Random Q's Flashcards
What is PICO?
Population, Intervention, Comparator, Outcome
Which vitamins cannot be absorbed as they are? How are they absorbed?
Vitamins A, D, E, K, also have to be absorbed via micelles.
Vitamin B12 has to be cleaved to intrinsic factor.
Where is pepsin produced?
Chief cells, produced as pepsinogen
What is FVC?
Forced Vital Capacity (Forced Expiratory Volume)
What are the four principles?
Autonomy, Non Maleficence, Beneficience, Justice
What causes the release of ADH/Vasopresin? What is it’s action?
Angiotensin II, Increase in CO2, Decrease in O2, low blood pressure
(Dehydration)
Causes water retention & vasoconstriction (concentration of urine) via increased aquaporin channels being inserted into DCT
In an ECG, what does the T Wave represent?
Ventricular Repolarisation
Which part of the respiratory tract has the highest resistance?
Trachea
What is required for an autonomous decision?
Mental Capacity
Informed Consent
What does ACE do and where is it produced?
In Lungs, and converts Angiotensin I to Angiotensin II.
What does G represent? What is this?
Vital Capacity. The maximum amount of air a person can expel from the lungs after a maximum inhalation. It is equal to the sum of inspiratory reserve volume, tidal volume, and expiratory reserve volume.
How is the gut divided? What is the blood & nervous supply to each division.
Foregut - oesophagus to first 2/3 of duodenum). Coeliac Trunk. Greater Splanchnic.
Midgut - lower duodenum to first 2/3 of transverse colon. Superior Mesenteric Artery. Lesser Splanchnic.
Hindgut - last third of transverse colon to upper part of anal canal. Inferior Mesenteric Artery. Least Splanchnic.
What is Helicobacter Pylori?
Gram negative bacterium found usually in stomach.
What is Poisseuilles Law?
In laminar flow: a small change in radius significantly affects either flow rate or pressure drop required to achieve the same flow. Bronchoconstriction in asthma is an example of this.
F = Pπr⁴ ÷ 8ƞL
F = flow, P = Pressure drop, R = radius, ƞ = velocity, L = length of pipe.
What is ventilation?
The exchange of air between atmosphere and alveoli. Air moves by bulk flow from a region of high pressure to low pressure.
What is blinding / double blinding?
A blind — or blinded — experiment is an experiment in which information about the test is masked (kept) from the participant, to reduce or eliminate bias, until after a trial outcome is known.
It is understood that bias may be intentional or unconscious, thus no dishonesty is implied by blinding.
If both tester and subject are blinded, the trial is called a double-blind experiment.
3 Situations where you can break confidentiality.
- Court Order 2. When it is in the public interest 3. When you have gained consent from the patient.
What is an airway obstruction (what will the FEV/1 ÷ FVC be?). Give an example
If it i higher than 0.7. Airway obstruction includes narrowing of bronchi and bronchioles, often due to excessive contraction of smooth muscle. Examples COPD and Asthma.
What is the downside of utilitarianism?
Doesn’t Look at the individual
At which week of development does Surfactant develop?
24 weeks
What is ideal blood pressure?
120/80mmHg
What is Boyle’s Law?
The absolute pressure of a gas is inversely proportional to the volume it occupies.
What is the Positive Predictive Value?
The proportion of positive test results that are True Positive.
What is cost effectiveness analysis?
A type of economic evalutation which compares the relative costs and outcomes of different courses of action. In health services, appropriate to monetise health effect. Typically a ratio. QALY (Quality-Adjusted Life Years - commonly used)
What does Angiotensin II do?
Increases Sympathetic Activity,
Tubular Na+ Cl- reabsorption and K+ excretion.
H20 Retention, Aldosterone Secretion.
Arteriolar Vasoconstriction, increase in blood pressure.
Acts on pituitary to secrete ADH.
What hormone causes ovulation?
