Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

test > Case 4-6 > Flashcards

Case 4-6 Flashcards

1
Q

What are the layers of the heart wall and what epithelium are they made of ?

A

Endocardium - simple squamous
Myocardium - striated sarcomeres
Epicardium - simple squamous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the significance of isovolumetric contraction ?

A

Short time in systole where AV and semilunar valves are shut. Volume constant with pressure ^

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give two examples that would increase after load by ^aortic pressure and systemic vascular resistance

A

Aortic stenosis or ventricle dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What substances cause vasoconstriction and vasodilation of the endothelium ?

A

Vasoconstriction; endothelin, vasopressin

Vasodilation; NO, ACh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do foam cells form during atherosclerotic plaque formation ?

A

Endo dysfunction ^LDL permeability. LDL oxidised in intima, monocytes enter -> macrophages. They bind to LDL -> foam cells ^inflam process , seen as yellow fatty lesions on arterial wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How does angina arise after foam cell formation ?

A

Collagen deposited forming cap over the plaque, this limits flow (stenosis) -> angina.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the difference between stable and unstable angina in terms of plaque rupture /

A

Stable, plaque more fibrous than lipid

Unstable, ^rupture risk lipid rich and inflamed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the difference between stable and unstable angina in terms of sx ?

A

Stable, sharp chest pain on exertion relieved by rest or GTN
Unstable, pain comes on at rest.
Both show no troponin increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How would you manage ACS clinically ?

A

GTN, b blockers (bisoprolol) , CCBs (amlodipine) , Nicorandil (vasodilator) , Ivabradine (rate limiter)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How would you manage ACS acutely ? (MONA)

A

Morphine, O2, Nitrates, aspirin until they can get to a Catheter lab for stenting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Name an anticoagulant medication and reason for use ?

A

Warfarin used at ^risk of clotting events in non vascular trauma causes eg. turbulent blood flow in AF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Clopidogrel ?

A

Inhibits platelet P2Y12 ADP receptor that normally triggers platelet activation (post MI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drug can be used to dissolve an existing drug ?

A

Fibrinolytic drug eg. Tenectaplase used when thrombus causes ischaemia. Recombinant form to tissue plasminogen activating factor (tPA) which mediates plasminogen to plasmin rapidly dissolving clots by fibrinolysis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the antidote for tenectaplase ?

A

Tranexamic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the action of Nicorandil ?

A

Vasodilator used in stable angia. Stimulates guanyl cyclase ^cGMP and PKG which decreases Ca and activates KATP efflux -> hyper polarisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the exogenous pathway ?

A

TAGs from gut to liver. Chylomicrons in blood go to peripheral tissues (lipoprotein lipase) break down into TAGs + FFA + glycerol. Chylomicron remnant ApoE binds to liver and endocytosed and hydrolysed in lysosomes again.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which pathway goes from liver to tissues and what is the first step of packaging ?

A

Endogenous pathway. TAG + cholesterol packaged with apolipoprotein B100 forms VLDL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where does VLDL go in the endogenous pathway ?

A

in blood meets HDL and matures. in tissue meets lipoprotein lipase -> glycerol/FFA (becomes IDL and HDL). IDL absorbed by liver where lipase removes TAGs -> LDL. LDL binds to tissue via apoB100 on LDL -> lysozyme -> cholesterol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How would a decreased preload affect a PV loop diagram ?

A

Decreases SV and EDV so curve goes down and left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If the curve on a PV loop got taller and thinner what change is likely to have happened ?

A

^afterload ^wall stress, aortic P and R both increase. CO falls as SV falls so width decreases and ESV ^.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does ^inotropy affect the PV loop ?

A

^SV so ^loop size with decreased ESV. Curve moves left and larger.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the difference between the Left and Right lung ?

A

Left has two lobes (sup/inf) divided by oblique fissure

Right has sup/middle/inf divided by horizontal and oblique fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What features does the trachea have that make in functional in the conducting airway ?

A

Has goblet cells and cilia. Serous and mucous glands to humidify and trap air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which bronchus is more prone to aspiration and why ?

