Summative Y2S1 2019 Flashcards
Patient comes in with wife with a history of head trauma 3 days ago. He has developed vomiting and confusion. Imaging shows a crescent shaped haematoma.
The rupturing of which vessel is behind this pathology?
A. Cerebral sinus
B. Middle cerebral artery
C. Cerebral vein
D. Meningeal artery
C. Cerebral vein –> bridging veins
Baby presents with increased irritability and vomiting after being weaned from breast milk to cow’s milk. Has had fatty diarrhea with a small amount of blood in the stool. Erythematous rash on body after last feed of cow’s milk. And swollen lips
If you suspect the cow’s milk is the cause, what is the likely pathology?
A. Autoimmune
B. IgE mediated
C. Lactase deficiency
B. IgE mediated
22 year old comes into ED with pain, blur and vision loss in the left eye. On swinging light test, as you move the light from the patient’s right eye to their left, you notice that their left eye dilates fully. You are performing this test in a dim room. Which cranial nerve is most likely affected? A. Abducens B. Oculomotor C. Ophthalmic branch of trigeminal D. Optic E. Trochlear
D. Optic
What is a key step in formation of the primary platelet plug?
A. Serine Protease activating the intrinsic pathway
B. Conversion of prothrombin by Factor X
C. Fibrin contraction
D. Release of ADP and Thromboxane A2
D. Release of ADP and Thromboxane A2
What does connective tissue proper consist of?
A. Cells, fibres, and ground substance
B. Cells, water, and extracellular matrix (ECM)
C. Collagen, cells, and extracellular matrix (ECM)
D. Fibroblasts, mast cells, and ground substance
A. Cells, fibres, and ground substance
Man with epilepsy asks you how phenytoin works.
Mechanism of phenytoin:
A. Reduce neuron excitability by inhibiting Na channels
B. Reduce neuron excitability by inhibiting Ca channels
C. Increase neuron excitability by prolonging opening of Na channels
A. Reduce neuron excitability by inhibiting Na channels
Aggregates of alpha synuclein are found in which of these? A. Alzheimer’s Disease B. Creutzfeldt-Jakob’s Disease C. Huntington’s Disease D. Parkinson’s Disease
D. Parkinson’s Disease
What class of antineoplastic drugs are most likely to cause myelosuppression? A. Monoclonal antibodies B. Immunosuppressants C. Kinase inhibitors D. Alkylating agents
D. Alkylating agents
Which of these conditions matches the definition “reduced oxygen supplied to the brain because of issues with structure, leading to lack of supply of nutrients and oxygen to brain”. A. Hypoxic ischaemia B. Anaemic ischaemia C. Anoxic ischaemia D. Ischaemic necrosis
A. Hypoxic ischaemia
Which of the following would be caused by efferent glomerular artery constriction?
A. Transient decrease in GFR
B. Increased renal blood flow
C. Increased hydrostatic pressure of glomerular capillary
D. Decreased excretion of water
C. Increased hydrostatic pressure of glomerular capillary
A man fell off scaffolding and you (GP) suspect left hemicord damage.
What would be the clinical sign?
A. Left side loss of proprioception and temperature, right side pain
B. Right side loss of proprioception and temperature, left side pain
C. Left side loss of pain and temperature, right side proprioception
D. Right side loss of pain and temperature, left side proprioception
D. Right side loss of pain and temperature, left side proprioception
What is the function and location of Golgi Tendon Organs?
A. Detect muscle stretch; parallel to muscle spindle.
B. Detect muscle stretch; in series with muscle spindle.
C. Detect muscle tension; parallel to muscle spindle.
D. Detect muscle tension; in series with muscle spindle.
D. Detect muscle tension; in series with muscle spindle.
A 26 year-old woman sees her GP because of frequent migraines. Which neurotransmitter system is strongly implicated in the pathogenesis of migraine? A. Dopamine B. GABA C. Glutamate D. Noradrenaline E. Serotonin
E. Serotonin
A 28 year old woman presents to your GP clinic with a history of feeling more tired than usual. She has also noted some tingling on her left upper arm. She reports that she had a period of double vision one month ago for 4 days. She noticed that she has to pass urine more frequently than usual.
