Quizzes Flashcards

1
Q

Commonly associated with bradykinesia and rigidity

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Pill rolling tremor

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2
Q

Lewy Bodies are found in post mortem brains in patients who have this movement disorder

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Pill rolling tremor

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3
Q

Dominantly inherited

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Huntingtons Chorea

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4
Q

Occurs following an infection

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Sydenhams chorea

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5
Q

In which of the above is the Substantia Nigra affected?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Pill rolling tremor

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6
Q

Which of the above movement disorders is caused by antiemetics and neuroleptics?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Pill rolling tremor

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7
Q

The movement disorder that occurs in Rheumatic fever?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Sydenham’s chorea

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8
Q

The movement disorder that occurs in Parkinson’s disease?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Pill rolling tremor

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9
Q

The movement disorder that is improved by alcohol?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Benign essential tremor

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10
Q

The movement disorder that is caused by long term alcohol abuse?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Intention tremor

Cerebellar atrophy occurs in long term alcohol abuse, resulting in an intention tremor.

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11
Q

The movement disorder mediated by the immune system?

Pill rolling tremor
Huntingtons Chorea
Sydenhams chorea
Benign essential tremor
Intention tremor
Spastic paraparesis
A

Sydenham’s chorea

(Sydenham’s chorea (also known as St Vitus’ dance) is a major criterion of acute rheumatic fever, and is now known to be mediated by the immune system.)

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12
Q

Fasting plasma glucose of 5.4 mmol/l in a patient who complains of polyuria and polydipsia

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Normal

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13
Q

Fasting plasma glucose of 6.7 mmol/l in a patient who complains of polyuria and polydipsia

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Impaired fasting Glucose (IFG)

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14
Q

Fasting plasma glucose of 6.5 mmol/l in a patient who complains of polyuria and polydipsia. He has a plasma glucose of 9.0 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Impaired Glucose Tolerance (IGT)

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15
Q

Fasting plasma glucose of 7.4 mmol/l in a patient who complains of polyuria and polydipsia. He has a plasma glucose of 9.5 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Type 2 diabetes mellitus

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16
Q

Fasting plasma glucose of 6.5 mmol/l in a patient who complains of polyuria and polydipsia. He has a plasma glucose of 12.5 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Type 2 diabetes mellitus

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17
Q

Fasting WHOLE BLOOD glucose of 6.9 mmol/l in a patient who complains of polyuria and polydipsia. He has a WHOLE BLOOD glucose of 9.5 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Type 2 diabetes mellitus

18
Q

Fasting WHOLE BLOOD glucose of 6.0 mmol/l in a patient who complains of polyuria and polydipsia. He has a WHOLE BLOOD glucose of 9.5 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Impaired Glucose Tolerance (IGT)

19
Q

Fasting WHOLE BLOOD glucose of 6.0 mmol/l in a patient who complains of polyuria and polydipsia. He has a WHOLE BLOOD glucose of 10.5 mmol/l two hours after 75g of glucose during an OGTT

Normal
Impaired fasting Glucose (IFG)
Impaired Glucose Tolerance (IGT)
Type 2 diabetes mellitus
Type 1 diabetes mellitus
A

Type 2 diabetes mellitus

20
Q

pH 6.9 bicarbonate 7.0

A.
respiratory acidosis

B.
respiratory alkalosis

C.
metabolic alkalosis

D.
metabolic acidosis

A

metabolic acidosis

21
Q

pH 6.9 bicarbonate 26

A.
respiratory acidosis

B.
respiratory alkalosis

C.
metabolic alkalosis

D.
metabolic acidosis

A

respiratory acidosis

22
Q

pH 7.6 bicarbonate 30

A.
respiratory acidosis

B.
respiratory alkalosis

C.
metabolic alkalosis

D.
metabolic acidosis

A

metabolic alkalosis

23
Q

pH 7.6 bicarbonate 14

A.
respiratory acidosis

B.
respiratory alkalosis

C.
metabolic alkalosis

D.
metabolic acidosis

A

respiratory alkalosis

24
Q

Calculate the anion gap from the data given.

Na = 131 K = 5 Urea = 6 glucose = 5 bicarbonate = 11 chloride = 85

A

40 ± 0%

The formula for anion gap is: AG = Na + K - bicarb - chloride.

The glucose and urea are not important here.

25
Q

Calculate the osmolality from the data given.

Na = 139 K = 5 Urea = 3 glucose = 9 bicarbonate = 26 chloride = 97

A

300 ± 0%

The osmolality is given by: osmolality = 2(Na + K) + Urea + glucose Since we can double the cations, we do not need to know the concentration of the anions (bicarbonate or chloride) to work out the osmolality.

26
Q

Calculate the osmolar gap in the following patient:

Measured osmolality = 298 Na = 136 K = 4 Urea = 4 Glucose = 4

A

10 ± 0%

Note that you should not confuse the anion gap with the osmolar gap, although both can be raised for the same reason, for example extra ketones.

In addition to calculating the osmolality you can also measure the osmolality by freezing the plasma, and measuring the freezing point change by the solutes present. The measured osmolality is higher than the calculated osmolality, as some minority ions are not used in the calculation. The difference is known as the osmolar gap, and it should be no more than 10mM. A high osmolar gap is caused by other uncalculated osmoles, such as ketones, ethanol or hypertriclycerideaemia. If the excess substance is charged (eg ketones) then the anion gap will be higher also

27
Q

Measured osmolality = 297 Na = 126 K = 5 Urea = 3 Glucose = 3

[Here is another patient who needs the osmolar gap calculated. Note that you do not need the bicarbonate or chloride here, as the calculated osmolality is derived by doubling the cations, and not measuring the anions.]

