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Semester 4 (NME) > General Questions > Flashcards

General Questions Flashcards

1
Q

What is respiratory acidosis?

A

Respiratory acidosis is a condition that occurs when the lungs cannot remove all of the carbon dioxide the body produces. This causes body fluids, especially the blood, to become too acidic.

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2
Q

What is Oliguria?

A

Reduced output of urine

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3
Q

What does MUST stand for?

A

Malnutrition universal screening tool

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4
Q

What is Bradykinin and what is it’s effect on blood vessels?

A

An inflammatory mediator

Causes dilation of BV’s

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5
Q

What is a pyelogram?

A

X-Ray imagine of urinary system, gathered of a radiopaque dye has been administered IV

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6
Q

When having a PSA test the patient must not have…?

A

Ejaculated in last 48hrs
Exercised rigorously in last 48hrs
Undergone DRE in last week
Have an active UTI

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7
Q

Define hypertrophy and hyperplasia:

A

Hypertrophy: Growth without increased cell numbers
Hyperplasia: Growth with increased cell numbers

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8
Q

The prostate secretes roughly what percentage of seminal fluid?

A

25%

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9
Q

What is the Gold standard best test to look at the bladder?

A

Cystoscopy

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10
Q

When would diffusion weighted imaging be used?

A

To see liquids

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11
Q

What type of tumour carries an increased risk of development with multiple head CT scans?

A

Meningioma

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12
Q

How long after contrast is injected are scans taken and why?

A

70 seconds

To maximise amount in kidney and ureter

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13
Q

What contrast medium is used for a cystogram and why?

A

Iodine as it is safe if it leaks into tissues (unlike barium)

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14
Q

What is fluroscopy?

A

Continues low dose x-rays are used to give real time view

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15
Q

Paediatrics uses more of what two types of scans?

A

Ultrasound and MRI

NB ultrasound is very operator dependant

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16
Q

What is a KUB radiograph?

A

Kidney, ureter, bladder

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17
Q

Very large kidney stones with irregular appearances are known as what?

A

Staghorn kidney stones

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18
Q

Name 4 risk factors for kidney stones?

A

Hyperthyroidism, obesity, personal/ fam history, dehydration

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19
Q

Why do patients with renal failure often hyperventilate?

A

To give respiratory compensation (blow off CO2) for the metabolic acidosis caused by leaking of bicarbonate from the kidney

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20
Q

Why is PCO2 decreased in patients with renal failure?

A

To give respiratory compensation (blow off CO2) for the metabolic acidosis caused by leaking of bicarbonate from the kidney

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21
Q

Why is cloudy urine seen in patients with renal failure?

A

Leak of proteins from the kidney into the urine

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22
Q

Why is Hb levels decreased in patients with kidney failure?

A

EPO is produced by the kidney

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23
Q

How is a DRE performed?

A

Use lubricated index finger, insert and turn finger 180degrees

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24
Q

UT obstruction increases susceptibility to X and Y. Unrelieved obstruction almost always leads to Z

A 
X+Y= UTI and stone formation
Z= Hydronephrosis (perm renal atrophy)
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25
Q

What it diuresis?

A

Increased or excessive production of urine

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26
Q

What is the most common cancer of the bladder?

A

TCC- Transitional cell carcinoma

SCC if risk factors such as chronic infection of inflammation

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27
Q

What are the three common sites of renal calculi in the ureters?

A

1- Uretopelvic junction
2- Pelvic inlet
3- Entrance to bladder (vesicoureteric junction)

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28
Q

What happens to potassium levels when there is renal damage?

A

P gets hyperkalaemia
As K+ is actively transported out into DCT by the kidney (so impaired kidney function means less K+ in DCT so more is retained)

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29
Q

What happens to urine sodium levels when there is renal impairment?

A

Decreased levels!
Na+ normally reabsorbed with H+/Na+ antiporter
P likely has acidosis (so raised H+ in serum) so this means they pull more H+ into urine therefore more Na+ out of urine (Also a decreased GFR means less kidney function and transport of Na)

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30
Q

What type of bacteria are most commonly responsible for UTI’s?

A

Gram negative

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31
Q

GI tract comes from which embryological layer?

A

Endoderm

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32
Q

Name the structures of the foregut?

A

Esophagus, stomach, upper duodenum, pancreas, gall bladder, liver, spleen

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33
Q

What are the structures of the midgut?

A

Lower duodeni, jejunum, ileum, cecum (plus iliocecal valve), ascending colon, and 2/3rd of the transverse colon

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34
Q

What are the structures of the hindgut?

A

Distal 1/3 of transverse colon, descending colon, sigmoid colon and rectum

35
Q

What are the three name types of pain you can get? What are their characteristics?

A

Visceral- Often dull pain, poorly localized
Parietal- Sharp, well localized
Referred-

36
Q

How is visceral pain described? What type of fibers carry it?

A

Poorly localized (due to poor receptor distribution)
Dull pain
Done by unmyelinated C-fibes (slower transmission and high threshold- so need big stimulus to elicit)

37
Q

Where are pain receptors often found in viscera ?

A

In the capsule of the organ

38
Q

What type of fibers carry parietal pain?

A

Myelinated alpha-fibers

So fast, with a lower threshold also

39
Q

Where is referred pain from viscera felt?

A

In the dermatomes at the spinal level which the supply to that organ synapses

40
Q

What are the two types of referred pain?

A

1- Somatic referral (to dermatome of the visceral nerves)

2- Where distant area affected because nerve which supplies that area damaged or affected

41
Q

What is the definition of metabolic acidosis?

A

Blood pH less than 7.35

Plasma bicarbonate less than 22mmol/L

42
Q

ERCP is used to do what?

