MOCK5.txt

• • secondary amyloid.
• • It is a breakdown product ->serum amyloid associated protein, an acute phase reactant that is elevated in chronic inflammatory states.

• • TB
• • leprosy
• • rheumatoid arthritis.

-breakdown product is immunoglobulin light chains.

• • multiple myeloma
• • Waldenstroms macroglobulinaemia
• • idiopathic amyloidosis.

• -Solitary cardiac involvement can be found in the elderly
• -related to a breakdown product of pre-albumin.

• cardiac or renal failure.

-> charged particles failing to distribute themselves evenly on either side of a semi-permeable membrane.

• -wide complex QRS complexes,
• ->usually with a RBBB morphology
• -follow a short R-R interval preceded by a prolonged R-R interval.
• -considered benign.

• • Nitrofurantoin
• • erythromycin
• • cephalosporins
• • NSAIDs
• • ACE inhibitors
• • TCAs
• • phenytoin
• • azathioprine
• • carbemazepine
• • oral contraceptive pills
• • diazepam
• • ketocaonazole amongst others.

->inclusions within red blood cells composed of denatured haemoglobin.

• • G-6-PD deficiency
• • NADPH deficiency
• • Chronic liver disease
• • Alpha-thalassaemia

• -pH 7.4.
• - osmolality 274 mOsm/L.
• -125 mmol/l of chloride compared with 0.9% saline which contains 154 mmol/l.
• -molecular weight 30,000.

• ->60-65% show subclinical disease and recover fully.
• -> 20-25% that contract it develop acute hepatitis.
• -> 5-10% that contract it develop chronic hepatitis.

->anterolateral tibia ->medial side of the lateral femoral condyle.

->posteromedial tibia -> lateral side of the medial femoral condyle.

->unclear, but it may be due to hormone mediated differences in muscle tension as well as general anatomical and muscle strength related reasons.

• ->rapid deceleration or landing.
• ->also occur as a consequence of hyperextension injuries and falls.
• -immediate pain and rapid swelling following an ACL injury.
• -often complain of hearing a pop.
• -knee is unstable, loose and prone to giving way.

-> 1,25-dihydrocholecalciferol by increasing the activity of alpha-hydroxyls in the kidney.

• • Periorbital ecchymosis (Racoon eyes)
• • Retroauricular ecchymosis (Battle's sign)
• • CSF rhinorrhoea or otorrhoea
• • 7th or 8th nerve palsy
• • Haemotympanum

->temporal lobe heamatoma or uncal herniation but not a basal skull fracture.

• The receptor-> is the sensing component that monitors and responds to changes in the environment.
• Regarding osmolarity
• ->The osmolarity is slightly less than the osmolality.
• ->The normal human reference range is 275-295 milli osmoles per kilogram.
• ->Calculated osmolarity is 2Na + 2K + glucose +urea.
• ->Alcohol is a cause of an elevated osmolar gap.
• Regarding candida
• -> frequently asymptomatic.
• -> Patients with oropharyngeal candidiasis often have a history of HIV infection.
• ->Approximately 10% of women experience repeated attacks without any precipitating risk factors.
• -> Candida albicans is responsible for 50-60% of candida infections.

• • 4% people
• The right coronary artery supplies the sino atrial node in
• -> 60% of patients.
• carpal tunel Anteriorly it is formed by
• • transverse carpal ligament which runs from the hamate and pisiform bones medially to the scaphoid and trapezium laterally.
• A total of 9 flexor tendons pass through the carpal tunnel. These are
• • 4 from flexor digitorum profundus
• • 4 from flexor digitorum superficialis
• • one from flexor pollicis longus.

• the thenar eminence.

• • It is most usually infection on the face ->angular vein and into the sinus.
• • Stahphylococcus aureus is the most common infectious microbe
• • Sixth nerve palsy is most common.

• very young, very old or debilitated.

• ->incubation period is usually 7-10 days in infants and young children.  
• ->If a patient displays an inspiratory whoop after coughing or posttussive emesis then the likelihood that the illness is pertussis is increased by four doubled.  
• ->Erythromycin or azithromycin are first line treatments.

-> pseudomonas septicaemia.

• ->Symptoms of campylobacter dysentery usually last 5-7 days.
• ->Standard treatment is with azithromycin as ciprofloxacin is no longer effective due to resistance.

->negative inotropic factor.

->negative inotropic factor.

-> 0.5-1.6 (millimetres) in length.

-> Congestive heart failure is a very rare known side effect.  

A double dummy technique is used when interventions are very different. In such cases all subjects appear to receive both interventions, although one is a placebo, in order to maintain blinding.

• ->suspected in patients that collapse after exercise.
• ->Mortality is around 10%.
• ->When core temperature is less than 39°C then active cooling should stop as hypothermia may occur.
• ->Anti pyretics such as paracetamol NO->should not be given. The most efficient way to cool the patient is to spray the naked patient with tepid water and blow air over them with fans.

• -> commences at the vertebral level L5.
• -> diaphragmatic opening -> vertebral level T8.

->combines the results of several studies.  

->attempts to access and review all of the pertinent articles in a particular field of study.  

• ->About 90% have an asymptomatic infection.
• ->“Ghon focus” is the primary site of infection in the lungs and is usually found
• ->either in the upper part of the lower lobe
• -> the lower part of the upper lobe.
• ->Without effective treatment the death rate for active TB is up to 66%.
• ->Miliary tuberculosis has a high fatality rate (about 30%) even with treatment.

• ->Obstructive uropathy is a contraindication to their use.
• ->They should be used with extreme caution in known or suspected GI infections because of decreased GI motility and retention of causative organism and/or toxins.
• -> Tachycardia is a common side effect.
• Regarding the pterygoid venous plexus
• ->situated between the temporalis muscle and lateral pterygoid mucle.
• ->receives the middle meningeal vein.
• ->It becomes the maxillary vein.
• ->It communicates with the cavernous venous sinus, meaning that infections of the superficial face can spread and cause cavernous venous sinus thrombosis.

->age, size and body posture.

• the compliance of the lung at any given time during actual movement of air.

• change in volume for any given applied pressure.

• ->The normal cerebral blood flow is approximately 50ml/100g/min.
• ->Cerebral blood flow represents approximately 14% cardiac output.
• ->An increase in carbon dioxide leads to cerebral vasodilatation.
• ->Hyperpotasemia-> vasodilatation.

-> relaxation of the ileocaecal valve.

->10% from the intravascular compartment to the extravascular compartment.

-> approximately 8 litres of fluid.

-> 500-1000cells/mm3.

• -> useful in ventricular arrhythmias following a myocardial infarction.
• ->mainly excreted by
• -> 95% metabolised by the liver and should be used with extreme caution in hepatic impairment.

• -> flecainide
• -> and in all grades of heart block.

• -> More cases occur in males than females.
• -> 50 – 100 times more infectious than the HIV virus.

• ->Over 80% are asymptomatic.
• ->Over 50% of the world’s population harbour H pylori in their upper GI tract.
• ->Infected individuals have a lifetime risk of developing gastric cancer of 1-2%.

• ->Oral corticosteroids should be used in the emergency department to treat moderate to severe exacerbations of Chron’s disease.
• ->Corticosteoids have a more rapid onset of action than salicylates.
• ->Immunosuppressants are commonly started in the emergency department.
• ->The landmark article of Truelove in 1955 showed a reduction in mortality from 24% in the placebo group to 7% in the steroid-treated group.

-> 285mOsml/L by ADH.  

• ->Cavitation on a chest radiograph is associated with a higher degree of infectiousness.
• ->spread by inhalation of infectious droplet nuclei.
• ->A person must inhale at least 10 bacteria to develop the infection.  
• -> When someone becomes infected, it takes 3-4 weeks before they become infectious enough to spread the disease to others.  

-> MEA= Metoprolol-Esmolol-Atenolol.

-> PLEM= Propanolol-Labetalol-Esmolol-Metoprolol

-> Sota Nadol hay un Corazon Ardiendo= Sotalol-Nadolol-Carvedilol-Atenolol.

