MT3

Question 1

Primary immunodeficiency?

Answer 1

Immunodeficiency that is due to an inborn defect, often genetic, rather than occurring as part of another disease process

Question 2

SCID, RAG 1/2 immunodeficiency

Answer 2

RAG 1 required for somatic recombination events between VDJ segment that produce t and B cell receptors

No adaptive immunity?

Question 3

Nut allergy leading to facial angiodema and low bp?

Answer 3

Peanut allergens bind to preformed anti peanut igE antibodies on surface of mast cells

Cross linking of contiguous epitomes of adjacent igE molecules activates mast cell degranulation, release of preformed mediators: histamine, tryptase and production of other leukotrienes.

Pharmalogical effects include increased capillary permeability, vasodilation, leading to clinical features of anaphylaxis

Question 4

Why is cross matching necessary precaution before transplanting a solid organ into a patient?

Answer 4

Antibodies in patients blood will react to donors antigen causing hyper acute rejection which is a life threatening complication

Question 5

Why is HLA matching not requirement for liver transplantation?

Answer 5

Highest urgency, less time

Well accepted despite mismatch

Liver carries passenger leukocytes that will colonise the host and give rise a chimeric immune system which helps induce tolerance

Question 6

Ibuprofen class?

Answer 6

NSAIDS

Question 7

Other examples of NSAIDS

Answer 7

Naproxen
Aspirin
Diclofenac
Indomethacin

Question 8

Side effect and toxicities of ibuprofen at standard doses?

Answer 8

Peptic ulcer
GI bleeding 
Abdominal pain
Nausea
Rash
Anaphalyaxis
Nephrotoxicity

Question 9

flexor digitorum superficialis and profundus insert where?

Answer 9

FDS middle phalanx

FDP distal phalanx

Question 10

Role of rectus femoris and gluteus medius?

Answer 10

Rectus femoris - flexor of thigh and extensor of leg

Gluteus medius- abduction and medial rotation

Question 11

Borders of femoral triangle?

Answer 11

Medial border of sartorius
Medial border of adductor longus
Inguinal ligament

Question 12

Clinical important of femoral triangle?

Answer 12

Site of femoral hernia, access to femoral nerve for nerve block, venepuncture, angioplasty

Question 13

Female patient who has developed a flat foot, pes planus. Which arch?

Answer 13

Medial longitudinal

Question 14

Which tendon is injured in flat foot?

Answer 14

Tibialis posterior

Question 15

Features of C6 cervical rediculopathy?

Answer 15

Neck pain radiating down the arm

Loss of supinator reflex

Numbness affecting thumb and index finger only

Question 16

Sensory and motor sign on examination of suggested carpal tunnel syndrome

Answer 16

Impairment of the loaf muscles

Loss of sensation in the lateral 3.5 fingers

Question 17

What is compartment syndrome?

Answer 17

Abnormally increased pressure within a specific anatomical region of the leg

Question 18

Slink all signs of acute compartment syndrome?

Answer 18

Pain out of all proportion of the original injury

Pain increased on passive stretching

Tense swollen limb

Early sensory loss

Reduced distal pulses

Weakness of compartment muscles

Question 19

Joints affected by rheumatoid arthritis?

Answer 19

Wrist MCPJ PIPJ, MTPJ, knee hip jaw ankle elbow cervical spine

Question 20

Abnormalities seen in tests for patient with rheumatoid arthritis/

Answer 20

Raised inflammatory markers ESR/CRP

Raised rheumatoid factor

Anaemia

Question 21

Short term treatment for rheumatoid arthritis?

Answer 21

Oral NSAIDs

Corticosteroid given by IM or intra-articular injection