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Medicine is hard Flashcards

1
Q

A 2-year-old child develops perianal itching, which is particularly bad at night

A

Enterobius vermicularis

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2
Q

left renal artery leaves aorta at

A

L1

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3
Q

Stimulates parietal cell maturation

A

Gastrin

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4
Q

HLA DRB1

A

Arthritis

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5
Q

Most common in cholangitis infections

A

E. coli

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6
Q

Bleeding gums and poor healing

A

Ascorbic acid deficiency

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7
Q

Location of thoracic duct in mediastinum

A

Posterior and superior

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8
Q

When does closure of neural tube occur

A

Week 4 of pregnancy

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9
Q

Hernia which may occur in infants

A

Indirect inguinal

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10
Q

Classical oncogenes

A

PDGF, ras, src

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11
Q

Chocolate agar with factors V and X

A

H. influenzae

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12
Q

Commonest cause of empyema

A

Strep pneumoniae

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13
Q

What is PCR for

A

Detecting mutated oncogenes

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14
Q

What is ELISA for

A

Detecting specific antibodies

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15
Q

Mutation of tumour suppressor gene in APC

A

Familial adenomatous polyposis

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16
Q

Coeliac disease deficiencies

A

Iron, folate and B12

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17
Q

Common organism causing post-birth infections

A

E. coli

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18
Q

volume of distribution formula

A

dose/plasma concentration

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19
Q

BCL-2

A

Follicular lymphoma gene

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20
Q

Hepatomegaly with history of malignancy

A

Liver metastasis

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21
Q

Vertebral arteries enter cranial cavity via

A

Foramen magnum

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22
Q

No male-male transmission in which inheritance type

A

X-linked recessive

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23
Q

Artery at risk with duodenal ulcers on the posterior wall

A

Gastroduodenal

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24
Q

Most common collagen type

A

Type 1 - bone, skin and tendons

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25
Q

Supplies transverse colon

A

Middle colic artery

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26
Q

Immunoglobin found in secretions

A

IgA

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27
Q

Watery diarrhoea one week after arriving in Mexico

A

E. coli

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28
Q

BRCA1

A

Tumour suppressor gene

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29
Q

First immunoglobulin secreted in response to infection

A

IgM

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30
Q

Alpha-1-antitrypsin deficiency association

A

Emphysema

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31
Q

Most common immunoglobulin produced in body

A

IgA

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32
Q

Acidosis shifts oxygen curve to the…

A

Right

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33
Q

Hyposplenism is complication of

A

Coeliac disease

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34
Q

Stains with dark ink

A

Cryptococcus neoformans

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35
Q

Mediate hyper acute organ rejection

A

B cells

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36
Q

Iron is absorbed in the

A

Duodenum

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37
Q

Activates macrophages

A

Interferon gamma

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38
Q

Inhibits reninin secretion

A

B-type natriuretic peptide

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39
Q

zymogens

A

inactive precursors of an enzyme

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40
Q

Contains the tail of the pancreas

A

splenorenal ligament

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41
Q

J wave ECG

A

Hypothermia

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42
Q

Janeway lesions/ Osler’s nodes

A

subacute bacterial endocarditis

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43
Q

Diminished/absent lower limb pulses

A

coarctation of the aorta

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44
Q

Right sided pleuritic chest pain

A

Pneumonia

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45
Q

Hepatitis associated with IV drug users/tattoos

A

Hep B

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46
Q

Hepatitis associated with third world countries (faecal oral route)

A

Hep A

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47
Q

Early to mid diastolic murmur 10 days post MI

A

Ischaemia of papillary muscle

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48
Q

Abdominal pain, rectal bleeding, metabolic acidosis

A

Mesenteric ischaemia

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49
Q

Dilated cardiomyopathy is associated with which disease

A

Haemochromatosis

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50
Q

Ligament that connects liver to anterior abdominal wall

A

Falciform

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51
Q

Thin squamous cells covering 97% of alveolar surface

A

Type 1 pneumocytes

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52
Q

Key molecule reduced in endothelial dysfunction

A

Nitric oxide

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53
Q

Smoke inhalation diagnosis until proven otherwise

A

Carbon monoxide poisoning (give high flow O2)

