Test 3 Clinical Applications Flashcards
Damage to lower motor neurons produces what:
a flaccid paralysis
Damage to upper motor neurons produces what?
A few weeks of spastic paralysis.
Characterized by increased muscle tone, exaggerated stretch reflexes and other sings of hyper active lower motor neurons.
What effect do upper motor neurons have on lower motor neurons?
They inhibit them.
This is seen because lower motor neurons are hyper active without them.
Clonus:
on oscillation of a foot or other appendage caused by hyperactive stretch reflexes. Example being hamstring feels overly stretched, and fires too hard, which stretches the quad, which fires to hard, which stretches the hamstring, and so on.
What is another term for lower motor neurons?
motoneurons.
Function:
Troponin C:
Troponin I:
Troponin T:
Troponin C: Binds calcium Troponin I: inhibits binding of myosin head to active site Troponin T: Binds to tropomyosin.
What is a preferred blood test for detecting myocardial infarction (it relates to proteins associated with muscle):
Testing for myocardial specific troponin T and I (uses antibodies to find)
Creatine kinase isoenzyme (not as specific to the heart)
Calcium Channel blockers have what overall function?
Block voltage gated Ca2+ channels in muscles and pacemaker cells.
Dihydropyridines:
- Are class of:
- Are relatively specific for:
- Cause what?
- Are class of: Ca2+ channel blockers (block DHP channels) - Are relatively specific for: vascular smooth muscle - Cause what? Vasodilation
Cardizem:
Ca2+ channel blocker
- Promotes slowing of the heart
- Promotes vasodilation
Palpitations:
a noticeably rapid, strong, or irregular heartbeat due to agitation, exertion, or illness.
Iron-deficiency anemia:
Low RBCs or hemaglobin.
results from insufficient iron for proper production of hemoglobin.
Pernicious anemia:
- Define:
- Possible causes:
- Define:
Due to a lack of intrinsic factor, which is necessary for absorption of B12
B12 in turn is necessary for production of hemaglobin - Possible causes:
autoimmune attack of gastric epithelium (and other causes)
Aplastic Anemia:
Damage to the bone marrow (chemo or radiation)
Plasia = growth or development. Aplasia would be a lack of growth or development. Aplastic anemia would be a lack of growth or development of RBCs, this is caused by an inability to develop (some form of insult to the bone marrow, an example being leukemia)
How might heavy menstruations and fatigue be related?
Cause extreme loss of blood, and more importantly iron. Results in iron-deficiency anemia (which in turn results in hypoxia)
Polycythemia:
abnormally large amounts of RBCs (opposite of anemia). May occur due to due to low oxygen levels in the environment.
Leukopenia:
abnormally low WBC count. Radiation is one potential cause.
Leukocytosis:
abnormally high WBC count, which can be caused by high cytokine levels during an infection
Leukocytosis:
Leuk = purtaining to WBCs
Cyto = cell
osis = Often swelling, which could be caused by increased proliferation. Leukocytosis = increased WBCs. (cyt = normal cells, not diseased)
Leukemia:
cancer of bone marrow, causes high number of abnormal and immature WBCs to appear in the blood.
Thrombocytosis:
- Causes:
- Regulation of the thrombin:
- Causes:
Elevated platelet count (due to bleeding injury, cancer, and others which stimulates the liver to produce excess thrombopoietin - Regulation of the thrombin:
However this production is normally adjusted automatically because the normal mechanisms which regulate thrombopoietin levels (mentioned elsewhere)
Hematopoietic stem cell transplants:
- Autologous tranplant:
- Allogeneic transplant:
- Autologous tranplant:
You can give patients granulocyte colony stimulating factor (G-CSF) and granulocyte/monocyte colony stimulating factor (GM-CSF). This increase in granulocytes and monocytes allows you to take the patients cells before chemo or radiation therapy and then give it back to them afterwards. This is called an Autologous tranplant. - Allogeneic transplant:
transplant someone else’s blood
G-CSF:
- Stands for what:
- Does what:
- Stands for what:
Granulocyte colony stimulating factor - Does what:
Increases granulocyte production
GM-CSF:
- Stands for what:
- Does what:
- Stands for what:
Granulocyte/monocyte colony stimulating factor: - Does what:
Increases granulocyte and monocyte production
Platelet aggregation inhibitors:
- Define:
- treats what:
- Define:
Inhibits platelet formation - treats what:
helps to prevent coronary thrombosis or pulmonary embolism
Aspirin mechanism of action:
Irreversibly inhibits the enzyme cyclooxygenase, which makes prostaglandin.
