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Foundations of Medicine JMO > Revision session unknowns > Flashcards

Revision session unknowns Flashcards

1
Q

What is the plasmalemma also known as?

A

Cell surface membrane

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2
Q

What molecules can diffuse easily through the cell surface membrane?

A

Water
Oxygen
Small, hydrophobic molecules

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3
Q

What are the characteristics of inclusions of a cell?

A

They are dispensable and may only be present as transients

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4
Q

What forms the microfilaments?

A

Actin molecules

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5
Q

Why are microfilaments dynamic skeletal elements?

A

Actin can assemble and dissociate

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6
Q

What are intermediate filaments made of?

A

6 different intermediate proteins

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7
Q

What are the microtubules formed from?

A

Alpha and beta tubulin
MAPs = Microtubule Associated Proteins

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8
Q

What is euchromatin?

A

Eu = Undergoing
DNA that is dispersed and is actively undergoing transcription

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9
Q

What is heterochromatin?

A

DNA that is tightly packed and is not undergoing transcription

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10
Q

What is the purpose of the golgi apparatus?

A

Modification and packaging
Adds sugars
Cleaves proteins
Sorts macromolecules into vesicles

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11
Q

What are the 3 main categories of intercellular junctions?

A

Occluding junctions (Zonula occludens)
Anchoring junctions
Communicating junctions (Gap junctions)

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12
Q

What are the 2 types of anchoring junctions?

A

Desmosomes (Macula adherens)
Adherent junctions (Zonula Adherens)

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13
Q

What are the main characteristics of an occluding junction?

A

Prevents diffusing (Occlude = block off)
Appears as a focal point between membranes

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14
Q

What are the characteristics of an adherent junction?

A

Link actin bundles via E-cadherin molecules

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15
Q

What are the characteristics of a desmosome?

A

Links intermediate fibres via attachment plaques
Common in skin

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16
Q

What are the characteristics of a communicating junction?

A

Contains a circular patch containing many connexion pores, allowing diffusion

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17
Q

Which type of epithelium produces keratin?

A

Squamous epithelium

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18
Q

What does a tendon connect?

A

Bone to Muscle

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19
Q

What does a ligament connect?

A

Bone to bone

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20
Q

What are the 4 main types of connective tissue?

A

Soft
Hard
Embryonic
Special

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21
Q

What are the 4 main types of soft connective tissue?

A

Loose
Dense
Reticular
Adipose

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22
Q

What are the 2 main types of dense connective tissue?

A

Dense regular
Dense irregular

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23
Q

What are the characteristics of a smooth muscle cell?

A

No striations
Cigar shaped nuclei
Form long fibres

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24
Q

What are the characteristics of a skeletal muscle cell?

A

Striations
Giant, multi-nucleated cells at sarcolemma periphery

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25
Q

What are the characteristics of a cardiac muscle cell?

A

Striations
Intercalated discs between cells
Single nucleus

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26
Q

What are the 2 main types of ground substance?

A

Glycoprotein
GAGs (Glycosaminoglycosides)

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27
Q

What supporting cells are found in the CNS?

A

Oligodendrocytes
Astrocytes
Microglia

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28
Q

What supporting cells are found in the PNS?

A

Schwann cells

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29
Q

What is the name of the connective tissue coat that surrounds the PNS?

A

Epineurium

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30
Q

What is the name of the connective tissue coat that surrounds the CNS?

A

Meninges

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31
Q

What is the function of microglia?

A

Immune surveillance

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32
Q

What is the function of an oligodendrocyte?

A

Produces myelin to myelinated nerves in the CNS

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33
Q

What is the function of an astrocyte?

A

Ion transport
Support
Forms the blood brain barrier

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34
Q

What are the 3 main layers of the GI tract?

A

Mucosa
Submucosa
Muscularis externa

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35
Q

What are the 3 layers of the Mucosa?

A

Epithelium
Lamina propria
Muscularis mucosa

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36
Q

What are the 2 layers of the muscularis externa?

A

Internal muscularis externa - Circular
External muscularis externa - Horizontal

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37
Q

What are the main layers of the blood vessel wall?

A

Tunica intima
Basal lamina
Basement membrane
Internal elastic membrane
Tunica media
External elastic membrane
Tunica adventitia

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38
Q

What is meant by dorsiflexion?

A

Flexion of the toes and foot upwards

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39
Q

What is meant by plantarflexion?

A

Extension of the toes and foot downwards

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40
Q

What action occurs when the thumb and pinkie are touched together?

A

Opposition
Reversed by reposition

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41
Q

What action occurs when the fingers are splayed out?

A

Abduction of digits
Reversed by adduction

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42
Q

What is meant by dorsal?

A

Posterior or Superior surface

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43
Q

What is the anterior surface of the hand called?

A

Palmar surface

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44
Q

What is the anterior surface of the wrist called?

A

Polar surface

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45
Q

What is the inferior surface of the tongue called?

A

Ventral surface

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46
Q

What is the inferior surface of the foot called?

A

Plantar surface

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47
Q

What are the 3 types of joints?

A

Synovial
Cartilaginous
Fibrous

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48
Q

What are the 2 types of cartilaginous joint?

A

Primary cartilaginous joint
Secondary cartilaginous joint

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49
Q

What is an example of a primary cartilaginous joint?

A

Synchondrosis - A joint at which bones connect via hyaline cartilage
e.g. epiphyseal growth plate

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50
Q

What is an example of a secondary cartilaginous joint?

A

Symphyses - A joint at which bones connect via fibrocartilage
e.g. intervertebral disc - A cartilaginous disc found between vertebrae

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51
Q

What are the 3 main types of fibrous joint?

A

Syndesmoses - Interosseous membrane
Sutures - Strong joint between skull bones
Fontanelle - Large suture between neonatal skull bones

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52
Q

What are the 3 main fontanelle types?

A

Anterior fontanelle
Posterior fontanelle
Lateral fontanelle

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53
Q

What are the 3 origins of the deltoid muscle?

A

Spine of scapula - Anterior
Acromion process of scapula - Middle
Lateral 1/3rd of clavicle - Posterior

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54
Q

What is the insertion of the deltoid muscle?

A

Deltoid tuberosity of humorous

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55
Q

What is the insertion of the biceps brachii?

A

Tuberosity of the radius

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56
Q

What are the origins of the biceps brachii?

A

Coracoid process of scapula
Supraglenoid tubercle of scapula

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57
Q

What type of muscle is the orbiculares oculi?

A

Circular

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58
Q

What type of muscle is the deltoid?

A

Pennate - meaning feather

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59
Q

What type of muscle is the biceps brachii?

A

Fusiform

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60
Q

What type of muscle is the external oblique?

A

Flat with aponeurosis

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61
Q

What type of muscle is the rectus abdominus?

A

Quadrate

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62
Q

What occurs in paralysis of a muscle?

A

No motor innervation, so reduced tone

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63
Q

What occurs in spasticity of a muscle?

A

No descending brain control
Increased, non descending tone

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64
Q

What is muscle atrophy?

A

Myocyte shrinkage

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65
Q

What is muscle hypertrophy?

A

Myocyte enlargement

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66
Q

What are the 3 main sections of the aorta?

A

Ascending aorta
Arch of aorta
Descending aorta

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67
Q

What are the 2 sections of the descending aorta?

A

Thoracic aorta
Abdominal aorta

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68
Q

What are the first 2 branches of the aorta (In the ascending aorta)

A

Left and right coronary artery

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69
Q

What are the 3 branches of the arch of the aorta?

A

Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

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70
Q

Describe the sequence of arteries in the arms?

A

Subclavian artery
Axillary artery
Brachial artery
Ulnar or radial artery

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71
Q

Describe the sequence of arteries to the legs?

A

Common iliac artery
External iliac artery
Femoral artery
Popliteal artery
Anterior or posterior tibial or fibular artery

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72
Q

.

A

.

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73
Q

What 3 structures are contained in the spermatic cord?

A

Vas deferens
Pampiniform plexus
Testicular artery

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74
Q

Where is spermatozoa formed in the testes?

A

Seminiferous tubules

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75
Q

What forms the pelvic inlet?

A

The top circle formed by the hip bones

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76
Q

What are the 3 layers of the uterine wall?

A

Perimetrium - outer
Myometrium - middle
Endometrium - inner

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77
Q

Where does the sympathetic outflow leave the spinal cord?

A

Between T1 and L2 spinal nerves

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78
Q

What are the 4 main parasympathetic ganglia of the parasympathetic cranial nerves?

A

Ciliary - 3
Pterygopalatine - 7
Submandibular - 9
Otic - 10

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79
Q

What is the name given to the end of the spinal cord?

A

Conus medullaris

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80
Q

What is the name given to the bundle of nerves that falls below the spinal cord (L2-S5 spinal nerves)

A

Cauda equina

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81
Q

What is the name given to the connective tissue below the conus medullaris?

A

Filum terminale

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82
Q

What bones from the appendicular skeleton?

A

Shoulder and pelvic girdle
Arm bones
Leg bones

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83
Q

What bones form the axial skeleton?

A

Skull
Chest (Sternum and ribs)
Vertebral column

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84
Q

Which bone does not articulate with any others?

A

Hyoid bone

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85
Q

What direction is DNA replicated?

A

5’ to 3’

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86
Q

What enzyme is involved in DNA replication?

A

DNA polymerase

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87
Q

What are the 4 main methods of genetic analysis?

A

FISH
Array CGH
PCR
Next Generation Sequencing

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88
Q

What is involved in FISH analysis?

A

Fluorescent probes are addd to DNA to detect specific genes

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89
Q

What is involved in Array CGH?

A

Analysis of the whole genome
Can’t detect balanced arrangement
DNA referred to a reference DNA sample

90
Q

What is involved in PCR testing?

A

Many copies of one small part of the genome is copied
These sections can then be sequenced

91
Q

What is involved in Next Generation Sequencing?

A

The whole genome or all known exons can be sequenced

92
Q

What is meant by a balanced change in genes?

A

All the genetic material is maintained, just in different places

93
Q

What is meant by an unbalanced change in genes?

A

Has missing or additional genetic material

94
Q

What is aneuploidy?

A

Whole extra or missing chromosomes

95
Q

What occurs in Down’s syndrome?

A

Trisomy 21 in which there is an extra copy of chromosome 21

96
Q

What occurs in Edward’s syndrome?

A

Trisomy 18 in which there is an extra copy of chromosome 18

97
Q

What will occur with trisomy 14?

A

Miscarriage

98
Q

What occurs in Turner Syndrome?

A

Only 1 X-chromosome in a female

99
Q

What occurs in triple X syndrome?

A

An extra X-chromosome in a female

100
Q

What occurs in Kleinfelter syndrome?

A

An extra X chromosome in a male

101
Q

What is meant by Robertsonian translocation?

A

2 chromosomes get stuck together
Only causes problems for offspring

102
Q

What is meant by reciprocal translocation?

A

Segments of genetic material are exchanged between chromosomes

103
Q

What is a polymorphism?

A

A variation in the human genome that occurs in >1% of the population

104
Q

What is meant by a Mendelian disorder?

A

A disorder caused by a mutation in a single gene, with a high penetrance

105
Q

What is an oncogene?

A

A mutated gene that allows for continuous cell division

106
Q

What is a tumour suppressor gene?

A

A gene that forms proteins to prevent cell division

107
Q

What is the most common antibody in the body?

A

IgG

108
Q

Which antibody is found in breast milk to provide neonatal protection?

A

IgA

109
Q

Which antibody is responsible for allergy and asthma?

A

IgE

110
Q

What is the main use of amoxacillin?

A

Both gram +ve and -ve bacteria

111
Q

What is the main use of flucloxacillin?

A

Streptococcus and Staphylococcus species

112
Q

What is the main use of Penicillin V?

A

Both gram +ve and -ve

113
Q

What are the 3 basic penicillins?

A

Benzathine - IM
Benzylpenicillin - IV
Phenoxymethyloenicillin - Oral

114
Q

Give an example of a glycopeptide?

A

Vancomycin

115
Q

Give an example of an aminoglycoside?

A

Gentamicin

116
Q

What is the main use of gentamicin?

A

Gram -ve aerobic organisms e.g. coliforms

117
Q

Give an example of a tetracycline?

A

Doxycycline

118
Q

What are the main uses of tetracyclines (Doxycycline)?

A

Intracellular bacteria
Atypical bacteria

119
Q

What are some examples of macrolides?

A

Erythromycin - Gram -ve
Clarithromycin - Gram -ve
Azithromycin - Gram +ve

120
Q

Which antibiotic groups target cell wall synthesis?

A

Penicillins
Cephalosporins
Carbapanems
Glycopeptides

121
Q

Which antibiotic groups target protein synthesis?

A

Tetracyclines
Aminoglycosides
Macrolides

122
Q

Which antibiotic groups target nucleic acids?

A

Metronidazole
Fluoroquinolones
Trimethoprim

123
Q

Which antibiotic should NEVER be taken with alcohol?

A

Metronidazole

124
Q

What are the 4Cs that increase C.diff risk?

A

Cephalosporins
Ciprofloxacin
Clindamycin
Co-amoxiclav

125
Q

What are the main uses of metronidazole?

A

Anaerobes and protozoa

126
Q

What are the bumps of the brain called?

A

Gyrii

127
Q

What are the crevices in the brain called?

A

Sulci

128
Q

What is meant by positive feedback?

A

The amplification of an initial change (e.g. increasing strength of contractions in birth)

129
Q

What is meant by negative feedback?

A

The opposition of an initial change

130
Q

What is the equation for Cardiac Output?

A

CO = Heart Rate x Stroke Volume

131
Q

What is the equation for MAP?

A

MAP = CO x SVR
MAP = [2D + S] ÷ 3

132
Q

What is the normal MAP range?

A

70-105 mmHg

133
Q

Describe the response to high blood pressure in the body?

A

Increased firing rate of Carotid and aortic baroreceptors
Increased stimulation of Herring’s nerve (Branch of Glossopharyngeal nerve) by carotid baroreceptors
Increased stimulation of Vagus nerve by aortic baroreceptors
This is sent to the Medulla oblongata
This leads to an increased parasympathetic tone along Vagus nerve, leading to decreased force of contraction and heart rate

134
Q

What is the formula of Stroke Volume?

A

SV=End Diastolic Volume-End Systolic Volume

135
Q

What are the functions of Angiotensin II?

A

Stimulates release of aldosterone
Causes vasoconstriction
Stimulates thirst
Stimulates ADH release

136
Q

What is the function of aldosterone?

A

It acts on the kidneys to increase sodium and water retention

137
Q

What are the 2 types of Natriuretic peptides?

A

ANP - Released in response to atrial distension
BNP - Important in heart failure diagnosis

138
Q

What is the control centre for thermoreception?

A

Hypothalamus

139
Q

What is an exergonic reaction?

A

A reaction with a -ve ∆G

140
Q

What is an endergonic reaction?

A

A reaction with a +ve ∆G

141
Q

What are the 4 main steps of translation?

A

Initiation
Elongation
Peptide bond formation
Termination

142
Q

What is the main molecule involved in elongation?

A

EF-1alpha and GTP

143
Q

What is the main molecule involved in translocation?

A

EF-2

144
Q

What is an enzyme on its own called?

A

An apoenzyme

145
Q

What is an enzyme with a co-factor called?

A

A Haloenzyme

146
Q

What type of enzyme performs phosphorylation?

A

Protein kinases

147
Q

What does the line weaver-burke plot of a competitive inhibitor vs no inhibitor look like?

A

2 lines that cross the y-axis at the same point
Km is read at the x-axis (Different Km)
Vmax is the y-intersect (Same Vmax)

148
Q

What does the line weaver-burke plot of a non-competitive inhibitor vs no inhibitor look like?

A

2 lines that cross the y axis at different points but cross the x-axis at the same point
Km is read at the x-axis (Same Km)
Vmax is read at the y-axis (Different Vmax)

149
Q

What does the michaelis-menten curve of a non-allosteric inhibitor look like?

A

A standard curve with a plateau

150
Q

What does the Michaelis-menten curve of an allosteric inhibitor look like?

A

A sigmoid curve

151
Q

What is potency?

A

The concentration of drug required to give a certain effect

152
Q

What is the formula for TI (Therapeutic Index)?

A

TI = TD50 ÷ ED50

153
Q

What occurs at the end of G1 (Checkpoint)?

A

CDK4 activated by Cyclin D
CDK4 phosphorylates Retinoblastoma
Retinoblastoma releases E2F
E2F allows progression into S phase

154
Q

What occurs in S phase?

A

E2F initiates DNA replication
E2F also increases Cyclin A levels
Cyclin A activates CDK2
CDK2 also promotes DNA replication

155
Q

What occurs at the end of G2 phase (Checkpoint)?

A

Checkpoint regulated by p53
p53 checks for DNA damage and can pause the entry into the cell cycle
It then attempts to either repair the DNA or stimulate apoptosis via the extrinsic pathway

156
Q

What is dysplasia?

A

Disordered growth, not in response to a stimulus (High grade = more disordered)

157
Q

What is Hyperplasia?

A

Increase in number of cells

158
Q

What is the double hit hypothesis?

A

The idea that 2 faulty genes are required to cause cancer so inheritance of 1 faulty gene still only increases chances, not causes it

159
Q

What is NER?

A

Nucleotide Excision Repair

160
Q

What occurs in Xeroderma Pigmentosa?

A

Genetic defect in NER, meaning mutations aren’t repaired

161
Q

How can HPV cause cancer?

A

E7 proteins binds to Rb and releases E2F
E6 proteins increase p53 destruction

162
Q

What are the main Hallmarks of cancer?

A

Sustained growth
Loss of growth inhibition
Unlimited replication
Resisting apoptosis
Inducing angiogenesis
Disordered repair mechanisms
Invasion and metastasis

163
Q

How do cancer cells maintain growth signalling?

A

Oncogenes stimulate growth and allow constant ‘green light’ for growth

164
Q

How do cancer cells prevent growth inhibition?

A

Mutation of tumour suppressor genes, which usually destroy damaged cells (e.g. p53)

165
Q

How do cancer cells gain unlimited replicative potential?

A

They can turn on telomerase genes that produces telomerase. This allows for constant regeneration of telomeres which usually run out and prevent growth

166
Q

How do cancer cells resist apoptosis?

A

Bcl-2 binds to Bax/Bac and prevents the intrinsic pathway

167
Q

How do cancer cells induce angiogenesis?

A

They can release VEGF (Vascular Endothelial Growth Factor) which forms more blood vessels, needed to keep up with Oxygen demands

168
Q

How can cancer cells disorder repair mechanisms?

A

They can mutate NER and MMR genes which repair damaged DNA

169
Q

How can cancer cells evade the immune system?

A

Cancer cells become very mutated and display non-self antigens, triggering an immune response
To avoid this, they release PDL-1 (Programmed Death Ligand) which inhibits T cell proliferation

170
Q

How can cancer cells invade tissue and metastasise?

A

Increased expression of Matrix MetalloProteins (MMPs) allows the tumour to chew through surrounding tissue and basement membrane

171
Q

What is a QALY?

A

Quality Adjusted Life Year
1 year of life spent in perfect health

172
Q

What cost is identified as cost effective?

A

£20,000 per QALY

173
Q

What is meant by incidence?

A

rate of new cases (Number of new cases in a given time)

174
Q

What is meant by prevalence?

A

The number of current cases at a specific time

175
Q

What is the SIMD?

A

Scottish Index of Multiple Deprivation

176
Q

What is meant by Evidence Based Medicine?

A

The use of current, best evidence to treat a patient

177
Q

What are some disadvantages of Evidence Based Medicine?

A

Keeping up
Gaps in research
Research quality
“Messy” real world settings

178
Q

What is meant by quantitative data?

A

Data that includes numeric values, preferably evaluated by statistical analysis

179
Q

What is meant by qualitative data?

A

Involves collection and interpretation of textual, verbal and visual data
Often used to determine relationships between data and question generation

180
Q

What makes good evidence?

A

Replication ability with the same findings regardless of time, people involved and measurement tools

181
Q

What are the most reliable forms of evidence?

A

Systematic reviews
Meta-analyses

182
Q

What is meant by systematic reviews and meta-analyses?

A

Forms of secondary analysis of primary data.
This clearly defines outcomes, criteria, exposure/treatment and research questions

183
Q

What does PICOS stand for in randomised control trials?

A

P - Population
I - Intervention
C - Control
O - Outcome
S - Study design

184
Q

What is meant by a false positive?

A

People who get a positive result but don’t have the disease

185
Q

What is meant by a false negative?

A

People who get a negative result but have the disease

186
Q

What is meant by sensitivity?

A

seNsitivity - Not Negative (Think opposite)
% people with disease that test positive
True positives / Total with disease

187
Q

What is meant by specificity?

A

sPecificity - Not Positive (Think opposite)
the percentage of people who test negative for a specific disease among a group of people who do not have the disease
True negatives / Total without disease

188
Q

What is meant by the Positive Predicted Value?

A

% people with a positive test that have it
Opposite of sensitivity
True positives / Total Positives

189
Q

What is meant by the Negative predicted value?

A

% people with a negative test that don’t have the disease
Opposite of specificity
True Negatives / Total Negatives

190
Q

What is meant by absolute risk?

A

Number of new cases in an at risk population ÷ Total number of at risk patients

191
Q

What is meant by relative risk?

A

Absolute risk of individuals exposed to risk factor ÷ Absolute risk of individuals not exposed

192
Q

What is meant by the Odds Ratio?

A

Odds of disease in population exposed to risk factor ÷ Odds of disease in population not exposed

193
Q

What name is given to epithelial cancers?

A

Carcinomas (Car = shell (Like skin))

194
Q

What is an adenoma?

A

Benign glandular epithelial tumour

195
Q

What is an adenocarcinoma?

A

Malignant glandular epithelial tumour

196
Q

What is a papilloma?

A

A benign squamous epithelial tumour

197
Q

What is a Squamous Cell Carcinoma?

A

A malignant squamous epithelial tumour

198
Q

What is a transitional/urothelial cell carcinoma?

A

A tumour of the bladder epithelium

199
Q

What are sarcomas?

A

Malignant lesions of the connective tissue

200
Q

What is a lipoma?

A

A benign fat tissue tumour

201
Q

What is a liposarcoma?

A

A malignant fat tissue tumour

202
Q

What is an osteoma?

A

A benign bone tumour

203
Q

What is an osteosarcoma?

A

A malignant bone tumour

204
Q

What is an enchondroma?

A

A benign cartilage tumour

205
Q

What is a chondrosarcoma?

A

A malignant cartilage tumour

206
Q

What is a rhabdomyoma?

A

A benign skeletal muscle tumour

207
Q

What is a rhabdomyosarcoma?

A

A malignant skeletal muscle tumour

208
Q

What is a leiomyoma?

A

A benign smooth muscle tumour

209
Q

What is a leiomyosarcoma?

A

A malignant smooth muscle tumour

210
Q

What is a neurofibroma?

A

A benign tumour of a nerve cell

211
Q

What is a schwannoma?

A

A benign tumour of the schwann cells

212
Q

What is a Malignant Peripheral Nerve Sheath Tumour?

A

A malignant tumour of the myelin sheath of the nerves of the PNS

213
Q

What is a haemangioma?

A

A benign blood vessel cancer

214
Q

What is an angiosarcoma?

A

A malignant blood vessel cancer

215
Q

What is a Kaposi’s sarcoma?

A

A malignant blood vessel cancer related to AIDS or Herpes Virus 8

216
Q

What is the medical name for a freckle?

A

Ephelis

217
Q

What is the medical name for a mole?

A

Naevus

218
Q

What is a malignant cancer of the melanocytes of the skin called?

A

A melanoma

219
Q

What is an ecological study?

A

The analysis of grouped data from summaries of individual data
They are fast and cheap
They don’t provide individual data and can succum to the ecological fallacy - Unsure if those with disease had the exposure

220
Q

What is a cross sectional study?

A

Measure of exposure and outcome variables at the same time
This can asses the prevalence of a condition and its distribution
It goes prevalence and is useful in chronic conditions
It can’t estimate incidence and is prone to bias as those with the condition are more likely to recall exposure

221
Q

What is a case control study?

A

Compare 2 groups of people with and without disease and with and without expose
It is fast, small sample size required and can evaluate multiple exposures
It can’t determine incidence and prevalence and is not useful in rare exposures

222
Q

What is a cohort study?

A

Group of individuals with and without an exposure are followed up over a long period of time to see if they develop a disease
They can determine incidence and causality of exposure
They are expensive and time consuming and people can die during the trial

Foundations of Medicine JMO (56 decks)

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