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anotha one Flashcards

1
Q

what mode of inheritance is gilberts

A

autosomal recessive

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2
Q

meaning of penetrance

A

likelihood of someone with a specific genes to express the phenotype ie me and my brother both have ADHD genes but he actually has ADHD - 50% penetrance

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3
Q

inotropic

A

contraction of muscles

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4
Q

chronotropic

A

change in HR

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5
Q

dromotropic

A

conduction speed

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6
Q

what valves are open/closed in inflow phase

A

mitral and tricuspid valves are open - blood flows through atria to ventricles

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7
Q

what happens when ventricular pressures exceeds atrial pressure

A

AV valves snap shut (S1)

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8
Q

what happens in isovolumetric contraction

A

ventricular systole - contracting of ventricles to raise pressure

no valves are opening

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9
Q

what happens in outflow

A

pressure in ventricles exceeds aorta/pulmonary artery

so semilunar valves open

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10
Q

isovolumetric relaxation

A

ventricles relax and pressure in aorta/pul artery exceeds again

no valves open

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11
Q

cardiac myocyte > myofribrils > sarcomeres

what makes up a sarcomere

A

thick and thin filaments

thick - myosin

thin - 3 types of protein

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12
Q

thin filaments

A

actin
tropomyosin
troponin complexes - C I T

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13
Q

troponin I

A

inhibition of actin and myosin binding

by breaking down ATP

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14
Q

troponin T

A

structural connection to tropomyosin

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15
Q

troponin C

A

calcium binding site

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16
Q

what results in a contraction

A

when actin and myosin bind together

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17
Q

what happens when calcium ions binds to troponin C

A

causes a conformation change in troponin complex and exposes binding sites to myosin can bind to actin > contraction

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18
Q

cardiac action potential duration

A

200ms - 400ms

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19
Q

elastic arteries

A

contain more elastin than muscular arteries (which contain external and internal elastic lamina)

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20
Q

what cells are found in crypts of leiberkuhn

A

enterocytes - absorbe nutrients

enteroendocrine cells - eg I cells secrete CCK

paneth cells - lysosomal enzymes

goblet cells - secrete mucous to promote movement

dendritic cells - mediate food antigen tolerance

peyers’ patches - lymph nodules, low cuboidal M cells

proliferating stem cells - line the wall of crypts

brunners glands - alkaline mucosa - neutralise chyme

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21
Q

what is intrinsic factor

A

binds to B12
a glycoprotein secreted by parietal cells

pernicious anaemia

IgG

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22
Q

where are peyers patches only found

A

ileum

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23
Q

how does glucose and galactose enter enterocytes

A

(SGLT-1) co-transport with sodium - active transport

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24
Q

how does fructose enter enterocytes

A

GLUT5 - facilitated diffusion

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25
exocrine pancreas secretions receptors
M1/M3 (Ach)
26
hydrolysis of triglycerides via
pancreatic lipase
27
absorption of lipids/triglycerides in the small intestine
1. trigs need to be emulsified by bile salts hydrophobic part buries into trig, while hydrophilic part stays sticking out on the membrane - breaking up the trig 2. pancreatic lipases (which are water soluble) hydrolyses the trig into a monosaccharide 2 fatty acids 3. it becomes a micelle - which can be absorbed by epithelial cells > enterocytes 4. golgi/RER/SER make it a trig again, drains into lymph, goes into lacteal and here a chylomicron will come get it and take it into circulation
28
cranial nerves responsible for saliva release
facial VII and glossopharyngeal IX
29
dry mouth constipation fluid retention confusion is due to what drug
anticholinergics - Ipratroprium
30
MoA inhaled corticosteroids
up regulation of anti-inflammatory genes and downregulation of pro-inflammatory genes ie TNFa
31
MoA ipratropium
bronchodilation - smooth muscle relaxation
32
what asthmatic tx causes candidiasis
inhaled glucorticoids
33
MoA montelukast
competes for receptor cytseinyl leukotriene receptor 1 - E4 D4
34
MoA theophylline
phosphodiesterase inhibitor
35
what counters the effects of theophylline
activated charcoal
36
what is the law of la place
smaller sphere > more intense surface tension > greater tendency to collapse
37
what does surfactant do
reduce alveolar surface tension, reduce collapsing pressure and increase lung compliance
38
define lung compliance
change in volume that the lungs achieve per unit change in pressure ie emphyema reduces compliance
39
dorsal respiratory group
frequency of inspiration | basic rhythm of inspiration
40
apneuistic centre
sleep breathing
41
respiratory control centres
medulla and pons
42
medullary resp centre :
dorsal - inspiratory ventral - expiratory DIVE
43
pneumotaxic centre
inhibits respiration / resets
44
cerebral cortex
allows for voluntary breathing ie hyperventilating
45
what is the forced vital capacity
air that can be maximally expired after a maximal inhalation
46
type 2 chronic resp. failure oxygen goal
88-92%
47
what do central chemoreceptors respond to
H+ ions - acidic
48
Fick's Law of diffusion
rate of diffusion = (alveolar area x diffusion constant x difference in partial pressure) / thickness of alveolar membrane
49
what would increase rate of diffusion of gas from alveoli to blood
thick alveolar membrane
50
where are S cells located
jejunum and duodenum
51
function of S cells
secrete secretin which is aq bicarbonate - neutralises stomach acid ie is responsive to low pH in the duodenum
52
D cell secretion
somatostatin
53
I cell secretion
CCK
54
what cells does omeprazole work on
parietal cells | secrete HCl acid via H+/K+ ATPase pump
55
chief cells
secrete proteases - pepsinogen and chymosin breaks down proteins
56
enterochromaffin cells
histamine - histamine promotes acid secretion
57
G cells
secrete gastrin
58
what does enterokinase do ?
trypsinogen > trypsin
59
enterogastric reflex
signal = chyme in the SMALL intestine - inhibits gastric secretion
60
MoA orlistat
-inhibits the hydrolysis of triglycerides - a pancreatic lipase inhibitor therefore can cause steatorrhea weight loss medication
61
what are the 3 gastric glands
cardiac - cardia pyloric - pylorus and gastric - fundus
62
which 2 gastric glands are histologically the same
gastric and pyloric - contain mostly surface mucous cells
63
gastric glands
contain : ``` parietal cells chief cells mucous neck cells enteroendocrine cells stem cells ```
64
what are gastric pits
invaginations in the gastric surface epithelium , they connect to gastric glands and allow glandular products to be secreted
65
when is exocrine pancreas secretion at its highest
intestinal phase e
66
MoA metaclopramide
