Formative EMQ Flashcards
Which blood vessels act as a resevoir
Systemic veins
Which vessels rely on the the windkessel effect?
Elastic arteries
Which blood vessels have valves?
Veins
Where does the blood pressure change the most?
Arterioles
What is the only connection between the Atria and Ventricles (electrically)
The AV bundle
What nerve loops under the aortic arch?
L recurrent Laryngeal Nerve
Which nerve supplies the parasympathetic control of the heart?
Vagus
Which Nerve travels in the carotid sheath?
Vagus
What did the black report find?
- Health standards directly linked to social class
- Probs linked with socio-economic factors: income, employment, poor environment, poor housing, education.
- Gov should spend more money on health education and prevention of illness - to reduce poverty in UK.
What is Myasthenia Gravis?
An autoimmune reaction against Acetylcholine receptors -> muscle weakness and loss of control.
What is released when an action potential reaches the neuromuscular junction/end of the motor neuron?
Voltage gated Calcium channels
What neurotransmitter is released at the Neuromuscular junction? What is its receptor?
Acetylcholine - nicotinic acetylcholine receptor
What is an ionotrophic receptor?
Ligand gated ion channel
What is Duchenne muscular dystrophy?
Recessive, X linked, progressive muscle weakness and degeneration - leads to paralysis. Life expectancy - 25 years old.
What is released from the muscle cell when Acetylcholine binds?
Sodium ligand gated channels open - Na leaves, K enters - depolarises - end plate potential.
What receptor does Atropine target?
Competitive antagonist to Muscarinic Acetylcholine receptors (has opposite effect to parasympathetic - increases HR, dilates pupils, reduced salivation).
What receptor does Doxazosin target?
alpha-1 adrenergic receptor blocker (reduced blood pressure)
What receptor does Salbutamol target?
B2 adrenergic agonist
What receptor does Salmetrol target?
B2 adrenergic Agonist
What receptor does Tiotropium target?
Muscarinic antagonist
What receptor does ipratropium target?
Muscarinic antagonist
What receptor does bisoprolol target?
Beta Blocker (slows HR): type β1 adrenergic receptor blocker
What receptor does Varenicline target?
Nicotinic Acetlycholine receptor agonist (used to stop smoking)
What do G cells do? Where are they?
Secrete Gastrin, in antrum. (inhibited by somatostatin)
What do D cells do? Where are they?
Produce somatostatin. Antrum. Damaged by h.pylori infection.
What do chief cells do? Where?
secrete pepsinogen (becomes pepsin). In fundus. Activated by vagus.
What do parietal cells do? where?
Secrete HCL and intrinsic factor (needed for B12 absorption). In fundus. stimulated by gastrin, vagus and histamine.
What do mucous cells in stomach do? Where?
Secrete mucous and pepsinogen. In Antrum. Stim. by vagus.
What test would you do for h. pylori?
Urea breath test.
- for unexplained gastritis
- if have gastric ulcer
What investigation could you do for suspected solid/cyst in liver?
Ultrasound
Overdose: Tachypnoea?
Asprin
Overdose dilated pupils?
Anti-cholinergics
Overdose: bradychardia?
Beta-blocker
Overdose: constricted pupils (miosis)
Opioids
Overdose: bruising a few days later?
Paracetamol
Overdose opiods - treatment/
Naloxone
Overdose antidote: Anticholinesterases
Atropine
Overdose antidote: Beta-blocker
glugagon
Overdose antidote:carbon monoxide
100% o2
Overdose antidote: Benzodiazepines
Flumazenil
Overdose antidote: Methanol
Ethanol
Overdose antidote: paracetamol
N-acetyl cystine
What is the volume of each normal breath?
around 0.5l
Someone has a wheeze + SOB… What might they have if they also: smoke
COPD
Someone has a wheeze + SOB… What might they have if they also: have a brother with nasal polyps, malabsorption and a wheeze?
Cystic fibrosis
Someone has a wheeze + SOB… What might they have if they also: wake at night, 5am, with a tight chest.
Constitutional Asthma
Someone has a wheeze + SOB… What might they have if they also: have a brother also with wheeze and SOB, doesn’t necessarily smoke.
Alpha-1 anti-trypsin deficiency
What can mature into osteoclasts and kuffner cells?
Monocytes
A child has diarrhoea, but then has persistent loose stooles and flatulence, what might they have/
Secondary lactose intolerance
What might cause a wide QRS complex?
Bundle branch block
What might cause a bifid P wave?
Left atrial enlargement
What might cause a deep Q wave (in some leads?)
Myocardial Infarction
What is the inheritance pattern of Huntingdons?
Autosomal dominant - any child has 50% chance.
What is the inheritance pattern of Duchenne Muscular Dystrophy?
X-linked recessive - transmitted by mother. If mother = carrier, daughter will have 50% of being another carrier, son will have 50% of having DMD (as he only has one X chrom - so will have it or not, can’t be a carrier).
What is the inheritance pattern of Cystic Fibrosis?
Autosomal recessive - if both parents carriers, 50% chance child will be a carrier, 25% chance child will have CF.
What is the inheritance pattern of Haemophilia A?
x- linked rexessive (30% spontaneous). Passed on by mothers. Mother is carrier, daughter - 50% carrier risk, son - 50% risk of having it.
What affect does cefalexin have on the GI system?
alters bowel flora - diarrhoea.
How does omeprazole act?
like a reversible, chemical vagotomy. a PPI.
What type of change in gastrulation?
Morphogenesis
What treatments are available for GORD?
Antacids - neautralise acid
Alginates - protective lining
PPI’s - eg. omeprazole
H2 receptor antagonists - stop histamine, eg ranitadine
What is a cause of isolated premature Adrenache in a girl?
Increased dihydroepiandrosteron
What might cause Weight gain of 100gm/week in early infancy?
Cystic fibrosis
What is normal growth from birth to 12 months?
an increase of 50% in length
What is total pulmonary blood volume (ml)
400 ml
What is the ratio of systemic to pulmonary pressure?
10
What is the oxygen conc in pulmonary venous blood?
200ml o2 per l
What is the oxygen conc pulmonary arterial blood?
150 ml O2 per l
What is a normal pulmonary arterial systolic pressure, in a resting subject?
25 mmHg
From which layer of cells does the primitive streak form?
Epiblast
What forms in the first step of gastrulation?
The primitive streak
What causes progressive lengthening of the PR interval preceding a non-conducted P wave
The Wenckebach phenomenon (Mobitz type 1 heart block)
What causes no relationship between the rate and rhythm of P waves and the rate and rhythm of QRS complexes with more P waves than QRS complexes.
Complete AV dissociation
What causes a broad QRS complex (>120 msec) with a 1:1 ratio of P waves to QRS complexes at a rate of 80 per minute.
Bundle branch block
What causes an irregular RR interval with no visible P waves.
Atrial fibrilation
What causes A prolonged PR interval (>200 msec) with a 1:1 ratio of P waves to QRS complexes at a rate of 80 per minute.
First degree heart block
What is used in post partum haemorrhage every 15mins intramuscularly up to maximum of 8 doses.
Carboprost (15 alpha-methyl prostaglandin)
What is Ergometrine used for?
To produce tetanic uterine contractions
What is Syntocinon used for?
To cause rhythmic uterine contractions.
What do they use Prostin (dinoprostone)
for?
Ripen the cervix.
