yh Flashcards

1
Q

What is Multiple Sclerosis?

A

Neurodegenerative disorder where oligodendrocytes which are the cells which produce myelin in the CNS are lost.

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2
Q

What innervates the Anterior and Posterior bellies of the Digastric muscle?

A

Anterior: Mylohyoid nerve Posterior: Facial nerve

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3
Q

What is the effect of Alpha-1 antitrypsin on the alveoli?

A

Enzyme that inhibits Trypsin

Trypsin = enzyme that breaks down neutrophil elastase

Elastase = enzyme that breaks down alveoli elastin

Alpha-1 antitrypsin inhibits trypsin –> trypsin can’t break down elastase –> elastase WILL break down alveoli elastin

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4
Q

What do neural crest cells give rise to?

A
  1. PNS neurons 2. Schwann cells
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5
Q

Which apolipoprotein do macrophages recognise in order to uptake lipids?

A

ApoB100

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6
Q

What receptor to MAC use to uptake LDL to make foam cells?

A

Scavenger cells

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7
Q

What is polycythaemia?

A

High RBC conc in blood

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8
Q

How does COPD cause high Hb?

A

Chronic hypoxia –> polycythaemia (high RBC) –> High Hb

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9
Q

How does pericarditis appear on an ECG?

A

Saddle-shaped ST elevation across all leads

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10
Q

What is the difference between Superior and Inferior MI?

A

Superior MI: ST elevation in V1, V2, V3

Inferior MI: ST elevation in leads II, III, and aVF

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11
Q

What is the most common brain tumour in children?

A

Astrocytoma

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12
Q

What are the most common primary liver tumours? (2 things)

A
  1. Hepatocellular carcinoma
  2. Cholangeocarcinoma
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13
Q

How is Hepatocellular Carcinoma diagnosed? (2 things)

A
  1. CT / MRI
  2. α-FP is high (alpha fetoprotein)

Biopsy NOT done because can seed the tumour

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14
Q

Where do tumours arise in Cholangiocarcinoma?

A

Bile ducts

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15
Q

Why can gram positive bacteria colonise but gram negative can’t?

A

Gram positive is tolerant to salt, urea and FA

Gram negative isn’t

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16
Q

What is unique to the structure of a gram-positive microorganism?

A

Teichoic acid in cell wall

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17
Q

What part of the brain is required for converting short term memory into long term memory?

A

Hippocampus

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18
Q

What are the roots of the femoral nerve?

A

L2, L3, L4

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19
Q

What does the femoral nerve supply?

A

(don’t) M I S V Q Scan for PE

  • *M** edial cutaneous nerve of the thigh
  • *I** ntermediate cutaneous nerve of the thigh
  • *S** aphenous nerve
  • *V** astus
  • *Q** uadriceps femoris
  • *S** artorius

PE ctineus

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20
Q

What is the triad of symptoms for nephritic syndrome?

A
  1. Haematuria
  2. Oliguria
  3. Hypertension
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21
Q

What is the commonest cause of glomerulonephritis?

A

iGA nephropathy (aka Berger’s disease)

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22
Q

What does iGA nephropathy (aka Berger’s disease) present with?

A

Haematuria following Upper Resp Tract infection

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23
Q

What does Labrynthitis present with? (2 things)

A
  1. Vertigo
  2. Nystagmus (invol eye movements)
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24
Q

What nerve is the external anal sphincter supplied by?

A

Inferior Rectal Branch of the Pudendal Nerve

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25
Q

How do the lateral ventricles communicate with the 3rd ventricle?

A

Interventricular foramina

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26
Q

How do the 3rd and 4th ventricles communicate?

A

Cerebral aqueduct

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27
Q

Where is the lesion in Wernicke’s aphasia?

A

Superior temporal gyrus

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28
Q

What connects the Brocas area to the Wernickes area?

A

arcuate fasciculus

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29
Q

Where is the lesion in Brocas aphasia?

A

inferior frontal gyrus

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30
Q

Speech is non-fluent, comprehension intact

Which type of aphasia?

A

Broca’s aphasia

(Broken speech)

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31
Q

Speech is non-fluent, comprehension impaired

Which type of aphasia?

A

Global aphasia

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32
Q

Speech is fluent, comprehension intact

Which type of aphasia?

A

Conduction aphasia

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33
Q

Speech is fluent, comprehension impaired

Which type of aphasia?

A

Wernickes aphasia

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34
Q

What term is used in genetics to describe conditions with a normal phenotype despite an abnormal genotype?

A

Low penetrance

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35
Q

What is the management of GAD? (4 things)

A
  1. SSRI anti-depressants
  2. beta-blockers
  3. benzodiazepines: use longer acting preparations e.g. diazepam, clonazepam
  4. cognitive behaviour therapy
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36
Q

What artery is compromised in a scaphoid fracture?

A

Dorsal carpal branch of radial artery

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37
Q

What causes a scaphoid fracture?

A

FOOSH

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38
Q

What are the side effects of Isoniazid?

A

Hand / feet numbness

Enzyme inhibitor

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39
Q

What are the side effects of Pyrazinamide?

A

Muscle / bone pain

Gout

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40
Q

What can Ethambutol be subsituted for in TB treatment?

A

streptomycin

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41
Q

What is the side effects of Ethambutol?

A

optic neuritis

visual defects innit

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42
Q

How does ELISA work?

Enzyme Linked Immunosorbent Assay

A

Used to detect antigens and antibodies

Uses a colour changing enzyme:

  • Enzyme attached to the antibody if looking for an antigen
  • or
  • to antigen if looking for an antibody

Sample changes colour if the antigen or antibody is detected

e.g HIV test

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43
Q

What are blotting molecular biological techniques used for?

A

Southern Blotting - detects specific DNA sequence in large DNA complexes

Northern Blotting - detects specific RNA sequence in large RNA complexes

Western blotting - detects protein (uses gel electrophoresis)

SNOW (South - NOrth - West)

DROP (DNA - RNA - Protein)

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44
Q

What is the most common kidney stone type?

A

Calcium oxolate

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45
Q

If the person has kidney stones and also has gout, what are the stones made of?

A

Uric acid

NOT calcium oxolate

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46
Q

What can prolonged use of broad-spectrum antibiotics cause?

A

vit K deficiency

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47
Q

What does Vitamin K deficiency present with? (3 things)

A
  1. prolonged PT
  2. prolonged aPTT
  3. normal platelet count
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48
Q

What are the vit K dependant clotting factors?

A

2, 7, 9, 10

widad remembers it like 2+7=9, and den 10

wt a spastic

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49
Q

What is used to detect mutated oncogenes?

A

PCR

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50
Q

What is Courvoisier’s sign? (2 things)

what does it suggest?

A
  1. Painless jaundice
  2. Palpable gall bladder

Cholgangiocarcinoma

(NOT gall stones / cholangitis bc they are painFUL)

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51
Q

What artery is Wernickes area supplied by?

A

INFERIOR division of the Left Middle Cerebral Artery

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52
Q

What artery is Brocas area supplied by?

A

SUPERIOR division of the Left Middle Cerebral Artery

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53
Q

Where is ADH secreted from?

A

Posterior pituitary

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54
Q

How does HypERthyroidism present?

A

S - weating

W - eight Loss

E - xtra Anxiety

A - ppetite increased

T - remor / Tachycardia (bc of AF)

I - ntolerance to heat / Irreg menstruation

N - ervousness

G - aloot (diarrhoea)

HypER so everything is up, (weight loss bc met is UP)

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55
Q

Interferon Gamma (in the IFN test for TB) is a cytokine released by which cell type?

A

Th1 cells

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56
Q

What is the difference between TRALI and TACO?

Transfusion Related Acute Lung Injury

Transfusion Associated Circulatory Overload

A

TRALI is hypotensive

TACO is hypertensive

Overload so hypER tension innit

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57
Q

What is Duchennes Muscle dystrophy caused by?

What is its symptoms? 2 things

A

Mutation in gene coding for dystrophin

Symptoms:

  1. Progressive proximal muscle weakness from 5 years
  2. Gower’s sign: child uses arms to stand up from a squatted position
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58
Q

What is the site of insertion of the long and short head of biceps femoris?

