Transition/Extras Flashcards

1
Q

Sciatica for 4 weeks, what sign is most likely?

A

Reduced plantarflexion

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2
Q

Inversion injury to right ankle after stumbling off kerb - what fracture is most likely?

A

Avuslion fracture to 5th metatarsal

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3
Q

Localised pain at left iliac crest worst on lateral flexion of spine?

A

Erector spinae

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4
Q

What muscle does adduction/extension of shoulder and internal rotation of humerus?

A

Lattisimus Dorsi

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5
Q

Femoral nerve roots?
Obturator nerve roots?
Sciatic nerve roots?
Pudendal?

A

Fem - L2-4
Out - L2-4
Sci - L4-S3
Pud - S2-4

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6
Q

Definition of aplastic process?

A

Poor differentiation - hard to tell where cells have come from

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7
Q

3 most common locations for cancer in kids?

A

Bone, Brain, Blood

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8
Q

What cell responds to foreign bodies?

A

Histiocyte (aka Macrophage)

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9
Q

Which cause of bleeding in pregnancy causes no increased hCG?

A

Placenta praevia

Vasa praevia

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10
Q

Causes of pseudohyponatraemia?

A

Myeloma, hyperlipidaemia

high proteins/lipoproteins therefore less space for sodium to dissolve

This is NOT COMMON

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11
Q

What are most coliforms sensitive to?

A

Gentamicin

Gm -ve rods e.g. E. coli and Pseudomonas
Penicillins will never work on these

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12
Q

Treatment for intra-abdominal sepsis?

If pen allergic?

A

Amox, met, gent

If pen all: vanc, met, gent

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13
Q

Most likely cause of meningitis in:

  • neonate?
  • Kid <4
  • Young adult
  • Adult
  • Elderly
A

neo - group B strep, e coli, listeria

<4 - HiB

teen - strep pneumo (if fresher then meningococcal)

Adult - strep pneumo

elderly - strep pneumo, amox

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14
Q

Causes of granuloma formation?

A

Macrophages secreting IL-12

Lymphocytes secreting IFN-gamma

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15
Q

What happens to T-cells whose antigen receptors bind strongly to self-antigens?

A

Killed off in thymus during development

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16
Q

Which surface receptor is involved in transplant rejections?

A

MHC

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17
Q

What to alpha/beta T cells recognise which are present on proteins?

A

Epitopes

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18
Q

Intracellular microorganisms within macrophages are more readily killed in the presence of what?

A

IFN - which comes from Th cells

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19
Q

What kills virally infected cells?

A

Tc and NK cells

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20
Q

Plasma cells secrete antibodies that are identical to what?

A

The one that is on the surface of the parent B cell

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21
Q

Role of IL-2?

A

Causes clonal proliferation of lymphocytes

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22
Q

Role of IFN-alpha/beta?

A

produced by virally infected cells which stimulates response from Tc and NK cells

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23
Q

Role of TNF?

A

Causes neutrophil infiltration and fever - acute inflammation

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24
Q

Screening for coeliac?

A

IgA anti-TG antibody

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25
Q

H1 receptor antagonists?

H2 receptor antagonists?

A

H1 - hypersensitivity

H2 - sedation, GORD

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26
Q

IgE molecules attach to mast cells via what?

A

Fc - constant region

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27
Q

Type I hypersensitivity?
Type II?
Type III?
Tive IV?

A

I - IgE mediated - mast cell, basophil, eosinophil - allergies

II - cytotoxic - antibody + antigen induced cell lysis - e.g. haemolytic anaemia, Rh incompatibility

III - immune complex mediated - IgG + IgM - e.g. SLE (can cause kidney damage)

IV - cell-mediated (delayed) - T cells - e.g. chronic transplant rejection, MS, RA

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28
Q

Neutrophil immunodeficinenct?

A

Chronic granulomatous disease - shortage of NADPH oxidase - recurrent pneumonia

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29
Q

B cell deficiency?

A

Selective IgA deficiency - most common primary antibody deficiency - recurrent URTI - assoc w coeliac disease and transfusion reactions

30
Q

T cell deficiency?

A

Di George syndrome - deletion on chr 22 - failure to develop 3rd and 4th pharyngeal pouches - heart defects, learning difficulties, hypocalcaemia, recurrent infection, cleft palate - NO THYMUS

31
Q

Combined T and B deficiency?

A

SCID - X-linked - defect in gamma chain - defective IL-2 - recurrent bacterial and fungal infection

32
Q

What activates peripheral chemoreceptors?

A

pO2 and H+

33
Q

What does low pO2 cause in pulmonary vasculature and why?

How does this compare to systemic circulation?

