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Year 1 MBchB > Semester 2 Content > Flashcards

Semester 2 Content Flashcards

1
Q

What anatomical features are used in gas exchange

A

Bronchiole capillaries alveoli

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2
Q

Define physiological dead space

A

Areas in the lunch where no gas exchange takes place

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3
Q

What controls ventilation

A

CO2 levels

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4
Q

PaO2 and PaCO2 in type 1 respiratory failure

A

Low O2 normal CO2

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5
Q

What type of respiratory failure: low O2 normal CO2

A

Type 1

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6
Q

What causes type 1 respiratory failure (definition)

A

Normal ventilation but not enough O2 in the blood

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7
Q

Three common causes of type 1 respiratory failure

A

Pneumonia, acute severe asthma, COPD

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8
Q

PaO2 and PaCO2 in type 2 respiratory failure

A

Low O2 high CO2

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9
Q

Three common causes of type 2 respiratory failure

A

Opioid overdose
Sever COPD
acute severe asthma

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10
Q

Two causes of hypoxaemia

A

Hypoventilation, V/Q mismatch

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11
Q

Three causes of hypoventilation

A

Opioid overdose, asthma, COPD

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12
Q

Cause of V/Q mismatch

A

Not enough O2 entering the lungs

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13
Q

Define hypertension

A

High BP where treatment does more harm than good

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14
Q

What is the normal BP

A

120/80

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15
Q

Common causes of secondary hypertension

A

Chronic kidney disease
Diabetes
Cushing syndrome
Hypo/ hyperthyroidism
Pregnancy

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16
Q

What anti hypertensive drug would be given for a white male under 55

A

ACE inhibitors

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17
Q

What anti hypertensive drug would be given for a white male over 55

A

Calcium channel blockers

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18
Q

Lisinorpil is what type of anti hypertensive drug

A

ACE inhibitor

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19
Q

Common adverse effects of ACE inhibitors

A

Dry cough, hyperkalaemia, hypotension

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20
Q

Doxazosin is what type of anti hypertensive drug

A

Alpha blockers

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21
Q

Amlodipine is an example of what type of anti hypertensive drug

A

Calcium channel blocker

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22
Q

Ankle oedema is common with what anti hypertensive drug

A

Calcium channel blocker

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23
Q

Dry cough is common with what type of anti hypertensive drug

A

ACE inhibitors

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24
Q

site of action for thiazide diuretics

A

Proximal part of the distal convoluted tubules

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25
Q

Three things hypertension is a risk factor for

A

Peripheral vascular disease
Atherosclerosis
Coronary artery disease

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26
Q

What can pulmonary hypertension cause

A

Right ventricular:
Hypertrophy
Dilation
Failure

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27
Q

Systemic hypertension is a risk factor for:

A

LV hypertrophy
Ischemic heart disease

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28
Q

Why is ABG measured

A

To diagnose respiratory failure

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29
Q

What controls blood pH

A

CO2 levels

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30
Q

Low pH High CO2 and high HCO3

A

Respiratory academia

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31
Q

Low pH low CO2 low HCO3

A

Metabolic academia

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32
Q

High pH low CO2 low HCO3

A

Respiratory alkalaemia

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33
Q

High pH high CO2 high HCO3

A

Metabolic alkalaemia

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34
Q

Base excess definition

A

Volume of base needed to return to normal pH

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35
Q

Use of bicarbonate in ABG

A

Buffer excreted from kidneys

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36
Q

What hormone increases sperm production in Sertoli cells

A

Testosterone

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37
Q

Advantages of sexual reproduction

A

Variation in offspring
Better adapted to changing environments

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38
Q

Disadvantages to sexual reproduction

A

Only half a genome is passed on
Energy expenditure in finding a mate

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39
Q

Sexual reproduction definition

A

The blending of characteristics from two individuals from the Nth generation to produce an individual of the (Nth+1) generation

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40
Q

What effects does FSH have on the secondary (ripening) follicle

A

More granulosa cells produced
Zona pellucida produced
Estrogen produced ( FSH + LH)

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41
Q

What is the effect of FSH in the late 2nd stage ( follicular)

A

Follicular fluid secreted
Estrogen produced (FSH+ LH)

