SAQ 2013

Question 1

What are two constitutional (systemic) symptoms that the patient may complain of?

Answer 1

sweats fever, pain, swelling R iliac!

Question 2

What is the principal cell involved in acute inflammation? (2m)

Answer 2

neutrophil

Question 3

Two actions of bradykinin

What enzyme breaks it down?

Answer 3

Bradykinin = prostaglandins, nitric oxide
Its a vasodilator, causes contraction in the gut and bronchi
-ACE

Question 4

Two roles of lymphatics in acute inflammation

Answer 4

Drain fluid exudate, carry antigens to lymph nodes

Question 5

Duties of a doctor

Answer 5

1. Protect and promote the health of patients and public
2. Work within limitations and capabilities
3. Treat patients as individuals and respect their dignity
4. Provide a good standard of practice and care
5. Work with colleagues in a way that best serves patient’s interests

Question 6

3 reasons for staging

Answer 6

Determine prognosis
Guide treatment
Give information

Question 7

What does PICO stand for?

Answer 7

Patient, intervention, comparison, outcome

Question 8

What is the difference between experimental and observational studies?

Answer 8

Experimental - variables are controlled and assigned to groups eg RCT

In Observational studies - can be retrospective or prospective, the patients are not allocated variables but instead possible variables in their current life are grouped to detect trends.

Question 9

What do you call the analysis of stats in a systematic review? (3m)
-What to consider when doing systematic review?

Answer 9

Meta analysis

Relevant studies
Identify all relevant studies
Access quality of the included studies
Consider all outcomes – individual, wider community, professionals
The type of data – continuous/discrete/etc

Question 10

What is penetrance?

Answer 10

Proportional of people with a genotype who show the expected phenotype 100% = all population shoes phenotype

Question 11

Name for phenomenon of son showing phenotype at younger age than his father
Increasing early onset with successive generation.

Answer 11

Anticipation

Question 12

Equations for Mean arterial pressure

Answer 12

MAP = 2/3 diastolic + 1/3 systolic 
MAR = CO X TPR

Question 13

1) Two things released by endothelial cells for vascular tone
2) Four things released by tissue to increase blood flow

Answer 13

1) -endothelin-1, nitric oxide

2) NO, endothelin, bradykinin, prostacyclin, adenosine, K+ is vasodilator of arterioles

Question 14

Which beta adrenergic receptor is involved in heart rhythm?

Answer 14

B1

Question 15

Example of a neurotransmitter that is secreted by the preganglionic sympathetic system?

Answer 15

Acetylcholine

Question 16

What is inotropic and chronotropic?

Answer 16

Inotropic - strength of contraction

Chronotropic - rate of contraction

Question 17

Para to eye - which muscle

Answer 17

Dilator pupillae

Question 18

Two COPD pathologies

Answer 18

Emphysema - destruction of alveoli
Bronchitis = constriction of bronchi

= Obstruction
decreased FEV1 : Vital capacity ratio
normal vital capacty

Question 19

Three indentations in normal barium swallow

Answer 19

Aortic arch, L main bronchus, L atrium

Question 20

Three layers of oesophagus - which plexi and where?

Answer 20

1. mucosa,
2. sub mucosa - Meissner’s
3. muscularis externa - Auerbach’s (between inner circular and outer longitudinal),

Question 21

What is the muscle that makes up the upper oesophageal sphincter? What innervates it?

Answer 21

Primary muscle is the cricopharyngeal portion of the inferior pharyngeal constrictor.

Supplied by superior laryngeal nerve

(all other laryngeal muscles are by recurrent)

Question 22

Symptoms of malabsorption

Answer 22

Diarrhea = fats, protein (
Smelly stools = fats
Brusing/slow clotting = Vit K
Swollen ankles = protein

Question 23

Stages of fat digestion

Answer 23

Emulsification,
Hydrolysis

( micelles, chylomicrons )

Question 24

a) Two features of intestinal epithelial surface that help increase absorption –
b) Two cells found on surface epithelium of duodenum
c) 3 endocrine secretions

Answer 24

a) Microvili, crypts
b) Simple columnar epithelial cells, Goblet cells, enterocytes
c) Somatostatin, insulin, glucogon, secretin

Question 25

What are the pacemaker cells for the small intestine called?

Answer 25

Cajal cell’s in muscular proprias

Question 26

Describe PPV and NPV?

Answer 26

Positive predictive value = the proportion of people with a positive result who have the disease

Negative predictive value = the proportion of people with a negative result who do not have the disease

Question 27

Which enzyme converts alcohol to acetylaldehyde –

Answer 27

alcohol dehydogenase

high alcohol = high ketones