Case 20 Questions

Question 1

Which lipoprotein is produced by the exogenous lipoprotein pathway

Answer 1

Chylomicrons

Question 2

Which is the largest and smallest lipoprotein

Answer 2

Largest- Chylomicrons

Smallest- HDL

Question 3

Which lipoprotein removes surplus cholesterol from the periphery and transports it to the liver for disposal

Answer 3

HDL

Question 4

Which lipoprotein transports dietary fat and cholesterol from the intestine

Answer 4

Chylomicrons

Question 5

Name the components of a lipoprotein

Answer 5

Phospholipid, Cholesterol ester, Apolipoprotein, Triglycerides

Question 6

A women has a blockage in her middle cerebral artery, where does the emboli originate from

Answer 6

The left atrium

Question 7

Epitaxis management

Answer 7

1) First aid
2) Sit up
3) Pinch soft part of the nose
4) Ice packs
5) Pulse and BP
6) Venous access ->FBC, G+S
7) Resuscitate

Question 8

Causes of Turbinate hypertrophy- swollen concahe

Answer 8

1) Allergy- skin prick test, RAST
2) Non-allergic
3) Vascular- curry, cold morning
4) Structural- air filled middle turbinate, concha bullosa

Question 9

Causes of Anosmia- complete loss of smell

Answer 9

1) Congenital- isolated, kallmann syndrome
2) Injury
3) Viral
4) Tumours
5) Biochemical i.e. drugs, hormones’
6) Neurodegenerative disorders
7) Structural poylps

Question 10

Nasal and skull base fracture

Answer 10

Causes- fighting, football
Exclude major facial injury through le fort classification
X ray- waste of time
Manipulate bones before they set
CT only for head injury criteria

Question 11

Main function of the golgi tendon organ

Answer 11

Measure tension

Question 12

Symptoms of a stroke which affects a branch of the anterior cerebral artery supplying pre and post central gyrus

Answer 12

Upper motor neurone signs affecting the lower limb, no sensation from lower limbs

Question 13

Symptoms of a spinal cord stroke that damages the dorsal column at T6

Answer 13

No touch sensation from lower limbs bilaterally, pain sensation intact bilaterally

Question 14

Symptoms of a slipped disc crushing the dorsal root on the left side at C7

Answer 14

Reduced touch, pain and temperature sensation on the back of hand and arm on the left side

Question 15

Symptoms of a slipped disc crushing spinal nerves on the left side at C7

Answer 15

Reduced touch, pain and temperature on the back of hand and arm on the left side. Similar muscle weakness

Question 15

Symptoms of a slipped disc crushing spinal nerves on the left side at C7

Answer 15

Reduced touch, pain and temperature on the back of hand and arm on the left side. Similar muscle weakness

Question 16

Symptoms of a fluid filled cyst expanding in the spinal canal and pressing on the surrounding tissues

Answer 16

No pain sensation bilaterally at the level of damage. Fine touch sensation intact

Question 17

Symptoms of a stroke damaging blood supply to the pyramids of the medulla

Answer 17

Paralysis/Paresis of muscles from the neck down

Question 18

What nerve is at the cerebello-pontine angle

Answer 18

Facial nerve

Question 19

What artery is on the lateral surface of the frontal and parietal lobe

Answer 19

Middle cerebral artery- supplies Broca’s area (lateral surface of the frontal lobe), parietal and part of the temporal lobe

Question 20

What is the most appropriate initial management for a stroke

Answer 20

CT head

Question 21

What brainstem nucleus does the carotid sinus afferent synapse with

Answer 21

The Solitary nucleus

Question 22

What cell type gives rise to parallel fibres within the cerebellar cortex

Answer 22

Granule cell

Question 23

The function of corticospinal fibres which allow unopposed contraction of flexor muscles

Answer 23

Excite the alpha and gamma motor neurones supplying the flexor muscle and inhibits the corresponding extensor alpha motor neurone

Question 24

The main function of vWF

Answer 24

It binds platelets to the subendothelium

Question 25

The region of the brainstem where the pyramids decussate

Answer 25

Caudal medulla

Question 26

Where in the nasal cavity do the maxillary sinuses drain into

Answer 26

The middle meatus via the hiatus semilunaris

Question 27

The spinal component of the reciprocal inhibitory pathway

Answer 27

Ia inhibitory interneurone

Question 28

Secondary prevention for a stroke

Answer 28

Antiplatelet therapy

Question 29

What type of haemorrhage causes a convex lens

Answer 29

Extradural haemorrhage

Question 30

ACBD2 tool

Answer 30

To complete this tool one needs to know:

the patient’s age,
the patient’s blood pressure,
the clinical features
the duration of their symptoms
the presence or absence of diabetes.

Question 31

The major biochemical effect of statine

Answer 31

Decrease LDL

Question 32

What fibre type allows communication between the Olive and the cerebellar cortex

Answer 32

Climbing fibres