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Medical Studies 1 > Quiz Revision > Flashcards

Quiz Revision Flashcards

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USMLE® Step 1 flashcards
1
Q

What does the term prodromal refer to when discussing disease characteristics?

A

Early stage of vague, non-specific symptoms

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2
Q

What is the difference between a sign and a symptom? and give an example of each.

A

Signs are objective and symptoms are subjective.
Sign – rash, tachycardia, fever.
Symptom – dizzy, nausea, pain

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3
Q

What is the name given to an increase in cell number via cellular division?

A

Hyperplasia

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4
Q

What does the term apoptosis mean?

A

Normal process of programmed cell death. Does not trigger an inflammatory response.

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5
Q

What are 2 characteristics of visceral pain?

A

Pain is usually referred, poorly localised, vague, and diffuse. Due to hollow organ stretching, hypoxia and inflammation.

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6
Q

What is the name given to an area of skin innervated by a specific spinal nerve?

A

Dermatome

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7
Q

Briefly define the term - iatrogenic.

A

Injury or disease caused by medical intervention or errors.

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8
Q

When discussing disease, what is the difference between incidence and prevalence?

A

Incidence is the number of new cases. Prevalence is the number of new, old, and existing cases.

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9
Q

List 2 chemical mediators that are involved in the inflammatory response.

A

Histamine, Cytokines, Leukotrienes, kinins, complement system, platelet activating factor.

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10
Q

Which area of the brain is responsible for temperature control?

A

Hypothalamus

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11
Q

What is the term given to the maintenance of a relatively constant internal environment?

A

Homeostasis

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12
Q

What fluid shifts occur when a hypotonic solution is infused into a normally hydrated patient?

A

Water will be drawn from the solution into the cells as the cells will have a higher solute concentration than the infused fluid.

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13
Q

Which hormone, secreted by the adrenal gland, stimulates the kidneys to reabsorb sodium and water? What effect would this have on blood pressure?

A

Aldosterone

Raises blood pressure

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14
Q

Which substance is released by the juxtaglomerular cells of the kidney in response to reduced blood volume?

A

Renin

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15
Q

An abnormal accumulation of water in the interstitial tissue is commonly referred to as what?

A

Oedema or Swelling

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16
Q

Which common electrolyte imbalance triggers the thirst reflex?

A

Hypernatraemia

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17
Q

Life threatening arrhythmias are a severe consequence of which electrolyte imbalance?

A

Hyperkalaemia

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18
Q

Which hormone “pulls” calcium from bones and increases absorption?

A

Parathyroid hormone

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19
Q

Which electrolyte is vital to support energy needs and oxygen transport?

A

Phosphorus

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20
Q

What is the name of the receptors that initiate a respiratory response to changes in pH?

A

Chemoreceptors

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21
Q

How long do renal compensatory mechanisms take to adjust pH?

A

Hours to days

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22
Q

Which acid-base imbalance is characterised by an excess of non-carbonic acid (non-volatile)?

A

Metabolic acidosis

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23
Q

What is the difference between volatile and non-volatile acids?

A

Volatile are excreted via respiration and non-volatile are excreted via the renal system.

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24
Q

In what stage of shock do rouleaux formations and capillary obstruction occur?

A

Decompensating. (Irreversible occurs when post capillary sphincters open allowing toxic by-products to circulate, widespread vasodilation occurs and
profound acidosis leading to organ failure)

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25
Q

Which coronary artery supplies blood to the conduction system?

A

Right

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26
Q

What is the formula for calculating MAP?

A

Diastolic pressure + 1/3 pulse pressure

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27
Q

What is the number 1 rule for shock management?

A

Always assume it is hypovolaemic until proven otherwise

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28
Q

What are the 4 stages of the progression of shock in the microcirculation?

A

Vasoconstriction, Capillary and venule opening, DIC, Multiple organ failure

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29
Q

What is the definition of cardiogenic shock?

A

Shock that occurs due to the inability of the heart to deliver adequate circulating volume for tissue perfusion.

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30
Q

List 3 non-modifiable risk factors for cardiovascular disease.

A

Gender, age, family hx, type 1 diabetes

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31
Q

Provide 3 management goals for the treatment of ACS.

A

Reduce workload, increase O2 delivery, minimise clot formation, initiate cardiac re-perfusion and prevent progression

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32
Q

Which type of angina is caused by vasospasm of the coronary artery?

A

Prinzmetal’s Angina – rather than by atherosclerosis or clots, typically occurs at rest through the night

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33
Q

What are the 2 main branches of the left main coronary artery?

A

Left anterior descending and circumflex

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34
Q

What type of MI is caused by micro-emboli becoming lodged in the distal coronary arteries?

A

Non-STEMI (STEMI occurs when a thrombus completely occludes a vessel for a prolonged period)

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35
Q

Describe the pharmacological management of chest pain of presumed cardiac origin.

A

Fentanyl, Oxygen, Nitrates, Aspirin (Fibrinolytic therapy)

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36
Q

What is the life-threatening condition that occurs as a result of left ventricular failure?

A

Acute Pulmonary Oedema

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37
Q

What condition is characterised by sudden syncope, pain in the back or abdomen and unequal BP readings?

A

Dissecting aneurysm

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38
Q

Asthma is a sudden or progressive narrowing of the airways caused by what 3 mechanisms?

A

Bronchospasm, swelling, increased mucous production

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39
Q

At what rate should an asthmatic patient be ventilated with a BVM?

A

4 – 6 breaths per minute

Allow extra time for air to be expelled

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40
Q

Which group of conditions results in destruction of alveoli and reduced surface area for gas exchange?

A

CAL – bronchitis and emphysema

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41
Q

An inability to lie flat due to breathing difficulties is termed?

A

Orthopnoea

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42
Q

What is the most effective long-term treatment for the management of chronic asthma?

A

Steroids

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43
Q

Describe the difference between high VQ and low VQ

A

High VQ – ventilation is normal but there is decreased perfusion “dead space” e.g., PE where vents are wasted

Low VQ – Ventilation is reduced but there is adequate perfusion “shunt” e.g., CAL, asthma, and APO

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44
Q

List 4 medical causes of seizures.

A

Hypoglycaemia, infection, tumours, febrile convulsions, drug withdrawal, eclampsia, CVA, epilepsy

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45
Q

What are the phases of an epileptic seizure?

A

Aura, Tonic, Clonic, Post-ictal

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46
Q

What is the medical terminology for difficulty speaking?

A

Dysphasia

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47
Q

Which type of strokes have a better prognosis – ischaemic or haemorrhagic?

A

Ischaemic

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48
Q

What are the 4 types of headaches identified?

A

Tension, Migraine, Cluster and Sinus

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49
Q

Typically, what percentage of beta cells are destroyed before Type 1 Diabetes manifests?

A

80-90%

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50
Q

List 3 common symptoms of hyperglycaemia.

A

Polyuria, polydipsia, polyphagia

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51
Q

What is the mechanism of action of Glucagon?

A

It stimulates glycogenolysis which requires stores of glycogen in the liver

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52
Q

Which autoimmune disease causes excess thyroid hormone secretion?

A

Graves

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53
Q

Cushing’s syndrome is caused by an excess of which hormone?

A

Cortisol (caused by excessive activity of the adrenal cortex)

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54
Q

In a hypersensitivity reaction which cells release Histamine?

A

Mast cells

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55
Q

Which type of disorder involves a failure in recognising or a loss of tolerance to self?

A

Autoimmune disorder

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56
Q

What types of immune cells differentiate into plasma cells?

A

B Cells

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57
Q

What is the main difference between T cells and B cells?

A

T cells respond directly to attack invading organism and B cells produce antibodies. (cellular vs humoral)

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58
Q

How many bones are in the human skull?

A

22/23

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59
Q

What is the only human bone not attached to another bone?

A

Hyoid

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60
Q

For what operation was a Portuguese surgeon awarded the Nobel prize for in 1949?

A

Prefrontal lobotomy

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61
Q

The two main branches of the left main coronary artery are the left anterior descending and the ________________ artery

A

circumflex

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62
Q

In the cardiac conduction cycle, ventricular repolarisation is represented by the:

A

T wave

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63
Q

An increased parasympathetic tone leads to positive chronotropic, dromotropic and inotropic effects. T/F

A

False

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64
Q

The ____________ _____________ is the amount of blood pumped by each ventricle in 1 minute.

A

cardiac output

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65
Q

An increased parasympathetic tone leads to positive chronotropic, dromotropic and inotropic effects. TF

A

False

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66
Q

The ____________ _____________ is the amount of blood pumped by each ventricle in 1 minute.

A

Cardiac Output

67
Q

The ___________ ___________ is the amount of blood ejected from each ventricle with each contraction.