A

Head of fibula

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59
Q

What is the origin and insertion site of the Sartorius?

A

Origin: Anterior superior iliac spine

Insertion: Medial surface of proximal tibia

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60
Q

What is the origin and insertion site of the Rectus Femoris?

A

Origin: Anterior inferior iliac spine

Insertion: Tibial tuberosity

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61
Q

What is the origin and insertion site of the Long head of Biceps femoris?

A

Origin: Ischial tuberosity

Insertion: Fibular head

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62
Q

What is the origin and insertion site of the Short head of Biceps femoris?

A

Origin: lateral supracondylar ridge of femur

Insertion: fibular head

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63
Q

What is the origin and insertion site of the Semimembranosus?

A

Origin: Ischial tuberosity

Insertion: Medial tibial condyle

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64
Q

What is the origin and insertion site of the Pectineus?

A

Origin: Pectineal line along superior ramus of pubis

Insertion: Lesser trochanter

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65
Q

Where does foetal implantation typically occur in the uterus?

A

anterior or superior uterine walls

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66
Q

When is the bilaminar disc formed?

A

week 2

bi 2

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67
Q

What happens in week 3 of embryology

A

Primitive streak formed

Notochord formed

Gastrulation (forming 3 germ layers)

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68
Q

What week do limb buds form?

A

week 4

4 limbs allie

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69
Q

what week does the neural tube close?

A

week 4

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70
Q

when does the foetal heart start to beat?

A

weak 4

4 bars allie

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71
Q

Is E coli gram negative or gram positive?

A

nEgative

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72
Q

What are plantar warts caused by?

A

HPV

They are self limiting

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73
Q

What is Ramsay Hunt syndrome?

What nerve does it affect?

What are the features? (2 things)

What is the treatment?

A

herpes zoster oticus

geniculate ganglion of CN 7

Features:

  1. Auricular pain + vertigo + tinnitus
  2. Facial nerve palsy

Treatment: acicolovir + corticosteroids

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74
Q

Which cell secretes the majority of tumour necrosis factor (TNF)?

A

MAC

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75
Q

What is the function of tumour necrosis factor (TNF) in the immune system?

A
  1. activates MAC and neut
  2. helps with T cell activation
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76
Q

What is diaphoresis?

A

Sweating

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77
Q

What does compression of the anterior interosseous nerve present with?

A

Inability to make an ‘OK’ symbol with thumb and finger

anterior interosseous nerve is a branch of the median nerve

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78
Q

What abx are given for MRSA?

A

Rifampicin + another abx

79
Q

What cells mediate hyperacute/acute/chronic organ rejection after a transplant?

A

B cells: hyperacute

Helper T cells: acute/ chronic

80
Q

What are the rotator cuff muscles? 4 muscles

A

S I t S (small t for teres minor)

Supraspinatus
Infraspinatus
teres minor
Subscapularis

81
Q

What is the action of the Supraspinatus?

A

abducts arm

82
Q

What is the action of the Infraspinatus?

A

lateral rotation of arm

83
Q

What is the action of the teres minor?

A

adduction

lat rot

84
Q

What is the action of the Subscapularis?

A

adducts

m rot

85
Q

What is ulipristal acetate?

A

selective progesterone receptor modulator

used for emergency contraception within 120 hours

inhibits ovulation

86
Q

What test should be done for suspected Myasthenia Gravis?

A

Serum acetylcholine receptor (AChR) antibody analysis

87
Q

What is the management of Myasthenia gravis?

A

acetylcholinesterase inhibitor

pyridostigmine

88
Q

What are the PTH, Ca, and Phosphate levels in PRIMARY hyperparathyroidism?

A

PTH - High

Ca - High

Phosphate - Low

89
Q

What are the PTH, Ca, and Phosphate levels in SECONDARY hyperparathyroidism?

A

PTH - High

Phosphate - High

Ca - Low / Normal

90
Q

What is the blood supply of the gall bladder?

A

Cystic artery (branch of Right hepatic artery)

91
Q

What is the venous drainage of the gall bladder?

A

directly to liver

92
Q

Which antibody is responsible for mediating type 1 hypersensitivity?

