Summative S1 2018 Flashcards
- Which of the following about the massive transfusion protocol is correct?
a. Can be adapted to local needs
b. Gathered from data collected from Australia, NZ and the UK
c. It is used in specific populations with major bleeding
d. Replaces the need for intervention from a haematologist/transfusion specialist
e. Provides guidance on monitoring of patients
c. It is used in specific populations with major bleeding
- A patient presents with a cut on their hand. They have numbness over the palmar surface of their thumb, index, middle finger and half of the ring finger. They also have weak pincer and pincer grip. They have weak wrist flexion, abduction and pronation. What nerve is affected?
a. Radial
b. Ulnar
c. Musculocutaneous
d. Median
e. Axillary
d. Median
- What causes thalassemia?
a. Globin synthesis dysfunction
b. Erythropoietin synthesis dysfunction
c. Problem with RBC DNA transcription
a. Globin synthesis dysfunction
- Which protein aggregation is in the picture of a lesion from Alzheimer’s disease?
a. Amyloid beta
b. Tau
c. Prion
d. Alpha synuclein
a. Amyloid beta
- Which immunoglobulin mediates the allergic reaction in anaphylaxis?
a. IgG
b. IgM
c. IgE
d. IgD
e. IgA
c. IgE
- What type of pain is the WHO pain management ladder used for?
a. Any pain
b. Neuropathic pain
c. Acute pain
d. Chronic pain
e. Cancer pain
a. Any pain
- What is the most common type of intracranial tumour?
a. Craniopharyngioma
b. Glioma
c. Meningioma
d. Metastatic cancer
e. Neuroblastoma
d. Metastatic cancer
Why is metastatic brain cancer most common?
It is secondary cancer –> more common
Primary cancer in adults is meningiomas
Primary cancer in children is glioma
- Patient with emphysema and alveolar loss. What lung parameter would be decreased?
a. Alveolar dead space
b. Lung compliance
C. Diffusion capacity
D. Airway resistance
E. Total lung capacity
C. Diffusion capacity
- 64 year old woman on warfarin, history of DVT. She is starting a new diet with green juices several times a day involving lots of leafy greens. What are you most concerned about?
a. Cognitive dysfunction
b. Increased risk of DVT
c. Increased risk of cerebral haemorrhage
d. Nausea and vomiting
e. Increased bruising
b. Increased risk of DVT
- Self-Reactive T cells are removed from the thymus during cell development. What name is given to the reduced effect on immune response?
a) Antigen modulation
b) Central tolerance
c) Immunological L.
d) Immunological anergy
e) Immunosuppression
b) Central tolerance
- Raised intracranial pressure can cause herniation of brain structures. Which type of herniation would cause brainstem compression?
a) Subfalcine
b) Supratentorial
c) Tonsillar
d) Transtentorial
c) Tonsillar
What is the main impact of a trans tentorial herniation?
Pressure on particularly the midbrain
What is the main impact of a tonsillar herniation?
Compression of the lower brainstem
- A 49 year old woman suffers an ischaemic stroke. What is the first line treatment?
a. Alteplase
b. Aspirin
c. Heparin
d. Warfarin
a. Alteplase
- What are the cytoplasmic inclusions in the substantia nigra in Parkinson’s Disease
a) Golgi Bodies
b) Lewy Bodies
c) NFTs
d) amyloid-beta aggregates
b) Lewy Bodies
- Liezel presents to your clinic with contact dermatitis. This is most likely to be a:
a. Type I Hypersensitivity Reaction
b. Type II Hypersensitivity Reaction
c. Type III Hypersensitivity Reaction
d. Type IV Hypersensitivity Reaction
d. Type IV Hypersensitivity Reaction
What is an example of a Type 1 hypersensitivity?
Anaphylaxis or allergic rhino conjunctivitis (IgE)
What is an example of a type 2 hypersensitivity?
Blood transfusions (IgG and IgM)
What is an example of Type 3 hypersensitivity?
Immune complex mediated eg lupus (IgG)
- 24 year old basketball player has a twisting injury of the knee. Swelling on medial aspect of knee, but full range of motion. Clicking, locking and pain on twisting motion. What is injured?
a. Anterior Collateral Ligament
b. Posterior Collateral Ligament
c. Medial collateral ligament
d. Lateral collateral ligament
e. Medial meniscus
e. Medial meniscus
- A sober alcoholic comes in with postural swaying. Which part of the brain is affected?
a. Cerebellar vermis
b. Lateral cerebellar hemispheres
c. Medullary olives
d. Primary motor cortex
e. Primary somatosensory cortex
a. Cerebellar vermis
What is the role of the cerebellar vermis?
Muscle tone for posture
What is the role of the lateral cerebellar hemispheres?
Involved in ataxia as well as gait (finger- nose, alternating movements etc)
What is the role of the medullary olives?
Motor movement learning and auditory perception
- Which of the following is characteristic of innate immunity?
a. Memory
b. Highly specific
c. No specificity
d. Rapid response
e. Slow response
d. Rapid response
- Old man who is a painter comes in with hypertension, hypercholesterolemia and diabetes. He describes an episode yesterday when he was painting where he suddenly felt weak in his right arm and leg and couldn’t hold his paintbrush anymore. He recovered in about one hour. What has most likely occurred?
a. Cerebral anoxia
b. Cerebral hypoxia
c. Partial cerebral occlusion from atherosclerosis
d. Complete cerebral occlusion from sickle cell disease
c. Partial cerebral occlusion from atherosclerosis
- Which of these is involved in the “early phase” of the allergic reaction development?
a. Eosinophil activation via IL-5
b. Mast cell degranulation by IgE
c. Antigen-presenting cell activation by IgE
d. Th2 activation by TCR
d. Th2 activation by TCR
- A 31 yr old woman presents with a history of fatigue. Her blood test results show decreased red blood cells and haemoglobin and increased mean corpuscular volume. What is the most likely diagnosis for her condition?
a. Folic acid deficiency
b. Iron deficiency anaemia
c. Hereditary spherocytosis
d. Thalassemia
a. Folic acid deficiency
What are some features of blood with folic acid deficiency?
Fatigue
Decreased RBC
Decreased Haemoglobin
Increased MCV
What are some features of blood with iron deficiency anaemia?
Fatigue
Decreased RBC
Decreased Haemoglobin (hypochromic)
Microcytic
- A patient got stabbed in the chest in the 5th intercostal space to the left of the sternum. Which structure is damaged?
a. Aorta
b. Left Ventricle
c. Right ventricle
d. Trachea bifurcation
e. Left atrium
c. Right ventricle
- What pathogen causes rheumatic fever?
a. Golden Staph
b. Group A Streptococcus
c. HIV
d. Campylobacter
b. Group A Streptococcus
28.A neurosurgeon does an electrical stimulation test on the right hemisphere of the brain in a specific part of the motor area. What effect will you see?
a. Complete body movement
b. Twitching on the left side
c. Twitching on right side
d. Complex movement on left
e. Complex movement on right
b. Twitching on the left side
- What changes would be seen on xray for a grade 2 sprain on ankle?
a. Changes to bony outline at ankle joint
b. Bone deformity at ankle joint
c. Soft tissue mass in calf
d. Soft tissue swelling only
e. Widening of the joint space
d. Soft tissue swelling only
- How do antihistamines cause vasoconstriction?
a. Histamine H2 receptor antagonist
b. Reduce NO mobilisation
c. Reduce kinase activity
d. Act on nerve endings
b. Reduce NO mobilisation
- What is the mutation involved in early onset Alzheimer’s dementia?
a. Tau
b. Amyloid precursor protein (APP)
c. Alpha synuclein
d. Prion
b. Amyloid precursor protein (APP)
- A patient had a previous respiratory infection. Her symptoms persist long after the infection clears. This is because self-reactive cells cross-react with bacteria. What is this a result of?
a. Molecular mimicry
b. Bystander immune cell activation
c. Release of sequestered antigens
d. Cytokine activation
a. Molecular mimicry
- Alvin presents with cholethiasis. His FBC shows he has small densely stained blood cells, low HgB, high MCHC. What is the cause of this?
a. Folate Deficiency
b. Iron deficiency
c. Spherocytosis
d. Thalassaemia
c. Spherocytosis
What is cholethiasis?
