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CS INT > Physiology > Flashcards

Physiology Flashcards

1
Q

O2 haem dissociation curve right shift cause

A

Cadet face right:

CO2 (high)

Acidosis

(2,3)DPG (high)

Exercise

Temperature (high)

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2
Q

Haldane effect

A

Left shift

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3
Q

Bohr effect

A

Right shift : at a given PO2, the oxygen is released more easily

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4
Q

Furosemide place of action

A

ascending loop of henle

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5
Q

Thiazide place of action

A

distal tubule and collecting segment

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6
Q

Spirnolactone place of action

A

Collecting tubule

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7
Q

Endocrine response to surgery

A

Increased ACTH and cortisol

Aldosterone

Vasopressin

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8
Q

Result of increased cortisol

A

Increased glucose

Protein breakdown

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9
Q

Lung volumes

A

Vital capacity (max inspiration and expiration)

Tidal volume (normal cycle)

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10
Q

A gamma fibres convey

A

Motor proprioception

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11
Q

A beta fibres convey

A

Touch and pressure

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12
Q

B fibres convey

A

autonomic NS

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13
Q

C fibres convey

A

mechanothermal stimuli

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14
Q

Optic tract lesions and visual field defects

A
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15
Q

Examples of oncogenes

A

Growth factors e.g. Sis

Transcription factors e.g. Myc

Receptor tyrosine kinase e.g. RET

Cytoplasmic tyrosine kinase e.g. Src

Regulatory GTPases e.g. Ras

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16
Q

Examples of tumour suppressor genes

A

BRCA 1 and 2

p53

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17
Q

Gastric acid secretion phases

A
  1. Cephalic 30%
  2. gastric 60%
  3. intestinal 10%
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18
Q

Cephalic phase of gastric acid secretion

A

Smell/taste

Vagal stimulation causing gastrin release from G cells

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19
Q

Gastric phase of gastric secretion

A

Stomach distension causes gastrin release

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20
Q

Intestinal phase of gastric acid secretion

A

High acidity inhibits CCK and secretin secretion

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21
Q

Factors inducing gastric secretion

A

Vagal activity

Gastrin

Histamine (from enterochromaffin cells)

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22
Q

Factors inhibiting gastric secretion

A

Secretin

Cholecystikinin

Somatostatin

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23
Q

Cells responsible for gastric acid release

A

Parietal cells

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24
Q

Which cells produce gastrin

A

G cells in antrum of stomach

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25
Q

Which cells produce CCK

A

I cells in upper intestine

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26
Q

Which cells produce secretin

A

S cells in upper intestine

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27
Q

Secretin vs CCK

A

Secretin: stimulates water and bicarb release to neutralise chyme acidity

CCK: stimulates enzymes release

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28
Q

Which cells produce VIP

A

Small intestine/ pancreas

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29
Q

Which cells produce somatostatin

A

Delta cells of pancreas and stomach

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30
Q

Which cells produce intrinsic factor

A

parietal cells

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31
Q

Obstructive lung disease pulmonary function test

A

FEV1 reduced

FVC normal

FEV1/FVC <70%

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32
Q

Restrictive lung disease pulmonary function test

A

FEV1 normal

FVC sig reduced

FEV1/FVC >70%

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33
Q

Brainstem respiratory centres

A

Medullary resp centre

Apneustic centre

Pneumotaxis centre

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34
Q

Medullary resp centre

A

Has both inspiratory and expiratory neurons

Depressed by opiates

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35
Q

Apneustic centre

A

Lower pons

Stimulates inspiration

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36
Q

Pneumotaxis centre

A

Upper pons

Inhibits inspiration (apneustic centre)

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37
Q

Where are peripheral chemoreceptors located

A

Birfurcation of carotid arteries

Arch of aorta

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38
Q

What do the peripheral chemoreceptors respond to

A

Drop in O2,

Increased CO2, H+

(In arterial blood)

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39
Q

Where are central chemoreceptors located

A

Medulla

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40
Q

What do central chemoreceptors respond to

A

Increased H+ in brain

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41
Q

Stages of wound healing

A

Haemostasis

Inflammation: Day 1-5

Regeneration: Day 7 to 56

Remodelling: 6 weeks to 1 year

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42
Q

Inflammation stage of wound healing

A

Neutrophils migrate

Growth factors: eg VEGF

Fibroblasts migrate

Macrophage and fibroblast matrix regeneration and clot substitution

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43
Q

Regeneration stage of wound healing

A

Growth factors stimulate fibroblasts to produce a collagen network

Angiogenesis occurs

Wound resembles granulation tissue

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44
Q

Remodelling stage of wound healing

A

Fibroblasts become myofibroblasts (tissue contraction)

Collagen remodelled

Microvessels regress leaving a pale scar

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45
Q

Drugs that impair wound healing

A

NSAIDs

Steroids

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46
Q

Stages of bone healing

A
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47
Q

Which hormones increase in response to surgery

A

Pituitary : GH, prolactin, ACTH

Adrenal: cortisol, aldosterone

Pancreas: glucagon

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48
Q

Which hormones reduce in level in response to stress

A

Insulin

Testosterone

Oestrogen

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49
Q

Phagocytosis stages

A

Stage 1: opsonisation (antibodies on surface of cells)

Stage 2: Adhesion to cell surface

Stage 3: Phagocytic vacuole formation

Stage 4: Lysosome fuse with vacuole and degrade content

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50
Q

Baroreceptor location

A

Carotid sinus

Arch of aorta

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51
Q

Baroreceptor refelx

A

Stimulated by arterial stretch

Carotid sinus afferent via CN9

Aortic arch afferent vis CN10

-> Increase PSN to SA node

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52
Q

Brainbridge reflex

A

Increased blood volume in right atrium causes an increase in HR (opposite of baroreceptor reflex)

(eg rapid transfusion leads to tachycardia)

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53
Q

What stimulates prolactin release

A

TRH

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54
Q

What inhibits prolactin release

A

Dopamine

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55
Q

Centre for thermoregulation

A

Hypothalamus

56
Q

Which electrolyte’s defficiency leads to calcium deficiency

A

Magnesium

(required for PTH secretion/ decreased mg makes cells hyperexcitable)

57
Q

TLCO def

A

Total carbon monoxide transfer factor

Rate of diffusion of a gas from alveoli into blood

58
Q

Conditions with increased TLCO

A

asthma

haemorrhage

left-to-right shunts

polycythaemia

59
Q

Water reabsorption site in GI tract

A

Majority absorbed in jejunum

60
Q

Water reabsorption site in renal tubule

A

2/3 in proximal convoluted tubule

61
Q

Drug causes of SIADH

A

Carbomezapine

SSRI

Sulfonylurea: eg gliclazide

TCA: eg amitriptyline

62
Q

Normal intracranial pressure range

A

7 - 15 mmHg

Can accommodate up to 24 before sx appear

63
Q

Metaplasia

A

Abnormal change in the nature of the tissue

eg Barrets oesophagus

64
Q

Dysplasia

A

Replacement of one type of tissue with another

65
Q

Heterotopia

A

the tissue type that is found in the abnormal location is present there from birth and does not migrate to that site subsequently or arise as a result of metaplasia

eg Meckels diverticulum with lined with gastric tissue

66
Q

How to measure functional residual capacity, residual volume and the total lung capacity

A

Cannot be measured by spirometry

Needs helium dilution measurement

67
Q

Interphase stages

68
Q

Mitosis and cytokinesis stages

A

Prophase: nuclear membrane breaks down

Metaphase: chromosomes aligned at the centre

Anaphase: chromosomes pulled opposite direction

Telophase: Nuclear membrane forms

Cytokinesis: cytoplasm divides

69
Q

What is absorbed in terminal ilieum

A

Bile salts

B12

70
Q

What is absorbed in duodenum

A

Calcium

Iron (and upper jejunum)

71
Q

Factors that increase 2,3 DPG

A

Chronic anaemia

High altitude

72
Q

Role of vasopressin

A

Aka ADH

Increased permeability to water in the distal tubule by insertion of aquaporin channels in apical membrane

73
Q

Fluid proportions

A

65% intracellular

35% extracellular:

  • 5% plasma
  • 24% interstitial
  • 3% transcelullar
74
Q

How to measure anatomical dead space

A

Fowlers method: Inhale 100% oxygen to fill up the dead space with O2, measure the nitrogen concentration in exhale: this nitrogen has come from alveoli and not the conducting zone so the difference is representing dead space

75
Q

Which acute phase proteins reduce in level in response to stress

A

Albumin

Transferrin

76
Q

Hassals corpuscle

77
Q

Chovsek vs trosseau’s sign

A

Both hypocalcaemia

Chovstek: tap on facial nerve

Trosseau: BP cuff makes wrist flexion

78
Q

Reasboprtion in kidneys

A

Majority in proximal convuluted tubule

79
Q

Where in kidneys do NSAIDs work

A

Afferent arteriole

80
Q

Where in kidneys do ACEi work

A

Efferent arteriole

81
Q

Where is chemical trigger zone situated

A

Outside BBB

82
Q

Effects of Low mg on Ca

A

Low mg inhibits PTH-> reduces Ca

83
Q

Effect of aldosterone on K

A

Reduced serum K

(primary hyperaldosteronism, aka conns)

84
Q

Cardiogenic shock physiological changes

SVR

HR

BP

CO

A

SVR up

HR up

BP low

CO low

85
Q

Hypovolaemic shock physiological changes

SVR

HR

BP

CO

A

SVR high

HR high

BP low

CO low

86
Q

Septic shock physiological changes

SVR

HR

BP

CO

A

SVR low

HR high

BP low

CO low

87
Q

Neurological shock

SVR

HR

BP

CO

A

HR low

BP low

CO normal

88
Q

Opiates receptors

A

Gamma: analgesia + antidepressant

Kappa: analgesia + dissociative state

Mu: analgesia, reduce gut mobility, miosis

89
Q

ECG changes in hyper K

A

Tall t wave

No P wave

Broad ventricular complex

90
Q

Effect of Conn’s on K

A

Increased aldosterone

Sodium retension and loss of K

91
Q

Effect of ACEi on K

A

Reduced aldosterone -> low K

92
Q

Light’s criteria for transudate vs exudate

A

It is exudate if one of the following is true:

Effusion Protein:serum protein >0.5

Effusion LDH:Serum LDH >0.6

Effusion LDH >2/3 of upper level of range of serum LDH

93
Q

Causes of exudate

A

Infection

Malignancy

Inflammation

94
Q

Causes of transudate

A

Cardiac failure

Nephrotic syndrome

Atelectasis

95
Q

Where is EPO produced

A

In adults, peritubular fibroblasts of renal cortex

In infants, hepatocytes

96
Q

Where in cell cycle does p53 act

A

Stops cells from entering S phase

‘gaurdian of genome’

97
Q

Apoptosis vs necrosis energy

A

A: energy dependent

N: not energy dependent

98
Q

Apoptosis vs necrosis regulation

A

A: regulated

N: not regulated

99
Q

Apoptosis vs necrosis cell integrity

A

A: intact

N: breakdown

100
Q

Menstrual cycle phases

A

Menstruation

Follicular phase

Luteal phase

101
Q

Spontaneous muscle contraction at what calcium level

A

At HYPO calcaemia

102
Q

How does air embolus lead to death

A

Causes right sided ventricular obstruction, circulatory collapse and death

103
Q

Primary and secondary stimuli of carotid body receptors

A

Primary:drop in PaO2

Secondary: rise in PaCO2 or fall in pH

Stimulates ventilation

104
Q

Saliva composition

A

Water 99.5%

Enzymes: lipase, amylase

Antimicrobial: IgA antibody, lysozomes

105
Q

Ferritin function

A

Binds iron and stores it within the cells

106
Q

Transferrin function

A

Transports iron in blood

107
Q

Iron storage in body

A

60-70% within haemoglobin and myoglobin

Rest mostly bound to ferrtin intracellularly

some as Haemosiderin

108
Q

What is haemosiderin

A

Intracellular iron storing complex, made off ferritin, denatured ferritin and other materials

