VIA III Flashcards

1
Q

What bacteria is associated with mesenteric adenitis?

A

yeseria

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2
Q

Criteria for Bariatric surgery?

A

BMI 35+ with comorbidity or

BMI 40+

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3
Q

What is the acute management of Cluster headache?

And long term?

A

100% o2 for 15min

and sumatriptan in the long term

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4
Q

What is a short synacthen test?

A

Stimulation test for deficiency of ACTH - Addison’s disease

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5
Q

Hyponatraemic + hyperkalaemic with weight loss, tiredness and nausea?

A

Addison’s disease

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6
Q

What is Addison’s disease?

A

Primary Adrenal insufficiency - decreased Cortisol and decreased Aldosterone

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7
Q

What is Conn’s syndrome?

A

Primary Hypothyroidism. Increased Aldosterone levels - leading to normal/low Na, increased fluid. The body loses hydrogen and hence the pH goes up.

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8
Q

Acute exacerbation of Gout caused by..?

A

90% caused by decreased renal clearance. Other causes include:

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9
Q

GORD + Constant heartburn and regurgitation and dysphasia. On gastroscopy you would see….

A

Barrett’s oesophagus

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10
Q

30 yo female + Unilateral blurring and acute pain + central scotoma + Right swollen disc

A

Optic Neuritis (MS)

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11
Q

Treatment of spontanenous Bacterial peritonitis?

A

Antibiotics - re-tap in 24 hours and neutrophil should have decreased by 50%.

You know its spontaneous bacterial peritonitis because the tap has neutrophils

If the tap didn’t have neutrophils therapeutic paracentesis would be first line.

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12
Q

What to avoid in Ventricular tachycardia?

A

Adenosine. Adenosine is given in SVT.

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13
Q

45yo man when to Africa two weeks ago - presenting fever, headache and maculopapular rash

A

HIV infection

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14
Q

How do you treat PCP ( Pneumocystis jirovecii)?

A

oral Co-trimoxazole

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15
Q

HIV is a DNA Virus?

T or F?

A

F - It is a retroviridae - works through reverse RNA transcriptase

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16
Q

Mixed upper motor neuron disease and lower motor neuron disease in the upper and lower limb

A

Motor neuron disease

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17
Q

Lower motor neuron signs in Upper limbs + Upper motor neuron signs in lower limb

A

Cervical cord compression

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18
Q

Signs of progressive bulbar palsy?

A

tongue fasiculations + difficulty swallowing and chewing

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19
Q

35 yo woman, two months post partum, 4 week history of joint pain, skin rash and fever. ESR: 40. Diagnosis?

A

SLE

RA wouldn’t have a rash.

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20
Q

Differentiating between discoid rash in SLE vs Eczema?

A

SLE would have other symptoms too

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21
Q

What is the genes affected by Coeliac?

A

HLA DQ2 and HLA DQ8

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22
Q

What do you see on histology with Coeliac?

A

The tiny, finger-like projections which line the bowel (villi) become inflamed and flattened

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23
Q

Investigations for Coeliac?

A

anti-tTG, genetics screening, Anti-endomysial antibodies (IgA)

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24
Q

When do you transfuse bloods in anaemia?

A

Transfuse blood when iron is less than 70.

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25
Q

Woman young, fat with increased intracranial pressure (damage to retina and optic disc swelling)?

A

Idiopathic (Benign) Intracranial hypertension

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26
Q

Why does oral analgesics not work in people that have migraine’s whilst having it?

A

There is gastric stasis and hence orally it is not helpfull.

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27
Q

Triggers for Migraine?

A

CHOCOLATE
Chocolate
H
OCP

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28
Q

How to manage migraine?

A

PREVENTATIVE (avoid triggers) + paracetamol, metachlopramide + aspirin

Migraine diary
triptans (intranasal)??

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29
Q

How to differentiate between IgA (can be triggered after sickness) and Post-Streptococcal gN?

A

IgA is rapid - 24 hrs.

Post Streptococcus occurs 2 weeks after illness.

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30
Q

Abdominal pain + Purpura + GN symptoms

A

HSP

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31
Q

Severe complication of MDMA and Serrotonin syndrome?

A

Fever

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32
Q

Treatment of neuroepeleptical malignant syndrome?

A

Benzotropine

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33
Q

How to treat alcohol withdrawal tremor?

A

Diazapem

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34
Q

Cannabis intoxication?

A

Dry mouth, increased appetite, conjunctival injection, tachycardia

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35
Q

Pupillary constriction with which drug?

A

Opiod intoxication

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36
Q

Signs of neuroepeleptical malignant syndrome?

A

HARM

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37
Q

Serotonin syndrome? (3)

A

CAN:
CNS
Autonomic system (temperature),
Neuromuscular excitation`

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38
Q

In acidic environment (Stomach) what sort of substance is more easily able to be absorbed?

A

An acidic substance - because it has to be non-ionised to be absorbed.

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39
Q

Episodic impairment of consciousness?

Fluctuating mental state in old people

A

Chronic sub-dural haematoma

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40
Q

Crescent shaped haemorrhage

A

Subdural haematoma

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41
Q

Lemon shaped haemorrhage?

A

Epidural haematoma

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42
Q

Drugs causing infiltrative lung disease? (BAM)

A

Bleomycin
Amiodarone
Methotrexate

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43
Q

Ground glass appearance/ Honeycomb appearance on CT?

A

Infiltrative lung disease (pulmonary fibrossi)

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44
Q

Young man , 47, with osteoporosis (causing vertebral collapse).. how would you investigate?

A

Testosterone concentration?

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45
Q

ddx for testosterone deficiency?

A
  • ## Genetic syndorme (Kleinfelter’s)-
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46
Q

Difference between primary and secondary polycthaemia?

A

Primary - renal cell carcinoma producing EPo

Secondary causes - due to a chronic disease

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47
Q

How do you check someone’s blood group

A

INDirect coombs test for cross matching to pick up on the antibodies!

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48
Q

When do you need FFP?

A

When coagulopathy problem?

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49
Q

How do you manage an asthamtic patient who quickly gets softer breath sounds?

A

immediate intubation!

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50
Q

Most frequent cause of blood stained nipple discharge?

A

Duct Papilloma

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51
Q

What is Paget disease?

A

DCIS of the nipple

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52
Q

Indian filed fashion of the breast

A

Invasive lobular breast cancer

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53
Q

Dengue fever presents with _______

A

back pain and myalgia and arthralgia

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54
Q

Mx of Malaria?

A

Chloroquinone

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55
Q

CA-125 is a marker for _____

A

Ovarian Cancer

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56
Q

CA-19-9 is tumour marker for __________

A

Pancreatic cancer

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57
Q

Organophosphate cause inhibition of ________

A

Acetylcholinesterase

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58
Q

Normal pressure hydrocephalus can occur be either idiopathic or secondary. Secondary is due to?

A

The secondary type of NPH can be due to a subarachnoid hemorrhage, head trauma, tumor, infection in the central nervous system, or a complication of cranial surgery.[1]

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59
Q

Most common cause of polyhydramnios?

A

Idiopathic polyhydramnios

or Gestational. So look at RF.

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60
Q

Severe oligohydramnios and no foetal bladder found

A

Renal Agenesis

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61
Q

How do you manage post menopausal bleeding due to and uterus procidentia?

A

Vaginal hysterectomy and repair

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62
Q

What is the gynaecologist preparing for by inserting ureteric stents before a hysterectomy?

A

Clamp and ligate uterine arteries

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63
Q

What additional steps have to be taken to remove the ovaries compared to a simple TAH

A

To ligate the infundibulopelvic ligaments

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64
Q

Complications in surgery after a women has had C-sections

A

Sharp dissection of he anterior lead (broad ligament) before reflecting onto the bladder

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65
Q

Bout of constipation, dehydration and serum potassium is low

A

Bartter syndrome

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66
Q

Progressively unstable walking. His mother mentions he always suffered from ear infections than his brother.

A

Ataxic telengectasia

Blood vessels in the ear makes hm more prone

67
Q

Floppy baby with absent tendon reflexes and hypotonia + fasciculation’s of his tongue

A

SMA

68
Q

Inverted champagne bottle legs - progressive distal muscular wasting

A

Charcot Marie tooth disease

69
Q

Broad wrists and ankles with a large forehead. Which Vitamin is he deficient in?

A

Vitamin D -

Bones unable to form properly

70
Q

Baby is admitted with potential sepsis. Massive hepatomegaly with no jaundice

A

Glycogen Storage disease

71
Q

Check ACE-i after ______ starting it

A

1 weeks

72
Q

Which anti-psychotic causes Bradykinesia?

A

Haloperidol

73
Q

Sclerotic lesion with a sunburst appearance on the fever

A

Osteosarcoma

Ewing sarcoma affects the shaft of the bone and is associated with onion sign

74
Q

Most commonly associated with long in-situ (non-invasive) phase

A

Mesothelioma

75
Q

What statistical test to compare two discrete values (two drugs)?

A

Chi-Square test

76
Q

What statistical test to compare to continuous values?

A

Linear regression

77
Q

Discrete X variable and continuous Y variable ….

A

T-Test

78
Q

Where should you listen for breath sounds from the right middle lobe?

A

Posteriorly, 5 cm below the mid clavicular line

79
Q

What is the only increased marker in Paget’s disease?

A

ALP

80
Q

What antibiotics do you use for Acute prostatitis?

A

Quinolone

81
Q

How do you treat Syphillis?

A

Singular IM injection of Benzathine penicillin

82
Q

How do you treat gingivitis (acute necrotising ulcerative)

A

Metronidazole

83
Q

5 Xray signs for Acute Pulmonary oedema?

ABCDE

A
Alveolar oedema (Bat wing appearance)
B Kerley lines
Cardiomegaly
Dilated upper lobe vessels
Effusions (Pleural)
84
Q

How do you manage APO?

LMNOP

A
Lasix
Morphine +/- Metoclopromide
Nitrogen
Oxygen
Positive pressure/Position
85
Q

Fluid retention in heart failure is a combination of 2 things..

A
  1. Reduced GFR

2. Activation of RAAS and sympathetic system

86
Q

A patient is symptomatic with CHF only on moderate extertion - what NYHA category does he fall in?

A

NYHA Class II

NYHA - Class I - Asymptomatic
NYHA Class III - Symptomatic with minimal extertion
NYHA Class IV - Symptomatic at rest

87
Q

Nephrotic syndrome related to Hep B?

A

Membranous

88
Q

Anit-Smith antibodies seen in _______-

A

Lupus nephritis

89
Q

Pleuritic Chest pain + Pyrexia after a previous MI

A

Dressler’s syndrome

90
Q

Haemolytic Uraemic syndrome is Gastro caused by which bug?

A

E. Coli

91
Q

Three common ECG changes seen with Hypokalaemia:

A

U waves
Flattened T waves
And ST depression

and prolonged PR interval!

92
Q

Alport has all of the following except:

CKD, Presentation in childhood, Loss of smell, Microscopic haematuria, Lenticonus

A

Loss of smell! It presents with sensorineural hearing loss

93
Q

You should cease Ace-I in a CKD patient if the eGFR is less than ____% or Rise of creatinine more than ____%

A

eGFR is less than 25% or Rise of creatinine more than 30%

94
Q

Which of the following is false for Haemolytic Uraemic syndrome?

  • Presence of Fragmented red blood cells
  • Raised Serum Haptoglobin
  • Decreased Platelets
A

You get DECREASED Haptoglobin.

All with anaemia and and AKI

95
Q

Three common drugs that cause P450 inducers and affect contraception use:

A

Carbamazepine (whilst use and 4 weeks after), Phenytoin (whilst and 4 weeks after) and Rifampicin (whilst and 8 weeks after)

96
Q

The optimum sub-bandage pressure for healing venous ulcers has been shown to be ___ mm Hg at the ankle graduating to____mm Hg at the knee

A

The optimum sub-bandage pressure for healing venous ulcers has been shown to be 40 mm Hg at the ankle graduating to 17mm Hg at the knee

97
Q

Which asthma medication is competitive selective phosphodiesterase inhibitor?

A

Aminophylline

98
Q

Which tumour excretes large levels of Serotonin?

And what symptoms does this lead to?

A

Carcinoid

Flushing, Diarrhea, Wheezing, Abdominal cramping

99
Q

Dysgraphia, Dyscalculi, Finger Agnosia + Left right orientation syndrome. Stroke affecting

A

Pareital Lobe

100
Q

What medication helps with Raynauds and Htn?

A

CCB - Dihydropyridine: amolodipine/Nifedipine

101
Q

Common causes of decreased middle ear mobility?

A

Middle ear fluid (OME). Other causes are increased stiffness of the eardrum (from scarring), tympanosclerosis (the formation of dense connective tissue around the auditory ossicles), cholesteatoma, or middle ear tumor

102
Q

Amitriptylline can cause ______

A

Bowel obstruction

103
Q

Which ulcer is painful - Syphillis or HSV?

A

HSV

104
Q

Sexually active male - Rash on palms and soles. What is it?

A

Syphillis

105
Q

Hypersegmented neutrophils:

A

B12 def

106
Q

How do you manage Vulval warts?

A

Imiquimod or Podophyllotoxin

107
Q

Which part of the nephron absorbs glucose?

A

PCT

108
Q

Carbimazole acts to reduce T3/T4 production by inhibiting _______

A

iodination

109
Q

Dendritic cells act to …..

A

initiate primary immune response

110
Q

Natural Killer cells induce apoptosis of infected cells which is triggered by the absence of ______ on target cells

A

MHC I

111
Q

CD3 cells?

A

T Cells

112
Q

CD4 Cells?

A

Helper T cells

113
Q

CD8 Cells?

A

Killer T Cells

114
Q

CD19/CD20 Cells?

A

B Cells

115
Q

BCL - 2 oncogene on Chromosome 14/18

A

Follicular lymphoma

116
Q

Myc activation on chromosome 18?

A

Burkitt’s lymphoma

117
Q

Clopidogrel acts to block ______ receptors on ____

A

Blocks ADP receptors on platelets

118
Q

Hypocellular bone marrow with increased fat spaces?

A

Aplastic anaemia

119
Q

Heinz Bodies?

A

G6PD

120
Q

Basophilic stippling

A

Thalassaemia

121
Q

Schistocytes

A

haemolysis

122
Q

X-linked haemarthrosis, prolonged APTT

A

Haemophilia A

123
Q

Heavy periods, bleeding after dental work , mildly prolonged APTT

A

vWillebrands factor

124
Q

Rouleax stacks?

A

Multiple Myeloma

125
Q

Reed-Sternberg cells

A

Hodgkin

126
Q

Burr cells

A

Uraemia

127
Q

What is the Cisterna Chyli?

A

It is the most inferior part of the thoracic duct

128
Q

The thoracic duct travels behind the aorta and drains into the ___________.

A

left subclavian vein

129
Q

The recurrent laryngeal nerves are a branch from _______

A

vagus nerve

130
Q

The ______ nerve goes below the aortic arch

A

Left recurrent laryngeal

131
Q

Which lobe is Broca’s located in ?

A

Frontal!

132
Q

Where is Wernicke’s lobe located?