What provisional diagnosis would you consider is most likely?
A. GBS
B. MS
C. MG
D. Poliomyelitis
B. MS
What is characteristic of dementia with Lewy bodies?
A. Atrophy
B. Deteriorating cognitive function with memory loss
C. Hippocampal destruction seen in MRI scan
D. Subcortical damage seen on CT scan
E. Visual hallucinations
E. Visual hallucinations
Which condition is associated with Type IV hypersensitivity? A. Conjunctivitis B. Contact dermatitis C. Mysasthenia Gravis D. Rheumatoid Arthritis E. Graft rejection
B. Contact dermatitis –> note: graft rejection is also Type 4
In which cells of the gut will you find telomerase activity A. Enteroendocrine cells B. Goblet cells C. Epithelial stem cells D. Paneth cells E. Mature brush border enterocytes
C. Epithelial stem cells
60 year old with burning pain in right foot, loss of sensation over arch. Left foot is completely normal. What is the most likely cause? A. Disc herniation of T12/L1 B. Glycosylation of myelin C. Nutritional deficiency D. Small vessel vasculitis E. Compression of peripheral nerve
E. Compression of peripheral nerve
What would you expect to find in a coagulation defect vs a platelet defect? A. Bleeding Gums B. Petechiae C. Retroperitoneal Bleeding D. Bruising on the surface of the skin
C. Retroperitoneal Bleeding
What is a symptoms for a platelet defect?
Bleeding gums
What is a symptoms for coagulation defect?
Joint bleeding
Retroperitoneal bleeding
What is the initiating event in the process of electrical impulse propagation across the surface of excitable cells? A. Binding of calcium B. Closing of chloride channels C. Closing of sodium channels D. Opening of potassium channels E. Opening of sodium channels
E. Opening of sodium channels
During surgery there was damage to the proximal LAD. where would the bleeding likely occur A. Anterior mediastinal space B. Left ventricular chamber C. Left atrium chamber D. Pericardial space E. Left plural space
D. Pericardial space
You are considering prescribing benzodiazepine/diazepam to your patient who has come to see you. She is a 33 year old female who is obese.
What are the consequences of prescribing benzodiazepine to patients with obesity?
A. Increased body mass requires higher dose which increases the risk of adverse effects
B. Faster movement across the blood brain barrier results in increased therapeutic responsiveness
C. Increased distribution in fatty tissue leads to prolonged action and slowed clearance
D. Increased drug plasma concentration leads to adverse effects
C. Increased distribution in fatty tissue leads to prolonged action and slowed clearance
What determines resting membrane potential?
A. The concentration gradient of calcium ions
B. The concentration gradient of chloride ions
C. The concentration gradient of sodium ions
D. The concentration gradient of potassium ions
E. The movement of calcium and chloride ions
D. The concentration gradient of potassium ions
Anna decides to do a project involving surveying some fellow students about their experience in PBL. She is told by her supervisor that she will not need human research ethics committee (HREC) approval for such a project. Which of the following is most clearly true?
A. HREC approval is required – the supervisor is wrong
B. HREC approval is not required because of the informal nature of the project
C. HREC approval is not required because no harm can come from this kind of project
D. Individual HREC approval is not necessary because student research is covered by a blanket institutional ethics accreditation, whereby supervisors take responsibility for ensuring that students comply with ethics
E. Individual HREC ethics approval is not necessary because the convenor of the MD has gained an exemption on behalf of its students for this component of the course
A. HREC approval is required – the supervisor is wrong
What does the acronym PICO stand for?
A. Patient, intervention, clinical, expected outcome
B. Patient, intervention, comparison, expected outcome
B. Patient, intervention, comparison, expected outcome
A 40 year old man came in saying that he had a ‘turn’ last night. He came in having a funny gait. Which of the following describes a hemiplegic gait?
