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Mixed Year 2 Questions > Random > Flashcards

Random Flashcards

1
Q

Peptic Ulcer is where?

a) Stomach
b) colon

A

Stomach

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2
Q

Which is the middle layer in stomach?

a) Lamina Propria
b) muscaris mucosa

A

Lamina Propria

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3
Q

Parietal cells secrete what?

a) Hydrochloric Acid
b) bicarbonate

A

Hydrochloric acid

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4
Q

Chief cells secrete what?

a) pepsinogen
b) secretin

A

pepsinogen

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5
Q

What does Gastrin stimulate?

a) parietal cells to secrete hydrochloric acid
b) Brunner cells

A

parietal cells to secrete hydrochloric acid

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6
Q

Where are Brunner Glands found?

a) duodenum
b) pancreas

A

duodenum

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7
Q

H Pylori are?

a) Gram Negative
b) gram positive

A

Gram Negative

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8
Q

Alternative cause of Peptic Ulcer?

a) NSAIDS
b) PPI

A

NSAIDS

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9
Q

Rare cause of peptic ulcer?

a) Zollinger Ellison Syndrome
b) HIV

A

Zollinger Ellison

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10
Q

Treatment of Peptic Ulcer?

a) Antibiotics and PPI eg Omeprazole
b) take the stomach out

A

a)Antibiotics and PPI eg Omeprazole

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11
Q

Barret’s Oesophagus is linked with?

a) Oesophageal Adenocarcinoma.
b) oesophageal squamous cell carcinoma

A

a) Oesophageal Adenocarcinoma.

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12
Q

Treatment for GORD?

a) Antacids, PPI eg Omeprazole and Fundoplication
b) Surgery

A

a) Antacids, PPI eg Omeprazole and Fundoplication

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13
Q

Gold Standard Gord Test?

a) Ph Manometry
b) colonoscopy

A

Ph Manometry

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14
Q

Ascending Cholangitis affects?

a) inflammation of bile ducts
b) inflammation of liver

A

Inflammation of bile ducts

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15
Q

Common cause of ascending cholangitis?

a) gallstones
b) liver disease

A

Gallstones

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16
Q

Common bacteria in ascending cholangitis?

a) E coli, Klebsiella and Enterococcus
b) strep pneumocccous

A

E coli, Klebsiella and Enterococcus

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17
Q

Charcot’s triad is made up of?

a) Fever, RUQ Pain and Jaundice
b) Fever, LUQ Pain and Jaundice

A

Fever, RUQ Pain and Jaundice

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18
Q

Diagnosis of Ascending Cholangitis?

a) bloods and ERCP
b) MRI

A

Bloods and ERCP

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19
Q

What does Intra hepatic mean?

a) inside liver
b) outside liver

A

inside liver

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20
Q

what does extra hepatic mean?

a) outside liver
b) inside liver

A

outside liver

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21
Q

Presentation with Primary Sclerosing Cholangitis?

a) Raised IgM and Panca
b) raised IgG

A

Raised IgM and Panca

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22
Q

Test results in Primary Sclerosing Cholangitis?

a) Raised Conjugated Bilirubin and ALP and GGT
b) Decreased Conjugated Bilirubin and ALP and GGT

A

Raised Conjugated Bilirubin and ALP and GGT

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23
Q

Test for Primary Sclerosing Cholangitis?

a) ERCP
b) Ultrasound

A

ERCP

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24
Q

Treatment for Primary sclerosing cholangitis?

a) immunosuppresant
b) antibiotic

A

Immunosuppresant

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25
Q

What is Primary Sclerosing Cholangitis?

a) Hardening of bile duct for no reason
b) softening of bile duct

A

Hardening of bile duct for no reason

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26
Q

Acute Cholecystitis is what?

a) inflammation of gallbladder
b) infection

A

Inflammation of gallbladder

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27
Q

Where does CCK come from?

a) gallbladder
b) pancreas

A

Gallbladder

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28
Q

Most common malignant tumour in Hepatic?

a) extrahepatic hilar
b) intrahepatic hilar

A

Extraheptic Hilar

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29
Q

Primary biliary cholangitis is said to be

a) intrahepatic
b) extra hepatic

A

Intrahepatic

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30
Q

What happens to serum alkaline phosphatase in Primary Biliary Cholangitis?

a) raised
b) decreased

A

raised

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31
Q

Cirrhosis is a response of the liver to?

a) chronic injury
b) acute injury

A

Chronic Injury

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32
Q

Hepatitis which causes Cirrhosis?

a) hep b and c
b) hep a

A

Hep B and C

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33
Q

What is Cholelithiasis

a) gallstones
b) liver tumour

A

Gallstones

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34
Q

Extra Hepatic Duct Obstruction cause?

a) gallstones
b) liver tumour

A

Gallstones

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35
Q

Calcular Obstructive Jaundice. What happens to weight?

a) no weight loss
b) weight loss

A

No weight loss

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36
Q

In presence of palpable gallbladder, jaundice is said to be?

a) unlikely to be caused by gallstones
b) likely to be gallstones

A

unlikely to be caused by gallstones

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37
Q

What vitamin deficiency in absence of bile?
a) Vitamin K
b Vitamin A

A

Vitamin K

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38
Q

Which Immunoglobulin is relevant to Coeliac?

a) IgA
b) IgG

A

IgA

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39
Q

Which conditions are associated with Coeliac?

a) Dermatitis, Autoimmune Hepatitis, Primary Biliary Cholangitis, Autoimmune Gastritis
b) Splenectomy

A

Dermatitis, Autoimmune Hepatitis, Primary Biliary Cholangitis, Autoimmune Gastritis

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40
Q

Colorectal Cancer Test Gold Standard?

a) colonoscopy and biopsy
b) Endoscope

A

Colonscopy and biopsy

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41
Q

An illeostomy is usually?

a) LIF
b) RIF

A

RIF

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42
Q

A colostomy is usually

a) LIF
b) RIF

A

LIF

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43
Q

Upper GI bleeds are said to be?

a) distal to ligament of trietz
b) proximal to ligament of trietz

A

Proximal to Ligament of Trietz

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44
Q

Lower GI bleeds are said to be?

a) distal to ligament of trietz
b) proximal to ligament of trietz

A

Distal to Ligament of Trietz

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45
Q

what would you expect to see regarding urea in upper GI bleeds?

a) elevated
b) depressed

A

elevated

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46
Q

Which condition causes recurrent poor healing duodenal ulcers?

a) Zollinger ellison
b) coeliac

A

Zollinger Ellison

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47
Q

Mallory Weiss Tear is a tear where?

a) oesophago-gastric junction
b) pyloric sphincter

A

Oesophago-Gastric Junction

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48
Q

Angiodysplasia is what?

a) vascular malformation
b) vascular growth

A

Vascular Malformation

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49
Q

In Ischaemic colitis what happens to mucosa?

a) dark blue, swollen
b) bleeding

A

dark blue, swollen

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50
Q

How to treat radiation proctitis?

a) APC, Enema
b) chemo

A

APC, Enemas

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51
Q

Telipressin does what in GI Bleed?

a) vasoconstrictor
b) vasodilator

A

Vasoconstrictor

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52
Q

Most common colorectal cancer?

a) adenocarcinoma
b) squamous cell

A

Adenocarcinoma

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53
Q

Are Adenomas Malignant?

a) No Pre-Malignant
b) yes

A

No Pre-Malignant

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54
Q

Most Colorectal Polyps are said to be?
a) Villous
B) Tubulovillous
C) Tubular

A

Tubular

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55
Q

Which oncogenes have to be activated in colorectal cancer?
A) Kras and Cymyc
b)APC,P53,DCC

A

Kras and Cmyc

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56
Q

Which genes are tumour suppressor?
A) Kras and Cymyc
b)APC,P53,DCC

A

APC,P53,DCC

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57
Q

Best test for Rectal Tumour?
A) CT
B)MRI

A

MRI

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58
Q

Is Bilary Dyskinesia Functional or Organic?

a) functional
b) organic

A

Functional

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59
Q

What happens in IBS-C?
a) Contractions Reeduced
B) Contractions Stronger

A

contractions reduced

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60
Q

Stapled Anopexy is used for what?

a) prolapse/haemorrhoids
b) rectal cancer

A

prolapse/haemorrhoids

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61
Q

Most common colorectal cancer site?

a) Right colon
b) left colon
c) transverse

A

left colon

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62
Q

How to treat Anorectal Adenocarcinoma?

a) neoadjuvant chemo
b) radiotherapy

A

neoadjuvant chemo

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63
Q

How to treat anorectal squamous cancer?

a) neoadjuvant chemo
b) radiotherapy

A

radiotherapy

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64
Q

What is dynamic bowel obstruction

a) increasing peristalsis
b) cessation of peristalsis
c) no interference of blood supply

A

a) increasing peristalsis

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65
Q

what is adynamic bowel obstruction?

a) increasing peristalsis
b) cessation of peristalsis
c) no interference of blood supply

A

cessation of peristalsis

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66
Q

what is simple bowel obstruction?

a) increasing peristalsis
b) cessation of peristalsis
c) no interference of blood supply

A

c) no interference of blood supply

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67
Q

Adhesions can cause an

a) inside wall obstruction
b) outside wall obstruction

A

outside wall obstruction

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68
Q

How to treat bowel obstruction?

a) ng tube
b) nothing

A

Ng Tube

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69
Q

Most common locations of volvulus

a) caecal or sigmoid
b) ascending colon

A

caecal or sigmoid

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70
Q

Coffee bean sign is seen on x-ray in which condition?

a) sigmoid volvulus
b) adhesive sbo

A

sigmoid volvulus

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71
Q

How to treat Sigmoid volvulus
a) Colonscopy
B) flex sigmoidoscopy

A

B) flex sigmoidoscopy

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72
Q

Adhesive SBO diagnosis is established by?

a) CT
b) MRI

A

CT

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73
Q

What can be given to patients that do not improve who have Adhesive SBO?

a) PPI
b) Gastrografin

A

Gastrografin

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74
Q

Gallstone Ileus is impaction where?

a) Terminal Ileum
b) sigmoid colon

A

Terminal Ileum

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75
Q

Lamina Propria is
a) Loose Connective Tissue
B) Thin Smooth Muscle

A

a) Loose Connective Tissue

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76
Q

Meissner’s Plexus is said to be
a) Parasympathetic
B) sympathetic

A

parasympathetic

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77
Q

Which two plexuses make up enteric nervous system?
a) Submucosal and Myenteric
B) Brachial and Somatic

A

a) Submucosal and Myenteric

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78
Q

Long reflexes are said to be

a) parasympathetic
b) ENS

A

parasympathetic

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79
Q

Short reflexes are said to be

a) parasympathetic
b) ENS

A

ENS

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80
Q

Superior Mesenteric Artery Supplies

a) Small intestine, caecum, ascending colon and transverse colon
b) descending colon, sigmoid colon, rectum.

A

a)Small intestine, caecum, ascending colon and transverse colon

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81
Q

Inferior Mesenteric Artery Supplies

A

b)descending colon, sigmoid colon, rectum.

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82
Q

Medical Management of Fissure?

a) GTN/Diltiazem + Lignocaine
b) PPI

A

a)GTN/Diltiazem + Lignocaine

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83
Q

Medical Management of Faecal Incontinence?

a) Loperamide
b) PPI

A

Loperamide

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84
Q

Most common gene associated with IBD?
a) PIMM
B) NDO2

A

NDO2

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85
Q

Smoking is what for Ulcerative Colitis?

a) Protective
b) destructive

A

protective

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86
Q

Aphthous Ulcers are associated with?
a)Crohns
B) ulcerative colitis

A

Crohns

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87
Q

Non caseating granulomatous reaction is typical feature in
a)Crohns
B) ulcerative colitis

A

crohns

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88
Q

What can be used to induct/maintain remission for mild/moderate colitis?
a) 5ASA
B) Systemic Corticosteroid

A

5ASA

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89
Q

What can be used to rescue severe colitis?

a) Systemic corticosteroid
b) 5asa

A

a) Systemic corticosteroid

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90
Q

What two drugs can be used for induction/maintain remission for moderate to severe colitis?

a) immunomodulators/biologics
b) topical corticosteroids/systemic corticosteroids

A

a) immunomodulators/biologics

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91
Q

What do immumomodulators do in colitis?

A

block purine metabolism

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92
Q

What do biologics in colitis do?

a) block tnf

A

block tnf

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93
Q

Name a biologic agent used in colitis?

a) inflimab
b) athioprine

A

infliximab

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94
Q

Strictures are common or uncommon in crohns
common
uncommon

A

common

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95
Q

Where does fat digestion take place?

a) small intestine
b) large intestine

A

small intestine

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96
Q

What aids fat digestion

a) pancreatic lipase
b) amylase

A

a) pancreatic lipase

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97
Q

Micelles are made up of

a) bile salt + monoglyceride + fatty acid + phospholipid
b) Bile Salt + Disaccharide + fatty acid + phospholipid

A

a) bile salt + monoglyceride + fatty acid + phospholipid

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98
Q

Are Micelles absorbed?

a) yes
b) no

A

no

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99
Q

Where are Fats reinforced into Triacylglycerols?
a) Smooth Endoplasmic Reticulum
B)Rough Endoplasmic reticulum

A

a) Smooth Endoplasmic Reticulum

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100
Q

Can vitamins be absorbed by active diffusion?

a) yes
b) no

A

no

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101
Q

Iron is transported across?

a) brush border membrane via DMT1 into duodenal enterocytes
b) brush border membrane via DMT2 into duodenal enterocytes

A

a) brush border membrane via DMT1 into duodenal enterocytes

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102
Q

Iron in blood binds to?

a) transferrin
b) feratin

A

a) transferrin

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103
Q

What does Hyperaemia do?

a) Increase ferritin
b) decrease ferritin

A

increase ferritin

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104
Q

What does Anaemia do?

a) increase ferritin
b) decrease ferritin

A

decrease ferritin

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105
Q

iron uptake by body is regulated by?

a) hepcidin
b) ferritin

A

hepcidin

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106
Q

Chewing is controlled by

a) somatic nerves
b) sympathetic nerves

A

somatic nerves

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107
Q

Amylase catalyses breakdown of polysaccharide into?

a) monosaccharide
b) disaccharide

A

polysaccharide

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108
Q

What does Sympathetic and parasympathetic nervous system do to secretion of saliva?

a) stimulate
b) inhibit

A

stimulate

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109
Q

Oesophagus is lined by?
a) Non Keratinised Stratified Squamous Epithelium
B) Keratinised Stratified Squamous Epithelium

A

a) Non Keratinised Stratified Squamous Epithelium

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110
Q

Upper 1/3 of Oesophagus s?
a) Skeletal
B) Smooth

A

Skeletal

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111
Q

Lower 2/3 of Oesophagus is?
a) Skeletal
B) Smooth

A

Smooth

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112
Q

Swallowing centre is?

a) medulla
b) pons

A

medulla

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113
Q

Stomach produces?

a) vitamin a
b) intrinsic factor

A

intrinsic factor

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114
Q

Chief cells produce?

a) pepsinogen
b) mucus

A

pepsinogen

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115
Q

Parietal cells produce

a) pepsinogen
b) chi

A

hci

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116
Q

In Gastric Acid Secretion. Neurocrine is modulated by?
a) Vagus/Local reflexes
B) gastrin

A

Vagus/Local reflexes

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117
Q

In Gastric Acid Secretion. Endocrine is modulated by?

a) Gastrin
b) histamine

A

gastrin

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118
Q

In gastric acid secretion. Paracrine is modulated by?

a) histamine
b) gastrin

A

histamine

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119
Q

Vagal/Enteric Reflexes are affected by?
A) ACH
b) gastrin

A

ACH

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120
Q

ECL Reflexes are affected by?

a) Histamine
b) gastrin

A

Histamine

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121
Q

Stopping eating does what to vagal activity?

a) increase
b) decrease

A

decrease

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122
Q

Decreased ph and increased HCI does what to gastrin in the gastric phase?

a) decreases
b) increases

A

decreases

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123
Q

Fat/CHO in duodenum does what to gastrin and parietal HCI?

a) decrease
b) increase

A

decrease

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124
Q

Acid in duodenum causes what to release?

a) secretin
b) gastrin

A

secretin

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125
Q

Enterogastrones does what?

a) Inhibit gastric acid secretion and reduce emptying
b) increase gastric acid secretion and increase emptying

A

a) Inhibit gastric acid secretion and reduce emptying

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126
Q

Pepsinogen is secreted by

a) chief cells
b) parietal cells

A

chief cells

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127
Q

Parietal cells secrete?

a) HCI
b) chief cells

A

HCI

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128
Q

Gastrin does what to contraction?

a) increases
b) decreases

A

increases

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129
Q

Bicarbonate is produced from?

a) Brunner cells
b) parietal cells

A

bruner cells

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130
Q

Endocrine portion of pancreas has?

a) Islets of Langherhan
b) acinar cells

A

Islets of Langherhan

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131
Q

What prevents auto digestion of pancreas?

a) zymogen
b) pepsinogen

A

zymogen

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132
Q

What converts trypsinogen to trypsin?

a) enterokinase
b) peptide

A

enterokinase

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133
Q

Bicarbonate secretion is stimulated by?

a) secretin
b) gastrin

A

secretin

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134
Q

Hco3 is secreted by

a) hepatocytes
b) duct cells

A

duct cells

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135
Q

CCK causes?

a) decreased gastric emptying
b) increased gastric emptying

A

decreased gastric emptying

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136
Q

Crypt cells secrete?
a) CI and water
B)H

A

CI and Water

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137
Q

Mucosa epithelium

a) simple columnar stratified squamous
b) cuboidal columnar

A

simple columnar stratified squamous

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138
Q

Defecation reflex is under

a) Parasympathetic via Pelvic Splanchic
b) sympathetic

A

a) Parasympathetic via Pelvic Splanchic

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139
Q

Voluntary delay of defecation comes from

a) ascending pathways
b) descending pathways

A

descending pathways

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140
Q

What do enterotoxigenic bacteria cause?

a) increased h20 secretion
b) decreased h20 secretion

A

increased h20 secretion

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141
Q

Adenocarcinomas are commonly

a) prox and mid third oesophagus
b) distal oesophagus

A

distal oesophagus

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142
Q

squamous cell carcinomas are commonly

a) prox and mid third oesophagus
b) distal oesophagus

A

a) prox and mid third oesophagus

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143
Q

Commonly raised bloods in alcoholic hepatitis?

a) Bilirubin, GGT and Alk P
b) Wcc

A

a) Bilirubin, GGT and Alk P

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144
Q

Refeeding is commonly associated with?

a) Hypophosphatemia
b) hypovolemia

A

a)Hypophosphatemia

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145
Q

Pancreatic Cancer. Does it have obstructive jaundice or not?

a) yes
b) no

A

yes

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146
Q

Recurrent pancreatitis. What would you question?

a) Pancreatic Cancer
b) Ascending Cholangitis

A

Pancreatic Cancer

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147
Q

Which skin condition can be associated with acute pancreatitis?

a) mumps
b) measles

A

mumps

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148
Q

Which oxidative product is associated with acute pancreatitis?

a) acetaldehyde
b) fatty acid ethyl esters

A

a) acetaldehyde

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149
Q

Which autosomal dominant genes are associated with chronic pancreatitis?

a) autosomal dominant (codon 29 and 122
b) autosomal recusant (codon 30 and 133)

A

a)autosomal dominant (codon 29 and 122

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150
Q

Which enzyme would you look for in Chronic pancreatitis?

a) elastase
b) amylase

A

elastase

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151
Q

Treatment for Peptic Ulcer

a) NSAIDS
b) Eradication therapy including PPI eg Omeprazole

A

b) Eradication therapy including PPI eg Omeprazole

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152
Q

Large bowel have villi or not?

a) no villi
b) have villi

A

no villi

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153
Q

Large bowel crypts

a) tubular
b) square

A

tubular

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154
Q

H2 Antagonists such as Rantidine used to treat/prevent

a) Peptic and Duodenal Ulcer
b) Rectal Ulcer

A

Peptic and Duodenal Ulcer

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155
Q

Cyclizine which is an antihistamine helps with?
a) Vomiting/Nausea
B) Headache

A

Vomiting/Nausea

156
Q

Myelin Sheath does what to conduction speed?

a) increase
b) decrease

A

increase

157
Q

myelin sheath is formed by what in PNS?

a) Schwann cells
b) oligodendrocytes

A

Schwann cells

158
Q

myelin sheath is formed by what in CNS?

a) Schwann cells
b) oligodendrocytes

A

oligodendrocytes

159
Q

Cerebellum is involved in?

a) Balance and coordination
b) memory

A

balance and coordination

160
Q

Where does the 3rd ventricle lie within?

a) diencephalon
b) hippocampus

A

a) diencephalon

161
Q

Where does the cerebral aqueduct lie?

a) midbrain
b) hindbrain

A

midbrain

162
Q

Where does the 4th ventricle lie?

a) hindbrain
b) midbrain

A

hindbrain

163
Q

How many lateral ventricles

a) 2
b) 4

A

2

164
Q

Which space contains CSF?

a) Subarachnooid
b) Subdural

A

Subarachnoid

165
Q

Where is CSF made?

a) choroid plexus
b) 3rd ventricle

A

choroid plexus

166
Q

where is csf absorbed

a) by arachnoid villi into saggital sinus
b) by Pia villi

A

a) by arachnoid villi into saggital sinus

167
Q

Neural tube develops from

a) endoderm
b) ectoderm

A

ectoderm

168
Q

Medulla Oblongata continues as spinal cord at which foramen?

a) foramen magnum
a) foramen munro

A

foramen magnum

169
Q

Surface feature of medulla oblongata laterally?

a) pyramid
b) olive

A

olive

170
Q

what connects medulla oblongata to cerebellum?

a) inferior cerebellar peduncle
b) anterior cerebellar peduncle

A

inferior cerebellar peduncle

171
Q

Which ventricle is posterior to pons)

a) IV
b) I

A

IV

172
Q

Which cranial nerves originate from Pons surface?

a) V,VI, VII, VIII
b) V,VI,VII,X

A

a) V,VI, VII, VIII

173
Q

The pyramidal tract is said to be

a) motor
b) sensory

A

motor

174
Q

Cerebral aqueduct connects which ventricles

a) III and IV
b) I and II

A

a) III and IV

175
Q

Midbrain develops from

a) diencephalon
b) mesencephalon

A

mesencephalon

176
Q

Central cavity of midbrain is

a) cerebral aqueduct
b) foramen of munro

A

cerebral aqueduct

177
Q

The midbrain is the origin of which cranial nerves

a) oculomotor and trochlear
b) trigeminal and accessory

A

a) oculomotor and trochlear

178
Q

Which nerve is the only nerve to originate posteriorly

a) trochlear
b) oculomotor

A

trochlear

179
Q

Cerebellum hemispheres separated by

a) vermis
b) sulci

A

vermis

180
Q

How many peduncles connect cerebellum to brainstem?

