Mixed Q’s 2 Flashcards

1
Q

Duodenal atresia associations ?

A

Assoc with Down’s syndrome
Double bubble sign
Polyhydramnios
Bile vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Oesophageal atresia is assoc with?

A

Polyhydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malrotation of volvulus presentation?

A

Asymptomatic at birth
Occurs after a few weeks
Bld in stool
Vomiting bilious material
Tender distended abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Imperforate anus presentation?

A

Inability to pass meconium in first 24 hrs
Assoc with
cardiac abnormalities, tracheoesophageal fistulas
renal agenesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of anal canal above the pectinate canal?

A

Columnar epithelium
Superior and middles rectal arteries bld supply
Non painful haemorrhoids
Lymph drainage to internal iliac nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where do haemorrhoids drain into?

A

Venous system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Li-Fraumeni syndrome?

A

A history of sarcoma, leukaemia, adrenal, brain and breast cancer.
2o to autosomal mutation of TP53

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cancers that cause sclerotic bone Mets ?

A

Osteoblastic ( sclerotic)
Prostate cancer
Small cell lung cancer
Hodgkin lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cancers that cause lucent bone Mets?

A

Osteolytic (lucent)
M2N2R
Multiple myeloma
Non small cell lung cancer
Non Hodgkin lymphoma
Renal cell carcinoma
Melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cancers that cause mixed bone Mets ?

A

Gastrointestinal cancer
Breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

BRAF is associated with ?

A

BRAF is a protooncogene
Mutation is assoc with
Melanoma
Non Hodgkin’s lymphoma
Papillary thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

BRCA1 and BRAC2

A

Tumour suppressor gene
Mutation associated with
Breast cancer
Ovarian cancer
Pancreatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MEN1 associated protein?

A

Tumour suppressor
Menin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

RET?

A

Protooncogene
Mutation associated with
MEN 2a + MEN 2b
Papillary thyroid cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is RB associated protein ?

A

Tumour suppressor gene
associated with with HPV
Leading to
Head and neck cancer
Cervical cancer
Anal cancer
Penile cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the first step in adenoma to carcinoma sequence?

A

Mutation of APC tumour suppressor gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Malignant cells metastasis pathway ?

A
  1. Down regulation of cadherin decrease cell adhesion
  2. Detachment from basement membrane by loosening integrin attachment
  3. Degradation of extracellular matrix by type IV collagenase
  4. Migration by upregulation non integrin Lamin receptors
  5. Dissemination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Hereditary nonpolyposis colon cancer?

A

Lynch Syndrome
MSH2 MSH1
Tumour suppressor gene
Assoc with
Colorectal cancer
Endometrial cancer
Ovarian cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Phosphorylation of Rb protein leads to?

A

Rb becomes inactive releasing the E2F transcription factor allowing cell to divide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which zone of the liver metabolises phenytoin?

A

Zone 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Annular pancreas is caused by?

A

Failure of pancreatic ventral bud to rotate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The pancreas and pancreatic duct are derived from?

A

The foregut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is Hirschsprung’s disease?

A

Failure of neural crest cell migration into the intestinal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hirschsprung disease presentation?

A

Functional bowel blockage
Neonate with chronic constipation
Tight anal sphincter and empty rectum
Rectosigmoid narrowing with proximally distended bowel loops on barium study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Failure to pass meconium, think?
Hirschsprung’s disease Cystic fibrosis (Imperforate anus)
26
What is the gold standard for diagnosis of Hirschsprung’s disease ?
Deep rectal suction biopsy —> shows lack of ganglion cells Nerve fibre hypertrophy
27
What is cause of achalasia ?
Damage to ganglion cells in the myenteric plexus (Auerbach’s plexus)
28
Achalasia presentation?
Loss of oesophageal motility Dysphagia for solids and liquids Bird beak sign on barium swallow
29
pilocarpine
MoA: muscarinic acetylcholine agonist Use:- glaucoma, dry mouth sjogren SE:- Sweating Urinary frequency Diarrhoea Bradycardia Nausea Weakness Flushing Hypotension Pupillary Miosis
30
Pleomorphic adenoma presentation?
Benign Painless, firm, mobile parotid swelling Histology :- disorganised tissue containing epithelial and cartilage components
31
Warthin’s tumour presentation?
Aka papillary cytadenoma lymphatosum Swelling of parotid Fluid filled cystic spaces with epithelial cells Assoc with smoking
32
Mucoepidermoid carcinoma presentation ?
Painful mass usually parotid Invading facial nerve Histo:- mix of squamous and epithelial cells
33
Congenital diaphragmatic hernia is due to a defect in the?
Pleuroperitoneal membrane
34
Direct inguinal hernia are medial to ?
Inferior epigastric artery
35
Indirect hernia is usually caused due to failure or which structure to close?
Processus vaginalis
36
Necrotising enterocolitis features?
GI emergency affecting newborns Bacterial invasion and necrosis of the bowel wall in prems after initiation of enteral feeding. Abdo XR :- curvilinear areas of lucency that parallel bowl wall lumen( pneumatosis intestinalis)
37
Acute diverticulitis presentation?
Pt > 60 Abdo pain Nausea and vomiting Change in bowel habit Low grade fever Leukocytosis Tender mass in LT Lower quad
38
Acute diverticulitis presentation?
Pt > 60 Abdo pain Nausea and vomiting Change in bowel habit Low grade fever Leukocytosis Tender mass in LT Lower quad
39
Diffuse oesophageal spasm presentation?
Periodic, simultaneous and non peristaltic contractions of the oesophagus due to impaired neural inhibition. Dysphagia for liquids and solids Chest pain 2o inefficient propulsion of food
40
Hepatitis B presentation?
Tender hepatomegaly and abnormal LFT With a suggestive hx Positive HBsAg
41
Hyperammonemia in advanced liver failure features?
Ammonia crosses blood brain barrier cause excess glutamine to accumulate in astrocytes. —-> Decreased glutamine available for conversion to glutamate in neurons Abdominal distention Jerky tremor
42
Innervation of external haemorrhoids?
Inferior rectal nerve a branch of the pudendal nerve
43
Which arteries would be affected by compression of splenic artery?
Short gastric artery
44
Primary sclerosing cholangitis features?
More common in males Assoc with UC Fatigue, pruritis, jaundice Raised ALP , bilirubin Histology :- fibrous obliteration of bile ducts and concentric periductal connective tissue deposition
45
Treatment with Vitamin B12 affect on retics in background on atrophic gastritis?
Retics count increases +++ and peaks at 1 week then gradually increases
46
Unconjugated excess bilirubin affect on newborn?
Deposits in basal gangilia and brain stem nuclei Can cause irreversible neurologic damage Chorea, dystonia Upward gaze palsy and hearing
47
Pathologic features of Chronic bronchitis?
Thickened bronchial walls Lymphocytic infiltration Mucous gland enlargement Patchy squamous metaplasia of bronchial mucosa Hx of smoking
48
Phaechormocytoma is derived from?
Chromaffin cells of adrenal medulla Originate from neural crest cells which also gives rise to melanocytes and neural ganglia
49
Cardiorespiratory response to exercise?
Incr HR Inc C.O Inc RR N PaO2 N PCo2
50
An outlier would affect which measures ?
Mean Median Std deviation Variance It does NOT affect mode
51
What is mode?
The most frequently observed data point
52
Pyruvate dehydrogenase deficiency presentation?
Unable to convert pyruvate to acetyl-CoA Causing lactic acidosis and neurologic defects Failure to thrive, hypotonia
53
High levels of what substance in pyruvate dehydrogenase will lead to increase energy without inc in lactic acid?
Ketogenic amino acids Lysine, leucine
54
Mgx for chest wall pain to parietal pleura and ribs?
Intercostal nerve block
55
Ileal resection complications?
Gall stones 2o to loss of bile salt absorption Fat malabsorption Loss of vit B12 absorption Loss of fluid absorption
56
Function of the HIV polyproteins?
Gp160, gp120 Glycosylated in RER and cleaved in Golgi apparatus Function is to help virion attach to target cell
57
Rett syndrome features ?
More common in girls Onset 6-18/12 Initial N development Regression of speech Loss of purposeful movement Development of stereotypical movements (e.g. clapping) Gait abnormalities Cause —> arrested brain development
58
Single gene sequencing used when?
Initial genetic test for an unknown mutation on a single gene (e.g Li Fraumeni)
59
What facilitate phagocytosis?
IgG and C3B
60
Criggler- Najjar features?
Absence of UDPglucoronyltransferase High >20 unconjugated bilirubin Appears in first days of life Can lead to kerniterus LFT normal
61
Gilbert’s syndrome features?
Increased unconjugated bilirubin Most asymptomatic Can develop jaundice after illness, heavy exertion, stress, menses
62
Dubin Johnson syndrome features?
AR Presents shortly after birth Or after taking OCP, or pregnancy Increased conjugated bilirubin N LFTs +/- hepatomegaly Black discoloration of liver
63
Alcoholic Hepatitis features?
AST:ALT > 2 AST >= 500 -1000 GGT increased 8-10x normal Asymptomatic Jaundice Hepatomegaly
64
Rotor’s syndrome features?
Benign condition Conjugated hyperbilirubinaemia N LFTs
65
In kernicterus bilirubin deposits where?
Basal ganglia and brain stem nuclei
66
Administration of omeprazole affect on gastric secretion, gastric acid secretion and parietal cell carbonic anhydrase activity?
Decreased gastric acid secretion Inc gastrin secretion Decreased parietal cell CA activity
67
How does ranitidine work?
H2 antagonist reduces acid secretion by blocking histamine activity leading to fall in intracellular cAMP
68
Zollinger Ellison syndrome features?
Due to gastrin producing tumour in pancreas or duodenum. Stimulating the increase of gastric acid production Leading to peptic ulcers Wt loss Abdo pain
69
Cause of pruritis in cholestasis?
Deposition of cholic and chenodeoxycholic
70
Function of pancreatic amylase?
To cleave starch into smaller polysaccharides
71
Initiating event of acute pancreatitis ?
Autodigestion due to activated trypsin
72
Released after a meal and correlated with increase HCO3?
Secretin
73
Which pancreatic enzyme catalyses the breakdown of a lipid rich meal?
Pancreatic lipase
74
Function of type II pneumocyte?
Regeneration of alveolar lining following injury Surfactant production
75
‘What is transference?
Unconscious recreation of patterns from past relationships in the present relationship
76
Impairment of ubiquitin-proteasome system leads to ?
Accumulation of misfolded proteins can lead to Parkinson’s
77
What is power 1-B?
The probability of rejecting a null hypothesis when it is truly false
78
Nitroglycerin effect on cardiac output, contractility and venous return?
Is a venodilator —> will cause pooling of bld in veins and decreased venous return. Does not affect contractility CO reduced because of reduced Venous return
79
What is the most highly oxygenated blood vessel in fetal circulation?
Umbilical vein which empties directly into IVC
80
Wiskott-Aldrich syndrome presentation?
X linked Recurrent infections that worsen with age Easy bleeding Eczema Combined B Andy cell deficiency Thrombocytopenia at birth
81
Endoscopic findings in achalasia?
Hypertrophy and thickening of circular muscle lawyer near lower oesphageal sphincter
82
Schatzki ring presentation ?
Complete obstruction of the oesophagus by a food bolus Found in distal oesophagus
83
Adenocarcinoma assoc risk factors ?
Obesity
84
HSV1 oepshagitis features?
Dysphagia Chest pain Punched out ulcers on endoscopy
85
Scleroderma oeshageal features are due to ?
Oesphageal Smooth muscle atrophy leading to reduced tone of lower oesphageal sphincter
86
INR, factor VIII, and albumin levels in hepatic cirrhosis ?
No change factor VIII ( produced elsewhere as well) Increased INR Low Albumin
87
Aetiologies assoc with Budd-Chari syndrome?
HCC Polycythaemia Vera Postpartum state Hypercoagulable states
88
Budd Chiari affects with zone in the liver?
Zone III ( centrilobular )
89
Acute alcoholic hepatitis features?
Hepatitis in the setting of acute binge drinking in pt with hx fo alcoholism RUQ pain Fever Jaundice Presence of Mallory bodies —> intermediate filaments in hepatocytes
90
Cause of liver abscess in US?
G -ve rods like E.coli, Klebsiella prnuemoiae
91
Antibodies seen in autoimmune hepatitis ?
ANA (sensitive) Anti-smooth muscle antibodies (specific)
92
Antibodies seen in autoimmune hepatitis ?
ANA (sensitive) Anti-smooth muscle antibodies (specific)
93
Hepatic angiosarcoma histology findings?
Atypical endothelial cells forming disorganised vascular structures
94
Infant botulinum toxin features?
Infants given honey Constipation Mild weakness Lethargy Poor feeding Flaccid paralysis Diagnostic : - C.Botulinum spores or toxin in stools
95
Which sugar substance has the fastest rate of metabolism in the glycolysis pathway
Fructose It avoids the rate limiting enzyme phosphofructokinase
96
Alcoholic hepatitis features?
Fever RUQ pain Jaundice AST:ALT >2:1 ( but below 500) Histo:- intrahepatic neutrophil infiltration, hepatocellular ballooning, Mallory bodies
97
Dumping syndrome features?
Abdo pain Cramps Diarrhoea Nausea Diaphoresis Palpitations Flushing Hypotension Tachycardia
98
Microscopic polyangitis features ?
Fatigue Muscle pain Unintentional wt loss Palpable purpura /necrotizing vasculitis Dark brown stool Inc creatinine No granuloma
99
What changes are seen in cardiac loop with AV fistula ?
Blood bypasses high resistance Decreased after load Increased preload Increased S.V Contractility unchanged
100
Disulfide bridges and triple helix assembly are ?
Properties of collagen synthesis
101
Causes of AR?
Bicuspid aortic valve Endocarditis Aortic root dilatation Rheumatic fever
102
Before starting amiodarone check?
TFT LFT CXR PFT
103
Where is the AV node found?
Rt atrium Intra atrial septum near opening of the coronary sinus
104
What’s Beck’s triad?
Pathognomic for Cardiac tamponade? Hypotension Raised JVP Distant/muffled heart sounds Other features: electrical alternans (QRS height alters every other beat) and pulsus alternans
105
Phenylcyclidine SE?
‘Angel dust’ NMDA receptor antagonist SE:- hallucinations Violent behaviour Loss of co-ordination Nystagmus Memory loss
106
Neiserria meningitidis virulence factor?
Lipo-oligosaccharide membrane
107
Leukocyte adhesion deficiency features?
AR Absent integrin CD18 Recurrent bacterial infection Delayed purulence Late separation of placenta Leukocytosis Neutrophilia
108
