8

Question 1

what does electromyography in likely MND show

Answer 1

a decrease in number of action potentials with increase in amplitude

Question 2

is chronic inflammation usually primary or secondary

Answer 2

usually primary

Question 3

describe the main features of chronic inflammation

Answer 3

angiogenesis predominates, macrophages, plasma cells and lymphocytes
healing by fibrosis

Question 4

when could you get splenic atrophy

Answer 4

coeliac disease

Question 5

in terms of peritoneum where is spleen located

Answer 5

almost entirely covered in peritoneum which adheres firmly to its capsule
recesses of greater sac separate it from the stomach and kidney

Question 6

what is most associated with early onset alz

Answer 6

presenilin 1

Question 7

what type of cells are seen in CLL

Answer 7

smear cells

Question 8

what is the mutation in sickle cell disease

Answer 8

point mutation in B chain and predisposes haemoglobin to polymerisation resulting in sickled cells and decrease RBC survival

Question 9

what are hereditary thrombophilias caused by

Answer 9

Factor V Leiden, antithrombin III deficiency, protein C deficiency, protein S deficiency

Question 10

what can female cells show

Answer 10

Barr bodies-inactivated condensed X chromosome

Question 11

where is the substantia gelatinosa and what does it do

Answer 11

pain and temperature in posterior horn

Question 12

describe pathway of anterior corticospinal tract (also called ventral)

Answer 12

the neurones converge and descend through the internal capsule
they remain ipsilateral, decussate and terminate in ventral horn of cervical and upper thoracic

Question 13

describe pathway of lateral corticospinal tract

Answer 13

neurones converge and descend through internal capsule, decussate in medulla and then terminate in the ventral horn

Question 14

what are the 2 parts of corticospinal tract and spinothalamic tract

Answer 14

both have anterior and lateral parts

Question 15

what does anterior spinothalamic tract carry

Answer 15

sensory modalitites of pressure and crude touch

Question 16

what does lateral spinothalamic tract carry

Answer 16

pain and temperature

Question 17

what do the 1st order neurones in spinothalamic tract do

Answer 17

arise from sensory receptors in periphery-enter spinal cord, ascend 1-2 vertebral levels and synapse in tip of dorsal horn-substantia gelatinosa

Question 18

what do second order neurones in spinothalamic tract do

Answer 18

from substantia gelatinosa to thalamus, they decussate within the cord and form 2 tract

Question 19

what 2 tracts does spinothalamic form

Answer 19

anterior and lateral

Question 20

where can ovarian tumours be derived from

Answer 20

surface epithelium, sex cord/stromal tumours, germ cell tumours

Question 21

name the types of germ cell ovarian tumours

Answer 21

teratoma, dysgerminoma, choriocarcinoma, yolk sac tumour

Question 22

name the types of sex cord/stromal tumours

Answer 22

fibroma, thecoma-granulosa, sertoli-leydig

Question 23

what are the main features of brenner tumour

Answer 23

usually benign, contain Watthard cell rests

typically coffee bean nuclei

Question 24

what is the other name for alemtuzumab

Answer 24

lemtrada

Question 25

how does lemtrada work

Answer 25

it acts against T cells in relapsing-remitting MS

Question 26

what is other name for Tysabri

Answer 26

natalizumab

Question 27

how does natalizumab/Tysabri work

Answer 27

acts against VLA-4 receptors that also allow immune cells

Question 28

what is the precursor to squamous cervical cancer

Answer 28

Cervical Intraepithelial Neoplasia-CIN

Question 29

what is the precursor to adenocarcinoma cervical cancer

Answer 29

Cervical Glandular Intraepithelial Neoplasia-CGIN

Question 30

when is a burst fracture typically seen

Answer 30

In young patients with trauma | there is involvement of the posterior elements

Question 31

when do you get a wedge fracture

Answer 31

typically in thoracic spin in patients with osteoporosis, metastatic disease (bony mets) and osteogenesis imperfect

