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SAQs > Shit you just gotta know - Renal to metabolism > Flashcards

Shit you just gotta know - Renal to metabolism Flashcards

1
Q

most common bacteria in UTI? name one other pathogen

A

E.Coli. Stap. Saprophyticus

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2
Q

name 4 endocrine products of the kidney

A

EPO, Renin, Vitamin D3, Prostacyclin

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3
Q

describe the position and function of the macula densa. what do they sense?

A

sensitive to the concentration of sodium chloride in the late thick ascending limb.

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4
Q

how do the kidney alter pH(2)?

A

can alter production and excretion of HCO3-.

Can alter excretion of H+

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5
Q

3 types of cell in the glomerulus

A

endothelial, mesangial and epithelial

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6
Q

what does Acute renal failure specifically refer to? how is it measured?

A

reduction in GFR reflected as reduced creatinine clearance.

measured by an increase in serum creatinine and urea

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7
Q

what is nephrotic syndrome (4)? what is the issue?

A

nonspecific kidney disorder characterised by: proteinuria, hypoalbuminemia, edema (whole body) and hyperlipidemia.
Problem is due to increased golmeruli permeability to proteins

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8
Q

3 forms of glumerulonephritis

A

IgA nephropathy (most common), Acute post infection (strep P. - more common rurally) and membranous nephropathy (common form causing proteinuria)

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9
Q

glomuerlonephritis is most commonly mediated by what?

A

immune complex deposition

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10
Q

most common cause of acute renal failure? whats it normally caused by?

A

acute tubular necrosis - caused by ischaemia

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11
Q

function of occulumotor nerve

A

somatic motor: SR, IR, MR, IO and elevates eyelid.

Visceral motor: sphincter Puppilae(constricts pupil) and Cilliary Muscle (changes lens- allows Focus).

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12
Q

function of trigeminal

A

all branches sensation to front half of head. V3 does ant 2/3s sensory of tongue and motor of tensor tympani and maasseter

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13
Q

function of accessory nerve

A

shrug shoulders SCM and trapezius

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14
Q

function of CN9?

A

motor: stylopharyngeal.
sensory: posterior 3rd of tongue, pharynx and middle ear.

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15
Q

Eye ant to post from cornea?

A

cornea > ant chamber > iris+pupil> post chamber > lens

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16
Q

3 layers of eye?

A

outer coat (sclera and cornea), middle (uvea) and inner (retina)

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17
Q

muscles of pupil and innervation

A 
Sphincter Puppilae (PNS - CNIII) constricts Pupil. 
Dilator Pupillae (SNS) dilates Pupil. Remember: adrenaline rush eyes dilate so sympathetic for dilator
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18
Q

function of ciliary muscle and innervation? what connects cilliary muscle to lens?

A

changes Shape of lens allowing focus - CNIII. Zonules connect muscle and lens

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19
Q

describe vascular pathway of eye.

A

all supplied by opthalmic artery which is branch of internal carotid.
Central Renal does inner part of retina.
Short and long Posterior - travel in choroid and do photoreceptors.
Anterior Cilliary - doesnt pierce globe - does anterior

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20
Q

describe blood supply of retina

A

dual supply - CRA does inner whilst posterior ciliary does outer

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21
Q

photoreceptors are hyper or de polarized by light? exaplain why

A

hyper. light causes cGMP gated Na gate to close, hyperpolarizing the cell

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22
Q

On bipolar cells are hyper or de polarized when active?

A

de

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23
Q

which photoreceptors are responsible for night vision?

A

rods

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24
Q

2 types of ganglion cells and thier function

A

M does motion, P does picture (colour, acuity).

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25
Q

describe which parts of brain process each eye

A

right visual hemisphere (right hand side of each eye) processed by left brain and vice versa

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26
Q

does nasal side of vision cross or stay

A

stay. lateral crosses

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27
Q

what is a saccadic eye movement?

A

shift fovea rapidly to new visual target

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28
Q

the dorsal pathway of visual processing is for what?

A

motion

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29
Q

what is a lack of red cone called? blue? green?

A

protanope, tritanope and deutonope

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30
Q

compare protonomal with protonope

A

nope has no red cones whereas normal has abnormal red cone

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31
Q

name the 3 scala within the ear from top to bottom. what they filled with?

A

vestibule (perilymph and low K), media (endolymph and high K) and tympani (perilymph and low K).

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32
Q

where does the spinal cord end?

A

L1/2

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33
Q

local anaesthetics block which channel?

A

Na

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34
Q

describe the 4 mechanoreceptors of the skin

A

merkel = surface and slow. Meissner = surface and fast.
ruffini = deep and slow. Pacinian = deep and fast.
The superficial are smaller so have a higher density

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35
Q

describe how the primary somatosensory cortex is organized

A

head down to toes in consequential order while different parts have differents amounts of brain corresponding to them (eg lips and hands more than leg).

