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Year 3 > Transition Block > Flashcards

Transition Block Flashcards

1
Q

Treatment for uncomplicated Lyme’s disease

A

doxycycline

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2
Q

treatment for TB

A

RIPE
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol

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3
Q

what side effect does isoniazid cause

A

peripheral neuropathy - pyridoxine (vit B6) given to prevent this
(zzzz makes your hands feel fuzzzzy)

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4
Q

what side effect does rifampicin cause

A

liver toxicity and bodily fluids orange
(‘picin out orange fluids’)

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5
Q

what side effect does ethambutol cause

A

visual disturbances
(alcohol makes you see blurry)

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6
Q

what side effect does pyrazinamide cause

A

liver toxicity, hyperuricaemia and athralgia

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7
Q

causative agent of whooping cough

A

bordetella pertussis

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8
Q

What is the definition of epistasis?

A

where expression of one gene is modified by expression of another gene/s

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9
Q

What is the definition of genetic anticipation?

A

symptoms of a genetic condition become more severe and start at younger age
seen in Huntington’s disease, myotonic dystrophy and fragile X syndrome

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10
Q

Which DNA bases can undergo methylation?

A

typically cytosine but also adenosine

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11
Q

What gene is responsible for sex determination in humans?

A

SRY gene

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12
Q

What mode of inheritance is Cystic Fibrosis?

A

autosomal recessive

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13
Q

What mode of inheritance is congenital adrenal hyperplasia and describe the presentation of it

A

autosomal recessive 21alpha hydroxylase deficiency
clinical features
present at birth
genital ambiguity
adrenal failure : collapse, hypotension, hypoglycaemia, poor weight gain

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14
Q

inheritance of two BRCA2 mutations leads to what condition?

A

fanconi anaemia

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15
Q

definition of sensitivity

A

portion of patients with the condition who have a positive result

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16
Q
A
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17
Q

what is tidal volume?

A

the volume of air inhaled and exhaled during a normal quiet breath
normal = 500mL (m) or 340 ml (f)

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18
Q

what is inspiratory reserve volume?

A

the volume of additional air inhaled above tidal volume
normal = 3000mL

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19
Q

what is expiratory reserve volume?

A

volume of air that can be forcefully exhaled after a normal resting expiration
leaves only residual volume in lungs
normal = 1000mL

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20
Q

what is the residual volume?

A

Forced Residual Capacity - Expiratory Reserve Volume = RV
volume of remaining air after maximal exhalation
normal = 1500mL

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21
Q

what is vital capacity?

A

IRV + TV+ ERV = VC
volume of air that can be forcefully exhaled after maximal inhalation
normal = 4500mL

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22
Q

what is inspiratory capacity?

A

TV + IRV = IC
volume of air that can be forcefully inhaled after quiet exhalation
normal = 3500mL

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23
Q

what is functional residual capacity?

A

ERV + RV = FRC
volume of remaining air in lungs after quiet expiration of tidal volume
normal = 2500mL

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24
Q

what is total lung capacity?

A

TV + IRV + ERV + RV = TLC
volume of air in lungs after maximal inhalation
normal = 6000mL

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25
Q

A tumour containing mucin will be what type?

A

an adenocarcinoma
(glandular)

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26
Q

management of torsades de pointes

A

magnesium sulphate and cardiac monitoring

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27
Q

management of asymptomatic bacteriuria in pregnant women

A

TREAT
1st and 2nd trimester = nitrofurantoin
3rd trimester= trimethoprim

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28
Q

classical presentation of klebsiella pneumoniae

A

Red jelly coloured sputum

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29
Q

Prader-Willi syndrome genetics

A

mutation on paternal chromosome 15

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30
Q

typical presentation of Campylobacter infection

A

flu-like prodrome followed by abdominal pain, vomiting and bloody diarrhoea

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31
Q

most sensitive test for current TB

A

Sputum culture

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32
Q

two shockable rhythms

A

ventricular fibrillation
pulseless ventricular tachycardia

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33
Q

two non shockable rhythms

A

asystole
pulseless- electrical activity

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34
Q

management of renal/ureteric stones

A

GOLD standard investigation = CT KUB
renal stones
<5mm watchful waiting
5-10mm = shockwave lithotripsy
10-20 mm = shockwave lithotripsy OR ureteroscopy
>20mm = percutaneous nephrolithotomy

uretic stones
<10mm= shockwave lithotripsy +/- alpha blockers
10-20 mm ureteroscopy

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35
Q

empirical antibiotics for staph aureus infection

A

flucloxacillin

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36
Q

empirical antibiotic for staph epidermidis

A

vancomycin

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37
Q

empirical antibiotics for strep pyogenes

A

doxycycline

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38
Q

empirical antibiotics for gram negative infection

A

clindamycin

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39
Q

empirical antibiotics for anaerobic infection

A

metronidazole

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40
Q

antibiotics that act on bacterial cell wall

A

penicillins - e.g. flucloxacillin, amoxicillin
cephalosporins - e.g. cefaclor, ceftriaxone
glycopeptides- e.g. vancomycin

