Staffs Paramedic PPCS1 Flashcards
Where in the brain is Blood Glucose level detected?
Hypothalamus
How is a cell stimulated to allow glucose to pass from the blood inside?
Insulin binds to the insulin receptor site on the cell stimulating the Signal Transduction Pathway, vesicles containing Glucose transport proteins within their membrane are stimulated to migrate to the cell membrane. Glucose is able to pass through the glucose transport protein into the cell.
Alpha cells produce
Glucagon
Beta cells produce?
Insulin
Where is the Pancreas found?
Sub sternal, posterior to the xyphoid process
What are the two functions of the pancreas?
Endocrine- Hormone production
Exocrine- Enzyme production
What does insulin binding to the receptor site of a cell stimulate?
The SIGNAL TRANSDUCTION PATHWAY
What are embedded in the phospholipid bilayer of the vesicles of a cell that enable glucose to pass across the membrane?
GLUCOSE TRANSPORT PROTEINS
What are the two most common causes of pancreatitis?
Alcohol consumption
and
Gall stones
In simplistic terms what happens to the pancreas resulting in pancreatitis?
The Enzymes produced begin to digest the tissues of the organ.
Why is bruising often seen on the abdomen of a patient with pancreatitis?
Because the pancreas is situated outside of the peritoneum
Bruising seen around the Umbilicus in a patient with/suspected pancreatitis?
CULLENS SIGN
Bruising seen in the flank of a patient with/suspected pancreatitis is called?
GREYS TURNER SIGN
What are the names of the two enzymes produced by the pancreas and released into the duodenum of the GI tract that help digestion of protein?
TRYPSIN
and
CHYMOTRYPSIN
What is the name of the route taken by enzymes produced by the pancreas snd concentrated bile from the gall bladder to the GI tract (duodenum)?
Pancreatic duct
What is the name given to enzymes that digest proteins?
Protease
What is the name given to enzymes that digest Fats?
Lipase
What is the name given to the enzymes that digest carbohydrates (sugars)?
Amylase
What syndrome is the prolonged over production of cortisol?
Cushing’s Syndrome
What is Cushing’s disease?
A benign tumour of the pituitary gland
Where is the pituitary gland found?
In the brain, inferior to the hypothalamus.
Tumours of the _____________, _____________, and _________________ can result in over stimulation of the adrenal glands and over production of cortisol.
Pituitary gland, Lungs and Adrenal glands.
A patient that has been treated with what type of medication for a long time is at high risk of developing Cushing’s syndrome?
Hydrocortisone or other corticosteroids
What are the three main implications of long term exposure to high levels of cortisol?
Immune suppression, Osteoporosis, and Diabetes
What is the name of the hormone produced by the pituitary gland, that stimulates the adrenal glands to secrete cortisol?
ACTH- Adrenocorticotropic Hormone
Where are the adrenal glands located
Superior to the kidneys
What hormone is produced by the adrenal glands as a response to stressors?
Cortisol (glucocorticoid steroids)
What is the affect on the body of glucocortico steroids?
Strong anti inflammatory
What are the two types of stroke?
Ischaemic - most common- a thrombus (clot) or embolus blocking blood supply causing an area of ischaemia in the brain.
Haemorrhagic- A bleed from a blood vessel in the brain causes reduced perfusion of an area of brain tissue
Where is Mc Burney’s point, and what is considered a positive finding?
Mc Burney’s point is 1/3 of the way between the anterior superior iliac spine (ASIS) and the naval.
If pain in the lower right iliac region is relieved by applying pressure to McBurney point but immediately returns when pressure from the point is removed, this is considered a positive finding for a differential diagnosis for ?APPENDICITIS.
What is Psoas sign and what is considered a positive finding?
Psoas sign is a positive for a differential diagnosis of ?Appendicitis. A positive Psoas sign is seen if a patient presenting with right iliac region pain of no know origin is unable to lie on their back and raise their right leg without an increase in the pain. Thisn
What is Rosvings sign and what would be considered a positive finding?
Rosvings sign is a diagnostic tool to help diagnose possible appendicitis in a patient presenting with right iliac region tenderness/pain of no known cause. A positive finding is seen when pressure is applied by hand to the left lower abdomen and quickly released causing an increase in the pain in the right side on rebound.
What is the result of hyperplasia of goblet cells in the epithelium of the lower respiratory tract?
