ESA 2 practise paper Flashcards
Difference between anabolism and catabolism
Anabolism requires ATP. Catabolism does not
What’s the importance of low energy signals
Indicate that cell has inadequate energy levels for its immediate needs so catabolism needs to occur to release energy from fuel molecules
Anabolic processes that TCA cycle provides precursors doe
Fa synthesis
Aa synthesis
Haem synthesis
Glucose synthesis
Medial boundary of cubital fossa
Pronator teres
Lateral boundary of cubital fossa
Brachioradialis
Cardiovascular compensatory mechanisms mediated by the sympathetic NS in hypovolemic shock
Vasoconstriction (inc systemic vascular resistance) Venoconstiction Inc Sv Inc renin release Inc contractility/ force of contraction
Clinical signs of acute ishcaemia of a limb
- pulselessness
- paraesthesia
- pallor
- cold touch
- paralysis/muscle weakness
- reduced capillary refil
How does the normal ventricular septum form?
Muscular portion grows upwards from floor of ventricles. The membranous portion is derived from endocardial cushions and grows downwards to fuse with muscular portion
Which part of the ventricular septum is most vulnerable to anomalous development?
Membranous portion
Causes of left to right shunt
Ventricular septal defect
Atrial septal defect
Patent ductus arteriosus
Behavioural differences between benign and malignant cells
Benign have expansive growth (hyperplasia) whereas malignant have expansive and invasive growth
Benign grow locally whereas malignant metastasise
Benign - retain original function. Malignant less likely to. And can acquire addditional functions due to mutations.
Expected bedside observations of septic patient
High resps
Low or normal oxygen
High pulse rate
Low (systolic) blood pressure
Sepsis definition
Life threatening organ dysfunction due to dysregulated host response to infection
Full E. coli name
Escherichia coli
Scoring system used to determine likelihood of DVT
Wells score
Why are women in late pregnancy predisposed to DVT
- hypercoaguable blood in preg
- presence of pelvic mass can compress venous outflow from leg > venous stasis
- patient less mobile > venous stasis
Define embolism
Blockage of a blood vessel by solid liquid of gas at a site distant from its origin
Saddle embolus?
A large embolus that straddles the bifurcation of an artery
What can embolise?
Air Amniotic fluid Nitrogen Medical equipment Fat/bone marrow
How is paracetamol overdose damaging to liver?
High levels of paracetamol- normal metabolism pathway saturated so metabolism switches pathway producing toxic product (NAPQI) > direct toxic effect on hepatocytes
> undergoes coagulation with glutathione and depletes the hepatocytes of this important antioxidant
Basal metabolic rate define
Energy required for the functioning of various tissues of the body at physical,digestive and emotional rest
Factors effecting BMR
body weight Gender Body temp Thyroid status Pregnancy Lactation
How are uncoupling proteins involved in heat generation in the body?
allow a leak of protons across the membrane
Reduce the proton motivated force so the energy is dissipated as heat rather than ATP
- UCP1 is expressed in brown adipose tissue and involved in thermogenesis
Ways in which a C. difficile infection can arise?
Hospital acquired infection
Normal bowel commensal> proliferates after abx therapy and altered the balance of bacteria in the intestine
Virulence factors of C. difficile that cause diarrhoea
Toxin A - has enterotoxin that causes excessive fluid secretion> acts on intestinal cell wall
Toxin B- cytotoxin that damages protein synthesis and cell structure> cytotoxin just a type of exotoxin (released by bacteria into surrounding env)
Why are spores able to survive?
Resistant to heat, acid, abx and alcohol based cleansers
Posterior dislocation after overflexing hip limb appears in what position?
Shortened and internally rotated
Which nerve is most at risk of damage during posterior dislocation of hip?
Sciatic
Sequence of vessels from femoral artery to coronary artery
Femoral artery
External iliac artery
Common iliac artery
Aorta
Where is the opening of LCA located?
Left aortic sinus
Just above left leaflet of aortic valve
Which acute ECG changes are seen if a thrombus occluded the anterior aspect of heart and inter ventricular septum?
ST EVEVATION
Which enzyme controls the rate of glycogenesis?
Glycogen synthase
Which enzyme controls the rate of glycogenolysis?
Glycogen phosphorylase
Features of TAGs that make it a good energy storage molecule
- hydrophobic so stored in anhydrous form
- fatty acids are highly reduces so yield a lot of energy when oxidised
Enzyme involved in mobilisation of TAGs from fat stores
Hormone sensitive lipase
Bacteria that commonly cause community acquired pneumonia
- streptococcus pneumoniae
- haemophilus influenzae
- moraxella catarrhalis
- staphylococcus aureus
- legionella pneumophila
- mycoplasma pneumoniae
Role of CRP
acts on opsonin by binding antigens on the surface of bacteria and initiating phagocytosis
Penicillins which class? Mode of action?
Beta lactam
Cell wall synthesis inhibitor