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41
Q

antibiotics that inhibit protein synthesis

A

macrolides - e.g. erythromycin, calrithromycin
aminoglycosides - e.g. gentamicin
others - clindamycin, chloramphenicol, tetracyclines

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42
Q

antibiotics that act on bacterial DNA

A

metronidazole
trimethoprim
fluroquinolones - e.g. ciprofloxacin, levofloxacin

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43
Q

hyperkalaemia management

A
  1. stabilisation of cardiac membrane - IV calcium gluconate (but does NOT lower serum potassium levels)
  2. combined insulin/dextrose infusion - short-term shift in potassium from extra to intra
  3. calcium resonium, loop diuretics, dialysis - removal of potassium from body
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44
Q

process involved in difficulty breathing in anaphylaxis

A

respiratory smooth muscle contraction -> caused by histamine release from mast cells (IgE) mediated

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45
Q

what factors cause a shift to the right of the oxygen dissociation curve?

A

the need for lowering affinity of oxygen to haemoglobin
-increased carbon dioxide concentration
-increased temperature
-increase 2.3-DPG
-increased H+ (decreased pH)

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46
Q

what factors cause a shift to the left of the oxygen dissociation curve?

A
  • need to maintain oxygen bound to haemoglobin
    decreased temperature
    decreased 2,3- DPG
    decreased CO2
    decreased H+ (increased pH)
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47
Q

What is the primary function of negative intrapleural pressure in the respiratory system

A

prevents lung collapse
- acts like a suction force maintaing adherence between lungs and chest wall

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48
Q

examples of inactivated whole cell vaccine

A

polio, hepatitis A, rabies, cholera

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49
Q

examples of inactivated fractional vaccines

A

hepatitis B, influenza, HPV, influenza type B, haemophilus

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50
Q

advantages of inactivated vaccines

A

can be made quickly
elicit good antibody response
easy to store
usually safe

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51
Q

disadvantages of inactivated vaccines

A

not very potent
require multiple injection - don’t stimulate clonal expansion of B and T cells

52
Q

examples of live attenuated vaccines

A

MMR, chicken pox, yellow fever, rotavirus, small pox, polio

53
Q

advantages of live attenuated vaccines

A

localised strong response
usually one dose required

54
Q

disadvantages of live attenuated vaccines

A

may cause infection- not always safe
must be stored and handled carefully

55
Q

is functional residual capacity increased or decreased in COPD

A

increased- elasticity increased so taking in more and losing more

56
Q

what percentage of total lung capacity is Functional Residual Capacity

A

40%
around 3L

57
Q

what is the normal FEV1/FVC ratio

A

> 75%

58
Q

what FEV1/FVC ratio is likely seen in pulmonary fibrosis

A

85% - restrictive lung pattern

59
Q

does COPD fev1/fvc respond to bronchodilators

A

no- but asthma does

60
Q

what does hyperventilation cause

A

respiratory alkalosis- CO2 being washed out

61
Q

what does a low PO2 cause in pulmonary vessels

A

vasoconstriction - diverts blood to better-oxygenated lung segments

62
Q

does parasympathetic cause bronchoconstriction or bronchodilation

A

bronchoconstriction

63
Q

does sympathetic cause bronchoconstriction or bronchodilation

A

bronchodilation

64
Q

examples of conditions causing decreased pulmonary compliance

A

pulmonary fibrosis
pulmonary oedema
lung collapse
pneumonia
absence of surfactant

65
Q

when is dynamic airway compression likely to occur in COPD patients

A

during active expiration

66
Q

what does decrease in pulmonary compliance mean to the change in pressure needed to produce a change in volume

A

a greater change in pressure is needed to produce change in volume

67
Q

what happens to intrapleural pressure during inspiration

A

falls- airways pulled open, thorax expands, diaphragm contracts (moves down)

68
Q

what happens to intrapleural pressure during expiration

A

rises - chest recoils, diaphragm relaxes (moves up)

69
Q

what does the rising pressure during expiration do to alveoli and airway

A

compresses it

70
Q

what happens to the pulmonary compliance in a patient with emphysema

A

increases - elastic recoil of lungs lost
patients have to work harder to get air out of lungs

71
Q

does compliance increase or decrease with age

A

increases

72
Q

what is likely to happen to blood pressure in patient with pneumothorax

A

patient likely to be hypotensive

73
Q

what happens to intrapleural pressure in tension pneumothorax

A

becomes more positive

74
Q

what side does the trachea deviate in tension pneumothorax

A

opposite side

75
Q

is PO2 dependent or independent on haemoglobin or saturation

A

independent

76
Q

is saturation dependent or independent on partial pressure

A

dependent

77
Q

what happens to PTH levels when calcium rises

A

PTH levels decrease

78
Q

pulmonary function results in a COPD patient

A

increased total lung capacity, decreased lung diffusion capacity and decreased FEV1/FVC ratio

