mock Flashcards
(297 cards)
1
Q
Which structure connects intermediate filaments in one cell to the intermediate filaments in another?
A
Desmosome
2
Q
What do Adherens junctions do?
A
joins an actin bundle in one cell to a similar bundle in it’s neighbouring cell
3
Q
what do Gap junctions do?
A
allows the passage of small, water-soluble ions and molecules
4
Q
what do Hemidesmosomes do?
A
anchors intermediate filaments in one cell to the basal lamina
5
Q
What do Zonula Occludens do?
A
also known as tight junction.
seal neighbouring cells together in an epithelial sheet to prevent leakage of molecules
6
Q
What type of protein structure would zinc fingers, helix-turn-helix and beta-alpha-beta be classed as?
A
Superior secondary
7
Q
what does periodic acid shift do?
A
stains brush borders and hexose sugars dark pink (magenta)
8
Q
What are test results for arterial blood gas of metabolic alkalosis?
A
high pH (normal: 7.35-7.45) normal O2 (10-14) normal CO2 (4.5-6.0) high H3O3- (22-26)
9
Q
In a 70kg male, how many litres of the total body water distribution are accounted for by the interstitial fluid?
A
11L
10
Q
Which enzyme unwinds the DNA double helix in DNA replication, relieving the supercoiling?
A
DNA topoisomerase
11
Q
what does DNA helicase do?
A
separates DNA by breaking the hydrogen bonds between bases
12
Q
what does DNA topoisomerase do?
A
unwinds the double helix, relieving the supercoils.
13
Q
what does DNA ligase do?
A
makes the DNA continuous by using the template strand to fill complementary bases
14
Q
what are Okazaki fragments?
A
fragments of DNA that are linked together by DNA ligase to create the “lagging strand” in DNA replication
15
Q
what does DNA primate do?
A
catalyses the synthesis of RNA primers which serve as the starting points for DNA synthesis
16
Q
what is endocytosis?
A
It is a process where cells ingest material from outside the cell by enclosing it within a portion of their cell membrane which buds off to form a vesicle
17
Q
does endocytosis involve active transport?
A
YES
18
Q
what is exocytosis?
A
the fusion of a vesicle from the Golgi apparatus resulting in expulsion of materials from a cell
19
Q
what is pinocytosis?
A
a type of endocytosis
the uptake of solutes dissolved in extracellular fluid by a cell
20
Q
what is phagocytosis?
A
a type of endocytosis
the engulfing of large, solid particles such as worn out cells, whole bacteria or viruses
21
Q
what is non-disjunction?
A
During Meiosis, the failure of homologous chromosomes or sister chromatids to separate can result in genetic disorders such as Trisomy 21 (Down’s syndrome)
22
Q
what is lyonisation?
A
the process of X-inactivation, by which one of the copies of the X chromosome is inactivated in females.
The inactive X chromosome is silenced by it being packaged into a transcriptionally inactive structure called heterochromatin.
23
Q
what is gametogenesis?
A
the process in which cells undergo meiosis to form gametes
24
Q
what is penetrance?
A
the extent to which a particular gene or set of genes is expressed in the phenotypes of individuals carrying it, measured by the proportion of carriers showing the characteristic phenotype.
25
what is basic substitution?
a type of gene-level mutation, which involves the swapping of one nucleotide for another during DNA replication
26
what is selection bias?
error in the process of selecting participants for the study and assigning them to particular arms of the study
27
what is measurement bias?
when information is recorded in a distorted manner (e.g. an inaccurate measurement tool)
28
what is observer bias?
when variables are reported differently between assessors
29
what is procedure bias?
subjects in different arms of the study are treated differently (other than the exposure or intervention)
30
what is misclassification bias?
occurs when a variable is classified incorrectly
31
describe the positive predictive value
The proportion of people with a positive test result who actually have the disease
32
describe the sensitivity of a test
The proportion of people with a disease who are correctly identified by a test
33
describe the specificity of a test
The proportion of people without the disease who are correctly excluded by the test
34
describe the incidence of a disease
The number of new cases, within a specified time period divided by the population size initially at risk
35
describe the prevalence of a disease
The proportion of the population found to have the disease
36
what does the ST segment correspond to?
the plateau phase (phase 2) of the action potential. An ST segment deviation can be an indication of an acute myocardial ischemia.
36
what does the ST segment correspond to?
the plateau phase (phase 2) of the action potential. An ST segment deviation can be an indication of an acute myocardial ischemia.
37
what does the T-wave reflect?
the rapid depolarisation of contractile cells (phase 3)
38
what does the QRS complex represent?
the depolarisation of the ventricles
39
what does the P wave reflect?
atrial depolarization
40
what does the PR segment reflect?
the slow impulse conduction through the AV node
41
what is the right marginal a branch of?
the right coronary artery
42
what is the correct order of conduction in the heart?
