Case 15 + 16 questions

Question 1

The Endocrine process that precedes gonadarche

Answer 1

A progressive increase in gonadotrophin amplitude and frequency triggering an increase in FSH and LH production

Question 2

What nutrient are people deficient in a vegan diet?

Answer 2

Vitamin B12

Question 3

Role of the Hypothalamus

Answer 3

Regulates body water through stimulating the release of ADH (vasopressin)

Question 4

Describe stress and its long term effects

Answer 4

Pathophysiological changes following exposure to diverse physical/ chemical or emotional challenges

Question 5

What hormone is released by the hypothalamus in response to stress

Answer 5

Corticotropin releasing hormone, acts on the pituitary gland to release ACTH

Question 6

How can chronic hyperactivation of the Hypothalmic Pituitary Axis (HPA) result in reduced immunity

Answer 6

Cortisol release suppresses leukocyte transmigration inhibiting leukocyte recruitment into the intestinal space

Question 7

Timing of scrotal enlargement

Answer 7

Scrotal enlargement typically occurs before the commencement of nocturnal seminal fluid emissions. Scrotal and penile enlargement occurs about a year after testicular enlargement

Question 8

The function of Thiamin (vitamin B1)

Answer 8

The synthesis of neurotransmitters

Question 9

Positives and negatives of social media

Answer 9

POSITIVE

1) Improved development of social and real world relationships
2) Improved development of self identity
3) Improved development of self expression.

NEGATIVE

1) Increased risk of anxiety/depression
2) Increased risk of negative body image
3) Sleep deprivation affecting daily life

Question 10

Examples of how a healthy lifestyle can help to prevent disease

Answer 10

1) Healthy eating - reduces chance of obesity (and subsequently risk of diabetes), heart disease, etc
2) Exercise - increases mood and reduced risk of mental health disease, reduced risk of heart disease etc
3) Good work/life balance - reduces risk of stress (and associated diseases) and anxiety, etc.

Question 11

What type of vaccine is MMR

Answer 11

Live attenuated vaccine

Question 12

Most common cause of tonsilitis

Answer 12

Streptococcus pyogenes

Question 13

The cause of hearing loss that can apply to both conductive and sensorineural hearing loss

Answer 13

Tumour

Question 14

A serotonin agonist which helps relieve headaches

Answer 14

Sumatriptan

Question 15

Describe the middle ear

Answer 15

The middle ear contains the tympanic cavity which communicates to the nasopharynx via the pharyngotympanic tube

Question 16

MoA of interferon based drugs

Answer 16

They are immunomodulators that enhance host defence

Question 17

Nerve supply to the pinna

Answer 17

The facial and vagus nerve

Question 18

The function of the auditory ossicles of the middle ear

Answer 18

To increase the amplification of sound waves reaching the middle ear

Question 19

The venous sinus which is found at the junction between the falx cerebri and the tentorium cerebelli and is triangular in cross section

Answer 19

Straight sinus

Question 20

What factor is a prerequisate for eradication of a pathogen

Answer 20

A highly efficacious vaccine must be available

Question 21

How do viral peptides aid the process of viral evasion

Answer 21

Viral peptides have ubiquitinylation and eventual degradation of MHC molecules

Question 22

Whats the most common reason for a speech delay in children

Answer 22

Conductive hearing loss

Question 23

What is the role of the basilar membrane in the cochlea

Answer 23

It spatially separates sound waves into different frequencies. Its positioned between the scala tympani and scala media but does not form a specific barrier

Question 24

Describe perilymph

Answer 24

Its a potassium ion poor, sodium ion rich fluid which transmits vibrations of sound to the scala media

Question 25

The virus that causes persistent and chronic infection

Answer 25

Hepatitis C

Question 26

The dural reflection that projects into the transverse cerebral fissure

Answer 26

Tentorium cerebelli

Question 27

Screening tests for hearing loss

Answer 27

Otoscopy:- to view ear canal and eardrum to look for (for example), infection, fluid effusion (otitis media) etc.

Rinne’s Test - tuning fork test to compare air conduction v bone conduction to differentiate between sensorineural or conductive deficits.

Weber’s Test - tuning fork test of bone conduction to both ears to aid differentiation between sensorineural or conductive deficits.

Question 28

State the key stages of measles

Answer 28

1) Following infection the incubation period for the measles virus is around 10 days
2) This is followed by 2-4 days of pro-dromal symptoms (malaise, fever, cough etc)
3) Once symptoms appear, individual is infectious
4) Around 4 days after symptoms first appear the measles rash appears
5) Still infectious up to 4 days following rash appearance.

Question 29

What are the next steps a GP must make when diagnosing a notifiable disease

Answer 29

1) Complete a notification form immediately on diagnosis of the suspected notifiable disease.
2) Don’t wait for laboratory confirmation of the suspected infection or contamination before notification.

Question 30

What is a notifable disease

Answer 30

A notifiable disease is a disease that must be reported to public health authorities at the time it is diagnosed because it is potentially dangerous to human or animal health