Practice 7

Question 1

what are the branches of the maxillary artery

Answer 1

mandibular, pterygoid and pterygopalatine

Question 2

describe the course of the maxillary artery

Answer 2

the larger of the two terminal branches of the external carotid artery, arises behind the neck of the mandible, and is at first imbedded in the substance of the parotid gland; it passes forward between the ramus of the mandible and the sphenomandibular ligament, and then runs, either superficial or deep to the lateral pterygoid muscle, to the pterygopalatine fossa.

It supplies the deep structures of the face

Question 3

what does the external carotid artery terminate as

Answer 3

the maxillary and superficial temporal

Question 4

what type of receptors does thyroid hormone act on

Answer 4

nuclear

Question 5

where is thyroid hormone stored in the thyroid gland

Answer 5

extracellularly within highly proteinaceous material called thyroid colloid

this is surrounded by thyroid follicular cells

Question 6

how much does the thyroid weight

Answer 6

20 g

Question 7

what does lissencephaly mean

Answer 7

smooth brain

Question 8

Arnold chairi malformation

Answer 8

downward displacement of cerebellar tonsils through the foramen magnum

this causes non communicating hydrocephalus

Question 9

what does holoprosencephaly mean

Answer 9

the forebrain fails to develop into two separate hemispheres

Question 10

what is Ehlers- Danlos syndrome

Answer 10

connective tissue disorder

Question 11

What is Dandy walker malformation

Answer 11

posterior cranial fossa anomaly leading to partial or complete absence of the vermis

Question 12

what artery supplies trapezius and rhomboids

Answer 12

transverse cervical

Question 13

what artery originates from either the second or third part of the subclavian artery

Answer 13

dorsal scapula

Question 14

what artery ascends posteromedially and gives off a branch which anastomoses with the occipital artery

Answer 14

costocervical trunk

Question 15

what stroke has a triad of hemiparesis, hemianopia and dysphasia

Answer 15

total anterior stroke

Question 16

what stroke presents with bilateral motor and sensory deficits

Answer 16

posterior circulation

Question 17

what type of haemorrhage is common in car accidents

Answer 17

intracerebral

Question 18

loss of the direct pupillary response but not the consensual. what cranial nerve is damaged

Answer 18

optic

Question 19

how much more common is depression in people with a chronic physical health problem

Answer 19

two or three

Question 20

what disease is HLA b27 associated with

Answer 20

ankylosing spondylitis

Question 21

what factor is responsible for activating macrophages

Answer 21

interferon gamma

Question 22

what is Conn’s syndrome

Answer 22

adrenal adenoma
primary hyperaldosteronism

excess production of aldosterone in the adrenals and low renin

high blood pressure

Question 23

what drug can be prescribed for Conns disease

Answer 23

spironolactone

Question 24

what value is used to diagnose diabetes 2 hours following the glucose tolerance test

Answer 24

11.1 mmol

Question 25

does somatostatin increase or decrease glucagon release

Answer 25

decreases

Question 26

what is the other name for growth hormone

Answer 26

somatotropin

Question 27

what substances inhibit growth hormone secretion

Answer 27

somatostatin (paraventricular nucleus) negative feedback of growth hormone IGF1 from the liver

Question 28

how does growth hormone exert short loop control

Answer 28

stimulates the secretion of somatostatin and inhibits GRH

Question 29

what effect does oestrogen have on GRH release

Answer 29

stimulates GRH thereby promoting GH secretion

Question 30

what thyroid hormone is needed for GRH to work

Answer 30

T3 | lack of thyroid hormone results in GH deficiency

Question 31

what is insulin like growth factor (IGF 1)

Answer 31

released from the liver and suppresses GH synthesis

Question 32

what is calcitriol

Answer 32

active form of vitamin D

Question 33

what disease may have tiredness, hypotension, weight loss and skin pigmentation as symptoms

Answer 33

addisons

Question 34

what is the short Synacthen test

Answer 34

adrenal insufficiency for addisons

Question 35

what is the most common cause of addisons in the UK

Answer 35

autoimmune adrenalitis destroys cells in the cortex which limits the production of steroid hormones, aldosterone and cortisol

Question 36

how can tuberculosis cause addisons

Answer 36

can destroy the whole adrenal gland through the production of a caseating granuloma

Question 37

What is waterhouse Freidrighson syndrome

Answer 37

Post meningococcal septicaemia leading to adrenal haemorrhage leading to acute insufficiency

Question 38

what cancer is likely to spread to the adrenals

Answer 38

small cell lung cancer

Question 39

what is the commonest cause of Cushings

Answer 39

long term therapeutic use of pharmacological doses of synthetic glucocorticoids

Question 40

what is the most common cause of primary cushings

Answer 40

adrenal tumour (often presents with skin pigementation)

Question 41

why is hyperglycaemia common in Cushings

Answer 41

glucocorticoids are diabetogenic

Question 42

what leads to large abdominal striae on people with cushings

Answer 42

lack of collagen synthesis

Question 43

what muscle groups are commonly wasted in cushings disease

Answer 43

proximal limb muscles

Question 44

in what endocrine disease are levels of erythropoietin and haematocrit raised

Answer 44

cushings

Question 45

in what endocrine disorder are pathological fractures common due to bone demineralisation

Answer 45

Cushings

Question 46

why are infections common in cushings disease

Answer 46

immune suppression

Question 47

what structure secretes oxytocin

Answer 47

hypothalamus and reaches the posterior pituitary

Question 48

what is the prevalence of PTSD following MI

Answer 48

16%

Question 49

what benzodiazepine may be prescribed in management of acute alcohol withdrawl

Answer 49

chlordiazepoxide

Question 50

what is zolpidem

Answer 50

short acting anxiolytic that acts on GABA a but is not a benzodiazepine

Question 51

what opiate drug is not commonly prescribed due to its ability to cause cardiac arrhythmias

Answer 51

dextropropoxyphene

Question 52

what is the ASA physical classification system

Answer 52

asseses the fitness of patients before surgery 1.healthy 2 mild systemic disease 3 severe 4 severe systemic disease which is a constant threat to life 5 a moribund patient who will not otherwise survive 6 brain dead patient whose organs are being removed

Question 53

what inhaled anaesthetic agent may cause respiratory tract irritation and is expensive

Answer 53

desflurane

Question 54

name some anaesthetic inhalation agents

Answer 54

isoflurane sevoflurane desflurane NO

Question 55

what is benztropine used for in the treatment of parkinsons disease

Answer 55

Parkinson's caused by use of antipsychotic dopamine antagonist

Question 56

what dopamine receptor is increased 6 fold in the striatum of schizophrenics

Answer 56

D4

Question 57

what is dementia of the Alzeimers type

Answer 57

all dementias that do not have an obvious organic cause

Question 58

what is memantine used to treat

Answer 58

Severe alzeimers

Question 59

describe the synthesis of adrenalin in chromaffin cells

Answer 59

``` tyrosine L dopa dopamine noradrenaline adrenaline ```

Question 60

describe the synthesis of vitamin D

Answer 60

cholecalciferol (d3) and ergocalciferol (d2) are converted in the liver to 25-hydroxycholecalciferol this is converted in the kidneys to 1, 25- hydroxycholecalciferol