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S5 > A1 IHS SAQ (2022/2023) > Flashcards

A1 IHS SAQ (2022/2023) Flashcards

1
Q

Compare the structure and function of compact bone and spongy bone (8)

A

Spongy vs Compact Bones
* Spongy Bones are also called cancellous bones
* They light, spongy and soft in nature
* They are made up of trabeculae
* They fill the inner layer of most bones
* Bone marrow cavity absent
* Bone marrow produces red corpuscles and white granular corpuscles
* It forms the epiphyses of long bones
* Trabeculae do not contain arteries

  • Compact bones are also called cortical bones
  • They are heavy, tough and compact in nature
  • They are made up of osteons
  • They fill the outer layer of most bones
  • Bone marrow cavity present in the centre
  • Bone marrow stores fat
  • It forms the diaphysis of long bones
  • Osteons contain arteries
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2
Q

Normocytic anemia causes

A

Any four:
* Blood loss
* Haemolysis
* Anaemia of chronic disease
* Renal disease
* Mixed nutritional (iron, b12/folate) deficiency
* Bone marrow failure (e.g. drugs, infiltration

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3
Q

List 2 red blood cell abnormalities that are causes of splenomegaly.

A

Hereditary spherocytosis
Sickle cell anaemia

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4
Q

Identify two metabolites that accumulate in body fluids and are used to confirm an acute
porphyric attack.

A

d-ALA, PBG

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5
Q

List and briefly describe 3 biochemical parameters by which the laboratory can distinguish
between in vivo and in vitro haemolysis

A
  • Unconjugated bili not raised (no time for haem metabolism)
  • Potassium often highly raised (released from red cell cytoplasm)
  • Haptoglobin is not decreased
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6
Q

Outline 3 ways to avoid causing haemolysis when performing a venesection

A

Avoid small needles
Transport tubes carefully
Avoid drawing rapidly

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7
Q

Acute porphoria gene invovled?

A

PPOX

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8
Q

What should drip contain - porphyric patient

A

Dextrose

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9
Q

3 Severe malaria symptoms?

A

Non-ambulant
Jaundice
Impaired mental functioning

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10
Q

Draw interaction between splenic dendritic cell and CD4+ T cell

A

Dendritic cell:
MHC II presenting peptide antigen
CD80/86

CD4 cell:
TCR
CD28
CD4

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11
Q

List 2 cytokines which would activate the CD4+ T cell to a Th1 phenotype?

A

IL-12, IFN-y

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12
Q

Name 2 plasma cell disorders other than myeloma

A

Amyloidosis
MGUS

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13
Q

State the name of the neoplastic cell in Hodgkin lymphoma.

A

Reed-sternberg

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14
Q

Name in full 3 pathogens that are associated with neutropenic sepsis.

A

Staph aureus
Escherichia coli
Klebsiella pneumonia

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15
Q

Define positive selection (T cell development)

A

Binding of TCRs of mature T cells to MHC in the thymus

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16
Q

Define negative selection (T cell development)

A

Removal of T cells that bind too strongly to self antigen presented on MHC

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17
Q

Why is negative selection of T cells important?

A

Prevents the formation of self reactive T cells.

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18
Q

Identify any four factors that are used to define the metabolic syndrome.

A
  • Increased waist circumference (Abdominal obesity)
  • Elevated triglycerides
  • Low HDL cholesterol
  • Elevated blood pressure
  • Raised blood glucose
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19
Q

List 2 causes for raised reticulocytes

A

Bleeding, haemolysis

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20
Q

Define hemolytic anemia

A

Reduced red cell survival, peripheral destruction

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21
Q

List 5 symptoms related to hyperviscosity of blood

A

Peripheral neuropathy
Gout
Headaches
Blurred vision
Hypertension

22
Q

Name the enzyme effected for both anemia and neurological disease caused by VitB12 deficiency

A

Methionine synthase

23
Q

List 2 malaria chemoprophylactic agents

A

Malarone
Doxycycline

24
Q

Define hyperparasitemia

A

> 5% parasitized RBCs

25
Q

Is Beta-thalassemia a quantitative or qualitative hemoglobinopathy? Why?

A

Quantitative. Produces correct structure, but not enough

26
Q

What is an advantage of being a haemoglobinopathy carrier?

A

Protection from cerebral malaria

27
Q

How do haemaglobinoapthies protect against severe malaria?

A

Ineffective haemopoeisis
Increased hemolysis

28
Q

What is the inheritence of beta-thalassemia

A

autosomal recessive

29
Q

List components of CD8 immunological synapse with liver cell

A

TCR binding to peptide presented on MHC-I
CD8+ stabilize
Fas on liver cell binding to Fas-ligand on CD8+ cell

30
Q

ADCC activates which cells?

A

NK cells

31
Q

Describe 3 stages in development of haematopoeitc system

A

Primitive, pro-definitive, definitive stages.

Primitive stage:
Blood islands along yolk sac
produces large nucleated RBCs, megakaryocytes, macrophages - invade embryo

Pro-definitive:
Generates eryhro-myeloid progenitors and lympho-myeloid progenitors

Definitive:

Dorsal aorta cells - produce clusters of HSCs located in lumen of aora through EHT

Pro-definitive and definitive wave progenitors travel to liver - RBCs, megakaryocytes, granulocytes, T/B cells, monocytes formed

32
Q

What are B symptoms?

A

temperature >38 degrees C
night sweats
>10% weight loss over 6 months

33
Q

Outline any three (3) possible clinical presentations caused by the infiltration of blasts into soft tissues and detectable by X-Ray examination.

A

Mediastinum mass - SOB
Lung parenchyma - SOB
Pleural effusion - SOB
Bone lesions - bone pain

34
Q

Name the Ph negative neoplasm associated with massive splenomegaly

A

Primary myelofibrosis

35
Q

Anele Makhamba is found to have splenomegaly associated with her diagnosis of leukaemia. List any five (5) other causes of splenomegaly

A

Congestion
Infection
Metastasis of neoplasm
RBC abnormalities
Autoimmunity
Storage disorders
Amyloidosis

36
Q

Differential diagnosis of generalized lymphoadenopathy

A

TB
HL
Burkitt lymphoma
Mono

37
Q

What investigations can be used to invest lymphadenopathy

A

Sputum
Needle biopsy

38
Q

How can lab tests assess renal function

A

Measure plasma creatinine - estimate GFR with equations

39
Q

Outline progression of acute varicella infection

A

Skin rash
Lesions at multiple stages of development
Macule - papule - vesicles - scabs
Itchy

40
Q

List complications of acute varicella infection in child

A

Secondary bacterial infection
Pneumonia
encephalitis
stroke
hemorrhagic varicella

41
Q

Outline implications of neonate whose mother had acute varicella infection during pregnancy

A

If <20 wk:
congenital varicella with microphtalmia, limb hypoplasia, skin scarring

If >20wk:
Risk of zoster early in life

Perinatal:
Neonatal varicella - severe infection.

42
Q

What class of hormone is cortisol

A

Steroid hormone, cholesterol precursor

43
Q

Compare storage of steroid and peptide hormones

A

Steroid hormones - not stored

Peptide hormones - membrane bound

44
Q

How would you screen for retinopathy?

A

Fundoscopy

45
Q

List three (3) microscopic lesions Kyle may develop in his kidneys as a result of poorly controlled
diabetes and provide a brief explanation of the pathogenesis of each. (6 marks)

A

Pappilary necrosis - ischemia

Pyelonephritis - glucose in urine cultures bacteria, poor inflammatory response

Glomerulosclerosis - proteinuria

46
Q

Dipstix of DKA

A

+++ glucose
+++ ketones

47
Q

Define non-thyroidal syndrome

A

Sick euthyroid syndrome - thyroid function changes due to severe illness

48
Q

What is the worst outcome of hypoglycemia

A

Coma - death

49
Q

Why is glucagon raised in diabetics?

A

No insulin. Insulin usually inhibits glucagon release

50
Q

Why can insulin and glucagon not enter cells?

A

Large polypeptides - too large and charged to cross plasma membrane

Requires membrane protein as receptor - second messenger systems

51
Q

Identify key difference between glycogen stores in liver vs glycogen stores in muscle

A

Glycogen stores in liver used to maintain constant BLOOD glucose levels in eg. fasted stated

In muscle, in low glucose states, glycogen stores used to replenish glucose to generate energy for muscle itself to use

S5 (21 decks)

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