Listy Things For SAQs Flashcards
1
Q
How do we classify the types of motor units? (3)
A
Speed of contraction
Fatiguability
Amount of tension generated
2
Q
What 4 factors influence tissue distribution of a drug?
A
Regional blood flow
Plasma protein binding
Capillary permeability
Tissue localisation
3
Q
What 3 protective mechanisms are there to protect following reflux?
A
Volume clearance (oesophageal peristalsis reflex) pH clearance (saliva buffers lowered pH) Epithelium (barrier properties)
4
Q
What are the 4 anatomical contributions to the LOS?
A
3-4cm distal oesophagus within abdomen
Diaphragm surrounds LOS (Lt and Rt crux)
Intacct phrenoesophageal ligament
Angle of His
5
Q
What 4 things contribute to mucosal protection?
A
Mucus film
HCO-3 secretion
Epithelial barrier
Mucosal blood protection
6
Q
What 3 mechanisms repair epithelial defects
A
Migration
Gap closed by cell growth
Acute wound healing
7
Q
Give 3 indication of a thyroid storm
A
Hyperthyroidism (blood tests) \+ any 2 of: - Hyperpyrexia (>41 degrees C) - Accelerated tachycardia/arrythmia - Cardiac failure - Delirium/frank psychosis - Hepatocellular dysfunction (jaundice)
8
Q
Give 3 properties of a disease for a screening programme to be successful
A
Should be able to identified early/before critical point (detectable)
Treatable
Prevent/reduce morbidity/mortality
9
Q
Give 3 properties of a good screening test
A
Acceptable/easy to administer
Cost effective
Reproductible and accurate results
10
Q
What are 3 components of the healthy child programme
A
Screening
General examination and immunisation
Health education/programme
11
Q
What 3 things contribute to the massive antigen load in the GI tract
A
Resident microbiota 1014 bacteria
Dietary antigens
Exposure to pathogens
12
Q
How can the epithelial barrier provide mucosal defense
A
Mucus layer - Goblet cells Epithelial monolayer - Tight junctions Paneth Cells (small intestine): ->Bases of crypts of Lieberkühn. ->Secrete antimicrobial peptides (defensins) & lysozyme.
13
Q
What are the 4 domains of a developmental assessment?
A
Speech and language skills
Social skills
Gross motor skills
Fine motor skills
14
Q
What 3 factors affect the amount of drug bound by a plasma protein?
A
Free drug concentration
Affinity for the protein binding sites
Plasma protein concentration
15
Q
How do prostaglandins in gastric mucosal cells protect from acid?
A
- Increased bicarbonate production (buffer)
- Increased mucous production (buffer)
- Increased blood flow (repair)
16
Q
Give 4 functions of the tear film
A
- Maintains smooth cornea-air surface
- Oxygen supply to cornea (no blood vessels)
- Remove debris (tear film and blinking)
- Bactericide
17
Q
How is the airway remodelling in allergic asthma
A
- Recruitment of eosinophils (and other immune cells)
- Increased goblet cells (mucus secreting)
- Thicker airway (more matrix, increased size and no. of smooth muscle cells)
18
Q
What are 5 characteristics of vulnerable plaques?
A
- Large soft eccentric lipid-rich necrotic core
- Increased VSMC apoptosis
- Reduced VSMC and collagen content
- Thin fibrous cap
- Infiltrate of activated macrophages expressing MMPs
19
Q
What are 3 roles of PDGF (platelet derived growth factor)
A
Vascular smooth muscle cell chemotaxis
Vascular smooth muscle cell survival
Vascular smooth muscle cell division (mitosis)
20
Q
What are 2 roles of TGF-B (transforming growth factor beta)
A
Increased collagen synthesis
Matrix deposition
21
Q
What 5 key functions are controlled by the endothelium
A
Inflammation Permeability Vascular Tone Thrombosis (coagulation) Angiogenesis
22
Q
What are the 4 mechanisms that contribute to the formation of atherosclerotic plaques?