Wiskott Aldrich syndrome features?
X linked Eczema Thrombocytopenia Immunodeficiency Defect in isoskeleton
109
Early onset lower lobe emphysema think?
Alpha 1 antitrypsin
110
West Nile Virus/Fever features?
Transmission via bird/mosquito Flu like illness Meningitis (neck stiffness, headache, fever) Encephalitis (confusion, tremor, seizures) Flaccid asymmetrical paralysis CSF:- lymphocytes pleocytosis Mgx:- supportive
111
Effect of increasing cardiac contractility?
Increase HR Increase LVESV ‘Heart is squeezing faster and more bld’
112
Levels of RBF, ADH and total body Na+ in ascites?
Decreased renal blood flow Increased ADH Increase total body Na+
113
Gastric varices are due to congestion of which vessels?
Short gastric vein in greater curvature drain into the splenic vein which drains into the portal vein
114
Spironolactone possible ecg changes?
Spironocaltone is K sparing. Use can be associated with hyperkalaemia ECG changes long QRS Absent p wave Peaked T wave
115
Lactulose changes in stool ?
Increase excretion of ammonia Increase concentration of fatty acid, H ion in stool Increased K and Mg in stool
116
Primary driving force of ascites ?
Increased capillary hydrostatic pressure 2o portal hypertension
117
Causes of acute pancreatitis ?
Gallstones Chronic alcoholism Hypertriglyceridaemia >1000mg/dl
118
How does hep B cause liver injury?
Viral HBsAG and HBcAG stimulate the host’s cytotoxic CD8+ T cells to destroy infected hepatocytes
119
Histo pathology of oesophageal sq cell carcinoma?
Solid nests of sq epithelial cells with intercellular bridges forming keratin pearls Eosinophilic cytoplasm
120
Pancreatic cancer risk factors?
Smoking Advanced age Chronic pancreatitis Genetics
121
Enteropeptidase in duodenal brush border activates?
Trypsin from trypsinogen Enteropeptidase deficiency presents with impaired fat and protein absorption, Diarrhoea, failure to thrive and hypoproteinaemia
122
High levels of oestrogen in cirrhosis can cause ?
Gynaecomastia Spider angiomata Palmar erythema Testicular atrophy
123
True positive equation?
TP= sensitivity x number of patients with the disease
124
False negative equations?
FN=(1-sensitivity) x (number of pts with the disease)
125
What forms the resting membrane potential of the cell?
High potassium conductance and some sodium conductance
126
Acalculous cholecystitis features?
Acute cholecystitis due to biliary sludge Seen in critically ill pts
127
Differentiating feature between ascending cholangitis due to G-ve bacteria and helminth?
G-ve bacteria —> neutrophilia predominant Helminth —> eosinophilia predominant
128
Porcelain gallbladder is due to which bacteria?
Salmonella typhi
129
Choledocholithiasis bld findings?
Stone blocking common bile duct Increased ALP > AST/ALT increased GGT Increased direct bilirubin Normal INR
130
Gallstone ileus triad?
Radio graphic appearance of pneumonia - pneumobilia Small bowel obstruction Ectopic Gallstone
131
Primary sclerosing cholangitis features?
Asymptomatic Assoc with UC Fatigue Pruritis Jaundice Dark urine Imaging dilatations and strictures of biliary tree Inc ALP +PANCA
132
1o biliary cirrhosis findings on liver biopsy?
Dense lymphocytic infiltration with Granulomatous inflammation
133
Ulcerative colitis classic finding on X-ray?
‘Lead pipe’ appearance —> smooth walls of rectosigmoid
134
Antibodies associated with 1o biliary cirrhosis?
Anti mitochondrial antibodies
135
Biliary atresia is associated with which finding?
Abnormal or absent gallbladder
136
Cells responsible for repithelisation after wound?
Keratinocytes Continue to migrate and proliferate until they make contact with other cells
137
Congenital heart defects commonly associated with maternal DM?
Transposition of the great vessels VSD Coarctation of the Aorta ASD PDA ‘ABC tune C,A,P,T VSD’
