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WJEC Medical Science-UNIT 6 > Pre-release > Flashcards

Pre-release Flashcards

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USMLE® Step 1 flashcards Biology 101 flashcards
1
Q

How does light enter the eye?

A

Through the front of the eye (cornea) through an opening (pupil) between rings of muscle (iris) and hits the lens. the lens then focuses light on a layer at the back of the eye called the retina which contains phtotreceptors cells called rods and cones.

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2
Q

What are cones repsonsible for?

A

detailed, high light intensity colour vision.

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3
Q

Where are cones mainly found?

A

at a region of the retina called fovea

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4
Q

What is the fovea?

A

A part of a larger section of the eye called the Macula. The macula takes up about 10% of our field of vision and it is where our vision is the sharpest.

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5
Q

what is age-related macular degeneration?

A

A disease that affects older people, usually over 50 years old. It is a gradula accumulation of damage to the macula, and therefore causes a loss of vision in the centre of field of view, where most detail is normally perceived

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6
Q

Patients with AMD, what can’t they do?

A

drive, read, watch televeison or do anything that requires detailed vision.

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7
Q

What are some other symtoms of AMD?

A

Charles Bonnet halloucinations

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8
Q

What can Charles Bonnet halloucinations form?

A

These can be simple unformed flashes of light, colours or shapes or more elaborate formds such as geometrical grids and lattices. Some people with CBS report seeing landscaped gardens or viastas, animals, people or processions of miniture costumed figures wearing hats, or even disembodies faces with staring eyes. The halloucinations are often seen in more vivid detail than real life.

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9
Q

What are the causes of AMD?

A

there is no known causes, however there may be a genetic element because AMD tends to run in families. Other causes include age, smoking, cardiovascular disease

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10
Q

What are the two forms of AMD?

A

Wet and dry

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11
Q

What is the difference between wet and dry AMD?

A

dry (gradual), wet (can be very rapid)

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12
Q

What is the wet form of AMD casued by?

A

the production of new blood vesseld under the macula in the eye, which are ‘leaky’. The leaky fluid may include blood and tissue fluid, whcih can dmage the photoreceptor cells and cause scarring of the macula. the new capillaries are made to grow by the production of a protein called vascualr endothelial growth factor (VEGF). Peopole with AMD tend to gave much higher levels of this protein than normal.

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13
Q

What is an optoneterist?

A

A healthcare professional who focuses on the physical mechanisms of the eye. they can carry out basic eye tests such as reading tests using corrective lenses

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14
Q

What is tonometry?

A

A test to messure the pressure of the fluid in the eye by pressing on the front of the eye, the cornea

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15
Q

What is tropicamide ?

A

Is a cholinergic anatgonist, which binds to acetylcholine receptors in the muscles of the iris to prevnt them from contracting. this causews the pupil to dilate and therefore tests, such as refraction tests with lenses and reading charts, can be more accurate

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16
Q

How is tropicamide administered?

A

as drops in the eye

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17
Q

What are some adverse reactions to tropicamide and what are these caused by?

A

stinging when applied=pain repsonse
blurred vision and sensitivity to light=extended action

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18
Q

What is an opthalmologist?

A

A medical doctor who specialises in the eye.

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19
Q

How does an angiogram work?

A

uses an oral or intravenous dye called florescein. this is added to the sytemic circulation and the eye illuminated with a specific wavelength or light. this highlights the blood vessels in the eye and allows a pciture to be taken of these vesseld to see if any are abnormal or ‘leaky’.

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20
Q

What are the tretament options for Dry AMD?

A

no treatment but glasses may be used to reduce the affects.

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21
Q

What do the treatments of wet AMD aim to do?

A

To reduce the production of new blood vessels caused by the increase in vascular endothelial growth fcator (VEGF).
These treatments don’t cure AMD, just significantly slow its progression.

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22
Q

What is the treatment ranibizumab do?

A

This is an antiangiogenic that cna be injected in the eye (about once to every 3 months). the drug is the FAB fragment of a monoclonal antibody that binds to VEGF and prevents it from binding to receptros. It was developed after anticancer antiangiogenics showed promise in treating wet AMD.

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23
Q

How is photodynamic therapy used for wet AMD?

A

A drug is injected into the bloodstream. very low power lasers are fired at the blood vessels at the back of the eye and this activates the drug, causing the formation of blood clos and sealing leaky vessels, reducing fluid build-up under the retina. this can only be used in specific cases of AMD.

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24
Q

What can a low vision clinic help with?

A

advice about contrast, lighting, magnification devices and other aids to help with low vision.q

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25
Q

Where are kidney stones mainly formed?

A

They can develop in one or both kidneys, and they mostly form in the pelvis/calyces or in the ureter.

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26
Q

what is the function of the kidneys?

A

Excretion (filtration of the blood to remove urea) and osmoregulation (Maintain blood at a constant water concentration despite salt and water intake).

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27
Q

what age do kidney stones mostly affect?

A

people over the age of 30

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28
Q

What are some symptoms of kidney stones?

A

Very samll kidney stones may go undetected and pass out painlessley when a patient urinates. larger stones can cause symptoms including:
-Pain in the side of the abdomen or groin
-severe abdominal pain that comes and goes.
-high temp (indicating infection)
-feeling sick or vomiting (indicating infection)
-urine infection, often with blood in the urine
-Persistant need to urinate or pain whilst urinating (kidney stones irrate the lining of the baldder, causing swelling and pain.

29
Q

Why can kidney stones cause infection?

A

This is because waste products are unable o pass teh blockage, which may cuase a build-up of bacteria. bacteria can release toxins and dmage tissue. this could trigger a humoral immune repsonse and further swelling.

30
Q

what are some causes of kidney stones?

A

One of the main risks is not drinking enough. people living in warm, dry climates or those that sweat a lot may be at higher risk of dehydration. other risk factors include family history, certain diets, obesity, digestive diseases, other medical conditions and certain supplements/medications.

31
Q

what are calcium stones?

A

The most common type of stone, usualluy in the form of calcium oxalate. oxalate is made by your liver or absorbed from your diet. certain foods have high oxalate content. high doses of vitamin D or metabolic disorders e.g. infalmmatory bowel disease or Crohn’s disease can increase concnetrations of calcium or oxalate. less commonly, stones are made of calium phosphate which can be as a result of renal tubular acidosis.

32
Q

What are some examples of struvite stones?

A

magnesium, ammonium, phosphate and calcium carbonate

33
Q

What are struvite stones usually casued by?

A

A urinary tract infection. The bacteria produce ammonia which can increase the PH of the urine and promoted formation of struvite.

34
Q

What are uric acid stones and what are they formed from?

A

Often found in the bladder. uric acid stones can form in people who lose too much fluid because of chronic diarrhea or malabsorption, those who eat a high-proetin diet, those with diabetes, meatbolic syndrome or gout. certain genetic fcators also may increase your rislk of uric acid stones

35
Q

For uric acid stones what happens when proteins are metabolised?

A

The PH of the urine drops below 5.5 and it becomes saturated with uric acid crystals.

36
Q

What are Cysteine stones?

A

These stones form in people with a hereditary disorder called cystinuria that cuases the kidneys to excrete too much of a specific amino acid (cysteine)

37
Q

Who will most likely diagnose kidney stones?

A

A GP will usually be able to diagnose kidney stones from a patient’s symptoms and medical histors.

38
Q

What are some diagnoatic tests that can be done for kidney stones?

A

-simple urine samples
- simple and complex urodynamic studies
-Examination of the stones that are passed
-Blood tests (haemotology

39
Q

How does a simple urine sample work in terms of kidney stones?

A

using a dipstick to checvk for substances in the urine including glucose, protein and ions.

40
Q

What do simple and complex urodynamic studies test for?

A

Includes any measurement technique which investigates how well the bladder, sphincters and urethra are storing and releasing urine.
-simple: recording the length of time is takes a person to produce a urinary stream, noting the volume of urine produced, the ability and inability to stop urine flow midstream.
-complex: taking pictures of the bladder filling and emptying, pressure monitors measuring the pressure inside the bladder and sensors recording muscle and nerve activity.

41
Q

What do blood tests measure in terms of kidney stones?

A

check taht the kidney’s are working properly, measurng ADH concentration oin the blood and the level of substances that could cause kidney stones.

42
Q

What are some treatment options for kidney stones?

A

Most kidney stones are small enough to be passed out in the urine and can be treated at home. to ease symptoms you can:
-drink plenty of fluids throughout the day
-over-the-counter painkillers, like ibuprofen
-An alpha-blocker such as tamsulosin which helps the stones pass.

43
Q

What is ibuprofen?

A

A non-sterodian anti-inflammatary drug (NSAID). Ibuprofen is a non-selective, reversible inhibior of COX enzymes. this decreases production of hormones involved with inflammation.

44
Q

How does tamsulosin work?

A

An alpha-blocker( bind to alpha adrenic receptors) which helps the stones pass. This is a selective adrenergic antagonist. Tamsulosin targets receptos on the sooth muscle or the urethra causing them to relax whcih eases the flow of urine.

45
Q

What is the recommended prevention of getting kidney stones?

A

Drink plenty of water each day to avoid dehydration. To prevent stones returning, three litres of fluid should be drunk throughhout the day.`

46
Q

What causes leptospirosis (weil’s disease)?

A

a bacterial infection of the blood and organs caused by bacteria of the leptospira genus of bacteria.
There are several different bacterial species who make up this genus.

47
Q

Who does leptospirosis cause disease in most?

A

most mammals including dogs, cats, cattle and pigs but it is especially prevelant in rats and other rodents.

48
Q

What type of bacteria is leptospira genus bacteria and how does it cause disease?

A

a gram-negative, spirochaete bacteria (spiral shaped) that migrates around the body of the animal host using its flagellum, until it reaches the kidneys. It then moves out of the blood and lives inside the proximal convoluted tubules in the microvilli of the epithelial cells. This means that individual bacterial cells are constantly ‘shed’ in the urine, and that is how bacteria passes from one host to another.

49
Q

How can leptospirosis be given to people?

A

water infected with the urine of infected animals can enter cuts, the eyes or mucous membranes of a person and the bacteria enters the blood. This can happen during outdoor swimming, kayaking or fishing, less commonly with people who work with animals or animal parts but is most common in sewage workers, farmers or rubbish collecters. It is more frequent after heavy rainfall in temperate and tropical areas.

50
Q

What are some symptoms of leptospirosis?

A

The most common symptom is a fever. Other symptoms include:
-headache
-nausea and vomiting
-aching muscles and joints
-red eyes
-loss of appetite

51
Q

What are these common symtoms for leptospirosis caused by?

A

The immune system of the infected person triggering the release of cytokines leading to inflammation.

52
Q

What happens if the bacteria from leptospirosis lives inside other organs of the body than the kidneys?

A

The bacteria causes dmage to these organs leading to multiple organ failiure.

53
Q

what happens to approximately 10% of leptospirosis cases?

A

They become serious which is reffered to as Weil’s disease.

54
Q

what are some seriou symptoms of leptospirosis ?

A

-jaundice (yellow skin and eyes caused by liver damage)
-being unable to urinate (kidney blockages)
-Swollen ankles, feet or hands
-chest pain, shortness of breath and coughing up blood (damage to alveolar walls of the lungs)
-Altered consciousness and sensitivity to light (brain swelling known as Meningoencephalitis-infection of both the meninges and brain tissue itself.)

55
Q

Who will most likely make a diagnosis of leptospirosis

A

a GP will diagnose after considering the symptoms shown by the patient and the risk of exposure of the patient to contaminated water supplies.

56
Q

Who needs to be notified by leptospirosis and why and how

A

It is a notifiable disease (to the UK helath security agency- previously knwon as Public Health England) and blood samples are sent to the National leptospirosis service (NLS) to confirm diagnosis

57
Q

What occurs in the testing for Leptospira DNA?

A

This is the test done within 5 days of symptoms. PCR is carried out on the blood smaple with primers designed to attach to Leptospira DNA. The blood cells and confounding proteins are removed from the blood sample and then the PCR is carried out. If the patient had the bacteria in their blood, the PCR will amplify the bacterial DNA. The new DNA is labelled with a fluorescent dye, so if the sample fluoresces under UV light, the bacterial DNA is present in the orginal sample.

58
Q

How does an ELISA test work for leptospirosis?

A

Detection of Leptospirosis antibodies in the patient’s blood (later stage infections).

59
Q

how does a microbiological culture of the leptospira bacteria work?

A

using liquid medium, leptospira bacteria can be directly observed using a microscope

60
Q

what is a treatment option for leptospirosis that isnt serious?

A

over-the-counter pain killers such as paracetamol, aspirin or ibuprofen

61
Q

What is an antibiotic used to treat leptospirosis ?

A

penicillin (Beta lactam-targets cell wall production)

62
Q

How can Doxycycline treat leptospirosis ?

A

Antibiotic- a tetracucline type antibiotic which interferes with bacterial ribosomes and prevents protein synthesis. these are usually given for 7 days.

63
Q

What happens if you have severe leptospirosis ?

A

Patients are taken to hospital and placed on intravenous doxycycline.

64
Q

What are some ways to prevent leptospirosis ?

A

-wash hands with soap and water after handling animals or animal products
-Clean any wounds as soon as possible and cover cuts and grazes.
-Do not touch dead animals with bare hands.
-Do not drink untreated water from rivers, canals or lakes.

65
Q

Why can age cause AMD?

A

Normal ageing processes can lead to structural and blood flow changes that can predispose patients to AMD

66
Q

How can family history (genetics) lead to AMD?

A

If you have a parent or sibling with AMD you have a 50% chance of getting it too.

67
Q

Why can smoking cause AMD?

A

Makes you up to 4 times more likely to develop AMD. The chemicals in the smoke are oxidants which can damage the retina.

68
Q

Why can Cardiovascular disease cause AMD?

A

The researcher suggested that the underlying heart and vascular disease likely compromises blood circulation in the eye which can lead to AMD.

69
Q

Why can vascular endothelial growth factor lead to AMD?

A

Plays a significant role in the formation of blood vessels that grow abnormally and leak beneath the macula. These blood vessels are fragile and can bleed which can lead to distortion of the retina.

WJEC Medical Science-UNIT 6 (14 decks)

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