Quick Facts 4 Flashcards
Which is the predominant ketone body in Diabetic Ketoacidosis (DKA)?
A Acetone
B Acetoacetate
C Beta-hydroxybutyrate
D Vaccenic acid
E Palmitoleic acid
Which is the predominant ketone body in Diabetic Ketoacidosis (DKA)?
A Acetone
B Acetoacetate
C Beta-hydroxybutyrate
D Vaccenic acid
E Palmitoleic acid
Which of the following is not considered a complication of diabetic ketoacidosis?
A Cerebral oedema
B Hyponatraemia
C Hypokalaemia
D Hypoglycaemia
E Adult-respiratory distress syndrome
Which of the following is not considered a complication of diabetic ketoacidosis?
A Cerebral oedema
B Hyponatraemia
C Hypokalaemia
D Hypoglycaemia
E Adult-respiratory distress syndrome
Which of the following is the most common cause for precipitation of Diabetic ketoacidosis (DKA)?
A Infection
B Non-compliance
C Inappropriate dose alteration
D New diagnosis of diabetes
E Myocardial infarction
Which of the following is the most common cause for precipitation of Diabetic ketoacidosis (DKA)?
A Infection
B Non-compliance
C Inappropriate dose alteration
D New diagnosis of diabetes
E Myocardial infarction
A 91-year-old female, with known congestive cardiac failure, is seen by the GP with increasing shortness of breath. She is now getting breathless while at rest and requiring an increasing amount of support at home.
What is this patient’s New York Heart Association (NYHA) functional classification stage?
A 0
B I
C II
D III
E IV
A 91-year-old female, with known congestive cardiac failure, is seen by the GP with increasing shortness of breath. She is now getting breathless while at rest and requiring an increasing amount of support at home.
What is this patient’s New York Heart Association (NYHA) functional classification stage?
E IV
I - Cardiac disease, but no symptoms and no limitations in ordinary physical activity
II - Mild symptoms on ordinary activity
III - Marked limitation on minimal activity, but comfortable at rest
IV - Severe limitations experienced at rest
State the different NYHA functional classifications [4]
I - Cardiac disease, but no symptoms and no limitations in ordinary physical activity
II - Mild symptoms on ordinary activity
III - Marked limitation on minimal activity, but comfortable at rest
IV - Severe limitations experienced at rest
Statins block HMG Co-A reductase. Which pathway does this cause to be inhibited? [1]
mevalonate pathway
Q
Whilst in general practice, you review Susan a 48-year-old patient with hypertension. Despite taking ramipril, her blood pressure remains clinically elevated. Based on current guidelines you consider add-on therapy with a thiazide-like diuretic.
Which of the following electrolyte disturbances may occur with this new treatment?
Hypercalciuria
Hyperkalaemia
Hypermagnesemia
Hypokalaemia
Hypolipidaemia
Q
Whilst in general practice, you review Susan a 48-year-old patient with hypertension. Despite taking ramipril, her blood pressure remains clinically elevated. Based on current guidelines you consider add-on therapy with a thiazide-like diuretic.
Which of the following electrolyte disturbances may occur with this new treatment?
Hypercalciuria
Hyperkalaemia
Hypermagnesemia
Hypokalaemia
Hypolipidaemia
Name a drug that reduces conductivity within the atrioventricular (AV) node and is a positive inotrope [1]
Digoxin
Which drugs would you use to manage IPF ? [2]
pirfenidone, nintedanib
Q
Name a common AE of digoxin
A
Gynaecomastia
Which of the following treatments for TB blocks causes mycoloic acid synthesis [2]
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Which of the following treatments for TB blocks causes mycoloic acid synthesis [2]
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Describe the MoA of desmopressin for the treatment of haemophilia [2]
Desmopresssin / DDAVP (S/C) -** causes the release of von Willebrand’s antigen from the platelets** and the cells that line the blood vessels where it is stored
. Von Willebrand’s antigen is the protein that carries factor VIII.
Describe the MoA of Ivabradin [1]
A
Ivabradine: lowers heart rate through inhibition of cardiac ‘funny channels’
Q
Which of the following can cause severe hypotension as an AE?
Amlodipine
Nicorandil
Diatelzem
Lisinopril
Verapamil
Q
Which of the following can cause severe hypotension as an AE?