A
Leukocyte recruitment
Permeability
Shear stress
Angiogenesis
23
Q
5 stages of gastrulation
A
Formation of the primitive streak Formation of the primitive groove Formation of the definitive endoderm Formation of the ectoderm Formation of the mesoderm
24
Q
What organs are formed by the ectoderm
A
CNS and neural tract
Skin epithelia
Tooth enamel
25
What organs are formed by the endoderm
GI tract
Liver, pancreas
Lung
Thyroid
26
What organs are formed by the mesoderm
Blood (endothelial cells, red and white blood cells)
Muscle (smooth, skeletal and cardiac)
Gonads, kidney and adrenal cortex
Bone, cartilage
27
Functions of oxytocin
Increases connectivity of myocytes in myometrium (syncytium)
Destabilise membrane potentials to lower threshold for contraction
Enhances liberation of intracellular Ca2+ ion stores
28
Which 2 factors affect extend of passive drug reabsorption
Drug metabolism
| Urine pH
29
What are the 2 principles of motor control (brain)
Hierarchical Organisation Principle
| Functional Segregation Principle
30
OCP Function
1. Anovulation
2. Thickening of Cervical Mucus
3. Thinning of Endometrial Lining
to reduce implantation
31
Why is there increased risk of foot ulceration in T2DM
Reduced sensation to feet (peripheral neuropathy)
| Poor vascular supply to feet (peripheral vascular disease)
32
How does rising estrogen levels drive prostaglandin action in the uterus (2)
1. Rising estrogen activates phospholipase A2 enzyme, generating more arachidonic acid for PG synthesis
2. Estrogen stimulation of oxytocin receptor expression promotes PG release.
33
What causes severe disease in pneumonia (3)
1. Highly pathogenic strains (zoonotic)
2. Absence of prior immunity
3. Predisposing illness/conditions
34
Respiratory epithelium defence mechanism (5)
- Tight junctions –prevents systemic infection
- Mucous lining and cilial clearance –prevents attachment, clears particulates
- Antimicrobials –recognise, neutralize and/or degrade microbes and their products
- Pathogen recognition receptors–recognise pathogens either outside or inside a cell.
- Interferon pathways –activated by viral infection. Promotes upregulation of anti-viral proteins and apoptosis.
35
What is the effect of disturbed blood flow on the endothelial (4)
- Thrombosis, inflammation (WBC adhesion)
- Endothelial apoptosis
- SMC proliferation
- Loss of NO production
36
What is the effect of laminar blood flow on the endothelial (4)
- Promotes anti-thrombotic, anti-inflammatory factors
- Endothelial survival
- Inhibition of SMC proliferation
- NO production
37
What are the effects on NO on the endothelium (6)
(Multiple protective effects)
- Dilates blood vessels
- Reduces platelet activation
- Inhibits monocyte adhesion
- Reduces SMC proliferation
- Reduced released of superoxide radicals
- Reduces oxidation of LOL cholesterol (major component of plaques)
38
What processes are angiogenesis essential for (3)
Embryonic development
Menstrual cycle
Wound healing
39
How do endothelial cells contribute to the initiation and propagation of covid19 (3)
SARS-CoV2 Infection
- >Cytokine storm
- >Endothelial activation
- >Procoagulant switch
40
What are some examples of a good screening test (newborn) (3)
- Newborn check (developmental checks)
- Newborn heading screen (deafness)
- Blood spot check (heel prick test, some biochemical disorders)
41
What is one test undertaken pre-conception, first trimester, 2/3rd trimerster, newborn period (4)
- Diabetic eye screening (for existing T1+T2DM)
- Sickle cell and thalassaemia (blood test)
- Down syndrome and fetal abnormality US
- Newborn blood spot
42
Methods of antigen sampling in the gut (2)
```
Microfold cells (FAE, Peyer's patches)
Trans-epithelial dendritic cells
```
43
Things that cause dysbiosis (5)
```
Infection/inflammation
Diet
Xenobiotics
Hygiene
Genetics
```
44
Things that dysbiosis causes (6)
```
Brain -> MS
Lung -> asthma
Liver -> NAFLD/NASH
Adipose tissue -> obesity
Intestine -> IBD
Systemic diseases -> T1DM
```
45
What is assessed in the MSE (Mental State Examination) (7)
```
Appearance and behaviour
Speech
Mood
Thoughts
Perceptions
Cognition
Insight
```
46
What are some examples of EPSE (extra-pyramidal side effects) (4)
Parkinsonism
Acute dystonia
Tardive dyskinesia
Akathisia
47
ADHD (attention deficit hyperactivity disorder) (3)
Inattention
Hyperactivity
impulsivity
48
How is the cytoarchitecture of the brain organised classified (3)
Cell size
Spacing/packing density
Layers
49
How are primary cortices' localisation of function
Function predictable
Organised topographically
Symmetry between left and right
50
How are secondary cortices' localisation of function
Function less predictable
Not organised topographically
Left-right symmetry weak or absent
51
How can the brain function be assessed (3)
Imaging
Encephalography
Brain stimulation
52
What features can be seen on MRI for a patient with Alzheimer's disease (4)
Medial temporal loss bilaterally
Hippocampal volume loss replaced with CSF
Dilated and enlarged ventricles
Narrowed gyri and widened sulci
53
What are the neuroadaptations ass. with chronic alcohol consumption (3)
Reduced function in the inhibitory system
GABA-A receptors become less sensitive
An upregulation of the excitatory system.
