CAP TEST

Question 1

What is the equation for mean arterial blood pressure?

Answer 1

Diastolic pressure + 1/3 (systolic-diastolic)

Question 2

What does increases skeletal muscle activity do to the venous return to the heart?

Answer 2

Increases the venous return to the heart

Question 3

What are the layers of the heart from superficial to deep?

Answer 3

(parietal serous pericardium) (CHECK)
(visceral serious pericardium)

Epicardium
Myocardium
Endocardium

Question 4

What is Organogenesis? (in relation to the germ layers formed during the gastrulation stage)

Answer 4

The development of the primordio of all the organs of the body

Question 5

What is fertilisation?

Answer 5

The union of the sperm and oocyte

Question 6

What is cleavage?

Answer 6

The earliest cell divisions of the embryo

Question 7

What is morphogenesis?

Answer 7

The formation of the body plan

Question 8

What is a tetramer and give an example?

Answer 8

a polymer comprising four monomer units.

Haemoglobin

Question 9

What would you give for a mild exacerbation of asthma?

Answer 9

Salbutamol via spacer in increments of 2 puffs every 5-10mins until patient responds

Question 10

What would you do for persistent severe brittle asthma with worsening breathlessness and wheeze?

Answer 10

Ventilate and incubation
IV aminophyline
IV magnesium may buy time

Question 11

What do patients with obstructive defects (like COPD) have in terms of FEV1 and FVC?

Answer 11

FVC - reduced/normal
FEV1 - reduced
FEV1/FVC - reduced

Question 12

What do patients with a restrictive defect usually have in terms of FEV1 and FVC?

Answer 12

FVC - reduced
FVC1 - reduced

FEV1/FVC - normal

Question 13

What will happen to the PEF where the FEV1/FVC ratio is low?

Answer 13

The PEF will always be reduced

Question 14

What is Barrets oesophagus?

Answer 14

Metaplasia of squamous epithelium to columnar epithelium in the lower 1/3 of the oesophagus - due to acid reflux. IT is premalignant

Question 15

50yr old man has has heartburn for many years, usually controls with antacids. Recently worsened, disrupting sleep and difficulty swallowing?

Answer 15

Barrett’s Oesophagus

Question 16

55yr old sore stomach after swallowing (Eating) pain in epigastrium, bloating and difficulty swallowing with black stools?

Answer 16

Peptic Ulcer

Question 17

What might peptic ulcer be caused by and describe the mechanism at which it destroys the muscoa?

Answer 17

H.Pylori which stimulates gastrin production which increases acid production, the increased gastric acid erodes the gastric mucosa leading to ulcer formation

Question 18

70yrs old difficulty and pain on swelling, long history of Barretts never smoked?

Answer 18

Adenocarcinoma of the lower 1/3 of oesophagus

Question 19

What cells do adenocarcinomas arise from?

Answer 19

Gland cells - Barretts is a risk factor

Question 20

Where would squamous cell carcinoma usually affect?

Answer 20

The upper 2/3rd of the oesophagus and it is associated with smoking and excess alcohol consumption - it arises from epithelial cells

Question 21

What does the autonomic inervation of the blood vessels do? (check)

Answer 21

Increases the venotone

Increases the venous return to the heart

Question 22

What is the rising phase of depolarisation in the contractile ventriclar muscle cells caused by?

Answer 22

The fast sodium influx during phase 0 of the ventricular action potential

Question 23

What is the section of the resp tract that contains the vocal cords?

Answer 23

The larynx

Question 24

What are the muscles which elevate the larynx?

Answer 24

The longitudinal muscles of the pharynx which function is extremely important during swallowing so that the laryngeal inlet is greatly reduced in size

Question 25

What are the layers of the lateral abdominal wall from superficial to deep?

Answer 25

``` Skin Fascia External oblique Internal oblique Transverse abdominis Trasversali fascia Parietal peritoneum ```

Question 26

What does the scalenus anterior muscle attach to?

Answer 26

The scalene tubercle of rib 1 and can act as an accessory muscle of respiration

Question 27

What would an enlarged and pleomorphic nuclei suggest?

Answer 27

Malignant process

Question 28

What is the different between type 1 and type 2 resp failure? (arterial gases)

Answer 28

Type 1 - low PO2, PCO2 normal | Type 2 - low PO2, PCO2 high

Question 29

What is the difference in FEV1 and FVC in asthma and COPD?

Answer 29

Asthma - decreased FEV1, normal FVC | COPD - decreased FEV1, decreased FVC

Question 30

How would you differentiate between mild and moderate community acquired pneumonia?

Answer 30

CURB score | Measure resp rate

Question 31

What is hypertrophic cardiomyopathy due to?

Answer 31

Left ventricular outflow tract obstruction from asymmetrical hypertrophy

Question 32

What should severe community acquired pneumonia be treated with?

Answer 32

IV co-amoxiclav | IV clarithromycin

Question 33

What should an aspiration pneumonia be treated with?

Answer 33

IV Amoxicillin Gentamicin Metronidazole

Question 34

What would you treat an exacerbation of COPD with?

Answer 34

Oral doxycycline if allergic to penicillin - so amoxicillin would be dangerous

Question 35

How long is the PR invteral normally?

Answer 35

0.12s-0.2s

Question 36

What does the PR interval represent?

Answer 36

AV nodal delay

Question 37

What is the P wave caused by?

Answer 37

Atrial depolarisation

Question 38

How long is the QRS normally?

Answer 38

< 0.12s

Question 39

When do the ventricles contract and relax in terms of ECG?

Answer 39

Contraint on ST segment | Relax on TP interval

Question 40

What is a granuloma?

Answer 40

A collection of macrophages that is a manifestation of an inflammatory process. Granulomatous inflammation has many causes including infectious agents.

Question 41

What is one of the most important infectious causes of granulomatous inflammation?

Answer 41

TB

Question 42

What is the ratio of amino-acids translated to protein to nucleotides?

Answer 42

3:1

Question 43

What is there a decrease of in sepsis?

Answer 43

Decrease in circulating blood volume due to endotoxins causing vasodilation and intravascular fluid leaking into adjacent tissue

Question 44

What is the most common cause of bacterial food positioning diagnosed in the UL?

Answer 44

Campylobacter

Question 45

What is bacillus cereus associated with?

Answer 45

Eating rice which has been stored too long at room temp

Question 46

What is sarcoidosis?

Answer 46

A gramulonatous diseases where non-ceaseting grandmas develop in many body organs including the lungs.

Question 47

What might present in the lungs in sarcoidosis?

Answer 47

An interstitial lung disease patterns develops with symptoms of breathlessness and dry cough and clinical signs of hilar lymphadenopathy on the CXR.

Question 48

What might be present on the shins ion sarcoidosis and what other symptoms might there be?

Answer 48

Erythema nodosum, may also see skin rashes, arthritis, joint swelling, blurred vision, dry eyes, fatigue and weight loss

Question 49

Worsening cough for the last few months, coughing up fresh blood, past few days got fever and producing which green sputum?

Answer 49

Squamous cell carincoma | may lead to lobar pneumonia also due to fever and sputum

Question 50

Describe what might cause squamous cell carcinoma and where it may develop?

Answer 50

Smoking and age are risk factor | More likely to develop nearer the larger airways of the lung, this can cause obstruction leading to a lobar pneumonia.

Question 51

15yr old girl, severe breathlessness, wheeze and cough, increasingly breathless over the past few days and wont take puffer.

Answer 51

Acute exacerbation of asthma

Question 52

What is asthma caused by?

Answer 52

Reversible airway obstruction and bronchospasm (relieved by B2 agonist)

Question 53

What does RNA polymerase do?

Answer 53

