Group questions ands Answers - topic overview Flashcards
Name the 5 classes of blood vessels
Arteries, arterioles, veins, venules, capillaries
Name the 3 layers of a blood vessel
Tunica intima, media, externa/adventitia
Name the membrane that the layers of epithelial cells sit on
Basement membrane
Name the 2 types of artery
Muscular, elastic
Name the 3 types of capillaries
Continuous, fenestrated, sinusoidal
What are the types of receptors in a blood vessels
Baroreceptors and chemoreceptors
What are the 3 types of memory
Sensory, Short term memory, long term memory
What are the 3 stages to memory
Encoding, storage, retrieval
What theory quotes the following - ‘ A child’s mind is not a miniature version of an adults mind.’ And ‘development proceeds through 4 stages’
Piaget’s stage theory
What are the stages of Piaget’s theory
Sensory motor, pre-operational, concrete operational, formal operational
What theorist believes “full cognitive development requires social interaction
Vygotsky’s (zone of proximal development)
Name the lymphatic organs
Lymph nodes and nodules, tonsils, spleen, thymus, lymph tissue, bone marrow
Function of the lymph nodes
Filtration
2 types of lymph nodes
Superficial and deep
Name the lymphatic ducts
Right lymphatic duct, left/thoracic thoracic duct
Role of the spleen
Filters blood and plays role in immunity
Regulation of the state of cells and of the body – is a definition of what?
Homeostasis
Name a positive and a negative feedback example
Positive – uterine contraction,
negative – body temp
Are the following ions found more extracellular or intracellular
Potassium
Sodium
Bicarbonate
Chlorine
Potassium - intra
Sodium - Extra
Bicarbonate - Extra
Chlorine – Extra
Name the type of transport that requires ATP
Primary active transport
Name the types of transport that require no ATP
Diffusion, secondary active
Regulation of blood pH is carried out by what organs
Kidneys and lungs
name the enzyme that catalysed this reaction – H2O + Co2 H2CO3
Carbonic anhydrase
What is the most abundant extracellular ion
Na+
Name the sex chromosomes you would find for male, and female
XY, XX
Name the components of DNA
Phosphate group, pentose sugar, base
Name the bases for DNA an RNA
AT, GC, U instead of T in RNA
Name the structure that DNA is packaged into
Chromatin
What is the fundamental subunit of ChRomatin
Nucleosome
Name the stages of the cell cycle
Interphase – g0/G1 to, S, G2, (mitosis) Prophase, metaphase, anaphase, telophase, cytokinesis
Which stage of mitosis do the spindle poles separate
Anaphase
How many amino acids commonly occur in the human body
20
What do amino acids consist of
Carboxyl side chain, amino side chain and an R group
What is the amino acid side group that forms a ring
Aromatic
Name the 4 types/levels of protein structure
Primary, secondary, tertiary, quaternary
What bonds hold proteins in their primary structure
Peptide
What bonds hold proteins in their secondary structure
Hydrogen
Name the 3 types of secondary structure
Beta sheets, alpha helix, beta turns
Two methods of signalling in excitable cells
Voltage, and ions
Cells have a resting membrane potential of….?
-70 to -90
Equilibrium potential of Na, K, Ca and Cl
Na - +60, K - -90, Ca - +123, Cl - -40
Resting potential of a neuron
-90
Which out of chemical and electrical is a ‘one way conduction’
Chemical
Name the life cycle of a neurotransmitter
Synthesis, storage, transport, fusion, release, action on post synaptic cell, signal termination
How cells respond to injury
Name the 4 main types of tissue
Epithelial, muscle, nervous, connective
How cells respond to injury
What are the 3 types of cells
Labile, stable, permanent
Labile cells continue to proliferate throughout life; stable cells retain this capacity but do not normally replicate; and permanent cells cannot reproduce themselves after birth.
How cells respond to injury
What types of cell have the ability to proliferate
Stem and progenitor cells
How cells respond to injury
2 types of cell injury
Necrosis, apoptosis
How cells respond to injury
4 types of cell adaptation
Hypertrophy, hyperplasia, atrophy, metaplasia
Types of hyperplasia
How the body recovers from injury
What are the precursors of macrophages
Monocytes
How the body recovers from injury
What are the 3 roles of macrophage activity
Chemotaxis, phagocytosis, pinocytosis
How the body recovers from injury
Tissue regeneration relies on what (to be able to occur)
Stem cells
How the body recovers from injury
Larger wounds require a step of what prior to the final step of scar formation
Granulation
That part of the healing process in which lumpy, pink tissue containing new connective tissue and capillaries forms around the edges of a wound.
Viruses SS DNA is which class of the baltimore system
2
Viruses
-SS RNA is which class of the baltimore system
5
Viruses
3 requirements of a successful infection
Sufficient virus, susceptible host, Antiviral defence absent or overcome
Viruses
Transmission between members of different species is classed as
Zoonotic
Viruses
Transmission between health care worker and patient is classed as
Latrogenic
Viruses
Name of a virus which can replicate in many organs
Pantropic
Lab features of bacteria, viruses and fungi
Gram positive bacteria has a cell wall consisting primarily of…?
Peptidoglycan layer
Lab features of bacteria, viruses and fungi
Gram negative bacteria has a cell wall consisting primarily of….?
