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Transition Block > 05/04/18 > Flashcards

05/04/18 Flashcards

1
Q

Where is the spermatic cord foudn in the testes?

A

posterosuperior aspect

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2
Q

What forms the pelvic outlet?

A

ischiopubic ramus; coccyx; pubic symphysis; ischial tuberosities and sacrotuberous ligament

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3
Q

give an example of a syndesomosis?

A

interosseous membraen

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4
Q

What joint normally has 180 degrees of flexion?

A

shoulder

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5
Q

Where are ribosomes produced?

A

nucleolus

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6
Q

What is the main site of lipid syntehssi in the cell?

A

smooth endoplasmic reticulum

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7
Q

What is the definition of epithelium?

A

an avascular polarised tissue that forms cohesive sheets, covering surfaces and lining caviites

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8
Q

How do enzymes increase the velocity of a reaction?

A

decreasing the energy of activation

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9
Q

Do enzymes change in free energy between substrates and products

A

no

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10
Q

what is a transciption factor?

A

protein other than RNA polymerase involved in transcription- bind to very specific DNA sequences

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11
Q

What are ribosomes made up of?

A

rRNA and protein

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12
Q

What is the quaternary structure of a protein?

A

relative orientation of different polypeptide subunits in a multiple subunit complex

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13
Q

What determiens the overall shape of a polypeptide?

A

tertiary structure

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14
Q

Waht determiens the path of the peptide backbone in 3D space?

A

secondary structure elements e.g helcies and sheet

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15
Q

Why can Dna only be synthesised in a 5’ to 3’ manner?

A

additional nucleotides can only be added to a freee 3’ hydroxyl group

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16
Q

Where does guanine nucleotide exchange in GPCRs occur?

A

alpha subunit

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17
Q

How many separate protein subunits form the GPCR?

A

all are a single protein

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18
Q

How is signalling in GPCRs termianted?

A

hydrolysis of GTP to GDP by the GTPase activity of the G-protein alpha subunit

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19
Q

What subunits form the nicotinic ACh receptors involved in epse?

A

a3 and b4 subunits

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20
Q

How is gangiolic transmission using ACh terminated?

A

hydrolysis of ACh by extracellular acetylcholinesterase

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21
Q

What is the action fo amphetamine?

A

dispalces noradrenaline for storage vesicles at noradrenergic synapses

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22
Q

Which area of the body are a4b2 nicotinic receptors found?

A

CNS

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23
Q

Which type of ACh receptor does atropine block?

A

muscarinic

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24
Q

What receptor acts as a presynpatic autoreceptor that inhibits release of transmitter at sympathetic neuroeffector junctions?

A

a2

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25
Q

What receptor acts as autoreceptors at parasympathetic neuroeffector junctions?

A

muscarinic ACh receptors

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26
Q

What transmitter do post-ganglionic sympathetics to the sweat glands use?

A

ACh

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27
Q

What is the mechanism of amphetamine?

A

substrate for uptake `1 that causes release of transmitter from sympathetic post-ganglionic nueorns independently of calcium

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28
Q

What is the difference between the mechanisms of cocain and amphetamine?

A

both bind to uptake 1 but cocaine isn’t transported as a substrate and doesn’t cause calcium independent release of NA

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29
Q

What is the mechanism of prazosin?

A

alpha-1 blocker

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30
Q

What is the normal range of MAP?

A

70-105mmHg

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31
Q

What is the resting membrane potential of a typical nerve cell?

A

-70mV

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32
Q

How does heat affect muscles?

A

decreases muscle tone

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33
Q

What does a body temp of 40-42 degrees indicate?

A

hyperthermia

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34
Q

What is the temp for hypothermia?

A

<35

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35
Q

What temperatures stimulate the anterior hypothalamic centre?

A

heat

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36
Q

What temperatures stimualte the posterior hypothalamic centre?

A

cold

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37
Q

Which parent is mitochondrial DNA inherited from?

A

mother

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38
Q

What type of inheritance results in no male-male transmission of the condition?

A

X-linked recessive

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39
Q

What is being analysed in transcipts within bone marrow cells ?

A

RNA

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40
Q

What family of proteins is invovled in apoptosis cascade?

A

caspases

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41
Q

Waht is the genus name of E.coli?

A

eschierichia

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42
Q

what is the species name of E.coli?

A

coli

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43
Q

What type of toxin do gram negative bacteria produce?

A

endotoxin

44
Q

Where is endotoxin exported from?

A

cell wall

45
Q

Where is exotocin exported from?

A

bacterial cell

46
Q

What is the usual incubation period of hep A?

A

less than 6 weeks

47
Q

Is hep B or hep C more likely to cause jaundice?

A

hep B

48
Q

Give examples of opsonins?

A

CRP; C3b; antibodies of IgG class

49
Q

How does the MAC cause death of cells?

A

through osmotic lysis

50
Q

Which type of MHC does CD8 interact with?

A

MHC-1

51
Q

Whcih cell type is responsible for coordinating the adaptive immune response?

A

CD4 T cell

52
Q

What is the mode?

A

number which appears most often in a group of data

53
Q

Whcih are the most common micronutrient deficincies globally?

A

vitamin A; iodine and iron

54
Q

Which colour of bag is used for confidential waste?

A

blue

55
Q

What type of waste is the red bag used for?

A

soiled laundry

56
Q

What type of waste is the yellow bag used for?

A

theatre/anatomy clinical waste e.g amputated digits

57
Q

What is the yellow sharps with a blue lid used for?

A

medication vials with residual medicine

58
Q

What is human factors sometimes described as?

A

non-technical skills wihch support and underpin performance of physcial and techincal skills

59
Q

What 4 diagnoses should be considered with polyuria; nocturia and polydipsia?

A

hypercalcaemia; DM; DI; psychogenic polydipsia

60
Q

How does ADH work in the kidney?

A

increases reabsorption of water by causing insertion of aquaporin-2 channels into apical membrane

61
Q

How is serum osmolality estimated?

A

2x (Na) + urea +glucose

62
Q

Waht is measured during a fluid restriction test?

A

hourly body weight; urine volume and urine osmolality

63
Q

What is benign prostatic hyperplasia?

A

nodular/diffuse proliferation of musculofibrous and glandular layers of the transitional zone

64
Q

What are the lifestyle measures for BPH?

A

avoid caffeine and alcohol; relax when voiding and void twice in a row; distracting exercises and bladder training

65
Q

What is first line tx for BPH?

A

alpha blockers e.g tamsulosin

66
Q

What is the function of alpha blockers in BPH?

A

decrease muscle tone

67
Q

what is second line for BPH?

A

5-alpha reductase inhibitors

68
Q

what is the function of 5-alpha reductase inhibitors in BPH?

A

reduces conversion of testosterone to more potent dihydroxytestosterone

69
Q

What is important in terms of sex with 5-alpha reductase inhibitors?

A

use condoms as excreted in semen- females should avoid contact

70
Q

What should painless haematuria make you think of?

A

bladder cancer

71
Q

When should a PSA and PR be done?

A

any lower urinary tract symptoms; erectile dysfunction; visible haematuria

72
Q

How many people with high PSA have cancer?

A

1 in 3

73
Q

What are the urgent referring guidelines for bladder cancer in the over 45s?

A

unexplained visible haemturia without UTI; visible haematuria that persistents or returns following UTI treatment

74
Q

Waht are the urgent referral guidlines for bladder cancer in the over 60s?

A

unexplained non-visible haematuria and either dysuria or raised WBCs on bloods

75
Q

Who should be give a non-urgent referral for bladder cancer?

A

60 and over with recurrent UTIs

76
Q

What is the urgent referral guidance for renal cancer?

A

same as for bladder cancer- >45s with unexplained visible haematuria without UTI or persistent after treatment

77
Q

What hypertonic hyponatraemia?

A

solutes in the extracellular fluid draw water from cells- hypglycaemia or mannitol infusion

78
Q

What can cause euvolaemic hyponatraemia?

A

SIADH; hypothyroidism and reduced solute intake

79
Q

Waht are the causes of hypervolaemic hyponatraemia?

A

heart failure; cirrhosis or nephrotic syndrome

80
Q

What type of lung cancer is particularly associated iwth SIADH?

A

small cell

81
Q

What drugs are implicated in SIADH?

A

SSRIs and antipsychotics

82
Q

What are small cell lung cancers thoguht to arise from?

A

neuroendocrine progenitor cells of the lining bronchial epithelium

83
Q

What is the cornerstone of treatment of SIADH?

A

fluid restriction

84
Q

Why should correction of electrolyte abnormality in SIADH be done gradually?

A

rapid correction can lead to osmotic demyelination in CNS- central pontine myelinolysis

85
Q

what electrolyte imbalance is caused by protein loss in nephrotic syndrome?

A

hypocalcaemia

86
Q

What often precedes minimal change?

A

URTI

87
Q

How long is the treatment in minimal change syndrome?

A

6-8 weeks

88
Q

What is the prognosis in minimal change?

A

majority of children make a full recovery with retention of normal renal function

89
Q

What is thought to be the pathogenesis of SLE?

A

clearance of apoptotic or necrotic cells leads to sensitisation of T and B cells to intracellular antigens: hypersensitivity type 3

90
Q

What are the common complications of SLE?

A

lupus nephritis; CVS disease

91
Q

What does activation of the TSH receptor in Grave’s cause?

A

thyroid follicular hyperplasia and hypertrophy

92
Q

What is seen on radio-iodine uptake studies with Grave’s?

A

unformly high intake

93
Q

What is seen on radio-iodine uptake studies iwth subacute thyroiditis?

A

low uptake

94
Q

What drug is used to treat Grave’s?

A

carbimazole

95
Q

What is the eye disease in Grave’s caused by?

A

autoreactive T cells to eye antigens- activation of orbital fibroblasts and ECM synthesis pushing eye forward

96
Q

What is the function of PSA?

A

liquefy semen

97
Q

What is Whipple’s triad in insulinoma?

A

symptoms associated iwth fasting or exercise; confirmation of hypoglycaemia during these episodes; reversal of symptoms on adminstering glucose

98
Q

What is C-peptide?

A

product from cleavage from po-insulin and is released with insulin from beta cells

99
Q

What do the autonomic symptoms in hypoglycaemia result from?

A

glucagon and adrenaline responses

100
Q

What is bilirubin excreted as in faeces?

A

stercobilin

101
Q

What is bilirubin excreted as in urine?

A

urobilinogen

102
Q

Why may elevated INR be seen in obstructive jaundice?

A

vitamin K malabsorption

103
Q

What is Courvosier’s law?

A

palpable gallbladder and painless jaundice- diagnosis isn’t gallstones

104
Q

What investigations should be done for paracetamol overdose?

A

UA (ketones); timed serum paracetamol level; LFTs; U&Es; clotting screen

105
Q

What detoxified N-acetyl-p-benzoquinoneimine?

A

glutathione

106
Q

What drug is give in paracetamol overdose to replenish glutathione stores?

A

acetylcysteine

107
Q

When should paracetmol levels be measured?

A

between 4 and 16 hours

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