Practise EMQ Flashcards
What is a disorder of the neuromuscular junction?
Myasthenia gravis
What is an inherited disorder associated with progressive weakness and degeneration of muscle fibres?
Muscular dystrophy
What injury occurs at the myotendinous junction?
A pull/strain
What is a viral disease that destroys the motor neurons?
Poliomyelitis
What is the common term for painful muscular contraction in response to ischaemia or metabolic disturbance?
Cramp
Which structures conduct most oxygen molecules diffusing through the walls of continuous capillaries?
Endothelial cells
Which structures conduct most glucose molecules diffusing through the walls of continuous capillaries?
Interendothelial junctions
Which structures may contain valves?
Lymphatics or veins
Which structure may contain purkinje fibres?
Bundle branches
What is the appropriate management for a traveller with chronic diarrhoea and weight loss?
Request a stool sample for microscopy for G. lamblia
What is the most appropriate management for a sick young child with dysentry?
Request a stool sample for culture and begin ABX treatment
What provides electrical insulation around neurons?
Myelin
The influx of what ion directly activates the synpatic release machinery to trigger the release of a neurotransmitter?
Calcium ions
The influx of what ion through voltage gated channels is associated with the rising phase of the action potential?
Sodium ions
Influx of what ion through ligand gated channels causes neuronal hyperpolarisation?
Chloride
What would you give to someone who has taken an overdose of anti-psychotic drugs?
Procyclidine
What cells of the adaptive immune system make up 25-35% of white cells in adult circulation?
B cells and T cells
What 2 cells contain histamine?
Mast cells and basophils
Name the granular cells of the innate immune system that make up about 65% of the white cells in adult circulation?
Basophils, eosinophils and neutrophils
What are the principle phagocytic cells of the innate immune system?
Macrophages, monocytes and neutrophils
What immune cells produce IFN and help to neutralise virally infected cells?
NK cells and T cells
Where along the GI tract do the foregut and midgut meet?
Duodenum
The vitelline duct may persist as an out-pocketing of which part of the GI tract?
Ileum
Which part of the GI tract is formed from both endoderm and ectoderm?
Anal canal
What is a category of systematic error due to differences in the quality of information obtained from different groups in a study, particularly common in case control studies?
Reporting error (or bias)
What is the term for the distortion of the relationship between 2 factors brought about by their mutual relationship with a 3rd factor?
Confounding
What is systematic error due to differences between those chosen for study and those not chosen?
Selection error (or bias)
The error of wrongly rejecting the null hypothesis when it is true?
Alpha, type I, error
The error of wrongly accepting the null hypothesis when it is false
Beta, type II, error
What percentage of a volume of 0.9% NaCl infused IV would remain in plasma after equilibrium between body and fluid compartments?
20
What % of a volume of 5% dextrose infused IV would remain in plasma after equilibration between body fluid compartments?
7
What drug is used to ripen the cervix?
Prostin (dinoprostone)
What drug can be used in post partum haemorrhage every15 minutes IM up to a maximum of 8 doses?
Carboprost (15 alpha-methyl prostaglandin)
What kind of heart block causes a prolonged PR interval (>200ms) with a 1:1 ratio of P waves to QRS complexes?
First degree heart block
What would cause an irregular RR interval with no visible P waves?
Atrial fibrillation
What causes a broad QRS complex with a 1:1 ratio of P waves to QRS complexes?
Bundle branch block
What causes progressive lengthening of the PR interval preceding a non-conducted P wave?
Wenckebach phenomenon, mobitz type 1 heart block
Gastrulation begins with the formation of what?
The primitive streak
What layer of cells does the primitive streak form from?
The epiblast
What lies immediately dorsal to the epiblast?
Amniotic cavity
What studies provide the weakest form of evidence relating to the cause of disease?
Case series and case reports
What studies provide the strongest evidence relating to the efficacy of health related intervention?
Systematic reviews with at least 1 RCT
What is the most powerful type of observational study in providing evidence relating to the cause of disease?
Cohort studies
What studies provide estimates of incidence and prevalence but no information on the cause of disease?
Cross sectional studies
What is a normal pulmonary arterial systolic pressure at rest?
25mmHg
diastolic is 8
What is the oxygen content of normal pulmonary arterial blood?
150ml/L
What is the oxygen content of normal pulmonary venous blood?
200ml/L
What is the ratio of systemic to pulmonary vascular resistance?
10:1
What is the total pulmonary blood volume?
400ml
What is the most likely cause of isolated premature adrenarche in a girl?
Increased dihydroepiandrosterone
What area of the GI tract is recognised by bands of longitudinal muscle?
Ascending colon
Starting drugs such as rifampicin or erythromycin with what treatment would have significant effects on plasma concentration?
Oral theophylline
In a small number of patients with asthma what drug can cause bronchospasm?
Oral ibuprofen
Experiencing a tremor is common from using what treatment?
Inhaled salbutamol
What drug can cause insomnia and should therefore be used in the morning?
Oral prednisolone
What drug can cause oral thrush when using it?
