State 4 fates of G6P (glucose-6-phosphate)
Glycogenesis
Glycolysis
Pentose phosphate pathway
Gluconeogenesis
What are the boundaries of the femoral triangle and what are its contents?
Adductor longus
Sartorius
inguinal hernia
Contents: NAVeL (lateral to medial)
An individual comes in with dark urine and complains of abdominal pain. Patient appears mildly jaundiced.
LFT
Albumin - normal
Protein - normal
Total bilirubin - elevated
GGT - elevated
ALP - elevated
AST - normal
ALT - normal
What condition is this most indicative off?
Cholestasis with elevated bilirubin
Hepatic injury would be indicated with elevated ALT and AST
List 5 population-based screening programs in Australia
Breast Screening program
Cervical screening program
Bowel cancer screening program
Newborn Bloodspot screening
Newborn Hearing Screening
What are 4 characteristics of a safe medical culture?
1. A reporting culture - make it easy and positive to report incidents and near misses
2. A flexible culture - able to adapt to change, sudden increases in workload and pressure
3. A learning culture - treat errors and near misses as a learning experience and opportunity to improve
4. A just culture - punishment must be proportional to error eg. don't get fired over forgetting to wash hands
Polydactylism is a dominant trait that results in extra fingers and toes in humans. A polydactyl man marries a woman with 10 fingers and toes. They have a child that has a normal number of digits. The phenotype of the man's father is unknown, but his mother has a normal phenotype. What are the genotypes of the married couple?
a) woman Dd, man dd
b) woman DD, man dd
c) woman dd, man DD
d) woman dd, man Dd
e) woman DD, man Dd or dd
woman dd, man Dd
Describe the role of the kidney in calcium homeostasis
The kidney excretes calcium and phosphate.
Parathyroid hormone acts on the kidney to induce wasting of PO4 and retention of Ca in response to hypocalcemia.
The renal enzyme 1a-hydroxylase converts 25-OH-Vitamin D into 1,25 –dihydroxyvitamin D (1,25(OH)2D), the most active form of Vitamin D.
1,25(OH)2D enhances the intestinal absorption of calcium and phosphate, and impacts on bone mineralisation to maintain plasma calcium and phosphate levels.
List 4 contraindications of spirometry.
increase in myocardial demand (blood pressure)
increase in intracranial or intraocular pressure (brain surgery <4wks, eye <1wk)
increase in sinus and middle ear pressure (surgery <1wk)
active or suspected transmissible respiratory infection
pneumothorax
Late-term pregnancy
In 2023, a town of 3000 people (1400 males, 1600 females) had 30 people with ovarian cancer. In 2024, 5 more people were diagnosed with ovarian cancer. What is the incidence of ovarian cancer in 2024 and define incidence.
Incidence = 0.318%
Incidence = The number of new cases identified divided by the number of subjects at risk of the disease in the population in a specified time period
Calculation = number of new cases / the number of at risk population
New cases = 5
At risk = 1600 females - 30 females who already have ovarian cancer therefore cannot be "at risk"
5/1570 x 100 = 0.318%
What are the NHMRC guidelines for reducing health risks for drinking alcohol to the unborn foetus or those who are breastfeeding
(1) No more than 10 standard drinks/week and no more than 4 standard drinks/day
(2) Reducing risk of injury and harm to people < 18 years old
(3) Prevent harm from alcohol
Explain how long term ibuprofen use causes gastric ulcers.
Ibuprofen reduces the production of prostaglandins formed by cox1 and reduces the integrity of the gastric mucosal barrier
Which cranial nerve foramen pair is incorrectly matched?
optic nerve: optic canal
maxillary division of V: foramen spinosum
mandibular division of V: foramen ovale
hypoglassal nerve: hypoglossal canal
maxillary division of V: foramen spinosum
When treating heat or thermal contact burns, what are 4 things you should NOT do?
remove clothing that is stuck on
ice water / ice
pop blister
put creams/ointments over the burn
What type of study could be done to determine prevalence of a disease?
