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Y1 Medicine > Phase 1 - Non Anatomy > Flashcards

Phase 1 - Non Anatomy Flashcards

1
Q

What is histology ?

A

The study of microscopic structures of biological tissues

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2
Q

What is cell theory ?

A

All living things are composed of one or more cells
The cell is the basic unit of life
New cells arise from pre-existing cells

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3
Q

What are the 4 types of tissue ?

A

CT
Epithelial
Muscle
Nervous

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4
Q

What are the 7 steals of epithelial cancer ?

A

Dedifferentiation
Growth in situ
Invasion of CT
Local invasion
Approaching vessels
Entering vessels
Dissemination (metastasis)

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5
Q

Outline fixation ?

A

Freezing (about -80 degrees) by dry ice or liquid nitrogen
Chemical fixation = aldehyde based
TISSUE PRESERVATION

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6
Q

Outline embedding?

A

Frozen samples
Paraffin wax used to embed
PROVIDES SUPPORT FOR SECTIONING

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7
Q

Outline sectioning ?

A

Thinner = higher resolution
MICROTOME USED TO CUT THIN SECTIONS

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8
Q

Outline staining ?

A

Non-specific or specific
COLOURS THE TISSUE

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9
Q

What does H&E staining do ?

A

H (BASIC) = stains acidic structures blue (nucleus)
E (ACIDIC) = stains basic structures pink (cytoplasm)

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10
Q

What is PAS staining used for ?

A

Complex carbs and glycogen
Tissue stained with PAS = PAS+
Stains mucus, BM, brush borders

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11
Q

Where is simple squamous epithelium found ?

A

Lining of blood vessels
Lining of heart
Alveoli
Lining of serous membranes
Some kidney tubules (bowman’s capsule + glomerulus)

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12
Q

Where is simple cuboidal epithelium found ?

A

Kidney tubules
Glands and their ducts
Lining of terminal bronchioles
Surface of the ovaries

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13
Q

Where is simple columnar epithelium found ?

A

Glands and some ducts
Bronchioles of the lungs
Auditory tubes
Uterus
Uterine tubes
Stomach
Intestines
Gallbladder
Bile ducts
Ventricles of the brain

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14
Q

Where is stratified squamous epithelium found ?

A

Keratinised = skin
Non-keratinised = mouth, throat , larynx, oesophagus, anus, vagina , INFERIOR URETHRA, cornea

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15
Q

Which part of a cell is replaced by keratin ?

A

The cytoplasm
These cells are dead

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16
Q

Where are Pseudostratified epithelial cells found ?

A

Lining of nasal cavity
Nasal sinuses
Auditory tubes
Pharynx
Trachea
Bronchi
ALMOST ALWAYS CILIATED WITH GOBLET CELLS

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17
Q

Where are transitional epithelial cells found ?

A

Lining of urinary bladder
Ureters
Superior urethra
Pelvis of the kidney

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18
Q

Give 5 examples of SDGs

A

End poverty
End hunger
Well-being
Quality education
Gender equality

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19
Q

What are SDHs ?

A

The chances someone has of living a healthy life, due to conditions they live in

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20
Q

How do SDGs relate to SDHs ?

A

Healthcare wise, focus on equity rather than equality. Ensuring those in challenging conditions have an extra box to stand on the help them reach the same height as those in more favourable conditions.

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21
Q

What structure gives a prickle cell appearance ?

A

Desmosomes

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22
Q

What is the mucus secreted by goblet cells composed of ?

A

Proteoglycans (modified carbs)

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23
Q

What staining is best for goblet cells ?

A

PAS

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24
Q

Which layer of skin contains fibroblasts ?

A

Dermis

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25
Q

What do fibroblasts produce ?

A

Collagen 1

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26
Q

What shape is neutrophil nuclei ?

A

Multi-lobed

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27
Q

What shape is monocyte nucleus ?

A

Horseshoe - shaped

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28
Q

What are characteristics of eosinophils ?

A

Bi-lobed nucleus
Large granules

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29
Q

What cell initiated vitamin D production in the skin ?

A

Keratinocyte

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30
Q

What cell junction is interrupted in epidermolysis bullosa ?

A

Hemi-desmosomes

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31
Q

What cells/ tissue type is characterised by clear voids when staining ?

A

Lipids , adipose tissue

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32
Q

Why do lipids appear empty ?

A

They are dissolved during processing

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33
Q

What initiates apoptosis within cells ?

A

Release of cytochrome C from the mitochondria to cytosol

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34
Q

What is the function of the RER ?

A

Protein synthesis

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35
Q

What is the function of the SER ?

A

Lipid synthesis
Calcium storage

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36
Q

What is the function of lysosomes ?

A

Degrade unwanted molecules

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37
Q

What do perioxisomes do ?

A

Perform biochemical reactions
Breakdown fatty acids

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38
Q

What are lamins and where are they found ?

A

Intermediate filaments
Found in nuclei of all eukaryotic cells

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39
Q

What is the nuclear lamina ?

A

Composed of lamins
Organisation, membrane support, chromatin organisation

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40
Q

What are microtubules composed of ?

A

Alpha and beta tubulin

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41
Q

What do kinesins do ?

A

Move cargo away from centrosome

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42
Q

What do dyneins do ?

A

Move cargo towards centrosome

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43
Q

What is the cytoskeleton of cilia called ?

