8 Flashcards

1
Q

what does electromyography in likely MND show

A

a decrease in number of action potentials with increase in amplitude

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

is chronic inflammation usually primary or secondary

A

usually primary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe the main features of chronic inflammation

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when could you get splenic atrophy

A

coeliac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

in terms of peritoneum where is spleen located

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is most associated with early onset alz

A

presenilin 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what type of cells are seen in CLL

A

smear cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the mutation in sickle cell disease

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are hereditary thrombophilias caused by

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can female cells show

A

Barr bodies-inactivated condensed X chromosome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

where is the substantia gelatinosa and what does it do

A

pain and temperature in posterior horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

describe pathway of anterior corticospinal tract (also called ventral)

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

describe pathway of lateral corticospinal tract

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the 2 parts of corticospinal tract and spinothalamic tract

A

both have anterior and lateral parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does anterior spinothalamic tract carry

A

sensory modalitites of pressure and crude touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what does lateral spinothalamic tract carry

A

pain and temperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what do the 1st order neurones in spinothalamic tract do

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what do second order neurones in spinothalamic tract do

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what 2 tracts does spinothalamic form

A

anterior and lateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

where can ovarian tumours be derived from

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

name the types of germ cell ovarian tumours

A

teratoma, dysgerminoma, choriocarcinoma, yolk sac tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

name the types of sex cord/stromal tumours

A

fibroma, thecoma-granulosa, sertoli-leydig

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are the main features of brenner tumour

A

usually benign, contain Watthard cell rests

typically coffee bean nuclei

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the other name for alemtuzumab

A

lemtrada

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how does lemtrada work

A

it acts against T cells in relapsing-remitting MS

26
Q

what is other name for Tysabri

A

natalizumab

27
Q

how does natalizumab/Tysabri work

A

acts against VLA-4 receptors that also allow immune cells

28
Q

what is the precursor to squamous cervical cancer

A

Cervical Intraepithelial Neoplasia-CIN

29
Q

what is the precursor to adenocarcinoma cervical cancer

A

Cervical Glandular Intraepithelial Neoplasia-CGIN

30
Q

when is a burst fracture typically seen

A

In young patients with trauma

there is involvement of the posterior elements

31
Q

when do you get a wedge fracture

A

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

32
Q

link between MND and FTD is because of

A

C90RF hexanucleotide repeat expansions

33
Q

wasting of thenar eminence is present in

A

MND

34
Q

what are the muscles of thenar eminence

A

Opponens pollicis Abductor pollucis brevis flexor pollicis brevis

35
Q

what are the muscles of thenar eminence supplied by

A

median nerve

36
Q

describe type I fibres

A

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

37
Q

describe type II fibres

A

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

38
Q

where are Golgi tendon organs forund

A

at the junction of muscle and tendon

39
Q

what do Golgi tendon organs do

A

monitor changes in muscle tension

40
Q

what is the relation to Golgi tendon organs and extrafusal fibres

A

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

41
Q

what are Golgi tendon orgnas innervated by

A

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

42
Q

most important prognostic indicator in VIN

A

spread to inguinal lymph nodes

43
Q

what is the motor neurone pool

A

collection of alpha motor neurones that innervate a single muscle

44
Q

side effects of carbamazepine

A

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

45
Q

side effects of lamotrigine

A

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

46
Q

side effects sodium valporate

A

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

47
Q

side effects for phenytoin

A

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

48
Q

dacrocytes are typical of

A

myelofibrosis

49
Q

how do you test for complement deficiency

A

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

50
Q

describe paroxysmal hemicranias

A

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

51
Q

what is first line treatment for trigeminal neuralgia

A

carbamazepine

52
Q

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

A

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

53
Q

which TCAs are the most dangerous in overdose

A

dosulepin and amitriptyline

54
Q

what is Uhthoffs phenomenon

A

worsening of vision following increase in body temperature

55
Q

Lhermitte’s syndrome

A

paraesthesia in limbs on neck flexion

56
Q

what is a straddle fracture

A

fracture to all 4 pubic rami

57
Q

what does prothrombin time look at

A

TF/VIIa

extrinsic system

58
Q

the extrinsic pathway is looked at by what

A

prothrombin time

59
Q

what does intrinsic pathway measure

A

APTT

60
Q

what is hairy leukoplakia caused secondary to

A

EBV