Cross-sectional study: a simple count of variable for interest in a specific population in a snap-shot in time.
A woman presents wanting to fall pregnant as wants to ask about Assisted reproductive technology. What are 4 material risks that you should notify her of?
1. Success rate (implantation is not guaranteed)
2. Multi-foetal pregnancy
3. Foetal and maternal morbidity and mortality associated risk with multi-foetal pregnancy
4. Risk of miscarriage
5. Birth defects --> associated risk amongst those conceived by ART
6. Prematurity
7. Low birth weight
8. Ectopic Pregnancy
9. Pre-Eclampsia
10. Risk associated with egg retrieval (damage to bowel, bladder)
11. Link of hormonal factors linked with ART
What are the key hormones involved in the menstrual cycle and where are they produced?
Hypothalamus (arcuate nucleus): gonadotropin releasing hormone (stimulates ant pit)
Anterior pituitary (basophilic cells): FSH and LH (stimulates ovaries)
Ovary: oestrogens, progestins, androgens
Describe the layers of the perineum
From most superficial to deep.
Skin > SC > superficial perineal fascia (2 layers: fatty & membranous) -> deep perineal fascia -> superficial perineal pouch -> perineal membrane -> deep perineal prouch -> levator ani
Define bradypnoea and tachypnoea, what respiratory rate defines these 2 states?
Bradypnoea: abnormally slow breathing (<8 bpm)
Tachypnoea: abnormally rapid breathing (>25 bpm)
Define exposure and outcome, state which one is the independent and dependent variable and on which axis they would be placed on in a graph.
Exposure = a variable that will be investigated as a potential cause of, or contributor to, a disease outcome. Also referred to as an independent variable. x axis
Outcome = the disease event of interest. For example, a new diagnosis of disease, or a measure of disease morbidity or mortality. Also referred to as a dependent variable. y axis
You find a 14 year old boy lying unconscious after being hit by a car. Can you treat him without consent? Why/why not?
In case of an emergency like in the case of an actively bleeding wound the boy is unconscious, then consent is not required.
For minors, however, in most cases consent needs to be obtained from the parents or guardians (if present).
what is the consequence of inferior pole fusion with left and right kidney during embryonic development?
horse shoe kidney
if the fusion is anterior to the aorta, the ascent will be blocked at IMA
if the fusion is posterior, it will continue to ascend
Describe the micturition process with reference to the nerve supply.
Micturition is parasympathetic
1. urine filling stretch detrusor muscle sending afferent nerve fibres of pelvic nerve to brain
2. micturition centre in pons activated by afferent stimulation increases PNS, decreases SNS
3. Pelvic splanchnic nerve (S2, 3, 4) stimulate M3 receptors on detrusor muscle --> contract
4. decrease hypogastric nerve (T12-L2) therefore decreased detrusor contraction
5. voluntary void --> somatic control of external urethral sphincter via pudendal nerve (S2, S3, S4)
What are key characteristics that an individual with a UMN lesion will present with?
Hyperreflexia
Hypertonia
Clonus
Babinski positive (toes flare out)
Weakness/atrophy
List 3 advantages and 3 disadvantages of population screening for disease. (6 marks)
Advantages
1. Improved prognosis for some cases detected by screening
2. Less radical treatment which cures some cases
3. reassurance for those with true negatives
Disadvantages
1. Longer illness for those whose prognosis is unaltered
2. Over treatment of questionable abnormalities
3. False reassurance for those with false negative tests
4. Anxiety and unnecessary medical intervention for those with false positives
5. Cost
6. Harmful side effects/hazards of the test
List five potential problems associated with complementary and alternative medicines.
1. Arising from the nature of herbal medicines
Multiple constituents (1)
Lack of standardisation (1)
Delaying or replacing more effective conventional therapies (1).
2. Contamination with other products (1)
3. Unrecognised or unpredicted effects
Adverse effects due to age, genetics or co morbidities (1)
Interactions with conventional and CAM combinations (1)
Allergic reactions and cross-sensitivities (1)
(1 mark each to a max of 5 marks)