CAP QUESTIONS Flashcards
(111 cards)
1
Q
During which stage of embryogenesis are the germ layers formed?
A
Gastrulation
2
Q
How many units does 1L of 40% proof spirits contain?
A
40 units
3
Q
What can be used to differentiate between mild and moderate community acquired pneumonia?
A
The CURB 65 score
- e.g resp rate
4
Q
Is there an increase or a decrease in the circulating blood volume in sepsis and why is this?
A
A decrease in the circulating blood volume due to endotoxins causing vasodilation and intravascular fluid leaking into adjacent tissue
5
Q
What conversion takes place to provide the energy for the production of lactic acid?
A
NADH is converted to NAD+
6
Q
If one parent has had a cancer, what will the childs risk most likely be?
A
Slightly above the population risk
7
Q
Increasing venomotor tone increases venous return to the heart. True/False?
A
True
8
Q
Which artery is located inferior to the retroinguinal space?
A
The femoral artery
9
Q
What is the most useful test to do for RIF pain in a patient following previous gynaecological surgery?
A
Laparoscopy - this type of pain suggest either ovarian or appendix pathology which this test will be able to look for
10
Q
Increasing intake of omega 3 fatty acids and reduction of trans fatty acids helps to improve survival post MI. True/ False?
A
True
11
Q
Uncontrolled proliferation of mucous gland cells in the lower 1/3rd of the oesophagus is suggestive of what?
A
Adenocarcinoma (due to Barrett’s Oesophagus)
- ‘Uncontrolled proliferation’ = cancer
- Mucous gland cells = adenocarcinoma arises from gland cells
- Adenocarcinoma is most likely to affect the lower 1/3rd of the oesophagus while squamous cell carcinoma is more likely to affect the upper 2/3rds of the oesophagus
12
Q
Why is adenocarcinoma most likely to affect the lower 1/3rd of the oesophagus?
A
Due to acid reflux - chronic inflammation
13
Q
What kind of shock is meningitis a classical cause of?
A
Septic shock
14
Q
What is the treatment of choice for severe community acquired pneumonia?
A
IV co-amoxiclav and IV clarithromycin
15
Q
What is the antibiotic management of COPD exacerbation in a patient with a penicillin allergy?
A
Doxycycline
16
Q
What is the best test for looking at pancreatic function?
A
Faecal elastase
17
Q
OGD (esophogastroduodenoscopy) and duodenum biopsy can be used to diagnose which two conditions
A
Coeliac disease and giardia
18
Q
Haemoglobin is a tetramer. True/ False?
A
True
19
Q
What is the life span of an enterocyte?
A
120 days
20
Q
Which has a greater affinity for haemoglobin - oxygen or carbon monoxide?
A
Carbon monoxide
21
Q
What is an accessory muscle of respiration which is attached to rib 1?
A
The scalenus anterior muscle
22
Q
What is the most common type of malignancy arising in the colon and the rectum?
A
Adenocarcinoma
23
Q
Why might a lung cancer patient present with green sputum/ signs of infection?
A
Lung cancer can cause pneumonia
24
Q
What does a low Km indicate?
A
High affinity of an enzyme for its substrate
25
Branching to give the terminal bronchioles occurs during which stage of lung maturation?
Pseudoglandular stage
26
Branching to the level of the lobar bronchi occurs in which stage of lung maturation?
Embryonic
27
Terminal sacs form and capillaries become closely associated with at what stage of lung maturation?
Saccular
28
Alveoli mature during which stage of lung maturation?
Alveolar (continues into childhood)
29
Healthy start vitamins can be provided to low-income pregnant women to reduce the prevalence of which condition?
Rickets/ Osteomalacia
| the vitamins contain folic acid and vitamin C and D - essential for calcium absorption
30
When is the valsava manoeuvre used and when is carotid sinus massage used?
Valsava manoeuvre is first-line for SVT
Carotid sinus massage is done for young patients who are at low stroke risk *N/B it is therefore not appropriate in patients with hyper cholesterol/ smokers
31
A woman is known to carry a mutation in the factor VIII gene that causes X-linked haemophilia. She experienced haemorrhage following surgery, What is the most likely mechanism here?
Normal X-inactivation
32
Increased pulmonary vascular resistance and right ventricular afterload is a result of hypoxic pulmonary arterial vasoconstriction. True/ False
TRUE
33
What process does airway remodelling and irreversible airway obstruction occur as a result of?
Collagen deposition in the brochial basement membrane and submucosa due to repair of chronic eosinophil inflammation
34
The most common cause of anaemia with no other symptoms in patients in their fifties and older is colorectal cancer. What investigation should be done for this?
Colonoscopy
35
Anaemia, weight loss and early satiety are alarm symptoms for upper GI malignancy. What test should be done for this?
Gastroscopy
36
a young patient develops anaemia. They have been travelling in Russia for several months. What is the best investigation?
Distal duodenal biopsy as this can investigate for both coeliacs disease and for giardia
37
What is the most common cause of renal failure in children under 5 years old?
E.Coli
38
E.Coli has a very low infecting dose. True/False?
True
39
A sarcoid like granulomatous infiltrate may be a reaction to nearby malignancy. True/ False?
True
40
What does infectious mononucleosis refer to?
Glandular fever/ Epstein-Barr virus
41
What is the best test for infectious mononucleosis?
Monospot test
42
How does infectious mononucleosis present?
* Young patients
* Spread by saliva
* May involve a rash but this often doesn't appear unless the patient is put on antibiotics
43
HIV patients are susceptible to pneumocystis carnii infection. How does this present?
Multiple small gas filled cavities in both lung apices and bilateral ground-glass opacification
*responds to treatment with co-trimoxazole
44
The detection of plasma viral load (RNA) in a patient with HIV can be done by what lab investigation?
Polymerase chain reaction
45
The measurement of T-lymphocyte subsets in blood can be done by what lab investigation?
Immunophenotyping
46
What is the correct rate of rescue breathing in an adult with a respiratory arrest?
10 times per minute
47
62 year old man with alcohol related cirrhosis and alcoholic hepatitis -can be given terlipressin. True/ False?
True - this will improve renal blood flow which is important if he has developed hepato-renal syndrome
48
Raised bilirubin in the absence of biliary disease requires what management and why?
Liver transplant
| - this indicates deteriorating liver function and liver failure
49
Vomiting and dysphagia to solids. Tight benign stricture seen at endoscopy. How could this patient be managed?
Oesophageal balloon dilation for rapid relief of symptoms
50
How could achalasia be managed?
Ballon oesophageal dilation or cardiomyotomy. If they are young and fit then cardiomyotomy (Heller's cardiomyotomy) is preferred as it doesn't require repeat procedures
51
Haemolysis is important for the classification of streptococcus. True/ False?
True
52
Elderly and frail patient with suspected colorectal cancer. What investigation should you do?
CT colonography (not colonoscopy as this is too invasive)
53
Which cranial nerve supplies somatic sensory to the dermatomes of the face?
Trigeminal nerve CNV
54
Which cranial nerve is responsible for the ability to change facial expression?
Facial nerve CNVII
55
Which cranial nerve causes movement of the vocal cords?
Vagus Nerve CNX
56
The lower the Km the higher or lower the affinity of an enzyme for its substrate?
The lower the Km, the higher the affinity
57
Woman carries a mutation in the factor VIII gene that causes X-linked haemophilia, she experienced haemorrhage following surgery, this is likely due to normal X inactivation. T/F?
True
58
Black stools and postural hypotension would suggest which kind of shock?
Hypovolaemic shock (blood loss from GI bleed)
59
Diclofenac is what kind of drug?
NSAID - Therefore considered a risk factor for an upper GI bleed
60
During which stage of development are the germ layers formed?
Gastrulation
61
A tight benign stricture could present with vomiting and dysphagia to solids. What can be done for rapid relief of symptoms?
Ballon oesophageal dilation
62
What procedure can be done for the management of achalasia?
Balloon oesophageal dilation or Heller's cardiomyotomy.
| cardiomyotomy should be done if the patient is young and fit and is good because it doesn't require repeat procedures
63
What can the epicardium also be called?
Visceral serous pericardium
64
Haemoglobin is a tetramer
TRUE
65
Pyruvate + NADH +H+ ------ Lactate + NAD+, what is the reducing agent?
NADH
66
Chronic agonist induced stimulation of airway beta 2 receptors results in what?
(this is due to loss of the protective function of LABAs)
Beta 2 receptor down regulation and reduced receptor coupling to G protein adenylyl cyclase
67
What effect does sensitisation of airway smooth muscle by asthmatic inflammatory mediators cause?
Enhanced airway hyper-reactivity on bronchial challenge testing
68
What acts on membrane bound beta-2 adrenoceptors on airway smooth muscle to mediate relaxation?
Adrenaline
69
What is a metabolite of the arachidonic acid pathway, released from eosinophils and mast cells which mediates smooth muscle contraction, increased vascular permeability and mucous secretion?
Leukotriene D4
70
Influenza A can cause pandemics. T/F
True
71
Are streptococci and staphylococci gram +ve or gram -ve?
Gram +ve
72
Which organism is classified by its haemolysis on blood agar?
Streptococci
73
Sarcoidosis involves non-caveating granulomas. T/F?
TRUE
74
Uncontrolled proliferation of epithelial cells in the large airways of the lung. What is the diagnosis?
Squamous cell lung cancer
75
What medication could be given to manage acute shortness of breath at night?
IV furosemide
76
What is 'performed initially when undertaking a *systemic patient assessment'?
Patency of the airway
77
Exacerbation of bronchiectasis can be caused by pseudomonas aeruginosa, what antibiotic can be used to treat this?
Ciprofloxacin
78
Give an example of a macrolide
Clarithromycin
79
The cell wall of gram negative or gram +ve has a thick layer of peptidoglycan?
Gram +ve
80
Which enzyme transcribes genetic material?
RNA polymerase
81
Which drug is used to treat a flare up of autoimmune hepatitis?
Steroids e.g prednisolone
82
What are anti-microbial proteins secreted by epithelial cells at mucosal surfaces?
Defensin
83
In which direction does sickle cell disease shift the oxyhemoglobin dissociation curve?
To the right
84
Which bone forms the heel of the foot?
Calcaneous
85
Which vertebrae has the odontoid process?
C2
86
Panton Valentine Leukocidin
A cytotoxin associated with highly virulent strains of staph aureus (MRSA) which causes necrolytic skin infections
87
Which cranial nerve is for special sensory innovation of the ear for hearing and balance?
Vestibulocochlear
88
What is the only organism that shows up golden on blood agar?
Staph Aureus
89
What kind of inheritance does sickle cell anaemia involve?
Co dominant
90
How many transmembrane proteins make up a G protein?
7 transmembrane proteins
91
Hypoplasia is a development disorder. T/F?
True
92
Which curve is sigmoidal and which is hyperbolic? (Hb and Myoglobin)
Haemoglobin - sigmoidal
| Myoglobin - hyperbolic
93
What gram -ve organism is resistant to most oral antibiotics?
Pseudomonas Aeruginosa
94
Detection of what measures the primary humoral immune response?
IgM
95
What is immunophenotyping?
Measurement of T-lymphocyte subsets in the blood
96
What is light microscopy?
Analysis of cells based on their physical form and structure
97
Which is catalase positive; staphylococci or streptococci?
Staphylococci is catalase +ve and streptococci is catalase -ve
98
Neisseria meningitidis
Aerobic gram -ve cocci (appears as diplococci)
99
Staphylococci and streptococci are both gram +ve. T/F?
TRUE
100
What cells are considered as the adaptive immune response?
T cells, B cells, dendritic cells and antibodies
101
What is the major facilitative transporter for glucose in the gut?
GLUT 5
102
Name a primary cartilaginous joint
Long bone epiphyseal growth plate (joined by hyaline cartilage)
103
Name a secondary cartilaginous joint
Intervertebral discs (joined by fibrocartilage)
104
What kind of joint is a fibrous joint?
Coronal suture
105
What kind of joints are metacarpopharyngeal and acromioclavicular joints?
Synovial
106
What forms most of the anterior surface of the heart?
The right ventricle
107
What forms most of the right border of the heart?
The right atrium
108
What forms most of the left border of the heart?
The left ventricle
109
M1 binding to Gq has what effect?
Stimulation of phospholipase C and Increased acid secretion
110
M2 binding to Gi has what effect?
Inhibition of adenylyl cyclase ad decreased heart rate
111
M3 binding o Gq has what effect?
Stimulation of phospholipase C and increased saliva and smooth muscle contraction (especially in the lungs)
