Summative Y2S1 2019 Flashcards

1
Q

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

A

C. Cerebral vein –> bridging veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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

A

B. IgE mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
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
A

D. Optic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

D. Release of ADP and Thromboxane A2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

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

A. Cells, fibres, and ground substance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

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

A. Reduce neuron excitability by inhibiting Na channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
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
A

D. Parkinson’s Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
What class of antineoplastic drugs are most likely to cause myelosuppression?
A. Monoclonal antibodies
B. Immunosuppressants
C. Kinase inhibitors
D. Alkylating agents
A

D. Alkylating agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
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

A. Hypoxic ischaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

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

A

C. Increased hydrostatic pressure of glomerular capillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

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

A

D. Right side loss of pain and temperature, left side proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

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.

A

D. Detect muscle tension; in series with muscle spindle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q
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
A

E. Serotonin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

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

A

B. MS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

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

A

E. Visual hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q
Which condition is associated with Type IV hypersensitivity?
A. Conjunctivitis
B. Contact dermatitis
C. Mysasthenia Gravis
D. Rheumatoid Arthritis
E. Graft rejection
A

B. Contact dermatitis –> note: graft rejection is also Type 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q
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
A

C. Epithelial stem cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
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
A

E. Compression of peripheral nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q
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
A

C. Retroperitoneal Bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a symptoms for a platelet defect?

A

Bleeding gums

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a symptoms for coagulation defect?

A

Joint bleeding

Retroperitoneal bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q
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
A

E. Opening of sodium channels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q
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
A

D. Pericardial space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

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

A

C. Increased distribution in fatty tissue leads to prolonged action and slowed clearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

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

A

D. The concentration gradient of potassium ions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

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

A. HREC approval is required – the supervisor is wrong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does the acronym PICO stand for?
A. Patient, intervention, clinical, expected outcome
B. Patient, intervention, comparison, expected outcome

A

B. Patient, intervention, comparison, expected outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

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

A. Semi-circumduction due to hypertonia of the extensors of the leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q
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

A. Cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
Which of the following tests are more specific for rheumatoid arthritis?
A. Anti-CCP
B. ANA
C. CRP
D. ESR
E. HLA-B27
A

A. Anti-CCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Anti-CCP used for?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is a HLA-B27 test and what is it used for?

A
  1. 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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is ANA test used for?

A
  1. Anti-nuclear antibody presence –> a group of autoantibodies
  2. Helps determine a suspected autoimmune disorder
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is CRP used for?

A

C reactive protein levels

  1. Results are levels of CRP
  2. Higher CRP in times of higher inflammation
  3. Used in detection of acute inflammation conditions as well as chronic conditions with flare ups
  4. Can be measured to measure response to inflammatory disorder treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is ESR used for?

A

Erythrocyte sedimentation rate

  1. Results are mm of clear plasma visible at the top of the tube after 1 hour
  2. There is a faster sedimentation rate when there is an increased level of protein
  3. This extra protein can be due to increased inflammatory proteins (CRP and fibrinogen)
  4. Hence this test is a crude measure for systemic inflammatory markers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q
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

A. Near light dissociation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the affect of Oculomotor nerve palsy on pupil reflex?

A

Will lose pupillary constriction to light –> and strength of eyelid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the affect of optic neuritis/optic palsy on pupil reflex?

A

Will lose papillary constriction ability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the difference between direct and consensual pupil reflex?

A

Direct –> eye with light

Consensual –> constriction in eye with no light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What happens to direct and consensual in optic nerve issue in left eye?

A

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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q
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
A

B. Decreased cardiac contractility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

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%

A

B. No greater risk than other Australian children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q
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
A

E. T1-L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q
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
A

D. Saphenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What sensation does superficial fibular do?

A

Posterio-lateral leg and knee joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What sensation does femoral nerve do?

A

Has sensory branches:
Anterior cutaneous branches –> anteromedial thigh
Saphenous nerve –> medial leg and foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What sensation does sural nerve do?

A

Lateral foot and lateral lower ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What sensation does deep fibular do?

