General Points 11

Question 1

Femoral Cancal

Answer 1

Laterally - femoral vein
Medially - lacunar ligament
Anteriorly - inguinal ligament
Posteriorly - pectineal ligament

Contents - lymphatic vessels, Cloquet’s lymph node

Physiological significance - allows the femoral vein to expand to allow for incresed venous return from the lower limbs

Pathological significance - as a potential space, it is the site for femoral hernias. Relatively tight neck places these at high risk for strangulation.

Question 2

Disorders of spleen

Answer 2

Causing massive splenomegaly

• myelofibrosis
• CML
• visceral leishmaniasis (Kala-azar)
• malaria
• Gaucher’s syndrome
• portal HTN
• lymphoproliferative disease (CLL, Hodgkin’s lymphoma)
• haemolytic anaemia
• infection - hepatitis, glandular fever (EBV)
• infective endocarditis
• sickle cell, thalassaemia
• RA (Felty’s syndrome)

Question 3

Acute vs chronic inflammation

Answer 3

Acute inflammation

• changes to existing vascular structure and increased permeability of endothelial cells
• infiltration of neutrophils
• process may resolve with suppuration, complete resolution, abscess formation, progression to chronic inflammation, healing by fibrosis

Chronic inflammation

• angiogenesis predominates
• macrophages, plasma cells and lymphocytes predominate
• healing by fibrosis is main result

Question 4

Froment’s sign

Answer 4

Pt is given a piece of paper to hold between his thumb and index finger. When the paper is pulled, the patient has difficulty maintaining a grip. Grip pressure is maintained by flexing the thumb at the interphalangeal joint. This is a positive result.

Tests for the function of adductor pollicis

Indicative of ulnar nerve palsy

Question 5

Jeanne’s sign

Answer 5

Pt is asked to make an OK sign with their hand. If the pt is unable to bring together the distal phalanx of the thumb and the index finger, then it is a positive result.

Tests for the the function of

Indicative of anterior interosseous nerve injury if there is no sensory deficit

Question 6

Drugs causing SIADH

Answer 6

Analgesia - opioids, NSAIDs
Barbiturates
Cyclophosphamide, chlorpromazine, carbemazepine
Diuretics (thiazide)

Question 7

Histology shows asteroid bodies

Answer 7

Sarcoidosis

Question 8

Site at which most calcium is absorbed

Answer 8

Small bowel 90%

Colon 10%

Question 9

History of gastrectomy + macrocytic anaemia

Answer 9

B12 deficiency

Question 10

Facial nerve lesion. Differentiate between UMN or LMN lesion.

Answer 10

Upper motor neurone lesions of the facial nerve - Paralysis of the lower half of face (forehead sparing)
Lower motor neurone lesion - Paralysis of the entire ipsilateral face (non-forehead sparing)