Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Years 1+2 > S4C3 > Flashcards

S4C3 Flashcards

1
Q

What us the cage questionnaire?

A

The CAGE is a simple screening questionnaire to identify potential problems with alcohol. “CAGE” is an acronym formed from the questionnaire (cut - annoyed - guilty - eye opener).
Two “yes” responses is considered positive for males
one “yes” is considered positive for females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the questions in CAGE?

A
  1. Have you ever felt you should Cut down on your drinking?
  2. Have people Annoyed you by criticising your drinking?
  3. Have you ever felt bad or Guilty about your drinking?
  4. Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover (Eye-opener)?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is ALT?

A

An enzyme found in your liver and kidney and is released into the blood when the liver is damaged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is ALP?

A

An enzyme found in your liver and bones, increased in response to cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is bilirubin? (brief)

A

Product of the breakdown of red blood cells and is excreted by the liver. High levels causes jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does high ESR show?

A

Inflammatory activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How much ethanol is in 1 unit of alcohol?

A

8g of pure ethanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Beck’s calculation?

A

Unit = amount (ml) x ABV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the pathway of alcohol?

A

Mouth + Oesophagus - Alcohol is diluted by saliva before being swallowed, Some is immediately absorbed
Stomach - More alcohol is absorbed here - leading to irritating the lining of the stomach and increasing the acidity
Small Intestine - Any remaining alcohol is passes here and is the site of the most alcohol absorption
Blood stream - Alcohol quickly diffuses through the body, affecting almost all cells
Brain - These cells are more susceptible because they are usually protected from toxins by the bbb
Liver - Blood-alcohol is metabolized in two stages and the respired into CO2. H2O and fatty acids
Excretion via urine, the lungs and sweat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the general effects of alcohol?

A

Stimulant at low levels

CNS depressant at moderate to severe doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does an acute administration of alcohol lead to?

A 
Increase inhibitory transmission at gamma-amino-butyric acid (GABA-A) channels
Increase serotonin (5HT-3)function
Increased dopamine release
Increased transmission at opiate receptors
reduction of excitatory transmission at the NMDA subtype of the glutamate receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the bad social effects of alcohol?

A

Unwanted pregnancy
STDs
Cause of road traffic accidents
Major cause of domestic, football and other violence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the bad physical effects of alcohol?

A 
Foetal alcohol syndrome
Increase risk of oral/head/neck cancers
Alcoholic cardiomyopathy
Systemic hypertension
Peripheral neuropathy
CNS e.g. Korsakoff' psychosis, Wernicke's encephalopathy
Withdrawal syndromes
Alcohol poisoning
Affect GI tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the symptoms of alcohol poisoning?

A 
Confusion
Loss of coordination
Vomiting
Seizures
Irregular or slow breathing (<8 breath/min)
Blue or pale skin
Hypothermia
Stupor - conscious but unresponsive
Unconsciousness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the affect of alcohol on the oesophagus?

A

Carcinoma of oesophagus, especially squamous carcinoma

Oesophageal varices, associated with chronic liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the affect of alcohol on the Stomach?

A

Acute gastritis
Acute ulceration
Chronic peptic ulceration
Portal gastropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the affect of alcohol on the Pancreas?

A

Acute pancreatitis

Chronic pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the basic normal function of the Liver?

A

Protein synthesis - albumin, clotting factors
Glycogen storage
Deamination
Detoxification of xenobiotics, hormones, ingested drugs
Bilirubin metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the stages of alcoholic liver disease?

A

Acute fatty Change
Alcoholic hepatitis
Hepatic fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the acute fatty change stage

A

Predominantly acinar zone 3
Mainly large droplet - macrovesicular
May cause acute hepatic failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe the Alcoholic hepatitis stage

A

Mallory’s hyaline
Intracytoplasmic accumulation of keratin
Associated neutrophil polymorph infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe the hepatic fibrosis stage

A

Starts in acinar zone 3
Initially pericellular fibrosis
Caused by activation of hepatic stellate (Ito) cell
Facultative myofibroblast
Leads to Cirrhosis which is irreversible and potentially to a Hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the mechanisms for Alcohol related disease?