Lutenizing Hormone
What is Meissner’s Plexus? Is it sympathetic or parasympathetic?
The submucosa plexus, lies in the submucsa of intestinal wall. Parasympathetic nerves coming from superior mesenteric artery.
What is the normal BMI Range?
18.5 - 24.9
How does pain travel to the brain? Where does it go to?
A Fibres - Myelinated - Faster travel - sharp pain
C Fibres - Dull Pain - burning pain
Hormones: Beta endorphins, cortisol
Pain awareness recognised in somatosensory cortex.
What does PTH do?
Regulation of serum calcium
Regulation of serum phosphate
Vitamin D synthesis
Give two examples of screening tests
Bowel Cancer Screening & Breast Cancer Screening
Which organs are Retroperitoneal?
S: suprarenal (adrenal) gland
A: aorta/IVC
D: duodenum (second and third part)
P: pancreas (except tail)
U: ureters
C: colon (ascending and descending)
K: kidneys
E: (o)esophagus
R: rectum
Name a local and hormonal vasodilator?
Local: Bradykinin, Hypoxia, Nitric Oxide
Hormonal: Adrenaline, Atrial Naturetic Peptide
What is Utilitarianism
Maximising Good - most happiness for the largest number of people.
In an ECG, what does the P wave represent?
Atrial Depolarisation
What layers is the epidermis divided into?
Stratum Corneum
Stratum Lucidum
Stratum Granulosum
Stratum Spinosum
Stratum Basale
Name three duties of a doctor (according to Tomorrows Doctors).
Make the care of your patient your first concern Treat patients as individuals and respect their dignity Be honest and open and act with integrity Take prompt action if you think that patient safety, dignity or comfort is being compromised. Never abuse your patients trust in you, or the public’s trust in the profession
What are the functions of the skin?
Protection
Sensation
Temperature Regulation
Immunity
Permits Movement and Growth
Excretion - Regulated by Sweat
Endocrine (Vitamin D Synthesis)
What are the functions of the nasal membrane?
- Cell Recognition
- Semi-Permeable
- Protective Barrier (Impermeable to ions)
- Containment and separation
- Cell signalling
What is Cardiac Output?
Cardiac Output (litres per minute) = Stroke Volume (ml) x Heart Rate (beats per minute)
What is LaPlace’s law?
The pressure within a bubble is equal to twice the surface tension divided by the radius.
P = 2T ÷ r (P = pressure within a bubble, T = surface tension, r = radius).
The smaller the bubble (i.e. the more curved the surface), the larger the radial component. The larger the radial component, the greater the tendancy to collapse. Smaller bubbles have greater internal pressure to keep them inflated
What are the stages of the ‘Stages of Change’ model?
Pre-contemplation, contemplation, preparation, action, maintenance, relapse.
What factors affect heart rate?
Autonomic Innervation, Hormones, Fitness Levels, Age
What is the anion gap?
Difference between the measured cations (positively charged) and measured anions (negatively charged) in serum, plasma and urine. Often calculated when attempting to identify cause of metabolic acidosis. If the gap is greater than normal then high-anion-gap metabolic acidosis is diagnosed.
What are the two types of skin corpuscles, how are they differentiated?
Pacinian and Meissners.
Pacinian are large, deep in the dermis and subcutaneous layer, sense course touch, vibration and tension. Onion appearance
Meissners are small, dermal papillae, sense lighht touch and have a spiral appearance.
What forms the carpal tunnel?
Flexor Retinaculum layer that median nerve and carpal bones are encapsulated within. Compression causes carpal tunnel syndrome.
How are conductive and sensorineural hearing losses differentiated?
Conductive. Problem or blockage in outer or middle ear, prevents sound from being conducted properly. Usually mild or moderate, can be temporary or permanent.
Sensorineural. Results from missing or damaged sensory cells (hair cells) in the cochlea. Can be mild, moderate, severe or profound. Irreversible and usually permanent. Hearing aids, middle ear implants or cochlear implants are reccomended.
What is secreted from Parietal Cells?
HCl & Intrinsic Factor
Which three places do the ureters narrow?
Exit from kidney
Pelvic Brim
Vesico-Ureteric Junction
Which cells begin stomach peristalsis?
Interstitial Cells of Cajal
What are C, D, and F
C : Expiratory reserve volume: the maximal volume of air that can be exhaled from the end-expiratory position
D : Residual Volume: the volume of air remaining in the lungs after a maximal exhalation
F : Functional Residual Capacity : the volume in the lungs at the end-expiratory position
Name a few criteria for screening programmes (Wilson & Jugner)
- The condition should be an important health problem 2. There should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific. 3. There should be an accepted treatment recognised for the disease. 4. The diagnosis and treatment should be cost-effective 5. There should be a recognisable latent or early symptomatic stage
What is an airway restriction (what will the FEV/1 ÷ FVC be?). Give an example
airway restriction if lower than 0.7. Lung Expansion is restricted. (TB, Pulmonary Fibrosis, Infant Respiratory Distress Syndrome - this is due to a deficiency of surfactant in lungs of a premature baby)
What are some of the causes of obesity?
Lack of physical activity, over-eating, sedentary lifestyles, not enough fruit or veg in diet, “Americanisation” of society, office-jobs, stress.
What are the two types of stress?
Distress - Negative
Eustress - Positive
How can you help someone to quit smoking?
NHS Helpline, Nicotine Replacement Therapy, Medication such as Bupropion
What happens when something is chronotropic?
Increase in the rate of contraction.
Krebs Cycle. What are the 8 acids?
Citrate
Isocitrate
Alpha-ketoglutarate
Succinyl Co-A
Succinate
Fumarate
Malate
Oxaloacetate
What is an amphipathic substance?
Both hydrophobic and hydrophilic.
Where is Angiotensinogen produced?
Liver
What are the four main functions of the kidneys?
Excretion of waste products and drugs. Involving Selective Reabsorption and excretion of substances as they pass through the nephron.
Regulation of body fluid volume and ionic composition. Homeostasis and acid-base balance.
Endocrine: Synthesis of Renin, Erythropoietin and Prostaglandins.
Metabolism: Vitamin D is metabolised to its active form in the liver. Major site of catabolism of low molecular weight proteins such as PTH, calcitonin and insulin.
Where is Aldosterone Synthase made? What does it do?
Zona Glomerulosa - It is a steroid enzyme involved in biosynthesis of aldosterone, which is essential in the Renin-Angiotensin-Aldosterone System.
What is the ation of OPG?
Non-competetive RANK-L Inhibitor. Reduces production of osteoclasts.
What are the three phases of digestion?
Cephalic Phase: Before food enters stomach. Results from sight, smell, thought or taste of food. Transmitted via vagus nerve and starts gastric secretion via ECL secretion of histamine which act on parietal cells.
Gastric Phase: Chemical, secretion from Chief cells, G cells, D cells, ECL cells, Parietal Cells.
Intestinal Phase: Negative and positive feedback mechanisms
What is the mucociliary escalator?
The non immunological defence mechanism involving ciliary action and flow of mucus from bronchioles through the bronchi and trachea to the larynx, by which particulate matter is removed from the respiratory tract.
What is M.U.S.T.?
Malnutrition Universal Screening Tool. Hospital test for whether someone is malnourished, have they eaten little/nothing for more than 5 days
What number should FEV1/FVC be?
0.7
What are the phases of drug metabolism in the liver?
Phase 1. CYP (Cytochrome P450 enzymes) = Oxidation/Reduction
Phase 2. Conjugation - Binding with Glucurolic Acid
Phase 3. Excretion
What will a lesion to the optic tract in the parietal lobe on the right side cause?
Inferior left homonymous quadrantionpia.
What is the innervation to the larynx?
Cricothyroid innervated by superior laryngeal nerve. The recurrent laryngeal nerve serves the rest of the thyroid.
What happens during isovolumetric contraction?
An event occurring in early systole during which the ventricles contract with no corresponding volume change. All valves are closed.
What is meta analysis?
The use of statistics in systematic reviews
What are the layers that oxygen has to diffuse through to red blood cells.
Surfactant
Alveolar Epithelium
Basement Epithelial Membrane
Interstitial Space
Capillary Membrane
Capillary Endothelium Membrane
Diffusion into Red Blood Cells
(pneumonic: Sometimes Andy Brings In Cray Cray Diseases)
What does Renin do, where is it produced?
Made in the kidney, joins with angiotensinogen to form angiotensin I
What does A represent? What is this?
Inspiratory Reserve Volume? The maximal volume that can be inhaled from the end-inspiratory level no matter who is the president
Where is Gastrin produced?
G Cells
What does Aldosterone do and where is it made?
Increases tubular Na+ Cl- reabsorption, and K+ excretion. H20 retention. Made in the Adrenal gland cortex.
How is fat digested?
Emulsification - bile from gallbladder
Triglyceride hydrolysis
Micellar Formation
4 Reasons why people smoke
Nicotine Addiction, Stress Relief, Trying to Lose Weight, Social Groups
What is Economic Efficiency?
A situation in which nothing can improve without something else being hurt.
How does the duodenum downregulate acid production?
Duodenal Distension, secretin, cck, parasympathetic innervation.
What happens when something is isotropic?
Increase in strength of muscular contraction.
What is Aurbach’s plexus? Is it sympathetic or parasympathetic?
Also known as the myenteric plexus. Motor Innervation to both muscular layers of the gut. Sympathetic input.
Which element is required in order for thyroid hormone to be effective?
Iodine
What four lipids make up the phospholipid bi-layer?
Phospholipids, Sphingolipids, Glycolipids and Cholesterol
In what forms is thyroid hormone released?
Tetra-iodothyronine, and triiodothyronine.
How does respiratory epithelium protect body from pathogens?
Cilia beats mucous along airway walls, trapping unwanted particles. eventually the mucus reaches the back of the mouth and the digestive system.
What hormonal reaction takes place when calcium levels are low?
Parathyroid glands release parathyroid hormone.
What is a systematic review?
Clearly formulated question that uses systematic methods to critically appraise evidence.
In an ECG, what does the QRS Complex represent?
Ventricular Depolarisation.
What is this graph showing? Fill in the blanks.
Myocyte Action Potential. Which ions go in and where.
What do the thyroid hormones do?
They act to increase the basal metabolic rate, affect protein synthesis, help regulate long bone growth (synergy with growth hormone) and neural maturation, and increase the body’s sensitivity to catecholamines (such as adrenaline) by permissiveness.
The thyroid hormones are essential to proper development and differentiation of all cells of the human body. These hormones also regulate protein, fat, and carbohydrate metabolism, affecting how human cells use energetic compounds. They also stimulate vitamin metabolism.
What is Daltons Law?
In a mix of gases, the pressure each gas exerts is independent of the pressure the others exert.
Ptotal = P1 + P2
What is the purpose of cost-utility analysis?
To estimate the ratio between the cost of a health related intervention and the benefit it produces in terms of the number of years lived in full health by the beneficiaries.
What is the mean arterial pressure?
Mean Arterial Pressure = Cardiac Output x Total Peripheral Resistance
Malabsorption of which vitamin can cause excessive bruising?
K
What do the thyroid hormones bind to when travelling in plasma?
Albumin & Thyroxine Binding Globulin
What does surface tension affect in respiration?
The alveolar lining. Surfactant keeps the surface tension at the right level for the pressure within the alveoli so they do not burst
What is FEV/1?
Forced Expiratory Volume in one second.
What are the three layers of the GI tract?
Mucosa, Submucosa, Muscularis Propria
Which enzymes are in the Krebs Cycle?
