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JMP Y2S2 > summatives 2018/19 i got wrong > Flashcards

summatives 2018/19 i got wrong Flashcards

1
Q

What is the main supporting ligament of the uterus?

A. Cardinal ligament
B. Broad ligament
C. Round ligament
D. Suspensory ligament

A

A. Cardinal ligament

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2
Q

You consult a 20 year old male law student. He is finding it difficult to cope with his academic workload. He also complains of forgetfulness, insomnia, headaches and low mood most mornings. He has used amphetamines a few times, has a few beers with his friends after class and says he smokes a “few cones” of marijuana every afternoon to help him relax. What is the most likely cause of his complaints?

A.	Bipolar 
B.	Personality disorder 
C.	Generalised anxiety disorder 
D.	Schizophrenia 
E.	Substance induced disorder
A

E. Substance induced disorder

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3
Q

Mother comes in 18 days after giving birth. The most common cause of late postpartum bleed?

A.	Endometritis 
B.	Laceration of the genital tract 
C.	Subinvolution of the placental bed 
D.	Placental retention
E.	Uterine atony
A

D. Placental retention

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4
Q

16 year old teenager brought in reluctantly by parents, who say she has displayed a lack of communication and mood swings. What do you do during the consult?

A. Ask her straight away if she has depression
B. Encourage the parents to stay for the whole consultation
C. Prescribe SSRIs for mood swings
D. Respect confidentiality no matter what she says
E. Start by asking her about her life at school and home

A

E. Start by asking her about her life at school and home

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5
Q

Functioning pituitary tumour with increased levels of ACTH. What are some of the symptoms she might be experiencing?

A. Acromegaly
B. Hyperthyroidism
C. Galactorrhea and menstrual problems
D. Increased weight and hypertension

A

D. Increased weight and hypertension

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6
Q

18 year old female currently 32 weeks pregnant. She has a small-for-dates baby 27cm symphofundal height. Diagnosed with intra-uterine growth restriction (IUGR). What is the most likely cause in this case?

A.	Young maternal age
B.	(Genetically) Small maternal size
C.	Placental insufficiency
D.	Maternal nutritional deficiencies
E.	Chromosomal aneuploidy
A

C. Placental insufficiency

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7
Q

Lithium is a mood stabiliser. Which is NOT correct about lithium:

A. Transient side effects include constipation, anorexia, increased thirst
B. Competes with sodium for excretion in the kidneys
C. Can’t be used with antipsychotics
D. Fine hand tremor or nausea indicates lithium toxicity and you should cease taking it immediately
E. Serum levels should be measured 10-14 hours after the last dose

A

A. Transient side effects include constipation, anorexia, increased thirst

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8
Q

Increased early awakenings are seen in?

A.	Mania
B.	Depression
C.	Anxiety states
D.	Schizophrenia 
E.	Conversion disorders
A

B. Depression

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9
Q

Man comes in with hypospadias. This is caused by which abnormality during embryological development?

A. Failure of the urinary channel to completely tubularise
B. Failure of labioscrotal fold to close
C. Urogenital sinus
D. Faulty positioning of the genital tubercle
E. Failure of urethral folds to close

A

E. Failure of urethral folds to close

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10
Q

The mother of a 6 week old baby presents to the GP 5 times over the past 3 weeks concerned about her baby. The Baby is in good health/weight, recently feeding well. Admits that she feels like she isn’t a good mother. She is having trouble sleeping, ____ and ____. She says she hasn’t really enjoyed anything since baby was born. What is the most likely diagnosis?

A. The “Baby blues”
B. Postnatal psychosis
C. Postnatal depression
D. Adjustment disorder

A

C. Postnatal depression

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11
Q

Which symptom is due to bladder (storage)-associated lower urinary tract symptoms?

A. Dribbling
B. Urgency
C. Hesitancy
D. Frequency

A

B. Urgency

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12
Q

Pt presents with heavy menstrual bleeding, takes ibuprofen for cramps. She and her dad have had a history of epistaxis. She is diagnosed with Von Willebrand disorder. What is this?

A. Platelet adhesion disorder due to membrane disruption
B. Intermittent decrease in platelets
C. Coagulation factor disorder of secondary haemostasis
D. Coagulation disorder of primary and secondary haemostasis
E. Functional platelet defect affecting secondary coagulation

A

A. Platelet adhesion disorder due to membrane disruption

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13
Q

A 30 yr old man who smokes 20 cigarettes a day comes in asking for recommendations for nicotine replacement therapy. According to the transtheoretical model of change, what stage is he in?

A.	Action
B.	Contemplation 
C.	Precontemplation
D.	Reaction
E.	Maintenance
A

B. Contemplation

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14
Q

What is the most critical function of astrocytes?