Reduced diameter of the lumen
What type of COPD patient is often referred to as a BLUE BLOATER
Chronic Bronchitis
What type of COPD patient is often referred to as a PINK PUFFER
EMPHYSEMA
What is an extrinsic trigger of an asthma attack?
Allergens
What is an intrinsic cause of an asthma attack?
Non allergens
(e.g.- infection, cold air, exercise, medication (NSAIDs etc), inhalation of irritants (smoke, pollution etc)
What is the equation for mean arterial pressure?
MAP = (Systolic) + 2(diastolic) / 3
What is the equation to work out cerebral perfusion pressure (CPP)
CPP = MAP - ICP
(ICP - Inter Cranial Pressure)
Why do signals move faster through Myelinated neurones that un-myelinated neurones?
Due to saltatory conduction - the action potential is able to jump between the nodes of ranvier
What is meant by the term
Half-life when referring to a medication?
The half-life is the time it takes for the plasma concentration of a drug to reduce by half, usually as a result of elimination.
How many half-lives does it take for most medication to be completely eliminated from the blood plasma?
Five (5)
If a medication has a half life of 5 hours and it takes 5 half lives for complete elimination how long will complete elimination of the drug take?
5 X 5 = 25
It will take 25 hours for complete elimination of the drug from the blood plasma.
What is meant by the term pharmacokinetics?
What the body does with or to a drug.
A, D, M & E
Absorption, Distribution, Metabolism and Elimination.
What is meant by the term pharmacodynamics?
What a drug does to you
Pharmacodynamics is the study of the mechanisms by which medications produce biochemical or physiological changes in the body.
What are the two types of pain experienced?
Nociceptive- damage caused to the body by external stimuli triggers nociceptive pain.
Neuropathic- pain stimulated by the nerves themselves without external stimuli
What is the name of the tract in the spinal chord that action potentials generated from external stimuli pass to the thalamus in the brain for interpretation?
The Spinothalamic tract
If low blood sugar is detected by the hypothalamus in the brain the production of what hormone is stimulated and where is it made?
Glucagon.
Made by alpha cells in the Islets of Langerhans in the Pancreas.
What tissue in the body does Glucagon bind to, what is broken down and what are the products when Glucagon binds to receptor sites?
Glucagon binds to receptor sites on the cells of Adipose tissue. Triglycerides are broken down into fatty acids (ketones) and glycerol.
Describe the process of glucose production when low blood sugars are detected by the hypothalamus.
Glucagon production is stimulated in the pancreas.
Glucagon binds to adipose tissue.
Triglycerides in the adipose tissue are broken down into glycerol and Ketones (fatty acids)
Ketones are used by the liver as energy to produce new glucose from the glycerol. (GlucoNeoGenisis)
Glucagon also binds to receptor sites on liver cells releasing the glycerol stored in the liver.
What are the four main types of Diabetes?
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Diabetes Insipidus
Gestational Diabetes
How does an expectant mother develop Gestational Diabetes?
Hormones produced by the placenta (mainly Oestrogen and cortisol) pass into the blood stream of the mother. They cause insulin resistance resulting in a rise in Blood sugars. Usually the pancreas increases insulin production to overcome resistance but in some mothers it is unable to cope with the demand.
Explain the process of the development of Type 1 Diabetes Mellitus.
In some people an auto immune response causes the destruction of some of all of the Beta cells in the Islets of Langerhans in the pancreas. Beta cells are responsible for the production of insulin and so these people are unable to produce their own insulin.
Describe the cause of Type 2 Diabetes Mellitus.
The Beta cells in the Islets of Langerhans in the Pancreas are unable to meet the demand of the body for insulin, usually as a result of the blood sugars remaining high due to poor diet or lack of exercise. The Insulin receptors on cells also become less reactive to the insulin that is produced.
What is the main aim of medication taken by Type 2 Diabetes patients?
To increase the production of insulin
and
To increase the reactivity of insulin receptors on tissue cells.
What causes Diabetes insipidus
A reduction in the production of anti diuretic hormone (ADH) causes the patient to urinate more often (Polyuria). This causes the blood to become more concentrated (as a result Blood sugar levels increase).
The S__________ T___________P___________ is stimulated by insulin molecules binding to the insulin receptor sites on cells.
Signal Transduction Pathway
Describe Bronchiectasis
Bronchiectasis is a chronic condition that causes the bronchi to widen, leading to a build up of mucus and leaving the patient more susceptible to respiratory tract infections.