A

Located in the posterior section of the superior temporal gyrus

133
Q

We get triglyceride breakdown and fatty acid export in ____

A

DM-1

134
Q

The sympathetic neurons provide a motor output in nerves ____

A

T1-L2

135
Q

The recurrent larygneal nerve is associated with which artery?

A

Inferior thyroid artery

136
Q

For dental surgery you need an ________ nerve block and ____ nerve

A

inferior alveolar nerve block and linguinal nerve block

137
Q

Three sites where kidney stones get stuck?

A
  1. Ureteric junction of pelvic (Pelvic ureteric junction)
  2. Where ureter crosses over the pelvic vessels (bifurcation)
  3. Where the ureter enter the bladder (VUJ)
138
Q

The common iliac artery forms at about nerve root (__) and bifurcates infront of the ________ into the internal and external branches.

A

Nerve root - L4. And bifurcates infront of the pelvic brim into the internal and external branches.

139
Q

Whilst sleeping __________ helps maintain glucose levels.

A

Gluconeogenesis whilst sleeping. Adipose tissue when at rest

140
Q

Muscle Glycogenolysis can occur during the flight or fight response but requires which enzymes?

A

Glucose-6-Phosphate. This is release by myocytes when under stress

141
Q

Chylomicrons transport lipids from _____ to ____, ___ and ____. They transport mainly Triglycerides

A

Transport lipids absorbed from the intestine to adipose, cardiac, and skeletal muscle tissue, where their triglyceride components are hydrolyzed by the activity of the lipoprotein lipase, allowing the released free fatty acids to be absorbed by the tissues

142
Q

LDL’s transport cholestrol from the liver to _______, which attracts ___ and leads to _____

A

Liver to artery walls - which attracts macrophages and leads to artherosclerosis

143
Q

Efficient phagocytosis requires ______ by complement or bacteria

A

Oponisation

144
Q

Osler’s nodes occur on the palms or fingertips? Pain/painless?

A

Generally fingertips and are generally tender

145
Q

Sally has been taught that if she pee’s in her pants then she will get a smacking. And if she doesnt pee in her pants she gets a Lolly. What sort of conditioning is this?

A

Operant conditioning

146
Q

Right before Mary Peed her pants She saw a pink dog. Now whenever she sees a pink dog she pees her pants!

A

Classical conditioning

147
Q

Ankle swelling (oedema) occurs due to ________

A

increased Venous pressure

148
Q

Treatment for H. Pylori?

A

Omeprazole, Clarithromycin and Amoxiciliin

149
Q

Fear is sensed by which part of the brain?

A

The amygdala

150
Q

Do pupils dilate or constrict in flight or fight response?

A

They Dilate!

151
Q

Difference between disinfecting and sterilising?

A

Disinfectant removes the most viable microorganism. Sterilisation removes ALL of them!

152
Q

Gram positive bacteria have a thick/thin peptidoglycan wall? And hence on gram stain are purple/pink?

A

THICK WALL and hence PURPLE.

153
Q

Spinal cord ends at what level?

A

L1-L2

154
Q

Tongue Deviates to stronger or weaker side?

A

Towards weaker side

155
Q

Heparin works on ______

A

Anti-thrombin III - makes it more active.

156
Q

Eversion of foot is done by _______ nerve

A

Superficial perineal nerve

157
Q

Dorsiflexion specifically is done by

A

Deep perineal nerve

158
Q

Ascending limb has low or high permeability to water? (Nephron)

A

Low

159
Q

Hcl and intrinsic factor is produced by which stomach cells?

A

Pareital cells!

160
Q

Chief cells of the stomach produce:

A

Pepsinogen!

161
Q

Azygous veins drains into _____

A

SVC

162
Q

What artery is ligated in nose bleeds?

A

Anterior ethmoidal artery

163
Q

Alcohol increases/decreases NADh/NAD+ ratio?

A

Increases

164
Q

Bisphosphonates inhibit the activity of _____

A

osteoclasts