A

Stroke volume

68
Q

Stable angina is part of a spectrum of clinical disease collectively referred to as Acute Coronary Syndrome (ACS). T/F

A

False

69
Q

Which of the following is NOT an underlying treatment goal for ACS patients?

Initiate re-perfusion measures
Increase platelet aggregation
Minimise clot formation
Reduce the workload of the heart

A

Increase platelet aggregation

70
Q

Unstable angina is typically precipitated by physical exertion or emotional stress. T/F

A

False

71
Q

When a spasm of the coronary artery causes a temporary occlusion and acute chest pain it is called:

A

Prinzmetal’s Angina

72
Q

A myocardial infarction is usually the result of a ____________ that has occluded a coronary artery.

A

thrombus

73
Q

An occlusion of the right coronary artery will result in an acute myocardial infarct in which area of the myocardium?

A

Inferior wall

74
Q

A STEMI is diagnosed by the development of elevated ST segments in two or more contiguous ECG leads. T/F

A

True

75
Q

An ______________ MI often shows mainly a parasympathetic response.

A

Inferior

76
Q

Which of the following signs/symptoms are not an indication of acute left sided heart failure?

Respiratory crackles
Shortness of breath
Peripheral oedema
Pink frothy sputum

A

Peripheral oedema

77
Q

What signs/symptoms make up Beck’s Triad as seen in cardiac tamponade.

A
  • hypotension,
  • jugular venous distension,
  • muffled heart sounds.
78
Q

What is an AAA?

A

Abdominal aortic aneurysm - occurs when atherosclerosis or plaque buildup causes the walls of the abdominal aorta to become weak and bulge outward like a balloon

79
Q

The most common site for a AAA is below the iliac arteries and above the femoral arteries. T/F

A

False

80
Q

Aortic aneurysms stay asymptomatic if they remain stable? T/F

A

True

81
Q

When a AAA ruptures the patient often presents with hypotension and bradycardia. T/F

A

True

82
Q

Bradycardia that is present in a suspected AAA rupture is due to stimulation of the ___________ nerve.

A

Vagus

83
Q

Which of the following signs/symptoms is NOT consistent with the rupture of an aortic arch aneurysm?

Vasodilation
Sudden onset maximal pain
Unequal BP’s
Tearing chest pain

A

Vasodilation

84
Q

An acute bacterial infection that results in vegetative growths on the valves of the heart is called _______________.

A

Endocarditis

85
Q

Endocarditis may cause characteristic signs including;

A

Janeway lesions
oslers nodes
splinter haemorrhages under the nails

86
Q

Pericarditis often presents with global ST depression on a 12 lead ECG. T/F

A

False

87
Q

The pericardium is made of 2 layers - the visceral and the ________________ layers.

A

Parietal

88
Q

Place the following airway structures in order from upper airway to lower airway.

A 
Oropharynx 
Larynx
Trachea
Bronchioles 
Alveoli
89
Q

What is the physiological function of surfactant?

A

Reduction of surface tension in the alveoli

90
Q

At the commencement of expiration, intrapulmonary pressure is lower than atmospheric pressure. T/F

A

FALSE

91
Q

The term given to the maximal volume of air expired following a passive expiration is;

A

Expiratory reserve volume

92
Q

The nerve that supplies the diaphragm is called the ____________ nerve.

A

Phrenic

93
Q

A patient suffering from a _________ VQ mismatch has adequate ventilation but reduced perfusion.

A

High

94
Q

The process of gas exchange between the alveoli and the capillary bed is called;

A

Diffusion

95
Q

A breathing pattern characterised by deep and rapid respirations is known as ________________ respirations

A

Kussmaul

96
Q

A respiratory disorder characterised by abnormal permanent enlargement of the distal air spaces is called;

A

Emphysema

97
Q

Which of the following physiological changes occur in emphysema?
- Altered VQ ration
- decreased structural support
- loss of elastic fibres
- airway narrowing
- loss of surface area for gas exchange

A

loss of surface area for gas exchange

98
Q

In CO2 dependent patients hypoxia becomes the driving force for their respiration. T/F

A

TRUE

99
Q

Patients with emphysema sometimes present with pursed lip breathing in an attempt to increase pressure in their ____________

A

Alveoli

100
Q

Chronic bronchitis is characterised by an increase in the amount of ________________ producing cells.

