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DP CAP Test 2015 > Questions > Flashcards

Questions Flashcards

1
Q 
On a 12 lead ECG you notice ST elevation in leads V2-5. What is the likely site of the infarct?
A. Anterior
B. Anteroseptal
C. Anterolateral
D. Inferior
E. Posterior
A 
A
(Anteroseptal is V1-3)
(Anterolateral is V4-6, I and aVL)
(Inferior is II, III and aVF)
(Posterior shows reciprocal changes in V1 and V2)
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2
Q

What is the most common cause of bronchiolitis?

A

Respiratory syncytial virus

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3
Q

What is the second most common cause of bronchiolitis (and was discovered in 2001)?

A

Metapneumovirus

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4
Q

What influenza virus can cause pandemics?

A

Influenza A

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5
Q 
Which of the following is true of sepsis?
A. Circulating blood volume is increased
B. The HR is lowered
C. Circulating blood volume is decreased
D. It is easily treated with antibiotics
E. Blood clotting remains normal
A

C

Endotoxins cause vasodilation and intravascular fluid to leak in tissues

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6
Q

What receptors does tonic discharge of sympathetic nerves and hence NA act on?

A

Alpha 1

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7
Q 
A 20 year old female returned from a three month stay in Malawi. She wants you to check for GI parasites. What is the investigation of choice?
A. Stool for antigen detection
B. Stool for culture
C. Stool for microscopy
D. Stool for PCR
E. Stool for toxin detection
A

C

This looks for ova, cysts and parasites

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8
Q

What part of the antibody binds to receptors on phagocytic cells?

A

Fc region (fragment, crystallisable)

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9
Q

What is the most appropriate management for a 56 year old man with increasing ascites, pyrexia and an ascitic fluid WCC of 340?

A

Co-trimethazole

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10
Q

What is the best management of a 62 year old man with alcohol related cirrhosis and alcoholic hepatitis who is anuric and his CVP is 12?

A

Terlipressin

This will improve renal blood flow

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11
Q

What is the best management of a 55 year old lady with known PBC whose bilirubin rose to 110 over six months? Abdominal ultrasound showed normal bile ducts.

A

Liver transplant

Her liver function is deteriorating and she is in liver failure

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12
Q 
An 18 year old university fresher presents with one week history of lethargy, headaches and a painful sore throat. No Hx of travel. He had no rash until his GP prescribed him antibiotics for a presumed bacterial infection, and now he has a wide-spread rash. He has a sore abdomen and pain when examined over the liver and spleen. He has lymphadenopathy. He has noticed his eyes are yellow.
What blood test would we perform?
A. Hep serology
B. HIV serology
C. CMV PCR
D. Monospot
E. Lyme disease serology
A

D

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13
Q

Which long bone has a tuberosity and a malleolus?

A

Tibia

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14
Q

Which flat bone provides an attachment for abdo wall muscles and forms part of the acetabulum?

A

Ilium

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15
Q

This bone has a proximal head, forms a tuberosity at the insertion of the biceps tendon and has sulci for several tendons on its distal dorsal aspect.

A

Radius

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16
Q

What happens to a CXR when the left lower lung love is diseased?

A

The silhouettes of the descending aorta and left hemidiaphragm may diseappear

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17
Q

What do Healthy Start Vitamins contain and what does this protect against in pregnant women?

A

Folic acid, Vitamin C and Vitamin D

Rickets and Osteomalacia

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18
Q

What causes Beri-Beri?

A

Thiamine (vitamin B1) deficiency

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19
Q

What causes Pellagra?

A

Niacin (vitamin B3) deficiency

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20
Q

A frail 82 year old women has an altered bowel habit, severe arthritis and iron deficiency anaemia. Investigation of choice?

A

CT colonography

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21
Q

A 55 year old with iron deficiency anaemia, weight loss and early satiety. Initial investigation?

