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260 Cards in this Set
- Front
- Back
What condition is shown in the image? |
Meningococcal sepsis causing purpura |
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What bacteria is responsible for the condition shown in the image? |
Neisseria meningitidis |
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What is the treatment for the condition shown in the image? |
IV antibiotics - Penicillin - Cefotaxime/ ceftriaxone |
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What condition is shown in the image? |
Bronchopneumonia |
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What is the most likely causative organism for the condition shown in the image? |
Streptococcus pneumoniae |
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What is the treatment for the condition shown in the image? |
Amoxicillin and clarithromycin - IV if severe - Possibly broader spectrum |
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What type of malaria is shown in the image? |
P. Falciparum |
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What are the main clinical markers of severity in P. Falciparum? |
Hyperlactaemia Hyperbilirubinaemia Pulmonary oedema Renal failure Parasite count >5% Metabolic acidosis Significantly raised PT Haemoglobinaemia |
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What is the best treatment for severe P. falciparum? |
Artesunate |
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What parasite is shown in the image? |
Trypansomiasis Rhodesensi |
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What disease is caused by the parasite shown in the image? |
Sleeping sickness |
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The patient in this image presented with fever 38.5C, tachycardia 110/min and severe sore throat. If a swab is taken what is likely to grow? |
Group A streptococcus |
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The patient in this image presented with fever 38.5C, tachycardia 110/min and severe sore throat. What are two reasons antibiotics are indicated? |
Temperature >38C Pus on tonsils Tachycardia |
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The patient in the image presents with fever and sweats. What is the diagnosis? |
Cellulitis |
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What are two common bacterial causes of cellulitis? (shown in image) |
Staphylococcus aureus B-haemolytic streptococcus |
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You are the F1 doctor and arecalled to see a 42yr old patient with a MEWS of 6 on the assessment suite. Thepatient has a high temperature of 39^C, a pulse rate of 120/min, a respiratoryrate of 35/min. The patients blood pressure is 80/40 and they have a painfulswollen lower right leg, with pain into the upper thigh. What 2 diagnoses must you make? |
Septic shockl Necrotising fasciitis |
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You are the F1 doctor and arecalled to see a 42yr old patient with a MEWS of 6 on the assessment suite. Thepatient has a high temperature of 39^C, a pulse rate of 120/min, a respiratoryrate of 35/min. The patients blood pressure is 80/40 and they have a painfulswollen lower right leg, with pain into the upper thigh. Name at least 4 measure which should be taken immediately to prevent death. |
Oxygen IV broad spectrum antibiotics IV fluids Close monitoring 1/2 hours obs |
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You are the F1 doctor and arecalled to see a 42yr old patient with a MEWS of 6 on the assessment suite. Thepatient has a high temperature of 39^C, a pulse rate of 120/min, a respiratoryrate of 35/min. The patients blood pressure is 80/40 and they have a painfulswollen lower right leg, with pain into the upper thigh. Give 2 urgent investigations as part of the standard response to this situation |
Lactate Blood cultures |
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1. A 75 year old is found unconscious at home and admitted toITU. Cerebrospinal fluid (CSF) reveals low glucose, high protein andneutrophils. Which organism is likely to be responsible? |
Streptococcus pneumoniae |
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A patient present with severe diarrhoea after eatingchicken and 2 weeks later develops guillian-barre syndrome. Which organism is likely to be responsible? |
Campylobacter jejuni |
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A patient has a sore throat and then develops strangemovements and on examination is found to have a new murmur, arthritis and aflitting rash What organism is likely to responsible? |
Group A streptococcus |
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A patient presents with fever, severe headache rigorshaving travelled to Kenya. Blood tests reveal high bilirubin, low platelets anddecreased haemoglobin. The patient goes on to have a seizure. What organism is likely to responsible? |
Plasmodium Falciparum |
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An infant of 6 months presents off food and with a pupuricrash What organism is likely to responsible? |
Neisseria Meningitidis |
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A bacteria which can cause epiglottitis but theincidence of which has reduced significantly with a vaccine. What organism is likely to responsible? |
Haemophilus Influenzae |
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A parasite that can have a dormant form in the liver. What organism is likely to responsible? |
Plasmodium Vivax |
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A gram negative bacteria which is found in the bowel, colonising soon after birth and with a biomass of around 2kg in the adult What organism is likely to responsible? |
Escherichia coli |
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A cause of atypical pneumonia, sometimes associated with cold agglutination. What organism is likely to responsible? |
Mycoplasma Pneumoniae |
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2 bacteria are associated with toxic shock syndrome. What organism is likely to responsible? |
Group A Streptococcus Staphylococcus aureus |
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Which letter indicates the fibriae? |
A |
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Which of the following statements regarding otitis media is incorrect? |
C |
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Which of these structures is found in gram-negative bacteria but not gram positive bacteria? |
C |
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Which of the following is a cause of fungal meningitis? |
C |
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Which of the following mechanisms of resistance is an example of inherent resistance? |
B |
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Which of the following antibiotics would be considered inappropriate for empirical treatment of a urinary tract infection? |
C |
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Which of the following components of gram-negative cell walls acts as an endotoxin? |
C |
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Which of the following ENT conditions should be treated with systemic antibiotics? |
B |
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Which of the following statements best describes endotoxins? |
C |
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Which of the following statements relating to anti-microbial resistance is true? |
B |
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Which of the following antibiotics main mechanism of action is to interfere with cell wall synthesis? |
A |
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A 68 year old man with recent travel history to Bangladesh during the rainy season has presented to A and E with diarrhoea of rice water stools and clinical features of dehydration. What is the most likely pathogen involved? |
C |
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Rheumatic fever and glomerulonephritis can be complications of pharyngitis caused by which bacteria? |
B |
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Which of the following statements is correct regarding fungal respiratory tract infections? |
E |
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Which of the following regarding notifiable diseases is true? |
B |
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A 25 year old patient is admitted with fever, rigors and abdominal pain. On examination the patient is tachycardic and pyrexial. Which of the following would suggest severe sepsis? |
B |
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Which of the following would be appropriate early management of a patient with severe sepsis? |
D |
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A patient has fever within 1 week of return from India, which of the following is true? |
C |
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Which of the following parasites is a common cause of anaemia in Sub-Saharan Africa? |
A |
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A man returns from India and develops recurrent cellulitis with consequent lymphoedema after 2 years. Blood tests reveal an eosinophilia. Which of the following is true? |
B |
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A patient presents with flu-like symptoms. Which of the following would be helpful as part of the diagnostic criteria for SIRS? |
B |
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Name an organism listed in the image that does not usually have a capsule |
B |
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Which features concerning exotoxins listed in the image is false? |
E |
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Which of the statements in the image is true of Salmonella infection? |
E |
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What condition is shown in the image? |
Chicken pox/ varicella |
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What virus is responsible for the condition in the image? |
Varicella zoster virus |
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What is the primary route of transmission of VZV? |
Aerosol/ respiatory |
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What virus family does VZV belong to? |
Herpesviridae |
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What condition is shown in the image? |
Shingles/ zoster |
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What is the relationship between shingles and chicken pox? |
Same virus Both have reactivation/ latency |
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What condition is shown in the image? |
Hand foot and mouth disease |
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Which virus group is responsible for the condition in the image? |
Enteroviruses |
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What are the lesions in this image called? |
Koplik spots |
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What condition is shown in the image? |
Measles |
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What is the cause of the lesions in the image? |
Molluscum contagiosum virus |
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This rash presented in an otherwise when child. What is the likely diagnosis? |
Slapped cheek disease/ fifth disease/ Parvovirus B19 |
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Which patient groups are cause for increased concern in Parvovirus? |
Pregnancy Immunosuppessed Any haemolytic anaemia |
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What condition is shown in the image? |
Genital warts/ HPV |
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How can HPV be prevented? |
Vaccination or sexual abstinence |
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A 65 year old is found unconscious at home and admitted toITU. Cerebrospinal fluid (CSF) findings are consistent with a viral CNSinfection and MRI shows evidence of temporal lobe changes. Which virus is the likely cause? |
Herpes Simplex Virus 1 |
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A four month old present to hospital with a runnynose and difficulty breathing. A diagnosis of bronchiolitis is made.
