MT1

Question 1

Three pathways activation complement cascade?

Answer 1

Classical- c1 binding to antigen antibody complex or CRP bound to phosphocoline on damaged cells or bacterial cell walls

Leptin- initiated by mannose binding Leyton or ficolins bound to pathogen

Spontaneous hydrolysis of c3 occurs, after which c3b binds to a pathogen cell membrane

Question 2

Complement cascade function?

Answer 2

Chemotaxis
Opsonisation 
Extravasion
Degranulation of mast cells 
Phagocytosis
Cell lysis membrane attack complex 
Production of inflammatory mediators 
Activation of inflammation

Question 3

Family of antimicrobial peptides includes?

Answer 3

Defensins
Histatins
Cathelicidins

Question 4

Which acute phase protein is measured as a clinical marker of inflammation?

Answer 4

C-reactive protein

Pentraxins

Question 5

Why do T cells need to work with antigen presenting cells?

Answer 5

T cells do not recognise native antigen so they need peptides to be presented to them in complex with MHC molecules

Question 6

What 2 possible pathways for antigen processing?

Answer 6

Exogenous and endogenous pathways

Question 7

What is the genetic process that creates diversity in the adaptive immune cell repertoire?

Answer 7

VDJ recombination- key enzymes in this process in RAG 1 and RAG 2, this involves splicing of a variables region a diversity region and a joining region

Question 8

What is immune tolerance?

Answer 8

Immune system;s ability to prevent immune responsiveness to self antigens or possibly immunologically not dangerous antigens

Question 9

Advantages of live-attenuated vaccine versus killed vaccines?

Answer 9

Less boosting requires as stronger memory response

Stimulate CD8 responses in addition to CD4, in case of viruses

Secondary infection of unvaccinated individuals

Lower coverage required to achieve herd immunity

Question 10

What increases stability of glenohumeral joint?

Answer 10

Glenoid labrum- deepens glenoid fossa

Coracoacromial arch- produces void for head of humerus, prevents superior dislocation

Question 11

Why is impingement of supraspinatus tendon a common sport injury?

Answer 11

Tendon has to pass through a narrow space under the coracoacromial arch

Question 12

C5 root innervated?

Answer 12

Shoulder muscles

Question 13

If musculocutaneous nerve is injures where might patient experience sensory loss?

Answer 13

Lateral side of forearm

Question 14

Which nerve and blood vessels become injured following a fracture of 1. Anatomical head of humerus
2. Mid shaft of humerus?

Answer 14

1. Axillary nerve and posterior circumflex humeral artery

2. Radial nerve and profunda brachii artery

Question 15

What does brachioradialis do?

Answer 15

Flexion fo forearm when half pronated

Question 16

What does flexor carpi radialis do?

Answer 16

Flexion or abduction of hand

Question 17

What does pronator teres do?

Answer 17

Pronation of forearm

Question 18

When a bone is broken what is the first stage of the process that happens immediately?

Answer 18

Haematoma- blood cells enter region of injury and form a clot

Inflammation

Question 19

Example of biphosphonate drug?

Answer 19

Alendronate, risedronate, etidronate

Question 20

Why do biphosphonates specifically affect bone cells and not other cells in the body?

Answer 20

Biphosphonates bind to calcium and bone has more of it

Osteoclasts ingest bone during resorption so they take up large quantities of drug

Question 21

What factors are important in the development of optimum peak bone mass during teenage years and early 20s?

Answer 21

Genetics- 60-70% peak bone mass
Gonadal hormones
Dietary intake of calcium/calories
Adequate blood levels of vit d from sun exposure or diet
Born loading from exercise