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MRCP > Clinical Sciences and Statistics > Flashcards

Clinical Sciences and Statistics Flashcards

1
Q

LVEF = ?

A

(SV / EDV) x 100

Left Ventricular ejection fraction = (Stroke volume/ End diastolic volume) x 100

Stroke volume (end diastolic - end systolic)

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2
Q

Standard error of the mean = ?

A

Standard error of the mean = standard deviation / square root (number of patients)

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3
Q

The power of a study is…

A

The power of a study is the probability of (correctly) rejecting the null hypothesis when it is false, i.e. the probability of detecting a statistically significant difference

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4
Q

where is phosphate reabsorbed?

A

proxmial tubule

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5
Q

What electrolytes are absorbed in the distal tubule (3)

A

sodium
potassium
calcium

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6
Q

Relative risk reduction = ?

A

Relative risk reduction = (EER - CER) / CER

EER = experimental event rate
CER = control event rate
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7
Q

Most immunoglobulin and antibodies are produced by…

A

plasma cells

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8
Q

Blood smear result for DIC

A

Schistocytes

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9
Q

p53 plays a crucial role in the cell cycle, it is responsible for…

A

Preventing entry into the S phase until DNA has been checked and repaired

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10
Q

Outline the 5 steps of atherosclerosis

A
  1. Endothelial dysfunction triggered by smoking, hypertension or hyperglycaemia.
  2. Pro-inflammatory, pro-oxidant, proliferative changes in the endothelium.
  3. Fatty infiltration of the subendothelial space by low-density lipoprotein (LDL).
  4. Macrophages phagocytose oxidised low-density lipoprotein.
  5. Smooth muscle proliferation and migration from the tunica media into the intima.
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11
Q

Peroxisome main function

A

Catabolism of long chain fatty acids (poly peptides)

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12
Q

Proteasome main function

A

degradation of protein molecules that have been tagged with ubiquitin

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13
Q

Ribosome main function

A

translation of RNA into proteins

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14
Q

Nucleolus main function

A

Ribosome production

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15
Q

Lysosome main function

A

breakdown of polysaccharides and proteins

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16
Q

Nucleus main function

A

DNA maintenance
RNA transcription
RNA splicing

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17
Q

Mitochondria main function

A

aerobic respiration

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18
Q

Golgi apparatus main function

A
  • packages molecules that are destined for cell secretion

- adds mannose-6-phosphate to proteins for transport to lysosome

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19
Q

Smooth endoplasmic reticulum main function

A

steroid, lipid synthesis

example of cells with SER: adrenal cortex, hepatocytes, testes, ovaries

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20
Q

Rough endoplasmic reticulum

A

translation and folding of new proteins
manufacture of lysosomal enzymes
site of N-linked glycosylation
examples of cells with extensive RER include pancreatic cells, goblet cells, plasma cells

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21
Q

Interferon-γ main source and function

A

T helper 1 cells

activates macrophages

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22
Q

Tumour necrosis factor (TNF) main source and function

A

Macrophage

induce fever, neutrophil chemotaxis

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23
Q

Likelihood ratio for a positive test result = ?

A

sensitivity/ (1 - specificity)

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24
Q

Likelihood ratio for a negative test results =?

A

(1 - sensitivity)/ specificity

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25
Q

Type 1 hypersensitivity
mechanism
examples

A

IgE

anaphylaxis, atopy

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26
Q

Type 2 hypersensitivity
mechanism
examples (guess a few)

A 
IgG/ IgM
  Autoimmune haemolytic anaemia
• ITP
• Goodpasture's syndrome
• Pernicious anaemia
• Acute haemolytic transfusion reactions
• Rheumatic fever
• Pemphigus vulgaris / bullous pemphigoid
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27
Q

Type 3 hypersensitivity
mechanism
examples

A

IgG, IgA - free antigen and antibody combine
• Serum sickness
• Systemic lupus erythematosus
• Post-streptococcal glomerulonephritis
• Extrinsic allergic alveolitis (especially acute phase)

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28
Q

Type 4 hypersensitivity
mechanism
examples

A 
T cell mediated
• Tuberculosis / tuberculin skin reaction
• Graft versus host disease
• Allergic contact dermatitis
• Scabies
• Extrinsic allergic alveolitis (especially chronic phase)
• Multiple sclerosis
• Guillain-Barre syndrome
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29
Q

Type 5 hypersensitivity
mechanism
examples

A

Antibodies bind to cell surfaces
Graves
Myasthenia gravis

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30
Q 
Vitamin B3 (Niacin) deficiency - Pellagra
Features (3)
A

diarrhoea
dermatitis
dementia

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31
Q 
Antidiuretic hormone (ADH) is secreted from the [X]. It promotes water reabsorption in the [Y] of the kidneys by the insertion of [Z].
eg. Desmopressin
A

X - posterior pituitary gland
Y - collecting ducts
Z - aquaporin 2 channels

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32
Q

Number needed to treat = ?

A

NNT = 1/ ARR

ARR = absolute risk reduction

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33
Q

Absolute risk reduction =

A

control event rate - experiment event rate

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34
Q

Layers of the skin (5)

A
  1. Stratum corneum - Flat, dead, scale-like cells filled with keratin
    Continually shed
  2. Stratum lucidum - Clear layer - present in thick skin only
  3. Stratum granulosum - Cells form links with neighbours
  4. Stratum spinosum - Squamous cells begin keratin synthesis
    Thickest layer of epidermis
  5. Stratum germinativum - The basement membrane - single layer of columnar epithelial cells
    Gives rise to keratinocytes
    Contains melanocytes
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35
Q

Variance is a measure of the spread of scores away from the mean.

Variance = ?

A

Variance = square of standard deviation

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36
Q

6 stages of Mitosis

A
  1. Prophase
  2. Prometaphase
  3. Metaphase
  4. Anaphase
  5. Telophase
  6. Cytokinesis
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37
Q

Mitosis steps 1 + 2

A

Prophase - Chromatin in the nucleus condenses

Prometaphase - Nuclear membrane breaks down allowing the microtubules to attach to the chromosomes

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38
Q

Mitosis steps 3 + 4

A

Metaphase - Chromosomes aligned at middle of cell

Anaphase - The paired chromosomes separate at the kinetochores and move to opposite sides of the cell

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39
Q

Mitosis steps 5 + 6

A

Telophase - Chromatids arrive at opposite poles of cell
Cytokinesis - Actin-myosin complex in the centre of the cell contacts resulting in it being ‘pinched’ into two daughter cells

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40
Q

P value is…

A

P value - is 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

41
Q

Significance tests

Parametric (2)

A

Parametric tests (something that can be measured, usually normally distributed)
Student’s t-test - paired or unpaired*
Pearson’s product-moment coefficient - correlation

42
Q

Significance test

Non-parametric (4)

A

Non-parametric tests:

  • Mann-Whitney U test - compares ordinal, interval, or ratio scales of unpaired data
  • Wilcoxon signed-rank test - compares two sets of observations on a single sample, e.g. a ‘before’ and ‘after’ test on the same population following an intervention
  • Chi-squared test - used to compare proportions or percentages e.g. compares the percentage of patients who improved following two different interventions
  • Spearman, Kendall rank - correlation
43
Q

Acute tubular necrosis microscopy

A

granular, muddy-brown urinary casts

44
Q

Clinical trials

A

Phase Goal Notes
I Determines pharmacokinetics and pharmacodynamics and side-effects prior to larger studies Conducted on healthy volunteers
II Assess efficacy + dosage Involves small number of patients affected by particular disease

May be subdivided into
IIa - assesses optimal dosing
IIb - assesses efficacy
III Assess effectiveness Typically involves 100-1000’s of people, often as part of a randomised controlled trial, comparing new treatment with established treatments
IV Postmarketing surveillance Monitors for long-term effectiveness and side-effects

45
Q

CD cluster

A

Cluster of differentiation Function
CD1 MHC molecule that presents lipid molecules
CD2 Found on thymocytes, T cells, and some natural killer cells that acts as a ligand for CD58 and CD59 and is involved in signal transduction and cell adhesion
CD3 The signalling component of the T cell receptor (TCR) complex
CD4 Found on helper T cells.
Co-receptor for MHC class II
Used by HIV to enter T cells
CD5 Found in the majority of mantle cell lymphomas
CD8 Found on cytotoxic T cells.
Co-receptor for MHC class I
Found on a subset of myeloid dendritic cells
CD14 Cell surface marker for macrophages
CD15 Expressed on Reed-Sternberg cells (along with CD30)
CD16 Bind to the Fc portion of IgG antibodies
CD21 Receptor for Epstein-Barr virus
CD28 Interacts with B7 on antigen presenting cell as costimulation signal
CD45 Protein tyrosine phosphatase present on all leucocytes
CD56 Unique marker for natural killer cells
CD95 Acts as the FAS receptor, involved in apoptosis

46
Q

standard error of the mean

A

Standard error of the mean = standard deviation / square root (number of patients)

47
Q

Troponin T binds to…

A

Troponin T binds to tropomyosin, forming a troponin-tropomyosin complex

48
Q

what bias is a particular problem in case-control studies

A

recall bias

49
Q

Selection bias is…

A

Error in assigning individuals to groups leading to differences which may influence the outcome.
eg. sampling bias, volunteer bias, non-responder bias

50
Q

Bias found in non-blinded trials. Observers subconsciously report data in a way that favours the expected outcome.

A

Expectation bias (Pygmalion effect)

51
Q

Hawthorn effect describes…

A

Describes a group changing it’s behaviour due to the knowledge that it is being studied

52
Q

X linked dominant conditions (3)

A

alports
retts
Vit D resistent rickets

53
Q

Post-test probability = ?

A

Post-test probability = post test odds / (1 + post-test odds)

54
Q

Cohort study usual outcome measure…

A

relative risk

55
Q

Turner’s most common cardiac abnormality

A

bicuspid aortic valve

56
Q

Cytokines - Main source + function
TNF a
IFN y

A

TNF a - from macrophage - induce fever, neutrophil chemotaxis
INF y - from Th1 cells - activate macrophage

57
Q

ADH (diabetes insipidus) is from [X} and acts upon [Y]

A

X - hypothalamus (supraoptic nuclei)

Y - collecting ducts

58
Q

Adrenal cortex mnemonic

A

Adrenal cortex mnemonic: GFR - ACD
Glomerulosa - Aldosterone (mineral corticoid)
Fasciculata - Cortisone (glucocorticoid)
Reticularis - DHEA (androgens)

59
Q

Adrenaline acts via

A

G protein coupled receptors

60
Q

Tay-Sachs

features

A

Developmental delay, Cherry red spot on macula, Nil hepato/ splenomegaly
Normally around 6 months old

61
Q

Insulin binds to what receptor

A

Tyrosine kinase

62
Q

C1q, C1rs, C2, C4 deficiency association

A

immune complexes - HSP, SLE

63
Q

C3 Deficiency association

A

recurrent bacterial infections

64
Q

C5 deficiency

A

Leiner disease, diarrhoea, dermatitis

65
Q

C5-9 deficiency

A

Neisseria Meningitidis

66
Q

Subunits of troponin bind to…
Trop C
Trop T
Trop I

A

C - Calcium
T - Tropomysin - forms Troponin-tropomysin complex
I - Actin

67
Q 
Homocystinuria
inheritance
pathophys
features
Ix
Mx
A

autosomal recessive
P - deficiency of cystathionine beta synthase
Fx - Marfinoid, learning difficulty, downward dislocation of lens
Ix - cyanide-nitroprusside test
Mx - Vitamin B6 (Pyridoxine)

68
Q

X-linked recessive conditions

female carriers -> 50% male effected; 50% female carrier; nil male-male transmission, females never effected

A

Muscular dystrophy, colour blindness, G6PD def, Haemophillia A, Nephrogenic DI, Fabrys… amongst others

69
Q

What supplement aids iron absorption in the gut?

A

Vitamin C (ascorbic acid)

70
Q

Case control outcome measure…

A

Odds ratio

71
Q

cohort study outcome measure…

A

relative risk

72
Q

HLA antigens encoded on which chromosome?

A

chromosome 6

73
Q

dry beriberi is..

A

thiamine deficiency leading to peripheral neuropathy

74
Q

wet beriberi is…

A

thiamine deficiency with heart failure

75
Q

Riboflavin is required for…

A

Hydrogen-transfer chain in mitochondria and production of ATP

76
Q

Features of Mitochondrial inheritance (is female only) (5)

A 
optic atrophy
neuropathy
diabetes
epilepsy
sensory neural hearing loss
77
Q

femoral nerve sensory supplies the

A

anterior-medial thigh

78
Q

Median nerve palsy

A

weakness of thumb abduction (abductor policis brevis)

79
Q

Ulnar nerve palsy

A

Inability to abduct or adduct fingers

80
Q

Radial nerve palsy

A

Wrist drop

81
Q

Gilbert’s syndrome Features (2)

A 
painless jaundice (normal LFTs other than BR)
non-specific illness
82
Q

Hypoglossal (CN XII) palsy

A

tongue deviates TOWARDS the side of defect - due to paralysis of tongue muscles

83
Q

Antiphospholipid syndrome antibodies (3)

A

B2 glycoprotein, lupus anticoagulant, anti-cardiolipin

84
Q

Causes of Respiratory Alkalosis - causes of hyperventilation

A 
Pregnancy
Anxiety
Hepatic failure
salicylates, progresterone
interstitial lung disease
85
Q

Peutz-Jeghers syndrome Features (3)

A

hyperpigmentation nose and mouth
GI bleeding
Risk of colon, pancreatic ca

86
Q

Marfans gene abnormality

A

Fibrillin-1

87
Q

Analysis of variance (ANOVA) statistical analysis description

A

comparison of two of more means

88
Q

Primary biliary cholangitis antibody

A

Anti mitochondrial M2

89
Q

Iron overdose antidote

A

Desferrioxamine

90
Q

Pancreatic Ca gene mutation

A

KRAS

91
Q

Hereditary spherocytosis gene mutation

A

Spectrum and ankyrin

92
Q

Autoimmune encephalitis antibody

A

Anti LGI 1 (previously VGKC)

93
Q

acute intermittent porphyria Mx

A

IV haem arginate

94
Q

RET oncogene related to which type of thyroid cancer

A

medullary

95
Q

Alkaptonuria/ Ochronosis features (2) - homogensitic acid oxidase deficiency

A

Chondrocalcinosis + arthritis

brown/ dark urine

96
Q

Respiratory alkalosis drug overdose causes (2)

A

salicylates (aspirin)
theophylline
(hyperventilation)

97
Q

Sjogrens disease antibodies

A

Anti RO

Anti La

98
Q

Mixed Connective tissue disaese
features
autoantibody

A

F - raynauds, ILD, pericarditis

Antibody - Anti-Ribonucleoprotein

MRCP (14 decks)

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