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medicine year 1 and 2 > case 5 > Flashcards

case 5 Flashcards

1
Q

what is a downstream approach to health?

A

treating what happens to the patients (as opposed to preventative). what most doctors do.

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2
Q

what is illness behaviour?

A

how people behave wen they have illness-an important part before they see the doctor.

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3
Q

when did zola make his triggers?

A

1973

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4
Q

what does the TCA cycle stand for?

A

tricarboxylic acid cycle

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5
Q

what can happen to the intermediates of the krebs cycle/

A

some of them when needed can be taken out and used for other reactions inside the cell.

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6
Q

in general, what happens in the krebs cycle?

A

energy from oxidation reactions is being generated and being stored in these electron carriers.

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7
Q

for each glucose/fructose, how many acetyl coAs are going into the Krebs cycle?

A

2

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8
Q

why is fat our main energy store?

A

because it has the highest calorific value.

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9
Q

what is TAG in terms of fat stores?

A

triacylglyceride. same as triglyceride. (or TG or triacylglycerol.) is an ester of glycerol and three fatty acids. the main constituents of body fat in humans.

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10
Q

why do you have a negative nitrogen balance in starvation?

A

you’re breaking down tissue protein for energy.

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11
Q

what are a-ketoacids?

A

acidic compounds that have a keto group adjacent to the carboxylic group in their structure. eg: amino acids without the amino group.

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12
Q

what is ketogenesis?

A

making ketone bodies

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13
Q

what are chylomicrons?

A

transport vesicles which transport fats around the body.

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14
Q

what is VLDL?

A

very low density lipoprotein (lol)

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15
Q

what happens in beta oxidation?

A

fatty acid molecules are broken down to generate acetyl-CoA, which enters the citric acid cycle, and NADH and FADH₂, which are co-enzymes used in the electron transport chain.

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16
Q

what type of fatty acid is palmitic acid?

A

long chained fatty acid

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17
Q

what is the main product of fatty acid synthesis?

A

palmitic acid-16C

18
Q

what is a mimetic?

A

mimics a drug

19
Q

what is the most commonly inherited defect of fatty acid oxidation?

A

MCADD (medium chain acyl-coA dehydrogenase deficiency)

20
Q

what is the inheritance of MCADD?

A

autosomal recessive

21
Q

what are the symptoms of babies with MCADD?

A 
poor feeding
drowsiness
sleepiness
vomiting
low energy
seizures (fits)
22
Q

what are some potential causes of airway obstruction?

A
  • drowsy/unconscious patients for whom the tongue can fall backwards
  • vomit
  • secretions
  • tissue swelling
  • laryngeal oedema
23
Q

what is central cyanosis?

A

generalized bluish discoloration of the body and the visible mucous membranes.

24
Q

what is the CRP test?

A

C-reactive protein test-blood test that levels measures of inflammation.

25
Q

what is tidal volume?

A

normal volume of air displaced between normal inhalation and exhalation.

26
Q

how can you tell if the heart is enlarged on a CXR?

A

if the heart is more than 50% the diameter of the chest.

27
Q

why can the brain use ketones but not fatty acids for energy?

A

ketones can cross the blood brain barrier

28
Q

what’s an example of an environmental factor being changed that affects health?

A

north tyneside council have planning permission restrictions for fast food outlets within a certain distance of schools.

29
Q

what do gastric bands do?

A

band is placed around your stomach, so you do not need to eat as much to feel full.

30
Q

what does ghrelin do?

A

produced by ghrelinergic cells in the gastrointestinal tract when the stomach is empty promoting hunger and its release is inhibited when the stomach is stretched (full of food).

31
Q

how does MCADD cause hypoglycaemia?

A
  • results in the accumulation of unusual medium chain fatty acid derivatives that inhibit gluconeogenesic enzymes
  • also, gluconeogenesis requires energy from fatty acid oxidation and this is does not occur in MCADD as the fatty acids cannot be oxidised properly.
32
Q

what does aldolase b deficiency lead to?

A

hereditary fructose intolerance.

33
Q

what should you discuss with a patient before taking their blood? (after introducing yourself, checking their ID, and washing your hands)

A
  • Consent
  • Whether they have fasted/last time of patient eating.
  • The risks like bleeding and bruising
  • If the patient has a preferred arm.
  • If the patient has allergies to plasters/latex
  • If they have needle phobia or if have ever fainted before while blood was being taken.
34
Q

if you’ve had a needle stick injury from yourself, what are the immediate steps you need to take?

A
  • Ensure patient is safe
  • Immediately encourage bleeding by applying pressure around the wound
  • Wash the area with soap under running water for approximately 5 minutes.
  • Inform the appropriate staff as an accident form will need to be completed and appropriate action taken.
35
Q

how should you dispose of a used syringe?

A

put in the clinical waste bin

36
Q

what is the pathological mechanism of type 2 diabetes?

A

Net insulin deficiency leading to hyperglycaemia (insulin deficiency/ insulin resistance)

37
Q

what are the possible chronic complications of type 2 diabetes?

A 
Retinopathy (visual loss)
Nephropathy (chronic kidney disease)
Neuropathy
Amputation
Coronary artery disease/ischaemic heart disease
Stroke/cerebrovascular disease
38
Q

what are the different levels of health prevention and their purpose?

A

1) Primary prevention - reduce risks of developing disease
2) Secondary prevention – identification and management of early manifestations of disease
3) Tertiary prevention – prevention of the chronic and disabling effects of disease

39
Q

what are the main medications used for basal bolus therapy?

A

Lantus (glargine) = long acting, onset approx. 2 hours, no real peak, duration 24 hours
Novorapid (aspart) = rapid acting, onset approx. 10-15 mins, peak 1-2 hours, duration 3-5 hours

40
Q

is ATP synthase part of the electron transport chain?

A

no <3

medicine year 1 and 2 (29 decks)

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