A

R bronchus is shorter and straighter so more common. Made of pseduostratified ciliated columnar epithelium with goblet cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How do the bronchioles differ from the bronchi ?
Bronchioles are simple cuboidal with no cartilage/goblet cells. Lots of SM to control air flow
26
What are the different cell types in the respiratory bronchioles ?
Clara cells produce surfactant Type 1 alveoli (pneumocytes) useful for diffusion joined by tight junctions Type 2 round/dark nuclei. Secrete surfactant and are a stem cell precursor for type 1
27
What is the function of Clara cells ? (5)
In terminal bronchioles have microvilli, they secrete glycosaminoglycans which reg hydration and H2O homeostasis. Maintain structure and function, modulate inflammatory response. Influence tissue repair and remodelling.
28
How is mucous viscosity determined ?
Cl moves from serous cells through Ch from interstitial to lumen pulling H2O with it so Cl^ and H2O ^. Important in CF
29
What is the R to L shunt ?
When blood goes straight to LV without being oxygenated due to poor perfusion of the alveoli
30
How is bronchoconstriction initiated ?
PSNS (vagus) ganglia synapse in large airways, contain NTs: ACh, VIP, NOS which innervate SM causing bronchoconstriction and vasodilation ^mucous flow
31
How is bronchoconstriction reversed ?
Atropine (muscular antagonist)
32
What is the effect of ACh on M1, 2 and 3 receptors ?
``` M1 = ^preganglionic transmission M2 = decreases Each M3 = ^SM contraction ```
33
What is the cough reflex ?
receptors/afferent nerves/eff nerves/effector muscles trigger deep inspiration ^intrathoracic P when larynx is closed -> when larnyx opens causes cough
34
What are the afferent nerves, efferent nerves and control centre involved in the cough reflex ?
Afferent nerves; CN IX, X Efferent nerves; vagus, phrenic, spinal motor Control centre; medulla, Nucleus tractus solitaris.
35
Which area of the lung is the best perfused and ventilated ?
The base/ bottom of lung
36
What is the difference between anatomical and physiological dead space ?
Anatomical; air in conducting resp tract that doesn't take part in gas exchange (top of lungs) Physiological; vol of air in resp zone not part of gas exchange
37
What is the indication if VA:Q = 0 and infinity?
0, perfused but not ventilated | Infinity, ventilated not perfused
38
How does smoking ^lung infection risk ?
Tobacco ^free radicals which inactive antiproteases and cause tissue damage -> neutrophil/macrophage elastase ^. Air is trapped in the lung and cilia too damaged to move mucous so rate ^
39
What def can worsen a prognosis of lung infection ?
alpha 1 AT deficiency
40
What is Cor pulmonale ?
RV hypertrophy from pulmonary HT
41
How is breathing controlled voluntarily and involuntarily ?
Voluntary; cortex -> spinal cord -> resp muscles. | Involuntary; limbic system/hypothalamus -> pneumotoxic + apneustic centre -> medulla -> spinal cord -> resp muscles
42
What is the difference between peripheral and central chemoreceptors ? (location, response, speed)
Peripheral; carotid and aortic bodies , O2 down/^CO2/pH down, rapid response Central; ventrolateral surface of medulla , pH of CSF, slower
43
Why is O2 contraindicated for COPD ?
Decreases the hypoxic drive so px would stop breathing
44
What is the difference between type 1 and 2 respiratory failure ?
1 (O2 fails) hypoxaemia with normal/low PCO2; decrease O2 (altitude) , diffusion deficit, VQ mismatch, R/L shunts 2 (ventilation failure) hypoxaemia and hypercapnia; depressed resp centre/muscle weakness, chest wall deformity, severe lung disease (COPD/asthma) , obesity, headache worse in morning
45
How would you tx obstructive sleep apnea ?
CPAP, weight loss, reduce alcohol consumption
46
What is compliance and how does it vary with age ?
How easily the lungs stretch. decreases in fibrosis, ^with age and emphysema (decreased elastin). Determined by surface tension and lung elasticity
47
What is the the function of surfactant ?
Produced by type 2 alveoli and Clara cells. Decreases surface tension so the lungs don't collapse. Hydrophobic heads immersed in H2O lining of the alveolar wall.
48
What is infant respiratory distress syndrome and what are the sx (3) ?
Not enough surfactant in newborn babies leads to lung collapse Sx; blue discolouration, ^RR, nasal flaring
49
What is asthma and what is the familial risk ?
Hyperactive airways -> obstructive disease that's reversible. Eczema and hay fever common 1 parent = 40% , 2 = 80%
50
What is bronchiectasis, what are the sx (3)and tx (3) ?
Chronic inflammation -> permanent dilation of bronchial tree. Sx; cough, mucous secretion, chest pain. Tx; airway clearance, mucolytics, inhalers
51
What are the common causes of commonly acquired and hospital acquired pneumonia ?
Common; less mortality, strep pneumoniae | Hospital; ^mortality, staph aureus
52
How would you assess pneumoniae and what would be the tx plan ?
CURB-65 (confusion, urea, RR, BP, >65) | If >2 give IV abx
53
What is the difference between pleural effusion and pneumothorax ?
``` effusion = fluid Pneumothorax = air ```
54
What are coal miners pneumoconiosis and pulmonary fibrosis examples of ?
Interstitial lung disease
55
How would restrictive and obstructive lung conditions differ in spirometry ?
Obstructive (COPD, asthma) <0.7 (long drawn out) | Restrictive >0.7 (both decrease but proportionally)
56
What is the difference between a severe of the fibres between the pons and medulla on resp control ?
Pons fine tunes and controls rate so patho causes irregular breathing Medulla is the main centre so patho causes no breathing.
57
What is the action of the cortex on resp action ?
Can override medulla, ^CO2 (holding breath) relays back to centre and forces inhale.
58
What is the flow of CSF up to 4th ventricle ?
Choroid plexus (lat ventricle) -> foramen of monro -> 3rd -> aqueduct of sylvias -> 4th
59
What is short term memory ?
Small amounts of info for a few seconds. Typically 7 +/- 2 items.
60
What is explicit memory ?
Branch of LTM that is open to intentional retrieval (consciousness)
61
How is declarative memory divided ?
Facts and events | Episodic (events/experience) and semantic (facts and concepts)
62
What is classical conditioning?
Learning procedure, neutral stimulus paired with response provoking stimulus such that stimulus causes response
63
Where is the hippocampus located and what is its function?
Medial temporal lobe. Explicit and declarative memory. Involved in creation of new memories
64
Where are stable LTM stored and how are memories consolidated ?
Neocortex is the store of 'remote memory'. Consolidation occurs between hippocampus and neocortex
65
What is anterograde amnesia ?
New info problems; encode, store, retrieve failure. Affects hippocampus so new memories can't be created.
66
Which memory is preserved in anterograde amnesia ?
Affects explicit memory not implicit so you can't learn new facts but you retain the subconscious skills you already have eg. driving.
67
What pathology arises from damage to the neocortex?
Retrograde amnesia, problems with memories of past events (can't store LTM)
68
What are some of the causes of amnesia ? (6)
Temporal lobe surgery, herpes simplex encephalitis, anoxia/hypoxia, Korsakoff syndrome (b1 def in alcoholics) , alzheimers (most common but not pure form of amnesia) , vascular dementia
69
How does the volume of the brain change with age, which area is affected the most ?
Vol of brain decreases 5% every decade over 40 | Frontal lobe shrinks most rapidly.
70
What effect does Alzheimers have on the brain ?
Hippocampus normally shrinks slowly but will rapidly shrink if AD.
71
How do the temporal and occipital lobes change with age?
They shrink slowly (limited change)
72
What type of memory is affected through ageing ?
Fall in episodic memory. Increase in semantic.
73
How do grey and white matter change in ageing ?
Grey matter shrinks (neuronal cell death) due to declining synaptic connections so reduced cognitive processing White matter, myelin shrinks with age so reduced conduction
74
How do the production of DA and 5HT change with age ?
Brain generates fewer NTs with ageing so decrease in cognition, memory and ^depression
75
How does Alzheimers affect the brain ?
Cortex shrivels so less planning, thinking and memory/ Ventricles fill with CSF grow larger. Hippocampus slowly shrinks
76
Which proteins are involved in Alzheimers ?
B amyloid protein extracellular and Tau protein intracellularly
77
What are the sx of Alzheimers ? (4)
Gradual onset progressive memory decline, anterograde amnesia key, semantic memory declines, remote memory affected last
78
What are the tx options for AD?
Reversible acetylcholinesterase inhbitors; Donepezil, Galantamine, Rivastigmine NMDA receptor antagonist and nAChR antagonist; Memantime
79
How does vascular dementia differ to AD ? (4)
More sudden onset, stepwise coarse. CV hx more important with neuropathy findings; sensory + motor sx, visual problems, EPSEs
80
Which dementia is linked to Parkinsons ?
Lewy body dementia. Cognitive fx dominate. Visual hallucinations from early on often of people and animals
81
What is Pick's disease and where does it affect ?
Frontotemporal dementia. Neurodegeneration <65 onset. Strong genetic link. Personality/behavioural changes often key early fx.

test (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions