CAP Test 2016 3rd Year Flashcards
In advanced CKD, what are often needed to maintain serum phosphate within the normal range?
phosphate binders
Does phosphate tend to be low or high in CKD?
high
Under what level of iron in the blood should require blood transfusion rather than just oral iron?
8g/l
When is IV iron indicated?
if there is no response to oral iron or a rapid increase in haemoglobin is needed e.g. major surgery
If one pill was missed in a pack, what should be advised?
take the missing pill now, resume as normal with next pill
When should extra measures be taken with missed contraceptive pills?
if two or more pills have been missed
What colour is CSF in viral meningitis?
clear
What does xanthochromic CSF suggest?
subarachnoid haemorrhage
What does cloudy CSF suggest?
acute bacterial infection
What colour is CSF normally or in MS?
clear
What would the predominant white cells in CSF be in an acute bacterial infection?
neutrophils
In whom are oligoclonal bands present?
MS patients (over 90%)
Does protein level increase or decrease in an acute bacterial infection on CSF?
increase
How are neutrophils recognized?
segmented nucleus
Which 3 cell types have segmented nuclei?
neutrophils, eosinophils and basophils
How can basophils be identified?
purple/black striking granules
How can eosinophils be identified?
red striking granules
Are neutrophils raised in pyogenic infections?
yes
What is the area responsible for receptive aphasia?
Wernicke’s area
What is the area responsible for expressive aphasia?
Brocca’s area
What is the area responsible for nominal aphasia?
angular gyrus
What would be the cause for amenorrhea in a teenager who has never had a period, but whose breasts have developed and is a normal height and weight?
imperforate hymen
Secondary amenorrhea, and previous chemotherapy?
POF
Secondary amenorrhea with facial/abdominal hair growth?
PCOS
What may explain bilateral leg oedema?
low serum albumin, which could be caused by nephrotic syndrome, where proteinuria occurs
Dysfunction of what causes dysfunction of the posterior columns of the spinal tract?
B12
What is the main mechanism of action of lamotrigine?
blockage of voltage sensitive sodium channels
Mode of inheritance for Wilson’s?
Autosomal recessive
Mode of inheritance for Becker’s MD?
X linked recessive
Mode of inheritance for myoclonic epilepsy with ragged red fibres?
mitochondrial
What is activated by the lectin, classic and alternative pathways?
c3
Should strength and balance training before knee replacement be recommended?
YES
Which abnormality of the HPA axis is associated with depression?
Cortisol non suppression following dexamethasone suppresion
Is anaemia common in patients with CKD? What treatment is needed?
yes, erythropoetin
What severity of learning disability is an IQ of 45?
moderate
Patient with a mother affected by breast cancer at 48, no other family history - what is risk?
slightly above population risk
Name a part of the peripheral nervous system containing parasympathetic nerves?
cranial nerve
What carries somatic sensory nerve fibres, which innervate upper limb structures?
anterior rami of thoracic and cervical spinal nerves
What is located in the most posterior part of the brain and is associated with the visual pathway?
calcarine sulcus
Flagellated protozoa, foul smelling discharge, STI?
trichomonas vaginalis
SPECT scan shows patchy attenuation throughout brain?
vascular dementia
Which hormone determines whether a woman has ovulated?
progesterone
Which hormone should be used to assess ovarian reserve before IVF treatment?
Anti-mullerian hormone
Which hormone could assess diagnosis of potential ectopic pregnancy?
HCG
Can chronic lung disease occur with prematurity?
no
List some complications associated with prematurity.
Intraventricular haemorrhage
Sepsis
Patent ductus arteriosis
RDS
If there is a pelvic infection eg chlamydia, what method of contraception should be used?
implant (intra uterine devices contraindicated here)
Anaemia, bone pain, renal failure and hypercalcaemia?
myeloma
Is the presence of a large paraprotein enough to be sure of the diagnosis of myeloma without a bone marrow result?
yes
Painless jaundice, exertional dyspnea and Direct Antiglobulin Test positive suggests what?
AUTOIMMUNE haemolytic anaemia
Generalised tonic clonic seizure lasting more than 5 minutes? Treatment?
status epilepticus, treatment = IV lorazepam
Treatment of gonnorhea?
IM ceftriaxone and oral azithromycin
Treatment of trichomonas?
metronidazole
Healthy start vitamins for pregnant women are most likey to avoid what?
rickets/osteomalacia
Embryo implants into uterus as a what?
blastocyst
With ageing, can body weight remain the same despite muscle loss?
yes
Screening for breast cancer?
from age 50, every 3 years
Diabetic retinopathy screening?
from age 12 every year
What type of drug is galantamine?
cholinesterase inhibitor
Which nerve can be injured by a pituitary adenoma?