A

Axonemes, allow bending and are composed of microtubules and dynein

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44
Q

What are Microfilaments polymers of ?

A

Actin

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45
Q

What are the 2 cell-cell junctions and what are the comprised of ?

A

Adherens : actin (+E-Cadherin)
Desmosomes : IF

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46
Q

What are the 2 cell-ECM junctions and what are the composed of ?

A

Focal adhesions = actin
Hemi-desmosomes = IF

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47
Q

What are tight junctions ?

A

Regulation of paracellular permeability
From apical(upper) and basolateral (lower) domains to create a diffusion barrier

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48
Q

What are GAP junctions ?

A

Cell-cell junctions
Allow passage if small molecules
Involved in electrical signalling
Composed of = hexamers + connexins

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49
Q

What is Kartangers syndrome ?

A

Lack of dynein arms (cilia)

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50
Q

What is Tay-Sachs disease ?

A

Failure of gene that encodes lysosomal enzymes

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51
Q

What does ubiquitination do ?

A

Targets protein for degradation

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52
Q

What are the degradation methods ?

A

Lysosomal = long-half life, membrane proteins
Proteosomal = short-halfllife , metabolic enzymes + defective proteins

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53
Q

What is the order of skin layers from superficial to deep ?

A

Stratum corneum
Stratum lucidum (only in thick skin)
Stratum granulosum
Stratum spinosum
Stratum basale
BM

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54
Q

What is the dermis composed of ?

A

CT = collagen 1, elastin, ground substance
Fibroblasts

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55
Q

What are the two layers of the dermis ?

A

Papillary - superficial
Reticular - deep (vasculature)

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56
Q

What are Meissners corpuscles and where are they found ?

A

Rapidly acting mechanoreceptors responsible for touch
Found in the papillary dermis

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57
Q

What are Pacinian corpuscles and where are they found ?

A

Detect deep pressure and vibration
Subcutis (adipose tissue)

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58
Q

Where are stem cells found in the epidermis ?

A

Stratum basale

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59
Q

What are merkel cells and where are they found ?

A

Responsible for sensation
Found in epidermis ( mainly basal layer)

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60
Q

What are langerhans cells and where are they found ?

A

Dendritic, antigen presenting cells
Epidermis (stratum spinosum + papillary dermis)

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61
Q

Are melanocytes and where are they found ?

A

Protect from radiation + skin pigmentation via melanin
Basal layer

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62
Q

What are mast cells and where are they found ?

A

Inflammatory mediator producers
Produce chemotactic factors for eosinophils and neutrophils
Found in DERMIS

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63
Q

What is a partial thickness wound ?

A

Epidermis + some dermis

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64
Q

What is a full thickness wound ?

A

Epidermis + all of dermis + deeper structures

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65
Q

What are the 3 phases of wound healing ?

A

Inflammatory (24-48 hours)
Proliferative (1-2 days)
Remodelling

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66
Q

Outline the inflammatory stage

A

Platelets initiate blood clot
Neutrophils + macrophages attracted to site
Dead disuse phagocytosed

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67
Q

Outline the proliferation stage

A

Epithelial cells loosen adhesions
Migrate and cover the granulation tissue
Once covered, keratinocytes prolif
Type 3 collagen formed
Blood vessel forms (angiogenesis)

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68
Q

Outline the remodelling phase

A

Collagen switched from type 3 to type 1
Final strength only returns to 70-80% at 1 year

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69
Q

What are the 5 conditions for valid consent ?

A

With capacity
Informed
Voluntary
Not coerced
Not manipulated

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70
Q

What is an example of a live attenuated virus ?

A

Polio
Rabies

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71
Q

What is an example of a conjugate vaccine ?

A

Streptococcus pneumoniae

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72
Q

Where do T lymphocytes mature ?

A

The thymus

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73
Q

What are the secondary lymphoid organs ?

A

Tonsils
Lymph nodes
Spleen
Peyers patches
Appendix

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74
Q

What colour does GRAM+ turn ?

A

Purple

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75
Q

What could does GRAM- turn ?

A

Pink

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76
Q

What makes GRAM- stain ?

A

Thinner cell wall

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77
Q

Give 2 examples of GRAM+ Cocci

A

Staphylococcus aureus
Staphylococcus pneumoniae

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78
Q

Give 2 examples of GRAM+ Rods

A

Listeria monocytes
Corynebacterium diphtheriae

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79
Q

Give an example of GRAM- Cocci

A

Neisseria meningiditis

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80
Q

Give 2 examples of GRAM- Rods

A

E.coli
Salmonella

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81
Q

What are sterile body sites ?

A

Blood
CNS
Lower respiratory tract
Sinuses
Renal system (down to posterior urethra)
Female reproductive tract (down to cervix)
Eye

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82
Q

What is the SIRS classification for sepsis ?

A

2 or more : Temp outwith 36-38, HR>90, RR >20 or PaCO2 <4.3 kPa

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83
Q

What are the 3 categories of sepsis ?

A

Sepsis = SIRS with infection
Severe sepsis = Sepsis with hypoxia, acidosis or cerebral dysfunction
Septic shock = Severe sepsis with hypotension despite fluid resus or ionotropic support

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84
Q

What are the 4 main signs of inflammation?

A

Rubour
Calor
Tumour
Dolor

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85
Q

What causes inflammation ?

A

ILs + TNF
Leukotrines
Platelet activating factor
Histamine
Clotting system (Bradykinin)
Complement

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86
Q

What is complement ?

A

A cascade of proteins in serum
Activated by antibody
Amplifies immune response
Directly kills pathogens or attract immune cells

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87
Q

What are the 4 stages of immune cell migration ?

A

Rolling adhesion
Tight binding
Diapedesis
Migration

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88
Q

What is humoral immunity ?

A

Antibody from B cells (immunoglobulins)

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89
Q

What is cell-mediated immunity ?

A

Due to T cells
Intracellular

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90
Q

Where do B cells mature ?

A

The bone marrow

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91
Q

What are CD4 T cells ?

A

Helper cells
Recognise antigen presented MHC II on the surface of antigen presenting cells and help them

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92
Q

What are CD8 T cells ?

A

Cytotoxic
Recognise antigen presented on MHC I and can be induced to kill

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93
Q

What happens to T cells in the thymus ?

A

Removal of auto-reactive cells to prevent autoimmunity

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94
Q

What cell expresses MHC II ?

A

Macrophage

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95
Q

What antibody type is the first produced in response to infection ?

A

IgM

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96
Q

What is an example of how a single base mutation effects a protein ?

A

Sickle cell anaemia
GAG —> GTG at 6th codon

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97
Q

Outline the hierarchy of stem cell potency

A

Totipotent
Pluripotent
Multipotent
Unipotent

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98
Q

What are induced pluripotent stem cells ?

A

iPSCs are a way to make pluripotent stem cells without embryos
Treated with TFs (Oct-3/4, SOX2, c-Myc) to switch in genes and induce pluripotency

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99
Q

What are the 4 types of shock ? (DOCH pneumonic)

A

Distributive
Obstructive
Cardiogenic
Hypovolemic

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100
Q

What is distributive shock ?

A

Failure of vasoregulation , severe peripheral vasodilation
Due to sepsis, anaphylaxis or neurogenic causes

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101
Q

What is obstructive shock ?

A

Barriers to cardiac flow or filling
Pulmonary embolism, cardiac tamponade, tension pneumothorax

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102
Q

What is cardiogenic shock ?

A

Pump failure
MI , arrhythmias, mechanical

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103
Q

What is hypovolaemic shock ?

A

Loss of blood
Haemorrhage (trauma, GI bleeding) , burns

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104
Q

What is the trauma triad of death ?

A

Blood clotting problem —> increased lactic acid
Acidic blood —> decreased heart performance
Low body temperature —> decreased coagulation

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105
Q

What is Class 1 shock ?

A

HR <100
BP = normal
RR 14-20
Urine output 30 ml/hr
Mental status normal

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106
Q

What is class 2 shock ?

A

HR >100
BP = normal
RR 20-30
Urine output 20-30 ml/hr
Mental status mild anxiety

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107
Q

What is class 3 shock ?

A

HR >120
BP = decreased
RR 30-40
Urine output 5-15 ml/hr
Mental status anxious

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108
Q

What is class 4 shock ?

A

HR >140
BP = decreased
RR >40
Urine output negligible
Mental status confused

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109
Q

What are the 5 steps in the cycle of enquiry?

A

Acquire
Ask
Assess
Apply
Appraise

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110
Q

What protein mutation causes sickle cell ?

A

Globin

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111
Q

What is added to blood to stop it clotting ?

A

Sodium citrate

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112
Q

What happens to coagulation if your replace calcium with chelated calcium ?

A

Coagulation doesn’t occur

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113
Q

What effect does benzamidine (protease inhibitor) have on coagulation ?

A

Coagulation takes longer

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114
Q

What molecule is a zymogen ?

A

Prothrombin

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115
Q

What is the mechanism of action of alteplase ?

A

It converts plasminogen to plasmin

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116
Q

what is NOT a high risk fluid ?

A

Urine / faecal matter
Saliva
Sweat
Vomit
(Unless blood stained)

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117
Q

What are general investigations?

A

Bloods
Imaging
Cultures

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118
Q

What’s are pathology specific investigations?

A

Cytology sampling - fluids, fine needle
Tissue sampling - biopsy, reaction
Immunohistochemistry
Genetic profiling

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119
Q

What are the 4 cellular responses to stress ?

A

Hyperplasia = multiplying
Hypertrophy = growth
Atrophy = shrinkage
Metaplasia = changing cell type

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120
Q

What happens if cellular stress is long term ?

A

Apoptosis
Necrosis
Inflammation
(Possibly neoplasm)

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121
Q

What is dysplasia ?

A

Abnormal/atypical cells due to a failure of differentiation

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122
Q

What are two key features of dysplasia ?

A

Pleomorphic nuclei
Mitotic figures

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123
Q

How does HER2 work ?

A

RTK pathway

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124
Q

What does HER2 over expression suggest in breast cancer ?

A

More aggressive cancer

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125
Q

What is the treatment for HER2 specific breast cancers ?

A

Herceptin

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126
Q

What occurs in colon cancer ?

A

MSI, caused by damage to the MMR system leading to damaged DNA being passed down to new cells making them more prone to cancer causing mutations
Occurs in 15% of colon cancers, better prognosis
Immunotherapies can benefit MSI colon cancers

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127
Q

What is the staging tool for neoplasm spread ?

A

TNM classification
Tumour - local invasion
Node - lymph nodes
Metastasis - distant tissues

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128
Q

What is the narrowest part of the uterine tube ?

A

Isthmus

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129
Q

What prevents premature implantation ?

A

Zona pellucida

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130
Q

What day is the morula formed ?

A

4

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131
Q

What are the 2 layers of blastocyst ?

A

ICM - forms embryo and extra embryonic tissues
Trophoblasts - contribute to placenta

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132
Q

What are the 3 important structures during gastrulation ?

A

Primitive streak
Notochord
Neural tube

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133
Q

At which end does the primitive streak form ?

A

Caudal end

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134
Q

What are the 2 layers of the bilaminar disc ?

A

Epiblast
Hypoblast

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135
Q

What happens during gastrulation ?

A

Invagination creates 3 germ layers

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136
Q

What is derived from the ectoderm ?

A

Epithelial linings of skin, moth and anus
Cornea and eye lens
Nervous system
Adrenal medulla

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137
Q

What is derived from mesoderm ?

A

Skeletal system
Muscles (except some smooth muscle)
Excretory system
Circulatory and lymphatic systems
Reproductive systems
Dermis

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138
Q

What is derived from the endoderm ?

A

Internal linings
Liver
Pancreas
Thymus
Thyroid and parathyroid

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139
Q

What are 3 proto-oncogenes ?

A

EGFR
HER2
BRAF

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140
Q

Give an example of a deletion/point mutation to form an oncogene

A

Ras : G protein that transducers signals from cell surface receptors
Mutation causes constantly ‘on’
30% of all tumours screened have Ras mutations

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141
Q

Give an example of a gene amplification mutation to give an oncogene ?

A

HER2 : transmembrane receptor that receives signals from other cells
Amplified in 20% of breast cancers

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142
Q

Give and example of chromosome rearrangement mutation giving an oncogene

A

Chromosome 22 bcr gene + chromosome 9 abl gene
Philadelphia translocation
Hybrid gene in chronic myeloid leukaemia (CML)

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143
Q

What growth factor induces angiogenesis ?

A

VEGF

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144
Q

What happens during prophase ?

A

Chromatin condensation
Nucleolus disappears

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145
Q

What happens during pro-metaphase ?

A

Nuclear membranes dissolve
Chromosomes attach to microtubules

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146
Q

What happens during metaphase ?

A

Spindle fibres align chromosomes along the metaphase plate

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147
Q

What happens during anaphase ?

A

Paired chromosomes separate and move to opposite sides of the cell

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148
Q

What happens during telophase ?

A

Chromatids arrive at opposite poles
New membranes form
Chromosomes decondense
Spindle fibres dispense

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149
Q

What cyclin CDK pair is responsible for progression to S phase ?

A

Cyclin D-CDK 4/6

150
Q

What cyclin CDK pair is responsible for progression into mitosis ?

A

Cyclin 1-CDK B (MPF)

151
Q

What are the 3 families of CKIs?

A

p21 CIP
p27 KIP
p16 INK

152
Q

When are the 2 DNA damage checkpoints ?

A

Late G1
Late G2

153
Q

When DNA damage is detected what is activated ?

A

p53 it inhibits cell cycle progression until damage is fixed

Damage is fixed via p21 but
if damage is extreme p53 causes apoptosis

154
Q

When is the spindle assembly checkpoint ?

155
Q

What happens at the spindle assembly checkpoint ?

A

APC (anaphase promoting complex) is inhibited until all chromosomes are attached

156
Q

When does organelle replication occur ?

A

G2 in preparation for mitosis

157
Q

What does cyclin B-CDK 1 phosphorylate ?

A

Condensins
Lamins

158
Q

What is endocrine range ?

A

Long distance via blood

159
Q

What is paracrine range ?

A

Nearby cells via diffusion

160
Q

What is juxtacrine range?

A

Neighbouring cell via cell-cell contact

161
Q

What is autocrine range ?

162
Q

Give an example of an intracellular receptor

A

Steroid hormones
Bind to intracellular receptors
Hormone-receptor complex acts as TF
Complex binds to DNA and alters gene expression

163
Q

Give an example of an ion-channel-linked receptor

A

Glutamate neurotransmitter
Ion flow into the cell changes it’s electrical properties
Used in nerve impulse transmission

164
Q

Give an example of a G-protein linked receptor

A

Adrenaline, serotonin, glucagon
Activated-G protein activated enzyme that passes on signal

165
Q

Give an example of enzyme-linked receptors

A

Growth factors, insulin
RTK linked type
e.g. EGF
Binding - receptor activation - autophosphorylation - docking - relay protein recruitment - SIGNAL TRANSMITTED

166
Q

Give an example of enzyme cascades

A

MAPK cascades - EGF
Relay proteins activate Ras
Ras activates MAP kinase cascade
Signal is amplified

167
Q

Give an example of second messengers

A

Adrenaline - G protein receptor
G protein activation activates cAMP
Protein kinase A is activated (PKA)
Effector proteins are phosphorylated
Cell responds

168
Q

How can specificity be achieved in signalling ?

A

Specific receptors for specific responses
e.g. adrenaline can activate multiple receptor and have differing effects

169
Q

Which cyclins are regulated by mitogens ?

170
Q

What is the composition of articulating cartilage ?

A

Chondrocytes
ECM : collagen mainly type 2, water

171
Q

What is a motor unit ?

A

All the muscle cells controlled by 1 nerve cell

172
Q

What is the refractory period ?

A

Period of time when muscle cells won’t respond to stimulus

173
Q

Which muscle type has the shorter refractory period ?

A

Skeletal , cardiac refractory is longer to avoid tetany

174
Q

What is the boundary of the sarcomere ?

A

The Z lines

175
Q

What is the H band ?

A

Only miosin filaments
BARE ZONE

176
Q

What binds to troponin ?

177
Q

What blocks myosin binding to actin ?

A

Tropomyosin

178
Q

What unhooks the head of myosin ?

179
Q

Describe muscle excitation

A

Nerve impulses reach NMJ
Acetylcholine is released
Ach binds with receptors in the muscle membrane to allow sodium entry
Sodium influx will generate an action potential in the sarcolemma
Action potential travels down T tubule
Sarcoplasmic reticulum releases Ca
Ca bind to troponin
Actin filament exposed

180
Q

In IVDs what does the annulus fibrous do ?

A

High tensile strength
Collagen rings, fibrocartilage inner zone

181
Q

In IVDs what does nucleus pulposus do ?

A

High resilience
Gelatinous
80-85% water

182
Q

What happens in slipped disc ?

A

Prolapse of IVD
Tear in the annulus fibrosus, nuclear pulposus can protrude
Can affect nerves or spinal cord

183
Q

What is between C1 and C2 ?

A

Odontoid process
No IVD

184
Q

What are the 2 spinal curvatures ?

A

Lordosis (inwards)
Kyphosis (outwards)

185
Q

What is Gibbs reflective cycle ?

A

Description
Feelings
Evaluation
Analysis
Conclusion
Action plan

186
Q

What are 5 viruses ?

A

COVID
HIV
Rhinovirus (common cold)
Influenza
Herpes

187
Q

What is a nucleocapsid ?

A

Complete unit of nucleic acid + capsid

188
Q

What is a viral envelop derived from ?

A

Host cell membrane

189
Q

Outline the structure of the Epstein-Barr and Herpes virus

A

Double stranded DNA
Enveloped
Icosahedral

190
Q

Outline the structure of rhinovirus, poliovirus and enterovirus (meningitis)

A

RNA SS+
Not enveloped
Icosahedral

191
Q

Outline the structure of COVID

A

RNA SS+
Enveloped
Helical

192
Q

Outline the structure of mumps, measles, influenza and Ebola

A

RNA SS-
Enveloped
Helical

193
Q

What is viral tropism ?

A

The ability of a virus to productively inject a cell, tissue or host species

194
Q

What are the stages of viral infection and replication

A

Attachment/absorption
Penetration
Uncoating
Synthesis
Assembly
Release

195
Q

What is antigenic drift ?

A

Small antigenic changes to avoid immune detection

196
Q

What is gene recombination ?

A

Causes extensive and sudden variations

197
Q

What is antigenic shift ?

A

Exchange of genetic material between 2 pathogens
Gives rise to epidemics and pandemics

198
Q

What causes type 1 hypersensitivity?

A

IgE
Mast cells

199
Q

What triggers allergic response ?

A

IgE with antigen binds to mast cell
Degranulation occurs
Histamine and other cytokines are release

200
Q

What type of langerhan cell is killed in type 1 diabetes ?

201
Q

What is primary immunodeficiency?

A

Congenital

202
Q

What is secondary immunodeficiency?

203
Q

Give an example of a primary immunodeficiency

A

SCID
Mutation in cytokines receptor IL-2
T + NK cells fail

204
Q

Give an example of secondary immunodeficiency

A

HIV - deletion of CD4 helper cells
Protein-calorie malnutrition - metabolic derangements inhibit lymphocyte maturation and function

205
Q

Which molecule recognises sialic acid on the plasma membrane of respiratory epithelia ?

A

Haemagglutinin

206
Q

What molecule acts as a co-receptor for HIV infection ?

207
Q

What is the frontal lobe function ?

A

LTM
Speech
Movement
Personality

208
Q

What is the parietal lobe function ?

A

Sensory
Language interpretation
Spatial/visual perception

209
Q

What is the occipital lobe function ?

A

Visual processing

210
Q

What is the temporal lobe function ?

A

Auditory cortex
Memory
Understanding language

211
Q

What is the role of astrocytes ?

A

CNS nutrient supply

212
Q

What is the role of Microglia ?

A

Defence role (phagocytic)

213
Q

What is the role of ependymal cells ?

A

CSF production

214
Q

What is the role of oligodendrocytes ?

A

CNS neuronal support + myelin formation

215
Q

What is the role of Schwann cells ?

A

Neuronal support and myelin formation in the PNS

216
Q

What are the 3 meninges ?

A

Dura mater - thick, dense irregular CT
Arachnoid mater - doesn’t pass into sulci, pressed against dura
Pia mater - delicate, allows BV passage to nourish brain

217
Q

What are the 31 pairs of spinal nerves ?

A

C1-8
T1-T12
L1-5
S1-5

218
Q

What are the 12 cranial nerves ?

A
  1. Olfactory - smell
  2. Optic - vision
  3. Oculomotor - eye movements
  4. Trochlear - eye movements
  5. Trigeminal - Musckes of chewing, facial sensory
    6.Abducens - eye movements
  6. Facial - muscles of facial expression
  7. Vestibulocochlear - hearing + balance
  8. Glossopharangeal - swallowing + taste
  9. Vagus - wandering nerve supply, lungs + heart
  10. Spinal Accessory - neck muscles
  11. Hypoglossal - tongue muscles
219
Q

What are sympathetic neurotransmitters ?

