Formatives Flashcards
1
Q
What is the name of the main effector cell in acute inflammation?
A
Neutrophil polymorphs
2
Q
Name of collagen producing cells in fibrous scarring?
A
Fibroblasts
3
Q
Name an example of acute inflammation?
A
Apendicitis
4
Q
What crystals are deposited in gout joints?
A
Uric acid crystals
5
Q
Name a condition in which granulomatous inflammation occur?
A
Chron’s
6
Q
Specific name of calcification in diseased (as opposed to normal) tissue?
A
Distrophic calcification
7
Q
Which illness starts as chronic inflammation?
A
Infectious Mononucleosis
8
Q
Which cells produce antibodies?
A
Plasma Cells
9
Q
Which tumour doesn’t metastasise?
A
Basal cell carcinoma
10
Q
What term describes a cancer not invaded through the basement membrane?
A
Carcinoma in situ
11
Q
What is the name of a malignant tumour of striated muscle?
A
Rhabdomyocarcinoma
12
Q
Which five tumours often metastasise to bone?
A
Breast, Prostate, Kidney, Thyroid, Lung
Let’s talk blood pressure, kids!
13
Q
What is the name of a glandular epithelium?
A
Adenoma
14
Q
Which tumour has no screening programme?
a. Breast Cancer
b. Colorectal cancer
c. Cervical cancer
d. Lung cancer
A
Lung cancer
15
Q
What isn’t a carcinogen in humans?
a. Ionising radiation
b. Asperigillus niger (black mould)
c. Etc
A
Asperigillus niger
16
Q
What is the name of a benign tumour of fat?
A
Lipoma
17
Q
What is the name of a benign tumour of glandular epithelium?
A
Adinoma
18
Q
Malignant tumours don’t:
a. Metastasise
b. Grow
c. Grow in relation to overall body growth
A
c. Grow in relation to overall body growth
19
Q
Is transitional cell carcinoma of bladder malignant or benign?
A
Malignant
20
Q
What is the name of a benign tumour of smooth muscle?
A
Leimyoma
21
Q
Radon gas can cause lung cancer?
a. True
b. False
A
True
22
Q
Is asbestos a carcinogen?
a. Yes
b. No
A
Yes
23
Q
What is the largest risk factor for tumour growth?
A
Smoking
24
Q
What is a cancer with very low median survival rate (~ 2 months)?
A
Anaplastic carcinoma of the thyroid
25
Where can ovarian cancer spread in?
Peritoneum
26
What is the name of a malignant tumour of glandular epithelium?
Adenocarcinoma
27
Activation of naive T cells is best achieved by which antigen presenting cells?
a) Neutrophils
b) Mast Cells
c) Macrophages
d) Dendritic cells
D) Dendritic cells
28
```
What cell type is described below?
"Located exclusively in tissues, has an important role in both the innate and adaptive immune system, are antigen presenting cells and have phagocytic properties"
a) Macrophage
b) Neutrophil
c) Eosinophil
d) Mast cell
e) Fibroblast
```
a) Macrophage
29
Which of the following is not involved in innate immune mechanisms?
a) Anatomic barriers
b) Phagocytic
c) Inflammatory mechanisms
d) Antibody production
e) Skin
d) Antibody production
30
T cells recognise antigen
a) In solution in plasma
b) When presented on RBCs
c) Following presentation on antigen presenting cells
d) In a 3D form
e) Following presentation on pattern recognition receptors
c) Following presentation on antigen presenting cells
31
Influenza vaccine is targeted towards 'at risk' groups in the UK. Which of the following are classified as 'at risk'?
a) Over 65s
b) 16 year old
c) The obese of any age
d) Teenagers
e) Under 2 years old
A) Over 65s and e) Under 2 years old
32
Which of the following is administered as a live attenuated vaccine in the UK?
a) Hep A
b) MMR
c) Tetanus
d) Flu
e) Polio
b) MMR
33
Complements are the proteins that are involved in the clearance of antigen/bacteria. Which of the following is not part of the Elimination phase of complement activation?
a) Opsonisation
b) Target Cell Lysis
c) Chemoattraction of leukocytes
d) Production of interferons
e) Phagocytosis
d) Production of interferons
34
Which of the following is a polysaccharide vaccine?
a) Anthrax
b) HIB (Haemophilius infuenza type b)
c) Rabies
d) Hep A
b) HIB (Haemophilius infuenza type b)
35
Which of the following are features of the adaptive immune response?
a) Does not require prior contact with the pathogen
b) It works with B and T lymphocytes
c) Lacks specificity
d) Distinguishes "self" from "non-self"
e) Enhanced by complement
b) It works with B and T lymphocytes
36
What are the two types of immune response in humans?
a) Immunological tolerance
b) Immune surveillance
c) Innate and Acquired
d) Intrinsic and Extrinsic
e) Overt and Covert
c) Innate and Acquired
37
Which of the following is NOT an organ-specific auto-immune disease?
a) Ulcerative colitis
b) Type 1 diabetes mellitus
c) Graves disease
d) Hashimoto's thyroiditis
e) Sjogren's syndrome
a) Ulcerative colitis
38
Which of the following is not a classical PAMP?
a) peptidoglycan, found in bacterial cell walls;
b) flagellin, a protein found in bacterial flagella;
c) lipopolysaccharide (LPS) from the outer membrane of gram-negative bacteria;
d) Interleukin 12
e) nucleic acids such as viral DNA or RNA.
d) Interleukin 12
39
There is bacteria with chains, purple cocci, alpha haemolysis in blood agar and is optochin sensitive.
what is it?
Streptococcus pneumoniae
40
There is a gram negative bacillus which is lactose fermenting. What is it?
Escherichia Coli
41
Which is a normally sterile site?
a) The pharynx
b) The urethre
c) Cerebrospinal fluid
d) The lung
e) Skin
C) Cerebrospinal fluid
42
Which of these is NOT a means by which viruses cause disease?
a) direct destruction of host cells
b) cell proliferation and cell immortalisation
c) inducing immune system mediated damage
d) endotoxin production
e) modification of host cell structure/function
d) Endotoxin production
43
When diagnosing viral infections which is not true?
a) The sample must come from a sterile site.
b) Electron microscopy is rarely used
c) Use a green swap not a black swab
d) PCR results take 1-2 days
e) A detectable IgM in serum may be diagnostic
a) The sample must be from a sterile site
44
Which pair is correct?
a) Pityriasis versicolor = bacterium
b) Ringworm = helminth
c) Aspergillus fumigatus = mycobacterium
d) Falciparum malariae = fungal
e) Giardia lamblia = protozoal
e) Giardia lamblia = protozoal
45
Mycobacteria. Which is not a feature?
a) Resistance to destaining by acid and alcohol
b) Cell wall contains lipoarabinomannan
c) They only divide ever 20hours
d) They cannot withstand phagolysomal killing
e) May cause meningitis
d) They cannot withstand phagolysomal killing
46
Regarding antimicrobial resistance, which is true?
a) It is spread by plasmid mediated gene transfer
b) spontaneous gene mutations do not occur
c) MRSA refers to vancomycin resistant S. aureus
d) Only Mereopenem is effective against all gram negative bacteria
a) It is spread by plasmid mediated gene transfer
47
Antimicrobials. Which pairing is incorrect?
a) S pyogenes: can use penicillin
b) Meropenem: a carbapenem
c) Glycopeptides: use for MRSA
d) Co-amoxiclav: contains a beta-lactamase inhibitor
e) Cefuroxime: a macrolide
e) Cefuroxime: a macrolide
48
A 21yo complains of myalgia, sore throat and tiredness. He is febrile and has an enlarged spleen. Which is the best answer?
a) He has sepsis and needs broad spectrum antimicrobial therapy with cefotaxime
b) A charcoal throat swab will confirm the diagnosis
c) Finding atypical lymphocytes on a blood film and a positive EBV IgM in serum would be consistent
d) PCR on a viral throat swap will confirm the diagnosis
e) This is a viral upper respiratory tract infection and doesn't warrant investigation or antimicrobial therapy
c) Finding atypical lymphocytes on a blood film and a positive EBV IgM in serum would be consistent
49
Which of these does NOT feature in the definition of sepsis?