Inhaled beclometasone
A 65 year old lady has been feeling low for 6 months, has gained 2 stone in weight and complains of feeling cold, lethargic and a hoarse voice. What is the most likely diagnosis?
A hypothyroid disorder
A 50 year old man has a 3 year history of feeling generally low and miserable, no sleep, appetite, or weight change. No time off work needed. What is the most likely diagnosis?
Dysthymia
What causes villous atrophy with crypt hyperplasia?
Coeliac’s disease
What infections biopsy sample will give a positive urease test?
H. pylori
What might be the pathology for goblet cells in an area that is normally squamous mucosa?
Barrett’s oesaphagus
What disease causes crypt abscesses and mucosal inflammation?
UC
What disease has inflammatory infiltrate with non-caseating granulomas?
Crohn’s disease
In which area of the GI tract would papillae be found?
The tongue
In which area of the GI tract would a biopsy from an endoscopy show Giardia parasites?
The duodenum
Which area of the GI tract would finger shaped villi be found?
The jejunum
Where in the GI tract are valvulae conniventes (plicae) found?
The SI
Which area of the GI tract has both smooth and striated muscle?
Oesophagus
Abx treatement during admission to an elderly care ward is most likely due to what?
C. difficile
What is a toxin produced by S. aureus that causes toxic epidermal necrolysis?
Exfoliative toxin
What toxin affects cAMP levels in the gut?
Cholera toxin
What toxin acts at the NMJ causing flaccid paralysis?
Botulinum toxin
What toxin causes scarlett fever?
Erythrogenic toxin
What toxin causes whooping cough?
Pertussis toxin
What is a common skin infection caused by a poxvirus that occurs most often in children? Small pearly-white lumps appear in clusters anywhere on the body
Molluscum contagiosum
What infection, widely controlled by vaccination, causes a fine pink rash and enlargment of postauricular, suboccipital and cervical lymph nodes. If encountered intrauterine it can lead to developmental defects
Rubella
In what condition are Koplik’s spots followed by a macular rash that starts at the head and spreads downwards?
Measles
What contains M cells that are specialised for Ag detection?
Peyer’s patches
What is the origin of all lymphocytes?
Bone marrow
What is the site of initial differentiation of T-cells?
Thymus
What wave coincides with atrial contraction?
a wave
What coincides with closure of the aortic and pulmonary valves?
The second heart sound
What coincides with the beginning of isovolumetric contraction?
First heart sound
What immediately preceeds atrial contraction?
P wave
What immediately follows the v wave?
y descent
66 year old women with haemoptysis, weight loss and hypokalaemia. Serum cortisol levels are high following a dexamethasone suppression test. Most likely diagnosis?
Cushing’s syndrome due to ectopic ACTH
What is the most likely diagnosis for a 16 year old women with primary amenorrhoea, hirsuitism, and some signs of virilisation with raised 17-hydroxyprogesteron concentrations following a synacthen test?
Congenital adrenal hyperplasia
34 year old women, infertility and oligomenorrhoea. Overweight, mild hirsuitism, serum LH/FSH raised, cortisol normal and testosterone upper limit of normal. Diagnosis?
PCOS
38 year old women, presents with pigmentation and secondary amenorrhoea, has raised ACTH and low serum cortisol. Most likely diagnosis?
Addison’s
42 year old women, previously well, drinks 20 units alcohol/week. 12 month history of easy bruising, difficulty getting up from sitting,weight gain and mild hirsuitism. Serum cortisol raised after dexamethasone suppression test. Diagnosis?
Cushing’s disease (pituitary adenoma)
25 year old man with a solid testicular mass and normal tumour markers - most likely diagnosis is?
Seminoma
65 year old man with testicular mass and normal tumour makers - most likely diagnosis is?
Lymphoma
23 year old man with a testicular mass and markedly raised tumour markers - most likely diagnosis?
Teratoma
What orgain/region of the alimentary tract has enterohepatic circulation?
Ileum
What produces gastrin?
Gastric antrum
What secretes enzymes in response to CCK?
Pancreas
Where does bacterial fermentation of of complex carbohydrates take place?
Caecum
What type of bone has a network of thin bony plates separated by wide narrow spaces?
Cancellous bone
What is a cavity in the bone matrix which is occupied by a bone cell?
Lacuna
What is often a characteristic of bone diseases and fracture repair tissues?
Woven bone
What is a dense fibrous layer that covers the outer surface of bone?
Periosteum
In a right handed 58 yo man with a proven carcinoma of the lung, how would you account for recent change in the voice with has become husky and weak?
Recurrent laryngeal nerve palsy
In a 58yo man, proven lung carcinoma, how would you account for tightness of the collar, with headache, facial congestion and distended non-pulsatile neck veins?
Superior vena caval obstruction
How would you account for weakness, confusion, convulsions with low serum Na, urea and creatinine?
Syndrome of inappropriate secretion of ADH
Which structures contribute to limb development and regulate proximodistal patterning?
Apical dermal ridge
Which structure will form the greater omentum?
Dorsal mesogastrium
Which structures will contribute to the ventricles of the heart?
Bulbus cordis
Which structure will form the anorectal canal?
Cloaca
