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Physiology MRCEM part 1 > Basics > Flashcards

Basics Flashcards

1
Q

3 components to the negative feedback systems

A

Detectors
Comparator (compare variable against set point)
Effector

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2
Q

Initiation of the action potential is an example of?

A

Positive feedback

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3
Q

Function of peroxisomes

A

Metabolise waste

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4
Q

Function of golgi apparatus

A

Modify proteins

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5
Q

Endoplasmic reticulum fx

Rough

Smooth

A

Assoc. with ribosombes to make secretary and membrane proteins

Makes lipids and store Ca2+

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6
Q

Potassium concentration inside cells?

A

150 mmol/L

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7
Q

Where is K+ filtered in the kidney?

A

glomerulus

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8
Q

What happens to K+ in the proximal tubule?

A

Approx 65-70% is reabsorbed down a conc gradient / solvent drag

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9
Q

How does Aldosterone regulate K+?

A

Increased K+ detected in the extracellular fluid of the adrenal cortex

Promotes synethesis and insertion into basolateral membrane (DCT and collecting duct) of Na+/K+ ATPase channels

Increases Na+ absorption and K+ secretion

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10
Q

How does pH influence K+ excretion?

A

High pH (alkalosis) promotes apical K+ channels and Na/K ATPas activity -> increase K+ secretion

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11
Q

Action of ADH on K+

A

reduces urinary flow rates but conversely stimulates apical K+ channel activity

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12
Q

Action of Mg3+ on K+ ?

A

Intracellular Mg can bind and block K+ channels therefore inhibiting K+ secretion

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13
Q

How is K+ reabsorbed in the ascending loop of henle (and how much)

A

20% reabsorbed by K/Cl co tranasporter

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14
Q

Which bits of the kidney adjust k+ when diet varies?

A

DCT and collecting duct

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15
Q

In DCT and collecting duct which cells secrete K+ back out of the blood into the lumen?

A

Principal cells

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16
Q

What parameter has the biggest effect on resistance (and therefore flow) in a tube?

A

Radius

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17
Q

Laminar vs turbulent blood flow ?

A

Laminar flow occurs when the flow is slowest near the vessel wall (where there is more friction) and fastest in the center of the blood vessel (where there is less friction). Turbulent flow describes a situation in which blood flows in all directions.

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18
Q

How does a dilated heart obtain the same (or similar) ventricular pressure?

A

Has to develop more wall tensin

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19
Q

Where do sympathetic preganglionic neurons originate?

A

Lateral horns of segement T1-L2 in the spinal cord

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20
Q

Where do PARAsympathetic preganglionic neurons originate?

A

Brain stem, run in cranial nerves III, VII, IX and X, and from 2nd/3rd sacral segments of the spinal cord

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21
Q

Parasympathetic action:

Pupils

Salvia

A

Constrict

Increase production

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22
Q

Parasympathetic action:

HR

Bronchi

A

Decrease

Constrict

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23
Q

Parasympathetic action:

Digestive organs

Pancreas gall bladder

A

Stimulate all

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24
Q

Parasympathetic action:

Urinary bladder

Genitals

A

Contracts

Stimulates erection

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25
Q

Sympathetic action:

Pupils

Saliva

A

Dilate

Inhibit

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26
Q

Sympathetic action:

Heart

Bronchi

A

Increase HR and contractility

Dilate

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27
Q

Sympathetic action:

Digestive organs / pancreas / gallbaldder

A

Inhibit all

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28
Q

Sympathetic action:

Adrenal medulla

A

Stimulate to release adrenaline and noradrenaline

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29
Q

Sympathetic action:

Urinary bladder

Genitals

A

Relaxes

Stimulates

30
Q

Base excess =

A

Amount of strong acid that must be added to each litre of fully oxygenated bloods to the return the pH to 7.40 at the temp of 37 and a pCO2 5.3 kPA

31
Q

Base deficit (negative base excess) =

A

Amount of strong base that must be added to each litre of fully oxygenated bloods to the return the pH to 7.40 at the temp of 37 and a pCO2 5.3 kPA

32
Q

When does the base excess become more positive?

A

Metabolic alkalosis

OR

in compensation for respiratory acidosis

33
Q

When does the base excess become more negative?

A

Metabolic acidosis

OR

in compensation for respiratory alkalosis

34
Q

What causes a metabolic acidosis?

