Quiz Revision Flashcards
What does the term prodromal refer to when discussing disease characteristics?
Early stage of vague, non-specific symptoms
What is the difference between a sign and a symptom? and give an example of each.
Signs are objective and symptoms are subjective.
Sign – rash, tachycardia, fever.
Symptom – dizzy, nausea, pain
What is the name given to an increase in cell number via cellular division?
Hyperplasia
What does the term apoptosis mean?
Normal process of programmed cell death. Does not trigger an inflammatory response.
What are 2 characteristics of visceral pain?
Pain is usually referred, poorly localised, vague, and diffuse. Due to hollow organ stretching, hypoxia and inflammation.
What is the name given to an area of skin innervated by a specific spinal nerve?
Dermatome
Briefly define the term - iatrogenic.
Injury or disease caused by medical intervention or errors.
When discussing disease, what is the difference between incidence and prevalence?
Incidence is the number of new cases. Prevalence is the number of new, old, and existing cases.
List 2 chemical mediators that are involved in the inflammatory response.
Histamine, Cytokines, Leukotrienes, kinins, complement system, platelet activating factor.
Which area of the brain is responsible for temperature control?
Hypothalamus
What is the term given to the maintenance of a relatively constant internal environment?
Homeostasis
What fluid shifts occur when a hypotonic solution is infused into a normally hydrated patient?
Water will be drawn from the solution into the cells as the cells will have a higher solute concentration than the infused fluid.
Which hormone, secreted by the adrenal gland, stimulates the kidneys to reabsorb sodium and water? What effect would this have on blood pressure?
Aldosterone
Raises blood pressure
Which substance is released by the juxtaglomerular cells of the kidney in response to reduced blood volume?
Renin
An abnormal accumulation of water in the interstitial tissue is commonly referred to as what?
Oedema or Swelling
Which common electrolyte imbalance triggers the thirst reflex?
Hypernatraemia
Life threatening arrhythmias are a severe consequence of which electrolyte imbalance?
Hyperkalaemia
Which hormone “pulls” calcium from bones and increases absorption?
Parathyroid hormone
Which electrolyte is vital to support energy needs and oxygen transport?
Phosphorus
What is the name of the receptors that initiate a respiratory response to changes in pH?
Chemoreceptors
How long do renal compensatory mechanisms take to adjust pH?
Hours to days
Which acid-base imbalance is characterised by an excess of non-carbonic acid (non-volatile)?
Metabolic acidosis
What is the difference between volatile and non-volatile acids?
Volatile are excreted via respiration and non-volatile are excreted via the renal system.
In what stage of shock do rouleaux formations and capillary obstruction occur?
Decompensating. (Irreversible occurs when post capillary sphincters open allowing toxic by-products to circulate, widespread vasodilation occurs and
profound acidosis leading to organ failure)
Which coronary artery supplies blood to the conduction system?
Right
What is the formula for calculating MAP?
Diastolic pressure + 1/3 pulse pressure
What is the number 1 rule for shock management?
Always assume it is hypovolaemic until proven otherwise
What are the 4 stages of the progression of shock in the microcirculation?
Vasoconstriction, Capillary and venule opening, DIC, Multiple organ failure
What is the definition of cardiogenic shock?
Shock that occurs due to the inability of the heart to deliver adequate circulating volume for tissue perfusion.
List 3 non-modifiable risk factors for cardiovascular disease.
Gender, age, family hx, type 1 diabetes
Provide 3 management goals for the treatment of ACS.
Reduce workload, increase O2 delivery, minimise clot formation, initiate cardiac re-perfusion and prevent progression
Which type of angina is caused by vasospasm of the coronary artery?
Prinzmetal’s Angina – rather than by atherosclerosis or clots, typically occurs at rest through the night
What are the 2 main branches of the left main coronary artery?
Left anterior descending and circumflex
What type of MI is caused by micro-emboli becoming lodged in the distal coronary arteries?
Non-STEMI (STEMI occurs when a thrombus completely occludes a vessel for a prolonged period)
Describe the pharmacological management of chest pain of presumed cardiac origin.
Fentanyl, Oxygen, Nitrates, Aspirin (Fibrinolytic therapy)
What is the life-threatening condition that occurs as a result of left ventricular failure?
Acute Pulmonary Oedema
What condition is characterised by sudden syncope, pain in the back or abdomen and unequal BP readings?
Dissecting aneurysm
Asthma is a sudden or progressive narrowing of the airways caused by what 3 mechanisms?
Bronchospasm, swelling, increased mucous production
At what rate should an asthmatic patient be ventilated with a BVM?
4 – 6 breaths per minute
Allow extra time for air to be expelled
Which group of conditions results in destruction of alveoli and reduced surface area for gas exchange?