A

vasoconstriction - don’t want bring in CO2 too quick - V/Q match

In systemic, low pO2 causes vasodilation

34
Q

Barrel shaped chest?

A

COPD

35
Q

Rifampicin induces enzymes - how does this affect Km and Vmax?

A

unchanged Km (conc at which drug works to half of Vmax)

Increased Vmax (conc at which drug works best)

36
Q

On line weaver burke what is Km and Vmax?

A

Km - Intersection with y axis

Km - intersection with x axis

37
Q

Patient on viagra who collapses - interaction?

A

Nitrate

38
Q

Statin + grapefruit juice?

A

Myalgia

+ drowsiness, dizziness, headache

39
Q

Pain relief for OA patient on warfarin?

A

Paracetamol

40
Q

Function of erector spinae?

A

extension and lateral flexion of spine

41
Q

Only CN to run through the middle of cavernous sinus?

A

CN VI

42
Q

Pharmacodynamics?

Pharmacokinetics?

A

Dyna - what drug does to body

Kine - what body does to drug

43
Q

Autonomy?
Justice?
Non - maleficence?
Beneficience?

A

Aut - pt’s right to make a choice based on personal values + beliefs

Justice - treat others equally, distribute benefit/burden fairly

Non-maleficence - do no harm

Beneficience - provide benefit

44
Q

Epidemiology triangle?

A

Agent, host, environment (time in middle)

45
Q

Sensitivity?

Specificity?

A

sens - how good it is at picking up disease

Spec - how good it is at not picking up other diseases

46
Q

How long to check for signs of life?
How long to breathe out for?
Child CPR?
Adult CPR?

A

10 secs
1 sec

Child - 5 breaths then 15:2

Adult - 30:2

47
Q

Case control trial?

A

People are matched to a control in order to get results

48
Q

Cross section?

A

Group of people in one snapshot - time and space

49
Q

RUQ pain radiating to shoulder?

A

cholecystitis

50
Q

Portal triad?

A

bile duct
portal vein
hepatic artery

51
Q

Loss of consciousness on turning head?

A

vertebrobasilar insufficiency

52
Q

Alteration between diarrhoea and constipation?

A

diverticular disease

53
Q

Mid diastolic murmur, tapping, undisplaced apex, best heart in left lateral position with bell?

A

mitral stenosis

54
Q

systolic murmurs radiating to axilla?

A

mitral regurg

55
Q

best heard when patient sits up, fully expires and stethoscope placed on left sternal border?

A

aortic regurg

56
Q

Causes of neonatal conjunctivitis?

A

Gm +ve cocci (S aureus)
Chlamydia
Gonorrhoea

57
Q

Vaccine givent o kids with asthma?

A

seasonal flu

58
Q

Vaccine given to newborns of IVDU

A

HepB

59
Q

Milestones:
standing?
smiling?
simple instructions?

A

stand - 12 months

smile - 6 weeks

simple instructions - 18 months

60
Q

Ix for malrotation (bilious vomit)?

A

upper GI contracts with follow through

61
Q

Reflex anoxic seizure?

A

paroxysmal, spontaneously reversing brief episodes of systole triggered by pain, fear or anxiety - due to increased vagal tone (bump to head, transient systole and collapse)

62
Q

Triad of ADHD?

Triad of autism?

A

hyperactivity, impulsivity, inattention

social, communication, repetitive behaviour
Aspergers only social

63
Q

Muscle problem in C5?

A

rotator cuff

64
Q

Muscle problem in C8

A

medial hand (small finger)

65
Q

Mid dilated pupil?

A

acute closed angle glaucoma

66
Q

Altitudinal field defects?

A

Ischaemic optic neuropathy

67
Q

Flame-shaped haemorrhage?

A

diabetic retinopathy - more superficial - rupture of microaneurysm

(dot/blot haemorrhage more deep)

68
Q

tearing, photophobia, reduced vision, redness?

A

scleritis

69
Q

Motor supply to tongue?

A

All hypoglossal

Except palatoglossus which is vagus

70
Q

SCC?

A

hyperkeratotic, crusted lump, fast growing

71
Q
Where is breslow thickness measured from?
<1mm?
1-2mm?
2.1-4mm?
>4mm?
A

granular layer to deepest point of invasion

<1mm - 95-100% 5-year survival
1-2 - 80-96%
2.1-4 - 60-75%
>4 - 50%

72
Q

How do robertsonian translocations work? Common one?

A

2 acrocentric chromosomes join together (e.g. 12 and 14) in one parent.

When reproduce with another normal person, 4 possibilities:

  • Normal
  • Balanced translocation
  • Trisomy 14 - mosaic - miscarriage
  • Trisomy 21 - Down Syndrome