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1st Year Exam - Basic Science > Cram Deck > Flashcards

Cram Deck Flashcards

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1
Q

Boyle’s Law

A

At a constant temperature, the pressure exerted by a gas is inversely proportionally to the volume the gas is in.

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2
Q

What 2 forces hold the thoracic wall and the lungs together?

A

Intrapleural fluid cohesiveness + Negative intrapleural pressure

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3
Q

What gives lungs their elastic behaviour?

A

Elastic connective tissue + alveolar surface tension (attraction between water molecules at liquid air interface)

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4
Q

LaPlace’s Law

A

The smaller the aveoli, the higher their tendency to collapse
P= 2T/r

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5
Q

What is respiratory distress syndrome in newborns?

A

Developing fatal lungs are unable to synthesise surfactant until very late in pregnancy -> premature babies may not have enough pulmonary surfactant -> restrictive lung disease

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6
Q

Forces keeping the alveoli open vs promoting alveolar collapse

A

Open: transmural pressure gradient, pulmonary surfactant, alveolar interdependence
collapse: elasticity of connective tissue, alveolar surface tension

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7
Q

accessory muscles of inspiration

A

sternocleidomastoid, scalenus, pectoral

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8
Q

active expiratory muscles

A

abdominal muscles, internal/innermost intercostal muscles

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9
Q

Explain dynamic airway compression

A

rising pleural pressure during ACTIVE expiration compresses alveoli and airways

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10
Q

What is pulmonary compliance decreased by?

A

E.g. pulmonary fibrosis, pulmonary oedema, lung collapse, pneumonia, absence of surfactant

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11
Q

What is pulmonary compliance increased by?

A

Emphysema, old age

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12
Q

What is the work of breathing increased by?

A

low pulmonary compliance, high airway resistance, low elastic recoil, need for increased ventilation

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13
Q

Difference between pulmonary and alveolar ventilation?

A

Alveolar ventilation is pulmonary ventilation (tidal volume x RR) minus the anatomical dead space.

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14
Q

Gas transfer is dependent on…?

A

Ventilation + Perfusion

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15
Q

What is alveolar dead space?

A

Alveoli that are ventilated but not sufficiently perfused

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16
Q

Dalton’s Law

A

The sum of partial pressures makes up the total pressure exerted by a gas.
P= P1 + P2 + P3 + P4 + P5+…+Pn

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17
Q

What is the respiratory exchange ratio (CO2 produced/O2 consumed) for someone eating a normal diet?

A

0.8

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18
Q

Out of O2 and CO2, which has the higher diffusion coefficient, which one the higher pressure gradient

A

Diffusion coefficient: CO2

Pressure gradient: O2

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19
Q

Fick’s Law of Diffusion

A

Thin membranes are easier to diffuse through

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20
Q

What are the factors that influence gas transfer across the alveolar membrane?

A

Partial pressure gradient
Diffusion coefficient
Surface area of membrane - exercise increases this
Thickness of membrane - increases with pulmonary oedema, fibrosis

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21
Q

Henry’s Law

A

The amount of gas dissolved in a liquid is proportional to its partial pressure above the liquid.

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22
Q

How many oxygen molecules can 1 haemoglobin molecule carry?

What are the groups called in adults and feotuses?

A

4.
Adult: 2 alpha, 2 beta
Foetus: 2 alpha, 2 gamma -> increased affinity

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23
Q

Oxygen delivery depends on…?

A

Arterial oxygen content

Cardiac output

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24
Q

Arterial oxygen content depends on…?

A

Hb concentration

Saturation of Hb with O2

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25
Q

Bohr effect. what causes it?

A

Shifts oxygen curve to the right - decreases affinity and promotes oxygen release at the tissues.
increased pCO2, increased H+ conc, increased temperature, increased 2,3-BPG

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26
Q

How is myoglobin different to haemoglobin?

A

Sits in skeletal and cardiac muscle cells, much higher affinity for oxygen, stores O2 for anaerobic conditions
Presence of this in the blood indicates muscle damage.

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27
Q

How is CO2 transported in the blood and what are its percentages?

A

Dissolved - 10%
Bicarbonate - 60%
Carbamino compounds - 30%

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28
Q

What enzyme catalyses the formation of carbonic acid, and in turn the formation of bicarbonate and H+?
And where does it happen?

A

Carbonic anhydrase

In red blood cells

29
Q

Haldane effect.

What causes it?

A

Oxygen shifts CO2 dissociation curve to the right - decreases affinity between Hb and CO2, replaces its, which increases oxygen uptake and CO2 removal.

30
Q

What is the major rhythm generator of respiration and what does it excite?

A
  • Dorsal respiratory neurones are excited by the Pre-Bötzinger complex in the medulla oblongata
  • When excitation subsides -> passive expiration
  • If dorsal neurones fire excessively, they activate adjacent ventral neurones which promote active expiration
  • pneumotaxic centre terminates inspiration
  • dorsal neurone firing can be increased by apneustic centre (IN THE PONS) -> prolonged inspiration
31
Q

What stimuli influences the rest centre

A

Higher brain centre, stretch receptors in the airways, juxtapulmonary receptors, joint receptors, baroreceptors, chemoreceptors

32
Q

Hering-Breuer-reflex

A

guard against hyperinflation, by pulmonary stretch receptors

33
Q

What do peripheral chemoreceptors sense?

Where are they?

A

O2, CO2, H+ conc

Carotid+aortic

34
Q

What do central chemoreceptors sense and where do they sit?

A

H+ conc in the cerebrospinal fluid, the more H+ the more CO2 due to bicarbonate reaction

35
Q

What is hypoxic drive?

A

Lack of oxygen stimulates chemoreceptors which increase respiration
->only significant if it falls below 8 kPa

36
Q

What causes hyperventilation at high altitudes?

A

Low PaO2 -> hypoxia -> stimulation of chemoreceptors

37
Q

Chronic adaptations at high altitudes

A 
Increase in: 
-RBC production
-2,3 BPG produced within RBC
-number of capillaries
-number of mitochondria
Decrease in:
-pH
38
Q

What part of the respiratory tract does the SNS innervate?

A

None, it acts on the adrenal gland to promote adrenaline release

39
Q

What is the Gq protein associated with?

A

Calcium release

40
Q

Gs

A

cAMP production

41
Q

Gi

A

inhibits cAMP production

42
Q

What does the phosphorylation of MLC through MLCK do?

A

Promotes the formation of myosin cross bridge -> contraction

43
Q

What does the dephosphorylation of MLC through Myosin phosphatase do?

A

myosin cross bridge release -> relaxation

44
Q

What two things does adrenaline do to airway smooth muscle?

A
  1. phosphorylation of myosin phosphatase -> induces relaxation
  2. phosphorylation of MLC - inhibits contraction
45
Q

What type of hypersensitivity reaction Is asthma?

A

Type I - early

Type IV - late

46
Q

What does PKA do in the airway smooth muscles?

A

Phosphorylation of MLCK and myosin phosphatase -> inhibition of contraction, stimulation of relaxation

47
Q

What are the most common side effects?

A 
Dysphonia (hoarse and weak voice)
Oropharyngeal candidas (thrush)
48
Q

What immune cells are involved in COPD

A

neutrophils, CD8+ T cells, macrophages

49
Q

Why are LAMAs (e.g. tiotropium) superior to SAMAs (e.g. ipratropium) in bronchodilation?

A

Ipratropium is non-selective -> acts on M1, M2, M3 receptors -> decreases M2’s inhibitory effect
Tiotropium is selective for M3 effector cells

50
Q

What do rhinitis and rhinorrhea do?

A
  • Increased mucosal flow
  • Increased blood vessel permeability

these cause swollen nasal mucosa -> difficulty breathing in

51
Q

What is the moa of sodium cromoglicate?

A

Mast cell stabiliser - stops them from granulating (releasing inflammatory mediators)

52
Q

What are the Gi tract’s layers from inside to outside and where are the nerve plexuses located?

A

Mucosa, submucosa, muscularis externa, serosa

Submucous (Meissner’s) plexus - submucosa
Myenteric (Auerbach’s) plexus - muscularis externa

53
Q

What is the electrical rhythm of the stomach, small intestine, and colon?

A

Stomach - 3/min
Small intestine - 8-12/min
Colon - 8-16/min

54
Q

What are the secretagogues that induce acid secretion from the parietal cells?

A
  • ACh - can act both directly on ECL-cells as well as parietal cells
  • Gastrin - can act both directly on ECL-cells as well as parietal cells
  • Histamine - released from ECL-cells, acts on parietal cells
55
Q

What is the migrating motor complex, and when does it happen?

A

Strong peristaltic movement cleaning out all the left-over shit, in between meals.

56
Q

What does SGLT1 do?

A

Uses 2Na+ gradient to pump in a glucose ,molecule against its conc gradient.

57
Q

Why is haustration important?

A

Non-propulsive segmentation allows time for fluid and electrolyte reabsorption

58
Q

Cullen’s sign

A

bruising around the umbilicus

59
Q

grey turner’s sign

A

bruising along the flanks

60
Q

Courvoisier’s law

A

Jaundice + enlarged/palpable mass = highly suspicious of pancreatic malignancy

61
Q

horner’s syndrome

A

miosis + ptosis + anhidrosis

62
Q

Cushing’s syndrome

A

too much cortisol

63
Q

Brugada syndrome

A

Inherited Na+ channel-patchy in the myocardium

64
Q

tetralogy of fallot

A
  1. pulmonary stenosis
  2. RVH
  3. ventricular septal defect
  4. overriding aorta

->combination of congenital abnormalities

65
Q

ALT

A
  • Serum transaminase, transfer amino groups for mitochondrial energy production, predominantly glucose
  • very sensitive
  • look for 10-fold increase
  • extremely high in cholelithiasis, >1-2000 U/L
66
Q

AST

A
  • Serum transaminase, transfer amino groups for mitochondrial energy production, predominantly glucose
  • usually becomes deranged with ALT
  • extra enzyme to show hepatocellular pathology
67
Q

ALP

A
  • catalyse the hydrolysis of esters on the epithelial cells of billiary ducts
  • cholestasis raises ALP levels as it enhances synthesis and release
  • look for 3-fold increase
68
Q

GGT

A
  • Enzyme involved in gluthionine metabolism in the liver
  • GGT is inducible (drugs, alcohol, other diseases can increase it)
  • can help determine whether raised ALP is of bone or liver origin
69
Q

Bilirubin

A
  • Breakdown product of heme
  • conjugated in the liver
  • bilirubin in the urine means that there is a post-hepatic obstruction (bile ducts)

1st Year Exam - Basic Science (1 decks)

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