a) Temperature >38.3 or <36
b) Heart rate >90
c) Systolic BP >130
d) White cell count >12
e) Hypoxia
c) Systolic BP >130
50
Infection control: which is false? The five steps of hand hygiene are to was hands.
a) Before contact with patient
b) Before bodily fluid exposure
c) Before aseptic techniques
d) After contact with patient surroundings
e) After patient contact
b) Before bodily fluid exposure
51
What is the risk of mother to child transmission of HIV?
a) 1%
b) 8.6%
c) 21%
d) 35%
e) 60%
d) 35%
52
What age group is most affected by HIV worldwide?
a) 0-14
b) 15-24
c) 25-34
d) 35-44
e) >44
15-24
53
What is the characteristic genetic abnormality in Chronic Myeloid Leukaemia?
a) t(15;17) ATRA gene
b) t(9;22) Philadelphia chromosome
c) t(8;21) AML/ETO gene
d) t(8;14) cMYC oncogene
t(9;22) Philadelphia chromosome
54
What age is common for chronic myeloid leukaemia?
Usually 40-60yrs age
55
Features of chronic myeloid leukaemia?
- Slow onset
| - Sometimes incidently
56
Features of chronic myeloid leukaemia?
- High WCC
- Splenomegaly
- Metabolic features
57
Investigation results features for chronic myeloid leukaemia?
FBC - High WCC
| Film - Left shift + basophilia
58
What is the key diagnostic features of chronic myeloid leukaemia?
Philadelphia chromosome, t(9;22). Results in Resulting in 210-kDa fusion protein –activated tyrosine kinase.
59
What mutation may result in chronic myeloid leukaemia?
Blocks abnormal tyrosine kinase activity
Can result in molecular remission
BCR-ABL mutations may result in resistance
60
What class of drug best describes Rituximab?
a) Cytotoxic chemotherapy
b) Disease-modifying therapy
c) Monoclonal antibody
d) Antibiotic
Monoclonal antibody
- Targets CD20 expressed on cell surface of B-cells
- Chimeric mouse/human protein
- Infusional side-effects
- Widely used
61
Which age group is characteristically affected by Hodgkin lymphoma?
- Children
- Teenagers and young adults
- Middle aged (40-60 yrs)
- Older aged (>60yrs)
-Teenagers and young adults and older aged
62
How is myeloma bone disease usually assessed?
- Plain X-ray
- Clinical assessment
- Isotope bone scan
- PET scan
-Plain X-ray
Skeletal survey
Production of Osteoclast-activating factors
OAFs include RANKL, IL-3 and TNF-α
63
What is the correct mechanism of action for the anti-emetic drug Ondansetron?
- Peripheral D2 antagonist
- Central D2 antagonist
- Anti-cholinergic
- 5HT3 antagonist
-5HT3 antagonist
64
What is the commonest cause of microcytic anaemia?
- B12 deficiency
- Iron deficiency
- Haematologic malignancy
- Hereditary spherocytosis
-Iron deficiency
65
What are the three main causes of microcytic anaemia?
Iron deficiency
Chronic disease
Thalassaemia
Rarely: Congenital sidertoblastic anaemia, lead poisining
66
What are the three main causes of normocytic anaemia?
- Acute blood loss
- Anaemia of chronic disease
- Combined haematinic deficiency
67
What are the three main causes of macrocytic anaemia?
- B12/folate deficiency
- Alcohol excess/liver disease
- Hypothyroid
HAEMATOLOGICAL: Antimetabolite therapy, Haemolysis, Bone marrow failure, Bone marrow infiltration
68
In sickle cell anaemia what would you expect to see the reticulocyte count?
- Absent
- Low
- Normal
- Raised
-Raised
- Chronic Haemolytic anaemia
- Reticulocyte response
- Film appearances
- Effect on MCV
- Marrow function
69
Bacterial infection usually causes:
- Low lymphocytes
- Low neutrophils
- High lymphocytes
- High neutrophils
-High neutrophils
70
Which best outlines the approach to the management of a patient with suspected febrile neutropaenia?