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36
Q

name 3 things the DCML picks up?

A

fine touch, vibration and pressure

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37
Q

name 3 things the Anteriorolateral Spinal Tract picks up?

A

temperature, pain and crude touch

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38
Q

route of anterio-lateral spinal tract

A

peripheral nerves > synapse in spinal cord 1-2 levels above > deccusates to synapse in thalamus > synapse in cortex

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39
Q

3 types of symp vs para interaction giving 1 example at each

A

genuinely antagonistic at cellular level (heart rate). Functionally antagonistic but via different cells (urinary voiding and continence).
Dif actions but not opposed (serous salivary and mucus salivary secretions)

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40
Q

most common bacterial causes of meningitis in adult? what feature do they have in common

A

H. influenzae (type B), N. meningitidis and Strep. Pneumoniae. They all encapsualted

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41
Q

enchephalitis is almost always caused by which organism. how does it differ clinically?

A

HSV. may have a altered conscious state in encephalitis.

42
Q

pathology in parkinsons?

A

degeneration of the dopaminergic nerve in substantia nigra

43
Q

dif b/w decorticate rigidity and decerebrate rigidity

A

decroticate arms flexed, legs extended. Decerebrate all extended

44
Q

3 types of strokes (in order of frequency)

A

infarction (75%), haemorrhage (20%) and subarachnoid haemorrhage [5%}

45
Q

particular sites of thrombotic occlusion in cerebral infarct (3)?

A

distal internal carotid, vertebral and basilar

46
Q

function of basal ganglia? (3)

A

initiating movement, selecting complex pattern movements, evaluating success in achieving movement goals

47
Q

name the components of the basal ganglia and describe their position on a coronal slice

A

caudate nucleus (either side of lat. ventricles), Putamen (most lateral), globus pallidus (external and internal, medially adjacent to putamen), subthalamic nucleus (under thalamus) & substantia nigra (under subthalamic)

48
Q

what are the pre and post-central gyrus respectively

A 
pre = primary motor cortex.
post = primary somatosensory cortex
49
Q

name 3 diseases cuaed by abnormal protein folding

A

parkinson’s, alzheimers and CJD

50
Q

The PFC is largely responsible?

A

planning (P for Planning)

51
Q

inhibition of innapropriate behavior is processed in which part of the cortex

A

orbito-frontal (smack yourself above eyes for being an idiot)

52
Q

motivation and emotion processing is carried out where?

A

MPFC (M for motivation)

53
Q

The DLPFC (dorsolateral) is essential for?

A

working memory(pull memories out the back of your head)

54
Q

which aphasia is fluent?

A

Weirneke’s

55
Q

which aphasia is associated with Right face and upper limb weakness

A

Broca’s

56
Q

which artery is associated with Broca’s? W’s?

A

superior MCA. Inferior MCA

57
Q

Frontotemporal dimension (age, progression, deficits)?

A

pre-senile, insidious, behavioural changes first

58
Q

subdural haemorrhage c.f. extradural? (vasculature, timecourse)

A

subdural venous and insidious (weeks to months)

59
Q

what is a fasciculation? upper or lower motor neuron problem?

A

flicker of muscle movement - LMN

60
Q

A 29 year-old man presented to ED with a sudden onset of a severe headache. A CT indicates a ruptured aneurysm was the cause of the man’s condition.

a. Epidural haemorrhage.
b. Skull fracture involving the pterion.
c. Subarachnoid haemorrhage.
d. Severe meningitis.
e. Depressed skull fracture and cortical laceration.

A

C - Spontaneous severe thunderclap headache (“worse headache I have ever had”) consistent with spontaneous rupture of berry aneurysms leading to subarachnoid haemorrhage.

61
Q

where would a lesion most likely result in loss of consciousness?

A

midbrain

62
Q

In regards to cranial nerve nuclei in the brainstem which is more medial (motor or sensory)

A

motor (m for medial)

63
Q

what is a tropic hormone? what is normal suffix? what is tophic?

A

hormone that controls secretion of another hormone - tropin. Trophic usually stimulates growth

64
Q

which 2 types of hormones have similar MOAs

A

Peptides with catecholamines and steroids with thyroid

65
Q

which hormones are lipophilic?

A

steroids and thyroid

66
Q

which hormones have a short half life?

A

peptides and catecholamines

67
Q

how are peptides and catecholamines transported?

A

dissolved in plasma

68
Q

what do steroids and thyroid do when activating receptors compared to peptides + catechols?

A

gene transcription and translation compared with 2nd messenger system

69
Q

what does Carbimazole do? MOA

A

treats Graves - Inhibits thyroid peroxidise (turns T4 to T3) which is a precursor for Thyroid Hormone

70
Q

Describe the structure of a thyroid histologically?

A

made of thyroid follicles which is colloid (yellow gel) surrounded by follicular cells. Occasional C cells on peripehery

71
Q

where is the TSH receptor?

A

on the follicular cell

72
Q

how do T3 and T4 travel in blood? (3)?

A

Albumin, transthyretin and TBG

73
Q

describe the adrenal medulla. what does it produce?

A

modified sympathetic ganglion - secretes catecholamines

74
Q

describe the adrenal cortex from outer to inner. what is produce in each section?

A

GFR (Zona Glomerulosa, Zona Fasiculata, Zona Reticularis).
G = aldosterone (minarelocorticoids).
F = Cortisol (glucocorticoids) (also input from R).
R = Sex Hormones (also input from F).

75
Q

what is addisons disease?

A

hyposecretion of cortisol and/or aldosterone

76
Q

What is HBA1c and what is it used for?

A

Glycated haemoglobin. a protein in RBCs that’s non enzymatically Glycated in hyperglycaemia.
Used as an inderct measure of blood glucose for last 3 months (RBCs live 3
Months.

77
Q

Describe an islet of langerhan, it’s cell types, proportions, relative positions and what they secrete.

A

Spherical core of beta cells (80%) surrounded by alpha (10%), delta (5%) and theta (5%).
Beta insulin + amylin. Alpha glucagon
Delta = somatostatin
Theta = pancreatic polypeptide

78
Q

What is an incretin? What causes incretin secretion? Which is the most potent incretin?

A

A gut hormone that induces insulin release. Nutrients - glucose, fatty acids, amino acids. GLP-1

79
Q

What does GLP -1 stand for and what does it do?

A

Glucagon like peptide.
Stimulates pro insulin & insulin biosynthesis.
Inhibits glucagon secretion and gastric emptying

80
Q

What is orlistat and how does it work?

A

Obesity drug that is a lipase inhibitor. Doesn’t allow fat to break down so decreases it’s absorption

81
Q

3 main complications of hyperglycemia

A

Retinopathy, nephropathy, neuropathy

82
Q

Describe the Macrovascular complications of diabetes

A

Atheroma is accelerated and more severe. It is in the usual places (aorta, coronies, carotids)

83
Q

Which cells do AGEs bind? (3)

A

Bind to receptors in inflammatory cells, endothelial cells and vascular smooth muscle cells

84
Q

Where does amylin come from and what does it do (3)?

A

Beta cells. Co secreted with insulin.

Inhibits glucagon secretion, delays gastric emptying, inhibits food intake

85
Q

Actions of metformin(4)? When is metformin contraindicated?

A 
Increase glucose uptake.
Reduce hepatic glucose production.
Decrease carb absorption.
Decrease LDL and triglycerides.
Contra with impaired renal function
86
Q

What is the MOA of ghrelin and it’s action?

Where is ghrelin secreted from?

A

Stimulates hunger by upregulating NPY.

Secreted mainly in the stomach but also other parts of GIT

87
Q

Name the fat soluble vitamins

A

ADEK

88
Q

Energy of NADH (Lj/mol)?

A

220

89
Q

What does ghrelin translate as, what is it’s MOA and when does it peak in blood

A

greek for grow Stimulates hunger by activating NPY (neuro peptide Y). Peaks 3 times per day (with meals)

90
Q

Energy of ATP (kj/mol)?

A

30.5

91
Q

Name the 4 main things that mitochondria do?

A

Acetyl-CoA production (pyruvate or fatty acid oxidation) Ketone body synthesis Krebs cycle Oxidative phosphorylation

92
Q

Where is GULT-4

A

Striated muscle (skeletal and cardiac) and adipose tissue

93
Q

Leptin is Greek for what? What does it do

A

Greek for thin Leptin signals body to that is is full (stop eating)

94
Q

What is corn deficient in and what dies this cause. which vitamin need this amino acid

A

Amino acid TRP. causes pellagra. niacin

95
Q

What is pellagra?

A

4 Ds (diarrhea, dermatitis, dementia and death)

96
Q

Why are low glycemic index diets justified?

A

The avoid high glucose peaks that can lead to insulin resistance

97
Q

Which GLUT is regulated by insulin?

A

GLUT-4

98
Q

Most common vitamin deficiency in Australia and it’s cause?

A

B1 thiamine WK syndrome in alcoholics

99
Q

What is an adverse side effect of statins and what should be used to counter this?

A

Skeletal and cardiac muscle complications. Supplement with Q10(ubiquinone)

100
Q

What does fibre protect against (2things)?

A

Diverticulosis and haemorrhoids

101
Q

Why are vitamins necessary?

A

Not made by body and are essential in biochemical function.

102
Q

What does PEM stand for? What causes it?

A

Protein-energy malnutrition Caused by inadequate intake of macronutrients

SAQs (13 decks)

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