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LopsNotes > Mixede Qs 8 > Flashcards

Mixede Qs 8 Flashcards

1
Q

Concentric left ventricular hypertrophy is due t o which substances

A

Due to Angiotensin II , endothelin

2o chronic untreated HTN

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2
Q

Cofactors in gluconeogenesis working on pyruvate carboxylase

A

Acetyl-coA

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3
Q

MHC Class I structure

A

Single heavy chain and beta 2 microglobulin

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4
Q

Chediak-Higashi syndrome

A

Defect in lysosomal trafficking

Presentation:- recurrent infections
Oculcutaneous albinism ( fair skin, silvery hair)
Nystagmus
Reduced visual acuity

Blood smear:-giant cytoplasmic granules in neutrophils

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5
Q

Interaction between nitrates and phosphodiesterase innhibitors ( sildenafil)

A

Presentation:- profound hypotension due to extreme vasodilation

Nitrates —> nitric oxide —-> increased Intracellular cGMP (2nd messenger)
Increased cGMP—-> vascular smooth muscle relaxation
Phosphodiesterase inhibitors inhibit breakdown of cGMP —> accumulation of cGMP—> ++vasodilation

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6
Q

Frameshift mutation

A

Deletion/addition of a number of bases not divisible by 3 in the coding region of a gene

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7
Q

Marker of HBV transplacental transmission

A

HBeAg

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8
Q

Which medication works by binding to cytocolic receptor and inhibiting nuclear factor kappa B ( NF-KB)

A

Glucocorticoids

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9
Q

Where does the trigeminal nerve exit the brain stem

A

At mid pons level of middle cerebellar peduncle

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10
Q

EPO signal transduction is mediated by

A

Janus kinase 2/signal transducer and activator of transcription (JAK2/STAT) pathway

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11
Q

HLA and MHC

A

HLA-DP, HLA-D2 and HLA-DR encode for MHC II expressed on APC after antigen is processed in lysosome

Absent of MHC II impairs activation of B and T cells —> seen in SCID

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12
Q

HLA and MHC I

A

HLA-A, HLA-B and HLA-C encode for MHC II expressed in nucleated cells after cytosolic antigen transported into endoplasmic reticulum

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13
Q

Exercise induced hypoglycaemia in DM

A

Increased expression of GLUT4 in cell membrane —> increased muscle glucose uptake independent of insulin

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14
Q

MRSA is resistant to which ABx

A

Beta lactate ABx

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15
Q

Latanoprost

A

Topical Prostaglandin agonist

MoA:Increased outflow of aqueous humor

USE: glaucoma

SE:- pigmentation of iris and eye lashes

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16
Q

Aedes mosquito transmits which viruses

A

Dengue ( haemorrhagic symptoms, fever, Brazil travel)
Chikungunya
Zika
Yellow fever

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17
Q

Complication of nitroprusside

A

Cyanide poisioning 2o inhibition of the Electron transfer of O2** it poisons the electron chain **

Symptoms:- flushing, neuro dysfunction, seizures, high lactic acidosis

Risk factor:- high dose, prolonged infusion, renal insufficiency

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18
Q

Wilson’s Disease

A

Accumulation of copper in liver, brain, cornea

Presentation:- child/ YA
Neuropsychiatric symptoms
Depression
Mania
Gait disturbance
Dysarthria

Labs: Abnormal LFTs
Decreased caeruloplasmin
Increased urinary copper execration

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19
Q

Spleen embryologic origin

A

Mesoderm
Like muscle, bone, kidney

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20
Q

ARR equation

A

ARR= Control rate - treatment rate

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21
Q

Heparin MoA

A

Bind to anti thrombin III

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22
Q

Mitochondrial vaculolisation is a sign of

A

Irreversible cell injury

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23
Q

Burkitts lymphoma Pathogenesis

A

Assoc EBV
Translocation between c-Myc ongogene on ch 8 and IgA heavy chain on ch 14 —>over expression of c-Myc which is a transcription activator

