Extra questions from SAQ

Question 1

Where would you hear a heart murmu if there was a problem with the tricuspid valve?

Answer 1

Left lower sternal border

Question 2

Name an antipyrectic

Answer 2

ibruprofen

Question 3

What is the structure of E coli?

Answer 3

Gram negative bacillus (important to say bacillus rather than rods)

Question 4

Name the four major causes of pneumonia in a community setting

Answer 4

Haemophilius influenzae/Streptococcus pneumoniae/Staphylococcus aureus/influenza

Question 5

Give two virulence factors of Streptococcus pneumoniae

Answer 5

pili/capsule

Question 6

What is the major function of CRP?

Answer 6

Opsonin (also has a minor role in acting as a chemokine for neutrophils)

Question 7

What is a tumbler test and when would you use it?

Answer 7

Press a clear glass against a rash to see if it blanches 0 NOTE - meningococcal septicaemia does not blanch

Question 8

Correct spelling of Neisseria meningitidis

Answer 8

T

Question 9

Describe the process by which HIV gains ENTRY to a cell

Answer 9

1) Preferentially binds to CD4+ve T cells
2) The virus then infects any cell with a CD4 receptor (dendritic cells, lymphocytes, monocytes etc.)
3) An additional co-receptor is required for entry to the cell
4) Once HIV is bound to its receptor a ‘fusion’ process must take place before it gains entry.

Question 10

Briefly explain how reverse transcriptase incorporates HIV into the host cells genome

Answer 10

ssRNA converted to ssDNA
Synthesis of DNA-RNA hybrid
RNAase activity degrades the parent RNA and synthesis of dsDNA takes place

Question 11

What as some risk factors for HIV transmission?

Answer 11

• Unprotected sexual intercourse
• IV drug use
• Blood transfusion outside UK
• Tattoos
• Known HIV contact

Question 12

Can women get thrush when they aren’t immunocompromised, how?

Answer 12

Lactobacillus population normally maintains the vaginal bacterial environment. If this for some reason is decreased thrush can occur due to candida building up

Question 13

Under what count is considered AIDS?

Answer 13

<200 cells/mm3 or <500 numerically CD4+ve T lymphocytes

Question 14

Name 4 AIDS defining INFECTIONS

Answer 14

CMV/TB/toxoplasmosis/cryptococcal disease

Question 15

Give 4 types of ARV drug for HIV

Answer 15

Reverse transcriptase inhibitors
Fusion inhibitors
Co receptor blockers
protease inhibitors 
integrase inhibitors

Question 16

Give two features of severe malaria

Answer 16

Kidney failure/fits/metabolic acidosis/arrythmias

Question 17

Which organ do sporozoites from the mosquito travel to first as their life cycle in the human?

Answer 17

Liver -> migration into RBC’s

Question 18

Explain G6PD deficieny

Answer 18

It’s the rate limiting enzyme in the pentose phosphate pathway -> insufficient NADPH production _> insufficient glutathione protection from oxidative streess -> increased haemolysis

NOTE - it has an x-linked recessive inheritance pattern

Question 19

What are the oxygen dependent and oxygen independent pathways of phagocytosis?

Answer 19

Dependent - use of free radicals to break down in phagosome

Independent - Fusion with lysosome

Question 20

Patients with splenectomies are at increased risk of infection from encapsulated bacteria, name the important ones

Answer 20

H. influenzae/N. meningitidis/S. pneumoniae