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Sanjana MRCS > physiology > Flashcards

physiology Flashcards

1
Q

JVP - upward deflections and downward deflections?

A

Up: A - atrial contraction C -valve shuts, ventricle contracts - pressure on triscuspid upwards V -venous filling Down: X - atria relaxes,valves open,blood flowing from atria to ventricles X1 -RV contracts so much pressure in atria drops due to increased space in pericardial sac Y - ventricular filling

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2
Q

JVP absent A waves ? Large A waves? Cannon waves? Prominent V waves? slow Y descent? steep y descent

A

AF TS, RV hypertophy Complete HB TR TS, right atrial myxoma RVF, constrictive pericarditis, TR

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3
Q

Factors affected by Heparin (4)

A

2, 9, 10, 11

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4
Q

factors affected by DIC?

A

1,2,5,8, 11

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5
Q

factors affected by Liver disease

A

1,2,5,7,9, 10, 11

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6
Q

treatment for VW disease?

A

TXA and DDAVP - except in type 2b where DDAVP is contraindicated. will not be useful in type 3 -as no VWF at all - replacement

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7
Q

pulmonary artery pressures? sys/dias

A

25/10mmhg

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8
Q

LA mean pressure?

A

8-10mmhg

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9
Q

raised pulmonary cap wedge pressure (PCWP) of >20mmhg indicate?

A

pulmonary odemea

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10
Q

cerebral perfusion pressure equation?

A

MAP-ICP where map is diastolic bp +0.33(sys-dias)

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11
Q

what ileostomy output requires iv fluids?

A

20ml/kg/24 hrs

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12
Q

Volume of secretions? salivary glands stomach duodenum pancreas bile jej/ileum colon

A

1500 1500 100-2000 1000 50-800 3000 100

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13
Q

ileostomies?

A

lose 500-100ml/day Na 126 K22 more proximal stomas need isotonic not hypotonic IVI - otherwise worsening electrolyte imbalance

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14
Q

Treatment for anaphylaxis

0-6 months?

6months -6 years

6-12 yrs

adult

A
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15
Q

4 classes of shock?

blood loss

% loss

HR

BP

RR

urine output

symptoms

A
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16
Q

Lung volumes - think of image

Tidal volume

Insipratory reserve

expiratory reserve

vital capacity

residual volume

functional residual volume

total lung capacity

A
17
Q

FEV1/FVC in obstructive vs restrictive?

A

FEV1/FVC in obstructive disease -low like 50% as its hard to breathe out against the airway resistance. In RESTRICTIVE disease - high or normal. 90%. Due to the high elastic recoil of stiff lungs

18
Q

minute ventilation?

alveolar ventilation?

dead space - anatomical vs physiological

A

minute ventilation =tidal volume xRR

anatomical dead space - 150ml. all the air in the resp tract like nose, throat etc

increased by standing up, and bronchodilators

physiological - all the air not involved in gas exchange - 150ml

physiological deadspace increased by VQ mismatch - PE, COPD etc

alveolar ventilation = amount of fresh air entering the alveolii per min

thus minute ventilation -deadspace

19
Q

Potassium secretions?

salivary glands?

stomach

bile

pancreas

small bowel

rectum

A
20
Q

CAUSES of SIADH?

ABCD

A
21
Q

Causes of INCREASED anion acidosis?

A

MUDPILES

22
Q

required sodium equation?

A

125 - serum sodium) x 0.6 x body weight = required mEq of sodium

23
Q

Drug causes of hyperuricaemia?

(CAN’T LEAP)

A

Ciclosporin

Alcohol

Nictinic acid

Thiazides

Loop diuretics

Ethambutol

Aspirin

Pyrazinamide

24
Q

Causes of Hyperuricaemia?

increased synthesis (6)

vs

Reduced excretion

A
25
Q

Treatment for B12 deficiency?

A
  • if no neurological involvement 1 mg of IM hydroxocobalamin 3 times each week for 2 weeks, then once every 3 months
  • if a patient is also deficient in folic acid then it is important to treat the B12 deficiency first to avoid precipitating subacute combined degeneration of the cord
26
Q

Source, stimulus, and action of Gastrin?

CCK?

Secretin?

VIP?

Somatostatin?

Histamine?

Pepsin?

GIP?

A

KEY POINTS

CCK -made in the I cells of small int. reduces gastric emptying vs secretin which reduces gastric acid secretion

GASTRIC ACID – made by the parietal cells (body of stomach) HISTAMINE – Enterochromaffin like cells –paracrine mediators – the histamine also acts on the parietal cells

Pepsin: Digestion of protein, secretion occurs simultaneously with gastrin

Gastric inhibitory peptide: (produced in response to fatty acids) inhibits gastrin release and acid secretion from parietal cells

27
Q
A

Sanjana MRCS (8 decks)

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