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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
Q

When whsould women with pre-eclampsia and mild/mod hypertension give birth?

A

34-36+6 weejs

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26
Q

What are the mechanisms of action of glitazones?

A

bind to PPARgamma receptors in adipocytes to promote uptake of fatty acids, increase production of adiponectin- reduces lipis in circulation

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27
Q

What is the function of amylin?

A

inhibits glucagon secretion

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28
Q

What hypoglycaemia agnet inhibits the intestinal brush border??

A

alpha-glucosidase inhibitors eg carabose

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29
Q

What is metabolic syndrome defined as?

A

3 or more of: increased waist circumference; BMI >30; raised TGs; reduced HDL; hypertension and raised fasting glucose

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30
Q

Why are sufonamides unsuiable for breast-feeding mothers?

A

may cause kernicterus

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31
Q

Why is lithium unsuitable for breast-feeding mothers?

A

may result in CVS collapse

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32
Q

what happens to the opening pressure in cryptococcal meningitis?

A

increases

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33
Q

How can viral and cryptococcal menignitis be differentiated on LP?

A

cryptococcal- icnreased opening pressure; increased protein and normal/decreased glucose whereas only change in viral is incraesed lym[hocytes

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34
Q

What haematological malignancy are patients with HIV most at risk of?

A

Non-hodgkins

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35
Q

Why is terfenadine no longer used?

A

implicated in long QT syndrome

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36
Q

What is the use for pseudoephedrine in allergic rhinitis?

A

short term relief- becomes ineffective long-term

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37
Q

How is a diagnosis of GCA made?

A

all people with suspected GCA should be sent for a temporal artery biopsy

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38
Q

What is the function of the efferents from teh medial pallidum and substantia nigra?

A

inhibitory to the motor thalamsu

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39
Q

What characterises multisystem atrophy?

A

parkinsonism with autonomic dysfunction

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40
Q

What is the quadrauple test for Down’s ?

A

AFP; unconjugated oestriol; free beta hCG; inhibin A and the womans age

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41
Q

when is the quadruple test done?

A

between 15 and 20 weeks

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42
Q

What is efficacy?

A

maxmial response that a drug can produce when all receptors are occupied

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43
Q

What bloods should be done in status epilepticus?

A

U&Es; LFT; FBC; glucose and calcium; toxicology screen; anticonvulsan level

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44
Q

What treatment should be given afetr 2 doses of lorazepam?

A

phenytoin

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45
Q

What are the causes of status epilepticus?

A

hypoglycaemia; pregnnacy; alcohol; drugs; CNS lesion; infection; compliance; hypertensive encephaloathy

46
Q

What is the function of IL6?

A

growth and differentiation of human B cells

47
Q

What is an isochromsome?

A

an abnormal chromosome formed by the duplication of one arm and loss of the other

48
Q

What is the best imaging for Perthes?

A

MRI

49
Q

What is Perthes disease?

A

idiopathic osteonecrosis of the capital femoral epiphysis

50
Q

What condition is apparent enophthalmos seen?

A

Horner’s syndrome

51
Q

What happens to the haemoglobin oxygen affinity curve with storage of blood?

A

decline in 2,3 DPG and progressive increase in Hb oxygen affinity-left shift

52
Q

How is clinical effectiveness calculated?

A

1-odds ratio

53
Q

What statistical number is type 1 error rate the value of?

A

p value

54
Q

What is relative risk reduction?

A

1-relative risk

55
Q

what infections are common in isckle cell?

A

pneumococal septicaemia and meningitis

56
Q

What is the function of hydroxyurea treatment in sickle cell?

A

stimulate HbF production

57
Q

What is the link between methyldopa and haemolytic anaemia?

A

causes production of IgG autoantibody with Rhesus blood group specificity, can also have warm AIHA

58
Q

Where does neutrophil maturation occur?

A

in the bone marrow

59
Q

why does the peripheral neutrophil count increase during sustained exercise?

A

demargination

60
Q

What is the definition of a cytokine?

A

soluble factor that can modify the behaviour and growth pattern of cells

61
Q

What is the major T cell region of lymph nodes?

A

paracortex

62
Q

What can be seen on UA in a healthy pregnancy?

A

small amounts of protein; glucose and leucocytes

63
Q

What is KA?

A

equilibrium constant

64
Q

What is a general feature of mixed insulins?

A

has a number e.g novomix 30 or humulin M3

65
Q

What does the number in a mixed insulin preparation indicate?

