Anatomy
A patient reports an inability to dorsiflex their ankle. Which nerve is most likely affected?
Dorsiflexion --> Anterior Leg --> Deep Fibular Nerve
A women is diagnosed with tonic seizures and the GP is concerned about starting anti-convulsant therapy given that the women is pregnant. What medication is most appropriate? What is its mechanism of action?
Lamotrigine. Valproate is not appropriate.
--> Inhibits Glutamate release and Inhibits Na+ channels.
A male patient with alcoholic liver disease comes in complaining of the worst pain ever from one of his joints. He is diagnosed with gout. What is the classical microscopic finding?
Calcium pyrophosphate crystals --> psuedogout
Brocha's area
Frontal lobe
A 40 year old woman presents with jaundice and pale stool. Her ALP and GGT are elevated and
Choledolithiasis.
A 52 year old man with Rheumatic Heart Disease is discovered to have thickened chornae tendinae. The cardiologist states that these span from the mitral valve to the .....
Papillary muscle
A 34 cancer patient is placed on metoclopramide because of the nausea and vomiting they are experiencing with their chemotherapy. What is the class of drug of metoclopramide?
D2 antagonist.
A 6 year old boy presents with oedema, hypoalbuminemia and proteinuria exceeding 3.5g. What is the most likely diagnosis and what test would you perform to confirm this?
Minimal Change GN --> loss of podocyte foot processes due on electron microscopy.
The pulmonary artery carries deoxygenated blood to the lungs? True or False
True. Only artery to carry deoxygenated blood
On routine cervical screening a 55 women is diagnosed with low grade squamous intraepithelial lesions. What are the main cytological features of this lesion?
> Increased nucleus to cytoplasm ratio
> Hyperchromatic
A patient reports impaired taste sensation from the posterior 1/3 of the tongue. Which cranial nerve is affected?
Cranial Nerve IX -- Glossopharyngeal
A 13 boy with severe asthma is placed on a new asthma medication. 5 days later he comes in complaining of seizures and arrhythmias. The doctor suspects an overdose due to the low therapeutic index of the drug administered. What is the likely drug name and class?
Theophylline --> Methylxanthine
A 16 year old male drops dead during a game of football due to heard disease caused by a genetic mutation sarcomere proteins most commonly autosomal dominant. What is this pathology?
Hypertrophic Cardiomyopathy
A person is breathing normally and takes a deep breath out. Which physiological process is occurring to enable this expiration?
a) External intercostal muscles contract and diaphragm moves down
b) External intercostals relax and the diaphragm moves up
c) External intercostals contract and the diaphragm moves up
b) External intercostals relax and the diaphragm moves up
Diaphragm moves up --> thoracic volume decreases --> pressure increases --> air flows out
A man gets hit over the head with a club and reports feeling fine for several hours after. Suddenly the man drops dead and an autospy is performed. What is the likely cause of death?
Lucid interval --> Epidural haemorrhage
An individual has lost the ability to elevate the pharynx and the larynx and is having difficulty swallowing. Damage to the nerve supply the muscle attaching to the styloid process is suspected. What is this muscle and what is it's nerve supply?
Stylopharyngeus m. --> Glossopharyngeal n.
A 75 year old female patient with Parkinson's is started on a new Parkinson's medication and is subsequently diagnosed with both pulmonary fibrosis and cardiac fibrosis. Which drug and class were likely administered?
Bromocriptine --> Ergot derived dopamine agonist.
A female patient is found to have decreased basal metabolic rate (BMR), reduced body temperature, increased weight and mental retardation. She is diagnosed with Hashimoto's thyroiditis. What autoantibodies are present?
Anti–TPO and Anti–TG are present which inhibit the production of thyroid production.
Platelets and RBC's are derived from a myeloid lineage. From which cell lineage are NK cells derived from?
Lymphoid Lineage
An 80 year patient is diagnosed with Alzheimer's disease. What are the microscopic features that you would find that would find that would confirm this diagnosis?
> Neuofibrillary tangles
> Neuritic plaques
A 87 year old female visits their GP with a right sided facial droop. The GP confirms that the patient's right upper forehead is spared. Describe the lesion involved and a possible cause
Left upper motor neuron defect --> stroke. Not Bells palsy as entire side would be affected.
Upper motor neuron lesions, such as a stroke, cause contralateral face weakness sparing the forehead, while lower motor neuron lesions, such as a facial nerve injury, typically cause weakness involving the whole ipsilateral face.
A 43 year old develops pneumonia in a hospital setting and gets very sick. The intern orders a culture which returns positive for MRSA. Which antibiotic would you likely prescribe?
Vancomycin --> Glycopeptide
An IV drug user with a history of sharing needles comes in complaining of chest pain and some shortness of breath. He is diagnosed with infective endocarditis. What is the likely pathogen and which valve is most commonly affected?
Staph azures. --> tricuspid valve.
A patient is put on an osmotic diuretic. The nephrologist states that this drug works on the water channels in the kidney. Which two locations in the nephron is water absorbed in this fashion?
Early PCT and Descending Loop of Henle
A woman, 35 years of age, complained of abdominal pain and dark urine. She was clinically mildly jaundiced. Her liver function tests were as follows:
Albumin
36 g/L (34–48)
Protein
83 g/L (65–85)
Total bilirubin
45 μmol/L (2–24)
GGT
439 U/L (<60)
ALP
285 U/L (30–110)
ALT
49 U/L (<55)
AST
43 U/L (<45)
What is most likely diagnosis?
Cholestasis is most likely due to elevated GGT and ALP.