A

Webbed skin between great toe and second toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q
What increases the half life of a drug?
A. Increased frequency of dosing
B. Increased rate of clearance
C. Increased rate of metabolism
D. Increased volume of distribution
A

D. Increased volume of distribution

50
Q

A 70 year old man presents to ED with a suspected bowel obstruction. An hour later he complains of sudden pain and his abdomen becomes rigid. You suspect he may have perforated his bowel.
What sign on abdominal X-ray would indicate a perforation?
A. Dilated loops of small bowel
B. Double wall sign
C. Centrally located dilated bowel
D. Haustra visible
E. Air in rectum

A

B. Double wall sign

51
Q
Female Danish exchange student with low mean corpuscular volume and high mean corpuscular haemoglobin. RBC membranes are also fragile. What would be seen on blood smear?
A. Sickle cell anaemia
B. Schistocytes
C. Spherocytes
D. Normal Red cells
E. Target cells
A

C. Spherocytes

52
Q

28 year old pregnant female presented with pruritus, was diagnosed with cholecystitis, what would you expect to see;
A. Decreased Alkaline Phosphatase in blood
B. Decreased urobilinogen in urine
C. Increased albumin in blood
D. Increased bile salts in GIT
E. Increased unconjugated bilirubin in urine

A

B. Decreased urobilinogen in urine

53
Q
What is the expected clinical finding in someone with right cerebral ischemia?
A. Left down going Babinski sign
B. Right leg fasciculation
C. Right thigh muscle wastage
D. Left leg spastic paralysis 
E. Bilateral
A

D. Left leg spastic paralysis

54
Q
What is an important component of joint articular cartilage?
A. Dense bundles of collagen 
B. Extensive ground substance
C. Hydrophobic
D. Proteoglycan aggregates 
E. Rich blood supply
A

D. Proteoglycan aggregates

55
Q
Which neurotransmitter is released by synaptic terminals of primary afferent nociceptors?
A. acetylcholine
B. Bradykinin
C. Enkephalin
D. Glutamate 
E. Serotonin
A

D. Glutamate

56
Q

What process do PPIs interfere with?
A. Breaks down proteins into polypeptides
B. Breaks down polypeptides into dipeptides
C. Breaks down fats
D. Breaks down starches

A

A. Breaks down proteins into polypeptides

57
Q
A 74 year old suffers cortical stroke which of the following is a likely symptom
A. Nystagmus
B. Inability to process speech 
C. Diplopia
D. facial weakness
A

B. Inability to process speech

58
Q
Which of the following is not included in Fresh Frozen Plasma (FFP)?
A. Albumin
B. Anticoagulants
C. Clotting factors
D. IgM anti-A and anti-B
E. Platelets
A

E. Platelets

59
Q

12 year old boy returns home from school with a bad cold.
What type of T lymphocyte lyses has this virus affected?
A. Cytotoxic
B. Helper
C. Inducer memory
D. Suppressor

A

A. Cytotoxic

60
Q
Cerebrospinal Fluid plays very important functions in the physiology of the central nervous system.
Where is cerebrospinal fluid produced?
A. Arachnoid Villi
B. Choroid Plexus 
C. Ciliary Bodies
D. Dural Sinus
E.Mammillary body
A

B. Choroid Plexus

61
Q

Which of the following mechanisms do not prevent the production of clots in healthy blood vessels?
A. Fibrinolytic pathway
B. Protein C Pathway
C. Serine protease inhibitor: antithrombin
D. Tissue Factor Pathway inhibitor

A

A. Fibrinolytic pathway

62
Q

What is the protein C pathway?

A

Prevents thrombosis

63
Q
Tibial nerve innervation.
A. dorsiflexion
B. plantarflexion
C. Knee flexion
D. Hip adduction
E. Knee extension
A

B. plantarflexion

64
Q

What nerve/muscle dorsiflexes the foot?

A

Deep peroneal nerve –> tibialis anterior

65
Q

What muscle for plantarflexion?

A

Gastrocnemius, soleus, plantaris

66
Q
15 year old boy presents to his GP complaining of hearing loss following his school swimming carnival a few days ago. When you perform a Rinne test, he says he can hear better through air conduction than bone conduction for both ears. On Weber test, he says the sound is louder on the left. What do you suspect?
A. Left conductive hearing loss
B. Left sensorineural hearing loss
C. Right conductive hearing loss
D. Right sensorineural hearing loss
A

D. Right sensorineural hearing loss

67
Q

What does Air conduction greater than bone conduction mean for Rinne?

A

Normal result –> hence will be inner ear issue –> sensorineural

68
Q

What does bone conduction greater than air conduction mean?

A

Negative result –> indicates conductive loss of hearing

69
Q

What side is weber louder?

A

Depends if determined conductive or sensorineural loss

Conductive loss –> bone louder –> hence will be louder in AFFECTED ear

Sensorineural loss –> louder on the UNAFFECTED ear (good ear working)

70
Q

16 year old boy presents with baseball strike to parietal lobe. Initial observations nil, after an hour became drowsy. Likely cause?
A. Raised ICP due to epidural haemorrhage
B. Raised ICP due to subdural haemorrhage
C. Raised ICP due to subarachnoid haemorrhage
D. Effects of analgesics given
E. Secondary seizure

A

A. Raised ICP due to epidural haemorrhage

71
Q

What are symptoms of an epidural haemorrhage?

A
Commonly triphasic --> altered consciousness --> lucid --> sharp neural decline
Altered consciousness
Headache
Vomiting
Confusion/seizures
Aphagia
72
Q

What are symptoms for subdural haemorrhage?

A

Very similar to epidural haemorrhage symptoms
Coma in 50% of cases
Triphasic/lucid interval less common

73
Q

What are symptoms for a subarachnoid haemorrhage?

A

Similar to epi and subdural
Often occurs with a sudden “thunderclap headache”
Can cause symptoms of irritated meninges:
-nuchal rigidity etc

74
Q

What is pain sensitive in the brain?

A

Meningeal layers

75
Q

What does the epidural haemorrhage CT shape look like?

A

Biconvex –> near skull

76
Q

What does a subdural haemorrhage CT shape look like?

A

Crescent shaped

77
Q

What does a subarachnoid haemorrhage CT shape look like?

A

Amorphous substance that fills the normally dark, CSF-filledsubarachnoidspaces around the brain –> can spread further than epi or subdural haemorrhage

78
Q

Why does a epidural haemorrhage show up as biconvex on CT?

A

Cannot cross the sutures lines as the dura matter is tightly adhered there

79
Q

Why does a subdural haemorrhage present as crescent shaped on CT?

A

can expand along the inside of the skull, creating a concave shape that follows the curve of the brain, stopping only atDural reflections like the tentorium cerebelli and falx cerebri.

80
Q

What is difference in most common source of blood for epidural vs subdural haemorrhage?

A

Epidural –> arterial

Subdural –> venous

81
Q

What can be different about the presentation of epidural vs subdural haemorrhage?

A

Subdural can present in elderly with no obvious origin of trauma and be classed as chronic –> may present as a long term dementia before presentation

82
Q

What is the most common cause/ source of blood for sub arachnoid haemorrhage?

A

Rupturing of an aneurism –> in particular the cerebral arteries

83
Q
Insulin secretion is stimulated when glucose enters which of the following transporters?
A. GLUT1
B. GLUT2
C. GLUT3
D. GLUT4
E. GLUT5
A

B. GLUT2

84
Q

A previously healthy 67 year old male presents with nausea, vomiting and jaundice, and is diagnosed with hepatitis A. His stools are pale and have a raised faecal fat content.
Which of the following would explain his fat malabsorption?
A. Disaccharidase deficiency
B. Duodenal villous atrophy
C. Decreased lipase secretion
D. Impaired micelle formation
E. Trypsinogen deficiency

A

D. Impaired micelle formation

85
Q

Boy with grade 1 ankle sprain, mother insists X-ray be done. What do you do?
A. Order an X-ray
B. Order an MRI
C. Order a CT scan
D. Reassure the mother that he doesn’t need an X-ray
E. Refer to orthopaedic surgeon

A

D. Reassure the mother that he doesn’t need an X-ray

86
Q

Bisphosphonate MOA

A

Uptake into osteoclasts and induction of osteoclastic apoptosis

87
Q

Mechanism of action of hepcidin on iron metabolism?

A

Binding and degrading ferroportin on intestinal mucosal cells and macrophages, which inhibits iron transport and thus iron metabolism

88
Q
What motion is detected by the horizontal semicircular canal
A. Linear acceleration
B. Head rotation around vertical axis 
C. Left-right tilt
D. Up-down tilt
A

B. Head rotation around vertical axis

89
Q

Young woman comes in with fatigue, diarrhoea, and you suspect that it is because she is taking thyroxine. Which one of these would you expect upon testing:
A. High free T4 and undetectable serum TSH
B. Low free T4 and high serum TSH
C. High T3 and suppressed TSH

A

A. High free T4 and undetectable serum TSH

90
Q

26 year old woman presents with 3-day history of blood in urine, ankle oedema and elevated serum creatinine 0.65. What is most likely acid base profile?
A. Metabolic acidosis with respiratory compensation
B. Metabolic alkalosis with no respiratory compensation
C. Metabolic alkalosis with respiratory compensation
D. Respiratory acidosis with renal compensation
E. Respiratory alkalosis with renal compensation

A

A. Metabolic acidosis with respiratory compensation

91
Q
During a heart catheterisation, you accidentally perforate the proximal left anterior descending artery. Perforation would cause bleeding in:
A. Left atrium
B. Left ventricle
C. Pericardial space 
D. Anterior mediastinum
A

C. Pericardial space

92
Q
What is the most important independent factor contributing to atherosclerosis?
A. Cigarette smoke
B. Diabetes mellitus
C. Familial Genetic Factor 
D. Hyperlipidaemia
E. Hypertension
A

D. Hyperlipidaemia

93
Q
According to the “injury hypothesis”, what is the initiating factor of atherosclerosis?
A. Endothelial injury 
B. Leukocyte adhesion
C. Platelet adhesion
A

A. Endothelial injury

94
Q

Patient with a lesion on half of the spinal cord on the left side. How would they present?
A. Pain and thermal affected on the right side, proprioception affected on the left side
B. Pain and thermal affected on the left side, proprioception affected on the right side
C. Pain and proprioception affected on the right side, thermal affected on the left side
D. Pain and proprioception affected on the left side, thermal affected on the right side

A

A. Pain and thermal affected on the right side, proprioception affected on the left side

95
Q
An EEG detects activity initiating in what structure?
A. Cortex 
B. Thalamus
C. Limbic system
D. Reticular formation
A

A. Cortex

96
Q
Which neurotransmitter afferent fibres for pain
A. Noradrenaline
B. Bradykinin
C. Enkephalin
D. Glutamate 
E. Serotonin
A

D. Glutamate

97
Q
Which one of these receptors transduce nociceptive pain
A. Chemoreceptors
B. Mechanoreceptors
C. Free nerve endings 
D. Pacini’s corpuscles
E. Temperature receptors
A

C. Free nerve endings

98
Q
Man with gunshot wound to posterior axillary region. He cannot extend his arms or wrists. What would be affected?
A. Cervical nerve root
B. Lateral cord
C. Posterior cord
D. Medial cord
A

C. Posterior cord

99
Q

What nerve does arm extension?

A

Radial nerve

100
Q

What nerve does arm flexion?

A

Musculocutaneous nerve

101
Q

What nerve does wrist extension

A

Radial

102
Q

What nerve does wrist flexion?

A

Ulna

103
Q
Which one of these do not target clot bound plasminogen?
A. Alteplase
B. Reteplase
C. Tenecteplase
D. Tissue plasminogen activator
E. Urokinase
A

E. Urokinase

104
Q

Patient comes in with the fear that she has had a TIA. Headache, sensory problem.
Which one of the clinical findings below make you more confident that the patient had a migraine aura than a transient ischaemic event?
A. Unremarkable examination of bilateral internal carotids / no bruits
B. Twin has patent foramen ovale, associated with migraines
C. Family history of migraine aura

A

C. Family history of migraine aura

105
Q

A female patient comes in with bone scan reveals she had low bone density. She is prescribed bisphosphonates, calcium salts and vitamin D supplements.
What is the mechanism behind calcitriol is wanted in this case?
A. Increase PTH
B. Increase intestinal epithelial absorption of calcium
C. Prevent osteomalacia

A

B. Increase intestinal epithelial absorption of calcium

106
Q
What is a risk factor of osteoporosis?
A. Anabolic steroid use
B. Excessive calcium intake
C. Low BMI
D. Low PTH
E. Male sex
A

C. Low BMI

107
Q
In which cell would you most likely find telomerase activity?
A. Enteroendocrine cell
B. Epithelial stem cell 
C. Mature enterocyte cell
A

B. Epithelial stem cell

108
Q
Expressive aphasia in most people is caused by a lesion in which region
A. Temporal lobe
B. Mediolateral frontal cortex
C. Left Frontal lobe 
D. Right Frontal lobe
E. Wernicke’s area
A

C. Left Frontal lobe

109
Q
By convention, what is believed to be retained when patient is unconscious?
A. Ability to access memory
B. Deep tendon reflex
C. Manipulation of abstract ideas
D. Orientation to time and place
A

B. Deep tendon reflex

110
Q

Patient presents with right sided facial dysfunction and also right sided cerebellar deficits and deficits of left sided upper and lower limb function.
Which blood vessel is most likely to be have been involved?
A. Basillar artery
B. Posterior cerebral artery
C. Posterior Inferior cerebellar artery

A

C. Posterior Inferior cerebellar artery

111
Q

What brain regions does the basilar artery supply?

A

cerebellum, brainstem, and occipital lobes.

112
Q

What brain regions does the posterior cerebral artery supply?

A

Occipital lobe, the inferior part of the temporal lobe, and various deepstructuresincluding the thalamus and theposteriorlimb of the internal capsule.

113
Q

What brain regions does the posterior inferior cerebellar artery supply?

A

Inferior(lower) portion of the vermis (the midline segment of the cerebellum), the lower medulla, and the posteroinferiorcerebellarhemispheres.

114
Q
Left facial issue, left hearing, vertigo --> where is the issue?
A. Left cerebellopontine angle 
B. Left rostral medulla
C. Right rostral medulla
D. Left pons
E. Right pons
A

A. Left cerebellopontine angle

115
Q
A patient diagnosed with dementia in Australia is most likely to have an aetiology of?
A. Alzheimer’s
B. Dementia with LB
C. Vascular dementia
D. Frontotemporal dementia
A

A. Alzheimer’s

116
Q

Patient presents with consistent symptoms to Dementia with Lewy bodies. Which additional clinical finding will make you more confident in diagnosing the patient with Dementia with Lewy Bodies?
A. Apathy
B. Deteriorating cognitive with memory loss
C. CT with vascular strokes
D. Visual hallucination

A

D. Visual hallucination

117
Q

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

A

C. Tonsillar

118
Q
GAS can cause rheumatic fever. What is the mechanism behind this?
A. Exotoxins including streptolysin O
B. Sequestered antigens
C. Bystander activation 
D. Molecular mimicry 
A

D. Molecular mimicry

119
Q
Could do without which part of brain for maintenance of consciousness?
A. Thalamus
B. Cortex
C. Corpus Callosum 
D. Locus Coeruleus
A

C. Corpus Callosum

120
Q

What brain structures are important for consciousness?

A

Thalamus
Cortex
Locus Coeruleus

121
Q

Lysyl oxidase and collagen. What does it do?
A. Hydroxylation of preprocollagen
B. Hydroxylation of procollagen

A

B. Hydroxylation of procollagen

122
Q
Something about rheuamtoid arthritis. What serum marker is most specific for RA?
A. Anti-CCP
B. ANA
C. C-reactive protein
D. Elevated ESR
A

A. Anti-CCP