Amlodipine
Nicorandil
Diatelzem
Lisinopril
Verapamil
Which of the following inhibits L type calcium channel [2]
Amlodipine
Nicorandil
Diatelzem
Lisinopril
Verapamil
Which of the following inhibits L type calcium channel [2]
Amlodipine
Verapamil
Explain mechanism of how heparin works to treat PE
Heparin binds to antithrombin and activates it; activated complex then inactivates factor Xa, preventing conversion of prothrombin to thrombin (thrombin converts fibrinogen into fibrin - integral step in clot formation)
Q
Which of the following is not considered a mechanism of GLP-1
A Inhibition of gastrointestinal motility
B Inhibition of gastrointestinal secretion
C Enhances the secretion of insulin
D Increases gastric emptying
E Promotes fullness and satiety
D Increases gastric emptying
Describe the MoA of Nicorandil [1]
Nicorandil: potassium channel agonist, which inhibits voltage-gated calcium channels leading to muscle relaxation
Describe the MoA of clonidine [1]
Stimulate presynaptic α2-adrenergic receptors in the CNS → dilates peripheral blood vessels → lowers peripheral resistance → reduces blood pressure
Describe the difference between DOACs MoA
E.g. Dabigatran direct thrombin inhibitor;
Rivaroxaban & Apixaban: Orally active factor Xa inhibitors – stop enzyme activating thrombin - prothrombin
What are the drug classes for Vaughan-Williams classification groups for antiarrhtmatic drugs? [4]
Class I - block sodium channels
Class II - beta-blockers
Class III - block potassium channels
Class IV - block calcium channels
Which of the following calcium channel blockers are selective for voltage gated calcium channels in blood vessels to cause vasodilation and decrease TPR.
Dobutamine
Verapamil
Diltiazem
Amlodipine
Nifedipine
Which of the following calcium channel blockers are selective for voltage gated calcium channels in blood vessels to cause vasodilation and decrease TPR.
Dobutamine
Verapamil
Diltiazem
Amlodipine
Nifedipine
Explain effect of ACE-Inhibitor like Ramipril on K levels [1]
Hyperkalaemia (Less Angiotensin II, NO aldosterone, less K secreted, less Na reabsorbed)
Which electrolyte abnormality would you expect with the use of high doses of salbutamol?
A Hypernatraemia
B Hypokalaemia
C Hyperkalaemia
D Hyponatraemia
E Hyperphosphataemia
Which electrolyte abnormality would you expect with the use of high doses of salbutamol?
A Hypernatraemia
B Hypokalaemia
C Hyperkalaemia
D Hyponatraemia
E Hyperphosphataemia
Which of the following disrupts the membrane potential in TB causing death?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Which of the following disrupts the membrane potential in TB causing death?
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
What pharmacological treatment consider for sarcoidosis?
A
Treat with corticosteroids (but has negative impact on immune system).
Remember than patients may have spontaneous resolution so have to weigh up options !!
What is the mechanism of action of atropine?
A Non-selective beta-adrenoreceptor agonist
B Beta-adrenergic receptor antagonist
C Reversible muscarinic acetylcholine receptor antagonist
D Calcium channel receptor antagonist
E Relaxation of smooth muscle
C Reversible muscarinic acetylcholine receptor antagonist
Atropine transiently blocks the action of the vagus nerve (i.e. parasympathetic nervous system) leading to increased SAN electrical activity and increased conduction through the AVN. This results in an increase in heart rate.
Name a longer acting alternative to GTN [1]
Isosorbide mono/dinitrate
Which of the following side-effects is commonly associated with metformin?
A Headache
B Gastrointestinal upset
C Reduced vision
D Hearing loss
E Nail changes
Which of the following side-effects is commonly associated with metformin?
A Headache
B Gastrointestinal upset
C Reduced vision
D Hearing loss
E Nail changes
Describe the MoA of: [2]
Streptokinase
Alteplase (tPA)
A
Streptokinase: Clot buster; Activates fibrinolytic pathway
Alteplase (tPA): Increase clot; breakdown by increasing Plasmin formation
Q
Which of the following reduce heart rates by prolonging refractory period of AVN?
Amlodipine
Nicorandil
Diatelzem
Lisinopril
Verapamil
Q
Which of the following reduce heart rates by prolonging refractory period of AVN?
Amlodipine
Nicorandil
Diatelzem
Lisinopril
Verapamil
Name 4 AEs of salbutamol [5]
A
trembling, particularly in the hands
nervous tension
headaches
suddenly noticeable heartbeats (palpitations)
muscle cramps
Which muscarinic receptor subtype is thought to be most important in the treatment of chronic airway disease?
A M1
B M2
C M3
D M4
E M5
Which muscarinic receptor subtype is thought to be most important in the treatment of chronic airway disease?
A M1
B M2
C M3
D M4
E M5
ICS acts on which of the following in asthma ptx?
IL-4
IL-5
IL-6
IL-7
ICS acts on which of the following in asthma ptx?
IL-4
IL-5
IL-6
IL-7
Dry powder inhalers should be taken in which of the following ways?
Quick and deep
Slow and steady
Slow and deep
Quick and steady
Dry powder inhalers should be taken in which of the following ways?
Quick and deep
Slow and steady
Slow and deep
Quick and steady
Q
Which of the following forms the right ventricle?
Truncus ateriosus
Bulbus cordis
Sinus venosus
Primitive ventricle
Primitive atria
Q
Which of the following forms the right ventricle?
Truncus ateriosus
Bulbus cordis
Sinus venosus
Primitive ventricle
Primitive atria
What receptor does T3 recruit to activate transcription? [1]
Retinoid acid receptor
Which antibodies are present in Grave’s disease? [2]
Anti-TPO and anti-TSHR
What morphological change will you see on the ECG of a patient with hypothyroidism? [1]
J waves
Which artery do the hypophyseal arteries branch from? [1]
ICA
Which two hormones do somatostatin inhibit? [2]
a)LH
b)FSH
c)TSH
d)GH
e)Prolactin
Which two hormones do somatostatin inhibit?
a)LH
b)FSH
c)TSH
d)GH
e)Prolactin
Which hormone stimulates production of GnRH?
a)Progesterone
b)Kisspeptin
c)Somatostatin
d)Ghrelin
Which hormone stimulates production of GnRH?
a)Progesterone
b)Kisspeptin
c)Somatostatin
d)Ghrelin
What does TPO do in healthy thyroids? [1]
Oxidises iodide ions using H2O2
Describe how the deiodinase enzymes work to control T3/T4 levels [3]
State the locations [3]
.
Which deiodinase enzyme is high during hypothyroidism? [1]
D2
Name an SGLT-2 inhibitor [1]
dapagliflozin
How can you treat sickle cell anaemia by stimulating production of foetal HB? [1]
Hydroxycarbamide /hydroxyurea
Which hormone does warfarin inhibit? [1]
Inhibits vitamin K epoxide reductase
Name a muscarinic antagonist used to treat bradycardia? [1]
Atropine is a muscarinic antagonist= bradycardia medication
Name a drug that activates the vagal nerve to reduce conduction via AVN [1]
Digoxin
How can you spot a drug is a SABA? [1]
How can you spot a drug is a LAMA? [1]
Have -but- in them; salbutamol; terbutaline
long acting muscarinic
antagonists: -ium
tiotropium, glycopyrronium
ium- in ur muscarinic system
What is first choice drug fo pneumonia? [1]
Doxycycline
Which cell types excrete H+ in nephron to help maintain acid-base balance and thus allowing H+ to bind to NH3 and HPO4- [1]
alpha intercalated cells
Q
A 45-year-old male is returned to a surgical ward following a renal transplant. 90 minutes after the transplantation, diuresis suddenly decreases. The patient is immediately transferred back to surgery where the transplanted kidney shows signs of hyperacute rejection and is removed. Histopathological examination is consistent with hyperacute rejection.
This patient has experienced which of the following types of reaction?
Type I hypersensitivity
Type II hypersensitivity
Type III hypersensitivity
Type IV hypersensitivity
Type V hypersensitivity
. Histopathological examination is consistent with hyperacute rejection.
This patient has experienced which of the following types of reaction?
Type II hypersensitivity
What is a normal and abnormal response to Dexamethasone suppression test? [2]
Abnormal: high levels of cortisol
Normal: low levels of cortisol
Inferior thyroid artery arises from which artery? [1]
Thyrocervical
What is the typical male urinary flow rate?
15-20ml/s
20-25ml/s
25-30ml/s
30-35ml/s
What is the typical male urinary flow rate?
15-20ml/s
20-25ml/s
25-30ml/s
30-35ml/s
Short synacthen test is used to diagnose
Addisons disease
Cushing syndrome
Conns syndrome
Graves disease
Short synacthen test is used to diagnose
Addisons disease
Cushing syndrome
Conns syndrome
Graves disease
Which blood vessel provides 75% of the blood supply for the Liver
Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct
Which blood vessel provides 75% of the blood supply for the Liver
Hepatic artery proper
Common hepatic artery
Hepatic vein
Hepatic portal vein
Common bile duct
Which enzyme is the final step in testosterone production?
21-hydroxylase
11B-hydroxylase
5a-reductase
17B-HSD
Which enzyme is the final step in testosterone production?
21-hydroxylase
11B-hydroxylase
5a-reductase
17B-HSD
Which of the following is the remnant of the umbilical vein?
A
B
C
D
Which of the following is the remnant of the umbilical vein?
A
B
C
D
What molecule is depleted in alcohol abuse?
Lactate
GTP
NADH
Pyruvate
What molecule is depleted in alcohol abuse?
Lactate
GTP
NADH
Pyruvate
Which protein guides the formation of neuron that will eventually cause releae of LH /FSH? [1]
Kal protein
What is an important AE of corticosteroids with reards to diabetic patients? [1]
Use of corticosteroids can worsen diabetic control due to their anti-insulin effects
Defecation involves the relaxation of which two muscles? [2]
EAS and puborectalis
The cremaster is formed from which muscle? [1]
Internal oblique
Salbutamol is a β2 receptor agonist. What metabolic effect can this drug have that you might need to monitor?
Hyperkalaemia
Hypernatraemia
Hypocalcaemia
Hyponatraemia
Hypokalaemia
Hypokalaemia
A 56-year-old woman was admitted 2 weeks ago due to pneumonia for which she was started on oral antibiotics. These antibiotics were changed after she developed a Clostridium difficile infection 9 days ago which she is still recovering from. Her pneumonia has now improved.
She is otherwise fit and well and is on no long-term medications.
What would be seen on her arterial blood gas?
Low anion gap metabolic acidosis
Normal anion gap metabolic acidosis
Normal anion gap metabolic alkalosis
Raised anion gap metabolic acidosis
Raised anion gap metabolic alkalosis
A 56-year-old woman was admitted 2 weeks ago due to pneumonia for which she was started on oral antibiotics. These antibiotics were changed after she developed a Clostridium difficile infection 9 days ago which she is still recovering from. Her pneumonia has now improved.
She is otherwise fit and well and is on no long-term medications.
What would be seen on her arterial blood gas?
Low anion gap metabolic acidosis
Normal anion gap metabolic acidosis
Normal anion gap metabolic alkalosis
Raised anion gap metabolic acidosis
Raised anion gap metabolic alkalosis
Growth Hormone regulation is derived from which nucleus?
Arcuate nucleus
Paraventricular nucleus
Supra-optic nucleus
Nucleus solitary tract
Growth Hormone regulation is derived from which nucleus?
Arcuate nucleus
Paraventricular nucleus
Supra-optic nucleus
Nucleus solitary tract
Why does salbutamol cause hypokalaemia? [1]
Salbutamol reduces serum potassium levels by increasing the shift of extracellular potassium into the intracelluar space.
Label A-C [3]
A: Inferior epigastric vessels
B: Direct hernia
C: Vas def
Which brain structure is responsible for regulating anterior pituitary hormone synthesis? [1]
Hypothalamus
Overtreament with hydrocortisone replacement may lead to what? [4]
A
Cushings syndome:
Hypokalameia (lose K, retain HCO3-)
Weight gain
Skin thinning
Met. alkalosis
What liver function test result would reveal that have cirrhosis ? [1]
An AST/ALT ratio higher than one (where the AST is higher than ALT) means you may have cirrhosis.
The synthetic replacement for aldosterone is known as? [1]
Fludrocortisone
A 5-year-old male is brought to the clinic by his mother for evaluation of his growth. The patient is in the 10th percentile for height and weight, with an otherwise normal physical evaluation. Which of the following plays a role as a growth hormone-releasing peptide and may be deficient in this child?
A. Cholecystokinin
B. Leptin
C. Ghrelin
D. Hormone peptide YY
A 5-year-old male is brought to the clinic by his mother for evaluation of his growth. The patient is in the 10th percentile for height and weight, with an otherwise normal physical evaluation. Which of the following plays a role as a growth hormone-releasing peptide and may be deficient in this child?
A. Cholecystokinin
B. Leptin
C. Ghrelin
D. Hormone peptide YY
An AST/ALT ratio of less than one (where the ALT is significantly higher than the AST) means you may have []
An AST/ALT ratio of less than one (where the ALT is significantly higher than the AST) means you may have non-alcoholic fatty liver disease.
Which hormone, secreted by which cells stimulate parietal cells to secrete hydrochloric acid? [2]
Gastrin is released by G cells and stimulates parietal cells to secrete hydrochloric acid.
The stomach is lined by which cell type?
A Stratified squamous epithelium
B Columnar epithelium
C Squamous epithelium
D Ciliated columnar epithelium
E Pseudostratified columnar epithelium
The stomach is lined by which cell type?
A Stratified squamous epithelium
B Columnar epithelium
C Squamous epithelium
D Ciliated columnar epithelium
E Pseudostratified columnar epithelium
Which cells are important in the secretion of pepsinogen?
A Parietal cells
B Chief cells
C Goblet cells
D G cells
E Enterochromaffin-like cells
Which cells are important in the secretion of pepsinogen?
A Parietal cells
B Chief cells
C Goblet cells
D G cells
E Enterochromaffin-like cells
Which of the following tests should be requested to investigate phaeochromocytoma?
A MRI pituitary gland
B Early morning cortisol
C Serum aldosterone:renin ratio
D Urinary 5-Hydroxyindoleacetic Acid
E Plasma metanephrines
Which of the following tests should be requested to investigate phaeochromocytoma?
A MRI pituitary gland
B Early morning cortisol
C Serum aldosterone:renin ratio
D Urinary 5-Hydroxyindoleacetic Acid
E Plasma metanephrines
What is the main mechanism of iodide transport into thyroid follicular cells from capillaries?
A Passive diffusion
B Facilitated diffusion
C Active transport
D Secondary active transport
E Tertiary active transport
What is the main mechanism of iodide transport into thyroid follicular cells from capillaries?
A Passive diffusion
B Facilitated diffusion
C Active transport
D Secondary active transport
E Tertiary active transport
Which enzyme is responsible for the activation of iodide in follicular cells?
A Thyroperoxidase
B Iodinase
C Polymerase
D Elastase
E DNA ligase
Which enzyme is responsible for the activation of iodide in follicular cells?
A Thyroperoxidase (TPO)
B Iodinase
C Polymerase
D Elastase
E DNA ligase
What is the most common cause of primary hyperparathyroidism?
A Parathyroid cancer
B Parathyroid hyperpalsia
C Multiple endocrine neoplasia
D Paraneoplastic syndrome
E Parathyroid adenoma
What is the most common cause of primary hyperparathyroidism?
E Parathyroid adenoma
Which amino acid is thyroid hormone derived from?
A Tryptophan (W)
B Glycine (G)
C Tyrosine (Y)
D Lysine (K)
E Proline (P)
Which amino acid is thyroid hormone derived from?
A Tryptophan (W)
B Glycine (G)
C Tyrosine (Y)
D Lysine (K)
E Proline (P)
Upon standing, receptors in the carotid sinus detect changes in the stretch of the arterial wall to help maintain perfusion to the brain.
What is the name of these receptors?
A Peripheral chemoreceptors
B Central chemoreceptors
C Baroreceptors
D Thermoreceptors
E Golgi organs
C Baroreceptors
Baroreceptors, a type of mechanoreceptor, are responsible for detecting changes in arterial stretch
Which of the following best explains the mechanism leading to osteopaenia in Cushing’s syndrome?
A Cortisol directly promotes resorption of bone
B Cortisol stimulates the release of calcitonin
C Cortisol promotes the activity of osteoclasts
D Cortisol inhibits the activity of osteoblasts
E Cortisol is toxic to the bone marrow
Which of the following best explains the mechanism leading to osteopaenia in Cushing’s syndrome?
A Cortisol directly promotes resorption of bone
B Cortisol stimulates the release of calcitonin
C Cortisol promotes the activity of osteoclasts
D Cortisol inhibits the activity of osteoblasts
E Cortisol is toxic to the bone marrow
Where are the targets of T4 / T3? [1]
Thyroxine (T4) and triiodothyronine (T3) are steroid hormones, which cross the cell membrane and bind intracellular targets.
A rising osmolarity is detected by osmoreceptors within the central nervous system that triggers the release of anti-diuretic hormone (ADH) and our thirst response.
Where are osmoreceptors primarily located within the central nervous system?
A Posterior pituitary gland
B Frontal lobe
C Midbrain
D Cerebral peduncles
E Hypothalamus
A rising osmolarity is detected by osmoreceptors within the central nervous system that triggers the release of anti-diuretic hormone (ADH) and our thirst response.
Where are osmoreceptors primarily located within the central nervous system?
A Posterior pituitary gland
B Frontal lobe
C Midbrain
D Cerebral peduncles
E Hypothalamus
Which enzyme is most commonly affected within congenital adrenal hyperplasia?
A Angiotensin-converting enzyme
B 11-beta-hydroxylase
C 21-hydroxylase
D 17-hydroxyprogesterone
E 5-alpha-reductase
Which enzyme is most commonly affected within congenital adrenal hyperplasia?
A Angiotensin-converting enzyme
B 11-beta-hydroxylase
C 21-hydroxylase
D 17-hydroxyprogesterone
E 5-alpha-reductase
Where is corticotropin-releasing hormone (CRH) synthesised?
