MD2002 Week 10/11 Flashcards
(82 cards)
1
Q
in what week do limbs rotate?
A
these rotate in week 7
2
Q
when do upper limb buds appear and b/w which somites
A
these limb buds appear day 24 b/w somites C5-T1
3
Q
when do lower limb buds appear and b/w which somites
A
these limb buds appear day 28 b/w somites L1-S2
4
Q
3 axes limb growth lies on
A
- proximodistal
- anteroposterior
- dorsoventral
5
Q
limb bud consists of… (3)
A
- core of mesenchyme derived from parietal layer of lateral plate mesoderm
- ectoderm
- AER
6
Q
zone following AER of undifferentiated, rapidly proliferating cells
A
progress zone
7
Q
which gene tells which somites to become limbs?
A
HOX-8
8
Q
2 genes initiate outgrowth of forelimb
A
- TBX5
2. FGF10
9
Q
2 genes AER secretes
A
- FGF4
2. FGF8
10
Q
outline limb development anteroposteriorly
A
zone of polarizing activity near posterior border of limb and expresses SHH, ensuring thumb grows on cranial side
11
Q
outline limb development dorsoventrally
A
BMP in ventral ectoderm induce EN1, repressing WNT7 so its restricted to dorsal ectoderm where it induces LMX1, specifying dorsal cell growth
12
Q
what transcription factors control upper and lower limb budding respectively?
A
TBX5 and TBX4 respectively
13
Q
phocomelia
A
absence of long bones in limbs
14
Q
most common non-chromosomal malformation
A
congenital heart defects are the most common
15
Q
are UL or LL abnormalities more common?
A
UL abnormalities are more common
16
Q
teratogen
A
agent that causes birth defects
17
Q
thalidomide
A
teratogen that used to be sleeping pill, causing phocomelia or amelia, intestinal atresia, and cardiac abnormalities
18
Q
Holt Oram syndrome
A
TBX5 mutation causing UL deformities and heart defects
19
Q
brachydactylyl
A
abnormally short digits
20
Q
bacteraemia
A
presence of bacteria in blood
21
Q
systemic inflammatory response syndrome (SIRS)
A
patient w/ 2 or more of:
- temp >38 or 100
- BR > 20/min
- leukocyte count >16,000/mm3 or 10% immature cells
22
Q
sepsis
A
SIRS plus a documented infection site
23
Q
severe sepsis
A
sepsis associated w/ organ dysfunction, hypoperfusion abnormalities or hypotension
24
Q
sepsis
A
SIRS plus a documented infection site
25
septic shock
sepsis induced hypotension despite fluid resuscitation plus hypo perfusion abnormalities
26
examples of hypperfusion abnormalities
- lactic acidosis
- oliguria
- acute alteration in mental status
27
sepsis six
1. give high flow oxygen
2. take blood culture
3. broad spectrum antibiotics
4. IV fluid challenges
5. measure serum lactate and haemoglobin
6. measure hourly urine output
28
what blood tests are done for sepsis?
WCC, CRP, platelets, clotting are tested
29
which skin infection lies superficially?
impetigo found on this level of skin
30
which skin infection lies just below epidermis?
erysipelas found on this level of skin
31
which skin infection includes epidermis and fermi?
cellulitis found on this level of skin
32
which skin infection encompasses epidermis, dermis, and hypodermis
necrotising fasciitis found on this level of skin
33
common bacteria found in animal bites
pasteurella multocida
34
conditions that can arise from pasteurella multocida
septic arthritis, septicaemia, meningitis, osteomyelitis can occur from this bacteria
35
most common type of animal bite
dog most common
36
what should never be used to treat animal bites?
clindamycin monotherapy
37
antibiotic course length for osteomyelitis
antibiotic course length for this condition is 6 weeks
38
optimal antibiotic for animal bites
co-amoxyclav
39
what muscle does tibial nerve lie under?
this nerve lies under soleus
40
deepest plantar flexor
tibialis posterior is the deepest
41
define stress
perceived discrepancy b/w demands of situation and resources someone has in a stressful situation
42
theories that explain stress (3)
1. stimulus (environment - stressor)
2. response (individual - strain)
3. transaction (process - stressor and strain)
43
compare primary and secondary appraisal in the stress coping paradigm
primary - benign/irrelevant/pos appraisal thus no coping
| secondary - stimulus appraised as stressor so cope
44
4 possible results of secondary appraisal in the stress coping paradigm
1. seek info
2. take direct action
3. do nothing
4. worry
45
outline general adaptation syndrome (4)
1. stressor
2. alarm
3. resistance
4. exhaustion
46
2 steps in physiological stress response
1. sympathetic activation: catecholamines produced
2. hypothalamic-pituitary-adrenocortical (HPA) activation: corticosteroids and brain opioids beta endorphin and enkephalin
47
short-term vs long term stress response
short (medulla): increase HR/BP/metabolism, broncho/vasodilation
long (cortex): retention of Na and H20 in kidneys, increase blood vol/BP, increase blood sugar, decrease immune system
48
examples of stress moderators
- social support
- beliefs
- personality
- genetic predisposition
- lifestyle
- etc
49
max alcohol intake
14 units a week for men and women
50
how to calculate units of alcohol
1L of x% = x units of alcohol
51
minimum physical activity guidelines
30m moderate 5 days a week or 20m vigorous 3 days a week or combination
52
definition of moderate-intensity exercise
this intensity of exercise slightly increases RR and HR and cause warmth and maybe sweat
53
definition of vigorous-intensity exercise
this intensity of exercise greatly increases RR and HR and unable to continue a conversation
54
minimum length of DPA for 5-18yo
minimum 1h DPA for this age group
55
minimum length of DPA for >5yo
minimum 3h DPA for this age group
56
define coping
process one manages the perceived discrepancy b/w demands of situation and resources one has in a stressful situation
57
2 types of coping
1. problem focused
| 2. emotion focused
58
examples of coping with illness (4)
1. normalising (interprets as normal)
2. denial (deny symptoms)
3. resignation (consumed w/ illness)
4. accommodation (deals w/ issue)
59
examples of coping resources
- personality
- info
- social support
- exercise
- etc
60
monitors vs blunters
one coper seeks info and the other avoids
61
which nerve provides the lateral cutaneous nerve of calf?
