practice 6

Question 1

How do you calculate a patient’s ABCD2 score for a TIA

Answer 1

Age ≥ 60 years +1
BP ≥ 140/90 mmHg +1 (Initial blood pressure reading. Either SBP ≥ 140 or DBP ≥ 90)
Clinical Features of the TIA- Unilateral Weakness +2, Speech Disturbance without Weakness +1, Other Symptoms= 0
Duration of Symptoms- <10 Minutes= 0, 10-59 Minutes+1, ≥ 60 Minutes+2
History of Diabetes +1

Question 2

what is the thyrocervical trunk a branch of

Answer 2

1st part of the subclavian artery

Question 3

what are the branches of the thyrocervical trunk

Answer 3

the inferior thyroid artery, transverse cervical artery and suprascapular artery

Question 4

what is the costocervical artery a branch of

Answer 4

2nd part of subclavian

Question 5

How is Leber’s hereditary optic neuropathy inherited

Answer 5

mitochondria

Question 6

Which muscle does the submandibular gland wrap around?

Answer 6

Mylohyoid

Question 7

what antidepressant can cause QT elongation

Answer 7

citalopram (an SSRI)

Question 8

what are some side effects of glucocorticoid treatment

Answer 8

cushings
irregular menstruation
osteoporosis
weight gain

Question 9

what hypoglycaemic can cause flatulence

Answer 9

acarbose

Question 10

what hormone is secreted by parafollicular cells in the thyroid

Answer 10

calcitonin

Question 11

what is calcitriol

Answer 11

vitamin D

Question 12

what secretes TSH

Answer 12

anterior pituitary gland

Question 13

where is thyroxine secreted

Answer 13

follicular cells in the thyroid

Question 14

which thyroid hormone is considered a prohormone

Answer 14

T4 which is metabolised to T3

Question 15

what level is defined as hypoglycaemia

Answer 15

2.2

Question 16

which hypoglycaemic functions to increase gene transcription of insulin genes

Answer 16

ploglitazone

Question 17

when is cortisol normally elevated

Answer 17

7-9 am

Question 18

why is mineralocorticoid excess associated with decreased potassium

Answer 18

mineralocorticoids increase sodium reabsorption and decrease potassium reabsorption

Question 19

what factor is responsible for activating macrophages

Answer 19

interferon gamma

Question 20

how many years of life are lost in women with a bmi of 30 compared to 25

Answer 20

7

Question 21

which of the following factors is linked to ankylosing spondilits

Answer 21

HLA-B27

Question 22

what enzyme metabolises adrenaline

Answer 22

monoamine oxidase

Question 23

what is lispro

Answer 23

short acting insulin

Question 24

which first line hypoglycaemic also encourages weight loss

Answer 24

metformin

Question 25

which hypoglycaemic mimic glucagon like peptide

Answer 25

exanitide

Question 26

which ions are the major constituents of intracellular fluid

Answer 26

sodium and phosphate

Question 27

what are the features of cushings syndrome

Answer 27

``` hypertension hyperglycaemia skin pigmentation wasting of proximal limb muscles increased appetite increased proteolysis bone demineralisation abnormal collagen (striae) increased red cell count ```

Question 28

what is the most common cause of cushings

Answer 28

long term use of synthetic glucocorticoids less common is a ACTH secreting tumour (ectopic or pituitary) or an adrenal tumour

Question 29

what proportion of those age 75-80 have two or more long term conditions

Answer 29

20-25%

Question 30

what is the most common cause of addisons in the uk

Answer 30

autoimmune adrenalitis | cells in the cortex are destroyed which limits the production of steroid hormones (aldosterone and cortisol)

Question 31

how can TB cause Addison's disease

Answer 31

caseating necrosis of the adrenals

Question 32

what is hereditary haemochromatosis

Answer 32

excess ion accumulates in organs

Question 33

what would expect to see with someone who has primary hypothyroidism

Answer 33

high TSH and low thyroid hormones

Question 34

what disease would cause elevated calcium levels

Answer 34

hyperparathyroidism

Question 35

what is somatropin

Answer 35

a growth hormone

Question 36

how is GH regulated

Answer 36

inhibition of GH secretion is induced by somatostatin | also negative feedback from GH

Question 37

what affect does somatostatin have on glucagon

Answer 37

inhibits glucagon release

Question 38

how does dopamine affect the hypothalamus

Answer 38

inhibits synthesis and release of prolactin