Clinical Sciences Flashcards by John Gillespie

What is the physiology of sepsis driving hypotension?

Increased production of IL-1

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Mechanism of hypotension in Addison’s?

Glucocorticoid deficiency

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Mechanism of fever in sepsis?

Increased production of IL-6

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Type of bias: occurs when two tests for a disease are compared, the new test diagnoses the disease earlier, but there is no effect on the outcome of the disease

Lead-time bias

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Equation for statistical power in a study?

1 - probability of making a type 2 error

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Equation for specificity in a study?

1- probability of making a type 1 error

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Down syndrome (Trisomoy 21).
what are the cytogenic causes?

1) Non-disjunction (94%)
2) Robertsonian translocation (usually onto chromosome 14)
3) Mosaicsm

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EBV is a risk factor for what cancers?

Burkitt’s Lymphoma
Hodgkins Lymphoma
Post transplant Lymphoma
Nasopharyngeal Carcinoma

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HPV strains 16/18 are a risk factor for what cancers?

Cervical cancer
Anal cancer
Penile cancer
Vulval cancer
Oropharyngeal Cancer

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Human herpes virus 8 is a risk factor for what cancer?

Kaposi’s Sarcoma

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Hepatitis B+C virus is a risk factor for what cancers?

Hepatocellular Carcinoma

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Human T-lymphotropic virus 1 is a risk factor for what cancer?

Tropical spastic paraparesis
Adult T cell leukaemia

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What diagram will demonstrate publication bias in a meta-analysis?

Funnel Plot

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What immunoglobulin is the most dominant in breast milk+most commonly produced in human body?

IgA

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Diabetic nephropathy histological findings

Kimmelstiel-Wilson lesions, nodular glomerulosclerosis

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Classical presentation of Pellagra?

Diarrhoea, Dermatitis and Dementia
(Niacin B3 deficiency)

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What deficiency causes angular cheilitis?

Riboflavin (B2)

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What deficiency would present with alopecia and scaly erythematosus?

Biotin (B7)

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What test do you use to measure the degree of correlation in:
1) Parametric (normally distributed) data
2) Non Parametric data

1) Pearson’s Coefficient
2) Spearmanns Coefficient

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What does the cardiac sensitive biomarker Troponin bind to when forming a troponin-tropomyosin complex?

Actin

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HLA antigens are encoded by genes on what chromosome?

SIX

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Haemochromatosis is associated with what HLA Antigen?

HLA-A3

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Bechets disease is associated with what HLA Antigen?

HLA-B51

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Ankylosing spondylitis, reactive arthritis, acute anterior uveitis and psoriatic arthritis is associated with what HLA antigen?

HLA-B27

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Coeliac disease is associated with what HLA antigen?

HLA-DQ2/DQ8

Narcolepsy and Goodpastures syndrome is associated with what HLA antigen?

HLA-DR2

Dermatitis Herpetiformis, Sjogrens syndrome, Primary biliary cirrhosis is associated with what HLA Antigen?

HLA-DR3

T1DM, rheumatoid arthritis, are associated with what HLA Antigen?

HLA-DR4

What test can be used to analyse measured (continuous) data that follows a normal distribution?

Students T-Test

Definition of the P value?

The probability of obtaining a result by chance at least as extreme as the one that was actually observed, assuming that the null hypothesis is true

What is a type 1 error when testing the null hypothesis?

Null hypothesis is rejected when it is true (False Positive)

What is a type 2 error when testing the null hypothesis?

Null hypothesis is accepted when it is in fact false (False negative)

What is the power of a study?

Probability of (correctly) rejecting the null hypothesis when it is false. Power = 1 - probability of type 2 error

Most appropriate significance test for data which is paired but not normally distributed?

Wilcoxon signed-rank test

Name the condition: -Mitochondrial Inheritance -Onset < 20 -External Ophthalmoplegia -Retinitis Pigmentosa

Kearns-Sayre syndrome

Nerve and vessels passing through the superior orbital fissure? (Located in Sphenoid Bone)

Vessels: 1) Superior Ophthalmic Vein 2) Inferior Ophthalmic vein Nerves: 1) Oculomotor nerve 2) Trochlear nerve 3) Abducens nerve

What receptor does insulin bind to in the cell membrane?

