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Yr 3 Questions to work on > Questions to work on from Pass Medicine > Flashcards

Questions to work on from Pass Medicine Flashcards

1
Q

Difference between ulcerative colitis and Crohn’s disease

A
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2
Q

Examples of hypothyroidism and hyperthyroidism (conditions)

A
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3
Q

What things are produced in the different areas of the adrenal gland?

A

GFR - ACD

Zona Glomerulosa → mineralocorticoids (aldosterone)

Zona Fasciculata → glucocorticoids (cortisol)

Zona Reticularis → androgens (DHEA)

Norepinephrine - adrenal medulla

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4
Q

When will the oxygen dissociation curve go to the left and when will it go to the right?

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5
Q

Explain the pelvic ligaments and where they connect and what structures are contained within them.

A
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6
Q

What are the cells in the innate immune system and their functions and properties?

A
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7
Q

What is the source, function and regulation of CORTISOL?

A
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8
Q

Label the diagram and say whether the CN is sensory, motor or both

A
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9
Q

What are the cells in the nervous system?

A
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10
Q

What is the difference between osteoarthritis and rheumatoid arthritis?

(Aetiology, gender, age, typical affects joints, typical history and X-ray findings)

A
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11
Q

Explain all the CN reflexes

A
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12
Q

What are the types of aphasia and explain them

A
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13
Q

What are the rotator cuff muscles and explain what they do

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14
Q

Label the diagram

A
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15
Q

What are the immune system cells in the adaptive immune cells and their functions and properties?

A
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16
Q

What are the common causes of respiratory alkalosis?

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17
Q

What are the types of macrocyclic anaemia?

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18
Q

Sources and function of oestrogen and progesterone?

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19
Q

Label the chest CT

A
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20
Q

What are the layers of the GI tract and explain them

A
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21
Q

What are the arteries in the brain and what happens when a stoke happens in this artery?

A
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22
Q

Give examples of the different types of bacteria

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23
Q

Draw and label a cardiac action potential

A
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24
Q

Explain the different types of asthma features (categories)

A
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25
Q

What antibiotic is used to treat C.diff infection?

A
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26
Q

What does troponin I bind to?

A
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27
Q

Where does CCK come from?

A

I cells in the small intestine

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28
Q

What will happen to the pupil in a oculomotor lesion?

A
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29
Q

Where is most filtered water absorbed?

A
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30
Q

Features of acromegaly

A
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31
Q

What is the mechanism of Rituximab?

A
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32
Q

Genetics of DMD

A
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33
Q

Which cell cycle protein does the HPV E6 protein inhibit in the process of cell transformation?

A
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34
Q

What is the shortest phase in the cell cycle?

A
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35
Q

What can transfusion of older RBC cause?

A
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36
Q

What does ADH result in?

A
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37
Q

Polycystic ovarian syndrome is the strongest risk factor for?

A
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38
Q

What adverse effect is associated with corticosteroids?

A
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39
Q

What is most likely to result in normocytic anaemia?

A
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40
Q

What class of drugs cause hypercalcaemia?

A
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41
Q

What can cause hypothyroidism?

  • Hypocalcaemia
  • Hypernmatraemia
  • Hyponatraemia
  • Hypercalcaemia
A
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42
Q

What is the gross mechanism of quinolones?

A
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43
Q

What is a cohort study?

A
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44
Q

What does ghrelin cause?

A
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45
Q

What nervous system cell removes excess potassium ions?

A
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46
Q

What does rantidine and infliximab do? mechanism

A
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47
Q

How does an intrauterine device work?

A
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48
Q

Structures that perforate the diaphragm and at what level?

A
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49
Q

Heart failure: diastolic vs systolic dysfunction

A
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50
Q

Examples of gram-negative rods vs gram-positive rods

A
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51
Q

Cranial nerve lesions V vs VII (features)

A
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52
Q

What does the posterior chord of the brachial plexus give rise to?