A Anterior pituitary
B Supraoptic nucleus
C Paraventricular nucleus
D Third ventricle
E Arcuate nucleus
Where is corticotropin-releasing hormone (CRH) synthesised?
A Anterior pituitary
B Supraoptic nucleus
C Paraventricular nucleus
D Third ventricle
E Arcuate nucleus
What is the name of synthetic cortisol? [1]
What is the name of synthetic aldosterone? [1]
Synthetic cortisol: Hydrocortisone
Synthetic Aldosterone: Fludrocortisone
Which drug would you use as a stress test for cushings? [1]
Dexamethasone
Which of the following treatment for diabetes increases glucose uptake in adipose tissue, increased adipogenesis and decrease circulating lipids
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes increases glucose uptake in adipose tissue, increased adipogenesis and decrease circulating lipids
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which drug class impairs onset of dementia? [1]
Angiotensin II blockers have been shown to slow the onset of dementia.
Q
Which of the folowing is an antibiotic which is an anti-anaerobe and useful for H. pylori
Metronidazole
Omeprazole
Ranitidine
Cimetidine
Q
Which of the folowing is an antibiotic which is an anti-anaerobe and useful for H. pylori
Metronidazole
Omeprazole
Ranitidine
Cimetidine
GLP-1 is cleaved by which drug class? [1]
Dipeptidyl-peptidase 4 (DPP-4)
Thiazolidinediones activate which molecule to initiate their mechanism of action for diabetes? [1]
PPARγ
Which DMT2 treatment causes increased uric acid secretion? [1]
SGLT2 inhibitors
A 66-year-old lady with a long history of poorly controlled type-2 diabetes is started on a new medication. She is told it works by increasing urinary glucose excretion and the doctor says it is an SGLT-2 inhibitor.
Which of the following medications is in this drug class?
Tolbutamide
Dapagliflozin
Exenatide
Linagliptin
Pioglitazone
Tolbutamide
Dapagliflozin
Exenatide
Linagliptin
Pioglitazone
Gliflozins - SGLT2 inhibitors
Describe the MoA of DPP-4 inhibitors [1]
DPP-4 inhibitors increase levels of incretins such as GLP-1 and GIP
sitagliptin is what class of diabetic drug? [1]
DPP-4 inhibitors
Tolbutamide is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Tolbutamide is which drug class
Sulfonylureas
Dulaglutide is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Dulaglutide is which drug class
GLP-1agonists
Rosiglitazone is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Rosiglitazone is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Empagliflozin is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Empagliflozin is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Linagliptin is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Linagliptin is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Exenatide is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
Exenatide is which drug class
DPP-4 inhibitor
SGLT-2 inhibitor
Biguanide
Thiazolidinediones
GLP-1agonists
Sulfonylureas
What is the mechanism of action of gliclazide?
Inhibits dipeptidyl peptides-4
Stimulates sulphonylurea-1 receptors
Inhibits alpha-glucosidase enzymes
Glucagon-like peptide-1 analogues
Inhibits sodium-glucose cotransporter 2
**What is the mechanism of action of gliclazide?
Inhibits dipeptidyl peptides-4
Stimulates sulphonylurea-1 receptors
Inhibits alpha-glucosidase enzymes
Glucagon-like peptide-1 analogues
Inhibits sodium-glucose cotransporter 2
He is keen to try an additional antidiabetic medication, and, after counselling on hypoglycaemic awareness, is started on tolbutamide.
Which of the following most accurately describes the mechanism of action of this new medication?
Increases insulin release by mimicking the binding of glucagon-like peptide-1 (GLP-1) to its receptor
Inhibits the enzyme dipeptyl peptidase-4 (DPP-4), preventing the degradation of incretins such as GLP-1
Reduces renal glucose reabsorption via inhibition of sodium-glucose transport protein 2 (SGLT2)
Stimulates peroxisome proliferator-activated receptor gamma (PPAR-γ), reducing insulin resistance
Binds to and shuts pancreatic beta cell ATP-dependent K+ channels, causing membrane depolarisation and increased insulin exocytosis
He is keen to try an additional antidiabetic medication, and, after counselling on hypoglycaemic awareness, is started on tolbutamide.
Which of the following most accurately describes the mechanism of action of this new medication?