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24
Q

Retinoblastoma

A

Presentation:- first 3 years of life
Leukocoria
Strabismus
Creamy white mass on fundoscopy

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25
Q

Retinitis pigmentosa

A

Progressive dystrophy of retinal pigmented epithelium and photoreceptors

Presentation;- night blindness
Loss of peripheral vision
Fudoscopy:- dark pigments and optic disc pallor

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26
Q

1o myelofibrosis

A

Malignancy stem cell- megakaryocytes
Presentation:- pancytopenia, hepatospleenomegaly, teardrop cells

Bone marrow biopsy:- dry tap
Fibrotic BM with clusters of atypical megakaryocytes

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27
Q

Testicular tumour

A

Solid firm/fixed nodule in the tunica albumin era non tender

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28
Q

Defence immunity against intracellular organisms like legionella and m to

A

Cell mediated
Th1 cells, IFN gamma and IL-2

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29
Q

Beta blockers affect

A

Reduce HR
Increase preload
Decrease LV contractility
Decrease end systolic volume

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30
Q

Mesothelioma histology

A

Spindle cells that stain +ve for cytokeratin

31
Q

SCLC histology

A

Small round cells +ve for chromogranin

32
Q

Silicosis histology

A

Whorled collagen fibers and dust laden macrophages

33
Q

Gilbert syndrome

A

Indirect hyperbilirubinaema due to decreased bilirubin conjugation. Can be triggered by stress

34
Q

Bleeding between skull and periosteum

A

Cephalohaematoma

Over parietal / occipital bone
Small, non fluctuant and doesn’t not cross suture line

35
Q

Bleeding between periosteum and galea apnoneurosis

A

Subgaleal haematoma

Diffuse, fluctuant swelling across scalp and neck , beyond suture lines

2o vacuum assisted delivery

36
Q

Acute cholangitis

A

Triad:- fever, acute RUQ pain, jaundice
Hypotension and altered mental status

2o biliary obstruction

37
Q

Typhoid fever

A

Caused by S typhir or paratyphi

Presentation:- escalating fever, abdominal pain, rose spots on chest/abdomen, constipation/ diarrhoea —> bowel perforation
Bradycardia

Transmission faeco-oral

38
Q

Down syndrome and Alzheimer’s

A

Pt with trisomy 21 have 3 copies of amyloid precursor protein in Ch 21 —> increase in amyloid beta accumulating in brain

39
Q

Amyloid A protein

A

Acute phase reactant
Assoc with systemic amyloidosis
Seen in RA, IBD

40
Q

Maple syrup urine disease Mgx

A

Restrict leucine, isoleucine, valine

41
Q

Diphertia immunisation generates

A

Protective IgG against exotoxin B subunit

42
Q

Yersinia pestis infection

A

Bubonic plague
transmission:- rodent fleas

Presentation: rapid onset of symptoms
High fever
Chills
Weakness headache
Painful purulent regional lymphadenitis

Mgx:- aminoglycosides —> block protein synthesis by binding to 30S ribosomal subunit

43
Q

Vancomycin MoA

A

Bind to D-Alanyl- D-alanyl terminus of peptidoglycan prevent elongation of peptidoglycan Chan in

44
Q

Arbovirus

A

Small RNA virus

Transmission:- biting arthropods during summer months

Causes: encephalitis outbreaks
Meningitis
Flu like symptoms

45
Q

Change in colour of bruise from blue to green is due to

A

Haem oxygenase converting haem to biliverdin

46
Q

Measles rash

A

Koplik spots
Rash starts in face spreads to trunk and extremities
Spares palm and soles

47
Q

Roseola infantum

A

HHV-6
High fever for 3-5/7
Followed by maculopapular rash starts on trunk then spreads to face and extremities