Transcribes messenger RNA from DNA that compromises the exon (coding) regions of a gene

Question 54

What is metaplasia?

Answer 54

The change from one mature cell type to another

Question 55

What is neoplasia?

Answer 55

Abnormal cell proliferation

Question 56

Where should the heel of the hand be places in CRP?

Answer 56

Heel of the hand should be placed in the centre of the patients chest

Question 57

During what gives rise to the terminal bronchioles?

Answer 57

During the pseduoglandular stage 16 generations of branching gives rise to the terminal bronchioles

Question 58

When does branching to the level of the lobar bronchi occur?

Answer 58

in the embryonic period

Question 59

When do the resp bronchioles and alveolar ducts form?

Answer 59

In the canalicular period

Question 60

When do the terminal sacs form and capillaries become associated with them form?

Answer 60

During the saccular periods

Question 61

When do the alveolar mature?

Answer 61

The alveolar period

Question 62

What is hypoxia a potent stimulus to?

Answer 62

Arterial smooth muscle construction causing increased pulmonary vascular resistance and associated pulmonary arterial hypertension this, leads to increased RV after load and initially compensatory RV hypertrophy followed eventually by RV dilution and failure (Cor Pulmonale)

Question 63

What does repair of unresolved airway inflammation result in?

Answer 63

Collagen deposition in the bronchial basement membrane, mucosa and submucosa as well as smooth muscle hypertrophy which in turn results in irreversible airways obstruction in asthma

Question 64

What should be minimised during resuscitation?

Answer 64

Pulse check, only to confirm cardiac arrest and to determine if return of spontaneous circulation has occured

Question 65

What does ST elevation in leads V2-V5 indicate?

Answer 65

Anterior MI

Question 66

What helps improve survival post MI?

Answer 66

Eating omega 3

Question 67

What drugs will heal oesphagitis?

Answer 67

PPI

Question 68

What would you do in a fibrous structure which was impairing feeding?

Answer 68

Oesophageal balls dilution for rapid relief of symptoms

Question 69

How do you treat achalasia?

Answer 69

Ballon oesophageal ballon dilatation or cariomyotomy (for young and fit as you dont need to repeat procedures)

Question 70

What would the pulse of a patient suffering from shock from substantial blood loss be like and why?

Answer 70

Fast pulse - due to sympathetic compensator response to low bp

Question 71

What is asthmatic inflammation responsive to corticosteroids typically characterised by?

Answer 71

Eosinophilic airway inflammation

Question 72

What type of inflammation is more typical of COPD?

Answer 72

Neutrophilic inflammation

Question 73

What is the most common cause of renal failure in children under 5?

Answer 73

E.coli

Question 74

What can coxiella brunet cause?

Answer 74

A pneumonia associated with sheep contact

Question 75

What would help relieve symptoms of SOB due to acute pulmonary oedema and LVF?

Answer 75

IV furosemide - a loop diuretic

Question 76

What type of malignant tumour arising in the colon is most common?

Answer 76

Adenocarcinoma

Question 77

What do HIV infection cause?

Answer 77

Reduced cell-mediated immunity and so are suspecital to opportunistic infections

Question 78

What BP would confirm high BP in ambulatory BP monitoring?

Answer 78

BP 140/90 or higher

Question 79

What causes a right shift in the oxyheamaglobin dissociation curve?

Answer 79

Hyperthermia Hyper capnia Acidosis Sickle cell anaemia

Question 80

Where is hep A common?

Answer 80

in developing countries - especially places with poor hygiene

Question 81

What is the typical incubation period for hep A?

Answer 81

28 days - jaundice is subtle at first

Question 82

What is resistance to blood flow inversely proportional to?

Answer 82

The radius of a blood vessel to the power 4

Question 83

What would the pulse in septic shock be?

Answer 83

Bounding due to hyper dynamic circulation

Question 84

Where is the femoral artery located?

Answer 84

Inferior to the retroinguinal space