Year 3 EMIs

Endothelial cells which form part of the filtration barrier

C

The structure ultimately responsible for medullary hypertonicity

E

The structure responsible for glucose reabsorption

A

The structure sensitive to vasopressin

G

Changes in the diameter of this are a key component in renal autoregulation of blood flow

H

Identify the consequence of nephrotic syndrome

Oedema

Identify the consequence of reduced erythropoietin synthesis

Anaemia

Identify the consequence of failure of renal bicarbonate reabsorption

Metabolic acidosis

Identify the consequence of loss of volume regulation

Secondary hypertension

Identify the consequence of hypocalcaemia and phosphate retention

Secondary hyperparathyroidism

Where bone loss, usually from periodontal disease, affects the base of the root trunk of a tooth where two or more roots meet

Furcation lesion

The hypothetical process leading to the loss of cervical tooth structure due to a combination of abrasion, erosion, and/or occlusal forces; data supporting this term as a discrete clinical entity a

Abfraction

A reactive overgrowth possibly in response to local irritation or trauma. This vascular mass often is ulcerated and may be smooth or lobulated and pedunculated or sessile

Pyogenic granuloma

A change from one adult cell type to another form which is not normal to that tissue.

Metaplasia

Loosely adherent, white curds of matter composed of dead cells, food debris, and other components of the dental plaque found on the tooth.

Materia alba

Annual number of kidney transplants in the UK

3000

The number of cases of CKD in the UK (thousands)

3000

The likelihood of CKD in BAME communities compared to other groups (percentage)

500

The number of CKD related premature deaths annually in the UK (thousands)

50

The number of children in the UK with CKD

1000

Identify the process at label A

Filtration

Identify the process at label B

Reabsorption

Identify the process at label C

Excretion

Identify the process at label D

Renal threshold

Identify the process at label E

Transport maximum

Glomerular filtration rate (GFR) age 20-29 (ml/min/1.73m2)

120

Glomerular filtration rate (GFR) age 50-59 (ml/min/1.73m2)

100

Glomerular filtration rate (GFR) indicative of stage 5 CKD (ml/min/1.73m2)

15

Urinary volume associated with stage 5 CKD (ml/hour)

50

Target systolic blood pressure for patients with stage 3 CKD (mmHg)

140

A model providing guidance for a shift from an acute, episodic health system focus to one that is required for effective chronic disease care

Chronic Care Model, CCM (Wagner, Austin & Von, 1996)

A model to integrate medical science with redesigned health care delivery systems so chronic patients in any setting can receive prompt diagnoses and care

Improving Chronic Illness Care, ICIC (Wielawski, 2011)

This model recognizes the broader policy environment that involves patients, their families, health care organizations, and communities.

Innovative Care for the Chronic Conditions, ICCC (WHO, 2002)

This model aims to provide participants with the self-efficacy and skills required to optimally manage their chronic conditions regardless of specific diagnosis.

Stanford Model (Stanford University, 2012)

A set of actions designed to ensure the coordination and continuity of healthcare as patients transfer between different locations or different levels of care within the same location

Transitional Care model (Naylor et al., 2004)

Diagnose - Weight gain of 11kg in 6 months, plethoric face, BP 180/120, serum potassium of 2.9mmol/L and fasting glucose of 11 mmol/L in 59 year old woman

Cushing syndrome

Diagnosis - A 46 year old woman with weight loss, fast arterial fibrillation and agitation

Thyrotoxicosis

Diagnosis - Loss of consciousness and falling in a 59 year old hypertensive man receiving nifedipine and frusemide, who has recently been started on an ACE

Postural hypotension

Diagnosis - A 52 year old woman with fatigue, malaise, weight loss and a serum sodium of 123 mmol/L, potassium of 5.9 mmol/L and pigmentation of her palmar skin creases

Addisons disease

Diagnosis - An 80 year old woman has been getting progressively more short of breath for 6 months. Recently she has been coughing up blood. Her Mantoux test is strongly positive

Tuberculosis

What medical condition might someone have if they experience symptoms such as shortness of breath, fatigue, swelling in the ankles or legs, and irregular heartbeats, often associated with a decrease in heart function over time?

Cardiomyopathy

What condition is characterized by elevated blood sugar levels, frequent urination, increased thirst, unexplained weight loss, and fatigue, often requiring careful management of diet, medication, and insulin injections to maintain proper control?

Diabetes mellitus

What medical condition shares symptoms such as excessive thirst, excessive urination (even at night), dehydration, and potentially electrolyte imbalances, yet differs from diabetes mellitus in its underlying cause related to insufficient production or ineffective response to antidiuretic hormone (ADH)?

Diabetes insipidus

What condition might result from an insufficient production of one or more hormones by the pituitary gland, leading to symptoms such as fatigue, weight loss, decreased libido, menstrual irregularities in women, and decreased bone density, often requiring hormone replacement therapy for management?

hypopituitarism

What medical condition is characterized by symptoms such as fatigue, weight gain, sensitivity to cold, dry skin, constipation, depression, and a general feeling of sluggishness, often stemming from an underactive thyroid gland and requiring thyroid hormone replacement therapy for management?

Hypothyroidism

Oral manifestations of thyroid disease- Associated with salivary gland enlargement and dysguesia

Hashimoto's disease

Oral manifestations of thyroid disease- In the severest form, it can cause enlargement of both jaws and such cases are known as osteitis fibrosa cystica

Hyperparathyroidism

Oral manifestations of thyroid disease- Associated with abnormal lip pigmentation, halitosis, periodontitis and candidaisis

Chronic kidney disease

Oral manifestations of thyroid disease-Signs and symptoms include increased susceptibility to caries and increased risk of burning mouth syndrome

Hyperparathyroidsm

Oral manifestations of thyroid disease- Dental signs include anterior open bite, delayed eruption and enamel hypoplasia

Hashimotos disease

The decline in stroke mortality in the USA since 1973

Demographic trend

The national health service breast cancer screening program

Secondary disease prevention

Prescription of statins to everyone aged over 50

Primary disease prevention

Action to reduce the prevelance of risk factors for a disease

Primary disease prevention

A cardiac rehabilitation programme

Tertiary disease prevention

What study - Post surgical clinical monitoring of soft tissue wound healing in periodontal and implant surgery

Narrative review

What study - Type II diabetes mellitus with oral abscess and obesity

Clinical case report

What study - PRF1 is a prognostic marker and correlated with immune infiltration in head and neck squamous cell carcinoma

Cross sectional study

What study - The relationship between oral and cardiovascular disease

Systematic review

What study- Manifestation of hypothyroidism

Clinical case report

Changing your preferred candidate to agree with the senior partner

Authority bias

Choosing between qualified candidates on the basis of culture fit

Affinity bias

Meeting as a team to review all the applications and draw up a short list

Conformity bias

Dismissing a candidate because their interview was worse that the person before them

Contrast effect

Shortlisting a candidate on the basis of the school they they attended

Halo effect

When undertaking the assessment B, in the ABCDE approach of basic life support, this rate could aid in ruling out an asthma attack.

15

This is the normal diastolic blood pessure measured when using a sphygomomanomater where the units for this are mm/Hg and as you get older, this value may increase, but then decrease as arterial elasticity is lost.

80

Any heart rate reading over this level will be clinically diagnosed as tachycardia.

100

A systolic pressure reading above this level would indicate high blood pressure

120

This segment represents atrial depolarisation. This occurs when the sinoatrial node triggers an action potential, which depolarises the atria.

A

This is prolongued during first degree AV block.

G

Crucial for assessing the electrical activity of the heart, particularly regarding ventricular depolarisation and repolarisation

I

Typically represents the period between ventricular depolarisation and repolarisation, and is often scrutinized for abnormalities suggestive of myocardial ischaemia or infarction

H

What physiological event is represented by the deflection on an ECG, that is often associated with ventricular repolarisation, but may also be influenced by electrolyte imbalances or medications

E

A model that is used to explain and predict individual changes to health behaviour based of 5 concepts including: perceived benefits, perceived barriers, perceived threat, self-efficacy and cues to action

Health Belief Model

An example of this model is than an individual was on Nicotine Replacement Therapy for 3 months but due to their new job being stressful they have begun to smoke again.

Transtheoretical Model

An example of this model is that individuals who do not think they will get the flu are less likely to get the flu shot

Health Belief Model

George is at high risk of caries but he carries on eating large amounts of sugar due to his perceived susceptibility that sugars are not that bad for his teeth. The dentist he sees carries out a bitewing radiograph and informs George of the multiple carious lesions present of which most are incipient. This is a cue for him to take action, but he needs to understand more about the severity of the decay and the benefits of cutting on his favourite sweets.

Health Promotion Scenario

The number of people (in millions) living with heart or circulatory disease in the UK.

7.5

The annual healthcare cost of CVDs in the UK (billion)

10

What percentage of heart attacks and strokes are associated with high blood pressure?

50

In England, what is roughly the rate of people under 75 years old who have prematurely died due to CVD's (per 100,000 people).

75

What percentage of people who come forward for early hospital treatment will survive a heart attack?

90

In mg/dL, this fasting plasma glucose level is associated with CVD risk in several studies, and is defined as an impaired fasting glucose.

100

What common over-the-counter medication, first introduced in the late 19th century, has been used for pain relief, fever reduction, and anti-inflammatory purposes, and is also known by its chemical name acetylsalicylic acid?

Aspirin

Which type of medication is commonly used to reduce cholesterol levels and lower the risk of cardiovascular disease by inhibiting the enzyme HMG-CoA reductase in the liver?

Atorvastatin

A drug which widens blood vessels, increases blood flow to the heart and reduces stress on the heart. Usually used to treat angina and chest pain

Glyceryl Trinitrate

A cardioselective beta-1 adrenergic antagonist, selectively binds to the beta-1 adrenergic receptors in vascular smooth muscle and the heart

Atenolol

A type of antiplatelet medication that works by inhibiting ADP from binding to P2Y12 receptor and therefore prevents platelet activation.

Clopidogrel

Known as a acetylsalicylic acid and works by blocking cyclooxygenase. There is a risk of bleeding when taking this drug and asthmatics can usually be sensitive to this drug. This should never be given to under 16's

Aspirin dispersible (300mg)

In a scenario where a patient presents with severe hypoglycemia and is unresponsive, what emergency intervention should be administered to rapidly raise their blood sugar levels?

Glucagon injection (1mg)

Causes release of NO in vascular smooth muscle, which increases cGMP causing smooth muscle relaxation and vasodilation

Glyceryl trinitrate (GTN) spray (400mcg/dose)

This medication binds to a receptor which activates Gsα and Gq, ultimately acting on protein kinase A. Side effects from administering this can include nausea, vomiting and tachycardia.

Glucagon injection (1mg)

This medication increases production of nitric oxide, initiating relaxation of smooth muscles to produce vasodilation.

Glyceryl trinitrate (GTN) spray

Used prophylactically at a low dose of 75mg daily. Taken (preferably with a meal) in order to prevent onset of cardiovascular diseases such as heart attack and stroke in individuals who are categorised high risk.

Aspirin

Among beta-blockers, which specific medication is often chosen for its cardioselective properties and is commonly prescribed to manage hypertension, angina, and certain heart rhythm irregularities?

Atenolol

This medication is indicated when there is stenoisis of the valves and is typically prescribed for 3-6 months. It most commonly alleviates symptoms of dyspnea on exertion and orthopnea.

Warfarin

What medication is typically administered at a daily dose of 75-81 mg/day, exerting its antithrombotic effect by irreversibly acetylating serine 530 of cyclooxygenase (COX)-1, thereby inhibiting platelet generation of thromboxane A2?

Aspirin

Where there is no evidence of a primary tumour, with no lymph node metastases and no distant metastases

T0, N0, M0

Jane has a tumor of 4cm or less, which has spread to 1 or more lymph nodes on the opposite side of the primary cancer, but none larger than 6cm. The cancer has not spread to other parts of her body. What TNM staging would she be?

T0-T2, N2, M0