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Year 2 EMS CS > General > Flashcards

General Flashcards

1
Q

Who is an autopsy done by?

A

Pathologist

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2
Q

What are the 2 types of autopsy?

A

Coronial & conserted

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3
Q

What is a coronial autopsy?

A

To examine the cause of death

- eg. violent death, suicide, unexplained

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4
Q

What is a conserted autopsy?

A

To gain insight into pathological processes/hospital care

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5
Q

When does a coroner hold an inquest?

A

If the death is violent/unexplained/in prison

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6
Q

What is a coroner?

A

Doctor/lawyer who enquire into deaths

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7
Q

What is the commonest acute admission in under 40s?

A

Paracetamol overdose

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8
Q

What does paracetamol overdose cause?

A

Death (necrosis) of liver cells

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9
Q

What are the main functions of the liver?

A
  • glucose/lipid/AA/bilirubin metabolism
  • vitamin storage
  • sepsis barrier (removes toxins)
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10
Q

What is an idiosyncratic reaction?

A

Unusual reaction to medication in a person

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11
Q

What are intrinsic hepatotoxins?

A

Some drugs (eg. paracetamol) cause liver damage in higher doses

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12
Q

What are the 3 pathways for paracetamol metabolism?

A

SMALL DOSE - glucuronyl transferase
HIGHER DOSE - sulfotransferase
DANGEROUS DOSE - rapqi formation (binds to cell membranes&raquo_space; severe damage)

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13
Q

What can prevent rapqi formation in paracetamol overdose?

A

Acetylcysteine (» glutathionine)

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14
Q

What is the difference between apoptosis and necrosis?

A 
APOPTOSIS = programmed cell death
NECROSIS = rapid death of cells/tissues
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15
Q

What problems does liver cell death cause?

A
  • Enzyme release (AST, ALT)
  • Jaundice (no bilirubin metabolism)
  • Confusion/coma (failure to detoxify)
  • Bleeding (failure to make proteins; FII, FVII, FIX, FX)
  • Renal failure (decreased glomerular filatration)
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16
Q

What are the criteria for an emergency liver transplant?

A
  • Prothrombin time >100 seconds (normal: 14)

- Creatinine >300 (normal: 100)

17
Q

What is the leading cause of death?

A

Ischaemic heart disease

18
Q

How is ischaemic heart disease treated?

A

No cure - just improve symptoms (e.g. medication, exercise)

19
Q

What is sudden cardiac death?

A

Umbrella term - unexpected death from loss of heart function

20
Q

What is hypertrophic cardiomyopathy?

A

Autosomal dominant disorder

Abnormasl structural proteins&raquo_space; increased LVH&raquo_space; arrythmia/SCD

21
Q

What is arrythmogenic RV dysplasia?

A

Abnormal cell-to-cell adhesion&raquo_space; fibrosis of RV muscle

22
Q

What is the total acid production in the body each day?

A

TOTAL CO2 - 25 mol/day
UNMETABOLISED ACIDS - 50 mmolday
PLASMA [H+] - 40nmol/day

23
Q

What are the main buffering systems in the body?

A

Haemoglobin
Bicarbonate
Phosphate
Proteins

24
Q

What causes a right-shift on an o2-Hb dissociation curve?

A

^ 2,3diPG
^ [H+] acidosis
^ Temperature

25
Q

Where is the dominant site of lactate metabolism?

A

The liver

26
Q

What is a co-oximeter used for?

A

Looks at types of Hb (detects damage)

27
Q

What are the main compensatory mechanisms in acid-base disorders?

A 
RESPIRATORY (seconds)
BICARBONATE REGENERATION (1-2 days)
HEPATIC SHIFT(~1 week. Urea synthesis/ammonia excretion)
28
Q

What is a normal [H+] range?

A

36-44 nmol/L

29
Q

What happens during metabolic acidosis?

A

Increased H+ formation
Increased acid ingestion
Decreased renal H+ excretion
Decreased bicarbonate

Increased H+ and pO2
Decreased pCO2

30
Q

What happens during metabolic alkalosis?

A

Increased bicarbonate generation (gastric)
Increased HCO3- generation (renal)
Increased bicarbonate ingestion
Increased H+ excretion (vomit)

Increased pCO2
Decreased H+ and pO2

31
Q

What happens during respiratory acidosis?

A

CO2 retention (inadequate ventilation, decreased perfusion, parenchymal lung disease)

Increased H+ and pCO2
Decreased pO2

32
Q

What happens during respiratory alkalosis?

A

Increased CO2 excretion (^ventilation)

Increased pO2
Decreased H+ and pO2

33
Q

What are the consequences of metabolic alkalosis?

A

K+&raquo_space; cells & urine
PO4&raquo_space; cells
Respiratory supression

34
Q

What are the 2 types of lactic acidosis?

A

Type a - shock

Type b - metabolic & toxic causes

35
Q

What causes increased H+ formation? (4)

A

Ketoacidosis
Diabetes
Poisoning
Alcohol

36
Q

What causes acidosis in alcoholics?

A

NAD+ depletion
»thiamine deficiency
»enhanced glycolysis for ATP
» keto-acids

37
Q

How does renal failure cause reduced H+ excretion?

A

Reduced volume of nephrons
» increased bicarbonate loss
» reduced NH4+ excretion

Year 2 EMS CS (4 decks)

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