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first year med > 2nd yr rev > Flashcards

2nd yr rev Flashcards

1
Q

in a lineweaver-Burk plot, which type of enzyme inhibition is occuring when both the lines cross the Y axis?

A

competitive
–> Vmax = same, Km = varies

(opposite for non-competitive)

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2
Q

which cranial nerves have afferent sensory fibres only?

A

CN I - olfactory

CN II - optic

CN VIII - vestibulocochlear

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3
Q

which Ig is actively transported across placenta from mother to baby + responsible for foetal immune protection?

A

IgG

–> most abundant Ig, only one that can cross placenta

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4
Q

which of these processes does NOT occur in phase 1 of drug metabolism: oxidation, conjugation, reduction, hydrolysis

A

conjugation
–> phase 2 - add endogenous compound, increasing polarity

transferases

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5
Q

what happens in phase 1 drug metabolism?

A

oxidation, reduction, hydrolysis

–> adds a chemically reactive group, cytochrome p450

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6
Q

how to calculate the negative predictive value?

A

true negative / (false neg + true neg)

ratio of those truly negative to those who had neg results

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7
Q

how does group A streptococcus stain on blood agar?

A

complete haemolysis (beta) - golden

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8
Q

how does strep pneumoniae stain on blood agar?

A

alpha haemolysis = partial = greenish

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9
Q

how does staph epidermis stain on blood agar?

A

gamma haemolysis = no haemolysis

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10
Q

mutation most assoc with breast cancer?

A

BRAC1 (also BRAC2)

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11
Q

which of the following is NOT included in the 4 Cs antibiotics most likely to cause Cdiff?
co-amoxiclav, clindamycin, ciprofloxacin, clarithromycin, cefuroxime

A

clarithromycin

co-amoxiclav
clindamycin
ciprofloxin
cefuroxime = cephalosporin

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12
Q

type of hypersensitivity is anaphylaxis

A

type 1 immediate

–> IgE most abundant

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13
Q

which cells secrete insulating material in the CNS?

A

ooligodendrocytes

schwann = PNS

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14
Q

length of TB treatment

A

2 months RIPE

4 months RI

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15
Q

side effects of TB meds

A 
rifampicin = orange fluids
isoniazid = neuropathy
pyrazinamide = joint pains
ethambutamol = colour blindness
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16
Q

vichows triad

A 
stagnant blood
hypercoaguable state (eg pregnancy)
endothelial damage
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17
Q

CURB 65 score of 3 + penicillin allergy, most appropriate antibiotic therapy?

A

IV levofloxacin

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18
Q

HIV positive with pneumonia, most likely causative organisim?

A

pneumocystitis jivrovecii

non-productive cough due to significantly increased mucous viscosity

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19
Q

3.5cm mass in left midzone of lung, non-smoker, found to be malignant, diagnosis?

A

adenocarcinoma
(midzone = peripheral)

(small cell - central + mestastasis early)

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20
Q

A 24 year old female asthmatic becomes increasingly breathless and wheezy and requires her reliever 4 times on most days and on at least 3 nights a week with coughing. She is taking salbutamol only. Serial peak flow measurement shows 30% diurnal variability.​

What regular treatment would you consider starting?​

A

inhaled corticosteroid alone

-> stepwise, add this then reasses before starting LABA

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21
Q

A 53yo woman has a cough. She has a history of central weight gain, easy bruising, abdominal striae and hyperpigmentation.
She undergoes investigation for suspected lung cancer.
What is the most likely histological diagnosis?

A

small cell

ectopic ACTH causing bilateral adrenal hyperplasia -> cushings

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22
Q

ST elevation in V1-V4

A

anteroseptal = left anterior descending (LAD)

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23
Q

ST elevation in II, III, aVF

A

inferior = right coronary artery

24
Q

ST elevation in V4-6, I, aVL

A

anterolateral = left anterior descending or left circumflex

25
Q

ST elevation in I, aVL +/- V5-V6

A

lateral = left circum flex

26
Q

40 year old man presents with increased dyspnoea on exertion. On auscultation a mid-diastolic murmur is heard in the apex region when the patient lies in the left lateral position.
What is the most likely diagnosis?

