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Transition Block > 13/04/18 > Flashcards

13/04/18 Flashcards

1
Q

Which branchial arch is the facial nerve associated with?

A

2nd

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2
Q

What is seen histologically with Paget’s disease of the breast?

A

Pagetoid cells- large vacuolated cells with small deeply staining nucleoli

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3
Q

What mainly stimulates gastrin release?

A

protein ingestion and gastric distension

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4
Q

What does epithelial cells in nipple discharge suggest?

A

malignancy

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5
Q

Which branch of the rgiht main bornchus are foreign bodies most likely to enter if patietn is erect?

A

inferior lobar bronchus

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6
Q

What happens to TSH and T4 in the early treatment of hyperthryoidism?

A

fT4 normalised while TSH remains low

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7
Q

What is the difference in the vaginal wall in BV compared to trichomonas and candidiasis?

A

in BV there is no inflammation of the vaginal wall (hence vaginosis not vaginitis)

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8
Q

Why is there hyperphosphataemia and hypocalcaemia in chronic renal failure?

A

thered a reduction in excretion of phosphate, reatined phosphate creates phosphate-calcium compounds in the blood–low free calcium

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9
Q

What can happen to the ears in salicylate intoxication?

A

tinnitus and deafness

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10
Q

List some MArfanoid features?

A

high arched palate; lens discolation; genu valgum; scoliosis

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11
Q

what is pectus carinatum?

A

pigeon chest

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12
Q

What differentiates homocystinuria and MArfans syndrome?

A

homocystinuria is assocaited with low IQ whereas MArfans isn’t

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13
Q

What are the most common presenting features of a posteiror inferior cerebellar artery lesion?

A

vertigo; nausea adn truncal ataxia

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14
Q

Why would anticonvulsatns cause osteomalacia?

A

induce liver enzymes resulting in increased breakdown of 25-hyroxycholecalciferol

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15
Q

What is hyoscine?

A

peripheral and central anticholinergic

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16
Q

When does the pain with acute salpingitis occur?

A

during intercourse; ovulation and pain that comes and goes

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17
Q

What are the 3 branches of the facial nerve at the geniculate ganglion?

A

greater petrosal nerve- parasympathetics; nerve to stapedius; chorda tympani

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18
Q

What is the difference between the actions of loops and thiazides on clacium?

A

loops increase urinary calcium whilst thiazides decrease

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19
Q

What area of the brain mainly controls thermoregulation?

A

hypothalamus

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20
Q

Where si the transverse sinus found?

A

behind the major vessels emerging from the ventricles but in front of the SVC

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21
Q

What is the visceral layer of the pericardium also known as?

A

epicardium

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22
Q

What is IM benzylpenicillin used for in menigitis treatment?

A

in the community for suspected cases

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23
Q

When should women with gestational hypertension be admitted to hospital?

A

if above 160/110

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24
Q

When should women with gestational hypertension be given anti-hypertensives?