- Encourage fluids and paracetamol
- Perform cultures and wait for results before starting antibiotics
- Perform cultures and start oral antibiotics
- Perform cultures and start broad spectrum iv antibiotics
-Perform cultures and start broad spectrum iv antibiotics
-Haematologic emergency
-ABC
-Perform cultures
-Broad spectrum iv Abs with 1 hour
E.g. Tazosin and Gentamicin
71
Malignant spinal cord compression usually presents with?
- Back pain, ataxia and sensory neuropathy
- Back pain, spastic paresis and a sensory level
- Perianal numbness and urinary incontinence
- Weak legs impaired joint position sense
-Back pain, spastic paresis and a sensory level
- Emergency
- Urgent MRI
- Bed rest + pressure area care
- Steroids
- Analgesia
- Chemo or Radiotherapy
72
How does Aspirin exert its antiplatelet effect?
- ADP receptor antagonist
- Inhibition of Cyclooxygenase enzyme
- Inhibition of Glycoprotein IIb-IIIa
- Inhibition of PAR4 receptor
-Inhibition of Cyclooxygenase enzyme
73
What proportion of women over 50 have a fracture due to osteoporosis?
50%
74
What is a T-Score?
Standard deviations from gender matched young adult mean.
75
Name two properties of bone other than bone mineral density which contribute to bone strength?
Size, geometry, microarchitecture, turnover, mineralisation.
76
What are the most commonly used drug in osteoporosis?
Bisphosphonates.
77
Which of the following clinical features is typical of osteoarthritis?
a) 60 mins of early morning stiffness
b) Painful, swelling across the metacarpophalangeal joints and proximal interphalangeal joints
c) Pain in the 1st carpo-metacarpal joints
d) Mobile, subcutaneous nodules at points of pressure
e) Alternating buttock pain
c) Pain in the 1st carpo-metacarpal joints
78
Which of the following is an extra-articular manifestation of rheumatoid arthritis?
a) Subcut nodules
b) Episcleritis
c) peripheral sensory neuropathy
d) Pericardial effusion
e) All of the above
e) All of the above
79
Which of the following is a classical feature of rheumatoid arthritis on xray?
a) Peri-articular sclerosis
b) Sub-chondral cysts
c) Osteophytes
d) Peri-articular erosions
e) New bone formation
d) Peri-articular erosions
80
53yo, lower back pain, builder, BMI 29, no neurological deficits/spinal deformity, not easily localised.
a) Given age, referred
b) X-ray
b) No sick note, return to work
d) Reassurance & advice, simple analgesics
e) Seek other employment
d) Reassurance & advice, simple analgesics
81
For a lytic tumour to be visible on X-ray, it mist have lost:
a) Greater than 6% bone density
b) Greater than 16% bone density
c) Greater than 60% bone density
d) Greater than 90% bone density
e) 100%
c) Greater than 60% bone density
82
57yo, 3 day history painful 1st MTP joint, red, very warm. BMI 32 & hypertension.. What dietary changes will reduce risk of similar episodes?
a) High red meat
b) High dairy products
c) Drinking >5 cans of non-diet fizzy drinks/day
d) Rich in sugary foodstuff
e) Switch from beer to lager
b) High dairy products
83
Which is not an autoimmune connective tissue disease?
a) Systemic lupus erythematosus
b) Ehler Danlos syndrome
c) Primary sjogren's syndrome
d) Systemic sclerosis
e) Dermatomyositis
b) Ehler Danlos syndrome
84
23yo woman, mouth ulcers, fever, painful white fingers & pleuritic chest pain. Antinuclear antibody ANA+, ESR 52 (0-15), WBC low. What would not be expected with her illness?
a) Deforming arthritis
b) Photosensitive rash
c) Seizures
d) Pulmonary embolism
e) Thrombocytosis
e) Thrombocytosis
85
Which of the following is used in the treatment of SLE?
a) Anti-TNF
b) Anti malarials
c) Ustekinuab (IL12/23 blocker)
d) Sulfasalzine
e) Allopurinol
b) Anti malarials