A

the percentage of short/rapid acting insulin it contains

66
Q

what is needed for a diagnosis of acute hepatitis B?

A

presence of hepatitis B surface antigen and IgM antibodies to hepB core antigen

67
Q

What are the ECG features of HCM?

A

left ventricular hypertrophy, ST elevation and T-wave inversion

68
Q

Which DMARD is assocaited with increased risk of lymphoma?

A

azathioprine

69
Q

What does a third heart sound mean?

A

rapid ventricualr relaxation- located in diastole

70
Q

What is the cardiac index?

A

relates cardiac output to body surface area

71
Q

What is the investigation for suspected Crohn’s ?

A

MR enterogrophy

72
Q

What artery provides the predominant blood supply to the thigh muscles?

A

profunda femoris

73
Q

What is protein S?

A

non-enzymatic cofactor to activated protein C

74
Q

What is the commonest form of brain damage?

A

contusion

75
Q

Is the Shiga toxin produced by E.coli 0157 an exo or endotoxin?

A

exotoxin

76
Q

What is the treatment for croup?

A

dexamethasone

77
Q

What is the mainstay of non-operative tratment for intussusception?

A

hydrostatic enema

78
Q

What sign may be seen with intussuscpetion on barium enema?

A

claw sign

79
Q

Does rubella vaccination confer life-long immunity?

A

no- 50% women have reinfection

80
Q

What causes reperfusion injury?

A

reperfusion of damaged cells results in generation of oxygen free radicals

81
Q

What is the effect of increased fibrinogen on atherosclerosis?

A

increases risk of atherosclerosis

82
Q

Waht is the effect of homocystein on vascualr endothelium?

A

toxic

83
Q

What can cause elevated homocyteine levels?

A

low folic acid; vit B6 or B12

84
Q

What is the function of CRH?

A

stimulates release of ACTH

85
Q

What do presynpatic potentials depend on?

A

sodium/potassium voltage-gated ion channels

86
Q

In which part of the neurone do membrane depolarisations summate?

A

axon hillock

87
Q

How often are bisphosphonates taken?

A

once weekly

88
Q

How do steroids cause OP?

A

reduce osteoblast activity

89
Q

What type of renal stones do bariatric surgery patients get?

A

calcium oxalate calculi

90
Q

What is a complciation of embolisation?

A

ischaemi

91
Q

What should foam in the venous line in dialysis make you think of?

A

air may be entering the dialysis circuit

92
Q

Where does an air emoblism tend to go if the patient is erect?

A

cerebral circulation- LOC or neuro symptosm

93
Q

Why is PE rare in dialysis patietns?

A

they are anticoagulated whilst on dialysis

94
Q

What is PDA defined as?

A

failure of the ductus arteriosus to close by 1 month post-term

95
Q

What are the calssic features of PDA?

A

large pulse pressure; continuous murmur louder in systole; collapsing pulse and prominent femoral pulses

96
Q

What antibiotics is give nfro UTI in children?

A

cephalosporin or co-amoxiclav

97
Q

How is acute infection of HIV best diagnosed?

A

p24 antigen or HIV RNA

98
Q

What is hte mechanism of calcium resonium?

A

bind potassium in the gut and helps to reduce total body potassium

99
Q

Why would you do a venous blood gas with an ECG suggestive of hyperkalaemia?

A

quick way of getting potassium result

100
Q

What is a deformity where the PIP is in flexed formation and DIP is in fixed extension ?

A

boutonniere deformity

101
Q

What causes the damage to the joint in RA?

A

pannus formation (fibromusclar granulation tissue )

102
Q

What is seen in the eyes with galactosaemia?

A

cataracts

103
Q

Is carbimazole CI when breastfeeding?

A

no

104
Q

What are the haematological SE of phenytoin?

A

megaloblastic anaemia; aplastic anaemia; thrombocytopenia; agranulocytosis

105
Q

What effects doe valproate have on haem system?

A

prolonged bleeding due to thrombocytpoenia and inhibition of platelet aggregation

106
Q

What nutritional deficiency are patietns with carcinoid syndrome at risk of developing?

A

Pellagra

107
Q

What are the signs of pellagra?

A

dermatitis; diarrhoea; dementia

108
Q

What anticonvulsant is implicated in hyponatraemia?

A

carbamazepine (SIADH)

109
Q

What is information bias?

A

way questions wtihin the questionnaire are worded or the way subjects are provided with information

110
Q

What effect does HRT have on carpal tunnel syndrome?

A

none

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