A

150/100-159/109

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25
When whsould women with pre-eclampsia and mild/mod hypertension give birth?
34-36+6 weejs
26
What are the mechanisms of action of glitazones?
bind to PPARgamma receptors in adipocytes to promote uptake of fatty acids, increase production of adiponectin- reduces lipis in circulation
27
What is the function of amylin?
inhibits glucagon secretion
28
What hypoglycaemia agnet inhibits the intestinal brush border??
alpha-glucosidase inhibitors eg carabose
29
What is metabolic syndrome defined as?
3 or more of: increased waist circumference; BMI >30; raised TGs; reduced HDL; hypertension and raised fasting glucose
30
Why are sufonamides unsuiable for breast-feeding mothers?
may cause kernicterus
31
Why is lithium unsuitable for breast-feeding mothers?
may result in CVS collapse
32
what happens to the opening pressure in cryptococcal meningitis?
increases
33
How can viral and cryptococcal menignitis be differentiated on LP?
cryptococcal- icnreased opening pressure; increased protein and normal/decreased glucose whereas only change in viral is incraesed lym[hocytes
34
What haematological malignancy are patients with HIV most at risk of?
Non-hodgkins
35
Why is terfenadine no longer used?
implicated in long QT syndrome
36
What is the use for pseudoephedrine in allergic rhinitis?
short term relief- becomes ineffective long-term
37
How is a diagnosis of GCA made?
all people with suspected GCA should be sent for a temporal artery biopsy
38
What is the function of the efferents from teh medial pallidum and substantia nigra?
inhibitory to the motor thalamsu
39
What characterises multisystem atrophy?
parkinsonism with autonomic dysfunction
40
What is the quadrauple test for Down's ?
AFP; unconjugated oestriol; free beta hCG; inhibin A and the womans age
41
when is the quadruple test done?
between 15 and 20 weeks
42
What is efficacy?
maxmial response that a drug can produce when all receptors are occupied
43
What bloods should be done in status epilepticus?
U&Es; LFT; FBC; glucose and calcium; toxicology screen; anticonvulsan level
44
What treatment should be given afetr 2 doses of lorazepam?
phenytoin
45
What are the causes of status epilepticus?
hypoglycaemia; pregnnacy; alcohol; drugs; CNS lesion; infection; compliance; hypertensive encephaloathy
46
What is the function of IL6?
growth and differentiation of human B cells
47
What is an isochromsome?
an abnormal chromosome formed by the duplication of one arm and loss of the other
48
What is the best imaging for Perthes?
MRI
49
What is Perthes disease?
idiopathic osteonecrosis of the capital femoral epiphysis
50
What condition is apparent enophthalmos seen?
Horner's syndrome
51
What happens to the haemoglobin oxygen affinity curve with storage of blood?
decline in 2,3 DPG and progressive increase in Hb oxygen affinity-left shift
52
How is clinical effectiveness calculated?
1-odds ratio
53
What statistical number is type 1 error rate the value of?
p value
54
What is relative risk reduction?
1-relative risk
55
what infections are common in isckle cell?
pneumococal septicaemia and meningitis
56
What is the function of hydroxyurea treatment in sickle cell?
stimulate HbF production
57
What is the link between methyldopa and haemolytic anaemia?
causes production of IgG autoantibody with Rhesus blood group specificity, can also have warm AIHA
58
Where does neutrophil maturation occur?
in the bone marrow
59
why does the peripheral neutrophil count increase during sustained exercise?
demargination
60
What is the definition of a cytokine?
soluble factor that can modify the behaviour and growth pattern of cells
61
What is the major T cell region of lymph nodes?
paracortex
62
What can be seen on UA in a healthy pregnancy?
small amounts of protein; glucose and leucocytes
63
What is KA?
equilibrium constant
64
What is a general feature of mixed insulins?
has a number e.g novomix 30 or humulin M3
65
What does the number in a mixed insulin preparation indicate?
the percentage of short/rapid acting insulin it contains
66
what is needed for a diagnosis of acute hepatitis B?
presence of hepatitis B surface antigen and IgM antibodies to hepB core antigen
67
What are the ECG features of HCM?
left ventricular hypertrophy, ST elevation and T-wave inversion
68
Which DMARD is assocaited with increased risk of lymphoma?
azathioprine
69
What does a third heart sound mean?
rapid ventricualr relaxation- located in diastole
70
What is the cardiac index?
relates cardiac output to body surface area
71
What is the investigation for suspected Crohn's ?
MR enterogrophy
72
What artery provides the predominant blood supply to the thigh muscles?
profunda femoris
73
What is protein S?
non-enzymatic cofactor to activated protein C
74
What is the commonest form of brain damage?
contusion
75
Is the Shiga toxin produced by E.coli 0157 an exo or endotoxin?
exotoxin
76
What is the treatment for croup?
dexamethasone
77
What is the mainstay of non-operative tratment for intussusception?
hydrostatic enema
78
What sign may be seen with intussuscpetion on barium enema?
claw sign
79
Does rubella vaccination confer life-long immunity?
no- 50% women have reinfection
80
What causes reperfusion injury?
reperfusion of damaged cells results in generation of oxygen free radicals
81
What is the effect of increased fibrinogen on atherosclerosis?
increases risk of atherosclerosis
82
Waht is the effect of homocystein on vascualr endothelium?
toxic
83
What can cause elevated homocyteine levels?
low folic acid; vit B6 or B12
84
What is the function of CRH?
stimulates release of ACTH
85
What do presynpatic potentials depend on?
sodium/potassium voltage-gated ion channels
86
In which part of the neurone do membrane depolarisations summate?
axon hillock
87
How often are bisphosphonates taken?
once weekly
88
How do steroids cause OP?
reduce osteoblast activity
89
What type of renal stones do bariatric surgery patients get?
calcium oxalate calculi
90
What is a complciation of embolisation?
ischaemi
91
What should foam in the venous line in dialysis make you think of?
air may be entering the dialysis circuit
92
Where does an air emoblism tend to go if the patient is erect?
cerebral circulation- LOC or neuro symptosm
93
Why is PE rare in dialysis patietns?
they are anticoagulated whilst on dialysis
94
What is PDA defined as?
failure of the ductus arteriosus to close by 1 month post-term
95
What are the calssic features of PDA?
large pulse pressure; continuous murmur louder in systole; collapsing pulse and prominent femoral pulses
96
What antibiotics is give nfro UTI in children?
cephalosporin or co-amoxiclav
97
How is acute infection of HIV best diagnosed?
p24 antigen or HIV RNA
98
What is hte mechanism of calcium resonium?
bind potassium in the gut and helps to reduce total body potassium
99
Why would you do a venous blood gas with an ECG suggestive of hyperkalaemia?
quick way of getting potassium result
100
What is a deformity where the PIP is in flexed formation and DIP is in fixed extension ?
boutonniere deformity
101
What causes the damage to the joint in RA?
pannus formation (fibromusclar granulation tissue )
102
What is seen in the eyes with galactosaemia?
cataracts
103
Is carbimazole CI when breastfeeding?
no
104
What are the haematological SE of phenytoin?
megaloblastic anaemia; aplastic anaemia; thrombocytopenia; agranulocytosis
105
What effects doe valproate have on haem system?
prolonged bleeding due to thrombocytpoenia and inhibition of platelet aggregation
106
What nutritional deficiency are patietns with carcinoid syndrome at risk of developing?
Pellagra
107
What are the signs of pellagra?
dermatitis; diarrhoea; dementia
108
What anticonvulsant is implicated in hyponatraemia?
carbamazepine (SIADH)
109
What is information bias?
way questions wtihin the questionnaire are worded or the way subjects are provided with information
110
What effect does HRT have on carpal tunnel syndrome?
none

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