Increases insulin release by mimicking the binding of glucagon-like peptide-1 (GLP-1) to its receptor
Inhibits the enzyme dipeptyl peptidase-4 (DPP-4), preventing the degradation of incretins such as GLP-1
Reduces renal glucose reabsorption via inhibition of sodium-glucose transport protein 2 (SGLT2)
Stimulates peroxisome proliferator-activated receptor gamma (PPAR-γ), reducing insulin resistance
Binds to and shuts pancreatic beta cell ATP-dependent K+ channels, causing membrane depolarisation and increased insulin exocytosis
A 45-year-old man with type 2 diabetes mellitus, currently taking metformin, comes in for his diabetic review. His glycaemic control is deemed to be not under control and gliclazide is added to his treatment regimen. The doctor is advising the patient about the side effects of sulfonylureas. Which of the following is a side effect of sulfonylureas?
Flatulence
Fluid retention
Nausea
Hypoglycaemia
Diarrhoea
A 45-year-old man with type 2 diabetes mellitus, currently taking metformin, comes in for his diabetic review. His glycaemic control is deemed to be not under control and gliclazide is added to his treatment regimen. The doctor is advising the patient about the side effects of sulfonylureas. Which of the following is a side effect of sulfonylureas?
Flatulence
Fluid retention
Nausea
Hypoglycaemia
Diarrhoea
Q
Which drug class does Tiamterene fall into?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Q
Which drug class does Tiamterene fall into?
Thiazide Diuretics
Loop Diuretics
Carbonic Anhydrase Inhibitors
Epithelial Sodium Channel Antagonist
Aldosterone Antagonists
Explain the mechanism of action of Propylthiouracil [2]
A
Blocks thyroxine deiodinase I in the liver
Blocks thyroxine deiodinase II in the periphery to stop T4 to T3 conversion
Explain the mechanism of botox to treat an overactive bladder [1]
A
Prevent ACh release at synaptic terminal
Which of the following treatment for diabetes causes increased GLUT 4 expression and increased insulin sensitivity
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which of the following treatment for diabetes causes increased GLUT 4 expression and increased insulin sensitivity
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which drug class does indapamide belong to?
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Which drug class does indapamide belong to?
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Sexual dysfunction can be a result of
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Sexual dysfunction can be a result of
DPP-4 Inhibitors
SGLT 2 Inhibitors
Metformin
Thiazolidinediones
Sulfonylureas
Ghrelin is involved with endocrine axis? [1]
GH
Describe the difference in role of the internal and external urethral sphincters [2]
The internal urethral sphincter regulates involuntary control of urine flow from the bladder to the urethra; prevent retrograde flow of semen into the bladder during ejaculation.
The external urethral sphincter provides voluntary control of urine flow from the bladder to the urethra.
POMC/CART neurones in arcuate nucleus of hypothalamus cause the release of which hormone? [1]
α-melanocortin-stimulating hormone (α-MSH)
Which enzyme converts arachidonic acid into a pro-inflammatory molecule?
Phospholipase A2
Renal stones are most commonly caused by:
Calcium oxalate
Struvite
Calcium phosphate
Uric acid
Cystine
Renal stones are most commonly caused by:
Calcium oxalate
Struvite
Calcium phosphate
Uric acid
Cystine
Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?
D1
D2
D3
D4
Which of the following deiodinase enzymes makes more inactive from of thyroid hormone?
D1 & D2 convert T4 to T3 and cause activation
D3
D4
Describe the action of calcineurin [1]
Calcineurin is an enzyme that activates T-cells of the immune system.
Out of metformin and gliclazide, which causes hypoglycaemia and why? [2]
gliclazide: Gliclazide is an insulin secretagogue, increasing the amount of endogenous insulin produced. Sometimes too much Insulin can be secreted, resulting in hypoglycaemia
Metformin is an insulin sensitiser and therefore makes the amount of insulin in the body more effective. While metformin reduces average blood sugars it very rarely causes hypoglycaemia. Therefore reducing the offending drug, gliclazide, is the most appropriate management option.
A 65-year-old man presents with severe upper abdominal pain, fever, and vomiting. He is diagnosed with acute pancreatitis. Which of the following liver function tests is raised disproportionately in pancreatitis?
Unconjugated bilirubin
Alanine aminotransferase (ALT)
Alkaline phosphatase (ALP)
Amylase
Gamma glutamyltransferase (GGT)
Amylase
Which of the following can cause hypocalcaemia?
Hyperparathyroidism
Respiratory alkalosis
Thiazide diuretics
Vitamin D intoxication
Which of the following can cause hypocalcaemia?