A. Generate stem cells that go on to make glial cells
B. Cause inflammatory response to damage of the CNS
C. Insulate neurons to provide faster transmission
D. Act as a semipermeable membrane for fluid filled structures in the CNS
E. Reuptake neurotransmitters and secrete neurotrophic factors

A

E. Reuptake neurotransmitters and secrete neurotrophic factors

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15
Q

Which of the following is not more likely when a woman smokes during pregnancy?

A.	Low birth weight
B.	Placental abruption
C.	Pre-eclampsia 
D.	Premature rupture of membranes
E.	Spontaneous miscarriage
A

C. Pre-eclampsia

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16
Q

Which of these is a bacterial cause of STIs?

A. Chlamydia
B. Hepatitis B
C. Herpes
D. Trichomoniasis

A

A. Chlamydia

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17
Q

Which development period has the longest period of susceptibility to teratogens during development?

A.	Central Nervous System 
B.	Eyes
C.	Ears
D.	Heart
E.	Peripheral Nervous System
A

A. Central Nervous System

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18
Q

What’s true about Nitrous Oxide?

A. Should not be used around combustive source as it could cause an explosion
B. Chronic use can cause thiamine deficiency and peripheral neuropathy
C. Can be used as a sole anaesthetic for analgesia when general anaesthesia is unnecessary
D. Can be used with oral narcotic agents in first stages of labour as an analgesic
E. Should not be used in a ratio less than 80:20 with oxygen due to inadequate analgesic effects

A

C. Can be used as a sole anaesthetic for analgesia when general anaesthesia is unnecessary

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19
Q

Which of the following is one standard drink?

A.	150 mL of wine 
B.	Mixed drinks with 15 mL spirits 
C.	375 mL full strength beer 
D.	285 mL full strength beer 
E.	375 mL light strength beer
A

D. 285 mL full strength beer

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20
Q

Untreated lactational mastitis can progress into breast abscess. What is the management for established breast abscess?

A. Remove child from her mother due to possibility of sepsis
B. Cease breastfeeding
C. Treatment with broad spectrum antibiotics for several weeks
D. Surgical aspiration if there is a large amount of pus

A

D. Surgical aspiration if there is a large amount of pus

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21
Q

28 weeks gestation, on ultrasound, foetus appears larger than normal. Mother’s blood glucose level is high. Which hormone produced by the placenta leads to increased glucose level in the mother?

A.	Human chorionic gonadotropin
B.	Human chorionic somatomammotropin
C.	Human chorionic glucotropin
D.	Oestrogen
E.	Progesterone
A

B. Human chorionic somatomammotropin

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22
Q

60+ yr-old male has a history of chronic alcohol abuse. He has cardiomyopathy from congestive heart failure, liver disease, and a history of acute esophageal variceal bleeding. He presents with a low BP and some blood on his shirt. What makes you suspect he has exacerbation of heart failure rather than hemorrhagic shock from variceal bleeding?

a) Poor peripheral circulation
b) Raised JVP
c) Tachycardia
d) Low hemoglobin

A

b) Raised JVP

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23
Q

Woman presents with headache, fatigue and weight loss. Normal investigations (such as FBC, thyroid tests etc) are performed with no abnormalities. On a follow up appointment, GP wants to do more examinations. He suspects Depression. What question would be most helpful for ruling this diagnosis in or out?

a) Can you look back on a happy childhood?
b) Do you still enjoy things you usually enjoy doing?
c) Do you ever hear or see things other people don’t hear or see?
d) Do you ever think that TV shows contain messages intended for you?
e) Is there an immediate family history of mental health issues?

A

b) Do you still enjoy things you usually enjoy doing?

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24
Q

A man has high LDL and VLDL. He has plaques in his coronary arteries. What would acute episodes of chest pain at rest indicate?

a) Plaque blocking ventricular conduction
b) Ruptured plaque causing thrombus and occlusion of artery
c) Greater than 75% of lumen occluded by plaque
d) Decrease in apolipoprotein B

A

b) Ruptured plaque causing thrombus and occlusion of artery

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25
Q

What would you not expect to see in a pregnant woman in 2nd trimester?

a) HR 80
b) BP 142/75
c) Fasting glucose 4.0 mmol/L
d) Bipedal oedema
e) Haemoglobin 100

A

b) BP 142/75

26
Q

In the early stages of atheroslerotic plaque formation, which cell endocytoses LDL?

a) Foam cell
b) Macrophage
c) Smooth muscle cell
d) Endothelial cell
e) T cell

A

b) Macrophage

27
Q

If a disease has a long and chronic course and ends in premature death, how would you describe the burden of disease to the community?

a) Disability adjusted life years
b) Mortality rates
c) Number of years lived with disability
d) Number of deaths
e) Number of life years lost due to premature death

A

a) Disability adjusted life years

28
Q

What position would the eye be in if there was a CNIII palsy?

a) Laterally and downward
b) Laterally and upward
c) Medially and downward
d) Medially and upward
e) Normal

A

a) Laterally and downward

29
Q

Where are first-order nociceptive neurons located?

a) Dorsal horn of spinal cord
b) Paravertebral ganglia
c) Spinal ganglia
d) Ventral horn of spinal cord

A

c) Spinal ganglia

30
Q

Echinocandin is an antifungal drug, often called the “penicillin of anti-fungals”. What is it’s MOA?

a. Cell wall lysis
b. Cell membrane
c. DNA replication + transcription
d. Mitosis

A

a. Cell wall lysis

31
Q
  1. Medial collateral ligament tear. What are you going to find on examination?

a. Abnormal passive abduction on full extension
b. Tibia can be displaced anteriorly with respect to femur
c. Tibia can be displaced posteriorly with respect to femur
d. On full extension there is pain on lateral rotation

A

a. Abnormal passive abduction on full extension

32
Q

5yo presents. Shows you she’s learning to read in school. Height percentile >3rd percentile, head > 97th percentile. Short proximal limbs and lateral lordosis of the spine. Mother has similar proportions.

a. 22q11 Mutation
b. Fibroblast growth factor receptor gene mutation
c. Something about SRY
d. 45XO karyotype
e. 47XXX karyotype

A

b. Fibroblast growth factor receptor gene mutation

33
Q

What is the most critical function of astrocytes?

a. Generate stem cells that go on to make glial cells
b. Cause inflammatory response to damage of the CNS
c. Insulate neurons to provide faster transmission
d. Act as a semipermeable membrane for fluid filled structures in the CNS
e. Reuptake neurotransmitters and secrete neurotrophic factors

A

e. Reuptake neurotransmitters and secrete neurotrophic factors

34
Q

A pregnant woman is considering pain relief for her upcoming delivery but is worried about the risks. What is a side effect of local anaesthetic?

a. Bradycardia
b. Hypotension
c. Hypertension
d. Stimulates bowel contractions

A

b. Hypotension

35
Q

Pregnant woman presents, 8 wks pregnant. Experienced light bleeding for the past 24 hours. She is O(-) blood type. Husband is overseas and thinks his blood type is A(+) or B(+). Had ultrasound last week (normal). What would be the next appropriate step in her management?

a. Anti-D administration
b. Order a cross match in case you need a blood transfusion
c. Urgent pelvic ultrasound
d. FBC + examination

A

a. Anti-D administration (due to the bleeding event)

36
Q

Child with history of recurrent upper respiratory tract infections and current respiratory syncytial virus infection. What predisposes him to this?

a. Type-2 biased immune response
b. Interferon-alpha secreted by alveolar cells
c. Born after 37 weeks

A

a. Type-2 biased immune response

37
Q

What best describes a “good enough” mother?

a. Anticipating almost every need of the baby
b. Being an average caregiver
c. Sometimes delaying soothing a crying baby
d. Teaching the child emotional regulation

A

c. Sometimes delaying soothing a crying baby

38
Q

Which statement about schizophrenia is not correct?

a. Affects 2.4 - 3.6% of the population
b. People with schizophrenia have a 20% reduction in life expectancy
c. Onset in males is 18-24
d. Onset in females is 24-30
e. Equally common in males and females

A

a. Affects 2.4 - 3.6% of the population

39
Q

Pre-renal cause of renal failure?
A. Fluid overload with severe hypertension
B. Thrombosis in left main coronary artery
C. Calculi in the renal pelvis
D. Prostatic enlargement
E. Acute bacterial Nephritis

A

B. Thrombosis in left main coronary artery

40
Q

Hepatitis B infection a year ago. Given antivirals and interferon as treatment. Pustules on legs?

a. Polyarteritis Nodosa
b. Hepatitis A
c. Vasculitis

A

a. Polyarteritis Nodosa

41
Q

Best way to determine the grade of a tumour?

a. Biopsy
b. Full body CT
c. Blood test for tumour markers

A

a. Biopsy

42
Q

What is AMH and when is it low?

A

Egg reserve test Anti-Mullerian Hormone (AMH) is a hormone secreted by cells in developing egg sacs (follicles). The level of AMH in a woman’s blood is generally a good indicator of her ovarian reserve. (LOW IN MENOPAUSE)

43
Q

What is DHEAS?

A

Dehydroepiandrosterone sulfate (DHEAS) is an androgen, a male sex hormone that is present in the blood of both men and women

44
Q

what is excess bleeding amount for vaginal delivery?

A

over 500ml

45
Q

is Leigh syndrome or Amyotrophic Lateral Sclerosis somatic mutation and not germ?