A

29 ± 0%

If the calculated osmolality is ever greater than the measured osmolality, there must be either a laboratory error, or a mathematical mistake. A negative osmolar gap is not possible.

28
Q

Which stimulates the release of glucocorticoid (cortisol)?

Corticotrophin (ACTH)
Renin
Adrenaline
Nor adrenaline
Cortisol
Aldosterone
Testosterone
Oestradiol
Gastrin
Histamine
A

Corticotrophin (ACTH)

ACTH stimulates the release of cortisol and renin stimulates the release of aldosterone indirectly by stimulating the conversion of angiotensinogen to angiotensin 1. The resulting angiotensin 2 directly stimulates the production of aldosterone

29
Q

Which stimulates the release of mineralocorticoid (aldosterone)?

Corticotrophin (ACTH)
Renin
Adrenaline
Nor adrenaline
Cortisol
Aldosterone
Testosterone
Oestradiol
Gastrin
Histamine
A

Renin

30
Q

Which is suppressed in Conn’s syndrome?

Corticotrophin (ACTH)
Renin
Adrenaline
Nor adrenaline
Cortisol
Aldosterone
Testosterone
Oestradiol
Gastrin
Histamine
A

Renin

31
Q

Which is commonly released from an adrenal phaeochromocytoma?

Corticotrophin (ACTH)
Renin
Adrenaline
Nor adrenaline
Cortisol
Aldosterone
Testosterone
Oestradiol
Gastrin
Histamine
A

Adrenaline

32
Q

Which is commonly released from an extra-adrenal phaeochromocytoma?

Corticotrophin (ACTH)
Renin
Adrenaline
Nor adrenaline
Cortisol
Aldosterone
Testosterone
Oestradiol
Gastrin
Histamine
A

Noradrenaline

“Nor” in nor adrenaline means “without a methyl group”. This methyl group is added to the adrenaline by an enzyme that is only present in the adrenal but is not present in nerve terminals. Thus adrenal phaeochromocytomas tend to secrete adrenaline whereas extra adrenal phaeochromocytomas secrete nor-adrenaline.
Question 9

33
Q

Na + K - bicarbonate - chloride

A.
osmolar gap

B.
main intracellular cation

C.
calculated osmolality

D.
main extracellular cation

E.
anion gap

A

anion gap

34
Q

measured osmolality - calculated osmolality

A.
osmolar gap

B.
main intracellular cation

C.
calculated osmolality

D.
main extracellular cation

E.
anion gap

A

osmolar gap

35
Q

2 * (Na + K) + Urea + glucose

A.
osmolar gap

B.
main intracellular cation

C.
calculated osmolality

D.
main extracellular cation

E.
anion gap

A

calculated osmolality

36
Q

Na

A.
osmolar gap

B.
main intracellular cation

C.
calculated osmolality

D.
main extracellular cation

E.
anion gap

A

main extracellular cation

37
Q

K

A.
osmolar gap

B.
main intracellular cation

C.
calculated osmolality

D.
main extracellular cation

E.
anion gap

A

main intracellular cation

38
Q

In diabetics, this substance is formed in increased quantities in cells that do not require insulin for glucose uptake. It is injurious to those cells

Sorbitol
Glucose
Ketone bodies
Beta oxidation
Glycogen synthase
GLUT1
GLUT4
Glucokinase
Elevated serum osmolality
LDL cholesterol
HDL cholesterol
Albumin
Lipoprotein lipase
A

Sorbitol

Sorbitol is believed to be toxic and hence responsible for some of the complications of diabetes. If diabetes is not diagnosed in a mother during pregnancy, the baby will be exposed to large amounts of glucose, and the babies pancreas will make large amounts of insulin to try and bring down the blood glucose. The baby will thus get fat. When born, the mothers extra source of glucose disappears, and the neonate has a hypoglycaemic fit.

39
Q

The infant of a mother whose haemoglobin A1C was 9.8% during pregnancy is noted to be irritable, then display seizure activity soon after birth. What substance is decreased in the baby to explain these findings

Sorbitol
Glucose
Ketone bodies
Beta oxidation
Glycogen synthase
GLUT1
GLUT4
Glucokinase
Elevated serum osmolality
LDL cholesterol
HDL cholesterol
Albumin
Lipoprotein lipase
A

Glucose

40
Q

A patient with a diagnosis of type 1 diabetes mellitus has not taken any insulin for several days. Her breath has a fruity odour. What is detectable in her urine to explain this finding

Sorbitol
Glucose
Ketone bodies
Beta oxidation
Glycogen synthase
GLUT1
GLUT4
Glucokinase
Elevated serum osmolality
LDL cholesterol
HDL cholesterol
Albumin
Lipoprotein lipase
A

Ketone bodies

41
Q

50-year-old male has serum glucose values of 14.5mmol/l and 16.7 mmol/l on visits to his GP last month. His body mass index is 31. He has not had any major illnesses. What is detectable in the urine?

Sorbitol
Glucose
Ketone bodies
Beta oxidation
Glycogen synthase
GLUT1
GLUT4
Glucokinase
Elevated serum osmolality
LDL cholesterol
HDL cholesterol
Albumin
Lipoprotein lipase
A

Glucose

42
Q

Which is switched off by insulin?

Sorbitol
Glucose
Ketone bodies
Beta oxidation
Glycogen synthase
GLUT1
GLUT4
Glucokinase
Elevated serum osmolality
LDL cholesterol
HDL cholesterol
Albumin
Lipoprotein lipase
A

Beta oxidation

Only beta oxidation of fatty acids (involved in the breakdown of fatty acids to produce ketone bodies and energy) is switched off by insulin.