79
Q

management of pulmonary oedema

A

POND
position
oxygen
nitrate infusion
diuretic - furosemide

80
Q

what conditions cause respiratory alkalosis

A

hyperventilation - breathing out a lot of CO2=> getting rid of acid

81
Q

venous drainage of the lower leg

A

anterior - dorsal venous network -> great saphenous vein -> femoral vein
posterior- short saphenous vein -> popliteal vein -> femoral vein

femoral vein -> external iliac -> common iliac -> IVC -> right atrium

82
Q

proximal progression of a DVT in the femoral vein will extend into which vein next

A

external iliac

83
Q

what muscles cause active flexion of the hip

A

iliopsoas, iliacus and psoas major

84
Q

what muscles cause active extension of the hip

A

gluteus maximus, long head of the biceps femoris, semitendinosus, and semimembranosus

85
Q

sensory supply to first web space

A

deep fibular

86
Q

what nerve supplies the posterior cutaneous division of arm

A

radial nerve

87
Q

what muscles does the radial nerve innervate

A

triceps brachii and extensors of forearm

88
Q

what ligament in most likely injured in an inversion injury to the ankle

A

anterior talofibular ligament
- calcaneofibular ligament can also be

89
Q

what ligament is most commonly injured with an eversion injury of the ankle

A

deltoid ligament

90
Q

what is impaired with severe sciatica

A

decreased power of plantar flexion

91
Q

what is seen with compression of the nerve at the cubital tunnel

A

ulnar nerve is compressed
- pins and needles of little finger and palm
- wasting of the muscles between metacarpal bones
- weakness of the right hand

92
Q

which injury causes a foot drop

A

fractured neck of fibula

93
Q

what vein runs along the medial aspect of the knee

A

long saphenous vein

94
Q

what compartment of the leg does the tibial nerve innervate

A

posterior compartment

95
Q

what conditions/ injuries cause a positive trendelenburg test

A

injury to superior gluteal nerve
weakness of gluteus medius
congenital hip dislocation

96
Q

what injuries cause inability to straight leg raise

A

fractured neck of femur
complete quadriceps or patella tendon tear

97
Q

what is the best study to determine the prevalence of disease

A

cross sectional study

98
Q

in a randomised control trial what is reduced by randomisation

A

selection bias

99
Q

what is an example of a cohort study

A

a study that looks at all children born at one hospital in 1 year and measures their height at intervals up to 4 years of age
- best study to explore disease aetiology

100
Q

what is an example of a controlled trial

A

a study comparing two groups of 4 year olds
- one group given growth drug and other the placebo

101
Q

what is an example of a cross sectional study

A

study aiming to establish normal height of 4 year olds by measuring height at school entry
- best study to determine prevalence of disease

102
Q

what best describes the term ‘external validity’

A

the extent to which one can appropriately apply results to other populations

103
Q

what is the best study design to research the aetiology of a disease

A

cohort study

104
Q

what is meant by sensitivity of a test

A

the proportion of subjects with the disease correctly diagnosed by the test

105
Q

how do you work out the sensitivity

A

people with the disease who have tested positive/ total number of people with the disease

106
Q

what is meant by specificity of a test

A

proportion of subjects without the disease correctly excluded by the test

107
Q

how do you calculate the specificity

A

people without the disease who tested negative/ total number of people without the disease

108
Q

what is meant by the positive predictive value

A

proportion of subjects with positive test who have the disease

109
Q

how do you calculate positive predictive value

A

number of people who tested positive for disease and have the disease/ total number of people who tested positive

110
Q

what is meant by the negative predictive value

A

number of people who test negative for disease and do not have the disease

111
Q

how do you calculate the negative predictive value

A

number of people who do not have the disease and tested negative/ total number of people who tested negative

112
Q

how to calculate the prevalence of a disease

A

total number of people with the disease/ total number of people tested

113
Q

what is definition of numbers needed to treat

A

number of patients you need to treat to prevent one additional bad outcome

114
Q

are natural killer cells part of innate or adaptive immunity

A

innate- don’t require prior exposure to know which cells to kill

115
Q

what key feature is required for vaccination

A

adapative immunity

116
Q

anti- Ro antibodies

A

sjrogren’s

117
Q

anti- Jo antibodies

A

polymyositis and dermatomysitis

118
Q

anti- cyclic citrullinated peptide (anti- CCP)

A

rheumatoid

119
Q

anti-scl-70

A

systemic sclerosis

120
Q

anti-acetylcholine receptor antibody

A

myasthenia gravis

121
Q

when is methotrexate contraindicated

A

liver disease
or immunodeficiency

122
Q

where is erythropoietin normally produced

A

kidneys - in response to low blood oxygen content

123
Q

what happens during the depolarisation stage of cardiac cycle

A

voltage gated sodium channels open - increase membrane potential

124
Q

what is meant by pharmacodynamic

A

what drug does to the body
(Dynamic- Drug)

125
Q

what is meant by pharmacokinetics

A

what body does to drug
- absorption
-distribution
-metabolism
-excretion

126
Q

what describes the changes in sodium and water balance in Addison’s disease

A

sodium depletion more than water

127
Q
A

Year 3 (13 decks)

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