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BM4 Year 1 - Quizlet Cards > LO Related (Part 3) > Flashcards

LO Related (Part 3) Flashcards

(89 cards)

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1
Q

What is ECOLOGICAL FALLACY

A

Error that arises when information about groups of people is used to make inferences about individuals

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2
Q

Causes of a raised anion gap metabolic acidosis

A

Severe kidney dysfunction

Ketoacidosis

Ingestion of acid

Lactic acidosis

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3
Q

Describe the two theories that allow AUTOREGULATION of GFR

A

MYOGENIC - contraction and relaxation of the afferent arteriole that results from the the ammount of strech caused by systemic BP

TUBULOGLOMERULAR - Macula densa cells in contact with the JGA monitor Na content can can relase vasoactive mediators

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4
Q

What drugs can IMPAIR RENAL FUNCTION

A

NSAIDS
ACEi/ARBS
Cyclosporin
Aminoglycoside antibitiotcis (e.g. gentamycine)

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5
Q

What is BIAS

A

Systematic DEVATION from the TRUTH

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6
Q

What is a CONFOUDNING VARIABLE

A

A factor other than the independent variable that may produce detectable results

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7
Q

FOUR phases of a CLINICAL TRIAL

A

Phase 1 - safety - small numbers of health patients

Phase 2 - large numbers of disease individuals

Phase 3 - full scale evaluation compared to the standard treatment

Phase 4 - post marketing surveillance

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8
Q

What is the creatinine clearance rate

What is it useful for?

A

Volume of blood plasma that is cleared of creatinine per unit time

This is a useful measure for approximating GFR

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9
Q

Creatinie clearance provides OVER/UNDER estimate of GFR

A

Over

There is some Cr secretion into the filtrate

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10
Q

Causes of pre-renal AKI

A

Hypovolaemia

Decreased renal perfusion

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11
Q

Causes of intra-renal AKI

A

Direct damage to the kidneys via inflammation, drugs and infections

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12
Q

Cloudy and lumpy urine can be a sign of

A

UTI

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13
Q

Acute complications of AKI

A

Fluid retention

Hypercalaemia

Increased urea and creatinine

Metabolic acidosis

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14
Q

Criteria for RRT (renal replacement therapy)

A

Worsening hyperkalaemia

Worsening acidosis

Fluid overload

Symptomatic uraemia

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15
Q

Strenghts and weaknesses of a CROSS SECTIONAL STUDY

A

+ fast, inexpensive, no loss to follow up, good for looking at prevalence

  • cant est causation, difficult with rare diseases
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16
Q

Strengths and weaknesses of a CASE CONTROL study

A

+ fast, inexpensive, good for rare disease

  • recall bias
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17
Q

Stengths and weaknesses of a COHORT study

A

+ assess multiple outcomes/exposures, demonstrate causality

  • time consuming, expensive, not good for rare diseases
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18
Q

What is the role of the 3 consitiutent parts of the FILTRATION BARRIER

A

CAP ENDOTHELIUM - stops blood cells

BASEMENT MEMBRANE - stop large proteins moving across, also repels -ve molecules

PODOCYTES - allow small ions through but not PROTEINS

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19
Q

Define AKI

A

Failure of renal function over hour days characteristed by a rise in serum urea and creatinine

Reversible

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20
Q

What is the creatinine clearance rate

What is it useful for?

A

Volume of blood plasma that is cleared of creatinine per unit time

This is a useful measure for approximating GFR

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21
Q

Creatinie clearance provides OVER/UNDER estimate of GFR

A

Over

There is some Cr secretion into the filtrate

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22
Q

Causes of pre-renal AKI

A

Hypovolaemia

Decreased renal perfusion

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23
Q

Causes of intra-renal AKI

A

Direct damage to the kidneys via inflammation, drugs and infections

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24
Q

Cloudy and lumpy urine can be a sign of

A

UTI

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25
Acute complications of AKI
Fluid retention Hypercalaemia Increased urea and creatinine Metabolic acidosis
26
Criteria for RRT (renal replacement therapy)
Worsening hyperkalaemia Worsening acidosis Fluid overload Symptomatic uraemia
27
Nephrotic diseases Main symptoms How do they come about
Generally due to DAMAGE to the BASEMENT MEMBRANE or to the PODOCYTES Proteinuria
28
Strengths and weaknesses of a CASE CONTROL study
+ fast, inexpensive, good for rare disease - recall bias
29
Stengths and weaknesses of a COHORT study
+ assess multiple outcomes/exposures, demonstrate causality - time consuming, expensive, not good for rare diseases
30
What is the role of the 3 consitiutent parts of the FILTRATION BARRIER
CAP ENDOTHELIUM - stops blood cells BASEMENT MEMBRANE - stop large proteins moving across, also repels -ve molecules PODOCYTES - allow small ions through but not PROTEINS
31
Define AKI
Failure of renal function over hour days characteristed by a rise in serum urea and creatinine Reversible
32
How can NSAIDS lead to AKI
NSAIDS inhibition production of PROSTAGLANDINS Local prostaglandins relax the afferent arteriole So NSAIDS lead to constriction of the afferent arteriole and decreased perfusion
33
Most common (3) causes of CKD
Diabetes Hypertension Glomerulonephrtisi
34
3 major functions of the kidney in ACID BASE BALANCE
1) Reabsorption of filtered bicarbonate 2) Excretes excess acid - as phosphoric acid and ammonium 3) Forms new bicarbonate through breakdwon of carbonic acid and glutamine
35
What is Anti-GBM disease? What it also caused
ANTI-GBM = GOODPASTURES Pulmonary and renal disease caused by anti-GBM antibodies
36
Anti-GBM nephrotic or nephritic
Nephritic
37
Give an example (and the MOA) of an antibody that promotes immune system activation
ANTI-CLTLA-4 (ipilimumab)
38
Minimal change disease is an example of which kind of disease
Nephrotic
39
What is the inner layer of the spleen What is its function
White pulp WBC action (removal of antibody coated microbes) and synthesis of antibodies Reservoir of monocytes
40
MOA Corticosteroids
Lipid soluble Binds steroid receptor - DIMERISATION Steroid receptor complex activates/inhibits pro/anti inflammatory genes in the nucleus
41
Describe how INDIRECT ALLORECOGNITION is able to occur
Peptides from donor MHC and minor HLA antigens presented to recipient T cells on MHCII on APCs Activation of recipitent T cells Production of chornic inflammaotry cycle
42
Non-immune causes of glomerular disease
Diabetes Amyloidosis
43
What occurs in IgA nephropathy Is Iga nephropathy nephrotic or nephritic
IgA depsition in the mesangium - the most common form of primary glomeruluonephrtisi This is a NEPHRITIC disease
44
Describe how DIRECT ALLORECOGNITION occurs
Intact foreign MHC presented directly to T cells Recipient T cells activated Recipient T cells attack foreign tissue
45
Main HLA loci to avoid mismatches
A B DR
46
What is SLE What sort of disease does it cause?
Systemic lupus erythematosus Causes immune mediated glomerular disease
47
What happens in MEMBRANOUS NEPHROPATHY
Subepithelial immune deposits often due to autoantibodies Chancges in the basement membrane
48
What is the worst HLA mismatch that you can have
HLA-B7-positive to HLA-A1-positive
49
Minimal change disease is an example of which kind of disease
Nephrotic
50
How does diabetes cause CKD
Hyperglycaemia causes non enzymatic glycation of the efferent arteriole - this makes it STIFF AND NARROW Leads to an increased pressure in the kidney leading to hyper-filtration and glomerulosclerosis
51
Describe why CORTICOSTEROIDS are good for PREVENTING transplant REJECTION
- Decrease cellular response to pro-inflammatory cytokines - Suppressed chemotactic and inflammatory mediators - Reduced activation and expression of MHCII on macrophages - Reduced recruitment of white blood cells
52
Symptoms of NEPHRTIC SYNDROME What is usually the underlying cause Give one example
Haematuria with hyperalbuminaemia and hyperlipidaemia Usually due to GLOMERULAR INFLAMMATION E.g. IgA nephropathy
53
Pros of HAEMODIALYSIS
Predictable Can be monitored by healthcare professional Only 3/4 times per week
54
What are the potential issues associated with the use of CORTICOSTEROIDS
Suppress pre-existing innate and adaptive immunity Long term can lead to Cushings syndrome Also long team - patients need to be WEANED off since the steroids will suppress production of corticotrophin releasing hormone by the hypothalamus
55
ANP inhibits what channel What does this promote
ENaC Naturesis
56
How can amyloidosis lead to CKD What type of syndrome does it cause
Abnormal deposition of amyloid proteins Leads to a NEPHRITIC disease
57
Define (in words) specificity
The proportion of people without the disease who test negative
58
What happens in MEMBRANOUS NEPHROPATHY
Subepithelial immune deposits often due to autoantibodies Chancges in the basement membrane
59
Symptoms of acute pyelonephrtisi
Fever Loin pain Tenderness
60
What does NEGATIVE LIKELIHOOD RATIO show Give the formula
How much more likely a negative test is in a person without the disease than in a person with the disease (1 - Sensitivity) / Specificity
61
What is KOILONYCHIA What is it a sign of
Spooning of the nails Seen in iron deficient anaemia
62
In what form is iron most easily absorbed
Fe2+ or as haem
63
Example of an INTRAVASCULAR RBC defect that causes HAEMOLYSIS
Transfusion reaction Infection Prosthetic heart valves Snake/spider bites
64
Example of an INTRINSIC RBC DEFECT that causes HAMEOLYSIS
Enzyme deficiency or membrane defect
65
What does a likelihood ratio of LESS THAN 1 mean
Test result is associated with absnecne of disease | Further from 1 = stronger associaion
66
Causes of microcytic anaemia
Iron deficient anaemia Hamoglobinopathies - thalassaemia Sideroblastic anaemia Lead poisoning
67
Define (in words) specificity
The prop
68
Coombs test is a trst for
HAEMOLYTIC ANAEMIA
69
Give some examples of drugs that can cause anaemia
``` NSAIDS Metformin High dose penicillins Ranitidine Furosemide Warfarin Glitazones ```
70
Causes of a NORMOCYTIC anaemia
Anaemia of chronic disease Acute blood loss Mixed deficiency Bone marrow failure
71
Bruising under the skin is a sign of which anaemia
Haemolytic
72
What is myelodysplasia
Family of bone marrow failure syndromes
73
Example of an EXTRINSCI RBC defect that causes HAMEOLYSIS
Autoimmune haemolytic anaemia Liver disease Infections Drugs
74
Stimuli for the release of gastrin What is the main effect of gastrin Where is it released from?
Rising gastric pH Neural (vagal) stimulation Presence of partially digested food INCREASES GASTRIC ACID SECRETION AND MOTILITY Released from G cells
75
What does a likelihood ratio of greater than 1 mean
Test result is associated with presence of disease The further from 1 it is the greater the association
76
Causes of microcytic anaemia
Iron deficient anaemia Hamoglobinopathies - thalassaemia Sideroblastic anaemia Lead poisoning
77
Structure and classification of H. Pylori
Gram -ve Helical Flaggella
78
Transamination describes the conversion OF WHAT, TO WHAT
Amino acid --> Keto acid
79
What is CORNEAL ARCUS
Lipid deposition in the cornea Sign of hypercholesterolaemia
80
Pancreas develops from a
DORSAL AND VENTRAL bud on the duodenum
81
What is proctitis
Inflammation of the rectum - this is commonly seen in ULCERATIVE COLLITIS
82
Symptoms of duodenal ulcers
Weight gain Eating that reduces pain
83
What are BRUNNERS GLANDS What do they produce
Glands that are unique to the duodenum Secrete bicarbonate to neutralise stomach acid
84
Stimuli for the release of gastrin What is the main effect of gastrin Where is it released from?
Rising gastric pH Neural (vagal) stimulation Presence of partially digested food INCREASES GASTRIC ACID SECRETION AND MOTILITY Released from G cells
85
Everyone with coeliac has which MHCs
DQ2 and DQ8
86
What is APECED
Autoimmune condition arising from the last of expression of self antigens in the thymus
87
Structure and classification of H. Pylori
Gram -ve Helical Flaggella
88
Ways in which Tregs suppress activation of CD4
Contact dependent killing and suppression High levels of CD25 (mop up IL-2) Hi CTLA-4 (mops up CD80/86) Bystander effect on nearby cytokines Production of immunosuppressive cytokines - IL-10
89
Defect in FOXP3 leads to
IPEX

BM4 Year 1 - Quizlet Cards (3 decks)

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