P: revision questions Flashcards by raphaela wiget

the size of which blood vessel is important in determining peripheral vascular resistance?

tone of ARTERIOLES

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why is systolic blood pressure higher than diastolic?

as systolic pressure needs to be high enough to propel blood to the tissues, where as diastolic is just minimum resting pressue when heart relaxes to

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what are the normal mechanisms that regulate blood pressure to keep it within normal range?

Baroreceptors** in carotid sinuses & aortic arch: stimulated when BP rises, inhibited when BP lowers

> brain
> RAS** = Renin Angiotension System
> vasodialation/constriction, increase or decrease CO
> Atrial Natriuretic Peptide**
> homeostasis returned

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what does systemic hypertension normally present as?

when BP is persistently higher than 140/90

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what can secondary hypertension result from?

Can arise from any condition that influences BP regulation

renal: sodium excretion, fluid retention
endocrine: response of arterioles to sympathetic stimulation - over production of cortisul, aldosterone of ACTH
renal artery stenosis: decrease B supply to kidney => renin => angiotension II => vasoconstriction => increase BP

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risk factors of hypertension?

enviro/lifestyle:

abdominal obesity
insulin resistance/type 2 diabetes
inactivity
alco

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principle mechanisms of cell injury?

1) reduced ATP
2) mitochondiral damage
3) influx Ca
4) increased Reactive Oxygen Species
5) loss of membrane integrity
6) DNA damage, protein misfolding

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igG?

Vaccination
forms antibody-antigen complex(binds to antigen) which leads to it being phagocytosed, they have good memory, secondary large response

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igM?

first response expressed by B cells, same response/magnitude errytime

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igE

allergies - hay fever, ASTHMA
immunity to parasite infections

Hypersensitivity 1!

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igA?

secreted across mucus membranes

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igD?

expressed on naive B cells

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hypersensitivity 1 is mediated by?

igE mediated
igE bind to mast cells
involved in anaphylactic reactions eg. asthma

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hypersensitivity 2 mediated by?

igG mediated
- cytotoxic
antibodies produced by the normal immune response bind to antigens on a patients own cells

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hypersensitivity 3 mediated by?

immune complex mediated

- damaging inflammation

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hypersensitivity 4 mediated by?

cell mediated

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how can chronic hypertension affect blood vessels?

atherosclerosis
hyaline arteriolsclerosis
benign nephrosclerosis
-> basically thickening of wall due to deposition of plasma proteins/extracellular matrix production, smooth muscle atrophy, scarring

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effect of chronic hypertension on heart?

coronary artery disease, ischaemia, angina,
increased afterload on left ventricle leading to concentric left ventricular hypertrophy..impairing heart muscle function.. possible heart failure

chronic hypertension effect on retina?

hyaline arteriolsclerosis damages arterioles within eye, then can rupture causing haemorrhages/small infarcts.
=> cotton wall spots

negative feedback

when a rise in a particular hormone is sensed by receptors in the body and control centers then counteract heighten levels by either turning off stimulus that creates it or release another hormone that counteracts it

define apoptosis?

controlled by AUTODIGESTION of cell components due to activation of ENDOGENOUS enzymes

define necrosis?

unregulated enzymatic digestion of cell components, loss of membrane integrity with uncontrolled release of products of cell death into the intracellular space, initiation of inflammation response

hormones of anterior pituitary:

FSH & LH = testes of male, ovaries of female test, estro, progesterone
GH -> liver -> somatomedins => bone/muscle/other tissues
PRL = mammary glands
ACTH -> adrenal glands => steroid hormones
TSH -> thyroid gland => thyroid hormones

hormones of posterior pituitary?

ADH = kidneys
OXT = smooth muscle men = ductus deferens/prostate
women = uterine and mammary glands

anterior hypopituitarism? | epithelial cells, kinda secondary, hypothalamus releases hormone

GH deficiency ACTH deficiency which leads to decreased adrenal production in adrenal cortex => AETIOLOGY => goitre DECREASED T3 & T4,

posterior hypopituitarism? posterior neurons cells hormones made in hypothalamus,

neurogenic diabetes insipidus?? | ADH effect on kidneys??

what is hypo/hyper pituitarism mostly due to?

tumours/lesions, infections etc.

anterior hyperpituitarism?

ADEMOMA of any hormones except TSH increase in GH....gigantism in children, acromegaly in adults, PRL - hyperprolactinaemia..lactotrope adenoma ACTH - ..excessive adrenal hormone CUSHINGS disease FSH & LH = gonadotrope adenoma, postmenopausal women

posterior hyperpituitarism?

syndrome of inappropriate ADH secretion

Hypothyroidism

Hashimotos disease AUTOIMMUNE decreased T3&T4, increased TSH can result in goitre

Hyperthyroidism:

Graves disease AUTOIMMUNE increased T4

thyroid hormone effect on the following: | metabolic, GIT, CVS & neuromuscular

``` metabolic = increase basal, temp GIT = glucose catabolism, protein synthesis, lipidosis CVS = normal cardiac fuction neuromuscular = normal neuronal function adults/development in fetus, normal function and development of bone and skeleton ```

symptoms/signs expected from hyperthyroidism?

- increase in BMR resulting in weightloss - decrease in lipidosis, and breakdown of glucose therefore low energy & fatigue - tremor - exophthalmos - bulging eyes - goiter

what is the most common CAUSE of hyperthyroidism?

graves disease - autoimmune attack of thyroid gland

signs/symptoms of hypothyroidism?

- depression & forgetfullness - dry skin(opposite of sweating) - weight gain - goiter

most common cause of HYPOthyroidism?

hashimotos disease! increased TSH and decreased T4&T3 and iodine deficiency

insulin:

stimulates synthesis of glycogen from glucose STORES

Glucagon:

breaks down glycogen into glucose

myocardial infarction typically occurs due to?

development of an occlusive thrombosis over a pre-existing atherosclerotic plaque - arrhythmias may arise

4 inflammatory exudate and what each contains?

1) purulent = neutrophils and bacteria 2) fibrinous = fibrin + leukocytes and fluid 3) serous = mainly fluid small amount 4) haemorrhagic = RBC, fibrin, fluid, leukocytes

what is granulation tissue? | what does it consist of?

intermediately tissue of repair, during healing via fibrosis macrophages(remove debris), fibroblasts(produce collagen) an newly formed blood vessels(to provide nutrients to the above cells)

osteophyte formation is for which bone disease?

osteoarthritis

difference between osteoporosis and osteoarthritis?

``` osteoporosis = mass and density decrease osteoarthritis = articular cartilage through FRICTION breakdown, chondrocytes, osteophytes ```

gluconenogenesis definition

production of glucose | breaking down of glycogen to form glucose