Goodnotes Flashcards
What are the 4 stages of pain?
Nociception
Transmission
Perception
Modulation
Which 2 conditions make up COPD?
Emphysema and Chronic Bronchtis
What happens to troponin levels in unstable angina?
Nothing they stay the same
What happens to troponin levels during an NSTEMI?
They rise due to damage to the myocardial cells
What happens to troponin levels during a STEMI?
They rise due to damage to the myocardial cells
What is pathophysiology?
The study of how disease processes affect the functioning of the body
What does the term ‘acute’ mean?
A sudden onset of illness
There are 3 types of cellular communication, What are they?
Nerve
Endocrine
Local
Describe the process of nerve signalling
Used exclusively by neurons
Uses neurotransmitters to send chemical signals through synapse to another neurone
It is fast and can travel long distances
Has specific routes of movement
Eg Parkinson’s disease
Describe the process of endocrine signalling
Sends chemicals called hormones into the blood stream
Received by a receptor cell to stimulate an action
Slow acting and diffuse around entire body
Eg Diabetes
Describe the process of local signalling
Occurs between cells that are close together
Cells will signal damage to other cells as part of body response to damage - inflammatory mediators
Eg Sprained ankle
Which cell change is described here? ‘Decrease in cell size, organ size may change if sufficient changes occur’
Atrophy
Describe atrophy
Decrease in cell size
Organ size may change if enough cells are affected
Eg Skeletal muscle atrophy in the elderly
What type of cell change is being described here? ‘Increase in cell size and volume, organ size may change if sufficient changes occur’
Hypertrophy
Describe hypertrophy
Increase in cell size and volume may cause enlargement of organ if sufficient changes occur
Eg Pyloric stenosis - increased muscle growth due to weight training
What cell changes are being described here? ‘Increase in number of cells. Occurs due to increased cell mitosis’
Hyperplasia
Describe hyperplasia
Increase in the number of cells occurs due to increased cell mitosis either for tissue or organ generation, compensatory reason or hormonal stimulation. Abnormal hyperplasia is an abnormal increase eg endometriosis
Eg Benign prostatic hyperplasia
What cell change is being described here? ‘A specific type of cell is replaced with another type that is less specific than the first’
Metaplasia
Describe metaplasia
This is where a cell of a specific type is replaced by another less specific cell. Commonly seen in smoking. Can turn dysplasia which can eventually turn into carcinoma.
Eg Barrats oesophagus
What cell change is being described? ‘Abnormal changes and variations in shape, size and organisation of cells’
Dysplasia
Describe dysplasia
Abnormal changes and variations in the shape, size and organisation of cells, can potentially turn to carcinoma
Eg Cervical dysplasia
What are the 2 types of cellular death?
Apoptosis and necrosis
What is being described here - ‘this is programmed cell death and is planned’
Apoptosis
What is being described here? ‘Unplanned or accidental cell death due to injury or damage to the cell’
Necrosis
Describe the process of necrosis ‘accidental cell death’
Happens due to injury, toxins, infections and trauma
May initially be reversible as part of the inflammatory process
Cell contents start to swell
Cell membrane becomes deform and loses integrity/ruptures
Cell contents and organ else leak out
Leakage stimulates inflammatory and immune responses when phagocytosed
Describe the process of apoptosis ‘programmed cell death’
Cell dies at the end of its life
Cell does not become damaged or rupture
Cell membrane forms blebs which contain cell contents and organelles
Blebs are removed by inflammatory cells such as macrophages.
Cell can be coerced into its own death by the immune system
Which of the following is NOT a common cause of Type 1 respiratory failure?
COPD
PULMONARY EMBOLISM
MUSCLE DISORDERS
ASTHMA
MUSCLE DISORDERS
Asthma is a chronic disorder of the airways that causes?
Episodes of airway obstruction, bronchial hyper responsiveness, airway inflammation
Bronchiolitis normally occurs in which age group?
Under 2 years
What are congenital heart defects?
Defects occurring during foetal development
Which of the following is NOT a cardiac arrest rhythm?
