ࡱ> HJGq !bjbjt+t+ &LAA] zvvvvvvvv'))))))$0$hM-vvvvvMvvvv>vv'v'dW'vR$ԑ  Section 1 Genitourinary Which substance is an inhibitor of crystal formation in the urine? nitrate cystine oxalate pyrophosphate uric acid Regarding renal calculi: are more common in women peak age of onset is 40-50 years are unilateral in 80% tend to be larger if formed in the renal pelvis struvite stones are the most common The most common cause of UTI is? proteus Klebsiella enterobacter streptococcus faecalis E. coli Acute tubular necrosis: is irreversible a reduction in tubuloglomerular feedback is an early feature necrotic damage is diffuse oliguria is a feature of the recovery phase injury due to nephrotoxins is most obvious in the proximal convoluted tubules Which is NOT a feature of chronic renal failure? hypocalcaemia polycythaemia dermatitis dehydration gastritis In the kidney: the proximal convoluted tubule is vulnerable to chemical damage, but rarely incurs ischaemic damage the macula densa is the principal source of renin the medulla is particularly resistant to ischaemic damage mesangial cells have an important role in the pathogenesis of glomerulonephritis monocyte macrophages are the principal phagocytic cells In acute tubular necrosis: decline in B.U.N. correspond with the onset of polyuria ischaemic acute tubular necrosis is characterised by diffuse damage to the proximal convoluted tubule nephrotoxic acute tubular necrosis is characterised by focal areas of necrosis in the proximal convoluted tubule pigment-induced acute tubular necrosis looks morphologically similar to ischaemic acute tubular necrosis the distribution of casts within the nephron helps distinguish nephrotoxic from ischaemic acute tubular necrosis Acute renal failure is usually reversible as long as renal blood flow doest NOT fall below: 5% of normal 10% of normal 20% of normal 30% of normal 40% of normal End stage renal disease can be caused by: diabetes mellitus hypertension glomerulonephritis polycystic kidney disease all of the above Renal calculi are caused by: calcium containing stones magnesium, ammonia, phosphate stones uric and stones (?????uric acid stones) cystine stones The order of commonest to least common is: 1, 3, 2, 4 2, 1, 3, 4 1, 2, 3, 4, 1, 2, 4, 3 2, 1, 4, 3 Section 1 Genitourinary Answers D C E E B D D C E C Section 2 Musculoskeletal The radiographic features of rheumatoid arthritis include all of the following EXCEPT: joint effusions narrowed joint spaces juxta-articular bone erosion subchondral bone cysts joint dislocations During fracture healing, the external callus is initially produced by: chondroblasts osteoblasts osteoclasts osteoprogenitor cells osteocytes Which is the principal form of collagen found in bone? collagen type I collagen type II collagen type III collagen type IV type V Which of the following fulfils the diagnostic criteria for rheumatoid arthritis in an adult? symmetrical arthritis causing morning stiffness and rheumatoid nodules morning stiffness in a patient with rheumatoid factor arthritis of hands bilaterally with morning stiffness rheumatoid nodules, morning stiffness and positive rheumatoid factor symmetrical digital arthritis, morning stiffness, and marginal erosions on x-ray Compression of the median nerve in the carpal tunnel produces: anaesthesia over the thenar eminence wasting of the hypothenar eminence loss of power of opposition of the thumb anaesthesia of the little finger loss of power of flexion of the thumb Rheumatoid arthritis: is thought to be initiated by Epstein-Barr virus 95% have serum rheumatoid factor Heberden nodes are often present in women men are more commonly afflicted rheumatoid vasculitis involves the kidneys Regarding normal bone: the main collagen is type II collagen woven bone is stronger than lamellar bone adults have 10% woven bone at any one time calcium hydroxyapatite contains 90% of the bodys calcium bone tissue is made only by osteoblasts Which is a factor in post-menopausal osteoporosis? decreased activity of osteoblasts increased activity of osteoclasts decreased activity of osteoprogenitor cells decreased activity of matrix-bound growth factors decreased secretion of