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Medicine year 1 semester 2 > Practise questions > Flashcards

Practise questions Flashcards

1
Q

Define MUS

A

Medically unexplained symptoms are defined as physical symptoms persisting for more than several weeks and for which adequate medical examination has not revealed a condition that explains the symptoms

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2
Q

List 2 impacts of mood and anxiety disorders on society?

A

1) School/work- reduced attendance and performance
2) Healthcare costs
3) Unemployment, difficult to return to work

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3
Q

Define empathy

A

Empathy is the capacity to understand the patient’s situation, perspective and feelings, and to communicate that understanding back to the patient

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4
Q

Explain the differences between empathy and sympathy

A

Empathy is understanding another persons suffering from with their frame of reference. Sympathy is a feeling of pity from an external perspective

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5
Q

Describe Cognitive Behavioural Therapy

A

A treatment that addresses the patient’s life events, thoughts, feelings, physical symptoms and behaviours

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6
Q

The enzyme involved in the phase 1 metabolism of ethanol?

A

Alcohol dehydrogenase

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7
Q

What biochemical marker is used to test for hepatocellular damage?

A

Alanine transaminase

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8
Q

What cell type plays a key role in fibrosis

A

Stellate cells

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9
Q

Where do caput medusae arise

A

In the Paraumbilical region

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10
Q

What triggers contractions of the gallbladder

A

Cholecystokinin (CCK)

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11
Q

The 6 data protection principles

A

1: that processing be lawful, fair and transparent.
2: that the purposes of processing be specified, explicit and legitimate.
3: that personal data be adequate, relevant and not excessive.
4: that personal data be accurate and kept up to date.
5: that personal data be kept for no longer than is necessary.
6: that personal data be processed in a secure manner

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12
Q

What enzyme activates trypsin

A

Enteropeptidase

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13
Q

Anterior borders of the oral cavity

A

1) Oral fissure
2) Lips
3) Oral vestibules

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14
Q

Posterior border of the oral cavity

A

1) Oropharyngeal isthmus

2) Oropharynx

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15
Q

Lateral borders of the oral cavity

A

1) Buccinator muscle

2) Mucous muscle

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16
Q

Superior border of the oral cavity

A

1) Hard palate

2) Soft palate

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17
Q

Inferior border of the oral cavity

A

1) Mylohyoid muscle
2) Geniohyoid muscle
3) Tongue
4) Salivary gland

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18
Q

Why do we give adrenaline in anaphylaxis

A 
Adrenaline is adrenergic receptor agonist and so opens airways to  breathing (beta2),
Cardiac stimulant (beta1),
Peripheral vasoconstrictor maintaining blood pressure (alpha1)
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19
Q

How do corticosteroids work?

A

Corticosteroid enhance transcription when bound to Glucocorticoid receptors, the receptor then moves to the nucleus

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20
Q

What cytokine increases the function of Macrophages?

A

Interferon-gamma is produced by NK cells and T cells and its main function is activation of macrophages

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21
Q

Where do the classical, lectin and alternative complement pathways converge in the complement cascade.

A

Creation of C3b

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22
Q

What is the most characteristic feature of granulation tissue?

A

Proliferating capillaries and fibroblasts

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23
Q

What leukotriene receptor antagonist is used in the treatment of asthma

A

Montelukast

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24
Q

What lymphocyte is involved in the innate immune responce

A

Natural killer cells

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25
Q

How does hyperglycaemia influence wound healing

A

Reduces endothelial retraction

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26
Q

Which zone of the liver is most prone to damage

A

Zone 3 (inner zone)- less oxygenated so more prone to ischaemia

27
Q

Phase 1 of drug metabolism

A

1) Make molecules more polar
2) Oxidation, reduction, hydrolysis
3) Results in more toxic substances

28
Q

Phase 2 of drug metabolism

A

1) Usually makes molecules more inactive
2) Most common reaction is production of glucuronides
3) Increases negative charge, makes molecules more hydrophilic

29
Q

Phase 3 of drug metabolism

A

Secretion

1) Products are transported out of the hepatocytes into canaliculi by ATP binding cassette (ABC) transporter

30
Q

Blood results for hepatocellular insult

A

ALT- greater than 10 fold increase

ALP- less than 3 fold increase

31
Q

Blood results for cholestasis

A

ALT- less than 10 fold increase

ALP- greater than 3 fold increase

32
Q

Structural change of cirrhosis

A

1) Bridging fibrous septa between portal triads
2) Parenchymal nodules
3) Diffuse whole level architectural changes

33
Q

Consequences of cirrhosis

A

1) Hepatorenal syndrome
2) Hepatocellular carcinoma
3) Encephalopathy
4) Reduced synthetic function- clotting factors, albumin
5) Portal hypertension- ascites, varices

