Integrative Medicine
Which of the following is NOT an indication for HSC transplantation?
Lymphoma
Macrocytic anaemia
Haemolytic anaemia
Aplastic anaemia
Leukaemia
What is the estimated lifetime of a red blood cell within the blood in days?
100
150
120
140
130
Which of the following is a myeloid cell?
B-lymphocytes
Natural Killer cells
Plasma cells
T-lymphocytes
Monocytes
Which of the following is not a means by which the INNATE response recognises a non-self cell?
Recognition of PAMPS
TLRs on macrophage cell surface
Recognition of antigen
Secretion of cytokines from immune cells
Use of PRRs
Which of the following are responsible for DIRECT killing of non-self cells only as part of the adaptive response?
CD4 +ve T-cells
CD8 +ve T-cells
B-lymphocytes
Null lymphocytes
Macrophages
Where is the location of the enzyme in which Ramipril is indicated for?
Liver
Kidneys
Lungs
Adrenal gland
Blood vessels
Which of set of physiological changes best represent a DECREASE in blood pressure?
Decreased eGFR, Decreased renin, Decreased blood volume & Vasodilation
Increased eGFR, Increased renin, Increased blood volume & Vasodilation
Increased eGFR, Increased renin, Decreased blood volume & vasodilation
Increased eGFR, Decreased renin, Decreased blood volume & Vasoconstriction
Increased eGFR, Decreased renin, Decreased blood volume & Vasodilation
Which of the following best describes the ABG above?
Metabolic acidosis without respiratory compensation
Metabolic acidosis with respiratory compensation
Respiratory acidosis without metabolic compensation
Respiratory acidosis with metabolic compensation
Respiratory alkalosis without metabolic compensation
Which of these below is the most suitable 1st line treatment for the electrolyte-based disturbance side effect associated with Lithium?
Isotonic saline
Water restriction
Sodium and water restriction
IV 5% dextrose
Oral potassium supplements
Which of the following is 1st line treatment for a patient with a K+ of 6.2 & the following ECG
Oral potassium supplements
IV 0.9% NaCl + 40 mmol KCL
Salbutamol nebulisers
Actrapid + IV dextrose
IV calcium gluconate
What are the two facets of the immune system?
Primary & Secondary immune systems
Active & passive immune systems
Innate & adaptive immune systems
Cellular & molecular immune systems
Which of the following can result in primary immunodeficiency?
Defects in stem cells
Defects in B+T cell maturation & regulation
HIV
A+B
A+B+C
What is the most common cause of secondary immunodeficiency worldwide?
Drugs (e.g. steroids)
Malnutrition
Diseases (e.g. Diabetes mellitus)
Infections (e.g. HIV)
Lifestyle choices (e.g. smoking & alcohol)
Which of the drugs cause immunosuppression?
Corticosteroids
Chemotherapy agents
Monoclonal antibodies
Calcineurin inhibitors
All of the above
Which vaccinations are important for people with hypospelism?
Pneumococcal, Meningococcal, Haemophilus
Hepatitis B
Tetanus
HPV
BCG
Which of the following is the best description of central tolerance?
The ability of the immune system to recognise & response to self-antigens
The suppression of immune responses against self-antigens during lymphocyte develpment
The process by which the immune system eliminates all self-reactive lymphocytes
The activation of cytotoxic T-cells against self-antigens
Which of the following is the primary cause of hyperacute rejection?
T-cell mediated immune response
Delayed-type hypersensitivity reaction
Pre-existing antibodies against donor antigens
Infection of the transplanted organ
The expression of allele HLA-B27 is associated with which of the following conditions?
Rheumatoid arthritis
Type 1 diabetes
Ankylosing spondylitis
Pemphigus vulgaris
Which type of hypersensitivity reaction is characterised by the involvement of immunoglobulin E (IgE) antibodies & immediate release of histamine, proteases and cytokines upon exposure to an allergen?
Type I hypersensitivity reaction
Type II hypersensitivity reaction
Type III hypersensitivity reaction
Type IV hypersensitivity reaction
Which of the following statements regarding the role of T-reg cells in the immune system is incorrect?
FOXP3 transcription factor is important for regulation of self-tolerance & functions as a master regulator in development & function of T-reg cells
T-reg cells act to suppress the immune response
T-reg cells play a critical role in preventing autoimmunity
Contribute to mechanisms involved in central tolerance
Which of the following is the most anti-cancer immune cell?
CD8+ T-cells
CD4+ T-cells
Memory B-cells
Dendritic cells
Macrophages
Which of the following is the correct order of events in cancer immunoediting
Equilibrium, Escape, Eliminate
Escape, Eliminate, Equilibrium
Eliminate, Equilibrium, Escape
Eliminate, Escape, Equilibrium
Equilibrium, Eliminate, Escape
Which cytokine released by tumour-associated macrophages stimulates angiogenesis?
IL-10
MMP-2
PD-L1
TGF-b
VEGF
Which of the following cancers is Cetuximab used to treat?
Metastatic Bowel Cancer
Metastatic Breast Cancer
Metastatic Small Cell Lung Cancer
Multiple myeloma
Metastatic Prostate cancer
Which of the following is a feature of a “HOT” tumour?
Few mutations
No T-cells inside the tumour
Large presence of PD-1 proteins
Moderate number of mutations
T-cells at the periphery
What are the features of a “COLD” tumour?
Few mutations
Few T-cells inside tumour
Many mutations
No PD-1 or PD-L1 proteins
Moderate PD-1 or PD-L1 proteins
Which of the following is not a feature of a “WARM” tumour?
Moderate number of mutations
T-cells at periphery of the tumour
Large presence of PD-1 or PD-L1 proteins
With or without PD-1 or PD-L1 proteins
Match the numbers to the sections of the cardiac action potential
Absolute refractory period
5
Plateau phase
2
Relative refractory period
3
Repolarisation
Depolarisation
1
4
What does the T-wave on an ECG represent?
Septal depolarisation
Atrial depolarisation
Ventricular repolarisation
End ventricular depolarisation
Atrial repolarisation
The normal QT interval is 0.36 - 0.44 seconds
True
False
A 48 year old is brought into hospital by ambulance following a high-speed RTC. He has sustained significant chest & abdominal injuries as well as a suspected femoral fracture. Temperature is 37.3ºC, pulse rate 110bpm, BP 78/58, RR 23 breaths per minute, O2% 98%, breathing 36% oxygen. What fluid would be first prescribed to him?
1 unit red blood cells (O-)
250ml 0.9% sodium chloride over 15 min
500ml 0.9% sodium chloride over 15 min
500ml Hartmann’s solution over 30 min
500ml 5% glucose over 30 min
A 17 year old is brought to hospital with abdominal pain, nausea and vomiting. They have a sweet smell on their breath. Given that the likely condition is DKA, which fluid has no role in management?
Actrapid/sodium chloride solution
Dextrose
Hartmann’s solution
Sodium chloride
Sodium chloride + potassium
Which of the following is the most common associated reaction related to transfusions?
Febrile non-haemolytic transfusion reaction
Transfusion associated circulatory overload (TACO)
Transfusion Related Lung Injury (TRALI)
Transmission of blood borne virus
Mother-foetus Rh blood type incompatibility problems can occur if the mother is _____ & her foetus is ______
Rh positive, Rh positive
Rh positive, Rh negative
Rh negative, Rh positive
Rh negative, Rh negative
Option 2 & 3
An 87 y.o. Man has undergone a RBC transfusion following a UPGI bleed. The nurse has asked you to review the patient due to his oxygen saturation dropping to 85%. He is now on 3L of oxygen & saturation at 95%. You suspect the patient is undergoing TACO. His Hb pre-transfusion was 60g/dL and is still having intermittent melena episodes. Which of the following steps would you undertake?
Get a CXR
Consider administering a diuretic such as Furosemide
Continue the blood transfusion but strictly monitor fluid balance & re-review after administration of diuretic
All of the above
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