Lipopolysaccharide
Cancer management
What are the 3 original ‘Pillars of cancer treatment’
Surgery
Chemotherapy
Radiation therapy
Tumour, Nodes, metastasis
Cancer management
What does T, N M stand for?
Tumour nodes metastasis
Cancer management
‘Treatment based on the molecular profile of a patients tumour’ – definition of what?
Personalised medicine
What is hyperplasia
Increase in the number of cells.
Physiologic hyperplasia: Occurs due to a normal stressor. For example, increase in the size of the breasts during pregnancy, increase in thickness of endometrium during menstrual cycle, and liver growth after partial resection.
Pathologic hyperplasia: Occurs due to an abnormal stressor. For example, growth of adrenal glands due to production of adrenocorticotropic hormone (ACTH) by a pituitary adenoma, and proliferation of endometrium due to prolonged estrogen stimulus.
Hypertrophy
Increase in the size of the cell.
Physiologic hypertrophy: Occurs due to a normal stressor. For example, enlargement of skeletal muscle with exercise.
Pathologic hypertrophy: Occurs due to an abnormal stressor. For example, increase in the size of the heart due to aortic stenosis. Aortic stenosis is due to a change in the aortic valve, which obstructs the orifice, resulting in the left ventricle working harder to pump blood into the aorta.
Atrophy define
ATROPHY
“Reverse growth”: atrophy refers to a decrease in the size of a body part, cell, organ, or other tissue. A decrease in cell size causes shrinkage in organ size that can be part of a normal healthy function based on aging or as a result of reduced workload, use, metabolic activity, blood supply, nutrition, disease, etc.
An example of atrophy is when the muscles of the uterus–which enlarge during pregnancy, atrophy after delivery.
Metaplasia def.
METAPLASIA
Metaplasia is an adaptation in which one cell type can convert to another cell type, based on a changing environment (stimulus).
In the uterus (pregnant or not), the cervix is the lowest part that is exposed to the vaginal environment (vaginal birth involves passage of the baby through the cervix as its exit from the uterus). Vaginal pH can cause the cells to convert from glandular (more “uterus-like”) to squamous (external, or more “vaginal”). Metaplasia is considered a reversible process.
Neoplasia def.
Neoplasia is an abnormal growth of tissue that if large enough to be a mass, is called a tumor. The words “mass,” “tumor,” and “neoplasia” are not always malignant, as a common wart is considered a neoplasia, a mass, or a tumor, technically. Therefore, not all neoplasias are malignancies, but all malignancies are neoplasia.
Why is tumour grading and staging critical?
Critical to accurate diagnosis and thereby correct prognosis and treatment choices
Tumour grading system
1
2
3
1 low grade well differentiated
cells almost normal, well diff. organised, slow growing, low MI
2 medium grade moderately differentiated
cells less normal (shape, nucleus, growth), some loss of differentiation. organised, faster growing, higher MI
3 high grade poorly differentiated
cells v abnormal, weird nuclei, poorly diff. poorly organised, rapid growing, high MI (really dangerous even if actual tumour is still very tiny) cells all sorts of sizes etc.
What are the 3 stages of the ‘Rites of Passage’ according to van Gennep? (birth/preg)
- Separation – the person leaves the old ways of being, takes on a new role, is seen differently by society. In pregnancy will visualise herself as a mother, through pregnancy and through birth
- Limen – betwixt the two of who she is, to who she is becoming
- Aggregation – recognised by society in her new role. Mother & child emerge together
- Name the five different perspectives of birth:
•
•
•
•
•
Physiological
birth is a normal physiological event, focus is woman centric, minimal intervention where possible
Biomedical
birth is a medical event, focus = illness, pathology, potential problems
Psychological
birth is an experience focus = satisfaction and fulfilment
Social
type of childbirth is socially determined e.g., increased intervention
Cultural
birth/motherhood is fulfilling
No single view is right or complete - biopsychosocial approach recognises this
Approximately, how many births in England (2018) are unplanned?
45% of pregnancies are unplanned
(Public Health England (PHE) 2018).
- Name the factors in birth ‘choices’ (reasons for abortion)
•
•
•
•
•
cultural/societal/physiological/medical/psychological
Is it cultural?
What are those around saying?
Is it societal?
What does society want her to do? She may be young & society expects her to have an education, be independent .. Maybe, domestic violence (keeping her pregnant means she has to stay?)
Is it physiological?
What is her body telling her to do? There may be inner conflict?
Is it Medical?
Is she at risk from a pregnancy? Is there an abnormality?
Is it psychological?
Perhaps she had a previous birth trauma or has a fear of birth (Tokophobia)
According to the MBRRACE report what % of women died from mental health conditions (see NB)
10% (during pregnancy or up to 6 weeks afterwards)
MBRRACE - Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK
What hormone is associated with irritability and mood swings during reproductive years and pregnancy?
progesterone
What impact can depression and mental health disorders have on the infant?
•
•
•
•
•
The babies cry more
Perceived by their mothers as having a ‘difficult’ temperament
More likely to have gastro-intestinal problems
Delayed growth
Lower mental development at the age of 2 years
etc….