A

Diagnose and treat problems of the pancreatic/ biliary ducts (e.g. gall stones)

43
Q

What are the three phases of the stress response?

A

Alarm- Fight or flight response
Resistance- (if >a few hrs). Dominated by cortisol
Exhaustion- When resistance phase can no longer be maintained

44
Q

Pain from the viscera is transmitted by which fibres? What sort of pain to these fibres transmit?

A

C-Fibres. Poorly localised pain

45
Q

What is the difference between visceral and parietal pain in regards to presentation and nerves involved?

A

Visceral: Poorly localised/ pain to whole dermatome/ travels along nerve from organ- C fibre
Parietal: Sharp and well localised/ travels along same nerve as abdo wall

46
Q

How long does it take for the stomach to empty/ chyme to traverse the SI/ LI

A

Stomach emptying: 3-5hrs
SI transit: 2-4hrs
LI transit: 8-60 hours

47
Q

Which nutrients are easiest to digest?

A

Carbs > proteins > lipids

48
Q

Where is thirst regulated in the brain?

A

Hypothalamus measures osmolarity
Chemo/baroreceptors measure pressue
High osmolarity/ low volume stimulates thirst and ADH release

49
Q

Which neurotransmitter is most involved in hunger signaling?

A

Neuropeptide Y (NPY)

50
Q

How does ghrelin regulate hunger?

A

Low glucose levels stimulate ghrelin release from ghrelin cells along the GI tract- this stimulates the brain to make more neuropeptide Y- increasing hunger levels

51
Q

How do leptin levels regulate hunger?

A

After meals leptin is released by (mainly) white adipose tissue. It inhibits neuropeptide Y so decreases hunger

52
Q

What are adipocytes?

A

Modified fibroblasts that store almost pure triglycerides in liquid form

53
Q

When will large quantities of fat start being deposited in the liver?

A

In any condition in which fat (instead of glucose) is used for energy

54
Q

When does ketogenesis occur and where?

A

In mitochondria of liver cells

When acetyl-coA is created from lipids rather than glucose (also when glucose is very high)

55
Q

What is the most abundant protein in adipose tissue?

A

Adiponectin (ACRP30)

56
Q

Where does the majority of chemical buffering in the body take place?

A

Inside cells (70%)

57
Q

What is the most important protein buffer which takes place inside RBC’s?

A

H+ + Hb = HHb

58
Q

What is the Isohydric principle?

A

That all buffer systems work together as they all share H+. Thus when H+ concentration changes all buffer systems change at the same time

59
Q

What do high and low ventilation rates do to pCO2 levels?

A

High ventilation rate = Low pCO2

Low ventilation rate= High pCO2

60
Q

How much of your HCO3- should be lost in urine?

A

0.01%

61
Q

In human cells, the reaction producing urea takes place in:

A

The cytosol

of hepatocytes

62
Q

In a normal ~70 kg healthy male, renal blood flow is:

A

1200mL/min

63
Q

The most selective pores in the glomerular filtration membrane are located in the…?

A

Podocytes

64
Q

What is the drug phenytoin used for?

A

Prevention and management of seizures

especially in neurosurgery etc

65
Q

What reaction is catalyzed by Asparate transaminase (AST)?

A

Aspartate (Asp) + α-ketoglutarate ↔ oxaloacetate + glutamate
(it transfers amino group from AA to keto acid)

66
Q

What effect does insulin have on lipolysis in adipose tissue?

A

Reduces it

67
Q

On histological examination of the kidney, how do the proximal convoluted tubules appear differentiated from distal convoluted tubules?

A

The PCT has a prominent brush border

68
Q

Which amino acid that plays a central role in nitrogen flow and disposal of excess waste nitrogen in mammals is?

A

Glutamate

69
Q

What is ammonia converted to in the body, where does this take place and why?

A

Ammonia is converted to urea
In hepatocytes
Because ammonia is toxic

70
Q

What is the first step in the break down of amino acids?

A

Removal of alpha-amino nitrogen (deamination)

- This results in ammonia.

71
Q

What is deamination?

A

Removal of an amine (nitrogen + lone pair)

72
Q

What is the urea cycle?

A

Conversion of ammonia (NH3) to urea ((NH2)2CO2)

73
Q

Where does glycolysis typically take place within mammalian cells?

A

The cytosol

74
Q

Which cells converts haem to bilirubin?

A

Hepatocytes

75
Q

Which cells can be exogenous stem cells for liver regeneration?

A

Bone marrow cells

76
Q

What is the most useful test to diagnose intestinal malabsorption?

A

Hydrogen breath test
(perform after 8-12hr fast)
Diagnose IBS and food intolerance’s
(Unabsorbed food metabolised by bacteria which produces hydrogen or sometimes methane)

77
Q

How is a urea breath test performed?

A

Px swallows 14C-labelled urea with 20 ml of water, then drinks another 20ml 3mins later
- 14CO2 then there is likely H.Pylori

78
Q

What is the most major cell cycle checkpoint (i.e what stages does it regulate progression between)?

A

G2 to M

79
Q

What is a zymogen?

A 
A proenzyme (inactive)
e.g pepsinogen
80
Q

When are ANP and BNP released?

A

In response to high blood volume (high BP)

81
Q

What is the action of ANP and BNP?

A

Vasodilate to lower BP

Causes increased GFR to get fluid/ solutes out

82
Q

What two hormones are produced by the posterior pituitary gland?

A

Oxytocin

ADH (aka vasopressin)

83
Q

What are the steps of glycolysis leading to the krebs cycle?

A

Acetyl CoA > 2xPyruvate (done by g-6-p)

Pyruvate > acetyl coA (decarboxylated by pyruvate dehydrogenase)

Semester 4 (NME) (24 decks)

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