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MRCP Revision > Clinical Sciences > Flashcards

Clinical Sciences Flashcards

1
Q

What is the physiology of sepsis driving hypotension?

A

Increased production of IL-1

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2
Q

Mechanism of hypotension in Addison’s?

A

Glucocorticoid deficiency

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3
Q

Mechanism of fever in sepsis?

A

Increased production of IL-6

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4
Q

Type of bias: occurs when two tests for a disease are compared, the new test diagnoses the disease earlier, but there is no effect on the outcome of the disease

A

Lead-time bias

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5
Q

Equation for statistical power in a study?

A

1 - probability of making a type 2 error

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6
Q

Equation for specificity in a study?

A

1- probability of making a type 1 error

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7
Q

Down syndrome (Trisomoy 21).
what are the cytogenic causes?

A

1) Non-disjunction (94%)
2) Robertsonian translocation (usually onto chromosome 14)
3) Mosaicsm

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8
Q

EBV is a risk factor for what cancers?

A

Burkitt’s Lymphoma
Hodgkins Lymphoma
Post transplant Lymphoma
Nasopharyngeal Carcinoma

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9
Q

HPV strains 16/18 are a risk factor for what cancers?

A

Cervical cancer
Anal cancer
Penile cancer
Vulval cancer
Oropharyngeal Cancer

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10
Q

Human herpes virus 8 is a risk factor for what cancer?

A

Kaposi’s Sarcoma

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11
Q

Hepatitis B+C virus is a risk factor for what cancers?

A

Hepatocellular Carcinoma

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12
Q

Human T-lymphotropic virus 1 is a risk factor for what cancer?

A

Tropical spastic paraparesis
Adult T cell leukaemia

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13
Q

What diagram will demonstrate publication bias in a meta-analysis?

A

Funnel Plot

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14
Q

What immunoglobulin is the most dominant in breast milk+most commonly produced in human body?

A

IgA

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15
Q

Diabetic nephropathy histological findings

A

Kimmelstiel-Wilson lesions, nodular glomerulosclerosis

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16
Q

Classical presentation of Pellagra?

A

Diarrhoea, Dermatitis and Dementia
(Niacin B3 deficiency)

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17
Q

What deficiency causes angular cheilitis?

A

Riboflavin (B2)

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18
Q

What deficiency would present with alopecia and scaly erythematosus?

A

Biotin (B7)

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19
Q

What test do you use to measure the degree of correlation in:
1) Parametric (normally distributed) data
2) Non Parametric data

A

1) Pearson’s Coefficient
2) Spearmanns Coefficient

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20
Q

What does the cardiac sensitive biomarker Troponin bind to when forming a troponin-tropomyosin complex?

A

Actin

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21
Q

HLA antigens are encoded by genes on what chromosome?

A

SIX

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22
Q

Haemochromatosis is associated with what HLA Antigen?

A

HLA-A3

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23
Q

Bechets disease is associated with what HLA Antigen?

A

HLA-B51

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24
Q

Ankylosing spondylitis, reactive arthritis, acute anterior uveitis and psoriatic arthritis is associated with what HLA antigen?

A

HLA-B27

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25
Q

Coeliac disease is associated with what HLA antigen?

A

HLA-DQ2/DQ8

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26
Q

Narcolepsy and Goodpastures syndrome is associated with what HLA antigen?

A

HLA-DR2

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27
Q

Dermatitis Herpetiformis, Sjogrens syndrome, Primary biliary cirrhosis is associated with what HLA Antigen?

A

HLA-DR3

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28
Q

T1DM, rheumatoid arthritis, are associated with what HLA Antigen?

A

HLA-DR4

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29
Q

What test can be used to analyse measured (continuous) data that follows a normal distribution?

A

Students T-Test

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30
Q

Definition of the P value?

A

The probability of obtaining a result by chance at least as extreme as the one that was actually observed, assuming that the null hypothesis is true

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31
Q

What is a type 1 error when testing the null hypothesis?

A

Null hypothesis is rejected when it is true (False Positive)

32
Q

What is a type 2 error when testing the null hypothesis?

A

Null hypothesis is accepted when it is in fact false (False negative)

33
Q

What is the power of a study?

A

Probability of (correctly) rejecting the null hypothesis when it is false.
Power = 1 - probability of type 2 error

34
Q

Most appropriate significance test for data which is paired but not normally distributed?

A

Wilcoxon signed-rank test

35
Q

Name the condition:
-Mitochondrial Inheritance
-Onset < 20
-External Ophthalmoplegia
-Retinitis Pigmentosa

A

Kearns-Sayre syndrome

36
Q

Nerve and vessels passing through the superior orbital fissure? (Located in Sphenoid Bone)

A

Vessels:
1) Superior Ophthalmic Vein
2) Inferior Ophthalmic vein
Nerves:
1) Oculomotor nerve
2) Trochlear nerve
3) Abducens nerve

37
Q

What receptor does insulin bind to in the cell membrane?

A

Tyrosine Kinase

38
Q

Oncogene ABL

A

Chronic Myeloid Leukaemia

39
Q

Oncogene c-MYC

A

Burkitts Lymphoma

40
Q

Oncogene N-MYC

A

Neuroblastoma

41
Q

Oncogene BCL-2

A

Follicular Lymphoma

42
Q

Oncogene RET

A

Multiple endocrine neoplasia

43
Q

Oncogene RAS

A

Pancreatic Cancer

44
Q

Oncogene erb-B2 (HER2/neu)

A

Breast and Ovarian

45
Q

DiGeorge Syndrome mnemonic ‘CATCH 22’

A

Cardiac abnormalities, Abnormal facies, Thymic aplasia, Cleft palate, Hypocalcaemia/hypoparathyroidism, Chromosome 22 deletion

46
Q

Why does high altitude mountain hiking lead to increased haematocrit?

A

Increased production of of hypoxia inducible factor-1 alpha leading to increased production of RBC

47
Q

Which structure may overlie the left renal hilum?

A

Tail of the pancreas

48
Q

Which structure may overlie the superomedial aspect of the left kidney?

A

Greater curvature of the stomach

49
Q

Which structure overlies the medium portion of the right kidney?

A

Second part of the duodenum

50
Q

Primary cause of hypoglycaemia in patients who are diabetic and have binged on alcohol?

A

Increased first phase insulin response

51
Q

Proximal humerus fracture, wrist drop, thumb and finger extension impaired. Nerve injured?

A

Proximal Radial Nerve

52
Q

What bacterial organism is most likely implicated in bacterial infection secondary to platelet transfusion?

A

Staphylococcus Epidermidis

53
Q

Which HLA Alleles increase the susceptibility to Rheumatoid Arthritis?

A

DRB1. (04:01) (04:04) (

54
Q

What occurs during Metaphase?

A

Cell division powered by microtubule polymerisation

55
Q

What occurs during Anaphase?

A

Stage of mitosis after metapahse
Replicated chromosomes are split and daughter chromatids move to opposite poles of the cell

56
Q

What occurs during early prophase?

A

Condensation of chromosomes and the mitotic spindle starts to form
Nucleolus disappears

57
Q

What occurs during prometaphase?

A

Chromosomes finish condensing
Nuclear envelope breaks down
Mitotic spindle grows further
Microtubules ‘capture’ chromosomes

58
Q

What occurs during Telophase?

A

Mitotic spindle breaks down
Formation of two new nuclei
De-condensation of chromosomes

59
Q

Where is the most pronounced effect of parathyroid hormone (PTH) on phosphate reabsorption?

A

Proximal Tubule

60
Q

Where does the passive reabsorption of calcium and magnesium occur?

A

Ascending loop of henle

61
Q

where does the reabsorption of water occur with the expression of aquaporin 2?

A

Collecting Duct

62
Q

Lactose is a disaccharide which contains?

A

Galactose and Glucose

63
Q

Maltose is a disaccharide, composed of?

A

Two glucose molecules linked by an α-1,4 glycosidic bond.

64
Q

Glucose and fructose combine to form?

65
Q

Is Fructose a monosaccharide or a disaccharide?

A

Monosachharide

66
Q

After biochemical tests which show a patient has recurrent renal stones with composition of calcium over 50% and hypercalciuria? What are the two licenced and recommended treatments for prevention of further stone formation?

A

1) Potassium Citrate
2) Thiazide diuretic (Hand restrict sodium intake to no more than 6Grams a day

67
Q

Mode of inheritance for Osler-Weber-Rendu syndrome?
(Recurrent epistaxis, telangectases,)

A

Autosomal dominant

68
Q

Physiological changes during Valsalva Manoeuvre?

A

-Increased intrathoracic pressure shifts blood from pulmonary circulation to left atrium
-reduced systemic return to right side of the heart
-JVP increases initially
-Cardiac output drops

69
Q

What immunoglobulin is responsible for hyperacute rejection?

A

IgG (Hyperacute rejections occur due to pre-circulating IgG immunoglobulin)

70
Q

Patient is treated with combination chemotherapy for testicular cancer. What is the dominant cellular process which explains why it was successful? (remission)

71
Q

When is the Chi Squared test used?

A

Expected vs observed results

72
Q

What 3 structures are the right kidney in direct contact with?

A

1) Suprarenal gland
2) Duodenum
3) Colon

73
Q

What 3 structures are the left kidney in direct contact with?

A

1) Left suprarenal gland
2) Pancreas
3) Colon

74
Q

5 Layers of Epidermis from deepest to superficial including function?
Striatum: Deepest to superficial
G, S, G, L, C

A

1) Germinativum (Basale) - Basement membrane single layer of columnar epithelial cells. Gives rise to Kerantinocyes. Contains Melanocytes.
2) Spinosum - Squamous cells begin to keratin synthesis. Thickest layer of epidermis.
3) Granulosum - Cells form links with neighbours
4) Lucidum - Clear layer, present in thick skin only
5) Corneum - Flat, dead, scale like skin filled with Keratin

75
Q

Way to remember layers of epidermis: Superficial to deep
Come Lets Get Sun Burned

A

Corneum
Lucidum
Granulosum
Spinosum
Basale (Germinativum)

MRCP Revision (17 decks)

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