54
What is measured in a water deprivation test (3)
```
Urine volumes
Urine concentration (osmolality)
Plasma concentration (osmolality)
```
55
What are the depression triads (3)
Core symptoms: low mood, anergia (low energy), anhedonia
Biological symptoms: sleep, libido, appetite
Psychological symptoms: the world, the future, oneself
56
What factors affect exercise capacity (4)
- Neurological (e.g. motor control, coordination)
- Respiratory (e.g. ability for lungs to ventilate, pulmonary perfusion, gas exchange)
- Cardiovascular (e.g. ability for heart to receive blood from lungs and pump to working muscles)
- Muscular (e.g. local perfusion, muscle cell enzymes)
57
Name 3 tests used to evaluate exercise capacity (3)
Cardiopulmonary exercise testing
The six minute walk test
Incremental shuttle walk test
58
What are the 4 stages of secondary (indirect) healing (4)
Endochondral healing
- Haematoma formation
- Soft callus formation
- Hard callus formation
- Remodelling
59
When does hypoglycaemia become a problem (4)
1. Excessive frequency
2. Impaired awareness (unable to detect low blood glucose)
3. Nocturnal hypoglycaemia
4. Recurrent severe hypoglycaemia
60
Risks of hypoglycaemia (6)
```
Risks of hypoglycaemia
Seizure / coma/ death (dead in bed)
Impacts on emotional well-being
Impacts on driving
Impacts on day to day function
Impacts on cognition
```
61
What is done in DM annual foot check (3)
- Look for foot deformity, ulceration
- Assess sensation(monofilament, ankle jerks)
- Assess foot pulses (dorsalis pedis and posterior tibial)
62
Management of diabetic foot disease - peripheral neuropathy (3)
1. Regular inspection of feet by affected individual
2. Good footwear
3. Avoid barefoot walking
Podiatry and chiropody if needed
63
Management of diabetic foot disease - peripheral neuropathy with ulceration (6)
1. Multidisciplinary diabetes foot clinic
2. Offloading
3. Revascularisation if concomitant PVD
4. Antibiotics if infected
5. Orthotic footwear
6. Amputation if all else fails
64
What are the 4 drug-receptor interactions (4)
Electrostatic interactions
Hydrophobic interactions
Covalent bonds
Stereospecific interactions
65
What are the 3 major routes for excretion in the kidney (3)
Glomerular filtration
Active tubular secretion (main)
Passive reabsorption from tubule
66
Function of the lens (5)
```
Transparency
Regular structure
Refractive Power 1/3 of the eye focusing power -higher refractive index than aqueous fluid and vitreous
Accommodation
Elasticity
```
67
What is the near response triad (3)
Pupillary constriction
Convergence
Accommodation
68
What is the indirect evidence of 5-HT hypofunction in depression (5)
- Anti-hypertensive drug (reserpine) causes 5HT depletion → could cause depression
- Antidepressant action
- Post mortem after suicide shows reduced 5HT in brainstem
- MAO A higher in MDD
- Tryptophan depletion triggers MDD relapse
69
What are the 3 models of addiction (3)
- Reward deficiency (positive reinforcement)
- Overcoming adverse state e.g withdrawal (negative reinforcement)
- Impulsivity, compulsivity
70
What can cause haemolytic anaemia (4)
Spherocytes + Elliptocytes
Sickle cell
G6PD deficiency
Hypersplenism
71
Laboratory evidence of haemolysis (3)
* LDH raised
* Unconjugated hyperbilirubinaemia
* Reduced haptoglobins
72
What are causes of microcytic anaemia (4)
Defect in haem synthesis
•Iron deficiency anaemia (Case 4)
•Anaemia of chronic disease (Case 5)-Defect in globin synthesis (thalassaemia
•Defect in α chain synthesis (α thalassaemia
•Defect in β chain synthesis (β thalassaemia)
73
What are causes of normocytic anaemia (7)
Recent blood loss:
-Gastrointestinal haemorrhagee
-Trauma
Failure of production of red cells
-Early stages of iron deficiency
-Bone marrow failure or suppression (e.g. chemotherapy)
-Bone marrow infiltration (e.g. leukaemia)
Pooling of red cells in the spleen
-Hypersplenism, e.g. liver cirrhosis
-Splenic sequestration in sickle cell anaemia`
74
What are the causes of macrocytic anaemia (4)
* Lack of vitamin B12or folic acid (megaloblastic anaemia, Case 6)
* Use of drugs interfering with DNA synthesis
* Liver disease and ethanol toxicity
* Haemolytic anaemia (reticulocytes increased)
75
What are the causes of haemolytic anaemia (4)
–Integrity of the membrane: Hereditary spherocytosis (Case 1), Autoimmune haemolytic anaemia (Case 2)
–Haemoglobin structure and function: Sickle cell anaemia
–Cellular metabolism: G6PD deficiency (Case 3)
76
What are the 4 functions of the kidney (4)
Homeostatic function
Endocrine function
Excretory function
Glucose metabolism
77
What are 3 ways to classify a pituitary tumour (3)
```
Radiological (MRI):
•Size
•Sellar or suprasellar
•Compressing optic chiasm or not
•Invading cavernous sinus or not
```
Function
Benign or malignant
78
What else can cause a raised prolactin (3)
Physiological
•Pregnancy/breastfeeding
•Stress: exercise, seizure, venepuncture
•Nipple/chest wall stimulation
Pathological
•Primary hypothyroidism
•Polycystic ovarian syndrome
•Chronic renal failure
```
Iatrogenic
•Antipsychotics
•Selective serotonin re-uptake inhibitors
•Anti-emetics
•High dose oestrogen
•Opiates
```
79
What can untreated hyperparathyroidism cause (3)
```
Osteoporosis
Renal calculi (kidney stones)
Impaired mood and mental function
```
80
What causes increase APPT, normal PT (4)
Haemophilia A
Haemophilia B
Factor XI def
Factor XII def
81
What causes increased PT, normal APPT (1)
Factor VII def
82
What causes increased PT and APPT (4)
Liver disease
Anticoagulant drugs eg. warfarin
DIC
Dilution following red cell transfer
83
What can use cerebral venous thrombosis (4)
Thrombophilia
Pregnancy
Dehydration
Behcets
84
Features of Blood Brain Barrier disruption (5)
```
Endothelial layer dysfunction
Collagen dysfunction
Fibrinogen leakage
Astrogliosis
Astrocytic end-feet change (damage)
```
85
Types of saccade (4)
Reflective saccade to external stimuli
Scanning saccade
Predictive saccade to track objects
Memory-guided saccade
86
What can be used to classify ARDS (4)
```
Berlin Definition
Timing (within 1 week)
Chest imaging (bilateral opacities)
Origin of oedema
Oxygenation (Pa02/Fi02 ratio)
```
87
What can be used to classify the severity of ARDS (4)
```
Murray Score
Pa02/Fi02 (on 100% air)
CXR
PEEP
Compliance (ml/cmH20)
```
88
List 3 common causes of acute respiratory failure
```
LRT infection
Aspiration
Trauma
Pancreatitis
Pulmonary vascular disease
TRALI
PE
```
89
List the 3 mechanisms of acute lung injury (3)
1. inflammation
2. infection
3. immune response
90
Name 2 imaging modalities that can be used to guide diagnosis and treatment in the management of ARDS
X-ray
CT
USS
91
List the advantages of using extra corporeal membrane oxygenation (6)
Advantage:
Improve O2 delivery
Improve C02 removal
Rest lung and prevent ventilator associated lung injury
Resolve respiratory acidosis
Reduce multiple organ dysfunction arising from hypoxaemia and hypercapnia
92
List the disadvantages of using extra corporeal membrane oxygenation (6)
Case selection
Not universally available/inequality of provision of care
Bleeding: intra-cerebral, venepuncture sites, epistaxis, haemoptysis
Haemolysis
Infection from central dwelling cannulae
Cost
93
What is the inclusion criteria for ECMO (2)
Severe respiratory failure (non-cardiac cause, ie Murray lung injury score 3.0 or above)
Positive pressure ventilation is not appropriate (eg. significant tracheal injury)
94
What is the exclusion criteria for ECMO (3)
Contraindication to continuation of active treatment
Significant co-morbidity -> dependency to ECMO support
Significant life limiting co-morbidity
95
What are the types of ventilation for ARDS (4)
Volume controlled
Pressure controlled
Assisted breathing modes
Advanced ventilatory support
96
What 3 risk factors are involved in the risk factor multiplication in atherosclerosis (3)
Hypertension
High cholesterol
Smoking
97
What are the two classes of monocyte-macrophages (2)
Inflammatory macrophages
| Resident macrophages
98
What do inflammatory macrophages do (1)
Adapted to kill microorganisms
99
What do resident macrophages do (4)
Normally homeostatic - supress inflammatory activity
Alveolar resident macrophages - surfactant lipid homeostasis
Osteoclasts - calcium and phosphate homeostasis
Spleen - iron homeostasis
100
What roles do macrophages in plaques have (5)
I. Generate free radicals that further oxidise lipoproteins
II. Phagocytose modified lipoproteins, & become foam cells
IIIa. Express cytokine mediators that recruit monocytes
IIIb. Express chemo-attractants & growth factors for VSMC
IIIc. Express Proteinases that degrade tissue
101
What free radicals are generated by macrophages in plaques (2)
NAPDH oxidase
| Myeloperoxidase
102
What are the ketone bodies (3)
Synthesized FROM Acetyl CoA:
Acetoacetate
Acetone
3-OH-hydroxybutyrate
103
4 important things to consider when treating NoF fractures
Intra/extracapsular
Displaced or undisplaced
Age of patient
Mobility of patient
104
Factors affecting tissue healing (6)
Mechanical environment:
Movement
Forces
```
Biological environment
Blood supply
Immune function
Infection
Nutrition
```
105
What are the general complications of a fracture (4)
Fat embolus
DVT
Infection
Prolonger immobility (UTI, chest infections, sores)
106
What are the specific complications of a fracture (6)
```
Neurovascular injury
Muscle/tendon injury
Non union/mal union/ Delayed union
Local infection
Degenerative change (intraarticular)
Reflex sympathetic dystrophy
```
107
What nuclei are involved in the corticobulbar tract (6)
```
Oculomotor nucleus
Trochlear nucleus
Trigeminal motor nucleus
Abducens nucleus
Facial nucleus
Hypoglossal nucleus
```
108
Name the 4 extrapyramidal tracts
Vestibulospinal
Reticulospinal
Tectospinal
Rubrospinal
109
What are the 2 phases of micturition?