Which virus is the likely cause? |
Respiratory Syncytial Virus (RSV) |
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What is an example from the list of an RNA virus that undergoes genetic shift? |
Influenza A |
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A 22 year old is admitted to hospital complainingof headache and neck stiffness, but is not particularly unwell. CSF shows ahigh white cell count which is 100% lymphocytes. The patient improves and goeshome without any antibiotic treatment. Which virus is the likely cause? |
Enterovirus Herpes Simplex Virus |
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Which virus from the list is a positive stranded RNA virus which is the commonest cause of the common cold? |
Rhinovirus |
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Which virus from the list can cause respiratory illness, conjunctivitis and gastroenteritis? |
Adenovirus |
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Which virus from the list can be treated using the neuraminidase inhibitor oseltamivir? |
Influenza A |
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A 70 year old is offered a vaccine by their GP to prevent a problem related to a particular virus. What is the virus in question? |
VZV or Influenza A |
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What is an example of a retrovirus from the list? |
HIV |
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Which virus from the list is a travel-associated mosquito borne virus causing rash and arthralgia? |
Chikungunya virus |
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Which letter indicates the viral envelope? |
C |
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Which of the following is not a mechanism by which viruses evolve? |
E |
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Which of the following is a feature of a viral infection amenable to eradication? |
D |
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Which of the viral infections in the image cannot be prevented by a currently licensed vaccine? |
F |
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What is currently the commonest route of transmission of Hepatitis C virus in the UK? |
B |
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Which of the following is not used to prevent mother to child HIV transmission? |
A |
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Which of the following is a clinical feature of symptomatic congenital CMV infection? |
B |
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Which of the following represents the incubation period for mumps virus infection? |
C |
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A 22 year old presents with a 5 day history of fever. On examination, discrete cervical lymph nodes are palpable bilaterally. Which of the following pathogens is unlikely to be the cause of this clinical presentation? |
B |
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A patient with hepatitis has the following serological profile. What is the interpretation? |
C |
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Which of the following can be associated with Herpes Simplex Infection? |
B |
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Which of the following human papilloma viruses are linked to >70% of cervical cancers? |
C |
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Which of the following is true of aciclovir? |
D |
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What is the infectious agent in Creutzfeld Jacob Disease? |
D |
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What is the commonest bacterial sexually transmitted infection in the UK? |
A |
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In the viral life cycle which of the following stages is common to all viral families? |
A |
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Which of the following influences the R(0) value for an outbreak of infection? |
B |
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Which of the following is not a common route of viral transmission in the UK? |
A |
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What is fomite transmission? |
Through objects such as clothing |
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Which of the following does not describe a major mechanism of transmission of HIV? |
A |
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Which of the following viruses is the commonest cause of congenital infection in the UK? |
A |
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Which of the following is not a recognised cause of hepatitis? |
D - A purely hypothetical virus |
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Which statement is true of Epstein Barr virus infection? |
E |
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Which of the following vaccines was included in the routine vaccination schedule for children over two years from Autumn 2014? |
B |
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Which of the following is not a class of drug used to treat HIV? |
B |
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What is the main treatment for soft tissue bacterial infections? |
Flucoxacillin |
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What is the main treatment for UTIs in men? |
Ciproflaxin |
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When can't trimethoprim be used in pregnancy? |
1st trimester |
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When can't nitrofurantoin be used in pregnancy? |
3rd trimester |
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What type of haemolysis turns blood agar green? |
Alpha |
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Who does legionella cause pneumonia in? |
Young people |
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Where is legionella commonly found? |
Contaminated water |
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What type of microorganism causes necrotising fasciitis? |
Group A Streptococcus |
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What can E. Coli cause in neonates? |
Meningitis |
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CURB-65 scoring system (image) |
