Past papers Flashcards
What hormones stimulate appetite?
Ghrelin, Neuropeptide Y (NPY), Agouti-related peptide (AgRP), Orexins, Endocannabinoids,Galanin
What hormones suppress appetite?
Leptin, insulin, Peptide YY (PYY), Glucagon-like Peptide-1 (GLP-1), Cholecystokinin (CCK), Oxyntomodulin, serotonin
Right heart cath trace
What causes right shift of oxyhemoglobin curve?
CADET
CO2
Acidosis
D)GP increased
e)xercise
high (t)emperature
Describe LP findings
Methaglobulinaemia vs carboxyhaemoglobulinaemia
both can have normal gas
methaglobulinaemia look cyanotic
can have neurological symptoms with carboxyhaemoglobulinaemia
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
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
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
Which of the following is most associated with Carbimazole?
a) Aseptic Meningitis
b) Agranulocytosis
c) Interstitial Nephritis
d) Sensorineural hearing loss
e) Hepatitis
Agranulocytosis
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
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
What is the action of alpha-1
Vasoconstriction
increased peripheral resistance
increase blood pressure
mydriasis
increase closure of bladder sphincters
What is the action of alpha 2
inhibits norepinephrine release
inhibits acetylcholine release
inhibits insulin release
What is the action of B1?
increase heart rate
increase lipolysis
increase myocardial contractility
increase renin
What is the action of beta 2?
*increase vasodilation
*decrease peripheral resistance
*bronchodilation
*increase glycogenolysis (muscle, liver)
*increase glucagon release
*relaxes uterine smooth muscle
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
