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Question 1

what is the unhappy triad

Answer 1

MCL injury, ACL rupture, medial meniscus tear (usually from a valgus force )

Question 2

what is another name for Jacks test

Answer 2

Hubscher’s manoeuvre-it involves dorsiflexion of the great toes to see if this exaggerates the medial arch formation, if it does then you have mobile flat footedness if not you have rigid flat footedness

Question 3

how is the bone affected in osteoporosis

Answer 3

quantitiative defect of bone

Question 4

how is the bone affected in osteomalacia

Answer 4

qualitative defect in bone with abnormal softening of bone due to deficient mineralisation of osteoid (immature bone)

Question 5

what is an osteoid osteoma

Answer 5

small nidus of immature bone surrounded by an intense sclerotic halo, most commonly in adolescence and common sites are proximal femur, diaphysis of long bones and vertebrae, usually small, lesss than 1.5cm in diameter

Question 6

what type of drug is latanoprost

Answer 6

prostaglandin

Question 7

what does latanoprost do

Answer 7

can be used to treat ocular hypertension and open angle glaucoma

Question 8

how does latanoprost work

Answer 8

it increases the uveoscleral outflow

Question 9

what should eye pressures be below

Answer 9

21mmhg

Question 10

what is scleritis associated with

Answer 10

50% have systemic disease eg RA, GPA

Question 11

give the appearance of scleritis

Answer 11

large injected vessels, may have headache or photophobia, very painful ocular movements, eye is very painful

Question 12

how do you treat scleriits

Answer 12

NSAIDS and very high dose steroids

Question 13

how is endopthalmitis treated

Answer 13

intravitreal amikacin and vancomycin

Question 14

how is bacterial keratitis treated

Answer 14

ofloxacin

Question 15

how often does keratitis need to be treated

Answer 15

need admission so that hourly drops can be administered

Question 16

what does keratitis look like

Answer 16

white area on the cornea-hypopyon usually

Question 17

what does a viral keratitis have

Answer 17

a dendritic ulcer

Question 18

what are the symptoms of open angle glaucoma

Answer 18

there are no symptoms, non painful but can get gradual progressive visual field loss

Question 19

duct of stenson connects to what gland

Answer 19

parotid

Question 20

what type of cells does small cell lung cancer come from

Answer 20

neuroendocrine cells

Question 21

what does the flatter upper part of the oxyhaemoglobin curve mean

Answer 21

that a moderate fall in alveolar PO2 will not much affect oxygen loading

Question 22

what does a steep lower part

Answer 22

means peripheral tissue gets a lot of O2 for a small drop in capillary po2

Question 23

what does the bohr effect do

Answer 23

facilitates the removal of o2 from haemoglobin at tissue level by shifting the o2-hb dissociation to the right

Question 24

what is residual volume

Answer 24

the min volume of air remaining in lungs even after maximal expiration

Question 25

what is functional residual volume

Answer 25

volume of air left in lungs after passive expiration

Question 26

what forms from the first pouch

Answer 26

Eustachian tube, middle ear, tympanic membrane

Question 27

what forms from the first cleft

Answer 27

external auditory meatus

Question 28

what are the otic placodes

Answer 28

thickenings of the ectoderm, one on each side overlying the hindbrain-rhombencephalon

Question 29

what does the utricular portion give rise to

Answer 29

the semicircular canals

Question 30

what does the saccular portion give rise to

Answer 30

the cochlea

Question 31

what is the difference in erythema and purpura

Answer 31

purpura is due to the extravasation of blood so it will not blanche but erythema is due to vascular dilatation so it will blanche on pressure

Question 32

what is petechial defined as

Answer 32

micro-haemorrhage 1-2mm in diameter

Question 33

what is littles area

Answer 33

where the anterior ethmoidal, sphenopalatine and facial arteries anastomose

Question 34

pencil in a cup deformity

Answer 34

psoriatic arthritis

Question 35

what are the symptoms of glaucoma

Answer 35

asymptomatic until visual field are badly impaired

Question 36

what are the risk factors for glaucoma

Answer 36

black race, family history, increasing age and hypertension and diabetes

Question 37

what type of vision predisposes to chronic open angle glaucoma

Answer 37

myopic

Question 38

what type of vision predisposes to closed angle glaucoma

Answer 38

hypermetropic

Question 39

what are some of the complications of glaucoma

Answer 39

vision loss, central retinal artery or vein occlusion and repeated episodes in either eye

Question 40

what are the causes of central retinal vein occlusion

Answer 40

glaucoma, polycythaemia, hypertension

Question 41

what is MEN I

Answer 41

parathyroid hyperplasia, pituitary adenoma, pancreatic tumours

Question 42

what type of tumours are in MENIIA

Answer 42

parathyroid hyperplasia, phaeochromocytoma, medullary thyroid cancer

Question 43

what type of tumours are in MEN IIB

Answer 43

phaeochromocytoma, medullary thyroid cancer, mucosal neuroma

Question 44

when examining the eyes what 5 things do you do/check

Answer 44

``` (inspect the eyes) visual acuity visual fields external eye movements fundi pupils ```

Question 45

what is the presentation of bacterial keratitis

Answer 45

rapid onset of pain, photophobia and decreased vision

Question 46

what does gluteus maximus do

Answer 46

extend the hip

Question 47

what does gluteus medius and minimus do

Answer 47

ABduct and medially rotate the hip

Question 48

what does the deep muscles of the hip do

Answer 48

laterally rotate the thigh and hip

Question 49

what is the nerve supply to the posterior thigh and what are its nerve roots

Answer 49

all supplied by the tibial division of sciatic nerve (L5,S1,S2) apart from short head of biceps femoris which is supplied by common fibular division of sciatic

Question 50

what is the nerve supply to the hamstring part of the adductor magnus

Answer 50

tibial nerve -L5,S1,S2

Question 51

what is the nerve supply to the short head of biceps

Answer 51

the common fibular nerve

Question 52

what are the nerve roots of the deep fibular nerve

Answer 52

L4,L5

Question 53

what are the nerve roots of the superficial fibular nerve

Answer 53

L5,S1,S2

Question 54

how do superficial lymph from the lower limb drain

Answer 54

follow saphenous veins, drain to superficial inguinal lymph nodes then to external iliac lymph nodes

Question 55

how do deep lymphatics from the lower limb drain

Answer 55

follow deep veins (popliteal lymph nodes) to deep inguinal nodes to external to common iliac to lumbar lymphatics

Question 56

what are the hip joint ligaments

Answer 56

iliofemoral, pubofemoral, ischiofemoral | they spiral from pelvis to femur

Question 57

what is the course of the obturator nerve

Answer 57

the obturator nerve, artery and vein enter the medial compartment of the thigh via the obturator foramen of the hip bone the nerve then divides into anterior and posterior at the upper border of adductor brevis

Question 58

what is the neurovascular bundle superficial to deep

Answer 58

``` tibial nerve (from sciatic) popliteal vein (posterior tibial) popliteal artery (continuation of femoral) lymphatics-popliteal lymph nodes are located along the popliteal vein in the fossa ```

Question 59

what does the ACL help prevent against

Answer 59

anterior displacement of the tibia on the femur and hyperextension of the knee joint also resists internal rotation

Question 60

what does PCL prevent against

Answer 60

posterior displacement of the tibia on the femur and helps prevent against hyperflexion of the joint

Question 61

what does genu varum increase the risk of

Answer 61

medial OA

Question 62

what separates the anterior and lateral compartments of the leg

Answer 62

the ANTERIOR intermuscular septum

Question 63

where does the fibularis longus attach distally

Answer 63

the fibularis longus passess beneath the sole of the foot to reach the bases of the 1st metatarsal

Question 64

where does the fibular brevis attach distally

Answer 64

base of the 5th metatarsal

Question 65

what forms the anterior wall of the axilla

Answer 65

pec major

Question 66

what is the axillary vein a continuation of

Answer 66

the brachial vein, it becomes the axillary vein at the lower border of teres major

Question 67

what is an eponychium

Answer 67

cuticle

Question 68

how do you treat hyperkalaemia

Answer 68

10mls of 10% calcium gluconate ASAP

Question 69

where is the quadrangular membrane

Answer 69

between vestibular ligament and epiglottis

Question 70

where is the conus elasticus

Answer 70

between cricoid and vocal ligament

Question 71

what is serostitis

Answer 71

inflammation of a serous membrane eg lungs, or pericardium

Question 72

what is there an accelerated risk for in SLE

Answer 72

IHD

Question 73

what can steroids cause in relation to the eye

Answer 73

cataracts and glaucoma

Question 74

what are the thyroid function results in sick euthyroid

Answer 74

everything may be low TSH, T3 and T4 (or TSH may be normal)

Question 75

where do amiloride and triamtere act

Answer 75

they block luminal Na channels on the apical membrane in late distal tubule and collecting ducts

Question 76

how do spironolactone and eplerenone wor

Answer 76

compete with aldosterone for binding to intracellular receptors causing decreased gene expression and reduced synthesis of a protein mediator that activated Na channels in apical

Question 77

what are aquaretics/vaptans

Answer 77

vasopressin receptor antagonists

Question 78

what do aquaretics/vaptans cause

Answer 78

an electrolyte free aquaresis, decrease urine osmolality increase serum sodium used in SIADH, CHF, cirrhosis

Question 79

where are Askanazy/Hurtle cells found

Answer 79

in Hashimotos thyroiditis and follicular thyroid cancer

Question 80

what is the gold standard test for acromegaly

Answer 80

GTT

Question 81

what does aldosterone cause excretion of

Answer 81

potassium

Question 82

what can malignant hyperparathyroidism cause

Answer 82

PThrP is formed by malignant squamous cell carcinomas, it mimics PTH resulting in decreased PTH, increased calcium and increased phosphate

Question 83

what is the issue with pseudohypoparathyroidism

Answer 83

it is PTH resistant

Question 84

what cancer is associated with SIADH

Answer 84

small cell lung cancer