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1
Q

The trophoblast gives rise to

A

the fetal part of the placenta

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2
Q

which bonds are the strongest?

a) covalent
b) vanderwaals
c) hydrogen

A

covalent

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3
Q

how are hydrogen atoms arranged

A

3 in a straight line

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4
Q

which statement best describes ligand-gated ion channels:
a) they are opened by antagonists binding in the extra cellular domain
b) the conduct cations selectively
C) the conduct ions more quickly than carrier molecules

A

c

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5
Q

what is preload affected by

give an example

A
  • venous return ( the greater the vr the greater the preload)
  • inc renin secretion (as this inc blood vol)
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6
Q

glyceryl trinitrate mechanism of action

A

gives rise to NO which causes vasodilation and inc blood flow to myocardium, in the process arginine is converted to guanylate cyclase

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7
Q 
what is the highest risk factor for atherosclerosis
a) familial atherosclerosis
b) obesity
c) diet high in cholestrol
D) smoking
E)aged >50
A

d

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8
Q

Name what views of the heart a,b,c and d are

A

A) lateral
B) inferior
C) anterior/septal
D)lateral

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9
Q

What vessels do a,b,c,d correspond to

A

A- circumflex
B- right coronary
C- lad
D- circumflex

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10
Q

What pathogen causes community acquired pneumonia
How is community acquired pneumonia treated
(use CURB)

A

Streptococcus pneumoniae
Curb65 0-2
Amoxycillin/doxycycline

Curb 3-5
Co amoxiclav IV + doxy

ICU co amoxi IV + clarithromycin (p allergic- levofloxin)

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11
Q

What pathogen causes hospital acquired pneumonia

How is it treated

A

Aerobic gram negative- pseudomonas aeruginosa, E. Coli, Klebsiella pneumoniae

Amoxicillin + gentamycin

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12
Q

What pathogen causes aspiration pneumonia

How to treat

A

Pneumococcus, haemophillus influenza, staph A.
Amoxicillin + metronidazole
If caused by legionella then treat w levofloxacin

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13
Q

Treatment for hypertension

A 
Examples of 
Ace: lisinopril
Arb: losartan 
Calcium channel blocker: amlodipine
Thiazide like diuretic (d): bendroflumethiazide
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14
Q

What nerve is stimulated by blowing

A

Vagus

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15
Q

What type of ulcer is this: leg claudication for over 2 months,
Cool peripheries, distal pulses, ulcer on great toe
How to treat

A

Arterial
Lifestyly advice- inc activity
2nd line surgery
3rd line vasodilator

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16
Q

What type of ulcer is this: history of t2 diabetes, painless ulcer

A

Neuropathic

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17
Q

What type of ulcer is this:

Abpi 0.90, ulcer on medial mallelous, pregnant woman

A

Venous

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18
Q

What side of the heart is failing in this presentation: no oedema, needs to prop themselves up at night to relieve sob (paroxysmal nocturnal dyspnoea), tired, bibasal fine crepitations

A

Left sided heart failure. Right does not have bibasal fine crepitations/ paroxysmal nocturnal dyspnoea. has oedema, raised jvp, asictes, tender hepatomegaly, anorexia

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19
Q

Heart failure treatment

Acute, reduced ejection fraction, preserved ejection fraction

A

Acute: (LMNOP) lasix (loop diuretic), morphine, nitrate (eg. Nitroglycerin), oxygen, position

Reduced ejection fraction:
Symptom relief- loop diuretic, bblocker for angina, aldosterone antagonist (spironolactone)
Reduce mortality- ace/arb

Preserved ejection fracture:
Loop diuretic

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20
Q 
Which malignancy is associated with the spread to a lymph node in the left supraclavicular fossa?
A- cholangiocarcinoma of the bile duct
B- duodenal adenorcarcinoma
C- gastric adenocarcinoma
D- leiomyosarcoma 
E- metastic melanoma
A

C

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21
Q

Is this a bronchospasm or urt obstruction:

No audible respiration, bounding regular pulse, exaggerated chest movement

A

Urt obstruction, wheezing will occur with bronchospasm

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22
Q

How to manage beclometasone in asthma when patient has an oral fungal infection

A

Take beclometasone via large volume spacer

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23
Q

What causes lower lobe collapse. Give examples

A

Blocked airway or pressure from outside the lung.

Eg. Carcinoma of bronchus causes lower lobe collapse

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24
Q

How to treat an acute asthma attack

A 
Oxygen
Salbutamol (nebulised!)
Hydrocortisone IV
Ipratropium bromide IV
Theophyline
Magnesium sulfate
ANaesthetist
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25
Q

What nerve passes through the root of the neck

A

Phrenic

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26
Q

What equation shld be used for ABG

A

H= PCO2/ HCO3

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27
Q

What is warfarin anticoagulation monitored by?

A

INR (ratio based on prothrombin time)

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28
Q

How is low molecular weight herapin monitored?

A

Anti factor Xa (anti-FXa)

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29
Q

In order of most reliable, research methods:

A

Meta analysis, randomised control trials, cohort, case control, case series

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30
Q

What disease causes a ziehl-neelson stain to test positive

A

Tb

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31
Q

What is likely to happen in an influenza pandemic

A

School closure

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32
Q

Fill in the blanks

A
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33
Q

What types of fibres do anterior rootlets and roots contain?

A

Motor fibres.
In T1- L2 somatic sympathetic
In S2,3,4 parasympathetic

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34
Q

What types of fibres are contained in posterior rootlets and roots

A

Sensory fibres

35
Q

Spinal nerves contain what type of fibres

A

Mixed: motor and sensory

36
Q

What vertebral level does the spinal cord end

A

L1/L2

37
Q

Where does fertilisation normally occur

A

Ampulla of uterine tube

38
Q

Which direction are amino acids added in

A

N terminal to C terminal

39
Q

Max number of amino acids a gene of 30 nucleotides can produce

A

10

As 3 nucleotides make up 1 amino acid

40
Q 
Which of the following enzymes transfer genetic material
A. Amino acyk transferase
B. DNA polymerase
C. DNA transciptase
D. RNA polymerase
A

D

41
Q

What does a charged tRNA have attached

A

An amino acid

42
Q

Which best describes transcription factors?
A) DNA sequences that regulate transcription
B) enhancers
C) polysaccharides that bind to the transcripts
D) proteins that bind to the DNA
E) RNA sequences that bind to the RNA polymerase

A

D

43
Q

Which of the following best refer to: quarternary structure, tertiary structure, secondary structure

A) the individual sub units
B) the overall shape of the polypeptide chain
C) the path of the polypeptide backbone in three dimensional soace
D) the relative orientation of 1 polypeptide to another polypeptide in a multi subunit protein
E) the sum of secondary and tertiary interactions

A

Quarternary structure- D
Tertiary structure- B
Secondary structure- C (eg. Helices)

44
Q

What type of reactions occur in phase I (drug) metabolism and for what purpose

A

Oxidation, reduction, hydrolysis.
To make drugs more polar/react-able in phase II
(This can make drugs more toxic)

45
Q

what occurs in phase II metabolism

give eg

A

Conjugation of drug (polar from phase 1) with an endogenous substrate eg. glucuronidation

46
Q

What phase of metabolism can make drugs carcinogenic

A

Phase I

47
Q

What type of reaction results in the desensitisation to drugs

A

Phosphorylation reaction (causes receptor to change shape into an inactive form)

48
Q

What is affinity (pharm)

A

A measure of how strongly a drug binds to a receptor

49
Q

What is efficacy

A

measure of the max biological effect resulting from a drug binding to its target

50
Q

What is tolerance

A

Situation when increased dose levels of a drug are required to produce the same effect

51
Q

What is dependance

A

Related to the bodys ability to adapt to the the presence of a drug

52
Q

What is potentcy

A

A measure of the amount of drug required to produce a defined biological effect

53
Q

What would happen if you were to double the rate of administration of a drug that exhibits first order kinetics

A

The steady state plasma would be doubled

In 1st order kinetics the rate of metabolism is equal to drug concentration

54
Q

Describe what the “apparent volume of distribution” is

calculation

A

The apparent volume of distribution is an extrapolated volume that can be calculated from the dose of the drug divided by the plasma concentration of the drug

55
Q

If a drug has a high volume of distribution do u give a high or low dose

A

High

56
Q

A man with an X linked disease has a son. What is the likelihood his son is affected

A

0% as son will get working X from mother.

57
Q

What does uniparental disomy refer to

A

The situation in which 2 copies of a chromosome come from the same parent, instead of 1 copy coming from mum and 1 from dad

58
Q

Which antibody type forms pentamers to increase blood viscosity

A

IgM

59
Q

What does immunophenotyping investigate?

A

The pattern of antigen expression on/in antibodies

Eg. Identification of lymphocyte subsets

60
Q 
Which lab technique is best suited to monitor viral load RNA in the patients blood?
A) IgG
B) IgM
C) immunophenotyping
D) light microscopy
E) polymerase chain reaction
A

E

Amplifies HIV genome using DNA template polymerase, primers and nucleotides

61
Q

What cystein rich cationic proteins are secreted by epithelial cells at mucosal surfaces?

A

Defensin

62
Q

Label the parts hidden

A

Ps. Contains disulphide bonds

63
Q

What is C3a

A

A protein formed by the cleavage of complement component 3 and is an anaphylatoxin (complement peptide)

64
Q

what does lectin activate

how

A

Complement. (The lectin pathway is a cascade reaction that activates complement in an antibody-independant manner) (sugar)

65
Q 
Which of the following is g+
A) candida
B) clostridia
C) enterobacter
E) neisseria
A

B
A) is fungus
C) is g-, rod shaped, facultative anaerobe
E) g-

66
Q 
Which of the following produce spores
A) enteroccocus faecalis
B) neisseria gonirrhoeae
C) C. Difficile
E) streptoccyd pyogenes
A

C. Diff

67
Q

What lab techniques can be used for determining the antibiotic resistance profile of a micro-organism?

A

16s gene sequencing, PCR

68
Q

What is the biggest advantage of 16s gene sequencing?

A

Allows the identification of microbes that cannot be grown under normal lab conditions

69
Q

Main advantages of PCR (4)

A

Its ability to measure DNA concentrations over a large range, sensitivity, processes multiple samples simultaneously & provides immediate information

70
Q

give examples of cell wall antimicrobials
and which of those have b lactam rings
B) are these bactericidal or bacteriostatic

A

B lactam:
penicillins, cephlasporins (cetriaxone), carbapenams (imepenem)

non b lactam ring:
glycopeptides (vancomycin)

b) bactericidal

71
Q

Give examples of antibiotics that affect nucleic acids

A

Metronidazole, ciprofloxacin

72
Q

Give examples of antibiotics that target protein synthesis

A

Aminoglycosides (gentamicin), tetracyclines (eg doxycycline) and macrolides (erythromycin)

73
Q

Amoxicillin has a b lactam ring. How does this effect its use against pathogens with b lactamases

A

Ineffective

74
Q

What is cachexia

A

A condition that causes extreme weight loss and muscle wasting

75
Q

What is infilltration

A

Movement of cancer cells from their normal location into the surrounding non cancerous tissue

76
Q

What is the sequence of scar healing

A

Heamostasis, inflammation, repair and remodelling

77
Q

Cells predominently found in Granulation tissue

A

Endothelial cells and myofibroblasts

Remember granulation tissue is new connective tissue that is healing from a wound. Not the same as Granulomas! (Mainly contain macrophages/histiocytes)

78
Q

What is liquefactive necrosis

A

Necrosis that takes place in CNS. Characterised by the absence of cell structure and a resulting viscous mass.
Example: stroke

79
Q

What is coagulative necrosis

A

Type of accidental cell death commonly caused by hypoxia. Characterised by preserving the architechture of dead tissue. Can become dry, hard, white.
Eg. MI

80
Q

What is primary prevention

A

Preventing disease eg. Smoking cessation

81
Q

What is secondary prevention

A

Detecting/treating disease asap. Eg. Screening, daily low aspirin dose to prevent further MIs

82
Q

What is tertiary prevention

A

Soften ongoing illness to improve quality of life. Eg. Stroke rehab

83
Q

What is primordial prevention

A

Precedes primary prevention, focuses on risk factor prevention. Eg. Sanitisation

Year 1 (20 decks)

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