BIOL 131

Question 1

What is coronary angioplasty?

Answer 1

Catheter inflated in obstructed vessel to remove obstruction and enable blood flow.

Question 2

What are the consequences of atheroma?

Answer 2

• Artery narrowing leading to ischaemia, hypoxia, angina pectoris, pain
• Thrombus formation on the plaque leading to myocardial infarction (MI)
• Bleeding into the plaque, which can occur in coronary arteries, also leading to MI
• Aneurysm

Question 3

What is the initial cause of atheroma development in coronary arteries?

Answer 3

Initial damage to endothelium in arteries (>2mm diameter) allowing cholesterol-rich low density lipoproteins to enter the intima.

Question 4

What are foam cells in the context of atheroma?

Answer 4

Fat-laden macrophages underneath endothelial cells.

Question 5

What is a lipid plaque?

Answer 5

A raised yellow smooth area formed by macrophages releasing lipid and collagen in response to chemical signals.

Question 6

What is acute myocardial infarction (AMI)?

Answer 6

Death of heart muscle tissue following a lack of blood supply, commonly due to coronary thrombosis.

Question 7

What are the diagnostic criteria for myocardial infarction (MI)?

Answer 7

Altered level of cardiac muscle biomarker (preferably troponin) plus crushing chest pain, ECG changes, or imaging evidence.

Question 8

What is the significance of troponins in diagnosing MI?

Answer 8

Troponins are specific for cardiac muscle damage and are released into the bloodstream during cardiac events.

Question 9

What are the three forms of troponin?

Answer 9

• Troponin C: binds calcium and regulates muscle contraction
• Troponin I: inhibits contraction in absence of calcium
• Troponin T: binds the troponin complex to tropomyosin

Question 10

What is the primary treatment for myocardial infarction?

Answer 10

• Thrombolytic agents (e.g., streptokinase, tissue plasminogen activator)
• Anticoagulants (e.g., heparin)

Question 11

What is coronary bypass?

Answer 11

Graft of artery or vein to coronary artery to enable blood to flow around an obstruction.

Question 12

What is atheroma?

Answer 12

Lipid-rich accumulation in arteries.

Question 13

What does arteriosclerosis refer to?

Answer 13

Thickening and hardening of artery wall.

Question 14

What does atherosclerosis refer to?

Answer 14

Thickening and hardening of high pressure artery wall caused by atheroma.

Question 15

What is the role of macrophages in atheroma development?

Answer 15

Macrophages take up low-density lipoproteins and secrete cytokines causing collagen secretion.

Question 16

What happens to the endothelium during atheroma formation?

Answer 16

It becomes fragile and often ulcerates.

Question 17

What is the coronary circulation supply structure?

Answer 17

• Left coronary artery: circumflex branch (left ventricle and left atrium), anterior interventricular branch (both ventricles)
• Right coronary artery: posterior interventricular branch (both ventricles), marginal branch (right ventricle)

Question 18

What are cardiac biomarkers?

Answer 18

• Creatine kinase (CKMB)
• Myoglobin
• Troponin I (cTnI)
• Troponin T (cTnT)

Question 19

What is myocardial infarction also known as?

Answer 19

Coronary thrombosis.

Question 20

True or False: Myocardial infarction is the commonest cause of mortality and morbidity in adults.

Answer 20

True.

Question 21

Fill in the blank: Calcium binding to _______ enables muscle contraction.

Answer 21

Troponin C.

Question 22

What is a Healthcare-Associated Infection?

Answer 22

An infection acquired during the course of receiving healthcare treatment for other conditions.

Question 23

List common sources of Healthcare-Associated Infections.

Answer 23

• Exogenous sources (from another person or the environment)
• Endogenous sources (from another site in the patient)

Question 24

Provide examples of the most common Healthcare-Associated Infections.

Answer 24

• Pneumonia and other respiratory tract infections
• Urinary tract infections (UTI)
• Surgical site infections
• Clinical sepsis
• Gastrointestinal infections

Question 25

Define sterilisation.

Answer 25

The process of killing or removing all viable microorganisms including viruses and spores.

Question 26

Define disinfection.

Answer 26

The process of removing or killing most, but not all, viable organisms.

Question 27

List examples of sterilisation procedures.

Answer 27

* Heat sterilisation * Autoclaving * Irradiation * Filtration * Chemical sterilisation

Question 28

List examples of disinfection procedures.

Answer 28

* Chemical disinfection * Boiling * Low pressure steam

Question 29

Who are considered susceptible patients with impaired immune defenses?