• -> under 80 years who have stage 1 hypertension and target-organ damage (e.g. left ventricular hypertrophy, chronic kidney disease, hypertensive retinopathy), cardiovascular disease, renal disease, diabetes, or a 10 year cardiovascular risk ≥ 20%
• ->in the absence of these conditions -> advise lifestyle changes and review annually.
• ->For patients under 40 years with stage 1 hypertension but no overt target-organ damage, cardiovascular disease, renal disease, or diabetes
• ->consider seeking specialist advice for evaluation of secondary causes of hypertension.

• ->wasting, chronic diarrhoea and widespread seborhhoeic  dermatitis.
• C3 deficiency leads to a problem with
• • opsonisation and tends to present in early life with overwhelming infection by encapsulated organisms.

• • glenohumeral
• • sternoclavicular
• • acromioclavicular.

-> 1-2% of cardiac output.

• • Approximately 90% of urinary calculi are radio-opaque.
• • most commonly consist of calcium oxalate and/ or calcium phosphate
• • Microscopic haematuria is present in >80% of patients with ureteric colic.  
• Regarding rhinovirus
• • most common cause of the common cold.
• • They preferentially grow at 33°C and hence infect the upper respiratory tract.  
• • Smoking increases the risk of respiratory infection by 50%.  
• • The incubation period is 12-72 hours.

-> 10-50μm

• -> 10-50µm.
• The components of a portal triad include a
• • proper hepatic artery
• • hepatic portal vein
• • common bile duct
• • lymphatic vessels
• • branch of the vagus nerve.

• • 10% bile salts.  
• Bile is important in the absorption of the fat soluble vitamins which are
• • vitamins are D, E, K and A.

• • activity against beta-lactamase producing organisms.
• • used in the treatment of otitis externa.
• • Cholestatic jaundice and hepatitis can rarely occur up to 2 months after treatment has stopped.
• • used in the treatment of osteomyelitis.

• • They are a cluster of 7 articulating bones.
• • The largest bone of the tarsus is the calcaneus.
• • arches of the foot are formed by the cuboid, navicular and 3 cuneiforms.

• transverse tarsal joint or Chopart’s joint.

-> oral lesions in 80% of cases and genital lesions in 20%.

• • It is an H1 receptor antagonist.
• • Drowsiness and xerostomia are common side effects. Headache is an UNcommon side effect. True
• • may rarely-> extra-pyramidal effects.
• • Palpitations and arrhythmias are recognised side effects.

->15-30 mmHg.

->100-140 mmHg.

• • It has 2 heads which are the superifical and deep.
• • primary action is to flex the proximal phalanx of the thumb.

• median nerve.

• ulna nerve.

• • parotid glands.
• submandibular glands produce about
• • 70-75% of saliva in the oral cavity.

• 98% water.

• antibacterial compounds such as hydrogen peroxide and immunoglobulin A.

-> acellular pertussis containing vaccine between 28-38 weeks of the pregnancy.

• • main function thermoregulation.
• • Arteriovenous anastomoses involved in thermoregulation are mainly found in the hands, feet and face.
• • Increase in cutaneous blood flow may be up to 30 times that of normal blood flow.

• It exits the skull via the jugular foramen.

• -> excretion is primarily hepatic and biliary.
• ->It reduces the clearance of other drugs including warfarin and digoxin.
• ->Patients on both warfarin and amiodarone should have their INR checked more frequently.
• ->Hypotension is an important side effect.
• ->It is contraindicated in torsades de pointes, as there may be an underlying prolonged QT which will be exacerbated by amiodarone.

• • transition from inspiration to expiration
• • these are the apneustic and pneumotaxic centres.

• • Children with sickle cell who are infected ->osteomyelitis.
• • They perish after being heated to 60°C for 12 minutes.
• • Most people will recover without treatment.
• • Some patients with salmonellosis will go on to develop reactive arthritis that can last for years.

• electrochemical potential difference created by pumping ions out of the cell is used.

• • studies with positive findings are more likely to be published than studies with negative findings.
• • This leads to over-representation of positive studies in systematic reviews.