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What are the Sepsis Six? |
1. Give high flow oxygen 2. IV fluid resuscitation 3. IV antibiotics 4. Take blood culture 5. Check haemoglobin and lactate 6. Accurate hourly urine output monitoring |
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What drug is used for radical cure of malaria? |
Primaquine |
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What types of malaria is a radical cure used on? |
P. Vivax P. Ovale |
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How is Leishmaniasis transmitted? |
Sandflies - Cutaneous - Mucocutaneous - Visceral (often hepatosplenomegaly) |
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What disease is transmitted by Tsetse flies? |
Trypansmiasis (sleeping sickness) |
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What disease is transmitted by water snails? |
Schistomiasis |
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What disease is transmitted through cat faeces? |
Toxoplasmosa gondii |
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What are interferons (IFN)? |
Signalling proteins made by (often virally) infected cells - Protect cells from viral infections - Activate NK cells, macrophages |
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What is the role of C3a in innate immunity? |
- Vasodilation through SM contraction - Increased vascular permeability - Induce histamine release through degranulation - Typically proinflammatory |
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Which three main cell types release histamine? |
Mast cells Basophils Enterochromaffin-like cells |
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What is the role of C3a in adaptive immunity? |
- Regulates B cell and monocyte production of IL-6 and TNF-alpha - Necessary for TH1 cell generation - CD28 and CD40L |
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What generates C3 and C5 convertases? |
C3b |
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What is the main function of C3b? |
Opsonisation - tagging cells for phagocytosis |
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What does deficiency of C5 cause? |
Leiner's disease - long lasting seborrhoea dermatitis and increased likelihood to infection - Typically diagnosed in early infancy |
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What inhibits the MAC? |
CD59 - deficiency causes paroxysmal nocturnal haemaglobinuria |
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What are the components of the MAC? |
C5b C6 C7 C8 C9 |
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What is the main antibody found in breast milk? |
IgA |
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What is the main antibody found in the mucosal lining? |
IgA |
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What do all B cells begin as? |
IgM |
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Which antibody is passed to the baby in the third trimester? |
IgG |
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What is the difference between necrosis and apoptosis? |
Necrosis - caused by factors external to the cell/ tissue such as infection, toxins or trauma which result in the unregulated digestion of cell components Apoptosis - naturally occurring programmed and targeted cause of cell death |
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What are the 6 types of necrosis? |
Coagulative Liquefactive Caseous Fat Fibrinoid Gangrenous |
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What is coagulative necrosis? |
Most common type, protein breakdown due to ischaemia. Can affect anywhere except brain |
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What is liquefactive necrosis? |
Bacterial or fungal infections resulting in pus (enzyme imbalance causing cell to digest itself) - Dead tissue softens |
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What is caseous necrosis? |
Cell structure completely destroyed due to degradation by enzymes - Caused by TB, histoplasmosis |
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What is fat necrosis? |
Digestion of fatty acids by enzymes - released from cells at death - Appear as chalky white deposits |
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What is fibrinoid necrosis? |
Protein accumulates in tissue matrix - Malignant hypertension, hyperacute transplant rejection |
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What is gangrenous necrosis? |
Critically insufficient blood supply - Infection - Diabetes |
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Which disease can be complicated with fistulas (deep sores/ ulcers turning into tracts) and strictures (scar tissue thickening bowel wall)? |
Crohn's |
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What is a mycotic aneurysm? |
One arising from bacterial infection of the artery wall |
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Which MMR virus has an incubation period of 10-14 days? |
Measles |
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Which virus features Koplik spots? |
Measles |
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Which live attenuated vaccines are licensed in the UK? |
MMR BCG (TB) Polio Yellow fever VZV/ Zoster/ shingles Intranasal influenza "Fluenz" |
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What symptoms is quite common in adults with Rubella? |
Joint pain |
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What is the cause of Roseola Infantum? |
HHV6 and 7 |
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What is the most significant virus not associated with worse outcomes in immunocompromised/ pregnancy/ neonates? |
Mumps |
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What drug inhibits viral polymerase to prevent DNA replication? |
Activated aciclovir |
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Which virus is associated with abnormal cancers such as Castleman's disease? (Castleman's = lymph node hyperplasia) |
HHV8 |
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What are the three serotypes of Chlamydia Trachomatis? |
Ab, B, Ba or C D-K L1, L2, L3 |
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What do serotypes Ab, B, Ba and C of Chlamydia Trachomatis cause? |
Trachoma - eye infection that can lead to blindness Think Abba - I (eye) have a dream |
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What do serotypes D-K of Chlamydia Trachomatis cause? |
Urethritis Pelvic inflammatory disease Ectopic pregnancy Neonatal pneumonia Neonatal conjunctivitis Think D--K, = genitals |
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What do serotypes L1, L2 and L3 cause? |
Lymphogranloma Venereum L for lymph |
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What type of virus causes SARS and MERS? |
Coronaviruses |
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Is confusion a symptom of meningitis or encephalitis? |
Encephalitis |
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Why is vCJD tough to eradicate? |
Not destroyed by peroxide or any chemicals/ heat |
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What are examples of folate synthesis inhibitors? |
Proguanil Pyrimethamine Trimethoprim |
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Which drugs can cause gum hypertrophy? |
Anticonvulsants (Phenytoin) Immunosuppressants (Cyclosporine A) Ca channel blockers (Nifedipine, verapamil, diltiazem) |
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What is the mechanism of action of aciclovir? |
- Converted to aciclovir monophosphate by viral thymidine kinase - Converted to aciclovir trophosphate by host cell kinases - Inhibits HSV-specific DNA kinases to prevent viral DNA synthesis without affecting normal cell processes |
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Who does C. Difficile commonly affect? |
Patients recently treated with antibiotics |
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What is the mechanism of action of viagra? |
PDE5 inhibitor - Prevents cGMP breakdown - SM relaxation, blood inflow to corpus cavernosum |
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What is climacteric? |
The period of life when fertility and sexual activity are in decline (menopause) |
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What are the 4 checkpoints in the cell cycle? |
Restriction point G1 - S S-phase checkpoint G2-M checkpoint Metaphase-anaphase transition |
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Which CDK-cyclin complexes are present at the G1-S checkpoint? |
Cyclin E CDK 2 |
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Which CDK-cyclin complexes are present at the S phase checkpoint? |
Cyclin A CDK 2 |
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Which CDK-cyclin complexes are present at the G2-M checkpoint? |
Cyclin A and B CDK 1 |
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Which CDK-cyclin complexes are present at G1 (metaphase-anaphase transition)? |
Cyclin D CDK 4, 6 |
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What does telomere shortening induce? |
Cellular senescence |
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What is the first call treatment for seizures? |
Lorazepam (benzodiazepine) |
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What is the interaction of Carbamazepine and Tramadol? |
Increased tramadol metabolism - shorter half life |
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Which types of cell have VDJ recombination? |
B cells and T cells only |
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Which HLAs are class I? |
A, B and C |
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What is required for positive selection of T lymphocytes within the thymus? |
T cell receptor must recognise a self MHC molecule expressed within the thymus |
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What are ectopic tissue antigens important for? |
Deletion of potentially auto-reactive T lymphocytes (central tolerance) |
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How can T cells express both CD4 and CD8 at the same time? |
When developing in the thymus |
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What should be avoided in prescription writing? |
"Micro" signs - better to use the word Decimal points |
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What dose do ADRs occur at? |
Therapeutic dose |
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What types of drugs are triptans? |
5-HT1 agonists |
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What is the purpose of CSF? |
Reduces brain weight Shock absorber |
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What does a lesion of the middle cerebral artery spare? |
Legs (Affects arms and face) |
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What does a lesion of the anterior cerebral artery spare? |
Arms (Affects legs and face |
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What are the symptoms of a cerebellar stroke? |
DANISH D ysdiadochokinesis A taxia N ystagmus I ntention tremor S lurred speech H ypertonia |
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What are the common symptoms of a CN VII lesion? |
Hyperacuisis Facial weakness |
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What do infections occurring above the belly button tend to be? |
Gram-positive |
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What do infections occurring below the belly button tend to be? |
Gram-negative |
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What does a positive catalase test indicate? (Catalase enzyme interacts with hydrogen peroxide) |
Staphylococcus |
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What does a negative catalase test indicate? |
Streptococcus |
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What do lymphocytes and neutrophils kill? |
Lymphocytes - viruses Neutrophils - bacteria |
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What does rust coloured sputum indicate? |
Streptooccus pneumoniase - Alpha-haemolysis of iron |
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How is Hep B transmitted? |
Secretions (e.g. sweat, semen) |
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How is Hep C transmitted? |
Blood |
