Week 21
BCS
CCS
PPH
PPD
100
Fill in the blanks:
Allergic asthma is characterised by the presence of [blank] cells, while non-allergic asthma is characterised by the presence of [blank] cells.
Allergic asthma is characterised by the presence of eosinophilic cells, while non-allergic asthma is characterised by the presence of neutrophilic cells.
100
Describe the structure of adult haemoglobin.
Haemoglobin A consists of four protein subunits—two alpha (α) chains and two beta (β) chains.
Each subunit contains a heme group, which includes an iron ion. The iron ion binds to oxygen (or carbon dioxide), allowing haemoglobin to transport oxygen from the lungs to the tissues and return carbon dioxide from the tissues to the lungss.
100
List four clinical signs of asthma.
1. Persistent, dry cough
2. Dyspnoea
3. End-expiratory wheeze
4. Chest tightness
5. Hyper-resonance to lung percussion
100
The sensitivity for Test A is 99%, and the specificity of Test A is 67%.
Which one of the following statements about false positive or negative rates is most correct? It has a:
A. Low false positive rate
B. Low false negative rate
C. High false positive rate
D. Medium false negative rate
E. Medium false positive rate
B. Low false negative rate
100
What is the duty of care?
A registered medical practitioner has an obligation to adhere to a standard of reasonable care to patients in the confines of a patient-doctor relationship. Duty of care is both an ethical and a legal concept.
200
Explain the mechanism of action of LAMAs in the treatment of asthma. Provide an example of a LAMA.
Long-Acting Muscarinic Receptor Antagonists (LAMAs) competitively inhibit M3 muscarinic receptors on bronchiole smooth muscle and produce bronchodilation.
Examples include: Ipratropium, Aclidinium, Tiotropium and Umeclidinium
200
What values characterise class III shock?
200
On a normal CXR, the cardio-thoracic ratio should be less than what percent?
On a normal CXR, the cardio-thoracic ratio should be less than 50%.
200
List four determinants of Aboriginal health.
Socioeconomic status
Education
Employment
Access to healthcare and other services
Housing/living conditions
Health behaviours (e.g. smoking, alcohol, diet and physical activity)
200
Fill in the blanks:
Failure to obtain consent can result in a charge of [blank].
Failure to provide information and disclose material risk can result in a charge of [blank].
Failure to obtain consent can result in a charge of assault and/or battery.
Failure to provide information and disclose material risk can result in a charge of negligence.
300
Interpret these ABG results:
- pH: 7.46 (7.35 - 7.45)
- PaCO2: 48 mmHg (36 - 44 mmHg)
- HCO3-: 28 mEq/L (21 - 28 mmol/L)
- PaO2: 92 mmHg (80 - 100 mmHg)
This patient would be in compensated metabolic alkalosis
300
List three ways an organism can withstand the effects of an antibiotic (mechanisms of antibiotic resistance).
1. Exclude drug from target site - decreased or no entry into cell
2. Antibiotic inactivation - enzymes cleave or modify the drug
3. Alter the drug so antibiotic can't bind or binds poorly
4. Remove the drug from the cell - "efflux" pumps
5. Bypass the drug action - use an alternative metabolic pathway
300
In a primary survey of a patient, how might you assess 'disability'?
A global scoring of consciousness (AVPU/GCS)
Assessment of pupils
Assessment for asymmetrical neurological signs
Measuring the blood sugar ("Don't ever forget glucose")
300
List two advantages and disadvantages of a randomised control trial
Gold standard for evaluating interventions
Investigator has control over research process
Time-consuming and usually costly
May be limited in generalisabilty
300
Describe two strategies that might be used when adopting an adaptive coping style to stress.
Active coping: Taking action to address the problem
Positive reframing: Looking for opportunities in a situation
Seeking support: Talking to your social network to gain emotional or practical support
Physical de-stressors: Looking after your body through exercise, relaxation, and a healthy diet
400
What would you expect to happen to a patient's FEV1, FVC, and FEV1:FVC ratio in a patient with restrictive lung disease?
Their FEV1 and FVC would decrease. However, their FEV1:FVC ratio would remain normal or be slightly increased.
400
Innervation of the urinary bladder involves:
A. Sympathetic fibres reaching the bladder from S2,3,4
B. Parasympathetic fibres reaching the bladder from L1,2
C. The pudendal nerve innervation of the external bladder
D. The detrusor muscle and external sphincter being supplied by the hypogastric nerve
E. Voluntary control of the internal sphincter of the bladder
C. The pudendal nerve innervation of the external bladder
400
Which of the following decreases during pregnancy?
Cardiac Output
Respiratory Rate
Diastolic BP
Metabolic rate
GFR
3. Diastolic BP
400
What factors may lead to the connection between poverty and increased rates of GIT infections?
Factors that lead to worse outcomes:
Poorer health, inferior education, lower living standards
Inadequate sanitation, unsafe drinking water, lack of effective waste disposal
Absent or intermittent electricity, use of dirty cooking fuels (wood, coal, etc)
Often live in close proximity to live stock and other animals (zoonotic diseases)
400
What hierarchy is used when determining a Substitutional Decision Maker (Person Responsible) when a patient does not have capacity?
Person responsible hierarchy:
- Guardian (enduring guardian)
- Spouse or de facto partner
- Unpaid carer
- Close friend/next of kin
500
Which PBL is the smartest PBL in the MEDI6001 2024 cohort?
"PBL K, duh"
- Dr. Z
500
Describe one of the mechanisms that iron is transported into an enterocyte
Iron is primarily absorbed by the enterocytes of the distal duodenum and proximal jejunum, via the following pathways:
1. Insoluble Fe3+ is converted by ferrireductase to soluble Fe2+, which then enters the enterocyte through the divalent metal transporter 1 (DMT1).
2. Iron-containing heme enters the enterocyte via the heme carrier protein 1 transporter (HCP1). Within the enterocyte, heme oxygenase breaks down heme, releasing Fe2+, carbon oxide (CO), and biliverdin.
3. Mucin-bound Fe3+ is absorbed into the enterocyte via the integrin receptor in the alkaline environment of the duodenum.
500
List four symptoms that would be indicative of pericarditis or pleurisy.
Sharp or stabbing pain
Not exertional
Present at rest
Unaffected by nitrates
Worse supine (pericarditis)
Worse with respiration
Pericardial or pleural rub
500
How does an adverse childhood experience (ACE) score correlate to health outcomes later in life?
An adverse childhood experience (ACE) score has a strong and graded relationship to health-related behaviours and outcomes during childhood and adolescence, including early initiation of smoking, sexual activity, illicit drug use, adolescent pregnancies and suicide attempts.
Having multiple ACEs is a major risk factor for many health conditions and represent ACE risks for the next generation.
500
Outline four reasons why a patient might consider using complimentary medicines and alternative therapies.
To manage chronic conditions and improve quality of life
Parents who utilize CAM themselves will often extend it to their kids
Desire for holistic care focusing on physical, emotional, and spiritual health
Belief in naturalness & safety of CAM (particularly when trying to avoid ADR of pharmaceuticals)
Part of traditional cultural practices that are integrated in their everyday life (e.g. ayurvedic medicine, traditional Chinese medicine etc.)
Feeling of control – for adolescents (manage cognition & psychological concerns or cancer patients (manage common side effects)