Definitions

Question 1

What is an aneurysm?

Answer 1

An abnormal localised dilatation of a blood vessel more than 1.5 x its normal diameter

Question 2

Define neoplasm

Answer 2

Abnormal mass of tissue in which growth is uncoordinated, exceeds that of normal tissue, and persists after cessation of stimulus

Question 3

Leukoplakia

Answer 3

A white patch or plaque on oral mucosa that cannot be removed by rubbing. These are not painful, irregularly shaped, and slightly raised.

Question 4

Hypersensitivity reaction

Answer 4

Exaggerated response of host immune response to a particular stimulus. Usually require pre sensitisation, cell mediated or humoral reactions, and undesirable tissue damage is present.

Question 5

Sepsis

Answer 5

life threatening organ dysfunction in response to dysregulated host responses to infection. Organ dysfunction defined as 2 or ore points on sofa score which is associated with an in-hospital mortality greater than 10%.

Question 6

Septic shock

Answer 6

subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%.

Question 7

quickSOFA (qSOFA) criteria

Answer 7

respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less.

Question 8

Tumour markers

Answer 8

are substances, usually proteins, produced by the body in response to cancer growth or by cancer tissue itself that provides information about a cancer

Question 9

Hamartoma

Answer 9

Tumour like malformation composed of a disorganised arrangement of different amounts of tissue found at that site. Under normal growth controls

Question 10

Metaplasia

Answer 10

reversible replacement of 1 fully differentiated cell type with another

Question 11

Dysplasia

Answer 11

is a reversible, abnormal growth of cells and differentiation. This is
characterised by increased nuclear size, increased mitosis and pleomorphism
Without the ability to invade the BM and metastasise

Question 12

adenocarcinoma

Answer 12

A malignant tumour arising from glandular structures in epithelial cells

Question 13

Adenoma, carcinoma sequence

Answer 13

Theadenoma-carcinoma sequencerefers to a stepwise pattern of mutational activation of oncogenes (e.g.K-ras) and inactivation oftumour suppressor genes(e.g.p53) that results in cancer.
- Initial mutation in APC gene, then KRAS and DCC, then finally in p53

Question 14

Disinfectant

Answer 14

reduces number of transmissible organisms

Question 15

Sterilisation

Answer 15

kills all microorganisms including bacterial, viruses, etc

Question 16

Gynacomastia

Answer 16

proliferation of benign male glandular breast tissue

Question 17

Carcinoma

Answer 17

Malignant tumour of epithelial tissue

Question 18

Sarcoma

Answer 18

malignant tumour of connective tissue

Question 19

Metastases

Answer 19

survival and growth of cells that have migrated from a malignant tumour to a site distal to the primary tumour

Question 20

Atrophy

Answer 20

Decrease in size of organ or tissue due to reduction in cell size or number

Question 21

Apoptosis

Answer 21

organised cell death characterised by auto-digestion of cells with no associated inflammation

Question 22

Sensitivity

Answer 22

True positive rate/ the number of people who have the disease that yeild a positive result

Question 23

Specificity

Answer 23

True negative rate: the number of people who do not have the disease that yield a negative results

Question 24

Abscess

Answer 24

A collection of pus surrounded by granulation or fibrous tissue

Question 25

Pus

Answer 25

Collection of neutrophils and dead or dying organisms

Question 26

Cyst v pseudocyst

Answer 26

An abnormal membranous sac which can contain gas, liquid, semisolid contents lined by epithelium. Pseudocysts are not lined by epithelium.

Question 27

Stoma

Answer 27

Surgical opening into a hollow viscus

Question 28

Acute inflammation

Answer 28

body’s stereotypical response to tissue injury characterised by : heat, swelling, pain, redness

Question 29

Stages of acute inflammation

Answer 29

1. Vaso constriction
2. Vasodilation and increased vascular permeability
3. Migration of neutrophils through vessel walls
4. Phagocytosis
5. Resolution or progression to chronic inflammation

Question 30

Complement cascade

Answer 30

• Component of innate immune system
• Cascade of proteins which result in the formation of MAC

3 main pathways it can be activated
- Classical: antigen, antibody
- Alternative: c3 in contact with microorganisms
- Mannose binding lectin pathway

Question 31

Sinus

Answer 31

A blind ending sac lined by granulation tissue which communicated with an epithelial surface

Question 32

Chronic inflammation

Answer 32

prolonged inflammatory response with simultaneous tissue healing and tissue destruction. Defined by the cell types present: macrophages, neutrophils, plasma cells.

Question 33

granuloma

Answer 33

collection of epitheliod macrophages

Question 34

Risk factors for breast cancer

Answer 34

Non modifiable:
Increasing Age, family history, genetic conditions (brca, lynch syndrome), nulliparity, early menarche, late menopause

Modifiable:
Obesity, smoking, alcohol intake , HRT,

Question 35

What are BRCA 1 and 2 mutations?

Answer 35

Tumour supressor genes.

BRCA 1 - on chromosome 17, increased liklihood of breast and ovarian cancer. 80% chance of breast ca if positive.

BRCA 2 - chromosome 13, associated with pancreatic cancer & malignant melanoma, lower chance of survival

Question 36

ARDS

Answer 36

A clinical syndrome comprising of non cardiogenic pulmonary oedema and acute respiratory failure.

Leads to hypoxaemia and reduced lung compliance refractory to oxygen therapy.

Question 37

Criteria for admission to ITU

Answer 37

1. Patient requiring or likely to require advanced respiratory support (endotracheal intubation and mechanical ventilation).
2. Patients requiring support for 2 or more failing organ systems: - Respiratory: Ventilation, CPAP.
   - Renal: Hemodialysis.
   - Cardiac: Inotropic support.
   - Neurological: ICP monitoring.
3. Patient requiring 1:1 nursing care.
4. Post op following operations (Cardiac)

Question 38

Indications for a surgical airway

Answer 38

Failed intubation
Laryngeal fracture
Upper airway obstruction due to trauma, swelling, haemorrhage
Max fax trauma

Question 39

Shelf life of RBC

Answer 39

35 days