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Where is Hep A commonly picked up? |
India |
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Where is Hep B commonly picked up? |
Thailand |
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Who most often suffers from Hep C? |
Students |
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Who most often suffers from Hep E? |
Farmers - large reservoir in pork |
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What is Icterus? |
Jaundice |
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What are the main antigen presenting cells? |
Dendritic cells |
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What are the functions of IL-1? |
Fever Activates lymphocytes |
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What are the functions of IL-6? |
Fever Acute phase proteins Activates lymphocytes Antibody production |
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What are the functions of IL-8 (CXCL8)? |
Neutrophil chemotaxis |
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What are the functions of IL-12? |
Activates NK cells Activates TH(1) cells |
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What are the functions of TNF-alpha? |
Increased vascular permeability Produced mainly by activated macrophages |
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Hot T-bone stEAK mnemonic |
IL-1 - fever (HOT) IL-2 - T cells IL-3 - bone IL-4 - IgE IL-5 - IgA IL-6 - aKute phase proteins |
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What are the functions of complement? |
- Bacterial cell wall lysis (MAC) - Opsonisation of bacteria - Recruitment of neutrophils (chemotaxis) - Activation of mast cells + basophils - Removal of immune complexes |
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What do complement deficiencies lead to? |
Recurrent pyogenic infection Streptococci and Hib most common infection as opsonisation critical for removal |
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What does deficiency of C5-9 lead to? |
Meningococcal infection |
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What do TH(2) cells promote? |
Antibody production by B cells and differentiation into plasma or memory cells |
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Where is MHC I found? |
All nucleated cells - Alerts killer T cells when something isn't right inside a cell |
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Where is MHC II found? |
Only on APCs - Informs T helper cells that problems exist outside of cells |
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What does IFN-gamma do? |
Blocks viral replication - Doesn't lyse cells - important to not spread virus further |
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ABCDEF classification |
Augmented Bizarre Chronic Delayed End of use Failure |
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Which of the following is not a type I hypersensitivity reaction?] Allergic rhinitis Urticaria Eczema Food allergy Anaphylactic shock Psoriasis |
Psoriasis |
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How is anaphylaxis treated? |
Epinephrine (vasoconstriction, increase HR) H1 antagonists (Chlorphenamine) Steroids (hydrocortisone to decrease production of inflammatory mediators) |
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Which prostanoid helps with sleep control? |
PGD2 |
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Which substances activate C pain fibres? |
Serotonin, kinins |
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What type of drugs are Tacrine, Donepezil, Rivastigmine and Galantamine? |
AChE inhibitors for Alzheimers - Donepezil commonly used, long half life |
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What type of drug is an antipsychotic? |
D2 antagonist - Typical e.g. Haloperidol - Atypical e.g clozapine, risperidone EPSE or galactorrhoea side effects |
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What is a partial seizure? |
Structural abnormality in a hemisphere (originates in one part of the brain) - Simple (no LOC) - Complex (Loss of consciousness) |
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What are the classes of generalised seizure? |
Absence (petit mal) Myoclonic Tonic clonic (Grand mal) Tonic Atonic |
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What are the two ways of treating epilepsy? |
Increase GABA - Benzodiazepines, Barbituates - Gabapentin, Vigabatrin Decrease membrane excitability through Na+ - Carbamazepine, phenytoin, lamotrigine, sodium valproate |
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Which drugs are used mainly for status epilepticus (fits that follow each other without a regain in consciousness)? |
Benzodiazepines Barbituates |
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What is the mechanism of action of Ethosuximide? |
Blockage of T-type Ca2+ channels to block 3Hz electrical activity - Absence seizures only |
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What are the three types of opioid receptor? |
Mu Kappa Delta |
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What is given for opioid overdose? |
Naloxone |
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What is the daily production of CSF? |
550mls - turned over 3-4x per day |
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What is the passage of CSF? |
Lateral ventricles 3rd ventricle (via interventricular foramen) 4th ventricle (via cerebral aqueduct) Subarachnoid space (via 2x medial and 2x lateral foramen) |
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Lumbar puncture analysis (table) |
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What are the most common locations for ruptured brain aneurysms? |
Posterior communicating + internal carotid Anterior communicating + anterior cerebral Posterior cerebral x2 |
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What shape are staphylococci and streptococci generally? |
Staph - triangle Strep - line |
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Mnemonic for cranial nerve functions (I-XII) |
Some Say Marry Money But My Brother Says Big Boobs Matter More (M = motor, S = sensory, B = both) |
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What are the contents of the foramen spinosum? |
Middle meningeal artery |
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What are the contents of the foramen ovale? |
CN V3 (mandibular) |
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What are the contents of the foramen rotundum? |
CN V2 (maxillary) |
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What are the contents of the foramen lacerum? |
Artery and nerve of pterygoid canal |
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What are the contents of the internal acoustic meatus? |
CN VII CN VIII |
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What are the contents of the jugular foramen? |
CN IX CN X CN XI Internal jugular vein |
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Nerve palsies (image) |
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What are the causes of bacterial meningitis in neonates - 3 month olds? |
E. coli Group B Streptococcus Listeria mlnocytogenes (also affects elderly/ immunocompromised) |
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What are the causes of bacterial meningitis in people aged 3 months+ ? |
Neisseria meningitidis Streptococcus pneumoniae Haemophilus influenzae |
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What are the immune functions of glucocorticoids? |
COX expression inhibition Induction of Annexin 1 (Lipocortin 1) - Inhibits leukocyte epithelial adhesion, migration, chemotaxis and phagocytosis - Inhibits phospholipase A2 |
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What is the mechanism of infection of HIV? |
1. Virus binds to CD4+ cell via glycoprotein 120 on the virus and CXCR4/ CCR5 coreceptors on the CD4 cell 2. Virus binds the cell via gp41 3. Reverse-transcription-RNA is uncoated and forms viral DNA 4. Viral DNA integrated into the host's genome 5. DNA used to form viral proteins 6. Budding - proteins assembled and virus released |
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What is the life cycle of the malaria parasite? |
1. Mosquito bite - sporozoites enter blood stream 2. Infect liver cells, multiply into merozoites and rupture liver cells 3. Infect RBCs, develop into ring form trophozoites and schizonts which in turn form further merozoites - Also forms gametocytes that can be taken back up by a mosquito to spread the infection |
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What is the typical subacromial painful arc? |
60-120 degrees |
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What is the typical glenohumeral painful arc? |
45-60 - 120 degrees (Also 170-180 for acromioclavicular) |
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What are the key components of the Declaration of Geneva (1948)? |
Re-confirms the role of the doctor as a servant to humanity and to first and foremost act for the benefit of the patient Places new emphasis on equality and the importance of doctors not violating human rights of civil liberties 'even under threat' |
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What are the key components of the Nuremberg Code? |
- Voluntary consent of human subjects essential - Results unprocurable by other methods - Anticipated results must justify performance - Avoid physical/ mental suffering/ injury - Should not perform where prior reason to believe death/ disabling injury will occur - Risk < importance of problem - Protect subject against injury - Only done by the scientifically qualified - Subject has option to end early - Must be prepared to terminate at any stage |
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What are the key features of the Declaration of Helsinki? |
Similar to Nuremberg code but allows for use of human remains, altering consent from essential to if possible. Introduces approval of ethic committee Must benefit the population taking part in the study to prevent exploitation |
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What are the key features of the Declaration of Tokyo? |
- No torture, inhuman/ degrading procedures (no presence/ provision of tools etc.) - Confidentiality of information - Complete clinical independence - No artificial feeding of prisoners that have refused nourishment Support of the physician and their family in the face of threat or reprisals resulting from refusal to condone torture etc. |
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What type of haemolysis does Group A Streptococcus cause? |
Beta |
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What is the most common cause of encephalitis? |
Viral e.g. HSV 1 |
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How does CD8 destroy infected cells? |
Release of perforin followed by granzymes via Fas ligand interactions |
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Which complement pathway is antibody dependent? |
Classical |
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What is the most rapidly produced immunoglobulin during an infection? |
IgG |
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What disease is commonly caused by a classical complement pathway deficiency? |
Systemic Lupus Erythematosus - Result of inability to clear circulating immune complexes |
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What diseases are commonly caused by Lectin/ Alternate complement pathway deficiencies? |
Pyogenic infection Pneumococcal/ neisserial infection |
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What are the consequences of deficiency in the complement regulatory pathway? |
Angioedema (hereditary or acquired) Paroxysmal nocturnal haemoglobinuria |
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What dose of adrenaline is given for anaphylaxis? |
0.5ml of 1 in 1000 IM |
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When is opioid overdose indicated? |
Respiratory rate <10 or GCS <10 - Reduced level of consciousness |
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How is each type of overdose countered? |
Aspirin/ TCA - Sodium bicarbonate Paracetamol - N-acetylcysteine Aspirin - Activated charcoal - to reduce absorption - first 1/2 hours only |