SA node > AV node > Bundle of His > Bundle branches > Purkinje fibres
43
Which type of blood cell is typically elevated in parasitic infections?
Eosinophil
44
Which type of blood cell is typically elevated in bacterial infections and acute inflammation?
neutrophils
45
what are T-helper cells used for?
to activate the adaptive immune system and help plasma cells develop antibodies
46
what are basophils involved in?
inflammatory reactions, especially to allergic reaction eg. anaphylaxis
47
Which type of blood cell is typically elevated in acute and chronic infections?
Cytotoxic (CD8) T-lymphocytes
48
What is ANP and what is it's role in blood pressure?
ANP is secreted by the atria in response to increased fluid in the vasculature.
It is secreted when the atria are stretched by the increased fluid. ANP inhibits the Renin-Angiotensin-Aldosterone system and increases excretion of sodium and water.
ANP also acts as a vasodilator.
49
What does angiotensin II do?
causes constriction of the blood vessels.
stimulates secretion of aldosterone which increases sodium reabsorption. These combine to increase fluid in the vascular system and increase blood pressure. This has the opposite effect of ANP.
50
What does vasopressin do?
increases the water reabsorption from the collecting duct which increases fluid in the blood. This increases blood pressure.
51
what does Stimulation of the β2 receptor in the heart do?
increases the contractility and the heart rate which both serve to increase cardiac output. Increased cardiac output increases the blood pressure.
52
what does aldosterone do?
increases sodium reabsorption from the renal tubules which draws in water into the blood. These factors increase the blood pressure.
53
what does stimulation of α2 receptor cause?
vasodilation of the peripheral vascular system and reduces blood pressure. Adrenaline can serve as a vasoconstrictor or vasodilator depending on the receptor it acts on.
54
What is the function of ductus arteriosus in utero?
shunts blood from the pulmonary trunk to the aorta
55
what does the activation of baroreceptors do?
decreased ADH, inhibit RAAS system to reduce blood, reduce cardiac output and activate the depressor region to reduce the sympathetic input to the heart
56
what causes the first heart sound?
closing of the AV valves
57
what is bradykinin?
a vasodilator that relaxes smooth muscle and will cause a decrease in blood pressure.
58
what are Prostaglandins?
vasodilators secreted by the endothelial cells that reduce blood pressure.
59
what is Endothelin-1?
vasoconstrictor that increases blood pressure.
60
is nitric oxide a vasodilator or vasoconstrictor?
vasodilator
61
when is atrial natriuretic peptide released? what does it do?
secreted by the atria in response to stretch.
| It inhibits the RAAS and dilates the blood vessels to decrease blood pressure.
62
what is the equation used to calculate blood pressure?
Cardiac output × Total Peripheral resistance
63
how is stroke volume measured?
Stroke volume = End diastolic volume – End systolic volume
64
how is mean arterial pressure calculated?
Mean arterial pressure = Diastolic pressure - 13 (Systolic – Diastolic pressure)
65
how is cardiac output calculated?
Cardiac output = Heart rate × Stroke volume
66
how is the ejection fraction calculated?
(Stroke volume/End diastolic volume) × 100
67
Define the functional residual capacity (FRC).
The volume of air present in lungs after a passive expiration
68
Define total lung capacity (TLC)
Volume of air present in chest after full inspiration
69
Define residual volume
The amount of air that remains in a person's lungs after fully exhaling
70
Define tidal volume
The amount of air a person inhales during a normal breath
71
define expiratory reserve volume (ERV)
The amount of extra air, above normal breath, exhaled on forceful expiration
72
What type of hypersensitivity does an anaphylactic response represent?
Type 1
73
Which part of the anatomic dead space has got the largest area?
Trachea
74
What type of the alveolar cells produce the surfactant?
Type 2 pneumocytes
75
What do goblet cells produce?
mucus
76
What are type 1 pneumocytes?
flat, elongated cells lining alveoli, responsible for the gas exchange
77
What are the spinal nerves of the phrenic nerve?
C3, C4, C5
| "3,4,5 keep the diaphragm alive"
78
Which epithelium lines the vocal folds?
Stratified squamous
79
What lines the GI system ?
simple columnar epithelium
80
where is stratified squamous epithelium found?
usually located in the areas where friction forces occur (skin, oesophagus, vagina, etc.)
81
where is simple cuboidal epithelium found?
usually found on secretory/ excretory surfaces (convoluted tubules, ependyma, thyroid etc.)
82
where is simple squamous epithelium found?
permeable epithelium, present in places where a transport of small molecules (via filtration or diffusion) occurs. It can be found in lungs, capillaries, alveoli.
83
what is the function of stratified columnar epithelium and where is it normally found?
Function - secretion and protection
| Normally found - parts of pharynx, anus, in the uterus, etc.
84
What levels of PaO2 and PaCO2 indicate type 2 respiratory failure?
Low PaO2, high PaCO2
| Both hypercapnia and hypoxia - type 2 means 2 things wrong!
85
What levels of PaO2 and PaCO2 indicate type 1 respiratory failure?
Low PaO2 - hypoxia
| PaCO2 remains low/normal
86
What FEV1/FVC indicates airway obstruction?
<0.7
87
Airway smooth muscle constriction is stimulated by Ach release acting on which type of receptors?
M3 subtype of muscarinic receptors
88
What do enteroendocrine cells secrete?
GI hormones - secretin, ghrelin
89
What do chief cells secrete?
pepsinogen
90
What do parietal cells secrete?
intrinsic factor and gastric acid (HCl)
91
What do G cells secrete?
gastrin
92
what do enterochromaffin-like cells secrete?
histamine
93
What is Vit K deficiency associated with?
blood clotting disorders
94
What is vit A deficiency associated with?
night blindness
95
What is Vit D deficiency associated with?
poor bone growth & abnormal bone metabolism
96
Where is McBurney's point?
one-third of the distance from the anterior superior iliac spine to the umbilicus. It is the approximate surface marking for the appendix in most individuals.
97
What is the effect of somatostatin?
GI hormone which has inhibitory effect on secretion of every hormone. Hence it decreases the secretion of all the above mentioned hormones, not increase them.
98
Which hormones, at the physiological level, has the strongest effect in inhibiting gastric emptying?
Cholecystokinin (CCK)
| Released as a result of fat and protein digestion products being in the duodenum
99
Which vessel is the ileocolic artery a branch of? What does it supply?
Branch of: Superior mesenteric artery
| Supplies: right colon and terminal ileum
100
NSAIDs such as ibuprofen and naproxen are well-known for causing duodenal ulcers. If a proximal duodenal ulcer gets too deep, it can erode into a nearby artery causing massive haemorrhage. Which artery is this most likely to be?
Gastroduodenal artery
101
What are the GI pacemaker cells?
Interstitial cells of Cajal.
102
What salivary gland has purely serous secretions?
Parotid gland
103
Which enzyme hydrolyses triglycerides to 2 fatty acids and 1 glycerol?
Lipoprotein lipase
104
what does hepatic lipase do?
converts intermediate density lipoprotein (IDL) into low density lipoprotein (LDL)
105
what does triglyceride lipase do?
breaks down dietary fats into fatty acids and glycerol.
106
what does aminotransferase do?
catalyses transamination of amino acids into alpha keto acids. It is used to measure liver function (ALT and AST)
107
what does gamma-glutamyl transferase do?
transfers a gamma-glutamyl group to an acceptor molecule.
| It is used to measure liver function (GGT).
108
Where is the main site of exocrine secretion within the pancreas?
Pancreatic acini
109
The pancreas is formed from a fusion of a ventral and dorsal bud. Which areas of the pancreas does the ventral pancreatic bud form?
Uncinate process, main pancreatic duct and pancreatic head
110
Through what process is glutamate converted to ammonium (NH4+)?
Oxidative deamination
111
Within a distribution of data, if the median is greater than the mean of the data, what is the data described as?
Negatively skewed
112
How is prevalence worked out?
Prevalence = (TP + FN) / (TP + FP + FN + TN) x100
113
How is odds calculated?
```
odds = number of events / number of non events
e.g. = died in new treatment / survived in new treatment group
```
114
What are delta cells? Where are they found?
somatostatin-producing cells which can be found in the stomach and pancreatic Islet of Langerhans
115
What are oligodendrocytes?
a type of neuroglia that myelinate axons within the central nervous system
116
What are Renshaw cells?
a specialised population of interneurons that are stimulated by alpha motor neurons and through a feedback system can be inhibited by alpha motor neurons causing autoinhibition.
117
Which cranial nerve innervates the posterior 1/3 of the tongue?
Glossopharyngeal
118
What does the anterior cerebral artery supply?
the medial part of the motor cortex which innervates the leg.
119
A patient is suffering from a cranial nerve palsy, causing one of her eyes to be locked in a characteristic ‘down and out’ position. Which cranial nerve has been affected?
III
120
What is the name of the ligament connecting the laminae of the adjacent vertebrae?
Ligamentum flavum
121
What vessels and nerves are within the cavernous sinus?
the internal carotid artery
oculomotor nerve (III)
trochlear nerve (IV)
ophthalmic branch of the trigeminal nerve (V1)
maxillary branch of the trigeminal nerve (V2)
abducens nerve (VI).
