Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My CLASP Y3 > Sudden Death > Flashcards

Sudden Death Flashcards

1
Q

What are motifs in genetics?

A

sequences which indicate where splicing should take place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the most likely genetic change to cause long QT syndrome?

A

premature stop codon in the exon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is NGS better than conventional sequencing?

A

allows more efficient analysis of multiple genes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is PCR used for?

A

looking for one gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the penetrance/frequency of Mendelian disorders?

A

high penetrance

low population frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are good drugs for hypercholesterolaemia?

A

PCSK9 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the major side-effect of statins?

A

myalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do you calculate the correct QT interval for long QT syndrome?

A

QT interval/square root R-R interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What arrhythmia are people with long QT at risk of?

A

Torsades de Pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the observations in sepsis?

A

tachycardia
low BP
longer capillary return
tachypnoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the treatment for long QT?

A

beta blockers and an ICD if recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is shock?

A

condition of inadequate perfusion to sustain normal organ function with resulting organ dysfunction and eventual death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the types of shock?

A 
hypovolaemic
cardiogenic
obstructive
distributive
cytotoxic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the cause of hypovolaemic shock?

A

loss of circulating volume with fall in CO due to hemorrhage, third space loss (eg massive inflammation) or severe dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the compensatory mechanism for hypovolaemic shock?

A

baroreceptor reflexes (receptors in carotid sinus and aortic arch inhibit parasympathetic and increase sympathetic) –> sympathetic neurohormonal response (chronotropy and inotropy with adrenaline, angiotensin, vasopressin etc which causes fluid redirection and lactic acidosis) –> capillary absorption of interstitial fluid –> endocrine response (renin is released and then angiotensin 2 enhances vasoconstriction and ADH secretion so renal reabsorption of Na and H2O)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is cardiogenic shock?

A

failure of heart to pump well so reduced CO, eg complication of acute MI, myocarditis or acute valve pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the presentation of a patient with cardiogenic shock?

A

hypotension, fatigue, syncope, pulmonary oedema, high JVP and hepatic congestion (poor forward flow and backpressure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is cardiogenic shock treated?

A

increase inotropy by beta and dopaminergic stimulation with adrenaline or dopamine or an intra-aortic balloon pump can be used

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is obstructive shock?

A

physical obstruction to heart or great vessels which impairs cardiac filling eg PE or tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is distributive shock?

A

septic, anaphylactic and neurogenic shock ie uncontrolled vasodilation and reduction in SVR overcomes the compensatory mechanisms of increased CO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is septic shock?

A
  • bacterial endotoxins so there are rising lactate levels

- vasopressors needed to improve perfusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is anaphylactic shock?

A
  • mast cell release and degranulation or histaminergic vasodilators
  • adrenaline is needed to vasoconstrict and stabilise mast cells
  • diagnosis is confirmed with serum mast cell tryptase levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is neurogenic shock?

A
  • loss of thoracic sympathetic outflow due to spinal injury and there will be bradycardia too
  • treatment is with dopamine and vasopressors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is cytotoxic shock?

A

haemoglobin or mitochondrial poisoning impairing oxygen transport or utilization eg from CO or cyanide poisoning

25
Q

What is clinical death?

A

reversible state but there is only a certain amount of time to reverse this

26
Q

What is biologic death?

A

irreversible state of cellular destruction

27
Q

What is agonal breathing?

A

can occur just before a cardiac arrest and is not a sign of life

28
Q

What is the best depth for CPR?

A

5-6cm

29
Q

What is trans thoracic impedance?

A

natural resistance of the body to current flow and is related to size, age and skin type

30
Q

What are the drugs given in CPR and when?

A

amiodarone and adrenaline are given after three shocks and then every 3-5 minutes

31
Q

Where does each colour of ECG lead go?

A

leads on each shoulder and down at the top of left pelvis (red right arm, yellow left arm and green leg)

32
Q

What is the normal PR interval?

A

0.12-0.20s

33
Q

What is the normal QRS width?

A

0.08-0.12s

34
Q

What is the normal QT interval?

