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randop Flashcards

1
Q

CA-125

A

ASSOC WITH OVARIAN CANCER

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1
Q

hpv assoc with cervical cancer

A

16 and 18

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2
Q

enzyme with cofactor

A

holoenzyme

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3
Q

action of ach

A

constricts airways
vasodilates and relaxes smooth muscle

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4
Q

foetal haemoglobin components

A

2 gamma , 2 alpha

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5
Q

parasympathetic nerves

A

II, VII, IX, X

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6
Q

Codon assoc

A

each codon specifies one amino acid / stop codon only

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7
Q

which secretagogue of parietal cells acts on m3

A

ach

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8
Q

what does gastrin act on

A

g / cck2

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9
Q

where dos histamine act

A

h2

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10
Q

hunger hormone

A

ghrelin

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11
Q

type of synovial joint - elbow

A

saddle type

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12
Q

where does the trachea bifurc

A

t4/5

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13
Q

sternal angle assoc

A

2nd rib

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14
Q

where is ace located

A

lung vascular endothelium

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15
Q

plays a role in memory immune cells

A

iGg

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16
Q

What is c-myc assoc with

A

burkitts lymphoma

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17
Q

psammoma

A

collections of calcium build up seen in mesothelioma

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18
Q

staging for colorectal cancer

A

dukes staging

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19
Q

inotropic

A

negative effect on force of contraction

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20
Q

chonotropic

A

negative effect on heart

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21
Q

effect ov vagus nerve

A

chonotropic

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22
Q

where are mhc2 seen

A

on surface of macrophages

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23
Q

junctions in sa node

A

gap junctions

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24
Q

What cells secrete mucins

A

goblet cells

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25
Q

action of club cells

A

Secrete glycoaminoglycans to portect epithelila lining

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26
Q

a tumour invading the what might cause fib, breathlessness, pleural effusion

A

pericardium

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27
Q

where is the large bore cannula inserted for tension pneumothorax

A

2nd intercostal space in the midclavicular line (ICS2-MCL) and the 4th/5th intercostal space in the mid axillary line (ICS 4/5-AAL)

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28
Q

ECG signs in PE

A

RBBB, tacky, S1Q3T3

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29
Q

what to perform in pe if in shock

A

alteplase

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30
Q

pink frothy sputum seen in…

A

left heart failure

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31
Q

inflamamtion seen in under 2s

A

bronchiolitis

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32
Q

medication for aspiration pneumonia

A

amoxicillin and metronidazole

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33
Q

HMG-CoA reductase drug

A

simvastatin

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34
Q

cancer showing raised calcium

A

squamous cell carcinoma

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35
Q

long term COPD patients shown

A

type 2 resp failure as rely on hypoxic drive

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36
Q

what to perform before acid fast d=to eliminate oedema and cap

A

chest xray

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37
Q

what to perform if no evidence of tension pneumothorax

A

chest xray

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38
Q

erythema nodusum

A

seen in tb
red lesions on shins

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39
Q

coffee bean sign

A

sigmoid volvulus

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40
Q

achalasia pathophysiology

A

lack of ganglia in auerbachs plexus

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41
Q

cirrhosis

A

hepatic stellate cells found in space of disse curve acitavted and changed into myofibroblasts

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42
Q

PSC a

A

auotimmune destruction of intra and extra hepatic bile ducts

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43
Q

PBC

A

destruction of intrahepatic bile ducts

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44
Q

main cause of acute appendicitis

A

faecolith obstuction

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45
Q

charcots triad for ascending cholangitis

A

ruq pain, jaundice, fever

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46
Q

dysentry

A

inflammation of intestines causing eithe rblood or mucus in stool

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47
Q

most common cause of fresh red blood in stool

A

haemmorihods

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48
Q

male most common type of hernia

A

inguinal

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49
Q

female most common type of hernia

A

femoral

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50
Q

procedure for uncontrollable variceal bleeding

A

TIPS

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51
Q

1ST line for variceal bleeding

A

endoscopic ligation

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52
Q

h.pylori eradication

A

amox, omep, clarity/ metron

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53
Q

what do chief cells produce

A

pepsinogen

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54
Q

what dp paretal cells produce

A

hydrocholric acid

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55
Q

what do g cell secrete

A

gatsrin

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56
Q

CEA

A

colorectal

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57
Q

CA-125

A

OVARIAN

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58
Q

Alpha fetaprotein

A

hepatocellular

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59
Q

CA-19

A

colon, stomach, bile duct

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60
Q

erythema nodusm

A

crohns , on shins

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61
Q

dermatiti sherpetifroms

A

coeliac, on elows

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62
Q

pyoderma gangrenosum

A

uc, opainful blisters on legs

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63
Q

cholestasis/ cholethiasis

A

deranged GGT and ALP

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64
Q

Anti-HBc

A

seen in previously affected ; not vaccinated

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65
Q

Anti-HBs

A

in vaccinated patients showing immunity

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66
Q

insulating matrial in CNS

A

oligodendrocytes

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67
Q

insulating material in pns

A

schwann cells

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68
Q

what is paraneoplastic syndorme seen in- weight gain

A

small cell lung cancer

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69
Q

tetraology of fallot

A

pulmonary stenosis, ventricular spetal defect, right ventrincular hypertrophy, overrding aorta

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70
Q

what is histamine secreted from

A

enterochromaffin like cells

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71
Q

norovirus assoc

A

short incubation time
24hrs
expolsive diarrhoea

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72
Q

how is norovirus detected

A

via pcr

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73
Q

right shift in oxyhaemoglobin cruve

A
  • Increased temp
  • Hypercapnia
  • Acidosis
  • Sicckle cell diseases
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74
Q

left shift of oxy curve

A

reduced 23dpg, hypothermia, alkalosis, carbon monoxide

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75
Q

superior to inferior branches of abdominal aorta

A

adrenal renal gonadal

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76
Q

parts of vertebrae

A

transverse process, pedicle, body,foramina

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77
Q

how does h.pylori lead to ulcr

A

stimulates gastrin production so erodes gastric mucosa as so much of it

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78
Q

what supplied greater curvature

A

left and right gasrtopiploic

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79
Q

what supplies lesser curvature

A

left gastric artery

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80
Q

what nerve supplies the ear

A

vestibulocochlear

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81
Q

what nerve innervates facial expressions

A

facial

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82
Q

narrow qrs tachycardia

A

supraventricular tachy

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83
Q

multiple nuceli

A

nuetrophil

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84
Q

benign tumour derived from glandular epithelium

A

adenoma

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85
Q

Cys-LT receptors blockage

A

montelukast

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86
Q

ipratropium MOA

A

blocks m3 muscarinic receptor to prevent bronchoconstriction

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87
Q

beclomethasone MOA

A

suppresses inflammatory mediators or activates anti inflammatory proteins

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88
Q

what virus can stay in the body in a latent state and reacticate to cause disease

A

herpes simplex virus

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89
Q

rusty coloured sputum

A

PNEUMOCOCOCAL PNEUMONIA A

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90
Q

Red currant jelly sputum

A

klebsiella

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91
Q

mucoid sputum

A

chlamydia psittaci

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92
Q

which cancer may cause cavities

A

squamous cell

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93
Q

what may cause radiofemoral delay

A

coarction of aorta

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94
Q

whihc hepatitis is dna rather than rna

A

hep b

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95
Q

what may show air under diaphragm

A

perforated ulcer

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96
Q

haemoglobin curve

A

sigmoid

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97
Q

myoglobin curve

A

hyperbolic

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98
Q

treatment for influenza a and b

A

oseltamivir

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99
Q

pleural rub

A

PE, pneumonia, pleurisy b

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100
Q

pleurisy

A

sharp chest pain when breathing deeply
pain is also felt in the shoulder
may be worse when you cough, sneeze or move around
may be relieved by taking shallow breaths

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101
Q

edward syndrome

A

trisomy 18

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102
Q

miscarriage

A

trisomy 14

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103
Q

turner syndrome

A

45X

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104
Q

47XXY

A

kinefelter syndrome

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105
Q

drug for stable a flutter

A

verapamil

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106
Q

management of hymaeodnaically unstable a flutter

A

dc cardio

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107
Q

pead referral genetic test

A

microarray comparative genomic hybridisation

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108
Q

which law defines resp distress in young

A

law of la place- smaller airways more liekly to fall

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109
Q

cells at base of crypt

A

paneth cells

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110
Q

branche from lung root

A

bronchus, pulmonary artery, 2 pulmonary veins , bronchial vessels, pulmonary plexus of nerves, lymphatic vessels

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111
Q

ductus venosus

A

allows blood in umbilical vein to bypass liver - essential for foetal circulation

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112
Q

where does blood travel through from right atrium to IVC

A

via umbilical veins through the ductus venosus

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113
Q

what transports fatty acids through mitochondris

A

carnitine

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114
Q

what does glycogen phosphorylase catalyze

A

glycogen breakdown

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115
Q

where is sperm produced

A

seminferous tubules

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116
Q

what drains semen into urethra

A

ejaculatory duct

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117
Q

does complex 2 pump protons as electorns are passing through

A

no

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118
Q

low risk clinical waste colour

A

orange bag

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119
Q

between transverse and descending colon

A

splenic flexure of colon

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120
Q

no assoc wiht baroreceptor reflex when bp decreases

A

vasodilation

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121
Q

what is derived from ectoderm

A

epidermis of skin, nervous system

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122
Q

what does the mesoderm give risue to

A

connective tissue including muscles

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123
Q

what does the enderm give rise to

A

epithelium of gut and lungs

124
Q

what is derived from neural crest

A

schwann cells, melanocytes

125
Q

where is cuboidal epithelium seeen

A

stomach as its thick

126
Q

what epithelium type is best for diffusion

A

squamous

127
Q

what would you usually not do in sepsis 6

A

measure glucose as most are hypergylcaemic anyway

128
Q

order to put ppe on

A

apron, mask, gloves

129
Q

a patient in shocks pulse is liekly to be..

A

fast due to compensatory mechanisms

130
Q

role of DNA polymerase

A

builds new dna tstrands in a 5’-3’ direction

131
Q

dna transcriptase

A

catalyses formation of rna from dna template during transcription

132
Q

rna polymerase

A

synthesises Mrna in elongation of transcription in a 5 to 3 direction

133
Q

baroreceptor reflex when bp increases

A

vasodilation

134
Q

why is lacttic acrid produced

A

cells have to convrt nadh into nad +

135
Q

smooth muscle tumour

A

leioma

136
Q

skeletal muscle tumour

A

rhabdo

137
Q

apex beat area

A

left 5th intercostal space

138
Q

mitral valve ausc

A

left 5th intercostal, mic clav

139
Q

are crypt abscesses seen in uc or crogns

A

uc

140
Q

risk factors for ascending cholangitis

A

biliary stent and ERCP

141
Q

anal asbcess formation

A

crohns

142
Q

what does adiarrhoea cause

A

METABOLIC ACIDOSIS

143
Q

what does vomitting cause

A

metabolic alkalosis as you are losing acid

144
Q

where does rna splicing occur

A

nucleus

145
Q

where are ribosomes proudced

A

nucleolus

146
Q

thromboxane a2 function

A

acitvated bybplatelets
potent vasoconstrictor
promoter of platelet aggregation

147
Q

aspirin moa

A

inhibits thromboxane a2

148
Q

what is prostacyclin produced by

A

endothelial cells

149
Q

prostacyclinn function

A

inhibits platelet aggregation
vasodilator

150
Q

compeititve inhibtion on vmax and km

A

vmax same, km change

151
Q

non competitive

A

vmax changes, km same

152
Q

AAA management

A

<3 cm, they are discharged

between 3 and 4.4 cm, they are invited back for yearly screening

between 4.5 and 5.4 cm, they receive an ultrasound scan every 3 months

Above 5.5 cm, they are referred to a vascular surgeon for consideration for repair