A

Direct toxic effect
Indirect metabolite effect - Acetaldehyde
Activation of free radicals
Induction of enzyme systems - Cytochrome p450
Nutritional deficiencies esp. B group vitamins Liver function impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What does the GMC say about respecting patients?

A

You must not use your professional position to pursue a sexual or improper emotional relationship with a patient or someone close to them.

You must not express your personal beliefs (including political, religious and moral beliefs) to patients in ways that exploit their vulnerability or are likely to cause them distress.

You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress, you should:

1. put matters right (if that is possible)
2. offer an apology
    3. explain fully and promptly what has happened and the likely short-term and long-term effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the PRIME theory of motivation?
1: It is wants and needs at each moment that drive our behaviour. 2: Our intentions and beliefs about what is good or bad only influence our actions if they create sufficiently strong wants and needs at the relevant moment. 3: Our image our ourselves and how we feel about that, our identity, is a potentially very strong source of wants and needs which can be enough to overcome ones arising from biological drives such as hunger.
26
What is the self-regulation model?
The planful action designed to change the course of one's behaviour The executive capacity to plan, guide and monitor ones behaviour flexibly according to changing circumstances Addictive behaviours are seen as the result of having an excessive reliance on external structures It is important in the development of drug use problems
27
What is the Cue exposure theory?
``` Classic conditioning Plays part in development and maintenance of addictive behaviours A cue that has been present when drugs were administered is more likely to elicit a conditioned response 2 types of cue Exteroceptive - occur before use Smell of alcohol Sight of needle Time of day Interoceptive Effects of receptors Mood cues ```
28
What causes Diarrhoea ?
Increased osmotic load in colon increases fluid in faeces Osmotic load - incomplete digestion and absorption of food Lack of enzymes or transporters Damage to mucosal cells Osmotic load - secretion of ions by gut
29
What can cause a lack of enzyme or transporters?
``` Congenital (neonate) = "Watery" SGLT1 mutations Lactase deficiency Disease of pancreas and biliary systems - stratorrhoea Pancreatitis CF Hepatitis Gall stones ```
30
What can cause damage to mucosal cells?
``` Immune/ autoimmune Coeliac disease Crohn's disease Infections (water and hygiene) Bacteria Shigella and Campylobacter cause destruction of intestinal wall - Decreases surface area + Blood in faeces (dysentery) Salmonella causes inflammation Protozoa (giardia or Entamoeba) UK main causes are rotavirus and norovirus ```
31
How do some bacteria effect the secretions of ions by gut?
Toxin produced by bacteria which "hi-jacks" normal cellular processes Intestinal cells normally secrete H2O (together with mucus and HCO3-) ~1L/ day In cholera secretion exceeds 20 L per day Toxins may also inhibit Na+ absorption but no SGLT1 - Basis of oral rehydration therapy
32
What is glucose-galactose malabsorption syndrome?
Genetic disease SGLT1 mutated - no absorption of glucose or galactose Severe and potentially fatal diarrhoea in infants Treatment: to avoid glucose and galactose
33
How can genetic diseases cause mild malabsorption?
B0 - hartnup disease | B0+ causes cystinuria and kidney stones
34
What are the 3 ways of absorption?
``` simple diffusion - lipids carrier-mediated - amino acids and sugar Secondary active Facilitated diffusion Receptor-mediated endocytosis Vit B12 + intrinsic factor Cholesterol ```
35
Where can digestion of proteins occur?
Stomach, pancreas, brush border
36
Where can digestion of polysaccharides occur?
Saliva, pancreas, brush border
37
Where can digestion of triglycerides occur?
Stomach, pancreas, bile salts
38
What are the different sites of absorption and what do they do?
Mouth, oesophagus and stomach - limited diffusion Duodenum and jejunum - Major site Ileum - Vit B12, Bile salts and K+ Colon - Na+, H2O and short-cahin fatty acids Rectum - limited diffusion
39
What are the features of the small intestine allowing absorption?
Expansion of absorptive surface Total area ~200m2 A decrease in surface area can lead to Malabsorption Polarised expression of transport proteins
40
How are glucose | and galactose absorbed?
Secondary active transport - energy derived from Na+ gradient created by Na+K+ pump. 3Na+ is pumped out to interstitial fluid (2K+ pumped in) Na+ gradient formed Glu brought in with 2Na+ from lumen by SGLT1 GLUT2 then pumps glu into isf
41
How is fructose absorbed?
Facilitated diffusion GLUT5 bring fruc in from lumen GLUT2 pumps it into interstitial fluid
42
How many amino acids are absorbed by PEPT1? How does PEPT1 work?
50% absorbed as di-/tri- peptides They become hydrolysed to aa in enterocyte. Works by contransporting H+
43
How does Bo transport amino acids? What type of aa does it transport?
Neutral a.a | Co-transports Na+
44
How does Bo+ transport amino acids? What type of aa does it transport?
cationic and cystine | Co-transports Na+
45
How does Xag- transport amino acids? What type of aa does it transport?
Anionic a.a | Co-transports Na+ and H+, K+ pumped other direction
46
What aa does PAT1 transport?
Proline
47
How is fat digested?
Dependent on bile salts Emulsification of large fat droplets - Increase surface area for action of pancreatic lipase Formation of mixed micelles - Stabilises products of triacylglycerol hydrolysis (into monoacylglycerol and 2 free fatty acids) while they are translocated to apical membrane
48
How is fat absorbed?
Simple diffusion of Free fatty Acid - Limited with a few FFAs in undissociated state (pKa ~ 4.9) FFA transporters - FAT plus CD36 Short-chain FA transporters in colon -Produced by bacterial fermentation Monoacylglycerol transport -Evidence for carrier-mediated mechanisms Triacylglycerol then gets re-synthesised in ER - Packaged in chylomicrons
49
How is cholesterol absorbed?
Duodenum Niemann-Pick C1-Like1 (NPC1L1) protein Receptor mediated endocytosis Ezetimibe inhibits endocytosis - Decreases plasma cholesterol
50
How is H20 absorbed?
H20 moves down osmotic gradient Osmotic gradient created by absorption of nutrients 8.4L absorbed in total per day 6.5L in small intestine, 1.9L in colon Route: Via junctional complexes between cells, Via SGLT1 And a.a. Transporters
51
How is Na+ absorbed in different parts of the GI tract?
In jejunum and ileum - Na/glucose or Na/aa cotransporters In duodenum and jejunum - Na-H exchanger In ileum and proximal colon - Parallel Na-H and Cl-HCO3 exchangers Distal colon - epithelial Na+ channel
52
How and where is Cl- absorbed?
In ileum and proximal colon - Parallel Na-H and Cl-HCO3
53
How is HCO3- and K+ absorbed?
HCO3- --> no active absorption in Si or LI K+ SI - paracellular diffusion in ileum LI - predominantly secretion
54
How much HCO3- and K+ are in faeces? What happens in cases of severe diarrhoea?
K+ = 90mM HCO3- = 30mM Severe diarrhoea - hypokalaemia and metabolic acidosis
55
How are vitamins absorbed?
Fat soluble: A, D, E and K Evidence of facilitated diffusion and/or endocytosis at physiological concentrations Require optimal fat digestion Deficiencies within pancreatic and biliary disease Water soluble: B and C Specific transporters (facilitated and secondary B12 - endocytosis
56
How is Ca2+ absorbed?
Can be absorbed either paracellular or transcellular Transcellular: Ca2+ transported into the cell by TRPV6 Transported into interstitial space by PMCA (brings H+ in uses ATP)
57
How is nonheme Fe3+ absorbed?
Dcytb reduces Fe3+ DMT cotransports Fe2+ with H+ Fe2+ binds to mobilferrin Fe2+ leaves the cell via Ferroportin and binds to transferrin in plasma after hephaestin oxidises
58
How is heme Fe2+ absorption?
Heme Fe2+ enters the cell Heme oxygenase oxidises the Fe2+ and releases it Fe2+ binds to mobilferrin Fe2+ leaves the cell via Ferroportin and binds to transferrin in plasma after hephaestin oxidises
59
What is the cost of alcohol to society?
£11 billion - alcohol related crime £7 billion - lost productivity through unemployment and sickness £3.5 billion - cost to NHS
60
What are the health statistics for alcohol?
10.8 million adults in England are drinking at levels that pose some risk to their health 1.6 adults may have some level of alcohol dependence Alcohol has been identified as a casual factor in over 60 medical conditions 333,014 hospital admission were alcohol related in 2013-2014 17,432 deaths from liver disease between 2011-2013 - 15% increase from 2002 150,640 receiving specialise treatment for alcohol dependence in 2014-2015 (60% problematic drinking, 40% alcohol alongside other substances)
61
What are the social factors which makes someone vulnerable to alcohol consumption?
Alcohol pricing, availability and regulation Drinking context Socio-economic statuc Culture
62
What are the individual factors which makes someone vulnerable to alcohol consumption?
Mental health Homelessness Gender Age
63
What is the pancreas?
A retroperitoneal organ, at the level of the transpyloric plane, located in the epigastrium and left hypochondrium regions. Lobulated capsule organ with septa The exocrine pancreas is classified as a lobulate, serous gland which produces digestive enzyme precursors.
64
How can the pancreas be divided?
Divided into 5 parts: Head - the widest part of the pancreas Lies within the C-shaped curve created by the duodenum Connected to duodenum by connective tissue Uncinate process - a projection arising from the lower part of the head Extends medially to lie beneath the body of the pancreas Lies posterior to the superior mesenteric vessels Neck - located between the head and body Overlies the superior mesenteric vessels which form a groove in its posterior aspect Body - centrally located, crossing the midline of the human body to lie behind the stomach and to the left of the superior mesenteric vessels Tail - lie within close proximity to the hilum of the spleen Contained within the splenorenal ligament with the splenic vessels Only part of the pancreas that is intraperitoneal
65
What is the duct system in the pancreas?
Acini are connected by short intercalated ducts The intercalated ducts untie with those draining adjacent lobules and drain into a network of intralobular collecting ducts, which in turn drain into the main pancreatic duct The main pancreatic duct runs the length of the pancreas and unites with the common bile duct Forming the hepatopancreatic ampulla of Vater - This opens into the duodenum via the major duodenal papilla Secretions in the duodenum are controlled by the sphincter of Oddi which surrounds the ampulla of Vater. The accessory pancreatic duct opens into the duodenum at the summit of the minor duodenal papilla
66
What is the arterial supply of the pancreas?
Derived from branches of splenic artery Multiple pancreatic arteries form several arcades with pancreatic branches of the gastroduodenal and superior mesenteric arteries The anterior and posterior superior pancreaticoduodenal arteries, branches of the gastroduodenal artery, and the anterior and posterior inferior pancreaticoduodenal arteries, branches of the SMA, form anteriorly and posteriorly placed arcades that supply the head of the pancreas
67
What is the venous supply of the pancreas?
Via corresponding pancreatic veins, tributaries of the splenic and superior mesenteric parts of the hepatic portal vein Most empty into the splenic vein
68
What is the lymphatics of the pancreas?
Most vessels end in the pancreaticosplenic lymph nodes which lie along the splenic artery Some vessels may end in the pyloric lymph nodes Efferent vessels from these nodes drain to the superior mesenteric lymph nodes or the celiac lymph nodes via the hepatic lymph nodes
69
What is the innervation of the pancreas?
Derived from the vagus and abdominopelvic splanchnic nerves passing through the diaphragm
70
What are the different endocrine cells in the pancreas? What do they secrete and what does that do?
β cells - insulin - increase blood glucose and satiety α cells - glucagon - lowers blood glucose δ cells - somatostatin - inhibits secretion of insulin and glucagon ε cells - ghrelins - increase appetite PP cells - pancreatic polypeptide - promotes GI fluid secretion and satiety
71
What are the components of pancreatic juice? Where are they produced and what controls them?
Bicarbonate (NaHCO3) in duct controlled by secretin | Enzymes - regulated by the vagal reflex and CCK in the acinus - also causes NaCl secretion
72
How does NICE make decisions on prioritising health care?
. NICE makes decisions based on the “accountability for reasonableness” conditions described above and lists scientific rigour, inclusiveness, transparency, independence, challenge, review, support for implementation, and timeliness as its key procedural principles

Years 1+2 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions