2011 module exam Flashcards
Anatomy (1-60) Pathology (61-80) Clinical medicine (81-83) Physiology (84-90) Biochemistry (91-98) Pharmacology (99-108) Microbiology (109-129)
Which muscle is involved in abduction?
Deltoid
Which muscle is responsible for shrugging the shoulder against resistance?
Trapezius
What muscle is innervated by the lower subscapular?
Teres major
Paralysis of which muscle would result in loss of retraction of the scapula?
Rhomboid major
Which muscle initiates abduction?
Supraspinatus
Which muscle is responsible for swinging the upper limb anteriorly and posteriorly when walking?
Deltoid
Damage to the subscapular nerve would result in loss of which function?
Medial rotation
Fracture of What part of the humerus would injure the axillary nerve?
Surgical neck
Fracture of what part of the humerus would injure the ulnar nerve?
Medial epicondyle
Which muscle is tested by flexion of the forearm against resistance?
Brachialis
Which nerve is damaged in loss of opposition of the thumb?
Median nerve
A 15-year-old boy came to the emergency room with a waiter’s tip deformity after falling off a horse. Which nerve roots are damaged?
C5,C6
A 4-month-old child has a claw hand deformity. Which nerve roots are damaged?
C8,T1
Which of the two muscle pairs are the major lateral rotators?
Infraspinatous and teres minor
What is the function of the subscapularis muscle?
Medial rotation
Which nerve injury results in a wrist drop?
Radial nerve
Which nerve when injured results in loss of forearm flexion?
a. Radial n
b. Median n
c. Ulnar n
d. Musculocutaneous n
e. Med cutaneous n
d. Musculocutaneous n
Which pair of nerves are responsible for supination of the forearm?
Radial and musculocutaneous N
Dislocation of the L2/L3 facet joint damages which of the following?
Spinal nerve
Which lymph node are the first to be affected where there is an infection on the medial side of the hand?
Humeral lymph nodes
The tendon of which muscle passes through the lesser sciatic foramen?
Obturator internus
What is injured in penetrating injury to the cubital fossa?
Median nerve
In which artery will the blood flow be reversed when we ligate the second part of the axillary artery?
Subscapular artery
A vein in the ankle is cannulated and the patient feels pain that radiates to the medial borders of the foot and leg, which nerve might have been affected?
Saphenous nerve
In which vein does the lesser saphenous vein drain?
a. Femoral
b. Popliteal
c. Tibial
b. Popliteal
Which nerve when injured results in loss of extension of the forearm?
Radial nerve
Which ligament prevents hyperextension of the hip joint?
Illiofemoral
Which of the following structures is injured by strong hyper-eversion?
Deltoid ligament
Which bone is affected in dancer’s fracture?
Metatarsals
Injury to which of the following structures will result in loss of function of the subclavius? A) medial cord B) lateral cord C) posterior cord D) superior trunk E) middle trunk F) musculocutanous nerve G) median nerve H) axillary nerve
D) superior trunk
injury to which of the following structures will result in loss of function of the subscapularis? A) medial cord B) lateral cord C) posterior cord D) superior trunk E) middle trunk F) musculocutanous nerve G) median nerve H) axillary nerve
C) posterior cord
Compression of the C6 ramus would affect which area?
lateral forearm
Compression of the C8 ramus would affect which area?
medial forearm
Which muscle is responsible for abduction and flexion of the hand at the wrist?
Flexor carpi radialis
Which muscle is responsible for flexion of the proximal interphalangeal joints and metacarpophalangeal joints?
Flexor digitorum superficialis
Which nerve, when damaged, will result in loss of sensation to the medial one and a half fingers?
Ulnar nerve
Which nerve is responsible for innervation of the major part of vertebral column?
Recurrent branch
Which of these is the main artery that supplies the head and neck of the femur?
Medial circumflex artery
Which of the following supplies inferior gamellus?
Nerve to quadrates femoris
Which muscle is likely to be affected in piriformis syndrome?
Biceps femoris
The tendon of which of the following muscles exits [or passes] the knee joint to attach to the tibia?
Semitendinosus
Which of these is an expansion of the semimembranosus?
a. oblique popliteal ligament
b. medial collateral ligament
c. patellar ligament
a. oblique popliteal ligament
When a person stands on one leg, the pelvis drops on the other side. Which muscle is affected?
Gluteus medius
Which nerve innervates the anterior compartment of the leg?
a. Femoral nerve
b. Common fibular nerve
c. Deep fibular nerve
d. Superficial fibular nerve
c. Deep fibular nerve
The lateral sural nerve is a branch of which nerve?
a. Femoral nerve
b. Tibial nerve
c. Obturator nerve
d. Superficial peroneal nerve
e. Common fibular nerve
e. Common fibular
What innervates the semitendinosus?
a. Femoral nerve
b. Tibial nerve
c. Obturator nerve
d. Superficial peroneal nerve
e. Common fibular nerve
b. Tibial nerve
Which of these is attached to the medial meniscus?
a. Fibular collateral ligament
b. Tibial collateral ligament
c. Lower border of the patella
d. Medial to the patellar ligament
e. Deltoid ligament
b. Tibial collateral ligament
What is lost when the common peroneal is compressed at the level of the head of the fibula?
Eversion
An elderly man fractured his hip. Which of the following is involved?
Neck of the femur
What is the most powerful plantar-flexor of the ankle joint?
Gastrocnemius
A person is unable to extend the knee joint. Which nerve is damaged?
Femoral nerve
Which of the following is has the most profound effect in destabilization of the knee joint [or paralysis of which muscle destabilizes the knee joint]?
Loss of function of the quadriceps femoris
Which of the following leg muscles flexes the knee?
Gastrocnemius
Which of the following is fractured during extreme/hyper dorsiflexion of the foot?
Talus
Which mesoderm gives the myotome?
Paraxial
Which of the following gives rise to the vertebra?
Sclerotome
What will result from failure of fusion of the two vertebral arches?
Spina bifida
What will result from non-ossification of one of the vertebral centers?
scoliosis
What is the most important function of the intervertebral disk?
Shock absorber
What articulates with the medial and lateral malleoli?
Talus
Which muscle is the primary dorsiflexor and invertor?
Tibialis anterior
Which of the following diseases is characterized by a mosaic pattern of bone and occurs in the elderly?
Paget’s disease
A child with vitamin D defieciency:
Rickets
Which of the following is a feature of dermatomyocitis?
Perifascicular atrophy
A 14-year-old boy sustained a humeral fracture following a fall from his bike 6 hours ago. What would be found at this stage?
Hematoma with an acute inflammation
Non-union of a spirally fractured bone would result in what?
Pseudoarthrosis
Gram-negative diplococcic with inflammation:
septic arthritis
Which of the following muscles diseases is characterized by ragged red fibers?
Mitochondrial disease
Which of the following muscle diseases is characterized by muscles that are PAS positive?
Pompe’s disease
PAS= periodic acid-Schiff; PAS positive lymphocyte vacuoles
Where do you see subchondral cyst and degeneration of articular cartilage?
Osteoarthritis
A 50-year-old woman with Rheumatoid arthritis since age 20 presents with heavy proteinuria. What do you expect to in the kidney biopsy?
Amyloid
You take a blood sample from a number of participants and when you screen them you find low specificity, low antigen affinity IgM antibodies directed to self antigens. What is the explanation?
They are self-reactive non-pathogenic antibodies normally found in the body
A woman suffers from myalgia and is positive for anti-nuclear antibodies. She later develops glomerulonephritis. What is the cause?
Immune complex deposition
What is found in the center of gouty tophi?
Monosodium urate
A 70-year-old obese woman with stiffness in both knee joints and loss of articular cartilage. What is the diagnosis?
Osteoarthritis
A 15-year-old boy is complaining of pain and swelling in his leg. Needle core biopsy of a tumor in his femur shows lace-like pink material, atypical cells with dark nuclei, and mitosis. What is the diagnosis?
Osteosarcoma
A patient presents with a deep-seated tumor in the thigh. Biopsy shows bundles of spindle-shaped cells with cigar shaped nuclei, necrosis, mitosis, and nuclear atypia. What is the diagnosis?
Leiomyosarcoma
A patient presents with a superficial well-defined tumor composed of mature adipocytes. What is the diagnosis?
Lipoma
A histological specimen from a well-defined tumor showed vascular spaces filled with blood. What is the diagnosis?
Hemangioma
A 50-year-old man develops fever, swelling and severe pain in the metatarsophalangeal joint of the big toe. He also has white depositions in his ear. He had recurrent episodes of the same problem 3 times in the same year. What is the diagnosis?
Gouty arthritis
What would you see in radiology of the knee in osteoarthritis?
Osteophyte formation
What are crystals seen in a chronic inflammatory disease and are flat, rectangular, and notched?
Cholesterol
What will synovial fluid analysis in a 70- year-old female with osteoarthritis show?
