PES
What are three signs of hyperlipidaemia?
Xanthelasma, Xanthomata, Corneal arcus
What is the rate limiting step in heme synthesis?
ALA synthase converting glycine and succinyl CoA to create ALA
Which hormone directly stimulates the thyroid gland to release thyroid hormones and where is it released from?
Thyroid-stimulating hormone (TSH), released from the anterior pituitary, stimulates the thyroid gland to produce and release T3 and T4
If there was an anterior STEMI, which leads would show it?
V1-V4
What is Crid's last name?
Way
What are three signs of infective endocarditis?
Janeway lesions, Osler's nodes, splinter hemorrhages
What species of malaria can relapse?
P. falciparum and P. vivax
Why is TSH typically low in primary hyperthyroidism?
High circulating T3 and T4 suppress TSH secretion from the anterior pituitary through negative feedback
Explain how class 1A antiarrhythmics work? 5 points
_______ is the powerhouse of the cell
Mitochondria
What liver span indicates splenomegaly?
Span greater than 13cm
What is the structure of normal adult haemoglobin (HbA), and why is this structure important?
Adult haemoglobin (HbA) consists of four globin chains (2 α and 2 β chains), each containing a heme group with a ferrous (Fe²⁺) iron atom. Each heme binds one oxygen molecule, allowing each haemoglobin molecule to carry up to four oxygen molecules.
Why can iodine deficiency cause a goitre?
Low iodine reduces thyroid hormone production, leading to increased TSH secretion, which stimulates thyroid enlargement (goitre)
Explain the bainbridge effect
Increased venous return resulting in stretch in the atrial wall which activates the sympathetic nervous system to increase HR & contractility
Which animal has 3 hearts?
Octopus
Where is Castell's point and what would constitute a positive finding (positive Castell's sign)?
Anterior axillary line, lowest intercostal space
Dull on percussion during inspiration (suggests spleen has moved down to Castell's point)
What is one benefit and one limitation of chloroquine?
Benefit: Effective against all malaria species
Limitation: Due to this, there is emerging chloroquine resistance
Why is propylthiouracil (PTU) preferred over methimazole during pregnancy?
Both methimazole and PTU cross the placenta but less gets across from PTU therefore less effect on fetal thyroid function
A patient with long-standing hypertension develops concentric left ventricular hypertrophy. Why does this occur, and what are the long-term consequences?
Chronic hypertension increases afterload, forcing the left ventricle to generate higher pressures. Myocytes respond by adding sarcomeres in parallel, producing concentric hypertrophy. Over time, the ventricle becomes stiff, impairing diastolic filling and potentially progressing to heart failure with preserved ejection fraction (HFpEF).
Where does the risorius originate from and what action does it produce?
Originates on the parotid fascia
Produces an insincere smile
What does a positive Pemberton's sign suggest? What would be the next course of action?
External jugular venous obstruction leading to
distended veins and possibly stridor and respiratory distress.
A positive sign suggests that earlier surgery might be
required to avoid complications of retrosternal goitre including venous thrombosis and tracheal compression.
Outline surgical treatment for a cyst with no daughter cells vs. a cyst with daughter cells
No daughter cells:
PAIR - puncture, aspirate, inject with betadine and re-aspirate
Daughter cells:
Surgical removal in toto (Remove in its entirety - do not burst cyst). OR marsupilisation - Essentially open and drain the cyst, remove the daughter cells, sterilize the cavity then suture the edges of the cyst to adjacent tissue creating an opening that allows continued drainage
How does methimazole reduce thyroid hormone production?
Methimazole inhibits thyroid peroxidase, preventing the iodination and coupling reactions required for T3 and T4 synthesis
From inflow surface to outflow surface, name the layers of the cardiac valves
Ventricularis/atrialis
spongiosa
fibrosa
**endothelial covering on both surfaces
What are the four features of Tetralogy of Fallot?
Right Ventricular outflow tract obstruction
Malalignment ventricular septal defect
Overriding aorta
Concentric RV hypertrophy