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Yr 2 EOYS ^2 > Quick Facts > Flashcards

Quick Facts Flashcards

1
Q

Broca’s area is which Brodmann areas? [2]

A

44 & 45

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2
Q

Wernicke’s area is which Brodmann area? [1]

A

22

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3
Q

Frontal eye field is which Brodmann area? [1]

A

8

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4
Q

Primary somatosenory cortex is which Brodmann’s areas? [3]

A

1,2,3

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5
Q

Primary motor cortex is which Brodmann area? [1]

A

4

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6
Q

Primary auditory cortex is which Brodmann area? [1]

A

41

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7
Q

Locus coeruleus causes the release of which hormone? [1]

A

Noradrenaline

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8
Q

Shingles is most likely to activate in which branch of the trigeminal nerve? [1]

A

V1; opthalmic nerve

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9
Q

Shaken baby syndrome has a triad of which three signs? [3]

A

Retinal haem.; encephalopathy; subdural haem.

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10
Q

Tx for status epilepticus? [1]

A

Lorezapam

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11
Q

A
B
C
D
E

A

C: thalamus

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12
Q

How would bilateral pleural effusion present on auscultation

a. Fine crackles
b. Course crackles
c. Wheeze
d. Increased breath sounds
e. Absent breath sounds

A

e. Absent breath sounds

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13
Q

What is the Thomas’ test assessing

a. Fixed flexion deformity
b. Fixed extension deformity
c. Fixed rotation deformity
d. Tenderness over the acetabulofemoral joint
e. Sciatic nerve compression

A

a. Fixed flexion deformity

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14
Q

What would be the results of the Weber and Rinne test in a sensorineural loss?

a. Weber’s test: Both ears equal, Rinne’s test: Bone louder than air
b. Weber’s test: Louder in affected ear, Rinne’s test: Bone louder than air
c. Weber’s test: Louder in unaffected ear, Rinne’s test: Air louder than bone
d. Weber’s test: Both ears equal, Rinne’s test: Air louder than bone
e. Weber’s test: Louder in affected ear, Rinne’s test: Bone louder than air

A

c. Weber’s test: Louder in unaffected ear, Rinne’s test: Air louder than bone

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15
Q

A medical student is testing pupillary reflexes, and notices that when they shine a light onto the left eye, the left eye constricts but the right eye stays the same. What nerve is most likely damaged?

a. Left optic nerve
b. Right optic nerve
c. Left oculomotor nerve
d. Right oculomotor nerve
e. Both optic and oculomotor nerves

A

d. Right oculomotor nerve

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16
Q

A patient is undergoing a neurological exam. When testing power, they are able to move when there is no resistance. What grade in the MRC power grading scale does this come under?

A

3

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17
Q

A patient presents with colicky pain, and upon examination is shown to have a positive Murphy’s test. He is not jaundiced. What does he most likely have, and where would the pathology be located? (vSAQ)

A

Gallstones, in the cystic duct / cholecystitis

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18
Q

Chronic myeloid leukaemia occurs from a translocation which two chromosomes? [2]

A

9 & 22

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19
Q

Colorectal cancer increases the liklihood of secreting with molecule? [1]

A

Serum carcinoembryonic antigen (CEA)

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20
Q

Substantia nigra
Arcuate nucleus
Ventral tegmental area
Caudal raphe nuclei
Dorsal raphe nuclei

A

Answer: Ventral tegmental area

The mesolimbic pathway is a dopaminergic pathway connecting the ventral tegmental area to the ventral striatum (the nucleus accumbens and the olfactory tubercle), the amygdala and the hippocampus.

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21
Q

Damage to the fornix causes what type of memory loss? [1]

A

Anterograde amenesia

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22
Q

Narrowing of the cerebral aqueduct leads to hydrocephalus. How can this present in patients? [1]

A

Bilateral vertical gaze palsy

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23
Q

The midbrain is supplied by which artery? [1]

A

PCA

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24
Q

The midbrain is supplied by which artery? [1]

A

PCA

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25
Q

Label A-D of this ECHO

A

A - Right ventricle
B - Left ventricle
C - Right atrium
D - Left atrium

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26
Q

Seropositive RA patients are associated with HLA [1] and which gene? [1]

A

HLA DRB1
Gene: PTPN22

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27
Q

Seronegative RA patients are associated with which gene? [1]

A

IRF5 = human interferon regulatory factor-5: Mediates virus induced immune response

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28
Q

Describe the 4 stages of Perthes disease [4]

A

Stage 1 ~ necrosis
Insufficient blood supply to femoral head causing ischaemia and subsequently necrosis
Femoral head begins to flatten
Crescent sign (subchondral translucency indicating susceptibility to fracturing) may be present on the femoral head

Stage 2 ~ fragmentation
Necrotic bone is re-absorbed and femoral hand flattens completely and fragments
Slight subluxation of femoral head out of acetabulum

Stage 3 ~ re-ossification
Growth of new bone to replace necrotic tissue

Stage 4 ~ healed
Femoral head has fully healed, however structural irregularities, such as enlargement or flattening of the femoral head, may be present

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29
Q

What stage of Perthe’s disease is this? [1]

A

Stage 3

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30
Q

What is A?

Femoral artery
Anterior tibial artery
Deep artery of the thigh
Posterior tibial artery
Brachial artery

A

What is A?

Femoral artery
Anterior tibial artery
Deep artery of the thigh
Posterior tibial artery
Brachial artery

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31
Q

Which of the following best describes the curvature of the vertebral column shown on this X-ray?

A

Kyphosis; concave curvature of the spine

Lordoses; convex curvature of the spine

Kyphosis; convex curvature of the spine

Scoliosis; lateral curvature of the spine

Lordoses; concave curvature of the spine

Normal; no extreme deviation of the spine

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32
Q

Explain the effect of Pott’s disease on reflexes [2]

A

Pott’s Disease can lead to exaggerated deep tendon reflexes due to damaging the descending corticospinal tracts.

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33
Q

What is C? [1]

A

Answer: Extensor pollicis brevis

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34
Q

Which of the following is responsible for percinious anaemia?

A
B
C
D
E

A

B

Characteristic histological features of gastric parietal cells include; eosinophilic cytoplasm and central, rounded nucleus. They have a ‘fried egg’ appearance

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35
Q

Less tan 1 day
1-3 days
3-7 days
1-3 weeks
3-6 weeks

A

3-7 days: prescence of macrophages indicates 3-7

At the 3-7 day window following a myocardial infarct, early granulation tissue (vascularised tissue which develops over wound sites) will form. Phagocytosis of dead myocardial cells and a hyperaemic border can also be observed.