IL-1, IL-6, and TNF Regarding fractures: fibrocartilaginous deposition forms the procallous degranulated platelets directly stimulate osteoblast activity all fractures contain cartilage in callus formation osteoprogenitor cells differentiate into chondroblasts lamellar bone is laid down first Section 2 Musculoskeletal Answers D A A D C A E B B Section 3 Miscellaneous A 15 year old girl suffers from a malabsorption syndrome characterised by the malabsorption of fat. In which vitamin is she MOST likely to be deficient? niacin B6 K pantothenic acid biotin Causes of oedema secondary to increased hydrostatic pressure include all of the following EXCEPT: congestive heart failure cirrhosis of the liver thrombosis constrictive pericarditis nephrotic syndrome Metastatic calcification: causes widespread tissue damage occurs with normal calcium levels can be caused by systemic sarcoidosis occurs in hypothyroidism is caused by drinking large quantities of milk Regarding giant cell arteritis, which statement is NOT correct? it affects medium arteries it affects small arteries including vertebral it affects small arteries including ophthalmic it has an increased prevalence of HLA-DR4 it has no gastrointestinal manifestations Manifestations of decompression sickness include: behavioural disturbance substernal pain caisson disease of bone vertigo all of the above Possible consequences of heroin addiction include all of the following EXCEPT: amyloidosis gastric erosions peripheral neuropathy myopathies acute pulmonary oedema A patient presents with a greater muscle mass in one lower limb than the other. Possible explanations include all of the following EXCEPT: muscular hyperplasia in the larger limb muscular atrophy in the smaller limb ischaemia of the small limb damage to motor nerves of the small limb hypertrophy of muscles in the larger limb Which vitamin deficiency is correctly matched with its characteristic symptom / sign? vitamin A deficiency - squamous metaplasia vitamin B2 deficiency - megaloblastic anaemia vitamin C deficiency - spinocerebellar degeneration vitamin D deficiency - pellagra vitamin E deficiency - night blindness Polyarteritis nodosa involves: pulmonary bed glomerulonephritis arterioles medium sized arteries venules Which of the following is NOT associated with metastatic calcification? milk-alkali syndrome hyperparathyroidism sarcoidosis hyperphosphatasia hypoparathyroidism Which of the following is NOT a common site for metastatic calcification? renal tubules gastric mucosa laryngeal cartilages alveoli blood vessels Which of the following is NOT a common site of dystrophic calcification? pineal gland old tuberculous lesions dead parasites atheromatous plaques uterine leiomyomata Regarding disorders of growth, which statement is INCORRECT? uterus undergoes both hyperplasia and hypertrophy in pregnancy atrophy occurs by apoptosis dysplasia is not an adaptive response dystrophy is a consequence of perverted nutrition hypervitaminosis A can cause squamous metaplasia Section 3 Miscellaneous C E C E E B A A D D C A E   , !!!55CJ$ cdlt|2V & Fh & F$d cdlt|2VWXYz{Ļ㲩xr                      e                         *VWXYz{#>j & Fh & F#>j ",-.=>_S - ȿ}ztnhb                                                   S           % ",-.=>_S -  & F & F| h & F & F  ( 6 D E F p q  - W f g h ¹vsmga[                y                             l   z          #  ( 6 D E F p q  - W f g h E & Fh & Fh      & F$d & FhE#        ú  $   &   (   *   ,   .   0   2   4   6       - . / 0 1 2 AB & F & Fh & F$d$dBP\h~op#hh & F & F%Hq#Mm & Fh & F.hp.024^`!Uh & F & F & F$d89Rit & F & Fh & F$d$d'@opqr+U & F & Fh`am~FGo\] & Fh & F6789XYgz%7LMNO & Fh & F & F. / < T c x !(!N!!!! & F & Fh!!!!!!!!!!!!!!!!!!!!!!!!!! & F $d$1h/ =!"#7$%  [@@@ Normal CJOJQJ_HaJmH sH tH <A@< Default Paragraph FontL!V h B!! !"#$%  ls2:{>Fx S^RYlwW^ P [ \ g h w ~ #+6D "1 Ud6Cbo9FGM%67I@KJacky Stephensondavidr6\\CHL1\DATA\USERS\ED\DAVIDR\mcqs\10) Genitourinary.doc s4& b8r%z?|)xd@j2@"VnosBXt_h ch B@z"VNh hh^h`o(hH) ^`o(hH) 88^8`o(hH) ^`o(hH() ^`o(hH() pp^p`o(hH()   ^ `o(hH. @ @ ^@ `o(hH.   ^ `o(hH.^`o()0^`0o( pLp^p`LhH. @ @ ^@ `hH. ^`hH. 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