Answer 29

* Very young or elderly * Patients lacking vaccinations * Patients with immune defects (HIV, cancer) * Patients on immunosuppressive drugs

Question 30

What is the significance of Semmelweiss's work in infection prevention?

Answer 30

Demonstrated that many hospital infections are preventable through handwashing.

Question 31

What is the approximate percentage of preventable HAIs in the USA per year?

Answer 31

15-30%.

Question 32

What are the most important causes of HAIs?

Answer 32

* Escherichia coli * Staphylococcus aureus * Pseudomonas aeruginosa * Legionella pneumophilia * Clostridium difficile

Question 33

True or False: MRSA is resistant to multiple antibiotics.

Answer 33

True.

Question 34

What is the role of the Health Act 2006 concerning HAIs?

Answer 34

It provides a Code of Practice for the Prevention and Control of Healthcare-Associated Infections.

Question 35

What are the three principles of infection prevention and control?

Answer 35

* Eliminate sources of infection * Interrupt transmission of infection * Enhance host's ability to resist infection

Question 36

Fill in the blank: The process of killing or removing all viable microorganisms is called _______.

Answer 36

sterilisation.

Question 37

Fill in the blank: The process of removing or killing most, but not all, viable organisms is called _______.

Answer 37

disinfection.

Question 38

What is Clostridium difficile associated with?

Answer 38

Diarrhoea and pseudomembranous colitis due to antibiotic disruption of normal gut flora.

Question 39

What is the significance of the '5 moments for hand hygiene'?

Answer 39

A guideline to promote effective hand hygiene in healthcare settings.

Question 40

What does the term 'endogenous' refer to in infection sources?

Answer 40

Infections arising from another site in the same patient.

Question 41

What does the term 'exogenous' refer to in infection sources?

Answer 41

Infections acquired from other patients, staff, or visitors.

Question 42

What are the key characteristics of surgical wound infections?

Answer 42

* Presence of inflammation * Pus or discharge * Isolation of organisms such as Staphylococcus aureus

Question 43

What is sepsis?

Answer 43

A clinical syndrome caused by the body's immune and coagulation systems being activated by an infection.

Question 44

What is the importance of investigating Healthcare-Associated Infections (HAI)?

Answer 44

To identify the extent of the problem, the source of infection, and propose effective control methods.

Question 45

What is the primary role of blood?

Answer 45

Transporting gases, nutrients, metabolic waste products, hormones, antibodies, and formed elements.

Question 46

What are the formed elements of blood?

Answer 46

* Red blood cells * White blood cells * Platelets

Question 47

What is Haemopoiesis?

Answer 47

The process of blood cell development.

Question 48

Where do pluripotent stem cells that give rise to blood cells reside?

Answer 48

In red bone marrow.

Question 49

What is the staining method used for blood cell examination?

Answer 49

Wright’s Stain.

Question 50

What is the structure of erythrocytes?

Answer 50

Biconcave with a mean diameter of 7.8 mm.

Question 51

Do erythrocytes have a nucleus?

Answer 51

No, they do not have a nucleus.

Question 52

What is the lifespan of a red blood cell?

Answer 52

120 days.

Question 53

What is the primary function of hemoglobin?

Answer 53

Oxygen transport.

Question 54

What are leukocytes?

Answer 54

White blood cells.

Question 55

What can a high count of neutrophils indicate?

Answer 55

Bacterial infection.

Question 56

What can a low count of lymphocytes indicate?

Answer 56

HIV infection.

Question 57

What are the components of hemoglobin?

Answer 57

* 2 x α globin chains * 2 x β globin chains * Hem (non-protein)

Question 58

What are haemoglobinopathies?

Answer 58

Abnormal hemoglobin production.

Question 59

What genetic condition is characterized by abnormal β chain hemoglobin?

Answer 59

Sickle cell anemia.

Question 60

What causes the deformation of erythrocytes in sickle cell anemia?

Answer 60

Deoxygenated hemoglobin chains stick together.

Question 61

What is thalassemia?

Answer 61

A reduced rate of synthesis of α or β globin chains.

Question 62

What are A and B antigens in blood groups?

Answer 62

Sugars.

Question 63

What is required for a blood transfusion?

Answer 63

ABO compatible blood.

Question 64

What are some complications of blood transfusions?

Answer 64

* Wrong blood given (ABO incompatible) * Iron overload * Infection

Question 65

What is 'autologous' blood transfusion?

Answer 65

Patients predeposit their own blood prior to elective surgery.

Question 66

Fill in the blank: Blood groups are determined by the presence of _______.

Answer 66

A and B antigens.

Question 67

True or False: Erythrocytes are responsible for the immune response.

Answer 67

False.