Formatives Flashcards by sandra popescu

What does the “19” in “COVID-19” refer to?
* There are 19 variants of the coronavirus

There are 19 symptoms of coronavirus disease
This is the 19th coronavirus pandemic
The coronavirus and the disease it causes were identified in 2019.

The coronavirus and the disease it causes were identified in 2019.

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Which of the following is not a component of innate immune mechanisms?

Mucosa
Inflammatory mechanisms
Antibody production
Skin
Antimicrobial peptides

Antibody production

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Which of the following are administered as a live attenuated vaccine in the UK
Hepatitis A

Tetanus

MMR

Flu

BCG (TB)

BCG (TB)
MMR

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Polysaccharide vaccines are composed of long chains of sugar molecules that make up the surface capsule of certain bacteria. These vaccines are available for the treatment of which of the following diseases?
Pneumococcal disease

Influenza type b

Rabies

Salmonella Typhi

Meningococcal disease

Pneumococcal disease

Salmonella Typhi

Meningococcal disease

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Antigen presenting cells process and present antigens for recognition by

Neutrophils

Red blood cells

Eosinophils

T cells

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Pattern recognition receptors include
LPS

PAMPs

Lipoteichoic acid

Chemoattraction of leukocytes

Phagocytosis

Chemoattraction of leukocytes

Phagocytosis

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Which antigen presenting cell is considered a professional at activating lymphocytes?

Neutrophils

Mast cells

Macrophages

Dendritic cells

Monocyte

Dendritic cells

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Which of the following are classical PAMPs?
Flagellin, a protein found in bacterial flagella

Lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria

Peptidoglycan, found in bacterial cell walls

Lipoarabinomannan of mycobacteria

Interleukin 12

Flagellin, a protein found in bacterial flagella

Lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria

Peptidoglycan, found in bacterial cell walls

Lipoarabinomannan of mycobacteria

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What are the two types of immune response in humans?

Innate and acquired

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Which of the following are features of the adaptive immune response?
Does not require prior contact with the pathogen

It works with B and T lymphocytes

Lacks specificity

Lectin type molecules

Unmethylated CpG sequences

It works with B and T lymphocytes

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Influenza vaccine is targeted towards ‘at risk’ groups in the UK. Which of the following are classified as ‘at risk’?
Asthmatics

16 years old

Diabetics

The obese of any age

6 months of age and over

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What cell type is described below?

These are the most abundant white blood cell in humans and are characterised by the multi-lobed shape of their nucleus.

Neutrophil

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A 69 year old man has been taking naproxen for back pain due to osteoarthritis for a number of weeks. He has no other past medical history and takes no other drugs. He is a smoker and drinks 14 units of alcohol a week. He has developed severe epigastric pain after eating on a number of occasions.

Which is the most likely cause of his symptoms?

a.	 Hypersensitivity to the drug

b.	 Increased gastric mucosal blood flow

c.	 Increased prostaglandin synthesis

d.	 Reduced gastric acid secretion

e.	 Reduction in mucus and bicarbonate secretion

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A 24 year old man has suffered from asthma since he was a young child. He takes a salbutamol inhaler as needed and a steroid inhaler as prophylaxis.

Which of these explains the improvement in symptoms he gets from his salbutamol inhaler?

a.	 Inactivation of K+ channels in smooth muscle cells

b.	 Increase in calcium entry into muscle cells

c.	 Increased mediators released from mast cells

d.	 Increased mediators released from mast cells

e.	 Relaxation of bronchial smooth muscle cells

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A 68 year old man with hesitancy and slow urinary flow is prescribed a selective alpha 1 adrenoceptor antagonist (tamsulosin). Since taking the drug he has noticed he feels dizzy and unwell when he gets out of bed in the morning.

Which is the most likely the cause of his symptoms?

a.	 Constriction of arteriolar resistance vessels

b.	 Dilatation of venous capacitance vessels

c.	 Inhibition of noradrenaline release

d.	 Reflex bradycardia due to parasympathetic activation

e.	 Reflex tachycardia due to sympathetic activation

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A 69 year old woman is taking warfarin for atrial fibrillation. She is otherwise fit and well. She attends the Emergency Department with a severe epistaxis and her INR is found to be 6.5 (target value 2.5).

Which medication will help to stop this patient’s epistaxis?

a.	 Vitamin A

b.	 Vitamin C

c.	 Vitamin D

d.	 Vitamin E

e.	 Vitamin K

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A patient is started on a commonly used medication. Unfortunately, they develop an adverse drug reaction you have not seen before. The patient is hospitalised due to the adverse drug reaction (ADR).

Which is the correct course of action once the drug has been stopped and the patient informed?

a.	 Contact the local pharmacist to inform them of the ADR

b.	 Contact the local pharmacist to inform them of the ADR

c.	 Report the ADR via the yellow card system

d.	 Send out a bulletin to all local GP’s to inform them of the ADR

e.	 Stop prescribing the drug for all patients

A 23 year old woman receives flucloxacillin for a superficial skin infection. A few hours after the first dose she develops a rash, flushing, wheezing and then collapses.

Which should be administered to this patient first?

a.	 Adrenaline

b.	 Chlorpheniramine

c.	 Hydrocortisone

d.	 Intravenous fluids

e.	 Salbutamol

An elderly patient was admitted with breathlessness and palpitations. An ECG showed fast atrial fibrillation. She was prescribed IV digoxin 1 mg given over two hours as she was nauseated but her cannula has stopped working before it could be given. She has refused another cannula. The nurse has asked you to prescribe an oral dose regime for the next 24 hours. Digoxin 0.25 mg tablets are available.

Digoxin is a cardiac glycoside used to control fast atrial fibrillation when given in the range 0.75-1.25 mg in 24 hours in divided doses. It has a bioavailabilty of 75% orally.

Which is the correct oral dose regime of the drug?

a.	 0.5 mg in the morning & 0.25 mg in the evening

b.	 0.75 mg in the morning & 0.5 mg in the evening

c.	 0.75 mg once daily

d.	 1 mg in the morning & 1 mg in the evening

e.	 1.25 mg once daily

Where does gas exchange begin?

Respiratory bronchioles

What breaks a breath hold

Raised CO2 in cerebrospinal flfluid

A pneumothorax is:

an accumulation of air in the pleural
cavity

The severity of stable COPD is assessed by:

FEV1 (% predicted)

Acute asthma severity is initially assessed by

Clinical examination

Which statement is true about Beta2 agonists?

Inhaled β2-agonists become more selective at escalating doses Repeated exposure to inhaled β-agonists up-regulates β receptors allowing decreased doses over time Long acting β-agonists are never used for acute symptoms Short acting β2-agonists are effective in controlling night-time symptoms **Intravenous β2-agonists may be used for asthma in critically ill patients**

Haemoptysis is least likely to be due to Pneumonia COPD Bronchiectasis Lung cancer Pulmonary embolism

Which is true In pulmonary embolism, Shock is heralded by pleuritic chest pain and haemoptysis DVT is usually clinically evident Prophylactic anticoagulation is overused Idiopathic PEs require at least 6 months of treatment. Treatment with NOACs is better than heparin in cancer.

Idiopathic PEs require at least 6 months of treatment

Impaired mucociliary clearance is a defifining feature of:

Primary Ciliary Dyskinesia

A 60 year old man has had a cough, producing sputum, for 10 years. A recent sputum culture has grown Pseudomonas aeruginosa. The likely diagnosis is:

Bronchiectasis

8 million people in the UK have an occupational illness 10 votes Most occupational disease is respiratory 20 votes An occupational history is not worth the time it takes to ask 0 votes A diagnosis of occupational lung disease always solves employment problems 0 votes  At least 10% of asthma cases are thought to be occupational

At least 10% of asthma cases are thought to be occupational

Epidemic flu… Only affects humans Is caused by antigenic drift Is defined by 2 or more linked cases Is prevented by Tamiflflu Is always prevented by immunisation

Is caused by antigenic drift

Which of these is NOT a paraneoplastic phenomenon associated with lung cancer? Syndrome of inappropriate ADH secretion Horner’s syndrome Cushing’s syndrome Hyperparathyroidism Lambert-Eaton myasthenic syndrome

Horner syndrome

Which of the following is true about mesothelioma? Radical surgery is usually curative This cancer responds well to chemotherapy Around 25% of cases do not involve the pleura If there is no history of asbestos exposure, the coroner need not be informed After death, the body must be cremated to prevent further asbestos exposure

Around 25% of cases do not involve the pleura

Which blood gas result demonstrates Type 1 respiratory failure: Normal ranges pO2 10.5-13.5 pCO2 4.7-6.0 pH 7.35-7.45 HCO3 22-26