefelxia

155
Q

What is the difference between the ebryological origins of the gut and spleen?

A

gut-endoderm; spleen0mesenchymal

156
Q

When should a woman be referred for colposcopy with mod or severe dyskarysosis?

A

2 weeks

157
Q

what is CGIN?

A

pre-invasive adenocarcinoma of the cervix

158
Q

What is the difference between the hemiparesis seen in anterior and middle cerebral artery lesions?

A

anteiror- lower more than upper; middle- upper more than lower

159
Q

What is seen with basilar aretry lesions?

A

locked in syndrome

160
Q

Which side of the body does a lesion of the cerebellar vermis cause?

A

bilateral

161
Q

Where is calcium mostly absorbed?

A

small bowel

162
Q

What are Barr bodies?

A

inactivated X chromsomes

163
Q

What cancause barr bodies in males?

A

klinefelters syndrome

164
Q

When may keratin pearls be seen?

A

SCC lung cancer

165
Q

Which muscle does the radial nerve lie on as it exits the axilla?

A

teres major

166
Q

What space of the shoulder does the radial nerve exit the axilla in?

A

triangular space

167
Q

What structures pass trhough the quadrangular space?

A

axillary nerve and posterior circumflex humeral artery

168
Q

What accompanies the radial nerve through the traingular space?

A

profunda brachii artery

169
Q

What does the profunda brachii supply?

A

triceps

170
Q

Waht is the most superficial fascia of the neck?

A

investing fascia

171
Q

What happens to the investing fascia around SCM and trapeziuz?

A

splits into 2 to completely surround the mucsles

172
Q

What is the found in the pretracheal fascia?

A

infrahyoid muscles; thyroids gland; trachea; oesophagus

173
Q

What is found in the prevertebral fascia?

A

around the vertebral column

174
Q

What triangle does the prevertebral fascia foudn the base of?

A

psoterior triangle

175
Q

When should a woman with CIN1 wtih HPV be referred for colposcoy?

A

6 weeks

176
Q

Who gets ovarian epithelial tumours?

A

elderly females

177
Q

What is a dysgerminoma?

A

seminoma in the ovary essentially

178
Q

Waht is the required for diagnosis for teratoma?

A

need all germ cell layers

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