Very young infants can be affected by and are highly sensitive to the environment and the quality of care and are likely to be affected by mothers with mental disorders as well. Prolonged or severe mental illness hampers the mother-infant attachment, breastfeeding and infant care (WHO 2020)
New-borns of depressed mothers also have neurotransmitter imbalances (e.g., higher cortisol and lower dopamine and serotonin levels),
They perform less optimally on several parameters, measured by the Brazelton Neonatal Assessment Scale (e.g., less auditory and visual orientation, motor tone, activity level, and robustness,
More irritability than new-borns of non-depressed mothers.
Also at risk of being reinforced by the disturbed postnatal interactions offered by their depressed mothers.
Reciprocally, infants born to depressed mothers may discourage the mother’s effort to interact with their infant and thereby entrain a vicious circle of disturbed and poorer interactions
What are some of the issues IVF can have on mental health?
Infertility is a life crisis with a wide range of socio-cultural, emotional, physical and financial problems impacting on all aspects of people’s lives.
Success rates continue to improve, with the average birth rate for women of all ages using their own eggs reaching 22%, while women under 35 using their own eggs have the highest birth rates with 30% for a fresh embryo cycle and 27% for a frozen embryo cycle.
The effects for those whose treatment is not successful can be devastating with an overwhelming sense of loss, failure & disappointment.
Even a successful implantation and on-going pregnancy can be fraught with anxiety for the women and their partners.
What are some of the risk factors for post-natal depression?
Previous postnatal depression
Expectations and experience of labour/ delivery/motherhood
Appearance and behaviour of baby
Mothers personality—obsessive or anxious
Quality of relationship with own parents/ partner
Antenatal anxiety/depression
Where can women seek support?
Mother and Infant Mental Health Service (MIMHS)
?
At what point is it suggested that bonding between the mother and baby begin?
In the womb
Name some of the adaptations in the baby that happen at birth
•
•
•
•
Lung function
Circulation
Endocrine support of the transition
Temperature control
What are some of the benefits of skin-to-skin practice?
•
•
•
•
For the baby:
Regulates the baby’s heart rate and breathing, helping them to better adapt to life outside the womb
Stimulates digestion and an interest in feeding
Regulates temperature
Reduces cortisol (stress) levels particularly following painful procedures
Enables colonisation of the baby’s skin with the mother’s friendly bacteria, thus providing protection against infection
For the mother:
Stimulates the release of hormones (oxytocin and prolactin) to support breastfeeding and mothering.
Where is the hormone Oxytocin produced?
What is the role of Oxytocin?
Hypothalamus
Increasingly recognised for its function in orgasm, pregnancy, uterine contractions, milk ejection in breast feeding, social recognition, bonding and maternal behaviours (Magon & Kalra 2011)
Why might some babies who are breast fed do better at intelligent tests than those who are formula fed?
- Protection from infections
- Reduced incidents of diarrhoea & vomiting
- Reduction in sudden infant death syndrome (SIDS)
- Reduction in obesity in babies and children
- Reduction in cardiovascular disease in adulthood
- It also has health benefits for the mother and helps to build a strong emotional bond between mother and baby
- this may be linked to socioeconomic position of the woman rather than just the nutritional value of breast milk.
Why is parent/infant bonding important?
are all very important for bonding, the infant’s emotional tie to the mother provides the foundation for all social relationships
Why is attachment important?
Secure attachment during childhood is important for future cognitive, emotional, and social development
Secure attachment leads to feelings that:
others will be available to us in times of need
we are competent and worthy of love and care
quality of attachment affects neurological development
limbic system - the “emotional brain”
temporal lobes - language
What might interrupt the mother’s adaptation to parenthood?
•
•
•
•
stress,
depression,
mood disorders and
trauma,
highlighting the need for vigilance during the perinatal period for mental health issues
It is considered that the role of the father in the U.K has changed over the last two decades, why might that be?
No longer the ‘sole’ breadwinner and patriarch of the family, as women have become more independent and professionals and ‘wage earners’ in their own right
But that leaves confusion for some, in what the role of the father now is… particularly around childbirth
Oxytocin is?
Prolactin is?
Oxytocin: hormone known for its roles in female reproduction. It is released in large amounts during labour, and after stimulation of the nipples, it is a facilitator for childbirth and breastfeeding
Prolactin: a protein best known for its role in enabling mammals, usually females, to produce milk
Embryoblast-
Inner cell mass
Gives rise to all tissues of embryo
Trophoblast-
Outer cell mass forms
Critical for implantation
Forms foetal membranes (foetal side of placenta)
When is Blastocyst released from zona pellucida?
Blastocyst released from zona pellucida at Day 4-5 post fertilisation
Definition of health, illness and sickness and health
A- Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Lay conceptions of health commonly include the absence of disease (objective symptoms), the absence of illness (subjective symptoms), functional fitness (the ability to go on(Sickness).
Mention 2 advantages and 2 Disadvantages of biopsychosocial model
Adv- It sets the patient in their wider social, cultural and economic context - holistic • It affords empathetic practice, and a toolkit for improving communication • It enables patient-centred care and practitioner reflexivity • It enables medical practitioners to tailor their approach and advice
Disadv - Can places responsibility for ‘health’ on individuals • Might be regarded as being scientifically feeble (‘soft science’). • Qualitative methodology—dominant in biopsychosocial research —sometimes regarded as inferior to quantitative methodology. • The incorporation of biopsychosocial medicine topics into the curriculum vary across clinical conditions (e.g. low for renal medicine, high for cardiovascular disease)
Outline the assumptions of biomedical approach and the disadvantages.
