Integrative

Question 1

normal range ph

Answer 1

7.35 - 7.45

Question 2

how anion gap calculated

Answer 2

NaK - ClHCO3

Question 3

causes of metabolic acidosis with normal anion gap

Answer 3

diarrhoea, renal tubular necrosis

Question 4

how t1dm lead to shock

Answer 4

DKA causing dehydration

Question 5

what is patient safty incident, near miss, serious untoward incident, never event

Answer 5

PSI - unintended event leading to pt harm
near miss - potential for harm
serious untoward incident - incident which may have legal or media reprecussions
never event - serious and largely preventable

Question 6

how report clinical incident

Answer 6

datix reporting, inform key line managers

Question 7

where haemotpoeisis in fetus

Answer 7

0-2 mths - yolk sac
3-5 mths - liver and spleen
6+ - BM

Question 8

what is red an dyellow BM

Answer 8

red - haematopoeitic

yellow - fatty

Question 9

what is red and white pulp of spleen

Answer 9

red - sinuses lined by endothelial macrophages

white - like lymph follicles

Question 10

anatomy of lymph node. where are b and t cells found

Answer 10

see book
cortex - B cell
paracortex - t cell

Question 11

what causes splenomegaly

Answer 11

increased work load, congestion e.g. portal hypertension, infilatration by WBC eg. brucellosis

Question 12

causes of hyposplenism

Answer 12

coeliac and sickle cell

Question 13

wat is aplastic anaemia

Answer 13

pancytopenia with hypocellular BM

Question 14

what is ataxia telangiectasia. treat?

Answer 14

thymic hyperplasia leading to reduced B cells. treat with BM transplant

Question 15

what is myelodysplasia

Answer 15

BM failure - reduced mature blood cells and increased erythrocytes. Abrnomal RBCs in blood

Question 16

what are stellate cells of liver

Answer 16

secrete collagen scar tissue in damage

Question 17

how does diastolic and systolic heart failure occur

Answer 17

diastolic - hypertrophy leading to stiff ventricles, improper diastole
systolic - dilated cardiomyopathy

Question 18

what is clonus

Answer 18

3+ beats

Question 19

what is folate

Answer 19

vit b9

Question 20

what is hoffman reflex

Answer 20

tap middle or ring results in flexion of thumb. pathological if asymmetrical (UMNL)

Question 21

haemorrhagic stroke causes

Answer 21

hypertension, anti coag, blood abnormalities, tumoue

Question 22

symptoms of TACS

Answer 22

all of following - hemianopia. hemiparesis, hemisensory loss, cortical dysfunction - HHHC

Question 23

symptoms of PACS

Answer 23

2 of HHH or cortical dysfunction

Question 24

symptoms of anaemia and signs

Answer 24

symptoms - tired, dizzy, palpitations, headaches, SOB, weakness, angina, HF
signs - palor, tachycardia, systolic flow murmur

Question 25

microcytic anaemia causes

Answer 25

TAILS - thalassemia, anemia of chronic disease, iron, lead, sideroblastic anemia

Question 26

macrocytic anemia causes

Answer 26

alcoholism, b12 or folate deficiency, hypothyroidism

Question 27

normocytic anemia causes

Answer 27

Bm failure, anaemia of chronic, mixed Fe and B12 def, bleeding(?)

Question 28

name for increased neutrophils and causes

Answer 28

neutrophilia - smoking, infection, cancer, haemorrhage, inflammation,

Question 29

name for increased monocytes and causes

Answer 29

monocytosis - chronic inflamm, chronic infection (TB), leukaemia

Question 30

name for increased eosinophils and causes

Answer 30

eosinophilia - drug hypersens, allergic disease, parasite infection

Question 31

name for increased basophils and causes

Answer 31

basophilia - UC, RA

Question 32

what causes leukoerythroblastic anemia and result?

Answer 32

SOL in BM leads to immature blood cells in blood

Question 33

what tests extrinsic and instrinsic clotting

Answer 33

extrinsic - INR | intrinsic - APTT

Question 34

reduces platelet function?

Answer 34

uremia, NSIADs, hypergammaglobulinaemia

Question 35

haemophilia factors A and B?

Answer 35

A - eight | B - nine

Question 36

caues of non epileptic seizures

Answer 36

trauma, hypoglyc, hypoxia

Question 37

give type1-4 hypersensitivty pathology and examples

Answer 37

1 - IgE - asthma, anaphylaxis 2 - IgG against cell surface antigens - autoimmune haemolysis, blood transfusion reaction 3 - Ag/Ab complex deposited in tissues leading to inflammation - RA, lupus 4 - Th1 cells activate macrophages which damage - graft rejection, hashimoto, TB

Question 38

vit b12 drug?

Answer 38

hydroxocobalamin

Question 39

metabolic pathways in RBC?

Answer 39

NADPH and (glucose to lactate and ATP)

Question 40

tests for haemolysis

Answer 40

bilirubin, blood films, reticulocyte count, DCT, haptoglobin

Question 41

anemia test

Answer 41

ferritin levels

Question 42

explain anemia of chronic disease and how treat and test

Answer 42

inflammation goes to increased IL-6 which increases hepcidin which reduces ferroportin. test - high ferritin with low % transferrin sat treat - EPO

Question 43

fluid in body?

Answer 43

40% of TBW in ICF | 20% of TBW in ECF - 20% in plasma and 80% in ISF

Question 44

how much g of solute in 5% solution

Answer 44

5g of solute in 100g of solution

Question 45

where is parotid fascia come from

Answer 45

investing layer of deep cervical fascia

Question 46

how is CSF circulated

Answer 46

help from ependymal cells in spinal cord

Question 47

name of segments in small bowel and large bowel? difference?

Answer 47

small - valvulae conniventies (go all the way) | large - Haustra only half way

Question 48

what happens to cells in hyperkalemia?

Answer 48

cell depolarised - Na channels inactivated. less AP

Question 49

give factors to identify biliary colic

Answer 49

fatty meal is worse. referred to back pain. R hypochondriac

Question 50

Diabetes type 2 management plan

Answer 50

lifestyle to metformin then sulphonylureas (above 7%) then TZD or insulin (above 7.5%)

Question 51

Define standardised mortality rate

Answer 51

taking into account confounders, death comparison