A

mitral stenosis

27
Q

MRS ASS

A

mitral regurg = systolic

Aortic stenosis = systolic

28
Q

tetralogy of fallot

A

puulmonary stenosis
overriding aorta
VSD
right ventricular hypertrophy

29
Q

A 52 year old Caucaisan woman has just been diagnosed with hypertension with no past medical history of note. Which of the following is the most appropriate first-line treatment?

A

lisinopril - ACEi

30
Q 
Which of the following is not a direct branch of the aorta?
Right coronary artery 
Left common carotid artery 
Brachiocephalic artery 
Left coronary artery 
Right common carotid artery
A

right common carotid

brachiocephalic splits into right subclavian + right common carotid

31
Q

first degree heart block

A

prolonged PR interval (>0.2s/5small square)

32
Q

second degree heart block, mobitz 1 vs mobitz 2

A

mobitz 1 = progressive prolongation of PR intergal until eventually QRS is dropped

mobitz 2 = consistent PR interval duration with intermittently dropped QRS complex

33
Q

heart condition assoc with Ehlers-Danlos

A

aortic dissection

34
Q

aortic dissection vs ruptured AAA

A

aortic dissection = tear in aortic intima creating false lumen with ortic media, tearing chest pain, aortic regurg (diastolic murmur), hypertension

AAA = hypotensive, pain lower down

35
Q

septal, anterior and lateral ECG leads

A 
V1 = septal
V2 = septal
V3 = anterior
V4 = anterior
V5 = lateral
V6 = lateral
36
Q

scoring system for infective endocarditis

A

duke criteria - diagnosis of infect endocard)

*dukes staging = severity of colorectal cancer

37
Q

DVT risk calculation

A

Wells score

38
Q

drug to stop oesophageal varice bleeding?

A

terlipressin - causes vasoconstriction

–> secondary prevention = propanolol

39
Q

skip lesions on endoscopy

A

crohns

40
Q

what do G cells secrete

A

gastrin

41
Q

what do enterochromaffin like cells secrete

A

histamine

42
Q

what do chief cells secrete

A

pepsinogen

pepsin formed by pepsinogen secreted by the chief cells

43
Q

which cells secrete hydrochloric acid?

A

parietal

44
Q

which cells secrete somatostatin

A

D cells

45
Q

A 47 year-old lady presents with RUQ pain. She appears is confused and systemically unwell with a high fever and low blood pressure. Physical examination reveals jaundice. She is known to have gallstones.
most likely diagnosis?

A

cholangitis

  • > charcots triad = RUQpain, jaundice, fever
  • history of gallstones
46
Q

Mx of cholangitis

A

IV antibiotics + ERCP to relieve obstruction

47
Q

acute cholecystitis vs cholangitis

A

cholangitis = RUQ pain, jaundice, fever

acute cholecystitis = positive murphys sign, no jaundice or hypotension

48
Q

murphys sign positive

A

acute cholecystits

49
Q

unresponsive peptic ulcer disease + urea breath test positive, management?

A

omeprazole + amoxicillin + metronidazole/clarithromycin

pen allergy = omeprazole + clarithromycin + metronidazole

50
Q

coeliac findings on biopsy

A

villous atrophy

51
Q

crypt abscesses on biopsy

A

UC

52
Q

difference between wilsons + haemochromatosis?

A

wilsons = copper, kayser-fleischer rings

haemochromatosis = iron, ferritin, bronzed diabetic

53
Q

A 27 year old woman presents to her GP with a unilateral hand tremor. She is also concerned because she feels that she has been experiencing mood changes. On examination, greenish-brown discolouration is seen around her eyes. The patient reports that her uncle died of liver cirrhosis at the age of 40 years.
What is the most likely diagnosis?

A

Wilsons

-> copper accumulation, tx = copper binding drugs (penicillamine)

54
Q

COPD vibes in non-smoker

A

alpha1 anti-trypsin deficiency

-> emphysema + cirrhosis due to excessive breadown of elastin

55
Q

gastroenteritis 24hr history after cruise ship holiday

A

norovirus

56
Q

tumour marker of hepatocellular carcinoma

A

alpha-fetoprotein

57
Q

CEA tumour marker

A

colorectal cancer

first year med (15 decks)

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