wrong quesmed

Question 1

in the presence of a competitive inhibitor, what happens to enzyme kinetics?

Answer 1

Km increases, vmax stays the same.
(km inc because comp inhib. binds to same site of anzyme as substrate therefore reducing the enzymes affinity for its substrate)

Question 2

What does the bohr effect have on CO2/O2 delivery

Answer 2

Increases o2 delivery, shifts curve to the the right
(does so by decreasing haem affinity for O2 when inc partial pressure of CO2/ dec pH/ inc H+)
No effect on CO2

Question 3

What does the haldane effect on co2/o2 delivery

Answer 3

Inc CO2 delivery to the lungs, shift (straight) line to the right
(does so by dec affinity for CO2 in high O2 blood)
No effect on o2

Question 4

What causes transudative pleural effusion

Answer 4

Fluid leave capillaries due to inc hydrostatic pressure (eg. Heart failure) /dec oncotic pressure (so when there are less proteins eg. Occurs in cirrohosis)

Question 5

What is exudative pleural effusion

Answer 5

Inflammation of pulmonary capillaries-= leaky. Large proteins leak out eg lactate dehydrogenase.
Cause by trauma, malignancy, infection (pneumonia)

Question 6

How to diff between transudative and exudative pleural effusion

Answer 6

Serum total protein normal and pleural fluid protein<25 = transudate
Pleural fluid protein>35 = exudate

Question 7

What are crypt abscesses a sign of

Answer 7

UC

Question 8

inc Goblet cells- uc or Crohns

Answer 8

Crohns.

Depletion of goblet cells in UC

Question 9

Bilateral upper zone consolidation, farmer, breathlessness, dry cough, myalgia, wl, finger clubbing- what is it, what type of organism

Answer 9

Hypersensitivity pneumonitis
(Type III hypersensitivity)
Thermophillic bacteria

Question 10

What is a pan systolic mumur indicative of

Answer 10

Mitral regurg
Or
Tricuspid regurg
Or 
Ventricular septal defect

Question 11

What are mucosal ulcers seen jn

Answer 11

UC

Question 12

Which disease most likely to have mucin depletion

Answer 12

UC

Question 13

COPD acute treatment

Answer 13

I SOAP
Ipratropium (sama)
Salbutamol (nebulised)
Oxygen (24-28%, keep saO2 between 88%-92%)
Amoxicillin (/doxy/clarithomycin)
Prednisolone oral (/hydro IV)

Aminophyline IV (if no response)
Non invasive ventillation + docapram IV
Consider intubated assisted ventilation if pH< 7.6

Question 14

What antibiotics do u have to be careful of when prescribing with other drugs

Answer 14

Macrolides (erythomycin) as they inhibit P450. This reduces the metabolism of drugs taken therefore makes it more concentrated in the blood.

Question 15

Anti mitochondrial antibodies (AMA) indicate…

What do anti nuclear bodies and anti smooth muscle antibodies indicate?

Answer 15

Primary biliary cirrhosis

Autoimmune hepatitis

Question 16

INR normal range

Answer 16

1.1 or below

2-3 is a generally effective range for people taking warfarin