Phase 2a

Question 1

Which layer of the bowel wall does ulcerative colitis effect?

Answer 1

Mucosa

Crohn’s- all layers, goblet cells, granulomas

Question 2

Histological features present in UC?

Answer 2

Increase in plasma cells in the lamina propria, crypt distortion/branching/abscess, ulceration

Question 3

Appearance of meningiococcal bacteria on microscopic examination?

Answer 3

Gram negative diplococci

Question 4

Who should be notified of meningiococcal sepsis?

Answer 4

Accept Consultant in Communicable Disease Control or Public Health England or local Health
Protection Team

Question 5

Parkinson’s presentation?

Answer 5

Resting tremor / pill-rolling tremor
Rigidity (either smooth/lead-pipe or oscillating/cog-wheel)
Bradykinesia / slowness of movement / decreased amplitude of movement/ paucity
of spontaneous movement
‘Freezing’ when starting to walk (start-hesitation), when turning or when crossing a
threshold e.g. a doorway, reduced arm swing

Question 6

Two main histopathological findings in Parkinson’s disease?

Answer 6

Loss of dopaminergic neurones (1 mark), in the substantia nigra

The presence of Lewy Bodies/ eosinophilic cytoplasmic inclusions

Question 7

Is the CT scan normal in Parkinson’s?

Answer 7

Yes

Question 8

Parkinson’s drugs and class?

Answer 8

L-Dopa plus peripheral dopa-decarboxylase inhibitor - (Sinemet, Madopar, cocareldopa)
Dopamine agonists - (pramipexole, ropinirole, cabergoline, bromocriptine)
Catechol-O-Methyl-Transferase inhibitors - (Comtess, tolcapone)
Monoamine oxidase B inhibitors - (selegiline, rasagiline)

Question 9

What is the reason for fat malabsorption in coeliac disease?

Answer 9

Mucosal surface area reduction due to villious atrophy

Question 10

Main type of cell in AML?

Answer 10

Blast cell

Question 11

Features of Huntington’s disease?

Answer 11

Features typical develop after 35 years of age
chorea
personality changes (e.g. irritability, apathy, depression) and intellectual impairment
dystonia
saccadic eye movements

Autosomal dominant

Question 12

Severe aortic stenosis?

Answer 12

A small volume and slow rising pulse

Question 13

Treatment for peripheral vascular diseae?

Answer 13

Stop smoking and exercise

Treat comorbidities

Statin/Clopidogrel

Question 14

HF investigation?

Answer 14

Brain natriuretic peptide level

Question 15

Which one of the following is the commonest dermatological manifestation of
inflammatory bowel disease?

Answer 15

Erythema nodosum

Question 16

What is raised in acute pancreatitis?

Answer 16

Serum amylase concentration

Question 17

Acute pancreatitis?

Answer 17

Features:
severe epigastric pain that may radiate through to the back
vomiting is common
examination may reveal epigastric tenderness, ileus and low-grade fever
periumbilical discolouration (Cullen’s sign) and flank discolouration (Grey-Turner’s sign) is described but rare

Question 18

Hypertension and hypokalaemia?

Answer 18

Conn’s syndrome (primary hyperaldostronism)

Question 19

Hypernatremia and hypokalaemia?

Answer 19

Addison’s

Toned, tired, tanned, tearful

Question 20

How does salbutamol inhaler work?

Answer 20

Relaxation of bronchial smooth muscle cells

Question 21

Features of bronchiectasis?

Answer 21

Features
Persistent productive cough. Large volumes of sputum may be expectorated
Dyspnoea
Haemoptysis

Question 22

Rheumatoid arthritis investigations?

Answer 22

RF 70-80% are positive

If negative or
Anti-CCP antibodies, same sensitivity but highly specific