A study looks at the use of amoxicillin in the treatment of acute sinusitis compared to placebo. The following results are obtained:
What is the odds ratio a patient achieving resolution of symptoms at 7 days if they take amoxicillin compared to placebo?
Correct Answer C:
Odds and odds ratio:
Odds are a ratio of the number of people who incur a particular outcome to the number of people who do not incur the outcome. The odds ratio may be defined as the ratio of the odds of a particular outcome with experimental treatment and that of control.
Odds ratios are the usual reported measure in case-control studies. It approximates to relative risk if the outcome of interest is rare.
For example, if we look at a trial comparing the use of paracetamol for dysmenorrhoea compared to placebo we may get the following results:
Where is somatostatin secreted from?
Correct Answer A:
D cells are also found in the stomach and intestine.
Gastrointestinal hormones:
Below is a brief summary of the major hormones involved in food digestion:
The fasting glucose for a patient is reported as follows:
What is the most likely underlying pathophysiological change?
Correct Answer D:
Impaired glucose regulation:
Impaired glucose regulation (IGR) may also be referred to as non-diabetic hyperglycaemia (NDH) or prediabetes.
It describes blood glucose levels which are above the normal range but not high enough for a diagnosis of diabetes mellitus. Diabetes UK estimate that around 1 in 7 adults in the UK have IGR. Many individuals with IGR will progress on to developing type 2 diabetes mellitus (T2DM) and they are therefore at greater risk of microvascular and macrovascular complications.
There are two main types of IGR:
IFG:
Definitions:
A result below 11.1 mmol/l but above 7.8 mmol/l indicates that the person doesn't have diabetes but does have IGT.
Management:
A 23-year-old man is admitted with sepsis. Blood cultures are reported as follows:
Which of the following complement proteins is the patient most likely to be deficient in?
Whilst C3 deficiency is associated with recurrent bacterial infections, C5 deficiency is more characteristically associated with disseminated meningococcal infection and other Gram negative diplococcal infections.
Complement deficiencies:
Complement is a series of proteins that circulate in plasma and are involved in the inflammatory and immune reaction of the body. Complement proteins are involved in chemotaxis, cell lysis and opsonization.
C1 inhibitor (C1-INH) protein deficiency:
C1q, C1rs, C2, C4 deficiency (classical pathway components):
C3 deficiency:
C5 deficiency:
C5-9 deficiency:
Which one of the following is least associated with Reye's syndrome?
Reye's syndrome:
Reye's syndrome is a severe, progressive encephalopathy affecting children that is accompanied by fatty infiltration of the liver, kidneys and pancreas. The aetiology of Reye's syndrome is not fully understood although there is a known association with aspirin use and a viral cause has been postulated.
The peak incidence is 2 years of age, features include:
Management is supportive: