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BM4 Year 1 - Quizlet Cards > LO Related (Part 1) > Flashcards

LO Related (Part 1) Flashcards

(113 cards)

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1
Q

Disadvantages the screening

A

Longer morbidity when prognosis is unaltered

Potential over treatment of abnormalities

Resource cost

False reassurance from false negatives

Anxiety from false positives

Hazard of the sreening test

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2
Q

Term in pregnancy

A

37-42 weeks

40 weeks on average

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3
Q

What anti epilieptic durg should be stopped during pregnancy

What if it isnt suitable to stop this drug?

A

Valproate

If cant then increase the dose of folic acid

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4
Q

Why are pregnant mothers usually given magnesium sulphate

A

Evidence that it aids neurological development

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5
Q

White blood cell with a kidney shaped nucleus

A

Monocytes

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6
Q

What is the exon-intron boundary AKA

A

Consensus sequence

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7
Q

White blood cell identification

  • Second most common
  • Large circular nucelus
  • Some granuels
A

Lymphocytes

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8
Q

White blood cell identification

  • Distinctive 3-5 lobed nucleus
A

Neutrophil

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9
Q

How many lobes of nuclei do eosoinophils have

A

Two

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10
Q

What does the APGAR score look at

What is is scored out of

What is a normal score

A 
Tone/activity
Colour
Breathing 
HR 
Reflexes

Out of 10 (rare to get a 10)

Get worried if less than 5

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11
Q

Why are basophils so names

Describe their appreance

A

They are basophilic (stain blue) with a bilobed nucleus

Also contain granules (likely to contain histamine)

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12
Q

How should you describe the risk of a baby having downs syndrome

A

SHould really say that CHANCE

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13
Q

How is the chance of a baby having DS calculated

A

Screening results plus the age of the mother

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14
Q

How many babies born with DS

A

1 in 800

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15
Q

Most common downs syndrome screening

A

Nuchal translucency and blood tests (combinesd)

These are offered to ALL eligible mothers between 10-20 weeks **usually at week 11-13

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16
Q

When are the TRIPLE and QUADRUPLE tests

When are they used?

How do they compare to the nuchal transluency and combined test

A

TRIPLE - 14 wks
QUADRUPLE - 20 weeks

Have lower detection rates

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17
Q

NICE guidance regarding who gets which DS screen

A

IN FIRST TRIMESTER
Combined test

IN SECOND TRIMESER
Triple or quadruple test

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18
Q

Two diagnostic tests for DS

When are they performed

What are the rates of miscarriage

A

CHORIONIC VILLUS SAMPLING
(10-13 weeks)
(1-2% miscarriage risk)

AMNIOCENTESIS
15 weeks (0.5-1% miscarriage risk)
If done at 14 weeks risk doubles
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19
Q

What is NIPT

What are the controversies around this

A

Non invasive prenatal testing

Testing the blood for cell free foetal DNA

High detection rate

BUT NEED TO HAVE AMNIOCENTESIS BEFORE A TERMINATION IS ABLE TO OCCUR

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20
Q

When is pregancy termination legal?

A

1) life of mother in danger
2) foetus have severe abnormalities
3) mental/physical health of mother will be harmed
4) other children will be harmed

MUST BE BEFORE 24 WEEKS (2 doctors required)

This is not the case if 1) or 3) apply (mothers life in danger, or mental/phys health may be harmed)

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21
Q

What is CHRONIC GRANULOMATOUSE DISEASE

A

X-linked mutation affecting NADPH OXIDASE

Defect in neutrophils and oxidative burst

Patients get severe bacterial infections and usually require life-long antibitoics

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22
Q

Complement regulatior proteins

A

Factor H and I (break down C3b)

C1INH

CFHR-1 (inhibits C5 converatase)

membrane cofactors which breakdwon C3b and C4b

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23
Q

Effects of genetic defects in C1-C4

A

Recurrent infection with pygenic bacteira

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24
Q

Effects of genetic defects in C5-C9

A

Failure to form MACs

Increases the suseptibility to N.Meningitiis

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25
Common assocaited condiitons with downsyndrome
``` Hearing problems (80-90%) Eye problems (60%) Cardiac defects (40-50%) Higher prevalence of autism, leukaemia and thyroid issues ```
26
What is the medical model of disability How does this compare the the social model of disability
MEDICAL MODEL - Disabillity is the problem the person has - and focusses on trying to improve this SOCIAL MODEL - Frames the disability as a problem with society which contains environmental, social and organisational barries to those with disabilities
27
Example where drug absorption may be directly affected by GI contents
Tetracylines (MOA - inhibit tRNA binding) bind to milk and to antacids
28
3 enteral routes that AVOID first pass metabolism
Buccal Sublingual Rectal
29
For a 70kg man what do the following mean???? Vd 5L Vd 10-15L Vd 40-42L
Vd 5L (drug is confied to the plasma) e.g. insluin Vd 10-15L (drug is confied to the interstitial fluid) e.g. mannitol Vd 40-42L (drug is also in the intracellular fluid) e.g. ethanol
30
Why might you have an impossibly high Vd
if the drug is not evenly distributed in body compartments I.e. it is being sequestered like FLUORIDE in BONE
31
What is ECTOPIA
The presence of differentiated cells in an abnormal location E.g. ectopic pancrease in the wall of the small intestine
32
Two examples of metaplasia
CIGARETTE SMOKERS Resp epithelium --> stratified squamous GORD (BARRETS) Oesoph (strat squamous) --> columnar glandular
33
% of DNA as INTRONS and EXONS
1.5% is exons 25% is introns
34
Small arm of chr = Long arm of chr =
P = small arm Q = long arm
35
Four breast cancer risk factoros
Early menache, late menopause Medication containing oestrogen (OCP) Environmental factors Genetics Also typical cancer RFs - obesity, diet, alochol, immunosuppp
36
What is the nottingham prognostic index
Assesses the chance of 15 year survival BASED ON TUMOUR SIZE, NODAL INVOLVEMENT AND GRADe
37
What should every women with suspected breast cancer be offered
TRIPLE ASSESSMENT Breast exam Mammography Biposy
38
How many pairs of chromosos
23
39
Sarcoma is
Cancer arrising from connective tissue
40
What is SPIIKES
Method for BREAKING BAD NEWS ``` Setting Perception Invitation Knowlege Emotions Strategy and summary ```
41
What are the first set of nodes draining the breast (and thus the nodes that are most likely to be affected by breast cancer)
Sentinel nodes
42
What types of neurones are usually UNmyelinated
Autonomic
43
What might cause an increase in disease PREVALENCE
True increase in risk Change in demogrpahic Longer duration of living with disease Artefacts
44
What is the metabolic syndrome
Combination of DIABETES, HYPERTENSION and OBESTIY this puts an indiv at hi risk of CVS disease
45
Main neuropeptide STIMULATING FEEDING
AGrP
46
Descirbe a low and VERY low calorie diet in terms of CALORIES/DAY EXPECTED WEIGHT LOSS IN 6 MONTHS
1000-1500 calories/day Roughly 8% weight loss in 6 months 300-800 calories/day Roughly 13% in 6 months
47
MOA ORLISTAT
Intestinal lipase inhibitor
48
What are the indications for bariatric surgery
BMI >40 or >35 Associated with severe health consequences and have not had sucess by other means Aged 18-60
49
What are the (4) tiers of obesity management/referral
TIER 1 - health promotion to prevent future weight gain TIER 2 - Lifestyle change for those who are overweight/obese TIER 3 - Specialist services for obesity TIER 4 - Surgery for morbid obesity
50
Define the clearance of a drug
Volume of blood from which the drug is cleared per unit time by a particular organ
51
What is the elimination rate of a drug
Ammount of drug cleared per unit time Clearance x plasma concentration
52
Disadvantages to subcutaneous insulin injection
Injection Systemic circ (liver exposed to less insluin) Loss of negative feedback between glucose concentration and insluin secretion
53
MOA and effects DOBUTAMINE
B1 agonist Mimics Nadr and the SNS to inc HR and inc contract
54
Example of where the PSNS and SNS are complementary
Salivary glands - both cause saliva prodcution PSNS - watery SNS - thick
55
First line treatment for T2DM
Lifestyle changes Metformin
56
Effects of metformin
LOWERS BLOOD GLUCOSE BY - Increasing uptake and storage - Reducing absorption in the SI - Suppressing hepatic gluconeogenesis
57
SITAGLIPTIN
DPP4-i
58
LIRAGLUTIDE
GLP-1
59
What is the commonest form of blindness in working age people
Diabetic retinopathy
60
Why is the incidence of T2Dm increasing
Population growth Ageing population Longer survival Western diets
61
When is metformin CId What are common side effects
CI;d in people with reduced renal function who cant clear lactate or biguandies Common S/E = GI upset and decreased absorption of B12 Rare SE = lactic acidosis
62
MOA pilocarpine
Muscarinic agonist So reduces occular pressure and can be used to treat glaucoma
63
Adherence =
Extent to which a patients behaviour corresponds with the doctors reccomendation
64
MOA Atropine
MAChr antagonist Reduces secretion before surgery ALSO decreases HR
65
Catabolism is
Breaking of large --> small
66
CN III
Occulomotor
67
Why are sulfonylureas not commonly used
Risk of hypo
68
Describe how lipids can be metabolised to ACoA for use in the Krebs cycle
Lipases break up into glycerol and FAs FATTY ACIDS - go through B-oxidation in Mt matric to form ACoA GLYCEROL - forms glycolysis intermediate
69
COMPLIANCE =
Degree to which patients obeys the recommendations of a doctor
70
S/Es of glicasides
Weight gain Fluid retention (oedema) Also heart failure and anaemia
71
MOA Prazosin
Alpha 1 antag Blocks NADr used in resitant hypertension
72
Where are a2 adrenoreceptors found
Presynaptic memebrane To inhibit any further neurotransmitter release
73
Tamulosin MOA
A1 blocker Relaxes smooth muscle in the bladder - used in prostate enlargement to control urination
74
What is an adenocarcinoma
Cancerous tissue of glandular tissue
75
What are two types of opsonins
Immunoglobulin and C3b
76
5 clinical features of inflammation
``` Red Pain Heat Swelling Loss of function ```
77
What are the main cell types involved in chronic inflammation
Lymphocytes and macrophages
78
What is PIGEON FANCIERS DISEASE
A type of HYPERSENSITIVITY PNEUMONITIS caused by bird droppings The luungs become inflammaed with granuloma formation
79
How many anterior ribs should be seen on a CXR
5-7
80
Omalizumab MOA
Binds and sequesters IgE this REDUCES mast cell DEGRANULATION
81
What chemokines can cause vascular dilation and increased vascular permeability
Histamine Prostaglandins
82
What in an FBC could indicate asthma
Increased eosinophils
83
When is a LABA only taken
When ALREADY taking INHALED CORTICOSTEROIDS
84
When is the intrapulmonary pressure negative
Inspiration
85
Why do COPD sufferers used PURSED LIP breathing
They have lost elastic recoil in the lungs They are trying to INCREASE THE PRESSURE in TERMINAL BRONCHIOLES
86
What is the triad for the diagnosis of pneumonia
EVIDENCE OF INFECTION SIGNS AND SYMPTOMS LOCALISED TO RESP TRACT NEW OR CHANGED INFILTRATE ON CXR
87
What gram class are NITRIMIDAZOLES most effective against
Gram +ve
88
Trachea will deviate AWAY from what?
Tension pneumothorax or a pleural effusion
89
First line treatment for sinusitis
Amoxicillin
90
What is Vc | FOR VACCINATIONS
Percentage of the population that need to be vaccinated to eradicate a disease 1- 1/R0
91
What is the first line PNEUMONIA antibiotic that should be given WITHIN 4 HOURS of admission
Penicillin and a macrolide
92
What is an epitope
Small defined region of an antigen to which the antibody binds
93
What are the THREE methods of BACTERIAL GENE TRANSFER
Transference (plasmids) Transduction (phage) Conjugation (sexpillus)
94
What vaccine type confers a strong humoural and strong cell mediated response?
Live attenuated
95
What cell type is required for CLASS SWITCHING
Th cells
96
Give an example of a macrolide
ErythroMYCIN
97
What types of VACCINE confer STRONG HUMORAL but WEAK CELL MEDIATED responses?
Sub unit vaccine Inactivated
98
Why is T cell INDEPENDENT B cell activation less good
``` No class switching Less memory cells ```
99
What is an exotoxin
Proteins that are SECRETED by gram +ve or -ve bacteria
100
In T cell DEPENDENT B cell activation What are the two signals
1) Bidning of an antigen to B cell receptor | 2) Presence of activated Th cell which has recognised the same antigen
101
MAX O2 with a venturi mask What is the advantage of a venturi mask
60% O2 More precise
102
What can a diffusion limitation result from?
Low inhaled O2 Impared alveolar interface
103
What is the HALDANE effect?
Deoxygenation of the blood increases its ability to carry CO2
104
What would cause an increase V/Q
PE Area of the lung that is ventilated but not perfused (As Q tends to 0, V/Q will tend to infinity)
105
Location of a chest drain
5th intercostal space in the mid axillary line IN THE TRIANGLE OF SAFETY
106
How is CO2 transported in the blood
Most as bicarbonate Some as carbamino compounds A little as dissolved CO2
107
How much O2 can be given using a NON RE-BREATHER mask
Up to 90% There is also a one way valve - THIS MEANS THE PATIENT IS NOT REBREATHING THE CO2
108
What forms when H+ react with Hb Why is this useful?
HHb - this is less acidic and is a BETTER PROTON ACCEPTOR This FACILITATES THE LOADING of CO2
109
What causes a rise in the hemidiaphragm
Volume loss in the lung above
110
Adverse effects of oxygen
IT IS MOSTLY SAFE Fire Toxic in large ammounts In CO2 retainers it can cause a reduced respiraotry drive
111
With a simple face mask how much O2 can be given
5-15L/min (this is around 30-50%)
112
What does a RAISED ANION GAP show
Presence of non-volatile acids e.g. lactic acid and ketoacids
113
Treatment for type 2 respiratory failure
Controlled O2 therpay Need to treat the underlying cause

BM4 Year 1 - Quizlet Cards (3 decks)

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