F- Treats the mind and body separately: mind/body dualism 2.Body can be repaired: mechanical metaphor 3.Prioritises technological responses 4.Focuses on the biological: reductionist at the expense of other influences 5.Doctrine of specific aetiology
What are the main components of the bone
A- Cortical (compact) bone: outer shell of the bone Trabecular/cancellous (spongy) bone: underneath joint surfaces Medullary (marrow) cavity: space in the diaphysis of a long bone that contains bone marrow Periosteum: external connective tissue membrane Endosteum: internal connective tissue membrane.
Name the different bone categories with one example each.
Long bone- Ulna; short bone – tarsals; flat bones – scapula; irregular bones- temporal; sesamoid bone- patella
What are the different types of bony elevations and depressions
C- Large • Process • Tuberosity • Trochanter • Epicondyle;
Small • Protuberance • Tubercle • Spine;
Linear • Line • Ridge • Crest;
Bony depressions • Fossa; Groove • Notch • Sulcus
Mention the major types of joint with example
D- Bony Joint (Synostosis) Metopic suture in the frontal bone. Fibrous joint (Synarthrosis) Three types of synarthroses: •gomphoses •syndesmoses •sutures Cartilaginous joints- Synchondrosis and symphysis (intervertebral disc) Synovial joints – Pivot, ball and socket, condyloid, saddle, hinge, plane.
In which zone of the growth plate does the chondrocytes become enlarged and the surrounding matrix becomes calcified?
Zone of hypertrophy and calcification.
____ is the fundamental units of the cortical bone that surrounds the harversian canal
Osteons
_____Canal connects the Haversian canal to the endosteum and the periosteum
Volkmann canal
List the 3 types of bone cells and their functions
Osteoclasts : Secretes organic acids to dissolve mineral component of bone; enzymes to destroy organic osteoid matrix • Resorb bone tissue for remodeling and to free calcium to the blood stream • Found in Howship lacuna (resorption bay)
Osteocytes: Former osteoblasts trapped in formed bone that communicate through small channels called canaliculi • Sense bone loading and trigger differentiation and activity of osteoblasts and osteoclasts
Osteoblast: Deposit collagen and bone matrix called osteoid
What is the main difference between classical conditioning and operant conditioning
Classical conditioning • Pairing of reflexive response with a new stimulus – to become a conditioned stimulus (CS) and conditioned response (CR)
Operant - Behaviours can be associated with reinforcers which promote a behaviour (i.e. make if more likely to happen)
What is the importance of imitation in learning
Learning can happen through imitation and observation of others by way of modelling which can be influenced by status, trustworthy, power and similarity.
what is the importance of learning in medical contexts.
Patients health behaviour can be affected or influenced by imitation or observing a trusted family or person. Doctors are expected to model healthy behaviours?
What is the mean age for women’s first period in 18th century compared to now.. what are the main possible causes of this change?
Norway 18th century - 17; now 13 UK now 12.9
Causes improved standard of living • Health and nutrition • body mass - girls ~ 17% body fat ~ 48kg / 7.5 stone
The process where the brain becomes more specialised and efficient in brain development is called _____
Reorganisation
Outline the sequence of brain development in adolescents
Part of the brain that controls movement —-Limbic system develops before the prefrontal cortex—- prefrontal cortex develop in early life into 20s(for rational executive brain function) —– by adulthood developed ability to: -focus on task for longer -make choices -restrain self from harmful activities -prospective memory
How does changes in cognition during adolescent affects decision and risk taking
Adolescents are more likely to take higher risks and make poor decisions. Adolescents might be dissatisfied with medical interactions, concerns about privacy and confidentiality • embarrassment about sensitive issues
which Cognitive development theory is linked to ‘role confusion’ where adolescent is unable to put together aspects of themselves.
Psychosocial development (Erikson)
What are the main characteristics of adolescent egocentrism
Preoccupied with what others think of them, feeling of being the centre of attention etc…..
Which part of the nervous system controls the activities of the internal organs and vessels
Autonomic nervous system
What is the difference in the type of nerve fibres carried by the ventral and dorsal root.
Ventral root- motor fibres
Dorsal roots – sensory fibres
What is the propagation of an AP along a myelinated axon that is faster than continuous conduction called.
Saltatory conduction
Name different glial cells in the nervous system and their functions
Oligodendrocytes- myelinating the CNS;
Microglia- brain immune protection;
Astrocytes- Structure and metabolic support;
Shwann – myelinating the PNS.
____is a characteristics that is objectively measured and evaluated as an indication of biological process, pathological process or pharmacologic responses to treatment.
biomarker
What is translational research and example
Applying basic research to a clinical setting. Examples; SARS COV2, antibody drug conjugate and TNF inhibitors
A clinical example of personalised medicine
??Gene editing -CRISPR/Cas9
specific sequence allowing an initial binding site for RNA polymerase is ______
Promoter region
_____ binds the DNA and allows for the DNA code to be converted to RNA with the help/interplay of other proteins called ______.
