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Phase 2a Introductory Clinical Science > Formative assessments > Flashcards

Formative assessments Flashcards

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1
Q

Which of these is an example of acute inflammation?

a) glandular fever
b) leprosy
c) appendicitis
d) tuberculotis

A

appendicitis
glandular fever is primary chronic inflammation
leprosy and tuberculotis are microbacterial infections that cause primary chronic inflammation

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2
Q

Which of these is an example of hyperplasia?

a) body builder’s bicep
b) enlarged left ventricle
c) benign prostate enlargement
d) wasting of quadriceps

A

benign prostate enlargement
body builder’s bicep has skeletal muscle and left ventricle has cardiac muscles. these types of muscles cannot replicate
wasting of quadriceps is atrophy

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3
Q

Which of these is an example of granulomatous inflammation?

a) crohn’s disease
b) appendicitis
c) infectious mononucleasis
d) lobar pneumonia

A

crohn’s disease
appendicitis and lobar pneumonia are acute inflammations
infectious mononuleasis is primary chronic inflammation

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4
Q

Which of these is not an inherited condition?

a) huntington’s disease
b) haemophilia
c) sickle cell anaemia
d) foetal alcohol syndrome

A

foetal alcohol syndrome

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5
Q

Which of these is not associated with dementia (any decline in cognitive function)?

a) down’s
b) huntington’s syndrome
c) Alzheimer’s disease
d) cerebral palsy

A

cerebral palsy

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6
Q

Which of these uses autosomal dominance inheritance?

a) familial adenomotous polyposis
b) colour blindness
c) cystic fibrosis
d) sickle cell disease

A

FAP
the other three are recessive
colour blindness is also X linked

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7
Q

Which of these is not an example of apoptosis?

a) loss of cells from tip of duodenal villi
b) loss of cells in embyrogenesis
c) renal infarction
d) graft vs host disease

A

renal infarction (necrosis)

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8
Q

which of these is a primary chronic inflammation?

a) appendicitis
b) cholecystitis
c) infectious mononucleosis
d) lobar pneumonia

A

infectious mononucleasis

the others are acute inflammation (with cholecystitis leading on to chronic inflammation after)

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9
Q

which cells can regenerate?

a) neurons
b) myocytes
c) hepatocytes
d) nephrons

A

hepatocytes

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10
Q

Which pathologies can end with full resolution?

a) lobar pneumonia
b) cerebral infarction
c) myocardial infarction
d) partial nephrectomy

A

lobar pneumonia

the others don’t have cells that can regenerate

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11
Q

Which neoplasm never metastases?

a) melanoma
b) small cell carcinoma of lung
c) basal cell carcinoma of skin
d) breast cancer

A

basal cell carcinoma

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12
Q

which neoplasm won’t metastasise to bone?

a) breast cancer
b) lung cancer
c) prostate cancer
d) liposarcoma

A

liposarcoma

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13
Q

which type of cancer doesn’t have screening in the UK?

a) breast cancer
b) colerectal cancer
c) cervical cancer
d) lung cancer

A

lung cancer

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14
Q

which carcinogen is not known to be a carcinogen of humans?

a) hep C virus
b) ionising radiation
c) aromatic amines
d) aspergillus niger

A

apergillus niger

it is a fungus that grows in showers when they are damp

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15
Q

what is not a feature of a malignant tumour?

a) vascular invasion
b) metastasis
c) increased cell division
d) growth related to overall body growth

A

growth related to overall body growth

hamartoma is a benign tumour and it does this.

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16
Q

what is most likely to cause cancer?

a) drinking 1/2 a bottle of wine per day
b) obesity
c) running
d) smoking 20 cigarettes a day

A

smoking 20 cigarettes a day

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17
Q

which tumour has the shortest median survival time?

a) basal cell carcinoma
b) malignant melanoma
c) breast cancer
d) anaplastic carcinoma

A

anaplastic carcinoma

has a median survival of 6 weeks

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18
Q

which of these infections are most often seen in patients with hypogammaglobulinemia?

a) cytomegalovirus retinitis
b) pneumocystis jirovecii pneumonia
c) streptococcus pneumoniae sinusitis
d) staphyloccus aureus abscesses

A

streptococcus pneumoniae sinusitis
(due to primary antibody deficiency)
[staphyloccus due to primary defects in phagocytic function which is less common than the first one)

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19
Q

which of these is not an organ-specific autoimmune disease?

a) type 1 diabetes mellitus
b) pernicious anaemia
c) hashimoto’s thyroiditis
d) ulcerative colitis
e) multiple sclerosis

A

ulcerative colitis

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20
Q

which of these is a classical PAMP?

a) heat shock protein
b) RIG 1
c) lipopolysaccharide
d) interleukin 1
e) TLR 2

A

lipopolysaccharide
(heat shock protein is DAMP)
(RIG1 and TLR2 are receptors that detect the PAMP and DAMP)
(interleukin1 released from cells to promote immunity)

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21
Q

which of these functions are true for T cells?

a) t cells mature in thyroid gland
b) all t cells secrete cytotoxic material
c) t cells respond to proteins on surface of host cells
d) t cells secrete IgG when activated

A

T cells respond to proteins on surface of host cells

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22
Q

the normal immunological control of tumours is called:

a) immunological tolerance
b) immune surveillance
c) type 3 hypersensitivity
d) immunological silence
e) superantigen recognition

A

immune surveillance

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23
Q

which of these features are true for the adaptive immune system?

a) its efficiency is not affected by prior contact with the pathogens
b) it would not work without lymphocytes
c) it lacks specificity
d) it generally distinguishes self from non-self
d) its effectiveness is enhanced by complement

A

it wouldn’t work without lymphocytes

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24
Q

which of these proteins is essential in inducing a cytotoxic t cell response?

a) IgG
b) complement C3
c) Mannose binding lectin
d) MHC 1
e) TLR4

A

MHC1

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25
Q

which of these statements are false for biological therapies of autoimmune disease?

a) delivered with low dose cytotoxic drug methotrexate
b) have no risk of bacterial infection, unlike conventional treatment
c) include adalimumab, tocilizumab, retuximan
d) are immunosuppresive and are always injected
e) are expensive and only prescribed in NHS once conventional therapies have failed

A

no risk of bacterial infection unlike conventional treatments

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26
Q

which of these is not part of the elimination phase of complement activation?

a) phagocytosis
b) target cell lysis
c) chemoattraction of leukocytes
d) production of interferons
e) opsonisation

A

production of interferons

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27
Q

which cell is being described (located only in tissues, responds to IgE coated objects by degranulation thus releasing inflammatory mediators, proteases, histamine)?

a) neutrophil
b) eosinophil
c) mast cell
d) macrophage
e) fibroblast

A

mast cell

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28
Q

Patient starts on commonly used drug, they develop an unusual ADR that you have never seen before, what should you do after stopping the drug and informing the patient?

  1. report the ADR on a yellow card
  2. contact the pharmaceutical company that makes the drug to inform them
  3. write the case up in a case report to educate other doctors
  4. contact the local pharmacy to tell them
  5. stop prescribing the drug to all patients
A
  1. report the ADR on a yellow card
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29
Q

woman has over-active bladder, she’s given anti-cholinergic drug to help, which of these symptoms are not a side effect of anti-cholinergic drugs?

  1. constipation
  2. constricted pupils
  3. dry mouth
  4. reduced sweating
  5. tachycardia
A

constricted pupils

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30
Q

a man has lower urinary tract symptoms and suffers from narrow angle glaucoma, which drug will help his lower urinary tract symptoms but will worsen his narrow angle glaucoma?

  1. 5alpha reductase inhibitor
  2. alpha1 receptor antagonist
  3. anticholinergic
  4. beta3 receptor agonist
A

anticholinergic

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31
Q

an iV abuser has reduced resp rate and pin-point pupils, which drug do you give to reverse his opioid overdose?

  1. flumazenil
  2. fentanyl
  3. glucagon
  4. naloxone
  5. neostigmine
A

naloxone

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32
Q

which of these drugs does not have a narrow therapeutic index?

  1. digoxin
  2. gentamicin
  3. lithium
  4. simvastatin
  5. warfarin
A

simvastatin

33
Q 
which side effect from morphine can contribute to hypoxia?
1. constipation
2. cough
3. neuromuscular paralysis
4. resp depression
tachypnoea
A

resp depression

34
Q 
which ADR is an anaphylaxis reaction to penicillin?
a
b
c
e
A

Type B

35
Q

a man says he hasnt been taking his statins as prescribed because he feels fine without them, which of the following seems the most important reason for his non-adherence?

  1. capacity and resources
  2. concerns about medication
  3. necessity beliefs about medication
  4. practical barriers to adherence
  5. specific beliefs about medication
A

necessity beliefs about medication

36
Q

a man has an anaphylactic reaction to penicillin, which antibody mediates this type of allergic reaction

  1. IGA
  2. IGD
  3. IGE
  4. IGG
  5. IGM
A

IGE

37
Q

pharmacokinetics is:

  1. The study of biological & therapeutic effects of drugs.
  2. The study of absorption, distribution, metabolism & excretion of drugs.
  3. The study of mechanism of action of drugs.
  4. The study of new drug development.
  5. The study of genetic differences in drug metabolism.
A

the study of absorption, distribution, metabolism, excretion of drugs

38
Q

what is half life?

  1. the time taken for the plasma drug concentration to fall to half its original value
  2. the time to metabolise half the drug into its active metabolite
  3. the time to absorb half the drug
  4. the time to bind half the drug to plasma proteins
  5. the time to maximum plasma levels after a dose of the drug
A

time taken for plasma drug conc to fall to half its original value

39
Q

which statement about ACh is true?

  1. It acts on M1 receptors on smooth muscle to cause bronchoconstriction
  2. Muscarinic receptors are the major preganglionic signalling receptor for sympathetic signalling
  3. Both sympathetic and parasympathetic systems use acetylcholine in preganglionic signalling
  4. It acts on beta 2 receptors to cause smooth muscle relaxation
  5. It acts in the eye to cause dilatation of the pupil
A

Both sympathetic and parasympathetic systems use acetylcholine in preganglionic signalling

40
Q

which drug would you give a patient with COPD who has atrial fibrillation?

  1. Propranolol is the beta blocker of choice to slow his heart rate
  2. Beta blockers are contraindicated because they can cause bronchoconstriction and dangerous wheezing
  3. A muscarinic agonist is standard treatment to safely slow the heart without affecting the airways
  4. A selective beta 1 blocker would be safe and effective treatment to slow the heart rate without affecting the airways
  5. A muscarinic antagonist will slow the heart effectively
A

A selective beta 1 blocker would be safe and effective treatment to slow the heart rate without affecting the airways

41
Q 
Chains of purple cocci seen on gram film. show alpha haemolysis in blood agar, don't grow near optochin disc. they are...
1strep. pneumonia
2staph. epidermidis
3strap. viridans
4group A streptocci
5neisseria meningitidis
A

strep. pneumonia

42
Q

which of these is gram neg bacillus that ferments lactose?

  1. shigella sonnei
  2. listeria monocytogenes
  3. neisseria meningitidis
  4. e. coli
  5. streptococcus pyogenes
A

e. coli

43
Q

which is wrong. haemophilus influenzae is important cause of:

  1. meningitis in preschool kids
  2. otitis media
  3. pharyngitis
  4. gastroenteritis
  5. exacerbations of COPD
A

gastroenteritis

44
Q 
normally sterile?
1 pharynx
2 urethra
3 CSF
4 Pleural cavity
5 skin
A

CSF

45
Q 
which is not a way virus cause disease?
A. direct	destruction	of	host	
cells	
B. cell	proliferation	and	cell		
immortalisation		
C. inducing	immune	system	
mediated	damage	
D. Endotoxin	production	
E. modification	of	host	cell	
structure	or	function
A

endotoxin production

46
Q 
when diagnosing viral infections which is false?
A. The	sample	must	come	
from	a	sterile	site	
B. Electron	microscopy	is	
rarely	used	
C. Use	a	green	swab	not	a	
black	swab	
D. PCR	results	take	1-2	days	
E. A	detectable	IgM	in	serum	
may	be	diagnostic
A

sample must come from sterile site

47
Q 
HIV virus envelope has?
A. RNA	+	capsid	+	DNA	
polymerase	
B. DNA	+	capsid	+	Reverse	
transcriptase	
C. DNA	+	p24	+	protease	
D. RNA	+	capsid	+	reverse	
transcriptase
A

rna and capsid and reverse transcriptase

48
Q 
which is correct?
A. Pityriasis versicolor =
bacterium
B. Ringworm = helminth
C. Aspergillus fumigatus =
mycobacterium
D. Falciparum malariae =
fungal
E. Giardia lamblia =
protozoal
A

giardia lamblia is protozoal

49
Q 
which is not a feature of mycobacteria?
A. Resistance	to	destaining	by	
acid	and	alcohol	
B. Cell	wall	contains	
lipoarabinomannan
C. They	only	divide	every	20	
hours	
D. They	cannot	withstand	
phagolysosomal	killing	
E. May	cause	meningitis
A

they cannot withstand phagolysosomal killing

50
Q 
which is true for antimicrobial resistance?
A. it	is	spread	by	plasmid	
mediate	gene	transfer	
B. spontaneous	gene	
mutations	do	not	occur	
C. MRSA	refers	to	vancomycin
resistant	S.	aureus
D. Only	Mereopenem	is	
effective	against	all	gram	
negative	bacteria
A

it is spread by plasmid mediated gene transfer

51
Q 
which is false?
A. S.	pyogenes :	can	use	
penicillin	
B. Meropenem	:	a	
carbapenem
C. Glycopeptides	:	use	for	
MRSA	
D. Ciprofloxacin	:	cause	C.	
difficile diarrhoea
E. Cefuroxime	:	a	macrolide
A

cefuroxime is a macrolide

52
Q 
21 year old has mylagia, sore throat, tired, febrile, large spleen. which is best answer?
A. He	has	sepsis	and	needs	broad	
spectrum	antimicrobial	therapy	
with	cefotaxime
B. A	charcoal	throat	swab	will	
confirm	the	diagnosis	
C. Finding	atypical	lymphocytes	on	
a	blood	film	and	a	positive	EBV	
IgM	in	serum	would	be	
consistent	
D. PCR	on	a	viral	throat	swab	will	
confirm	the	diagnosis	
E. This	is	a	viral	upper	respiratory	
tract	infection	and	doesn’t	
warrant	investigation	or	
antimicrobial	therapy
A

C

53
Q 
34yr old gay man prolonged diarrhoea presents with short breath with dry cough and hypoxia. which is most true?
A. This	is	bacterial	pneumonia	
caused	by	pneumocysitis
jirovecii.	
B. It	is	too	early	for	a	4th
generation	HIV	test	to	be	
positive		
C. The	CD4	T	cell	count	will	be	
between	500	and	750	
D. Even	if	the	HIV	test	is	
negative	this	man	has	AIDS	
E. With	appropriate	therapy	
he	has	a	good	prognosis
A

E

AIDS just for HIV

54
Q 
Sepsis: infection and systemic inflammatory response. which is false for systemic inflam. response?
A. Temperature	>38.3C	or	
<36C	
B. Heart	rate	>90	
C. Systolic	blood	pressure	
>130	
D. White	Cell	count	>12	
E. Hypoxia
A

systolic blood pressure >130

In sepsis should be below 90

55
Q 
Which is false? the give steps of hand hygiene are to wash hands?
A. Before	contact	with	
patient	
B. Before	bodily	fluid	
exposure	
C. Before	aseptic	procedures	
D. After	contact	with	patient	
surroundings	
E. After	patient	contact
A

before bodily fluid exposure

56
Q

Which of these is not causing a reduction in transfer factor?

1) idiopathic pulmonary fibrosis
2) pulmonary hypertension
3) asthma
4) Anaemia
5) COPD

A

3)ASTHMA IS THE ANSWER because normal structure of alveolar, problem is moving air in and out
IPF: scarring between alveolar and blood so less transfer so less transfer factor
PHypertension: heart working hard, blood flow reduced to lungs so less transfer
Anaemia less RBC so less O2 taking so less transfer
COPD less alveolar ability from emphysema esp. so less transfer

57
Q

Which is not a pathological description of findings seen in interstitial lung disease?

1) usual interstitial pneumonia
2) non-specific interstitial pneumonia
3) de-squamative interstitial pneumonia
4) obliterative bronchiolitis
5) diffuse alveolar damage

A

Obliterative bronchiolitis

All the others are seen in ILD

58
Q

Which of these is not seen with lobar collapse?

a) triangular opacity with apex at the hilum
b) veil like opacity over right hemi-thorax
c) sickle sign of air around aortic knuckle
d) loss of right hemi-diaphragm
e) sail sign

A

Veil like opacity over right hemi thorax

the others can be seen sometimes

59
Q

which lung condition does not have an occupational component?

1) asthma
2) idiopathic pulmonary fibrosis
3) sarcoidosis
4) pigeon fancier’s lung
5) COPD

A

pigeon fancier lung (from hobby not job)

60
Q

To establish COPD which of these is not necessary?

1) substantial smoking history
2) progressive airflow obstruction
3) lack of reversibility
4) reduced FEV1/FVC ratio
5) lack of change over several months

A

substantial smoking history is not needed

61
Q

Which is the right criteria for home O2 in COPD?

1) PACO2 less than 7.3
2) assessed while stable
3) assessed twice, 6 weeks apart
4) assessed off treatment
5) PA02 more than 7.3

A

Assessed while stable
The others are wrong:
PACO2 should be more than 7.3 and PAO2 less than 7.3
Assessed twice 3 weeks apart and assessed on treatment

62
Q

Which is true?

1) 80% of lung cancer are SCLC
2) 10 year survival is 10%
3) traditional radiotherapy is as good as daily therapy
4) chemotherapy gives a 4% rise in 2year survival compared to traditional treatment
5) performance status 4 is assosciated with good one year survival

A

chemotherapy gives a 4% rise in 2 year survival compared to traditional treatment
the others are false
SCLC make up a small proportion

63
Q

pick true response?

a. 4.2 million people in UK have occupational illness
b. most of these are respiratory
c. occupation history is not worth time it takes to ask
d. diagnosis of occupational lung disease can solve significant problems – cause problem because have to deal with employment or unemployment etc.
e. at least 10% of asthma is thought to be occupational

A

at least 10% of asthma is thought to be occupational

64
Q
  1. which of these occupations are not associated with occupational lung disease?
    a. baker
    b. lab technician
    c. joiner
    d. metal worker
    e. prawn sheller
    f. none
A

NONE
Lab tech- animal allergy
Joiner-asbestos
Prawn sheller-allergies

65
Q

in pulmonary embolism which is true?

a. shock is heralded by pleuritic chest pain and haemoptysis
b. DVT is usually seen
c. prophylaxis is over used
d. idiopathic PEs usually require at least 6 months of treatment
e. treatment with NOACs is better than heparin in cancer

A

answer; Idiopathic PE need at least 6 months treatment
shock is heralded by pleuritic chest pain and haemoptysis – these steps don’t usually happen sometimes patients just collapse with PCPain without haemoptysis etc
DVT rare to be seen
Prophylaxis life saving
heparin is best for cancer

66
Q
  1. Epidemic flu is:
    a. crosses international boundaries
    b. caused by antigenic drift
    c. 2 or more linked cases
    d. prevented by Tamiflu
    e. prevented by immunisation
A

Answer: caused by antigenic drift

Not prevented by these things just reduce transmission.

67
Q

70 yr old woman presents with 1 month history of irritative bladder symptoms. she’s on antibiotics for presumed UIT with no symptom improvement. She’s complaining of a 1 week history of visible haematuria. renal ultrasound is normal and dipstick shows blood and leukocytes. what further investigations do u do?

  1. flexible cystoscopy
  2. MRI KUB
  3. urine culture
  4. Non-contrast CT KUB
  5. U+E blood test
A

Flexible cystoscopy
you’re worried for bladder cancer due to no cause of UTI showing, sudden onset of irritative bladder symptoms and blood.
If cancer you would then do CT contrast afterwards.

68
Q 
flexible cystoscopy reveals a 3cm papillary bladder lesions. a transurethral resection of bladder tumour occurs. what is the chance of tumour being muscule invasive in histology
50%
20%
40%
60%
80%
A

20% muscle invasive

80% superficial

69
Q

59 year old man shows with 2 day history of sudden onset left loin to groin pain with pain 9/10 severity and is intermittent pain. normally fit and on no regular medication. what investigation would most likely establish diagnosis.

  1. urine dipstick
  2. XR
  3. renal ultrasound
  4. contrast enhanced CT
  5. Non-contrast CT
A

NON-CONTRAST CT
contrast is same colour as stone
XR after stone to compare and check you can also see it on XR so you can do XR follow up instead of CT follow ups

70
Q 
pharmacies offer tests for lots of STIs. what kind of public health approach is this?
secondary prevention
tertiary prevention
health improvement
primary prevention
health promotion
A

secondary prevention

71
Q 
may and anderson 1987 transmission model describes how infections are spread. what is the best term relating to number of opportunities for transmission?
infectivity rate
partner rate over time
duration of infection
reproductive rate
contact tracing
A

partner over time

72
Q 
asymptomatic bacteriuria should be treated in which of the following situations:
men >65
pregnant women
women>65
both bacteria and wbc seen on microscopy
indewlling catheter is in situ
A

pregnant women

73
Q 
which of the following is a first line antibiotic for UTI
nitrofurantoin
tazocin
fosfomycin
benzylpenicillin
ceftriaxone
A

nitrofurantoin

74
Q

30 year old women presents with pyrexia, rigors, low BP, loin pain and renal angle tenderness. Urine WBC >10^5. what is the best diagnosis:

  1. cystitis
  2. diverticulitis
  3. pyelonephritis
  4. renal abscess
  5. pelvic inflammatory disease
A

pyelonephritis

cystitis (bladder inflammation)

75
Q

which is the most appropriate investigation to pyelonephritis
abdominal exam not including vaginal exam
bloods
imaging
abdo exam with vag exam, bloods, cultures, midstream urine, imaging

A

abdo exam with vag exam, bloods, cultures, midstream urine, imaging
(vag exam to check doesn’t have pelvic inflammatory disease)

76
Q 
the most common cause of UTI is:
Klebsiella
staph. aureus
candida
e. coli
enterococcus
A

e. coli uropathogenic

77
Q 
35 year old man in road traffic accident undergoes CT of abdo which picks up 6.5 cm left renal mass and no injuries. mass confined to renal parenchyma and no evidence of lymph or metastatic spread and its though to be a renal cell carcinoma. what is the T stage?
t1a
t1b
t2a
t2b
t3
A

T1B

T1 is 0-7cm mass. T1A is <4cm. T1B is >4cm

78
Q

with urosepsis, ACEi and angiotensin receptor blockers and more likely to result in:
reduced glomerular filtration pressure and worsening renal function
increased glom filtration pressure and improved renal function
reduced efficacy meaning the dose should be doubled
reduced thirst meaning patient needs IV fluids
all of above

A

reduced glom filtration pressure and worse renal function

acei protective in chronic renal damage but not in acute case

79
Q

most common inherited cause of kidney failure is
phenylketonuria
autosomal dominant polycystic kidney disease
auto recessive polycystic kidney disease
von hippel lindau disease
anderson fabry disease

A

auto dom polycystic kidney disease

Phase 2a Introductory Clinical Science (7 decks)

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