Hyperparathyroidism
Respiratory alkalosis
Thiazide diuretics
Vitamin D intoxication
Osteocytes secrete which of the following involved in Ca homeostasis
Calcitriol
Vit D
FGF23
PTH
1 alpha hydroxylase
Osteocytes secrete which of the following involved in Ca homeostasis
Calcitriol
Vit D
FGF23
PTH
1 alpha hydroxylase
Flavinoids are important because they reduce inflammatory enzymes such as []
NADPH oxidase
What are K levels like in compartment syndrome? [1]
Hyperkalaemia
Label A & B
A: Floccus
B: Tonsil
Which numbers are the floccus and tonsil? [2]
Floccus: 10
Tonsil: 3
Which numbers are the floccus and tonsil? [2]
19 Tonsil of cerebellum
20 Flocculus of cerebellum
Which numbers are the floccus and tonsil? [2]
30 Flocculus of cerebellum
31 Cerebellar tonsil
Yellow arrow is pointing at?
Tonsil
vermis
flocculonodular node
anterior lobe
posterior lobe
Yellow arrow is pointing at?
Tonsil
vermis
flocculonodular node
anterior lobe
posterior lobe
Damage to area D results in
apraxia to internal commands
aphasia
loss of conjugate gaze
apraxia to external commands
loss of voluntary control of movements
Damage to area D results in
apraxia to internal commands
aphasia
loss of conjugate gaze
apraxia to external commands
loss of voluntary control of movements
Identify structure A
Stria terminalis
Anterior commissure
Fornix
Corpus callosum
Posterior commisure
Identify structure A
Stria terminalis
Anterior commissure
Fornix
Corpus callosum
Posterior commisure
dentify the arrowed structure
uncus
optic nerve
olfactory gyrus
midbrain
Wernicke’s area
dentify the arrowed structure
uncus
optic nerve
olfactory gyrus
midbrain
Wernicke’s area
The image shows deep brain stimulation to control Parkinson’s disease. Into which basal ganglia nucleus are the rods
Caudate
Putamen
Globus pallidus external
Globus pallidus internal
subthalamic
The image shows deep brain stimulation to control Parkinson’s disease. Into which basal ganglia nucleus are the rods
Caudate
Putamen
Globus pallidus external
Globus pallidus internal
subthalamic
In this decerebrate patient, the location of the lesion is
In the medulla
Between the vestibular nuclei and red nuclei
Above the red nucleus
Between the vestibular nucleus and trochlear nucleus
Between the red nucleus and anterior lobe of the cerebellum
In this decerebrate patient, the location of the lesion is
In the medulla
Between the vestibular nuclei and red nuclei
Above the red nucleus
Between the vestibular nucleus and trochlear nucleus
Between the red nucleus and anterior lobe of the cerebellum
Decerebrate posturing means which tract is not function ? [1] Explain why you see this position [1]
Rubrospinal tract
red nucleus output reinforces antigravity flexion of the upper extremity. When its output is eliminated then the unregulated reticulospinal and vestibulospinal tracts reinforce extension tone of both upper and lower extremities.
Identify the brain region that is tested by asking a patient to draw a symmetrical object such as a clock face.
A
B
C
D
E
Identify the brain region that is tested by asking a patient to draw a symmetrical object such as a clock face.
A
B
C
D
E
Loss of dopaminergic input to the BG leads to
insufficient activation of D1 receptors
Activation of direct pathway
Insufficient activation of D2 receptors
Activation of thalamus
Inhibiton of internal globus pallidus
Loss of dopaminergic input to the BG leads to
insufficient activation of D1 receptors
Activation of direct pathway
Insufficient activation of D2 receptors
Activation of thalamus
Inhibiton of internal globus pallidus
The pathology shown in this image is
Left tonsillar herniation
Right tonsillar herniation
Left uncal herniation
Right uncal herniation
Left subfalcine herniation
Right subfalcine herniation
The pathology shown in this image is
Left tonsillar herniation
Right tonsillar herniation
Left uncal herniation
Right uncal herniation
Left subfalcine herniation
Right subfalcine herniation
The pathology shown in this image is
Left tonsillar herniation
Right tonsillar herniation
Left uncal herniation
Right uncal herniation
Left subfalcine herniation
Right subfalcine herniation
The pathology shown in this image is
Left tonsillar herniation
Right tonsillar herniation
Left uncal herniation
Right uncal herniation
Left subfalcine herniation
Right subfalcine herniation
B is
- Nucleus raphe magnus
- Dorsal horn
- Reticular formation
- periaqueductal grey
- locus coeruleus
B is
1. Nucleus raphe magnus
2. Dorsal horn
3. Reticular formation
4. periaqueductal grey
5. locus coeruleus
What is indicated by letter A?
PAG
Nucleus raphe magnus
Nucleus reticularis paragigantocelluaris
Dorsal horn
VTA
What is indicated by letter A?
PAG
Nucleus raphe magnus
Nucleus reticularis paragigantocelluaris
Dorsal horn
VTA
