Pass Semester revision: Pat Flashcards
What is a way to remember nerve roots for arm flexion?
C5-C6 pick up sticks (arm flexion)
What is a way to remember arm extension?
C7-c8 lay them straight (arm extension)
What is a way to remember knee extension?
L3-L4 kick the door (knee extension)
What is a way to remember knee flexion?
It is just s1 I think
What is a way to remember plantarflexion?
S1-s2 point your shoes (plantarflexion)
- An exchange student presents to the GP complaining of fatigue and lethargy. Routine bloods show low MCV, high MCHC. RBC membranes are also fragile. What would be seen on blood smear?
a. Sickle cell anaemia
b. Schistocytes
c. Spherocytes
d. Normal red cells
Target cells
c. Spherocytes
- What is the mechanism of anaemia of chronic disease?
a. Downregulate intestinal DMT1 transporters
b. Increased iron excretion via FET1 proteins
c. Reduced activity of ferroportin
d. Downregulation of transferrin
c. Reduced activity of ferroportin
What causes the reduced activity of ferroportin in chronic disease?
Hepcidin
- Which of the following is involved in the formation of a primary platelet plug?
a. Fibrinogen activation
b. Serine protease amplification in the intrinsic pathway
c. Tranexamic acid release
d. Chemical mediators including ADP and TXA2
d. Chemical mediators including ADP and TXA2
What is another name for fibrinogen?
Factor 1
- Which of the following mechanisms does not prevent the production of clots in healthy blood vessels?
a. Fibrinolytic pathway
b. Protein C pathway
c. Serine protease inhibitor antithrombin
d. Tissue factor pathway inhibitor
a. Fibrinolytic pathway
- A female with a PMHx of DVT is taking Warfarin. She decides to start a new diet with leafy green smoothies and juices. What are you most concerned about?
a. Cognitive dysfunction
b. Increased risk of cerebral haemorrhage
c. Nausea and vomiting
d. Increased bruising
e. Increased risk of DVT
e. Increased risk of DVT
- A 45-year-old male presents to the GP complaining of fatigue, lethargy and chronic dyspnoea. His blood results reveal an elevated MCV with normal blasts. Which of the following aetiologies would be consistent with these results?
a. B12 deficiency
b. Folate deficiency
c. Iron deficiency
d. Chronic alcohol use
d. Chronic alcohol use
What is different between b12 and folate deficiency vs chronic alcohol on blood?
B12 and folate are megaloblastic
Chronic alcohol is normal blasts
- A woman comes in with joint pain and stiffness. You suspect she has rheumatoid arthritis. What is most likely correct about rheumatoid arthritis?
a. Decreased release of cytokines
b. Increased activity of osteoclasts
c. Increased activity of osteoblasts
d. Decreased activity of osteoclasts
e. Type I hypersensitivity
b. Increased activity of osteoclasts
- What nerve elicits the triceps reflex?
a. C4
b. C5
c. C6
d. C7
e. T1
C7
- Which of the following is the most important cause of non-melanoma skin cancer?
a. Chronic sunburn resulting in an increased melanin activity in the skin
b. Chemical exposure decreasing skin desmoglein
c. Immunosuppression resulting in increased risk of HPV infections
d. Ionising radiation resulting in keratinocyte apoptosis
e. Chronic UVB exposure disrupting DNA in keratinocyte
e. Chronic UVB exposure disrupting DNA in keratinocyte
- Group A Streptococcus can cause rheumatic fever. What is the mechanism behind this?
a. Exotoxins including streptolysin O
b. Bystander activation of immune cells
c. Molecular mimicry
d. Sequestered antigens
c. Molecular mimicry
- Which of the following drugs is most likely to cause myelosuppression?
a. Alkylating agents
b. Monoclonal antibodies
c. Tyrosine kinase inhibitors
d. Hormonal therapies
e. Immunosuppressants
a. Alkylating agents
What are some examples of anti-metabolites that also cause myeloid suppression?
5-fluro-uricil
Methotrexate
Fludarabine
- A motorbike rider presents to the emergency department with a loss of sensation in the outer upper arm. An X-ray of the arm reveals a surgical neck fracture. Which nerve is most likely damaged?
a. Median nerve
b. Radial nerve
c. Axillary nerve
d. Musculocutaneous nerve
e. Ulnar nerve
c. Axillary nerve
What does the axillary nerve accompany around the surgical neck of the humerus?
