year 3 exam Q Flashcards
NAME 2 BIOMARKERs which are a measure of inflammation in the body
C-reactive protein is produced by the liver in response to inflammation. its levels increase rapidly in inflammation in conditions such as disease, infections.
prostaglandins are inflammatory pain (that act on smooth muscle) mediators which are biomarkers for inflammation.
prostaglandin
histamine
bradykinin
what is the cause of lymph nodes which are painful when drinking
Hodgkins lymphoma
list questions you would ask a patient which you suscpet has cancer
have you had any bowel or bladder changes recently
has the lymph nodes enlarged since pain started
does your paln go away with sleep or emdication
do you have any persistent coughing
have you had any unusual bleeding or disharge
what are the stages of hypertension
Normal Less than 120 Less than 80
Elevated 120-129 Less than 80
stage 1= systolic 130-139mmhg
diastolic 80-89
lifestyle changes, meds
stage 2= systolic 140+mmhg
diastolic 90+mmhg
more sever, life style changes and blood pressure lowering meds. increase risk of HA , stroke, kidney damage
Hypertensive Crisis (Emergency situation):
Systolic: Higher than 180 mmHg
Diastolic: Higher than 120 mmHg
Interpretation: A hypertensive crisis is a medical emergency
describe the mechanism involved in the renin-angiotensin-aldosterone system and its function in affecting blood pressure.
describe how this system can both increase or decrease blood pressure
the function of this system is to control BP, fluid balance, na+ homeostasis.
stage 1= decrease bp and renal blood flow is detected by the kidneys and renin is released
stage 2=renin acts on angiotensinogen which is produced by the liver and secreted into the blood stream. converted to angiotensin 1.
stage 3=converted to angiotensin 2 via angiotensin-converting enzyme (ACE) which is found in the lungs
stage 4=angiotensin 2 causes vasoconstriction in arterioles, increasing vascular resistance and blood pressure.
angiotensin 2 stimulates the adrenal glands to release aldosterone
stage 5=aldosterone acts on the kidneys where it promotes sodium and water retention and potassium excretion. this leads to an increase in bp and blood volume
stage 6= once increased, negative feedback is provided to the kidneys and they reduce the stimulus for the renin release. this helps maintain blood pressure. this can b impaired by kidneys disease or heart failure
RAAS inhibitors can blodk systems activation and Lower th blood pressure
what does GERD stand for
Gastroesophageal Reflux Disease
yoru patient presents with new onset epigastric and retrosternal pain. she feels nauseous on occasion which is relieved when eating. pain increases 1-3hours post/ night pain 11-2am where she feels burning in this area. give diagnosis
gastroesophageal reflux disease (GERD) which presents with heart burn which worsens with lying down and spicy food.
peptic ulcer disease
pain relied by eating then return a few hours later is characteristic of ulcer. pain often occurs at night and can cause epigastric pain.
list 4 main symptoms of bowel cancer
change in bowel habits
blood in stool
constiation and urgency to defecate
abdominal pain or discomfit
where does liquefactive necrosis occur most often?
brain
what is the effect of glucagon on blood sugar levels
increase blood glucose levels
opposition to insulin which lowers blood sugar levels
helps maintain glucose homeostasis
20-year old female presents with acute, severe right lower abdominal quadrant pain. identify 4 potential different diagnosis for right lower quadrant pain
ovarian torsion (twisting on the ovary)
appendicitis
around the umbilicus but later migrates to right lower quadrant
ectopic pregnancy (outside the uterus, mc in fallopian tue)
pelvic inflammatory disease from STI
compare and contrast crowns disease and ulcerative colitis including age and demographics, genetic association, cancer risk, location and distribution, clinical features, complications and extra-intestinal manifestation
both are inflammatory bowel disease.
both have a higher risk if a family member has it
crohns disease can affect people of any age but mc is 15-35. it is more prevalent in urban areas. more common for women.
UC is mc in caucasians. mc age is before 30 but can be up to 60yo. more common for men
crohns disease is the inflammation of the gastrointestinal tract that can occur from th mouth to the anus. mc found at the end of small intestine. it can be caused by autoimmune disorders, genetic factors, smoking, infections such as salmonella and some antibiotics which alter the gut microbiome and diet.
UC is an inflammatory autoimmune disease that causes ulcers in the lining of the colon and rectum. it is believed to be caused by genetic factors and autoimmune issues.
clinical feature of crohns= abdominal cramps (right iliac region) post meals, epigastric discomfort, diarrhoea, fever, strictures, fistulae, cobble stoning mucosa or ulceration.
UC= mucosal inflammation and ulcers in the colon and rectum, GI bleeding, abdominal pain, fatigue, fever, wait loss, urgency to defecate.
extra-intestinal crohns
manifestations= arthritis, kidneys stones, fever and skin rash
UC=arthritis, skin issues
complications of crohns= strictures, fistulas, abscesses, intestinal obstruction
higher risk of bowel cancer
UC= sever bleeding, perforated colon, increased risk of colon cancer
medications for IBD are non steroidal anti-inflammatory drugs to reduce inflammation. lifestyle changes like stopping smoking to drinking. extreme case is surgery.
identify possible aetiologies of cor pulmonate and describe pathogenesis of the symptoms associated with the condition
cor pulmonale is the abnormal enlargement of the right side of the heart as a trust of disease of lungs or pulmonary. it can cause right sided heart failure
it can be caused by pulmonary embolism, interstitial lung disease, cystic fibrosis and other conditions like
the lungs diseases such Chronic bronchitis and emphysema (COPD) is the leading cause of cor pulmonale
COPD is a progresive lung disease that can result in pulomary hypertension and lead to cor pulmonate.
chronic bronchitis is long term inflammation of bronchi. this leads to increased mucus production and persistent cough that occurs at least 3 months, wheezing, peripheral oedema, obesity and peripheral oedema
emphysema is the destruction of the alveolar walls and the loss of lung elasticity which leads to decreased SA decreasing efficiency of gaseous echnage. therefore the removal of co2 decreases.
typically it is casted by smoke, and other environmental pollutants. this can cause cor pulmonae. symptoms are shortnesss of breath, chronic cough and wheezing, barrel chest due to hyperinflation of the lungs, cyanosis .
cor pulmonate results from impaired pulmonary blood flow which leads to elevated pressure in the pulmonary arteries. factors which increase this resistance is hypoxia (low o2 levels causing vasoconstriction), inflammation (COPD) and thrombosis or embolism (increased pressure). this increases pulmonary artery pressure on right ventricle causing hypertrophy of the right ventricle which dilates and is less efficient. as the right ventricle continues it becomes overwhelmed and fails, leading to right sided heart failure. this makes blood back up into the venous system affecting liver, abdomen and legs.
what are the primary endocrine glands and vitamins that play a role in bone health?
parathyroid gland, parathyroid hormone. this regulates calcium in the body by stimulating osteoclast activity to resorb bone and release calcium. promotes activation of vitamin D
Thyroid gland can release t3 and t4 to regulate metabolism of bone cells and regulate actibyt of osteoblasts and osteoclasts
your patients is 30 year old, plays football and has recently recovered from a tibia/fibular fracture. she has her plaster removed and complains of posterior knee pain. it is red and inflamed and sore to touch. patient is taking oral contraceptive birth control pill. what condition are you most concerned about the patient might be experiencing? include reasoning
deep vein thrombosis
patient has recently had a fracture which likely required immobilisation which is a known risk factor for dot as it can cause stasis of blood flow in the veins, particularly in lower expetemities.
posterior knee pain indicates DVT in popliteal vein.
it presents with localised pain, swelling, tenderness in affected area.
oral contracpetive are associated with an increased risk of thrombosis (blood cots). they increase oestrogen which can contribute to hyperocagubility which increases risk of DVT
Redness anf inflammation could be related to post injury symptoms of DVT are similar.
an ultrasound would enable the diagnosis of the DVT .
It could potentially be a bakers cyst however, I would be more concerned with a DVT because it is potentially life threatening as it could turn to a pulmonary embolism if the blood clot was transported around the body.
