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BM4 Year 1 - Quizlet Cards > LO Related (Part 1) > Flashcards

LO Related (Part 1) Flashcards

1
Q

Disadvantages the screening

A

Longer morbidity when prognosis is unaltered

Potential over treatment of abnormalities

Resource cost

False reassurance from false negatives

Anxiety from false positives

Hazard of the sreening test

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2
Q

Term in pregnancy

A

37-42 weeks

40 weeks on average

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3
Q

What anti epilieptic durg should be stopped during pregnancy

What if it isnt suitable to stop this drug?

A

Valproate

If cant then increase the dose of folic acid

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4
Q

Why are pregnant mothers usually given magnesium sulphate

A

Evidence that it aids neurological development

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5
Q

White blood cell with a kidney shaped nucleus

A

Monocytes

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6
Q

What is the exon-intron boundary AKA

A

Consensus sequence

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7
Q

White blood cell identification

  • Second most common
  • Large circular nucelus
  • Some granuels
A

Lymphocytes

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8
Q

White blood cell identification

  • Distinctive 3-5 lobed nucleus
A

Neutrophil

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9
Q

How many lobes of nuclei do eosoinophils have

A

Two

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10
Q

What does the APGAR score look at

What is is scored out of

What is a normal score

A 
Tone/activity
Colour
Breathing 
HR 
Reflexes

Out of 10 (rare to get a 10)

Get worried if less than 5

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11
Q

Why are basophils so names

Describe their appreance

A

They are basophilic (stain blue) with a bilobed nucleus

Also contain granules (likely to contain histamine)

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12
Q

How should you describe the risk of a baby having downs syndrome

A

SHould really say that CHANCE

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13
Q

How is the chance of a baby having DS calculated

A

Screening results plus the age of the mother

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14
Q

How many babies born with DS

A

1 in 800

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15
Q

Most common downs syndrome screening

A

Nuchal translucency and blood tests (combinesd)

These are offered to ALL eligible mothers between 10-20 weeks **usually at week 11-13

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16
Q

When are the TRIPLE and QUADRUPLE tests

When are they used?

How do they compare to the nuchal transluency and combined test

A

TRIPLE - 14 wks
QUADRUPLE - 20 weeks

Have lower detection rates

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17
Q

NICE guidance regarding who gets which DS screen

A

IN FIRST TRIMESTER
Combined test

IN SECOND TRIMESER
Triple or quadruple test

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18
Q

Two diagnostic tests for DS

When are they performed

What are the rates of miscarriage

A

CHORIONIC VILLUS SAMPLING
(10-13 weeks)
(1-2% miscarriage risk)

AMNIOCENTESIS
15 weeks (0.5-1% miscarriage risk)
If done at 14 weeks risk doubles
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19
Q

What is NIPT

What are the controversies around this

A

Non invasive prenatal testing

Testing the blood for cell free foetal DNA

High detection rate

BUT NEED TO HAVE AMNIOCENTESIS BEFORE A TERMINATION IS ABLE TO OCCUR

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20
Q

When is pregancy termination legal?

A

1) life of mother in danger
2) foetus have severe abnormalities
3) mental/physical health of mother will be harmed
4) other children will be harmed

MUST BE BEFORE 24 WEEKS (2 doctors required)

This is not the case if 1) or 3) apply (mothers life in danger, or mental/phys health may be harmed)

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21
Q

What is CHRONIC GRANULOMATOUSE DISEASE

A

X-linked mutation affecting NADPH OXIDASE

Defect in neutrophils and oxidative burst

Patients get severe bacterial infections and usually require life-long antibitoics

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22
Q

Complement regulatior proteins

A

Factor H and I (break down C3b)

C1INH

CFHR-1 (inhibits C5 converatase)

membrane cofactors which breakdwon C3b and C4b

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23
Q

Effects of genetic defects in C1-C4

A

Recurrent infection with pygenic bacteira

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24
Q

Effects of genetic defects in C5-C9

A

Failure to form MACs

Increases the suseptibility to N.Meningitiis

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25
Q

Common assocaited condiitons with downsyndrome

A 
Hearing problems (80-90%)
Eye problems (60%)
Cardiac defects (40-50%)
Higher prevalence of autism, leukaemia and thyroid issues
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26
Q