A
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53
Q

In the distal ⅓ of the upper arm where is the musculocutaneous nerve located?

A
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54
Q

Person presented with fever and pleuritic thoracic pain after having an MI 4 weeks ago with a STEMI… what is the diagnosis?

A
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55
Q

Cranial nerve lesions VIII vs III (features)

A
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56
Q

Patient hip drops to the right so positive Trendelenburg sign… Which muscle/muscles are weaker?

A
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57
Q

Embryological layers and their structures and blood supply

A
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58
Q

What is an adverse effect of lithium?

A

Diabetes Incipidus

59
Q

What hormone increases growth hormone secretion:

  • CCK
  • Glucagon
  • Calcitonin
  • Angiotensin II
  • Cortisol
    • Leptin
A

Glucagon

60
Q

At what vertebral level does the left renal artery leave the aorta?

A

L1

61
Q

What is most likely to cause a third heart sound?

A

Constrictive pericarditis

62
Q

Drug mechanism of Sulfonylureas

A

Increased pancreatic insulin secretion

63
Q

Patient noted to have early-to-mid systolic murmur 10 days after beinng admitted for MI stereotypical history of?

  • Aortic stenosis
  • Ischaemia of the papillary muscles
  • Left ventricular free wall rupture
  • Atrial myxoma
  • Aortic regurgitation
  • Aortic regurgitation
A

Ischaemia of the papillary muscles

64
Q

What does gastrin do?

A

Stimulates parietal cell maturation

65
Q

Complications of Coeliac disease

A

Lactose intolerance

66
Q

Which one of the following is/are characteristic of subacute thyroiditis?

  • Pretibial myxoderma
  • Abdominal striae
  • Tendon xanthoma
  • Hyperpigmentation of the palmar creases
  • Raised ESR
A

Raised ESR

67
Q

A 40 year olld woman with letharygy, weakness and weight loss. Examination BP 80/50mmHg and there is hyperpigmentation of the skin:

  • Cushing’s syndrome
  • Pheochromocytoma
  • Hashimoto’s disease
  • Addison’s disease
  • Riedel’s thyroiditis
A

Addison’s disease

68
Q

What is the acronym for asthma and COPD treatment?

A

Oxygen

H

Salbutamol

Hydrocortisone IV (or prednisolone oral)

Ipatropium (bromide)

Trimethoprim

Magnesium (sulphate)

Escalate

69
Q

What is the acronym for treatment of ACS (acute coronary syndrome)?

A

Morphine

Oxygen (if needed <94%)

Nitrogen (GTN spray)

Aspirin (300mg STAT, 75mg OD)

70
Q

A 60-year-old female, who is a known type 2 diabetic, presents to the GP for a diabetes review. She is already on metformin and her GP decided to start her on a sulphonylurea to help gain better control of her blood sugar. What is the mechanism of action of this medication?

A

Closes potassium - ATP channels on beta cells

Sulfonylureas - bind to an ATP-dependent K+(KATP) channel on the cell membrane of pancreatic beta cells

They act to block these channels causing membrane depolarisation and thus opening of voltage-gated calcium channels. This process results in the stimulation of insulin release.

71
Q

Type I error

A

Type I error - the null hypothesis is rejected when it is true

72
Q

Marfan’s syndrome is caused by

A

Marfan’s syndrome is caused by a mutation in a protein called fibrillin-1

73
Q

Methotrexate moa

A

Methotrexate prevents cell growth by blocking folic acid metabolism

74
Q

Thromboxane moa 2nd one

A

Thromboxane causes vasoconstriction

75
Q

What is in the cavernous sinus?

A

Occulomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Carotid artery
Abducent nerve (VI)
T

O

T

O

M

C

A

T

76
Q

Cerebellar lesions

A

Mark is most likely to develop symptoms on the left side of his body. Cerebellar lesions cause ipsilateral signs. This means that signs occur on the same side of the body as the lesion (e.g. lesion on the left cerebellum leads to symptoms on the left side of the body).

Cerebellar signs can be remembered using the mnemonic ‘DANISH’: dysdiadochokinesia & dysmetria, ataxia, nystagmus, intention tremor, slurred speech and hypotonia

77
Q

What do macrolides inhibit?

A

Macrolides inhibit the 50S subunit of ribosomes

78
Q

How to work out Systemic vascular resistance

A

SVR = MAP / CO.

79
Q

What does secretin do?

A

Decreases gastric acid secretion

80
Q

What condition has a strong correlation with HLA-DQ2?

A

Coeliac disease

81
Q

How does sildenafil work?

A

PDE 5 inhibitors (e.g. sildenafil) cause vasodilation through an increase in cGMP

82
Q

How does insulin decrease K+ levels?

A

Insulin decreases serum potassium through stimulation of the Na+/K+ ATPase pump

83
Q

What can rheumatic fever cause?

A

Mitral stenosis

84
Q

What does atrial naturetic peptide do?

A

Atrial natriuretic peptide is an antagonist of angiotensin II

Atrial natriuretic peptide is an antagonist of aldosterone.

85
Q

What does brain naturetic peptide do?

A

B-type natriuretic peptides suppress sympathetic tone and the renin-angiotensin-aldosterone system.

86
Q

What cells needed to confirm Barrett’s oesophagus?

A

Goblet cells

87
Q

How does atenolol work?

A

Inhibits the release of renin in the kidneys

88
Q

What tumour marker elevated in colon cancer?

A

CEA - Carcinoembryonic antigen

89
Q

Management of C. dif

A

Oral vancomycin

90
Q

Water passes under the bridge = …

A

Ureter passes underneath uterine artery

91
Q

What drug causes gynaecomastia?

A

Rinitidine (H2 receptor antagonists)

92
Q

What’s the first line medication for hypertension?

A

ACE inhibitors

93
Q

Which vitamin K clotting factor first to decrease?

A

Factor VII as has shortest half life

94
Q

What is seen on CT in Alzeihmer’s?

A

Alzheimer’s disease causes widespread cerebral atrophy mainly involving the cortex and hippocampus

95
Q

How does Metoclopramide work? (anti-emetic)

A

Metoclopramide functions both at the chemoreceptor trigger zone and on 5-HT receptors in the GI tract

96
Q

What receptors in blood vessels allow vasoconstriction?

A

Smooth muscle contraction in blood vessels is mediated by α1 adrenergic receptors

97
Q

Statistical value of cardiomegaly

A

Cardiomegaly is defined as a cardiothoracic ratio of greater than 50%.

98
Q

During what kind of seizures can hallucinations happen?

A

Hallucinations can occur in temporal lobe seizures

99
Q

What drug to avoid when someone has GORD?

A

Amlodipine (calcium channel blocker as can relax the lower oesophageal sphincter thus, increasing reflux)

100
Q

Which cells secrete testosterone?

A

Leydig cells in response to LH secretion

101
Q

Difference between a cyst and pseudocyst?

A

A pseudocyst is surrounded in granulation tissue, as opposed to a true cyst which is surrounded with epithelial tissue

102
Q

What is the first line treatment for heart failure?

A

ACE-inhibitor and a Beta blocker

103
Q

What is the second line treatment for heart failure?

A

Aldosterone antagonist e.g. mineralocorticoid receptor antagonists e.g. spironolactone

104
Q

Drug class of Montelukast

A

Montelukast is in a class of medications called leukotriene receptor antagonists (LTRAs).

105
Q

Which branch of CN V carries motor innervation?

A

Mandibular branch

106
Q

Which bone is the internal acoustic meatus in?

A

Temporal

107
Q

What does the glossopharyngeal nerve (IX) innervate?