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36
Q

A 53-year-old female patient was diagnosed with HER-2 positive breast cancer after having discovered a lump in her breast in the shower. She was referred for surgery, but was also prescribed two monoclonal antibody treatments, pertuzumab and trastuzumab.

Which of the following is a major side effect of the monoclonal antibody treatment trastuzumab?

alopecia

arthritic swelling

chronic kidney disease

congestive heart failure

liver toxicity

A

chronic kidney disease

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37
Q

Rheumatic fever develops following an immunological reaction [] infection

Haemophilus influenzae

Pseudomonas aeruginosa

Staphylococcus aureus

Streptococcus pneumoniae

Streptococcus pyogenes

A

Streptococcus pyogenes

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38
Q

Rheumatic fever develops following an immunological reaction [] infection

Haemophilus influenzae

Pseudomonas aeruginosa

Staphylococcus aureus

Streptococcus pneumoniae

Streptococcus pyogenes

A

Streptococcus pyogenes

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39
Q

Rectocoele

Cystocoele

Vaginocoele

Uterocoele

A

Cystocoele

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40
Q

What type of treatment for OA is this? [1]

A

Mosaicplasty

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41
Q

Name this sign of gout [1]

A

podogra

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42
Q

RA particularly affects the eye because of the high composition of which type of collagen?

Type 1
Type 2
Type 3
Type 4

A

Type 2

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43
Q

The image shows an anterior view of a right humerus. What muscle has attachment at the label A?

Coracobrachialis
Deltoid
Lattisimus dorsi
Teres major
Pectoralis major

A

Deltoid

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44
Q

What is the origin of the long head of triceps brachii tendon?

Infraglenoid tubercle
Acromion
Posterior surface of humerus
Supraglenoid tubercle
Coracoid process

A

Infraglenoid tubercle

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45
Q

Which of the rotator cuff muscles inserts onto the lesser tubercle of the humerus?

Subscapularis
Teres major
Supraspinatus
Teres minor
Infraspinatus

A

Subscapularis

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46
Q

A new drug is discovered to help improve erythropoiesis in fetuses suffering from an inability to produce adequate amounts of fetal hemoglobin. However, this drug must be injected directly into the organ where the majority of erythropoiesis occurs. Given a fetus with a gestational age of 20 weeks who is struggling to produce enough fetal hemoglobin, into which organ should this drug be injected?

A. Endodermal yolk sac
B. Bone marrow
C. Spleen
D. Liver

A

Most of the hematopoiesis occurs in the liver during gestation

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47
Q
A

B = Iliohypogastric

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48
Q

Lateral cutaneous nerve of the thigh is

A
B
C
D
E
G

A

E

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49
Q

The cremaster is controlled by:

A
B
C
D
E
F
G

A

D: Genitofemoral Nerve

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50
Q

Rheumatoid factor is [] that targets the fc portion of a []

  • IgG; targets IgA
  • IgA; targets IgM
  • IgM; targets IgG
  • IgA; targets IgM
  • IgG; targets IgA
A

- IgM; targets IgG

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51
Q

Tetralogy of Fallot

Hypoplastic left heart syndrome

Coarctation of the aorta

Transposition of the Great Vessels

Ventricular septal defect

A

Coarctation of the aorta

On an X-ray, it can be identified through the presence of notching of the ribs and the figure 3 sign. Rib notching occurs due to increased blood flow being redirected to the intercostal arteries supplying the ribs. This results in distortion of the inferior aspect of the ribs, with ribs 3 to 8 being most commonly affected. The figure 3 sign arises from dilatation of the aortic arch and subclavian artery proximal to the site of constriction, a notch at the constriction site and finally dilatation of the descending aorta distal to the site of constriction. In severe cases, enlargement of the left ventricle may be observed due to an increased pressure being generated to pump out the backlog of blood.

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52
Q

Cloaca
Mesonephros
Metanephros
Nephric Duct
Pronephros

A

Metanephros

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53
Q

Pedunculated

Subserosal

Submucosal

Intramural

A

Subserosal

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54
Q
A

A

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55
Q

Dipyridamole is a non-specific phosphodiesterase inhibitor and decreases cellular uptake of []

A

adenosine

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56
Q

A positive Trendelenburg sign indicates damage to which nerve? [1]

A

superior gluteal nerve

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57
Q

State the effect of hypothyroidism on Na+ levels [1]

A

Hypothyroidism causes hyponatraemia

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58
Q

State the role of the mamillary bodies with regards to memory [1]

A

Recollective memory

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59
Q

State a musculoskeletal symptom of Wilson’s disease [1]

A

Chorea

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60
Q

Which cancer drug causes pulmonary fibrosis as a side effect? [1]

A

Bleomycin

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61
Q

State the vertebral levels that causes ankle reflex [1]

A

S1 / S2

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62
Q

State the effect of sciatic nerve lesions on:

Plantar, ankle and knee reflex [3]

A

Plantar and ankle reduced
Knee intact

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63
Q

State which disease causes reduced lung compliance [1]

A

Pulmonary fibrosis

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64
Q

Macrolides include erythromycin, clarithromycin, azithromycin, fidaxomicin and telithromycin.

What is their MoA? [1]

A

Inhibit 50S ribosomal subunit and inhibit protein synthesis

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65
Q

What dermatome is the knee? [1]

A

L3

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66
Q

Central sensitisation of a migraine occurs due to connection of which two parts of the brain? [2]

A

spinal trigeminal (SpV) to thalamus

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67
Q

Describe the Na+ and K+ concentration of endolymph [2]

A

Low Na+; High K+

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68
Q

Leptin targets which nucleus? [1]

A

Arcuate nucleus

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69
Q

Labyrinthitis occurs from infection to which structures? [1]

A

Semi-circular canals

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70
Q

Which spinal cords are carried in the lateral spinothalamic cords?
Which spinal cords are carried in the anterior spinothalamic cords?

A

Lat: Adelta and C
Ant: Adelta, Abeta & C

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71
Q

Which does the lateral spinothalamic cords pathway finish?
Which does the anterior spinothalamic cords pathway finish?

A

Lat: rostral insula, ACC
Ant: primary somatosensory cortex

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72
Q

The mesolimbic pathway occurs between which two locations? [1]

Which NT? [1]

A

VTA to NA
Uses noradrenaline

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73
Q

Cocaine decreases activation of which dopamine receptor? [1]

A

D2

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74
Q

Drug addiction causes chronic activation of which gene? [1]

A

FOSB

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75
Q

Locked in syndrome occurs from damage to which part of the brain stem? [1]

A

Ventral pons

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76
Q

Which benzodiazepine is used in chronic sleep insomnia? [1]

A

Eszopiclone

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77
Q

Which is the only tongue muscle to be innervated by the CN X [1]

A

Palotoglossus

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78
Q

State the difference between alpha and beta EEG waves [2]

A

Alpha: occurs with eyes closed
Beta: eyes open

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79
Q

Which molecule is involved with cheese and phenelzine? [1]

A

Tyramine

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80
Q

Which drug is used to treatment resistent SCH [1]

A

Clozapine

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81
Q

Which enzyme inactivates cortisol? [1]

A

11HSD B2

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82
Q

Which enzyme activates vit D? [1]

A

1 alpha hydroxylase

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83
Q

Which hormone decreases the action of 1 alpha hydroxylase? [1]

A

FGF23

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84
Q

What is the effect of B3 and M3 activation at the bladder? [2]

A

B3: relaxes the bladder
M3: contracts the bladder

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85
Q

Which drug inhibits the production of NH3 in the gut? [1]

A

Rifaximin

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86
Q

Which drug inhibits glutamine to glutamathine

A

l-ornithine larginine

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87
Q

What is the most common cause of optic neuritis? [1]

A

MS

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88
Q

What is the MoA of carbimazole? [1]

A

prevents iodination of tyrosine to thryoglobin

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89
Q

Inheritance of haemophilia? [1]

A

X-linked

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90
Q

You ID breast cysts histologically via what method? [1]

A

Some of the larger cysts in fibrocystic change may have a bluish appearance from outside (blue-domed cysts)

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91
Q

ID which is a breast cyst and which is apocrine metaplasia [2]

A

Apocrine metaplasia: left
Cyst: Right (have bluish tint around them)

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92
Q

Jenny, a 35-year-old actress has recently been diagnosed with cervical cancer. She went through the 2-week cancer patient pathway and had surgery to remove her tumour. She was then followed up with adjuvant radiotherapy to minimize the risk of reoccurrence of the cancer.

Which drug which acts as a radiosensitizer was given at the same time as radiotherapy, to enhance the effect of the radiation?

Abraxane

Velcade

Lutrate

Idarubicin

Cisplatin

A

Cisplatin

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93
Q

Which brain region is stimulated in treatment resistant depression?

Anterior of the fornix

Hypothalamus

Nucleus accumbens

Subcallosal cingulate

Thalamic centromedia/parafascicular complex

A

Subcallosal cingulate

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94
Q

A 92-year-old female is brought into the emergency department following a fall at home. She was found by her neighbour and told the paramedics she had fallen 6 hours before but had been unable to get up due to osteoarthritis in her knees.

Which blood test is it important to do in a patient who has had a long duration of time lying on the floor unable to move?

Calcium

Sodium

Troponin

Creatine kinase

BNP

A

Creatine kinase

In an elderly person who has had a long lie, the pressure of muscles can lead to muscle necrosis and rhabdomyolysis. This results in skeletal muscle breakdown and the release of muscle contents into the circulation. An important consequence of this is hyperkalaemia. This is a medical emergency and can lead to cardiac arrest.

Thus in patients who have had a long lie testing creatine kinase is important to identify and diagnosis rhabdomyolysis. Creatinine kinase will be raised and may be up to several 10,000s.

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95
Q

The narrowing of renal arteries is known as renal artery stenosis (RAS), which typically gives rise to []

A

The narrowing of renal arteries is known as renal artery stenosis (RAS), which typically gives rise to resistant hypertension

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96
Q

Which vertebral layers does the thyroid cartilage sit between

C3-T2
C4-T2
C5-T2
C4-T1
C5-T1

A

Which vertebral layers does the thyroid cartilage sit between

C3-T2
C4-T2
C5-T2
C4-T1
C5-T1

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97
Q

What is the effect of IGF-1 activated on renal GNG [1] and glucose transport? [1]

A

GH is a regulator of IGF1, specifically it decreases renal GNG and increases glucose transport

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98
Q

Which of the following secretes FGF-23

osteoblast
osteoclast
chondrocyte
osteocyte

A

Which of the following secretes FGF-23

osteoblast
osteoclast
chondrocyte
osteocyte

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99
Q

technetium-99m is used in a radio-active scan to diagnose which overactive organ? [1]

A

parathyroid

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100
Q

Which type of diuretic may be used to treat kidney stones?

Loop diuretics
Thiazide like diuretics
K sparing diuretics
Carbonic anhydrase inhibitors

A

Thiazide like diuretics: cause hypercalcemia

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101
Q

Where are the 3 places that kidney stones get stuck in the ureters? [3]

A

Uteropelvic junction
Pelvic inlet (and iliac vessels)
Uterovesical junction

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102
Q

Short synacthen test is used to diagnose

Addisons disease
Cushing syndrome
Conns syndrome
Graves disease

A

Addisons disease

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103
Q

Why might HCO3- rise in Ptxs? [4]

A

As H+ is lost:
* Diarrhoea
* Diuretics
* Mineralocorticoid excess
* Vomiting/NG drainage

As H+ moves into cells: Hypokalaemia

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104
Q

How do you treat congenitial Listeria? [2]

A

Ampicillin plus an aminoglycoside

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105
Q

Drug management for herpes? [3]

A

Acyclovir, Famciclovir, Valaciclovir

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106
Q

Defects in which factors can cause repeated miscarriages? [2]

A
  • Defects in factor XIII and factor XII
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107
Q

What is typically the first symptom of an ectopic pregnancy?

lower abdominal pain
vaginal bleeding
dizziness
breast tenderness
syncope

A

lower abdominal pain

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108
Q

Q
When during gestation is surfactant started to be made? [1]

By how many weeks gestation is it that babies produce enough to breathe normally by? [1]

A

Starts between weeks 24 and 28 of pregnancy.

By 34 weeks babies produce enough to breathe normally by.

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109
Q

How do you treat postnatal psychosis? [3]

A

Mood stabilizer: (lithium, valproic acid and carbamazepine)

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110
Q

How can you distinguish a direct and indirect hernia clinically? [1]

A

A direct hernia can be distinguished from an indirect hernia clinically by reducing it then putting manual pressure over the deep inguinal ring and asking the patient to cough.

A direct hernia should reappear; an indirect hernia should no

111
Q

which hormone causes endometrial thickening?

LH
FSH
Oestrogen
Progesterone
Testosterone

A

LH

112
Q

what happens during the menstrual cycle when FSH and LH fall? [1]

A

FSH and LH fall, the corpus luteum degenerates

Degeneration of the corpus luteum results in loss of progesterone production.

The subsequent falling level of progesterone triggers menstruation and the entire cycle begins again

113
Q

Late neonatal death occurs for a child of how old? [1]

A

7-28 days

114
Q

IUGR is associated with which congenital heart defect in neonates? [1]

A

Patent ductus ateriosus - causes hypoxia

115
Q

What serotype has the strongest association with this disease?

