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past paper exam Qs > MEQ 2004 > Flashcards

MEQ 2004 Flashcards

1
Q

State the two key histological features of a granuloma.

A

Epithelioid histiocytes (2 marks), Cuff of lymphocytes, giant cells

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2
Q

State three non-specific (innate) mechanisms that prevent micro-organisms from reaching the lungs.

A

Nasal hair, muco-ciliary escalator, mucus, coughing, sneezing, warming of inspired air by nose, humidification of inspired air by nose

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3
Q

State two socioeconomic factors that are associated with an increased prevalence of tuberculosis

A

Two from: Poverty, overcrowding, poor nutrition, low socio-economic class, migrants

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4
Q

If BP = blood pressure, PVR = peripheral vascular resistance, and CO = cardiac output, write an equation that indicates the interrelationship between these parameters.

A

BP = CO X PVR

Total Peripheral Resistance = (Mean Arterial Pressure - Mean Venous Pressure) / Cardiac Output

Blood pressure (BP) is a measure of the force being exerted on the walls of arteries as blood is pumped out of the heart.

Mean arterial pressure = 2/3 diastolic + 1/3 systolic *at rest

MAP = also perfusion pressure

  1. Cardiac output (as we have already discussed)
  2. Blood viscosity (the thickness of the blood)
  3. Total peripheral resistance ‘TPR’ (the resistance the blood encounters on its voyage within the blood vessels)
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5
Q

Which type of blood vessel is the major site of peripheral vascular resistance?

A

Arteriole

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6
Q

State three metabolic or physiological factors that reduce peripheral vascular resistance.

A

Nitric oxide/metabolic breakdown products, hypoxia, hypercapnia, reduced sympathetic stimulation, parasympathetic stimulation

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7
Q

List two anatomical sites where arterial baroreceptors are locat

A

Aortic arch, carotid sinus

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8
Q

State two effects that stimulating arterial baroreceptors has on systemic blood pressure.

A

Two from: Decreased sympathetic nervous system stimulation, decreased arteriolar vasoconstriction, decreased blood pressure

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9
Q

What is the normal systolic and diastolic blood pressure for an adult male aged 30?

A

120/80 (range of 100/70 to 144/94)

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10
Q

Describe three characteristics of the pain caused by an acute myocardial infarction.

A

Crushing, central, pain in jaw or neck, pain in arm, lasts over 30 mins, severe

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11
Q

Ischaemia

A

Reversible damage to tissues (1 mark) as a result of impaired vascular perfusion
depriving tissues of vital nutrients and oxygen. (No marks for just ‘hypoxia’)

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12
Q

Infarction

A

Irreversible death/necrosis of tissue due to ischaemia

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13
Q

State four features describing the structure and components of an atheromatous fibrolipid plaque.

A

Four from: Fibrous cap, lipid core, smooth muscle cells, macrophages, lymphocytes, calcium, cholesterol crystals

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14
Q

List two possible complications that she may suffer as a result of her infarct.

A

Two from: Death, arrhythmias, mural thrombus, embolic phenomena, rupture of valve/heart, heart failure, infarct extension/expansion, papillary muscle damage, pericarditis, pericardial effusion, etc.

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15
Q

Q1. The normal oesophagus is lined by what type of epithelium?

A

Strat Squamous NK

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16
Q

Q2. List three structures that lie anterior to the oesophagus in the thorax.

A

Heart/left atrium, trachea, left main bronchus, diaphragm

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17
Q

Q1. State two likely pathophysiological reasons why her ankles are swollen.

A

Raised systemic venous pressure or raised venous pressure, salt and water retention

R-heart failure = raised systemic venous pressure = odema due to salt and water retention

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18
Q

Q2. What is the most likely cause of her tiredness?

A

decreased CO

19
Q

Q3. Why does this patient have a fast pulse rate?

A

Stimulation of the sympathetic system

20
Q

She mentions that over the last three weeks she has lost her appetite and that her abdomen has become swollen.

Q5. State two abnormalities that you might expect to find on examination of abdomen.

A

Two from: enlarged liver, pulsatile liver, ascites, oedema of skin(1 mark)

21
Q

Q7. Why does she suddenly become breathless whilst in bed at night?

A

Pulmonary oedema or acute heart failure or alveolar oedema

22
Q

State three clinical features of shock.

A

From: Low blood pressure, low urine output, sweating, pallor, rapid pulse

23
Q

Q2. Your patient has been passing black tarry stools for 2 weeks prior to this admission. What is this explanation of this?

A

Loss of blood from the stomach

24
Q

Q4. You suspect your patient has a gastric ulcer. State three possible causes of such ulcers.

A

From: Hyperacidity, alterations in mucin, duodeno-gastric reflux, H. pylori

25
Q

Q5. What hormone is responsible for the production of gastric juice, and which 2 organs secrete it?

A

Gastrin; Stomach, Pancreas

26
Q

Q5. On examining your patient, you note a mass in the abdomen. Name two features that would lead you to conclude that it is the spleen.

A

From:Left upper quadrant; can’t feel an upper border on palpation; or get above it; notch felt.

27
Q

Define median survival

A

The median survival is the time at the end of which 50% of index cases are still alive.

28
Q

Q6. The usual way to determine “how many people die from” a disease is with five year survival rates. How is a five year survival rate determined?

A

The proportion of diagnosed patients still living five years after diagnosis of the disease.

29
Q

Q1. How much absolute alcohol is there in a unit of alcohol? Give one example of a standard drink typically containing one unit of alcohol.

A

8 grammes of absolute alcohol. Half a pint of beer, 1 small glass of wine, 1 glass of sherry, 1 pub measure of spirits.

30
Q

Q2. State two pathological changes that occur in the liver with continued consumption of excessive amounts of alcohol.

A

Fatty liver, alcoholic hepatitis, cirrhosis

31
Q

Q3. Assume that this patient’s oedema is caused solely by his liver disease. State one possible pathophysiological mechanism for the oedema.

A

From: Hypoalbuminaemia, Fluid retention secondary to hyperaldosteronism.

32
Q

Types of stress

A

Distress and Eustress

From: Biochemical, Behavioural, Cognitive, Emotional

Biochemical: endorphin levels altered
Behavioural: increased alcohol, poor sleep, absenteeism
Cognitive: negative thoughts, poor concentration
Emotional: feeling tearful, mood swings, irritability
Physiological =

33
Q

Q2. State three functions of the cell membrane of bronchial epithelial cells.

A

From: Separating the intracellular contents from the extracellular environment; Regulating access to the cell; Acting as a semi-permeable membrane; Regulating molecular transport into and out of the cell; Intercellular signalling/hosting membrane receptors; Maintaining cell shape; Allowing movement of the cell

34
Q

What are amphipathic substances

A

Amphipathic substances are both hydrophilic and hydrophobic.

35
Q

Q1. What are the three key surface markings of the oblique fissure?

A

Back:T2; Mid-axillary line: 4th rib; Anteriorally: end of 6th rib.

36
Q

Q2. State one reason why the patient is centrally cyanosed.

A

Excess reduced haemoglobin

37
Q

Why do small changes in the diameter of a blood vessel have a very great effect on the resistance to flow of a fluid through that vessel?

A

Pouiselle’s law

38
Q

What part of the heart is the apex beat?

A

LV

39
Q

Feature of malabsorption and why

A

Pale and smelly = fats
Bruising = vit K
Swollen ankles = protein

40
Q

What are the two key stages of fat digestion in the gut?

A

Emulsification

Triglyceride hydrolysis

41
Q

Triggers of asthma, which vessels

A

Bronchioles

-Exercise, allergens, infection, temp change

42
Q

What causes wheezy cough + clear sputum

A

Three from: Muscle spasm, narrowed airway (1 mark), swelling of wall, excess mucus

43
Q

State two non-pulmonary conditions of which this patient may give a past medical history.

A

Hey fever, eczema

44
Q 
Anaphylaxis is caused by the cross-linking of an immunoglobulin on the surface of an inflammatory cell, resulting in the release of a potent chemical mediator.
Q4. State the class of the immunoglobulin, the name of the cell and the name of the chemical mediator.
A

immunoglobin - igE
cell - mast cell
chemical mediator - histamine

past paper exam Qs (29 decks)

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