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54
Q

Produced by the ventricles in response to stretch, elevated in heart failure

A

BNP (Brain natriuretic peptide)

55
Q

Deficiency common in alcoholics

A

Thiamine (B1)

56
Q

Reduction in intrinsic factor (from gastrectomy etc) leads to

A

B12 deficiency / pernicious anaemia

57
Q

Asbestos (20-40 years after exposure) causes

A

Mesothelioma

58
Q

Absolute contraindication to thrombolysis

A

Brain neoplasm

59
Q

Immobilisation after fracture, now at significant risk for

A

DVT, then pulmonary embolism

60
Q

Acute aspiration can cause

A

Atelectasis (lung colapse)

61
Q

Femoral triangle

A

Femoral vein, artery and nerve

62
Q

Pain of appendicitis stimulated by flexion and internal rotation of the hip (indicates inflamed appendix lies close to obturator internus)

A

Cope’s/obturator sign

63
Q

Lower lobe consolidation, from inhalation of liquid, saliva, etc

A

Aspiration pneumonia

64
Q

Treatment for uncomplicated AF

A

Medical cardioversion (amiodarone or flecainide)

65
Q

Beck’s triad

A

Muffled heart sounds, low systolic BP, distented neck veins

66
Q

Levels are raised in acute pancreatitis

A

amylase (lipase after 24 hours)

67
Q

Lateral,
Anterior/septal,
Inferior limbs lead correspond to

A

Circumflex
Left anterior descending
Right coronary

68
Q

Tearing pain, radiates through to back

A

Aortic dissection

69
Q

What type of jaundice causes:

  • rise in ALP and bilirubin
  • rise in ALT and AST
A
  • Obstructive

- Hepatic

70
Q

Parasympathetic G-protein coupled receptors

A

m1 (Gq) - increases acid secretion
m2 (Gi) - decreases HR
m3 (Gq) - brochoconstriction and saliva secretion

71
Q

Sympathetic G-protein coupled receptors

A

b1 (Gs) - increases HR and force
b2 (Gs) - relaxation of bronchial and vascular smooth muscle

a1 (Gq) - contraction of vascular smooth muscle
a2 (Gi) - inhibition of NA release

72
Q

Action of Gq, Gi, and Gs

A

Gq - stimulates phospholipase C
Gi - inhibits adenylyl cyclase
Gs - stimulates adenylyl cyclase

73
Q

Primary lymphoid tissue

A

Bone marrow and thymus

74
Q

Strict aerobes

A

pseudomonas and legionella

75
Q

Strict anaerobes

A

clostridium and becteroids

76
Q

What binds vitamin B12

A

intrinsic factor

77
Q

What do parietal cells secrete

A

HCl and intrinsic factor

78
Q

What stimulates HCl secretion in the oxyntic mucosa

A

Histamine

79
Q

To diagnose H. pylori

A

stool antigen test
urease breath test
serology (IgA antibodies)

80
Q

mediate contraction of circular/longitudinal muscle

A

ACh and substance P

81
Q

Consists of chemo-attraction, rolling, tight adhesion and transmigration

A

Leucocyte extravasation

82
Q

Afterload is increased by what

A

Ventricular dilation

83
Q

Autoimmune disease caused by antibodies to intrinsic factor +/- autoimmune destruction of gastric parietal cells

A

Pernicious anaemia

84
Q

What type of gene is HSH2 gene (non-polyposis colorectal cancer)

A

DNA mismatch repair

85
Q

Pentamer with highest complement activation capacity

A

IgM

86
Q

C3a and C5a can activate what cells

A

mast cells and basophils

87
Q

Sentinel loop seen on CXR

A

Acute pancreatitis

88
Q

Which antibodies change in autoimmune hepatitis

A

Anti-smooth muscle antibodies

89
Q

CT of lungs: region of ground glass opacity surrounded by denser lung tissue

A

Atoll sign

90
Q

Friction rub

A

Pericarditis

91
Q

Raised urea

A

Gastric ulcer

92
Q

Complication of ERCP

A

Pancreatitis

93
Q

Main immunoglobulin found in breast milk

A

IgA

94
Q

What is preload the same as

A

end diastolic volume

95
Q

which vitamin is a cofactor for the pyruvate dehydrogenase complex

A

B1

96
Q

develops through molecular mimicry of the bacterial M protein

A

Rheumatic fever

97
Q

one of the key features in the development of steatorrhoea

A

loss of lipase

98
Q

biggest risk factor for adenocarcinoma of the oesophagus

A

Barrett’s oesophagus

99
Q

Acts as a cofactor in the carboxylation of clotting factors (II, VII, IX, X)

A

Vitamin K

100
Q

Most commonly produced immunoglobulin in the body

A

IgA

101
Q

inhibit peptidoglycan cross-linking

A

Cephalosporins

102
Q

spread by the parenteral, sexual and vertical transmission route

A

Hepatitis C

103
Q

α1 adrenergic receptors cause

A

smooth muscle contraction

104
Q

non reversible COX 1 and 2 inhibitor

A

Aspirin

105
Q

what can differentiate heart failure from COPD

A

Orthopnoea

106
Q

most common cause of mitral stenosis

A

Rheumatic fever

107
Q

Incompetent venous valves is the cause of

A

varicose veins

108
Q

Cardiac size, contractility, preload and afterload are the 4 factors affecting…

A

stroke volume

109
Q

_____ malabsorption can lead to steatorrhoea and Vitamin A, D, E, K malabsorption

A

Bile acid

110
Q

can present with ipsilateral elevation of the hemidiaphragm due to compression of phrenic nerve

A

Lung cancer

111
Q

can indicate an upper GI bleed versus lower GI bleed

A

High urea levels

112
Q

Replacement of pancreatic enzymes is part of the management of patients with ____ to help aid digestion of food

A

chronic pancreatitis

113
Q

Alpha-1 antitrypsin deficiency causes _____ giving an _____ pattern of lung disease

A

emphysema

obstructive

114
Q

What disease causes increased lung compliance

A

Emphysema

115
Q

Increases plasma calcium and plasma phosphate

A

Vitamin D

116
Q

What does arterial stretch stimulate

A

Baroreceptors

117
Q

Most common site affected by ischaemic colitis

A

splenic flexure

118
Q

what vaccine is contraindicated in patients who are HIV positive, pregnant or have existing TB

A

BCG

119
Q

fructose 1,6 bisphosphatase is the rate limiting enzyme for what reaction

A

gluconeogenesis

120
Q

Where in the heart has the fastest conduction

A

Purkinje fibres

121
Q

principal inhibitory neurotransmitter of the spinal cord

A

glycine

122
Q

What layers does cellulitis involve

A

Deeper dermis and subcutaneous tissues

123
Q

Muscarinic receptors in airway smooth muscle cause _____ when activated

A

constriction

124
Q

Which pneumocytes secrete pulmonary surfactant and which are the simple squamous epithelial cells lining the alveoli

A

Type 2 - surfactant

Type 1 - squamous lining alveoli

125
Q

Which cranial nerves exclusively carry parasympathetic nerve fibres

A

2, 7, 9 and 10

126
Q

The ____ connects the pulmonary trunk to the aorta in the foetal circulation and closes to form the _____ three weeks after birth.

A

ductus arteriosus, ligamentum arteriosum

127
Q

new growth which occurs in the absence of a normal stimulus.

A

neoplasia

128
Q

What is type one and type two respiratory failure

A

1 - low O2

2 - low O2, high CO2

129
Q

Embolic stroke is a risk associated with which arrhythmia

A

AF

130
Q

Coffe bean sign

A

sigmoid volvulus

131
Q

Tetralogy of Fallot

A

Pulmonary stenosis
right ventricular hypertrophy
ventricular septal defect
overriding aorta

132
Q

investigation of choice to confirm a diagnosis of bronchiectasis

A

High resolution computed tomograpahy (HRCT)

133
Q

Pathogen in the majority of bronchiolitis cases

A

RSV - respiratory syncytial virus

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