GEP (Life Cycle) Week 5 Flashcards
What is the theories of Ageing: Telomere Theory
**The Telomere Theory **
* With each cell replication, telomere length shortens through the action of telomerase
* Progressive shortening of telomeres with age leads to senescence, apoptosis, or oncogenic transformation of somatic cells
* Shorter telomeres have been associated with increased incidence of diseases and poor survival
-Telomerase is the enzyme responsible for maintenance of the length of telomeres by addition of guanine-rich repetitive sequences. Telomerase activity is exhibited in gametes and stem and tumor cells.
-Senescence: the condition or process of deterioration with age
-Apoptosis: A type of cell death in which a series of molecular steps in a cell lead to its death. This is one method the body uses to get rid of unneeded or abnormal cells. The process of apoptosis may be blocked in cancer cells. Also called programmed cell death.
What is the theories of Ageing: The Disposable Soma Theory
**The Disposable Soma Theory **
* An organism has limited resources to allocated to different processes
* Organisms age due to an evolutionary trade-off between growth, reproduction, and DNA repair maintenance
* A greater investment in growth and reproduction would result in reduced investment in DNA repair maintenance, leading to increased cellular damage, shortened telomeres, accumulation of mutations, compromised stem cells, and ultimately, senescence
* Aging and decline is essentially a trade-off for increased reproductive robustness in youth
* No scientific consensus
What is Malnutrition and how can it arise
1) Lack in diet – eg poor quality food, limited variety
2) Issue with swallowing or absorbing nutrients - eg coeliac or Crohn’s
3) Increased demand for nutrients – eg after surgery, burns, tremors
What is the result of Malnutrition
- Fatigue
- Slow or poor wound healing and increasedsusceptibility to infections
- Depleted fat and muscle, increased risk of hypothermia and of falls and fractures
- Oedema due to extreme lack of protein
Who is at risk of Malnutrition
- People living in poverty
- Those with chronic illnesses
- Those with alcohol dependency
- Those with issues with cognition
- Those effected by mental health
- Those effected by dentition or mobility
- people who take several different medications
- The elderly
What is Iron, B12, Folate, Vitamin: A, B6, B12, C, D, K known as and its significance
B12 can make the tounge beefy-red and cause glossitis
How can you help identify and reduce falls?
Full systems review can help to identify physiological causes of falls - e.g. cardiac, respiratory, neurological, genitourinary, endocrine, MSK, ENT
What are the main medications to be aware of with fall prone patients
**Medications to be aware of:**
* Beta-blockers (bradycardia)
* Diabetic medications (hypoglycaemia)
* Antihypertensives (hypotension)
* Benzodiazepines (sedation)
* Antibiotics (intercurrent infection)
What are the main causes of Falls
Define Osteoporosis and Osteopenia
- Osteoporosisinvolves a significant reduction in bone density.
- Osteopeniarefers to a less severe decrease in bone density. Reduced bone density makes the bones weaker and prone to fractures.
What is the pathophysiology of Osteoporosis
Osteoporosis is a metabolic bone disease that, on a cellular level, results from osteoclastic bone resorption not compensated by osteoblastic bone formation. This causes bones to become weak and fragile, thus increasing the risk of fractures.
What are the risk factors of Osteoporosis
The factors used in QFracture score in men and women include
* age
* body mass index
* smoking status (non smoker, ex smoker, light, moderate, heavy)
* alcohol use
* rheumatoid arthritis
* cardiovascular disease
* type 2 diabetes
* asthma
* use of tricyclic antidepressants (at least 2 scripts in last 6 months)
* use of corticosteroids (at least 2 scripts in last 6 months)
* history of falls
* chronic liver disease
- Additional factors are used in women:
- use of Hormone Replacement Therapy
- parental history of hip fracture/osteoporosis
- menopausal symptoms (vaginal dryness, hot sweats)
- gastrointestinal absorption (including Crohns disease, ulcerative colitis, celiac disease, steatorrhoea, blind loop syndrome)
- other endocrine disorders (thyrotoxicosis, primary or secondary hyperparathyroidism, Cushings syndrome) (2)
Post-menopausal women are an important group where osteoporosis should be considered. Oestrogen is protective against osteoporosis but drops significantly after menopause. Hormone replacement therapy (HRT) is protective against osteoporosis.
What is the Q fracturescore for Osteoporosis
This is a new prediction algorithm which estimates the 10 year absolute risk of osteoporotic fractures and hip fractures in men and women specifically developed by doctors and academics for use in the UK it extends the age range and also takes into account additional variables than compared to FRAX, such as falls, type 2 diabetes, cardiovascular disease, use of HRT, menopausal symptoms, and use of tricyclic antidepressants
does not require any laboratory testing or clinical measurements hence can be used in primary care
How do you diagnose Osteoporosis
DEXA (dual x-ray absorptiometry) scans measure bone density (thickness and strength of bones) by passing a high and low energy x-ray beam (a form of ionizing radiation) through the body, usually in the hip and the spine.
How do you manage Osteoporosis
- Step 1: addressreversible risk factors. For example, increase physical activity, maintain a healthy weight, stop smoking and reduce alcohol consumption.
- Step 2: addressinsufficient intake of calcium(less than 700mg per day) andinadequate vitamin D(e.g., limited sun exposure) with additional:
-Calcium(at least 1000mg)
-Vitamin D(400-800 IU) - Bisphosphonates are the first-line treatment for osteoporosis.
-Recommended for patients with osteoporosis based on a DEXA scan.
-Considered in patients on long-term steroids.
-Work by interfering with the way osteoclasts attach to bone, reducing their activity and the reabsorption of bone.
Biphosphonates inhibits the function of osteoclast function.
What does Dorsal and Ventral translate to anatomically
Dorsal: Posterior
Ventral: Anterior
Name the hidden anatomical areas
What is a Colles Fracture
- ‘Wrist’ fracture but doesn’t involve the carpal bones
- Distal radius fracture
- Most commonly caused by FOOSH - fall on an outstretched hand
- Distal radius moves posteriorly
- Colles - Dorsally Displaced Distal radius → Dinner fork Deformity
What is depression and how do we diagnose depression
NICE criteria for diagnosis of depression are based on
Fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
11th revision of the International Classification of Diseases (ICD-11)
See image for the Criteria
