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Semester 2 Flashcards

1
Q

Genetic predisposition celiac’s

A

HLA-DQ2>HLA-DQ8

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2
Q

Autoantibodies in Celiac

A

Auto Ab vs gliadin and ETG

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3
Q

Celiac classification

A
  1. Classic
  2. Atypical
  3. Asymptomatic
  4. Latent
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4
Q

Diagnosis peptic ulcer

A

Urease breath test and biopsy

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5
Q

Diagnosis of lactose intolerance

A

Hydrogen breath test and stool pH

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6
Q

Pathogenesis model of IBD

A
  1. Environmental factors
  2. Autoimmunity
  3. Genetic factors
  4. Intestinal microbiome
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7
Q

2 major differences between ulcerative colitis and chrons

A
  1. Ulcerative colitis involves rectum

2. Ulcerative colitis has vidible bleeding while chron does not

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8
Q

Extra intestinal symptoms of U.Colitis (3)

A
  1. Anemia
  2. Arthritis
  3. Ocular lesions
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9
Q

Acute complications of ulcerative colitis

A
  1. Severe bleeding
  2. Fulminant colitis
  3. Toxic megacolon and perforation
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10
Q

Genetic factors for Chron’s

A

Modifications in JAK2 and STAT3 pathways

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11
Q

Diagnosis of Chron’s disease

A
  1. Endoscopy (cobblestone mucosa)
  2. Imaging (fistulas)
  3. Stool calprotectin and lactoferrin
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12
Q

Therapy of Chron’s disease

A
  1. Corticosteroids
  2. Vedolizumab (ab vs integrin)
  3. Anti TNF drugs
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13
Q

What is portal hypertension

A

The difference between portal vein and hepatic vein exceeds 10-12mmHg

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14
Q

What is icterus?

A

Bilirubin level is above 2-2,5 mg/dL

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15
Q

Laboratory diagnosis of liver failure

A
  1. Hepatocyte integrity : transaminases
  2. Bile secretion : bilirubin serum conc. + urine conc.
  3. Synthetic function : serum proteins + coagulation factors
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16
Q

Factors which activate stellate cells

A
  • CCL 2,7,8 : recruitement

- TGFb : activation

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17
Q

Role of stellate cells

A

Production of ECM and growth factors after liver injury

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18
Q

Diagnosis of viral hepatitis

A

HAV : serum ig
HBV : serum antigens
HCV : PCR

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19
Q

Metabolic pathologies causing liver failure

A
  1. NAFLD
  2. Haemochromatosis
  3. Alpha 1 anti trypsin deficiency
  4. Wilson’s disease
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20
Q

Mutation in Wilson’s disease

A

ATP7B protein mutation

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21
Q

Role of alpha 1 antitrypsin

A

Serin protease inhibitor

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22
Q

Enzymes of ethanol metabolism

A
  1. ADH (cytosol)
  2. CYP2E1 (ER)
  3. Catalase (peroxisome)
  4. Acetaldehyde dehydrogenase
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23
Q

Variations in ethanol metabolism

A
  1. ADH polymorphism
  2. ALDH -> ALDH2
    3 Disufiran
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24
Q

Forms of acute alcohol intoxication

A
  1. 100-300mg/dL : mild
  2. 300-400 : moderate
  3. 400-500 : severe
  4. 500 and over : death
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25
Q

Preglomerular acute renal failure causes

A
  • embolus
  • thrombotic microangiopathy
  • vasculitis
  • severe hypertension
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26
Q

Cause of IgA vasculitis

A

Overproduction of galactose deficient IgA

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27
Q

Primary causes of nephrotic syndrome (3)

A
  • MCD (minimal change disease)
  • FSGS (focal segment glomerulosclerosis)
  • CNF (congenital nephrotic syndrome finnish type)
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28
Q

Symptoms of nephrotic syndrome

A
  • edema
  • albuminuria
  • albumin deficiency
  • polyuria
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29
Q

Symptoms of nephritic syndrome

A
  • edema
  • hematuria
  • oligoanuri
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30
Q

Diabetic nephropathy manifestations

A
  • glomerulosclerosis, albumineria

- tubulointerstitial fibrosis

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31
Q

Stages of renal failure

A

Stage 1 : risk
Stage 2 : kidney damage, GFR > 60
Stage 3 : deterioration, GFR < 60, creatinin 2-5mg/mL
Stage 4 : CRF, GFR 15-30, creatinin > 5mg/mL

32
Q

Uremic toxins based on size

A

Small : urea
Mid : beta 2 microglobulin
Big : albumin

33
Q

Uremic toxins based on origin

A

Endogenous : PTH, adipokines
Flora : phenols, indols, amines
Exogenous : oxalate

34
Q

Hematopoietic changes in RF

A
  1. Normocytic anemia

2. Thrombocytes : haematophilia

35
Q

Bio markers of smoking induced inflammation (4)

A
  • CRP (c-reactive protein)
  • IL-1B, IL-6, IL-8
  • Fibrinogen (platelet aggregation)
  • TNFa
36
Q

Types of smoking related inflammation in body

A
  1. Blue bloater (cyanotic obese cardiac failure)

2. Pink puffer (severe dyspnoe, cahexia)

37
Q

Heart failure and copd %

A

20-30% have both

38
Q

FEV1

A

Forced expiratory volume : volume you can push out in 1 sec

39
Q

FVC

A

Forced vital capacity : volume to expire after taking in a deep breath

40
Q

Normal and COPD FEV/FVC

A

Normal : 80%

COPD : less than 65%

41
Q

Normal anion gap

42
Q

ECG signs of right heart strain

A
  1. ST depression and T inversion in right leads
  2. Right axis deviation
  3. RBBB (wide QRS)
  4. S1Q3T3
43
Q

Causes of metabolic acidosis (3)

A
  • Increased AG : diabetic ketoacidosis, lactic acidosis

- Normal AG : renal tubular acidosis

44
Q

Lactic acidosis value

A

> 2mmol/L plasma lactate

45
Q

Hypernatremia and hyponatremia

A

Na > 145mmol/L

Na < 135mmol/L

46
Q

Euvolemic hyponatremic disorder

A

SIADH : syndrome of inappropriate ADH

47
Q

Rate of rehydration severe hypernatremia

A

10mmol/L/day

48
Q

Renal control mechanisms for K+ (4)

A
  1. Na/K/ATPase and NaC expression by aldosterone
  2. Ça activated K+ channel
  3. NCC : sodium chloride transporter (increases excretion)
  4. Alpha intercalated cells : H/K/ATPase (increases reabsorption)
49
Q

Circulatory shock

A

Acute systemic circulatory failure with inadequate blood supply, leading to cell and organ damage

50
Q

Classifications of circulatory shock

A
  1. Hypovolemic
  2. Cardiogenic
  3. Obstructive
  4. Distributive
51
Q

Stages of circulatory shock

A
  1. Compensated
  2. Progressive
  3. Irreversible
52
Q

Tennis staging of hypovolemic shock

A
  1. Less than 750mL blood loss
  2. 750-1500mL blood loss
  3. 1500-2000mL blood loss
  4. More than 2L blood loss
53
Q

What causes irreversibility of circulatory shock (3)

A
  1. Vicious circles (positive feedback)
  2. Death of cells (necrosis) bc of metabolic changes
  3. MOF
54
Q

Effects of circulatory shock ischemia on kidney

A
  1. Brush border damage

2. Increase of intracellular Ca2+

55
Q

Possible causes of cardiogenic shock

A
  1. Myocardial infarction
  2. Heart valve failure
  3. Arrythmia
  4. Cardiomyopathy
  5. Myocarditis
56
Q

Systemic changes in cardiogenic shock

A
  • Systolic (decreased SV,CO)

- Diastolic (LVEDP, pulmonary congestion)

57
Q

Treatment of cardiogenic shock

A

Dobutamine : increases contractility and decreases sympathetic reflex

58
Q

Septic shock (3)

A
  • Severe circulatory and metabolic abnormalities
  • requires vasopressor therapy
  • Plasma lactate > 2mM
59
Q

What do PAMP and DAMP factors cause the release of in sepsis?

A
  • NF-kb
  • IRF 3/7
  • AP 1
60
Q

Mechanisms of distributive shock

A
  • Capillary leakage and edema

- systemic vasodilation (bad distribution of CO)

61
Q

Parameters of SIRS (only need 2 for it)

A
  • BT lover than 36 or higher than 38
  • Heart rate > 90bpm
  • RR > 20/min
  • White blood cell count < 4000/µL or > 12000/µL
62
Q

Anti inflammatory cytokines released in sepsis

A
  • IL-10

- TGFbeta

63
Q

What cytokines released by effect of NF-kB

A

IL1, IL12, IL18

64
Q

What is the effect of compliment activation in sepsis

A
  • activation of plasminogen activator inhibitor

- release of TF, which activates prothrombin to thrombin

65
Q

What is the effect of reduced thrombomodulin in spesis?

A

No active protein C so no inactivation of the intrinsic pathway

66
Q

What is aging?

A

Progressive deterioration of physiological function associated with declining health and increased mortality

67
Q

Syndromes that make you age fast

A
  1. Hutchinson gilford

2. Werner

68
Q

What is the divison limit set by telomeres?

69
Q

How many bp lost per division on telomeres?

A

50-100bp per division

70
Q

How do epigenetics play a role in aging?

A

Increased methylation with age leads to certain gene not being expressed anymore

71
Q

3 nutrient sensing pathways

A
  1. mTOR
  2. AMPkinase
  3. Insulin/IGF1 signaling
72
Q

Role of IGF1in cognition

A
  • synaptic plasticity

- dendritic growth

73
Q

How much does muscular strength decrease if immobilization?

A

10-20% per week

74
Q

What is muscle atrophy

A

Loss of nuclei in the fiber

75
Q

Effect of myostatin on muscle (3)

A
  1. Inactivates PI3K pathway for protein synth
  2. Inhibits myogenic genes
  3. Release of ROS, causing apoptosis
76
Q

What molecule causes osteoporosis in immobilization

A

Sclerostin

W/Pathophysiology (4 decks)

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