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Medicine 2 > Keeping people healthy > Flashcards

Keeping people healthy Flashcards

1
Q

In the thyamus what is often found in the medulla and what is it?

A

Thymic/ Hasel’s corpuscles

Dead clumped epitheioreticular cells

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2
Q

What are the two processes of filtration in the lymph nodes?

A

Mechanical filtration

Biological filtration

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3
Q

What’s the disease called when someone has no thyamus and what’s the outcomes of this?

A

Di George’s syndrome

No T cell formation

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4
Q

What type of connections do E-Cadherins have?

A

Homotypic connection

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5
Q

What do epithelial cells become when they lose their E-cadherins?

A

Epithelial mesenchymal transitional tissue

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6
Q

To diagnose depression what core symptoms must a person have?

A

Low mood and:

  • Anhedonia - loss of happiness in things
  • fatigue

Everyday for 2 weeks +

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7
Q

What is the clinical term for someone who starts to believe they are dead? or have parts of them that are dead?

A

Cotard’s syndrome

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8
Q

What type of drug is amitriptyline?

A

tri-cyclic anti-depressant

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9
Q

A form of monoamine oxidase enzymes are found in the G.I and break down what substance? and if this substance is blocked from being broken down what can it cause?

A

Tyramine

Hypertensive crisis

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10
Q

What is checklist criteria for assessing one’s mental health?

A

Appearance

Behaviour

Speech

Mood and Affect

Thought form

Perception

Cognition

Insight

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11
Q

What are the types of Delusions?

A

Persecutory - perceived threat from others

Grandiose - Overestimation of self - believing they have powers

Nihilistic - believing they are dead or part of them is dead

Delusions of reference - believing external things are talking to them

Thought interference - insertion, withdrawal or contrast

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12
Q

What’s the difference between hallucination and illusion?

A

Hallucination is based on NO stimuli

Illusion is based on a stimuli that is miss - interrupted

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13
Q

What is mood and how can it be broken down?

A

Mood is the generalised emotional state - over weeks and months.

Subjective - what patients says the feel
Objective - what the clinician observes

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14
Q

What is affect and what can it be broken down to?

A

The affect is the moment by moment monitoring of the mood of someone.

reactive? - appropriate to discussion 
Expansive? - exaggerated effects 
Flattened? - limited reaction 
Blunted? - no reaction 
Labile? - excessive emotions
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15
Q

What are differential diagnosises for depression?

A

Dysthymia - not bad enough to be depression

Clyclothymia - not enough to be bipolar

Atypical depression - SAD

Adjustment reaction - grief usually 1 month afterwards and lasts 6 months

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16
Q

What are the core features of depression?

A

Low mood with:

  • Anhedonia
  • Fatigue
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17
Q

What enzyme is checks the protein has folded correctly within the R.E.R? and what is it checking?

A

Glucosyltransferase

Checking for stretches of hydrophobicity. If large amoutn present it is re-folded or destroyed

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18
Q

What is internal locus of control?

A

People see that they have agency and control over their illness.

  • more likely to comply
  • can lead to feelings of guilt
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19
Q

What is external locus of control?

A

Where they do not believe they have control but instead is due to external agency

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20
Q

What are some barriers to adjustment?

A

Characteristic of the illness - pain? fatigue? uncertainty?

Treatment - burdensome? long?

Societal - stigma? rejection? does society see you as ill?

Co-moralities

Personality - locus of control

Social circumstances - fiances? support?

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21
Q

What is secondary gain of illness?

A

where there is subconscious increase in the person illness.

Their wife won’t leave them as long as their ill

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22
Q

What are 2nd auditory halluciations? and how does this compare to 3rd auditory halluciations?

A

2nd auditory - is to you “you are useless”

3rd auditory - is hearing voices talking about you “He’s useless”

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23
Q

What is the gene defect in Chronic Myloid Leukemia

A

Abl (chromosome 9) Bcr (chromosome 22)

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24
Q

What is the Abl Bcr?

A

It is a Tyrosine Kinase protein - only found in cancer cells from the mutation of chromosome 9 and 22

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25
Q

What is a x-linked recessive genetic condition that can cause haemolysis? and why does this affect the african population more?

A

glucose - 6 - phosphate dehydrogenase

It is useful against malaria - which is prevalent in africa

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26
Q

What properties are needed for metastasis?

A

Reduced Cellular adhesion - loss of E-cadherins becoming mesenchymal epithelial transitional tissue

Cell Substratum - intergrin mutations

Increased motility - Hepatocyte growth factor - scatter factor

Increased proteolytic enzymes - MMPs & serine proteases

Angiogenesis - VEGF, PDGF

Ability to extravasate and intravasate - selectins up regulation like leukocytes

Ability to proliferate at ectopic site - seed and soil hypothesis, mechanical hypothesis

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27
Q

Whats the most common BRAF mutation in melanoma?

A

V600

28
Q

What is the deficiencies seen in alcohol abuse that increase the liver disease? and what the mechanism by which they do?

A

Folic Acid
Vitamin B6
Vitamin B12

disrupts methionine pathway causing:
- increased: S-Adenosyl Homocysteine - increase pro-apoptic genes

Decreases: S- Adenosyl Methionine - decrease in normal gene expression

Decreases: glutathione - lack of anti- oxidant

29
Q

What is binge drinking?

A

This is where more than 6 Units of alcohol are consumed in one sitting.
- essentially drinking to get drunk.

*note this recently changed from 8 Units.

30
Q

Name 4 mental state examinations:

A

Mini Mental state examination: 30 q’s. Cut off 24.

Abbreviated Mental test: 10 q’s. Cut off 7-8

Addenbrookes Cognitive assessment: 100 q’s. Cut off 82

6 item cognitive impairment

31
Q

What test can be done to evaluate the pre-frontal cortex?

A

Frontal assessment battery

32
Q

What is dysphasia? and how does it compare to aphasia?

A

Able to produce language but it is nonsensical. `it is fluent (able to express easily) but is incorrect in its produce.
- receptive dysphasia

Aphasia is the inability to produce language

33
Q

What does the Frontal Assessment Battery consist of?

A
  1. Similarities - orange and banana (3correct - 0 correct)
  2. Lexical Fluency - name as many words beginning with M (>9 words = 3, <3 = 0)
  3. Motor serious planning - hitting leg with fist closed and then get them to repeat
  4. conflicting instructions - “tap twice when I tap once”
  5. Inhibitory control- “do not tap when I tap twice”
  6. Prehension behaviour - telling them not to grap hands when you put them out
34
Q

What is odynophagia?

A

Painful swallowing

35
Q

What is Strangury?

A

Desire to pass urine every couple of minutes

36
Q

What are some general clinical features seen in someone with alcohol miss use?

A

Spider naevi - above SVC area

Telangiectasia

Facial mooning - due to enlargement of parotid gland

Dupuytren’s contractures

37
Q

What is the guidelines for alcohol consumption? and what does this equate to in wines and beers?

A

14 units

Six 175ml of wine at 13%

Six pints of beer at 4%

38
Q

What is the drink drive limit in Scotland?

A

22micrograms per 100ml of breath

50mgl/100ml of blood

39
Q

What is the sign, that if a person has a palpable mass, with painless jaundice it is unlikely to be gallstones. furthermore, what is it likely to be?

A

Courvoisier’s sign

Pancreatic cancer

40
Q

What is the lymph node called that cancer first reaches?

A

Sentinel lymph node

41
Q

What is the daily requirement of thiamine?

A

1-2mg

42
Q

What are the symptoms of Weirnkes Korsakoff syndrome?

A

Confusion with recent memory loss

Ngstagmus

Gaze paralysis

Ataxia

43
Q

What is the hyperacut reaction to organ donors?

A

Where a person has Anti HLA antobodies towards the donors particular HLA.

antibodies bind this triggers an immediate compliment cascade with neutophil involvement destroying blood supply to tissue.

44
Q

Chronic allography nephropahty, what are the two ways it degrades?

A

Immunological - due to immune damage

Non - immunological - due to state of organ prior to donation

45
Q

What is the term for an organ donation between the same species?

A

Allograft

46
Q

What is a transplant which involves the tissue of the same person onto the same individual?

A

Autograft

47
Q

What is a transplant between species?

A

Exongraft

48
Q

What are the core features of ADHD?

A

Poor concentration - moving from 1 task to another without completion

Excessive activity - disorganised/ restless

Impulsive

  • poor awareness of danger or consquence
  • lack if inhibition
  • poor peer relationships
  • emotionally unstable

*symptoms must be before age 7 and present in more than 1 environment with them usually being worse in evening

49
Q

What are associated disorders with ADHD?

A

Sleep disorders - 50%

Behaviour difficulties - 25%

Learning difficulties - 25%

Social Communication difficulties - 25%

50
Q

Diagnosis of ADHD includes?

A

NO set diagnostic test. it involves:

Direct observation 1:1

Pyschoeducational assessment

Questionnaires to parents and teachers - SNAP-IV

Developmental history

  • alcohol use by parents
  • feeding patterns/ sleeping patterns
  • drug use
  • birth weight
  • milestones

Family setting?

51
Q

What medical problems should be considered when assessing for ADHD?

A

head injury

past or current illnesses

Tics

Hearing disturbance

52
Q

Outline some behavioural training programmes for ADHD?

A

Encouragement of consistency

Not personalising behaviour

Postiviely reinforce behaviour

assist parents in maintaining routines and quiet times

Have childs attention before giving instructions

53
Q

What affect does alpha 2 agonist have in pre-frontal cortex?

A

Strengthen synaptic connections.

Reduce noradrenaline release

54
Q

What does phychosis mean?

A

Altered mind - wrapped sense of reality

55
Q

Outline some biological etiologies of depression:

A

Genetic - 60%
co-moralities - hypothyroidism
Drugs - steroids
Neurochemical - 5HT reduction - monoamine hypothesis

56
Q

Name some socio-economic causes of depression:

A

Poor quality of living

poor social support

northern hemisphere

57
Q

Give reference to the severity of depression:

A

Mild: core symptoms +2>associated symptoms

Moderate: core symptoms +4> associated symptoms

Severe: core symptoms +6> associated symtoms + psychosis

58
Q

What is a major risk of an ERCP?

A

Acute pancreatitis

59
Q

What are the stages to giving up addiction?

A

Pre-contemplation

Contemplation

Preparation

Action

Maintenance

Relapse

60
Q

when assessing someones thoughts - during the discussion they rapidly move from one topic to the next which seem to have connections - but it is just very fast. What is this suggestive off?

A

Mania

61
Q

During the assessment of thought, the person makes lots of different jumps in their topics when talking. these seem to have no discernible connections, what is this called and what is it suggestive off?

A

Knights move

Schizophrenia

62
Q

How does liver disease lead to gynecomastia?

A

reduced breakdown of oestrogens and reduced sex-hormone binding proteins, leading to more accessible amount in the blood.

63
Q

What are acute psychological effects of alcohol intoxication?

A

Insomina

Depression

anxiety

Amnesia

Suicidal

64
Q

Define dependence

A

Compulsion

controlling

withdrawal effects

Persistence

Neglect

65
Q

What is treatment for alcoholism?

A

Assistance withdrawal home detox

Individual cognitive models to help with motivation

Groups = AA

Pharmacology

treatment of co-morbilites

Medicine 2 (28 decks)

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