A

Mucus

101
Q

Which of the following signs/symptoms are NOT associated with chronic bronchitis?

Hypocapnia
polycythemia
cor pulmonale
pulmonary hypertension

A

Hypocapnia

102
Q

Intravenous adrenaline should be administered immediately in an acute severe asthma attack.

A

False

103
Q

Intrinsic asthma is non-allergic and first occurs later in life. T/F

A

TRUE

104
Q

A decrease in systolic blood pressure and and pulse pressure during inspiration is called;

A

Pulsus paradoxus

105
Q

A patient suffering a respiratory arrest secondary to asthma should be ventilated at a rate of 12 - 16 breaths per minute. T/F

A

False

106
Q

Streptococcus Pneumoniae is still responsible for up to 90% of bacterial pneumonias. T/F

A

Flase

107
Q

In the treatment of acute pneumonia broncholdilators are recommended to help relieve dyspnoea.

A

False

108
Q

The Pneumonia Severity Index helps to identify ______________ acquired pneumonia that can safely be treated with outpatient antibiotics.

A

Community

109
Q

Which of the following physiological changes is consistent with acute respiratory distress syndrome (ARDS)?

  • Decreased capillary permeability
  • Diffuse alveolar capillary injury
  • Increased systolic blood pressure
  • Bronchoconstriction
A

Diffuse alveolar capillary injury

110
Q

Croup is a common _____________ infection that often presents with a seal bark cough in children.

A

Viral

111
Q

A very serious bacterial infection that causes a severe sore throat and may result in laryngeal spasm is _________________.

A

Epiglottitis

112
Q

Less than 50% of pulmonary embolisms occur as a result of deep vein thrombosis. T/F

A

FALSE

113
Q

Pain that is referred, poorly localised or vague and diffuse is called ______________ pain.

A

Visceral

114
Q

A ___________________ is an area of skin innervated by a specific spinal nerve.

A

Dermatome

115
Q

Regeneration is the process of damaged tissue being replaced with functional cells. T/F

A

True

116
Q

Necrosis is the process of programmed cell death. T/F

A

FALSE

117
Q

As the body works to maintain homoeostasis, any significant deviation from the normal range will be resisted and homeostasis restored through a process called a ___________ loop.

A

Negative feedback

118
Q

When a disease develops quickly and has a short duration it is described as?

A

Acute

119
Q

When a cell increases in size it is called

A

Hypertrophy

120
Q

Angiotensin II is a potent vasoconstrictor that stimulates the release of _________________________ when circulating blood volume is reduced.

A

Aldosterone

121
Q

Mannitol is a hypertonic solution that when infused into a normally hydrated person will cause the cells to swell and lyse. T/F

A

False

122
Q

Insulin actively moves Glucose into the cell from the extracellular fluid. This is an example of;

A

Facilitated diffusion

123
Q

Which of the following types of fluid lies between the cells and includes cerebrospinal fluid?

A

Interstital fluid

124
Q

Which of the following types of fluid lies between the cells and includes cerebrospinal fluid?

A

Interstitial fluid

125
Q

_______________________________ is the maintenance of a relatively constant internal environment.

A

Homeostasis

126
Q

A condition resulting from over stimulation of the blood clotting mechanisms, in response to a disease or injury, that may be fatal is;

A

DIC

127
Q

A patient that is exhibiting anxiety, confusion, irritability, muscle cramps, seizures and tetany should be suspected of suffering from;

A

Hypocalcaemia

128
Q

Antidiurectic Hormone Acts on which of the following structures?

A

Descending loop of henle

Collecting ducts

129
Q

Any condition that increases carbonic acid, or decreases the base bicarbonate, causes…

A

Acidosis

130
Q

Hypercalcemia occurs when the rate of calcium entry in the ECF exceeds the rate of excretion by the kidneys. T/F

A

TRUE

131
Q

Hypernatremia can be caused by all of the following EXCEPT:

Fever and heat stroke
Diabetes Insipidous 
Near drowning in salt water
Rapid infusion of large volumes of fluid 
Extensive burns
A

Rapid infusion of large volumes of fluid

132
Q

Hyponatraemia refers to a deficiency of K+ in relation to body water, and is a common electrolyte imbalance T/F

A

FALSE

133
Q

Persistent hypernatraemia only occurs in people who can’t drink voluntarily such as infants, the elderly, or unconscious patients.