Aconitase
Isocitrate Dehydrogenase
alpha-ketoglutarate dehydrogenase
succinyl coA synthetase
succinate dehydrogenase
fumarase
malate dehydrogenase
Where does the gut derive from embryologically?
Endoderm.
A problem with the Sino Atrial Node will cause which wave to increase in size?
P Wave
What does Cholecystokinin do?
Causes contraction of the gallbladder and sphincter of Oddi opens.
What are the 5 body responses to stress? Give examples.
Biochemical - Lowered immune function, increased metabolic rate, altered hormone levels (adrenaline, cortisol, ACTH)
Physiological - High Blood Pressure , increased heart rate
Behavioural - Eating Habits, Use of alcohol/drugs
Cognitive - Poor memory, lack of concentration, worrying
Emotional - Low Moods, Anxiety, fatigue, loss of humour
What does B represent? What is this?
Tidal Volume. That volume of air moved into or out of the lungs during quiet breathing.
What is the hormone tested for in a pregnancy test?
Human Chorionic Gonadotrophin
Name a local and hormonal vasoconstrictor?
Local: Endothelin-1
Hormonal: ADH
Which metabolic factors reduce resistance and cause vasodilation?
Nitric Oxide. Phosphate. ADP. Hypoxia/Hypercapnia
Where is the major site of peripheral resistance?
Arterioles
What factors affect stroke volume?
Heart size, fitness, gender, contractility, duration of contraction, preload (EDV), Afterload (Resistance)
What are the four types of hypersensitivity?
Type I - IgE-Mediated Hypersensitivity (IgE is an antibody, essential in allergic reactions)
Type II - IgG Mediated Cytotoxic Hypersensitvity (IgG is a type of antibody, 75% of antibodies circulating in humans - 2 antigen binding sites)
Type III - Immune Complex Mediated Hypersensitvity
Type IV - Cell-Mediated Hypersensitvity
What is respiratory epithelium?
Pseudostratified Ciliated Columnar Epithelium
What is opportunity cost?
The cost of the next best alternative given up, in order to consume/produce a good or service.
The value (not the benefit) of the choice of a best alternative cost while making a decision. When a choice needs to be made between several mutually exclusive alternatives; assuming the best choice is made, it is the “cost” incurred by not enjoying the benefit that would have been had by taking the second best available choice.
Which week does sex differentiation occur at and how?
Week 7
Y Chromosome carries SRY gene - testis determining factor.
Wolffian Duct forms which forms Vas Deferens, Epididymis, Seminal Vesicles. Ejaculatory Duct.
In girls, the mullerian duct develops.
Describe Brown Séquard Syndrome.
Brown Séquard: Same side will lose Dorsal Medial Leminiscus Pathway & Corticospinal tract. Opposite side will lose spinothalamic.
Paralysis (Hemiplegia) and loss of proprioception, weakness, and loss of vibration sense and fine touch on the ipsilateral side.
Loss of pain and temperature sensation and crude touch on the contralateral side. 1 or 2 segments below level of lesion.
Where are baroreceptors located? What do they do?
The most important arterial baroreceptors are located in the carotid sinus (at the bifurcation of external and internal carotids) and in the aortic arch. They sense the blood pressure and relay the information to the brain, so that a proper blood pressure can be maintained. Exited by stretch of a blood vessel
What is Specificity?
The proportion without the disease that are correctly diagnosed.
Which cells release histamine?
Enterochromaffin-like cells (ECL Cells)
What will a lesion to the optic tract in the temporal lobe cause?
Meyers Loop. Superior left homonymous quadrantanopia.
What muscles are in the GI tract, are there any exceptions?
Mostly two muscles - longitudinal and circular.
In the stomach there are 3 muscle layers, oblique, longitudinal and circular
What is Henry’s Law?
The amount of gas dissolved will be directly proportional to the partial pressure of the gas with which the liquid is in equilibrium.
What is sensitivity?
The proportion with the disease that are correctly diagnosed.
How is stroke volume calculated?
Stroke Volume (SV) = End Diastolic Volume (EDV) - End Systolic Volume (ESV)
What are the protective components of the respiratory tract?
Mucus membrane. cilia, hair in nasal cavity, alveolar macrophages, airway constriction, coughing
What are some disadvantages to RCTs?
Expensive. High Drop out rates. Time Consuming.
What is a Randomized Control Trial?
A study in which people are allocated at random (by chance alone) to receive one of several clinical interventions. One of these interventions is the standard of comparison or control. The control may be a standard practice, a placebo (“sugar pill”), or no intervention at all. Someone who takes part in a randomized controlled trial (RCT) is called a participant or subject. RCTs seek to measure and compare the outcomes after the participants receive the interventions. Because the outcomes are measured, RCTs are quantitative studies.
What is an acinus?
Respiratory Bronchiole, Alveolar Duct, Alveolar Sac, Alveolus
Which cells produce surfactant?
Type II pneumocytes
Which organelles are responsible for the synthesis of proteins?
Ribosomes
What will a lesion to the optic chiasm cause?
Bi-temporal hemi-hemaniopia.
What are the function of the phospholipid membrane?
- Cell Recognition
- Semi-Permeable
- Protective Barrier (Impermeable to ions)
- Containment and separation
- Cell signalling
What are the functions of the nose?
nhalation and exhalation of air, olfactory organ, warming, humidifying and catching foreign bodies before air is passed into pharynx, larynx, trachea and lungs.
Downside to Deontology ?
You can’t always apply the principle. Duties can conflict.
How do negative feedback loops generally work?
When Gland X releases hormone X, this stimulates target cells to release hormone Y. When there is an excess of hormone Y, gland X “senses” this and inhibits the release of hormone X. Often the hypothalamus and pituitary involved.
What does E represent?
Inspiratory Capacity: the sum of IRV and TV
What are the carpal bones of the hand?
Trapezium, Trapezioid, Capitate, Hamate
Scaphoid, Lunate, Triquetrium, Pisiform
What stimulates baroreceptors?
Decrease in sympathetic stimulation.
Decrease in arteriolar vasoconstriction.
Decrease in blood pressure.
What are the layers of the adrenal cortex?
GFR. Zona Glomerulosa, Zona Fasciculata. Zona Reticularis
Which types of collagen are present in skin?
Type 1 collagen and type 3 collagen
Which nerves innervate the hand?
Median and Ulnar nerve. Median nerve thumb and first two finers.
Ulnar nerve little finger and part of fourth finger.
What is the difference between primary prevention, secondary prevention and tertiary prevention?
Primary Prevention: Before Disease - e.g. public health campaigns
Secondary Prevention: Early Disease - e.g. screening
Tertiary Prevention: Chronic Disease Management. Reducing long term effects. e.g. cardiac/stroke rehabilitation
What will a lesion to the right optic nerve cause?
Total loss of vision in the right eye
Which cells are the specialised macrophages of the liver?
Kupffer Cells
What is the formula for BMI? Include units.
Weight (kg)/ Height (m)²
Which of the virtue ethics is most applicable to doctors?
Deontology
What P Value would be statistically significant?
less than 0.05 reject null hypothesis, statistically significant
What is bile made up of?
Cholesterol and lecithin, also water, bile salts and bilirubin. Produced in liver and stored in gallbladder.
Where is 1,25 OH hydroxyvitamin D produced?
Kidneys
What stimulates Renin secretion?
Water and salt retention. Decrease in renal perfusion.
What is the inhibitory hormone of the gastric phase and where are they produced?
Somatostatin, secreted by D Cells
What increases acid production?
Histamine, Acetylcholine & Gastrin act on Parietal cells to produce more acid.
What inhibits ADH/Vasopresin?
Cortisol, Atrial Natriuretic Peptide