How does the A-wave in a ductus venosus doppler ultrasound present in a normal and IUGR fetus? [2]

A

Normally ductus venosus shows positive A wave.

Reversal of the A wave may be seen in severe intrauterine growth restriction as well as in tricuspid regurgitation.

116
Q

Which HLA is most associated with CD ? [1]

A

HLA DQ2

117
Q

Which brain region is the deep brain stimulation (DBS) probe placed in for dystonia [1] and tremor [2]

A

Dystonia: Globus pallidus internal
Tremor: subthalamic nuclei; zone incerta

118
Q

Two roles of SMA? [2]

A

Urgency of movement
Guides internal actions

118
Q

Two roles of SMA? [2]

A

Urgency of movement
Guides internal actions

119
Q

Describe the neurological effect of glycine [1]

A

Glycine acts as an inhibitory neurotransmitter by increasing chloride transmission across a cell membrane

120
Q

suprachiasmatic nucleus (SCN) role? [1]

Does it promote or inhibit sleep? [1]

A

Controls circadian rhythm: promotes sleep

121
Q

Which of the following antipsychotics is more likely to cause hyperglycaemia, insulin resistance and dyslipidaemia?

A

Clozapine

122
Q

What is the role of calcium gluconate? [1]

A

Stabilises the myocardium to protect against hyperkalaemia

does NOT lower potassium levels

123
Q

During somatic gene alterations in Wilm’s tumour

  • Epigenetic changes at which locus? [2]
A
  • Epigenetic changes at IGF2/H19 locus
124
Q

Which oncogenes are involved with neuroblastoma? [3]

A

MYCN amplification, ALK & PHOX2B

125
Q

What are the distinctive cell abnormalites that often occur in Pro-B cells and Pre-B cells? [2]

A

There are distinctive cell abnormalities:
Pro-B (CD19+, CD10-) always have translocation of MLL gene translocated

Pre-B always have translocation of chromosomes 12 & 22

126
Q

What is the prognosis for patients with:

Pro-B ALL? [1]
Pre-B ALL [1]

A

Pro-B ALL / MLL translocation: unfavourable for children
Pre-B ALL: ETV6-RUNX1 translocation: more favourable

127
Q

Which hormone decreasing creates atretic follicles? [1]

A

Triggered by decrease if FSH

128
Q

Which cell type is the arrow pointing to? [1]

A

Reticulocyte

129
Q

A patient with moderate - severe pneumonia should be prescribed with antibiotics for how
5 days
10 days
12 days
14 days

A

A patient with moderate - severe pneumonia should be prescribed with antibiotics for how
5 days
10 days: 7-10 days
12 days
14 days

130
Q

What is the minimum number of days a patient with pneumonia should receive antibiotics for?
5 days
10 days
12 days
14 days

A

What is the minimum number of days a patient with pneumonia should receive antibiotics for?
5 days
10 days
12 days
14 days

131
Q

An absent a wave on a JVP waveform would indicate
Pulmonary hypertension
Complete heart block / ventricular arrhythmias
Tricuspid regurgitation
Atrial fibrillation

A

An absent a wave on a JVP waveform would indicate
Pulmonary hypertension
Complete heart block / ventricular arrhythmias
Tricuspid regurgitation
Atrial fibrillation

132
Q

Ejection fraction is defined as the % of blood to leave the:

Right ventricle
Left ventricle
Right & left ventricle
Right and left ventricles and atria

A

Left ventricle

133
Q

Which co-morbidity is most strongly associated with chronic pain?

Depression

Lack of energy

Difficulty sleeping

Anxiety

Concentration difficulties

A

Difficulty sleeping

134
Q

Describe diagnosis of pre-eclampsia [2]

A

Gestational hypertension is BP = 140/90 mmHg on two occasions, arising after 20 weeks of pregnancy. Resolves 6 weeks after having the baby.

Pre-eclampsia = Gestational hypertension + proteinuria. 300mg of protein in the urine in a 24 hour collection.

135
Q

What is the name of the fatty acid transporter on a muscle cell? [1]

A

CD36

136
Q

How do you close [1] and open [1] a PDA

A

Close: NSAIDs

Open: Prostaglandin E1

137
Q

Which of the following is group A strep?

Streptococcus bovis
Streptococcus agalactiae
Staphylococcus aureus
Streptococcus pyogenes
Streptococcus viridans

A

Streptococcus pyogenes

138
Q

What are potential secondary bacterial infections of VZV? [1]
Name a consequence of this secondary bacterial infection [1]

A

Strep. infection (specifically Strep A)
Causes Necrotizing fasciitis

139
Q

Which two markers are rasied in non-seminoma cancers? [2]

A

AFP (alpha-fetoprotein) and/or beta-hCG are elevated in 80-85%

140
Q

At what stage of James Tanner puberty is irreversible to treatment for precocious puberty? [1]

Stage 1
Stage 2
Stage 3
Stage 4
Stage 5

A

Stage 3

141
Q

Age related changes in the immune system:

Which cell type sees an incresed CD16+ pro-inflammatory population?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

A

Age related changes in the immune system:

Which cell type sees an incresed CD16+ pro-inflammatory population?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

142
Q

Ageing affect on immune system.

Which of the following cell types makes less IL12 due to older age?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

A

Ageing affect on immune system.

Which of the following cell types makes less IL12 due to older age?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

143
Q

Ageing affect on immune system.

Which of the following cell types makes same level of IFN-ϒ?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

A

Ageing affect on immune system.

Which of the following cell types makes same level of IFN-ϒ?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

144
Q

Ageing affect on immune system.

Which of the following cell types increases in number with old age?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

A

Ageing affect on immune system.

Which of the following cell types increases in number with old age?

Neutrophils
Dendritic cells
Macrophages
Lymphocytes
Natural killer cells

145
Q

Describe the physiopathology of Leri-Weill dyschonrosteosis (LWD):

  • Inheritance pattern? [1]
  • Mutation to which gene? [1]
  • How do LWD individuals present? [4]
A

Leri-Weill dyschonrosteosis (LWD):

Autosomal dominant skeletal dysplasia

Short stature homebox gene (SHOX) - found on pseudoautosomal region of X & Y genes

Presentation:
- mesomelic (mid parts) limb shortening
- Bowing of radius
- dorsal dislocation of ulna
- Premature epiphyseal fusion

146
Q

What endocrine disorders might you think about for proprionate short stature? [2]

A

Hypothyroidism
Hypercortisolism

147
Q

Explain the link between methylation of DMD region and IGF-2 in mother and father

A

Mother:
* demethylated DMD region drives coding of H19 region

Father:
* DMD methylated (inactivated)
* Prevents coding of H19
* Causes IGF-2 to be created - drives growth of child in adolesence and middle age

