ACED !!!!

Pharmacology

100

sulphonamides:are Static / Cidal ? 

 Bacteriostatic

compete with para amino benzoic acid for dihydropteroate synthetase, part of folic acid cycle, stops formation of dihydrofolic acid, eventually purines and DNA

200

Which opioid effect does not develop significant tolerance?

Constipation

300

Side effects of Trimethoprim (3) Please ont say Nausea 

Thrombocytopenia
Leucopenia
Neutropenia

400

Explain how a β₂-agonist such as salbutamol produces bronchodilation, including the receptor it acts on and the resulting effect on airway smooth muscle.

• Salbutamol stimulates β₂ receptors on bronchiole smooth muscle.

• This causes bronchodilation → airway smooth muscle relaxes.

• It can also reduce mast cell mediator release and increase mucus clearance. 

500

A patient with STEMI is given alteplase. Explain the mechanism of action of alteplase and how it leads to breakdown of the coronary thrombus.

• Alteplase binds to fibrin in the thrombus

• Converts plasminogen → plasmin

• Plasmin breaks down fibrin

• Fibrin degradation causes thrombus breakdown

• This process is called fibrinolysis (thrombolysis) 

Anatomy

100

Drooping of the breasts over time, as well as Peau d’orange, are both deformities of what structural component of the breast?

Suspensory ligaments.

200

What is the function of the iliofemoral ligament?

To prevent anterior dislocation of the hip joint.

300

Which vertebral levels do the Coeliac trunk, SMA, IMA, Renal arteries and abdominal aortic bifurcation occur?

CT- T12. SMA- L1. Renal Arteries: L2 IMA- L3.. AA bifurcation: L4.

400

What is the lymphatic drainage of the posterior cervix?

Sacral lymph nodes.

500

A Pt presents himself to the ED with severe angina. Upon cardiac catherisation, it is found that he has a significant occlusion in his RCA, just distal to the right sinus of the aortic valve. His collateral circulation is minimal. Name the arteries that might have reduced blood flow due to this.

 Right marginal, Posterior interventricular, SA Nodal, AV Nodal

CCS Neuro

100

Which cranial nerve provides parasympathetic innervation to the parotid gland?

Glossopharyngeal nerve

200

A patient has facial weakness and cannot close one eye tightly. Which cranial nerve is affected, and how would you test it?

• CN VII — facial nerve

• Raise eyebrows

• Smile

• Blow out cheeks

• Close eyes tightly against resistance

• Compare both sides 

300

A patient has weakness in all four limbs with brisk reflexes and extensor plantar responses. What are the main anatomical possibilities?

• Cervical spinal cord lesion

• Bilateral pyramidal lesions 

400

A patient has bilateral leg weakness with increased tone, brisk reflexes and extensor plantar responses. Where is the lesion most likely to be?

• Thoracic spinal cord
• Produces a bilateral UMN pattern affecting the lower limbs. 

500

What is the difference between Erb’s palsy and Klumpke’s palsy in terms of the brachial plexus roots and characteristic posture?

• Erb’s palsy: C5–T1 → “waiter’s tip” posture

• Klumpke’s palsy: C8–T1 → claw hand 

Miscs/Histology

100

Rupture of what structure would lead to a subdural haemorrhage?

The cortical bridging veins.

200

In an ultrasound of a breast tumour, will the tumour appear hyper or hypo echoic?

Hypo echoic- absorbing sound waves.

300

Which histological zones of the prostate do BPH and prostatic carcinomas occur?

Transitional zone: BPH. Peripheral zone: Carcinoma.

400

Explain how protein structure determines protein function, using cytochromes, myoglobin and haemoglobin as examples.

• A protein’s 3D structure determines its function by creating specific binding sites for other molecules.

• Cytochromes: contain a heme group with iron, allowing reversible Fe²⁺/Fe³⁺ changes for electron transport.

• Myoglobin: has a single polypeptide chain with one heme group, allowing it to bind and store O₂ in muscle.

• Haemoglobin: has 4 subunits (2α + 2β), each with a heme group, allowing cooperative O₂ binding and transport.

• Therefore, differences in protein structure give each protein its specific function.

500

What are the main hormonal steps involved in spermatogenesis, from puberty to sperm maturation?

• ↑ GnRH → ↑ FSH & LH

• LH → Leydig cells → testosterone

• FSH → Sertoli cells → supports spermatogenesis

• Spermatogonia → spermatocytes → spermatids → spermatozoa

• Sertoli cells support final sperm maturation