Filling phase
| Voiding phase
110
3 places where the urethra is slightly constricted
Pelvic ureteric junction
Pelvic brim
As passes through bladder wall
111
3 things to look for the in synovial fluid analysis for crystal arthritis
Crystal (type)
Shape
Bifringence
112
What 4 biologicals can be used to treat RA
Inhibition of tumour necrosis factor-alpha (TNF-a)
Modulation of T cell co-stimulation
Inhibition of interleukin-6 signalling
B cell depletion
113
When does developmental assessment occur (2)
* Opportunistically
| * Planned as part of programme of reviews
114
With whom does developmental assessment occur (4)
* Parents
* All doctors
* Nursery nurses
* Teachers
115
Patterns or abnormal development (3)
Slow but steady
Plateau
Regression
116
Types of delay (5)
Global delay
| Specific delay - language, motor, sensory, cognitive
117
4 areas of child development
Gross motor
Vision and fine motor
Hearing, speech and language
Social, emotional and behavioural
118
4 primitive reflexes
Morrow reflex
Standing reflex
Grasp reflex
Parachute reflex
119
What things could caused delayed development (4)
Ill-health
Decreased inherent potential (genetics)
Sensory/motor impairment
Lack of physical and/or pyscholoigcal stimuli
120
Causes of motor delay (7)
* Cerebral palsy
* Global delay eg Down’s syndrome
* Congenital dislocation hip
* Social deprivation
* Muscular dystrophy-Duchenne’s
* Neural tube defects: spina bifida
* Hydrocephalus
121
Causes of language delay (6)
```
•Hearing loss
•Learning disability
•Autistic spectrum disorder
•Lack of stimulation
•Impaired comprehension of language
-Developmental dysphasia
•Impaired speech production
-stammer, dysarthria
```
122
Causes of global delay (5)
•Chromosomal abnormalities
e.g. Down’s syndrome, Fragile X
•Metabolic
e.g. hypothyroidism, inborn errors of metabolism
•Antenatal and perinatal factors
Infections, drugs, toxins, anoxia, trauma, folate def
* Environmental-social issues
* Chronic illness
123
Factors which affect the developing human at any time in the lifecycle (3)
Prenatal- iron, folatye, vit b12
Perinatal- check for o2 depeation, drugs uses like glcuoce can egect hear
Postnatal - traiuma, mengitis
124
What are the two ways to prevent DOHaD mechanism leading to disease?
NHS Healthy Child Programme
| Sure start
125
Associations between early environmental exposures and which diseases?
* Cardio-vascular disease
* Type 2 diabetes
* Lung disease
* Cancer risk
* Neurological, special sense and intellectual development
* Allergic and auto-immune diseases
126
Aims of the the NHS Healthy Child Programme?
Aims to prevent disease and promote good health
•universal
•reduce health inequalities
127
Things to measure for Murrary Score (4)
02 saturation
Positive end point pressure
Chest radiology
Compliance
128
What does TNM8 lung cancer staging use to score lung cancer progression (4)
Primary tumour site
Tumour size
Regional lymph node metastases
Extrathoracic metastasis
129
What else imp. to know before carrying on with treatment (lung cancer) (3)
Comorbidities
Medication history
Lung function
130
How could inhibiting prostaglandin action prevent pre-term birth (5)
```
Inhibit leukocyte recruitment
Inhibit interleukin release
Inhibit membrane destabilization
Inhibit monocyte connectivity
Inhibit lower uterus relaxation
```
131
What prostaglandins are involved in labour (3)
PGE2
PGF2 alpha
PGI2
132
What is the action of PGE2 (3)
Cervix re-modelling:
Promotes leukocyte infiltration into the cervix
IL-8 release
Collagen bundle re-modelling
133
What is the action of PGF2 alpha (2)
Myometrial contractions:
Destabilises membrane potentials
Promotes connectivity of myocytes (with Oxytocin)
134
What is the action of PGI2 (2)
Myometrium:
Promotes myometrial smooth muscle relaxation
Relaxation of lower uterine segment
135
What is implicated in cervical remodelling (3)
PGE2
Peptide hormone - relaxin
Nitric oxide (NO)
136
What promotes connectivity of myocytes (2)
PGF2 alpha
| Oxcytoxin
137
Consequences of persistent gastro-oesophageal reflux disease (4)
Oseophagitis
Peptic stricture
Barett's oseophagus
Oseophageal cancer
138
What is the role of labour (3)
Safe expulsion of the fetus at the correct time
Expulsion of the placenta and fetal membranes
Resolution/healing to permit future reproductive events
139
How does rising estrogen levels drive prostaglandin action in the uterus (2)