common peroneal nerve provides this cutaneous branch
62
what does the dorsal venous arch drain into?
this drains into the great and small saphenous vein
63
bones that make up medial longitudinal arch of foot (4)
1. calcaneus
2. talus
3. navicular
4. medial 3 MT
64
bones that make up lateral longitudinal arch of foot (3)
1. calcaneus
2. cuboid
3. lateral 2 MT
65
what bones does the calcaneus articulate with?
this bone articulates w/ talus and cuboid
66
what bones does the talus articulate with?
this bone articulates w/ tibia, fibula, calcaneus, and navicular
67
what artery supplies the Mts and phalanges?
arcuate artery supplies these
68
what bones make up the ankle joint?
tibia, fibula, and talus make up this
69
mechanism of alkylating agents
form covalent bonds w/ DNA by intrastrand crosslinking: N7 of guanine alkylated so guanine turns from keto to enol tautomer and mispairs w/ T. apoptosis.
70
outline cyclophosphamide
nitrogen mustard activated in liver by P450 into aldophosphamide, turns into cytotoxic phosphoramide in tissue (Mesna counteracts side product acrolein)
71
describe the 2 nitrosoureas
1. lomustine/carmustine: lipid soluble so cross BBB (brain tumours)
2. busulphan: effects bone marrow so prevents granulocyte and platelet formation (low dosage) and RBC (high dosage). little effect on lymphoid tissue or GI. used chronic granulocytic leukaemia)
72
cisplatin
a platinum based compound
73
an antifolate drug
methotrexate
74
2 antipyrimidines and their mechanism
1. fluorouracil (5-FU): converts into fraudulent nucleotide (FDUMP), inhibiting thymidylate synthase so DTMP cannot be made
2. gemcitabine: analogue of cytarabine which is a cytosine analogue w/ arabinose instead of ribose which undergoes phosphorylation to give cytosine araboniside triphosphate, inhibiting DNA polymerase
75
2 antipurines and their mechanism
1. mercaptopurine: converts to 6-mercaptopurine-ribose phosphate "Lethal Synthesis", inhibiting de novo synthesis of purines
2. fludarabine: inhibits DNA polymerase
76
anthracyclin drugs and their mechanism
doxorubicin/-rubicins/mitoxantrone: stabilizes DNA topoisomerase II complex after strands are separated, stopping DNA/RNA synthesis
77
mechanism of dactinomycin
this drug intercalates b/w G-C, interfering RNA polymerase and thus preventing transcription
78
mechanism of bleomycin
this drug chelates ferrous iron and interacts w/ oxygen, oxidizing iron and generating DNA damaging radicals
79
mechanism of mitomycin
alkylates O6 of guanine
80
plant derivatives and mechanisms (4)
1. vinca alkaloids (vincristine, vinblastine): bind tubulin and prevent polymerization into microtubules
2. taxanes (paclitaxcel, docetaxel): freeze microtubules
3. camptothecins (irinotecan): inhibit topoisomerase I
4. etoposide: inhibit mitochondria function, nucleoside transport, topoisomerase II
81
6 miscellaneous agents and their mechanisms
1. hormone antagonists (tamoxifen): block estrogen effects in breast cancer
2. procarbazine: inhibit DNA/RNA synthesis
3. hydroxycarbamide (hydroxyurea): inhibits ribonucleotide reductase
4. crisantaspase: against lymphoblastic leukaemia cells
5. amsacrine: acts on topoisomerase II
6. mitotane: stops synthesis of adrenocortical steroids
82
4 novel targeted agents and mechanisms
1. rituximab: targets B cell surface protein ( B cell lymphomas)
2. tastuzumab (Herceptin): targets epidermal growth factor receptor (breast cancer)
3. imatinib (Gleevac): inhibits bcr-abl gene (chronic myeloid leukemia)
4. Acelarin (Gemcitabine analogue): pancreatic cancer
