Basic Science Flashcards by Scot Jenkins

Most comon cause of AKI

Acute Tubular Necrosis

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Causes of Acute Tubular Necrosis

Aminoglycosides (gent etc)
Rhabdo
Radiocontrast
Sepsis

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Autosomal Dominant conditions

Achondroplasia
Porphyria
Polycystic disease
Ehlors Danlos
Hereditary Telangiectasia/spherocytosis
Huntington’s
Marfans
Noonan
Neurofibromatosis
Peutz-jeghers
tuberous sclerosis
von willibrand
von hippel lindau

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Autosomal Recessive conditions

Albinism
Ataxic Talengiectasia
cystic fibrosis
cystinuria
fanconi anemia
freidrich atacxia
gilberts
homocystinuria
haemochromotosis
sickle cell
thalassemia
wilsons

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selection bias

Error in assigning individuals to groups leading to differences which may influence the outcome

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Recall bias

Difference in the accuracy of the recollections retrieved by study participants

CASE CONTROL

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Publication bias

failure to publish

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Work-up bias (verification bias)

Sometimes clinicians may be reluctant to order the gold standard test unless the new test is positive, as the gold standard test may be invasive (e.g. tissue biopsy).

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Expectation bias (Pygmalion effect)

Only a problem in non-blinded trials. Observers may subconsciously measure or report data in a way that favours the expected study outcome.

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Hawthorne effect

Describes a group changing it’s behaviour due to the knowledge that it is being studied

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Lead-time bias

Occurs when two tests for a disease are compared, the new test diagnoses the disease earlier, but there is no effect on the outcome of the disease

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Drugs that can be given in breastfeeding

The following drugs can be given to mothers who are breastfeeding:
antibiotics: penicillins, cephalosporins, trimethoprim
endocrine: glucocorticoids (avoid high doses), levothyroxine*
epilepsy: sodium valproate, carbamazepine
asthma: salbutamol, theophyllines
psychiatric drugs: tricyclic antidepressants, antipsychotics**
hypertension: beta-blockers, hydralazine
anticoagulants: warfarin, heparin
digoxin

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Drugs that can’t be given in breastfeeding

The following drugs should be avoided:
antibiotics: ciprofloxacin, tetracycline, chloramphenicol, sulphonamides
psychiatric drugs: lithium, benzodiazepines
aspirin
carbimazole
methotrexate
sulfonylureas
cytotoxic drugs
amiodarone

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Rapid depolarisation of cardiac tissue casued by

rapid sodium influx

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early replarisation of cardiac tissue caused by

efflux of potassium

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plateua phase of cardiac tissue depolarisation caused by

slow influx of calcium

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resting potential of cardiac depolarisation is caused by

NA/k ATPase

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Cell cycle: G0

‘resting’ phase

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Cell cycle: G1

Gap 1, cells increase in size
determines length of cell cycle
under influence of p53

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Cell cycle: S

Synthesis of DNA, RNA and histone
centrosome duplication

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Cell cycle: G2

Gap 2, cells continue to increase in siz

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Cell cycle: M

Mitosis - cell division
the shortest phase of the cell cycle

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Palsy results in
ptosis
‘down and out’ eye
dilated, fixed pupil

CN3

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Palsy results in defective downward gaze → vertical diplopia

CN4

Lesions may cause: trigeminal neuralgia loss of corneal reflex (afferent) loss of facial sensation paralysis of mastication muscles deviation of jaw to weak side

CN5

Palsy results in defective abduction → horizontal diplopia

CN6

Lesions may result in: flaccid paralysis of upper + lower face loss of corneal reflex (efferent) loss of taste hyperacusis

CN7

Lesions may result in; hypersensitive carotid sinus reflex loss of gag reflex (afferent)

CN9

Lesions may result in; uvula deviates away from site of lesion loss of gag reflex (efferent)

cnX

Lesions may result in; weakness turning head to contralateral side

cn xI

Type I - Anaphylactic

IgE mAST CELLS Anaphylaxis Atopy

Type II - Cell bound

IgG or IgM ITP Goodpastures hemolytic transfusion reaction

Type III - Immune complex

Free antigen and antibody (IgG, IgA) combine * Serum sickness * Systemic lupus erythematosus * Post-streptococcal glomerulonephritis * Extrinsic allergic alveolitis (especially acute phase)

Type IV - Delayed hypersensitivity

T-cell mediated Tuberculosis / tuberculin skin reaction * Graft versus host disease * Allergic contact dermatitis * Scabies * Extrinsic allergic alveolitis (especially chronic phase) * Multiple sclerosis * Guillain-Barre syndrome

Features precocious puberty cafe-au-lait spots polyostotic fibrous dysplasia short stature

McCune-Albright syndrome

Metabolic alkalosis: causes?

Causes vomiting / aspiration (e.g. peptic ulcer leading to pyloric stenos, nasogastric suction) vomiting may also lead to hypokalaemia diuretics liquorice, carbenoxolone hypokalaemia primary hyperaldosteronism Cushing's syndrome Bartter's syndrome Mechanism of metabolic alkalosis activation of renin-angiotensin II-aldosterone (RAA) system is a key factor aldosterone causes reabsorption of Na+ in exchange for H+ in the distal convoluted tubule

Numbers needed to treat (NNT)

It is calculated by 1/(Absolute risk reduction)

Oncogenes: cMYC

Burkitts

Oncogenes: ABL

CML

Oncogenes: n-MYC

neuroblastoma

oncogenes: BCL-2

Follicular

oncogenes: RET

MEN

Oncogene: RAS

Pancreatic

Oncogenes erb/HER2

Breast and ovarian

High PTH High Calcium Low phosphate

Primary hyerparathyroidism

PTH high Ca low/normal Phosphate elevated

Secondary hyperparathyroid

Ca Normal PTH high Phosphte low/normal VIt D normal /low

tertiary hyperparathyroidsism

Type 1 pneumocytes

Very thin squamous cells which cover around 97% of the alveolar surface

Type 2 pneumocytes

Cuboidal cells Secrete surfactant

Relative risk

Relative risk (RR) is the ratio of risk in the experimental group (experimental event rate, EER) to risk in the control group (control event rate, CER).

Sensitivity

TP / (TP + FN ) Proportion of patients with the condition who have a positive test result

Specificity

TN / (TN + FP) Proportion of patients without the condition who have a negative test result

Positive predictive value

TP / (TP + FP) The chance that the patient has the condition if the diagnostic test is positive

Negative predictive value

TN / (TN + FN) The chance that the patient does not have the condition if the diagnostic test is negative

compares ordinal, interval, or ratio scales of unpaired data

Mann-Whitney U test

compares two sets of observations on a single sample, e.g. a 'before' and 'after' test on the same population following an intervention

Wilcoxon signed-rank test

used to compare proportions or percentages e.g. compares the percentage of patients who improved following two different interventions

chi-squared test

Cohort study

Observational and prospective. Two (or more) are selected according to their exposure to a particular agent (e.g. medicine, toxin) and followed up to see how many develop a disease or other outcome. The usual outcome measure is the relative risk.

Case-control study

Observational and retrospective. Patients with a particular condition (cases) are identified and matched with controls. Data is then collected on past exposure to a possible causal agent for the condition. The usual outcome measure is the odds ratio.