Formative/Practice Questions Flashcards
(119 cards)
1
Q
The right atrium possesses
A
an opening for the coronary sinus
2
Q
The tricuspid valve is located between
A
right atrium and right ventricle
3
Q
The azygous vein empties into the
A
SVC
4
Q
The internal jugular vein and subclavian veins form from the
A
brachiocephalic vein
5
Q
The brachiocephalic vein becomes the
A
SVC
6
Q
Fossa ovalis is a depression in the
A
right atrium
7
Q
Fossa ovalis is a remnant of
A
thing fibrous sheet that covered the foramen ovals during foetal development
8
Q
Gap junctions are found in
A
cardiac muscle
9
Q
Action potential is short in _____ and long in ______
A
skeletal
cardiac
10
Q
Skeletal muscle can exhibit
A
tetanus
cardiac refractory period is too long so it cant
11
Q
Skeletal muscle RMP is
A
very stable
depolarises in response to activation by motorneurone
12
Q
Cardiac muscle RMP is
A
very unstable
randomly depolarise
are pacemakers
13
Q
In development, which pair of arches give rise to the common carotid arteries/arch?
A
3rd pair of aortic arches
14
Q
The 1st and 2nd pair of aortic arches =
A
disappear early
1st one forms arch of maxillary aa.
15
Q
4th left aortic arch =
A
arch of aorta
16
Q
4th right aortic arch =
A
right subclavian
17
Q
5th aortic arch =
A
disappears on both sides
18
Q
6th aortic arches form the
A
pulmonary arteries
19
Q
Arterioles function as resistance vessels because
A
they have a narrow lumen and strong muscular wall
20
Q
In the heart, the fast depolarising phase of the cardiac action potential is caused by
A
influx of Na+
21
Q
the P wave shows
A
the depolarisation of atria
22
Q
the QRS complex shows
A
ventricular depolarisation
23
Q
the T wave shows
A
ventricular repolarisation
24
Q
atrial repolarisation signal is swamped by
A
QRS complex
25
The second heart sound is when
semilunar valves close
26
The first heart sound is when
atrio-ventricular valves close
27
A HR in excess pf 150bpm is likely to
decrease preload
| decrease SV
28
Activation of B1-adrenoreceptors on cardiac myocytes will
increase contractility
| increase SV
29
Most significant features of pulmonary circulation =
pulmonary arterioles constrict in response to local hypoxia
30
During exercise, venous pressure (+ venous return to heart) may be increased by
increase in systemic filling pressure
contraction of smooth muscle around veins
increased rate and depth of respiration
rhythmic contraction of skeletal muscle
31
intermittent rapid regular palpitations terminated by the valsalva manoeuvre is most likely to be
supraventricular tachycardia
32
the valsalva manoeuvre increases
vagal (parasymp) tone
33
```
sudden severe breathlessness
PND
tachycardia
elevated JVP
lung crackles
peripheral oedema
SIGNS OF .......
TREATMENT =
```
heart failure
| IV diuretic
34
exertional angina treated with
beta blockers
35
beta blockers
reduced workload of heart
reduce O2 requirements
less pain
36
most useful investigation for severe 'white coat' hypertension
24 hour ambulatory blood pressure recording
37
in the first trimester of pregnancy, what can be used to treat a DVT?
low molecular weight heparin
38
warfarin is teratogenic in which trimester?
1st
39
coarctation of aorta
short stature
neck webbing
gondal dysgenesis
= ????