What is the medical model of disability

How does this compare the the social model of disability

A

MEDICAL MODEL - Disabillity is the problem the person has - and focusses on trying to improve this

SOCIAL MODEL - Frames the disability as a problem with society which contains environmental, social and organisational barries to those with disabilities

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27
Q

Example where drug absorption may be directly affected by GI contents

A

Tetracylines (MOA - inhibit tRNA binding) bind to milk and to antacids

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28
Q

3 enteral routes that AVOID first pass metabolism

A

Buccal

Sublingual

Rectal

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29
Q

For a 70kg man what do the following mean????

Vd 5L

Vd 10-15L

Vd 40-42L

A

Vd 5L (drug is confied to the plasma) e.g. insluin

Vd 10-15L (drug is confied to the interstitial fluid) e.g. mannitol

Vd 40-42L (drug is also in the intracellular fluid) e.g. ethanol

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30
Q

Why might you have an impossibly high Vd

A

if the drug is not evenly distributed in body compartments

I.e. it is being sequestered like FLUORIDE in BONE

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31
Q

What is ECTOPIA

A

The presence of differentiated cells in an abnormal location

E.g. ectopic pancrease in the wall of the small intestine

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32
Q

Two examples of metaplasia

A

CIGARETTE SMOKERS
Resp epithelium –> stratified squamous

GORD (BARRETS)
Oesoph (strat squamous) –> columnar glandular

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33
Q

% of DNA as INTRONS and EXONS

A

1.5% is exons

25% is introns

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34
Q

Small arm of chr =

Long arm of chr =

A

P = small arm

Q = long arm

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35
Q

Four breast cancer risk factoros

A

Early menache, late menopause

Medication containing oestrogen (OCP)

Environmental factors

Genetics

Also typical cancer RFs - obesity, diet, alochol, immunosuppp

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36
Q

What is the nottingham prognostic index

A

Assesses the chance of 15 year survival

BASED ON

TUMOUR SIZE, NODAL INVOLVEMENT AND GRADe

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37
Q

What should every women with suspected breast cancer be offered

A

TRIPLE ASSESSMENT

Breast exam

Mammography

Biposy

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38
Q

How many pairs of chromosos

A

23

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39
Q

Sarcoma is

A

Cancer arrising from connective tissue

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40
Q

What is SPIIKES

A

Method for BREAKING BAD NEWS

Setting 
Perception 
Invitation 
Knowlege 
Emotions 
Strategy and summary
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41
Q

What are the first set of nodes draining the breast (and thus the nodes that are most likely to be affected by breast cancer)

A

Sentinel nodes

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42
Q

What types of neurones are usually UNmyelinated

A

Autonomic

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43
Q

What might cause an increase in disease PREVALENCE

A

True increase in risk

Change in demogrpahic

Longer duration of living with disease

Artefacts

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44
Q

What is the metabolic syndrome

A

Combination of DIABETES, HYPERTENSION and OBESTIY this puts an indiv at hi risk of CVS disease

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45
Q

Main neuropeptide STIMULATING FEEDING

A

AGrP

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46
Q

Descirbe a low and VERY low calorie diet in terms of

CALORIES/DAY
EXPECTED WEIGHT LOSS IN 6 MONTHS

A

1000-1500 calories/day
Roughly 8% weight loss in 6 months

300-800 calories/day
Roughly 13% in 6 months

47
Q

MOA ORLISTAT

A

Intestinal lipase inhibitor

48
Q

What are the indications for bariatric surgery

A

BMI >40 or >35

Associated with severe health consequences and have not had sucess by other means

Aged 18-60

49
Q

What are the (4) tiers of obesity management/referral

A

TIER 1 - health promotion to prevent future weight gain

TIER 2 - Lifestyle change for those who are overweight/obese

TIER 3 - Specialist services for obesity

TIER 4 - Surgery for morbid obesity

50
Q

Define the clearance of a drug

A

Volume of blood from which the drug is cleared per unit time by a particular organ

51
Q

What is the elimination rate of a drug

A

Ammount of drug cleared per unit time

Clearance x plasma concentration

52
Q

Disadvantages to subcutaneous insulin injection

A

Injection

Systemic circ (liver exposed to less insluin)

Loss of negative feedback between glucose concentration and insluin secretion

53
Q

MOA and effects

DOBUTAMINE

A

B1 agonist

Mimics Nadr and the SNS to inc HR and inc contract

54
Q

Example of where the PSNS and SNS are complementary

A

Salivary glands - both cause saliva prodcution

PSNS - watery

SNS - thick

55
Q

First line treatment for T2DM

A

Lifestyle changes

Metformin

56
Q

Effects of metformin

A

LOWERS BLOOD GLUCOSE BY

  • Increasing uptake and storage
  • Reducing absorption in the SI
  • Suppressing hepatic gluconeogenesis
57
Q

SITAGLIPTIN

A

DPP4-i

58
Q

LIRAGLUTIDE

A

GLP-1

59
Q

What is the commonest form of blindness in working age people

A

Diabetic retinopathy

60
Q

Why is the incidence of T2Dm increasing

A

Population growth

Ageing population

Longer survival

Western diets

61
Q

When is metformin CId

What are common side effects

A

CI;d in people with reduced renal function who cant clear lactate or biguandies

Common S/E = GI upset and decreased absorption of B12

Rare SE = lactic acidosis

62
Q

MOA pilocarpine

A

Muscarinic agonist

So reduces occular pressure and can be used to treat glaucoma

63
Q

Adherence =

A

Extent to which a patients behaviour corresponds with the doctors reccomendation

64
Q

MOA Atropine

A

MAChr antagonist

Reduces secretion before surgery ALSO decreases HR

65
Q

Catabolism is

A

Breaking of large –> small

66
Q

CN III

A

Occulomotor

67
Q

Why are sulfonylureas not commonly used

A

Risk of hypo

68
Q

Describe how lipids can be metabolised to ACoA for use in the Krebs cycle

A

Lipases break up into glycerol and FAs

FATTY ACIDS - go through B-oxidation in Mt matric to form ACoA

GLYCEROL - forms glycolysis intermediate

69
Q

COMPLIANCE =

A

Degree to which patients obeys the recommendations of a doctor

70
Q

S/Es of glicasides

A

Weight gain

Fluid retention (oedema)

Also heart failure and anaemia

71
Q

MOA Prazosin

A

Alpha 1 antag

Blocks NADr

used in resitant hypertension

72
Q

Where are a2 adrenoreceptors found

A

Presynaptic memebrane

To inhibit any further neurotransmitter release

73
Q

Tamulosin MOA

A

A1 blocker

Relaxes smooth muscle in the bladder - used in prostate enlargement to control urination

74
Q

What is an adenocarcinoma

A

Cancerous tissue of glandular tissue

75
Q

What are two types of opsonins

A

Immunoglobulin and C3b

76
Q

5 clinical features of inflammation

A 
Red
Pain
Heat
Swelling 
Loss of function
77
Q

What are the main cell types involved in chronic inflammation

A

Lymphocytes and macrophages

78
Q

What is PIGEON FANCIERS DISEASE

A

A type of HYPERSENSITIVITY PNEUMONITIS caused by bird droppings

The luungs become inflammaed with granuloma formation

79
Q

How many anterior ribs should be seen on a CXR

A

5-7

80
Q

Omalizumab MOA

A

Binds and sequesters IgE

this REDUCES mast cell DEGRANULATION

81
Q

What chemokines can cause vascular dilation and increased vascular permeability

A

Histamine

Prostaglandins

82
Q

What in an FBC could indicate asthma

A

Increased eosinophils

83
Q

When is a LABA only taken

A

When ALREADY taking INHALED CORTICOSTEROIDS

84
Q

When is the intrapulmonary pressure negative

A

Inspiration

85
Q

Why do COPD sufferers used PURSED LIP breathing

A

They have lost elastic recoil in the lungs

They are trying to INCREASE THE PRESSURE in TERMINAL BRONCHIOLES

86
Q

What is the triad for the diagnosis of pneumonia

A

EVIDENCE OF INFECTION

SIGNS AND SYMPTOMS LOCALISED TO RESP TRACT

NEW OR CHANGED INFILTRATE ON CXR

87
Q

What gram class are NITRIMIDAZOLES most effective against

A

Gram +ve

88
Q

Trachea will deviate AWAY from what?

A

Tension pneumothorax or a pleural effusion

89
Q

First line treatment for sinusitis

A

Amoxicillin

90
Q

What is Vc

FOR VACCINATIONS

A

Percentage of the population that need to be vaccinated to eradicate a disease

1- 1/R0

91
Q

What is the first line PNEUMONIA antibiotic that should be given WITHIN 4 HOURS of admission

A

Penicillin and a macrolide

92
Q

What is an epitope

A

Small defined region of an antigen to which the antibody binds

93
Q

What are the THREE methods of BACTERIAL GENE TRANSFER

A

Transference (plasmids)

Transduction (phage)

Conjugation (sexpillus)

94
Q

What vaccine type confers a strong humoural and strong cell mediated response?

A

Live attenuated

95
Q

What cell type is required for CLASS SWITCHING

A

Th cells

96
Q

Give an example of a macrolide

A

ErythroMYCIN

97
Q

What types of VACCINE confer STRONG HUMORAL but WEAK CELL MEDIATED responses?

A

Sub unit vaccine

Inactivated

98
Q

Why is T cell INDEPENDENT B cell activation less good

A 
No class switching 
Less memory cells
99
Q

What is an exotoxin

A

Proteins that are SECRETED by gram +ve or -ve bacteria

100
Q

In T cell DEPENDENT B cell activation

What are the two signals

A

1) Bidning of an antigen to B cell receptor

2) Presence of activated Th cell which has recognised the same antigen

101
Q

MAX O2 with a venturi mask

What is the advantage of a venturi mask

A

60% O2

More precise

102
Q

What can a diffusion limitation result from?

A

Low inhaled O2

Impared alveolar interface

103
Q

What is the HALDANE effect?

A

Deoxygenation of the blood increases its ability to carry CO2

104
Q

What would cause an increase V/Q

A

PE

Area of the lung that is ventilated but not perfused

(As Q tends to 0, V/Q will tend to infinity)

105
Q

Location of a chest drain

A

5th intercostal space in the mid axillary line

IN THE TRIANGLE OF SAFETY

106
Q

How is CO2 transported in the blood

A

Most as bicarbonate

Some as carbamino compounds

A little as dissolved CO2

107
Q

How much O2 can be given using a NON RE-BREATHER mask

A

Up to 90%

There is also a one way valve - THIS MEANS THE PATIENT IS NOT REBREATHING THE CO2

108
Q

What forms when H+ react with Hb

Why is this useful?

A

HHb - this is less acidic and is a BETTER PROTON ACCEPTOR

This FACILITATES THE LOADING of CO2

109
Q

What causes a rise in the hemidiaphragm

A

Volume loss in the lung above

110
Q

Adverse effects of oxygen

A

IT IS MOSTLY SAFE

Fire

Toxic in large ammounts

In CO2 retainers it can cause a reduced respiraotry drive

111
Q

With a simple face mask how much O2 can be given

A

5-15L/min (this is around 30-50%)

112
Q

What does a RAISED ANION GAP show

A

Presence of non-volatile acids e.g. lactic acid and ketoacids

113
Q

Treatment for type 2 respiratory failure

A

Controlled O2 therpay

Need to treat the underlying cause

BM4 Year 1 - Quizlet Cards (3 decks)

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