A

three

181
Q

Diecenphalon is found near?

a) III ventricle
b) IV ventricle

A

III ventricle

182
Q

Internal carotid arteries enter skull through?

a) foramen lacerum
b) foramen munro

A

a) foramen lacerum

183
Q

Vertebral arteries enter skull through

a) foramen lacerum
b) foramen magnum

A

foramen magnum

184
Q

Middle cerebral arteries supply

a) lateral aspect of cerebral hemispheres
b) medial aspect of cerebral hemispheres
c) inferior aspect of cerebral hemispheres and occipital lobe

A

a) lateral aspect of cerebral hemispheres

185
Q

Anterior cerebral arteries supply

a) lateral aspect of cerebral hemispheres
b) medial aspect of cerebral hemispheres
c) inferior aspect of cerebral hemispheres and occipital lobe

A

b)medial aspect of cerebral hemispheres

186
Q

Posterior cerebral arteries supply

a) lateral aspect of cerebral hemispheres
b) medial aspect of cerebral hemispheres
c) inferior aspect of cerebral hemispheres and occipital lobe

A

c) inferior aspect of cerebral hemispheres and occipital lobe

187
Q

How many semi circular canals in each ear?

a) 2
b) 3

A

3

188
Q

Saccule gives

a) vertical acceleration
b) rotational acceleration
c) horizontal acceleration

A

a) vertical acceleration

189
Q

semi circular canals give

a) vertical acceleration
b) rotational acceleration
c) horizontal acceleration

A

b)rotational acceleration

190
Q

Utricle canals give

a) vertical acceleration
b) rotational acceleration
c) horizontal acceleration

A

c) horizontal acceleration

191
Q

Sensory cells of semi circular canals are where?

a) macule
b) ampulla

A

ampulla

192
Q

The macula in the utricle are orientated on the?

a) horizontal plane
b) vertical plane

A

horizontal plane

193
Q

The saccule are orientated on the?

a) vertical plane
b) horizontal plane

A

vertical plane

194
Q

Tilt of the head is detected by the?

a) macula in the utricle
b) ampulla

A

macula in utricle

195
Q

What connects the 2 hemispheres of the brain?

a) Corpus Callosum
b) Corpus Mallosum

A

Corpus Callosum

196
Q

Area 17 The Primary Visual Cortex in the brain is also known as

a) limbic lobe
b) occipital lobe

A

occipital lobe

197
Q

Visual Association Cortex in Occipital lobe is also called?

a) Areas 18 and 19
b) area 20

A

areas 18 and 19

198
Q

The hippocampus is found where?

a) medial aspect of temporal lobe
b) lateral aspect of temporal lobe

A

a) medial aspect of temporal lobe

199
Q

Where does Substantia migraine lie?

a) Midbrain
b) hindbrain

A

midbrain

200
Q

Which area is motor speech area?

a) broca
b) wernicke

A

broca

201
Q

Which area is auditory association area?

a) broca
b) wernicke

A

wernicke

202
Q

Internal capsule blood supply is from?

a) middle cerebral artery
b) anterior cerebral artery

A

middle cerebral artery

203
Q

Temporal lobe is involved in?

a) hearing and smell
b) vision

A

hearing and smell

204
Q

Which areas are associated with temporal lobe/primary auditory cortex?

a) areas 41 and 42
b) areas 19 and 20

A

areas 41 and 42

205
Q

Parietal lobe is associated with what and which area

a) sensory and areas 3,1 and 2
b) motor and areas 3,1 and 2

A

a) sensory and areas 3,1 and 2

206
Q

Frontal lobe is associated with?

a) motor
b) sensory

A

motor

207
Q

area 4 is associated with?

a) precentral gyrus/primary motor cortex
b) sensory and areas 3,1 and 2

A

a) precentral gyrus/primary motor cortex

208
Q

area 44 and 45 is associated with?

a) inferior frontal gyrus/broca
b) precentral gyrus/primary motor cortex

A

) inferior frontal gyrus/broca

209
Q

Subcortical nuclei are

a) white matter
b) grey matter

A

grey matter

210
Q

Posterior part of cerebral hemisphere is

a) sensory
b) motor

A

a) sensory

211
Q

anterior part of cerebral hemisphere is

a) sensory
b) motor

A

motor

212
Q

Is a meningioma benign or malignant?

a) benign
b) malignant

A

benign

213
Q

What happens to FEV1/FVC ratio in restrictive lung disease?

a) normal
b) increased
c) decreased

A

normal

214
Q

Questionaire for sleep apnoea?

a) montreal
b) epworth

A

epworth

215
Q

TACS Stroke must have?

a) Hemniopia
b) Diplopia

A

hemniopia

216
Q

TACS Stroke has

a) incomplete hemiparesis
b) complete hemiparesis

A

complete

217
Q

Tacs Stroke has

a) Heminopia (loss of vision on eye side)
b) loss of vision both sides

A

a) Heminopia (loss of vision on eye side)

218
Q

Lacunar stroke will not have

a) Will not have dysphasia, inattention or hemianopia
b) hemiparesis

A

a)Will not have dysphasia, inattention or hemianopia

219
Q

Which feature is common in mitral stenosis?

a) malar flush
b) pan systolic murmur

A

malar flush

220
Q

which feature is common in mitral stenosis

a) loud apex beat
b) tapping apex beat

A

tapping apex beat

221
Q

Treatment for Heart disease

a) ACE
b) Diuretics, AntiCoag and Sometimes Surgery

A

b) Diuretics, AntiCoag and Sometimes Surgery

222
Q

Which feature is common in mitral regurg

a) pan systolic murmur
b) loud apex beat

A

a) pan systolic murmur

223
Q

what is common in aortic stenosis

a) low pulse pressure
b) wide pulse pressure

A

a)low pulse pressure

224
Q

which features are common in aortic regard?

a) wide pulse and corrigan sign
b) pan systolic murmur

A

a) wide pulse and corrigan sign

225
Q

Repair AAA at what size
a) >5.5cm
b<5.5cm

A

a) >5.5cm

226
Q

How to diagnose AAA?

a) ultrasound
b) ct

A

ultrasound

227
Q

Stage 2 Hypertension is
a) 160/100
b 140/80

A

a) 160/100

228
Q

How to treat Hypertension in white person <55
a) ACE
B) Beta blocker

A

Ace

229
Q

How to treat hypertension in >55 or Black

a) ARB
b) ccb

A

ARB

230
Q

Patient with No ST elevation and no troponin rise

a) Unstable Angina
b) NSTEMI

A

Unstable Angina

231
Q

Irregular irregular pulse is seen in?

a) Atrial fibrillation
b) ventricular fibrillation

A

a) Atrial fibrillation

232
Q

How to test for Angina

a) bloods and ecg
b) echo

A

bloods and egg

233
Q

How to treat angina

a) GTN and b blocker
b) ARB

A

gtn and b blocker

234
Q

What to use in Heart failure

a) diuretics
b) ccb

A

diuretics

235
Q

Common in ECG with Cor Pulmonale?

a) Right axis deviation
b) left axis deviation

A

a) Right axis deviation

236
Q

Common features in critical limb ischaemia?
a) Hairless, Ulcers
B) heat

A

a) Hairless, Ulcers

237
Q

What does Horners Syndrome present as?

