Which one of the following defines the standard error of the mean?
Correct Answer D: Standard error of the mean = standard deviation / square root (number of patients).
Standard error of the mean: The standard error of the mean (SEM) is a measure of the spread expected for the mean of the observations - i.e. how 'accurate' the calculated sample mean is from the true population mean Key point:
Therefore the SEM gets smaller as the sample size (n) increases A confidence interval for the mean can be calculated in a similar way to that for a single observation, i.e. The 95% confidence interval:
A 24-year-old man is investigated for visual loss and is diagnosed as having Leber's optic atrophy. Given the mitochondrial inheritance of this condition, which one of the following relatives is most likely to be also affected?
Correct Answer B: Mitochondrial diseases follow a maternal inheritance pattern.
All the children of an affected mother will inherit a mitochondrial condition. His sister will therefore also be affected.
Mitochondrial diseases: Whilst most DNA is found in the cell nucleus, a small amount of double-stranded DNA is present in the mitochondria. It encodes protein components of the respiratory chain and some special types of RNA.
Mitochondrial inheritance has the following characteristics:
Histology:
Examples include:
Ptosis may be seen:
You review a patient in the respiratory clinic who has a history of recurrent pulmonary embolism despite anticoagulation with warfarin.
Which one of the following physiological changes would be expected?
Correct Answer B: Transfer factor: The transfer factor describes the rate at which a gas will diffuse from alveoli into blood. Carbon monoxide is used to test the rate of diffusion. Results may be given as the total gas transfer (TLCO) or that corrected for lung volume (transfer coefficient, KCO):
KCO also tends to increase with age. Some conditions may cause an increased KCO with a normal or reduced TLCO:
A 24-year-old female who is 10 weeks in to her first pregnancy presents for review. Her blood pressure today is 126/82 mmHg.
What normally happens to blood pressure during pregnancy?
Correct Answer A:
Hypertension in pregnancy: The classification of hypertension in pregnancy is complicated and varies. Remember, in normal pregnancy:
Hypertension in pregnancy in usually defined as:
One of your colleagues confides in you that he has just been diagnosed with hepatitis B. He has not told anyone else as he is worried he may lose his job. He is currently working as a general surgeon in the local hospital. You try to persuade him to inform occupational health but he refuses.
What is the most appropriate action?
Correct Answer D: Whilst this may seem harsh patient safety has to be paramount. Please see the updated GMC guidelines for further details.
GMC guidance: confidentiality: Click the link below for more detailed information.
https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/confidentiality
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