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1st year revision - all Flashcards

1
Q

What are some causes of chronic gastitis

A

Autoimmune (autoimmune destruction of parietal cell, G cell adn ECL cell hyperplasia)
Bacteria; (h. pylori)
Chemical (NSAID/alcohol)

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2
Q

What is the difference between functional and organic dyspepsia?

A

Functional is with no structural disease (usually underlying gut disease)
Organic cause of NSAID/ulcer

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3
Q

What are some causes of dyspepsia

A

Peptic ulcer disease, gastric cancer

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4
Q

What deficiencies can an ileostomy result in?

A

B12 deficiency and steatorrhea as malabsorption of B12 and fat soluble vitamins in bile

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5
Q

A patient presents with painless jaundice and a palpable mass -

A

Pancreatic cancer/cholamgiocarcinoma

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6
Q

Where does adenoma/adenocarcinoma arise from?

A

Mucosal lining

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7
Q

What are adenomas an example of as a tumour sign?

A

Dysplasia

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8
Q

What is the most common predominating factor and sign of mesothelioma?

A

Asbestosis exposure and presents as pleural effusion

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9
Q

What are the central and peripheral lung tumours?

A

Small cell/squamous cell are central and adenocarcinoma/large cell are peripheral

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10
Q

How is many small bowel disease treated?

A

Supportive management unless at risk of ischemia, strangulation or perforation then surgery!

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11
Q

What type of pain is associated with IBD and ischemia?

A

Cramping pain

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12
Q

What is the histological explanation of coeliac disease?

A

Exposure to gluten causes damage to enterocyte which causes villous atrophy and malabsorption

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13
Q

What is thumbprinting in Crohn’s a sign of?

A

mucosal inflamation/oedema

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14
Q

What is the general treatment of diverticulitis?

A

Abx, liquid diet and painkillers

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15
Q

Fistula formation - urinary

A

The connection between 2 epithelium
- Urinary sepsis is highly suggestive of this
- Diverticular disease can cause an abscess which can form a fistula due to erosion

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16
Q

When does paralytic ileus commonly present?

A

As bowel obstruction following surgery

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17
Q

What is the common presentation of IBS

A

INTERMITTENT Abdo pain Bloating and Change in bowel habit

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18
Q

What is faecal calprotein buzzy for?

A

Inflammation in bowel tract - IBD, ischemia
- NOT RISEN IN IBS

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19
Q

What is the difference in presentation of small to large bowel obstruction

A

Small bowel presents with vomiting before constipation, and large is the opposite

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20
Q

Are non-polar substances hydrophobic or hydrophilic

A

Non-polar - hydrophobic

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21
Q

What is the effect of beta blockers

A

Rate control by reducing rate of depolarisation

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22
Q

What is the effect of CCB?

A

Rate control by slowing AV/SA conduction and also reducing rate of contraction

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23
Q

What are postitive and negative ionotropic drugs and their effects?

A

Positive - increase CO in shock/heart failure e.g. digoxin/amiodarone
Negative - decrease heart workload e.g. BB/CCB

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24
Q

What is the caseating organism for HIV/immunosuppressed patient

A

Pneumocystic jivoreci

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25
What is an example of a glycopeptide/aminoglycoside
Vancomicin - glycopeptide Gentamicin - aminoglycoside
26
What are examples of immunosuppressant given in IBD
Azathioprine - both Methotrexate - only in severe Crohn's
27
What is typically seen on left side of GI tract (disease)
Colitis pain, colorectal cancer majority
28
What is an example of a quinolone/cephalosporin
Quinolone - ciprofloxacin Cephalasporin - cefriaxone
29
What is the gold standard investigation for coeliac disease
Intestinal mucosa biopsyq
30
What valvular diseases leads to increased pre-load
Regurgitation
31
What are the treatment for venous and arterial thrombus?
Venous - antiplatelet Arterial - anticoagulant
32
What is H. influenza associated with?
COPD, bronchiectasis, epiglottitis
33
Characteristics of Klebsiella pneumonia
Red-currant jelly sputum, alcohol exposure
34
What are some association of tricuspid regurgitation
RHS failure Pulmonary hypertension IVDU Increased JVP/ascites
35
What are examples of causes of hypoxia, and what is the result of this
Causes - pulmonary hypertension and poor alveolar ventilation Result - pulmonary vaso-constriction -> RHS heart failure
36
What are some presentations of interstitial lung disease
Early presentation of alveolitis developing to scarring - Bilateral fine end-inspiratory crackles - Clubbing - SOB and cough
37
When is steroids typically prescribed
Severe allergen reaction
38
Symptoms of sarcoidosis
Bilateral hilar lyphandenopathy Hypercalcaemia Non-caseating granuloma Multi-system failure Eryhterum nodosum
39
What muscarinic receptor does atropine block?
M2 eeceptors to decrease heart rate
40
What muscarinic receptor does LAMA block?
M3 receptors to reduce bronchial contraction
41
What are typical bacterias of HAP?
Gram -ve such as e.coli, klebsiella, pseudomonas
42
What does alpha a1 antitrypsin present with?
Emphysema like COPD and also with live cirrhosis
43
What are common features of bronchiectasis
Recurrent large purulent sputum production, frequent infections, hemoptysis and weight loss
44
What can cystic fibrosis be risk factors for?
Bronchiectasis, pneumothorax, intestinal obstruction
45
What is the mechanism of smoking for causing COPD?
Inactivated A1 anti-trypsin which leads to break down of elastic tissue and cause emphysema
46
What are some tests for acute liver disease
Confused!! LFT, USS, virology, rarely biopsy
47
What is the progression of alcohol/non-alcohol liver disease
Steatosis -> NASH (inflammation) -> fibrosis -> cirrhosis
48
What are the investigations for stages of development of liver disease
Statosis - USS NASH - biopsy
49
What are the common complication of cirrhosis
Hepatic encepalopathy, ascites, oesophageal varices
50
What is the treatment of autoimmune hepatitis
Prednisolone then onto azathoprine to prevent flare up and relapsing conditions
51
What is the typical presentation of someone with heamochromatosis
The bronzed diabetic
52
What LFT's are representative of acute liver failure
PT/albumin/bilirubin
53
What is budd-chiari associated with
Hepatic vein thrombosis and young women on the pill
54
What is the most predominant risk factor for hepatocellular carcinoma
Cirrhosis
55
What are causes of acute hepatitis
A/B/E or EBV/CMV
56
What is a risk in AST or ALT associated with
AST - alcohol association ALT - chronic liver failure
57
What is polycystic liver disease
A symptomatic polycystic liver disease which is due to an embryological malformation of the bile ducts
58
Gram positive bacilli
Clostridium
59
What causes upper and lower zone fibrosis?
Upper zone - little ones e.g. EAA, coal workers, sarcoidosis, Tb) Lower zone - idiopathic PF, drug induced,asbestosis
60
What are some drug induced causes of pulmonary fibrosis
Amiodarone Oral contraceptive pill
61
What is the difference between dysplasia and metaplasia
Dysplasia - no stimulus Metaplasia - in response to stimulus
62
What is the difference between ionotrope and chronotrope
Ionotrope - drugs which alter contractility Chronotrope - drugs which alter heart rate
63
What type of drug is digoxin
Ionotrope and Chronotrope used in severe heart failure (with af)
64
What 3 secretions cause increased partietal cell secretions
Histamine, ACh and gastrin
65
What is the action of CCK, secretin and somatostatin
66
Where in the stomach is different cells located
Pyloric gland - D and G cells Fundus and body - parietal and ECF cells
67
IF there is a malignant ulcer, where is it more likely to be located
Gastric ulcer (hardly ever duodenal)
68
What are the drugs causes of secondary hypertension
NSAID Steroid Oral contraceptive
69
What troponin is specific to cardiac muscle damage that can be used to diagnose MI?
Troponin T
70
What is aortic dissection and the presentation
Tear in the tunica media - can present with widened mediastinum, chest pain radiating to the back, false lumen
71
What is a differentiating factor of LHS heart failure and COPD
Orthopnoea
71
What is common side effects of gentamicin
Renal damage and Cn XIII damage
72
What do chemokines do when released from site of inflammation/injury
Increase endothelial integrin affinity
73
What is the difference between primary and secondary lymphoid tissues
Primary - production of cells Secondary - Initiating immune response
74
What are antibodies aka and what are their three uses
Immunogloblins Act as antibodies, cell adhesion molecules and opsonins
75
What is strictly contraindicated in hepatocellular adenoma
Oral contraceptive pill
76
What is the general treatment of hepatitis A, B and C
A/B - vaccine for high risk, spontaneous cure is possible C - low lever of spontanous cure but anti-virals provide a cure
77
When is doxycycline used
2nd line COPD exacerbation 1st line atypical pneumonia
78
How does pulmonary oedema typically present on CXR
Batwing radiating from the hilum turning into airspace shadowing
79
What muscarinic receptor does SAMA block?
Non-specific muscarinic antagonist
80
What hypersensitivity is involved in asthma
Initial - T1 Late stage - T4
81
What presents as a pneumonia which is slow to resolve
Effusion, empyema, abscess
82
What toxins are produced by gram negative organisms and where do these come from
Endotoxins - these are lipopolysaccharides
83
What kind of oxidation occurs in aerobic respiration
Glycolsis and TCA cycle - substrate oxidation Electron transport chain - ... oxidation
84
What can be associated with bone and heaptic/biliary causes?
ALP (GGT used to differentiate)
85
What is the definition of chronic gastritis
Parietal cell hypersensitivity
86
What are the risk factors and causes of acute pancreatitis
RISK - Fat, female, forty, fertile, fair Causes - I GET SMASHED
87
How does biliary colic present?
Severe and acute post-prandial pain
88
What is the function of ANP
Decresase renin secretion which increases vasodilation and decreases blood pressure
89
What does PCSK9 proteins do? and therefore what does PCSK9 inhibitors do?
Mediate the expression of LDL receptors in the liver. PCSK9 inhibitors prevent PCSK9 proteins from degrading these receptors therefore increasing uptake of LDL for digestion by the liver
90
What are some examples of systolic dysfunction and diastolic dysfunctions?
Systolic - IHD, myocarditis, dilated cardiomyopathy Diastolic - restrictive cardiomyopathy, HOCM, cardiac tamponade
91
What is the common rate and rhythm control for AF?
Rate - BB/CCB Rhythm - cardioversion
92
What coronary artery supplies the AV node?
RCA
93
What do peripheral chemoreceptors detect
Decreased PaO2 - cause hyperventilation and increased CO Compensate for metabolic acidosis by causing elimination of CO2
94
What class is amiodarone and its mechanism of action
Class 3 anti-arrhythmic which blocks K channe;s
95
If there is a rise in JVP during inspiration, what does this suggest?
Pericarditis
96
Are AV block narrow or wide complex?
Wide
97
What is gluconeogenesis and the precursors?
The opposite of glycolysis Lactate, amino acids and glycogen
98
What is the dependance of zero and first order kinetics?
Zero - independant of concentration First - dependant on t1/2 and clearance, directly proportional to concentration independent of dosage rate
99
How does the time to steady state altered in drugs with first-ordered kinetics
Dependent on clearance and half-life and independent of dosage rate
100
What is the difference between ketogenic and glucogenic amino acids?
Ketogenic cannot be used for gluconeogenesis and glucogenic can be
101
What is the michael-menten equation and what does it show
V = Vmax[s]/Km+[s] and it demonstrates that rate of enzyme catalysed reaction depends on concentration of enzyme and substrate
102
What is the value of the line in the lineweaver-burk plot
Km/Vmax
103
What are causatitive organisms at different time periods?
1-6 hours - staph aureus and bacillus cereus 12-48 hours - Salmonella4 2-14 days - campylobacter and e-coli
104
What are the different screenings/investigatios for cystic fibrosis and coeliac disease?
CF - human faecal elastase screening test CD - raised anti-tissue transglutaminase, diarrhoea, weight loss and mucosal tissue biopsy
105
What do central chemoreceptors and peripheral chemoreceptors do?
Cental - respond to changes in H+ in CSF fluids Peripheral - respond to changes in local PO2 and PCO2 as it leaves in arterial blood

1st year revision (1 decks)

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