Foundation 2023 Flashcards
Positive feedback
amplify an initial change (increasing strength contractions in birth).
Negative feedback eg BP control
Opposes an initial change in a regulated variable
MAP?
MAP= (SV/3)+Diastolic
CO definition
is the volume of blood pumped by each ventricle per minute
CO equation
CO = SV x HR
MAP for SVR
MAP = CO X SVR
higher BP= higher SVR
Baroreceptors are located in the carotid sinus and aortic arch. Which nerves
CN IX (carotid, GLOSSO) and CN X (aortic,VAGUS)
The vagus nerve in heart? Parasympathetic
which Muscarinic receptors does it bind to?
Ach binds to M2. Slows SA node + increase delay to AV node.
Result
decrease in HR, and CO
Sympathetic nerves does what to the heart?
increases rate of firing from SA node, decreases AV node delay
increases force of contraction of myocardium
via noradrenaline acting on B1
ANP -
Atrial natriuretic peptide
released in response to atrial distension.
BNP -
important for heart failure diagnosis. (ventricles)
HF= Pro BNP
Radiation -
Radiation is the emission of heat energy in the form of electromagnetic waves which can transfer heat upon striking another surface.
Conduction -
transfer of heat between objects in direct contact.
Convection -
transfer of heat by air or water currents that help to carry heat away from the body.
Evaporation
Evaporation is the process by which a liquid, changes into a gas or vapor when it is heated or exposed to air.
The posterior hypothalamus
is activated by cold and causes vasoconstriction of skin arterioles, increased muscle tone
anterior hypothalamus
activated by warmth and causes vasodilation of skin arterioles, production of sweat, and decreased muscle tone to dissipate heat.
Fever mechanism
macrophages –> pyrogens–>prostaglandins –>hypothalamus
Prostaglandins raise heat and increase temp.
Saltatory conduction -
AP jumps from one node of Ranvier to another.
Where is ADH stored?
Posterior pituitary
Peptides and proteins have which 3 things?
an amino acid group, side chain and carboxyl group
Glucose, Sucrose, Glycogen
Glucose monosaccharide,
Sucrose is an example of a disaccharide / olygo sach
glycogen polysaccharide.
Van der Waals interaction-
interaction of electrons in non-polar substances.
Strongest to weakest bonds
Covalent→ionic→hydrogen→hydrophobic interaction→van der Waals interaction
OILRIG
loosing electrons = oxidised and is therefore the reducing agent.
What is Oxidised, = reducing agent
gaining electrons = to become more negative so it is being reduced, therefore, it is the oxidising agent.
Reducer= oxidising agent
1st law thermodynamics
energy is neither created nor destroyed- energy may be converted from one form to another but the total energy before and after the conversion is the same
2nd law thermodynamics
when energy is converted from one form to another, some of this energy becomes unavailable to do work. From this we can infer that no energy transformations are 100% efficient
ΔG = ΔH – TΔS (T is the temperature in K)
The most important change is in free energy
- enthalpy (heat content):
*
enthalpy = H and a change in enthalpy is represented by deta H(ΔH)
entropy
is the degree or randomness or disorder entropy is represented by an S and a changed in enthalpy is represented by delta S (ΔS)
An exergonic reaction
1) releases heat to the environment,
2) spontaneously
3) No energy source to proceed.
4)EG glucose breakdown
endergonic reaction,
Needs energy
Not spontaneously
synthesis of glucose in photosynthesis
Metabolism =
catabolism + anabolism
Catabolism-
complex molecules into smaller ones, releases energy e.g. glycolysis
Anabolism-
Small + Small= Big/complex i.e. gluconeogenesis
Dna–>RNA–>Protein
Transcription then translation
DNA polymerase which direction
5’ → 3’
mRNA → ribosome (composed of rRNA) → tRNA.
rRNA is the structural component of ribosomes;
mRNA carries genetic info from DNA to ribosomes for protein synthesis;
tRNA transports amino acids to ribosomes for protein assembly
transfer RNA (tRNA) –
tRNA carries A.M from mRNA
messenger RNA (mRNA) – why does it differ from dna
carries the genetic information for protein synthesis
CONTAINS URACIL (NO THYMINE)
Enzyme without cofactor is called ?
Enzyme with cofactor is called ?
inactive precursor of an enzyme?
Enzyme without cofactor is called apoenzyme
Enzyme with cofactor is called holoenzyme
Zymogen
As you can see allosteric enzymes have a ?
Whereas “simple” non-allosteric enzymes have a ?
allosteric = sigmoidal curve. like S shape
non-allosteric simple=hyperbolic curve.
