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Medicine year 1 semester 2 > Questions > Flashcards

Questions Flashcards

1
Q

Digesting Maltotriose and Maltose

A

Enzyme- Maltase

Products- Glucose

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2
Q

Digesting Lactose

A

Enzyme- Lactose

Products- Glucose and Galactose

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3
Q

Digesting Sucrose, Maltotriose and Maltose

A

Enzyme- Sucrase

Products- Fructose and Glucose

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4
Q

Digesting α-limit dextrins, (Sucrose), Maltose & Maltotriose

A 
Enzyme= Sucrase-isomaltase
Products= Glucose and Fructose
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5
Q

Products of colonic fermentation

A

Digestion of carbohydrates by bacterial enzymes (to varying degrees) produces short-chain fatty acids, H2 & CH4.

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6
Q

Lactase deficiency

A 
Lactose intolerance (diarrhoea, cramps, flatulence).
Increased breath H2 due to bacterial digestion.
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7
Q

Glucose-galactose malabsorption

A

Defective intestinal SGLT1.
Osmotic diarrhoea.
Increased breath H2 due to bacterial digestion.

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8
Q

Sucrose-Isomaltose deficiency

A

Branched starch (alpha-limit dextrins) not digested fully to glucose.
Osmotic diarrhoea.
Increased breath H2 due to bacterial digestion.

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9
Q

Trypsin deficiency

A

Trypsin deficiency - marked protein malabsorption.

Severe diarrhoea, failure to thrive, hypoproteinaemia & resulting oedema.

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10
Q

Enterokinase deficiency

A

Presents as trypsin deficiency

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11
Q

Hartnups disease

A

Autosomal-recessive
Defective neutral amino acid transport; System B (apical membrane).
Neutral aminoaciduria- neutral amino acid are absorbed by alternative amino acid transporters or in the di/peptide form but less are reabsorbed by the kidney, thus lost in the urine
Increase protein in diet to overcome any potential deficiencies, e.g. tryptophan

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12
Q

Cystinuria

A

Autosomal-recessive.
Defective system B0,+ or b0,+ (apical membrane).
Increased urinary excretion of cystine (stones for if urine is neutral or acidic, precipitates out) & cationic amino acids.
No nutritional imbalance as absorption in di/tripeptide form compensates for defective amino acid uptake. However cationic amino acids and cystine liberated in the body are not reabsorbed by the kidney

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13
Q

Lystinuric protein intolerance

A

1) Autosomal-recessive.
2) Defective cationic amino transport, System y+L, (basolateral membrane).
3) Cationic aminoaciduria. Vomitting, diarrhoea and coma when fed protein.
4) Arginine & ornithine deficiency- restricted urea cycle (hyperammonaemia).
5) Lysine deficiency - skeletal & immunological abnormalities.
6) Restrict protein in diet. Supplement with citrulline (neutral) to increase urea cycle function as it can enable sufficient urea cycle function for adequate protein absorption to live.

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14
Q

Nucleic acid absorption

A

1) Digestion in the Gut lumen- Pancreatic DNAse and RNAse
2) Absorption in small intestines- Nucleotides and Nucleosides. Na+ coupled and accumulative transport (N1, N2). Facilitative transport
3) Semi-essential- supplemented in formula milk

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15
Q

Differences between the jejenum and Ileum

A

Jejenum- left upper quadrant, thick wall, longer vasa recta, few arcades, less fat in mesentery
Ileum- lower right quadrant, thin wall, shorter vasa recta, many arcades, more fat in mesentery, Peyers patch

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16
Q

Where does the rectum begin

A

S3- rectosigmoid junction

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17
Q

Blood supply to the rectum

A

Superior rectal artery- branch of IMA
Middle rectal artery- branch of internal iliac
Inferior rectal artery- branch of internal pudenal artery from the internal iliac

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18
Q

Femoral hernias

A

Herniation of the abdominal contents through the femoral canal. Occurs below the inguinal ligament at the top of the thigh. Goes through the femoral ring.
Risk of- incarceration, obstruction, strangulation

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19
Q

Contents of the femoral triangle

A

Femoral nerve, femoral artery, femoral vein. Y-fronts and femoral canal (containing lymphatic vessels and nerves

20
Q

Identifying direct hernias

A

Reduce hernia, palpate the deep inguinal ring and ask the patient to cough, if it reappears then its a direct hernia

21
Q

Direct inguinal hernia

A

1) The peritoneum enters the inguinal canal via a weakness in Hesselbachs triangle and will proceed to the superficial inguinal ring.
2) Occurs medially to the epigastric vessels