a) Miotic Pupils, Ptosis and Anhydrosis
b) Mydriasis

A

a) Miotic Pupils, Ptosis and Anhydrosis

238
Q

Crohns Treatment

a) Meselazine and Prednisolone
b) Sodium valproate

A

a) Meselazine and Prednisolone

239
Q

Name an anti platelet drug?

a) Clopidogrel
b) Warfarin

A

a) Clopidogrel

240
Q

Treatment for Parkinsons?

a) Levodopa
b) Sodium Valproate

A

Levodopa

241
Q

Where is Eustachian tube in the ear located?

a) mid
b) inner
c) outer

A

mid ear

242
Q

Ratio of Tympanic Membrane to Stapes in middle ear is?

a) 17.1
b) 16.1

A

17.1

243
Q

Which humour is in anterior segment of eye?

a) aqueous
b) vitreous

A

aqueous

244
Q

Sclera in eye is said to be?

a) Opaque
b) Transparent

A

Opaque

245
Q

What produces aqueous humour in eye?

a) ciliary body
b) sclera

A

ciliary body

246
Q

What does Ciliary Body do in eye?

a) suspend lens and produce aqueous humour
b) control diameter of pupil

A

a) suspend lens and produce aqueous humour

247
Q

What does Choroid do in eye?

a) supply blood
b) control diameter of pupil

A

a) supply blood

248
Q

Rods and Cones in the eye are situated where?

a) retina
b) choroid

A

retina

249
Q

What is accommodation in eye?

a) focusing
b) refraction

A

focusing

250
Q

what controls the sharpness of vision in eye?

a) refraction
b) accommodation

A

refraction

251
Q

Light waves from an object bend where in the eye?

a) cornea
b) retina

A

cornea

252
Q

What is the cornea’s bending power?

a) 45D
b) 15d

A

45d

253
Q

What is the lens bending power?

a) 45d
b) 15d

A

15d

254
Q

When an object is close what happens to the lens?

a) thicker/more powerful
b) thinner/more powerful

A

a)thicker/more powerful

255
Q

What happens to eyes in accomodation

a) pupils constrict and eyes converge
b) pupils dilate and eyes converge

A

a)pupils constrict and eyes converge

256
Q

Which muscle in eye contracts to make lens thicker?

a) oblique inferior
b) ciliary muscle

A

b) ciliary muscle

257
Q

What causes ciliary body contraction?

a) parasympathetic
b) sympathetic

A

parasympathetic

258
Q

Which muscles of the eye are used to converge?

a) Medial rectus
b) oblique rectus

A

medial rectus

259
Q

Which opsins are present in eye cones?

a) S,L and M
b) S,L and N

A

a) S,L and M

260
Q

Visual pigment rhodopsin is made up of?

a) opsin and 11 cis retinal
b) opsin and 13 cis retinal

A

a) opsin and 11 cis retinal

261
Q

In the dark what happens to depolarised Na+ and Ca+ channels in eye?

a) Open
b) Closed

A

Open

262
Q

Which fluid in eye helps maintain intraocular pressure?

a) aqueous
b) vitreous

A

aqueous

263
Q

Conjuntiva does not cover which part of eye?

a) Inner eyelid
b) cornea

A

cornea

264
Q

Intrinsic eye muscles do what?

a) control diameter
b) move eye

A

control diameter

265
Q

extrinsic eye muscles do what?

a) control diameter
b) move eye

A

move eye

266
Q

The superior oblique muscle in eye arises from?

a) roof of orbit posteriorly
b) floor of orbit posteriorly

A

a)roof of orbit posteriorly

267
Q

The inferior oblique muscle in eye arises from?

a) roof of orbit posteriorly
b) floor of orbit posteriorly

A

b) floor of orbit posteriorly

268
Q

The eye rectus muscles insert onto sclera?

a) anteriorly
b) posteriorly

A

anteriorly

269
Q

Superior oblique muscle of eye origin?

a) lesser wing of sphenoid
b) greater wing of sphenoid

A

a) lesser wing of sphenoid

270
Q

which nerve supplies lateral rectus of eye?

a) trochlear
b) abducens

A

abducens

271
Q

Which nerve supplies superior oblique of eye?

a) trochlear
b) abducens

A

trochlear

272
Q

What is intorsion of eye?

a) when top of eyeball rotates towards nose
b) then top of eyeball rotates away from nose

A

a) when top of eyeball rotates towards nose

273
Q

What does Medial rectus of eye do?

a) adduction
b) abuction

A

adduction

274
Q

what does lateral rectus of eye do?

a) abduction
b) adduction

A

abduction

275
Q

What does superior rectus of eye do?

a) elevation
b) depression

A

elevation

276
Q

what does inferior rectus of eye do?

a) depression
b) elevation

A

depression

277
Q

What do oblique muscles of eye do?

a) Intorsion/extorsion
b) depression

A

intorsion/extorsion

278
Q

What happens in the eyes with increased illumination?

a) parasympathetic constriction
b) sympathetic dilation

A

parasympathetic constriction

279
Q

The pupillary reflex fibres go where in afferent limb?

a) EWL Fibres of one side
b) EWL fibres of both sides

A

b)EWL fibres of both sides

280
Q

Trochlear nerve arises from?

a) dorsal part of midbrain
b) ventral part of midbrain

A

a) dorsal part of midbrain

281
Q

Trochlear nerve supplies

a) superior oblique of eye
b) inferior oblique of eye

A

a) superior oblique of eye

282
Q

Oculomotor nerve synapses at

a) ciliary ganglion
b) optic ganglion

A

ciliary ganglion

283
Q

Abducens nerve supplies

a) lateral rectus
b) superior rectus

A

a)lateral rectus

284
Q

Nasociliary nerve supplies medial part of orbit, ethmoidal air sinus and nasal cavity by going?

a) medially
b) laterally

A

medially

285
Q

Lacrimal branch supplies lateral part of orbit and lacrimal gland by going?

a) medially
b) laterally

A

laterally

286
Q

The cavernous sinus is?

a) immediately posterior to apex of orbit
b) immedlately anterior to apex of orbit

A

a)immediately posterior to apex of orbit

287
Q

Central retinal artery supplies

a) inner layers of retina
b) outer layers of retina

A

a) inner layers of retina

288
Q

Long Posterior ciliary arteries supply

a) anterior choroid, ciliary body and iris
b) retina

A

a) anterior choroid, ciliary body and iris

289
Q

The lacrimal gland is situated in orbit?

a) laterally
b) medially

A

laterally

290
Q

Tears drain on which side of each eyelid?

a) medial
b) lateral

A

medial

291
Q

Tears eventually drain into?

a) inferior meatus
b) superior meatus

A

inferior meatus

292
Q

Surface ectoderm forms?

a) eyelids, conjunctiva, corneal epithelium
b) choroid, cornea, sclera and extraocular muscles

A

a)eyelids, conjunctiva, corneal epithelium

293
Q

Mesenchyme forms?

a) eyelids, conjunctiva, corneal epithelium
b) choroid, cornea, sclera and extraocular muscles

A

b)choroid, cornea, sclera and extraocular muscles

294
Q

The eye oblique muscles do what when the eye is adducted?

a) depress/elevate
b) abduct

A

depress/elevate

295
Q

The eye rectified do what when eye is abducted?

a) depress/elevate
b) aduct

A

a)depress/elevate

296
Q

Cornea histology?

a) stratified squamous non keratinised
b) non stratified squamous non keratinised

A

a)stratified squamous non keratinised

297
Q

Are there any blood vessels in cornea?

a) no
b) yes

A

no

298
Q

How is transparency maintained in cornea

a) regular arrangement of collagen in stroma
b) irregular arrangement of collagen in stroma

A

a)regular arrangement of collagen in stroma

299
Q

What s a corneal transplant called

a) Keratoplasty
b) Meratoplasty

A

a) Keratoplasty

300
Q

Layer 1 of Tear film is known as?