• • asymmetrical.
• • This is due to the absence of small negative results.

• publication bias.

• eliminate heterogeneity.

• • The incubation period is usually 16-18 days.
• • Post pubertal males have a 30% risk of developing orchitis.  
• • 30% risk of developing orchitis.
• • 4% of cases-> Pancreatitis

• • the agreement between initial test results and further results of repeat measurements taken at a later date.
• inter-rater reliability. The measure of this agreement is
• • quantified by the correlation coefficient Kappa. Kappa can also be described as the chance-corrected proportional agreement statistic.
• Cronbach’s α is a correlation coefficient that is used for
• • It is used with complicated tests with several parts or for measuring several variables.

• reliability of a test that is divided into two parts and tests the same material under similar circumstances.

• target oxygen saturations of 88-92%.  

• 94-98%.

• • chronic obstructive pulmonary disease
• • PaO2 < 7.3 kPa
• • when breathing air during a period of clinical stability.

• • 4 weeks after an exacerbation.
• Regarding clostridial gas gangrene
• • Clostridium perfringens ->80-90% of cases
• • myonecrosis can spread as fast as 2cm/hour.
• • Systemic toxicity and shock can be fatal within 12 hours.
• • Treatment ->debridement and excision with amputation necessary in many cases.

• Mortality is high at approximately 10%.

• • It commences at the level -> 6th cervical vertebra.
• • 23-25 cm long.
• • Enters the abdomen through the diaphragm at the level ->10th thoracic vertebra.

• • The head of the bed should be at 30-45°, as this brings the heart closer to the anterior chest wall.
• Regarding pulmonary blood flow
• • Mean pulmonary arterial pressure-> 12-15mmHg.
• • Pulmonary vascular resistance is about 1/10 that of the systemic circulation.
• • The total gas exchange capillary surface area is around 70m2.
• • It is around 70m2.
• • Pulmonary arterioles constrict in response to hypoxia.

• ->Adenosine is an endogenous purine nucleoside.
• ->It has an inhibitory effect on the central nervous system.

• ->The incubation period usually lasts 9-12 days.
• ->Approximately 1 in 1000 patients will develop encephalitis, which is fatal in about 10% of patients.
• ->Subacute sclerosing panencephaltis is a rare->late complication.

• • use of proton pump inhibitors is associated with an increased risk.  
• • Increasing rates of community acquired clostridium difficile infection are associated with drugs used to suppress gastric acid.

• 2-5% of the population.

• Blood supply is mainly via the greater palatine artery.
• nasopalatine nerve supplies the mucous membrane of the anterior part of the hard palate.
• The greater palatine nerve supplies most of the hard palate.

• -> It is a first generation cephalosporin.
• ->(Antibiotic associated colitis It is more common with 2nd generation cephalosporins.)
• ->About 0.5-6% of patients who are allergic to penicillin will be allergic to cephalexin.  
• ->Agranulocytosis is a recognised complication.

• formed by the ventral divisions of the first four lumbar nerves and contributions from the subcostal nerve.

• • genitofemoral nerve from segments L1-L2 -> cremaster muscle in the male.
• • femoral nerve ->quadriceps femoris.
• • obturator nerve -> adductor longus and brevis.

• • It is less active against gram negative bacteria than benzylpenicillin .  
• • It is not active against beta-lactamase producing bacteria.
• • used for the prophylaxis of rheumatic fever.
• • Side effects include interstitial nephritis.

• • The osmolarity is slightly less than the osmolality.
• • The normal human reference range is 275-295 milli osmoles per kilogram.
• • Calculated osmolarity is 2Na + 2K + glucose +urea.
• • Alcohol -> elevated osmolar gap.

• 50% even with anti-microbial therapy.

• urinary tract infections in older persons.  second to E Coli.

• aspirating oropharyngeal microbes.

• as high as 100%.

• • It is used in the treatment of bipolar disorder -> in lithium resistant cases.
• • Side effects are more common in the elderly.
• • AV conduction abnormalities are a contraindication to use.
• • SLE is a recognised side effect.

• 40% occur in children <4 years of age.

• deterioration of a patient that apparently survived successful resuscitation after submersion.

• alcohol intoxication.

• Approximately 10-20%-> water -> larynx -> laryngospasm -> death by asphyxiation.

• • responsible for 30%-40% of all acute respiratory tract infections in infants and children.
• • incubation period is 1-7 days

• HPIV-1

• • About 5 % of carbon dioxide is transported unchanged, simply dissolved in the plasma.
• • About 10 % of carbon dioxide is transported bound to haemoglobin and plasma proteins.

 

• • anterior talofibular ligament
• • calcaneofibular ligament (much thicker and stronger than ant talofibular lig)
• • posterior talofibular ligament.

• superficial and deep deltoid ligaments.

• anterior talofiular ligament

• sinus pauses followed by junctional or other escape beats

• • degree of uncertainty around an estimate.  
• • The width of the confidence intervals measure the degree of uncertainty around the estimate.

• any difference in the results from two groups is due to chance.

• statistically significant. The P value refers to the probability of getting the observed results if the null hypothesis is correct.

• long acting insulin.

• coeliac disease.

• • It arises from the lateral 2/3 of the superior nuchal line of the occipital bone.
• • inserts into the galea aponeurotica.
• • raise the eyebrows and wrinkle the forehead. 
• • innervated by the facial nerve.

• • abduct the thigh at the hip.
• • It gives an expansion to the capsule of the hip joint and is a local stabiliser of the hip.
• • The anterior fibres medially rotate the thigh at the hip.
• • innervated by the superior gluteal nerve

• • encapsulated yeast.  
• • If the disease is confined to the lungs patients are usually immunocompetent.
• • Cavitation is uncommon.
• • Pulmonary cryptococcosis in an immunocompetent host may resolve without treatment.

• all study participants are included in analyses regardless of whether or not they completed the study.

• the last recorded results of subjects that dropped out are carried forward to the end of the trial and incorporated into the final analysis of the results.

• only data from those patients who sufficiently complied with the trial protocol are considered in the analysis.

• • Renal blood flow is approximately 20% of cardiac output.
• • The glomerular filtration rate is approximately 120ml/min.
• • glomerular filtration rate of less than 15ml/minute is a sign of renal failure.  
• • Proteins with a molecular mass of over 10kDa are not filtered at the glomerulus.

• • from the transverse processes of the 2nd to 6th cervical vertebrae.
• • innervated by the anterior branches of C5-C8.

• pH of 1.5 to 3.5 and is composed of hydrochloric acid (HCl), and large quantities of potassium chloride (KCl) and sodium chloride (NaCl).

• neutralises and decreases gastric acid secretion, to increase it’s own survival.

• • irreversibly block the H+/K+ ATPase of the gastric parietal cells.
• • reduce gastric acid secretion by up to 99%.
• • Common side effects include headache and nausea.
• • Long term use is associated -> hypomagnesaemia.

• • 50-60%.
• • Up to 20% of neonates with chlamydial conjunctivitis may develop pneumonia.

• similar results and any observed differences are due to random variation.

• heterogeneity. When used in a meta-analysis the tests shows whether any variation between the results is over and above that would be expected by chance.

• meta-regression analysis. For example meta-regression analysis can be used to see whether treatment effects are greater in studies of low quality than in studies of high quality.

• sensitivity analysis. This is used to see if there would be a significant change in the results of a study if key decisions in the set up and methodology of the trial were changed.

• • It exits the middle cranial fossa via -> foramen ovale. 
• • It gives motor supply -> mylohyoid + anterior belly of digastric.
• • It’s branch the lingual nerve also carries fibres from the facial nerve.
• • It supplies the outer side of the tympani membrane, the auricle and the external auditory meatus.

• • Immunisation is not recommended after the age of 25.
• • Immunisation consists of two doses given at 3 and 4 months of age, with a booster dose at 12-13months.
• • A single dose of meningococcal C conjugate vaccine is recommended for all individuals attending university regardless of age

• Neiserria meningitidis serotypes B and C.