MSK
Damage to which trunk and nerve roots of the brachial plexus causes Erb's palsy?
Upper trunk C5-C7
The right lung has this number of lobes.
3
At which of the following spinal levels does the esophagus pass through the diaphragm into the abdominal cavity?
T10
What would the serum calcium and phosphate levels be in primary hyperparathyroidism?
Hypercalcemia, hypophosphatemia
Name one change that increases GFR.
Anything that changes the Starling equation:
E.g.
Dilation of afferent arterioles.
Constriction of efferent arterioles
Decrease in plasma oncotic pressure
A patient comes in with a winged scapula. They say they previously had mastectomy done that involved dissection of the axillary lymph node. Which nerve was damaged, and what muscle was effected in this patient?
Long thoracic nerve innervating serratus anterior
During which phase of the cardiac cycle does most ventricular filling occur?
Early diastole (passive filling)
A 50-year-old inpatient requires a magnetic resonance cholangiopancreatography for possible gallstones. It was found in the morning that he had eaten a fatty meal and thus the team wanted to delay the investigation. As the patient has released cholecystokinin (CCK), in response to the meal, his gallbladder would be more difficult to visualize. Which intestinal cells release CCK?
I cells
What is the effect of 11-beta-hydroxylase deficiency on blood K+ levels and blood pressure?
Hypokalemia, hypertension
A 55-year-old man with poorly controlled hypertension and chronic kidney disease is referred for assessment. Routine blood tests reveal: plasma renin activity 2.5 nmol/L/h. What is the substrate and product of the reaction catalyzed by this enzyme?
Angiotensinogen → angiotensin I
A woman presents with numbness and paresthesia radiating from the heel to big toe and first 3 toes. Her symptoms are elicited by tapping on the area posterior to the medial malleolus. What movement of the foot is controlled by the nerve affected?
Plantarflexion/inversion of the foot - actions of the tibial nerve
According to Fick’s law, gas diffusion across the alveolar membrane is directly proportional to surface area and inversely proportional to this factor.
Membrane thickness
A 44-year-old woman presents to the emergency department with a history of rapid-onset profuse vomiting, rigours and fever. She has a history of cholecystitis. Magnetic resonance cholangiopancreatography (MRCP) shows a gallstone blocking the proximal ampulla of Vater at the point where two ducts merge. What two structures (ducts) would be seen to dilate first in this clinical scenario?
The pancreatic duct and the common bile duct.
What are the 3 molecules that upregulate glycogen synthase?
Insulin, cortisol, glucose-6-phosphate
A 75-year-old lady with bilateral pitting edema extending above the knee is started on furosemide. What is the mechanism of action of furosemide(a loop diuretic)?
Prevents reabsorption of sodium, chloride, and potassium by inhibition of the NKCC cotransporter in the thick ascending loop of Henle.
A man comes in with pain in his lower back and right buttock that shoots down his leg. Active dorsiflexion of the right foot is weak and there is decreased sensation in the plantar suface of the right foot. The most likely affected nerve passes through which 2 muscles as it leaves its origin?
Piriformis and superior gemellus
An infant is born in respiratory distress with a scaphoid abdomen and decreased breath sounds on the left. Imaging reveals bowel loops within the thoracic cavity and compressed ipsilateral lung tissue.
Which embryological process was disrupted, leading secondarily to this pulmonary complication?
Failed closure of the pleuroperitoneal membrane (causing a congenital diaphragmatic hernia)
A 19-year-old woman currently completing her exams presents to her GP with fatigue and generalised weakness. She has also noted that her skin and the whites of her eyes appear yellow. The GP diagnoses the patient with Gilbert's syndrome and advises her that no treatment is necessary. She also orders liver function tests to determine the patient's baseline liver function. What would be the expected total bilirubin, ALP, AST/ALT, albumin levels (higher/lower/normal)?
Higher total bilirubin (due to higher unconjugated bilirubin), normal ALP, AST/ALT, albumin.
What is the pathophysiology of Grave's Disease and its resulting effect on thyroid hormone levels?
Autoimmune disease where circulating thyroid-stimulating antibodies (TSIs) mimic TSH activity, resulting in a constitutive signal for release of thyroid hormone, leading to hyperthyroidism
A 48-year-old female presents to the day surgery unit for a bilateral salpingo-oophorectomy (the removal of both the fallopian tube and the ovary from one side or both sides). The surgeon explains the procedure to her. Which of the following ligaments would the surgeon have to open to access the ovaries and the fallopian tubes?
Broad ligament
An anaesthesiologist decides to give spinal anesthesia to a patient who has suffered from a hip fracture. What are all the layers (including ligaments and spaces), in anatomical order, in which the needles need to pass through to reach the cerebrospinal fluid?
Skin -> supraspinous ligament -> interspinous ligament -> ligamentum flavum -> epidural space -> subdural space -> subarachnoid space
A 1-day-old infant develops profound cyanosis that does not improve with 100% oxygen. Echocardiogram reveals that the aorta arises from the right ventricle and the pulmonary trunk from the left ventricle, with the two circulations running in parallel.
This condition results from abnormal development of which embryological structure?
Malrotation of the aorticopulmonary septum
A 52-year-old Caucasian man presents to his general practitioner with a 3-month history of heartburn. The patient describes gnawing epigastric pain that is worse between meals and improves with food. The pain does not radiate and is improved with over-the-counter antacids. The patient is referred for a gastroscopy, revealing a 2x3cm bleeding ulcer in the first segment of the duodenum. What is the most likely cause of this patient's ulcer?
H.pylori infection.
A patient with Cushing's syndrome is found to have high ACTH. We carry out a dexamethasone test to distinguish between Cushing's Disease and ectopic ACTH secretion. What would be the result for both scenarios, with a 1. Low dose, and 2. high dose dexamethasone test?
1. Low dose: no suppression for both
2. High dose:
CD: some cortisol suppression
Ectopic: no suppression
A 26-year-old woman presents to the emergency department with severe lower abdominal pain in the right iliac fossa and vaginal bleeding. The pain has been going on for the last 3 hours and radiates to the tip of her shoulder. She had a positive pregnancy test 8 weeks ago. What is the most common site of the likely cause of her symptoms?
Ampulla, due to ectopic pregnancy