122
Describe the path of sperm to outside
SREEVEN UP
```
Seminiferous tubules ->
Rete testis ->
Efferent ducts ->
Epididymis ->
Vas deferens ->
Ejaculatory duct ->
nothing ->
Urethra ->
Penile urethra
```
123
What hormone is likely to show as high in a menopausal woman?
FSH
| due to lack of negative feedback from oestrogen and decline if inhibin
124
What does the urogenital sinus differentiate into?
external genitalia: lower 1/3 vagina, labia majora, labia minora and clitorus
125
What does the Mullerian duct differentiate into?
uterine tubes, cervix and upper 2/3 vagina
126
The urogenital organs are developed from which layer of the germ cells?
intermediate mesoderm
127
What level does the renal artery come off the abdominal aorta?
L2
128
At what level does the oesophagus pass through the abdomen?
T10
129
Where does the aorta pass through the abdomen?
T12
130
At what level does the superior mesenteric artery branch off the aorta?
L1
131
At what level do the renal arteries branch off the aorta?
L2
132
At what level does the inferior mesenteric artery branch off the aorta
L3
133
What do the urethral folds develop into?
Females: labia minora
Males: corpus spongiosum (enclosing urethra)
134
What does the tubercle become?
Males: glans penis
Females: clitoris
135
The labioscrotal folds fuse to form what?
Males: scrotum and ventral penis
Females: labia majora
136
What does the superficial perineal pouch contain?
erectile tissues that form the penis and clitoris, and 3 muscles: ischiocavernosus, bulbospongiosus and superficial transverse perineal muscles
137
What does the cremasteric artery supply?
testes
138
What is the immediate precursor molecule to adrenaline?
noradrenaline
139
What are the 5 steps within catecholamine synthesis?
tyrosine -> l-dopa -> dopamine -> noradrenaline -> adrenaline
140
What is the order of the histological layers of the epidermis from exterior to interior?
```
Corneum
Lucidum
Granulonum
Spinosum
Basale
```
141
Which cells in the kidney tubule are responsible for controlling acid-base balance? Where are they present?
intercalated cells
in the collecting duct
Type A: control H+ conc
Type B: control HCO3- conc
142
What dermatome is responsible for the suprapubic region?
L1
143
What dermatome is responsible for the nipple?
T4
144
What dermatome is responsible for the umbilicus?
T10
145
What dermatome is responsible for the inguinal region?
L2
146
Which part of the adrenal gland is responsible for the production and release of aldosterone?
Zona glomerulosa
147
What does the zone reticularis release?
androgens
148
What does the zone fasciculate release?
glucocorticoids
149
What is the order of development of the renal system?
The pronephros develops first followed by the mesonephros and then the metanephros.
Each section develops caudally to the last.
150
Where do the kidneys develop in embryo and how to they migrate?
the kidneys develop low in the pelvis and ascend.
151
What is carpal tunnel syndrome?
Compression of the median nerve as it passes through the carpal tunnel
Can lead to: tingling in hand, specifically the thumb, index finger, middle finger and part of her ring finger
152
Patient presents with inability to flex the knee. What nerve is most likely effected?
Sciatic nerve
153
What does the sciatic nerve innervate?
he posterior compartment of the thigh – the hamstring muscles which flex the knee
154
What is the anatomical snuffbox?
a triangular depression found on the lateral aspect of the dorsum of the hand.
155
What are the borders of the anatomical snuffbox?
Posterior border – tendon of extensor pollicis longus
Anterior border – tendons of extensor pollicis brevis and abductor pollicis longus
Proximal border – styloid process of radius
Distal border – apex of snuffbox triangle
Floor – trapezium and scaphoid
156
What are the contents of the anatomical snuffbox?
radial artery, branch of the radial nerve, cephalic vein
157
During a hip examination, a 70-year-old male is found to have a positive Trendelenburg’s sign. When he stands on only his left leg, his right pelvis drops. Which muscles are affected?
Left gluteus medius and gluteus minimus
| Ride sided pelvis drop -> weakness on the left side
158
Cartilage is an example of what type of collagen?
type 2 collagen
159
placenta is an example of what type of collagen?
type 5 collagen
160
bone skin and teeth are an example of what type of collagen?
Type 1 collagen
161
basement membranes are an example of what type of collagen?
Type 4 collagen
162
arteries are an example of what type of collagen?
type 3 collagen
163
What are the Big 5 CAM (complimentary and alternative medicines) used in the NHS?
Acupuncture, chiropractic, herbal medicine, homeopathy, osteopath.
The Big 5 are professionally organised alternative therapies. They have an individual diagnostic approach and some scientific evidence of efficacy.
164
What is the sequence of phases in stress response?
Alarm, adaptation, exhaustion
165
What is the incremental cost-effectiveness ratio (ICER) and how is it calculated?
a statistic used in cost-effectiveness analysis to summarise the cost-effectiveness of a health care intervention
ICER = difference in costs/difference in benefits
166
Describe the stress-illness model
“An individual’s susceptibility to disease or illness is increased because an individual is exposed to stressors which cause strain upon the individual, leading to psychological and physiological changes.”
167
Describe eustress
A positive stress which is positive and motivating
168
Wilson’s disease is a type of genetic disorder affecting the active transport in the body. What is the Na+/K+ -ATPase an example of?
Primary active transport
169
What shape nucleus does a monocyte have?
Reniform (kidney bean shaped)
170
Which artery is the main supply to the atrioventricular node (AVN)?
Posterior inter ventricular artery
(70% Right coronary artery only
20% Right & Left coronary arteries
10% Left coronary artery only)
171
The maxillary artery arises from which of the aortic arches?
1st aortic arch.
172
What is contained within the dense granules of platelets?
ADP and thromboxane A2
173
What does the bulbus cordis develop into?
Right ventricle
174
What is the function of the periciliary fluid?
It keeps the mucous at an optimum distance from the epithelia
175
There are many tests that are very useful to help diagnose respiratory diseases. What is the purpose of exhaled nitric oxide test?
Indirect measuring of airway inflammation
176
Where can you find central chemoreceptors?
In the brainstem
177
What percentage of the surface area of an alveoli does a type 1 pneumocyte usually make up?
90%
178
Which of the following cartilages are attached to the vocal cords?
Arytenoid
179
What are the single cartilages?
cricoid cartilage, thyroid cartilage & epiglottis
180
What are the 6 paired cartilages?
arytenoid, corniculate & cuneiform cartilages
181
At which thoracic vertebral level does the hiatus for the inferior vena cava lie?
T8
182
At which thoracic vertebral level does the hiatus for the oesophagus lie?
T10
183
At which thoracic vertebral level does the hiatus for the descending aorta lie?
T12
184
What are Peyer's patches an example of?
mucosa-associated lymphoid tissue (MALT)
185
Fluid is absorbed in the gastrointestinal tract by the small intestine. What percentage of fluid is absorbed in the small intestine?
80%
186
Which is the main hormone stimulating bile secretion?
Cholocystokinin
187
SIADH has a genetic component to it. What is a method of genetic testing in pregnancy?
Chorionic villus sampling OR amniocentesis
188
Define penetrance in genetics
Proportion of people with a gene/genotype who show the expected phenotype
189
Where does haematopoiesis occur in an adult and where does it occur in a foetus?
Adult = axial bone marrow
Foetus = one of: yolk sac OR liver OR spleen
190
State the structural differences of foetal haemoglobin compared to adult haemoglobin
```
Foetal = 2 alpha & 2 gamma chains
Adult = 2 alpha & 2 beta
```
191
Total lung capacity was also measured. Name a method that can be used to measure total lung capacity.
Gas dilution OR total body plethysmography (body box)
192
The gentleman’s FVC is below 80% of the predicted value for someone his age. What is this a sign of?
airway restriction
193
State 2 effects of ageing on lung function.
```
Delayed response to hypercapnia/hypoxia
decreased FEV/FVC
impaired gas exchange
decreased immune function change in shape of thorax stiffening of thoracic cartilage in ribs, decrease in respiratory muscle mass
loss of elastic recoil
```
194
Where in the stomach are you most likely Enteroendocrine (G) cells?
Antrum
195
Name 2 features that you can use to distinguish the small intestine from the colon?
Small intestine has mesentery. Large intestine has haustra
196
What are 4 functions of the cell plasma membrane?
Acts as semi-permeable membrane
Hosts cell membrane receptors
Regulates what goes in and out of cell
Separates intracellular cell contents from extracellular cell contents
197
What are the 3 lipid groups that make up the plasma membrane?
Phospholipids
Glycolipids
Sphingolipids
Cholesterol
198
If BP = blood pressure, PVR = peripheral vascular resistance, and CO = cardiac output, write
an equation that indicates the interrelationship between these parameters.
BP = CO x PVR
199
State three metabolic or physiological factors that reduce peripheral vascular resistance.
Nitric oxide/metabolic breakdown products, hypoxia, hypercapnia, reduced sympathetic
stimulation, parasympathetic stimulation
200
State two effects that stimulating arterial baroreceptors has on systemic blood pressure.
Decreased sympathetic nervous system stimulation, decreased arteriolar vasoconstriction,
decreased blood pressure
201
Which part of the stomach has parietal cells?
Fundus and body
202
What do parietal cells secrete?
HCl and intrinsic factor
203
What do chief cells secrete?