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42
Q

How is the antrum formed

A

Formed by granulosa follicular fluid

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43
Q

In the critical stage, what happens if no LH is provided

A

Cell death

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44
Q

In the critical stage, what happens if LH is provided

A

The primary follicle becomes a follicle

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45
Q

Obstructive lung disease definition

A

Narrowing of the airway

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46
Q

Common obstructive diseases

A

Asthma COPD Cystic fibrosis

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47
Q

Two factors which decrease the internal diameter of the bronchioles

A

Mucus production
Inflammation

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48
Q

What does a peak flow test measure

A

Maximum speed of expiration

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49
Q

What two investigations are used in obstructive lung disease

A

Spirometry
Peak flow test

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50
Q

What does FEV1 and FVC measure

A

FEV1- forced expiatory in one second
FVC- total exhalation

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51
Q

What FEV1/FVC ratio is diagnostic of an obstructive airways condition

A

FEV1/FVC ratio less than 0.7

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52
Q

What is the neurotransmitter acting at muscarinic receptors

A

ACh

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53
Q

What is the agonist acting at beta 2 adrenergic receptors

A

Salbutamol

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54
Q

What neurotransmitter acts at the nicotinic receptors

A

ACh

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55
Q

What is the main function of the parasympathetic nervous system

A

Basic body functions
Decrease in heart rate
Constrict bronchioles

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56
Q

What is the main function of the parasympathetic nervous system

A

Fight or flight
Increased heart rate
Dilates bronchioles

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57
Q

Name two catecholamine neurotransmitters

A

Adrenaline and noradrenaline

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58
Q

Four things to ask people who are planning a pregnancy

A

Diet, exercise, smoking, alcohol intake, underlying health conditions

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59
Q

How long should methotrexate be stopped prior to conceiving

A

3 months

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60
Q

What is methotrexate used to treat

A

Rheumatoid arthritis

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61
Q

What is sodium valproate used to treat

A

Epilepsy

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62
Q

Name three complications when taking sodium valproate during pregnancy

A

Neural tube defects
Oral
Cardiac
Urogenital defects

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63
Q

Why are NSAIDS a danger in pregnancy

A

NSAIDS block the arachidonic pathway. This inhibits the production of PGE
PGE is used to keep the ductus arteriosus open during pregnancy

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64
Q

Name two complications of premature closing of the ductus arteriosus

A

Pulmonary hypertension
Organ and tissue oedema

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65
Q

Dosage of folic acid required in pregnancy

A

400 mcgms until week 12

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66
Q

Function of the ductus arteriosus

A

Connect the pulmonary artery to the aortic arch to allow oxygenated blood into the body but bypassing the lungs

67
Q

Physical features of fetal alcohol syndrome

A

Thin upper lip
Low nasal bridge
Smooth Philtrum (bow)

68
Q

Definition of diabetes

A

A condition in which the pancreas does not make enough insulin or none at all

69
Q

Type 1 diabetes definition

A

Autoimmune disease
Immune system attacks insulin producing cells

70
Q

Type two diabetes definition

A

Not enough insulin or no response to insulin

71
Q

Symptoms of diabetes

A

Frequent urination
Excessive thirst
Blurred vision
Slow healing cuts
Weight loss
Fatigue

72
Q

Investigations of diabetes

A

Blood glucose test
126-200> diabetes

73
Q

Treatment of type 2 diabetes

A

Diet changes
Exercise
Stop smoking

74
Q

Treatment of type 1 diabetes

A

Insulin therapy

75
Q

Risk factors of type 2 diabetes

A

Obesity
Age
Family history of disease
Low socioeconomic status
Smoking

76
Q

Hyperglycemia regulation

A

Beta cells release insulin from pancreas
Fat cells take in glucose

77
Q

Hypoglycemia regulation

A

Alpha cells release glucagon in pancreas
Liver releases glucose into the blood

78
Q

Virchows triad

A

Hyper coagulation
Venous stasis
Vascular injury

79
Q

Risk factores for DVT

A

obesity
Immobilized in hospital
Previous VTE
family history

80
Q

Epidemiology of DVT

A

1/1000 per annum
30% presents as sudden death
30% develop recurrent thrombosis

81
Q

Physiology of DVT

A

often in lower limbs
Common arteries: splenic mesenteric, cerebral

82
Q

Presentation of DVT

A

Unilateral
Pain
Swelling
Increased temperature of limb

83
Q

Investigations of DVT

A

D-diner as a negative predictor
Venous ultrasonography of femoral or popliteal vein
Wells DVT score

84
Q

Treatment of DVT and PE

A

Rapid initial anti coagulation
Extended therapy to prevent recurrent thrombosis

85
Q

Clinical presentation of pulmonary embolism

A

Collapse, faintness
Pleuritic chest pain
Difficulty breathing
Haemoptysis

86
Q

Investigations of pulmonary embolism

A

Chest X ray
ABG
V/Q scan
CT pulmonary angiogram

87
Q

Complications of thrombosis

A

Embolism
Occlusion

88
Q

Aneurysm definition

A

Artery dilates 1.5x it’s normal size

89
Q

Six P’s of compartment syndrome

A

Pain
Pallor
Perishingly cold

Parasthesia
Pulseless
Paralysis

90
Q

Symptoms of arterial claudicación

A

Reduced walking ability
Improves in rest
Sore leg at night

91
Q

What can chronic claudicación lead to

A

Necrosis and gangrene

92
Q

Two main features of COPD

A

Emphysema and chronic bronchitis

93
Q

A 38 year-old woman with a strong family history of cardiovascular disease has tests to assess her cardiovascular risk.
CRP
HDL
HOMOCYSTEINE
LDL
TOTAL CHOLESTEROL

Which of the following would be the most reassuring, regarding risks of cardiovascular disease, if it were raised?

A

HDL decrease the risk of CVD

94
Q

An ultrasound scan of a pregnant woman reveals the presence of twins, each of which has its own amniotic cavity and its own chorionic cavity.
Which type of twining is this?

A

Moño amniótico twinning

95
Q

Which one of the following is a common adverse effect of dihydropyridine calcium channel blockers (e.g. amlodipine) when used for the treatment of hypertension?

A

Ankle oedema flushing, headaches

96
Q

A 25 years old person with Asthma present to hospital acutelt SOB. You perform an arterial blood gas and it shows the following:

•PO2 7.0 (12-15 kPa)
•PCO2 4.5 (4.4-6.1 kPa)
•H+ 45 (36-44 nmol/l)
•HCO3 27 (21-27.5mmol/l)

What does their blood gas show?

A

Type 1 respiratory failure

97
Q

What terminology is used to describe the combination of a base and a sugar?

A

Nucleotide

98
Q

Which of the following immune cells can undergo NETosis?

99
Q

Name two primary lymphoid organs

A

Thymus and bone marrow

100
Q

Which of the cytokines is produced by muscles during exercise and assist in immune system homeostasis?

101
Q

What regulates embryo growth

A

The growth hormone secreted by the pituitary

102
Q

What determines sex of the embryo

A

The presence of Y chromosome (SRY gene)

103
Q

Where is the SRY gene activated

A

In the somatic cells of the gonad

104
Q

Name two transcription factors

A

Tryptophan receptor
LAC receptor

105
Q

Tryp repressor + tryptophan= ?

A

No transcription

106
Q

Lac represssor+ lactose=?

A

Transcription

107
Q

What is chromatin made up of

A

DNA histones other proteins

108
Q

What do transcription factors attract

A

Histone modification enzymes
ATP Dependent chromatin remodeling complexes

109
Q

Define DNA methylation

A

Regulates gene expression by repressing unwanted genes
Inhibits transcription factors
Recruits histone modifying factors

110
Q

One multi potent haematopoetic cell can differentiate into…

A

Many different types of cells found in the blood

111
Q

Two types of lymphoid cells

A

T cells B cells

112
Q

Two types of myeloid cells

A

Macrophages neutrophils

113
Q

What cell signal controls haematopoesis

A

Stromal cell signals from the bone marrow

114
Q

Three things which influence size

A

Cell growth division and death

115
Q

What controls the final cell number

A

Proliferation and cell death

116
Q

Describe the exogenous pathway of lipid absorption

A

Triglycerides are turned into mono glycerides by gastric and pancreatic lipase
These are absorbed into enterocytes and reassembled into triglycerides
Apoprotein c and LPL turns triglycerides into fatty acids which are taken up by the muscle cells

117
Q

What lipoprotein decreases the risk of cardiovascular disease

118
Q

Function of lipoproteins

A

To transport triglycerides and cholesterol around the body

119
Q

Describe the process of atherosclerosis

A

Formation of fatty streaks
Collection of foam cells in arterial wall
Plaque formation
Necrosis of foam cells leave a cholesterol pool
Plaque rupture causes tissue ischemia

120
Q

What is the function of statins

A

To reduce LDL
Inhibits HMB-COA reductase

121
Q

High cholesterol causes a …. Risk of CVD

122
Q

Three signs of familial hyper cholesterolaemia

A

Tendon xanthoma, corneal arcus, xanthalasma

123
Q

What blood tests are taken for high cholesterol

A

Total cholesterol
HDL
triglycerides

124
Q

P wave abnormalities
Peaked tall
Notched broad

A

Peaked tall: right atrial hypertrophy
Notched broad: left atrial hypertrophy

125
Q

QRS Complex abnormalities

A

Wide: Bundle branch block, Wolff Parkinson’s white syndrome
Narrow: left ventricular hypertrophy

126
Q

ST Segment abnormalities
Raised
Depressed

A

Raised: acute MI, pericarditis
Depressed: ischemia

127
Q

T wave abnormalities

A

Peaked: hyperkalaemia
Flat: hypokalemia
Inverted: ischemia, MI

128
Q

Defenses against respiratory infection

A

Mucus
Coughing
Sneezing
Nasal hairs
Broncho constriction
Alveolar surfactant
Alveolar macrophages