dopamine antagonist promotes gastric emptying - relaxation of the LOS stops nausea and vomitting - is a anti-semitic
67
pressure gradient that drives pulmonary blood flow in upright lung base
arterial pressure is greater than venous pressure
68
primary vasoactive substance that regulates pulmonary vascular resistance
oxygen
69
perfusion pressure in zone 1 lung
PA > Pa > Pv results in alveolar dead space as alveolar pressure exerts itself on the capillaries - compressing them - reducing blood flow *dead space = alveoli are ventilate but not perfused
70
perfusion in lung zone 2
Pa > PA > Pv Pa is greater here due to the effects of gravity - Pa > PA drives pulmonary blood flow
71
lung bases - zone 3
Pa > Pv > PA highest pulmonary blood flow here
72
is lobar pneumonia a type 1 resp failure
yes
73
pathophysiology of chronic bronchitis
chronic exposure to smoke or air pollutants leading to mucus hyper secretion in the bronchi
74
pathophysiology of interstitial lung disease
irreversible scarring of pulmonary connective tissue due to chronic inflammation
75
abnormal irreversible enlargement of the alveoli due to alveolar wall destruction
emphysema
76
most common bacteria - community acquired
streptococcus pneumonia
77
nerve damaged most likely to cause respiratory failure
phrenic nerve
78
guillane barre syndrome
autoimmune neuropathy
79
glycopeptides
eg = vancomycin, bleomycin bacterial cell wall - mode of action
80
sulphonamide + trimethoprim
co - trimoxazole via folate
81
penicillin MoA
inhibits peptidoglycan cell wall by preventing the cross-linking by binding to transpeptidase
82
protein synthesis antibiotics
tetracycline - these ones form complexes with other ions aminoglycosides macrolides
83
cephalosporins
ie ceftriaxone works well against gram - bacteria can pass the blood brain barrier
84
fluoroquinolone
eg ciprofloxacin inhibits the p450 liver enzymes they inhibits DNA gyrase - bactericidal
85
amino glycoside
ie gentamicin can cause ototoxicity protein synthesis inhibitor
86
treatment of TB
RIPE rifampicin - orange wee Isoniazide Pyrazinamide Ethambutol 2 months of RIPE 4 months of RI
87
mantoux test +
TB
88
widespread downsloping ST segments can be caused by what drug
digoxin
89
sinus bradycardia 1stTx
IV atropine
90
beck's triad
pericardial tamponade : muffled heart sounds low bp Raised JVP
91
what is beck's triad associated with
cardiac tamponade
92
how to treat cardiac tamponade
pericardiocentesis if haem. unstable
93
Tx acute pericarditis
NSAIDS + colchicine 2. corticosteroids 3. abx / pericardiocentesis
94
atrial flutter
P waves irregularly irregular sawtooth / flutter baseline
95
homelessness
TB
96
infective endocarditis signs + main inv
``` tricuspid valve splinter haemorrhage staph. aureus , strep viridans poor dentition osler nodes janeway lesions roth spots ``` 3 cultures at 3 different times/sites > then trans thoracic echo
97
what hepatitis has a high associated with hepatocellular cancer
B must screen using alpha-fetoprotein
98
carcinoid syndrome
carcinoid tumour broken down systemically into circulation causing flushing and wheeze as a GI symptom urinary 51AA - investigation
99
campylobacter jejuni
Guillaine Barre Milk
100
wilsons
caeruloplasmin
101
haemochromatosis
ferritin
102
acute/severe UC tx
IV corticosteroids
103
erythema nodosum
mainly crohns
104
beading of bile ducts / onion skinning
primary sclerosis cholangitis
105
infections that seem like IBDs
whippleis giardiasis bacterial overgrowth >>would need to do a stool microscopy
106
65-year-old lady who has recently been diagnosed with polycythaemia rubra vera, is admitted to the Emergency Department with sudden onset abdominal pain and swelling. On examination, she had a tender, palpable liver, with moderate abdominal distension and shifting dullness. What is the most likely diagnosis?
budd chiara - hepatic vein thrombosis
107
tx for watery diarrhoea + shigella
ciprofloxacin + iv fluids
108
if curb65 <2
manage patient at home with antibiotics for 7days and sort appointment soon
109
swinging fever
empyema
110
chlamydophila psitacci
bird - pneumonia
111
pulmonary fibrosis investigation
high-resolution CT
112
what type of pneumonia would show hyponatreamia
legionella
113
TB - where ?
geographically - india most common anatomically - upper/middle lungs
114
BNP +
pulmonary hypertension
115
type 2 resp. failure when: PCO2 >6 PO2 <8 how do we manage
non-invasive ventilation
116
type of pleural effusion likely due to HF
transudate ie protein <25g/L
117
protein 35g/L
indicates infection
118
gram negative coccobacilli associated with COPD
haemophilus influenza
119
hospital acquired bacteria (most common ones)
pseudomonas aerginosa staph aureus enteroabacteria
120
klebsiella
red currant jelly | alcoholics
121
mycoplasma pneumonia
joint pain-y pneumonia younger patients
122
pneumocystis pneumonia
HIV

random shit i be finding hard (8 decks)

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