Last minute (Year 1) Flashcards
(231 cards)
1
Q
What structures form first from the trachea, behind the oesophagus, during development?
A
Lung buds
2
Q
What embyrological structure forms the tongue?
A
Tuberculum impar
3
Q
What is meant by oesophageal atresia?
A
This is the formation of a blind ending oesophagus, in which there is no connection between the distal and proximal oesophagus
4
Q
What can arise from oesophageal atresia?
A
The baby can’t swallow amniotic fluid, which it usually does to maintain homeostasis
This causes a build up of amniotic fluid around the baby known as polyhydramnios
5
Q
What is polyhydramnios?
A
This is a build up of amniotic fluid around a baby
6
Q
What trilaminar layer forms the lining of the respiratory tract?
A
Endoderm
7
Q
What trilaminar layer forms the cartilage and smooth muscle surrounding the bronchial tree?
A
Visceral mesoderm
8
Q
What stage of respiratory development occurs between 26 days and 6 weeks?
A
Embryonic
9
Q
What stage of respiratory development occurs between 6 and 16 weeks?
A
Pseudoglandular
10
Q
What stage of respiratory development occurs between 16 and 28 weeks?
A
Canalicular
11
Q
What stage of respiratory development occurs between 28 and 36 weeks?
A
Saccular
12
Q
What stage of respiratory development occurs between 36 weeks and early childhood?
A
Alveolar
13
Q
What occurs in the embryonic period of respiratory development?
A
Respiratory diverticulum forms
Initial branching to give lungs, lobes and segments
14
Q
What occurs in the pseudoglandular stage of respiratory development?
A
14 more generations of branching, forming the terminal bronchioles
15
Q
What occurs in the Canalicular stage of respiratory development?
A
Terminal bronchioles branch into respiratory bronchioles and alveolar ducts
16
Q
What occurs in the Saccular stage of respiratory development?
A
Terminal sacs form
Capillaries establish close contact
17
Q
What occurs in the alveolar stage of respiratory development?
A
Alveoli mature
18
Q
What type of cell forms the blood-air barrier?
A
Type I pneumocystis
19
Q
What are the functions of the nasal cavity?
A
Warming
Moistening
Filtering
Olfaction
20
Q
Where in the nasal cavity are the olfactory receptors?
A
Roof
21
Q
What type of cell lines the vestibule (Opening) of the nasal cavity?
A
Keratinised stratified squamous epithelium
22
Q
What is respiratory epithelium?
A
Pseudostartified ciliated columnar epithelium with goblet cells
23
Q
What type of epithelium lines the nasal cavity?
A
Respiratory epithelium
24
Q
What epithelium lines the oropharynx?
A
Non-keratinised, stratified squamous epithelium
25
What epithelium lines the anterior and upper epiglottis?
Non-keratinised, stratified squamous epithelium
26
What epithelium lines the distal epiglottis?
Respiratory epithelium
27
What type of cartilage forms the epiglottis?
Elastic cartilage
28
What epithelium lines the vocal folds?
Stratified, squamous epithelium
29
Where do most foreign objects travel in the bronchial tree?
Right main bronchus
30
What joins the 2 ends of the C shaped tracheal cartilage?
Tracheal muscle
31
Describe the changes as the move towards the terminal bronchioles
Hyaline cartilage lost
Goblet cells lost
Columnar -> Cuboidal
32
What are terminal bronchioles?
These are the smallest bronchioles that lack respiratory capability
33
What are respiratory bronchioles?
These form from the terminal bronchioles
They can perform respiration
They form alveoli
34
What are clara/club cells?
Non-cilated cells that project above the level of adjacent ciliated cells found in terminal bronchioles
35
What is the function of clara/club cells?
Stem cells
Detoxification
Immune modulation
Surfactant production
36
What are the 2 types of alveolar cells?
Type I pneumocytes
Type II pneumocytes
37
What is the function of type I pneumocytes?
Form the blood air barrier
Simple squamous epithelial cells
38
What are type II pneumocytes?
Polygonal shaped cells with mirovili
Contain membrane bound lamellar bodies which contain surfactant, which can be released via exocytosis
39
What are alveolar macrophages?
Aka dust cells or heart failure cells, which are found in the septa or migrate over luminal surfaces and phagocytose inhaled particles, before moving up the bronchial tree and getting swallowed, or moving into the septal connective tissue
40
Describe the histology of the visceral pleura
Simple squamous epithelium (Mesothelium)
Backed by layers of fibrous and elastic connective tissue
41
What is an ecological study?
Analysis of grouped data from summaries of individual data
Disease rates and exposures measured in a population and their relation is examined
42
Strengths of ecological study?
Rapid
Inexpensives
43
Limitations of ecological study
No individual data
Unsure is those with disease had exposure (Ecological fallacy)
44
What is a cross sectional study?
Measurement of exposure and outcome simultaneously
Asses prevalence and distribution of a disease in a population
45
Strengths of cross sectional study?
Provides prevalence
Better for chronic illnesses
46
Limitatuons of cross sectional study?
Can't estimate incidence
Prone to bias (Those with disease more likely to remember exposure)
47
What is incidence?
rate of disease
48
What is prevalence?
Number with disease at any one time
49
What is a case control study?
Comparing 2 groups of people, with and without disease, and with and without exposure
50
What are some strengths of case control study?
Quick
Small sample size
Evaluate multiple exposures
51
Limitations of case control study?
Cannot determine incidence or prevalence
Cannot determine causality
Not useful for rare exposure
52
What is a cohort study?
Group of people with or without exposure are followed up over a long period of time to see if they develop the disease
53
What are the strengths of a cohort study?
Determines incidence
Detemines causality of exposure
54
What are the limitations of cohort study?
Expensive
Time consuming
Can lose people in the trial
55
What is pre-load?
Initial stretching of heart wall due to blood
56
What is after-load?
The force with which the heart must pump to move blood out
57
What is the Frank-Starling mechanism?
Increased end diastolic volume => Increased stroke volume as the heart will pump harder
58
Give the calculation for resistance to flow
59
What performs extrinsic control of blood vessels?
Nerves and hormones
60
What type of innervation innervates the vascular smooth muscle?
Sympathetic
61
What adrenoceptor is found in vascular smooth muscle?
Alpha 1
62
What is the vasomotor tone of blood vessels?
This is a the tonic, low level sympathetic discharge of sympathetic nerves, due to noradrenaline, causing constant, partial constriction
63
How does increased sympathetic tone affect blood vessels?
Vasoconstriction
64
How does decreased sympathetic tone affect blood vessels?
vasodilation
65
Where is adrenaline released in the body
Adrenal medulla of the adrenal glands
66
What are the affects of adrenaline on the body?
Vasoconstriction (Alpha 1)
Bronchodilation (Beta 2)
67
What are intrinsic mechanisms of blood vessels?
These are local changes in blood flow to match the needs of tissue
68
Which is more dominant, extrinsic or intrinsic mechanisms?
Intrinsic mechanisms can override extrinsic mechanisms
69
What types of stimuli can affect instrinsic mechanisms?
Chemical metabolites
Physical stimuli
70
What are some types of chemical metabolites that affect intrinsic mechanisms?
Local metabolites
Local humeral agents
Organic nitrates
71
What are some factors that cause releases eof local metabolites and thus cause vasodilation?
Decreased local pO2
Increased local pCO2
Decreased local pH
Increased extra-cellular K+
Adenosine release from ATP
72
What are some local humoral agents that cause vasodilation?
Histamine
Bradykinin
Nitric oxide
73
What are some local humeral agents that cause vasoconstriction?
Serotonin
Thromboxane A2
Leukotrienes
Endothelin
74
How is nitric oxide released?
Stress of vascular endothelium causes the release of calcium in the cells, which activates nitric oxide synthase
Nitric oxide synthase converts L-arginine into nitric oxide in the vascular endothelium
75
What are some physical stimuli that can affect blood vessels?
Temperature
Myogenic response to stretch
Sheer stress
76
How does cold affect blood vessels?
vasoconstriction
77
How does warm affect blood vessels?
Vasodilation
78
What is the myogenic response to stretch?
The brain is tightly enclosed in the skull
This means blood vessels can't expand
So if MAP rises, the blood vessels constrict to prevent increased intracranial pressure
If MAP falls, the blood vessels dilate to prevent decreased intracranial pressure
79
How does sheer stress affect blood vessels?
Dilatation f arterioles causes sheer stress in arteries upstream, making them dilate
80
What sensory nerves are involved in sneezing?
V1 and V2
81
Where are cough receptors located?
