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todays questions Flashcards

1
Q

Both ALP and GGT are elevated

A

Bile duct disease, liver

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2
Q

Liver function biomarker most raised in post-hepatic jaundice

A

ALP

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3
Q

Reticulonodular shadowing in lower lobe

A

Mycoplasma

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4
Q

Muscles used in forced expiration

A

Internal intercostals

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5
Q

Stimulates action of central chemoreceptors

A

Hydrogen ions

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6
Q

Reduced levels of G6PD effect on rbcs

A

More susceptible to stress, more haemolysis

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7
Q

Franky starlingy lawwwwww

A

As EDV increases, SV increases

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8
Q

Axes of FS curve

A

Y SV and X EDV

Y Save Very much when you can eXpend on EDVentures

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9
Q

Normal ejection fraction

A

60%

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10
Q

GLP-1 affect on pancreas

A

Stimulates insulin synthesis from b cells

Increases somatostatin increase in D cells

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11
Q

GLP-1 and GLP-2 released from

A

Enteroendocrine L cells

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12
Q

Reversal drug for digoxin

A

Digibind

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13
Q

Electrolyte imbalance that exacerbates digoxin toxicity

A

Hypokalaemia

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14
Q

Reduced transient Ca(2+) in heart

A

Reduced contractile force

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15
Q

Left ventricular ejection =

A

SV / EDV

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16
Q

ACE inhibitors SEs

A

Cough obvs
Angioedema
Hypotension
Hyperkalaemia

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17
Q

Sudden decrease in perfusion triggers

A

Vasodilation

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18
Q

Furosemide

A

LOOP diuretic

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19
Q

How does fuosemide treat heart failure

A

Increased water excretion and salt by kidneys and peripheral vasodilation

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20
Q

Most common HAP causes

A

Pseudomonas aeruginosa, staph aureus and enterobacteria

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21
Q

Dullness to percussion

A

Pneumonia

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22
Q

Pleural rub

A

Pneumonia

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23
Q

Bronchial beathing

A

Pneumonia

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24
Q

Increased vocal resonance

A

Pneumonia

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25
Q

Urine investigations in pneumonia

A

Legionella or pneumococcal

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26
Q

Cephalic phase of acid secretion

A

Vagal stimulation of chief, parietal and ECL cells

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27
Q

Inhibiting bile acid reuptake reduces

A

Rate of bile acid production by liver

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28
Q

Parietal cells action

A

In fundus and body of stomach, secrete HCL (gastric acid duh) using H+/K+ ATPase pump

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29
Q

PPIs inhibit

A

H+/K+ ATPase pump used by parietal cells

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30
Q

Profuse vomiting effect on ABGs

A

Metabolic Alkalosis

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31
Q

Your anus sphincter is under the control offffff

A

Somatic innervation

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32
Q

2 forms of vitamin K

A

Phylloquinone ( Diet)

Menaquinones ( Gut bacteria )

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33
Q

Clotting factor 2

A

Prothrombin

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34
Q

Trypsin responsible for

A

Protein digestion - released by pancreas will give you that one for free ;)

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35
Q

Brunner’s gland

A

Provide alkaline mucous to neutralise chyme from stomach

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36
Q

Enterogastric reflex

A

Stimulated by distension of SI by presence of chyme - stops vagal stimulation and gastric acid secretion

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37
Q

Incretin ( GIP ) release triggered by

A

eating a meal containing glucose

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38
Q

Pernicious anaemia

A

Parietal cells undergo autoimmune destruction

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39
Q

Loop diuretics inhibit

A

Na -K-Cl cotransporters

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40
Q

Why does ramipril cause dry cough

A

Increases bradykinin levels

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41
Q

Amiodarone

A

Potassium-channel blocker, class III anti-arrhythmic

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42
Q

Amlodipine and amiodarone

A

Ones a CCB and ones a K channel blocker silly fresher

43
Q

PPAR? receptor

A

Nuclear receptor that increases transcription of genes for lipoprotein lipase, increasing LDL uptake and reducing levels in blood

44
Q

Fibrates action

A

decrease serum triglycerides

45
Q

Statins mechanism of action

A

Competitive HMG-CoA reductase inhbitor

46
Q

Process of atherosclerosis

A

1 - Endothelial destruction - altered NO synthesis
2 - Cell injury - adhesion molecules expressed
3 - Foam cell formation - LDL oxidised and taken up by macrophages - foam cells
4 - Foam cell fatty streak
5 - Smooth muscle proliferation and connective tissue deposition
6 - Plaque rupture

47
Q

HMG-coA reductase reductase

A

Catalyzes conversion of HMG to mevanolic acid (rate-limiting) Competitively inhibited by statins

48
Q

Na-K-l cotransporters location

A

Thick ascending limb of the loop of henle

49
Q

Digoxin

A

Increases vagal outflow and has a negative chronotropic effect on the heart

50
Q

Inotropic

A

Force of contraction

51
Q

Chronotropic

A

Change in rate

52
Q

Cardiac glycosides

A

Inhibit Na/K ATPase pump, increasing intracellular sodium

53
Q

Rhabdomyolysis

A

Breakdown of skeletal muscle

54
Q

Foam cells

A

Macrophages that have absorbed LDL

55
Q

Test that should be done before putting patient on a statin

A

LFTs

56
Q

Asthma patients should not be prescribed

A

NON SELECTIVE beta blockers such as Propanolol

57
Q

Aldosterone

A

Mineralocorticoid

58
Q

Spironolactone

A

Mineralocorticoid antagonist

59
Q

Mineralocorticoids produced in

A

zona glomerulosa of adrenal cortex

60
Q

How much water is reabsorbed in SI?

A

90%

61
Q

How much water is reabsorbed in Li

A

10%

62
Q

Anterior structure to pancreas

A

Stomach

63
Q

Erythema nodosum

A

Sarcoidosis and IBD and TB legit anything babes

64
Q

Sheep exposure

A

Coxiella Burnetii

65
Q

Small cell lung cancer produces

A

ADH and ACTH

66
Q

Squamous cell lung cancer produces

A

PTH

67
Q

Respiratory syncytial virus causes

A

Rotavirus

68
Q

Why do you get increased mucus cell in chronic bronchitis?

A

Increased goblet cell numbers

69
Q

Asthma pyramid

A

SABA - Inhaled steroid -Theophylline/Leukotriene antagonist/LABA - Oral steroid

70
Q

Faecal calprotectin

A

A protein found in stool during intestinal intestinal inflammation

71
Q

How can H pylori lead to duodenal ulceration?????

A

Well chronic antral gastritis cause hypergastrinaemia due to gastrin release from antral G cells

72
Q

Peptic ulcer

A

Break in superficial epithelial cells penetrating down to muscularis mucosa

73
Q

Diagnosis of H.Pylori

A

Stool antigen test/C-Urea breath test, patient shoulda had no PPIs for 2 weeks and nooo antibiotics for 4

74
Q

5 receptors of the chemoreceptor trigger zone

A

5-HT, H1, Muscarinic, D2, Substance P

75
Q

Causes of upper GI haemorrhage

A

G+D ulcers, haemorrhagic gastropathy and erosions, gastric and oesophageal varices, mallory-weiss, reflux oesophagitis, gastric carcinoma

76
Q

Acute diarrhoea

A

Less than 14 days

77
Q

Chronic diarrhoea

A

30 + days

78
Q

Diagnosing IBS

A

Last 3 months, at last 1 day per week recurrent abdominal pain with 2 or more:

  • w/ pooping
  • change in frequency of stool
  • change in form of stool
79
Q

Action of sodium cromoglicate

A

Prevents histamine release from mast cells

80
Q

Dihydropiridine calcium channel antagonists

A

Amlodipine and nifedipine, act preferentially on vascular smooth muscle. Typically used as anti-hypertensive not antiarrhythmic

81
Q

Dihydropiridine calcium channel antagonists

A

Amlodipine and nifedipine, act preferentially on vascular smooth muscle. Typically used as anti-hypertensive not antiarrhythmic

82
Q

Verapamil

A

Phenylalkylamine + more active on calcium channels in cardiac tissue

83
Q

Flecainide

A

Class I anti-arrhythmic

84
Q

Funny (notsofunny) current

A

Mixed sodium and potassium current activated by hyperpolarisation

85
Q

Central chemoreceptors dorsal or ventral medulla

A

Ventrl

86
Q

PPI mechanism of action

A

Irreversibly blocks H+K+-ATPase in parietal cells

87
Q

Acute abdomen pain

A 
Observations
Analysis 
Oxygen 
Fluids 
Nausea + pain
- Bloods + amylase, ABGs, radiology, AXR and CXR, CT
88
Q

Perianal disease

A

Crohn’s

89
Q

Stenosis formation

A
  1. Endothelial dysfunction triggered by smoking, hypertension or hyperglycaemia.
  2. Pro-inflammatory, pro-oxidant, proliferative changes in the endothelium.
  3. Fatty infiltration of the subendothelial space by low-density lipoprotein (LDL).
  4. Macrophages phagocytose oxidised low-density lipoprotein.
  5. Smooth muscle proliferation and migration from the tunica media into the intima.
90
Q

Secretory diarrhoea

A

Transformation of absorptive gut to secretive gut

91
Q

Rhabdomyolysis

A

Breakdown of muscle due to direct or indirect muscle injury

92
Q

Caseating granuloma

A

TB

93
Q

Increased goblet cells

A

Crohns

94
Q

Non-caseating granuloma

A

Crohn s

95
Q

Endothelin

A

Potent vasoCONSTRICTOR

96
Q

Mitral regurgitation 2-7 days post MI

A

Rupture of papillary muscle

97
Q

Hypokalaemia riddle thing

A

You have no pot and no T but a long PR and a long QT

98
Q

S4

A

Atria contracting forcefully in an effort to overcome an abnormally stiff ventricle

99
Q

Hesselbach’s triangle

A

Direct hernias pass through:

Superolateral - epigastric vessels, medial - lateral edge of rectus muscle and Inferiorly - Inguinal ligament

100
Q

Cholecystitis vs cholangitis

A 
Cholecystitis = Inflammation of gallbladder 
Cholangitis = Inflammation of bile duct system - charcot's - fever, jaundice and RUQ
101
Q

Tetralogy of Fallot

A

Pulmonary stenosis, RVH, VSD and overriding aorta

102
Q

AAA screening

A

Offered to men from 65th birthday, positive is d>3cm, 3-4.4 is annual surveillance and 4.5-5.4 is 3 monthly surveillance, 5.5+ urgent referral

103
Q

Virchow’s triad

A

Endothelial injury, hypercoagulability and blood stasis

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