Pepsinogen
204
How do NSAIDs predispose you to peptic ulcers in the stomach?
Block COX (cyclo-oxygenase) → reduce PG (prostaglandin) production → reduced mucosal defence
205
Explain how food in the duodenum can stimulate the downregulation of parietal cells in the
stomach.
Somatostatin + CCK inhibit gastrin and histamine.
| Somatostatin release from pancreas inhibits HCl production by parietal cells.
206
What hormones are secreted from Thyroid follicular epithelial cells?
Thyroxine
207
What do Parafollicular cells release?
Calcitonin
208
Dietary nutrient and amino acid required for hormone secreted by thyroid follicular epithelial
cells.
Dietary nutrient: Iodine
| Amino acid: Tyrosine
209
What two proteins in the blood do the hormones from the thyroid bind to?
Albumin
Thyroxine Binding Globulin
Transthyretin
210
What eye-related features do you see in Grave’s disease?
Bulging eyes (exophthalmos)
Lid lag
Ophthalmoplegia
Lid retraction
211
Name the hormones synthesised in the different zones of the glomerulus
Zona glomerulosa - Aldosterone, mineral corticoids
Zona fasciculata - Cortisol, glucocorticoids
Zona reticularis - DHEA, androgens
Go Find Rex Make Good Sex
212
What enzyme is present in Zona glomerulosa that is not present anywhere else?
Aldosterone synthetase
213
factors that activates secretion of aldosterone
increased K+
| angiotensin II
214
What is the hormone used to detect pregnancy?
Human chorionic gonadotropin
215
4 Cardiovascular changes in pregnancy
Increased cardiac output,
decreased blood pressure,
decreased total peripheral resistance,
increased uterine blood flow
216
Hormone that prevents myometrial contraction during pregnancy
progesterone
217
What two hormones are secreted in the kidney?
Renin
| Erythropoietin
218
What hormones are secreted elsewhere but activated in the kidney?
Calcidiol,
| Angiotensinogen
219
Causes of metabolic acidosis?
```
Lactic acidosis
Ketoacidosis
Diarrhoea
hyperkalaemia?
renal tubular acidosis
salycyclic acid overdose
methanol intoxication
```
220
Name the 3 joints in the synovial cavity in the knee?
```
Medial Tibiofemoral (condyloid)
Lateral Tibiofemoral (condyloid)
Patellofemoral (gliding)
```
221
What protects the knee joint from dislocating anteriorly
Anterior Cruciate Ligament
222
What causes a valgus deformity
Medial Collateral Ligament
223
What protects the knee joint from dislocating posteriorly/ strengthens the back of the knee
Oblique popliteal
224
Most common arthritis affecting the knee
osteoarthritis
225
What is the difference between analgesic and anaesthetic?
Analgesic - loss of pain. Dulls sensation of pain.
| Anaesthetic - loss of pain, temperature and touch. Blocks the sensation of pain
226
Definition of distress
Negative stress, damaging and harmful
227
Definition of eustress?
Positive stress, beneficial and motivating
228
Signs of stress - 4 types and 4 examples apart from physiological
Biochemical - Altered endorphin levels, increase in cortisol
Behavioural - Increase in absenteeism, smoking and alcohol
Cognitive - Negative thoughts, loss of concentration
Emotional - Tearful, mood swings, irritable, aggressive, apathy
229
What chronic stressors apart from work should the doctor ask about
Relationships, unstable financial status, lack of friends, poor physical health
230
Name 2 non-pharmacological factors which mediate the effect of stress?
Social support, beliefs, personality, lifestyle, exercise
231
In which part of the brain is the somatosensory cortex?
Left parietal lobe, post-central gyrus
232
In which part of the brain is the premotor cortex?
Frontal lobe
| Pre central gyrus
233
What is the motor speech part and which lobe of the brain is affected.
Broca’s area
| Frontal lobe of the dominant hemisphere
234
What is the internal capsule?
Projection fibre
| Axons from motor cortex to deep brain structures
235
which lobe is affected?
| Somatosensory
parietal lobe
236
which lobe is affected?
| muscle twitching
frontal lobe
237
Which lobe is affected?
| Visual flashing lights
occipital lobe
238
Which lobe is affected? Auditory hallucination
Temporal lobe
239
What lobe is affected?
| Dejavu, visual hallucinations, fear
temporal lobe
240
What structure joins the hemispheres together to allow a mirrored lesion so epilepsy affects contralateral side?
Corpus callosum
241
Describe the role of a healthy liver in preventing bruising
Liver produced bile salts, essential for Vit K absorption
Vit K needed for synthesis for clotting factors 10,9,7,2
1972!
242
Explain the effects of low levels of albumin in the blood.
- Albumin is a plasma protein that maintains oncotic pressure (2) because its presence causes the water concentration of the blood to be slightly lower than the water concentration in the interstitial fluid
- This means that there is net flow of water into the blood (1) from the interstitial fluid
- Low levels of albumin cause a decrease in the oncotic pressure (2) - This results in movement of water out of the blood into the interstitial fluid, causing oedema (1)
243
Describe how changes in the osmolality of the extracellular fluid are detected.
Detected by osmoreceptors in the hypothalamus
244
Describe how antibodies are specific to one antigen
Antibodies are bound to antigens via the variable region (1)
- The variable region determines the specificity of the antibody to the different amino acids that it contains, which change the shape of the antigen binding site (1)
245
A key complication of type 1 diabetes is diabetic ketoacidosis. Explain the process of ketogenesis in the liver
High rates of fatty acid oxidation result in large amounts of acetyl-CoA production that exceed the capacity of the Krebs cycle (1)
- 2 molecules of acetyl-CoA are converted into acetoacetyl-CoA by the enzyme thiolase (1)
- Acetoacetyl-CoA is converted into acetoacetate (1)
- This is then converted into b-hydroxybutyrate by b-hydroxybutyrate dehydrogenase and acetone spontaneously (1)
246
Explain the mechanism of inheritance of Duchenne muscular dystrophy and why women are carriers
Duchenne muscular dystrophy is inherited in an X-linked recessive pattern (1) - This means that the mutated gene is located on the X chromosome (1) - Heidi is a carrier because females have 2 copies of the X chromosome
therefore one affected copy can be inherited, but is not enough to produce the affected phenotype (1)
247
Name the process of X chromosome inactivation.
Lyonization
248
What is preload?
The initial stretching of the cardiac myocytes (1) prior to contraction (1)
249
What is afterload?
The pressure the left ventricle must overcome to eject blood (1) during systole / contraction (1)
250
What does it mean if something is negatively chronotropic?
decreases heart rate
251
Describe oesophageal innervation in terms of nervous innervation and voluntary/involuntary action.
- Vagus nerve (1)
- Upper portion of the oesophagus has voluntary (striated) fibres (1)
- Lower portion of the oesophagus has involuntary (smooth) fibres (1). - (The middle third has a mixture of these).
252
Name 3 differences between appearance of thoracic and cervical vertebrae.
Thoracic vertebrae have inferiorly slanting spinous process AND cervical have bifid spinous processes
- Thoracic vertebrae have costal facets AND cervical do not
- Thoracic vertebrae don’t have transverse foramina AND cervical do - Thoracic vertebrae have smaller heart shaped vertebral foramen AND cervical have larger more oval shaped one
253
What sensory modalities does the spinothalamic tract carry, and where does this tract decussate?
- Pain, crude touch, pressure and temperature (any 2)
| - Decussation at 1-2 vertebral levels above the level of entry into the spinal cord (2)
254
Which spinal tract is responsible for proprioception, and would this be lost ipsilaterally or contralaterally in Brown-Sequard syndrome?
DCML
| ipsilateral
255
What cells produce CSF, and where are these located?
Ependymal cells (1) in the choroid plexus (1) of the ventricles
256
What is the name of the structure connecting the third and fourth ventricles?
Cerebral aqueduct
257
CSF returns to venous circulation after drainage through dural venous sinuses. Which vein do all dural venous sinuses drain into?
internal jugular vein
258
what colour does periodic acid schiff turn sugars?
pink/magenta
259
what colour does Van Grieson stain elastics?
brown
260
what colour does Alcian blue stain mucin
blue
261
what colour does Perl’s stain iron
blue
262
Lipofuscin is a pigment formed from peroxidation of lipids in older cells. What colour is it?
orange/brown
263
Lipofuscin is a pigment formed from peroxidation of lipids in older cells. What organs is it most commonly found in?
liver and heart
264
What are the two types of adipose tissue?
white adipose tissue
| brown adipose tissue
265
One of these types is found down the back and across the shoulders of a newborn child. What is its function?
thermoregulation
266
Which type of muscle has no striations?
smooth
267
Which type of muscle has nuclei that are not central?
skeletal
268
Which type of muscle has branching?
cardiac
269
Which type of muscle has intercalated discs?
cardiac muscle
270
Which type of muscle has multiple nuclei?
skeletal
271
Describe the effect that having cysts in the renal medulla may have on Francis’ urinary output.
- The loop of Henle of juxtamedullary nephrons extend deep into the renal medulla
- These are responsible for generating an osmotic gradient in the medulla that functions to reabsorb water
- Cysts in the renal medulla, therefore, causes the patient to produce large volumes of dilute urine because the loop of Henle is unable to reabsorb water sufficiently
272
Upon confirmation that Francis has PKD, the doctor prescribes ACE inhibitors. Explain the role of the kidneys in regulating blood pressure.
- Juxtaglomerular cells in the afferent arterioles are stimulated to release renin when the cells in the macula densa of the distal convoluted tubule detect less NaCl, sympathetic stimulation and little/no arterial stretch
- Renin enters the bloodstream and cleaves angiotensinogen into angiotensin I
- Angiotensin I is converted by angiotensin-converting enzyme (ACE) into the active agent, angiotensin II
- Angiotensin II stimulates the cells of the zona glomerulosa in the adrenal cortex to release the steroid hormone, aldosterone
- Aldosterone acts to vasoconstrict the efferent arteriole, increasing the pressure and causing an increased glomerular filtration rate
273
State what is meant by glomerular filtration rate and give the equation used to calculate this.
- The volume of fluid filtered from the glomerulus into Bowman’s space per unit of time
- GFR = filtration coefficient (glomerular capillary hydrostatic pressure – Bowman’s space hydrostatic pressure – osmotic pressure in glomerular capillary)
274
Describe how parathyroid hormone affects the kidneys.
Directly increases C2+ reabsorption in the kidneys
| to decrease urinary excretion and increase plasma calcium
275
List 3 main functions of the skin.
- Protection against trauma
- Barrier to pathogens / infection
- Regulation of water loss
- Protection against UV light
- Thermoregulation
- Vitamin D synthesis
276
State 2 causes of hypoxia.
V/Q mismatch, hypoventilation, diffusion impairment, shunting
277
Oxygen is transported in the blood via haemoglobin. Explain how the blood carries oxygen with reference to the oxygen dissociation curve.
At high partial pressures of oxygen, haemoglobin binds to oxygen to form oxyhaemoglobin (1)
- The oxygen dissociation curve is a sigmoid shape because oxygen cooperatively binds to haemoglobin
- This means that haemoglobin has a greater ability to bind to oxygen after a subunit has already been bound to oxygen (haemoglobin is most attracted to oxygen when 3 or 4 of the subunits are already bound)
278
The patient also complains of coughing up small amounts of mucus. Describe how mucus is moved through the airways.
- Mucus is transported by air flow and the mucociliary escalator (1) from the lower respiratory tract to the pharynx (1)
- The mucociliary escalator brings up mucus by the cilia beating in directional waves up the airways (1)
279
State the most common type of pulmonary macrophage and explain how these fight infections.
Alveolar macrophage
They destroy bacteria via phagocytosis
Bacteria is engulfed by phagosome
the membrane fuses with a lysosome, forming a phagolysosome
enzymes from the lysosome break down and destroy bacteria
280
What is the anatomical name for where these dopamine neurons are found?
substantia nigra, pars compacta
281
Which cortical tract is responsible for movement, and where does it decussate?
Corticospinal
| Medulla oblongata
282
If this patient had a lesion in the left parietal optic radiation (posterior to the optic chiasm and anterior to the visual cortex), how would you describe this visual defect?
right sided, homonymous, inferior, quadrantanopia
283
Which specific area of the brain is involved in the ability to produce speech?
Frontal lobe
| Broccas area
284
A stroke affecting which area of the brain may result in difficulty in speech comprehension and results in a ‘word salad’ where the patient is able to physically
say words but they make no sense. Which specific area is affected, what lobe is it located in, and what Brodmann area is this?
Wernickes area
temporal lobe
brodmans area 22
285
A patient present with a ‘foot drop’. State which nerve is affected, and its root
Common peroneal nerve
| L5
286
define osteoporosis
low bone density which presents with fractures (T score < -2.5)
287
define osteopenia
decreased bone density
| T score -1 > n > -2.5
288
define osteomalacia
poor bone mineralisation
289
Which three muscles form the anterior compartment of the upper arm, and what nerve innervates these muscles?
Biceps brachii
Coracobrachialis
Brachialis
Innervation - Musculocutaneous nerve
290
What are the two measurements that are taken in spirometry that lead to a diagnosis of an obstructive disease, and the values you would expect to see?
FEV1 - <0.8
| FVC - <0.7
291
What happens to FEV1 and FVC in a restrictive lung disease
both reduce equally
292
In spirometry, state the volumes that make up total lung capacity.
Inspiratory Capacity (IRV + TV) + Functional Residual Capacity (ERV + RV)
293
The blood levels of what substances are detected by peripheral chemoreceptors?
PaO2
PaCO2
pH
294
Where are peripheral chemoreceptors found?
Carotid bodies and aortic bodies e.g.
| bifurcation of common carotid and aorta
295
Where are central chemoreceptors found?
medulla
296
Which lung receptors are rapidly adapting and initiate the cough and gasp responses?
irritant
rapid activated stitch receptors (RASR)