A. Semi-circumduction due to hypertonia of the extensors of the leg
B. Hip drop on one side while walking
C. Scissoring with hip adductors
D. Wide-based gait
E. Foot drop
A. Semi-circumduction due to hypertonia of the extensors of the leg
A woman who came in with blood in urine and urinary incontinence. She had stinging on urination. Pain in suprapubic area. No history of fever or chills. No other pain. A. Cystitis B. Pyelonephritis C. Stress incontinence D. Urge incontinence
A. Cystitis
Which of the following tests are more specific for rheumatoid arthritis? A. Anti-CCP B. ANA C. CRP D. ESR E. HLA-B27
A. Anti-CCP
What is Anti-CCP used for?
Rheumatoid arthritis
Detecting presence of autoantibodies for cyclic citrullinated peptide.
Higher than normal levels suggest RA
Test can be used to identify people with a more rapidly erosive form of the disease
What is a HLA-B27 test and what is it used for?
- Detecting levels of human leukocyte antigen B27
2. Helps predict likelihood of immune disorder from the presence of a HLA antigen on the surface of self cells.
What is ANA test used for?
- Anti-nuclear antibody presence –> a group of autoantibodies
- Helps determine a suspected autoimmune disorder
What is CRP used for?
C reactive protein levels
- Results are levels of CRP
- Higher CRP in times of higher inflammation
- Used in detection of acute inflammation conditions as well as chronic conditions with flare ups
- Can be measured to measure response to inflammatory disorder treatment
What is ESR used for?
Erythrocyte sedimentation rate
- Results are mm of clear plasma visible at the top of the tube after 1 hour
- There is a faster sedimentation rate when there is an increased level of protein
- This extra protein can be due to increased inflammatory proteins (CRP and fibrinogen)
- Hence this test is a crude measure for systemic inflammatory markers
Patient has bilateral small pupils. With light response, both pupils had brisk constriction. What is the most likely cause of this? A. Near light dissociation B. Oculomotor nerve palsy C. Optic neuritis/ optic palsy D. Opioid use
A. Near light dissociation
What is the affect of Oculomotor nerve palsy on pupil reflex?
Will lose pupillary constriction to light –> and strength of eyelid muscle
What is the affect of optic neuritis/optic palsy on pupil reflex?
Will lose papillary constriction ability
What is the difference between direct and consensual pupil reflex?
Direct –> eye with light
Consensual –> constriction in eye with no light
What happens to direct and consensual in optic nerve issue in left eye?
Left direct reflex = lost
Right consensual = lost (right eye will not constrict when light in left)
Right direct = intact
Left consensual = intact (left eye will constrict when light in right)
67 year old man presents with distended jugular vein, tachycardic, tachypnoeic, hypotensive Does he have... A. Decreased preload B. Decreased cardiac contractility C. Increased intravascular volume D. Increased TPR
B. Decreased cardiac contractility
Norwegian woman with MS concerned about the likelihood of her Australian-born children also getting MS.
A. No greater risk than other Norwegian children
B. No greater risk than other Australian children.
C. Less than 15%
D. Greater than 25%
E. Between 15 and 25%
B. No greater risk than other Australian children.
Which central nervous system region(s) supply the output motor neurons for the sympathetic nervous system? A. All spinal segments B. Brainstem C. S2-S4 D. T12-L4 E. T1-L2
E. T1-L2
17-year old boy, laceration to medial left knee. Numbness medially down leg and foot. No motor deficits. What nerve is involved? A. Deep fibular B. Femoral C. Sural D. Saphenous E. Superficial fibular
D. Saphenous
What sensation does superficial fibular do?
Posterio-lateral leg and knee joint
What sensation does femoral nerve do?
Has sensory branches:
Anterior cutaneous branches –> anteromedial thigh
Saphenous nerve –> medial leg and foot
What sensation does sural nerve do?
Lateral foot and lateral lower ankle
What sensation does deep fibular do?
Webbed skin between great toe and second toe