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PPQs > DUMES - principles > Flashcards

DUMES - principles Flashcards

1
Q

what is the law explaining this newborn’s condition where premature baby by 10 weeks, is found to be tachypnoeic. On examination, there is intercostal recession, nasal flaring, and cyanosis. The baby is placed on NCPAP in NICU. Which phenomenon best explains the reason for this baby’s respiratory distress?

A

law of La Place.
It states that the tension exerted on a spherical wall of set pressure is inversely proportional to that sphere’s thickness.
Alveoli are prone to collapse due to alveolar surface tension. Pulmonary surfactant is a fluid which increases alveolar thickness and thus reduces alveolar surface tension.

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2
Q

when does resp distress syndrome arise?

A

Respiratory distress syndrome arises in premature newborns with insufficient surfactant

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3
Q

Which neurotransmitter acts on muscarinic receptors and what is its action in the airways?

A

Acetylcholine, constriction of the airways

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4
Q

Which of the following statements correctly explains the difference between foetal and adult haemoglobin?

A

Foetal haemoglobin has gamma subunits instead of beta subunits, causing it to have a higher affinity for oxygen than adult haemoglobin

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5
Q

In the foetal circulation, which shunt connects the pulmonary trunk to the aorta?

A

Ductus arteriosus

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6
Q

Which of the following statements correctly describes the intent of neo-adjuvant treatment?

A

Neo-adjuvant treatment is given before surgery to shrink the tumour for surgical removal

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7
Q

what is the ductus venosus

A

The ductus venosus allows oxygenated blood from the placenta to bypass the hepatic circulation

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8
Q

what is the foramen ovale

A

The foramen ovale shunts oxygenated blood from the right atrium to the left atrium, bypassing the pulmonary circulation.

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9
Q

what is adjuvant treatment

A

Adjuvant treatment is given after surgery, aimed at reducing the risk of recurrence

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10
Q

Which option is an example of metaplasia?

A

Squamous epithelium changing to columnar epithelium in response to contact with gastric acid

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11
Q

Which option correctly defines the following:

“Normal genes which stimulate cell division”

A

Proto-oncogenes

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12
Q

what happens to proto-oncogenes during cancer

A

In cancer, these proto-oncogenes are changed to oncogenes which enable uncontrolled cell proliferation

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13
Q

what are tumour suppressor genes

A

Tumour suppressor genes are normal genes that inhibit cell division - loss of both copies of a tumour suppressor gene can allow cancer to develop.

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14
Q

genetic code is unambiguous

A

each codon specifies a single amino acid or stop codon only

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15
Q

genetic code is degenerate

A

which means a single amino acid is coded for by more than one codon (e.g leucine, coded for by CUU, CUC, CUA and CUG).

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16
Q

describe the action of ACh, Gastrin and ghrelin

A

Acetylcholine acts on M3 muscarinic receptors. Gastrin binds to G/CCK2 receptors, histamine acts via H2 receptors and ghrelin is the “hunger hormone” which does not act on parietal cells.

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17
Q

Which of the following options correctly describes a nonsense mutation?

A

A nonsense mutation causes a premature stop and hence an abnormally short protein.

18
Q

What is the rate-limiting enzyme for each of the following processes?

1) Glycogenesis (synthesis of glycogen from glucose)
2) Glycogenolysis (breakdown of glycogen from glucose)
3) Gluconeogenesis (synthesis of glucose within the body from non-carbohydrate precursors)
4) Lipogenesis (the metabolic formation of fat)

A

1) Glycogen synthase
2) Glycogen phosphorylase
3) Fructose 1,6-bisphosphonate
4) acetyl-coA carboxylase

19
Q

IgA

A

IgA is found in breast milk, saliva and tears and is transferred to the neonate via colostrum and breast milk.

20
Q

IgG

A

IgG is the most abundant immunoglobulin found in blood serum, is dominant in the memory immune response and is transferred across the placenta into the foetal circulation

21
Q

IgM

A

IgM is produced first in the adaptive immune response

22
Q

IgE

A

IgE mediates Type I hypersensitivity reactions

23
Q

Which of the following cancers is associated with a c-MYC mutation?

A

Burkitt’s lymphoma is associated with c-MYC mutations.

24
Q

You are looking at a patient’s histology slides and find psammoma bodies (pictured below). Which of the following cancers is associated with psammoma body formation?

A

Psammoma bodies are collections of calcium found in biopsy samples of mesothelioma, a pleural malignancy caused by inhaled asbestos fibres.

25
Q

Which of the following lung cancers is most likely to arise in non-smokers?

A

Adenocarcinoma is the variant of lung cancer most likely to arise in non-smokers

26
Q

Which cancer is associated with the tumour marker CA-125?

A

The CA-125 tumour marker is associated with ovarian cancer.

27
Q

Which classification is used to predict the prognosis of patients with colorectal cancer?

A

Dukes staging predicts the prognosis of colorectal cancer by its histological appearance

28
Q

Which types of human papilloma virus (HPV) are associated with cervical cancer?

A

HPV types 16 and 18 cause 70% of cervical cancers. There is now an HPV vaccination scheme and cervical screening programme in Scotland to help mitigate this risk. Note that HPV types 6 and 11 cause genital warts.

29
Q

what is neuroblastoma associated with

A

n-MYC

30
Q

follicular lymphoma

A

BCL-2

31
Q

pancreatic cancer

A

RAS

32
Q

chronic myeloid leukaemia

A

ABL

33
Q

gel and coombs?

A

Gel and Coomb’s classification relates to hypersensitivity reactions

34
Q

what cancer is associated with asbestos inhalation

A

mesothelioma

35
Q

Benign neoplasm of squamous epithelium

A

Papilloma

36
Q

Malignant neoplasm of glandular epithelium

A

Adenocarcinoma

37
Q

Malignant neoplasm of bone

A

Osteosarcoma

38
Q

turns green on blood agar due to partial haemolysis

A

alpha haemolytic - strep pneumiae and strep. viridian’s

39
Q

turns yellow on blood agar due to complete haemolysis

A

group A and B strep

40
Q

large gram negative bacillis

A

coliforms eg e.coli 0157 causing gastroenteritis

PPQs (9 decks)

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