RNA polymerase and…. transcription factors
_______ acts a switch in the transcription process
Phosphorylation
The process of generating a variant of genes by removing Introns and keeping exons after transcription to from a mature mRNA is called _________.
splicing
Function of Cap and Poly-A tail in transcription
Cap and polyA tail- protection and stability in the cytosol, promotes ribosome binding, regulates nuclear exports.
An example of disease resulting from splicing mutation is______.
Cystic Fibrosis
describe the process of translation
Ribosome binds to mRNA at start codon—- tRNA carrying the right amino acid binds—the next tRNA that matches the adjacent codon binds——the amino acids are joined and the tRNA moves across one codon, the tRNA drops off & another tRNA binds—- mRNA is translated into peptides (strings of amino acids), which will go on to form proteins (multiple peptides).
What are the points of control of gene expression
transcription control, RNA processing control, RNA transport and localisation control, mRNA degradation control, translation control, protein activity control, inactive protein control.
mention the 4 molecular mechanism of action of drugs.
Direct physiochemical effect, transport system(ionotropics, transport protein and ion pumps),, enzyme and drug receptors.
____ bind and stimulates physiological regulatory effects of endogenous compounds which can be full or partial.
agonists
When a drug binds to a an allosteric site or the same site of a receptor but does not have regulatory effects and prevent the binding of endogenous compounds, this drug receptor interaction is called ______.
non-competitive antagonist
what are the other 2 types of antagonism
Functional or physiological and Chemical
Explain therapeutic window
The range of drug concentrations within which the drug exhibits maximum efficacy (desired effect) and minimum toxicity in the majority of patients • Quantified by the therapeutic index • TI = TD50 / ED
describe the steps involved in getting acetylcholine into the synapse
Syhthesis in cytosol — packaged into synaptic vesicles ;buds off the endosome, docking, priming — synaptic vesicles fuse with presynaptic membrane — Ach released into the synaptic cleft cleft(exocytosis) —— Ach binds to postsynaptic membrane.
List some examples of acetylcholine pharmacology
Acetylcholinesterase inhibitors (e.g. neostigmine and physostigmine); Depolarizing (e.g. succinylcholine) and non-depolarizing agents (e.g. curare); Choline uptake inhibitors (e.g. hemicholinium-3); Disruption of vesicle release (e.g. conotoxin and botulinum) or stimulation of release (e.g. 4- aminopyridine).
Which ion is responsible for sarcomere contraction
ca2+
the steps of the Crossbridge Cycle of actin-myosin contraction in skeletal muscle including the requirements for ATP & Ca2+
influx of Ca+ - ca+ binds troponin under undergoes conformational changes tropomyosin moves out of the grove actin binding site exposed actin and myosin able to interact to form cross-bridging. While….
Myosin binds to ATP allowing it to dissociate from actin hydrolysis of ATP to ADP changes the head group angle to release phosphate power stroke muscle contraction
A rare long term condition causing weakness in the skeletal muscle, normally worsens after periods of activity and improves after rest. Cause – autoimmune reaction against the acetylcholine receptors. What condition is this ________. This condition is linked to increase size/abnormal growth of which gland?
Myasthenia gravis and Thymus
Outline the cells of the innate immune system.
Macrophages, Neutrophil, Eosinophil, Basophil, Dendritic cell
Differentiate between PRR and Adaptive response receptor
Pattern recognition receptors
Binds to a limited array of pathogenassociated molecular patterns (PAMPs)
Responds to PAMPs that may be protein, carbohydrate or lipid based
Exhibits no molecular memory or ability to improve/adapt during an immune response
Genes are entirely germ line encoded
Adaptive response receptor
Binds to a potentially infinite array of pathogen-associated peptides
Antigens are always protein peptides (for T cells) and very occasionally carbohydrates or lipids (B cells)
Induces molecular memory and exhibits an ability to improve/adapt during the immune response
Gene editing results in modification to the genome in somatic immune cells
mention the soluble factors that play a role on innate immunity
Complement factor-(destabilising the membranes of invading bacteria, opsonisation, chemotaxis).
Lysozyme - A hydrolytic enzyme present in saliva, tears. • Destroys the bacterial cell wall.
Cytokines
The process of putting together chains of antibody molecules by splicing VDJC gene segments which contributes to antibody diversity is called _____. This process requires _______.
Somatic recombination and The reaction requires recombination signal sequences, recombination activation enzymes (including RAG-1/2) and epigenetic* changes to the DNA structure that include changes to methylation and acetylation.
_________ involves minor changes in the amino acid sequence of the variable domain in the mature B cell once it encounters antigen for the first time.
affinity maturation
Which domain of antibody is switched during isotype switching?
constant domain
Which antibody is more abundant in the secondary phase of an infection.
IgG
- What are the mechanisms of taking an x-ray?
- Sudden deceleration of fast moving electrons when they collide and interact with the target anode.
- What are the mechanisms of an ultrasound?
- Pressure wave pulses transmitted by a handheld transducer. Reflection of sound back to transducer provides an image.
- What does CT scan stand for and why is it used?
- Computed Tomography. Improves visualisation of organs, blood vessels and pathology.
- What are the mechanisms of a PET scan?
- Patient injected with a positron emitting radiopharmaceutical such as fluorodeoxyglucose (FDG). FGD metabolised to FGD-6 which cannot be metabolised by tumour cells.
- What are the risks of using contrast agents?
- Allergic reactions. Contrast induced nephrotoxicity. Nephrogenic systemic fibrosis. Skin developing firm patches with oedema.
- What were the findings of the Lian, O and Bondevik 2015 study?
- Comparative study on exhaustion. Exhaustion changed from being a normal male-connoted high status condition, to an abnormal female connoted low status condition.
- If patients acted feminine in social terms, they would fit the diagnosis for a mental illness.
What were the findings of the Broverman and Broverman 1979 study?
Signs and symptoms listed in depression manuals are commonly female behaviours in terms of social norms
- How do social factors influence definitions of health and normality?
- Societal influences change over time and what is deemed as healthy will change.
Example; Cigarettes were encourages in pregnant women as a stress reliever. Long term exhaustion study. Weight; body sizes increase over time but social norm is to be a smaller size
- Define normative
- An idea that something is correct/normal
- What is molecular biology the study of?
looking at things at a cellular level
DNA/RNA analysis -
What is immunology the study of?
Misbehaving antibodies in our body, e.g. when they turn against our own tissues (autoimmunity)
What is microbiology the study of?
Infectious microbes/pathogens and identifying with antibiotics they will respond to
What is biochemistry the study of?
Measure of various molecules in the blood which is important to monitor the function of organs
- What is haematology the study of?
size morphology number of blood cells
Counting of blood cells using machines and examining the morphology of blood cells
What is pathology?
The study of diseases at cellular and molecular levels
What is cellular pathology?
Examination of the morphology of cells and tissues.
Histology; cut tissue into thin slices, put on glass slide and stain it.
Cytology; smear fluid on slide and stain it.
- Describe paracrine signalling
- Signalling molecules released from one cell and diffuse locally to neighbouring cells. Uses local medicator in between.
- Describe Neuronal signalling
- Derives from nerves. Neurotransmitters travel across synaptic gap to adjacent target cell.
- Describe juxtarine signalling
- Contact dependent. Immediate neighbours signal to each other via membrane bound molecules.
- Describe autocrine signalling
- Cells secrete signalling molecules that bind to their own receptors to generate a change in their own behaviour
- Describe endocrine signalling
- Slow chemical communication. Hormones released and circulated in blood.
- How are signalling molecules controlled? Give examples
- Post translational modification e.g. phosphorylation
By regulating whether a G protein has bound GDP or GTP
By provisions of activators such as Calcium and cAMP
- Describe Cytoplasmic/Nuclear receptors
- Small molecules and hydrophobic molecules can cross the cell membrane and bind directly to the receptors in the cytoskeleton or the nucleus.
- What are the three types of transmembrane/cell surface receptors?
- Ligand gated ion channels. GPCR. Kinase linked receptors.
- What are the five steps of intercellular signalling?
Synthesis and release of signalling molecule
Transport of signalling molecule to target cell
Detection of signal by specific receptor
Change in cellular behaviour triggered by activation of receptor
Removal of signal
- Describe tight junctions
- Seals neighbouring cells together in an epithelial sheet to prevent leakage of molecules between them
- Describe gap junctions
- Allows passage of small water soluble ions and molecules through.
- Describe adherent junctions
- Joins an actin bundle in one cell to a similar bundle in a neighbouring cell
- Describe hemidesmosomes
- Anchors intermediate filaments to the basal lamina
- Describe desmosomes
- Joins intermediate filaments in one cell to those of a neighbour (think epithelial, skin? linings)
- What are the five levels of prevention?
- Primordial. Primary. Secondary. Tertiary. Quaternary.
- What are the four types of screening?
- Population based. Selective. Multiphasic. Opportunistic.
- What is the purpose of screening tests?
- To detect potential disease indicators
- Define specificity
- Proportion of true negatives that are correctly identified by a test.
- Define sensitivity
- Proportion of true positives that are correctly identified by the test
- What is the phase I trial?
- Human pharmacology. Safety, tolerability, PK, PD, food interaction trial, drug-drug interaction trial
- What is the phase II trial?
- Therapeutic exploratory. Randomised clinical trials on patients to show proof of principle. Enables dose selection for phase III.
- What is the phase III trial?
- Therapeutic confirmative. At least two randomised control trials on patients. Safety and efficacy compared to the standard of care
- What is the phase IV trial?
- Further scientific data. Real world evidence. Disease registration.
- What is the SmPC?
- Summary of Product Characteristics. Information about medication with known side effects, interactions and contra-indications.
- What is the black triangle on medication boxes?
- Indicates its new to the marker or is being used for a new reason/route
- How would you report adverse reactions?
- To the MRHA through the yellow card scheme.
- What are the two types of pathogens?
- Professional – almost always cause disease. Opportunistic – Only cause disease in immunocompromised patients.
- What is the chain of infection? 6 parts
- Causative agent. Reservoir. Portal of exit. Mode of transmission. Portal of entry. Susceptible host.
- What are the six modes of transmission?
- Contact – direct or indirect. Droplet. Airborne. Ingestion. Inoculation. Transplacental.