1. Rising estrogen activates phospholipase A2 enzyme, generating more arachidonic acid for PG synthesis
2. Estrogen stimulation of oxytocin receptor expression promotes PG release.
140
Maternal oxygen and perfusion changes (4)
-Maternal cardiac output increases
30% during first trimester (stroke vol & rate)
-Maternal peripheral resistance decreases
up to 30%
-Maternal blood volume increases to
40% (near term (20-30% erythrocytes, 30-60% plasma)
-Pulmonary ventilation increases
40%
141
What factors may affect timely diagnosis of physical disorders in people with mental illness (4)
* Illness behaviour
* Diagnostic overshadowing
* Stigma
* Lack of resources
142
Three ways to classify psychiatric drugs (3)
Based on chemical structure- just have the name e.eg: Clomipramine - WHO Classification System
Based on what illnesses they treat- e.g: antidepressants
Based on their pharmacology - NbN ; Neuroscience based Nomenclature
143
Types of treatment in psychiatry (4)
Chemical –drugs/medicines
e.g. drugs for psychosis e.g. drugs for depression
Electrical stimulation
e.g. ECT for depression e.g. neurostimulation for pain syndromes
Structural rearrangement - surgery & orthopaedics
e.g. psychosurgery/deep brain stimulation for severe depression
Talking (pycho) therapies
e.g Cognitive Behaviour Therapy (CBT) e.g. exposure for phobias
144
What are the 4 components of clubfoot (4)
Cavus
Adductous of foot
Varus
Equinous
145
How can we describe child fractures (5)
```
Pattern
Anatomy
Intra/Extra-articular
Displacement
Salter-Harris Criteria
```
146
2 ways in which gradient is created for water reabsorption
Countercurrent multiplication
| Urea recycling``
147
How do you classify mechanical intestinal obstruction?
Speed of onset
Site
Nature
Aetiology
148
What are 3 important things regarding pharmacodynamics (3)
Where is the effect produced
What is the target of the drug
What is the response of after drug interaction with a target
149
What are 4 important things regarding pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
150
Surgical Tx for stress UI (3)
Mid-urethral sling
Colposuspension
Periurethral bulking agents
151
What systems deficits can limit exercise (4)
Neurological
Respiratory
Cardiovascular
Muscular
152
Why do enterocytes and goblet cells have such a rapid turnover (36h lifespan)? (3)
- Enterocytes are the first line of defence and may be directly affected by toxic substances (in the diet or from bacteria)
- Effects of agents which interfere with cell function will therefore be diminished.
- Any lesions will be short lived.
153
Bebenefits of gut microbiota (4)
- provide essential nutrients that we can't manufacture
- metabolise indigestible compounds
- defence against colonisation opportunistic pathogens
- contribute to intestinal architecture
154
What are the risks with thyroid surgery? (4)
Risk of voice change
Risk of also losing parathyroid glands
Scar
Anaesthetic
155
What is key in growth arrest? (2)
Location
| Timing
156
What are red flags of lower back pain (4)
Weight loss
Fever
Night pain
Less than 19yrs
157
What are the red flags of leg pain (3)
Bowel/bladder dysfunction
Saddle anaesthesia
Profound neurological deficit
158
What are the goals of surgery for acute mesenteric ischaemia (2)
Restoration of SMA blood flow
| Resection of nonviable bowel
159
CRH functions in labour (3)?
- promotes fetal ACTH and cortisol release
- Increasing cortisol drives placental production of CRH -> Positive feedback!
- stimulates DHEAS production by the fetal adrenal cortex -> substrate for estrogen production
160
What do neurotrophic factors do (2)?
Prevent neuronal death
| Promote growth of neurons after injury
161
What 3 things does montelukast do?
Decreased:
Eosinophil migration
Bronchoconstriction
Inflammation-induced oedema
162
What are the 4 types of nerual crest cells?
Cranial NC
Cardiac NC
Trunk NC
Vagral & Sacral NC