A
  • Posterior ⅓ of tongue for taste and general sensation
  • Innervates the stylopharyngeus muscle in the pharynx
108
Q

What CN innervate the pharynx?

A
  • Glossopharyngeal IX → stylopharyngeaus
    • Vagus X → all other pharynx muscles
109
Q

What does the recurrent laryngeal nerve innervate?

A
  • Off the vagus nerve
    • All the larynx muscles except cricothyroid (innervated by the superior laryngeal nerve off the vagus)
110
Q

What type of innervation does CN X have?

A
  • Sensory
  • Motor
  • Parasympathetic
111
Q

Explain what happens to the spinal part of the CNXI (accessory)

A
  • Spinal part (C1-C5/6) enters the cranial cavity via the foramen magnum and then leaves the cranium via the jugular foramen
112
Q

Explain the purpose of the hypoglossal nerve (CN XII)

A
  • Somatic motor
    • Innervating the muscles of the tongue
      • All intrinsic and extrinsic muscles of the tongue except the palatoglossus muscle by vagus nerve (CN X)
      • Cranial plexus (spinal part) joins on C1-2
113
Q

What are the contents of the cubital fossa?

A

Really

Need

Beer

To

Be

At

My

Nicest

Radial nerve, brachial tendon, brachial artery, median nerve

114
Q

Mechanism of macrolides?

A
  • Inhibit protein synthesis
    • By inhibiting 50s ribosome
115
Q

MOA of oseltamivir

A

Neuraminidase inhibitor

116
Q

Draw out an ECG of an SVT, and the management of an SVT and pathophysiology

A
117
Q

Which rhythms are shockable and which ones aren’t?

A
118
Q

What is the difference between SVT and VT? (& wide and narrow complex tachycardia)

A

Wide QRS complexes = VT

Narrow QRS complexes = SVT

<0.12s = narrow complex tachycardia (NCT)

>0.12s = wide complex tachycardia (WCT)

119
Q

Symptoms of hypothyroidism

A

Bradycardia

Reflexes (decrease)

Ataxia

Dry hands

Yawn

Cold

Aches

Receding hair line

Deflated

Intolerance to cold

Constipation (coronary problems)

120
Q

What is Cushing’s syndrome?

A

Cushing’s syndrome is a disorder caused by the body’s exposure to an excess of the hormone cortisol. Cortisol affects all tissues and organs in the body. These effects together are known as Cushing’s syndrome.

121
Q

What is the difference between Cushing’s syndrome and Cushing’s disease?

A

What’s the difference between Cushing’s syndrome (Hypercortisolism) and Cushing’s disease? Cushing’s disease is a type of Cushing’s syndrome. Cushing’s disease is caused by a benign tumor located in the pituitary gland that secretes too much ACTH (adrenocorticotropic hormone), which in turn increases cortisol.

122
Q

How does hyperventilation lead to paraesthesia?

A
  • As blood plasma becomes more alkalotic, the concentration of freely ionized calcium, the biologically active component of blood calcium, decreases (hypocalcaemia).
  • Because a portion of both hydrogen ions and calcium are bound to serum albumin, when blood becomes alkalotic, the bound hydrogen ions dissociate from albumin, freeing up the albumin to bind with more calcium and thereby decreasing the freely ionized portion of total serum calcium leading to hypocalcaemia.
  • This hypocalcaemia related to alkalosis is responsible for the paraesthesia often seen with hyperventilation.
123
Q

What does V3 do in the tongue?

A

Anterior ⅔ general sensation

124
Q

What does VII do in the tongue? (& face and lacrimation)

A

Anterior ⅔ taste

Muscles of facial expression

Lacrimation SMG, SLG, mouth and nose glands

125
Q

What does VIII do?

A

Hearing and balance

126
Q

What gland does IX innervate?

A

Parotid gland

127
Q

What does XII do?

A

Innervates intrinsic and extrinsic muscles of the tongue (NOT palatoglossus)

128
Q

A 63-year-old man attends the dialysis unit three times a week to receive haemofiltration. In normal functioning kidneys, what detects changes in salt concentrations (such as sodium chloride) and adapts the glomerular filtration rate accordingly?

Juxtaglomerular cells

Mesangial

Macula densa

Podocytes

Principal cells

A

Macula densa

129
Q

What does calcium gluconate do?

A

Calcium gluconate only stabilises the myocardium and does NOT lower potassium levels

130
Q

A 50-year-old woman is seeing her GP for her annual hypertension review. She has developed a dry cough with the medication she is currently on, so the GP switches her to an angiotensin receptor blocker (ARB).

What change will this medication have on this patient to reduce her blood pressure?

A

Angiotensin II - stimulates aldosterone release

131
Q

A 25-year-old man is stabbed in the upper arm. The brachial artery is lacerated at the level of the proximal humerus, and is being repaired. A nerve lying immediately lateral to the brachial artery is also lacerated. Which one of the following is the nerve most likely to be?

A

Median artery

132
Q

What does anuric mean?

A

The kidneys not producing any urine, in practice is defined as passage of less than 100 millilitres of urine in a day.

133
Q

How can gentamicin cause AKI?

A

Gentamicin causes AKI by causing renal cell apoptosis

134
Q

What organ in the digestive system absorbs the most water?

A

Jejunum

Colon absorbs the rest of the water

By the time indigestible materials have reached the colon, most nutrients and up to 90% of the water has been absorbed by the small intestine. The role of the ascending colon is to absorb the remaining water and other key nutrients from the indigestible material, solidifying it to form stool.

135
Q

A 72-year-old woman is brought into the emergency department with drowsiness and confusion, found at home by her carers. She has vomited three times and complains of a headache. This morning, she was unable to recognise her carers and is communicating with short phrases which often make little sense.

Her past medical history is type 2 diabetes and chronic kidney disease (stage 3). She lives alone but requires once-daily carers to assist with washing and mobilises with a frame.

CT head report: generalised cerebral and cerebellar oedema with narrowed ventricles and effaced sulci and cisterns.

What is the most likely cause for this patient’s presentation?

A

Hyponatraemia

136
Q

What drug can cause isolated creatinine increase?

A

Trimethoprim

137
Q

Where are the lymph tissue in the body?

A

Lymphoid Tissue

  1. Normal locations include the:
    a. regional lymph nodes.
    b. tonsils and adenoids (Waldeyer tonsillar ring)
    c. Peyer patches and appendix
    d. white pulp of the spleen.
  2. Locations of B cells include the:
    a. germinal follicles in lymph nodes.
    b. peripheral areas of the spleen white pulp.
  3. Location of T cells include the:
    a. paracortex (parafollicular) in the lymph nodes
    b. periarteriolar sheath in the spleen
    c. thymus (primary site for T cell maturation)
138
Q

Draw out a lymph node

A
139
Q

What is this disease?

A

Non-Hodgkin lymphoma. Lymph node enlargement is typical. The lymph nodes have a firm consistency and are fused together. On cut section, they have a “fish flesh” appearance.

140
Q

What is this disease?

A

Plain chest x-ray showing an upper anterior mediastinal mass in non-Hodgkin lymphoma. This location can be associated with compression of the superior vena cava causing the superior vena cava syndrome

141
Q

What is this disease?

A

Hodgkin’s lymphoma

Classic Reed-Sternberg cell with two mirror image nuclei, each with reddish-purple nucleolus surrounded by a pale halo.

142
Q

What is this condition?

A

Hodgkin disease (stage IIA). Note the marked enlargement of cervical lymph nodes in this patient. It is painless and may be confined to only one area or may affect two or more areas

143
Q

Explain the staging in Hodgkin’s lymphoma

A
144
Q

Draw out haematopoiesis

A

Yr 3 Questions to work on (1 decks)

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