Set 4

Question 1

HNPCC

Answer 1

Hereditary nonpolyposis colorectal cancer
= Lynch syndrome
Autosomal dominant genetic condition associated with high risk of colon cancer (+ other cancers)

Question 2

FAP

Answer 2

Familial adenomatous polyposis

Rare, inherited condition caused by defect in adenomatous polyposis coli (APC) gene

Question 3

Tenesmus

Answer 3

Feeling of needing to evacuate bowels, with little or no stool passed

Question 4

Pain due to blockage of bile duct by gallstone

Answer 4

Biliary colic

Question 5

Atelectasis

Answer 5

The collapse of a lung
Reduced or absent gas exchange
Part or whole of lun affected

Question 6

Papillodema

Answer 6

Swelling of optic nerve at back of eye
Visual disturbances, headaches, nausea
Due to build up of pressure in or around the brain

Question 7

Dysparenuria

Answer 7

Pain in pelvis during sexual intercourse

Question 8

Nystagmus

Answer 8

Involuntary + uncontrollable eye movement

Question 9

Micelle vs chylomicron

Answer 9

Micelle - bile coated lipid droplets in lumen of small intestine
Chylomicron - protein coated lipid found in the absorptive cell of the small intestine, transported into the blood

Question 10

Pancreatic protease enzyme that, once activated, is itself a catalyst for the activation of other pro-enzymes

Answer 10

Trypsin

Trypsinogen -> trypsin (activated by enterokinase)

Question 11

Indirect inguinal hernia

Where does hernia leave abdomen?

Answer 11

Deep inguinal ring

Passes through inguinal canal

Question 12

Sympathetic supply to the foregut structures (e.g. stomach)

Answer 12

Greater splanchnic nerve
(Visceral afferent nerves travel back to the spine along the same path as the sympathetic supply that viscera but in the opposite direction)

Question 13

GLUT-2

Answer 13

Transporter that moves glucose out of the enterocytes across the basolateral membrane

Question 14

GLUT-5

Answer 14

Moves fructose across the apical membrane of the enterocytes

From gut lumen into enterocyte

Question 15

SGLT-1

Answer 15

Sodium glucose linked transporter that co-transports Na and glucose from the gut into the enterocyte

Question 16

ALT

Answer 16

Alanine transaminase
Specific to hepatocytes
Released into plasma when hepatocytes damaged

Question 17

ALP

Answer 17

Alkaline phosphatase

Tends to rise in biliary obstruction and bone disease

Question 18

AST

Answer 18

Aspartame aminotransferase
Raised in liver damage
Also present in reasonable quantities in cardiac and skeletal muscle
Not specific to the liver

Question 19

Major artery at risk of haemorrhage if gastric ulcer erodes through posterior aspect of body of stomach

Answer 19

Splenic artery

Question 20

Part of stomach particularly prone to ulceration

Answer 20

Lesser curve of stomach

Question 21

Most common location for peptic ulceration

Answer 21

First part of duodenum

Question 22

CURB-65 score

Answer 22

Used to assess severity of pneumonia
Confusion
Urea concentration
Respiratory rate
Blood pressure
Age > 65

Question 23

Organism causing atypical community acquired pneumonia

Answer 23

Mycoplasma pneumoniae

Question 24

Examples of organisms causing community acquired pneumonia

Answer 24

Streptococcus pneumoniae 
Haemophilus influenzae 
Mycoplasma pneumoniae 
Moraxella catarrhalis
Staphylococcus aureus

Question 25

Signs of life threatening asthma

Answer 25

Exhaustion
Confusion
Hypotension
Silent chest of auscultation

Question 26

Finger tremor in life threatening asthma

Answer 26

Finger tremor is side effect of Beta 2 agonist therapy (e.g. Salbutamol)

Question 27

Criteria for diagnosis of acute severe asthma

Answer 27

Inability to complete a sentence in one breath
Heart rate > 100 bpm
Respiratory rate > 25
Peak flow 48% of previous best

Question 28

Amount of carbonic anhydrase activity in plasma

Answer 28

Little activity

Little effect of reaction of CO2 with water in plasma

Question 29

Direction of dissociation curve when temperature rises

Answer 29

Rise in temperature
Curve shifts to right
Binding less O2 (i.e. more O2 given up)

Question 30

Most common causative organism in infective endocarditis overall (acute + subacute)

Answer 30

Staphylococcus aureus
Highly virulent, high mortality rate, often IV drug users

Strep viridans - cause in 50-60% of subacute infective endocarditis cases

Question 31

Cause of hyponatraemia in SIADH

Answer 31

Excess water reabsorption in the collecting duct

ADH causes up-regulation of aquaporin channels in collecting duct, increased water resorption

Question 32

Cause of diabetes insipidus

Answer 32

Inappropriate secretion of ADH from posterior pituitary

Question 33

Hormones stored in the posterior pituitary gland

Answer 33

Oxytocin
Vasopressin (ADH = antidiuretic hormone)

Question 34

Urine specific gravity

Answer 34

Renal concentrating ability

Normal concentrating capacity: less water intake = increased specific gravity

Question 35

Dipsogenic diabetes insipidus (= primary poly dips is = psychogenic polydipsia) cause

Answer 35

A defect or damage to the hypothalamus causing malfunction of the thirst mechanism

Excessive thirst regardless of fluid status
Individual consumes large volumes of fluid, suppresses secretion of vasopressin (ADH), increases urine output

Question 36

Action of ADH

Answer 36

Vasoconstriction
Activation of V1 receptor on vascular smooth muscle to cause vasoconstriction triggering the thirst response in the hypothalamus

Produced by hypothalamus, stored in posterior pituitary