Circumflex artery
- Which of the following is the most specific for SLE?
a. Anti-dsDNA
b. Anti-CCP
c. RF
d. ESR
e. CRP
a. Anti-dsDNA
- Which of the following are more specific for rheumatoid arthritis?
a. ANA
b. CRP
c. ESR
d. HLA-B27
e. Anti-CCP
e. Anti-CCP
What is HLA-B27 specific for?
Ankylosing spondylitis Reactive arthritis IBD Psoriasis and something else cant remember
- Which of the following is characteristic of innate immunity?
a. Memory
b. Highly specific
c. No specificity
d. Rapid response
e. Slow response
d. Rapid response
- What does connective tissue proper consist of?
a. Cells, water and extracellular matrix (ECM)
b. Collagen, cells and extracellular matrix (ECM)
c. Fibroblasts, mast cells and ground substance
d. Cells, fibres and ground substance
d. Cells, fibres and ground substance
What do fibres and ground substance make?
ECM
- What is an important component of joint articular cartilage?
a. Dense bundles of collagen
b. Extensive ground substance
c. Hydrophobic
d. Proteoglycan aggregates
e. Rich blood supply
d. Proteoglycan aggregates
- What vessel would most likely be affected with a mid-shaft fracture?
a. Brachial
b. Axillary
c. Radial
d. Ulnar
e. Profunda brachii
Subscapular
e. Profunda brachii
- A 63-year-old woman complained about pain and deformity in the distal and proximal interphalangeal joints (DIP and PIP) and at the base of the thumb for several months. She also complained about stiffness of her hands in the morning but indicated that it does not last more than 30 minutes. The most likely diagnosis is:
a. Psoriatic arthritis
b. Rheumatoid arthritis
c. Septic arthritis
d. Osteoarthritis
e. Osteoporosis
d. Osteoarthritis
What is the pattern of pain for RA?
Will not have issue with distal joint (DIP)
Only Proximal (PIP)
Better with activity –> worse with rest
Hot, red
What is the pattern of pain for OA?
Can be proximal and distal joints
Worse with activity –> better with exercise
- A woman with poorly managed asthma receives a new diagnosis of hypertension. What medication should be avoided?
a. Captopril
b. Irbesartan
c. Labetalol
d. Amlodipine
c. Labetalol
- Which antihypertensive increases nitric oxide?
a. Beta-blockers
b. ACEi
c. Loop diuretics
d. Thiazide diuretics
e. Calcium channel blockers
b. ACEi
- A patient complaining of chest pain at rest and shortness of breath presents to the emergency department. ECG reveals ST segment elevation in the leads V3 and V4. Which of the following coronary arteries is most likely occluded?
a. Right coronary artery
b. Left circumflex artery
c. Left anterior descending artery
d. Posterior descending artery
c. Left anterior descending artery
- Which of the following correctly describes the mechanism of action of GTN?
a. Improved cardiac contractile force leading to more efficient ejections
b. Increased afterload to improve cardiac perfusion
c. Prolongation of ventricular filling to optimize cardiac output
d. Decreased preload leading to decreased cardiac work
d. Decreased preload leading to decreased cardiac work
- A 67-year-old asymptomatic female has a doppler U/S discovers decreased perfusion to the left kidney due to renal artery stenosis. She has a BP of 190/140 and the rest of her examination unremarkable. Her UEC is normal. Which of the following hormones would have most contributed to her HTN?
a. Atrial natriuretic peptide
b. Adrenaline
c. Epinephrine
d. Nitric Oxide
e. Renin
f. Thyroxine
e. Renin
- Which of the following is a risk factor for osteoporosis?
a. Anabolic steroid use
b. Excessive calcium intake
c. Low BMI
d. Low PTH
e. Male gender
c. Low BMI
- A woman presents with low bone density and is prescribed bisphosphonates. What is the mechanism of action?
a. Antagonise RANKL causing decreased bone resorption by osteoclasts
b. Stimulate osteoblasts by promoting calcium deposition
c. Ingestion by osteoclasts inducing apoptosis
d. Inhibit calcium release from bones into bloodstream
c. Ingestion by osteoclasts inducing apoptosis
What is the naming system for bisphosphonates?
End in dronate –> eg aledronate, etridronate
Alongside bisphosphonates driving apoptosis what do they do?
Stop osteoclasts binding to the bone