Cammy's Bible notes Flashcards
What shape is the Hb dissociation curve
Sigmoidal
What shape is the myoglobin dissociation curve
Hyperbolic
Which Ig is found in breast milk
IgA
Which Ig is associated with hypersensitivity
IgE
What receptors does IgE bind to bring about a response
Fc receptors
What is the most common type of Ig/antibody
IgG
Passed onto foetal circulation
What is the first antibody/Ig to appear in response to an antigen
IgM
What produces endotoxin
gram negative bacteria
What antibiotic is used for gram positive cover
Vancomycin
What is the key enzyme of glycolysis and what net ATP gain does it yield
phosphofructokinase
Uses 2 ATP, makes 4 ATP– net +2ATP
Name 2 classic oncogenes and what they do
ras/myc – stimulate cell growth and inhibit death
Name 3 tumour suppressor genes and what they do
p53/APC/BRCA1, inhibit cell growth and stimulate death
Is erection sympathetic or parasympathetic
parasympathetic
Is ejaculation sympathetic or parasympathetic
sympathetic
What provides myelination in the PNS
Schwann cells
What provides myelination in the CNS
oligodendrocytes
Name the 2 CNA glial cells and what they do
Astrocytes – homeostasis
Microglia – immune surveillance
What produces exotoxin
Gram positive bacteria
What 2 shapes can gram positive bacteria be and which genera do these belong to
cocci (sphere shaped) or bacilli (rod shaped)
What colour do Gram negative bacteria stain
Pink
What colour do Gram positive bacteria stain
Purple
where is trachea palpated
suprasternal/jugular notch
Where is the sternal angle clinically palpable
rib 2 line
where does larynx become trachea and pharynx become oesophagus
C6
where does trachea bifurcate (vertebral levels)
T5-T7/carina
nerve that supplies the diaphragm
C3,4,5 keep the diaphragm alive (phrenic nerve)
Horners syndrome - 3 osis’s and what they mean
ptosis - drooping or falling of the upper eyelid
miosis - excessive constriction of the pupil of the eye
anhydrosis - inability to sweat
Non-smoker lung cancer
adenocarcinoma
antigen in squamous cell carcinoma of lung
p63
What is the Rima glottidis and why is it significant
narrowest part of larynx where foreign bodies tend to block
which obstructive lung disease involves raised eosinophils
Asthma
which obstructive lung disease involves raised neutrophils
COPD
Asian man with night sweats, fever and weight loss?
Tb
Urine antigen test buzzword
Legionella
Ziehl-Neelsen stain positive for acid fast bacilli buzzword
Tb
4 C’s of fibrosis?
clubbing, cyanosis, crackles, cough
D sign on X ray buzzword
Empyema
Define transudate and exudate pleural effusions
Exudate (extra protein >30) and transudate (less protein <30)
Thumbprint sign on head xray buzzword
Epiglottitis
Causative organism of Epiglottitis
Sark Mith
lol, jk
H. Influenzae
Treatment for Epiglottitis
Ceftriaxone
Where is respiratory rhythm established
Medulla
Pneumonic for breathing control
DIVE – doral firing is inspirate, ventral firing is expiratory
Describe respiratory epithelium
pseudostratified ciliated columnar epithelium with goblet cells
What kind of lung cancer produces mucin
adenocarcinoma
Which investigation you would do to look for bone metastasis
radionuclide bone scanning
Treatment for Large P.E
Thrombolysis
Treatment for small P.E
LMWH
COPD exacerbation treatment pneumonic
ISOAP Ipratropium Salbutamol Oxygen Amoxicillin Prednisolone
What does Alpha 1-antitypsin deficiency lead to
Liver damage and early COPD
What is caplans syndrome
Rheumatoid arthritis and pneumoconiosis
What is Samster’s triad and what can it cause
asthma, salicylate sensitivity (Aspirin) and nasal polyps- aspirin induced asthma
What is centriacinar emphysema caused by
Smoking
What is panacinar emphysema caused by
A1AT deficiency
Commonest cause of bronchiolitis, diagnosed by PC
RSV
Where is the middle lung lobe auscultated
on right side between rib 4 and 6
Where are the horizontal and oblique fissures auscultated
Oblique fissure – rib 6, Horizontal fissure – right rib4
Anterior intercostal spaces blood vessels
internal thoracic artery/vein
Posterior intercostal spaces blood vessels
thoracic aorta/azygous vein
Treatment for Tb Pneumonic
2 RIPE 4 RI
Quadruple therapy for 2 months and dual therapy (rifampin and isoniazid) for 4 months
Tb drugs side effects
Rifampin – side effect of red-orange discoloration of urine and tears, rashes and hepatotoxicity.