Self limited

48
Q

Rubella rash

A

Starts on face then spreads to trunk and extremities Spares

49
Q

Southern blotting is used to identify

A

Gene mutations using DNA fragments

50
Q

Bacteria that produce IgA protease and can cleave IgA at hinge

A

N meningitidis
N gonorrhoea
S pneumonia
H influenzae

Help mucosal adherence of bacteria

51
Q

Disseminated gonococcal infection presentation

A

Triad:-
Arthritis
Dermatitis
Tenosynovitis

In sexually active person

52
Q

How does alcogel kill influenza virus /enveloped viruses

A

By dissolving the lipid bilayer membrane

53
Q

Echinocandins e.g. caspofungin/micafungin

A

MoA inhibit synthesis of polysaccharide glucan

cell wall attack

Use against candida and aspergillus

54
Q

Immune privilege

A

Occurs in eye and testes to protect the other side
If there’s a disruption —> T cells recongnising self antigens as foreign and launch attack on ‘normal’ side

55
Q

Reverse transcriptase PCR

A

Used to detect and quantify mRNA

Used to diagnose CML

56
Q

Meckel’s diverticulum

A

True diverticulum consists of all 3 layers
Outpouching from ileum with a fibrous band connected to umbilicus

57
Q

Damage to the piriform recess can cause damage to which nerve

A

Internal laryngeal nerve —> affecting cough reflex

58
Q

Campylobacter jejuni

A

G-ve oxidase +ve curved rod , grows in 42oC culture

Transmission:- undercooked poultry

Causes:- fever, abdominal pain and bloody diarrhoea
Complication:- Guillain barre

59
Q

Vibrio cholera

A

G-ve oxidase positive curved rod, grows in alkaline culture

Causes: massive watery diarrhoea

60
Q

Relative risk

A

Used for cohort studies to compare incidence between exposed and non exposed

61
Q

Odds ratio

A

Used in case control studies
Frequency of exposure to risk factor is compared between control and cases to estimate association between risk and outcome

62
Q

Beta thalassemia trait presentation

A

Mild microcytic Anaemia
Elevated HbA2
Bld smear showing: - poikilocytosis —> spherocytes, target cells

Defect :- gene mutation in mRNA processing —> decreased beta globin chain

63
Q

Spherocytosis

A

Hereditary haemolytic anaemia
Jaundice
Spleeomegaly
Abdo pain
Pigmented gallstones
Dark urine

Triggered by stress, fatigue , pregnancy

64
Q

Doxycycline

A

MoA:- 30S ribosome subunits
Use:- chlamydia

65
Q

Acute tubular necrosis location common

A

Can occur due to decreased renal perfusion
Affect the renal medulla which include
PCT and ascending loop of Henley ( most active parts)

Muddy brown casts pathognomic

66
Q

Septic abortion

A

Presentation:- fever, abdo pain, uterine tenderness malodorous discharge

Pathogens: S aureus, group A strep, enterobacteriaceae

67
Q

Separation anxiety

A

Excessive and distressing anxiety 2o separation from attachment figures
Children >4/54
Adults >6/12

68
Q

Hx of cirrhosis, ascites and Rt pleural effusion

A

Hepatic hydrothorax 2o fluid passage through the diaphragm - transudative

69
Q

Flutamide

A

Non steroid anti androgen
MoA:- competitive inhibitor of testosterone receptor
Use : prostate Ca with GnRH

70
Q

Biospy for prostate Ca

A

Transrectal route multiple random biopsies

71
Q

SVC embryonic origin

A

Common cardinals veins

72
Q

Lithium

A

Mood stabiliser
Use:- manic and depressive features

SE: hypothyroidism, neprhogenic diabetes insipidus

73
Q

Sepsis Hgb O2 assoc curve

A

Moves to the RT
Weaker HgB o2 bonding

74
Q

Sepsis cellular features

A

Decreased mitochondrial oxidative phosphorylation
—> acumulation of lactic acid

Hypovoluaemia
Hypoxeamia
Vasodilation
Microthrombosis
Oedema

LopsNotes (15 decks)

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