a) mucinous layer overlying corneal epithelium
b) aqueous layer overlying mucinous layer

A

a) mucinous layer overlying corneal epithelium

301
Q

Layer 2 of Tear film is known as?

a) mucinous layer overlying corneal epithelium
b) aqueous layer overlying mucinous layer

A

b)aqueous layer overlying mucinous layer

302
Q

Roseacea is known as chronic or acute inflammation?

a) chronic
b) acute

A

chronic

303
Q

Pulmonary Artery travels where?

a) away from heart
b) towards heart

A

away from heart

304
Q

Which lung has a horizontal fissure?

a) Right lung
b) left lung

A

right lung

305
Q

Type 1 Cells in Alveoli are?

a) gas exchange
b) synthesise surfactant

A

gas exchange

306
Q

Type 2 Cells in Alveoli are?

a) gas exchange
b) synthesise surfactant

A

synthesise surfactant

307
Q

How many times do the bronchi branch?

a) 12
b) 22

A

22

308
Q

What is pulmonary circulation

a) deliver co2 to lungs and pick up 02
b) deliver 02 to lungs and pick up co2

A

a)deliver co2 to lungs and pick up 02

309
Q

Parietal or Visceral is sensitive to pain?

a) parietal
b) visceral

A

parietal

310
Q

Pleural fluid is positive or negative?

a) negative
b) positive

A

negative

311
Q

Boyle’s Law is what?

a) increase volume = decrease pressure
b) decrease volume=decrease pressure

A

a) increase volume = decrease pressure

312
Q

Histamine acts as

a) bronchoconstrictor
b) bronchodilator

A

bronchoconstrictor

313
Q

Pressure inside pleural cavity is always?

a) negative
b) positive

A

negative

314
Q

Anatomical dead space volume is?

a) 150ml
b) 200ml

A

150ml

315
Q

What is tidal volume?

a) volume of air breathed in or out of lungs during single expiration or inspiration
b) volume of air air which can be expelled from lungs at end of normal expiration

A

a)volume of air breathed in or out of lungs during single expiration or inspiration

316
Q

What is expiratory reserve volume?

a) volume of air breathed in or out of lungs during single expiration or inspiration
b) volume of air air which can be expelled from lungs at end of normal expiration

A

b)volume of air air which can be expelled from lungs at end of normal expiration

317
Q

What is residual volume?

a) volume of air breathed in or out of lungs during single expiration or inspiration
b) volume of gas in lungs at end of max expiration

A

b) volume of gas in lungs at end of max expiration

318
Q

Vital capacity is made up of

a) tidal volume + inspiratory and expiratory reserve volumes
b) tidal volume + residual volume + inspiratory reserve volume

A

a)tidal volume + inspiratory and expiratory reserve volumes

319
Q

Total lung capacity is made up of

a) Vital Capacity + Residual Volume
b) Tidal volume + inspiratory reserve volume

A

a)Vital Capacity + Residual Volume

320
Q

Inspiratory capacity is made. up of ?

a) tidal volume + inspiratory reserve volume
b) expiratory reserve volume _+ residual volume

A

a) tidal volume + inspiratory reserve volume

321
Q

Functional Residual volume is made up of?

a) tidal volume + inspiratory reserve volume
b) expiratory reserve volume _+ residual volume

A

b)expiratory reserve volume _+ residual volume

322
Q

Surfactant production starts at?

a) 25 weeks gestation
b) 36 weeks gestation

A

a) 25 weeks gestation

323
Q

Compliance does what from base to apex?

a) declines
b) increases

A

declines

324
Q

What happens in emphysema to elasticity?

a) loss
b) increase

A

loss

325
Q

What can be measured directly by spirometry?

a) tidal volume, expiratory volume, inspiratory reserve volume, inspiratory capacity and vital capacity?
b) residual volume

A

a) tidal volume, expiratory volume, inspiratory reserve volume, inspiratory capacity and vital capacity?

326
Q

Pulmonary Ventilation is product of?

a) tidal volume and respiratory frequency
b) tidal volume and heart rate

A

a) tidal volume and respiratory frequency

327
Q

Ventilation control is by

a) vagus nerve
b) phrenic nerve

A

phrenic nerve

328
Q

Which nerve innervates external intercostal muscles?

a) phrenic
b) intercostal

A

intercostal

329
Q

What happens with increase in thoracic cavity?

a) decrease in pressure
b) increase in pressure

A

decrease in pressure

330
Q

Ventilation control is within

a) pons and medulla
b) hind brain

A

pons and medulla

331
Q

What happens if you sever above C3-5?

a) breathing increases
b) breathing ceases

A

breathing ceases

332
Q

Dorsal or ventral is associated with respiration?

a) Dorsal
b) ventral

A

dorsal

333
Q

Dorsal respiratory group is?

a) inspiratory muscles
b) exhalation

A

a) inspiratory muscles

334
Q

Central chemoreceptors respond directly to?

a) hydrogen ions
b) calcium

A

hydrogen ions

335
Q

Peripheral chemoreceptors are located?

a) carotid and aortic bodies
b) medulla

A

carotid and aortic bodies

336
Q

What happens when rise in hydrogen ions concentration for breathing?

a) reflex stimulation of ventilation
b) reflex inhibition of ventilation

A

a) reflex stimulation of ventilation

337
Q

What happens when there’s a rise in carbon dioxide in blood?

a) rise in hydrogen ions
b) decrease in hydrogen ions

A

rise in hydrogen ions

338
Q

What happens with vomiting in respiratory?

a) Alkalosis and Ventilation inhibited
b) acidosis and ventilation inhibited

A

inhibited

339
Q

Barbiturates and Opoids do what to respiratory centre?

a) depression
b) increase

A

depression

340
Q

Gaseous anaesthetic agents do what to breathing?

a) increase respiratory but decrease tidal volume so decrease alveolar ventilation
b) decrease respiratory and tidal volume

A

a) increase respiratory but decrease tidal volume

341
Q

Ntrous oxide does what to peripheral chemoreceptor?

a) blunts it
b) activates it

A

Blunts it

342
Q

What do patients with chronic lung disease rely on?

a) changes in po2
b) changes in pco2

A

changes in po2

343
Q

Hyperventilation does what to po2 and pco2?

a) increase po2 and decrease pco2
b) decrease po2 and increase pco2

A

a) increase po2 and decrease pco2

344
Q

In anaemia what happens to pao2?

a) low
b) normal

A

normal

345
Q

Respiratory cause of type 1 respiratory failure?

a) pneumonia or PE
b) lung cancer

A

a) pneumonia or PE

346
Q

Type 2 respiratory failure respiratory causes

a) asthma, copd
b) pneumonia

A

asthma, copd

347
Q

What happens to Paco2 in Type 2 respiratory failure?

a) increased
b) decreased

A

increased

348
Q

In respiratory embryology. Pseudo-glandular is?

a) 5-17 weeks
b) 16-26 weeks

A

5-17 weeks

349
Q

In respiratory embryology. Canalicular is?

a) 5-17 weeks
b) 16-26 weeks

A

16-26 weeks

350
Q 
The heart is situated anterior to which vertebrae in the recumbent (lying down) position? 

	A    C4 - C7

	B    T1 - T5

	C    T5 - T8

	D    T6 - T9

	E    T10 - T12
A

T5-8

351
Q

What features are common to both skeletal and cardiac muscle?
A Myocytes in both are electrically connected via gap-junctions

B    The duration of the depolarising phase of the action potential in both is less than 5 msec

C    They both exhibit sustained contraction (tetanus) in response to high frequency stimulation

D    They both have an unstable resting membrane potential

E *None of the above features are shared in common

A

None of the above features are shared in common

352
Q 
During embryological development, which pair of aortic arches give rise to the common carotid arteries?

	A    2nd pair of aortic arches 

	B     3rd pair of aortic arches 

	C    4th pair of aortic arches

	D    5th pair of aortic arches 

	E    6th pair of aortic arches
A

B 3rd pair of aortic arches

353
Q

What anatomical features allow arterioles to function as resistance vessels?

A    They have a relatively narrow lumen and a thin elastic wall

B     They have a relatively narrow lumen and strong muscular wall 

C    They have a relatively wide lumen and a thin elastic wall

D    They have a relatively wide lumen and strong muscular wall

E    The statement is wrong; arterioles are not resistance vessels
A

B They have a relatively narrow lumen and strong muscular wall

354
Q 
5.    In the heart, the fast depolarising phase of the cardiac action potential is caused by the influx of which ions?

	A    Influx of Ca2+

	B    Influx of Cl-

	C    Influx of K+

	D    Influx of Mg2+
E.            Influx of Na+
A

Influx of Na+

355
Q
  1. What event causes the second heart sound?
A    Blood entering the aorta

B    Closure of the semilunar valves 

C    Closure of the the atrioventricular valves

D    Contraction of the atria

E    Opening of the atrioventricular valves
A

B Closure of the semilunar valves

356
Q

What effect is a heart rate in excess of 150 beats per minute is likely to have on the stroke volume?

A    Decrease afterload and therefore decrease stroke volume

B    Decrease contractility and therefore decrease stroke volume

C    Decrease preload and therefore decrease stroke volume 

D    Increase afterload and therefore decrease stroke volume

E    Increase preload and therefore decrease stroke volume
A

C Decrease preload and therefore decrease stroke volume

357
Q

What effect will activation of beta1-adrenoceptors on cardiac myocytes have on stroke volume?

A    Increase afterload and therefore decrease stroke volume

B    Increase afterload and therefore increase stroke volume

C    Increase contractility and therefore increase stroke volume 

D    Increase preload and therefore decrease stroke volume
E    Increase preload and therefore increase stroke volume
A

C Increase contractility and therefore increase stroke volume

358
Q

What is the distinguishing feature of the pulmonary circulation?

A    Most pulmonary blood flow occurs during diastole

B     Pulmonary arterioles constrict in response to local hypoxia

C    Pulmonary arterioles express beta1-adrenoreceptors 

D    The pulmonary circulation shows excellent pressure autoregulation

E    The pulmonary circulation shows good active (metabolic) hyperaemia
A

B Pulmonary arterioles constrict in response to local hypoxia

359
Q
  1. During exercise, what mechanism causes an increase in venous pressure, and hence venous return to the heart?
A    An increase in the systemic filling pressure

B    Contraction of smooth muscle surrounding the veins

C    Increased rate and depth of respiration

D    Rhythmic contraction of skeletal muscle

E     All of the above
A

E All of the above

360
Q 
12.    A 46 year old woman has intermittent rapid regular palpitations that are terminated by the valsalva manoeuvre. She feels well between these episodes.
	
	Which is the most likely diagnosis?

	A    Atrial fibrillation

	B    Supraventricular tachycardia

	C    Ventricular ectopics

	D    Ventricular fibrillation

E    Ventricular tachycardia
A

B Supraventricular tachycardia

361
Q 
13.    A 65 year old woman with hypertension is admitted to the acute medical admissions unit with sudden onset of severe breathlessness, and paroxysmal nocturnal dyspnoea (PND). She is tachycardic with an elevated jugular venous pressure (JVP), crackles in both lung fields to the midzones and significant peripheral oedema. 
	
	Which is the most appropriate initial drug treatment?

	A    Angiotensin converting enzyme inhibitor

	B    Angiotensin II blocker

	C    Beta blocker

	D    Calcium channel blocker

E. Diuretic
A

E. Diuretic

362
Q 
A 68 year old man presents with exertional angina. 
	
	Which is the most appropriate treatment to improve symptoms?

	A    Angiotensin-converting-enzyme (ACE) inhibitor

	B    Aspirin 75mg/day

	C    Beta blocker 

	D    Low dose warfarin

E    Simvastatin
A

C Beta blocker

363
Q 
A 40 year old man is found to have high blood pressure. You believe he may suffer from “white coat hypertension”. 
	
	Which investigation would confirm this?

	A    24 hour ambulatory blood pressure recording 

	B    24 hour urinary catecholamines

	C    Echocardiography

	D    Renal arteriography

	E    Renal ultrasound
A

24 hour ambulatory blood pressure recording

364
Q 
16.    A 26 year old woman has a hot, swollen right leg following a flight from Australia. Ultrasound confirms deep vein thrombosis (DVT) in the right lower limb.
	
	Which is the most appropriate initial treatment?

	A    Aspirin

	B    Clopidogrel

	C    Low molecular weight heparin

	D    Thrombolysis

	E    Warfarin
A

C Low molecular weight heparin

365
Q 
A child is born with coarctation of the aorta, short stature, neck webbing and gonadal dysgenesis.
	
	Which is the most likely diagnosis?

	A    Down syndrome

	B    Noonan syndrome

	C    Shprintzen syndrome

	D    Turner syndrome 

	E    Williams syndrome
A

D Turner syndrome

366
Q 
18.    A 70 year old man has a three month history of pain in the back of both his calves after walking 100 metres. He is a smoker of 53 pack years.
	
	Which is the most likely diagnosis?

	A    Arterial thromboembolus

	B    Baker's cyst

	C    Deep vein thrombosis

	D    Peripheral vascular disease

	E    Varicose veins
A

D Peripheral vascular disease

367
Q 
A newborn infant with a murmur is found to have an atrio-ventricular septal defect on echocardiography. The baby is hypotonic. 
	
	Which is the most likely diagnosis?

	A    22q11 microdeletion

	B    Down syndrome 

	C    Foetal alcohol syndrome

	D    Multifactorial congenital heart disease

	E    Turner syndrome
A

B Down syndrome

368
Q 
A 70 year old man presents with an ulcer of his left leg. His sleep is being interrupted by severe leg pain. 
	
	Which is the most likely cause of his ulcer?

	A    Chronic venous insufficiency

	B    Critical limb ischaemia 

	C    Diabetic neuropathy

	D    Post-phlebitic syndrome

	E    Squamous carcinoma
A

Critical limb ischaemia

369
Q 
1.  The maximum volume of air that can be voluntarily exhaled following a maximum inspiration is called:
	
	A. Expiratory Reserve Volume 
	B. Functional Residual Capacity 
	C. Residual Volume volume 
	D. Vital Capacity  
	E. Vital Volume
A

D. Vital Capacity

370
Q 
2.  Air flows into the lungs during inspiration because:- 

A.  The external intercostal and diaphragm muscles contract and thoracic volume decreases

B.  The external intercostal and diaphragm muscles contract and thoracic 
      volume increases 

C.  The internal intercostal and abdominal muscles contract and thoracic volume decreases 

D.  The internal intercostal and abdominal muscles contract and thoracic volume increases 

E.  The internal intercostal and diaphragm muscles contract and thoracic volume increases
A 
B.  The external intercostal and diaphragm muscles contract and thoracic 
	      volume increases (correct answer)
371
Q 
A male patient has a respiratory rate of 10 breaths per minute and a tidal volume of 700ml. If his residual volume measures 1000ml and his dead space volume measures 200ml what is his alveolar ventilation?
	
	A.  5000ml/min 
	B.  7200ml/min  
	C.  8000ml/min
	D.  9000ml/min
E. 10,000ml/min
A

5000ml/min (correct answer) (TV-DS) x RR = alveolar ventilation

372
Q 
The partial pressure of oxygen in mixed venous blood is typically around:
	
	A. 40 mmHg (5.3kPa) 
	B. 46 mmHg (6.1kPa)
	C. 100mmHg (13.3kPa)
	D. 160 mmHg (21.3kPa)
E. 200 mmHg (26.7kPa)
A

A. 40 mmHg (5.3kPa)

373
Q

rterial partial pressure of oxygen will be reduced in which of the following conditions?

A.  Anaemia resulting from iron deficiency
B.  Anaemia resulting from vitamin B12 deficiency
C.  Carbon monoxide poisoning
D.  Emphysema
E.  Traumatic peripheral haemorrhage
A

D. Emphysema (correct answer) this is the only answer where oxygen concentration in solution (PaO2) will be reduced. The other conditions may result in significant decreases in total oxygen content (due to lack of oxygen binding to Hb or loss of Hb) but oxygen in solution in plasma will be unaffected.

374
Q

Which of the following statements is NOT true for individuals with chronic lung disease?

A.  Arterial PCO2 levels are elevated due to poor alveolar ventilation
B.  Nitrous oxide is a safe sedative to use 
D.  They have decreased sensitivity to PCO2 
E.  They rely on their peripheral chemoreceptors for stimulating ventilation
A

Nitrous oxide is a safe sedative to use (correct answer) Nitrous oxide blunts the peripheral chemoreceptor response to falling oxygen, and as these patients are on “hypoxic drive” this effectively leaves them with no intrinsic means of controlling their ventilation.

375
Q

“Shunt” is a term that would be associated with which of the following situations:

A.  Bulk transport of oxygen via haemoglobin to peripheral tissues
B.  Movement of air through the conducting airways to the alveoli during inspiration
C.  Pulmonary embolism (blockage of the pulmonary vessels by coagulated blood)
D.  When perfusion exceeds ventilation in L/min 
E.  When ventilation exceeds perfusion in L/min
A

D. When perfusion exceeds ventilation in L/min (correct answer)

376
Q 
Which of the following is most likely to shift the haemoglobin oxygen binding curve to the right?
	
	A.  Asthma attack
	B. Hypothermia 
	C.  Presence of foetal haemoglobin 
	D.  Respiratory alkalosis 
	E.  Voluntary hyperventilation
A

Asthma attack (correct answer) poor ventilation would mean increased PCO2 in plasma, one of the factors that shifts the curve to the right, along with the associated acidosis

377
Q 
The articulation of the rib with the vertebrae allows for respiratory movements. At the costovertebral joints the head of the 9th rib articulates with the body of vertebra/e:
	
	A.  T 8
	B.  T8 and T9 
	C.  T9
	D.  T9 and T10
	E.  T10
A

T8 and T9

378
Q

The lungs are dissimilar in their gross anatomical features. The left is characterised by:

A. A cardiac notch in its posterior border
B. An absence of visceral pleura within its fissures
C. An eparterial bronchus in its hilum
D. Oblique and transverse fissures
E. Upper and lower lobes separated by the oblique fissure
A

Upper and lower lobes separated by the oblique fissure

379
Q

A 45 year old man has been smoking 30 cigarettes a day for 20 years.
Calculate his pack years. (20 cigarettes = 1 pack)
A. 20
B. 30
C. 40
D. 50
E. 60

A

30
Pack years is calculated by dividing the number of cigarettes smoked per day by 20 (no. of cigarettes in a pack) and multiplying by the number of years smoked.
(30/20) x 20 = 30

380
Q 
A 59-year-old man with known squamous carcinoma of the lung is admitted to hospital as an emergency with abdominal pain, constipation and confusion. 
	The most appropriate investigation would be:
	
	A.   Bronchoscopy 
	B.   Chest x-ray 
	C.   Mediastinoscopy 
	D.   Serum calcium 
	E.   Sputum cytology
A

Serum calcium (correct answer) Squamous cell lung cancer associated with hypercalcaemia due to parathyroid hormone related protein. Symptoms in this case classic for hypercalcaemia.

381
Q

55 year old obese business man complains of excessive daytime somnolence, snoring and frequent napping. He undergoes overnight oximetry which shows 10 desaturations per hour.

	His classification on the Obstructive Sleep Apnoea Severity scale is: 

	A    Mild 

	B    Moderate

	C    Normal - no further investigation required

	D    Normal - should be referred for limited sleep study

	E    Severe
A

Mild

382
Q 
A 50 year old oil man has lobar pneumonia.
		The most likely organism to be involved is:
	
		A    Chlamydia psittaci
	
		B    Haemophilus influenzae
	
		C    Legionella pneumoniae
	
		D    Pseudomonas aeruginosa
	
E    Streptococcus pneumoniae
A

Streptococcus pneumoniae

383
Q

A 38-year-old with exacerbation of asthma is too tired to do a peak flow.
Normal values: pH 7.37 – 7.43, PaO2 11 – 15 kPa, PaCO2 4.6 – 6.4 kPa

His blood gas results are most likely to be:

A.   pH 6.91,    PaO2 16.7 kPa,     PaCO2 2.9    kPa, on air

B.   pH 7.5,      PaO2 6.6   kPa,     PaCO2 11.2  kPa, on air

C.   pH 7.15,    PaO2 29.6 kPa,     PaCO2 10.6  kPa, on air

D.   pH 7.22,    PaO2 7.8   kPa,     PaCO2 8.6    kPa, on air
A

D. pH 7.22, PaO2 7.8 kPa, PaCO2 8.6 kPa, on air (correct answer) Exhaustion and decreased ventilation leads to hypercapnia, hypoxia and acidosis

384
Q

A 17 year old man is newly diagnosed with asthma.
Which initial medication should he be started on?
A. Inhaled beta-2 agonist and leukotriene receptor antagonist
B. Inhaled beta-2-agonist
C. Inhaled corticosteroids and inhaled beta-2-agonist
D. Inhaled leukotriene antagonist
E. Inhaled sodium cromoglycate

A

Inhaled corticosteroids and inhaled beta-2-agonist

385
Q 
A 19-year-old healthy man experiences sudden onset of sever right sided chest pain and breathlessness whilst walking upstairs. 
	Which is the most likely diagnosis?
	
	A.  Acute interstitial pneumonitis (Haman-Rich syndrome) 
	B.  Aspiration pneumonia 
	C.  Bronchiectasis
	D.  Primary pneumothorax
	E.  Pulmonary sequestration
A

Primary pneumothorax

386
Q 
A 32-year-old man is recovering from a bad attack of pneumonia for which he has been off work for several weeks. He goes on to develop rigors, a persistently poor appetite and increasing shortness of breath on exertion. He has not improved after one week of oral antibiotic treatment. 
	What is the most likely diagnosis?
	
	A.  Acute interstitial pneumonitis (Haman-Rich syndrome)
	B.  Aspiration pneumonia
	C.  Empyema thoracis 
	D.  Giant pulmonary bulla
	E.  Tuberculosis
A

Empyema thoracis

387
Q 
A 30-year-old woman is admitted to the emergency department with an acute exacerbation of her chronic asthma. Her PaO2 was 7.8 kPa (normal 11- 15 kPa) and her PaCO2 was 8.6 kPa (normal 4.6 – 6.4 kPa) on air. Her arterial gas on admission confirmed type 2 respiratory failure requiring admission to the intensive care unit for possible ventilation.
	Which is the most appropriate immediate treatment?
	
	A.   Inhaled beta-2 agonist 
	B.   Inhaled corticosteroids
	C.   Leukotriene receptor antagonist
	D.  Nebulised beta-2 agonist 
	E.  Oral beta-2 agonist
A

Nebulised beta-2 agonist

Mixed Year 2 Questions (6 decks)

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