Oropharyngeal mucosa
Laryngopharyngeal muscosa
Laryngeal mucosa
82
What are carotid sheaths?
These are tubes of deep fascia that contain the common carotid arteries, the internal jugular vein and the vagus nerve
They attach to the bones of the posterior skull
83
What nerve sense a stimulus to cause a cough in the nasal and oral pharynx?
IX - Glossopharyngeal
84
What nerve senses a stimulus to cause a cough in the laryngopharynx and larynx?
X - Vagus
85
What nerves form the pulmonary plexus of nerves?
Post-synapetic parasympathetic
Vagus nerve branches
Visceral afferents
86
What nerves sense a stimulus to cause a cough in the lungs?
Visceral afferent nerves that travel to the medulla
87
What nerve closes the rima glottidis in a cough?
Vagus - X
88
What muscles cause closure of the rima glottidis?
Intrinsic muscles of the larynx
89
IN what direction do the external oblique muscles travel?
Hands in pockets
90
In what direction do internal oblique muscles travel?
Hands on pecs
91
IN what direction do transversus abdominus muscles travel?
Horizontal
92
What nerves supply motor innervation during a cough?
X and IX
93
Gram negative, obligate aerobic bacilli
Legionella
Pseudomonas
94
Gram negative, aerobic diplococci
Neisseria gonorrhoea
Neisseria meningitides
95
Small, aerobic, gram negative bacilli
Bordetella pertussis
Haemophilus influenza
96
Gram negative, aerobic, bacilli, coliforms
E.coli
Klebsiella
Salmonella
Shigella
97
Gram negative, obligate anaerobe, bacilli
Bacterioides
98
Gram negative, microaerophilic curved bacilli (Coccobacilli)
Campylobacter
99
Gram negative microaerophilic spiral bacilli
Helicobacter
100
Gram negative, facultative anaerobic curved rod
Vibrio cholerae
101
Gram positive aerobic cocci in chains with alpha haemolysis
Streptococcus pneumoniae
Streptococcus viridans
102
Gram positive aerobic cocci in chains with beta haemolysis
GAS (Strep progenies)
GBS
103
Gram positive aerobic cocci in chains with gamma haemolysis
Enterococcus
104
Gram positive aerobic cocci in clumps, coagulase positive
Staphylococcus aureus
105
Gram positive aerobic cocci in clumps, coagulase negative
Staphylococcus epidermidis
Staphylococcus saprophiticus
106
gram positive aerobic small bacilli
corynebacterium diphtheriae
107
gram positive aerobic large bacilli
Bacillus cereus
Bacillus anthracis
108
Gram positive anaerobic bacilli
Clostridioides tetani
Clostridioides difficile
Costridioides perfringens
109
Antibiotic classes against cell wall
Penicillins
cephalosporins
glycopeptides
110
Targeted by amoxicillin
+ve and -ve
111
Targeted by flucloxicillin?
Staph
Strep
112
Targeted by penicillin V
+ve
113
Targeted by cephalosporins?
1st gen = gram -ve
4th gen = broad spectrum
114
Glycopeptide examples
Vancomycin
Teicoplanin
115
Targeted by glycopeptides
+ve only
116
Antibiotics that target nucleic acids?
Metronidazole
Fluoriquinolones
Trimethoprim (Folic acid)
117
Antibiotics that target protein synthesis
Tetracyclines
Macrolides
Aminoglycosides - Gentamicin
118
Side effects of gentamicin?
Cranial nerve damage
Nephrotoxic
119
Targeted by gentamicin
Gram -ve aerobes, e.g. coliforms
120
Types of macrolide
Erythromycin -ve
Clarithromycin -ve
Azithromycin +ve
121
Effects of tetracyclines?
Staining and structural damage to teeth and bone
122
colitis and bloody diarrhoea in immunosuppressed?
CMV
123
C diff antibiotic regime?
1st: Vancomycin - 10/7
2nd: Fidaxomicin
3rd: Faecal transplant
124
Reheated rice
Profuse vomiting
Bacillus cereus
125
Raw milk
Soft cheeses
Leads to meningitis or bacteraemia
listeria - Advice pregnant women
126
Rice water diarrhoea
Vibrio cholerae
127
Travel to SE asia
Poultry or raw milk
IBS
Guillan-Barre
Camplylocater
128
Eggs
Turtle stomachs
Dairy
Salmonella non-typhi
129
Dysentery
HUS
Raw milk
Shigella dysenteriae
130
Bloody diarrhoea
Beef or animal contact
HUS
Recent traveller
E.coli 0157
131
Seafood
Vibrio non-cholera
132
Carribean or India
Steatorrhoea or weight loss
Tropical sprue
133
Diarrhoea
Steatorrhoea or weight loss
Arthritis
HLA-B27 antigen
Whipple's disease (Tropheryma whipplei)
134
Mimic appendicitis
Exposure to pigs
Travel to Asia
Yersinia enterocolitica
135
Return from Indian subcontinent
Enteric fever
Headache
Constipation or diarrhoea
Dry cough
Salmonella type/paratyphi
136
Bloody diarrhoea
Toxic megacolon risk
Weight loss
Pain
Possible liver problems
Amoebiasis - Entamoeba histolytica
137
Swimming in lakes
Morning explosive diarrhoea
Explosive eggy burps
Malabsorptive diarrhoea
SE Asia travel
Giardia lamblia
138
Anal itching in children
Enterobius
139
prolonged diarrhoea in immunosuppressed
Nutritional deficiency
Cryptosporidium
140
Signs of HUS
Abdominal pain
Fever
Pallor
Petechiae (Red spots on ankles)
Oliguria (Low urine output)
141
Cyanotic CHDs?
Hypoplastic left heart syndrome
Tetralogy of Fallot
Transposition
142
Acyanotic CHDs
VSD
ASD
PDA
Coarction or interruption of aorta
143
Patent ductus arteriosus treatment?
NSAIDs or clips
144
Collapse at duct closure treatment?
Prostaglandin E2 infusion
145
Common in trisomy 21 (CHD)
Atrio-ventricular septal defect
146
Hypoplastic left heart syndrome?
Narrow aorta
Small left ventricle
Atrial septal defect
147
Hypoplastic left heart syndrome treatment
TCPC - Total cavo pulmonary connection
148
Tetralogy of Fallot?
Narrow pulmonary trunk
VSD
Large right ventricle
Pulmonary stenosis
149
CXR sign of transposition of great vessels?
Egg on string
150
Ddx narrow complex tachycardia
Sinus tachycardia
Supraventricular tachycardia
Atrial fibrillation
Atrial flutter
151
DDx broad complex tachycardia
Ventricular tachycardia
Polymorphic ventricular tachycardia
Atrial fibrillation + BBB
Supraventricular tachycardia + BBB
152
Monomorphic VT
153
Polymorphic VT
154
Torsades du pointes
155
Unstable VT + pulse treatment
DCCV
156
Pulseless VT
Defibrillation
157
Stable VT
1st: Amiodarone
2nd DCCV
158
Torsades du pointes
IV magnesium
159
Ventricular fibrillation
160
Short term v-fib treatment
Defibrillation
Adrenaline
Amiodarone
161
Long term v-fib treatment
ICD
162
Premature ventricular complexes treatment?
ß-Blockers
163
Atrial fibrillation
164
Paroxysmal A fib treatment
1st: ß-blocker
Rate limiting Ca2+ blocker
Digoxin
2nd: AV node ablation
165
Prolonged or permanent A fib treatment
1st: DCCV or Amiodarone
2nd: Left atrial ablation
166
A flutter
167
A flutter treatment
Ablation or pharmacological cardioversion
168
3 types of SVT
AVNRT
AVRT
Atrial tachycardia
169
Stages of SVT treatment
1st: Vagal manouvres
2nd: Adenosine IV
3rd: Verapamil or ß-Blocker
4th: Synchronised DCCV
170
Adenosine action
Slows cardiac conduction through AV node via A1 receptors
171
doses of adenosine in SVT
1st: 6mg
2nd: 12mg
3rd: 18mg
172
Atropine action?
Increases heart rate via blocking muscarinic synapses
173
Sinus tachycardia treatment
ß-Blockers
Treat underlying cause
174
sinus bradycardia treatment
Atropine
Pacing (If haemodynamic compromise)
175
Asystole risk treatment?
1st: Atropine
2nd: Isoprenaline or adrenaline
3rd: Pacing
176
Native valve acute IE treatment
Flucloxicillin IV
177
Native valve sub-acute IE treatment
Amoxicillin +Gentamicin IV
178
Prosthetic valve IE treatment
Vancomycin + gentamicin IV + Rifampicin PO
179
Suspected MRSA IE treatment
Vancomycin + Gentamicin IV + Rifampicin PO
180
PWID IE treatment?
Flucloxicillin
181
Staph aureus treatment
Flucloxicillin IV
182
Viridans streptococci
Benzylpenicillin + Gentamicin IV
183
Staph epidermidis treatment
Vancomycin + Gentamicin IV + Rifampicin PO
184
Enterococcus treatment
Amoxicillin/Vancomycin + Gentamicin IV
185
Non severe HAP treatment?
PO amoxicillin
**PO doxycycline if allergic**
186
Severe HAP treatment?
IV amoxicillin + gentamicin
**PO doxycycline if allergic**
187
CURB 0-2 treatment?
Amoxicillin
**Doxycycline if allergic**
188
CURB 3-5 treatment?
Co-amoxiclav IV + Doxycycline IV
**Just Levofloxacin if allergic**
189
ICU pneumonia treatment?
Co-amoxiclav IV + Clarithromycin
**Just Levofloxacin if allergic**
190
Sensitivity
(True +ve) ÷ (Total with disease)
Number of people with the disease that test positive
191
specificity
(True -ve) ÷ (Total without disease)
Number of people without disease that test negative
192
PPV
(True +ve) ÷ (Total +ve)
Number of people who test positive that have the disease
193
NPV
(True -ve) ÷ (Total -ve)
Number of people who test negative that don't have the disease
194
PSA tumour marker
prostate
195
HCG tumour marker
Germ cell cancer
196
AFG (Alpha-Fetoprotein)
Hepatocellular carcinoma
197
CA125
Ovarian
198
CA15-3
Breast
199
CA19-9
Pancreatic or biliary
200
CEA
Colon
201
CgA
Neuroendocrine
202
Most affected by PSC
Men
203
Ducts affected by PSC
Large or medium, extra hepatic
204
Antibodies in PSC
pANCA
ANA
205
Most affected by PBC
Women
206
Ducts affected by PBC
Small, intra-hepatic
207
Antibodies in PBC
AMA
ANA
208
Hep A transmission
Faecal-oral
209
Hep B transmission
Vertical
Blood
Sexual
210
Treatment of hep B
Tenofivir
Entecavir
211
Hep C transmission
Blood - tattoos, transfusions
212
neutrophil
Multilobes nucleus
Barr body
213
Basophil
Bilobed nucleus
Obscured by basic dye of granules
214
Eosinophil
Bilobed nucleus
Eosin (Pink) stained granules
215
Lymphocyte
No visible granules
Large round nucleus
216
Kidney-bean shaped nucleus
217
Squamous cell carcinoma paraneoplastic syndrome
Parathyroid related hormone production -> Hypercalcaemia
218
Small cell carcinoma paraneoplastic syndrome
SIADH -> Hyponatraemia
Cushings (ACTH)
Lambert-Eaton (Anti-Ca2+ antibodies)
219
Adenocarcinoma paraneoplastic syndromes
Gynaecomastia
Hypertrophic pulmonary osteoarthropathy
220
At what level does the aorta cross the diaphragm?
T12
221
At what level does the thoracic duct cross the diaphragm?
T12
222
At what level does the azygous vein cross the diaphragm?
T12
223
What can be damaged by foreign bodied lodged in the piriform recess?
Internal laryngeal nerve
224
What is the treatment for Whipple's disease?
1 year course Co-trimoxazole
225
Is the tail of the pancreas intra- or retro- peritoneal?
Intraperitoneal
226
What is the triad of Wernickes encephalitis?
Ataxia
Confusion
Ophthalmoplegia
227
What causes Wernickes encephalitis in alcoholic patients?
Vitamin B1 deficiency
228
What is Gilbert's disease?
This is a genetic disease resulting in a deficiency of an enzyme responsible for bilirubin conjugation, leading to increased levels of unconjugated bilirubin, which at times of stress, can cause isolated jaundice
229
What respiratory disorder is CF a risk factor for?
Pneumothorax
230
Why is prothrombin a better measure of acute liver failure than albumin?
It has a shorter half life
231
Where do thiazide-like diuretics act and how?
They inhibit Na+ reabsorption by blocking the Na+Cl- symporter at the proximal end of the distal convoluted tubule
