Basic Science

Question 1

ECG changes with hypokalaemia

Answer 1

Prominent P waves
Prolonged PR
Widespread ST
T wave inversion/flattened
U wave
Long QT

Question 2

Contents of adductor canal

Answer 2

Saphenous N.
Superficial femoral A/V

Question 3

Blood film in hyposplenism (post-splenectomy)

Answer 3

Howell-Jolly bodies
Pappenheimer bodies
Target cells (Poikilocytes)
Erythrocytes containing siderotic granules
Heinz bodies

Question 4

Boundaries and 4 small triangles of anterior triangle of the neck

Answer 4

Anterior: midline of the neck
Posterior: anterior border of sternocleidomastoid
Base: Lower border of the body of the mandible

The triangle is further divided into 4 triangles by 2 bellies of digastric muscle superiorly and superior belly of the omohyoid inferiorly
1. Carotid triangle
2. Muscular triangle
3. Submandibular triangle
4. Submental triangle

Question 5

Contents of anterior triangle of the neck

Answer 5

Contents :
Carotid triangle
- Carotid sheath (Common carotid A. Internal jugular V. Vagus N)
- External carotid artery branches
- Hypoglossal N.
- Superior root of ansa cervicalis

Muscular triangle
- Muscle L sternothyroid, Sternohyoid
- Thyroid gland
- Parathyroid glands

Submandibular triangle
- Submandibular gland
- Hypoglossal N
- Mylohyoid N.
- Parts of facial A + V
- submandibular lymph nodes

Siubmental tringle
- Submental lymph nodes
- veins which form anterior jugular V.

Question 7

Boundaries and 2 small triangles of posterior triangle of the neck

Answer 7

Anterior: stenocleidomastoid muscle
Posterior: Anterior border of Trapezius
Base : Clavicle

Further divided by the inferior border of omohyoid muscle
1. Occipital triangle
2. Subclavian triangle

Question 8

Contents of the posterior triangle

Answer 8

Nerves and plexus:
- Spinal accessory N.
- Cervical plexus
- Roots and trunks of the brachial plexus
- Phrenic N.

Vessels:
3rd part of the subclavian A.
External jugular V.

Lymph:
Supraclavicular + Occipital lymph nodes

Muscles:
Omohyoid muscle, Scalene

Question 9

Ciprofloxacin - pharmacokinetics and side effects

Answer 9

Ciprofloxacin = Quinolones

• DNA gyrase
• tendinitis, tendon rupture

Question 10

Vacomycin pharmacokinetics and side effects

Answer 10

Glycopeptide (Vancomycin, teicoplanin)
- For MRSA infections

Question 11

2 bacteria that produce ESBL (extended beta-lactamase, E.coli)

Answer 11

• E.coli
  -Klebsiella species
  1st line ABx - Meropenem, Imipenem (Carbapenems)

Question 12

Mechanism and actions of Dabigatran

Answer 12

Direct thrombin inhibitors, renally extracted drug

Question 13

Mechanism and actions of Rivaroxaban

Answer 13

Direct Factor Xa inhibitor, Preventing from thrombin to Prothrombin

Question 14

Mechanism and actions of Fondaparinux

Answer 14

Inhibit Factor Xa selectively by including an irreversible conformational change in antithrombin III

Question 15

Mechanism and actions of Clopidogrel

Answer 15

Pro-drugs that irreversibly inhibit platelets creating a prolonged antiplatelet effect.
Clopidogrel requires hepatic activation and produces variable platelet inhibition based on genetic polymorphisms.