CAL – bronchitis and emphysema
An inability to lie flat due to breathing difficulties is termed?
Orthopnoea
What is the most effective long-term treatment for the management of chronic asthma?
Steroids
Describe the difference between high VQ and low VQ
High VQ – ventilation is normal but there is decreased perfusion “dead space” e.g., PE where vents are wasted
Low VQ – Ventilation is reduced but there is adequate perfusion “shunt” e.g., CAL, asthma, and APO
List 4 medical causes of seizures.
Hypoglycaemia, infection, tumours, febrile convulsions, drug withdrawal, eclampsia, CVA, epilepsy
What are the phases of an epileptic seizure?
Aura, Tonic, Clonic, Post-ictal
What is the medical terminology for difficulty speaking?
Dysphasia
Which type of strokes have a better prognosis – ischaemic or haemorrhagic?
Ischaemic
What are the 4 types of headaches identified?
Tension, Migraine, Cluster and Sinus
Typically, what percentage of beta cells are destroyed before Type 1 Diabetes manifests?
80-90%
List 3 common symptoms of hyperglycaemia.
Polyuria, polydipsia, polyphagia
What is the mechanism of action of Glucagon?
It stimulates glycogenolysis which requires stores of glycogen in the liver
Which autoimmune disease causes excess thyroid hormone secretion?
Graves
Cushing’s syndrome is caused by an excess of which hormone?
Cortisol (caused by excessive activity of the adrenal cortex)
In a hypersensitivity reaction which cells release Histamine?
Mast cells
Which type of disorder involves a failure in recognising or a loss of tolerance to self?
Autoimmune disorder
What types of immune cells differentiate into plasma cells?
B Cells
What is the main difference between T cells and B cells?
T cells respond directly to attack invading organism and B cells produce antibodies. (cellular vs humoral)
How many bones are in the human skull?
22/23
What is the only human bone not attached to another bone?
Hyoid
For what operation was a Portuguese surgeon awarded the Nobel prize for in 1949?
Prefrontal lobotomy
The two main branches of the left main coronary artery are the left anterior descending and the ________________ artery
circumflex
In the cardiac conduction cycle, ventricular repolarisation is represented by the:
T wave
An increased parasympathetic tone leads to positive chronotropic, dromotropic and inotropic effects. T/F
False
The ____________ _____________ is the amount of blood pumped by each ventricle in 1 minute.
cardiac output
An increased parasympathetic tone leads to positive chronotropic, dromotropic and inotropic effects. TF
False
The ____________ _____________ is the amount of blood pumped by each ventricle in 1 minute.
Cardiac Output
The ___________ ___________ is the amount of blood ejected from each ventricle with each contraction.
Stroke volume
Stable angina is part of a spectrum of clinical disease collectively referred to as Acute Coronary Syndrome (ACS). T/F
False
Which of the following is NOT an underlying treatment goal for ACS patients?
Initiate re-perfusion measures
Increase platelet aggregation
Minimise clot formation
Reduce the workload of the heart
Increase platelet aggregation
Unstable angina is typically precipitated by physical exertion or emotional stress. T/F
False
When a spasm of the coronary artery causes a temporary occlusion and acute chest pain it is called:
Prinzmetal’s Angina
A myocardial infarction is usually the result of a ____________ that has occluded a coronary artery.
thrombus
An occlusion of the right coronary artery will result in an acute myocardial infarct in which area of the myocardium?
Inferior wall
A STEMI is diagnosed by the development of elevated ST segments in two or more contiguous ECG leads. T/F
True
An ______________ MI often shows mainly a parasympathetic response.
Inferior
Which of the following signs/symptoms are not an indication of acute left sided heart failure?
Respiratory crackles
Shortness of breath
Peripheral oedema
Pink frothy sputum
Peripheral oedema
What signs/symptoms make up Beck’s Triad as seen in cardiac tamponade.
- hypotension,
- jugular venous distension,
- muffled heart sounds.
What is an AAA?
Abdominal aortic aneurysm - occurs when atherosclerosis or plaque buildup causes the walls of the abdominal aorta to become weak and bulge outward like a balloon
The most common site for a AAA is below the iliac arteries and above the femoral arteries. T/F
False
Aortic aneurysms stay asymptomatic if they remain stable? T/F
True
When a AAA ruptures the patient often presents with hypotension and bradycardia. T/F
True
Bradycardia that is present in a suspected AAA rupture is due to stimulation of the ___________ nerve.
Vagus
Which of the following signs/symptoms is NOT consistent with the rupture of an aortic arch aneurysm?
Vasodilation
Sudden onset maximal pain
Unequal BP’s
Tearing chest pain
Vasodilation
An acute bacterial infection that results in vegetative growths on the valves of the heart is called _______________.
Endocarditis
Endocarditis may cause characteristic signs including;
Janeway lesions
oslers nodes
splinter haemorrhages under the nails
Pericarditis often presents with global ST depression on a 12 lead ECG. T/F
False
The pericardium is made of 2 layers - the visceral and the ________________ layers.
Parietal
Place the following airway structures in order from upper airway to lower airway.
Oropharynx Larynx Trachea Bronchioles Alveoli
What is the physiological function of surfactant?
Reduction of surface tension in the alveoli
At the commencement of expiration, intrapulmonary pressure is lower than atmospheric pressure. T/F
FALSE
The term given to the maximal volume of air expired following a passive expiration is;
Expiratory reserve volume
The nerve that supplies the diaphragm is called the ____________ nerve.
Phrenic
A patient suffering from a _________ VQ mismatch has adequate ventilation but reduced perfusion.
High
The process of gas exchange between the alveoli and the capillary bed is called;
Diffusion
A breathing pattern characterised by deep and rapid respirations is known as ________________ respirations
Kussmaul
A respiratory disorder characterised by abnormal permanent enlargement of the distal air spaces is called;
Emphysema
Which of the following physiological changes occur in emphysema?
- Altered VQ ration
- decreased structural support
- loss of elastic fibres
- airway narrowing
- loss of surface area for gas exchange
loss of surface area for gas exchange
In CO2 dependent patients hypoxia becomes the driving force for their respiration. T/F
TRUE
Patients with emphysema sometimes present with pursed lip breathing in an attempt to increase pressure in their ____________
Alveoli
Chronic bronchitis is characterised by an increase in the amount of ________________ producing cells.
Mucus
Which of the following signs/symptoms are NOT associated with chronic bronchitis?
Hypocapnia
polycythemia
cor pulmonale
pulmonary hypertension
Hypocapnia
Intravenous adrenaline should be administered immediately in an acute severe asthma attack.
False
Intrinsic asthma is non-allergic and first occurs later in life. T/F
TRUE
A decrease in systolic blood pressure and and pulse pressure during inspiration is called;
Pulsus paradoxus
A patient suffering a respiratory arrest secondary to asthma should be ventilated at a rate of 12 - 16 breaths per minute. T/F
False
Streptococcus Pneumoniae is still responsible for up to 90% of bacterial pneumonias. T/F
Flase
In the treatment of acute pneumonia broncholdilators are recommended to help relieve dyspnoea.
False
The Pneumonia Severity Index helps to identify ______________ acquired pneumonia that can safely be treated with outpatient antibiotics.
Community
Which of the following physiological changes is consistent with acute respiratory distress syndrome (ARDS)?
- Decreased capillary permeability
- Diffuse alveolar capillary injury
- Increased systolic blood pressure
- Bronchoconstriction
Diffuse alveolar capillary injury
Croup is a common _____________ infection that often presents with a seal bark cough in children.
Viral
A very serious bacterial infection that causes a severe sore throat and may result in laryngeal spasm is _________________.
Epiglottitis
Less than 50% of pulmonary embolisms occur as a result of deep vein thrombosis. T/F
FALSE
Pain that is referred, poorly localised or vague and diffuse is called ______________ pain.
Visceral
A ___________________ is an area of skin innervated by a specific spinal nerve.
Dermatome
Regeneration is the process of damaged tissue being replaced with functional cells. T/F
True
Necrosis is the process of programmed cell death. T/F
FALSE
As the body works to maintain homoeostasis, any significant deviation from the normal range will be resisted and homeostasis restored through a process called a ___________ loop.
Negative feedback
When a disease develops quickly and has a short duration it is described as?
Acute
When a cell increases in size it is called
Hypertrophy
Angiotensin II is a potent vasoconstrictor that stimulates the release of _________________________ when circulating blood volume is reduced.
Aldosterone
Mannitol is a hypertonic solution that when infused into a normally hydrated person will cause the cells to swell and lyse. T/F
False
Insulin actively moves Glucose into the cell from the extracellular fluid. This is an example of;
Facilitated diffusion
Which of the following types of fluid lies between the cells and includes cerebrospinal fluid?
Interstital fluid
Which of the following types of fluid lies between the cells and includes cerebrospinal fluid?
Interstitial fluid
_______________________________ is the maintenance of a relatively constant internal environment.
Homeostasis
A condition resulting from over stimulation of the blood clotting mechanisms, in response to a disease or injury, that may be fatal is;
DIC
A patient that is exhibiting anxiety, confusion, irritability, muscle cramps, seizures and tetany should be suspected of suffering from;
Hypocalcaemia
Antidiurectic Hormone Acts on which of the following structures?
