Qs Flashcards
Where is Broca’s area?
inferior frontal gyrus
Where is Wernicke’s area?
superior temporal gyrus
SMA blood supply
Jejunum and ileum and parts of colon
Chronic non-healing ulcers affect which layer of the skin?
Reticular dermis
Spinal accessory nerve innervation
CN XI
Innervates trapezius and sternocleidomastoid
Long thoracic nerve innervation
serratus anterior
injury -> scapular winging
Innervation of deltoid
Axillary nerve
What does the coefficient tell us in correlation analysis
on average, how much y increases with each additional x
What factors influence precision
Sample size and standard deviation
What is an ogive
A continuous cumulative frequency curve where the central point has 50% of values above and 50% of values below it
Positive and negatively skewed data
Positive skew:
mean > med > mode
Negative skew:
mode > med > mean
Present median and range in skewed data
Absolute risk reduction =
- relative risk reduction x placebo event rate
- 1/NNT
What is the power of a study
the probability of correctly rejecting the null hypothesis when it is false
synonymous with sensitivity
Relative risk =
incidence in exposed/incidence in non-exposed
95% confidence interval =
mean +/- 2standard errors
Standard error =
SD/ sq.root of n
Type 2 error
False negative ie. incorrectly accepting null hypothesis
SD =
sq root of variance
Type 1 error
False positive ie. incorrectly rejecting null hypothesis
drugs causing hirsutism
ciclosporin
anabolic steroids
danazol
minoxidil
metoclopramide
methyldopa
phenothiazines
progesterones
What drugs to hold prior to contrast procedures
metformin
ACEi
Renal TB
sterile pyuria
haematuria
dysuria
renal tract calcification
Blood test most likely to be elevated in nephrotic syndrome
cholesterol
High anion gap acidosis
Cyanide
Aminoglycosides
Toluene
Methanol
Uraemia
DKA
Paracetamol
Isoniazid
Lactate
Ethanol
Salicylates
Causes of T1 RTA
PBC
SLE/sjogrens
Amphotericin B
Hypokalaemia
Urine pH > 5.5
Met acidosis
Hyperchloraemia
Causes of T2 RTA
Multiple myeloma
Acetazolamide
Primary hyperparathyroidism
Fanconi syndrome
Wilsons disease
Causes of type 4 RTA
DM
Addison’s
Sickle cell
hyporeninaemic hypoaldosteronaemic
Incidence of contrast induced nephropathy
General pop - 2-7%
In pt. with impaired renal function - 25%
Positive urinary cyanide nitroprusside
cystinuria -> hexagon shaped crystals on urinalysis
Wilms tumour
aniridia, genitourinary problems, intellectual disability
Assoc. with Ch 11 short arm deletion
Renal microscopy - fused podocyte foot processes
minimal change disease
Sickle cell nephropathy
reduced urine osmolality - medullary damage due to sickling
Absolute contraindication to lithotripsy
pregnancy
uncorrected coagulation disorder
uncorrected obstruction distal to stone
acute urosepsis
Dialysis disequilibrium syndrome
Neuro symptoms typically in patients undergoing first dialysis session
Symptoms: headache, nausea, blurred vision
can progress to confusion, seizure, coma and death
Why is long term dialysis assoc. w/ carpal tunnel syndrome
b2 microglobulin deposition
Risk factors for contrast induced nephropathy
Age > 75
DM
Uncontrolled HTN
Renal impairment (100% of patients with Cr > 400 and DM get CIN)
Prior dehydration
NSAIDs
Gingival hypertrophy secondary to which renal transplant med
Ciclosporin
Pollakiuria
Increased daytime urinary frequency
assoc. w/ risperidone
Acute interstitial nephritis causes
Pencillins
NSAIDs
Sulfa containing drugs eg co-trimoxazole
Positive Rinne’s test
air conduction > bone
normal/SNHL
Positive Webers test
lateralises to one side either ipsilateral conductive hearing loss or contralateral SNHL
presbycusis
bilateral SNHL
otosclerosis
progressive conductive hearing loss
TCA overdose
within 1 hr- gastric lavage
if cardiac involvement- sodium bicarb
if seizure- iv benzo
Docetaxel MoA
binds to microtubules reducing tubulin availability and therefore reducing mitotic activity