Turner Syndrome
40
Downs syndrome causes
atrioventricular septal defects
hypotonic baby
reduced tone
41
Noonan syndrome causes
pulmonary stenosis
| septal defects
42
Shprintzen syndrome is associated with
teratology of Fallot
43
Williams syndrome cause
supravalvular aortic stenosis
44
calf pain on exertion =
intermittent claudication
45
22q11 micro deletion leads to
DiGeorge syndrome
| associated with teratology of Fallot
46
FAS mainly associated with
neurological, craniofacial defects
| some atrial/ventricular septal defects
47
ulcer on leg
sleep interrupted by severe lower limb pain
MOST LIKELY TO BE ???
critical limb ischaemia
48
Marfan syndrome signs
```
tall
joint mobility
pneumothorax
myopic
stretch marks
systolic murmur
```
49
a chest x-ray in marfan's would show
apical blebs
50
an ECG in marfan's is to assess
aortic root diameter at sinus of valsalva
| clarify reason for murmur
51
pelvic x-ray in marinas would show
protrusio acetabulae
52
MRI scan of lumbar spine in marina's would show
dural ectasia
53
Family history needed in Marfan's patient
```
fathers details
cause of death in father's brother
did uncle have features?
paternal grandparents
signs of marina's in them all
```
54
signs of systolic murmur
dyspnoea (worsening)
55
causes of systolic murmur
aortic sclerosis
aortic stenosis
mitral regurgitation
56
mitral regurgitation clinical signs
loudest at apex
radiates to axilla
pan systolic murmur
maximal on expiration
57
aortic stenosis clinical signs
rising upstroke in pulse waveform
low output pulse
murmur radiating to carotid
58
aortic sclerosis clinical signs
does not radiate to carotids
59
investigations for systolic murmur
FBC
ECG
CXR
biochemical screen + thyroid function
60
severe aortic stenosis is fixed with
surgical aortic valve replacement
61
Vital capacity =
maximum volume of air that can be exhaled following a maximum inspiration
62
Expiratory reserve volume =
volume of air that can be voluntarily forcibly exhaled after normal expiration
63
Function residual capacity =
volume left in lungs after normal respiration
| ERV + RV
64
Residual volume =
volume of air in lungs that cannot be voluntarily expired
65
Tidal volume =
volume of air breathed in or out at rest
66
Air flows into the lungs during respiration because
external intercostals and diaphragm contract
| thoracic volume increases
67
Alveolar ventilation =
(TV - DS) x RR
68
the partial pressure of oxygen in mixed venous blood is usually
40mmHg (5.3 kPa)
69
Arterial blood pressure of oxygen will be reduced in
pulmonary oedema
70
What do the following conditions have in common?
```
anaemia (iron deficiency)
anemia (vitamin B12 deficiency)
blood loss (child birth)
CO poisoning
```
decrease in total oxygen content due to lack of O2 binding to Hb or loss of Hb
O2 in solution in plasma unaffected
71
In chronic lung disease, arterial PCO2 levels are
elevated due to poor alveolar ventilation
72
In chronic lung disease, is NO safe to use? Why?
No
| Blunts peripheral chemoreceptor response to falling O2 levels, hypoxic drive, no control over ventilation
73
In chronic lung disease, patients are on _______ because _______
hypoxic drive
chronic elevation of PCO2 blunts central response to CO2
74
In chronic lung disease patients have
decreased sensitivity to PCO2
| rely on peripheral chemoreceptors for ventilation
75
Shunt describes when
perfusion exceeds ventilation in L/min
76
Hypothermia causes the haem-ox curve to shift ________ causing ________
to the left
| difficulty to offload oxygen to peripheral tissues
77
Hypothermia is a decrease in
body temperature
78
Presence of foetal haemoglobin shifts to haem-ox curve
left
| higher affinity for oxygen than adult haemoglobin
79
Respiratory alkalosis shifts the haem-ox curve left because
decrease in [H+] pulls CO2 equilibrium to right, reducing PCO2
80
Running a marathon shifts the haem-ox curve right because
increase in body temp, CO2, lactic acid
oxygen extraction in peripheral tissues easier, increases oxygen delivery
81
Voluntary hyperventilation causes the haem-ox curve to go left because
decreases PCO2
82
At the costovertebral joints, the head of the 9th rib joins with the body of which vertebra(e)?
T8 and T9
| same number and one above it
83
The cardiac notch is located
anterior border of left lung
84
All lung fissures contain
visceral pleura
85
The right lung has 2 fissures called
oblique
| transverse
86
The left lung has a ______ fissure
oblique
87
The right lung contains what extra structure? Why?
eparterial bronchus in its hilum
| it has three lobes
88
The lobes in the left lung are separated by
the oblique fissure
89
To investigate a patient with squamous carcinoma, abdominal pain, constipation and confusion, you should carry out a
serum calcium test
90
Squamous cell lung cancer is associated with
hypercalcaemia due to parathyroid hormone related protein
91
In a patient with a peripheral speculated opacity and an enlarged lymph node (supraclavicular) you should investigate with:
fine needle aspiration of the lymph node
to get sample of cancer type
easy access
92
If a patient has daytime somnolence but can sleep for 9 hours a night on holiday, this shows
poor sleep hygiene
93
The most likely organism infecting CF lungs is
pseudomonas aeruginosa
94
The most likely cause of lobar pneumonia is
streptococcus pneumoniae
95
normal blood Ph values =
7.37 - 7.43
96
normal PaO2 values are
11 - 15 kPa
97
normal PaCO2 values are
4.6 - 6.4 kPa
98
low pH, low PaO2, high PaCO2 is most likely
a severe exacerbation of asthma (too tired to do a peak flow)
99
A patient with new asthma who is waking up at night because of it should be treated with
inhaled CCS and beta-2-agonist
100
A healthy person with sudden severe chest pain, SOB is most likely a
primary pneumothorax
101
A patient recovering rom severe pneumonia develops rigors, poor appetite and SOB on exertion. What is wrong now?
Empyema thoracis
102
What is empyema thoracis?
thick-walled lung abscess = pus in pleural space
103
Typical cause of empyema thoracic is
consolidation of pneumonia
104
What do the following values show?
```
PaO2 = 7.8 kPa
PaCO2 = 8.6kPa
```
Type II Resp failure
105
What treatment should be used in Type II rest failure?
Nebulised beta-2-agonist
106
Coughing up blood is also called
haemoptysis
107
haemoptysis is most likely to show signs of
lung cancer
108
what are the clinical signs of lung cancer in hands?
finger clubbing
109
what are the clinical signs of lung cancer felt in the abdomen?
hepatomegaly
110
signs of lung cancer found in the neck =
lymphadenopathy
SVC obstruction
tracheal deviation
111
imaging techniques used to view the extent of a lesion are
chest radiograph
CT
MRI
112
other than imagine, how else can lung cancer be investigated?
biopsy
| bronchoscopy
113
4 main types of lung cancer
```
small cell
non-small cell:
- squamous
- adenocarcinoma
- large cell
```
114
where else does lung cancer commonly spread?
```
lymph nodes
adrenal gland
lung
liver
brain
bone
```
115
List signs of left lower lobe pneumonia
```
tachypnoea
tachycardia
fever
cyanosis
reduced expansion of left chest
dullness at left base
bronchial breathing at left base
crackles
increased vocal resonance
```
116
In a healthy person, what can cause pneumonia?
```
chlamydia psittaci
streptococcus pneumoniae
mycoplasma pnemoniae
staph. aureus
haemophilus influenza
```
117
Investigations for pneumonia =
```
CXR
sputum/blood culture
acute + convalescent serology
mycoplasma IgM
atypical serology
FBC
ESR/CRP
legionella/pneumococcal urinary antigen
```
118
What two classes of drugs can be used to treat pneumonia?
beta-lactams
| macrolides
119
```
A patient has these measurements:
temp 38
RR 20bpm
BP 98/60mmHg
HR 120bpm
oxygen sats 90%
```
How do you manage them in hospital?
supplemental oxygen
analgesia
intravenous fluids
anti-pyretics