Tyrosine Kinase

Oncogene ABL

Chronic Myeloid Leukaemia

Oncogene c-MYC

Burkitts Lymphoma

Oncogene N-MYC

Neuroblastoma

Oncogene BCL-2

Follicular Lymphoma

Oncogene RET

Multiple endocrine neoplasia

Oncogene RAS

Pancreatic Cancer

Oncogene erb-B2 (HER2/neu)

Breast and Ovarian

DiGeorge Syndrome mnemonic 'CATCH 22'

Cardiac abnormalities, Abnormal facies, Thymic aplasia, Cleft palate, Hypocalcaemia/hypoparathyroidism, Chromosome 22 deletion

Why does high altitude mountain hiking lead to increased haematocrit?

Increased production of of hypoxia inducible factor-1 alpha leading to increased production of RBC

Which structure may overlie the left renal hilum?

Tail of the pancreas

Which structure may overlie the superomedial aspect of the left kidney?

Greater curvature of the stomach

Which structure overlies the medium portion of the right kidney?

Second part of the duodenum

Primary cause of hypoglycaemia in patients who are diabetic and have binged on alcohol?

Increased first phase insulin response

Proximal humerus fracture, wrist drop, thumb and finger extension impaired. Nerve injured?

Proximal Radial Nerve

What bacterial organism is most likely implicated in bacterial infection secondary to platelet transfusion?

Staphylococcus Epidermidis

Which HLA Alleles increase the susceptibility to Rheumatoid Arthritis?

DRB1. (04:01) (04:04) (

What occurs during Metaphase?

Cell division powered by microtubule polymerisation

What occurs during Anaphase?

Stage of mitosis after metapahse Replicated chromosomes are split and daughter chromatids move to opposite poles of the cell

What occurs during early prophase?

Condensation of chromosomes and the mitotic spindle starts to form Nucleolus disappears

What occurs during prometaphase?

Chromosomes finish condensing Nuclear envelope breaks down Mitotic spindle grows further Microtubules 'capture' chromosomes

What occurs during Telophase?

Mitotic spindle breaks down Formation of two new nuclei De-condensation of chromosomes

Where is the most pronounced effect of parathyroid hormone (PTH) on phosphate reabsorption?

Proximal Tubule

Where does the passive reabsorption of calcium and magnesium occur?

Ascending loop of henle

where does the reabsorption of water occur with the expression of aquaporin 2?

Collecting Duct

Lactose is a disaccharide which contains?

Galactose and Glucose

Maltose is a disaccharide, composed of?

Two glucose molecules linked by an α-1,4 glycosidic bond.

Glucose and fructose combine to form?

Sucrose

Is Fructose a monosaccharide or a disaccharide?

Monosachharide

After biochemical tests which show a patient has recurrent renal stones with composition of calcium over 50% and hypercalciuria? What are the two licenced and recommended treatments for prevention of further stone formation?

1) Potassium Citrate 2) Thiazide diuretic (Hand restrict sodium intake to no more than 6Grams a day

Mode of inheritance for Osler-Weber-Rendu syndrome? (Recurrent epistaxis, telangectases,)

Autosomal dominant

Physiological changes during Valsalva Manoeuvre?

-Increased intrathoracic pressure shifts blood from pulmonary circulation to left atrium -reduced systemic return to right side of the heart -JVP increases initially -Cardiac output drops

What immunoglobulin is responsible for hyperacute rejection?

IgG (Hyperacute rejections occur due to pre-circulating IgG immunoglobulin)

Patient is treated with combination chemotherapy for testicular cancer. What is the dominant cellular process which explains why it was successful? (remission)

Apoptosis

When is the Chi Squared test used?

Expected vs observed results

What 3 structures are the right kidney in direct contact with?

1) Suprarenal gland 2) Duodenum 3) Colon

What 3 structures are the left kidney in direct contact with?

1) Left suprarenal gland 2) Pancreas 3) Colon

5 Layers of Epidermis from deepest to superficial including function? Striatum: Deepest to superficial G, S, G, L, C

1) Germinativum (Basale) - Basement membrane single layer of columnar epithelial cells. Gives rise to Kerantinocyes. Contains Melanocytes. 2) Spinosum - Squamous cells begin to keratin synthesis. Thickest layer of epidermis. 3) Granulosum - Cells form links with neighbours 4) Lucidum - Clear layer, present in thick skin only 5) Corneum - Flat, dead, scale like skin filled with Keratin

Way to remember layers of epidermis: Superficial to deep Come Lets Get Sun Burned

Corneum Lucidum Granulosum Spinosum Basale (Germinativum)

Clinical Sciences Flashcards

(76 cards)