A

Gastroscope

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22
Q

Do competitive inhibitors alter the Km and the Vmax of a reaction?

A

No. They only alter the Km

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23
Q

True or false. On a well-centred CXR the distance between the hilum and the adjacent chest wall should be equal on both sides.

A

False.

On a well-centred CXR, distance from the medial clavicles to the thoracic spinous processes is equal on both sides

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24
Q

True or false. At least four anterior ribs should be visible above the diaphragm

A

False

At least 6 anterior ribs are visible on a well inspired exam

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25
Q

True or false. A lateral projection is sometimes used to clarify the position of an abnormality seen on a PA view

A

True

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26
Q

What does a lower Km indicate?

A

A high affinity of an enzyme for its substrate

Km is inversely proportional to affinity

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27
Q

A 52 year old man with hypertension wakes up suddenly during the night feeling short of breath. On examination he has bilateral basal crackles. Which medication would provide rapid symptom relief?

A

IV furosemide

28
Q

A 45 year old woman complains of palpitations. Investigations confirm the diagnosis of thyrotoxicosis and AF with a ventricular rate of 100 bpm. What medication would provide rapid relief of symptoms?

A

Bisoprolol

29
Q

A 57 year old man complains of central chest pain radiating to his left arm caused by exertion. What medication would cause rapid relief of his symptoms?

A

GTN spray

30
Q

A 50 year old male has a Hx of alcoholism, recurrent abdo pain and canal abdo calcification on AXR. He also presents with malabsorption. What investigation would confirm the diagnosis?

A

Faecal elastase
(Note this is chronic pancreatitis, so serum amylase, while high in acute pancreatitis, may be normal in chronic pancreatitis)

31
Q

A 24 year old backpacker to St Petersburg with pale floating stool which is difficult to flush away presents with malabsorption. What investigation would confirm the diagnosis?

A

OGD and Duodendum (D2) biopsy

Could be small bowel malabsorption [giardiasis] or coeliac disease

32
Q

A 53 year old female supermarket worker with systemic sclerosis presents with malabsorption. What investigation would confirm the diagnosis?

A

Glycoholic breath test

Systemic sclerosis can allow bacterial overgrowth

33
Q

This vessel in the most inferior of the paired anterolateral branches of the abdominal aorta.

A

Gonadal artery

34
Q

A 35 year old man who works in a chicken factory presents with abdominal pain and diarrhoea. You want to test for a campylobacter infection, how would you do so?

A

Stool culture

35
Q

This acts on the post junctional muscarinic end plate receptor on airway smooth muscle to mediate constriction

A

Acetylcholine

36
Q

This acts on the membrane bound beta-2 adrenoceptor on airway smooth muscle to mediate relaxation

A

NA

37
Q

Metabolite of arachadonic acid pathway released from eosinophils and mast cells which mediates airway smooth muscle contraction, increased vascular permeability and mucous secretion.

A

Leukotriene D4

38
Q

What is the normal life span of an erthyrocyte?

A

120 days

39
Q

What is the rate of rescue breaths in an adult with respiratory arrest?

A

1 breath every 6 seconds (10 per minute)

40
Q

What does an increased capillary refill time indicate?

A

A problem with the patients peripheral circulation

41
Q 
Which of the following protein components of the inner mitochondrial membrane transfers energy associated with the proton motive force into high energy phosphate bonds found in ATP?
A. FiFoATPase
B. Complex I
C. Complex II
D. Complex III
E. Complex IV
A

A

42
Q

During singe rescue CPR the rescuer should palmate the patients pulse to determine return of effective heartbeat when…
A. After every 10 breaths
B. After one minute of CPR
C. After five minutes of CPR
D. Only if the patient responds with purposeful movement
E. Never

A

D

43
Q

A 75 year old lady on warfarin for AF is admitted with an acute upper GI bleed. Her Hb is 10.8 g/dL and her INR is 7.6. She is given fluid resuscitation and 10mg IV vitamin K. What blood product would we prescribe?

A

Prothrombin complex concentrate
(Contains the four vitamin K dependent factors [II, VII, IX and X])
This reverses warfarin quickly.
She is also given vitamin K so that when the PCC wears off she can make her own factors to reduce the risk of re-bleeding.

44
Q

A 54 year old lady with chronic liver disease is listed for an ERCP. She has a platelet count of 102x10^9/L and a PT of 28s and an APTT of 41s. Her coagulation has not improved with vitamin K. What blood product would we prescribe?

A

Fresh frozen plasma

45
Q

What is the most likely mechanism for a mutation in the factor VIII gene that causes X-Linked haemophilia?

A

Normal X-inactivation

46
Q

How would we differentiate between…
A. Type 1 or Type 2 respiratory failure
B. COPD or Asthma
C. Mild or Moderate CAP

A

A. ABGs
B. Spirometry
C. Measure respiratory rate

47
Q

Asthmatic inflammation responsive to corticosteroids is typically characterised by what type of inflammation?

A

Eosinophilic

48
Q

What type of inflammation is common in COPD?

A

Neutrophilic

49
Q

What carries somatic sensory and motor nerve fibres to the upper limbs?

A

Anterior rami of cervical and thoracic spinal nerves

50
Q

What is located in the most posterior lobe of the brain and is part of the visual pathway?

A

Calcarine sulcus

51
Q 
What nerves are found in the following?
A. Abdominopelvic splanchnic nerves
B. Cardiopulmonary splanchnic nerves
C. Pelvic splanchnic nerves
D. Anterior rami of sacral spinal nerves
A

A. Sympathetic
B. Sympathetic
C. Parasympathetic
D. Parasympathetic

52
Q

What does handgrip dynamometry measure?

A

Upper extremity muscle strength

53
Q

What does the triceps skin fold thickness measure?

A

Total body fat

54
Q

What does ulna length measure?

A

Height

55
Q

What does mid upper arm circumference estimate?

A

BMI

56
Q 
Which of the following is activated by the classical, alternative and lectin pathways?
A. C3
B. C5b
C. MAC
D. C5
E. IgG
A

A

57
Q

A patient in shock from hypovolaemia will have what kind of pulse?

A

Fast (due to sympathetic compensatory response to low BP)

58
Q 
An 80 year old female patient with a Hx of antibiotic treatment presents with a two day Hx of severe diarrhoea, a white cell count of 25 cells x10^9/L and a distended tender abdomen. The stool sample is positive for C. diff. Which antibiotic regime would be prescribed?
A. IV vancomycin
B. Oral vancomycin
C. IV metronidazole
D. Oral metronidazole
E. Oral metronidazole and IV vancomycin
A

B

Oral vancomycin is the first line treatment but she may require IV metronidazole added on

59
Q

True or false. p53 protein is encoded by RNA tumour viruses.

A

False

DNA tumour viruses encode proteins that bind to an inactivate p53

60
Q

True or false. HPV encoded E6 protein targets p53 protein for breakdown by the proteasome.

A

True

61
Q

What cause of food poisoning is associated with eating rice which has been stored too long at room temperature?

A

Bacillus cereus

62
Q

Why is the DNA molecule replicated in the form of Okazaki fragments on one strand?

A

Nucleic acids are always synthesised in a 5’ to 3’ direction

63
Q

Treatment of a tight benign peptic stricture?

A

Balloon oesophageal dilatation

64
Q

Treatment of achalasia in a young women?

A

Hellers cardiomyotomy

65
Q 
Which of the following causes the rising phase of depolarisation in contractile ventricular muscle cells?
A. Fast sodium efflux
B. Voltage gated calcium influx
C. Fast sodium influx
D. Potassium influx
E. Potassium efflux
A

C (this is Phase 0)

DP CAP Test 2015 (1 decks)

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