CNII
Which nerve can cause pain across the posterior triangle of the neck?
CNVII
Name a type of cancer associated with a high CA125 index.
ovarian
Is warfarin contraindicated in breastfeedinh?
no
Is tertracycline contraindicated in breastfeeding?
yes
Which area of the brain is affected first in Alzheimer’s?
nucleus basalis of Meynert
Belief of people plotting against them, talking about them, fashions weapons?
Paranoid schizophrenia
Voices told her to kill her baby?
Puerpal psychosis
What type of drug may cause gout?
benzoflumethiazide (thiazide diuretic)
All food has metallic taste, like someone is poisoning me?
gustatory hallucination
Can’t get rid of bad smell no matter what, others cannot smell it
olfactory hallucination
Which genetic cause of learning disability increases risk of schizophrenia?
Velocardiofacial syndrome
URTI and macroscopic haematuria?
IgA nephropathy
Is haematuria a typical feature of minimal change nephropathy?
no
Is prenatal testing for Huntington’s possible?
yes
When should soap and water be used?
before inserting a cannula, if hands are visibly soiled, or dealing with MRSA or c.difficile
Which artery is most likely to bleed during insertion of a lateral abdominal port in a female laporoscopic procedure?
inferior epigastric artery
Which artery is most likely to bleed during incision of a BArtholin’s abscess?
inferior pudendal artery
Which artery is most likely to bleed during dissection of the lower end of the ureter?
uterine artery
With AKI, should an ultrasound always be requested?
yes
Green nipple discharge, lump, more common in smokers?
duct ectasia
minor accident + breast lump?
fat necrosis
Hot tender breast with overlying cellulitis, antibiotics do not fix?
inflammatory breast cancer
Biceps reflex, matching nerve root?
c5/6
ankle reflex, matching nerve root?
s1
Knee reflex, matching nerve root?
l3/4
Blood pressure tablet to reduce proteinuria eg in IgA nephropathy?
lisinopril
Poor memory, abnormal limb movements unable to control, family history?
Huntington’s disease
Most abundant antibody type?
IgG
Antibody existing as dimer in breast milk, tears and saliva?
IgA
Antibody existing as pentameric molecule?
IgM
Does lupus cause haematuria and proteinuria?
yes
How may polycystic kidney disease present?
Loin pain, haematuria, family history also common
Universal routine neonatal check is designed to pick up what?
congenital cataract
What happens to blood pressure during pregnancy?
decreases in second trimester, returns to normal by third trimester
Which neurotransmitter is most involved in appetite and approach systems?
dopamine
Which artery is located inferior to the retroinguinal space
femoral
What doses of folic acid should non obese and obese women take?
non obese - 400mg
obese- 5mg
In the early stages what characterizes diabetic nephropathy?
proteinuria
What do twin studies show about bipolar disorder?
has a high heritability
Name the extrapyramidal side effect of severe back/neck pain, unable to move, caused by administration of an anti-psychotic e.g. haloperidol?
Acute dystonic reaction
What are the features of metabolic syndrome (associated with atypical antipsychotic use)?
central obesity, increased risk of MI, hypertension, hypercholesterolaemia, insulin resistance
Name the extrapyramidal side effect associated with anti-psychotic use for many years, involving rapid frequent involuntary eye blinking.
tardive dyskinesia
Desire to void usually occurs when the bladder is what size?
250mls
What is an effective treatment for endometriosis and heavy menstruation?
combined oral contraceptive pill
In withdrawal from sedative -hypnotic drugs, what is reduced? (may cause epilepsy)
GABA
Which neurotransmitter is likely to be abnormal in schizophrenia?
Dopamine
Which neurotransmitter is likely to be abnormal in depression?
5-hydroxytryptamine
Abnormal head movements, neck pain, uncomfortable to keep head facing forward?
cervical dystonia
p53 is encoded by DNA or RNA tumour viruses?
RNA tumour viruses
Which hepatitis is common in the UK and spread by faecal oral route?
A
Vague GI and resp symptoms, achy, in nursing home?
legionella
Spirocheate, does not gram stain, STI?
treponema pallidum
Myasthenia gravis is an autoimmune condition in which antibodies are directed against which type of receptors?
postsynaptic Ach receptors
What sort of symptoms does carotid sinus hypersensitivity cause?
acute dizziness/collapse
NOT increase postural SWAY
no sway