153
Q

what are doacs contraindicated in for afib

A

those with creatine clearance <15 as they are renally excreted

154
Q

common side effects of ace inhibs - not cough

A

kidney failure as they vasoldiate the renal glomeruli and so reduce the egfr

155
Q

alternative drug if ace inhib causes renal failure

A

ccb

156
Q

other side effect of ace inhibs- not cough/ renal failure

A

angiodema so causing swelling of lips and throat

157
Q

synchronised cardioversion

A

for pulse

158
Q

unsynchronised cardioversion

A

for no pulse

159
Q

pulseless v tach

A

start compressions and unsynchronised

160
Q

management for afib in asthmatics

A

diltiazem

161
Q

sinus pauses, symptomatic Brady, spells of tachy

A

sick sinus syndrome

162
Q

what is first- atropine or transcutaenous pacing

A

atropine then if that doesnt work do transcutaneous pacing

163
Q

initial treatment for nstemi

A

aspirin

164
Q

gold standard for aortic dissection

A

contrast enhanced computed tomography

165
Q

recent viral illness, sinus tachycardia, ST changes and T wave inversion

A

myocarditis

166
Q

consequence of chronic mitral regurg

A

atrial fibrillation

167
Q

when are crts used §

A

used in moderate to severely affected heart failure patients to improve cardiac output

168
Q

third line for hypertension

A

indapamide

169
Q

third line for stable angina

A

beta blocker and ccb

170
Q

fourth line for stable angina

A

beta blocker, ccb, and long acting nitrarte

171
Q

wide oulse pressure

A

aortic regurgitation

172
Q

what kind of drug is amiodarone

A

potasssium bcloker

173
Q

would a pansystolic mumro be heard in dresslers syndrome

A

no

174
Q

how would dresslers syndrome present

A

weeks to months post mi, pericardial friction rub may be heard

175
Q

is afib a narrow or broad complex

A

narrow

176
Q

managemnt of nstemi

A

aspirin and p2y12 inhibitor such as triglaceolr

177
Q

bet a blocker overdose if atropine hasnt helped

A

glucagon

178
Q

factors affected by warfarin

A

1972 menumonic
II, XII, IX,X

179
Q

which anticaog is contraindicated in pregnancy

A

warfarin

180
Q

which diuretic inhibits the sodium potassium chlordie co transporter

A

furosemide in the thick ascending loop on of henle

181
Q

where are baroreceptors which detect bloop pressure located

A

carotid sinus

182
Q

stroke volume calc

A

difference betwene end diastolic and end systolic

183
Q

last step in the formation of an atheroma

A

Smooth muscle proliferation and migration from the tunica media into the intima

184
Q

starlings law of the heart

A

end diastolic volume is proportional to the stroke volume

185
Q

what cells are responsible for fat uptake in plaque formation

A

macrophages

186
Q

where is there a tear in the aorta in aortic dissection

A

tunica intima

187
Q

acts on the distal convulated tubule

A

bedroflumthiazide

188
Q

menumonic for coeliac trunk branches

A

left hand side
left gatsric
hepatic
splenic

189
Q

which diuretics may cause hypokalaemia

A

loop

190
Q

does warfarin have a long half life

A

YES

191
Q

What is the equivalent to cardiac preload

A

end diastolci volume

192
Q

triglacelor MOA

A

inhibits ADP binding to platelet receptors

193
Q

Which myopathy causes diastolic dysfunction

A

hypertrophic

194
Q

which myopathy causes systolic dysfunction

A

dilated

195
Q

bendroflumthiazide moa

A

inhibits sodiumnchloride transporter

196
Q

where does inapamide act

A

distal convulated tubule

197
Q

what is the plateau phase caused by

A

slow influx of calcium

198
Q

what does WPWS do to the pr interval

A

shortens it

199
Q

which leads does brugada syndrome affect

A

v1 and 2

200
Q

brugada syndrome on ecg

A

ST elevation >2mm in V1-2 with subsequent negative T waves.

