last day Flashcards
treatment for influenza a and b
oseltamivir
does cancer cause fine end inspiratory crackles
no - dull percussion
what solute does water absorption depends on in the intestines
sodium
what is gastrin
a peptide hormone
what cells make intrinsic factor
parietal cells
ie pernicious anaemia associated with parietal cell destruction
what other enzyme is needed for optimal action of protein lipase
colipase
inhibit bile salt action
what is the hepatic vein formed of
splenic veins and SMV
main supplier to the liver
where are brunner’s glands found
only in the submucosa of the duodenum
what are some of the facts about GLP-1 and GLP-2
GLP-1 is expressed in more organs
GLP-1 has a half life of 2 mins while GLP-2 has a half-life of about 5-7 mins
both are secreted by L cells and target GPCRs
they are typically responsible for lowering glucose levels
resistance to laminal blood flow is dependent on what
vessel diameter and viscosity of blood
what can cause an increase in venous pressure
inspiration - due to decreased RA pressure
any type of squeezing of venous vessels
how to calculate cardiac output
stroke volume x hr
in litres
frank starling law
an increase in end diastolic volume leads to a subsequent increase in stroke volume
why is there a delay in conduction at the AVn
allows atria to fully empty before ventricular contraction
what happens after a sudden decrease in perfusion pressure
vasodilation to increases diameter to increase blood flow
how to calculate ejection fraction
find out the stroke volume and divide by end diastolic
stroke volume = end diastolic - end systolic
how to calculate blood flow
change in pressure divided by resistance
PR interval
AVn conduction
P wave
atrial contraction
funny current ions
sodium and potassium
what feature of the cardiac septum allows foetal blood to bypass pulmonary circulation
blood flow via the septal wall formed by septum primum and septum secundum
foramen ovale
what do the peripheral chemoreceptors respond to
oxygen , carbon dioxide and hydrogen ions
found in the aortic arch / carotids
common cause of high v/q ration
PE
what is a normal TLC
6000ml / 6L
what is a normal tidal volume
5ooml
inspiratory reserve volume
air that can be maximally inhaled after TV
about 3L
expiratory reserve volume
air that can be maximally exhaled after TV
1.2L
residual volume
air remaining after ERV also about 1.2L
inspiratory capacity
TV + IRV
functional residual capacity
air remaining after a quiet tidal volume expiration
ie ERV + RV = FRC about 2.4L
are the terminal bronchioles ciliated
yes - last structures to be ciliated
is the right bronchus more vertical and has more branches than the left
yes - most aspirates end up in the right lower lobe
what makes up the conducting zone
trachea, bronchi and terminal bronchioles
what makes up the respiratory zone
respiratory bronchioles, alveoli and such
what part of the resp tree contains cartilage
trachea and bronchi
vital capacity
IRV + TV + ERV about 5L
central chemoreceptors
respond to H+ ions only in the CSF ie pH
ie if arterial partial pressure of carbon dioxide increases > pH more H+ > hyperventilation
describe lung compliance in a tension pneumothorax
compliance decreases as intrapleural pressure becomes greater than atmospheric pressure
what do C cells secrete in thyroid gland
calcitonin - in response to increase calcium
is pulmonary capillary wedge pressure (PCWP) increased or decreased in heart failure
increased ie above 15
what controls the excretion of calcium and phosphate ions
kidneys
when should you retest for H-pylori / check for eradication
4 weeks after antibiotic use
2 weeks after PPI use
is PBC associated with iBDs
NO - PSC only
what is a complication of coeliacs disease
t - cell lymphoma
a t -cell mediated autoimmune inflammatory disease
vit C deficiency symptoms
pale conjunctiva
soft swollen haemorrhage gums
low platelets
bulging eyes
-scurvy
first line for crohns flair up
glucocorticoids - prednisolone
- infliximab is for when crohns isn’t responding
what can be used as an add on for crohns remission treatment to prednisolone
1st = azathioprine
2nd = methotrexate
is gilberts unconjugated or conjugated bilirubin
unconjugated
management of acute UC
iv corticosteroids
then if not working after 72 hours then iv ciclosporin
when is surgery considered for UC
toxic megacolon that doesnt settle with 24-72 hours of iv steroids
investigation for haemochromatosis
transferrin levels
what investigation do you use if you’re unsure about what type of IBD / coeliacs / malignancy
ileocolonoscopy with biopsies
management for mobitz type II
permanent pacemaker
regular tachycardia with narrowed QRS
SVT
what territories are v1-4
anterior
ie LAD
what territories are I, avL, v5-v6
lateral
what is rheumatic fever due to - bacteria wise
strept A
how to treat rheumatic fever
iv benzylpenicillin and penV
first line for aortic dissection
IV Bbs
common secondary cause of hypertension
renal disease
complication of AF
stroke - patient needs to be anticoagulated with DOACS
features of left sided heart failure
pink frothy sputum
pul oedema
paroxysmal dyspnea
cardiac wheeze
permanent pacemaker, asymptomatic bradycardia, brief sinus pause ?
sick sinus syndrome
meigs syndrome
ovarian cancer
pleural effusion
ascites
caplans
intrapulmonary nodules
rheumatoid arthritis
history of dust exposure
first line investigation for hospital admission of pneumonia
abgs
high suspicion of PE ivx
CTPA
low suspicion of PE ivx
D-dimer (wells score of less than 4)
what would small cell lung cancer show on CXR
perihilar / central lesion with mediastinal widening
squamous is more peripheral