Isoniazid – peripheral neuropathy
Pyrazinamide – joint pain, rash, allergic reaction, yellow skin or eyes, worsening gout
Ethambutol – change in vision, optic neuritis and red-green colour blindness.
Bone scan used to diagnose osteoporosis
DEXA bone scan
Side effect of ACEI
different option?
Dry Cough
ARB
ACEi and ARB contra-indication
Renal artery stenosis
pregnancy
Main cause of Infective endocarditis
staph aureus – main cause (prosthetic valves or IV drug users)
When is Strep viridans causative of infective endocarditis
present in mouth after dental surgery
Ductus arteriosus is a connection between which two vessels
pulmonary artery and descending aorta
Strawberry milkshake coloured blood buzzword
Hyperlipidaemia
Herpes zoster virus (shingles) dermatome level
T4/T5
Nipple dermatome
T4
Belly Button dermatome
T10
Rate limiting enzyme in cholesterol synthesis
HMG-CoA reductase
MABP calculation
Diastolic + 1/3(pulse pressure)
What is the longest vein in the body
great saphenous
which coronary artery supplies the SA node
Right coronary artery
Tetralogy of fallot consists of?
VS defect, overriding aorta, pulmonary stenosis, RV hypertrophy
Anterior branches of thoracic aorta
bronchial, oesophageal, mediastinal, pericardial, phrenic arteries
A counter regulatory mechanism to RAAS system and when it is triggered
ANP – released in response to atrial distension/hypervolemia – acts as a vasodilator and decreases renin release
Nerve that supplies the rectum
S4, inferior rectal nerve
Treatment of H.pylori
PPI + amoxycillin 1g bd + clarithromycin 500mg bd
PPI + metronidazole 400mg bd + clarithromycin 250mg bd
what is Virchows node and what does it link to
left supraclavicular lymph node – gastric cancer
Corkscrew oesophagus on barium swallow
diffuse oesophageal spasm
Lowest part of peritoneal cavity when supine
hepatorenal recess/morrisons pouch
Area between rectum and uterus in females
rectouterine pouch – pouch of douglas
Area between rectum and bladder in males
rectovesical pouch
Muscle of the cheek that moves food during mastication
Buccinator
Treatment for campylobacter
if co morbid
Ciprofloxacin or erythromycin
Treatment for salmonella
if co morbid
Ciprofloxacin or cefotaxime
Treatment for peritonitis
Metronidazole + gentamicin
Antibody for Primary biliary cirrhosis
Anti-mitochondrial antibody (AMA)
Antibody for autoimmune hepatitis
Anti-smooth muscle antibody (ASMA)
Antibody for Hepatocellular carcinoma
Alpha feto protein
AFP
Signs of Diffuse Stomach cancer
Signet ring cells seen on biopsy
Antibody for coeliac disease
Anti-transglutaminase antibody, anti endomysial antibody
Antibody for UC or PSC
perinuclear-ANCA (pANCA)
Antibody for PSC
Antineutrophil Cytoplasmic Antibodies (ANCA) (cANCA)
Signs of pancreatitis
Raised amylase, lipase, vomiting, pain
Q fever causative organism
Coxiella burnetti
What is Pickwickian disease
Obesity hypoventilation syndrome
obese people whose body fat preventing air getting in. Causes sleep apnoea and hypercapnia (high levels of carbon dioxide in the blood). Buzzword: overnight nasal ventilation
what is Guillian-Barre disease
disease which causes paralysis. Normally preceded by a strep. throat/infection of respiratory or GI tract. A.K.A polyneuritis (meaning rapidly progressive, ascending motor neurone paralysis, beginning in the feet and ascending to the other muscles)
How do you differentiate between a gastric and a duodenal ulcer
Pain from gastric ulcer is brought on by eating whereas it is relieved by eating in a duodenal ulcer
If someone is HBsAg positive, what does that mean
had a previous infection, acute or chronic
If someone is AntiHBsAg positive, what does that mean
clinical recovery and immunity
If someone is HBeAg positive, what does that mean
highly infectious
If someone is IgM antiHBc positive, what does that mean
Acute infection
If someone is IgG antiHBc positive, what does that mean
Chronic infection
Which hepatitis only presents with another one
Hep D
Only presents with Hep B
Pharmacological treatment for ascites
Spironolactone
What is Charcot’s triad and what does this indicate
RUQ pain, Fever, Jaundice
Ascending Cholangitis
Treatment for hemochromatosis
phlebotomy, blood letting
Lifelong copper chelating drugs
What is Leukonychia and what does it indicate
white nails
hypoalbuminaemia
What is Koilonychia and what does it indicate
nail spooning
iron deficiency anaemia
What do Mallory hyaline bodies indicate
alcoholic liver disease