A

Pre ganglion : Ach
Post ganglion : noradrenaline

220
Q

What is the function of B1 receptors ?

A

Increase HR
Increase SV

221
Q

What is the function of B2 receptors ?

A

Smooth muscle relaxation

222
Q

What is the parasympathetic neurotransmitter?

A

Pre + post = Ach

223
Q

Where are sympathetic ganglia ?

A

Near spinal cord

224
Q

Where are parasympathetic ganglia ?

A

Near site of action

225
Q

What are the receptors for Ach ?

A

Nicotinic
Muscarinic

226
Q

What is the function of the spinothalamic tract ?

A

Ascending
Sensory
Pain
Temperature

227
Q

What is the function of the corticospinal tract ?

A

Descending
Motor
Voluntary movement

228
Q

What is contained in the subarachnoid space ?

229
Q

What can diagnose meningitis ?

A

High WBC in CSF (lumbar puncture between L4-5)

230
Q

Where is CSF produces ?

A

Choroid plexus in lateral and 4th ventricles

231
Q

What is CSF similar to ?

A

Plasma
Much less proteins
Different electrolyte levels

232
Q

What created the BBB?

A

Tight junctions
They restrict movement and stop passage of molecules

233
Q

What is the BBB permeable to ?

A

DIFFUSION : Water, small lipophilic molecules, gases
ACTIVE TRANSPORT : glucose, amino acids

234
Q

What is the central dogma ?

A

DNA - RNA - protein

235
Q

What is gene structure ?

A

Codons
Exons
introns (spliced out)

236
Q

What are the 3 steps of transcription ?

A

Initiation - RNA polymerase II pulls DNA strands apart
Elongation - RNA gets longer (forms transcription bubble
Termination - RNA synthesis stops

237
Q

What are 2 TFs?

238
Q

How does TIC regulate transcription ?

A

RNA polymerase cannot bind directly to DNA
TATA box activate the process

239
Q

How does Myc enhance transcription ?

A

It means when TFs bind at Myc sites, they interact with the TIC

240
Q

What do enhancers do ?

A

Make it more likely that a promoter is activated

241
Q

What do silencers do ?

A

Make it less likely a promoter is activated

242
Q

Give an example of an activator

A

E2F
Activates transcription of genes needed for S phase

243
Q

Give an example of a repressor

A

Snail
Represses E-Cadherin in epithelial cancers, causing less cell-cell adhesion and more invasive ability

244
Q

What is constitutive gene expression ?

A

Genes which are expressed in all cells all the time
Beta-actin
Ribosomal proteins

245
Q

What is inducible gene expression ?

A

Genes which are only expressed in certain cells/tissues or only expressed at certain time
Cell specific = CD4,CD8, collagen 1 +2
Time specific = cyclins, melatonin, inflammatory cytokines (IL-2, IL-6, TNF-alpha)

246
Q

How do genes vary ?

A

Alternative splicing
Post-transcriptional regulation (microRNAs)

247
Q

What is the threshold voltage ?

A

55mV in most human nerve cells

248
Q

What enzyme switch the action of Ach off ?

A

Acetylcholinesterase

249
Q

What allows electrical signals to pass through GAP junctions ?

250
Q

What is guided therapy ?

A

Cause of infection identified agent selected based on sensitivity testing

251
Q

What is empirical therapy ?

A

Best guess therapy in urgent circumstances

252
Q

What is prophylactic therapy ?

A

Perverting infection before it begins

253
Q

What is a bacteriocidial antibiotic ?

A

Kills bacteria

254
Q

What is a bacteriostatic antibiotic ?

A

Suppresses growth

255
Q

Name 2 antibiotics that target cell wall

A

Penicillins
Glycopeptides

256
Q

Name 2 antibiotics that target ribosomes

A

Macrolides
Aminoglycosides

257
Q

Name an antibiotic that targets DNA

A

Quinolones

258
Q

Name an antibiotic that targets metabolism

A

Trimethoprim

259
Q

Which mutation is most likely to result in reduced levels of a gene product

A

Point mutation in the promoter

260
Q

What does tamoxifen inhibit ?

A

Transcription

261
Q

What cells line the central spinal canal ?

A

Ependymal cells

262
Q

What bacterial infection would not be treated with vancomycin?

263
Q

What are RARs?

A

Rapidly adapting pulmonary stretch receptors
Activated by dust, smoke, ammonia, oedema
Cough reflex

264
Q

What is 1st order kinetics ?

A

Drug decreases at a constant proportion of the drug is eliminated per unit time

265
Q

What is 0 order kinetics ?

A

Drug decreases at constant amounts per unit of time

266
Q

What is the roles of saliva ?

A

Buffer mouth pH
Protect mouth and gut surface
Antimicrobial

267
Q

What is the role of the gallbladder ?

A

Storage and concentration of bile
Aids fat digestion

268
Q

What is in saliva that starts starch digestion ?

269
Q

What is churned food and drink called ?

270
Q

What does chyme pass through to get from the stomach to the intestines ?

A

A sphincter

271
Q

Name the three parts of the small intestines

A

Duodenum
Jejunum
Ileum
Digestion —> absorption

272
Q

What enter the duodenum ?

A

Pancreas secretions - aid fat, protein and starch digestion + bicarbonate fluids to maintain alkaline pH
Bile - aid fat digestion
Chyme

273
Q

What passes into the large intestine ?

A

Any material not digested or absorbed

274
Q

Outline GI tract histology

A

Epithelium
Lamina propria - CT, inflammatory cells + support + nutrition
Muscularis mucosae - smooth muscle (whole GI tract)
Submucosa - CT, vascularised, nerves
Muscularis propria - smooth muscle, peristalsis
Adventitia - CT (not in stomach or smal, intestines)
Serosa - reduces friction, CT , whole GI tract

275
Q

What is the role of brunner’s glands ?

A

Secrete bicarbonate to neutralise stomach acid

276
Q

What are peyers patches ?

A

Lymphoid follicles that prevent growth if dangerous bacteria

277
Q

Outline the 3 pharynx’s

A

Nasopharynx = base of skull — soft palate
Oropharynx = soft palate — epiglottis
Laryngopharynx = epiglottis — trachea and oesophageal split

278
Q

What is the muscle types in the oesophagus?

A

Upper - skeletal
Middle - mixed
Lower - smooth

279
Q

What is the sphincter of the stomach called ?

A

Pyloric sphincter

280
Q

How many layers of muscle in the stomach wall ?

281
Q

What stimulates hydrochloric acid production in the stomach ?

282
Q

What does hydrochloric acid break down ?

A

Pepsinogen to pepsin - produced from chief cells

283
Q

What is the surface specialisation of the intestinal epithelia ?

284
Q

What delivers bile and pancreatic juices to the duodenum ?

A

Sphincter of Oddi

285
Q

What does the pancreas do ?

A

EXOCRINE : digestive enzymes, bicarbonate
ENDOCRINE : hormones , insulin (for glucose absorption), glucagon (for glucose release) + somatostatin (reduces acid secretion, slowing digestion)

286
Q

How many lobes does the liver have ?

287
Q

What is the role of the liver ?

A

Produces bile
Detoxifies and processes everything absorbed from GI tract

288
Q

What are the 6 areas of the large intestine ?

A

Caecum
Ascending colon
Transverse colon
Descending colon
Sigmoid colon
Rectum

289
Q

What prevents reflux of bowel contents to the ileum ?

A

Ileocaecal valve

290
Q

What is the taenia coli ?

A

3 longitudinal bands of smooth muscle on the A, T and D colon

291
Q

What is haustra ?

A

Ring like circular muscle

292
Q

What do goblet cells do in the colon ?

A

Produce mucous
Large intestines role is to absorb fluid from GI tract

293
Q

What are the 3 vessels of the GI tract ?

A

Coeliac trunk = forgut
Superior mesenteric artery = midgut
Inferior mesenteric artery = hind gut

294
Q

Outline eat well guide

A

1/3 carbs
1/3 veg + fruit
Proteins is the next largest
Dairy is a small part
Processed food to be kept to a minimum
6-8 glasses of water daily

295
Q

What is the structure of dietary fats ?

A

Triglycerides

296
Q

What is the structure of dietary proteins ?

A

Polymers of amino acids
9 essential (only through diet)

297
Q

What is the structure of carbs ?

A

Monosaccharides = glucose, fructose, galactose
Disaccharides = sucrose, maltose, lactose
Polysaccharides = starch

298
Q

What digestion begins in saliva ?

A

Carbs (amalyse)
Lipids (lingual lipase)

299
Q

What digestion starts in the stomach ?

A

Proteins (hydrochloric acid)

300
Q

What is the livers role in fat digestion ?

A

Bile emulsifies fat particles
Aids absorption by forming micelles

301
Q

What activated trypsin in the duodenum ?

A

Enterokinase

302
Q

What enzymes are contained in the brush borders of villi ?

A

Peptidases , lactase , sucrase, Maltase

303
Q

What is Bulimia Nervosa ?

A

Recurrent episodes of overeating accompanied with compensatory behaviours

304
Q

What is the treatment for Bulimia Nervosa ?

A

CBT FBT, antidepressant may be used

305
Q

What is BED ? (binge eating)

A

Frequent, recurring episodes of binge eating. Loss of control over eating behaviour

306
Q

What is the treatment for BED ?

A

CBT , interpersonal therapy

307
Q

What is Anorexia Nervosa ?

A

Low body weight due to persistent pattern of behaviours to prevent weight restoration (BMI <18.5)
BDD accompanied (body dysmorphia)

308
Q

What is the treatment for Anorexia ?

A

FBT, CBT, Olansapine for adults

309
Q

What is ARFID?

A

Abnormal eating or feeding behaviours that result in intake of insufficient quantity or variety of food
Causes weight loss/ nutrient deficiency

310
Q

What is OSFED ?

A

Atypical eating disorder, doesn’t fit criteria

311
Q

Where is erythropoietin secrete and what does it do ?

A

Kidneys
Response to hypoxia or low blood glucose

312
Q

What is the function of the PCT ?

A

Active reabsorption of glucose , amino acids, Na and K + water

313
Q

What is the function of the LOH ?

A

Solute pumping OUT of the tubule

314
Q

What is the function of the DCT ?

A

More suite reabsorption and secretion

315
Q

What is the function of Collecting Ducts?

A

Concentration of urine

316
Q

What happens when electrolyte levels fall ?

A

Aldosterone increases , increases reabsorption of Na + Cl ions from LOH, DCT + Duct
Also increases K secretion

317
Q

What is the activity of prostate-specific antigen (PSA) ?

A

Serine protease

318
Q

What specialisation of muscle supports bladder function ?

A

Fibres arranged in multiple directions

319
Q

What molecule is produced as part of the kidneys endocrine function ?

320
Q

What other organ participated in Vit D synthesis?

321
Q

What molecule should not be found in the golmerular filtrate ?

322
Q

Which ligament maintains the ante flexi on or the uterus ?

323
Q

What is the sclera ?

A

The white of the eye
Fibrous and elastic tissue

324
Q

What is the pupil ?

325
Q

What is the iris ?

A

Smooth muscle structure which controls pupil diameter
Sphincter pupillae and dilator pupillae

326
Q

What is the cornea ?

A

Avascular covering , transplant

327
Q

What does aqueous humour do ?

A

Secreted from ciliary bodies
Maintains eye pressure
Nutrients
Protection

328
Q

What is the vitreous chamber ?

A

Contains vitreous humour
Contains phagocytes to remove debris
Mainly water, avascular

329
Q

What is the retina ?

A

Light sensitive
Posterior
Contains rods (black + white) and cones (colour)

330
Q

What is the route of visual impulses ?

A

Retina
Optic nerve
Optic chiasm
Radiation
Occipital lobe

331
Q

What is the conchae (turbinates) ?

A

Increases nasal surface area
Increases chance of olfactory exposure

332
Q

What is fungiform papillae ?

A

Mushroom like
Front 2/3 of tongue

333
Q

What is foliate papillae ?

A

Leaf like
Vertical ridges
On the SIDE

334
Q

What is filiform papillae ?

A

Threadlike
Coating mechanism
Creates rough and abrasive texture

335
Q

What is vallate papillae ?

A

Only about 12
Contain minor salivary glands and some taste buds

336
Q

What is the chorda tympani ?

A

Branch of facial nerve
Carrier taste fibres from anterior 2/3

337
Q

What does the linguinal nerve carry ?

A

Sensory fibres to the anterior 2/3

338
Q

What does the glossopharangeal nerve do ?

A

Supplies posterior 1/3

339
Q

What does the hypoglossal nerve do ?

A

Motor control of most tongue muscles

340
Q

What is in the middle ear ?

A

Malleus - attached to tympanic membrane
Incus (anvil)
Stapes (stirrup)

341
Q

What is the function of the ear ossicles (MIS) in the middle ear ?

A

Transmit vibrations

342
Q

What is the oval window ?

A

Opening into vestibule of inner ear
Closed by base of stapes

343
Q

What is the round window ?

A

Opening into the cochlear portion of ear

344
Q

What is the function of the cochlea ?

A

Sound amplification
Conversion from vibrational to electrical signal

345
Q

How does the cochlea transmit signals ?

A

Cochlear part of vestibulocochlear nerve

346
Q

What are the semicircular canals ?

A

For balance

347
Q

How do the semicircular canals send signals?

A

Vestibular part of the vestibulocochlear nerve

348
Q

What is otitis media ?

A

Infection causing inflammation and fluid build up behind the eardrum

349
Q

What are the 2 protective muscles in the inner ear ?

A

Stapedius reflex
Tensor tympani

350
Q

What is the Eustachian tube (auditory tube) ?

A

Connects nasopharynx to middle ear
Keeps air pressure the same as atmosphere
This allows tympanic membrane to vibrate

351
Q

What is the organ of Corti ?

A

In the Scalia media
Sensory epithelium containing auditory hair cells

352
Q

Where do sound vibrations terminate ?

A

The round window

353
Q

Where do high frequency sounds travel to ?

A

Base of cochlea

354
Q

Where do low frequency sounds travel to ?

A

The apex of the cochlea

355
Q

What do inner hair cells do ?

A

Turn vibrations into signals

356
Q

What do outer hair cells do ?

A

Amplify vibrations

357
Q

What is the tonotopic map ?

A

Arrangement of frequencies in cochlea
This is maintained up to primary auditory cortex

358
Q

What are the 5 primary tastes ?

A

Sour
Salty
Sweet
Bitter
Savoury

359
Q

What brain regions are responsible for taste ?

A

Solitary nucleus of the medulla
Thalamus
Gustatory cortex

360
Q

What are scent molecules dissolved by ?

A

Nasal mucus

361
Q

What is scent molecules on nasal mucus detected by ?

A

Rhodopsin-like detectors on the dendrites of olfactory cells

362
Q

What brain regions are responsible for smell ?

A

Amygdala
Hippocampus
Parahippocampul gyrus

363
Q

What is anosmia ?

A

Loss of smell
Caused by fractures, tumours and neurological disorders (+some viruses)
Effects quality of life

364
Q

Production of what molecules in inhibited by paracetamol ?

A

Prostaglandin

365
Q

What is PICO method ?

A

Population
Intervention
Comparison/control
Outcome

366
Q

What nerve doesn’t pass through the thalamus ?

367
Q

What type of receptors are the odorant receptors?

A

G-protein coupled

368
Q

What is the purpose of the inter-aural time difference ?

A

Localise the direction of sound

369
Q

What results due to opening of channels blocked by auditory hair ?

A

Depolarisation due to potassium influx

370
Q

What neurotransmitter is release from the basal surface of auditory hair cells ?

Y1 Medicine (5 decks)

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