A

0.35-0.43s

35
Q

What is one small square on an ECG?

A

0.04s

36
Q

What are the different ways to calculate HR on an ECG?

A

300/R-R interval in large squares OR number of cardiac cycles in 6s (30 large squares) and times by 10

37
Q

What is pre-load of the heart?

A

volume and stretch of the ventricular myocardium at the end of diastole

38
Q

What is after-load of the heart?

A

amount of pressure against which the left ventricle must work during systole to open the aortic valve

39
Q

What is the diagnosis of a patient who is clammy and unwell but is then normal again?

A
  • Brugada
  • wide QRS and potential ST elevation
  • test=provocation testing
40
Q

What is a stillbirth?

A

baby dies after 24 weeks of pregnancy which can be ante-partum or intrapartum

41
Q

What is a miscarriage?

A

loss of a baby before 24 weeks

42
Q

What are the main causes of stillbirth?

A
  • placental causes
  • congenital abnormalities
  • during birth (can be infection, placental abruption etc)
  • mother’s health
43
Q

What are the risk factors for stillbirth?

A
  • obesity
  • lifestyle
  • extremes of age
  • ethnic minorities
  • prolonged pregnancies
  • twins
  • smoking during pregnancy
  • previous stillbirths
44
Q

What should women who are pregnant take?

A
  • vit D
  • folic acid
  • get flu jab
45
Q

What is used within the MDT to review baby deaths?

A

Perinatal Mortality Review Tool

46
Q

What is SUDI?

A

Sudden unexpected death in infancy includes all deaths which happen suddenly with no reason and will be called this if and when a cause can be found PM

47
Q

What is sudden infant death syndrome?

A

no pathology or risk factors present and this is a diagnosis of exclusion so these are a subset of all the SUDIs investigated

48
Q

What are the risk factors for SIDS?

A
  • preterm birth
  • being small
  • maternal smoking
  • infection
  • prone position
  • overheating
  • head covering
  • deprived areas
  • co-sleeping
49
Q

What is the best way to protect babies from dying young?

A

sleep on their backs

50
Q

What are the main causes of unexplained SUDI?

A

infections including pneumonia, myocarditis and sepsis

51
Q

What are the possible additional tests done during a post-mortem?

A
  • histology
  • toxicology
  • genetics
  • neuropathology
  • microbiology
52
Q

What is sudden death?

A

death within 24 hours of the onset of symptoms

53
Q

What are the reversible causes of cardiac arrest?

A
  • hypoxia
  • hypovolaemia
  • hypo/hyperkalaemia
  • hypothermia
  • thrombosis
  • tamponade
  • toxins
  • tension pneumothorax
54
Q

How do hypoxia and hypovolaemia cause cardiac arrest?

A
  • Hypoxia: asthma, epiglottitis/swollen tonsils, pneumothorax, choking (small red capillaries from struggle), drowning, respiratory depression from drugs and aspiration
  • Hypovolaemia: upper or lower GI bleed, aneurysms including AAA and trauma of various types
55
Q

How do hypo/hyperkalaemia and hypothermia cause cardiac arrest?

A
  • Hypo/Hyperkalemia: diabetic or alcoholic ketoacidosis and toxins, treated with calcium chloride and then insulin and dextrose solution
  • Hypothermia: cold (Wischnewski ulcers), alcoholic and drugs
56
Q

How does tamponade cause cardiac arrest?

A
  • after MI
  • pericarditis
  • aortic dissection
  • trauma
  • neoplasm
57
Q

How do toxins and tension pneumothorax cause cardiac arrest?

A
  • Toxins: overdose, incorrect dose and poisoning

- Tension pneumothorax: trauma or due to chronic lung disease

58
Q

How does thrombosis cause cardiac arrest?

A
  • lungs from DVT or otherwise
  • coronary arteries (ear lobe crease or corneal arcus from hyperlipidaemia) leading to MI (and then to pericarditis and cardiac aneurysm)
  • hypertensive heart disease (cardiomegaly)
  • significantly frightening altercation or event

My CLASP Y3 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions