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Semester 1 > Fall at home > Flashcards

Fall at home Flashcards

1
Q

functions of skeleton

A
  • protection of vital organs
  • movement (attachment of muscles)
  • structural support
  • storage of minerals
  • haematopoiesis
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2
Q

what is the structure of cortical bone?

A
  • made up of basic units called osteons
  • osteons contain osteocytes inside lacunae
  • canaliculi connect osteocytes and allow them to share nutrients
  • circular layer of bone that make up an osteon are called concentric lamellae
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3
Q

what is the function of cortical bone?

A

weight bearing bone that provides stiffness and strength

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4
Q

what is the structure of trabecular bone?

A
  • found in the proximal and distal ends of long bones
  • greater surface area
  • more vascular
  • spaces contain haematopoietic cells and fat
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5
Q

What is the function of trabecular bone?

A
  • allows the distribution of stress at the ends of long bones
  • provides support to the weight bearing bone
  • high surface area is to regulate metabolism
  • the spaces between allow for the existence of bone marrow and blood cells formation
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6
Q

What do mesenchymal cells differentiate into and where are they found?

A

chondroblasts and osteoblasts found in the periosteum

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7
Q

bone cells and what they do

A

osteocytes:
- mature bone cells –> formed from osteoblasts once they’ve laid down
- embedded within lacunae
- communicate via canaliculi

osteoblasts:
- bone forming cells
- deposit collagen, then hydroxyapatite

osteoclasts:
- break down bone (resorption)
- releases H+ and hydrolytic enzymes to dissolve mineral
- regulated by hormones (e.g. oestrogens) + osteoblasts

osteogenic:
- stem cells which give rise to the osteoblasts

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8
Q

what is ricketts disease?

A

deficiency in vitamin D –> poor ca absorption –> decreased activity of osteoblasts –> weakened bones

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9
Q

what is scruvy disease?

A

deficiency in vitamin C –> lack of collagen –> weakened bones

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10
Q

What are the stages in interphase?

A

G1:
- cells preparing for S phase
- each chromosome = single, unreplicated structure
G0: resting phase
G1-S transition
- restriction point (R), commitment is made to DNA replication and subsequent cell division
S
- DNA replication occurs only once per cycle
- chromosomes consist of 2 sister chromatids joined together
G2
- cell prepares for mitosis

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11
Q

Cyclin CDKs at each stage

A 
M: Cyclin B/CDK 1
G1: Cyclin D/CDK4/6
G1-S: Cyclin E/CDK2
S: Cyclin A/CDC 2
G2: Cyclin A/CDK1
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12
Q

Role of retinoblastoma protein

A

G1-S cyclin D/CDK4 catalyses the phosphorylation of retinoblastoma (RB)

  • RB acts as an ihibitor of the cell cycle at the R/restriction point in late G1
  • The cyclin-CDK action causes a change on its 3D stucture causing rb inactivation

active RB blocks cell cycle and inactive RB-P allows cell cycle

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13
Q

the ubiquitnlation process

A
  1. Ub attached to Ub activating enzyme E1 forming high energy bond
  2. Ub transferred onto E2 (but not enough for reaction specificity)
  3. this comes from E3 enzymes. facilitate the transfer of activated Ub onto substrate
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14
Q

stages of mitosis following interphase

A

prophase:
- chromatin coils
- chromosomes consist of identical, paired sister chromatids
centrosomees move to opposite poles

prometaphase
- nuclear envelope breaks down

metaphase

  • Chromosomes become alined in a plane at the equator
  • spindle checkpoint (checkpoint that’s targeted by chemotherapy)

anaphase:

  • paired sister chromatids are separate
  • new daughter chromosomes begin to move towards the poles

telophase
- the daughter chromosomes reach the poles
as telophase concludes, nuclear envelopes and nucleoli reform, chromatin condenses

cytokinesis

  • cytoplasm cleaved
  • cells enter interphase again
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15
Q

mechanism of action of NSAIDs

A

all inhibit cyclo-oxygenase (COX) but do so by 2 main mechanisms:

  1. an irreversible, time dependent inhibition of the enzyme (Aspirin)
  2. a rapid, reversible competitive inhibition of the enzyme (the rest)
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16
Q

COX 1 or COX 2

A

COX 1:

  • is safer so we just use that mainly now.
  • constitutive
  • imp. to maintain GIT integrity

COX 2

  • was found to cause stroke
  • inducible
  • involved in inflammatory response
  • implicated in cancer development
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17
Q

define tolerance

A

decrease in the effects of the drug due to chronic administration

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18
Q

define dependence

A

durg induces a rewarding experience; drug taking becomes compulsive

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19
Q

define withdrawal

A

a group of symptoms which occur at cessation of a psychoactive substace

20
Q

how to treat neuropathic pain

A

tricyclic antidepressant

gabapentin/pregabalin

21
Q

screening tool for nutritional risk

A

step 1: BMI score
step 2: weight loss score
step 3: acute diseasse effect score

1+2+3 = step 4: overall risk of malnutrition

22
Q

X-rays: MoA, advnatages/disadvantages

A
  • X-rays find it more difficult to pass through denser parts of body –> creates image
  • cheap, portable, quick
  • limited differentiation, cancer risk, 2D
23
Q

CT scan: MoA, advnatages/disadvantages

A
  • takes a series of measurements of X-ray absorption around the patient
  • quick, improved contrast to X-rays
  • 2D, not portable
24
Q

MRI: MoA, advnatages/disadvantages

A
  • magnet creates field that aligns the protons of H atoms in the body
  • protons exposed to radiowaves causing them to rotate
  • good tissue resolution, no radiation, functional MRI
  • Magnet: not suitable for everyone, claustrophobic, loud
25
Q

Ultrasound: MoA, advnatages/disadvantages

A
  • high frequency sound waves reflected off tissues
  • safe, portable, quick
  • can’t see through bone, gas, calcium, operator dependent.
26
Q

What is bone?

A

Made up of collagen fibre framework (gives bone its tensile strength).

Inside collagen matrix, there is hydroxyapatite crystals (gives bones its compressional strength)

Made of osteoblasts, osteocytes and osteoclasts

supplied by blood vessels and nerves

contains bone marrow

27
Q

What are the two major kinds of bone and what are their functions?

A

Trabecular/Cancellous
(spongy and porous)
• gives supporting strength to the ends of the weight-
bearing bone

Cortical (solid)
• bone on the outside forms
the shaft of the long bone
• provides stiffness and strength

28
Q

What is trabeculae?

A
  • allow distribution of stresses

- have high surface area for metabolism

29
Q

What are the blood supply to/from bone?

A
  • Haversian canals carry blood along the long axis of the bone
  • Volkman’s canals carry blood perpendicularly
  • Majority of cells in very close contact to blood vessels
  • not all cells in direct contact with blood supply - osteocytes
30
Q

Hormones that control the different bone cells

A

Calcitonin:

  • decreases activity of osteoclasts
  • i.e. decrease blood ca2+ levels

Parathyroid hormone:

  • increases activity of osteoclasts
  • releases ca2+
31
Q

Trabecular bone remodelling cycle

A
  1. Quiescence
  2. resorption by osteoclasts
  3. Reversal
  4. osteoblasts lay down new bone
32
Q

Osteoporosis risk factors

A 
Modifiable: 
• Increased weight-bearing exercise*
• Adequate calcium intake
• excess alcohol
• smoking
• Fall prevention
Non-modifiable: 
• Biological sex
• Age 
• Family history
• Race
• (previous fracture gives high risk of another)
33
Q

What do the checkpoints look for?

A

G1:

  • damaged DNA
  • unfavourable extracellular environment

S:
- damaged or incompletely replicated DNA

G2:
- damaged or incompletely replicated DNA

M:
- chromosome improperly attached to mitotic spindle

34
Q

What do the cyclin dependent kinase inhibitors do?

A

transcription of inhibitors can be induced if conditions are not right for cell division

35
Q

What is the response to DNA damage?

A
  • response depends on stage of cell cycle
  • p53- directs transcription of CDK-inhibitors
  • CHK2 is activated - inhibits cdc25
36
Q

Classification of helminths

A

Helminths => nematodes, cestodes and trematodes

37
Q

Treatment of helminths

A

Nematodes:

  • benzimidazoles
  • DEC
  • ivermectin

Cestodes and trematodes:
- praziquantel

38
Q

Define sensitivity and specificity

A

Sensitivity: the ability of a test to detect all of the true positives
(no. of +ve obtained/total no. +ves)

Specificity: Ability to identify the number of true negatives
(no. of -ve obtained/total no. -ve)

39
Q

What are the theories underpinning the position of elderly people?

A
  1. Disengagement theory
    - give way for younger generation by disengaging
  2. structured dependency theory
    - rather than disengaging, they’re actively excluded
  3. the third age
    - rewarding old age - early retirement
  4. cultures of ageing
    - anti-ageing industry e.g. wrinkle cream, jeans
40
Q

Treatment of nociceptive pain ladder

A

Step 1 mild pain:
continue simple analgesics

Step 2: moderate pain:
use mild opioid

Step 3: severe pain:
use strong opioid

41
Q

what are the three MOA of paracetamol?

A
  1. work on paroxidase site which then acts of the COX
  2. stimulates serotinergic pathway involved in descending inhibition
  3. anti-pyuretic effect
42
Q

Advantages of paracetamol

A
  • Cheap
  • Safe in therapeutic dosage
  • Synergistic effect with NSAIDS and opioids
  • Antipyretic action but poor anti-inflammatory action
43
Q

opioid receptors

A
  • mu opioid peptide receptor (MOP) - most common
  • Kappa (KOP)
  • Delta (DOP)
  • Nociception (NOP)
44
Q

what are the causes of malnutrition?

A
  • Decreased intake
  • Impaired digestion and/or absorption
  • Increased nutritional requirements
  • Increased nutrient losses
45
Q

Describe nutritional assessment

A 
A - anthropometry
B - biochemical 
C - clinical condition
D - dietary 
E - environment social and physical
46
Q

What are the intrinsic causes of falls?

A
  • Transient
  • Pre-existing but reversible
  • Pre-existing and irreversible

Semester 1 (13 decks)

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