129
Q

What cell produces alveolar surfactant

A

Alveolar type 2 cells

130
Q

Three factors which increase risk of infection

A

Weak immune system
Diabetes
Organ transplant

131
Q

Causation of bacterial pneumonia

A

Streptococcus pneumoniae

132
Q

Symptoms of pneumonia

A

Cough
Sputum
Fever
Breathlessness
Chest pain
Fluid in pleural space
Confusion

133
Q

Investigations of pneumonia

A

Chest x ray- pneumonia has radiological evidence
In no evidence- chest infection
Blood test- U+E CRP ABG

134
Q

Treatment of pneumonia

A

Oxygen
Fluids
Antibiotics

135
Q

Presentation of TB

A

Bad cough
Chest pain
Sputum
Fatigue
Chills
Fever
Weight loss

136
Q

Investigations of TB

A

Mantoux test
Chest x ray
Blood test
ABG

137
Q

FEV1 and FVC in obstructive lung disease

A

In obstructive lung disease, FEV1 would be less than 80% of predicted, as the airway obstruction limits air flow and increases resistance during expiration. FVC can either remain normal or decrease. The reduction of FEV1 is more drastic than FVC, resulting in a reduced FEV1/FVC ratio of <0.7.

138
Q

Tidal volume definition and normal measurement

A

Tidal volume (TV): the volume of air inhaled and exhaled during a normal quiet breath, normal TV: 500mL.

139
Q

Which class of anti-hypertensive drug can be used as an alternative to an ACE-inhibitor, if they are not tolerated?

A

Angiotensin receptor blocker

140
Q

What blood tests are indicated in a patient with signs and symptoms of heart failure?

A

BNP as a negative predictor
FBC to exclude reversible causes of hf
U+E set baseline before diuretics
Glucose and lipids for CVD risk

141
Q

What are the causes of pulmonary oedema?

A

Right ventricular failure
Calcium channel blockers
Pulmonary embolism

142
Q

What are some of the common adverse effects of Beta blockers?

A

Bradycardia
Hypotension
Fatigue
Dizziness

143
Q

FEV1 and FVC in restrictive lung disease

A

In restrictive lung disease, both FEV1 and FVC decrease
but the reduction of FVC is more drastic than FEV1, due to the limited lung expansion,
resulting in a normal or increased FEV1/FVC ratio.

144
Q

Topic: Hypertension Question: Malignant Hypertension Definition

A

Malignant hypertension is a syndrome involving severe elevation of arterial blood pressure, resulting in end-organ damage.

145
Q

What makes a good screening test

A

Cheap, reliable, minimally invasive, fast, easy access

146
Q

Name three common health screening tests

A

Prostate cancer
Diabetic eye
Hyper lipidaemia
CVD risk
Cervical cancer
Bowel cancer

147
Q

What are two risks of screening

A

Unreliable- under or over diagnosis
Follow up complications

148
Q

Name four risk factors for breast cancer

A

Family history
Obesity
Excess alcohol intake
Inactivity
Hormone replacement therapy
Pregnancy

149
Q

Breast cancer presentation

A

Breast mass
Skin changes
Metastatic disease

150
Q

Treatment of breast cancer

A

Hormone therapy
Chemotherapy
Surgery
Radiotherapy
Targeted therapy

151
Q

All cancers are treated with ______

152
Q

What week of gestation does the heart and vascular system develop

153
Q

What days does the embryo heat beat

A

Days 21-23 week 3/4

154
Q

What week does blood flow to the embryo

155
Q

Define gastrulation

A

The process by which the single layered blastocyst turns into a multi layered structure

156
Q

What forms the myocardium

A

Myocardial progenitor cells

157
Q

Function of the cardiac jelly

A

Separates the myocardium from the cardiac tube

158
Q

Vitelline veins function in fetus

A

Returning poorly oxygenated blood from the yolk sac

159
Q

Umbilical veins function in fetus

A

Carrying oxygenated blood from the chorionic sac

160
Q

What is the function of common cardinal veins

A

Returns poorly oxygenated blood from the embryo to the heart

161
Q

What is the function of the Inter ventricular septum? When does this form

A

Forms at week 8 to separate the right and left ventricles

162
Q

Why does fetal blood go straight from RA to LA

A

Since the lungs are not yet functional oxygen rich blood flows from the placenta into the RA and goes directly to the LA

163
Q

What is the most common form of hole in the heart

A

Patent foramen ovale- abnormal resorption of septum primum

164
Q

Name two rare congenital heart defects

A

Truncus arteriosus- pulmonary artery and aorta remain as one single vessel

Transposition of great arteries- pulmonary artery and aorta are swapped

Year 1 MBchB (3 decks)

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