june 2020 test Flashcards
- Pathophysiology of lung abscess is not correct (Lower Respiratory Tract Surgery)
a) Hoarse voice
b) Immunosuppressive state may be important
c) Poor dental hygiene may play a role
d) Gastro oesophageal reflux would be an insignificant finding.
d) Gastro oesophageal reflux would be an insignificant finding.
- Clinical presentation of lung abscess is not correct (Lower Respiratory Tract Surgery)
a) history of night sweats
b) weight loss
c) presentation clinically different from pneumonia
d) Sputum may be purulent
c) presentation clinically different from pneumonia
3) Statements regarding investigations is not correct (Immunology - slide 9)
a) On x ray it is common to see an air fluid level within the abscess cavity
b) CT scan may show cavitation with the adjacent consolidation
c) Bronchoscopy is helpful to rule out associated endobronchial obstruction
d) Ultrasound is the investigation of choice because of accuracy and non invasiveness and convenience
d) Ultrasound is the investigation of choice because of accuracy and non invasiveness and convenience
- Not regarded as a principle of management of lung abscess
a) Causative organisms should be identified ASAP
b) Adequate drainage into the tracheobronchial tree is desirable
c) Even though response to medical treatment is generally poor, it should be started to avoid surgery
d) External drainage is indicated if there is no drainage into the tracheobronchial tree
c) Even though response to medical treatment is generally poor, it should be started to avoid surgery
- Not correct regarding patient management
a) Mobilization is contraindicated because it promotes spread of infection to lower lobes
b) Postural drainage is a key element
c) Educate pt regarding management
d) Physio plays a major role
a) Mobilization is contraindicated because it promotes spread of infection to lower lobes
- Regarding auto immune disease is not correct
a) Auto immunity is an immune response against a self antigen
b) Endocrine glands appear to be susceptible
c) Any organ can be affected
d) Type 2 diabetes is an example of a generalized non-organ specific form of an auto immunity
d) Type 2 diabetes is an example of a generalized non-organ specific form of an auto immunity
- Regarding type 1 hypersensitivity is not correct
a) degranulation of cells and release of chemical mediators
b) type 1 involves IgM antibody which binds to mast cells
c) type 1 reaction is immediate
d) Auto-immune haemolytic anaemia is a good example of type 1
b) type 1 involves IgM antibody which binds to mast cells
d) Auto-immune haemolytic anaemia is a good example of type 1
- Which of the following conditions is not an example of type IV/cell-mediated hypersensitivity (Autoimmune- Slide 10)
a) Allergic asthma
b) Contact dermatitis
c) rheumatoid arthritis
d) tuberculosis
a) Allergic asthma
- Regarding molecular mimicry is not correct (Autoimmune)
a) RA involves infection and mimicry
b) with certain infections there is a structural similarity between microbial antigens and self proteins
c) Rheumatic fever typically involves infection and mimicry
d) Similarity results in activation of self-reactive lymphocytes
c) Rheumatic fever typically involves infection and mimicry
- Regarding RA is not correct (Autoimmune)
a) Pt may have associated anaemia
b) 20-40 years
C) Small joints in the hands and feet are affected
b) 20-40 years
- Regarding radiation is not correct (Radiation & Chemotherapy)
a) ionizing radiation may be used to treat cancer but may also be used for diagnosis of disease
B) Ionizing radiation is capable of removing tightly-bound electrons to form ions within tissues of the body
c) Production of ions requires energy of long wavelength and low frequency
d) Radiation is the emission of energy in the form of waves or high speed particles
c) Production of ions requires energy of long wavelength and low frequency
- Regarding radiation-induced cellular injury is not correct (Radiation & Chemotherapy)
a) Radiation may result in the generation of free radicals which are capable of causing damage
b) DNA may be damaged but chromosomes are not
c) Injured cells are eliminated by apoptosis
d) Radiation may directly injure cellular organelles such as mitochondria
b) DNA may be damaged but chromosomes are not
- Not a determinant of the biological effects of ionizing radiation (Radiation & Chemotherapy)
a) The larger the dose of radiation the more the tissue damage
b) Continuous radiation more damaging than intermittent or periodic treatment that delivers the same total amount
c) During radiation treatment cell injury may be less in hypoxic tissue or enhanced by hyperbaric oxygen treatment
d) Slowly-dividing cells are highly susceptible to radiation, allowing more adage to occur to them during the treatment
d) Slowly-dividing cells are highly susceptible to radiation, allowing more adage to occur to them during the treatment
- Effects of ionizing radiation is not correct (Radiation & Chemotherapy)
a) serious consequences may arise if bone marrow and the lymphoid system are affected
b) fibrosis within tissue is a common consequence
c) every effort should be made to protect the adult brain from injury due to its extreme sensitivity
d) injury to blood vessels is common
c) every effort should be made to protect the adult brain from injury due to its extreme sensitivity
- Not a typical respiratory consequence of irradiation
a) pneumonia
b) cor pulmonale
c) productive cough