baclofen MoA
GABAb agonist
Drugs that undergo high rates of first pass metabolism
Propranolol
Verapamil
Morphine
When to discontinue metformin
in women when Cr > 130
in men when Cr > 150
Anti-emetic for motion sickness
Cinnarizine - vestibular system depression and suppresses SM contraction in gut
What is prothrombin complex concentrate
inactivated factors II, IX and X + variable amounts of factor VII
Carbimazole side effects
alopecia, nausea, agranulocytosis, jaundice, rash, arthralgia, pruritus
Entamoeba histolytica treatment
metronidazole
Hazardous drugs in desensitisation therapy for allergies
ACEi
Bosentan class of drug
Endothelin A and B antagonist
Ambrisentan = selective for endothelin A
First line for schizophrenia
risperidone
Risk factors for ciprofloxacin induced achilles tendonitis
concomitant steroid use
age > 60
previous tendon rupture
renal impairment
organ transplant
HLA A3
haemochromatosis
HLA-B51
Behcet’s
HLA-B27
Reactive arthritis
ankylosing spondylitis
HLA-Cw6
Psoriasis
HLA-DR2
Goodpasture’s syndrome
MS
HLA-DR4
Rheumatoid arthritis
HLA-DR3
Addison’s disease
HLA-DQ2 and DQ8
Coeliac
Factors that shift Hb-O2 dissociation curve to the right (Decreasing oxygen affinity)
Rise in 2,3-DPG
Rise in CO2
Fall in bicarb
Rise in temp
Arthus reaction
type III hypersensitivity reaction following vaccination due to formation of immune complexes as vaccination site
Action potential phases
Phase 0 - sodium influx
Phase 2 - plateau phase - potassium channels open (K out of cell) AND calcium channels open (Ca into cell) = stable, no change
Phase 3 - Calcium channels close tf. more potassium efflux
Grade C oesophagitis
Lower oesophageal sphincter pressure
< 75% of mucosal circumference involved
Where is intrinsic factor produced
parietal cells in fundus of stomach
Surfactant
Made of phospholipids by type 2 pneumocytes
Where in cell is circular double stranded DNA found?
Mitochondria
NB - nucleus contains linear DNA
What are Type C drug reactions?
Type C reactions occur in the setting of prolonged drug use, such as analgesic nephropathy or visual-field defects with vigabatrin
What characterizes Type B adverse drug reactions?
Type B adverse drug reactions are unpredictable, not related to a predictable pharmacological effect, idiosyncratic, unexpected, usually rare, and may be serious
Type B reactions are typically not dose-related.
What are Type A adverse drug reactions?
Type A adverse drug reactions occur as an anticipated effect arising from a particular pharmacological property of the drug and are dose-related
An example is bradycardia as an adverse effect of B-adrenoceptor blocking drugs.
What is the defining feature of Type D adverse drug reactions?
Type D adverse drug reactions emerge late after treatment, such as teratogenic or carcinogenic reactions
An example is phocomyelia after administration of thalidomide in pregnancy.
What do Type E adverse drug reactions relate to?
Type E adverse drug reactions are related to drug withdrawal phenomena observed after a drug is discontinued
Examples include SSRI cessation and agitation, or opioid withdrawal syndrome.
Hereditary haemochromatosis genetic mutation
C282Y
Symptoms warranting endoscopy in GORD
> 55 +
Anaemia
Loss of weight
Anorexia
Rapid onset of progressive symptoms
Melaena/haematemesis/dysphagia
Diagnosis of PSC
associated with IBD (UC > Crohn’s)
MRCP or ERCP
MRCP preferred because less invasive
What is proven to reduce mortality in management of UGI bleed
Antibiotics
X Ray finding in psoriatic arthritis
pencil in cup deformity
x ray findings in rheumatoid arthritis
bony erosions
juxta-articular osteoporosis
osteopaenia
subluxation
Tamoxifen MoA
mixed oestrogen receptor antagonist and partial agonist
2ry hyperparathyroidism management
calcium or 1 alpha calcidol supplementation
Scanning for phaeo
- USS
- CT
- MIBG (131 metaidobenzylguanidine) scan
