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CR Qs Flashcards

1
Q

per CO, which of the following is supplied the most blood?

a) brain
b) heart
c) lungs
d) kidneys

A

per CO, which of the following is supplied the most blood?

a) brain
b) heart
c) lungs

d) kidneys

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2
Q

why does changing resp. rate impact the excretion of co2 but not o2? [1]

A

pressure gradient for co2 is much less than for 02 (6 mmHg vs 60 mmHg) changing resp. rate can alter excretion of CO2 without significantly affecting uptake of O

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3
Q

A 14-year-old girl wakes up with a dry cough and a very rapid breathing. Her mother notices that her lips are turning blue. Because she was diagnosed with allergic asthma last month, the mother immediately applies a short-acting bronchodilator prescribed by her daughter’s pediatrician, which resolves the symptoms. Which cells are the main factors in the pathogenesis of this allergic reaction?

goblet cell
mast cell
fibrocyte
alveolar macrophage
exocrine bronchiolar cells

A

A 14-year-old girl wakes up with a dry cough and a very rapid breathing. Her mother notices that her lips are turning blue. Because she was diagnosed with allergic asthma last month, the mother immediately applies a short-acting bronchodilator prescribed by her daughter’s pediatrician, which resolves the symptoms. Which cells are the main factors in the pathogenesis of this allergic reaction?

goblet cell
mast cell
fibrocyte
alveolar macrophage
exocrine bronchiolar cells

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4
Q

Which structure separates the tracheal epithelium from the lamina propria? [1]

A

basement membrane

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5
Q

Which one of the following actions is directly caused by glucagon?

Increases appetite

Decreases gallbladder contraction

Inhibits insulin secretion

Decreases gastric emptying

Decreases pancreatic secretions

Increases lipolysis

A

Which one of the following actions is directly caused by glucagon?

Increases appetite

Decreases gallbladder contraction

Inhibits insulin secretion

Decreases gastric emptying

Decreases pancreatic secretions

Increases lipolysis

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6
Q

You are designing a research project looking at the sensitivities and specificities of various markers in relation to myocardial necrosis. Specifically you want to assess the molecule which troponin C binds to.

Which molecule will you study in your research project?

Ca ions
Tropomyosin
Actin
Myosin
Sarcoplasmic Reciticulum

A

You are designing a research project looking at the sensitivities and specificities of various markers in relation to myocardial necrosis. Specifically you want to assess the molecule which troponin C binds to.

Which molecule will you study in your research project?

Ca ions
Tropomyosin
Actin
Myosin
Sarcoplasmic Reciticulum

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7
Q

In respect of skeletal muscle contraction, contains the entire length of a single thick filament:

T-tubule

M-line

I-band

Troponin-C

H-zone

A-band

A

In respect of skeletal muscle contraction, contains the entire length of a single thick filament:

T-tubule

M-line

I-band

Troponin-C

H-zone

A-band

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8
Q

which of the following is not a potential reason for oedema?

a) lymphatic blockage
b) increase in plasma oncotic pressure
c) increase in capillary hydrostatic pressure
d) decrease in plasma oncotic pressure
e) increased capillary permeability

A

which of the following is not a potential reason for oedema?

a) lymphatic blockage
* *b) increase in plasma oncotic pressure**
c) increase in capillary hydrostatic pressure
d) decrease in plasma oncotic pressure
e) increased capillary permeability

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9
Q

What is the normal duration of a QRS complex?

  1. 12 seconds
  2. 16 seconds
  3. 04 seconds
  4. 08 seconds
A

What is the normal duration of a QRS complex?

0.12 seconds
0.16 seconds
0.04 seconds
​0.08 seconds

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10
Q

Which one of the following is not a branch of the hepatic artery?

Pancreatic artery
Cystic artery
Right gastric artery
Right hepatic artery
Gastroduodenal artery

A

Which one of the following is not a branch of the hepatic artery?

Pancreatic artery
Cystic artery
Right gastric artery
Right hepatic artery
Gastroduodenal artery

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11
Q

name a location you would find:

i) multi unit smooth muscle
ii) single unit smooth muscle

A

name a location you would find:

i) multi unit smooth muscle: smooth muscle of eye
​ii) single unit smooth muscle: GI tract / bladder / uterus (walls of hollow organs)

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12
Q

Which one of the following is the predominant finding during phase 0 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Slow influx of calcium

Rapid sodium influx

Efflux of calcium

A

Which one of the following is the predominant finding during phase 0 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Slow influx of calcium

Rapid sodium influx

Efflux of calcium

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13
Q

the superior and middle conchae are part of which bone?
what about the inferior concahe

A

super and middle conchae are part of the ethmoid bone

inferior concahe is a seperate bone

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14
Q

Which one of the following is the predominant finding during phase 0 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 0 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

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15
Q

A 30-year-old man presents with worsening retrosternal chest pain which is pleuritic in nature and radiating to the neck and shoulders. On examination, a pericardial friction rub is heard at the end of expiration. He is diagnosed with pericarditis - inflammation of the pericardium.

Which nerve is responsible for supplying this area?

Long thoracic nerve
Medial pectoral nerve
Phrenic nerve
Thoracdorsal nerve
Vagus nerve

A

A 30-year-old man presents with worsening retrosternal chest pain which is pleuritic in nature and radiating to the neck and shoulders. On examination, a pericardial friction rub is heard at the end of expiration. He is diagnosed with pericarditis - inflammation of the pericardium.

Which nerve is responsible for supplying this area?

Long thoracic nerve
Medial pectoral nerve
Phrenic nerve
Thoracdorsal nerve
​Vagus nerve

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16
Q
A
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17
Q

Often termed the ‘reliever’ by patients:

Long-acting beta-agonists (LABA)

Oral corticosteroids

Leukotriene receptor antagonists

Inhaled corticosteroids (ICS)

Short-acting beta-agonists (SABA)

A

Often termed the ‘reliever’ by patients:

Long-acting beta-agonists (LABA)

Oral corticosteroids

Leukotriene receptor antagonists

Inhaled corticosteroids (ICS)

Short-acting beta-agonists (SABA)

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18
Q

What view of the heart do leads II, III and aVF represent?

Anterior
Septal
Lateral
Inferior

A

What view of the heart do leads II, III and aVF represent?

Anterior
Septal
Lateral
Inferior

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19
Q

You are on the ward and notice that a patient lying supine in a monitored bed is hypotensive, with a blood pressure of 90/70mmHg and tachycardic, with a heart rate of 120 beats/minute. You adjust the bed to raise the patient’s legs by 45 degrees and after 1 minute you measure the blood pressure again. The blood pressure increases to 100/75 and you prescribe a 500mL bag of normal saline to be given IV over 15 minutes.

What physiological association explains the increase in the patient’s blood pressure?

Stroke volume is raised by the level of adrenaline the body produces
Stroke volume is raised by the level of noradrenaline the body produces
Preload is inversely proportional to stroke volume
Venous return is proprortional to stroke volume

A

You are on the ward and notice that a patient lying supine in a monitored bed is hypotensive, with a blood pressure of 90/70mmHg and tachycardic, with a heart rate of 120 beats/minute. You adjust the bed to raise the patient’s legs by 45 degrees and after 1 minute you measure the blood pressure again. The blood pressure increases to 100/75 and you prescribe a 500mL bag of normal saline to be given IV over 15 minutes.

What physiological association explains the increase in the patient’s blood pressure?

Stroke volume is raised by the level of adrenaline the body produces
Stroke volume is raised by the level of noradrenaline the body produces
Preload is inversely proportional to stroke volume
Venous return is proprortional to stroke volume

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20
Q

What type of blood gas abnormality does neuromuscular disease most commonly cause?

Respiratory acidosis

Respiratory alkalosis

A

What type of blood gas abnormality does neuromuscular disease most commonly cause?

Respiratory acidosis

Respiratory alkalosis

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21
Q
A
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22
Q

Which cells make up the alveolar sac and allow gas exchange between the alveoli and the capillaries? [1]

A

type one pneumocyte [1]

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23
Q

Which of the following best describes the ECG leads shown below?

Right axis deviation
Left axis deviation

A

Which of the following best describes the ECG leads shown below?

Right axis deviation
Left axis deviation

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24
Q

In respect of skeletal muscle contraction, binds with calcium ions:

Actin

Troponin-C

Sarcoplasmic reticulum

Tropomyosin

Myosin

Titin

A

In respect of skeletal muscle contraction, binds with calcium ions:

Actin

Troponin-C

Sarcoplasmic reticulum

Tropomyosin

Myosin

Titin

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25
Q

Which one of the following actions is directly caused by growth hormone?

Inhibits insulin secretion

Increases osteoclastic activity

Increases gut absorption of phosphate

Stimulates parietal cell maturation

Increases proximal tubule Na+/H+ activity

Stimulates release of insulin-like growth factors

A

Which one of the following actions is directly caused by growth hormone?

Inhibits insulin secretion

Increases osteoclastic activity

Increases gut absorption of phosphate

Stimulates parietal cell maturation

Increases proximal tubule Na+/H+ activity

Stimulates release of insulin-like growth factors

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26
Q
A
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27
Q

name three classes of drug used for heart failure? [3]

A
  • positive inotropic drugs
  • vasodilators
  • misceallaneous drugs for chronic failure
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28
Q

A 72-year-old man attends the emergency department following a syncopal episode. He has an ECG which shows a prolonged PR interval, with every second QRS complex dropped. The width of the QRS complexes are normal.

In which part of the heart is the conduction delay likely to be coming from?

Apex
AVN
Bundle of His
SAN
Left ventricle

A

A 72-year-old man attends the emergency department following a syncopal episode. He has an ECG which shows a prolonged PR interval, with every second QRS complex dropped. The width of the QRS complexes are normal.

In which part of the heart is the conduction delay likely to be coming from?

Apex
AVN
Bundle of His
SAN
​Left ventricle

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29
Q

Inspiratory capacity:

Equals tidal volume + inspiratory reserve volume

Equals vital capacity + residual volume

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

500ml in males, 350ml in females

Equals tidal volume * (PaCO2 - PeCO2) / PaCO2

Maximum volume of air that can be expired after a maximal inspiration

A

Inspiratory capacity:

Equals tidal volume + inspiratory reserve volume

Equals vital capacity + residual volume

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

500ml in males, 350ml in females

Equals tidal volume * (PaCO2 - PeCO2) / PaCO2

Maximum volume of air that can be expired after a maximal inspiration

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30
Q

which class of antiarrhythmic drugs causes acts on K+ channels?

Class I

Class II:

Class III

Class IV

A

which class of antiarrhythmic drugs causes acts on K+ channels?

Class I

Class II:

Class III

Class IV

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31
Q

Which one of the following is the predominant finding during the plateau phase of the cardiac action potential?

Efflux of potassium

Slow influx of calcium

Rapid potassium influx

Efflux of calcium

Rapid sodium influx

A

Which one of the following is the predominant finding during the plateau phase of the cardiac action potential?

Efflux of potassium

Slow influx of calcium

Rapid potassium influx

Efflux of calcium

Rapid sodium influx

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32
Q

which part of larynx is the only complete ring of cartilage?

a) thyroid cartilage
b) cricoid cartilage
c) artyenoid cartilage
d) cuneiform cartilage
e) corniculate cartilage

A

which part of larynx is the only complete ring of cartilage?

a) thyroid cartilage
* *b) cricoid cartilage**
c) artyenoid cartilage
d) cuneiform cartilage
e) corniculate cartilage

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33
Q

what happens to pulmoanary arterial resstiance during exercise? [1]
what happens to pulmoanary arterial pressure during exercise? [1]

A

what happens to pulmoanary arterial resstiance during exercise? [1]
massively drops

what happens to pulmoanary arterial pressure during exercise? [1]
slightly increases

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34
Q

Efflux of potassium is the predominant finding during which phase of the cardiac action potential?

Phase 2

Phase 1

Phase 0

Phase 4

Phase 3

A

Efflux of potassium is the predominant finding during which phase of the cardiac action potential?

Phase 2

Phase 1

Phase 0

Phase 4

Phase 3

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35
Q

where exactly do you find the apex beat? [1]

A

5th intercostal space in the mid-clavicular line

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36
Q

A 32-year-old gentleman presents to the emergency department after being attacked by a man with a baseball bat. The soft tissue surrounding his eye shows significant swelling, to the point where the patient cannot see out of that eye. A CT scan shows a fracture of the floor of the orbit. Fracture of the floor of the orbit creates an abnormal communication between the orbit and which of the following areas of the face?

