SAQ 2011 Flashcards
(41 cards)
Describe the symbols in a pedigree
Circle = female square = male
coloured = diseased shaded or half/half = carrier blank = normal
line through = deceased
Define laws of mendelian inheritance
- Law of segregation = During gamete formation, the alleles for each gene segregate from each other so that each gamete carries only one allele for each gene.
- Law of independent assortment = Genes for different traits can segregate independently during the formation of gametes. (during metaphase of meiosis)
- Law of dominance = Some alleles are dominant while others are recessive; an organism with at least one dominant allele will display the effect of the dominant allele.
Name the cells of the stomach, what they secrete and where they are found
G cells - antrum
Parietal – BODY AND FUNDUS
Chief cells – body, FUNDUS AND PYLORUS - secrete pepsinogen (HCl activates to pepsin - protein digestion)
(Enterchromaffin-like = release histamine gastric glands in vicinity of parietal cells)
Where is somatostatin released from?
- Delta cells in the pyloric antrum, the duodenum and the pancreatic islets
- Acts on parietal cells in the stomach to reduce HCl secretion, can also act of G cells and ECM-like cells
What 3 processes would you advise someone to go through to quit?
Ready – plan, find out info from GP, stead-set a date and throw out lighters, cigerettes etc, go- make a plan for the plan and try to avoid triggers, reward yourself
Ethics – 14 year old girl having sex without a condom, has contracted STI and refuses to use condoms even though she’s on the contraceptive pill
o What are 2 ethical considerations in this case?
Autonomy – respecting her decision to make her own decisions,
Utilitarianism– if she doesn’t start using condoms she is likely to spread STI and hurt other people
What is a disadvantage of virtue ethics
- what is ‘right’ can be culture specific
- too broad?
- individual understanding can ignore social and communal dimensions
- which are the most important virtues when they contradict each other?
What is a limitation of deontology?
What document by the GMC advocates the use of deontology?
Can duties conflict?
1- It does not take into consideration the complexity of life situations and sometimes the results of the decisions taken by deontologists can be very drastic (it might reach the death of an innocent person like case study 1).
2- It faces big dilemma when 2 principles are involved and usually applying it would not be effective.
-Duties of a doctor - deontology/virtue ethics
What type of theory is used to maximize greater good
Utilitarianism = max good for max people
Consquentialism
Describe the main ethical theories
Ethical Theory - philosophical attempts to create ethical theories:
i virtue ii categorical iii imperative iv utilitarianism v 4 principles (autonomy, beneficence, non-maleficence, justice)
What utilitarian/consequentialism (teleological)
- An act is evaluated solely in term of its consequences
* Maximising good and minimizing harm
What is KANTIANISM (Deontological)?
KANTIANISM (Deontological)
• Features of the act themselves determine worthiness (goodness) of that act
• Following natural laws and rights
• Categorical imperatives - a set of universal moral premises from which the duties are
derived (do not lie; do not kill; …)
• A person is an end itself, never a means to an end
• deon = duty (from the Greek)
• Know the criticisms
What is virtue ethics? What are the five focal virtues?
VIRTUE ETHICS (Deontological)
• Focus is on the kind of person who is acting, deemphasizes rules
• Is the person in action expressing good character or not?
• We become virtuous only by practicing virtuous actions
• Integration of reason and emotion
• The Five Focal Virtues: (CDTIC) i Compassion ii Discernment iii Trustworthiness iv Integrity v Conscientiousness • Know the criticisms!
What are the 4 principles
THE FOUR PRINCIPLES (Prima Facie)
- Autonomy (self-rule, the obligation to respect the decisions of our patients)
The decision is intentional
The decision is done with understanding
There are no major controlling influences over the decision - Benevolence (providing benefits, balancing the benefits against risks)
- Non-maleficence (do no harm, reduce or prevent harm)
- Justice (Utility/QUALY, need vs. benefit, fairness in the distribution of benefits and risks)
What are the GMC duties of a doctor?
- Protect and promote the health of patients and the public
- Provide good standard of practice and care
- Recognise and work within the limits of your competence
- Work with colleagues in the ways that best serve patients’ interests
- Treat patients as individuals and respect their dignity
What are the 4 principles?
Autonomy
Beneficence
Non-maleficence
Justice
What are the challenges of utilitarianism?
Should minorities suffer for the sake of the majority?
Should ethically questionable experiments be conducted for the greater good of the population?
How can you define ‘good’ or ‘better’?
What are the fraser guidelines for?
Contraception advice to under 16s
- that the girl (although under the age of 16 years of age) will understand his advice;
- that he cannot persuade her to inform her parents or to allow him to inform the parents that she is seeking contraceptive advice;
- that she is very likely to continue having sexual intercourse with or without contraceptive treatment;
- that unless she receives contraceptive advice or treatment her physical or mental health or both are likely to suffer;
- that her best interests require him to give her contraceptive advice, treatment or both without the parental consent.”(Gillick v West Norfolk, 1985)
(Gillick in general)
What is mean arterial pressure?
Mean Arterial Pressure– the average arterial pressure in the body
MAP can be used to approximate afterload (↑MAP leads to in ↑resistance and increase↑afterload)
Equation 1 MAP= CO x Total Peripheral Resistance
Equation 2 MAP = 2/3 diastolic + 1/3 systolic
What is ejection fraction?
Ejection Fraction– Stroke volume / End diastolic volume.
measurement of the percentage of blood leaving your heart each time it contracts
Where are the baroreceptors found?
Carotid sinus (just after where carotid bifurcates into internal and external, inside internal @ C4) and aortic arch
What are 2 effects of stimulating baroreceptors on peripheral BP
Increase in parasym, decrease in symp = this means that BP decreases as blood vessels dilate
- Bradykinin = peptide that causes dilation because it releases nitric oxide and endothelium-derived hyperpolarising factor
- Nitric oxide
- Prostacyclin
- ANP powerful vasodilation
What stimulates vasoconstriction?
Hormones = angiotensin II, vasopressin, adrenaline
local = endothelin and myogenic contraction
Name 3 types of cells found in an atheroma
Macrophages, lymphocytes, smooth muscle
