bits for your tits

Question 1

level of spleen

Answer 1

ribs 8-11, left hypochondrium

Question 2

ascites

Answer 2

accumulation of free fluid in the peritoneal cavity

Question 3

conditions that may cause ascites

Answer 3

chronic liver disease
chronic heart disease
abnormal malignancy

Question 4

gynaecomastia

Answer 4

due to increased oestrogen levels - decreased clearance of oestrogen by the diseased liver

Question 5

location of portal triad (tract)

Answer 5

corners of lobules

Question 6

portal triad

Answer 6

branches of portal vein and hepatic artery, and the bile duct. Also contains lymphatics

Question 7

sinusoidal cell lining is specialised. How?

Answer 7

endothelium is fenstrated, enhancing permeability. Kuppfer cells lie in the endothelial layer and are phagocytic

Question 8

space of disse

Answer 8

region between the hepatocytes and the sinusoidal lining. Increases interface between hepatocytes and fluid passing from/to the lumen via the fenestrations - facilitating exchange of substances between the blood and hepatocytes.

Question 9

cirrhosis

Answer 9

diffuse process marked by cycles of destruction of hepatocytes followed by regeneration of the lost cells. There is deposition of collagenous tissue leading to scar formation. Characterised by nodules of regenerated hepatocytes separated by collagenous tissue

Question 10

where does pahrynx become continuos with oesophagus

Answer 10

lower limit of the larynx (cricoid cartilage). C6 vertebra

Question 11

oesophagus entering the abdominal cavity

Answer 11

passes through the right crus of diaphragm, at level of T10, slightly to the left of the mid-line

Question 12

the hiatus and where structures pass through them

Answer 12

vena cava (8 letters) T8, oesophagus 10 letters (T10), aortic hiatus 12 letters (T12)

Question 13

anatomical and physiological arrangements protecting against gastro-oesophageal reflux

Answer 13

lower oesophageal sphincter, angle between the lower oesophageal sphincter and the fundus of the stomach, mucosal soette formed by folds of mucosa at the gastro-oesophageal junction, oesophageal peristalsis, gastric peristalsis

Question 14

hiatus hernia

Answer 14

where part of the stomach protrudes up through the diaphragm into the thoracic cavity
Sliding - where the gastro-oesophageal junction protrudes up int the chest.
Rolling - where the gastric fundus protrudes up alongside the oesophagus

Question 15

intrinsic factor

Answer 15

produced by parietal cells. Binds B12 and allows it to be absorbed from the ileum

Question 16

four mediators that augment stomach acid secretion

Answer 16

gastrin, somatostatin, histamine, ACh

Question 17

biochem results in CKD

Answer 17

high serum creatinine, hypocalcaemia, high urea, mild hyperkalemia, anaemia, hyperphosphataemia, hypoalbuminaemia, high Alk phos

Question 18

renal osteodystrophy

Answer 18

bone disease due to combination of disturbed vitamin D metabolism and secondary hyperparathyroidism found in patients with CKD

Question 19

insulin regime during period of illness

Answer 19

increase insulin as increased cortisol levels will counter the effect of insulin

Question 20

three ketones produced during keto-acidosis

Answer 20

acetoacetate, beta-hydroxybutyrate, acetone

Question 21

anion gap

Answer 21

normally <18.
Normal anion gap - suggests HCl is being retained or NaHCO3 is being lost
Increased anion gap - unmeasured anions present in large quantities

Question 22

anion gap ketoacidosis

Answer 22

increases due to accumulation of organic acids

Question 23

hyperosmolar non-ketotic coma

Answer 23

endocrine emergency that can occur in type II diabetes

Question 24

three things that activate parietal cell

Answer 24

histamine, ACh, gastrin