When sodium levels increase, ADH causes water to be retained, which helps lower sodium levels. T/F

A

TRUE

134
Q

Slight movement outside the normal ranges for serum potassium (K+) is inconsequential T/F

A

FALSE

135
Q

Vomiting, diarrhoea, diaphoresis, CCF and renal failure may lead to…

A

Hyponatremia

136
Q

What is the normal pH range in humans?

A

7.35 - 7.45

137
Q

Which of the following conditions would not result in a metabolic acidosis

Shock
Chronic Steroid use
Diabetic Ketoacidosis
Renal failure

A

Chronic steroid use

138
Q

Which electrolyte imbalances results in flatten T wave and ST segment depression

A

Hypokalaemia

139
Q

Hypercapnia is the retention of….

A

CO2

140
Q

Shock can be defined as…

A

a condition characterised by a progressive decrease in tissue perfusion due to a reduction in effective circulating volume

141
Q

The amount of blood pumped by the ventricles in one minute is the _______________ ________________

A

Cardiac output

142
Q

Preload is the total resistance against which blood must be pumped and is affected by total peripheral vascular resistance.

A

False

143
Q

When a patient is developing shock, the initial response is vasoconstriction. Which of the following physiological changes are occurring during this stage?

A

Post-capillary venules constrict
Increased capillary hydrostatic pressure
Pre-capillary arterioles constrict

144
Q

You are attending to a 75 year old patient suffering heart failure. On examination you find his blood pressure to be 105/60 mmHg. You decide to calculate his Mean Arterial Pressure and it is;

A

75 mmHg

145
Q

Failure to properly treat shock during vasoconstriction will cause pre-capillary sphincters to relax resulting in expansion of the vascular space. T/F

A

TRUE

146
Q

During the decompensatory phase of shock a decrease in the amount of oxygen to the cells results in which acid base imbalance?

A

Respiratory acidosis

147
Q

Which electrolyte imbalance occurs during the ‘washout phase’ of Disseminated Intravascular Coagulation where the cells lyse and die?

A

Hyperkalaemia

148
Q

During the compensatory phase of shock the signs and symptoms include an increase in heart rate, increase in respiratory rate and ___________________ in systolic blood pressure.

A

Increase

149
Q

Severe and prolonged diarrhoea and vomiting can result in __________________________ shock.

A

Hypovolemic

150
Q

The hypotension in anaphylactic shock is caused by decreased capillary permeability allowing fluid to leak into the interstitial space. T/F

A

False

151
Q

Crystalloid solutions do not exert as much ___________________ pressure as colloid solutions resulting in faster equilibrium between the intravascular and extravascular spaces.

A

Osmotic

152
Q

A patient presenting in respiratory arrest secondary to an opiate overdose is likely to be suffering respiratory alkalosis.

A

False

153
Q

During an airway obstruction and subsequent respiratory acidosis the body will attempt to compensate for the acid base imbalance by;

A

Kidneys conserve bicarbonate and excrete hydrogen ions

154
Q

Metabolic acidosis secondary to extreme exertion occurs due to anaerobic metabolism resulting in a build up of _______________ _______________.

A

Lacitc acid

155
Q

Diabetic Ketoacidosis occurs as a result of a diabetic patient taking too much Insulin which leads to the cells not receiving enough glucose and breaking down fats for energy. T/F

A

FALSE

156
Q

Kussmaul’s respirations and excessive thirst are signs of metabolic acidosis secondary to;

A

Diabetic ketoacidosis

157
Q

The acid base imbalance respiratory _________________ is caused by an increased elimination of carbon dioxide through hyperventilation.

A

Alkalosis

158
Q

Blood is composed of approximately 55% plasma and 45% formed elements. T/F

A

TRUE

159
Q

Your patient has a temperature of 39 degrees and is hypotensive. For every degree the patient’s body temperature rises their insensible fluid loss increases by ________ mls. per day.

A

200

160
Q

Osmosis is the diffusion of water through a semi permeable membrane from an area of low water concentration to an area of high water concentration. T/F

A

FALSE

161
Q

Which of the following electrolytes has a significant role in action potentials, glycogen storage and acid base balance?

A

Potassium

162
Q

An under-active parathyroid gland may result in hypocalcaemia. T/F

A

TRUE

163
Q

Which electrolyte imbalance is characterised by kidney stones, bony pain, arrhythmias and decreased muscle tone?

A

Hypercalcaemia

Medical Studies 1 (11 decks)

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