Gallstone disease
- Which of the following best describes the function and structure of the Golgi tendon apparatus?
a. Muscle stretch and arranged in parallel with muscle fibres
b. Muscle stretch and arranged in series with muscle fibres
c. Muscle tension and arranged in parallel with muscle fibres
d. Muscle tension and arranged in series with muscle fibres
d. Muscle tension and arranged in series with muscle fibres
- A 74 year old man has a stroke. What signs would mean that is was a cortical cerebral stroke?
a. Impaired respiration
b. Weak facial muscles
c. Impaired coordination
d. Impaired thermoregulation
e. Impaired ability to understand speech
e. Impaired ability to understand speech
- Sharon had bowel surgery. After 2 weeks, she has painful, swollen right leg which she cannot walk on. On doppler ultrasound you find a DVT from peroneal vein to common femoral vein. It is non-compressible. What is the next step?
a. CT Scan
b. Therapeutic anticoagulants
c. Urgent referral to vascular surgeon
d. Surveillance
e. MRI
b. Therapeutic anticoagulants
- How do the majority of seizure medications work?
a. Increase refractory period of Na+ channels
b. Degrade GABA
c. Increase glutamate release
d. Increase sodium excretion during latent period
a. Increase refractory period of Na+ channels
- 31 year old woman presents with fatigue and amenorrhea. Thyroid tests show low T3, low t4 and very low TSH. What is the most appropriate next test?
a. Thyroid antibodies test
b. Thyroid ultrasound
c. Thyroid iodine uptake scan
d. MRI of pituitary gland
e. Monitor 24 hour iodine excretion
d. MRI of pituitary gland
What is amenorrhea?
Absence of menstrual periods
- What’s the best way to take an image of the head while minimising ionising radiation and maximising image definition?
a. Ultrasound
b. MRI
c. CT
d. X ray
b. MRI
- Endothelial cells regulate thrombus formation. How does it do this?
a. Releases zygomen inhibitors
b. Releases nitric oxide
c. Activation of thrombin
d. Releases plasminogen inhibitors
c. Activation of thrombin
- John, 70, presents with eye trouble. He has 6/6 acuity with glasses. His eyes feel heavy and he gets double vision after an hour of reading. His eyes recover after short rest but get worse after shorter and shorter rest times. No other tiredness is noted. What disease is likely?
a. Degeneration of CNS
b. Demyelination
c. Inflammatory polyneuropathy
d. Disease of the NMJ
d. Disease of the NMJ
- A young girl has ORIF surgery for a fractured ulna/radius. Six hours after her surgery she is still in severe pain. The registrar fears compartment syndrome. What is a late sign of compartment sign?
a. Pain
b. Pallor
c. Pulselessness
d. Palpable mass
e. Paraesthesia
c. Pulselessness
What is ORIF surgery?
Open reduction and internal fixation (ORIF) is a type ofsurgeryused to stabilize and heal a broken bone. You might need this procedure to treat your broken ankle
What is Paraesthesia?
an abnormal sensation, typically tingling or pricking (‘pins and needles’), caused chiefly by pressure on or damage to peripheral nerves.
- Where are neurofibrillary tangles first found in Alzheimer’s Disease?
a. Dentate gyrus
b. Entorhinal cortex
c. Hippocampus
d. Neocortex
e. Substantia nigra
b. Entorhinal cortex
- Therapeutic hyperventilation is used to treat increased intracranial pressure. What is the mechanism behind this?
a. Hypocapnia causes vasoconstriction
b. Hypercapnia causes vasodilation
c. Increases heart rate causing vasoconstriction
d. Increases O2
a. Hypocapnia causes vasoconstriction
- There is an RCT that wants to assess the effects of different types of exercise in 2 groups over a 6 month period. What is the best way in which individuals could be randomised between the 2 groups?
a. Random numbers generated by a computer
b. Using the date of births of the individuals
c. Pre-selecting the groups by student number
d. Sequential order
e. Self-selection
a. Random numbers generated by a computer
- The famous neurosurgery patient ‘HM’ underwent surgery for his epilepsy which resulted in anterograde amnesia. This indicated the importance of this area in declarative memory formation. Which area of the brain was affected?
a. Diencephalon
b. Dorsolateral prefrontal cortex
c. Medial temporal lobe
d. Medial prefrontal cortex
e. Right parietal lobe
c. Medial temporal lobe
- Indigenous male presents with double vision when both eyes are open. You notice his left eye is slightly medially deviated and he has trouble abducting his left eye. He has diabetes. Which cranial nerve is likely to be causing this?
a. Abducens
b. Facial
c. Oculomotor
d. Trigeminal
e. Trochlear
a. Abducens
What eye related movements does the facial nerve do?
Closes the eyes –> via the orbicularis oculi muscle
What eye related movements does the oculomotor nerve do?
Opens the eye –> via elevator palpebrae
Elevates the eyeball
Depresses eyeball
Adducts eyeball (outwards)
Lateral rotation
What eye related movements does the trochlear do?
Innervates the superior oblique to depress and intort the eyeball.
What does the abducens do in the eye?
Abducts