- What risk factors may accelerate an infection?
- Age (<6months or elderly), nutrition, sociocultural, open wounds, immunocompromised, presence/number of infectious microorganisms.
- What are commensal bacteria?
Bacteria which are normally present and non harmful but may use ‘opportunity’ to cause disease. Usually not harmful.
- What are the five types/sections of spinal nerves and how many do they each have?
- Cervical-8. Thoracic-12. Lumbar-5. Sacral-5. Coccygeal-1(Or 0)
- What are the five components of a neuron?
- Dendrites, Soma, Axon, Myelin sheath, Axon terminal
- What are the four main types of neuroglia and where are they found (CNS/PNS)?
- Oligodendrocytes (CNS). Microglia (CNS). Astrocytes (CNS). Schwann cells (PNS)
- What are the two broad types of junctions between the axon terminal and target cells?
- Electrical synapses and chemical synapses.
- What are the two forms of conduction?
- Continuous – slow, non-myelinated tissue. Saltatory – fast, propagation of action potential along myelinated axon.
- What is the key difference between schwann cells and oligodendrocytes?
- Schwann cells myelinate one axon at a time, whereas oligodendrocytes myelinate multiple axons at a time.
- How many pairs of cranial nerves are there?
12
- What are the two components of the PNS?
- Somatic (voluntary) and autonomic (involuntary)
- What parts of the brain make up the CNS?
- Forebrain, Midbrain and Hindbrain
CNS v PNS
CNS = brand and spinal column
PNS the rest
- What are the four layers in the epidermis?
- Horn cell layer (stratum corneum). Granular cell layer (Stratum granulosum). Prickle cell layer (stratum spinosum). Basal cell layer (stratum basale).
- What are the three main classes of cell shape?
- Squamous. Cuboidal. Columnar.
- What are the three structural components of connective tissue?
- Cells, fibres and ground substance.
- What is the lamina propria?
- A thin layer of connective tissue that supports epithelial linings in various organs(mucosa that lines respiratory tract, GI tract and urogenital tract)
- What are the four types of cells based on their layers?
- Simple, stratified, pseudostratified, transitional
- What are cilia and where are they found?
- Long, hair like projections of epithelial cells. Contain microtubules/contractile elements. Found in the upper respiratory tract.
- What are microvilli and where are they found?
- Fine, finger like projections. Contain microfilaments. Found in the gut.
- What are the two classifications of glands?
- Exocrine – secretions transported via ducts
Endocrine – ductless gland. Secretions released directly into blood.
- What are the three methods of secretions in glands?
- Apocrine (mammary), With apocrine secretion, part of the cell breaks off and is released.
- Merocrine (Or Eccrine. Most), Merocrine secretion doesn’t result in damage to the cell (exocytosis)
- Holocrine (Sebaceous). Holocrine secretion destroys the whole cell.
- What are the three main classifications of connective tissue?
- Connective tissue proper. Supportive connective tissue. Fluid connective tissue.
- What are the three types of cartilage?
- Hyaline, (weak, bone precursor) Fibro (strong, lost of collagen) and Elastic. (lots of elastin)
- Hyaline - most common, found in the ribs, nose, larynx, trachea. Is a precursor of bone.
- Fibro- is found in invertebral discs, joint capsules, ligaments.
- Elastic - is found in the external ear, epiglottis and larynx.
- Briefly describe the plasma membrane
- Phospholipid bilayer with hydrophilic heads (-ve charged phosphate) and hydrophobic tails (2 fatty acids). Cholesterol alters fluidity.
- What are transport proteins?
- Help move molecules that can’t freely diffuse across cell membrane. Channel proteins and carrier proteins.
- What is a eukaryotic cell composed of?
- Plasma membrane, Cytoplasm, Ribosomes, Lysosomes, Mitochondria, Nucleus, Golgi complex, Peroxisome, Endoplasmic reticulum.
- What is the role of peroxisome?
- Breaks down long fatty acids to medium sized one. By product of hydrogen peroxide. Peroxidase converts this to water and oxygen.
- What are the two parts of the endoplasmic reticulum?
- Smooth and rough
- Describe the membrane of the mitochondria
- Double membrane. Inner; Impermeable and has a large number of foldings (cristae)
Outer; Permeable due to presence of porins.
- What are the three fibrous proteins that make up the intermediate filaments?
- Keratin, Vimentin and Lamins
- What are microtubules?
- Long, tube like structures composed of a and b tubulin. Utilised as a transport medium for structural motility and cell division.
what are neurons myelinated by? (cell type)
Oligodendrocytes within CNS
Schwann cells within PNS
How does saltatory conduction work in neurons?
Saltare - leap
Leaps a potential from each node of ranvier past the myelination along the axon
The action potential is generated by an influx of Na; with subsequent release of K from the neuron.
Oligodendrocytes within CNS (1 oligodendrocyte : multiple axons)
Schwann cells within PNS (1:1)
What do astrocytes do?
Form and maintain the protective blood brain barrier
Providing structural support
Supply nutrients [glucose]
Maintain ionic environment [remove K+]
Neurotransmitter uptake
What do spinal nerves do?
Motor [somatic motor] and sensory[somatosensory] supply to whole body, except for the head and parts of neck
•Sympathetic supply to whole body
Paarasympathetic v sympathetic?
