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Pass Medicine notes > Pre-clinical SAQs (Foundation topics) > Flashcards

Pre-clinical SAQs (Foundation topics) Flashcards

1
Q

young girl, PMH of long bone fractures, resulting from minor injuries.

sclerae appears blue, skin is hyperextensible and she has difficulty hearing.

patient most likely has

A
  • osteogenesis imperfecta

- type 1 collagen defect

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2
Q

effect of dietary deficiency of vitamin C on collagen

A
  • ascorbic acid required as a co-factor
  • required for hydroxylation of amino acids in collagen (proline and lysine)
  • hydroxylation allows increased hydrogen bonding
  • to stabilise triple helix
  • lack of vitamin C –> weak tropocollagen triple helices –> scurvy
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3
Q

how might you screen for CF?

A
  • newborn screening via immunoreactive trypsinogen
  • The concentration of IRT is elevated in babies with CF since pancreatic ducts are partially blocked leading to abnormal enzyme drainage.
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4
Q

penetrance

A

proportion of individuals carrying a particular variant of a gene that also expresses an associated phenotype

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5
Q

CF briefly caused by

A
  • autosomal recessive

- CFTR mutation on chromosome 7

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6
Q

Duchennes muscular dystrophy is inherited as

A

X-linked recessive

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7
Q

skeletal muscle

A
  • striated
  • peripheral located nuclei
  • multi-nucleated
  • voluntary
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8
Q

smooth muscle

A
  • non-striated
  • centrally located nuclei
  • spindle shaped cells
  • involuntary

Smooth criminal in central station ;)

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9
Q

cardiac muscle

A
  • striated
  • centrally located nuclei
  • branching cells
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10
Q

markers of muscle cell damage

A
  • myoglobin
  • troponin
  • AST
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11
Q

Duchenne muscular dystrophin

A

no dystrophin protein produced,

dystrophin needed for sarcolemma stability

progressive proximal muscular dystrophy

distinctive psuedohypetrophy of calves

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12
Q

Beckers muscular dystrophy

A

abnormal dystrophin produced

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13
Q

which cells form collagen in cartilage

A

chondrocytes

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14
Q

factors that cause a right shift of the oxygen dissociation curve

A
  1. increased temp
  2. decreased pH
  3. increased 2,3 DPG
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15
Q

60 y/o male, sudden dysponea, pleuritic chest pain. D-Dimer elevated. resp rate 32. BP 95/60mmHg

A

pulmonary embolism

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16
Q

summarise 4 neurological cells in brain

A
  1. astrocytes
  2. oligodendrocytes (myelin sheath in CNS)
  3. microglial cells (scavenger cells that remove cellular debris from sites of injury)
  4. ependymal cells (production of CSF)
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17
Q

by which process is bone formed directly without using cartilage as a template?

A
  • intramembranous ossification

- process uses mesenchymal tissue in development of long bones

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18
Q

endochondral ossifcation

A
  • uses hyaline cartilage

- as a model for formation of long bones

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19
Q

goblet cells are what type of epithelium

A

simple columnar epithelium

20
Q

what type of epithelium is found in areas that are highly secretive or absorptive

A

simple columnar epithelium

21
Q

what epithelium is found is larger respiratory airways of the nasal cavity, trachea and bronchi

A

psuedostratified epithelium

22
Q

transitional epithelium is found in

A

tissues that stretch

like the lining of bladder and urethra

23
Q

which cells secrete glycosaminoglycans to protect the bronchiole lining?

A
  • clara cells

- found in ciliated simple epithelium

24
Q

how does alcohol cause hypoglycaemia?

A
  • excess alcohol intake leads to increase in ratio of NADH:NAD+
  • build up of NADH inhibits gluconeogenesis
  • leading to hypoglycaemia
25
Q

why is bicarbonate low in patients with diabetic ketoacidosis?

A
  • compensatory reaction

- bicarb is used up to react with ketoacids to achieve normal pH

26
Q

why does diabetic ketoacidosis commonly occur as a result of:

A
  • insulin deficiency
  • excess stress hormone release
  • absence of insulin results in decreased glucose uptake peripherally by muscle and fat
  • excess stress hormone causes mobilisation of free fatty acids from fat cells
27
Q

two clinical features associated with Cushings

A
  • hypernatraemia

- hypokalaemia

28
Q

why does diabetes result in polyuria?

A
  • excess glucose filtered out
  • glucose in urine
  • glucose draws in water via osmosis
29
Q

type 1 diabetes

A

autoimmune destruction of beta cells in the islet of langerhans

30
Q

type 2 diabetes

A

reduced insulin secretion and/or increased insulin resistance

31
Q

45 y/o female, increased sweating and palpitations. los 2kg in past six months. appears agitated, non tender mass on anterior aspect of neck.

bloods show:
high free T3
high T4
low TSH

A

Grave’s disease
- hyperparathyroidism

IgG autoantibodies bind and activate G protein coupled thyrotrophin receptors.

32
Q

40 y/o woman presents with fever and dysphagia, examination reveals tender and enlarged thyroid, blood tests reveal raised T3 and T4 with decreased TSH. has previous viral infection

likely cause of her presentation

A

De Quervain’s thyroiditis

- commonly occurs post viral infection

33
Q

23 y/o female presents to clinic complaining of shortness of breath, palpitations/ she is disproportionately tall and thin with long arms and legs compared to her trunk.

on auscultation you hear a systolic murmur

which protein is affected in this underlying condition

A

Marfan’s syndrome

autosomal dominant

mutations in FBN1 gene that encodes fibrillin 1

34
Q

58 y/o woman presents with fatigue, feeling cold, with constipation and weight gain. on examination you notice her skin is dry, she has a pulse rate of 45 bpm. thyroid is firm and enlarged.

what test might you do to confirm diagnosis

A
  • hypothyroidism
  • usually elevated TSH and low T4
  • thus measurement of TSH levels
35
Q

how does chronic alcoholism lead to chronic liver cirrhosis?

A
  • damage to hepatocytes
  • releasing reactive oxygen species
  • inducing activation of hepatic stellate cells
  • subsequent liver injury
  • causes apoptosis of hepatocytes
  • leads to tissue inflammation, fibrogenesis and cirrhosis
36
Q

35 y/o female with muscle weakness, double vision, drooping of eye, weakness being worse during exertion but improves with rest.

pathophysiology behind condition

A
  • Myasthenia Gravis
  • autoimmune
  • antibodies to nicotinic acetylcholine receptors at junction between the nerve and muscle
37
Q

Phase 1 metabolism

A
  • involves modification that can be via oxidation, reduction or hydrolysis
38
Q

Phase 2 metabolism

A
  • involves conjugation making the metabolite more water soluble
  • therefore facilitating excretion
39
Q

Barret’s oesophagus is an example of

A

metaplasia

40
Q

granuloma

A
  • consists of epitheloid macrophages
  • which fuse together
  • to form a giant cell
41
Q

MHC class II molecules present antigen to ….

A

helper CD4+ cells

42
Q

MHC class I molecules present antigen to ….

A

cytotoxic CD8+ cells

43
Q

briefly describe the allergic response

A
  1. extrinsic allergen causes a TH2 response
  2. causes B cells to produce IgE antibodies (priming)
  3. IgE antibodies bind to receptors on surface of mast cells (mast cells now sensitised)
  4. re-exposure to allergen (elicitation) causes IgE to trigger release of mediators
    - ————> histamine
    - ————> prostaglandins
  5. mediators cause
    - ———–> vasodilation
    - ———–> smooth muscle contraction
44
Q

why are adrenaline and corticosteroids given in anaphylactic reactions?

A
  1. Adrenaline
    - –> constriction of resistant arterioles on alpha-1 receptors
    - –> increases BP and relaxes airways via beta-2 receptors
  2. corticosteroids
    - –> suppress allergic immune/inflammatory effect
45
Q

Type 4 hypersensitivity involves

A

T cells

46
Q

in viral infection, which cells are responsible for antigen recognition and how are the antigens generated within a cell?

A

Cytotoxic T cells

  • antigens are degraded into peptides within the cell
  • displayed at surface of the cell with MHC class I
  • which are recognised by CD8+ T cell
47
Q

opsonins

A

molecule that enhances phagocytosis by binding to another molecule

Pass Medicine notes (34 decks)

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