case 5

Question 1

what is a downstream approach to health?

Answer 1

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

Question 2

what is illness behaviour?

Answer 2

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

Question 3

when did zola make his triggers?

Answer 3

1973

Question 4

what does the TCA cycle stand for?

Answer 4

tricarboxylic acid cycle

Question 5

what can happen to the intermediates of the krebs cycle/

Answer 5

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

Question 6

in general, what happens in the krebs cycle?

Answer 6

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

Question 7

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

Answer 7

2

Question 8

why is fat our main energy store?

Answer 8

because it has the highest calorific value.

Question 9

what is TAG in terms of fat stores?

Answer 9

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.

Question 10

why do you have a negative nitrogen balance in starvation?

Answer 10

you’re breaking down tissue protein for energy.

Question 11

what are a-ketoacids?

Answer 11

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

Question 12

what is ketogenesis?

Answer 12

making ketone bodies

Question 13

what are chylomicrons?

Answer 13

transport vesicles which transport fats around the body.

Question 14

what is VLDL?

Answer 14

very low density lipoprotein (lol)

Question 15

what happens in beta oxidation?

Answer 15

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.

Question 16

what type of fatty acid is palmitic acid?

Answer 16

long chained fatty acid

Question 17

what is the main product of fatty acid synthesis?

Answer 17

palmitic acid-16C

Question 18

what is a mimetic?

Answer 18

mimics a drug

Question 19

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

Answer 19

MCADD (medium chain acyl-coA dehydrogenase deficiency)

Question 20

what is the inheritance of MCADD?

Answer 20

autosomal recessive

Question 21

what are the symptoms of babies with MCADD?

Answer 21

poor feeding
drowsiness
sleepiness
vomiting
low energy
seizures (fits)

Question 22

what are some potential causes of airway obstruction?

Answer 22

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

Question 23

what is central cyanosis?

Answer 23

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

Question 24

what is the CRP test?

Answer 24

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

Question 25

what is tidal volume?

Answer 25

normal volume of air displaced between normal inhalation and exhalation.

Question 26

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

Answer 26

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

Question 27

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

Answer 27

ketones can cross the blood brain barrier

Question 28

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

Answer 28

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

Question 29

what do gastric bands do?

Answer 29

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

Question 30

what does ghrelin do?

Answer 30

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).

Question 31

how does MCADD cause hypoglycaemia?

Answer 31

- 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.

Question 32

what does aldolase b deficiency lead to?

Answer 32

hereditary fructose intolerance.

Question 33

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

Answer 33

- 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.

Question 34

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

Answer 34

- 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.

Question 35

how should you dispose of a used syringe?

Answer 35

put in the clinical waste bin

Question 36

what is the pathological mechanism of type 2 diabetes?

Answer 36

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

Question 37

what are the possible chronic complications of type 2 diabetes?

Answer 37

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

Question 38

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

Answer 38

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

Question 39

what are the main medications used for basal bolus therapy?

Answer 39

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

Question 40

is ATP synthase part of the electron transport chain?

Answer 40

no <3