148
Q

Expand how each of the following present in ADHD children

Hyperactivity [2]
Inattention [3]
Impulsivity [2]

Where do symptoms need to occur for a diagnosis of ADHD? [1]

A

Symptoms need to be present in two locations (e.g. school and home)

Hyperactivity
* Restless and fidgety
* Unable to wait

Impulsivity
* Acts without thinking
* Answers before questions finished

Inattention
* Jumps from task to task
* Careless mistakes
* Doesnt listen properly

149
Q

What are the pharmacological treatments for ADHD? [2]

A

Methlyphenidate (aka ritalin)
Lisdexamfetamine

150
Q

Describe the indirect pathway of the dorsal ganglia

A

Excitation of dorsal striatum causes the release of dorsal striatum GABA (inhibitory)

This causes projects onto globus pallidus external segment: causes increased inhibition of GPe

This causes the globus pallidus external segment to release inhibitory GABA onto the subthalamic nucleus: causes reduced inhibition of STN

This causes the subthalamic nucleus to release inhibitory GABA onto the globus pallidus internal segment: which increases the activation of GPi

This causes the globus pallidus internal segment to release inhibitory GABA onto the motor thalamus: which creates increased inhibition of motor thalamus

OVERALL DEACTIVATION OF MOTOR THALAMUS -> decreased motor cortex activation.
NO GO pathway.

151
Q

Describe the effect of the activation of the D2 dopaminergic receptors

A

The D2 dopaminergic receptor activated:

  • decreases cAMP
  • Decreaes the sensitivity of striatal GABA neurons to glutamate (makes the glutatemate LESS EXCITABLE)
  • Causes increased inhibition of the sub-thalamic nucleus
  • This means get increaed inhibition of the GPi
  • This causes less inhibition of the VL / VA

End result: INCREASED MOTOR ACTIVITY

152
Q

Explain pathophysiology of Parkinsons disease [2]

A

-Loss of dopaminergic neurons in the substantia nigra, which project to and innervate the dorsal striatum.
- Less D1 and D2 activation
- The indirect pathway is therefore faciliated and becomes dominant

153
Q

What is the name for this symptom?

Lesions to which region causes this symptom?

Subthalamic nuclei
Substantia nigra
Pre supplementary motor area
Lentiform nucleus
Dorsal striatum

A

athetosis

Lesions to which region causes this symptom?

Subthalamic nuclei
Substantia nigra
Pre supplementary motor area
Lentiform nucleus
Dorsal striatum

154
Q

Which drug used to treat Huntingdons Disease works by the mechanism of action depicted by A? [1]

A

Tetrabenazine

acts primarily as a reversible high-affinity inhibitor of mono-amine uptake into granular vesicles of presynaptic neurons by binding selectively to VMAT-2

155
Q

Which treatment used in PD is good at managing tremors

Haloperidol
Ritotigone
L-DOPA
Orphenadrine

A

Which treatment used in PD is good at managing tremors

Haloperidol
Ritotigone
L-DOPA
Orphenadrine: anticholinergic

156
Q

Pharmacological management of Parkinson’s disease

Name two drugs that can combined with L-DOPA (aka levodopa) that means it doesn’t get metabolised to dopamine outside the BBB [2]

What is their MOA? [1]

A

L-DOPA (levodopa) & carbidopa or benserazide

carbidopa, benserazide are decaboxylase inhibitors: allows L-DOPA to pass BBB where it can then be converted to dopamine

157
Q

Pharmacological management of Parkinson’s disease

Name three drugs that are monoamine oxidase inhibitors [3]

Describe their MoA [1]

A
  • rasagiline
  • selegiline (in PBL)
  • safinamide

MAO-B inhibitors stop Monoamine oxidase type B breaking down dopamine into DOPAC or homovanillic acid

158
Q

Extrapyramidal tracts:

Desribe the function and path of medial vestibulospinal tract

A

Function: Performs the synchronization of the movement of the eyes with the movement of the head so that eyes do not lag behind when the head moves to one side

Pathway: Descends bilaterally in the medial longitudinal fasciculus. Synapses with the excitatory and inhibitory neurons of the cervical spine

159
Q

Describe the function and path of the rubrospinal tract [2]

A

Function: Controls muscle tone in flexor muscle groups; Inhibits extensor tone

Path:
- Arises from the red nucleus in the brainstem
- crosses at medulla
- terminates primarily in the cervical and thoracic portions of the spinal cord

160
Q

Which of the following controls flexor muscle tone

rubrospinal tract
reticulospinal tract
lateral vestibulospinal tract
medial vestibulospinal tract

A

Which of the following controls flexor muscle tone

rubrospinal tract
reticulospinal tract
lateral vestibulospinal tract
medial vestibulospinal tract

161
Q

Which of the following synapses on the extensor antigravity motor neurons

rubrospinal tract
reticulospinal tract
lateral vestibulospinal tract
medial vestibulospinal tract

A

Which of the following synapses on the extensor antigravity motor neurons

rubrospinal tract
reticulospinal tract
lateral vestibulospinal tract
medial vestibulospinal tract

162
Q

Alert waking is marked by what type of EEG? [3]

A

Desynchronised

Low amplitude

High frequency

163
Q

In what phase of a tonic-clonic seizure would you observe cyanosis? [1]

A

In the tonic phase, muscles stiffen.

Stiffening of the chest walls may can impair breathing –> decreasing oxygen intake and causing cyanosis.

164
Q

Methotrexate derived from folic acid acts on which section of the cell cycle? [1]

A

S phase

165
Q

Rheumatoid arthritis is an example of a type [] hypersensitivity reaction.

A

Rheumatoid arthritis is an example of a type 3 hypersensitivity reaction.

166
Q

Which one of the following cells secretes the majority of tumour necrosis factor in humans?

Neutrophils

Macrophages

Natural killer cells

Killer-T cells

Helper-T cells

A

Macrophages

167
Q

s part of your full cerebellar and neurological examination for Parkinson’s disease you test for coordination of the lower limbs by asking him to place his right foot on his left knee and then slide the foot down his leg.

What is the most important muscle involved in this action?

Gastrocnemius
Psoas major
Tibialis anterior
Soleus
Sartorius

A

Sartorius

168
Q

Huntington’s disease is an autosomal dominant disease, associated with changes in the Huntingtin gene.

Which amino acid is abnormally repeated as a result of the mutations in the gene?

Alanine

Cysteine

Glutamine

Histidine

Methionine

A

Glutamine

169
Q

What is the MoA of Propofol?

A

Propofol is a GABA receptor agonist

170
Q

Describe the effect of D1 neurones on direct pathway [2]
Describe the effect of D2 neurones on indirect pathway [2]

A

D1 activates the direct pathway: causes more movement (as usually is GO)
D2 inhibits the indirect pathway: causes more movement (as indirect usually causes NO GO)

171
Q

What is the frequency of tremor of PD? [1]

A

Tremor
* most marked at rest, 3-5 Hz

172
Q

At what stage of levodopa dose are dyskinesias most likely to be seen? [1]
Name three types [3]

A

◦ dyskinesias at peak dose: dystonia, chorea and athetosis (involuntary writhing movements)

173
Q

more likely than levodopa to cause hallucinations in older patients. Nasal congestion and postural
hypotension are also seen in some patients

This applies to which drug class? [1]

A

Dopamine agonists

174
Q

Which of the following blood markers provides the earliest indication of rheumatoid arthritis?

Anti-Ca-Fib

Anti-Ca-FCS

Anti-CCP

CRP

IgM-RF

A

Anti-CCP

175
Q

Which of the Parkinson’s disease drugs below, should an individual presenting with ‘mild/moderate motor disability and no cognitive impairment’ be started on?

Amantadine

Benserazide

Rotigotine

Selegiline

Tolcapone

A

Rotigotine

176
Q

What type of rhythm would you expect to see in the EEG of an individual in REM sleep? [1]

A

Beta

177
Q

Which protein does dystrophin attach to in the intracellular cytoskeleton of the cell? [1]

A

Actin

178
Q

Which spinal tract is responsible for mediating reflex coordination of the head and neck muscles with the extraocular eye muscles so that objects can be maintained in view despite movement of the body?

Reticulospinal tract

Rubrospinal tract

Tectospinal tract

Lateral vestibulospinal tract

Medial vestibulospinal tract

A

Medial vestibulospinal tract

179
Q

What effect do benzodiazepines have on the receptors in which they bind to?

  • Increase the frequency of channel opening so that chloride ions enter & hyperpolarise the membrane
  • Increase the frequency of channel opening so that potassium ions enter & hyperpolarise the membrane
  • Increase the frequency of channel opening so that sodium ions enter & hyperpolarise the membrane
  • Increase the duration of channel opening so that chloride ions enter & hyperpolarise the membrane
  • Increase the duration of channel opening so that potassium ions enter & hyperpolarise the membrane
A
  • Increase the frequency of channel opening so that chloride ions enter & hyperpolarise the membrane
180
Q

What effect do benzodiazepines have on the receptors in which they bind to?

  • Increase the frequency of channel opening so that chloride ions enter & hyperpolarise the membrane
  • Increase the frequency of channel opening so that potassium ions enter & hyperpolarise the membrane
  • Increase the frequency of channel opening so that sodium ions enter & hyperpolarise the membrane
  • Increase the duration of channel opening so that chloride ions enter & hyperpolarise the membrane
  • Increase the duration of channel opening so that potassium ions enter & hyperpolarise the membrane
A
  • Increase the frequency of channel opening so that chloride ions enter & hyperpolarise the membrane
181
Q

Which areas of the brain become hyperactive? [4]

Which areas of the brain become hypoactive [2]

A

Hyperactive:
* amygdala
* hippocampus
* subgenual cingulate cortex
* medial prefrontal cortex

Hypoactive:
* Dorsolateral prefrontal cortex
* ventrolateral prefrontal cortex

182
Q

Which area of the brain the has the biggest increase in DMD during depresision? [1]

A

increased connectivity between DMN and fronto-parietal networks: especially left subgenual cingulate area

183
Q

What are the different parameters for the Post Trauma amnesia scoring used to assess TBI? [3]

A

PTA:
Mild: less than 24hrs
Mild: 1-7 days
Severe: >7days

184
Q

Where in the brain does locked-in syndrome occur because of injury to? [1]

Which tracts are effected if this area is damaged? [2]

A

A
ventral pons

causing interruption to corticospinal and corticobulbar tracts

185
Q

primary erythromyalgia is exclusively caused by mutations in the gene [], the encoding the channel []

A

PE is exclusively caused by mutations in SCN9A, the encoding gene of sodium channel subtype Nav1.7

186
Q

An uncul herniation commonly compresses which cranial nerve? [1]

A

CN3

187
Q

Optic radiation

The paired optic tracts sweep posteriorly and send most axons to synapse in the [], in the [] nucleus.

A

The paired optic tracts sweep posteriorly and send most axons to synapse in the thalamus, in the lateral geniculate nucleus of the thalamus.

188
Q

What is the role of the insula? [1]

A

Emotional aspect of risk taking

189
Q

State the movement the following muslces do:

Superior rectus: [3]

Inferior rectus: [3]

A

Superior rectus: elevation, adduction and intorsion

Inferior rectus: depression, adduction and extorsion

190
Q

Which of the following commonly causes damage to axons in the underlying brain

Epidural
Sub dural
Sub arachnoid
Intracranial

A

Sub dural

Blood from the ruptured vessels spreads freely through the subdural space and can envelop the entire hemisphere. Because of the forces involved in producing a subdural haemorrhage, there is very often damage to axons in the underlying brain as well

191
Q

which foramen is this?

Foramen ovale
Foramen spinosum
Internal acoustic meatus
Foramen lacerum
Foreman rotundum

A

Foramen lacerum

192
Q

Label A-D

A

A: foramen rotundum
B & D: foramen spinosum
C: foramen ovale

193
Q

Where is the danger triangle of the face? [1]

Explain why this region is called the danger triangle [2]

A

The angular and ethmoidal veins drain this region of the face into the opthalmic veins which drain into the cavernous sinus.

This provides a potential route of infection from the nasal area to the brain, causing cavernous sinus thrombosis, meningitis or brain abscess.

194
Q

Which amino acids can undergo this hyperphosphorlation post translational modification of tau? [3]

A

Tyrosine, serine and threonine.

195
Q

What type of imaging would need to be conducted to ID a brainstem injury after TBI? [1]

A

MRI

196
Q

Which spinal cord controls general arousal of the spinal cord? [1]

A

Reticulospinal tract

197
Q

The primitive heart tube fusion happens on which day? [1]

A

21

198
Q

Describe the effects of cocaine [1] and morphine [1] on:

spine density and dendrite branching in the medial prefrontal cortex (mPFC) and the nucleus accumbens (NAc)

A

Cocaine: increases
Morphine: decreases

199
Q

Phenelzine, tranylcypromine belong to which drug class? [1]

A

Irreversible MONOAMINE OXIDASE INHIBITORS

200
Q

Name two 5HT-1A agonists and one B-adrenoreceptor antagonists used as anxiolytics [3]

A

A
5-HT1A agonists: buspirone ipsapirone

β-adrenoceptor antagonists: propranolol

201
Q

which area of the brain would you use DBS to treat treatment resistant depression?

A

subcallosal cingulate

202
Q

Name two SNRIs and two SSRIs used as anxiolytics [4]

A

SSRIs
* fluoxetine, escitalopram, paroxetine
* can be used to treat panic and social phobias

SNRIs:
* venlafaxine, duloxetine

203
Q

Important AEs of TCAs? [4]

A

Dangerous (cardiotoxic) in overdose

Anti-cholinergic: dry mouth; blurred vision, constipation, urinary retention, aggravation of narrow angle glaucoma, fatigue, postural hypotension, dizziness, loss of libido, arrhythmias

Antihistaminic: sedation, weight gain.

Block alpha 1 adrenoreceptors: orthostatic hypotension - blood pressure drops on standing, cardiac effects

As a result aren’t the first choice!

204
Q

Which drug class reduce renin secretion? [1]

A

Beta blockers

205
Q

substancia nigra pars compacta have mainly [] neurons

substancia nigra pars reticulata has mainly [] neurons

A

substancia nigra pars compacta have mainly dopaminergic neurons

substancia nigra pars reticulata has mainly GABAnergic neurons

206
Q

Q
Give an example that is a chimeric monoclonal antibody used for treating B-Lymphomas [1]

What is the target? [2]

A

Rituximab: targets CD20 on malignant B-cells and CD3 on normal T cells

Together enhance cytotoxicity

207
Q

Which of the following binds to CD19 in its mechansim of action to treat cancer?

Tisagenlecleucel (Kymriah)
Atezolizumab
Rituximab
Ipililumbab
Nivolumab

A

Tisagenlecleucel (Kymriah)

208
Q

Which virus is most commonly linked to a higher risk of developing Burkitt’s lymphoma ?

Epstein- Barr virus

Cytomegalovirus

Herpes simplex virus

HPV 16

HPV 18

A

Epstein- Barr virus

209
Q

Name two drugs that inhibit CTLA-4

A

Ipilimubab
Tremelimubab

210
Q

Which of the following is targeted by Atezolizumab

PD-1
CTLA-4
PD1-Ligand
LAG-3
PD2-Ligand

A

PD1-Ligand

211
Q

What may a prolonged expiratory phase indicate in a patient? [1]

A

Asthma

212
Q

What is MART / SMART therapies? [1]

A

is a form of combined ICS and LABA treatment in which a single inhaler, containing both ICS and a fast-acting LABA, is used for both daily maintenance therapy and the relief of symptoms as required.

213
Q

What would ascultation of lungs of a pnwumonia patient sound like? [1]

A

Focal coarse crackles These are air passing through sputum in the airways similar to using a straw to blow in to a drink.

214
Q

Name a second generation tyrosine kinase inhibitor for EGFR in NSCLC [1]

A

Osimertinib

215
Q

Where would LINAC based treatments: MV photons (mega voltage) [1]

What is dosing regimen like? [1]

A

More penetrative treatment and dose at depth

High dose radical treatments are fractionated (broken up into smaller daily treatments) to deliver treatment safely and avoid damage to adjacent normal tissues/organs

216
Q

Name a cancer that neo-adjuvant chemotherapy is common for [1]

A

Ovarian

217
Q

Name a common AE of alkylating agent [1]

A

hemorrhagic cystitis: condition in which the lining of the bladder becomes inflamed and starts to bleed.

218
Q

A patient with complex mental health problems who is on a variety of medications comes into the clinic complaining of weight gain. Which of the following medications is likely to be responsible for this side effect?

Olanzapine

Sodium Valproate

Tramadol

Diazepam

Citalopram

A

Olanzapine

219
Q

What is second line treatment of HER2-positive breast cancer? [2]

A

Trastuzumab - emtansine (Kadcycla)

220
Q

Describe MoA of platinum agents [1]

A

Primary mode of cell death is damage to cellular DNA by the development of covalent adducts

221
Q

Q
Which chemotherapy drug would cause Peri-Orbital Oedema?

Capecitabine
Bleomycin
Doxorubicin
Imatinib

A

Imatinib

222
Q

Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia?

Capecitabine
Bleomycin
Doxorubicin
Imatinib

A

Which chemotherapy drug would cause Palmar-Planter Erythrodysesthesia?

Capecitabine
Bleomycin
Doxorubicin
Imatinib

223
Q

Most common form of radiotherapy are the [], which are used to treat deeper cancers.

A

Most common form of radiotherapy are the MV photons, which are used to treat deeper cancers.

224
Q

What is the inheritance pattern of Duchenne muscular dystrophy?

Autosomal dominant

Autosomal recessive

X-linked dominant

X-linked recessive

Y-linked

A

X-linked dominant

225
Q

What is the approximate duration of 1 sleep cycle?

Alternatives
You selected D when answering this question
The contributor suggests C is the correct option

20-30 minutes

50-70 minutes

80-100 minutes

120-140 minutes

170-190 minutes

A

80-100 minutes: average is 90mins

226
Q

What class of drug is venlafaxine?

SSRI

SNRI

TCA

MAO inhibitor

NARI

A

SNRI

227
Q

Which brain region is the DBS electrode implanted into in a patient with epilepsy? [1]

A

Anterior nucleus of thalamus

228
Q

What BPM would indicate a foetus had tachycardia? [1]

A

> 160 bpm

229
Q

What direction do the stereocilia of the vestibular apparatus bend in to trigger depolarisation? Which ion channel opens?

Towards the kinocilium
Na+ ion channel

Away from the kinocilium
Na+ ion channel

Towards the kinocilium
K+ ion channel

Away from the kinocilium
K+ ion channel

Away from the kinocilium
Ca2+ ion channel

A

Away from the kinocilium
K+ ion channel

230
Q

When ivestigating AD; what sample would you take, what results would you of

A

CSF sample taken

Low levels of amyloid beta

Elevated levels of p-tau

231
Q

Hyperacute transplant rejection is an example of a type [] hypersensitivity reaction

A

Hyperacute transplant rejection is an example of a type II hypersensitivity reaction

232
Q

Which gene below, when mutated, folic acid cannot convert to folate, causing infertility? [1]

A

MTHFR

233
Q

What is the normal Q angle? [1]

A

15-20 degrees

234
Q

A 59-year-old man is prescribed the most highly negatively inotropic drug for hypertension. His GP advises to not take beta-blockers with it as it may cause heart block. He does not have a history of diabetes.

What drug was most likely prescribed? [1]

A

Verapamil

Verapamil is the most highly negatively inotropic calcium channel blocker

235
Q

On which day of the menstrual cycle is progesterone measured? [1]

A

Day 21

236
Q

Which spinocerebellar tract [anterior / posterior] decussates twice? [1]

A

Anterior

237
Q

What is the inheritance pattern for erythromelalgia? Which gene and ion channel are affected?

