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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
How does hyperglycaemia influence wound healing
Reduces endothelial retraction
26
Which zone of the liver is most prone to damage
Zone 3 (inner zone)- less oxygenated so more prone to ischaemia
27
Phase 1 of drug metabolism
1) Make molecules more polar 2) Oxidation, reduction, hydrolysis 3) Results in more toxic substances
28
Phase 2 of drug metabolism
1) Usually makes molecules more inactive 2) Most common reaction is production of glucuronides 3) Increases negative charge, makes molecules more hydrophilic
29
Phase 3 of drug metabolism
Secretion | 1) Products are transported out of the hepatocytes into canaliculi by ATP binding cassette (ABC) transporter
30
Blood results for hepatocellular insult
ALT- greater than 10 fold increase | ALP- less than 3 fold increase
31
Blood results for cholestasis
ALT- less than 10 fold increase | ALP- greater than 3 fold increase
32
Structural change of cirrhosis
1) Bridging fibrous septa between portal triads 2) Parenchymal nodules 3) Diffuse whole level architectural changes
33
Consequences of cirrhosis
1) Hepatorenal syndrome 2) Hepatocellular carcinoma 3) Encephalopathy 4) Reduced synthetic function- clotting factors, albumin 5) Portal hypertension- ascites, varices
34
Risk factors for Hepatocellular adenoma
1) Oestrogen containing contraception | 2) Anabolic steroids
35
Risk factors for hepatocellular carcinoma
1) Hepatitis B and Hepatitis C 2) Anabolic steroids 3) Alcohol 4) Cirrhosis 5) Aflatoxins
36
What causes release of bile
1) Parasympathetic stimulation- Vagus nerve 2) Secretin 3) Cholecystokinin
37
Two types of bile
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
Risk factors for cholesterol gallstones
1) High cholesterol diet 2) Oestrogen containing oral contraception 3) Pregnancy
39
Why do cholesterol gallstones form
1) Too much cholesterol in the bile 2) Not enough bile salts to stop cholesterol from precipitating 3) Gall bladder stasis
40
How to treat gallstone obstruction
ERCP
41
Intrahepatic cholangiocarcinoma
Expansible, firm, white tumour. Vague and insidious presentation
42
Hilar cholangiocarcinoma
Infiltrating, ill-defined, fibrous tumour. Jaundice, itch, abdominal pain, weight loss and fever
43
Charcot's triad
1) Fever 2) Jaundice 3) Abdominal pain Seen in ascending cholangitis
44
Causes of Pancreatitis
``` I GET SMASHED Idiopathic Gallstones Ethanol Trauma Steroids Mumps/malignancy Autoimmune Scorpion sting High triglycerides/hypercalcaemia ERCP Drugs (hydrochlorothiazide, azathioprine etc.) ```
45
Describe the mechanism of action of Sulphonamide antibiotics
They interfere with folic acid metabolism
46
How is sweat secreted in eccrine sweat glands
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
What is the virulence factor of s.pyogenes which causes sepsis
Protein F
48
What is the growing phase of the hair cycle
Anagen
49
Main side effect of Carbimazole
Pruritic rash
50
Time period for a diagnosis of generalised anxiety disorder
Excessive anxiety for more days than not for at least a period of 6 months
51
Advantages of SSRI's
Selective serotonin reuptake inhibitors are the best tolerated and are the least dangerous in overdose.
52
How long does Levothyroxine take to have its effect
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
Neuromorphological change that occurs as a result of chronic depression.
Decrease in hippocampus size and connections causing memory problems
54
Function of centroacinar cells
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
Dyspepsia
Impaired digestion for 4 or more weeks, presents with upper abdominal pain, heartburn, acid reflux and nausea
56
Melaena
Black, tarry stools that contain blood
57
Three protective factors of the gastric mucosa
1) Mucus layer 2) Surface epithelia connected by tight junction 3) Bicarbonate
58
Damaging factors of the gastric mucosa
1) Excess gastric acid secretion 2) H.pylori 3) NSAID's 4) Smoking
59
Peptic ulcer disease
A breach of the epithelium that penetrates the muscularis mucosa in the stomach or duodenum
60
Risk factors for peptic ulcer disease
1) H.pylori infection 2) Drugs- NSAID's and aspirin 3) Smoking, alcohol and stress
61
Barretts's Oesophagus
An oesophagus in which any portion of the normal distal squamous epithelial lining has been replaced by metaplastic columnar epithelium,
62
Main requirements for the clinical trial to be ethical
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
Complications of peptic ulcer disease
1) Haemorrhage 2) Perforation 3) Gastric outlet obstruction 4) Gastric malignancy
64
Pernicious anaemia and gastritis
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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