22
Q

Hesslebachs triangle

A

Rectus abdominis muscle- medial border
Inferior epigastric vessels- lateral border
Poupart’s ligament (inguinal ligament)

23
Q

Indirect inguinal hernia

A

1) More common than direct
2) Peritoneum enters the inguinal canal via the deep inguinal ring and proceeds down the inguinal canal to the superficial ring and reaches the scrotum
3) Lateral to the epigastric vessels
4) Can lead to a big herniations of the peritoneal contents such as the bowel down into the scrotum

24
Q

Identifying an indirect inguinal hernia

A

Reduce the hernia, palpate the deep inguinal ring and ask the patient to cough. The hernia will remain reduced

25
Q

Where is S.aureus found

A

Cold and cured meats- caused by staphylococcal enterotoxins A and B

26
Q

Vibrio cholera

A

Profuse rice water diarrhoea
Severe dehydration resulting in weight loss
Not common amongst travellers

27
Q

Differences between Secretory and Osmotic diarrhoea

A

Secretory- ion transport defect, not relieved by fasting, small osmotic gap. Caused by bile toxins, enterotoxins, laxatives, neuroendocrine, tumours, medications, allergies
Osmotic- Malabsorption, will stop after fasting, large osmotic gap. Caused by laxatives (osmotic), non-absorbed food, congenital/acquired defects

28
Q

Osmotic laxative

A

Lactulose

29
Q

Domperidone

A

Increases motility without purgation

30
Q

Muscles of the anterolateral wall

A

(1) Flat muscles – three flat muscles (external oblique, internal oblique and transversalis abdominis muscles), situated laterally on either side of the abdomen.
(2) Vertical muscles – two vertical muscles (rectus abdominis and pyramidalis), situated near the mid-line of the body.

31
Q

Difference between direct and indirect hernias

A

Direct inguinal hernias occur medial to the inferior epigastric vessels when abdominal contents herniate through a weak spot in the fascia of the posterior wall of the inguinal canal, which is formed by the transversalis fascia.
Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis.

32
Q

The percentage of GI cases in the under 5 caused by a viral cause

A

60%

33
Q

The main agent that causes Gastroenteritis

A

Norovirus- a single stranded RNA virus

34
Q

Infliximab

A

A monoclonal antibody directed against tumour necrosis factor alpha. Treats psoriasis, UC and Crohns

35
Q

Aminosalicyate

A

Consists of the sulphonamide sulfapyridine linked to 5-aminosalicylic acid, the latter forms the active moiety when released in the colon

36
Q

Paraumbilical hernias

A

More common in adults (especially women) than children. Associated with obesity and weak abdominal muscles

37
Q

Divarication of the abdominal wall

A

Not considered a hernia. Occurs when the rectus abdominus muscle becomes separated from the midline. The linea alba / aponeurosis becomes stretched but there is no hole. Not surgically treated

38
Q

Blood supply to the transverse colon

A

The transverse colon receives its blood supply from both superior and inferior mesenteric arteries. The proximal two thirds (lying towards the right colic flexure) are supplied by the middle colic artery, which is a branch of the superior mesenteric artery. The distal third (lying towards the left colic flexure) is supplied by the left colic artery, which is a branch of the inferior mesenteric artery.

39
Q

Types of Granulocytes

A

Eosinophil, Neutrophil, Basophil, Mast cell

40
Q

3 causes of increased vascular permeability

A

1) Direct cell damage
2) Endothelial cell retraction
3) Leukocyte mediated endothelial injury

41
Q

Sentinel cells

A

Mast cells, Macrophages and Dendritic cells

42
Q

What’s the side effects for adrenoreceptor antagonists

A

1) Tremor
2) Tachycardia
3) Cardiac dysrhythmias

43
Q

Nerve supply to the sublingual and submandibular duct

A

Parasympathetically by the Chorda tympani branch of the facial nerve (CNVII)

44
Q

Nerve supply to the parotid gland

A

Parasympathetically supplied by the Glossopharyngeal nerve

45
Q

What can cause a pleural effusion

A

Hypervolemia, decreased fluid protein, haemothorax, infection and inflammation

46
Q

Types of inflammation

A

1) Serous inflammation- skin blisters due to burns
2) Catarrhal inflammation- Allergic rhinitis
3) Fibrinous inflammation- fibrinous pericarditis
4) Haemorrhagic inflammation- acute pancreatitis
5) Suppurative/Purulent- abscess due to pyrogenic bacteria

Medicine year 1 semester 2 (61 decks)

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