A

Autosomal dominant

SCN9A

Nav1.7

238
Q

A 46-year-old man presents to his GP due to haemoptysis. He notes that he wakes up due to severe sweating, and he has lost considerable weight in the last few weeks. He returned from a holiday in Pakistan just over a month ago. PCR on a sputum confirms the suspected diagnosis of tuberculosis. He is started on 4 different antibiotics and is prescribed pyridoxine, as one of these antibiotics causes vitamin B6 deficiency.

Which antibiotic is responsible for this side effect?

Pyrazinamide

Rifampicin

Isoniazid

Ethambutol

Amikacin

A

He is started on 4 different antibiotics and is prescribed pyridoxine, as one of these antibiotics causes vitamin B6 deficiency.

Which antibiotic is responsible for this side effect?

Isoniazid

239
Q

What is the threshold for a bronchodilator reversibility test that would facilitate an asthma diagnosis in adults? [1]

A

> 12 %

240
Q

Which of the following biological disease modifying anti-rheumatic drugs (bDMARD) works by blocking the action of CD80? [1]

A

Abatacept

241
Q

Which option below best describe how Lamotrigine works?

Calcium channel blocker

GABAA receptor postive allosteric modulator

Neurotransmitter release inhibitor

Neurotransmitter uptake inhibitor

Sodium channel blocker

A

Which option below best describe how Lamotrigine works?

Sodium channel blocker

242
Q

Hypersecretion of which hormone is associated with increased incidence of spontaneous abortion? [1]

A

LH

243
Q

EPO controls erythropoiesis through which methods? [2]

A

EPO controls erythropoiesis through the following methods:

increases the speed of maturation of erythroblasts
increases proerythroblast formation

244
Q

EPO controls erythropoiesis through which methods? [2]

A

EPO controls erythropoiesis through the following methods:

increases the speed of maturation of erythroblasts
increases proerythroblast formation

245
Q

What percentage of cancer patients now survive at least 10 years? [1]

A

50%

246
Q

Which congenital defect is most associated with the condition foetal alcohol syndrome? [1]

Which congenital defect is most associated with the congenital rubella [1]

A

VSD - FAS
PDA - Associated with congenital rubella

247
Q

Which type of brain herniation causes ipsilateral mydriasis (pupil dilation)? [1]

A

Uncal

248
Q

Calcium is important in long-term potentiation (LTP).

As a result of calcium’s entry into the cell, which receptors move into the synaptic membrane thereby leading to the strengthening of the synapse? [1]

A

AMPA

249
Q

Which structures make up the lentiform nucleus? [2]

A

Globus Pallidus

Putamen

250
Q

Which autoantibodies are associated with more severe, erosive rheumatoid arthritis?

Anti-CCP

Anti-CarP

Anti-MPO

Anti-PAD4

IgM-RF

A

Anti-PAD4

251
Q

Label A-C

A

A: optic tract
B: lateral geniculate nucleus
C: optic radiations

252
Q

What process in gout pathophysiology causes MSU crystals to precipitate even more? [1]

A

Nuetrophils piereced;

253
Q

prescription of colchine would indicate that someone is suffering from what pathology? [1]

A

acute gout

254
Q

which drug for chronic gout catalyses the conversion of uric acid to allantoin? [1]

A

Rasburicase

255
Q

Describe the inheritence pattern of Duchenne & Becke Muscular Dystrophies?

A

Duchenne & Becke Muscular Dystrophies;

X-linked - recessive

256
Q
A

The left marginal artery is a branch of the left circumflex artery and supplies the left ventricle.

257
Q

Increased expiration time

Increased tactile fremitus

Wheezing on auscultation

Hyper-expanded chest

Increased respiratory rate

A

Increased tactile fremitus

Tactile/vocal fremitus acts as an indirect measure of the amount of air and the density of tissue present within the lungs. In emphysema, due to the trapping of air and decreased density of the lung parenchyma, tactile fremitus is reduced.

258
Q
A

C + D

The Functional Residual Capacity (FRC) is the volume of air left in the lungs following passive expiration. It is calculated by adding the Expiratory Reserve Volume (ERV) to the Residual Volume (RV).

259
Q

What is this pathology? [1]

A

Slipped upper femoral epiphysis

260
Q

Explain mechanism of action of Dabigatran [1]

A

Direct thrombin inhibitor

261
Q

An elderly male enters the general practice for his regular monitoring of his INR. His warfarin was prescribed five years ago after being diagnosed with atrial fibrillation.

What enzyme does the drug inhibit?

Protein C1

Epoxide reductase

Gamma-glutamyl carboxylas

CYP2C9

Thrombin

A

An elderly male enters the general practice for his regular monitoring of his INR. His warfarin was prescribed five years ago after being diagnosed with atrial fibrillation.

What enzyme does the drug inhibit?

Epoxide reductase

262
Q

Describe the effect of ACE-inhibitor on afferent and effernet arterioles of the glomerulus [2]

A

Vasodilation of the efferent arteriole
No effect on other

262
Q

Where is EPO made?[1]

A

Kidney

263
Q

What does Q wave represent? [1]

A

Depolarisation of interventricular septum

264
Q

What is the most common type of supraventricular tachycardia? [1]

A

AVNRT

265
Q

How long does the normal delay in conduction at the atrioventricular node last?

A 120 ms
B 100 ms
C 90-200 ms
D 120-200 ms
E > 200 ms

A

How long does the normal delay in conduction at the atrioventricular node last?

D 120-200 ms

266
Q

How can you tell from an ECG lead that the heart has normal axis deviation? [2]

A

If the QRS complex is upright (positive) in both lead I and lead aVF, then the axis is normal

267
Q

How can you tell if heart has nromal deviation from an ECG? [1]

A

If the QRS complex is upright (positive) in both lead I and lead aVF, then the axis is normal

268
Q

What effect would salbutamol have on an ECG? [1]

A

sinus tachycardia

269
Q

Name a cause of third degree heart block [1]

A

Lyme disease

270
Q

Where would you put the 10 leads for an 12-lead ECG trace? [10]

A

Red: right arm

Yellow: left arm

Green: left leg

Black: right leg

V1: sternal edge, right 4th intercostal space

V2: sternal edge, left 4th intercostal space

V3: between V2 and V4

V4: midclavicular line, left 5th intercostal space

V5: between V4 and V6, left 5th intercostal space

V6: mid-axillary line, left 5th intercostal space

271
Q

P wave should be not more than about 2 small squares long ([] s or [] ms)

A

A

P wave should be not more than about 2 small squares long (0.08 s or 80 ms)

Yr 2 EOYS ^2 (42 decks)

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