SUPERVENTRICULAR TACHYCARDIA
VENTRICULAR FIBRILLATION
ASYSTOLE
PULSELESSNESS VENTRICULAR TACHYCARDIA
SUPERVENTRICULAR TACHYCARDIA
Name 4 potential causes of atherosclerosis
From childhood
Hypercholesterolemia
Smoking
Hypertension
Diabetes
What interventions can be used in ischaemic heart disease?
Lifestyle modifications
Control of hypertension
Control high cholesterol
Thrombosis development control
Glycaemic control
Symptom management
Describe some interventions used to treat acute coronary syndromes
Analgesia, GTN, opiates
Aspirin
Oxygen
Continuous monitoring - ECG
Cardiac monitor - NEWS2
Troponin T levels
CABG or PCI
Describe the physiology of emphysema
Destruction of the alveoli
Loss of surface area which reduces gas exchange
Loss of muscular surface prevents movement of air in alveoli
Causes inflammatory and immune responses causing alveolar walls to break down.
Describe the pathophysiology of chronic bronchitis
Damage to bronchus and bronchioles
Cellular damage - inflammation
Exudate
Bronchoconstriction
Bronchospasm
Hypertrophy of goblet cells
Explain how the body responds to hypotension to increase blood pressure
Renin released from kidneys in response to low perfusion in the glomerulus.
Renin diffuses into the bloodstream and converts angiotensinogen from the liver into angiotensin 1.
Angiotensin converting enzyme is released from the lungs.
ACE converts angiotensin 1 to angiotensin 2.
Angiotensin 2 causes vasoconstriction.
Suggest possible causes with examples for an acute kidney injury
Pre-renal: lack of or reduced perfusion, failure of auto regulation, perfusion needed to maintain glomerular filtration
Intra-renal: damage to kidney tissue, may be referred to by location, nephrotoxicity
Post-renal: obstruction below the kidney/lower urinary tract, full or partial blockage, likely to cause reduction in urine output, increase pressure prevents glomerular filtration
Name some causes of pre-renal AKI
Trauma
Post operative bleeding
Hypotension
Dehydration
Medication
D&V
Burns
Cardiac failure
Sepsis
Name some causes of intra-renal AKI
Ischaemia
Nephrotoxic injury
Immunity
Vascular disease
Name some causes of post-renal AKI
Tumour
Kidney stones
Urtheral blood clot
Enlarged prostate
Retention
Blocked catheter
What does renin convert angiosinogen into?
Angiotensin I
Where is angiotensin converting enzyme produced?
In the lungs
Which blood test is used to assess the functioning of the kidney?
Estimated Glomerular Filtration Rate (eGFR)
Will all patients with an acute kidney injury have a drop in urine output? YES or NO
NO
Which test is used to aid the diagnosis of COPD?
Spirometry
At which point does bronchiolitis peak in its symptoms?
3-5 days
The most common cause of bronchiolitis is?
Respiratory syncytial virus
Asthma is regarded as an allergic inflammatory response. Which type of inflammatory mediator cell releases histamine in asthma?
Mast cells
What immunoglobulin attaches to mast cells causing them to release histamine which produces the symptoms of asthma?
IgE
Which of the following assessment findings demonstrate severe asthma?
A) Increased respiratory rate
B) Normal oxygen saturation
C) Silent chest on auscultation
D) Wheeze
C) Silent chest on auscultation
What is the initial management for an AKI?
Monitor patient
Maintain circulation
Minimise further kidney insults
Manage acute illness
Define Chronic Kidney Injury
Irreversible, long term condition
Characterised by decline in kidney function over many years
Failure of homeostasis as disease progresses
Increased risk of other conditions such as CVD
Major cause of morbidity and mortality
What are the symptoms of chronic kidney disease?
Normally asymptomatic until late stages
Then: swollen ankles, hands or feet
Shortness of breath
Fatigue
Blood in urine
Urinary frequency
Insomnia
Itchy skin, muscle cramps, headache
Erectile dysfunction
Which of the following is a non-pharmacological treatment of depression?
A) Supporting the person to get over it
B) Monoamine oxidase inhibitors
C) Cognitive behavioural therapy
D) SSRIs
C) Cognitive behavioural therapy