Clear viscous fluid with WBCs between 200-2000
What is a feature of fast muscle fibers?
Few mitochondria
What generates maximal force of contraction?
100% overlap between actin and myosin
Which of the following is responsible for the ATP dependent power stroke?
Myosin head
What is the effect of tetrodotoxin?
Inhibits action potential formation
What is the effect of black spider widow toxin?
Calcium independent excessive exocytosis
alpha-latrotoxin
Which of the following is responsible for unidirectional propagation of action potential?
Hyperpolarization during the refractory period
Which proteins are involved in the docking of vesicles to the membrane?
Syntaxin and synaptobrevin
Which of the following functions as an immediate source of ATP in muscles?
Creatine phosphate
What enzyme generates an ATP molecule from 2 ADP molecules?
Adenylate kinase
What is responsible for the extended structure of proteoglycans?
Polysaccharides with charge [charged polysaccharides]
Which amino acid is modified to generate covalent cross-linkage in collagen molecules?
Lysine
Which of the following is the most direct precursor for uric acid synthesis?
Hypoxanthine
Which organ is most likely to be affected by mitochondrial dysfunction?
Muscles
A 14-year-old boy presents with exercise intolerance and lactic acidosis. What is the likely mechanism?
Mutation in mitochondrial t-RNA
Which enzyme do we inhibit to prevent recurrent attacks of gout?
Xanthine oxidase
Why do we give paracetamol and not aspirin to a 3-year-old child with fever?
To avoid Reye’s syndrome
What is a selective COX-2 inhibitor?
Celecoxib
Which of the following is an irreversible inhibitor of COX?
Aspirin
Which of the following drugs is an anti-pyretic and analgesic but has low anti-inflammatory activity?
Paracetamol
What is the drug that inhibits IL-2 production?
Cyclosporine A
The toxicity of which drug is facilitated by allopurinol?
Azathioprine
Which of the following drugs is an effective chelator of copper and is used in Wilson’s disease?
D-penicillamine
Which of the following drugs is an inhibitor of dihydroorate reductase?
Ieflunomide
The function of which drug is enhanced by allopurinol?
Azathioprine
Which drug is metabolized to a competitive inhibitor of xanthine oxidase?
allopurinol
What commonly causes acute osteomyelitis?
Staphylococcus aureus
A 3-year-old child has osteomyelitis. What is the causative organism?
Hemophilus infleunzae
What type of bone is affected by chronic osteomyelitis caused by M. tuberculosis?
Vertebra
Antibody to which molecule is diagnostic of SLE?
ds-DNA
Anti-dsDNA antibodies and ANA antibodies are SLE specific
Someone who works with cattle and develops sacroiliitis. What is the causative organism?
Brucella abortus
What causes chronic osteomyelitis of the sacroiliac and sternoclavicular joint?
Pseudomonas aeruginosa
A 55-year-old man respiratory symptoms, muscle tenderness, and diffuse myalgia. What is the viral cause?
Influenza A
Which virus causes dilated cardiomyopathy?
Coxsackie B
A patient has arthritis as a result of immune complex deposition. What is the viral cause?
Hepatitis B
A 25-year-old woman has a macular rash on the face and polyarthritis. What is the cause?
Parvovirus B19
Rubella has a mculo-papular rash, Parvovirus has a lacy rash
A man in Ohio presents with a bone infection. Biopsy shows intracellular budding yeast. What is the cause?
Histoplasmosis
Broad based budding yeast indicate which organism?
Blastomycetes
Which of the following causes mild self-limiting arhtirtis [desert rheumatism]?
Coccidiomycosis
A neutropenic patient suffers from an infection. Biopsy shows septate hyphae branched at acute angles. What is the cause?
Aspergillosis
Aneutropenic patient with a catheter suffers from an infection at the catheter site. Biopsy shows nonseptate hyphae. What is the cause?
Mucoralis
Which of the following is associated with a higher risk of rheumatoid arthritis?
HLA-DR
Which of the following cytokines activates T-cells in a rheumatoid joint?
IL-6
Which of the following cytokines is increased in SLE?
IL-4
Which of the following is responsible for nonspecific tissue damage in SLE?
Immune complex deposition
DMARDs [disease modifying anti-rheumatic drugs] were developed against which of the following cytokines [Which cytokine is now targeted as therapy for rheumatoid arthritis]?
TNF-α
What causes septic arthritis in a diabetic patient?
Streptococcus agalacteiae
diabetic+septic arthritis= Streptococcus agalacteiae
diabetic+osteomyelitis= Pseudomonas aeruginosa