Just gonna chuck it all in here Flashcards
1
Q
What substance does GTN spray exert most of its effecton?
A
Calcium
Nitrates cause a decrease in intracellular Calcium
2
Q
Which vessels are lateral relations of the parathyroid gland?
A
Common carotid arteries
Internal jugular veins
3
Q
What is the mechanism of action of adenosine?
A
A1 receptor agonist
Acts in the AV node
4
Q
Which male reproductive component is absent in CF patients?
A
Vas Deferens
Absent in 99% of male CF patients
5
Q
The marginal artery of the colon (AKA marginal artery of Drummond) connects which two vessels?
A
Superior and inferior mesenteric arteries
6
Q
What does ticagrelor do?
A
Inhibits ADP binding to platelets
7
Q
What drug type is clopidogrel?
A
Anti platelet
8
Q
What are some drugs which should be avoided with warfarin?
A
Penicillins Quinolones Metronidazole Cephalosporins Aspirin Acetaminophen Ibuprofen Naproxen Fluoxetine
9
Q
What causes prepubertal atrophic vaginitis?
A
Lack of vaginal oestrogen resulting in an infection-prone alkaline environment
10
Q
Is abdominal pain typical of hyperemesis gravidarum?
A
No
Suggests other GI pathology
11
Q
Which structure is commonly injured in sports requiring explosive bending of the knee?
A
Biceps femoris tendon
Pain may start in posterior aspect of thigh then localise in lateral aspect of knee
12
Q
Why is FBC so important while on aminosalicylates like mesalazine?
A
Check for haematological adverse effects like agranylocytosis
13
Q
How does terlipressin work?
A
Constriction of splanchnic vessels
14
Q
Why should metoclopramide be avoided in bowel obstruction?
A
Promotes gastric emptying
15
Q
How does UC progress?
A
Progressive distal to proximal manner
16
Q
Where do the ureters lie?
A
Anterior to L2 to L5
17
Q
What would you expect to find on a blood test for chronic fatigue syndrome?
A
Chronic fatigue syndrome is a diagnosis of exclusion, so routine blood tests should be normal
18
Q
Which syndrome is associated with gout?
A
Lesch-Nyhan
19
Q
Which nerve is affected in tingling in thumb, middle and index fingers?
A
Median
20
Q
What is a complication of RA which may present with enlarged cheeks, dry mouth and early signs of bronchiectasis on CT?
A
Sjorgen’s syndrome
21
Q
What is Onuf’s nucleus and where is it found?
A
Group of neurons located in anterior horn in sacral nerve roots
Maintains micturation, defecatory continence and helps muscular contraction during orgasm
22
Q
What is olecranon bursitis?
A
“Student’s elbow”
Gradual onset hot, tender, elbow swelling with soft fluctuant mass on posterior elbow
Caused by prolonged pressure, trauma or RA
23
Q
What causes winged scapula?
A
Paralysis of serratus anterior
Also affects arm abduction
24
Q
Which anti-hypertensives should be avoided in gout patients?
A
Thiazides
25
What is a good anti-hypertensive for hypertensive patients with gout?
Losartan
26
What is the most likely cause of a third nerve palsy presenting with headache/pain?
Posterior communicating artery aneurysm
27
What is the ice test for myaesthenia gravis?
Ice held on dropping eyelid for about 2 mins
| Ptosis is relieved for a bit
28
Does myasthenia gravis affect the pupil?
No
| MG classically presents with ptosis, fatigability and can be assessed with the ice test
29
Would a patient with an UMN facial palsy be able to wrinkle their whole forehead?
Yes
| UMN facial palsies spare the upper face i.e. forehead
30
Do LMN facial palsies affect the forehead?
Yes
31
What is an antiemetic used to promote gastric emptying?
Metoclopramide
32
How does cyclizine work?
Blocks histamine and muscarinic receptors in the vomiting centre
33
Which cancers are screened for in Scotland?
Bowel
Breast
Cervical
34
What is the most superficial structure on the parotid gland?
Facial nerve
35
Where do most appendixes lie?
Retrocaecal position
36
What is the most common kind of lung cancer?
Adenocarcinoma
37
How does the deep inguinal ring relate to the epigastric vessels?
It is lateral to them
38
What is the medial longitudinal fasciculus?
Set of crossed fibres with ascending and descending fibres
Links the three main nerves which control eye movements, i.e. the oculomotor, trochlear and the abducent nerves, as well as the vestibulocochlear nerve
39
What is a possible complication of polycystic kidney disease which could present with severe headache?
Cerebral aneurysm
40
What is the substrate of renin?
Angiotensinogen
41
Which aberrant electric pathway is associated with AF?
Between the pulmonary veins and the left atrium may overwhelm the regular impulses from the sinus node
42
How does Ehlers-Danlos syndrome usually present?
```
Skin hyperelasticity
Joint hypermobility
Increased tendency to bruise
Abnormal scarring
Collagen III affected
```
43
Which venous plexus do parathyroid veins drain into?
Thyroid plexus
44
What is the preferred option of delivery for a fetus in transverse lie?
C section
45
Is smoking protective against any kinds of cancer?
Endometrial
46
How does menopause affect FSH, LH and oestrogen?
High FSH
High LH
Low oestrogen
47
What abdominal examination finding is consistent with right sided heart failure?
Pulsatile liver edge
48
Where is a femoral hernia likely to be found?
Neck of the hernia usually inferior and lateral to pubic tubercle
49
What does the umbilical vein become after birth?
Ligamentum teres
| Round ligament of liver
50
What is the 4th heart sound caused by?
Atria contracting forcefully in an effort to overcome an abnormally stiff ventricle
51
Which nerve supplies the epricardium?
Phrenic nerve
52
What is Wallerian degenration?
Active process of degeneration that results when a nerve fibre is cut or crushed and the part of the axon distal to the injury degenerates
53
What separates the PCL from the popliteal artery?
Oblique popliteal ligament
54
What is IgA nephropathy?
Haematuria
Dysuria
Hypertension
Results from immune complex deposition in the glomeruli
55
How does acute pancreatitis present?
```
Acute abdominal pain in epigastric region
High HR
Low BP
Blue discolouration of flank regions
Increased serum amylase
```
56
How do bisphosphonates like risedronate affect osteoporosis?
Inhibit osteoclasts to reduce bone resorption
57
Damage to which nerve is usually associated with hoarseness or a croaky voice?
Recurrent laryngeal
58
Which lobe contains Wernicke's area?
Temporal
59
What separates the endothelial cells of the tunica intima in blood vessels?
Gap junctions
60
What separates the tunica media smooth muscle layer from the tunica intima in blood vessels?
Internal elastic lamina
61
What separates the tunica media and tunica adventitia in blood vessels?
External elastic lamina
62
What is contained in the cavernous sinus?
```
Occulomotor nerve
Trochlear nerve
Opthalmic nerve
Maxillary nerve
Internal carotid artery
Abducent nerve
```
63
What is autonomic dysreflexia?
Spinal cord injury T6 OR ABOVE
| Brings on excessively high BP
64
Nicorandil is sometimes considered as an alternative when CCB's aren't tolerated. How does it work?
Vasodilation through activation of guanylyl cyclase which results in increased cGMP
65
What is cGMP?
Cyclic guanosine monophosphate (cGMP) is a cyclic nucleotide derived from guanosine triphosphate (GTP)
Acts as a second messenger much like cyclic AMP
66
How does nausea affect gastric acid secretion?
Decreases it via higher cerebral activity and sympathetic innervation
67
What are some expected histological findings 3-14 days post MI?
Macrophages and granulation tissue at margins
| High risk of free wall rupture, papillary muscle rupture
68
High risk of free wall rupture 3-14 days post MI can lead to what?
Mitral regurgitation
69
Which structure separates the intervertebral discs of the spinal cord?
Posterior longitudinal ligament
70
What kind of cyst me be lined by hair and squamous epithelium?
Dermoid cyst
71
What is contained in the adductor canal?
Saphenous nerve
| Superficial branch of the femoral artery
72
Which is the weight bearing bone of the forearm?
Radius
73
Where is the most likely sight of fracture in a fall onto outstretched hand?
Distal shaft of radius
74
Which organism most commonly causes septic arthritis?
Staph Aureus
75
What is the most common cause of death in RA patients?
Coronary heart disease
| RA thought to cause increased risk of atherosclerotic disorders
76
How does acanthosis nigricans present?
Areas of darkened and thickened skin in the axillary creases
Commonly associated with obesity. Cushing's syndrome and polycystic ovary syndrome
Also associated with some drugs like nicotinic acid, insulin and corticosteroids
77
What is a good blood test for SLE?
Anti-nuclear antibodies (ANA)
| Over 99% of SLE patients are ANA positive so it's a good rule out test
78
What is Froment's test?
Pinching paper from the table
| Tests for palsy of adductor pollicus of the thumb and so function of the ulnar nerve
79
What is an adverse effect of denosumab?
Hypocalcaemia
80
What kind of tumour is associated with vinyl chloride which workers may be exposed to in big factories?
Angiosarcoma
81
How does vincristine (chemo drug) work?
Inhibits formation of microtubules
| Microtubules separate chromosomes during cell division
82
What skin condition presents with tear drop plaques?
| More common in teens
Guttate psoriasis
83
Which condition commonly presents with small pustules on palms and soles?
Palmo-plantar psoriasis
84
Which variation of psoriasis presents with well-defined plaques on extensor surfaces?
Chronic plaque psoriasis
85
Where does flexural psoriasis most commonly occur?
Axillae
Sub-mammary
Groin
86
What derm condition tends to present with deep red colour all over
Erythrodermic psoriasis
87
What causes anaemia during pregnancy?
Haemodilution due to increased plasma volume
88
Which cancer is associated with elevated serum HCG?
Choriocarcinoma
| Also associated with feeling hot, vaginal bleeding, recent pregnancy
89
Which salivary glands produce most of the saliva?
Submandibular
| 70%
90
Which obstetric emergency is increased risk with gestational diabetes and macrosomia?
Shoulder dystocia
| Obstructed labour
91
Which virus causes plantar warts?
HPV
| Presents with a warty lesion with a black dot in the middle
92
What is the most common cause of PPH?
Uterine atony
93
Which hormone is responsible for the secretion of milk by alveolar epithelial cells of the breast?
Prolactin
94
How does Perthes disease present?
Knee pain
Antalgic gait
Apparent right leg shortening
Flattening of femoral head
95
What is contained in the rectus sheath?
Pyramidalis
Superior epigastric artery and vein
Inferior epigastric artery and vein
Rectus abdominis
96
What is celecoxib?
Reversible COX-2 inhibitor
| NSAID
97
What is a common adverse effect of thiazides?
Hyponatraemia
98
Where are venous ulcers usually distributed?
Gaiter area
99
Can patients with an incomplete neck of femur fracture weight bear?
Yeah maybe
100
Is low body weight as risk factor for osteoporosis?
Yes
101
Which nerve innervates biceps brachii?
Musculocutaneous nerve
| Elbow flexion is affected when this nerve is damaged
102
Which stage of menstruation is indicated by a slight rise in body temperature?
Luteal
| Body temperature rises following ovulation
103
What is a good rule out test for SLE?
ANA
| Over 99% of SLE patients are ANA positive
104
How does vasa praevia present?
Fresh PV bleeding following membrane rupture
| Foetal heart abnormalities like bradycardias and deceleration
105
Which nerve is at risk during submandibular gland excision?
Marginal mandibular nerve
106
How does antidiuretic hormone work?
Promotes water reabsorption by the insertion of aquaporin-2 channels
107
How does pes anserinus bursitis present?
Often in athletes due to overuse
Pain in medial proximal tibia
Pain when climbing stairs
Sartorius, gracilis and semitendinosus tendons inserting into the anteromedial proximal tibia affected
108
Chronic lymphocytic leukaemia is associated with what kind of anaemia?
Warm autoimmune haemolytic anaemia
109
Which nerve is most likely affected by anterior compartment syndrome in the lower leg?
Deep peroneal
110
What is the most common cause of heel pain in adults?
Plantar fasciitis
111
Which nodes receive lymph drainage from the scrotum?
Superficial inguinal
112
What kind of blood cells are affected by thymus problems such as failure of development in DiGeorge syndrome?
T lymphocytes
113
What kind of cancer is associated with low neutrophil count?
Acute myeloid leukaemia
| Neutrophils are derived from common myeloid progenitor cells
114
Which artery is used in coronary artery bypass surgery?
Internal thoracic artery
| AKA internal mammary artery
115
Which deficiency is associated with an anaphylactic response to blood products?
Selective IgA deficiency
116
How does tranexamic acid work?
Anti-fibrinolytic
| Binds plasminogen and prevents plasmin from breaking down fibrin clots
117
What is the commonest childhood malignancy?
Acute Lymphoblastic Leukaemia
| ALL
118
What condition may be a side effect of hydralazine?
Drug induced lupus
119
Which vitamin is noticeably lacking in breast milk?
Vitamin K
120
Which is the most common leukaemia in adults?
Chronic Lymphocytic Leukaemia
| CLL
121
Hoe does multiple myeloma cause hypercalcaemia?
Increased osteoclast activity in response to cytokines released by myeloma cells
122
What kind of tumour do s-100 markers indicate?
Melanoma
| Schwannoma
123
Which pathogen causes erysipelas?
Strep pyogenes
124
How does rivaroxaban work?
Direct factor Xa inhibitor
125
Which nerve palsy is indicated by "waiters tip" from upper trunk brachial plexus injury?
Erb's Palsy
126
What is "waiters tip" as indicated for Erb's palsy?
Medial rotation of the arm with wrist flexion
127
Injury to the lower trunk of the brachial plexus causes which palsy?
Klumpke's
| Mainly affects intrinsic muscles of the hand resulting in claw hand
128
What is a major target for cANCA, causing autoimmune vasculitis?
Serine proteinase 3
129
Which blood vessel, lying between the sub-mandibular gland and mandible, is most at risk during sub-mandibular gland excision?
Facial artery
130
How does azathioprine work?
Its metabolite inhibits purine synthesis
