Revision

Question 1

Ischaemia on ECG

Answer 1

ST depression

Question 2

Left BBB on ECG

Answer 2

• A delay in the contraction of the left ventricle

- May see the depolarisation of both the ventricles separately on the ECG

Question 3

Complete Heart Block on the ECG

Answer 3

Gives a regular heart rate on the ECG

No relation between the P and Q waves

Question 4

PGE2

Answer 4

Maintains the ductus arteriosus

> If open at birth, then give a prostaglandin inhibitor

Question 5

Chronotropic

Answer 5

Changes the heart rate

Question 6

Inotropic

Answer 6

Changes the heart force of contraction

Question 7

Collapsing Pulse

Answer 7

Aortic Regurgitation

Question 8

Afterload

Answer 8

The pressure on the wall of the left ventricle

Question 9

Increased Afterload (causes)

Answer 9

Systemic Hypertension
Pulmonary Hypertension
Aortic Stenosis (must overcome the pressure gradient)
Aortic Regurgitation

Question 10

Decreased Afterload

Answer 10

Mitral Regurgitation (decreases the afterload as there is an extra pathway for the blood to move)

Question 11

Causative Organism in CAP after recent influenza infection

Answer 11

Staph. aureus

Question 12

Causative Organism of Gastroenteritis after eating rice/starchy foods

Answer 12

Bacillus cereus

Question 13

Anterior leads show STEMI changes

Answer 13

LAD

Question 14

Inferior leads show STEMI changes

Answer 14

Right coronary

Question 15

Lateral leads show STEMI changes

Answer 15

Left circumflex

Question 16

Odynophagia

Answer 16

Painful swallowing

Question 17

Summary of the action of PPIs

Answer 17

Irreversible blockade of H+/K+/ATPase channels

Question 18

Tenesmus

Answer 18

Cramping rectal pain, feeling that need to have a bowel movement even if have just had one

Question 19

Rosving’s sign

Answer 19

Pain experienced in the RIF when pressure is applied to the LIF = acute appendicitis

Question 20

Hyperkalaemia on the ECG

Answer 20

• Tall tented T waves
• Small/absent P waves
• Increased PR interval and wide QRS complex

Question 21

Treatment of hyperkalaemia

Answer 21

Insulin (moves extracellular potassium into the cells)

Question 22

What is WPW syndrome a result of?

Answer 22

An accessory pathway

Question 23

Post MI drug routine

Answer 23

ACE inhibtor
B-Blocker
Aspirin
Statins

Question 24

Transmission of signals from the carotid sinus to the medulla

Answer 24

Afferents travel via CN IX

Question 25

Transmission of signals from aortic baroreceptors

Answer 25

Afferents travel in the vagus nerve (CN X)

Question 26

Action of Baroreceptors

Answer 26

Increase the rate of firing as the blood pressure increases (working to reduce blood pressure)

Question 27

Causes of exacerbation of bronchiectasis

Answer 27

H. influenzae

Question 28

Causes of croup

Answer 28

Parainfluenza viruses

Question 29

Pathophysiology of Oedema in CLD

Answer 29

Reduced albumin synthesis = hypoalbuminaemia

Question 30

Pathophysiology of Ascites in CLD

Answer 30

Hypoalbuminaemia Secondary hyperaldosteronism (Aldosterone causes water and sodium retention) Portal Hypertension

Question 31

Haematemesis

Answer 31

Ruptured oesophageal varices due to portal hypertension

Question 32

Spider naevi/gynaecomastia

Answer 32

Hyperoestrogenism

Question 33

Bleeding and purpura

Answer 33

Reduced clotting factor synthesis

Question 34

Coma

Answer 34

Failure to eliminate toxic gut bacterial metabolites

Question 35

Respiratory Causes of Clubbing

Answer 35

``` Bronchial Carcinoma Bronchiectasis Lung Abscess Empyema Idiopathic Lung Fibrosis Pleural/Mediastinal Tumours ```

Question 36

Cardiovascular Causes of Clubbing

Answer 36

Cyanotic Heart Disease Sub-acute infective endocarditis Atrial myxoma

Question 37

Other Causes of Clubbing

Answer 37

Congenital Cirrhosis IBD

Question 38

Childhood causes of Bronchiectasis

Answer 38

Pneumonia Whooping Cough Measles

Question 39

Chylothorax

Answer 39

Presence of Lymphatic Fluid in the pleural space (2y to leakage from the thoracic duct)

Question 40

Hypokalaemia on ECG

Answer 40

U waves

Question 41

CF mutation

Answer 41

The CFTR gene | Chromosome 7

Question 42

Bifurcation of the trachea

Answer 42

T4

Question 43

Boot-shaped Heart on x-ray

Answer 43

Pericardial Effusion

Question 44

Treatment of Wilson's Disease

Answer 44

Penicillamine and low Copper diet

Question 45

Seperation of the subclavian vein and subclavian artery

Answer 45

The anterior scalene muscle

Question 46

Macrophages and Lipid take up

Answer 46

Macrophages take up lipids by apolipoprotein B100

Question 47

Molecules expressed by endothelial cells in pro-atherosclerotic conditions

Answer 47

VCAM-1

Question 48

Primary Event in AAA

Answer 48

Loss of elastic fibres from the media

Question 49

Cannon A waves

Answer 49

Atria contracting against a closed tricuspid valve | Increases the JVP dramatically

Question 50

Parietal Cells

Answer 50

Secrete HCl, Ca, Na, Mg and intrinsic factor

Question 51

Chief Cells

Answer 51

Secrete pepsinogen

Question 52

Surface Mucosal Cells

Answer 52

Secrete mucus and bicarbonate

Question 53

Duodenal Ulcers

Answer 53

- Can invade the gastroduodenal artery | = major bleeding

Question 54

Immunoglobulin pattern of alcoholic liver disease

Answer 54

Elevation of IgA