Last Years Exam

Question 1

Write 4 prioritised questions to ask a patient?

Subjective assessment
- 60 YO male
- Chronic LBP
- Low energy
- Unexplained weight loss

Answer 1

1. Have you noticed any other symptoms such as night sweats, fever, or night pain?
2. Have you had any recent changes in bowel or bladder movement?
3. Have you had any recent significant stress or changes in your life?
4. How long have you been experiencing LBP has it changed in location, intensity or nature over time?

Question 2

What is the most likely diagnosis for a 60 YO patient with:

• Chronic LBP
• Unexplained weight loss
• Low energy

Answer 2

Hodgkins lymphoma

Question 3

Name 2 bio markers which are a measure for inflammation in the body

Answer 3

C-reactive proteins & Procalcitonin

Question 4

BP between 130-139 and 80-90 is defined as what stage of hypertension?

Answer 4

Stage 1

Question 5

Describe the mechanism in the renin-aldosterone system & its effect on BP

Answer 5

Renin released from kidney - triggered by low BP, low sodium or sympathetic activation

Renin converts angiotensinogen to angiotensin 1

ACE in lungs converts angiotensin 1 to angiotensin 2

Angiotensin 2 causes vasoconstriction, stimulates aldosterone release & increases BP

Aldosterone promotes sodium & water retention in kidney, increasing blood volume & therefore higher BP

Negative feedback ensures the system returns to baseline once BP is restored

Question 6

Identify 4 potential differential diagnoses for right lower quadrant pain

Answer 6

Appendicitis
UTI
Gastroenteritis
Ovarian torsion

Question 7

List 4 main symptoms of bowel cancer

Answer 7

Blood in stool
Change in bowel habits
Abdominal pain
Unexplained weight loss

Question 8

Which gland is known as the master gland?

Answer 8

Pituitary gland

Question 9

A patient having trouble voiding, burning, intermittent flow & dribbling may be experiencing problems with which gland?

Answer 9

Prostate gland

Question 10

Where does liquefactive necrosis most often occur?

Answer 10

CNS (brain & spinal chord)

Question 11

Identify the hormone associated with arthritis & muscle weakness

Name a disease associated with too much of this hormone

Answer 11

Cortisol

Cushing’s syndrome

Question 12

What is the effect of glucagon on blood sugar levels?

Answer 12

Glucagon increases blood sugar levels by stimulating the liver to release glucose from glycogen stores via gluconeogenesis

Prevents hypoglycaemia (low blood sugar) and ensures steady supply of glucose in periods of fasting or increased energy demands

Question 13

What does ABCDE mnemonic refer to when assessing skin lesions

Answer 13

A - asymmetry
B - border
C - colour
D - diameter
E - evolution

Question 14

Describe the process of a blood clot formation

Answer 14

Vascular spasm - narrowing of blood vessels to reduce blood flow

Platelet adhesion, activation & aggregation - form a temporary platelet plug

Coagulation cascade - activates clotting factors, fibrinogen converted to fibrin to form a clot

Fibrinolysis - removes the clot once the vessel is repaired

Question 15

Identify possible aetiologies of Cor Pulmonale & describe the pathogenesis

Answer 15

Cor pulmonale (aka right sided heart failure)

COPD -
• chronic bronchitis
• emphysema

Question 16

Name primary endocrine glands & pathway

Answer 16

Hypothalamus
Pituitary
Thyroid
Parathyroid
Adrenals
Pancreas
Ovaries
Testes

Question 17

What vitamins play a role in bone health

Answer 17

Vitamin D - enhances calcium absorption & bone mineralisation

Vitamin C - collagen synthesis providing structural matrix for bones

Vitamin K - involved in protein synthesis & calcium binding

Question 18

What could be the cause of burning in the retrosternal area?

Answer 18

GERDS - reflux of gastric contents into lower oesophagus due to sphincter relaxation

Question 19

Age & demographics of Chron’s disease & Ulcerative colitis

Answer 19

Chron’s disease:
• 15-35 YO

Ulcerative Colitis:
• 20-30 & 50-70 YO
• Females > males