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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
What receptor acts as autoreceptors at parasympathetic neuroeffector junctions?
muscarinic ACh receptors
26
What transmitter do post-ganglionic sympathetics to the sweat glands use?
ACh
27
What is the mechanism of amphetamine?
substrate for uptake `1 that causes release of transmitter from sympathetic post-ganglionic nueorns independently of calcium
28
What is the difference between the mechanisms of cocain and amphetamine?
both bind to uptake 1 but cocaine isn't transported as a substrate and doesn't cause calcium independent release of NA
29
What is the mechanism of prazosin?
alpha-1 blocker
30
What is the normal range of MAP?
70-105mmHg
31
What is the resting membrane potential of a typical nerve cell?
-70mV
32
How does heat affect muscles?
decreases muscle tone
33
What does a body temp of 40-42 degrees indicate?
hyperthermia
34
What is the temp for hypothermia?
<35
35
What temperatures stimulate the anterior hypothalamic centre?
heat
36
What temperatures stimualte the posterior hypothalamic centre?
cold
37
Which parent is mitochondrial DNA inherited from?
mother
38
What type of inheritance results in no male-male transmission of the condition?
X-linked recessive
39
What is being analysed in transcipts within bone marrow cells ?
RNA
40
What family of proteins is invovled in apoptosis cascade?
caspases
41
Waht is the genus name of E.coli?
eschierichia
42
what is the species name of E.coli?
coli
43
What type of toxin do gram negative bacteria produce?
endotoxin
44
Where is endotoxin exported from?
cell wall
45
Where is exotocin exported from?
bacterial cell
46
What is the usual incubation period of hep A?
less than 6 weeks
47
Is hep B or hep C more likely to cause jaundice?
hep B
48
Give examples of opsonins?
CRP; C3b; antibodies of IgG class
49
How does the MAC cause death of cells?
through osmotic lysis
50
Which type of MHC does CD8 interact with?
MHC-1
51
Whcih cell type is responsible for coordinating the adaptive immune response?
CD4 T cell
52
What is the mode?
number which appears most often in a group of data
53
Whcih are the most common micronutrient deficincies globally?
vitamin A; iodine and iron
54
Which colour of bag is used for confidential waste?
blue
55
What type of waste is the red bag used for?
soiled laundry
56
What type of waste is the yellow bag used for?
theatre/anatomy clinical waste e.g amputated digits
57
What is the yellow sharps with a blue lid used for?
medication vials with residual medicine
58
What is human factors sometimes described as?
non-technical skills wihch support and underpin performance of physcial and techincal skills
59
What 4 diagnoses should be considered with polyuria; nocturia and polydipsia?
hypercalcaemia; DM; DI; psychogenic polydipsia
60
How does ADH work in the kidney?
increases reabsorption of water by causing insertion of aquaporin-2 channels into apical membrane
61
How is serum osmolality estimated?
2x (Na) + urea +glucose
62
Waht is measured during a fluid restriction test?
hourly body weight; urine volume and urine osmolality
63
What is benign prostatic hyperplasia?
nodular/diffuse proliferation of musculofibrous and glandular layers of the transitional zone
64
What are the lifestyle measures for BPH?
avoid caffeine and alcohol; relax when voiding and void twice in a row; distracting exercises and bladder training
65
What is first line tx for BPH?
alpha blockers e.g tamsulosin
66
What is the function of alpha blockers in BPH?
decrease muscle tone
67
what is second line for BPH?
5-alpha reductase inhibitors
68
what is the function of 5-alpha reductase inhibitors in BPH?
reduces conversion of testosterone to more potent dihydroxytestosterone
69
What is important in terms of sex with 5-alpha reductase inhibitors?
use condoms as excreted in semen- females should avoid contact
70
What should painless haematuria make you think of?
bladder cancer
71
When should a PSA and PR be done?
any lower urinary tract symptoms; erectile dysfunction; visible haematuria
72
How many people with high PSA have cancer?
1 in 3
73
What are the urgent referring guidelines for bladder cancer in the over 45s?
unexplained visible haemturia without UTI; visible haematuria that persistents or returns following UTI treatment
74
Waht are the urgent referral guidlines for bladder cancer in the over 60s?
unexplained non-visible haematuria and either dysuria or raised WBCs on bloods
75
Who should be give a non-urgent referral for bladder cancer?
60 and over with recurrent UTIs
76
What is the urgent referral guidance for renal cancer?
same as for bladder cancer- >45s with unexplained visible haematuria without UTI or persistent after treatment
77
What hypertonic hyponatraemia?
solutes in the extracellular fluid draw water from cells- hypglycaemia or mannitol infusion
78
What can cause euvolaemic hyponatraemia?
SIADH; hypothyroidism and reduced solute intake
79
Waht are the causes of hypervolaemic hyponatraemia?
heart failure; cirrhosis or nephrotic syndrome
80
What type of lung cancer is particularly associated iwth SIADH?
small cell
81
What drugs are implicated in SIADH?
SSRIs and antipsychotics
82
What are small cell lung cancers thoguht to arise from?
neuroendocrine progenitor cells of the lining bronchial epithelium
83
What is the cornerstone of treatment of SIADH?
fluid restriction
84
Why should correction of electrolyte abnormality in SIADH be done gradually?
rapid correction can lead to osmotic demyelination in CNS- central pontine myelinolysis
85
what electrolyte imbalance is caused by protein loss in nephrotic syndrome?
hypocalcaemia
86
What often precedes minimal change?
URTI
87
How long is the treatment in minimal change syndrome?
6-8 weeks
88
What is the prognosis in minimal change?
majority of children make a full recovery with retention of normal renal function
89
What is thought to be the pathogenesis of SLE?
clearance of apoptotic or necrotic cells leads to sensitisation of T and B cells to intracellular antigens: hypersensitivity type 3
90
What are the common complications of SLE?
lupus nephritis; CVS disease
91
What does activation of the TSH receptor in Grave's cause?
thyroid follicular hyperplasia and hypertrophy
92
What is seen on radio-iodine uptake studies with Grave's?
unformly high intake
93
What is seen on radio-iodine uptake studies iwth subacute thyroiditis?
low uptake
94
What drug is used to treat Grave's?
carbimazole
95
What is the eye disease in Grave's caused by?
autoreactive T cells to eye antigens- activation of orbital fibroblasts and ECM synthesis pushing eye forward
96
What is the function of PSA?
liquefy semen
97
What is Whipple's triad in insulinoma?
symptoms associated iwth fasting or exercise; confirmation of hypoglycaemia during these episodes; reversal of symptoms on adminstering glucose
98
What is C-peptide?
product from cleavage from po-insulin and is released with insulin from beta cells
99
What do the autonomic symptoms in hypoglycaemia result from?
glucagon and adrenaline responses
100
What is bilirubin excreted as in faeces?
stercobilin
101
What is bilirubin excreted as in urine?
urobilinogen
102
Why may elevated INR be seen in obstructive jaundice?
vitamin K malabsorption
103
What is Courvosier's law?
palpable gallbladder and painless jaundice- diagnosis isn't gallstones
104
What investigations should be done for paracetamol overdose?
UA (ketones); timed serum paracetamol level; LFTs; U&Es; clotting screen
105
What detoxified N-acetyl-p-benzoquinoneimine?
glutathione
106
What drug is give in paracetamol overdose to replenish glutathione stores?
acetylcysteine
107
When should paracetmol levels be measured?
between 4 and 16 hours

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