COPD first line and second
1st LABA(salmeterol) / LAMA (Tio) +
SABA/SAMA(Ipra)
2nd LABA/LAMA/ICS(beclo)
IL-6 & IL-1, what do they do?
induces fever (macrophages)
Immune cells bind to which region?
Fc region of antibody (Immunogoblin)
IgG enhance?
phagocytosis
Cytotoxic T cells do what after surgery?
Organ transplant rejection
Classical pathway activated by which immunoglobulins?
IgM/IgG
IFN-γ- who is it produced by
and what does it do
activated by who
produced by NK, TH1
activated by macrophages
Kill TB virus
anaphylactic shock- which Ig and which white cell
IgE/Mast Cells
where does Adrenaline treat anaphylactic?
alpha adrenergic receptors
IgA where from? what i love
Breast / Tears / Saliva
B cells do what
antibody producing cells
IgA produced by what? think coeliac
Plasma cells/ Specialised B cells (Coeliac question)
IL-8, macon vs bale
Chemotaxi for neutrophils
Helper T cells (CD4+)
MHCII (ANTIGEN PRES. CELLS ONLY IE MACROPHAGES)
IL-1 main source
Macrophages
T cells produced where and MATURE WHERE?
produced in bone marrow and mature
in the thymus gland
B cells MATURE where?
Bone marrow
HIV
CD4, Cell surface protein
Parasite immunity from which immunoglobulin
IgE
ACID EGG-T
Type 1 Hyper= Anaphylactic (E)
Type 2 Hyper= Cytotoxic (blood issue) G
Type 3 Hyper= Immune complex (Lupus/sirum sickness
extrinsic allergic alveolitis) G
Type 4= Delayed (Contact dermatitis, TB, Metal/oak allergy) T CELLS
IgA where? mucous secretions where?
GI/Resp Tract
IgA shape
Dimer/Monomer
IgM Shape
Pentamer
HLA-A3 gene?
Haemochromatosis
MHII
Helper T Cells CD4+
Fix comliment which 2 immunoglobulins
IgM + IgG
IgG can pass what?
Pass fetal circulation
IgE (adaptive ) binds to what?
Mast Cell- then releases anti inflam stuff
What does TH1 secrete
IL-2
Common cold?
IL-1
IgM, size and what does it activate
Pentamer, activates compliment system
B Cells- what is their job
Antibody production
TH-1 secretes what? ashwin
cytokine IFN-Gamma
promotes macrophage activation,
cytokine IFN-Gamma regulates TH1-TH2
Cytotoxic T Cells- what do they do?
Induce Apoptosis
Rate of elimination equation (top)
Rate of elimination = Clearance x Plasma concentration
Clearance = rate at which a drug is removed from the bloodstream
plasma concentration = amount of the drug in bloodstream.
Cpss equation
steady state
Cpss = maintenance dose rate/clearance
Cpss is the steady-state plasma concentration of a drug in the bloodstream that is achieved when the rate of drug administration equals the rate of drug elimination
what happens during pro-inflamittary response:
4 players
1) endothelial cells express VCAM and ICAM.
2) TNF, IL-1 cytokines
Sensitivity
% of people with the disease that have a positive test.
Specificity
% of people without the disease that have a negative test
Positive predictive value
% of people with a positive test that have the disease
Negative predictive value
% of people with a negative test that don’t have the disease
- Case report –
watson
looking at disease and symptoms together to find a link. Maybe with Post Mortem.
- Case series -
Identifying common stuff between patients
Case-control study
Comparing
comparing survivors who were sick vs non-survivors
- Prospective cohort study
Following
follow disease free people with issues i.e. high cholesterol -
find out over time who get’s disease and who doesn’t
- RCT - gold standard
group of people at risk, one half treatment, other half placebo. Double blind - neither patient not researcher know who is getting what. Randomised into groups. Gold standard.
- Systematic reviews and meta-analyses -
someone puts together all the existing evidence.
Simple squamous epithelium
3 places
HBL
heart, blood vessels, lymphatic
Simple cuboidal
kidneys
Simple columnar
stomach, intenstines,
pseudostratified columnar
Upper Resp
including the nasal cavity, trachea, and bronchi.
Fibroblasts, what do they make
Fibroblasts make connective tissues.
are cells that synthesize and maintain the extracellular matrix.
Adipose
fat cells, store triglycerides
Osteocytes
Osteoblasts
Osteocytes: Mature bone cells.
Osteoblasts: Bone-forming cells.
Chondrocytes
cartilage cells
Loose connective tissue -
Dense regular connective tissue -
Dense irregular connective tissue - .
Loose connective tissue -organs, blood vessels, and nerves.
Dense regular connective tissue - This type of tissue is found in tendons and ligaments.
Dense irregular connective tissue - This type of tissue is found in the skin.
Skeletal muscle -
Smooth muscle -
Cardiac muscle -
Skeletal muscle - voluntary, striated, multinucleated, cylindrical cells.
Smooth muscle - no striations, spindle-shaped cells, simple.
Cardiac muscle - less striations, single nucleus, intercalated discs
Oligodendrocytes -
Astrocytes -
Microglia -
Schwann cells -
Oligodendrocytes: produce myelin in the CNS
Astrocytes- CNS support cells
Microglia: immune surveillance MI5
Schwann cells: produce myelin in the PNS
Condyle =
Condyle = smooth rounded elevation knee
most flexible most likely to dislocate
Synovial:
Hinge: Elbow/ knee
Ball and socket: Hip/ shoulder
Pivot: Neck and head
Periarticular circulation
refers to the blood supply to the tissues surrounding a joint.
MITOSIS
One diploid parent cell = results in 2 identical diploid daughter cells
MEIOSIS
The process by which gametes (sex cells) are produced
One diploid parent cell results in 4 haploid daughter cells
FISH
Uses fluorescent probes that bind to specific DNA sequences
TRISOMY 21/downs
Array CGH
detect chromosomal imbalances, such as deletions or duplications
Down syndrome
47 XY + 21
Trisomy 21
Miscarriage
47 XY + 14
Edward syndrome
47XY + 18 Trisomy
Turner syndrome
45 X Monosomy
missing Y/X chromosome
Klinefelter syndrome
47 XXY
trisomy
neutrophils- how many lobes,
what do granules contain
Multi-lobed nucleus
Granules contain lysozome and myeloperoxidase
eosinophils-
Bi-lobed nucleus
Granules contain chemicals toxic to pathogens
Role
Destroys multicellular parasites - protozoan and helminthic infections
Disease association
Associated with allergy and asthma
RED
basophils and Mast cells (M)
how many lobes
what colour
how many granules
BB
bilobed nucleus - obscured by blue dyed granules
Mast= Many granules
Basophils= Few granules
Dendric Cells
use PRRs to detect PAMPs (bad guys)
monocytes shape
kidney bean
Penicillins
3 things
Beta-lactam ,
stops wall synthesis
bac static
Co-amoxiclav
what makes it
inhibits what and where
amoxicillin with clavulanic acid,
which inhibits the action of beta-lactamases.
binds to cell wall.
Cephalosporins, inhibits what, and cidal or static?
inhibit cell wall synthesis
bactericidal
Glycopeptides (vancomycin)
end peptide chains
Aminoglycosides (gentamicin)
stop protein synthesis
30S ribosomes,
bac cidal.
G-ve, coliforms
Tetracyclines (doxycycline) -
protein synthesis inhibitor
Macrolides type 4 hyper
type 4 hypersensitivity RELATED TO TB!!!
Macrolides (erythromycin, clarithromycin, azithromycin) -
lipophilic
intracellular bacteria.
what kills intracellular pathogens
Doxycycline (tetracycline )
What antibiotic must you avoid alcohol with?
Metronidazole
Gentamicin (aminoglycoside) mechanism
protein synthesis
First-order kinetics:
Reaction rate is directly proportional to the concentration of one reactant.
Zero-order kinetics:
Reaction rate is independent of the concentration of one reactant.
water comes out of tank at same rate regardless of how much water in tank
Sepsis
organ dysfunction caused by a dysregulated host response to an infection.
obstructive FEV1/FVC,
FVC
FEV1/FVC reduced
FVC Normal
News charts: 5 steps
1) Make sure all boxes checked on chart
2) Check low oxygen target STEM
3) Check ‘‘on air or on Oxygen’’
4) Check consciousness in STEM
confusion voice pain unresponsive
PBC bile ducts
Probably Blowing Cock
intrahepatic bile ducts destruction
PSC bile ducts
Probably sucking clit
destruction intra and extra hepatic bile ducts
Murphy’s sign, no what?
acute cholecystitis, no jaundice
McBurny’s sign
Appendicitis
Charcots Triad, investigation
ascending cholangitis (RUQ pain, jaundice , fever)
ERCP
Terlipressen
Prophylactic , suspected variceal bleeding
Uncontrolled Oesophageal bleeding- procedure?
TIPS
Low B12 and Vit D
Crohn’s
increase ALP and bilirubin =
Cholelithiasis
“chole-“ refers to bile or the gallbladder
“-lith-“ means stone
“-iasis” means a pathological condition or diseas
