15th April

Question 1

Cholestatic LFTs

Answer 1

Alkaline phosphatase and GGT

Question 2

Hepatocellular or hepatic LFTs

Answer 2

ALT

Question 3

Liver damage tests

Answer 3

ALT/AST, ALP, GGT

Question 4

Liver damage LFT results

Answer 4

Increased ALT/AST

Normal ALP and GGT

Question 5

Cholestasis LFT results

Answer 5

Normal ALT/AST

Increased ALP/GGT

Question 6

Rheumatic fever results from infection with

Answer 6

Group A streptococcus

Question 7

Hi

Answer 7

Hello

Question 8

Yellow men and women in their 70s and 80s

Answer 8

Pancreatic cancer / cholangiocarcinoma

Question 9

Signs of infective endocarditis

Answer 9

JORS 
Janeway lesions 
Osler nodes 
Roth spots 
Splinter haemorrhages

Question 10

Duke’s criteria

Answer 10

Assesses Infective endocarditis

Question 11

2 causes of infective endocarditis

Answer 11

Presence of organism

Abnormal cardiac endothelium

Question 12

Usual antibiotic treatment for severe pneumonia

Answer 12

IV co-amoxiclav and IV clarithromycin

Question 13

Cavitating, upper lobes and redcurrant sputum

Answer 13

Klebsiella

Question 14

Legionella blood results

Answer 14

Lymphoma, hyponatraemia and deranged LFTs

Question 15

2 types of adrenoceptor found in blood vessels

Answer 15

Alpha 1 adrenoceptors and beta 2 adrenoceptors

Question 16

Adrenoceptors

Answer 16

G-protein coupled receptors targeted by noradrenaline and adrenaline

Question 17

Funny current

Answer 17

Slow continuous flow of sodium ions into resting cardiomyocytes in pacemaker regions, allows cells to depolarise spontaneously

Question 18

Length of axon difference para and symp

Answer 18

Para = long pre and short post 
Symp = short pre and long post

Question 19

Parasympathetic neurotransmitter

Answer 19

Ach only

Question 20

Sympathetic neurotransmitter

Answer 20

Ach and then noradrenaline

Question 21

Silver stain

Answer 21

Pneumocystis pneumonia

Question 22

Vessels of the superior mediastinum

Answer 22

Aortic arch, Brachiocephalic veins, Superior vena cava, azygous vein arch

Question 23

Bicuspid valve

Answer 23

Mitral

Question 24

Inlets into the RA

Answer 24

IVC, SVC and cardiac veins

Question 25

Bronchomotortone is maintained by

Answer 25

Vagaries efferents

Question 26

co2 forms of carrying

Answer 26

bicarbonate, carbamino compounds and in solution

Question 27

Where is pancreatic lipase produced

Answer 27

Acinar cells of the exocrine pancreas

Question 28

Procolipase is activated by

Answer 28

Trypsin

Question 29

Function of pancreatic lipase

Answer 29

Hydrolyses dietary fat - triglycerides to monoglycerides

Question 30

Treatment of emphysema

Answer 30

Chest drain

Question 31

2,3 - diphosphoglycerate

Answer 31

Promotes haemoglobin transition from a high to low oxygen affinity state

Question 32

Calculating anion gap

Answer 32

(na + k) - (cl + hco3)

Question 33

Normal anion gap

Answer 33

12

Question 34

Hepcidin

Answer 34

Peptide secreted by hepatocytes that decrease no of iron transporters

Question 35

Reduced hepcidin

Answer 35

Adaptation of IDA sufferers, allows greater absorption of iron

Question 36

Patients with chronic hypercapnia are more reliant on

Answer 36

Hypoxic drive

Question 37

Chief cells secrete

Answer 37

Pepsinogen

Question 38

Gastric mucosa epithelium

Answer 38

Simple columnar

Question 39

Parietal cells produce

Answer 39

HCl and intrinsic factor

Question 40

Fluid filled cavity in the pancreas lined with granulation tissue

Answer 40

Pancreatic pseudocyst

Question 41

Symptoms of pancreatic abscess

Answer 41

Systemic fever, rigors and palpable mass

Question 42

Steatorrhea

Answer 42

Loss of lipase

Question 43

Barretts oesophagus

Answer 43

Squamous to columnar AND goblet cells

Question 44

How does the ductus arteriosus close with first breaths

Answer 44

Increased pulmonary flow enhancing prostaglandin clearance

Question 45

Hepatic artery proper provides how much liver blood supply

Answer 45

1/3rd

Question 46

How does vitamin D increase calcium absorption

Answer 46

Increases expression of calbindins

Question 47

Autoregulation

Answer 47

Mechanism that allows vascular resistance to be adjusted to maintain constant blood flow in an organ across a range of arterial pressures. KIDNEYS AND BRAIN

Question 48

Valsalva manoeuvre

Answer 48

Forceful exhalation against a closed airway to change intrathoracic pressure, affecting venous return, arterial pressure, heart rate and CO - SUPRAVENTRICULAR TACHYCARDIA

Question 49

Pellagra

Answer 49

Caused by niacin deficiency. Inflamed skin, diarrhoea, dementia and mouth sores