Ethmoidal air cells
Nasal cavity
Frontal sinus
Sphenoid sinu
Maxillary sinusa

A

A 32-year-old gentleman presents to the emergency department after being attacked by a man with a baseball bat. The soft tissue surrounding his eye shows significant swelling, to the point where the patient cannot see out of that eye. A CT scan shows a fracture of the floor of the orbit. Fracture of the floor of the orbit creates an abnormal communication between the orbit and which of the following areas of the face?

Ethmoidal air cells
Nasal cavity
Frontal sinus
Sphenoid sinu
Maxillary sinus

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37
Q

A 43-year-old man presents to the emergency department with shortness of breath, fever and a productive cough. He has no past medical history and does not take any regular medications.

On examination, there is bronchial breathing and coarse crackles at the right lung base.

Plain radiography of the chest demonstrates consolidation in the right lower zone.

Arterial blood gas:

pH7.36(7.35-7.45)

pO27.2 kPa(11-13)

pCO24.1 kPa(4-6)

SaO287%(94-98)

Given the likely diagnosis, which of the following is a predicted initial physiological response?

Bradycardia
Reduced resp. rate
Reduced tidal volume
Vasoconstriction of the pulmonary arteries
Vasodilation of the pulmonary arteries

A

A 43-year-old man presents to the emergency department with shortness of breath, fever and a productive cough. He has no past medical history and does not take any regular medications.

On examination, there is bronchial breathing and coarse crackles at the right lung base.

Plain radiography of the chest demonstrates consolidation in the right lower zone.

Arterial blood gas:

pH7.36(7.35-7.45)

pO27.2 kPa(11-13)

pCO24.1 kPa(4-6)

SaO287%(94-98)

Given the likely diagnosis, which of the following is a predicted initial physiological response?

Bradycardia
Reduced resp. rate
Reduced tidal volume
Vasoconstriction of the pulmonary arteries
​Vasodilation of the pulmonary arteries

**Pulmonary arteries vasoconstrict in the presence of hypoxia

Vasoconstriction of pulmonary arteries is the correct response. The patient has clinical and radiographic evidence of pneumonia along with type 1 respiratory failure. In response to hypoxia, the small pulmonary arteries vasoconstrict so as to direct blood flow from poorly ventilated areas of the lung to areas with better ventilation. This results in better overall efficiency of gas exchange between blood and alveoli.**

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38
Q

A 68-year-old man is about to undergo surgery for transitional cell carcinoma of the left kidney. As part of the operation, the left renal artery must be located and dissected.

At what vertebral level would the surgeon find the origin of this artery?

T12
L1
T10
L4
L3

A

A 68-year-old man is about to undergo surgery for transitional cell carcinoma of the left kidney. As part of the operation, the left renal artery must be located and dissected.

At what vertebral level would the surgeon find the origin of this artery?

T12
L1
T10
L4
​L3

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39
Q

what is the equation to calculate alveolar ventilation? [1]

A

alveolar ventilation: (tidal volume - dead space) x resp rate (breaths per minute) [1]

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40
Q

which receptors in the alveoli are stimulated by the enlargement of pulmonary capillaries / pulm. oedema [1]

what do they cause? [1]

A
  • **J receptors
  • cause brachycardia / hypotension**
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41
Q
A
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42
Q

this picture depicts a lymph node. what are the correct labels for A, B & C?

a) A = trabeculae, B = cortex, C = medulla
b) A = capsule, B = trabeculae, C = medulla
c) A = capsule, B = trabeculae, C = cortex
d) A = cortex, B = trabeculae, C = medulla
e) A = capsule, B = medulla, C = trabeculae

A

this picture depicts a lymph node. what are the correct labels for A, B & C?

a) A = trabeculae, B = cortex, C = medulla
* *b) A = capsule, B = trabeculae, C = medulla**
c) A = capsule, B = trabeculae, C = cortex
d) A = cortex, B = trabeculae, C = medulla
e) A = capsule, B = medulla, C = trabeculae

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43
Q

what is outlined here? [1]

A

iliotibial band

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44
Q

In respect of skeletal muscle contraction, zone of thin filaments that is not superimposed by thick filaments:

A-band

Tropomyosin

I-band

Actin

M-line

H-zone

A

In respect of skeletal muscle contraction, zone of thin filaments that is not superimposed by thick filaments:

A-band

Tropomyosin

I-band

Actin

M-line

H-zone

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45
Q

Vagal trunk perforates the diaphragm:

L1

L4

L2

T10

L3

T12

A

Vagal trunk perforates the diaphragm:

L1

L4

L2

T10

L3

T12

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46
Q

Which one of the following is an example of perfusion-limited exchange?

Oxygen (normal conditions)

Oxygen (emphysema)

Oxygen (lung fibrosis)

Carbon monoxide

Oxygen (during strenuous exercise)

A

Which one of the following is an example of perfusion-limited exchange?

Oxygen (normal conditions)

Oxygen (emphysema)

Oxygen (lung fibrosis)

Carbon monoxide

Oxygen (during strenuous exercise)

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47
Q
A
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48
Q

What view of the heart do leads V1 and V2 represent?

Septal
Lateral
Anterior
Inferior

A

What view of the heart do leads V1 and V2 represent?

Septal
Lateral
Anterior
Inferior

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49
Q

the mediastinal pleura receives innervation from:

a) vagus nerve
b) phrenic nerve only
c) intercostal nerve only
d) vagus and phrenic nerve
e) phrenic nerve and intercostal nerve

A

the mediastinal pleura receives innervation from:

a) vagus nerve
* *b) phrenic nerve only**
c) intercostal nerve only
d) vagus and phrenic nerve
e) phrenic nerve and intercostal nerve

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50
Q

Which one of the following muscles is supplied by the external laryngeal nerve?

Transverse artyenoid
Cricothyroid
Thyro-artyenoid
Posterior crico-arteynoid
Oblique artyenoid

A

Which one of the following muscles is supplied by the external laryngeal nerve?

Transverse artyenoid
Cricothyroid
Thyro-artyenoid
Posterior crico-arteynoid
Oblique artyenoid

The others are all supplied by the recurrent laryngeal nerve.

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51
Q

what are effects of RAAS system? [4]

A

differing effects depending on where it binds:

  • *i) proximal tubule**: Increases Na+ reabsorbtion, which increases blood flow, which increases BP
  • *ii) adrenal cortex:** increases aldosterone, which causes increase Na+ reabsorbtion in distal tubule, increase bloodflow and BP
  • *iii) systemic arterioles**: binds to GPCR = artriolar vasoconstriction = increases BP
  • *iv) brain:** stimules release of ADH = increase Na reabsorbtion
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52
Q

what do J receptors detect? [1]
what response do they cause? [1]

A

what do J receptors detect? [1]

  • pulmonary capillary widening
  • pulmonary oedema

what response do they cause? [1]

  • brachycardia
  • hypotension
  • bronchoconstriction
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53
Q

Thiazide diuretics act on which part of the nephron?

a) descending loop of Henle
b) ascending loop of Henle
c) distal tubule
d) collecting duct
e) promixal tubule

A

Thiazide diuretics act on which part of the nephron?

a) descending loop of Henle
b) ascending loop of Henle
* *c) distal tubule**
d) collecting duct
e) promixal tubule

Thiazide diuretics like bendroflumethiazide (Aprinox) inhibit reabsorption of sodium and chloride ions from the distal convoluted tubules in the kidneys by blocking a Na+/Cl− cotransporter.

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54
Q

If there were 3 large squares in an R-R interval what would the heart rate be?

90 bpm
100 bpm
80 bpm
70 bpm

A

If there were 3 large squares in an R-R interval what would the heart rate be?

90 bpm
100 bpm
80 bpm
​70 bpm

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55
Q

A 34-year-old man is shot in the postero- inferior aspect of his thigh. Which one of the following lies at the most lateral aspect of the popliteal fossa?

Popliteal artery
Popliteal vein
Common peroneal nerve
Tibial nerve
Small saphenous vein

A

A 34-year-old man is shot in the postero- inferior aspect of his thigh. Which one of the following lies at the most lateral aspect of the popliteal fossa?

Popliteal artery
Popliteal vein
Common peroneal nerve
Tibial nerve
Small saphenous vein

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56
Q

what is identified on this CXR?

Azygous vein
IVC
Right atrium
Left atrium
Right ventricle
Left ventricle

A

what is identified on this CXR?

Azygous vein
​IVC
Right atrium
Left atrium
Right ventricle
Left ventricle

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57
Q

A 65-year-old man with long standing atrial fibrillation develops an embolus to the lower leg. The decision is made to perform an embolectomy, utilising a trans popliteal approach. After incising the deep fascia, which of the following structures will the surgeons encounter first on exploring the central region of the popliteal fossa?

Popliteal vein
Common peroneal nerve
Popliteal artery
Tibial nerve
None of the above

A

A 65-year-old man with long standing atrial fibrillation develops an embolus to the lower leg. The decision is made to perform an embolectomy, utilising a trans popliteal approach. After incising the deep fascia, which of the following structures will the surgeons encounter first on exploring the central region of the popliteal fossa?

Popliteal vein
Common peroneal nerve
Popliteal artery
Tibial nerve
None of the above

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58
Q

which part of olfactory cavity produces mucous? [1]

A

Bowmans glands

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59
Q

Rapid sodium influx is the predominant finding during which phase of the cardiac action potential?

Final repolarisation

Rapid depolarisation

Early repolarisation

Plateau

A

Rapid sodium influx is the predominant finding during which phase of the cardiac action potential?

Final repolarisation

Rapid depolarisation

Early repolarisation

Plateau

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60
Q

which of the following acts on vascular smooth muscle?

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
A

which of the following acts on vascular smooth muscle?

  • *- alpha 1 adrenoreceptors**
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
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61
Q

Which one of the following actions is directly caused by growth hormone?

Increases gut absorption of calcium

Decreases appetite

Increases proximal tubule Na+/H+ activity

Increases lipolysis

Decreases renal reabsorption of phosphate

Increases glycogenolysis

A

Which one of the following actions is directly caused by growth hormone?

Increases gut absorption of calcium

Decreases appetite

Increases proximal tubule Na+/H+ activity

Increases lipolysis

Decreases renal reabsorption of phosphate

Increases glycogenolysis

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62
Q

the cardiac notch is located at which rib?

rib 2
rib 3
rib 4
rib 5
rib 6

A

the cardiac notch is located at which rib?

rib 2
rib 3
rib 4
rib 5
rib 6

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63
Q

Testicular and ovarian arteries leave the aorta:

L3
T12
L2
L1
L4

A

Testicular and ovarian arteries leave the aorta:

L3
T12
L2
L1
L4

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64
Q

In a patient with pneumonia, a past medical history of COPD is most associated with which organism?

Pneumocystis jiroveci

Mycoplasma pneumoniae

Staphylococcus aureus

Klebsiella pneumoniae

Haemophilus influenzae

Legionella pneumophilia

A

In a patient with pneumonia, a past medical history of COPD is most associated with which organism?

Pneumocystis jiroveci

Mycoplasma pneumoniae

Staphylococcus aureus

Klebsiella pneumoniae

Haemophilus influenzae

Legionella pneumophilia

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65
Q

out of the following, where does paracellular diffusion occur?

a) kidneys
b) lungs
c) heart
d) spleen

A

out of the following, where does paracellular diffusion occur?

  • *a) kidneys**
    b) lungs
    c) heart
    d) spleen
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66
Q

hyperventilation is characterised by:

  • metabolic acidosis
  • metabolic alkaosis
  • respiratory acidosis
  • respiratory alkolosis
A

hyperventilation is characterised by:

  • metabolic acidosis
  • metabolic alkaosis
  • respiratory acidosis
  • *- respiratory alkolosis**
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67
Q

An 81-year-old man presents to the emergency department with central, crushing chest pain. His ECG shows ST-segment elevation in leads V1-4.

Which electrical state in the heart is likely to be affected according to his ECG?

Atrial depolrisation

The time between onset of atrial depolarisation and the onset of ventricular depolaristion

The start of ventricular depolarisation

The period when the entire ventricle is depolarised

There is no link betweenthe electrical state of the heart and the ST segment of the ECG

A

An 81-year-old man presents to the emergency department with central, crushing chest pain. His ECG shows ST-segment elevation in leads V1-4.

Which electrical state in the heart is likely to be affected according to his ECG?

Atrial depolrisation

The time between onset of atrial depolarisation and the onset of ventricular depolaristion

The start of ventricular depolarisation

The period when the entire ventricle is depolarised

There is no link betweenthe electrical state of the heart and the ST segment of the ECG

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68
Q

What would happen if the papillary muscles in the left ventricle did not contract?

a) blood would regurgitate into the left atria
b) blood would pass into the aortic valve early
c) there would be increased turbulence as blood passed through the aortic valve
d) blood would regurgitate into the right atria

A

What would happen if the papillary muscles in the left ventricle did not contract?

  • *a) blood would regurgitate into the left atria**
    b) blood would pass into the aortic valve early
    c) there would be increased turbulence as blood passed through the aortic valve
    d) blood would regurgitate into the right atria
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69
Q

Which one of the following is most likely to represent a contraindication to the prescription of beta-blockers?

CKD (eGFR < 30ml/min/1.73m2)

Concurrent nitrate therapy

Cerebrovascular disease

Asthma

Recent myocardial infarction

Ischaemic heart disease

A

Which one of the following is most likely to represent a contraindication to the prescription of beta-blockers?

CKD (eGFR < 30ml/min/1.73m2)

Concurrent nitrate therapy

Cerebrovascular disease

Asthma

Recent myocardial infarction

Ischaemic heart disease

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70
Q

What would it suggest if lead I became more positive than lead II and lead III became negative?

Left axis deviaton
Right axis deviaton

A

What would it suggest if lead I became more positive than lead II and lead III became negative?

Left axis deviaton
Right axis deviaton

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71
Q

Which one of the following is the predominant finding during phase 2 of the cardiac action potential?

Rapid sodium influx

Resting potential is restored by Na+/K+ ATPase

Efflux of potassium

Rapid potassium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 2 of the cardiac action potential?

Rapid sodium influx

Resting potential is restored by Na+/K+ ATPase

Efflux of potassium

Rapid potassium influx

Efflux of calcium

Slow influx of calcium

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72
Q

What is structure A?

Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

A

What is structure A?

Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

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73
Q

which wave in ECG represents ventricle septal depolarisation?

  • P wave
  • Q wave
  • R wave
  • S wave
    ​- T wave
A

which wave in ECG represents ventricle septal depolarisation?

  • P wave
    - Q wave
  • R wave
  • S wave
    ​- T wave
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74
Q

what is the role of tropomyosin? [1]

A

covers the myosin-binding sites on actin

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75
Q

Are used in the management of stable adult asthma for adults not controlled with a SABA + ICS:

Oral corticosteroids

Inhaled corticosteroids (ICS)

Short-acting beta-agonists (SABA)

Leukotriene receptor antagonists

A

Are used in the management of stable adult asthma for adults not controlled with a SABA + ICS:

Oral corticosteroids

Inhaled corticosteroids (ICS)

Short-acting beta-agonists (SABA)

Leukotriene receptor antagonists

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76
Q

surfactant reduces alveoli surface tension. what is it mostly made from?

a) glycoprotein
b) glycolipid
c) phospholipid
d) lipid
e) glycophosolipid

A

surfactant reduces alveoli surface tension. what is it mostly made from?

a) glycoprotein
b) glycolipid
* *c) phospholipid**
d) lipid
e) glycophosolipid

structure: 50% phospholipid - dipalmitoylphosphatidylcholine (DPPtdCho)

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77
Q

at which level in respiratory system do you find clara cells?

a) trachea
b) bronchus
c) bronchioles
d) alveoli

A

at which level in respiratory system do you find clara cells?

a) trachea
b) bronchus
* *c) bronchioles**
d) alveoli

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78
Q

which part of respiratory tree are zones 17-19

  • terminal bronchioles
  • conducting bronchioles
  • respiratory bronchioles
  • lobar bronchus
  • segmental bronchioles
A

which part of respiratory tree is zone 17-19?
​
- terminal bronchioles
- conducting bronchioles
- respiratory bronchioles
- lobar bronchus
- segmental bronchioles

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79
Q

Which one of the following best describes the mechanism of action of salbutamol?

Increases cGMP leading to smooth muscle relaxation

Increase pancreatic insulin secretion

Beta receptor agonist

Antimuscarinic

H2 antagonist

H1 antagonist

A

Which one of the following best describes the mechanism of action of salbutamol?

Increases cGMP leading to smooth muscle relaxation

Increase pancreatic insulin secretion

Beta receptor agonist

Antimuscarinic

H2 antagonist

H1 antagonist

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80
Q

A 62-year-old man presents to his GP with shortness of breath on exertion. He has a transthoracic echo to determine the function of his heart.

How would the echo be used to calculate his cardiac output?

(stroke volume / end diastolic LV volume) * 100%
(end diastolic LV volume - end systolic LV volume) / HR
(end systolic LV volume - end diastolic LV volume) x HR
(end diastolic LV volume - end systolic LV volume) x HR
(systolic pressure - diastolic pressure) x HR

A

A 62-year-old man presents to his GP with shortness of breath on exertion. He has a transthoracic echo to determine the function of his heart.

How would the echo be used to calculate his cardiac output?

(stroke volume / end diastolic LV volume) * 100%
(end diastolic LV volume - end systolic LV volume) / HR
(end systolic LV volume - end diastolic LV volume) x HR
(end diastolic LV volume - end systolic LV volume) x HR

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81
Q

where would an inhaled object most likely be lodged in bronchiole tree and why? [2]

A

right bronchus [1]
more vertical than left bronchus [1]

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82
Q

sciatic nerve is halfway between which two points? [2]

A

sciatic nerve is halfway between which two points? [2]
greater trochanter and ischial tuberosity

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83
Q

* how do u calculate net filtration pressure? *

A

NFP = (HPc - HPif) - (OPc - OPif)

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84
Q

The space between the vocal cords is referred to as which of the following?

Piriform recess
Rima vestibuli
Vestibule
Glottis
Rima glottidis

A

The space between the vocal cords is referred to as which of the following?

Piriform recess
Rima vestibuli
Vestibule
Glottis
Rima glottidis

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85
Q
A

Vestibular Folds – Mucous membranes encasing vestibular ligaments. Protective function.

Rima Vestibuli – Space between vestibular ligaments

Vocal Folds (Vocal Cords) – Mucous membranes encasing vocal ligaments

Rima Glottidis - Space between vocal ligaments

Glottis – Vocal apparatus of larynx including vocal folds, ligaments and Rima Glottidis

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86
Q

what is A?

a) K+
b) Na+
c) Ca2+
d) Cl-
e) H+

A

what is A?

  • *a) K+**
    b) Na+
    c) Ca2+
    d) Cl-
    e) H+
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87
Q

which strucutres contribute to the nasal septum? (3)

A
  • septal cartilage
  • ethmoid
  • vomer
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88
Q

Thoracic duct perforates the diaphragm:

L3

T8

L2

T10

L4

T12

A

Thoracic duct perforates the diaphragm:

L3

T8

L2

T10

L4

T12

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89
Q

A 22-year-old man is stabbed in the chest at the level of the junction between the sternum and manubrium. Which structure is at greatest risk?

Left atrium
Oesphagus
Thyroid gland
IVC
Aortic arch

A

A 22-year-old man is stabbed in the chest at the level of the junction between the sternum and manubrium. Which structure is at greatest risk?

Left atrium
Oesphagus
Thyroid gland
IVC
Aortic arch

At the level of the Angle of Louis (Manubriosternal angle), is the surface marking for the aortic arch. The oesophagus is posteriorly located and at less risk.

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90
Q

beta blockers for antihypertensive drugs target which of the following:

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
A

beta blockers for antihypertensive drugs target which of the following:

​- alpha 1 adrenoreceptors

  • alpha 2 adrenoreceptors
  • *- beta 1 adrenoreceptors**
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
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91
Q

what are two causes of lympahtic blockage? (2)

A

primary: genetic cause

secondary: damage to lymphatic system (e.g. surgery, elephantiasis - worm infection, tissue injury)

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92
Q

neutropenia is a decrease in neutrophils, in which of the following would you see neutropenia?

  • infection
  • inflammation
  • tissue damage
  • ​HIV
  • haemorrhage
A

neutropenia is a decrease in neutrophils, in which of the following would you see neutropenia?

  • infection
  • inflammation
  • tissue damage
  • *- ​HIV**
  • haemorrhage

(others would cause neutrophilia - increase)

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93
Q

which of these would not be found in normal tissue?

  • plasma cells
  • mast cells
  • macrophage
  • neutrophils
  • B cells
  • T cells
A

which of these would not be found in normal tissue?

  • plasma cells
  • mast cells
  • macrophage
  • neutrophils
  • B cells
  • T cells
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94
Q

What type of blood gas abnormality does COPD most commonly cause?

Respiratory alkalosis

Respiratory acidosis

A

What type of blood gas abnormality does COPD most commonly cause?

Respiratory alkalosis

Respiratory acidosis

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95
Q

Which one of the following adverse effects is most characteristically associated with ACE inhibitors?

Ankle swelling

Hypocalcaemia

Heart failure

Precipitation of digoxin toxicity

Pruritus

Angioedema

A

Which one of the following adverse effects is most characteristically associated with ACE inhibitors?

Ankle swelling

Hypocalcaemia

Heart failure

Precipitation of digoxin toxicity

Pruritus

Angioedema

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96
Q

what is the function of bundle of his? [

A

It is a collection of cells that carry electrical signals from the AV node to the to the ventricles of the heart.

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97
Q

what does the big arrow point to in this pictutre of cardiac histology? [1]

A

bundle of His

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98
Q

what are the nasopharynx, oropharynx and laryngopharynx innervated by? [3]

A

nasopharynx: CN V2
oropharynx: CN IX
laryngopharynx: CN X

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99
Q

A patient’s ECG shows abnormal broad complex QRS complexes, indicating either a ventricular origin problem or aberrant conduction. What is the normal resting membrane potential of the heart’s ventricular contractile fibres?

-90mV
-50mV
0mV
+50mV
+90mV

A

A patient’s ECG shows abnormal broad complex QRS complexes, indicating either a ventricular origin problem or aberrant conduction. What is the normal resting membrane potential of the heart’s ventricular contractile fibres?

-90mV
-50mV
0mV
+50mV
+90mV

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100
Q

Which area of the brain stem coordinates the basic rhythm of breathing?

Thalamus
Midbrain
Upper pons
Lower pons
Medulla oblongata

A

Which area of the brain stem coordinates the basic rhythm of breathing?

Thalamus
Midbrain
Upper pons
Lower pons
​Medulla oblongata

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101
Q

Vital capacity:

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

Equals tidal volume + inspiratory reserve volume

Volume of air remaining after maximal expiration

Equals fuctional residual capacity - expiratory reserve volume

Equals inspiratory capacity + expiratory reserve volume

Maximum volume of air that can be expired at the end of a normal tidal expiration

A

Vital capacity:

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

Equals tidal volume + inspiratory reserve volume

Volume of air remaining after maximal expiration

Equals fuctional residual capacity - expiratory reserve volume

Equals inspiratory capacity + expiratory reserve volume

Maximum volume of air that can be expired at the end of a normal tidal expiration

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102
Q

which glucose transporters do erythrocytes use?

GLUT1
GLUT2
GLUT3
GLUT4
GLUT5

A

which glucose transporters do erythrocytes use?

GLUT1
GLUT2
GLUT3
GLUT4
​GLUT5

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103
Q

Which of the paranasal sinuses is located on the roof of the posterior nasal cavity, inferior to the pituitary gland?

Ethmoid air cells
Carotid sinus
Frontal sinus
Sphenoid sinus
Maxillary sinus

A

Which of the paranasal sinuses is located on the roof of the posterior nasal cavity, inferior to the pituitary gland?

Ethmoid air cells
Carotid sinus
Frontal sinus
Sphenoid sinus
​Maxillary sinus

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104
Q

which nerve supplies most of the muscles of the larynx, causing phonation?

superior laryngeal nerve
inferfior laryngeal nerve
recurrent laryngeal nerve
vagus nerve

A

which nerve supplies most of the muscles of the larynx, causing phonation?

superior laryngeal nerve
inferfior laryngeal nerve
recurrent laryngeal nerve
vagus nerve

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105
Q

What type of blood gas abnormality does anxiety leading to hyperventilation most commonly cause?

Respiratory alkalosis

Respiratory acidosis

A

What type of blood gas abnormality does anxiety leading to hyperventilation most commonly cause?

Respiratory alkalosis

Respiratory acidosis

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106
Q

where is sensor for the hormonal control of BP?

A

sensor: juxtaglomerular apparatus of the distal tubule of the kidney

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107
Q

which of the following would you not find in the red pulp of spleen?

a) old erythrocytes
b) lymphocytes
c) macrophages
d) plasma cells
e) damaged erythrocytes

A

which of the following would you not find in the red pulp of spleen?

a) old erythrocytes
b) lymphocytes
c) macrophages
* *d) plasma cells**
e) damaged erythrocytes

white pulp: B and T cells, APCs and plasma cells
red pulp: old & damaged RBC, macrophages, lymphocytes

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108
Q

A gentleman presents to the emergency department with haemorrhage after being involved in a road traffic accident. Despite his blood loss, his blood pressure has remained stable.

Which of the following is true about the receptors responsible for maintaining his blood pressure?

Baroreceptors are present throughout the arterial system
The baroceptor reflex only acts on the sympathetic NS
Baroceptor impulses travel via the SNS
Baroceptors are stimulated by arterial stretch
Barcoreptors only activate when BP drops

A

A gentleman presents to the emergency department with haemorrhage after being involved in a road traffic accident. Despite his blood loss, his blood pressure has remained stable.

Which of the following is true about the receptors responsible for maintaining his blood pressure?

Baroreceptors are present throughout the arterial system
The baroceptor reflex only acts on the sympathetic NS
Baroceptor impulses travel via the SNS
Baroceptors are stimulated by arterial stretch
Barcoreptors only activate when BP drops

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109
Q

which layer of heart valves do you find in the

i) atria
ii) ventricle
iii) middle of heart valve

A

which layer of heart valves do you find in the

i) atria: spongosia
ii) ventricle: ventricularis
iii) middle of heart valve: fibrosa

(on picture - first arrow: Fibrosa, middle, spongiosa, last - ventricularis)

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110
Q
A
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111
Q

In respect of skeletal muscle contraction, binds with calcium ions:

Actin

Troponin-C

Sarcoplasmic reticulum

Tropomyosin

Myosin

Titin

A

In respect of skeletal muscle contraction, binds with calcium ions:

Actin

Troponin-C

Sarcoplasmic reticulum

Tropomyosin

Myosin

Titin

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112
Q

A 19-year-old man has a routine ECG as part of his new employee health check. The ECG shows varying P-P intervals with slight changes in the ventricular rate. The P waves have a normal morphology and the P-R interval remains constant. His only past medical history is that he is asthmatic and has been using his inhalers more frequently since increasing his running mileage. You reassure the patient that his ECG is normal and record the rhythm as sinus arrhythmia. What is the most likely explanation for this rhythm?

Ventricular rate changes with ventilation
The patient is anxious
SAN firing has slight variation n fit patients
Use of salmutamol inhaler before appointment
Incorrect diagnosis

A

A 19-year-old man has a routine ECG as part of his new employee health check. The ECG shows varying P-P intervals with slight changes in the ventricular rate. The P waves have a normal morphology and the P-R interval remains constant. His only past medical history is that he is asthmatic and has been using his inhalers more frequently since increasing his running mileage. You reassure the patient that his ECG is normal and record the rhythm as sinus arrhythmia. What is the most likely explanation for this rhythm?

Ventricular rate changes with ventilation
The patient is anxious
SAN firing has slight variation n fit patients
Use of salmutamol inhaler before appointment
Incorrect diagnosis

- Sinus arrhythmia is a normal physiological phenomenon which is commonly seen in young, healthy patients. The heart rate varies with ventilation, inspiration increases heart rate and expiration decreases (only very slightly but detectable on ECG).

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113
Q

what are the two MOA for calcium channgel blockers?

A
  • intracellular Ca2+ influx stopped
    i) Left ventricle and HR decrease: less o2 consumption in myocardium
    ii) vascular smooth muscle contraction inhibition: coronary artery dilation = coronorary BF increaeed, o2 supply in myocardium increased

decreases angina

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114
Q

Work by relaxing the smooth muscle of airways:

Inhaled corticosteroids (ICS)

Oral corticosteroids

Leukotriene receptor antagonists

Short-acting beta-agonists (SABA)

A

Work by relaxing the smooth muscle of airways:

Inhaled corticosteroids (ICS)

Oral corticosteroids

Leukotriene receptor antagonists

Short-acting beta-agonists (SABA)

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115
Q

what is the name of when neutrophils move through capillary cell wall? [1]

A

diapedesis

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116
Q

what does hypoxia cause to occur to local blood vessels in alveoli? [1]

A

vasconstriction at the alveoli with poor ventilation. redirect blood to alveoli with better ventilation [1]

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117
Q
A
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118
Q

which type of capillaries are found in CNS? (1)

A

continous capilarries (without caveolae)

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119
Q

Taken everyday for the treatment of asthma, regardless of whether the patient has symptoms:

Short-acting beta-agonists (SABA)

Oral corticosteroids

Long-acting beta-agonists (LABA)

A

Taken everyday for the treatment of asthma, regardless of whether the patient has symptoms:

Short-acting beta-agonists (SABA)

Oral corticosteroids

Long-acting beta-agonists (LABA)

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120
Q

Where are the greatest proportion of musculi pectinati found?

Right ventricle
Left ventricle
Right atrium
Pulmonary valve
Aortic valve

A

Where are the greatest proportion of musculi pectinati found?

Right ventricle
Left ventricle
Right atrium
Pulmonary valve
Aortic valve

The musculi pectinati are found in the atria, hence the reason that the atrial walls in the right atrium are irregular anteriorly.

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121
Q

Which one of the following is the predominant finding during phase 3 of the cardiac action potential?

Slow influx of calcium

Rapid sodium influx

Resting potential is restored by Na+/K+ ATPase

Efflux of potassium

Efflux of calcium

Rapid potassium influx

A

Which one of the following is the predominant finding during phase 3 of the cardiac action potential?

Slow influx of calcium

Rapid sodium influx

Resting potential is restored by Na+/K+ ATPase

Efflux of potassium

Efflux of calcium

Rapid potassium influx

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122
Q
A
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123
Q

which leukocytes are found in the tissue? [5]

A

tissues:

  • **mast cells
  • macrophage (derived from monocytes)
  • B & T cells
  • plasma cells**
124
Q

how do you calculate co2 and o2 exchange?

A

Room o2 = 21%
alveolar o2 = 14%

O2 input: 4.2 (volume of alveolar ventilation) X (21 - 14 / 100) = 0.294 L/min

125
Q

Which cells of the respiratory tract increase in number with chronic exposure to irritants such as smoking? [1]

A

goblet cells

126
Q
A
127
Q

What is structure D?

Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

A

What is structure D?

​Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

128
Q

Which one of the following is the predominant finding during C of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during C of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

129
Q

label 1 & 2

A 
1 = The costodiaphragmatic recesses 
2 = The costomediastinal recess
130
Q

Here is a photomicrograph of the surface of the lung. What does the arrow indicate?

Stratified sqaumous epithelial cells
Fibroblasts
Simple cuboidal epithelial cells
Mesothelial cells
Endotheilial cells

A

Here is a photomicrograph of the surface of the lung. What does the arrow indicate?

Stratified sqaumous epithelial cells
Fibroblasts
Simple cuboidal epithelial cells
Mesothelial cells
Endotheilial cells

On the surface of the lung is the visceral pleura. It has a serosal lining. There is a thin layer of simple squamous epithelial cells (mesothelium) supported by connective tissue. This epithelium allows a little serous (watery) fluid to cross and lubricate the lungs as they move in the closed pleural cavity. There is only one layer of flattened nuclei (reddish colouration) visible at the surface. The few other nuclei underlying the mesothelium are fibroblast nuclei in the connective tissue. It does not resemble stratified squamous epithelium.

131
Q

What does ST-elevation suggest? [1]

A

myocardial infarction

132
Q

capillaries are held together by:

a) gap junctions
b) desmosomes
c) hemidesmosomes
d) tight junctions

A

capillaries are held together by:

a) gap junctions
b) desmosomes
c) hemidesmosomes
* *d) tight junctions**

133
Q

What type of blood gas abnormality does pulmonary embolism most commonly cause?

Respiratory acidosis

Respiratory alkalosis

A

What type of blood gas abnormality does pulmonary embolism most commonly cause?

Respiratory acidosis

Respiratory alkalosis

134
Q

Which one of the following is most characteristically caused by thiazides?

Hypocalcaemia

Hyperkalaemia

Hypernatraemia

Hypercalcaemia

A

Which one of the following is most characteristically caused by thiazides?

Hypocalcaemia

Hyperkalaemia

Hypernatraemia

Hypercalcaemia

135
Q

Which of the following is a common cause of right axis deviation?

Ventricular septal defect

Atrial septal defect

Right ventricular hypertrophy

Left ventricular hypertrophy

A

Which of the following is a common cause of right axis deviation?

Ventricular septal defect

Atrial septal defect

Right ventricular hypertrophy

Left ventricular hypertrophy

136
Q

Which one of the following are not generally supplied by the right coronary artery?

  • SAN
  • the circumflex artery
  • AVN
  • most of right ventricle
  • right atrium
A

Which one of the following are not generally supplied by the right coronary artery?

  • SAN
    - the circumflex artery
  • AVN
  • most of right ventricle
    ​- right atrium

The circumflex artery is generally a branch of the left coronary artery.

137
Q

Which one of the following is an example of perfusion-limited exchange?

Oxygen (during strenuous exercise)

Oxygen (emphysema)

Oxygen (lung fibrosis)

Carbon monoxide

Carbon dioxide

A

Which one of the following is an example of perfusion-limited exchange?

Oxygen (during strenuous exercise)

Oxygen (emphysema)

Oxygen (lung fibrosis)

Carbon monoxide

Carbon dioxide

138
Q

which of these is correct about leukocytes?

a) most common = lymphocyte, least common = basophil
b) most common = neutrophil, least common = basophil
c) most common = basophil, least common = eosinophil
d) most common = monocyte, least common = neutrophil
e) most common = lymphocyte, least common = eosinophil

A

which of these is correct?

a) most common = lymphocyte, least common = basophil
* *b) most common = neutrophil, least common = basophil**
c) most common = basophil, least common = eosinophil
d) most common = monocyte, least common = neutrophil
e) most common = lymphocyte, least common = eosinophil

139
Q

what is JVP from? [1]

A

atria contracting and causing back pressure in jugular vein [1]

140
Q

Ischaemic changes in leads I, aVL +/- V5-6 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

A

Ischaemic changes in leads I, aVL +/- V5-6 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

141
Q
A
142
Q

which of the following is not granular leukocyte?

a) lymphocyte
b) neutrophil
c) basophil
d) eosinophil

A

which of the following is not granular leukocyte?

a) lymphocyte
b) neutrophil
c) basophil
​d) eosinophil

143
Q

which of the following lack pinocytic vesicles

a) fenestrated capillary
b) discontinous capillary
c) continous capillary

A

which of the following lack pinocytic vesicles

a) fenestrated capillary
* *b) discontinous capillary**
c) continous capillary

144
Q

what are the figures of V/Q at

i) base of the lung
ii) apex of the lung

A

what are the figures of V/Q at

i) base of the lung: 0.63
ii) apex of the lung 3.33

145
Q

closure of which channels determines rate of firing of cardiac pacemaker cells?

  • Na
  • Ca
  • K
  • GLUT4
A

closure of which channels determines rate of firing of cardiac pacemaker cells?

  • Na
  • Ca
  • *- K**
  • GLUT4
146
Q
A
147
Q

where do you find B & T cells in lymph node? [2]

A

B cells: lymphoid nodules in cortex
T cells: paracortex or thymus-dependent region

T cells further in !!

148
Q

at which point is cartilage lost in the respiratory tree?

  • terminal bronchioles
  • conducting bronchioles
  • respiratory bronchioles
  • lobar bronchus
  • segmental bronchioles
A

at which point is cartilage lost in the respiratory tree?

  • terminal bronchioles
  • *- conducting bronchioles**
  • respiratory bronchioles
  • lobar bronchus
  • segmental bronchioles
149
Q

Control of ventilation. Which statement is false?

Peripheral chemoreceptors are located in the bifurcation of the carotid arteries and arch of the aorta
Central chemoreceptors respond to changes in O2
The respiratory centres control the rate and depth of respiration
Involuntary control of respiration is from the medulla and pons
Irritant receptors cause bronchospasm

A

Control of ventilation. Which statement is false?

Peripheral chemoreceptors are located in the bifurcation of the carotid arteries and arch of the aorta
Central chemoreceptors respond to changes in O2
The respiratory centres control the rate and depth of respiration
Involuntary control of respiration is from the medulla and pons
Irritant receptors cause bronchospasm

Central chemoreceptors: Respond to increased H+ in BRAIN INTERSTITIAL FLUID to increase ventilation.

150
Q

which cells make the conducting system of the heart? [1]

A

purkinje fibres

151
Q

which of the following is not one of the 4 main types of CVD?

a) stoke
b) CHD
c) pulmonary disease
d) aortic disease
e) peripheral arterial disease

A

which of the following is not one of the 4 main types of CVD?

a) stoke
b) CHD
* *c) pulmonary disease**
d) aortic disease
e) peripheral arterial disease

152
Q

What is the duration of a normal PR-interval?

  1. 04 - 0.08 secs
  2. 12 - 0.2 secs
  3. 08 - 0.12 secs
  4. 04 - 0.12 secs
A

What is the duration of a normal PR-interval?

  1. 04 - 0.08 secs
    * *0.12 - 0.2 secs**
  2. 08 - 0.12 secs
  3. 04 - 0.12 secs
153
Q
A
154
Q

which organ are hassal corpuscles found in?

spleen
thymus
lymph node
spleen and thymus
spleen and lymph node

A

which organ are hassal corpuscles found in?

spleen
thymus
lymph node
spleen and thymus
spleen and lymph node

155
Q
A
156
Q

A 32-year-old man is brought to the Emergency Department coughing and wheezing after an episode of alcohol intoxication. On examination, he has reduced breath sounds on the one side. Imaging studies show he has aspirated a foreign body, which is occluding an airway structure. Which is the most likely location for this foreign body to be stuck in?

Trachea
Left mainstem bronchus
Right superior lobar bronchus
Right mainstem bronchus
Left superior lobar bronchus

A

A 32-year-old man is brought to the Emergency Department coughing and wheezing after an episode of alcohol intoxication. On examination, he has reduced breath sounds on the one side. Imaging studies show he has aspirated a foreign body, which is occluding an airway structure. Which is the most likely location for this foreign body to be stuck in?

Trachea
Left mainstem bronchus
Right superior lobar bronchus
Right mainstem bronchus
​Left superior lobar bronchus

157
Q

If ST-elevation was noted in leads II, III and aVF, what would it suggest?

  • posterior myocardial infarction
  • An inferior myocardial infarction
  • A septal myocardial infarction
  • An anterior myocardial infarction
A

If ST-elevation was noted in leads II, III and aVF, what would it suggest?

  • posterior myocardial infarction

- An inferior myocardial infarction

  • A septal myocardial infarction
  • An anterior myocardial infarction
158
Q

A young man presents with acute onset palpitations and shortness of breath, his ECG shows tachycardia. Which of the following cardiac structures usually depolarises at the fastest rate?

AVN
SAN
Ventricular epicardium
Bundle of His
Purkinje fibres

A

A young man presents with acute onset palpitations and shortness of breath, his ECG shows tachycardia. Which of the following cardiac structures usually depolarises at the fastest rate?

AVN
SAN
Ventricular epicardium
Bundle of His
Purkinje fibres

159
Q

What view of the heart do leads I, aVL, V5 and V6 represent?

Anterior
Septal
Lateral
Inferior

A

What view of the heart do leads I, aVL, V5 and V6 represent?
​
Anterior
Septal
Lateral
Inferior

160
Q

name two places ANP can be released from? [2]

A

right atrium
IVC

161
Q

Residual volume:

Equals tidal volume * (PaO2 - PeO2) / PaO2

4,500ml in males, 3,500 mls in females

Maximum volume of air that can be expired at the end of a normal tidal expiration

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

Increases with age

500ml in males, 350ml in females

A

Residual volume:

Equals tidal volume * (PaO2 - PeO2) / PaO2

4,500ml in males, 3,500 mls in females

Maximum volume of air that can be expired at the end of a normal tidal expiration

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

Increases with age

500ml in males, 350ml in females

162
Q

* how do u calculate net filtration pressure? *

A

NFP = (HPc - HPif) - (OPc - OPif)

163
Q

what is the role of 2,3 DPG (2,3- di phosphoglycerate) [1]

A

The presence of DPG displaces the dissociation curve to the right and so aids the unloading of O2 at active tissues.

164
Q

which beta receptor do Beta Blockers work at?

a) B1
b) B2
c) B3

A

which beta receptor do Beta Blockers work at?

  • *a) B1**
    b) B2
    c) B3

antagonisitically !

165
Q

A 58-year-old gentleman presented with abdominal pain exacerbated by eating, nausea and weight loss. After imagining, it is suspected that he has median arcuate ligament syndrome. This is causing a compression of the branch of the abdominal aorta supplying the foregut, so he is scheduled for surgical decompression of this vessel.

What are the 3 branches of this occluded branch of the aorta?

Cystic, hepatic, splenic
Hepatic, pancreatic, splenic
Left gastric, hepatic, splenic,
Left gastric, right gastric, hepatic
Right gastric, hepatic, pancreatic

A

A 58-year-old gentleman presented with abdominal pain exacerbated by eating, nausea and weight loss. After imagining, it is suspected that he has median arcuate ligament syndrome. This is causing a compression of the branch of the abdominal aorta supplying the foregut, so he is scheduled for surgical decompression of this vessel.

What are the 3 branches of this occluded branch of the aorta?

Cystic, hepatic, splenic
Hepatic, pancreatic, splenic
Left gastric, hepatic, splenic,
Left gastric, right gastric, hepatic
​Right gastric, hepatic, pancreatic

166
Q

Which one of the following is the predominant finding during phase 3 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 3 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

167
Q

what is average GFR for both kidneys for healthy adult?

A

The total amount of fluid filtered through ALL the glomeruli in BOTH kidneys in a fit adult is about 120-125 ml/min.

168
Q

Which one of the following actions is directly caused by cortisol?

Stimulates release of insulin-like growth factors

Increases Na+ reabsorption in the renal distal tubule

Vasoconstriction of vascular smooth muscle

Increases osteoclastic activity

Increases glycogenolysis

Increases gastric H+ secretion

A

Which one of the following actions is directly caused by cortisol?

Stimulates release of insulin-like growth factors

Increases Na+ reabsorption in the renal distal tubule

Vasoconstriction of vascular smooth muscle

Increases osteoclastic activity

Increases glycogenolysis

Increases gastric H+ secretion

169
Q

name two locations you might find a discontinous capillary [2]

A

spleen
thymus
bone marrow

170
Q

Which one of the following are not characteristic features of central chemoreceptors in the control of ventilation?

They are located in the medulla oblongata
They are stimulated primarly by venous hypercapnia
They are relatively insensitve to hypoxia
They may be affected by changes in the pH of CSF
During acute hypercapnia the carotid sensor receptors will be stimulated first

A

Which one of the following are not characteristic features of central chemoreceptors in the control of ventilation?

They are located in the medulla oblongata
They are stimulated primarly by venous hypercapnia
They are relatively insensitve to hypoxia
They may be affected by changes in the pH of CSF
During acute hypercapnia the carotid sensor receptors will be stimulated first

They are stimulated by arterial carbon dioxide.

171
Q

which transporter do thiazide diuretics work on?

Na/K
Na/K/Cl2
Na/Cl
ROMK
SGLT

A

which transporter do thiazide diuretics work on?

Na/K
Na/K/Cl2
Na/Cl @ DCT
ROMK
SGLT

172
Q

Ischaemic changes in leads V1-V4 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

A

Ischaemic changes in leads V1-V4 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

173
Q

A 45-year-old man has a long femoral line inserted to provide CVP measurements. The catheter passes from the common iliac vein into the inferior vena cava. At which of the following vertebral levels will this occur?

L5
L4
S1
L3
L2

A

A 45-year-old man has a long femoral line inserted to provide CVP measurements. The catheter passes from the common iliac vein into the inferior vena cava. At which of the following vertebral levels will this occur?

L5
L4
S1
L3
​L2

174
Q

Azygous vein perforates the diaphragm:

T8

L2

T12

L1

T10

L3

A

Azygous vein perforates the diaphragm:

T8

L2

T12

L1

T10

L3

175
Q

what is the name for oxidised Hb?

A

methaemoglobin

176
Q

The radiologist notes a bowel obstruction at the level of L1.

Which of the following is the most likely to be affected?

Caecum
Duodenum
Ileum
Rectum
Transverse colon

A

The radiologist notes a bowel obstruction at the level of L1.

Which of the following is the most likely to be affected?

Caecum
Duodenum
Ileum
Rectum
Transverse colon

177
Q

which cells produce fibroblasts? [1]

A

pericytes

178
Q

name two causes of a decreased V/Q ratio [2]

A

COPD
Asthma

179
Q

which of the following [2] is S wave largest on?

V1
V2
V3
V4
V5
V6

A

which of the following [2] is S wave largest on?

V1
V2
V3
V4
V5
​V6

180
Q

Used first-line if a patient is experiencing an exacerbation of asthma:

Leukotriene receptor antagonists

Oral corticosteroids

Short-acting beta-agonists (SABA)

Long-acting beta-agonists (LABA)

Inhaled corticosteroids (ICS)

A

Used first-line if a patient is experiencing an exacerbation of asthma:

Leukotriene receptor antagonists

Oral corticosteroids

Short-acting beta-agonists (SABA)

Long-acting beta-agonists (LABA)

Inhaled corticosteroids (ICS)

181
Q

which, out of the parietal and visceral pleura, is sensitive to pain? [1]

A

parietal

182
Q

Which artery is most likely to be affected in the context of ST elevation being present in leads V3 and V4?

Left anterior descending coronary artery
Left circumflex coronary artery
Right coronary artery
All of the above

A

Which artery is most likely to be affected in the context of ST elevation being present in leads V3 and V4?

Left anterior descending coronary artery
Left circumflex coronary artery
Right coronary artery
All of the above

Leads V3 and V4 represent the anterior portion of the heart. ST elevation in these leads would be suggestive of anterior myocardial infarction. The anterior portion of the heart is supplied primarily by the left anterior descending artery.

183
Q

Which two factors influence the work of the heart? [2]

A
  1. Diameter of arterioles (main)
  2. Viscosity of blood
184
Q

A 67-year-old man undergoes a carotid endarterectomy and seems to recover well following surgery. When he is reviewed on the ward post operatively he complains that his voice is hoarse. What is the most likely cause?

Damage to the accessory nerve
Damage to the cervical plexus
Damage to the glossopharnygeal nerve
Damage to the hypoglossoal nerve
Damage to the vagus

A

A 67-year-old man undergoes a carotid endarterectomy and seems to recover well following surgery. When he is reviewed on the ward post operatively he complains that his voice is hoarse. What is the most likely cause?

Damage to the accessory nerve
Damage to the cervical plexus
Damage to the glossopharnygeal nerve
Damage to the hypoglossoal nerve
Damage to the vagus

185
Q

Which one of the following is the sensory nerve that branches off the superior laryngeal nerve?

Left vagus nerve
Left recurrent laryngeal nerve
External laryngeal nerve
Internal layngeal nerve
Right recurrent laryngeal nerve

A

Which one of the following is the sensory nerve that branches off the superior laryngeal nerve?

Left vagus nerve
Left recurrent laryngeal nerve
External laryngeal nerve
Internal layngeal nerve
​Right recurrent laryngeal nerve

186
Q

to undertake a blood smear, you use which stain:

a) wrights stain
b) toluidine blue
c) silver nitrate
d) haematoxylin and eosin
e) ziehl-neelsen stain

A

to undertake a blood smear, you use which stain:

  • *a) wrights stain**
    b) toluidine blue
    c) silver nitrate
    d) haematoxylin and eosin
    e) ziehl-neelsen stain
187
Q

A 66-year-old man with a suspected ruptured abdominal aortic aneurysm is rushed to the emergency department. On arrival, the patient is cold, clammy, and looks pale. His observations are as follows: temperature 35.3 degrees Celsius, respiratory rate 40, heart rate 116bpm, and blood pressure 90/65mmHg.

On a drop in the blood oxygen concentration, his inspiratory centre is stimulated and overrides any voluntary cortical control of breathing pattern. Where are the peripheral chemoreceptors that detect these changes?

Internal carotid artery
Aortic arch
SVC
Pulmonary vein
Pulmonary artery

A

A 66-year-old man with a suspected ruptured abdominal aortic aneurysm is rushed to the emergency department. On arrival, the patient is cold, clammy, and looks pale. His observations are as follows: temperature 35.3 degrees Celsius, respiratory rate 40, heart rate 116bpm, and blood pressure 90/65mmHg.

On a drop in the blood oxygen concentration, his inspiratory centre is stimulated and overrides any voluntary cortical control of breathing pattern. Where are the peripheral chemoreceptors that detect these changes?

Internal carotid artery
Aortic arch
SVC
Pulmonary vein
​Pulmonary artery

The aortic and carotid bodies contain the peripheral chemoreceptors which can respond to changes in carbon dioxide concentration in the arterial blood. They are situated in the aortic arch and carotid bodies (at the bifurcation of the common carotid artery). They are less sensitive than the central chemoreceptors in the medulla oblongata, which monitors the CSF. There are no peripheral chemoreceptors in veins.

188
Q

In respect of skeletal muscle contraction, middle of the sarcomere, cross-linking myosin:

I-band

H-zone

Actin

Titin

M-line

Tropomyosin

A

In respect of skeletal muscle contraction, middle of the sarcomere, cross-linking myosin:

I-band

H-zone

Actin

Titin

M-line

Tropomyosin

189
Q

explain the MOA for beta blockers for treating angina? [4]

A

Beta Blockers

  • B1 receptor antagonist: [1]
  • causes reduced HR (@ SA node) [1]
  • decrease in o2 demand at SA node [1]
  • negative inotropic effect [1]
  • decrease BP [1]
  • decreased myocardial oxygen demand
190
Q

what is the level of the notch of the cartilage?

C1
C2
C3
C4
C5

A

what is the level of the notch of the cartilage?

C1
C2
C3
C4
​C5

191
Q

Where are the greatest proportion of musculi pectinati found?

  • right ventricle
  • left ventricle
  • right atrium
  • pulmonary valve
  • aortic valve
A

Where are the greatest proportion of musculi pectinati found?

  • right ventricle
  • left ventricle
    - right atrium
  • pulmonary valve
    ​- aortic valve

The musculi pectinati are found in the atria, hence the reason that the atrial walls in the right atrium are irregular anteriorly

192
Q

Which structuresare are located between the submucosa and tunica adventitia of the trachea? [2]

A

hyaline cartliage
perichondrium

193
Q

which stain would you use to identify reticulocytes?

a) ziehl neelsen
b) orcein
c) H&E
d) methylene blue
e) gram

A

which stain would you use to identify reticulocytes?

a) ziehl neelsen
b) orcein
c) H&E
* *d) methylene blue**
e) gram

194
Q

where do you find the mesangial cells:

a) wall of distal tubule
b) between afferent and efferent arterioles
c) loop of Henle
d) wall of proximal tubule
e) around the wall of the afferent and efferent arterioles

A

where do you find the mesangial cells:

a) wall of distal tubule
* *b) between afferent and efferent arterioles**
c) loop of Henle
d) wall of proximal tubule
e) around the wall of the afferent and efferent arterioles

195
Q

Which one of the following actions is directly caused by glucagon?

Stimulates release of insulin-like growth factors

Inhibits insulin secretion

Inhibits inflammatory and immune responses

Increases gluconeogenesis

Decreases appetite

Increases secretion of water from pancreas and intestines

A

Which one of the following actions is directly caused by glucagon?

Stimulates release of insulin-like growth factors

Inhibits insulin secretion

Inhibits inflammatory and immune responses

Increases gluconeogenesis

Decreases appetite

Increases secretion of water from pancreas and intestines

196
Q

name two locations the ANP works on increasing Na+ reabsorbtion [2]

A

CD and DCT

197
Q

which cells do you find in the myocardium? [1]

A

cardiomyocytes

198
Q
A
199
Q

A 64-year-old presents acutely with shortness of breath, ankle swelling and chest pain. He is diagnosed with heart failure. His stroke volume is failing to respond appropriately to which of the following?

Afterload
VN impulses
Preload
Aortic pressure
Systole

A

A 64-year-old presents acutely with shortness of breath, ankle swelling and chest pain. He is diagnosed with heart failure. His stroke volume is failing to respond appropriately to which of the following?

Afterload
VN impulses
Preload
Aortic pressure
​Systole

200
Q
A
201
Q

what are the three different reasons that RAAS system might be activated [3]

A
  1. sympathetic nerve activation (via B-adrenoreceptors)
  2. renal artery hypotension
  3. decreased sodium delivery to the distal tubules of the kidney
202
Q

Residual volume:

Volume of air remaining after maximal expiration

Equals tidal volume * (PaCO2 - PeCO2) / PaCO2

Equals tidal volume + inspiratory reserve volume

500ml in males, 350ml in females

Maximum volume of air that can be expired at the end of a normal tidal expiration

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

A

Residual volume:

Volume of air remaining after maximal expiration

Equals tidal volume * (PaCO2 - PeCO2) / PaCO2

Equals tidal volume + inspiratory reserve volume

500ml in males, 350ml in females

Maximum volume of air that can be expired at the end of a normal tidal expiration

Maximum volume of air that can be inspired at the end of a normal tidal inspiration

203
Q

what is angina? [1]
name three drug classes you would use to treat angina [3]

A

what is angina? [1]
decrease o2 supply to heart

name three drug classes you would use to treat angina [3]
nitrates [1]
CCB [1]
BB [1]

204
Q

Joanna is a 62-year-old female who has recently been diagnosed with hypertension. Her doctor explains to her that her average blood pressure is determined by multiple bodily processes, including action by the heart, nervous system, and blood vessel diameter. Theoretically, on average, Joanna’s cardiac output (CO) is 4L/min. On examination today, her mean arterial pressure (MAP) is measured at 140mmHg.

Given these figures, what is Joanna’s systemic vascular resistance (SVR)? [1]

A

Joanna is a 62-year-old female who has recently been diagnosed with hypertension. Her doctor explains to her that her average blood pressure is determined by multiple bodily processes, including action by the heart, nervous system, and blood vessel diameter. Theoretically, on average, Joanna’s cardiac output (CO) is 4L/min. On examination today, her mean arterial pressure (MAP) is measured at 140mmHg.

Given these figures, what is Joanna’s systemic vascular resistance (SVR)? [1]

35 mm Hg min mL-1

The calculation used to calculate systemic vascular resistance is: SVR = MAP / CO. Therefore, in this case, SVR = 140/4 = 35mmHg⋅min⋅mL-1.

205
Q

where do you find the macula densa cells:

a) wall of distal tubule
b) between afferent and efferent arterioles
c) loop of Henle
d) wall of proximal tubule
e) around the wall of the afferent and efferent arterioles

A

where do you find the macula densa cells:

  • *a) wall of distal tubule**
    b) between afferent and efferent arterioles
    c) loop of Henle
    d) wall of proximal tubule
    e) around the wall of the afferent and efferent arterioles
206
Q

bronchodilation at the lungs is caused by sympathetic innervation on which adrenergic receptors?

a) alpha 1
b) alpha 2
c) beta 1
d) beta 2
e) beta 3

A

bronchodilation at the lungs is caused by sympathetic innervation on which adrenergic receptors?

a) alpha 1
b) alpha 2
c) beta 1
* *d) beta 2**
e) beta 3

207
Q

what do the vocal cords attach to i) anteriorly ii) posteriorly?

A

anterior: thyroid cartilage
posterior: artyenoids

208
Q

A man presents to his GP and has his lying and standing blood pressures measured. When he stands his baroreceptors detect decreased stretch, activating the baroreceptor reflex. This decreases baroreceptor activity, which causes an increase in sympathetic discharge.

What is the action of the neurotransmitter released?

Noradrenaline binds to β 1 receptors in the SA node increasing depolarisation
Noradrenaline binds to a 1 receptors in the SA node increasing depolarisation
Noradrenaline binds to β 1 receptors in the AV node decreasing depolarisation
Noradrenaline binds to a 1 receptors in the AV node increasing depolarisation

A

A man presents to his GP and has his lying and standing blood pressures measured. When he stands his baroreceptors detect decreased stretch, activating the baroreceptor reflex. This decreases baroreceptor activity, which causes an increase in sympathetic discharge.

What is the action of the neurotransmitter released?

Noradrenaline binds to β 1 receptors in the SA node increasing depolarisation
Noradrenaline binds to a 1 receptors in the SA node increasing depolarisation
Noradrenaline binds to β 1 receptors in the AV node decreasing depolarisation
​Noradrenaline binds to a 1 receptors in the AV node increasing depolarisation

209
Q

Which one of the following is the predominant finding during phase 1 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 1 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

210
Q

what is the equation to calculate cardiac output? [1]

A

CO (L/ min) = HR X SV

211
Q

Ventricular muscle has an unusual shape of action potential. It starts like a normal nerve action potential with sodium influx, however this is followed by a prolonged depolarisation phase called the plateau. This plateau is due to a late and prolonged entry of which ion into the cell?

a) K+
b) Na+
c) Ca2+
d) Cl-
e) H+

A

Ventricular muscle has an unusual shape of action potential. It starts like a normal nerve action potential with sodium influx, however this is followed by a prolonged depolarisation phase called the plateau. This plateau is due to a late and prolonged entry of which ion into the cell?

a) K+
b) Na+
* *c) Ca2+**
d) Cl-
e) H+

212
Q

Ischaemic changes in leads II, III, & aVF would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

A

Ischaemic changes in leads II, III, & aVF would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

213
Q

which sinus does sinisitus most commonly occur in?

a) temporal
b) maxillary
c) ethmoidal
d) sphenoidal

A

which sinus does sinisitus most commonly occur in?

a) temporal
* *b) maxillary**
c) ethmoidal
d) sphenoidal

happens most commonly in maxillary sinus: drainage hole is in the superior part of maxillary sinus

214
Q

where do find Hassal’s corpuscles?

a) MALT
b) bone marrow
c) lymph nodes
d) spleen
e) thymus

A

where do find Hassal’s corpuscles?

a) MALT
b) bone marrow
c) lymph nodes
d) spleen
* *e) thymus**

215
Q

Internal laryngeal nerve and superior laryngeal artery enter the larnx at

a) cricothryoid membrane
b) thryoid cartilage
c) artyenoid cartliage
d) thyrohyiod membrane
e) cunieform cartilage

A

Internal laryngeal nerve and superior laryngeal artery enter the larnx at

a) cricothryoid membrane
b) thryoid cartilage
c) artyenoid cartliage
* *d) thyrohyiod membrane**
e) cunieform cartilage

216
Q
A
217
Q

what is the nerve supply to the

i) diaphragmatic pleura? [2]
ii) mediastinal pleura? [1]

A

i) diaphragmatic pleura: intercostal and phrenic nerves
ii) mediastinal pleura: phrenic nerve

218
Q

What is the typical stroke volume in a resting 70 Kg man?

10 ml
150 ml
125 ml
45 ml
70 ml

A

What is the typical stroke volume in a resting 70 Kg man?

10 ml
150 ml
125 ml
45 ml
70 ml

219
Q

what is effect of nitroglycerin (and glyceryl trinitrate) in low doses?

  • increases afterload
  • decreases afterload
  • increases preload
  • decreases preload
  • decreases preload and afterload
A

what is effect of nitroglycerin (and glyceryl trinitrate) in low doses?

  • increases afterload
  • decreases afterload
  • increases preload
  • *- decreases preload**
  • decreases preload and afterload

**low doses = decreases preload
high does = decreases afterload

BOTH cause decrease in o2 demand at heart**

220
Q

which of the following would you associate with an allergic reaction, parasitic infections and chronic inflammation?

a) eosinophils
b) lymphocytes
c) basophils
d) monocytes
e) neutrophils

A

which of the following would you associate with an allergic reaction, parasitic infections and chronic inflammation?

  • *a) eosinophils**
    b) lymphocytes
    c) basophils
    d) monocytes
    e) neutrophils
221
Q

Which one of the following is the predominant finding during D of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during D of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

222
Q

what type of cells are Hassals corpuscles made from? [1]
what is the function of HC? [1]

A

epithelial reticulocytes
activate dendritic cells

223
Q

which organ is directed the most blood from C/O?

a) heart
b) brain
c) liver
d) kidney
e) lungs

A

which organ is directed the most blood from C/O?

a) heart
b) brain
c) liver
d) kidney
​e) lungs

224
Q

what is type 1 and type 2 respiratory failure from? [2]

A

type 1 respiratory failure: hypoxaemia (PaO2 <8kPa) without hypercapnia
type 2 respiratory failure: hypoxaemia with hypercapnia

225
Q

which of the following [2] is T wave largest on?

V1
V2
V3
V4
V5
​V6

A

which of the following [2] is T wave largest on?

V1
V2
V3
V4
V5
​V6

226
Q

what is the the structure that connects the cartilage in trachea?

  • tunica adventitia
  • smooth muscle
  • skeletal muscle
  • cardiac muscle
  • collagen
A

what is the the structure that connects the cartilage in trachea?

  • tunica adventitia
    - smooth muscle
  • skeletal muscle
  • cardiac muscle
    ​- collagen
227
Q

what are the three different reasons that RAAS system might be activated?

A
  1. sympathetic nerve activation (via B-adrenoreceptors) [1]
  2. renal artery hypotension [1]
  3. decreased sodium delivery to the distal tubules of the kidney [1]
228
Q

Which one of the following vessels does not drain directly into the inferior vena cava?

Superior mesentric vein
Right common iliac
Right hepatic vein
Left hepatic vein
Right testicular vein

A

Which one of the following vessels does not drain directly into the inferior vena cava?

Superior mesentric vein
Right common iliac
Right hepatic vein
Left hepatic vein
Right testicular vein

229
Q

Which one of the following is the predominant finding during phase 4 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 4 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

230
Q

A 73-year-old woman presents to the Emergency Department with acute shortness of breath following a 5-day febrile illness. On initial assessment, her oxygen saturation is 75% on room air with a PaO2 of 4.5kpa on an arterial blood gas.

Which of the following would be the expected physiological response in this patient?

Increased tidal volume with decreasesd resp. rate
Pulmonary vasoconstriction
Pulmonary artery vasodilation
Reduced tidal volume with increases resp rate
Systematic vasonstriction

A

A 73-year-old woman presents to the Emergency Department with acute shortness of breath following a 5-day febrile illness. On initial assessment, her oxygen saturation is 75% on room air with a PaO2 of 4.5kpa on an arterial blood gas.

Which of the following would be the expected physiological response in this patient?

Increased tidal volume with decreasesd resp. rate
Pulmonary vasoconstriction
Pulmonary artery vasodilation
Reduced tidal volume with increases resp rate
Systematic vasonstriction

Pulmonary arteries vasoconstrict in the presence of hypoxia
Systemic vasculature, unlike the pulmonary vessels, vasodilates in response to hypoxia.

231
Q

which wave in ECG represents ventricular depolarisation?

  • P wave
  • Q wave
  • R wave
  • S wave
    ​- T wave
A

which wave in ECG represents ventricular depolarisation?

  • P wave
  • Q wave
    - R wave
  • S wave
    ​- T wave
232
Q

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘c’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
​Atrial venous filling

A

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘c’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
​Atrial venous filling

233
Q

Which one of the following is the predominant finding during phase 1 of the cardiac action potential?

Rapid sodium influx

Efflux of potassium

Slow influx of calcium

Efflux of calcium

Rapid potassium influx

Resting potential is restored by Na+/K+ ATPase

A

Which one of the following is the predominant finding during phase 1 of the cardiac action potential?

Rapid sodium influx

Efflux of potassium

Slow influx of calcium

Efflux of calcium

Rapid potassium influx

Resting potential is restored by Na+/K+ ATPase

234
Q

A 48-year-old male suffered a work-related facial burn. During the morning ward round, you notice that in the surgeons’ notes he states that the arterial blood supply, via the facial artery, is good. Thus he is hopeful for satisfactory healing. Which large artery is the facial artery a branch of?

External carotid artery
Internal carotid artery
Vertebral artery
Subclavian artery
Brachiocephalic artery

A

A 48-year-old male suffered a work-related facial burn. During the morning ward round, you notice that in the surgeons’ notes he states that the arterial blood supply, via the facial artery, is good. Thus he is hopeful for satisfactory healing. Which large artery is the facial artery a branch of?

External carotid artery
Internal carotid artery
Vertebral artery
Subclavian artery
​Brachiocephalic artery

235
Q

ECG changes in II, III, aVF would be most likely caused by a lesion of the:

Right coronary

Left posterior descending

Left anterior descending

Right circumflex

Left circumflex

A

ECG changes in II, III, aVF would be most likely caused by a lesion of the:

Right coronary

Left posterior descending

Left anterior descending

Right circumflex

Left circumflex

236
Q

A 25-year-old male smoker is seen in the vascular clinic with a history of pain and claudication in both legs. On examination, he is found to have poor pedal pulses, loss of leg hair and a necrotic looking ulcer over the base of his 5th toe. An angiogram reveals corkscrew vessels of the vasa vasorum, the blood vessels feeding the larger blood vessels of the legs.

In what part of the blood vessel wall might you find these corkscrew vessels?

Tunica adventitia
Elastin layer
Serosa
Tunica media
Tunica intima

A

A 25-year-old male smoker is seen in the vascular clinic with a history of pain and claudication in both legs. On examination, he is found to have poor pedal pulses, loss of leg hair and a necrotic looking ulcer over the base of his 5th toe. An angiogram reveals corkscrew vessels of the vasa vasorum, the blood vessels feeding the larger blood vessels of the legs.

In what part of the blood vessel wall might you find these corkscrew vessels?

Tunica adventitia
Elastin layer
Serosa
Tunica media
Tunica intima

237
Q
A
238
Q

A 60-year-old gentleman suffering from heart failure presents to his GP with peripheral oedema. He is found to be fluid overloaded which causes atrial natriuretic peptide is released by the atrial myocytes. What is the mechanism of action of atrial natriuretic peptide?

Promote sodium reabsorbtion
Agonist of aldosterone
Antagonist of angiotension II
Agonist of angiotension I

A

A 60-year-old gentleman suffering from heart failure presents to his GP with peripheral oedema. He is found to be fluid overloaded which causes atrial natriuretic peptide is released by the atrial myocytes. What is the mechanism of action of atrial natriuretic peptide?

Promote sodium reabsorbtion
Agonist of aldosterone
Antagonist of angiotension II
Agonist of angiotension I

239
Q
A
240
Q

Which one of the following is not contained within the middle mediastinum?

Main bronchi
Arch of the azygos vein
Thoracic duct
Pericardium
Aortic root

A

Which one of the following is not contained within the middle mediastinum?

Main bronchi
Arch of the azygos vein
Thoracic duct
Pericardium
Aortic root

241
Q
A
242
Q

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘v’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
​Atrial venous filling

A

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘v’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
​Atrial venous filling

243
Q

which of the following acts on cardiac muscle?

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
A

which of the following acts on cardiac muscle?

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • *- beta 1 adrenoreceptors**
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
244
Q

what is thoracic inlet formed by? [3]

A

T1 vert, manubrium & rib1

245
Q

which sympathetic receptor do you find on the heart?

alpha 1
alpha 2
beta 1
beta 2
beta 3

A

which sympathetic receptor do you find on the heart?

alpha 1
alpha 2
beta 1
beta 2
beta 3

246
Q

Thoracic duct perforates the diaphragm:

T12

L3

T10

L4

L2

T8

A

Thoracic duct perforates the diaphragm:

T12

L3

T10

L4

L2

T8

247
Q

Which one of the following adverse effects is most characteristically associated with loop diuretics?

Tachycardia

Increased risk of fractures

Steven-Johnson syndrome

Hypocalcaemia

Tremor

Constipation

A

Which one of the following adverse effects is most characteristically associated with loop diuretics?

Tachycardia

Increased risk of fractures

Steven-Johnson syndrome

Hypocalcaemia

Tremor

Constipation

248
Q

which part of the kidney nephron controls blood pressure? (1)

A

juxtaglomerulus apparatus

249
Q

A 34-year-old gentleman presents to the emergency department with bradycardia. Cardiac muscle is likely to remain in phase 4 of the cardiac action potential for a prolonged amount of time.

What occurs in phase 4 of the cardiac action potential?

Slow sodium influx
Rapid potassium influx
Na+/K+ ATPase acts
Slow calcium influx
Rapid sodium infleux

A

A 34-year-old gentleman presents to the emergency department with bradycardia. Cardiac muscle is likely to remain in phase 4 of the cardiac action potential for a prolonged amount of time.

What occurs in phase 4 of the cardiac action potential?

Slow sodium influx
Rapid potassium influx
Na+/K+ ATPase acts
Slow calcium influx
​Rapid sodium infleux

250
Q

which class of antiarrhythmic drugs causes acts on Ca2+ channels?

Class I

Class II:

Class III

Class IV

A

which class of antiarrhythmic drugs causes acts on Ca2+ channels?

Class I

Class II:

Class III

Class IV

251
Q

the diaphragmatic pleura receives innervation from:

a) vagus nerve
b) phrenic nerve only
c) intercostal nerve only
d) vagus and phrenic nerve
e) phrenic nerve and intercostal nerve

A

the diaphragmatic pleura receives innervation from:

a) vagus nerve
b) phrenic nerve only
c) intercostal nerve only
d) vagus and phrenic nerve
* *e) phrenic nerve and intercostal nerve**

252
Q

which two factors cause an increase in resp workload? [2]

A

compliance
airway resistance

253
Q

Which one of the following structures lies deepest in the popliteal fossa?

Popliteal vein
Common peroneal nerve
Popliteal artery
Tibial nerve
None of the above

A

Which one of the following structures lies deepest in the popliteal fossa?

​Popliteal vein
Common peroneal nerve
Popliteal artery
Tibial nerve
None of the above

254
Q

which of the following is not a cause of normocytic amaemia?

a) acute blood loss
b) renal failure
c) leukaemia
d) sickle cell disease
e) alcholism

A

which of the following is not a cause of normocytic amaemia?

a) acute blood loss
b) renal failure
c) leukaemia
d) sickle cell disease
* *e) alcholism**

255
Q

where in the respiratory system would you not find goblet cells? [1]

what cell type would you find instead? [1]

A

olfactory epithelium
bowmans glands

256
Q

how do u measure clearance? [1]

A

clearance = (urine concentration of substance / plasma concentration of substance) x urine flow rate

257
Q

what is the name of the muscle lining the heart’s

i) atria [2]
ii) ventricles [1]

A

what is the name of the muscle found in the heart’s

i) atria: crista termanlis (smooth); pectinate muscle;
ii) ventricles: trabeculae carnae

258
Q

where do posterior intercostal arteries 1 & 2 orginate from?

  • descending aorta
  • costocervical trunk
  • internal thoracic artery
  • subclavian artery
A

where do posterior intercostal arteries 1 & 2 orginate from?

  • descending aorta
  • *- costocervical trunk**
  • internal thoracic artery
  • subclavian artery
259
Q
A
260
Q

Ischaemic changes in leads V1-V3 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

A

Ischaemic changes in leads V1-V3 would be most likely caused by a lesion of the:

LAD
Left circumflex
Right coronary
LAD or left circumflex

261
Q

which wave in ECG represents the depolarisation of the Purkinje fibres?

  • P wave
  • Q wave
  • R wave
  • S wave
  • T wave
A

which wave in ECG represents the depolarisation of the Purkinje fibres?

  • P wave
  • Q wave
  • R wave
    - S wave
    ​- T wave
262
Q

A 5-year-old boy is playing with some small ball bearings. Unfortunately he inhales one. To which of the following lung regions is the ball most likely to settle?

Right lower lobe
Left main bronchus
Right upper lobe
Left lower lobe
None of the above

A

A 5-year-old boy is playing with some small ball bearings. Unfortunately he inhales one. To which of the following lung regions is the ball most likely to settle?

Right lower lobe
Left main bronchus
Right upper lobe
Left lower lobe
None of the above

263
Q

A 22-year-old man is undergoing an endotracheal intubation. Which one of the following vertebral levels is consistent with the origin of the trachea?

C2
T1
C6
C4
C3

A

A 22-year-old man is undergoing an endotracheal intubation. Which one of the following vertebral levels is consistent with the origin of the trachea?

C2
T1
C6
C4
​C3

264
Q

You are a medical student on placement in the pathology lab. The pathologist is examining a section of a blood vessel. What separates the tunica media from the tunica adventitia?

Gap junctions
Internal elastic lamina
Endothelium
Fibroblasts
External elastic lamina

A

You are a medical student on placement in the pathology lab. The pathologist is examining a section of a blood vessel. What separates the tunica media from the tunica adventitia?

Gap junctions
Internal elastic lamina
Endothelium
Fibroblasts
External elastic lamina

265
Q

In respect of skeletal muscle contraction, allows rapid conduction of the action potential to allow co-ordinated muscule contraction:

T-tubule

Actin

Tropomyosin

Troponin-C

Sarcomere

Sarcoplasmic reticulum

A

In respect of skeletal muscle contraction, allows rapid conduction of the action potential to allow co-ordinated muscule contraction:

T-tubule

Actin

Tropomyosin

Troponin-C

Sarcomere

Sarcoplasmic reticulum

266
Q

what level does the larynx start and finish at?