201
Q

definitive management for brugada

A

implantable cardiac defib

202
Q

what heart block are seen in fit athletes

A

type 1 and mobitz type 1

203
Q

represent liver parenchymal cells

A

ast and alt

204
Q

repreent synthetic liver function

A

prothrombin time and albumin

205
Q

beefy red tongue

A

vit b12 def

206
Q

investigations for heart failure

A

bnp first
echo next

if previous mi then do ecg first

207
Q

to check if peptic ulcer has perforated

A

chest xray

208
Q

acute pain on defeeacation

A

anal fissure

209
Q

what requires valve replacement in valve disease

A

syncope

210
Q

site of b12 absorb

A

terminal ileum

211
Q

iron absorption

A

duodenum

212
Q

what process is used in pcr

A

denaturation, annealing and elongation

213
Q

what to perform is oxygen below 92 in a patient with pneumonia

A

ABGS, blood, blood culture then sputum culture

214
Q

ph below 7.2 in pneumonia with foul smelling sputum suggestive of

A

empyema

215
Q

managemnt of empyema

A

chest drain

216
Q

what might rheumatoid arthritis cause

A

BRONCHIEACTASAIS

217
Q

best investiagtion for ipf

A

high resolution ct

218
Q

which side would the tension pneumo be on; reduced chest expansion and breath sounds or where the trachea is deviated to

A

reduced chats expansion and breath sounds

219
Q

most specific sign for ARDS

A

new pulmonary infiltrates

220
Q

ipratroprium

A

sama used in copd

221
Q

next step for asthmatics with steroid and prevnteor

A

montelukast

222
Q

pneumonia assoc with herpes

A

strep pneumonia

223
Q

signet ring on ct

A

bronchieactasis

224
Q

airway thickening and dilatation

A

bronchieactasis

225
Q

most common site of metastaiss of lung cancer

A

brain

226
Q

where do pancoast tumours normally present

A

kung apex

227
Q

where are the resp centres locatd

A

brain stem

228
Q

what is ipsilateral elevation of the hemidiaphragm in lung cnacer due to

A

compression of phrenic nerve

229
Q

cause of copd in non smokers

A

alpha-1 antitrypsin deficiency

230
Q

moa of alpha 1 antitrypsin

A

protect the lung cells against the destructive action of neutrophil elastase that destroys alveolar walls causing emphysema and thereby COPD

231
Q

which nerve supplies the pericardium

A

phrenci

232
Q

what does type 2 hypersens involve

A

igm and igg binding to surface molecules

233
Q

what releases histamine in response to allergy

A

basophils

234
Q

malt assoc

A

h.pylori

235
Q

t cell lymphoma assoc

A

coeliac

236
Q

where are the central chemoreceptors

A

medulla oblongata

237
Q

what is excoriations assoc with

A

raised bilirubin - causing itching

238
Q

spontaneous bacterial peritonitis results

A

> 250

239
Q

most affected area in crohns

A

terminal ileum and colon

240
Q

what should strep bovis endo patients have

A

a colonoscopy

241
Q

management of pneumothorax

A

ASPIRATE

242
Q

management of pneumothorax if have high risk characteristics i.e copd

A

chest drain

243
Q

what is cck released from

A

i cells

244
Q

how does gastrin increase h+ secretion

A

by gastric parietal cells

245
Q

what does secretin increase

A

secretion of bicarbonate-rich fluid from pancreas and hepatic duct cells

246
Q

what secretes gastric acid

A

parietal cells

247
Q

impaired cftr

A

low hco3

248
Q

s cells mOA

A

secrete secretin in response to reduced pH in the stomach

secretin acts to increase the rate of bicarbonate production in the pancreas

Increased bicarbonate neutralizes gastric acid in the duodenum to allow pancreatic enzymes to function