A

Gain of acid or loss of base as bicarbonte

35
Q

Causes of metabolic acidosis linked to increased production of H+

A

Lactiacidosis
Ketoacidosis - DKA / alcohol / starvation

36
Q

Causes of metabolic acidosis linked to ingestion of H+ (or drugs metabolised to acids)

A

Salicylate overdose

Ethylene glycol poisoning

37
Q

Causes of metabolic acidosis linked to impaired renal excretion of H+

A

Acute or chronic renal failure

38
Q

Cause of metabolic acidosis linked to loss of HCO3- in the urine

A

Renal tubular acidosis

39
Q

Cause of metabolic acidosis linked to loss of HCO3- in the GI tract?

A

Chronic diarrhoea
Ileal conduits
Fistulae
Small intestinal / pancreatic / biliary drains

40
Q

Compensatory response to metabolic acidosis?

A

Hyperventilation

41
Q

What happens to the blood pressure at low pH?

A

BP falls due to reduced peripheral resistance and impaired myocardial contractility

42
Q

Metabolic alkalosis arises from?

A

Addition of bicarb to the blood or loss of H+ ions from the body

43
Q

Cause of metabolic alkalosis linked to loss of H+ in the GI tract?

A

Vomiting, pyloric stenosis and NGT drainage

44
Q

Cause of metabolic alkalosis linked to loss of H+ in the kidneys?

A

Diuretic therapy

45
Q

Cause of metabolic alkalosis linked to ingestion of absorbable alkali?

A

e.g. Sodium bicarb / antacid overdose

46
Q

Cause of metabolic alkalosis linked to increased renal bicarbonate reabsorption?

A

Primary hyperaldosteronism

Secondary to volume depletion

Secondary to hypokalaemia

47
Q

Metabolic alkalosis associated with what calcium and potassium levels?

A

Hypocalaemia and hypokalaemia

48
Q

Respiratory alkalosis usually result of?

A

Decrease in pCO2 due to hyperventilation

49
Q

Respiratory acidosis usually caused by?

A

Decrease in ventilation due to depression of the respiratory centre / physical impediment to breathing

50
Q

Plasma is always what charge?

A

NEUTRAL

51
Q

The anion gap determines the presence of…?

A

unmeasured anions

52
Q

Anion gap formula

A

([Na+] + [K+]) - ([Cl-] + [HCO3-])

53
Q

Normal range for the anion gap

A

6 -16 mmol/L

54
Q

In metabolic acidosis, an increased anion gap occurs if…..

A

New acid is added to the body. This dissociates producing free H+ (uses up bicarb) and anions which take the place of bicarb

55
Q

In metabolic acidosis, a normal anion gap occurs if …

A

there is simple loss of bicarbonate, compensatory rise in Cl- so the anion gap is normal

56
Q

Causes of an increase anion gap metabolic acidosis

MUDPILES

A

Methanol

Ureaemia (renal failure)

DKA

Infection / iron overdose, isonoazid, inborn errors of metabolsim

Lactic acidosis

Ethylene glycol overdose

Salicylate overdose

57
Q

Causes of a normal anion gap metabolic acidosis

FUSEDCARS

A

Fistula (pancreatic duodenal)

Ureteroenteric conduit

Saline administration

Endocrine

Diarrhoea

Carbonic anhydrate inhibitors

Renal tubular acidosis

Spironolactone

58
Q

Haematocrit ratio =

A

Ratio of RBCs to plasma

59
Q

How long does the average RBC circulate?

A

120 days

60
Q

Where do potential T lymphocytes mature?

A

Thymus and spleen

61
Q

Where do potential B lymphocytes mature?

A

Lymphoid tissue of the intestines / spleen & bone marrow

62
Q

Granulocyte WBC include

A

Neutrophils, eosinophils and basophils

63
Q

Agranulocyte WBC include

A

Monocytes and lymphocytes

64
Q

Functional unit in skeletal muscle

A

Sarcomere

65
Q

Endomysium =

A

Supportive layer of protective tissue that surrounds individual muscle fibres

66
Q

Perimysium =

A

Surrounds a bundle of muscle fibres, forming a fascicle (functional unit)

67
Q

Epimysium =

A

Connective tissue surrounding the whole muscle

68
Q

What type of neurons stimulate skeletal muscle?

A

Alpha motor neurons

69
Q

When an action potential arrives at NMJ what ion channels open?

and what is released into the synaptic cleft?

A

Ca2+

Acetylcholine

70
Q

Sarcolemma =

A

plasma membrane of the muscle cell

Physiology MRCEM part 1 (7 decks)

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