Question 32

link between MND and FTD is because of

Answer 32

C90RF hexanucleotide repeat expansions

Question 33

wasting of thenar eminence is present in

Answer 33

MND

Question 34

what are the muscles of thenar eminence

Answer 34

Opponens pollicis Abductor pollucis brevis flexor pollicis brevis

Question 35

what are the muscles of thenar eminence supplied by

Answer 35

median nerve

Question 36

describe type I fibres

Answer 36

slow oxidative ATP from oxidative phosphorylation slow contraction and relaxation-fatigue resistant red fibres=high myoglobin content

Question 37

describe type II fibres

Answer 37

2 categories-type IIA=oxidative phosphylation-fast contraction and relaxation, fatigue resistant type IIB=ATP from glycolysis, fast contraction but NOT FATIGUE RESISTANT, pale in colour and poorly vascularised

Question 38

where are Golgi tendon organs forund

Answer 38

at the junction of muscle and tendon

Question 39

what do Golgi tendon organs do

Answer 39

monitor changes in muscle tension

Question 40

what is the relation to Golgi tendon organs and extrafusal fibres

Answer 40

in series with extrafusal fibres (intrafusal fibres in parallel with extrafusal fibres)

Question 41

what are Golgi tendon orgnas innervated by

Answer 41

Ib sensory afferents (these are myelinated and slightly slower conducting than 1a)

Question 42

most important prognostic indicator in VIN

Answer 42

spread to inguinal lymph nodes

Question 43

what is the motor neurone pool

Answer 43

collection of alpha motor neurones that innervate a single muscle

Question 44

side effects of carbamazepine

Answer 44

leucopenia, diplopia, blurred vision, impaired balance, drowsiness, mild generalised rash, SIADH

Question 45

side effects of lamotrigine

Answer 45

SJS, TEN, diplopia, blurred vision, photosensitivity, tremor, agitation, vomiting, aplastic anaemia

Question 46

side effects sodium valporate

Answer 46

VALPORATE-alopecia, liver failure-watch LFTs, pancreatitis, oedema, ataxia, teratogenicity, tremor, thrombocytopaenia, encephalopathy (due to increased ammonia)

Question 47

side effects for phenytoin

Answer 47

nystagmus, diplopia, tremor, dysarthria, ataxia, decreased intellect, depression, corase facial features, acne, gum hypertrophy, polyneuropathy, gum dyscrasis

Question 48

dacrocytes are typical of

Answer 48

myelofibrosis

Question 49

how do you test for complement deficiency

Answer 49

normal IgG and vaccine response but symptoms of primary immunodeficiency disease main test is CH50 and AP50 test

Question 50

describe paroxysmal hemicranias

Answer 50

typically in the elderly women>men shorter duration and more frequent than cluster severe unilateral headache, autonomic features 10-30mins 1-40 a day absolute response to INDOMETHACIN

Question 51

what is first line treatment for trigeminal neuralgia

Answer 51

carbamazepine

Question 52

what is the typical position of the uterus in endometriosis and why

Answer 52

fixed retroverted from scar tissue which forces uterus out of its normal position

Question 53

which TCAs are the most dangerous in overdose

Answer 53

dosulepin and amitriptyline

Question 54

what is Uhthoffs phenomenon

Answer 54

worsening of vision following increase in body temperature

Question 55

Lhermitte's syndrome

Answer 55

paraesthesia in limbs on neck flexion

Question 56

what is a straddle fracture

Answer 56

fracture to all 4 pubic rami

Question 57

what does prothrombin time look at

Answer 57

TF/VIIa | extrinsic system

Question 58

the extrinsic pathway is looked at by what

Answer 58

prothrombin time

Question 59

what does intrinsic pathway measure

Answer 59

APTT

Question 60

what is hairy leukoplakia caused secondary to

Answer 60

EBV