The parasympathetic nervous system restores the body to a calm and composed state and prevents it from overworking. The sympathetic nervous system, on the other hand, prepares the body for fight and flight response.
What are lumbar spinal nerves 2 and downwards called? What do they innervate?
Cause equip, horses tail (end of core spinal cord) = bundle of spinal nerves and their roots pertaining to L2-L5, S1-5 and the coccygeal nerve. (c0/1)
responsible for the innervation of the pelvis and lower limbs; as well as the internal/external anal sphincters
What does the dorsal root of a spinal nerve do
Afferent [somatosensory]
sense - Arrive Afferent
Ventral root of spinal nerve?
Ventral root – Efferent [somatic motor/sympathetic]
what is a Dorsal root ganglia
A cluster of cell bodies of the dorsal root, aka afferent somatosensory neurons
Where do spinal nerve roots reside and how to spinal nerves exit?
In the vertebral canal, exit via intervertebral foramen
How do the dorsal and ventral root form a spinal nerve?
They join to form the spinal nerve before exiting the vertebral canal (intravertebral foramen)
What do spinal nerves divide into
Dorsal/posterior primary ramus [plural rami]
Ventral/anterior primary ramus
what does dorsal primary ramus innervate
Skin over paravertebral gutter
Erector spinae muscles
Facet joints of vertebral column
What does ventral primary ramus innervate?
Supplies rest of the body, except head/parts of neck
[i.e. skin and musculoskeletal system]
Much larger nerve
what is a nerve plexus
4 main examples
A nerve plexus is where ventral primary rami merge to form nerves that contain axons from multiple spinal nerves
cervical, brachial, lumbar, and sacral plexus]
Dermatome:?
An individual area of skin innervated by a single spinal nerve [primary ramus]; this being the area of skin responsible for sensory input to the dorsal root.
Myotome:?
An individual set of muscles innervated by a single spinal nerve [primary ramus]
Which dermatome maps to umbilicus (there is obvs some. variation)
T10 is umbilicus
What do the intercostal nerves innervate?
Intercostal muscles supplied by intercostal nerves [T1-T11] and dermatomes T1-11
What’s the autonomic nervous system? How is it subdivided?
Defined as the involuntary aspect of the peripheral nervous system
Involuntary control:
Regulates operation of the internal organs
Maintains internal environment
Two main divisions of the ANS:
Sympathetic
Parasympathetic
ANS: where do parasympathetic nerve stims come from
Craniosacral = parasympathetic
ANS: where do sympathetic nerve stims come from
Thoracolumber = sympathetic
What is an autonomic ganglia?
Where preganglionic neurons synapse with postganglionic neurons
* Ganglia = a structure containing several nerve cell bodies
How is adrenal medulla supplied by sympathetic nervous system?
preganglionic con only, no ganglia
what are the paravertebral ganglia?
form the sympathetic trunk…
All preganglionic sympathetic axons enter the sympathetic trunk
Extends length of vertebral column
interconnected
It allows nerve fibres to travel to spinal nerves that are superior and inferior to the one in which they originated.
Why is the blood brain barrier important?
BBS creates microenvironment for CNS with reduced proteins, reduced calcium [Ca2+] and reduced potassium [K+] when compared to plasma. This microenvironment, maintained by an effective BBB, is essential for the survival of the cells therein
How can nervous system dysfunction?
Strokes - ischaemic and haemorrhage
Trauma
Tumours - Primary and Secondary
Infections and immune reactions
Demyelinating conditions
Neurodegenerative diseases [multiple; the dementias]
What is demyelination?
A loss of myelin sheath leading axonal conduction block and neurodegeneration. Note: a demyelinated cell is not the same as a non-myelinated cell.
demyelination of CNS/PNS examples
Multiple sclerosis is a progressive condition, characterised by focal areas of demyelination within the CNS. oligodendrocytes and Schwann cells.
Guillain Barre syndrome [acute] or Chronic inflammatory demyelinating polyneuropathy [chronic], along with Charcot–Marie–Tooth disease, are examples of demyelinating disorders of the PNS.
Altered nerve conduction caused by loss of myelin results in weakness and/or paralysis. Initially myelin and oligodendrocytes are targeted, while neurons are spared. Later, neurons are lost.
What happens at a motor end plate?
ACh transmision at NMJ from Neuron to myocte
how does a neuron use ACh to stimulate a myocte
•ACh is synthesized in cytosol and packaged into synaptic vesicles•
Synaptic vesicles fuse with presynaptic membrane•
ACh released into the synaptic cleft and binds to receptors in postsynaptic membrane
What is the process of ACh delivery and recycling? What stimulates release?
Exocytosis and endocytosis (vesicular budding) stimulated by Ca2+ influx
Two ACh receptor types?
Which is found at NMJ?
•Muscarinic receptors (mACh receptors), these are G-protein coupled, and found in the brain•
Nicotinic receptors (nACh receptors), these are ligand-gated ion channels found at the NMJ, and the 2nd messenger is ion flow•
Nicotinic receptors are non-selective cation channels, allowing both Na+ and K+ to pass through
What enzyme breaks down ACh at NMJ cleft
Acetylcholinesterase
breaking down ACh