Inhibits platelet formation of the prostaglandin thromboxane A2
Hemophilia A:
Caused by a defect in clotting factor 8
Interferes with intrinisic pathway
X linked recessive
Von Willbrand’s Disease:
Due to defect in a subunit of factor 8
Causes defective von willebrand’s factor
X linked recessive
Hemophilia B (Christmas Disease):
Clotting factor IX defect
X linked
Recentrly treated with gene therapy
Thrombolytic agents:
- Define:
- List:
- Treat:
- Define:
Drugs that function as protease enzymes and convert plasminogen to plasmin. - List:
tPA, urokinase (bacteria made), streptokinase (bacteria made) - Treat:
This helps to treat any type of thrombosis (internal blood clot), including deep vein thrombosis, stroke, coronary thrombosis, and pulmonary embolism.
Rivaroxaban:
Inactivates factor X
breaks the clotting cascade, no formation of complex V
Auscultatory Chest Positions:
- Best place to hear mitral valve:
- Best place to hear tricuspid valve:
- Best place to hear aortic semilunar valve:
- Best place to hear pulmonary semilunar valve:
- Best place to hear mitral valve: fifth left intercostal space - Best place to hear tricuspid valve: Either side of the lower sternum - Best place to hear aortic semilunar valve: second left intercostal space - Best place to hear pulmonary semilunar valve: second right intercostal space
Atrial fibrilation:
- What is it:
- Effect on health:
- Treatment:
- What is it: Failure of the atria to contract - Effect on health: You'll live, but excursive is more tiring. Also have increased risk of blood clot formation in atria (and therefore stroke) - Treatment: Anticoagulant: warfarin (blocks vitamin K reduction) aspirin (blocks thromboxane A2) rivaroxaban (inhibits factor X activity)
Digitalis or digoxin:
- Mechanism of action:
- Effect on the heart:
- Mechanism of action:
Inactivates Na+/K+ atpase pumps in myocardial cells (cannot pump Na out of the cell) plasma membrane - Effect on the heart:
Ca/Na exchanger normally pumps out Ca and brings in Na.
Digitalis increases intracellular Na, which causes the pump to run the other way. Increases intracellular Ca2+ levels (including in the SR). Increases the strength of the contraction of the heart.
Also slows conduction across AV node.
Aneurism:
- Define:
- Possible positions:
Balloon like swelling in an artery, or in weakened ventricular wall.
- Thoracic:
- Abdominal:
Dissected Aorta:
Split in an aneurism
Fibroblast growth factor effect on angiogenesis:
It inhibits it.
Avastin:
- Treats what:
- How:
- Treats what:
cancer, neovascular-age related macular degeneration - How:
Antibody which binds to and inactivates VEGF (vascular endothelial growth factor)
Lucentis:
- Is similar to what?
- How is it different?
- Is similar to what?
Avastin - How is it different?
It can work in the eye (without killing it)
Varicose Veins:
- Define:
- Causative factors:
- Therapeutic routes:
- Define:
Enlarged surface veins (lower limbs) due to venous valves which no longer close - Causative factors:
Genetic susceptibility, standing often, obesity, age, pregnancy - Therapeutic routes:
Moving helps
Compression stocking
Leg elevation
Sclerotherapy
Laster therapy
Ligation and strippnig (typing of and removing veins)
Sclerotherapy:
Scaring of veins with chemicals to shrink varicose veins.
What does varicose veins increase the chance of?
A deep vein thrombosis.
Venous thromboembolism.
Statins:
- Mechanism of action:
- Surprising other effect:
- Mechanism of action:
Inhibit HMG-coenzyme A reductase.
This is the rate limiting enzyme in liver cholesterol synthesis.
This causes increased production of LDL receptors, to increase intracellular cholesterol. Lowering plasma LDL conc. - Surprising other effect:
Slightly increase HDL levels.
Eating fish, walnuts, soybean, canola oil helps lowers LDL contains what:
Omega three fatty acids
Uterine Fibroids:
Benign tumors (leiomymoma) of the myoometrium
70% - 80% of women at age 50 have fibroids
Can be removed through surgery including a hysterectomy
Can cause profuse menstrual bleeding, loss of pregnancy, urinary inconsistencies or pelvic discomfort
Polycistic ovarian syndrome:
- Define:
- Symptoms:
- Define:
Ovaries have follicles which are fluid filled cysts. - Symptoms:
High levels androgens
Elevated insulin (prone to type 2 diabetes)
amenorrhea, dysmenorrhea (painful menstruations), reduced fertility, excessive growth of body hair, male pattern baldness and acne.
