Formatives Flashcards
What is the name of the main effector cell in acute inflammation?
Neutrophil polymorphs
Name of collagen producing cells in fibrous scarring?
Fibroblasts
Name an example of acute inflammation?
Apendicitis
What crystals are deposited in gout joints?
Uric acid crystals
Name a condition in which granulomatous inflammation occur?
Chron’s
Specific name of calcification in diseased (as opposed to normal) tissue?
Distrophic calcification
Which illness starts as chronic inflammation?
Infectious Mononucleosis
Which cells produce antibodies?
Plasma Cells
Which tumour doesn’t metastasise?
Basal cell carcinoma
What term describes a cancer not invaded through the basement membrane?
Carcinoma in situ
What is the name of a malignant tumour of striated muscle?
Rhabdomyocarcinoma
Which five tumours often metastasise to bone?
Breast, Prostate, Kidney, Thyroid, Lung
Let’s talk blood pressure, kids!
What is the name of a glandular epithelium?
Adenoma
Which tumour has no screening programme?
a. Breast Cancer
b. Colorectal cancer
c. Cervical cancer
d. Lung cancer
Lung cancer
What isn’t a carcinogen in humans?
a. Ionising radiation
b. Asperigillus niger (black mould)
c. Etc
Asperigillus niger
What is the name of a benign tumour of fat?
Lipoma
What is the name of a benign tumour of glandular epithelium?
Adinoma
Malignant tumours don’t:
a. Metastasise
b. Grow
c. Grow in relation to overall body growth
c. Grow in relation to overall body growth
Is transitional cell carcinoma of bladder malignant or benign?
Malignant
What is the name of a benign tumour of smooth muscle?
Leimyoma
Radon gas can cause lung cancer?
a. True
b. False
True
Is asbestos a carcinogen?
a. Yes
b. No
Yes
What is the largest risk factor for tumour growth?
Smoking
What is a cancer with very low median survival rate (~ 2 months)?
Anaplastic carcinoma of the thyroid
Where can ovarian cancer spread in?
Peritoneum
What is the name of a malignant tumour of glandular epithelium?
Adenocarcinoma
Activation of naive T cells is best achieved by which antigen presenting cells?
a) Neutrophils
b) Mast Cells
c) Macrophages
d) Dendritic cells
D) Dendritic cells
What cell type is described below? "Located exclusively in tissues, has an important role in both the innate and adaptive immune system, are antigen presenting cells and have phagocytic properties" a) Macrophage b) Neutrophil c) Eosinophil d) Mast cell e) Fibroblast
a) Macrophage
Which of the following is not involved in innate immune mechanisms?
a) Anatomic barriers
b) Phagocytic
c) Inflammatory mechanisms
d) Antibody production
e) Skin
d) Antibody production
T cells recognise antigen
a) In solution in plasma
b) When presented on RBCs
c) Following presentation on antigen presenting cells
d) In a 3D form
e) Following presentation on pattern recognition receptors
c) Following presentation on antigen presenting cells
Influenza vaccine is targeted towards ‘at risk’ groups in the UK. Which of the following are classified as ‘at risk’?
a) Over 65s
b) 16 year old
c) The obese of any age
d) Teenagers
e) Under 2 years old
A) Over 65s and e) Under 2 years old
Which of the following is administered as a live attenuated vaccine in the UK?
a) Hep A
b) MMR
c) Tetanus
d) Flu
e) Polio
b) MMR
Complements are the proteins that are involved in the clearance of antigen/bacteria. Which of the following is not part of the Elimination phase of complement activation?
a) Opsonisation
b) Target Cell Lysis
c) Chemoattraction of leukocytes
d) Production of interferons
e) Phagocytosis
d) Production of interferons
Which of the following is a polysaccharide vaccine?
a) Anthrax
b) HIB (Haemophilius infuenza type b)
c) Rabies
d) Hep A
b) HIB (Haemophilius infuenza type b)
Which of the following are features of the adaptive immune response?
a) Does not require prior contact with the pathogen
b) It works with B and T lymphocytes
c) Lacks specificity
d) Distinguishes “self” from “non-self”
e) Enhanced by complement
b) It works with B and T lymphocytes
What are the two types of immune response in humans?
a) Immunological tolerance
b) Immune surveillance
c) Innate and Acquired
d) Intrinsic and Extrinsic
e) Overt and Covert
c) Innate and Acquired
Which of the following is NOT an organ-specific auto-immune disease?
a) Ulcerative colitis
b) Type 1 diabetes mellitus
c) Graves disease
d) Hashimoto’s thyroiditis
e) Sjogren’s syndrome
a) Ulcerative colitis
Which of the following is not a classical PAMP?
a) peptidoglycan, found in bacterial cell walls;
b) flagellin, a protein found in bacterial flagella;
c) lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria;
d) Interleukin 12
e) nucleic acids such as viral DNA or RNA.
d) Interleukin 12
There is bacteria with chains, purple cocci, alpha haemolysis in blood agar and is optochin sensitive.
what is it?
