ICAST

Question 1

which cells is initially recruited in a fungal nail infection?

Answer 1

dendritic cell

Question 2

which neurotransmitter is affected in huntington’s disease?

Answer 2

GABA

Question 3

what are the lymph nodes at the base of the neck/under the chin?

Answer 3

submandibular

Question 4

which cancers commonly metastasise to bone?

Answer 4

breast
lung
GI
renal
thyroid
prostate

Question 5

what level of the neck is posterior and contains the spinal accessory nerve?

Answer 5

level 5

Question 6

what would happen if there was damage to spinal accessory nerve?

Answer 6

paralysis of sternocleidomastoid and trapezius muscles

Question 7

why would a patient with skin cancer present with a parotid gland mass?

Answer 7

intraparotid lymph nodes drain skin of face, scalp and external acoustic meatus so skin cancers may metastasise to the parotid lymph nodes

Question 8

presentation of GI cancer

Answer 8

may only appear as iron deficiency anaemia due to chronic low grade blood loss from tumour
ensure to investigated for occult GI malignancy

Question 9

what lymph nodes drain the dorsum of the hand?

Answer 9

epitrochlear or supratrochlear lymph nodes

Question 10

which lymph nodes drain the areola of the breast?

Answer 10

level 3 axillary lymph nodes

Question 11

which lymph nodes run along the axillary vein?

Answer 11

lateral axillary lymph nodes

Question 12

what parts of the brain does the vertebral artery drain?

Answer 12

posterior - cerebellum, brainstem and occipital lobes

Question 13

what disease causes atrophy of the caudate nucleus?

Answer 13

Huntington’s

Question 14

what does the supraspinous ligament do?

Answer 14

stabilises spine - prevents hyperflexion

can be torn and cause instability of vertebral column and risk of cord injury

Question 15

main muscle of mastication

Answer 15

masseter

Question 16

what nerve supplies the masseter?

Answer 16

mandibular branch of trigeminal nerve

Question 17

what measure is needed to prevent aspiration?

Answer 17

nasogastric feeding tube

Question 18

vertebral foramen

Answer 18

contains spinal cord

Question 19

what does damage to the L3/4 intervertebral foramen cause?

Answer 19

shooting pain to leg, pain and numbness of knee/medial thigh
weakness of knee extension
diminished knee jerk

Question 20

why does a 3rd cranial nerve palsy cause ptosis?

Answer 20

it innervates levator palpebrae which opens eyelid

Question 21

what giant cells are found in the primary motor cortex?

Answer 21

giant pyramidal/ betz cells

Question 22

what anatomical structure is found at L1 where the cauda equina begins?

Answer 22

conus medullaris

Question 23

what are the respiratory effects of severing the spinal cord at L5 level

Answer 23

pelvic floor muscles will be paralysed and so raising abdominal pressure is difficult and coughing is not effective

Question 24

what is patellar alta?

Answer 24

condition where person is born with patella positioned higher in front of knee than average

Question 25

what is patellar baja?

Answer 25

where patella is positioned lower in front of knee than average - congenital

Question 26

which screening tool can be used to determine whether someone with an ankle injury needs radiographic imaging?

Answer 26

ottawa ankle rules

Question 27

what is the paronychium?

Answer 27

skin on each side of the neail

Question 28

what is the hyponychium?

Answer 28

skin distal to nail bed

Question 29

pathophysioology of huntington's

Answer 29

marked destruction and gliosis of GABAergic enkephalin and substance P containing neurons in caudate nucleus and putamen

Question 30

what are the functions of melanocytes?

Answer 30

melanin/pigment deposition | immune/antigen presentation

Question 31

what are the layers of the epidermis?

Answer 31

``` stratum corneum stratum lucidum stratum granulosum stratum spinosum stratum basale ```

Question 32

what are the components of a tripartite synpase?

Answer 32

presynaptic and postsynaptic neurone | astrocyte/glial cell

Question 33

in glutatmate mediated excitotoxicity what ion is responsible for causing cell damage in postsynaptic neuron and what organelle is responsible for clearing it?

Answer 33

calcium ions | mitochondria

Question 34

from which branch of the aorta does the spleen's blood supply arise?

Answer 34

coeliac axis

Question 35

53 year old woman with history of alcohol excess presents with splenomegaly, what process causes this?

Answer 35

portal hypertension due to chronic liver disease/cirrhosis

Question 36

which lymph nodes drain the skin over the scapular?

Answer 36

posterior/subscapular axillary nodes

Question 37

axillary lymph node levels

Answer 37

levels 1-3

Question 38

level 1 axillary lymph nodes

Answer 38

anterior, lateral and posterior nodes

Question 39

level 2 axillary lymph nodes

Answer 39

central nodes

Question 40

level 3 axillary lymph nodes

Answer 40

apical nodes

Question 41

what passes through the foramen transversarium?

Answer 41

vertebral artery

Question 42

fracture of foramen transversarium

Answer 42

may injure vertebral arteries | risk to areas of brain supplied by vertebrobasilar system

Question 43

what parts of the brain are supplied by the vertebrobasilar system?

Answer 43

cerebellum brainstem occipital lobes

Question 44

what disease is caused by atrophy to caudate nucleus?

Answer 44

huntington's chorea/disease

Question 45

signs of upper motor neurone lesion

Answer 45

``` spastic paralysis clasp knife reflex babinski's sign moderate muscle wasting hyperreflexia clonus ```

Question 46

what type of signalling function for movement control is projected by giant pyramidal cells in the primary motor cortex?

Answer 46

excitatory signal

Question 47

what neurotransmitter is released by giant pyramidal cells?

Answer 47

glutamate

Question 48

myotome for dorsiflexion of ankle

Answer 48

L4 and L5

Question 49

myotome for plantarflexion of ankle

Answer 49

S1 and S2

Question 50

where does the internal mammary/thoracic artery arise?

Answer 50

1st part of subclavian artery

Question 51

what does the basilar artery supply?

Answer 51

brainstem cerebellum occipital lobes

Question 52

what does a thrombosis of the basilar artery cause?

Answer 52

sudden drop in GCS | respiratory and cardiac arrest

Question 53

what respiratory muscles will be paralysed when the spinal cord is severed at T2 spinal cord level?

Answer 53

T3-12 intercostal muscles abdominal muscles pelvic floor muscles upper limb muscles used in forced expiration

Question 54

what prominence does the patella tendon insert onto?

Answer 54

tibial tuberosity

Question 55

what are the ottawa ankle rules?

Answer 55

bony tenderness along distal 6cm of posterior edge of fibular or tip of lateral malleolus, distal 6cm of posterior edge of tibia/tip of medial malleolus, base of 5th metatarsal, navicular, inability to bear weight both immediately after injury and for 4 steps during initial evaluation

Question 56

what structure is injured if there is swelling of the medial aspect of foot, loss of arch of foot and patient is unable to perform single limb heel rise?

Answer 56

tibialis posterior tendon

Question 57

risk factors for injury to tibialis posterior tendon?

Answer 57

``` most common over 40 females obesity hypertension diabetes ```

Question 58

which compartment will a ruptured aneurysm of the middle cerebral artery bleed into?

Answer 58

subarachnoid space

Question 59

what symptoms occur when a patient fractures their skull base?

Answer 59

CSF rhinorrhoea anosmia confirm CSF with dipstick test for glucose

Question 60

what leaves the skull via the foramen ovale?

Answer 60

mandibular branch of trigeminal nerve

Question 61

what does damage to V3 cranial nerve cause?

Answer 61

weakness of muscles of mastication | altered sensation to skin over mandible