Midsem Polishing Flashcards
Which GI plexus(es) does the vagus nerve innervate?
Only myenteric (X = better = muscular plexus)
Name two blood tests that we can run to differentiate between type 1 and type 2 diabetes, and expecting
- C-peptide (connects alpha/beta chains of proinsulin; expected low in T1DM)
- Diabetes autoantibody panel (expected high in T1DM)
HHS vs DKA: common type of associated diabetes, blood sugar level, and level of insulin
- DKA is associated with type 1. No insulin, therefore ketones produced. Lower blood sugar level than HHS.
- HHS is associated with type 2. Some insulin, therefore no ketones produced. Higher blood sugar level than DKA.
DKA Symptoms
- Polyuria/polydipsia (high blood glucose levels)
- Abdominal pain
- Nausea/vomiting (in response to acidosis)
- Fruity-smelling breath (on ketones)
- Kussmaul breathing
HHS Signs/Symptoms
- Extreme hyperglycaemia
- Loss of consciousness
- Polydipsia/polyuria (due to high BGL)
- Hallucinations
What are 3 effects of chronic stress on the Gastrointestinal system?
- Decreased regenerative capacity of mucosa
- Increase in permeability (?pathobiont -> gut inflammation)
- Harmful effects on microbiota
What are the five diagnostic characteristics that can be measured to diagnose metabolic syndrome? How many are required for diagnosis?
- Criteria: high waist circ., low HDL, high BP, high fasting glucose, high TAG
- Three must be present (there are specific ref. ranges)
Describe the pattern of oestrogen secretion during the menstrual cycle
- Rise during mid-follicular phase, and drop sharply after ovulation
- Rise during mid-luteal phase, and fade as endometrial lining is shed
Diabetes cutoff for OGTT, fasting glucose test, HbA1c
OGTT: >11.1mmol/L (TT = repeat = 11.1)
Fasting: 7.0mmol/L
HbA1c: 6.5%
Describe levels of oestrogen, progesterone, and gonadotrophs during perimenopause/menopause
Perimenopause
- Oestrogen: fluctuating
- Progesterone: lowered
- FSH: fluctuating
- LH: lowered
Menopause:
- Oestrogen/progesterone: decreased
- FSH/LH: increased (no negative feedback)
Innervation of pituitary gland (incl. type of fibre)
Sympathetic fibres of superior cervical ganglia
Normal range of vital signs?
BP: 90/60 to 120/80mmHg
HR: 60-100
O2: >95%
RR: 12-20
Temp: 36.1-37.9°C
Strategies for communicating with patients with disability/illness
- Make appropriate adjustments
- Ask shorter questions/speak slower/wait for them to finish
- Book a longer appointment
- Avoid jargon
- Establish a baseline
- Involve the patient as much as possible in the decision making process
Ethical issues with genetics and stem cells.
- Will only the wealthy have access to it?
- How do we gauge the side effects to determine risk/benefit?
- A newborn child cannot consent to genetic engineering that will last for the rest of their life. How do we regulate it to minimise the probability of undesirable outcomes?
Why is it significant that some steroid hormones are produced/modified in peripheral tissues, rather than just in the adrenals, gonads, and placenta?
- Localised modulation (so the hormone might not act everywhere)
- Adaptation in response to local changes (injury, inflammation, stress etc.)
- Tissue-specific inactivation/metabolism of steroids