A

IgE

93
Q

Which antibodies are responsible for mediating type 2 hypersensitivity?

A

IgM and IgG

2 for 2

94
Q

What electrolyte deficiency will prolonged broad spec abx lead to?

A

vit K deficiency

95
Q

What Interleukin is produced by macrophages and is mainly responsible for neutrophil chemotaxis

A

IL 8

96
Q

Is forehead affected with bells palsy?

A

YES

97
Q

Which hormonal replacement therapy helps with libido?

A

Tibolone

Has oestrogenic, progestogenic, and androgenic activity

98
Q

What is Trimethoprim?

What is its MOA?

A

Abx used for UTI

Interferes with DNA synthesis

99
Q

What does Gastroenteritis caused by E Coli present as?

A

NWA

Nausea

Watery stools

Abdominal cramps

100
Q

Why can alcohol bingeing cause polyuria?

A

Leads to ADH suppression in the posterior pituitary gland

101
Q

What is the INTRINSIC pathway of the clotting cascade measured by?

A

apTT

102
Q

What is the EXTRINSIC pathway of the clotting cascade measured by?

A

prothrombin time (PT).

103
Q

What present antigens to cytotoxic T cells so the immune system can respond to this infection?

A

MHC class I molecules

MHC class I = bind with CD8 receptors –> expressed on cytotoxic T cells.

MHC class II = bind with CD4 receptors –> expressed on T helper cells.

104
Q

At which level is the hilum of the left kidney located?

A

L1

105
Q

Which testicular cancer has normal serum AFP and HCG levels?

A

Seminoma

AFP and HCG levels raised in teratomas and yolk sac tumours

106
Q

What is elevated in Seminoma cancer?

A

LDH (lacate dehydrogenase)

ah-seminoma-el-di-haycha

107
Q

What can be seen in Seminoma cancer?

A

Granulomas

108
Q

What reflex is lost in testicular torsion?

A

Cremasteric reflex

109
Q

What are the first line Abx for UTI’s? 2

A

Nitrofurantoin

Trimethoprim

110
Q

Which Abx for UTI can you not give in 1st trimester of pregnancy, and why?

A

Trimethoprim

Because it is teratogenic (bc anti-folate –> X DNA synthesis)

Remember: TRIMEthoprim trimester innit

111
Q

When do Nephroblastomas (aka Wilms tumour) occur?

A

In the first 4 years of life

112
Q

How does nephroblastoma (aka wilms tumour) present as?

A

Haematuria

Pyrexia

113
Q

What is Rovsing’s sign?

A

Sign of appendicitis

When palpation of the LIF elicits pain in the RIF

Left makes the Rov Sing

114
Q

What is Murphy’s sign?

A

Upper border of doctors hand under rib cage on RUQ

Pain on inhalation, as gall bladder falls down and catches on hand

Maraara aka gall bladder aka Murphys sign

115
Q

What is Cullen’s sign?

A

Bruising around belly button

Because of retroperitoneal bleeding

e.g

acute pancreatitis

ectopic pregnancy

cullen cullen coloured belly button

116
Q

What is Grey Turners sign?

A

Bruising of flanks

Another sign of retroperitoneal bleeding

when you turn it will be grey in the flanks jus picture it nigga

117
Q

What is Battle’s sign?

A

Bruising behind ear

Because basal skull fracture in posterior cranial fossa

Bruising Behind ear Basal Bosterior

118
Q

What is Raccoon eyes a sign of?

A

Basal skull fracture

119
Q

What is CLEAR rhinorrhea a sign of?

A

basal skull fracture

120
Q

What is Obturators sign?

A

Pain in RIF when Internal rotating right thigh

Shows appendicitis

121
Q

What is the formula for a sensitivity test?

And what does it describe?

A

sensitivity / (1 - specificity)

Sensitivity = Likelihood ratio for a positive test result

122
Q

What is the formula for specifity?

What does it describe?

A

Specificity / (1 - sensitivity)

Proportion of patients without the condition who have a NEGATIVE test result

123
Q

What is the antidote for heparin?

A

Protamine sulphate

124
Q

Where is the bleeding in a Epidural (extradural) haematoma?

A

Between dura mater and skull

(extra dural aka outside da dura)

125
Q

What is the shape of a Epidural (extradural) haematoma?

A

(its outside mater so pushes against it)

126
Q

What artery is ruptured in a epidural (extradural) haematoma?

What region of the head is haematoma in?

A

Middle Meningeal Artery

Temporal region

127
Q

Where is the bleed in a Subdural haematoma?

A

In dura mater

(outermost meningeal layer)

128
Q

What is the shape of a Subdural haematoma?

A

(It’s inside the dura mater so bleed runs along it)

129
Q

What are the risk factors of a subdural haematoma? 3 things

A

old age

alcoholism

anticoagulation

130
Q

What region does Subdural haemoatomas most commonly occur in?

A

Frontal and parietal lobes

131
Q

What causes a Subarachnoid haemorrhage?

A

ruptured cerebral aneurysm

132
Q

What can be seen in a Subarachnoid haemorrhage CT scan?

A

Light grey areas of blood on brain

(instead of dark grey CSF)

133
Q

What is a common feature in thyrotoxicosis? 2 things

A

Anxiety

AF

134
Q

What is a gynaecological feature in hypothyroidism?

A

Menorrhagia

(heavy period)

135
Q

What inhibits insulin secretion?

A

somatostatin

136
Q

Label da rasclart

A
137
Q

What is the sign of Mitral regurgitation?

A

Split S2 sound

138
Q

What is the sign of Mitral stenosis?

A

Low volume pulse

139
Q

What are the symptoms of Coeliac disease? 4 things

A
  1. Diarrhoea
  2. Abd bloating
  3. Anaemia (b12, folate, fe deficiency: cah cant absorb dem cah tranglutaminase of gut clarted)
  4. Weight loss
140
Q

What hormone is responsible for spiral artery development?

A

Progesterone

141
Q

What are the Afferent and Efferent nerves of the Corneal Reflex?

A

Afferent: Opth V1

Efferent: Facial 7

142
Q

What are the Afferent and Efferent nerves of the Jaw Jerk Reflex?

A

Aff: Mandib V3

Eff: Mandib V3

143
Q

What are the Afferent and Efferent nerves of the Gag Reflex?

A

Aff: Gloss 9

Eff: Vagus 10

144
Q

What are the Afferent and Efferent nerves of the Carotid Sinus Reflex?

A

Aff: Gloss 9

Eff: Vagus 10

145
Q

What are the Afferent and Efferent nerves of the Pupillary Light Reflex?

A

Aff: Optic 2

Eff: Occul 3

146
Q

What are the Afferent and Efferent nerves of the Lacrimation Reflex?

A

Aff: Opth V1

Eff: Facial 7

147
Q

Label da CT scan

A
148
Q

What are the causes of Macrocytic MEGALOBLASTIC anaemia?

A

vit B12 def

folate def

149
Q

What are the causes of Macrocytic NORMOBLASTIC anaemia?

A

Alcohol

Hypothyroidism

Pregnancy

Reticulocytosis

150
Q

What is Webers syndrome?

A

Stroke of Post Cerebral Artery supplying midbrain

Fx:

Ipisilat CN III Palsy

Contralat weakness of upper + lower limbs

151
Q

What hormones inhibit GH secretion? 2

A

Glucagon

Somatostatin

152
Q

What are the side effects of Inhaled corticosteroids?

A

Oral candidiasis

153
Q

What are the side fx of SABAs?

A

tremor

154
Q

What do basophils and mast cells express on cell surface?

A

IgE receptors

155
Q

What immune cell has a multilobed nucleus?

A

Neut

156
Q

What Ig enhances phagocytosis of bacteria and viruses?

A

IgG

157
Q

What blood gas abnormality does CNS disorders (stroke / subarachnoid haemorrhage) most commonly cause?

A

Resp Alkalosis

158
Q

What do thiazide diuretics inhibit?

A

Na+ Cl- cotransporter

159
Q

What is the opposite of the RAAS cycle?

A

atrial natriuretic peptide (ANP)

Binds to kidney and blood vessel receptors

Lowers blood pressure

160
Q

What statistical method estimates survival rate?

A

Kaplan-Meier estimator

161
Q

What are the 4 stages of leucocyte extravasation?

A
  1. Chemoattraction
  2. Rolling
  3. Tight Adhesion
  4. Transmigration
162
Q

What pathogen causes bronchiolitis?

A

Respiratory syncytial virus (RSV)

163
Q

What are the CVS changes in pregnancy?

A

Increased: Plasma Volume, HR, SV, CO

164
Q

From which embryological structure is the ureter derived?

A

Mesonephric duct

165
Q

What is active compound is azathioprine metabolised to?

A

Mercaptopurine: purine analogue that inhibits purine synthesis

166
Q

What is nystagmus?

A

involuntary eye movements.

167
Q

How is benign paroxysmal positional vertigo (BPPV) diagnosed?

A

Dix-Hallpike manoeuvre

Patient quickly lowered from sitting to supine position and observed for nystagmus (invol eye movements)

168
Q

How is benign paroxysmal positional vertigo (BPPV) treated?

A

Epley manoeuvre

Dislodges otoliths by promoting movement of fluid in ears semi-circular canals

169
Q

What is the mechanism of ductus arteriosus closure?

A

First breath –> enhances prostaglandin clearance (decrease)

170
Q

What are the calcium levels in Addisons?

A

HypERcalcaemia

171
Q

What is a side effect of corticosteroids?

A

Increased susceptibility to severe infection

172
Q

What is a side efffect of amiodarone?

A

HypERthyroidism

173
Q

What is the action of amiodarone?

A

antiarrhythmic

blocks K channel that does repolarization

174
Q

How is Primary Biliary Cirrhosis diagnosed?

A

IgM serum (B looks like an M sideways widad)

Raised bilirubin

175
Q

What are the 3 antigen presenting cells?

A

B cells

Macrophages

Dendritic cells

176
Q

what electrolyte diturbance do thiazide diuretics do?

A

Hypercalcaemia

177
Q

What are the TSH and T4 levels in Thyroticosis?

A

TSH: Low

T4: High

178
Q

What sound is heard in aortic stenosis?

A

Soft S2

179
Q

What sound is heard is on mitral stenosis?

A

Opening snap

180
Q

antimetabolites for cancer treatment

where do they act?

2 examples + how

A

stops DNA synthesis

  1. methotrexate –> clarts folate (needed for DNA synthesis)
  2. 5-FU –> clarts pyrimidine
181
Q

What is Cholesterol deposition in nodules a feature of?

A

RA

182
Q

What medications inhibit Prostaglandin synthesis? (2 things)

Hence what congenital defect is this used for infants?

A

Indomethacin / Ibuprofen

Patent ductus arteriosus (promotes closure)

183
Q

What nerve innervates the MEDIAL leg + MEDIAL foot?

A

Saphenous nerve

184
Q

What nerve innervates the LAT foot + POSTEROLATERAL leg?

A

Sural nerve

185
Q

Which nerve innervates the ANTEROLATERAL leg?

A

Superficial fibular nerve

186
Q

Which leg nerve is the most likely to be damaged in Varicose vein surgery?

How will this present?

A

Sural nerve

Loss of Sensation @ LATERAL foot + POSTEROLATERAL leg

187
Q

What is hCG secreted by?

A

syncytiotrophoblast

188
Q

What is the purpose of the hCG secreted by the syncytiotrophoblast?

A

Stim Corpus Luteum to secrete progesterone

189
Q

What is the most common inherited thrombophilia?

A

Factor V Lieden

(aka activated Protein C resistance)

190
Q

How can a Shizophrenic get nipple discharge? (4 steps)

A
  1. They take Olanzapine aka Dopamine ANTagonist
  2. Dopamine usually inhibits Prolactin secretion
  3. Prolactin now disinhibited
  4. Milk secreted
191
Q

When you give Ocreotide (somatostatin analogue) for Acromegaly, what does it do? (2 things)

A
  1. Inhibits Growth Hormone secretion from Ant Pit
  2. Inhibits Insulin + Glucagon secretion from Pancreas
192
Q

What is the formula for Stoke Volume?

A

Stroke volume = end diastolic LV volume - end systolic LV volume

193
Q
A