SAQ 2010

Question 1

a. Cell components of atheromatous plaque

Answer 1

Fatty/lipid middle, calcified, cholesterol, macrophages and lymphocytes, tough fibrous capsule
Underlying cholesterol crystals

Question 2

3 Processes of NHS guidelines for stopping smoking

Answer 2

1. Ready (prepared and aware), 2.steady (set a quit date, throw away),
2. stop (set plan for day, avoid triggers)

Question 3

a. Medical Treatments for smoking

Answer 3

NRT (Nicotine Replacement Therapy)
i patches, gums, nasal spray, microtab, inhalator

Non-nicotine pharmacotherapy

i Varenicline (Champix) (mimics dopamine)
ii Bupropion (Zyban)
Transtheoretical Model 
(blocks dopamine reuptake)

Question 4

Definition of osteomalacia

Answer 4

bone mineralization does not occur properly so bones are weak

Question 5

3 causes of osteomalacia

Answer 5

• Vit D
• Woman
• Asian’s at more risk

Question 6

Two internal organs linked to osteomalacia

Answer 6

Liver and Kidney

Question 7

3 abnormalities you may see in her bony profile - of osteomalacia

Answer 7

Cortical zone is narrower, the trabeculae are thinner and less numerous.
(less calcified bone - this stains black)

Question 8

You are the on-call doctor in A&E seeing a 78-year-old female patient who complains of a gradual onset of visual problems. It is difficult to take the history from her since she struggles to understand your questions, but examination of her visual fields nevertheless reveals an upper quadrant heminanopia to the right. A CT scan of the head identifies a brain tumour as the underlying cause for her visual problems.

a. State the projection of the (a) nasal and (b) temporal fibres of the retinal ganglion cells

Answer 8

The nasal fibres project to the contralateral geniculate corpus
The temporal fibres project to the ipsilateral geniculate corpus

Question 9

a. At one point during the examination the patient is looking at the tip of your nose. Behind you, on your left hand side, is standing a tall medical student. What would be the patients’ retinal representation of the image of this students’ face?

Answer 9

Student’s face is in the right superior quadrant so retinal image is at inferior left corner

Question 10

They then ask you what the differences are between them. State two functional differences between rods and cones in the retina

Answer 10

Cones = colour, visual acuity Rods = more sensitive to light, peripheral vision,

Question 11

a. Name one other type of neuronal cell in the retina, other than ganglion cells, rods and cones –

Answer 11

horizontal cells, nipolar, amacrine, interplexiform

Question 12

a. 2 principles healthcare officials use to allocate scarce resources

Answer 12

a. Age, social status, prognosis, causation

Question 13

3 types of economic evaluation

Answer 13

° Cost minimization analysis – outcomes equivalent
° Cost effectiveness analysis – outcomes measured in natural units
° Cost utility analysis – outcomes measured in QALY
° Cost benefit analysis – outcomes measured in monetary units

Question 14

a. Know how to calculate incremental costs and effectiveness ratios

Answer 14

Incremental costs= New treatment cost – old treatment cost

Effectiveness ratio = incremental cost / difference in QALY

Question 15

What are the BMI ranges

Answer 15

• Underweight 40.0

Question 16

SEVEN KEY DOMAINS OF ENERGY BALANCE

Answer 16

1. Food environment (energy intake of population level)
2. Food consumption (individual food consumption)
3. Individual activity
   (energy expenditure)
4. Activity of the environment
   (activity of population)
5. Societal influences
   (both intake and expenditure)
6. Individual psychology
   (both intake and expenditure
7. Individual biology
   (both intake and expenditure)

Question 17

a. Characteristics of an obesogenic environment (physical, social, individual behavior causes; 2 marks each)

Answer 17

° Physical – TV remote, lifts cars
° Socio-cultural – safety fears, family eating patterns
Economic environment – expensive fruit and veg

Question 18

Outline the function of each lobe – and what would happen with damage

Answer 18

Frontal = personality, decision and planning, brocas = expression aphasia
Personality changes, inappropriate social behavior, motor cortex – contralateral damage
Parietal = somatosensory, visuospatial = loss of contra sensation
Temporal = auditory, Wernicke’s areas = receptive aphasia, memory and info retrieval
Occipital = eye sight, loss of contralateral visual field

Question 19

a. Parkinson’s – what area is affected and what substance is deficient?
- where is nerve stimulation?

Answer 19

Dopamine, affects substantial nigra (pars compacta)

-subthalamic nuclei

Question 20

Huntington’s – what is the area affected and what is the neurotransmitter defected?

Answer 20

affects caudate nucleus, less GABA so less inhibition of movement

Question 21

five functions of the skin

Answer 21

Barrier to infection, protection against trauma, protection against UV, vitamin D synthesis, thermoregulation, regulates water loss, sensory organ

Question 22

Two hormones that regulate melanin secretion

Answer 22

• Melanocyte-stimulating hormone (MSH) (intermediate lobe of pit gland)
• adrenocorticotropin hormone (anterior pit)

Question 23

3 histological characteristics of the secretory phase?

Answer 23

Arteries lengthen and become spiral
Stroma odema
Becomes torturous