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MBChB 3 2009 Questions _1_ _1_

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					MBChB 3 2009 Paper 1

Short Notes

1.        Blood Film Appearances (list one cause and explain):

         Normochromic, normocytic                                                       (2.5)
         Hypochromic, microcytic                                                        (2.5)
         Macrocytic                                                                     (2.5)
         Reticulocytosis                                                                (2.5)
         Thrombocytopenia                                                               (2.5)
         Neutrophilia                                                                   (2.5)
         Eosinophilia                                                                   (2.5)
         Atypical mononuclear cells                                                     (2.5)

2.        DMD Genetics:

         Draw family tree                                                               (8)
         3 features of family tree                                                      (3)
         Identify type of inheritance                                                   (2)
         Identify obligate carriers                                                     (2)
         Why does obligate carriers have normal phenotype                               (1)
         Risk of mother getting affected child                                          (2)
         What does the gene testing tell you about mother’s carrier status              (1)
         What genetic advice would you give mother                                      (1)

3.        Alcoholism:

         Interviewing strategies to assess and influence alcoholism                     (4)
         Where are how alcohol metabolism occur                                         (3)
         Describe 2 accepted mechanisms of how alcohol interferes with brain function   (2)
         List 6 signs/symptoms of alcoholism found on clinical examination              (3)
         Describe 3 investigations of alcoholism and why                                (3)
         List clinical features of withdrawal                                           (2)
         Name 1 class of drug that can help with withdrawal                             (1)
         Name 2 drugs that can help with alcohol dependency                             (2)

MEQs

A.        Atrial Fibrillation and Heart Failure

         Calculate HR                                                                   (1)
         2 distinguishing features of AF                                                (2)
         Describe the anatomy of the electrical conduction of the heart                 (3)
         Describe the control of HR and the neurohormonal mechanisms involved           (5)
         Mechanism of warfarin                                                          (2)
         Describe what is INR and what does a value of 2.5 in the patient means         (1)
         2 conditions that predisposes to AF                                            (2)
         List a drug used for AF and explain how it would work                          (2)
         Explain HF symptoms (breathlessness, fatigue, raised JVP, peripheral oedema)   (8)
         Explain mechanism of action and 2 side effects of ACEI and spirinolactone      (4)

Bi.       Depression
          List 3 conditions that could have caused patient’s low mood                  (3)
          Clinical features of depression (1 mark for severe and 0.5 for non-severe)   (4)
          Describe the biochemical theory behind depression                            (2)
          List factors that show patient is at risk of completed suicide               (4)
          List 2 drug classes (spell out completely) and 1 side effect each            (2)

Bii.       Multiple Sclerosis

          List 5 signs/symptoms of optic neuritis on clinical examination              (5)
          Identify location of lesion with neurological examination                    (1)
          List cranial nerve innervations of extra-ocular muscles                      (1)
          List and explain 2 causes of diplopia that arises from lateral gaze          (2)
          List and explain possible findings of 2 investigations for MS                (4)
          List 2 drug classes for MS                                                   (2)

MBChB 3 2009 Paper 2

Short Notes

4.         Hypovolemic Shock and Septic Shock


5.         Psoriasis


6.         Osteoarthritis and Rheumatoid Arthritis



MEQs

C.         Asthma and COPD


D.         Cervical Cancer

				
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