Descending loop of henle
Collecting ducts
Any condition that increases carbonic acid, or decreases the base bicarbonate, causes…
Acidosis
Hypercalcemia occurs when the rate of calcium entry in the ECF exceeds the rate of excretion by the kidneys. T/F
TRUE
Hypernatremia can be caused by all of the following EXCEPT:
Fever and heat stroke Diabetes Insipidous Near drowning in salt water Rapid infusion of large volumes of fluid Extensive burns
Rapid infusion of large volumes of fluid
Hyponatraemia refers to a deficiency of K+ in relation to body water, and is a common electrolyte imbalance T/F
FALSE
Persistent hypernatraemia only occurs in people who can’t drink voluntarily such as infants, the elderly, or unconscious patients.
When sodium levels increase, ADH causes water to be retained, which helps lower sodium levels. T/F
TRUE
Slight movement outside the normal ranges for serum potassium (K+) is inconsequential T/F
FALSE
Vomiting, diarrhoea, diaphoresis, CCF and renal failure may lead to…
Hyponatremia
What is the normal pH range in humans?
7.35 - 7.45
Which of the following conditions would not result in a metabolic acidosis
Shock
Chronic Steroid use
Diabetic Ketoacidosis
Renal failure
Chronic steroid use
Which electrolyte imbalances results in flatten T wave and ST segment depression
Hypokalaemia
Hypercapnia is the retention of….
CO2
Shock can be defined as…
a condition characterised by a progressive decrease in tissue perfusion due to a reduction in effective circulating volume
The amount of blood pumped by the ventricles in one minute is the _______________ ________________
Cardiac output
Preload is the total resistance against which blood must be pumped and is affected by total peripheral vascular resistance.
False
When a patient is developing shock, the initial response is vasoconstriction. Which of the following physiological changes are occurring during this stage?
Post-capillary venules constrict
Increased capillary hydrostatic pressure
Pre-capillary arterioles constrict
You are attending to a 75 year old patient suffering heart failure. On examination you find his blood pressure to be 105/60 mmHg. You decide to calculate his Mean Arterial Pressure and it is;
75 mmHg
Failure to properly treat shock during vasoconstriction will cause pre-capillary sphincters to relax resulting in expansion of the vascular space. T/F
TRUE
During the decompensatory phase of shock a decrease in the amount of oxygen to the cells results in which acid base imbalance?
Respiratory acidosis
Which electrolyte imbalance occurs during the ‘washout phase’ of Disseminated Intravascular Coagulation where the cells lyse and die?
Hyperkalaemia
During the compensatory phase of shock the signs and symptoms include an increase in heart rate, increase in respiratory rate and ___________________ in systolic blood pressure.
Increase
Severe and prolonged diarrhoea and vomiting can result in __________________________ shock.
Hypovolemic
The hypotension in anaphylactic shock is caused by decreased capillary permeability allowing fluid to leak into the interstitial space. T/F
False
Crystalloid solutions do not exert as much ___________________ pressure as colloid solutions resulting in faster equilibrium between the intravascular and extravascular spaces.
Osmotic
A patient presenting in respiratory arrest secondary to an opiate overdose is likely to be suffering respiratory alkalosis.
False
During an airway obstruction and subsequent respiratory acidosis the body will attempt to compensate for the acid base imbalance by;
Kidneys conserve bicarbonate and excrete hydrogen ions
Metabolic acidosis secondary to extreme exertion occurs due to anaerobic metabolism resulting in a build up of _______________ _______________.
Lacitc acid
Diabetic Ketoacidosis occurs as a result of a diabetic patient taking too much Insulin which leads to the cells not receiving enough glucose and breaking down fats for energy. T/F
FALSE
Kussmaul’s respirations and excessive thirst are signs of metabolic acidosis secondary to;
Diabetic ketoacidosis
The acid base imbalance respiratory _________________ is caused by an increased elimination of carbon dioxide through hyperventilation.
Alkalosis
Blood is composed of approximately 55% plasma and 45% formed elements. T/F
TRUE
Your patient has a temperature of 39 degrees and is hypotensive. For every degree the patient’s body temperature rises their insensible fluid loss increases by ________ mls. per day.
200
Osmosis is the diffusion of water through a semi permeable membrane from an area of low water concentration to an area of high water concentration. T/F
FALSE
Which of the following electrolytes has a significant role in action potentials, glycogen storage and acid base balance?
Potassium
An under-active parathyroid gland may result in hypocalcaemia. T/F
TRUE
Which electrolyte imbalance is characterised by kidney stones, bony pain, arrhythmias and decreased muscle tone?
Hypercalcaemia