(commonly found within macrophages in areas where haemorrrahge has occured)

109
Q

Metabolic response to surgery

A

Initial slowing down ‘Ebb’

Followed by speeding up ‘flow’

110
Q

Events during Ebb phase

A

Reduced cardiac output

Reduced metabolic rate

Reduced glucose tolerance

Lasts up to 24hrs

111
Q

Events during flow phase

A

Increased CO, metabolic rate and glucose tolerance

Muscle catabolism and negative nitrogen balance

Lasts up to weeks post Ebb phase

112
Q

Changes caused by obesity to cardiovascular system

A

Increased blood volume -> left ventricular dilation -> reduced compliance of left ventricle

113
Q

What is the most important stimulus to respiration central chemoreceptors

A

H+ ions don’t cross BBB, whilst CO2 does.

Increased in the concentration of H ions in CSF stimulates the central chemoreceptors to fire

114
Q

Ejection fraction formula

A

Stroke volume/end diastolic volume

60%

115
Q

Starvation brain energy source

A

Ketone bodies from metabolising fatty acids

116
Q

Loop of henle physiology

A

Descending: concentrates as water is passively reasborbed

Ascending: dilutes as sodium is actively reabsorbed

117
Q

Anasarca

A

generalised oedema secondary to cardiac or liver failure (as opposed to specific site oedema)

118
Q

Blood brain barrier location

A

Most areas of the brain are covered in BBB,

119
Q

Brain blood barrier function

A

To avoid entry to toxins and pathogens into the CSF

120
Q

Examples of areas not covered by BBB

A

Posterior pituitary (needs holes big enough to release hormones into blood)

Medial hypothalamus (hormones from anterior pituitary enter the blood through this)

Area postrema (part of brainstem responsible for picking up toxins)

121
Q

BBB structure

A

Astrocytes surround tight junctions of the capillaries

122
Q

The normal range for anion gap

A

10 - 18 mmHg

123
Q

Causes of raised anion gap

A

Addition of either intrinsic or extrinsic acid

Lactate: shock, hypoxia

Ketones: diabetic ketoacidosis, alcohol

Urate: renal failure

Acid poisoning: salicylates, methanol

124
Q

Causes of reduced anion gap

A

Low albumin

High Ca, Mg

125
Q

Salicylate poisoning acid base disturbance

A

First causes stimulation od resp centre leading to resp alkalosis

Later direct acid effect of salicylate + acute renal failure causes met acidosis

126
Q

Laplace’s law

A

A hollow organ with a circular cross section, total circumferential wall tension depends on wall thickness, circumference of the wall and wall tension

eg a rise in ventricular pressure during ejection is due to change in heart size, a dilated heart will have impaired systolic function

127
Q

Starlings Law

A

increased end-diastolic volume produces a larger stroke volume

128
Q

Peristalsis in oesophagus

A

Circular muscle contracts so the food doesn’t go backwards

Longitudinal muscle contracts and propels the food forward

129
Q

Primary vs secondary peristalsis

A

Primary lasts 9 seconds and moves food from the oesophagus to stomach

Secondary occurs when food left in the oesophagus stimulates the stretch receptors to push it into oesophagus

130
Q

Types of colonic peristalsis

A

Segmentation contractions

Antiperistaltic contractions towards ileum

Mass movements

131
Q

GFR definition

A

total volume of plasma per unit time leaving the capillaries and entering bowman’s capsule

132
Q

Renal clearance

A

volume plasma from which a substance is removed per minute by the kidneys

133
Q

Effect of activated vit d vs PTH on phosphate

A

Vit d: increases renal reabsorption

PTH: reduces renal reabsorption

134
Q

Vit D effects

A

Increase Ca and PO4 (through kidney and gut)

Low level: increases osteoblastic activity

High level: increases osteoclastic activity

135
Q

Which cells does PTH work on

A

Activates osteoblasts to produce a signal which leads to activation of osteoclasts

136
Q

Mech of action of carbimazole

A

Inhibits thyroid peroxidase enzyme

CS INT (13 decks)

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