EFA 9

Question 1

In humans, the glycosaminoglycans bound by the F and G proteins of Respiratory Syncitial Virus are expressed:

A. more widely in the lower respiratory tract than the upper tract B. more widely in the upper respiratory tract than the lower tract C. throughout the respiratory tract D. primarily in pneumocytes E. primarily in the nasal epithelium

Answer 1

=C. throughout the respiratory tract

Question 2

The production of which cytokine by Th2 cells is responsible for eosinophil recruitment to the airways in allergic asthma?

Answer 2

IL-5

Question 3

Complete deficiency in Factor XI results in what phenotype?

A. Lethality B. Spontaneous bleeding C. Bleeding into joints D. No bleeding E. Bleeding after trauma

Answer 3

Bleeding after trauma

Question 4

In an IVF protocol, GnRH antagonists are administered in order to:

A. Inhibit ovulation B. Promote the MI to MII transition in the oocyte C. Prevent ovarian hyperstimulation syndrome D. Promote follicle growth E. Stabilise the corpus luteum to promote implantation

Answer 4

A. Inhibit ovulation

Question 5

Which of the following is an opioid antagonist used in the longer-term management of heroin addiction?

A. Methadone; B. Naltrexone; C. Acamprosate; D. Naloxone; E. Buprenorphine

Answer 5

B. Naltrexone

Question 6

A 36 year old male has previously been diagnosed with asthma. He has been on low dose inhaled corticosteroid for six months, but has found he needs to use his acute relief inhaler 4-5 times per week following the onset of the hayfever season. You have confirmed that they are adhering well to their inhaled corticosteroid programme. What would you recommend as the next step in his treatment?

Answer 6

Long-acting beta agonist (inhaled LABA)

Question 7

What two platelet activities characterize primary haemostasis?

Answer 7

Platelet activation

Platelet aggregation

Question 8

The destruction of platelets by antiplatelet autoantibodies is the cause of which disorder?

Answer 8

Immune thrombocytopenia (ITP)

Question 9

Give one example of how progesterone in the oral contraceptive pill acts directly on the female reproductive tract to inhibit implantation.

Answer 9

Thinning of the endometrium

Thickening of cervical mucus

Question 10

Which psychiatric medication acts on glycogen synthase kinase and requires monitoring of the drug level in the blood every three months, for the first year?

Answer 10

Lithium

Question 11

A 35 year old woman presents suffering regular prolonged nosebleeds and has noticed she bruises easily when playing sport. She also notes that her menstrual bleeding has been heavier than usual in recent months.

1. What phase of haemostasis is likely to be disrupted in this patient? (1 mark)
2. What would you expect their platelet concentration to be? (1 mark)

Answer 11

1. primary
2. <40 x 109 platelets/litre

Question 12

3. Give two possible investigations you would undertake (2 marks)
4. The patient shows no evidence of petetchiae. What cause of the symptoms might this allow you to rule out? (1 mark)

Answer 12

3) Any two of the following:

Platelet count,

PFA100/platelet function analysis 100,

vwf/von Willebrand factor assay,

clinical examination

4) thrombocytopenia

Question 13

5. What would you expect the patients’ prothrombin time test results to be? (1 mark)
6. What medication would you advise the patient to avoid taking (1 mark)
7. The patient’s VWF is found to show reduced platelet adhesion, what type of Von Willebrand disease does this indicate? (1 mark)

Answer 13

5) normal
6) asprin/NSAIDS
7) Type 2