22/6

Question 1

A GRACE score of what indicates coronoary angio?

Answer 1

> 3%

Question 2

Malnutrition = ?

Answer 2

Unintentional weight loss >10% in the last 3-6mnths

or if have a BMI <20 - weight loss >5% in 3-6months

Question 3

Explain anion gaps

Answer 3

Allows to identify causes of metabolic acidosis

Calculate by calculating diff between +ve ions (Na+ and K+) and (Cl- and HCO3-)

Raised = increase in -ve ions production
- lactate = shock/sepsis
- ketones = DKA
- salicylate = aspirin OD

Normal = losing HCO3
- diarrhoea
- kidney dysfunction

Question 4

Describe the ABG that you get with aspirin OD

Answer 4

Resp alkalosis followed by metabolic acidosis

Question 5

What drugs can have an impact on INR

Answer 5

Inducers (increase the clearance of warfarin = decrease INR)
- SCARS
Smoking
Chronic alcohol intake
Antiepileptics
Rifampicin
St Johns Wort

Inhibitors (decrease the clearance of warfarin = increase INR)
ASS-ZOLES
Antibiotics - ciprofloxacin, erythromycin, isoniazid, clarithomycin
SSRIs
Sodium valporate
-Zoles

Question 6

Hyperparathyroidism increases the risk of psuedo or normal gout?

Answer 6

Pseudo

Question 7

Why do they get erectile dysfunction in haemochromatosis?

Answer 7

Iron accumulates in the pituitary and blocks it from producing gonadotrophins

Question 8

How do you confirm cellultiis?

Answer 8

You don’t - it’s a clinical diagnosis

Question 9

Look over sickle cell again

Question 10

How is a vaso-occlusive crisis diagnosed>

Answer 10

Clinical diagnosis

Question 11

Go over antibodies

Question 12

How can you tell the difference between beta thalassemia trait and major

Answer 12

Major = symptomatic and young and significant anameia
Trait = microcytic but mild anaemia so not v symptoamtic

Question 13

What can infleunce type 1 and type 2 errors?

Answer 13

Type 1 (likelihood of rejecting a true H0) = low p-value
Type 2 (likelihood of accepting a false H0) = higher power

Question 14

What is Hawthorne effect

Answer 14

Group changing behaviour cos they know they are being studied

Question 15

Difference between Phase I,II, III, IV cliniucal trials

Answer 15

I = very small human trials often healthy - check side effects
II = efficancy and dosing regimes in people who have the disease
III = pre-market approval, multi-centre and establishes effectiveness vs current regimes
IV = long-term effects post market licenseing

Question 16

When analysing survival over time what ratio should be used?

Answer 16

Hazard

Question 17

How do you calculate the standard error of the mean?

Answer 17

SD/square root of n

Question 18

How do you calculate the likelihood of +ve/-ve result

Answer 18

Likelihood ratios

Negative = specificity/(1-sensitivty)
+ve = sensitivity/(1-spec)

Question 19

What is a Weber’s syndrome

Answer 19

Midbrain stroke

• ipsilateral CN III palsy
• contralateral hemiparesis

Question 20

Cause of vertical vs horizontal nystagmus

Answer 20

Vertical - looking up and round to the cerebellum = cerebellar cause

Horizontal - looking side to side = viral labrynthitis