Past papers Flashcards by Aisha Yaseen

What hormones stimulate appetite?

Ghrelin, Neuropeptide Y (NPY), Agouti-related peptide (AgRP), Orexins, Endocannabinoids,Galanin

How well did you know this?

Not at all

Perfectly

What hormones suppress appetite?

Leptin, insulin, Peptide YY (PYY), Glucagon-like Peptide-1 (GLP-1), Cholecystokinin (CCK), Oxyntomodulin, serotonin

How well did you know this?

Not at all

Perfectly

Right heart cath trace

How well did you know this?

Not at all

Perfectly

What causes right shift of oxyhemoglobin curve?

CADET
CO2
Acidosis
D)GP increased
e)xercise
high (t)emperature

How well did you know this?

Not at all

Perfectly

Describe LP findings

How well did you know this?

Not at all

Perfectly

Methaglobulinaemia vs carboxyhaemoglobulinaemia

both can have normal gas
methaglobulinaemia look cyanotic
can have neurological symptoms with carboxyhaemoglobulinaemia

How well did you know this?

Not at all

Perfectly

Describe immunofluorescence of membranous nephropathy, minimal change disease, focal segmental glomerulosclerosis

membranous- Granular IgG and complement deposition on capillary walls

minimal change disease- Negative or minimal staining

FSGS- IgM and C3 deposits in affected segments

How well did you know this?

Not at all

Perfectly

Describe the different phases of clinical trials

Phase 1: First time in man, 20-80 healthy people, assess safety and dosing

Phase 2: Larger group of people 100–300 to determine its effectiveness in disease + safety

Phase 3: large groups of people (1,000–3,000), compare with standard or similar treatment

Phase 4: After drug has been made public

How well did you know this?

Not at all

Perfectly

What is the predominant cell type implicated as the cause of the acute inflammatory process in pulmonary sarcoidosis?
a) Eosinophils
b) Monocytes
c) Lymphocytes
d) Macrophages
e) Neutrophils

Lymphocytes

How well did you know this?

Not at all

Perfectly

Which of the following is most associated with Carbimazole?
a) Aseptic Meningitis
b) Agranulocytosis
c) Interstitial Nephritis
d) Sensorineural hearing loss
e) Hepatitis

Agranulocytosis

How well did you know this?

Not at all

Perfectly

Which of these risk factors confers the greatest risk of extension of a pre-existing Abdominal Aortic Aneurysm?

a) Diabetes Mellitus
b) High blood pressure
c) Hypercholesterolaemia
d) Smoking
e) Obesity

smoking

How well did you know this?

Not at all

Perfectly

What is the mechanism by which Dobutamine increases cardiac output?
a) Cell surface dobutamine receptors
b) Inhibition of α-adrenergic receptors
c) Activation of β-adrenergic receptors
d) Relaxation of vascular smooth muscle
e) Inhibition of cyclic AMP breakdown

Activation of B-adrenergic receptors

How well did you know this?

Not at all

Perfectly

What is the action of alpha-1

Vasoconstriction
increased peripheral resistance
increase blood pressure
mydriasis
increase closure of bladder sphincters

How well did you know this?

Not at all

Perfectly

What is the action of alpha 2

inhibits norepinephrine release
inhibits acetylcholine release
inhibits insulin release

How well did you know this?

Not at all

Perfectly

What is the action of B1?

increase heart rate
increase lipolysis
increase myocardial contractility
increase renin

How well did you know this?

Not at all

Perfectly

What is the action of beta 2?

*increase vasodilation
*decrease peripheral resistance
*bronchodilation
*increase glycogenolysis (muscle, liver)
*increase glucagon release
*relaxes uterine smooth muscle

How well did you know this?

Not at all

Perfectly

A new sepsis protocol is introduced into seven hospital sequentially (one after the other). However, it is introduced into different hospitals randomly. Mortality rates are measured prior to, and after the sepsis protocol has been introduced. What is the name for this type of study design?
a) Case Control
b) Cluster Randomised
c) Randomised Control Trial
d) Stepped Wedge
e) Time Series

Stepped Wedge

What is the rheumatoid factor directed against?

Fc portion of IgG

What is the MOA of sulfonylurea? and S/E

Acts on B-cells
Promotes closure of K+ channels in beta cells –> depolarization of Ca2+ cannels open –> insulin release by exocytosis

S/E: weight gain, GI discomfort, liver toxicity, hypoglycaemia

What is the MOA of metformin

Main effect: decreases hepatic glucose production by inhibiting gluconeogenesis (main effect)
Inhibits action of glucagon
Increases glucose uptake from blood

What Is the MOA of DPP-4

Inhibits DPP-4 protease enzyme that deactivates GLP-1

What is the MOA Of SGLT2

Block reabsorption of glucose in PCT

What substrate is used for the hydrogen/methane test in the diagnosis of small intestinal bacterial overgrowth?
a) Glucose
b) Fructose
c) Lactose
d) Mannitol
e) Sorbitol

Lactulose for distal bowel
And glucose for first metre of bowel. Glucose is more sensitive but can’t detect distal bowel

Describe a JVP

Insulin is stored in vesicles within the pancreatic beta cell which is then released in response to rising blood glucose. In which molecular form is insulin stored? a) Monomer b) Hetero-oligomer with c-peptide c) Hetero-oligomer with glucagon d) Dimer e) Hexamer

E- hexamer

On which chromosome is the amyloid precursor protein gene located?

chromosome 21

Which of the following tumour markers is known to increase with smoking? a) CA-125 b) CEA c) CA-19.9 d) β-hCG e) αFP

CEA

Impaired movement of which of the following ions is implicated in torsades de pointes? a) Sodium b) Potassium c) Chloride d) Calcium e) Magnesium

potassium

What is a normal anion gap?

8-12 (without potassium) 12-16 (with potassium)

What is the MOA of CTLA-4 inhibitors and PD-1 inhibitors?

Both inhibitors work by activating T cells to allow killing of cells. Normally CTLA-4 prevents T-cell activation by binding to B7, preventing co-stimulation that is required for T cell activation. Normally PD-1 binds to PD-L1, preventing T cell activation

Which of the following is/are the major protein(s) that are abnormally deposited in Alzheimer’s Dementia? a) Tau protein b) β-amyloid and Tau protein c) α-synuclein d) α-synuclein and Tau protein e) 14-3-3 protein

B- beta amyloid and tau proteins

Magnesium losses occur predominantly secondary to intestinal losses rather than renal losses with which of the following medications? a) Erlotinib b) Omeprazole c) Carboplatin d) Cyclosporin e) Bumetanide

b- omeprazole

Which metabolic abnormality is most commonly seen in refeeding syndrome such as when malnourished individual is commenced on aggressive nutritional supplementation? a) Hypocalcaemia b) Hypomagnesaemia c) Hypophosphatasemia d) Hyponatraemia e) Hypokalaemia

C) hypophosphataemia

Febuxostat lowers uric acid levels by inhibiting which of the following? a) Cyclooxygenase-2 b) Hypoxanthine transferase c) Interferon-1a d) Urate transporter e) Xanthine oxidase

E) xanthine oxidase

A 29-year-old female has had 5 miscarriages in the first trimester. Chromosomal analysis of the products of conception revealed an unbalanced chromosomal translocation: 46 XX, der (10) t (10; 11) (p15, q21).) Which of the following is the best test to investigate for parental balanced translocations? a) Array-based comparative hybridization b) Barr body analysis c) Cell-free foetal-DNA in maternal blood d) Standard karyotyping e) Whole-exome sequencing

d) Standard karyotyping

Which parameter in the pulmonary function test has the greatest measurement variability? a) FVC b) FEV1 c) TLC d) RV e) DLCO

d) RV The residual volume, which is derived from three measurements ((FRC + IC) – vital capacity) is the most variable measurement and because it is dimensionally a small number, it is more susceptible to variation.

Which of the following is most suggestive of diastolic heart failure on transthoracic echocardiography? a) Reduced fractional shortening b) E/A ratio of < 1 c) Reduced mitral leaflet excursion d) Left Ventricular dysfunction e) Increased end-diastolic left ventricular diameter

b) E/A ratio of < 1

What is the role of trans-cobalamin II in vitamin B12 metabolism? a) To bind to liberated vitamin B12 in the stomach b) To co-operate with intrinsic factor c) To transport vitamin B12 to the terminal ileum d) To transport vitamin B12 to the peripheral tissues e) To transport vitamin B12 to the liver

d) To transport vitamin B12 to the peripheral tissues

Following an adrenaline infusion, which of the following would be an expected biochemical reaction? a) Hyperkalaemia b) Hyperlactataemia c) Hypermagnesaemia d) Hypocalcaemia e) Hypoglycaemia

b) Hyperlactataemia

Which of the following antibodies is most effective at fixing complement? a) IgA b) IgD c) IgE d) IgG e) IgM

e) IgM

With regards to Technetium labelled SPECT-CT use in patients with cognitive impairment, which of the following is the major focus of the assessment? a) Diffusion b) Glucose uptake c) Perfusion d) Apoptosis e) Inflammation

c) Perfusion

What is 14-3-3 found in?

Creutzfeldt-Jakob disease (a prion disease) and Alzheimer's disease