138
Potter’s syndrome presentation?
Bilateral renal agenesis Oligohydramnios Pulmonary hypoplasia Limb deformities Flat facies
139
What are mRNA vaccines?
Encoded foreign protein engulfed by APC and expressed —> adaptive immunity
140
Pulsus paradoxes seen in ?
Constrictive pericarditis Croup COPD Obstructive sleep apnoea Asthma Tamponade
141
Kussumal sign seen in ?
(Increased JVP with inspiration) Cardiac tamponade Constrictive pericarditis Restrictive cardiomyopathy RV MI
142
Colchicine is used in the treatment of?
Gout Pericarditis Familial Mediterranean Fever
143
G-ve cocci in pairs ?
Moraxella
144
Epigastric pain that decreases with food ?
Duodenal ulcer
145
Autoimmune gastritis affects which part of the stomach?
Gastric fundus causing inflammation
146
Duodenal ulcer histology shows?
Submucosal gland (Brunner’s gland) hypertrophy
147
H Pylori features
G-ve bacilli Triple positive +ve catalase, +ve oxidase, + urease Uses flagella for motility
148
Lactose fermenting G-ve rods include?
E.Coli Enterobacter Klebsiella Cirtobacter Serratia
149
Posterior duodenal ulcers are at risk of causing bleeding from which artery?
Gastroduodenal artery a branch of the common hepatic artery
150
Risk factors for gastric adenocarcinoma ?
H Pylori infection Smoking Obesity Consumption of NDMA (nitrosmaine)
151
Abnormal D-xylose test suggests?
Whipple’s disease Small intestine bacterial overgrowth
152
Pathologic hallmark of whipple’s diease?
Foamy macrophages in the laminate propria PAS +ve
153
Whipple’s disease presentation?
Diarrhoea Abdominal pain Wt loss Migratory joint pain
154
Tropical spruce is associated with which finding in bld?
High MCV 2o folate deficiency
155
Antibody testing for Coeliac disease?
IgA anti-tissue transglutaminase IgG anti-tTG used only in IgA deficiency
156
Pancreatic pseudocyst features ?
Occurs around 4/52 Failure to improve Failure of amylase/ lipase to normalise Abdo pain persists/ recurs
157
Diagnosis of acute pancreatitis requires?
2 of 3 Epigastric pain High amylase/lipase 3x normal CT findings consistent with acute pancreatitis
158
GLP-1 agonist mechanism ?
Stimulate release of insulin via incretin pathway
159
Acute pancreatitis 2o hypertryglyceridaemia may involve?
Increased chylomicrons Turns bld thick milky white
160
Factors that indicate poor prognosis in acute pancreatitis ?
Age >55 WBC >16,00 Glucose >200 LDH>350 AST >250 Low calcium Low duodenal pH
161
Chronci pancreatitis can lead to?
Fat malabsorption DM
162
Osmotic laxative used for treatment of hyperkalemia?
Sodium polystyrene sulfonate
163
Antacid SE constipation?
Aluminum hydroxide
164
In Carcinoid tumour deficiency in tryptophan leads to what presentation?
Tryptophan deficiency —> niacin (B3) deficiency —> pellagra
165
In Carcinoid tumour deficiency in tryptophan leads to what presentation?
Tryptophan deficiency —> niacin (B3) deficiency —> pellagra
166
Pellagra presentation?
Deficiency of niacin (B3) 3 D’s Diarrhoea Dermatitis Dementia
167
Carcinoid syndrome cardiac complication?
Rt sided valvular lesion
168
Hirschsprung’s diease diagnostic test?
Rectal suction biopsy
169
Commonest cause of mechanical small bowel obstruction in adults ?
Adhesions ( fibrous scar tissue)
170
Commonest cause of ileus in adults?
Recent abdominal surgery Medication (opioids)
171
Ulcerative colitis extra-intestinal associations?
Pyoderma gangrenosum 1o sclerosing cholangitis Ankylosing spondylitis Uveitis
172
Ulcerative colitis extra-intestinal manifestations?
Pyoderma gangrenosum 1o sclerosing cholangitis Ankylosing spondylitis Uveitis
173
Ulcerative colitis common colon finding?
Pseudopolyps
174
Toxic mega colon is associated with?
Ulcerative colitis
175
Which cell medicate response assoc with which IBD?
Ulcerative ColitisTh2 (no granuloma) Crohn’d disease Th1 ( Granulomatous disease)
176
Which treatment for ulcerative colitis can cause oligospermia?
Sulfasalazine
177
Lynch syndrome is caused by which genetic defect?
DNA mismatch repair gene defect leading to instability of micro satellite DNA
178
What is Gardner’s syndrome?
AD 2o defect in APC gene on ch 5 Adnenomatous polyposis (hundreds) Soft tissue tumours (osteoma in mandible, epidermis cysts, congenial hypertrophy of retinal pigment epithelium) 100% chance of developing colorectal cancer by age 50
179
Juvenile polyposis syndrome presentation?
Multiple polyps >10 Benign hamartomas Usually pedunculated Usually in rectum Painless rectal bleeding Increased risk of Ca
180
Peutz-Jeghers syndrome presentation?
AD Hamartomatous polyps GI tract Mucosal hyperpigmentation Increased risk of Ca
181
Common sites of Mets for colon Ca?
Liver via haematogenous spread Lung via haematogenous spread LN via lymphatic spread Peritoneum via seeding
182
Low pulse pressure is seen in ?
Volume depletion Haemorrhage Heart failure
183
High pulse pressure is seen in ?
Exercise Inotropic drugs (Increase C.O)
184
What happens to Coronary blood flow in tachycardia?
Decreases (Coronary bld flow occurs in early diastole)
185
Angiogenesis in a tumour is driven by?
FGF VGEF
186
What moves venous return curve to the RT
(I.e inc venous return) Increase volume Decrease TPR Increase venous tone (pushing more bld) SNS stimulation Exercise
187
What moves venous return curve to the LT?
Decrease volume/haemorrhage Decrease venous tone (bld pooling in veins) Increase TPR
188
What moves Starling curve to the RT
(Decrease contractility) Ca Channel blockers B blockers Heart failure Narcotic overdose Increase resistance / vasopressors
189
What moves Starling curve to the LT?
(Increase contractility) Exercise Stress Dopamine Dobutamine Epinephrine/norepinephrine Digoxin Vasodilators
190
What is the equation for mean arterial pressure?
DBP +1/3 (SBP-DBP)
191
Pulse pressure equation?
PP= SBP-DBP
192
Persistent splitting of S2 is found in ?
RBBB Pulmonary HTN (Split widens with inspiration)
193
Loud P2 is seen in ?
Pulmonary HTN
194
6 P’s of acute limb ischaemia?
Paraesthesia Pain Pallor Paralysis Poikilothermia Pulselessness
195
MCA stroke can be caused by what pathology in the heart?
In AF —> LT atrial appendage thrombus In Sinus—> Lt ventricular thrombus
196
Changes in muscle cell in endurance training vs resistance training?
Endurance training:——-> non change in # of myocyte, increase in protein actin/myelin, increase in # of mitochondria Resistance training ——> no change in # of myocyte, increase in protein actin/myelin, no change in # of mitochondria
197
T wave inversion seen in ?
Subendocardial ischaemia Raised ICP BB Block Resolving pericarditis Ventricular hypertrophy
198
No human subjects used in trial ?
Preclinical study
199
Small amount of healthy subjects used. Testing for safety, pharmacokinetics and pharmacodynamics?
Phase I
200
Phase II clinical study ?
Testing efficacy in small # of diseased pts
201
Phase III clinical study?
Testing safety and effectiveness compared to placebo
202
Phase IV clinical study?
Studies adverse affect overtime in the market
203
Concentration of Na and K across the proximal tubule?
No change
204
Concentration of creatinine and urea along the proximal tubule?
Increases
205
Concentration of bicarbonate, glucose and amino acids along the proximal tubule?
Decrease
206
Parathyroid hormone affect on Ca and Po4?
Increases Ca levels Increases renal Po4 excretion
207
Effect of panic attack on cerebral bld flow?
Hyperventilation —> hypercapnia Result is reduced cbf leading to symptoms seen with panic attacks