Week 1
A 55-year-old man with hypertension and hyperlipidaemia has early atherosclerotic change in a coronary artery. Endothelial dysfunction has allowed LDL to enter the tunica intima, where it becomes oxidised. Monocytes then migrate into the vessel wall, differentiate into macrophages, and ingest oxidised LDL to become foam cells, forming a fatty streak.
Which process occurs next in the development of an atherosclerotic plaque?
Smooth muscle cells migrate from the tunica media into the tunica intima, proliferate, and produce extracellular matrix/collagen to form a fibrous cap.
A 68-year-old man has an ECG performed after presenting with dizziness. The QRS complex is upright in lead I, downward in aVF.
Which axis deviation is present?
Left axis deviation
A 47-year-old female undergoes an ultrasound where the probe is placed just to the left of the sternum in the 3rd–4th intercostal space, and the orientation marker is directed toward the patient’s left shoulder. Images are obtained at the mid-papillary muscle level and at the level of the aortic valve. What view is this?
Transverse - Parasternal Short Axis (PSAX)
What tissue type is the outermost surface of valves made from?
Endothelium
What anatomical structure is a postductal aortic coarctation distal too?
Ductus arteriosus
What leads would show ST elevation in an inferior STEMI?
lead II, III and aVF
A 24-year-old medical student is reviewing the electrophysiology of cardiac pacemaker cells. During repolarisation of sinoatrial (SA) node cells, specific ion channels open, allowing positively charged ions to move out of the cell. This process restores the membrane potential to its resting level after depolarisation. Which phases and ion movements describes this process?
Phase 3 – K⁺ efflux through delayed rectifier channels
A 70-year-old man receives a large intravenous fluid bolus. Shortly afterwards, his cardiac output increases. This occurs because increased blood returning to the heart causes stretching of the cardiac muscle fibres, leading to a stronger contraction. Which mechanism/law explains this response?
Frank–Starling law: Increased stretch leads to stronger contraction.
You are in PES and are palpating an artery posterior and inferior to the medial maliolous. What two arteries does this artery bificate into?
medial and lateral plantar arteries
What does cGMP activate in order to dilate peripheral arteries and veins?
Protein kinase G
A researcher is selecting a genetic test to diagnose trisomy 18 in a fetus. They choose a method that evaluates entire chromosomes to detect large-scale abnormalities such as aneuploidy. Name three cytogenetic tests that can be conducted
(this could be wrong... I didn't like this lecture)
Karyotyping
FISH (Fluorescent In Situ Hybridisation)
Microarray (CMA/aCGH)
A 68-year-old man with a history of long-standing chronic obstructive pulmonary disease (COPD) presents with progressive lower extremity swelling and abdominal distension. On physical exam, he has pitting edema of the legs and ascites. Laboratory studies show mild elevations in liver enzymes. A liver biopsy reveals a mottled appearance with dark centrilobular areas surrounding pale periportal regions, often described as a “nutmeg liver.” What is the underlying cause of this patient’s liver findings?
Right-sided heart failure
A 24-year-old patient develops cerebral oedema after head trauma. A doctor explains that even a small increase in fluid in the brain can be dangerous because the skull limits expansion. In contrast, the liver normally allows much freer exchange of fluid and proteins between blood and tissue. Which capillary type is found in the brain and which is found in the liver?
Brain: continuous capillaries.
Liver: sinusoidal/discontinuous capillaries.
This uncommon type of angina is caused by coronary artery spasm, is unrelated to physical activity, and responds well to vasodilators.
Prinzmetal angina
A 6-year-old child is brought to the clinic with fever, ear pain, and irritability. He is diagnosed with acute otitis media and prescribed amoxicillin. After several days, his symptoms worsen, and cultures reveal a strain of Escherichia coli producing an enzyme that hydrolyses the beta-lactam ring of the antibiotic. A second drug is added that has little intrinsic antibacterial activity but restores the effectiveness of the antibiotic by inhibiting this enzyme. What is the CLASS of the ORIGINAL antibiotic?
Beta-lactams (Pencillins/Cephalosporins)
A 12-year-old boy presents with fever and migratory joint pain affecting his knees and ankles. His mother reports that he had a sore throat about 3 weeks ago that resolved without treatment. On examination, a new heart murmur is heard. Laboratory tests show elevated ESR and positive antistreptolysin O (ASO) titers. What mechanism explains the cross-reactivity between streptococcal antigens and host tissues?
Molecular Mimicry
What receptors in the kidney does ADH work on to induce water retension?
V2
These alternating pale platelet/fibrin layers and darker red blood cell layers are seen in thrombi formed before death.
Lines of Zhan
While in the ED being treated for an MI, a 62-year-old man develops frequent premature ventricular contractions and runs of ventricular tachycardia. A drug is administered that preferentially binds to open sodium channels during phase 0, has rapid dissociation kinetics, and shortens the action potential duration in ventricular myocytes.
Lidocaine/Lignocaine
A 47-year-old female has been diagnosed with sepsis. She has been prescribed IV ampicillin plus an IV antibiotic with anti-pseudomonal properties. However, the dose needs to be monitored carefully to prevent ototoxicity. What is the drug?
Gentamicin