249
Q

what does secretin increase

A

rate of bicarb production

250
Q

what does increased bicarb do

A

neutralizies the gastric acid allowing oancreatic enzymes to function

251
Q

effec of pulmonary oedema on lung compliance

A

reduces it

252
Q

examples of monosachharides

A

glucose and fructose

253
Q

disachs

A

lactose and sucrose and maltose

254
Q

what happens upon eating

A

pancreas releases insulin due to increased glucose

this jelps move glucose into all cells for energy

255
Q
A
256
Q

effect of insulin on liver

A

makes it store glucose as glycogen in aprocesscalled glycogenesis

257
Q

what is amylase, lipase and trypsinogen secreted by

A

acinar cells in pancreas

258
Q

what receptors do ductal cells ahve

A

cck, ach, secretin

259
Q

what are acinar cells stimulated by

A

ach and cck

260
Q

when does bicarb increase

A

when there is demand for acid neutralisation

261
Q

hypertensive crisis managemnt

A

iv labetalol

262
Q

strongest risk factor for barretts

A

gord

263
Q

widespread downslopping st segmetns

A

digoxin

264
Q

reciprocal st changes for lateral

A

III,AVF downslope

265
Q

constricitve pericarditis assoc

A

assoc with dresslers syndrome

266
Q

secondary cause of hypertension

A

renal disease

267
Q

radio femoral delay assoc

A

coarction of aorta distal to ;eft subclavian

268
Q

radial radial delay assoc

A

coarction of aorta porximal to left subc;aviam

269
Q

How liver failure leads to oesophaeagl varices

A

Relief of portal pressure by diversion of blood through portosystemic collaterals

270
Q

most common pathogens assoc with sponatneous bacterial peritontiits

A

gram neg rods- e.coli, klebsiella

271
Q

pneumonia in alcoholics, homless and diabetics

A

klebsiella

272
Q

first line pharmacotherapy for pulmonary fibroiss

A

pirfenidone

273
Q

what is infliximab linked with

A

reactive tb

274
Q

what might group a strep cause

A

throat infection (pharyngitis), tonsil infection (tonsillitis), scarlet fever, skin sores (impetigo) and skin infection (cellulitis).

275
Q

campy organism

A

gram negative bacilli

276
Q

strict aerobes

A

pseudmonas and legionella

277
Q

treatment for coliforms

A

gentamicin

278
Q

partial haemolysis

A

strep pneumonia

279
Q

ciprofloxacin good activity against..

A

gram negative rods such as pseudomonas

280
Q

drug inudced rash

A

iv vancomycin

281
Q

what is the mrna molecule called

A

a transcript

282
Q

does movement of the skeleton occur proximal or distally to a join

A

neither, occur at the joint

282
Q

where are keratinocytes found

A

squamous epithelium

283
Q

what indicates severe aortic stensois

A

presence of an s4

284
Q

what is an s4 due to and what does it indicate

A

severe left ventricular hypertrophy (LVH) and indicates the presence of increased resistance to left ventricular filling

285
Q

pr prolongation in aortic root abscess

A

suspicious for aortic root abscess

286
Q

amaylase assoc

A

raised in acute pancreatitis but may not be raised in chronic

287
Q

what do low levels of faceal elastase confirm

A

pancreatic exocrine insufficiency.

288
Q

what comes before oral mesalazine

A

mesalazine enma - rectum

289
Q

what firbosis does pneumoconiosis caude

A

apical

290
Q

causes basal fibrosis

A

amiodarone

291
Q

supra vt treatment

A

adenosine

292
Q

stable vtach treatment

A

amiodarone

293
Q

torsades de pointes treatment

A

magnesium sulphate

294
Q

pambertons sign positive

A

diagnostic test for svc obstruction

295
Q

secondary prevention for mI

A

ace inhib, bb, statin, aspirin, anti platelet

296
Q

5HT3 antagonist use

A

for nausea and vomitting prevention in chemo

297
Q

most common organisms i bronchieactasis

A

Haemophilus influenzae, Pseudomonas aeruginosa, TB, Bordetella pertussis

298
Q

cor pulmonale

A

right heart failure due to chornic lung condition

299
Q

signs of right heart failure

A

ankle/sacral pitting oedema, ascites, tender smooth hepatomegaly, and a raised JVP

300
Q

what can raise a d-dimer

A

surgery and infections so isnt specific

301
Q

first line investigation post surgery for pe and high wells score

A

CTPA

302
Q

type 4 autoimmune conditions

A

type 1 diabetes
rheumatoid arthirtis

303
Q

autoimmunity

A

presence of immune responses agaisnt self antigens

304
Q

type 2 interferons

A

ifn gamma

305
Q

role of ifn gamma

A

activates cd 4

306
Q

halitosis, regurg, older male, bulging neck on swallowing

A

haryngeal pouch

307
Q
A

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