The Patient

Question 1

Excitable cells

Answer 1

Neurones
Skeletal
Cardiac
Some smooth muscle
Some endocrine cells

Question 2

Non-excitable cells

Answer 2

Fibroblasts
Epithelial
Adipocytes
Blood cells

Question 3

Total peripheral resistance equation

Answer 3

(Mean arterial pressure-right aterial pressure)/cardiac output

Question 4

Who developed chemo

Answer 4

Paul Erlich

Question 5

What was first developed for sleeping sickness but why wasn’t it used

Answer 5

Atoxyl

It was toxic

Question 6

What was developed from atoxyl

Answer 6

666-Salvarsan

Question 7

Angina drug treatments

Answer 7

First line - aspirin, b blocker, calcium channel blocker

Second- nitrates, nicorandil, ivabradine,randazine

Question 8

Beta blocker aims

Answer 8

Reduce CO
Reduce myocardial oxygen demand
Reduce heart rate (50-60bpm)
Reduce blood pressure

Question 9

Calcium channel blocker names

Answer 9

Nifedipine
Amlodipine
Diltiazem
Verapamil

Question 10

Initial heart attack treatment

Answer 10

Morphine 1-10mg

Antiemetic - cyclizine 50mg or metoclopramide 10mg
Oxygen - if sats less than 94
GTN
Aspirin 300mg

Question 11

Nicotine can receptor agonists

Answer 11

Nicotine

Suxaethonium

Question 12

Nicotinic receptor antagonists

Answer 12

Attacurium
Turbocurarine
Alpha bungarotoxin

Question 13

What kinds of drugs act at the nicotinic receptor

Answer 13

Drugs for surgery

Drugs to treat nicotine addiction

Question 14

Which kinds of drugs act at the muscarinic receptor

Answer 14

Antiemetics
Anti asthma
For eye exams
To treat glaucoma

Question 15

VW Class 1

Target and examples

Answer 15

Targets sodium channels
Lidocaine
Flacainide
Disopyramide

Question 16

VW Class 2

Target and Examples

Answer 16

Targets Beta 1 adrenoreceptor
Atenolol
Metoprolol
Propranolol

Question 17

VW Class 3

Target and examples

Answer 17

Targets potassium channels
Amioderone
Soralol

Question 18

VW Class 4

Target and examples

Answer 18

Targets Calcium channels
Verapamil
Diltiazem

Question 19

Verapamil side effects

Answer 19

Dangerous in ventricular dysrhythmia 
Cardiodepression
Hypotension
AV node block
Oedema 
Headache
Constipation

Question 20

Amiodarone/ Sotalol side effects

Answer 20

Micro crystals in cornea - greater dazzling
Photo toxic reactions from microcrystals
Thyrotoxicosis or hypothyroidism due to structural similarity
Hepotoxicity
Diffuse pulmonary alveolitis, pneumonitis and fibrosis
Bradycardia and conduction disturbances

Question 21

B blocker side effects

Answer 21

Bronchoconstriction
Sudden cardiac failure/heart block
Hypoglycaemia 
Cold extremities
Vivid dreams

Question 22

Ace inhibitor examples

Answer 22

Captopril
Enalapril
Trandolapril
Ramipril
Lisinopril

Question 23

Angiotensin 1 blocker examples

Answer 23

Losartan
Valsartsan
Candesartan

Question 24

Cell membrane potential definition

Answer 24

Voltage difference across the cell membrane between the interior and exterior of the cell

Question 25

Graded potential definition

Answer 25

Change in membrane potential that may or may not result in an AP

Question 26

Action potential

Answer 26

Large, rapid, reversible depolarization of the membrane

Question 27

What is automaticity

Answer 27

The ability of a tissue or organ to function without an external control

Question 28

What are the differences between muscle cells, pacemaker cells and conducting cells?

Answer 28

Muscle - specialized for contraction Pacemaker- generate AP's spontaneously and control rate of cardiac cycle Conducting- transmit AP's between areas of the heart

Question 29

What are conduction problems ABOVE the ventricles called?

Answer 29

Supraventricular

Question 30

What are conduction problems IN the ventricles called?

Answer 30

Ventricular arrhythmia

Question 31

What does a deep and wide QRS interval indicate?

Answer 31

myocardial infarction

Question 32

What does a notched QRS interval indicate?

Answer 32

Bundle block

Question 33

Name common heart rhythm problems

Answer 33

``` Sinus tachycardia/bradycardia Atrial fibrillation Ventricular fibrillation Torsade de Pointes:Fatal dysrhythmia Heart block Myocardial infarction ```

Question 34

Describe Torsade de Pointes

Answer 34

QT long - no nice order

Question 35

Describe heart block

Answer 35

1st degree = Prolonged PQ interval 2nd degree = missed ventricular beats 3rd degree = P wave absent or disconnected from QRS

Question 36

Describe myocardial infarction

Answer 36

Abnormal Q wave Lack of blood supply to ventricles ST segment changes can indicate ischemic tissue

Question 37

What happens during cardiac fibrosis?

Answer 37

Cells not intact so AP can't spread easily and instantly - gap junctions not intact

Question 38

What is the afterload and pre load of the heart?

Answer 38

Afterload - flow resistance to pump against | Preload- loading of heart, how far it has to stretch before contracting

Question 39

What is vascular smooth muscle tone?

Answer 39

The tension muscle has Regulated by sympathetic nervous system and vasoactive mediators Provides many drug targets

Question 40

What is compliance?

Answer 40

How easily a vessel stretches in response to an internal pressure change in vol/change in pressure

Question 41

Do arteries have high or low compliance?

Answer 41

low | Thick walls of smooth muscle

Question 42

Do veins have high or low compliance?

Answer 42

High | Thin walls

Question 43

Total peripheral resistance equation and normal range

Answer 43

R= (MAP-RAP)/CO 0.2-4 HIGH PRESSURE HIGH RESISTANCE

Question 44

Total pulmonary resistance range

Answer 44

0.03-1 PRU | LOW PRESSURE LOW RESISTANCE

Question 45

What is the critical closing pressure?

Answer 45

Arterial pressure less then 20 mmHg

Question 46

What is the constriction of large veins called and what does this cause?

Answer 46

Venoconstriction Lowers total vascular volume Increases venous return (increases end diastole vol and stroke vol)

Question 47

What does systemic homeostatic blood control involve?

Answer 47

Set total flow rate (CO) Adjust distribution to organs Maintain stable flow conditions

Question 48

What does local homeostatic blood control involve?

Answer 48

Delivery of O2 and nutrients to meet local tissue demand Removal of waste Stable flow in all tissues

Question 49

What is hyperaemia? What are the two types?

Answer 49

An increase in local blood flow Functional - after exercise/meal ect Reactive - pathological - response to inflammation

Question 50

Which mechanism can directly adjust blood flow to meet its metabolic demands?

Answer 50

Pancrine mechanism

Question 51

Which receptors does adrenaline act on and what does it cause?

Answer 51

a1 in all smooth muscle = vasodilation | b2 on muscle cells of arterioles in cardiac and skeletal muscle = vasodilation

Question 52

What is the humoral control of vascular tone?

Answer 52

Preganglionic sympathetic neurone to chromaffin cells located in the adrenal medulla Renin-angiotensin-aldosterone system

Question 53

Role of erythrocytes

Answer 53

Glycolysis Carbonic anhydrase-co2 transport Package haemoglobin - 02 and co2 transport

Question 54

How is blood loss prevented?

Answer 54

Vascular spasm - vasoconstriction Platelet plug Blood coagulation Fibrous tissue

Question 55

What are the three roles of lipids

Answer 55

Structural Storage Signalling

Question 56

Cholesterol ideals

Answer 56

Total: healthy 5 High risk 4 ``` LDL 3 2 HDL more than 1 ``` TG less than 1.7

Question 57

Lipid lowering drugs and their action

Answer 57

Statins - block chol biosynthesis Ezetimibe and resins - block chol absorption PCSK9-increase LDLR expression Nicotinic acid ect-reduce TG and cholesterol Fibrates - Reduce high TG levels