General points 10

Question 1

Causes of long QT interval

Answer 1

Congenital - Jervell-Lange-Nielsen syndrome, Romano-Ward syndrome
Antiarrhythmics - amiodarone, sotalol, class 1a antiarrhythmic drugs
Tricyclic antidepressants
Antipsychotics
Chloroquine
Terfenadine
Erythromycin
Electrolyte - hypocalcaemia, hypokalaemia, Hypomagnesaemia
Myocarditis
Hypothermia
Subarachnoid haemorrhage

Question 2

Management of Torsades de Pointes

Answer 2

Peri-arrest call
IV magnesium sulphate 2g over 10 minutes
May deteriorate into ventricular fibrillation and hence lead to sudden death

Question 3

Risk factors for pseudogout

Answer 3

Hyperparathyroidism
Hypothyroidism
Haemochromatosis
Acromegaly
Electrolytes - hypomagnesaemia, hypophosphataemia
Wilson's disease

Question 4

Transfusion reactions

Answer 4

Got a bad unit

Graft vs. Host disease
Overload
Thrombocytopaenia

Alloimmunization

Blood pressure unstable
Acute haemolytic reaction
Delayed haemolytic reaction

Urticaria
Neutrophilia
Infection
Transfusion associated lung injury

Question 5

Which procedure is most likely to increase the risk of gallstone formation?

Answer 5

Ileal resection - bile salt resorption occurs in the ileum, so more cholesterol gallstones occur

Question 6

Pt is receiving unfractionated heparin infusion pre-operatively for embolism prophylaxis. How long before the surgery should this be stopped?

Answer 6

6 hours

Question 7

Lymph node biopsy for a pt with TB

Answer 7

Granuloma formation and central necrosis

Question 8

Acute inflammation phases

Answer 8

1 - changes in blood vessel and flow (flush, flare, wheal)
2 - fluiud exudates (rich in protein i.e. immunoglobulins, coagulation factors) produced via increased vascular permeability
3 - Cellular exudates mainly containig neutrophil plymorphs pass into extravascular space

Question 9

Neutrophil transportation into tissues

Answer 9

1 - margination of neutrophils to the peripheral plasmatic of the vessel rather than the central axialstream
2 - pavementing - adhesion of neutrophils to the endothelial cells i venules at site of acute inflammation
3 - emigration - neutrophils pass between endothelial cells into the tissue

Question 10

PTH effects

Answer 10

Bone - binds to osteoblasts which signal to osteoclasts to cause resoprtion of bone and release calcium

Kidney - active reabsorption of calcium and magnesium from the distal convoluted tubule and decreases reabsorption of phosphate

Intestine via kidney - increases intestinal calcium absorption by increasing activated vitamin D (activated vitamin D increases calcium reabsorption)