d) dyspnea
c) productive cough
- Acute Coronary Syndrome
a) Coronary artery dissection
b) vasculitic syndromes
c) coronary embolism from a deep vein thrombosis
d) coronary trauma
c) coronary embolism from a deep vein thrombosis
- Cardiovascular effects of drugs is not correct
a) b-adrenergic blockers affect myocardial contractility
b) nitrates affect afterload
c) b-adrenergic blockers affect heart rate
d) nitrates affect myocardial contractility
d) nitrates affect myocardial contractility
- ECG characteristics is not associated with myocardial infarction
a) Inverted T wave
b) Deep Q wave
C) ST segment elevation
d) inverted q/p waves
d) inverted q/p waves
19) which drug does not increase peripheral vascular resistance
a) dopamine
b) adrenaline
c) phenylephrine
d) propranolol
d) propranolol
20) regarding cell injury is not correct (cell injury)
a) damage to endoplasmic reticulum affects protein synthesis
b) cell membranes are damaged
c) cells may become waterlogged
d) energy production is impaired due to damage to the nucleus
d) energy production is impaired due to damage to the nucleus
- Regarding ischaemia is not correct (ischaemia and infarction)
a) hypoxia causes irreversible tissue whereas ischaemia does not
b) clearance of metabolites is compromised
c) ischaemia involves cellular injury from reduced blood flow to tissues
d) ischaemia may be due to reduced venous drainage
a) hypoxia causes irreversible tissue whereas ischaemia does not
- regarding hypoxic cell injury not correct (Cell Injury)
a) Sodium accumulates within cells
b) There is failure of aerobic respiration
c) Failure of the cells energy dependent sodium pump system
d) Intracellular lactic acid levels and ph increase
d) Intracellular lactic acid levels and ph increase
- not correct in relation to phase 1 cardiac rehabilitation (Cardiac Rehabilitation)
a) Activities of daily living are not relevant for this phase of rehab
b) patient has some knowledge of heart disease
c) Patient has clear lungs and is able to clear secretions
d) patient is able to cope with symptoms
a) Activities of daily living are not relevant for this phase of rehab
- not a contraindication for exercise as part of cardiac rehab (Cardiac Rehabilitation)
a) Uncontrolled hypertension
b) Resting heart rate > 100 beats per minute
c) any drop in blood pressure on standing up
d) uncontrolled diabetes
c) any drop in blood pressure on standing up
- Regarding cardiac patients performance and functioning is not correct (Cardiac Rehabilitation)
a) Participation restrictions imply difficulties a group of similar patients has in performing group activities
b) disabilities are important determinants of quality of life
c) activity limitations imply difficulties an individual has in executing a task or action
d) activity limitations are important determinants of quality of life
a) Participation restrictions imply difficulties a group of similar patients has in performing group activities
- Regarding stroke is not correct (Stroke Notes)
a) HIV is an independent risk factor
b) TIA is a risk factor
c) If symptoms of TIA disappear within one hour then one should suspect another pathology
d) Stroke implies an acute neurological deficit resulting from an intracranial obstructive or haemorrhagic lesion
c) If symptoms of TIA disappear within one hour then one should suspect another pathology
- Regarding ischaemic stroke is not correct (Stroke Notes)
a) Intravenous plasminogen activator facilitates thrombolysis
b) Cornerstone of treatment is removal of obstruction and restoration of blood flow
c) Plasminogen activator is not used for hemorrhagic stroke
d) Majority of stroke victims reach hospital within 3-4 hour window for administration of intravenous plasminogen activator
d) Majority of stroke victims reach hospital within 3-4 hour window for administration of intravenous plasminogen activator
- Regarding stroke in SA is not true (Stroke Reading)
A) Responsible for >250 000 deaths per annum
B) Black females have highest race/gender/100 000 mortality rate
C) More than 80% occurs in low/middle income countries
D) Most common cause of death in people >50
A) Responsible for >250 000 deaths per annum
- Which morphological feature of cerebral infarct is not correct (Dr. Reena Mohenal Lecture on Stroke)
a) Oedema around the infarct results in local mass effect
b) Within the first 12 hours there is a clear evidence of cerebral swelling and loss of definition between grey and white matter
c) Infarcts may be haemorrhagic if reflow occurs
d) By the third week the infarcted tissue undergoes colliquative necrosis
b) Within the first 12 hours there is a clear evidence of cerebral swelling and loss of definition between grey and white matter
- Which is not a feature of malignant hypertension (Dr. Reena Mohenal Lecture on Stroke)
a) Diastolic BP >120
b) Intimal proliferation of medium sized renal arteries
c) Proteinuria and renal failure
d) Papilloedema
b) Intimal proliferation of medium sized renal arteries
- Not found in diabetic patients
a) Glaucoma
b) Nephrotic syndrome
c) Neuropathy affecting motor neurons
d) Autonomic nerve dysfunction affecting the bladder
d) Autonomic nerve dysfunction affecting the bladder
- Regarding the therapeutic target values in a patient with a metabolic syndrome is not correct
a) Target post prandial blood sugar <8mmol
b) Target hba 1c <4%
c) Target fasting glucose is <6
d) Target BP is <130 systolic and <80 diastolic
b) Target hba 1c <4%