Streptococcus pneumoniae
There is a gram negative bacillus which is lactose fermenting. What is it?
Escherichia Coli
Which is a normally sterile site?
a) The pharynx
b) The urethre
c) Cerebrospinal fluid
d) The lung
e) Skin
C) Cerebrospinal fluid
Which of these is NOT a means by which viruses 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/function
d) Endotoxin production
When diagnosing viral infections which is not true?
a) The sample must come from a sterile site.
b) Electron microscopy is rarely used
c) Use a green swap not a black swab
d) PCR results take 1-2 days
e) A detectable IgM in serum may be diagnostic
a) The sample must be from a sterile site
Which pair is correct?
a) Pityriasis versicolor = bacterium
b) Ringworm = helminth
c) Aspergillus fumigatus = mycobacterium
d) Falciparum malariae = fungal
e) Giardia lamblia = protozoal
e) Giardia lamblia = protozoal
Mycobacteria. Which is not a feature?
a) Resistance to destaining by acid and alcohol
b) Cell wall contains lipoarabinomannan
c) They only divide ever 20hours
d) They cannot withstand phagolysomal killing
e) May cause meningitis
d) They cannot withstand phagolysomal killing
Regarding antimicrobial resistance, which is true?
a) It is spread by plasmid mediated 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
Antimicrobials. Which pairing is incorrect?
a) S pyogenes: can use penicillin
b) Meropenem: a carbapenem
c) Glycopeptides: use for MRSA
d) Co-amoxiclav: contains a beta-lactamase inhibitor
e) Cefuroxime: a macrolide
e) Cefuroxime: a macrolide
A 21yo complains of myalgia, sore throat and tiredness. He is febrile and has an enlarged spleen. Which is the 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 swap will confirm the diagnosis
e) This is a viral upper respiratory tract infection and doesn’t warrant investigation or antimicrobial therapy
c) Finding atypical lymphocytes on a blood film and a positive EBV IgM in serum would be consistent
Which of these does NOT feature in the definition of sepsis?
a) Temperature >38.3 or <36
b) Heart rate >90
c) Systolic BP >130
d) White cell count >12
e) Hypoxia
c) Systolic BP >130
Infection control: which is false? The five steps of hand hygiene are to was hands.
a) Before contact with patient
b) Before bodily fluid exposure
c) Before aseptic techniques
d) After contact with patient surroundings
e) After patient contact
b) Before bodily fluid exposure
What is the risk of mother to child transmission of HIV?
a) 1%
b) 8.6%
c) 21%
d) 35%
e) 60%
d) 35%
What age group is most affected by HIV worldwide?
a) 0-14
b) 15-24
c) 25-34
d) 35-44
e) >44
15-24
What is the characteristic genetic abnormality in Chronic Myeloid Leukaemia?
a) t(15;17) ATRA gene
b) t(9;22) Philadelphia chromosome
c) t(8;21) AML/ETO gene
d) t(8;14) cMYC oncogene
t(9;22) Philadelphia chromosome
What age is common for chronic myeloid leukaemia?
Usually 40-60yrs age
Features of chronic myeloid leukaemia?
- Slow onset
- Sometimes incidently
Features of chronic myeloid leukaemia?
- High WCC
- Splenomegaly
- Metabolic features
Investigation results features for chronic myeloid leukaemia?
FBC - High WCC
Film - Left shift + basophilia
What is the key diagnostic features of chronic myeloid leukaemia?
Philadelphia chromosome, t(9;22). Results in Resulting in 210-kDa fusion protein –activated tyrosine kinase.
What mutation may result in chronic myeloid leukaemia?
Blocks abnormal tyrosine kinase activity
Can result in molecular remission
BCR-ABL mutations may result in resistance
What class of drug best describes Rituximab?
a) Cytotoxic chemotherapy
b) Disease-modifying therapy
c) Monoclonal antibody
d) Antibiotic
Monoclonal antibody
- Targets CD20 expressed on cell surface of B-cells
- Chimeric mouse/human protein
- Infusional side-effects
- Widely used
Which age group is characteristically affected by Hodgkin lymphoma?
- Children
- Teenagers and young adults
- Middle aged (40-60 yrs)
- Older aged (>60yrs)
-Teenagers and young adults and older aged
How is myeloma bone disease usually assessed?
- Plain X-ray
- Clinical assessment
- Isotope bone scan
- PET scan
-Plain X-ray
Skeletal survey
Production of Osteoclast-activating factors
OAFs include RANKL, IL-3 and TNF-α
What is the correct mechanism of action for the anti-emetic drug Ondansetron?
- Peripheral D2 antagonist
- Central D2 antagonist
- Anti-cholinergic
- 5HT3 antagonist
-5HT3 antagonist
What is the commonest cause of microcytic anaemia?
- B12 deficiency
- Iron deficiency
- Haematologic malignancy
- Hereditary spherocytosis
-Iron deficiency
What are the three main causes of microcytic anaemia?
Iron deficiency
Chronic disease
Thalassaemia
Rarely: Congenital sidertoblastic anaemia, lead poisining
What are the three main causes of normocytic anaemia?
- Acute blood loss
- Anaemia of chronic disease
- Combined haematinic deficiency
What are the three main causes of macrocytic anaemia?
- B12/folate deficiency
- Alcohol excess/liver disease
- Hypothyroid
HAEMATOLOGICAL: Antimetabolite therapy, Haemolysis, Bone marrow failure, Bone marrow infiltration
In sickle cell anaemia what would you expect to see the reticulocyte count?
- Absent
- Low
- Normal
- Raised
-Raised
- Chronic Haemolytic anaemia
- Reticulocyte response
- Film appearances
- Effect on MCV
- Marrow function
Bacterial infection usually causes:
- Low lymphocytes
- Low neutrophils
- High lymphocytes
- High neutrophils
-High neutrophils
Which best outlines the approach to the management of a patient with suspected febrile neutropaenia?
- Encourage fluids and paracetamol
- Perform cultures and wait for results before starting antibiotics
- Perform cultures and start oral antibiotics
- Perform cultures and start broad spectrum iv antibiotics
-Perform cultures and start broad spectrum iv antibiotics
-Haematologic emergency
-ABC
-Perform cultures
-Broad spectrum iv Abs with 1 hour
E.g. Tazosin and Gentamicin
Malignant spinal cord compression usually presents with?
- Back pain, ataxia and sensory neuropathy
- Back pain, spastic paresis and a sensory level
- Perianal numbness and urinary incontinence
- Weak legs impaired joint position sense
-Back pain, spastic paresis and a sensory level
- Emergency
- Urgent MRI
- Bed rest + pressure area care
- Steroids
- Analgesia
- Chemo or Radiotherapy
How does Aspirin exert its antiplatelet effect?
- ADP receptor antagonist
- Inhibition of Cyclooxygenase enzyme
- Inhibition of Glycoprotein IIb-IIIa
- Inhibition of PAR4 receptor
-Inhibition of Cyclooxygenase enzyme
What proportion of women over 50 have a fracture due to osteoporosis?
50%
What is a T-Score?
Standard deviations from gender matched young adult mean.
Name two properties of bone other than bone mineral density which contribute to bone strength?
Size, geometry, microarchitecture, turnover, mineralisation.
What are the most commonly used drug in osteoporosis?
Bisphosphonates.
Which of the following clinical features is typical of osteoarthritis?
a) 60 mins of early morning stiffness
b) Painful, swelling across the metacarpophalangeal joints and proximal interphalangeal joints
c) Pain in the 1st carpo-metacarpal joints
d) Mobile, subcutaneous nodules at points of pressure
e) Alternating buttock pain
c) Pain in the 1st carpo-metacarpal joints
Which of the following is an extra-articular manifestation of rheumatoid arthritis?
a) Subcut nodules
b) Episcleritis
c) peripheral sensory neuropathy
d) Pericardial effusion
e) All of the above
e) All of the above
Which of the following is a classical feature of rheumatoid arthritis on xray?
a) Peri-articular sclerosis
b) Sub-chondral cysts
c) Osteophytes
d) Peri-articular erosions
e) New bone formation
d) Peri-articular erosions
53yo, lower back pain, builder, BMI 29, no neurological deficits/spinal deformity, not easily localised.
a) Given age, referred
b) X-ray
b) No sick note, return to work
d) Reassurance & advice, simple analgesics
e) Seek other employment
d) Reassurance & advice, simple analgesics
For a lytic tumour to be visible on X-ray, it mist have lost:
a) Greater than 6% bone density
b) Greater than 16% bone density
c) Greater than 60% bone density
d) Greater than 90% bone density
e) 100%
c) Greater than 60% bone density
57yo, 3 day history painful 1st MTP joint, red, very warm. BMI 32 & hypertension.. What dietary changes will reduce risk of similar episodes?
a) High red meat
b) High dairy products
c) Drinking >5 cans of non-diet fizzy drinks/day
d) Rich in sugary foodstuff
e) Switch from beer to lager
b) High dairy products
Which is not an autoimmune connective tissue disease?
a) Systemic lupus erythematosus
b) Ehler Danlos syndrome
c) Primary sjogren’s syndrome
d) Systemic sclerosis
e) Dermatomyositis
b) Ehler Danlos syndrome
23yo woman, mouth ulcers, fever, painful white fingers & pleuritic chest pain. Antinuclear antibody ANA+, ESR 52 (0-15), WBC low. What would not be expected with her illness?
a) Deforming arthritis
b) Photosensitive rash
c) Seizures
d) Pulmonary embolism
e) Thrombocytosis
e) Thrombocytosis
Which of the following is used in the treatment of SLE?
a) Anti-TNF
b) Anti malarials
c) Ustekinuab (IL12/23 blocker)
d) Sulfasalzine
e) Allopurinol
b) Anti malarials
