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PHASE 1 > SAQ - POWERPOINT > Flashcards

SAQ - POWERPOINT Flashcards

1
Q

What type of enzymes catalyse phase I reactions

A

Cytochrome P450 dependent enzymes

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2
Q

What is the length of stores of glycogen and lipids in the body?

A

12 hours - Glycogen

3 months - Lipids

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3
Q

What binds to unconjugated bilirubin in the blood?

A

Albumin

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4
Q

Define: Allele?

A

One of two or more alternative forms of the same gene. Alleles occupy the same loci on homologous chromosomes

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5
Q

What artery provides and anastamosis between the superior and inferior mesenteric arteries?

A

Marginal artery

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6
Q

Which three muscles make up the abdominal wall?

A

External oblique
Internal oblique
Transversus abdominus

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7
Q

Where are the bile salts reabsorbed?

A

Terminal Ileum

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8
Q

What hormones are secreted by the duodenum and what do the stimulate secretion of?

A

CCK - bile

Secretin - Pancreatic juices

Gastrin - HCl

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9
Q

What is the role of glucagon?

A

Stimulates the conversion of glycogen to glucose (glycogenolysis) and gluconeogensis

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10
Q

What is the normal BMI range?

A

18.5 - 25

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11
Q

What is a stroma?

A

The connective tissue between the base of an organ and a tumour

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12
Q

What dermatomes are at the:

Nipples
Umbilicus
Crotch?

A

Nipples = T4

Umbilicus = T10

Crotch = L1

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13
Q

What are some notifiable diseases?

A 
Measles 
Plague 
Rubella
Leprosy 
Yellow Fever
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14
Q

What do raised serum levels of aminotransferase enzymes indicate and why?

A

Liver damage as the enzymes may of leaked from the damaged hepatocytes

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15
Q

What causes lactose intolerance?

A

Lactase deficiency

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16
Q

Three functions of salvia ?

A

Lubrication to assist in swallowing

Moistens mouth and tongue to facilitate speech

Initiates carbohydrate digestion

Maintains neural pH in the mouth, buffering mouth acid

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17
Q

What is another name for oxyntic cells?

A

Parietal cells

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18
Q

What effect does secretin have on gastrin and pancreatic secretion?

A

Regulates duodenal pH by reducing gastric acid from parietal cells, increases pancreatic bicarbonate secretion

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19
Q

What cells secrete cholecytoskinin and secretin and where are they located?

A

Duodenum (enteroendocrine - CCK)

S cells - secretin

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20
Q

What are the folds of the stomach known as?

A

Rugae

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21
Q

Where are the haustra found?

A

Large intestine between the tanae coli

The haustra are small pouches caused by sacculation

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22
Q

What cells secrete gastrin?

A

G cells in the pylorus

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23
Q

Where are the pacemaker cells in the stomach and what is its basic electric rhythm?

A

Interstital cells of Cajal are located along the greater curvature in the body of stomach

3 contractions per minute

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24
Q

Where are the crypts of Librkuhn located?

A

Small intestinal mucosa

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25
Q

State three factors that stimulate bile secretion by the liver?

A

Vagus stimualtion
Secretin
Presence of bile salts

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26
Q

Where are the islets of Langerhans found and what do they produce?

A

Pancreatic Endocrine cells

Insulin = Beta cells
Glucagon = Alpha cells
Stomatosatin = Delta cells
Pancreatic polypeptide = PP cells

Also amylin

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27
Q

What are the three types of jaundice?

A

Haemolytic jaundice: Caused by the destruction of RBCs

Obstructive jaudice: Caused by a blockage in the pathway where bilirubin is make in liver cells and where bile goes into duodenum

Hepatic jaundice: Damage to liver cells

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28
Q

Why is urine dark coloured and stools light in obstructive jaundice?

A

Plasma excess of water soluble conjugated bilirubin turns urine dark

Lack of sterocobilinogen causes pale faeces

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29
Q

Where do the thoracic duct and lymphatic ducts drain into systemic circulation?

A

Left and right brachiocephalic veins

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30
Q

Define phase I reactions?

A

Biotransform substancess

Aim is to make the drug more hydrophilic so that it can be excreted by the kidneys, easier to conjugate

Oxidation/Reduction

Microsomal enzymes mainly phase I e.g. Cytochrome P450

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31
Q

Define phase II reactions?

A

Glucuronidation

Conjugation to water soluble substance that can be excreted in urine by kidneys

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32
Q

What cartilage is responsible for altering tension on the vocal cords?

A

Arytenoid cartilage

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33
Q

What muscles are involved in respiration?

A

Diaphragm, intercostal and abdominal muscles

External intercostals and diaphragm only during quiet breathing

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34
Q

What is the costodiaphragmatic recess?

A

The largest of the pleural recesses, lying between the diaphragm and the thoracic wall into which the basal border of the lung encroaches during inspiration.

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35
Q

Where are the alveoli first found in the respiratory tract?

A

Respiratory bronchioles

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36
Q

What type of molecules is the blood brain barrier permeable to?

A

Small ions and water molecules can cross the blood-brain barrier through ion channels e.g. K+ and Na+

However, hydrogen ions CANNOT cross BBB

Glucose, O2 and CO2 are transported across

Small lipophilic molecules that can be transported passively across the cell.

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37
Q

Three ways that CO2 is transported in the blood?

A

Bound to haemoglobin - carboaminohaemoglobin

HCO3-

Dissolved in plasma

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38
Q

What is chloride shift and why do we need it ?

A

As CO2 enters an RBC, some of it is converted into H2CO3 which dissociates into HCO3-

This diffuses out leaving the H+ and the Cl- moves into to keep the cell neutral

39
Q

Name three type of receptor involved in ventilation and what affect their stimulation has?

A
  1. Juxtapulmonary receptors (J receptors): Chemical stimulated. Close to blood capillaries in alveolar/bronchial walls, decrease blood pressure and heart rate
  2. Stretch receptors: Pressure stimulated, smooth muscle in bronchial walls, Shorter and shallower breathing
  3. Irritant receptors: throughout respiratory tract, causes coughing in upper respiratory tract and increased respiration in lower respiratory tract
40
Q

What is normal blood pH range?

A

7.35 to 7.45

41
Q

When does phyisological shunting occur?

A

Adequate perfusion

No ventilation

Caused by COPD, asthma lung collapse and Type 2 respiratory failure

42
Q

Describe FEV1?

A

Forced Expiratory Volume in one second

A normal FEV1 is where the result is 80% or greater than the predicted value

43
Q

Describe FVC?

A

Forced Vital Capacity, the total amount of air forcibly expired

Less reproducible than FEV1

A normal FVC is where the result is 80% or greater than the predicted value

A low FVC is airways restriction

44
Q

What is the significance FEV1/FVC ratio?

A

If the ratio of FEV1/FVC is below 0.7 = airways obstruction

If the ratio is above 0.7 but the FVC is low = airway restriction

45
Q

Describe type 1 respiratory failure?

A 
pO2 = low 
pCO2 = low OR normal

Pulmonary embolism morst common cause

46
Q

Describe type 2 respiratory failure?

A 
pO2 = low 
pCO2 = high

Hypoventilation causes Type 2

47
Q

What is physiological deadspace?

A

Ventilation but no perfusion

It is the sum of the anatomical dead space (nose, trachea bronchi) plus alveolar dead space (can be caused by pulmonary embolism)

48
Q

What are the types of T lymphocytes and their role?

A

CD4 helper cells = Recognise antigens and release cytokines that activate CD8 cytotoxic cells

CD8 cytotoxic cells kill infected cells

49
Q

How do you calculate maximum heart rate?

A

220-age

50
Q

What should be administered in a hypoglcaemic emergency?

A

15 to 20g of carbohydrates orally

If this is not possible then glucagon can be administered by injection

51
Q

What is the function of screening?

A

It is designed to detect people who probably have a disease from those who do not from those that are likely to have it.

Not diagnostic, further tests and investigation is required

52
Q

Which cancers commonly metastasise to the bones?

A

Bronchus, breast, thyroid, kidney and prostate

53
Q

What is a gene?

A

A segment of DNA that codes for a protein

54
Q

Give an example of an autosomal dominant condition?

A

Huntingdon’s disease

55
Q

Where are the four heart sounds listened to?

A

Mitral - 5th ic space along mid clavicular line

Tricuspid - 4th ic space right sternal margin

Pulmonary - 2nd ic space left sternal margin

Aortic - 2nd ic space right sternal edge

56
Q

Where is the dorsalis pedis pulse located?

A

First interosseus space on the dorsum of the foot

57
Q

What is the last rib to directly link to the sternum?

A

7th

Ribs 1-7 = true ribs as they attach to sternum

Ribs 8-10 = false ribs as they attach to 7th costal cartilage

Ribs 11-12 = Floating ribs

58
Q

What is the level of:

Angle of Louis (sternal angle)

Xiphi Sternum?

A

Angle of Louis = T4

Xiphi Sternum = T9/10

59
Q

The right coronary artery splits into?

A

Right acute marginal artery

Right posterior descending artery

60
Q

The left coronary artery splits into?

A

Left anterior descending - diagonal artery

Circumflex - Left marginal

61
Q

What supplies the SAN?

A

Right marginal 60% of people

Circumflex 40% of people

62
Q

Surface markings of the oblique and horizontal fissures?

A

Oblique:
2nd rib posteriorly
4th rib mid axillary
6th rib mid clavicular

Horizontal fissure runs along the 4th intercostal space

63
Q

What is the infundibulum?

A

Also known as conus arteriousus

Non contractile inflow portion of ventricle, develops from the bulbus cordis

64
Q

What is the significant of the moderator band in the right ventricle?

A

Carries the right AV bundle

65
Q

Surface markings of:

Bifurcation of trachea 
Upper oesophageal sphincter 
Bifurcation of the aorta 
Coeliac artery 
Superior Mesenteric artery 
Inferior Mesenteric Artery 
SVC entering right atrium
A

Bifurcation of trachea = T4

Upper oesophageal sphincter = C6

Coeliac artery = T12

Superior mesenteric artery = L1

Inferior mesenteric artery = L3

SVC entering right atrium= 3rd right costal cartilage

66
Q

What is an auricle ?

A

Auricles are wrinkled pouch like structures attached to the atria that aim to increase the capacity of the atria

67
Q

What level are the thyroid and cricoid cartilages?

A

C4 and C5 respectively

68
Q

What are the three pharyngeal constrictor muscles?

A

Superior, middle and inferior constrictor muscles

Split into cricopharyngeal and thyropharyngeal

69
Q

What are the cartilages of the larynx?

A

Epiglottis
Thyroid
Cricoid

Arytenoid x 2
Cuneiform x 2
Corniculate x 2

70
Q

Under which ribs does the spleen sit?

A

9, 10 and 11

71
Q

Which peritoneal organs are connected by a mesentery?

A

Part of the duodenum, remainder of small intestine, transverse colon, sigmoid colon

72
Q

Which organs are retroperitoneal?

A

S: Suprarenal (adrenal)glands
A: Aortia/IVC
D: Duodenum (except proximal 2cm)

P: Pancreas (except tail) 
U: Ureters 
C: Colon 
K: Kidneys 
E: Eesophagus 
R: Rectum
73
Q

What are Kupffer cells?

A

A form of macrophage, derived from circulating blood monocytes that partly line the hepatic sinusoids

74
Q

What are sinusoids?

A

Small blood vessels in the liver that receive O2 rich blood from the hepatic portal artery and nutrient rich blood from the hepatic portal vein allowing diffusion into hepatocyte through the space of Disse

75
Q

What is the role of transferrin?

A

Transports iron from the breakdown of RBCs in the spleen, through the blood to the bone marrow to be incorporated into the new RBCs

76
Q

What is the precursor that all blood cells are developed from?

A

Pluripotent haematopoietic stem cells

77
Q

From which cells are platelets derived?

A

Megakaryocytes

78
Q

How is (a) glucose/galactose and (b) fructose absorbed in the small intestine?

A

(a) secondary active transport with Na+

(b) Facilitated diffusion through GLUT 5

79
Q

How are (a) amino acids and (b) di/tripeptides absorbed in the small intestine?

A

(a) active transport with Na+
(b) Secondary active transport with H+

Diffusion into blood stream

80
Q

How are short chain fatty acids absorbed in the small intestine?

A

Simple diffusion in and out

81
Q

How are fats absorbed in the small intestine?

A

After emulsification and transport in micelles, micelles release long chain lipids and monoglycerides to diffuse across the intestinal lining

They aggregate in chylomicrons which pass into the lymph drainage system through thoracic duct into the blood stream

82
Q

What organs does an ERCP look at?

A

Liver, gall bladder pancreas, bile ducts and pancreas

83
Q

Name two differences between the mitral valve and tricuspid valve

A

2 vs 3 cusps

2 vs 1 papillary muscles per cusps

84
Q

What is the rough inside surface of the right auricle known as?

A

Muscular pectinae

85
Q

What three areas does the phrenic nerve innervate?

A

Motor: Diaphragm
Sensory: Diaphragm peritoneum
Sensory: Pericardium

86
Q

What do the adenoids consist of and what condition can they contribute to?

A

Lymphoid tissue

Swelling causes obstruction and obstructive sleep apnoea

87
Q

What innervates the muscles of the pharynx?

A

Pharyngeal plexus (IX and X)

Cricopharyngeus - external laryngeal nerve

88
Q

What innervates the intrinsic muscles of the larynx?

A

Recurrent laryngeal nerve

EXCEPT

Cricothyroid - extenteral laryngeal

89
Q

Describe the course of the left recurrent laryngeal nerve?

A

Left recurrent laryngeal nerve is a branch of the vagus and hooks under the arch of the aorta

90
Q

Describe the course of the right recurrent laryngeal nerve?

A

Right recurrent laryngeal nerve loops under the right subclavian and it is a branch of the vagus

91
Q

Describe the arrangement of vessels and nerves at the Hilum of the lung?

A

Artery bronchus vein superior to inferior

Phrenic to vagus anterior to posterior

92
Q

The caudate and quadrate lobes are anatomically and physiologically on which side of the liver?

A

Anatomically - right

Physiologically - left

Functional division is from the IVC to the gall bladder

93
Q

Between which muscles are the intercostal vascular bundles situated?

A

The internal and the innermost intercostal muscles?

PHASE 1 (7 decks)

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