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1 ICPP > Clinical Conditions > Flashcards

Clinical Conditions Flashcards

1
Q

What is thyrotoxicosis?

A
  • Thyrotoxicosis is a disease caused by excessive concentrations of free thyroid hormones (most often T4)
  • It presents with tremor, tachycardia, fatigue and heat intolerance
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2
Q

What is hyperthyroidism?

A
  • Hyperthyroidism is an endocrine disorder wherein the thyroid gland is overactive and produces an excess amount of T3/T4
  • It presents with fatigue, weight loss and excessive sweating
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3
Q

What is hypothyroidism?

A
  • Hypothyroidism is an endocrine disorder wherein the thyroid gland is underactive and produces an insufficient amount of T3/T4
  • It presents with tiredness, weight gain and feeling depressed
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4
Q

What is asthma?

A

Asthma is a long-term inflammatory disorder of the lungs characterised by airway hyper-responsiveness which causes variable and reversible airflow obstruction

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5
Q

Name and explain 2 haemolytic anaemias.

A

Hereditary sperocytosis:

  • Spectrin depleted 40-50%
  • Erthrocytes=more round
    • Less resistant to lysis

Hereditary eliptocytosis:

  • Defect in spectrin molecule
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6
Q

Name 2 toxins which interfere with G-protein function

A
  • Cholera toxin
  • Pertussis toxin
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7
Q

How does the pertussis toxin work?

A

Corrupts Gαi protein- uncouples it

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8
Q

How does the cholera toxin work?

A

Prevents GTPase activity

Permanently ON pathway

(Corrupts GalphaS)

Loss of fluid and electrolytes

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9
Q

Explain how interactions with ß1 -adrenoreceptors can increase the force of contraction in the heart.

(positive inotropic effect)

A

G alpha S subunit- active- acitivates adenylyl cyclase

Adenylyl cyclase- ATP to Cyclic AMP

Cyclic AMP- activates PKA

PKA causes complement modification of VOCC

Higher intracellular Ca2+ conc

Increased contractility

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10
Q

How can sympathetically release noradrenaline cause vasoconstriction (smooth muscle contraction)?

A

Acting on: α₁-adrenoreceptors

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11
Q

How can parasympathetically released acetylcholine cause bronchoconstriction?

A

Act on: M3-muscarinic receptor

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12
Q

What are the normal plasma levels of calcium?

A

8-10mg/dL

1.9-2.3mM

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13
Q

What processes are changes in calcium ion concentration responsible for?

A
  1. Muscle contraction
  2. Neurotransmission
  3. Fertilisation
  4. Cell death
  5. Metabolism regulation
  6. Learning and memory
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14
Q

Name the different types of calcium ion transporters

A
  • PMCA: Plasma membrane calcium ATPase (ATP dependent)
  • SERCA: Sarcoplasmic ER calcium ATPase (ATP dependent)
  • NCX: Sodium-calcium exchanger
  • VOCC: Voltage operated calcium channel (influx)
  • LGIC: Ligand gated ion channels
  • CICR: Calcium induced calcium release receptors
    • amplify Ca2+ change in cytoplasm (ER/SR release)
  • IP3R: receptors (ER/SR release)
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15
Q

Which of the following can Na+ and K+ pass through (without proteins etc)?

  • Capillary wall
  • Cell membrane
A

Capillary wall - not cell membrane

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16
Q

What is the normal osmolarity of intracellular fluid?

A

280-310mOsm/kg

17
Q

How is serum osmolarity estimated clinically?

A

Doubling serum sodium

18
Q

What is the Permeability coefficient?

A

Transport flux of material through membrane per unit driving force per unit membrane thickness

19
Q

What do each of the letter stand for in this equation?

J = P (C1 - C2)

A

J= net rate of transport

P= permeability coefficient

C=concentration

20
Q

Which of the following ions is higher intracellularly than extracellularly?

  1. Na+
  2. Cl-
  3. K+
  4. Ca2+
A

K+

21
Q

What are 2 types of co-transporters?

A

Symport - same direction

Antiport- opposite direction

22
Q

What does sodium-potassium ATPase do?

A

Generates ion gradients

Allows for:

  • secondary active transport
  • action potentials
23
Q

Why does calcium end up entering the cell in an uncontrolled way in ischaemia?

A
  • Low oxygen
  • Low ATP production
  • Gradients of Na+ not maintained
24
Q

Name 3 membrane proteins which control cell pH.

A
  1. Acid extruders:
    1. NHE: Sodium/hydrogen exchanger
      1. 1:1
      2. Activated by growth factors
      3. Inhibited by amiloride
    2. NBC: Sodium bicarbonate co-transporter
  2. Base extruders:
    1. AE: Anion exchanger
      1. Exchange Cl- with HCO3-
25
Q

What is often the first line of treatment for mild hypertension?

A

Renal control of circulating Na+ concentration

EG.

  • Water tablet conc
  • Diuretic
26
Q

Which cells in the body have the highest resting membrane potentials?

A

Cardiac and skeletal muscle cells

(-80–> -90 mV)

27
Q

What are the ionic concentrations for a typical cell of:

Na+

K+

Cl-

Anions (-) eg phosphate, bicarbonate, amino acids

A
  • Na+
    • ​Intracellular: 12mM
    • Extracellular: 145mM
  • K+
    • ​Intracellular: 155mM
    • Extracellular: 4.5mM
  • Cl-​
    • ​Intracellular: 4.2mM
    • Extracellular: 123mM
  • Anions (-) eg phosphate, bicarbonate, amino acids:
    • ​Intracellular: 167mM
    • Extracellular: 40mM
      • ​Intracellular:
        • Extracellular:
28
Q

What does the nernst equation allow us to calculate?

A

Membrane potential

29
Q

What is the GHK equation and what does it describe?

A

Goldman-Hodgkin-Katz

Describes the ionic flux across a cell membrane as a function of the transmembrane potential and the concentrations of the ion inside and outside of the cell.

30
Q

What are the 2 types of fast synaptic transmission?

(Receptor protein=ion channel–>

Transmitter binding- opens channel)

A
  1. EPSP: Excitatory post-synaptic potential
    1. Excitatory transmitters (eg acetylcholine, glutamate) open ligand gated ion channels- caused membrane depolarisations
  2. Inhibitory synapses
    1. ​Transmitters (glycine)- Open ligand-gated channels- cause hyperpolarisation
31
Q

What are the 2 types of slow synaptic transmission?

A
  • Direct G-protein gating
    • ​Localised, quite rapid
    • Gating via intracellular messenger
32
Q

What is Devic’s disease?

A

Conduction of action potential in CNS affected (optic and spinal nerves) due to break down of myelin sheath.

33
Q

Name 2 diseases which affect the PNS and cause breakdown or damage to the myelin sheath.

A

Landry-Guillain-Barre syndrome

Charcot-Marie-Tooth disease

1 ICPP (3 decks)

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