A

C3-C6 [1]

267
Q

A 75-year-old man presents to the emergency department in respiratory arrest. His partner tells you that he has a history of congestive heart failure and that he recently has had an infection. After the patient is mechanically ventilated, you notice that they have low lung compliance.

What is the reason for this finding?

Ephymsema
Increased lung surfactant
Loss of lung connective tissue with age
Pulmonary oedema
Upright posture

A

A 75-year-old man presents to the emergency department in respiratory arrest. His partner tells you that he has a history of congestive heart failure and that he recently has had an infection. After the patient is mechanically ventilated, you notice that they have low lung compliance.

What is the reason for this finding?

Ephymsema
Increased lung surfactant
Loss of lung connective tissue with age
Pulmonary oedema
Upright posture

268
Q

A 63-year-old man is undergoing a right pneumonectomy for carcinoma of the bronchus. As the surgeons approach the root of the lung, which structure will lie most posteriorly (in the anatomical plane)?

Phrenic nerve
Main bronchus
Vagus nerve
Pulmonary vein
Pulmonary artery

A

A 63-year-old man is undergoing a right pneumonectomy for carcinoma of the bronchus. As the surgeons approach the root of the lung, which structure will lie most posteriorly (in the anatomical plane)?

Phrenic nerve
Main bronchus
Vagus nerve
Pulmonary vein
​Pulmonary artery

269
Q

Which one of the following is the predominant finding during B of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during B of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

270
Q

What is structure B?

​Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

A

What is structure B?

​Main bronchi
Pulonary trunk
SVC
Pulmonary arteries
Ascending aorta
Descending aorta

271
Q

Total lung capacity:

4,500ml in males, 3,500 mls in females

Maximum volume of air that can be expired after a maximal inspiration

Equals vital capacity + residual volume

Equals inspiratory capacity + expiratory reserve volume

500ml in males, 350ml in females

Equals tidal volume + inspiratory reserve volume

A

Total lung capacity:

4,500ml in males, 3,500 mls in females

Maximum volume of air that can be expired after a maximal inspiration

Equals vital capacity + residual volume

Equals inspiratory capacity + expiratory reserve volume

500ml in males, 350ml in females

Equals tidal volume + inspiratory reserve volume

272
Q

Which tissues connect the free ends of the incomplete cartilage rings of the trachea? [3]

A
  • fibrous CT
  • elastic CT
  • smooth muscle
273
Q

Which one of the following is the predominant finding during the rapid depolarisation phase of the cardiac action potential?

Efflux of calcium

Rapid sodium influx

Slow influx of calcium

Rapid potassium influx

Efflux of potassium

A

Which one of the following is the predominant finding during the rapid depolarisation phase of the cardiac action potential?

Efflux of calcium

Rapid sodium influx

Slow influx of calcium

Rapid potassium influx

Efflux of potassium

274
Q

which of the following is not present in the olfactory epithelium?

a) goblet cells
b) cililated pseudostratitfied columnar cells
c) olfactory cells
d) Bowmans glands

A

which of the following is not present in the olfactory epithelium?

  • *a) goblet cells**
    b) cililated pseudostratitfied columnar cells
    c) olfactory cells
    d) Bowmans glands
275
Q

where does your spinal cord end?

T12
L1
L2
L3
L4

A

where does your spinal cord end?

T12
L1
L2
L3
​L4

276
Q

where would you not find mucosa associated lymphoid tissue (MALT)?

a) duodenum
b) kidneys
c) oesphagus
d) bronchus
e) testes

A

where would you not find mucosa associated lymphoid tissue (MALT)?

a) duodenum
* *b) kidneys**
c) oesphagus
d) bronchus
e) testes

277
Q

which structures enter the larynx at the thryohyoid ligament?

  • internal laryngeal nerve and superior laryngeal artery
  • external larnygeal nerve and superior laryngeal artery
  • external laryngeal nerve and inferior laryngeal artery
  • internal laryngeal nerve and inferior laryngeal artery
A

which structures enter the larynx at the thryohyoid ligament?

  • *- internal laryngeal nerve and superior laryngeal artery**
  • external larnygeal nerve and superior laryngeal artery
  • external laryngeal nerve and inferior laryngeal artery
  • internal laryngeal nerve and inferior laryngeal artery
278
Q

Which one of the following is the predominant finding during A of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during A of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

279
Q

A 22-year-old women has recently undergone a surgical excision of the submandibular gland. She presents to the follow up clinic with a complaint of tongue weakness on the ipsilateral side to her surgery. Which nerve has been damaged?

Hypoglossal nerve
Lingual nerve
inferior alevolar nerve
Facial nerve
Lesser petrosal nerve

A

A 22-year-old women has recently undergone a surgical excision of the submandibular gland. She presents to the follow up clinic with a complaint of tongue weakness on the ipsilateral side to her surgery. Which nerve has been damaged?

Hypoglossal nerve
Lingual nerve
inferior alevolar nerve
Facial nerve
Lesser petrosal nerve

280
Q

label A-C

A

A: omohyoid
B: SCM
C: sternohyoid

281
Q

what is the level of the cricoid cartilage?

C2
C3
C4
​C5
C6

A

what is the level of the cricoid cartilage?

C2
C3
C4
​C5
C6

282
Q

Which one of the following is the predominant finding during phase 2 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

A

Which one of the following is the predominant finding during phase 2 of the cardiac action potential?

Resting potential is restored by Na+/K+ ATPase

Rapid potassium influx

Efflux of potassium

Rapid sodium influx

Efflux of calcium

Slow influx of calcium

283
Q

macrophages are dervived from:

a) neutrophils
b) lymphocytes
c) basophils
d) monocytes
e) mast cells

A

macrophages are dervived from:

a) neutrophils
b) lymphocytes
c) basophils
* *d) monocytes**
e) mast cells

284
Q

A 66-year-old lady presents to the emergency department with palpitations. Her ECG shows tall tented T waves. The T wave corresponds to phase 3 of the cardiac action potential.

Which of the following is responsible for the shape of the T wave?

Slow depolaration due to influx of sodium
Slow depolaration due to influx of potassium
Repolarisation due to efflux of calcium
Repolorisation due to efflux of potassium
Resting potential restored by Na/K ATPase

A

A 66-year-old lady presents to the emergency department with palpitations. Her ECG shows tall tented T waves. The T wave corresponds to phase 3 of the cardiac action potential.

Which of the following is responsible for the shape of the T wave?

Slow depolaration due to influx of sodium
Slow depolaration due to influx of potassium
Repolarisation due to efflux of calcium
Repolorisation due to efflux of potassium
Resting potential restored by Na/K ATPase

285
Q
A
286
Q

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘a’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
​Atrial venous filling

A

A 43-year-old lady is recovering on the intensive care unit following a Whipples procedure. She has a central venous line in situ. Which one of the following will lead to the ‘a’ wave on the waveform trace?

Ventricular contraction
Emptying of the right atrium
Emptying of the right ventricle
Atrial contraction
Atrial venous filling

287
Q

what is normal range % for ejection fraction?

A

50-70%

288
Q

A 65-year-old man with heart failure presents to his GP. He has a stroke volume of 33% and asks what affects stroke volume.

Which of the following would increase stroke volume in a normal individual?

Heart failure
Increased parasympathetic activation
Hypertension
Increased central venous pressure
Decreased inotropy

A

A 65-year-old man with heart failure presents to his GP. He has a stroke volume of 33% and asks what affects stroke volume.

Which of the following would increase stroke volume in a normal individual?

Heart failure
Increased parasympathetic activation
Hypertension
Increased central venous pressure
Decreased inotropy

289
Q

which is the main laryngeal cartilage used for phonation?

a) cricoid cartilage
b) thryoid cartilage
c) artyenoid cartliage
d) corniculate cartilage
e) cunieform cartilage

A

which is the main laryngeal cartilage used for phonation?

a) cricoid cartilage
b) thryoid cartilage
* *c) artyenoid cartliage**
d) corniculate cartilage
e) cunieform cartilage

290
Q

What view of the heart do leads V3 & V4 represent?

Anterior
Septal
Lateral
Inferior

A

What view of the heart do leads V3 & V4 represent?

Anterior
Septal
Lateral
Inferior

291
Q

A man with suspected heart failure has a transthoracic echocardiogram (TTE) to investigate the function of his heart. The goal is to measure his ejection fraction, however, to do this first his stroke volume must be measured.

What is the formula for stroke volume?

ESV - EDV
EDV - ESV
Systolic pressure - diastolic pressure
End systolic volume + end diastolic volume

A

A man with suspected heart failure has a transthoracic echocardiogram (TTE) to investigate the function of his heart. The goal is to measure his ejection fraction, however, to do this first his stroke volume must be measured.

What is the formula for stroke volume?

ESV - EDV
EDV - ESV
Systolic pressure - diastolic pressure
End systolic volume + end diastolic volume

292
Q

Which electrolyte maintains the resting potential of ventricular myocytes?

Calcium
Potassium
Phosphate
Sodium
Chloride

A

Which electrolyte maintains the resting potential of ventricular myocytes?

Calcium
Potassium
Phosphate
Sodium
​Chloride

293
Q

which of the following acts on bronchiole smooth muscle?

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • beta 2 adrenoreceptors
  • beta 3 adrenoreceptors
A

which of the following acts on bronchiole smooth muscle?

  • alpha 1 adrenoreceptors
  • alpha 2 adrenoreceptors
  • beta 1 adrenoreceptors
  • *- beta 2 adrenoreceptors**
  • beta 3 adrenoreceptors
294
Q

In response to stretch, cells release atrial natriuretic peptide (ANP). Where do you these cells?

a) left atrium and IVC
b) left atrium and SVC
c) right atrium and IVC
d) right atrium and SVC
e) IVC & SVC

A

In response to stretch, cells release atrial natriuretic peptide (ANP). Where do you these cells?

a) left atrium and IVC
b) left atrium and SVC
* *c) right atrium and IVC**
d) right atrium and SVC
e) IVC & SVC

295
Q

in which of the following would you find hassal’s corpsucles?

lymph node
spleen
thymus
bone marrow

A

in which of the following would you find hassal’s corpsucles?

lymph node
spleen
thymus
​bone marrow

296
Q

liddles syndrome is caused by the ubquination of which channels:

  • aquaporins
  • ENAC
  • ROMK
  • NaKCC
  • NaK ATPase
A

liddles syndrome is caused by the ubquination of which channels:

  • aquaporins
  • *- ENAC - causes increased Na absorbtion at DCT**
  • ROMK
  • NaKCC
  • NaK ATPase
297
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia TB Small cell carcinoma **Asthma** Squamous cell carnicoma *resp epithelium with goblet cell hyperplasia eosinophils in lam prop +++ thickened BM SM hypertrophy mucous in lumen*

298
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia **TB** Small cell carcinoma Asthma Squamous cell carnicoma *Under the microscope multinucleate giant cells and granulomatosis are seen*

299
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia TB **Small cell carcinoma** Asthma Squamous cell carnicoma *Multiple mitotic figures are identified as well as scattered apoptotic tumor cells. The finely dispersed or salt and pepper chromatin with no distinct nucleoli is apparent in many of the cells, although the crush artifact caused by the biopsy process can make this feature more difficult to distinguish. The small cells lie among a background of delicate stroma that is sparse compared to the dense sheet of tumor cells*

300
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia TB **Small cell carcinoma** Asthma Squamous cell carnicoma

301
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia **TB** Small cell carcinoma Asthma Squamous cell carnicoma *Caseous necrosis and granulomatosis*

302
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? **Pneumonia** TB Small cell carcinoma Asthma Squamous cell carnicoma

303
Q

Describe the pathological changes that you would expect to see in the lungs of a smoker. [3]

A

* many dust cells (macrophages that have taken up carbon particles. * damage to the cilia that typically lines the airways, an increase in mucous-producing cells, squamous metaplasia, (protective adaptation) * Metaplastic and dysplastic structural changes could eventually lead to lung cancer.

304
Q

Premature children do not produce adequate amounts of pulmonary surfactant. Name two cells that are involved and explain why this greatly increases the risk of death. What would you expect to see on a histological preparation of lung tissue from such an infant? [3]

A

**Type II pneumocytes** and **Clara cells** are both involved in surfactant production. The lung tissue histology of such an infant would appear with **collapsed alveoli**. [1]

305
Q

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma Squamous cell carnicoma

A

Which pathology is depicted here? Pneumonia TB Small cell carcinoma Asthma **Squamous cell carnicoma** *Squamous cell carcinoma, well differentiated: epithelium shows marked keratinization and minimal nuclear pleomorphism.*

Y1 Qs (11 decks)

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