A

ALS

46
Q

What is the pathogenesis of coeliac disease?
A. IgE mast cell
B. IgG
C. T cell mediated
D. Immune complex deposition of glucose and antibody

A

C. T cell mediated

47
Q 
Guy who has an overactive detrusor muscle. Which of the following drug classes would help?
A.	Alpha-1 agonist
B.	Beta-3 adrenergic agonist 
C.	Muscarinic M3 receptor agonist
D.	Nicotinic receptor agonist
A

B. Beta-3 adrenergic agonist

48
Q 
On FBC the patient has increased RBC, decreased Haemoglobin, increased MCV
A.	Hereditary Spherocytosis
B.	Thalassemia
C.	Folate deficiency anaemia
D.	Iron deficiency anaemia
A

C. Folate deficiency anaemia

49
Q

Young woman is rude and dismissive to other people after joining political group, to people that don’t share the same beliefs as her. What would be evidence for a personality disorder?
A) Always been rude and dismissive before joining the political group
B) Being rude and submissive has been a change for the woman
C) She changed to being rude and submissive after joining political group
D) Her beliefs don’t align with the majority of society

A

A) Always been rude and dismissive before joining the political group

50
Q

A woman with iron deficiency comes in and asks her GP about how iron is transported around the body. The GP explains this using terms like ferritin and transportin. What would be the correct explanation below.
A) Ferrous iron is transported into enterocytes by transportin
B) Ferrous and ferric iron are stored in the liver with ferroportion
C) Ferric iron from haeme is transported into the intestinal epithelial cells using the DMT1 transporter
D) Ferric iron is stored in intestinal enterocytes bound to ferritin

A

D) Ferric iron is stored in intestinal enterocytes bound to ferritin

51
Q

What is most true about screening programs?
A) Screening mammogram is diagnostic for breast cancer
B) HPV can be screened for because any hyperplasia of cells caused by HPV can be seen
C) Now that vaccinations for HPV is in place, the NSW law has changed so that women need to be screened every 2 years.
D) Self breast examination is good at picking up small lesions
E) Screening is good for pathological…

A

B) HPV can be screened for because any hyperplasia of cells caused by HPV can be seen

52
Q

Guy taking alpha-1 antagonist gets dizzy when he stands up. Why ?
A) Cannot constrict peripheral resistance vessels
B) Heart rate cannot increase
C) Decreased vagal tone

A

C) Decreased vagal tone

53
Q 
Psychomimetic drugs that cause hallucinations act on which of the following receptors?
A)	Adrenergic beta 2
B)	Dopaminergic 
C)	Serotonergic-2A
D)	One other
A

C) Serotonergic-2A

54
Q 
A couple is trying to get pregnant but are unable to for 13 months with unprotected vaginal intercourse, what type of infertility is it?
A)	Normal fertility 
B)	Primary infertility
C)	Secondary infertility
D)	Tertiary infertility 
E)	Something else
A

C) Secondary infertility

55
Q 
Which of the following neurotransmitters is important in achieving an erection?
A.	Neuropeptide Y (NPY)
B.	Substance P
C.	Nitric oxide 
D.	Noradrenaline
A

C. Nitric oxide

56
Q

Vaccination for hepatitis - what blood test accounts for vaccine-induced immunity?
A. HBsAg - Hepatitis B surface antigen
B. HBcAg - Hepatitis B core antigen
C. HBeAg - Hepatitis B E antigen
D. Combination of both Hepatitis B core and Hepatitis B surface antigen

A

A. HBsAg - Hepatitis B surface antigen

57
Q 
The ureter has a long and windy course that invariably narrows when it passes near other structures. As such it has to expand when passing calculi. Which of the following epithelial cell types lines the ureter and allows this expansion to happen?
A.	Simple squamous
B.	Transitional
C.	Stratified squamous
D.	Simple columnar
E.	Stratified cuboidal
A

B. Transitional

58
Q

Interpret ABG: pH 7.2, normal PaCO2, high lactate, base excess -4, low bicarbonate.
A) Respiratory alkalosis from hyperventilation
B) Metabolic acidosis with inadequate respiratory compensation
C) Respiratory acidosis with adequate compensation
D) Respiratory acidosis with inadequate renal compensation

A

B) Metabolic acidosis with inadequate respiratory compensation

59
Q

What is it called when you have an irrational belief that is not shared by others?
A) Delusion
B) Hallucination
C) Illusion

A

A) Delusion

60
Q

A man is brought in by his wife because she was concerned about him. Fluctuating consciousness , irritated easily (angry) and then appears fine. Had dementia a couple of weeks ago and was deemed fine. What’s the most likely
A) Deterioration of dementia
B) Delirium
C) Cerebral haemorrhage

A

B) Delirium

61
Q

Man becomes sweaty, loses control over steering wheel while driving. What would provide reassurance that the man is having a panic attack?
A) Flashback to a previous car crash
B) He was thinking about being embarrassed about his performance while driving
C) The symptoms reside within 10 mins

A

C) The symptoms reside within 10 mins

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