34
Q

Risk factors for Hepatocellular adenoma

A

1) Oestrogen containing contraception

2) Anabolic steroids

35
Q

Risk factors for hepatocellular carcinoma

A

1) Hepatitis B and Hepatitis C
2) Anabolic steroids
3) Alcohol
4) Cirrhosis
5) Aflatoxins

36
Q

What causes release of bile

A

1) Parasympathetic stimulation- Vagus nerve
2) Secretin
3) Cholecystokinin

37
Q

Two types of bile

A

1) Secreted from duct cells (bile acid-independent) – composed of sodium, potassium, chloride and bicarb – composition altered by flow rate
2) Secreted from hepatocytes (bile acid-dependent) – bile salts, albumin, conjugated bilirubin, cholesterol

38
Q

Risk factors for cholesterol gallstones

A

1) High cholesterol diet
2) Oestrogen containing oral contraception
3) Pregnancy

39
Q

Why do cholesterol gallstones form

A

1) Too much cholesterol in the bile
2) Not enough bile salts to stop cholesterol from precipitating
3) Gall bladder stasis

40
Q

How to treat gallstone obstruction

A

ERCP

41
Q

Intrahepatic cholangiocarcinoma

A

Expansible, firm, white tumour. Vague and insidious presentation

42
Q

Hilar cholangiocarcinoma

A

Infiltrating, ill-defined, fibrous tumour. Jaundice, itch, abdominal pain, weight loss and fever

43
Q

Charcot’s triad

A

1) Fever
2) Jaundice
3) Abdominal pain
Seen in ascending cholangitis

44
Q

Causes of Pancreatitis

A 
I GET SMASHED
Idiopathic 
Gallstones
Ethanol
Trauma 
Steroids
Mumps/malignancy
Autoimmune
Scorpion sting
High triglycerides/hypercalcaemia
ERCP
Drugs (hydrochlorothiazide, azathioprine etc.)
45
Q

Describe the mechanism of action of Sulphonamide antibiotics

A

They interfere with folic acid metabolism

46
Q

How is sweat secreted in eccrine sweat glands

A

Merocrine- the sweat is excreted via exocytosis from secretory cells into an epithelial-walled duct or ducts and then onto a bodily surface or into the lumen

47
Q

What is the virulence factor of s.pyogenes which causes sepsis

A

Protein F

48
Q

What is the growing phase of the hair cycle

A

Anagen

49
Q

Main side effect of Carbimazole

A

Pruritic rash

50
Q

Time period for a diagnosis of generalised anxiety disorder

A

Excessive anxiety for more days than not for at least a period of 6 months

51
Q

Advantages of SSRI’s

A

Selective serotonin reuptake inhibitors are the best tolerated and are the least dangerous in overdose.

52
Q

How long does Levothyroxine take to have its effect

A

Due to the genomic action of these drugs, they take longer than other drugs to have their effects as there is a transcriptional output. The maximum effect from specific dose can take several weeks to occur.

53
Q

Neuromorphological change that occurs as a result of chronic depression.

A

Decrease in hippocampus size and connections causing memory problems

54
Q

Function of centroacinar cells

A

They are within the pancreatic acinus and function to produce bicarbonate ions, which in turn produce an alkaline environment when secreted into the duodenum

55
Q

Dyspepsia

A

Impaired digestion for 4 or more weeks, presents with upper abdominal pain, heartburn, acid reflux and nausea

56
Q

Melaena

A

Black, tarry stools that contain blood

57
Q

Three protective factors of the gastric mucosa

A

1) Mucus layer
2) Surface epithelia connected by tight junction
3) Bicarbonate

58
Q

Damaging factors of the gastric mucosa

A

1) Excess gastric acid secretion
2) H.pylori
3) NSAID’s
4) Smoking

59
Q

Peptic ulcer disease

A

A breach of the epithelium that penetrates the muscularis mucosa in the stomach or duodenum

60
Q

Risk factors for peptic ulcer disease

A

1) H.pylori infection
2) Drugs- NSAID’s and aspirin
3) Smoking, alcohol and stress

61
Q

Barretts’s Oesophagus

A

An oesophagus in which any portion of the normal distal squamous epithelial lining has been replaced by metaplastic columnar epithelium,

62
Q

Main requirements for the clinical trial to be ethical

A

1) Value- enhancement of health
2) Scientific validity
3) Fair subject selection
4) Favourable risk-benefit ratio
5) Independent review
6) Informed consent
7) Respect for enrolled subjects
8) Transparent- aware of risks and funding
9) Demonstrate clinical equipoise- uncertain about which arm is more beneficial

63
Q

Complications of peptic ulcer disease

A

1) Haemorrhage
2) Perforation
3) Gastric outlet obstruction
4) Gastric malignancy

64
Q

Pernicious anaemia and gastritis

A

1) Pernicious anaemia is associated with autoimmune gastritis
2) Autoimmune gastritis is associated with increased risk of gastric carcinoma

Medicine year 1 semester 2 (61 decks)

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