Semester 2 Content Flashcards
1
Q
What anatomical features are used in gas exchange
A
Bronchiole capillaries alveoli
2
Q
Define physiological dead space
A
Areas in the lunch where no gas exchange takes place
3
Q
What controls ventilation
A
CO2 levels
4
Q
PaO2 and PaCO2 in type 1 respiratory failure
A
Low O2 normal CO2
5
Q
What type of respiratory failure: low O2 normal CO2
A
Type 1
6
Q
What causes type 1 respiratory failure (definition)
A
Normal ventilation but not enough O2 in the blood
7
Q
Three common causes of type 1 respiratory failure
A
Pneumonia, acute severe asthma, COPD
8
Q
PaO2 and PaCO2 in type 2 respiratory failure
A
Low O2 high CO2
9
Q
Three common causes of type 2 respiratory failure
A
Opioid overdose
Sever COPD
acute severe asthma
10
Q
Two causes of hypoxaemia
A
Hypoventilation, V/Q mismatch
11
Q
Three causes of hypoventilation
A
Opioid overdose, asthma, COPD
12
Q
Cause of V/Q mismatch
A
Not enough O2 entering the lungs
13
Q
Define hypertension
A
High BP where treatment does more harm than good
14
Q
What is the normal BP
A
120/80
15
Q
Common causes of secondary hypertension
A
Chronic kidney disease
Diabetes
Cushing syndrome
Hypo/ hyperthyroidism
Pregnancy
16
Q
What anti hypertensive drug would be given for a white male under 55
A
ACE inhibitors
17
Q
What anti hypertensive drug would be given for a white male over 55
A
Calcium channel blockers
18
Q
Lisinorpil is what type of anti hypertensive drug
A
ACE inhibitor
19
Q
Common adverse effects of ACE inhibitors
A
Dry cough, hyperkalaemia, hypotension
20
Q
Doxazosin is what type of anti hypertensive drug
A
Alpha blockers
21
Q
Amlodipine is an example of what type of anti hypertensive drug
A
Calcium channel blocker
22
Q
Ankle oedema is common with what anti hypertensive drug
A
Calcium channel blocker
23
Q
Dry cough is common with what type of anti hypertensive drug
A
ACE inhibitors
24
Q
site of action for thiazide diuretics
A
Proximal part of the distal convoluted tubules
25
Three things hypertension is a risk factor for
Peripheral vascular disease
Atherosclerosis
Coronary artery disease
26
What can pulmonary hypertension cause
Right ventricular:
Hypertrophy
Dilation
Failure
27
Systemic hypertension is a risk factor for:
LV hypertrophy
Ischemic heart disease
28
Why is ABG measured
To diagnose respiratory failure
29
What controls blood pH
CO2 levels
30
Low pH High CO2 and high HCO3
Respiratory academia
31
Low pH low CO2 low HCO3
Metabolic academia
32
High pH low CO2 low HCO3
Respiratory alkalaemia
33
High pH high CO2 high HCO3
Metabolic alkalaemia
34
Base excess definition
Volume of base needed to return to normal pH
35
Use of bicarbonate in ABG
Buffer excreted from kidneys
36
What hormone increases sperm production in Sertoli cells
Testosterone
37
Advantages of sexual reproduction
Variation in offspring
Better adapted to changing environments
38
Disadvantages to sexual reproduction
Only half a genome is passed on
Energy expenditure in finding a mate
39
Sexual reproduction definition
The blending of characteristics from two individuals from the Nth generation to produce an individual of the (Nth+1) generation
40
What effects does FSH have on the secondary (ripening) follicle
More granulosa cells produced
Zona pellucida produced
Estrogen produced ( FSH + LH)
41
What is the effect of FSH in the late 2nd stage ( follicular)
Follicular fluid secreted
Estrogen produced (FSH+ LH)
42
How is the antrum formed
Formed by granulosa follicular fluid
43
In the critical stage, what happens if no LH is provided
Cell death
44
In the critical stage, what happens if LH is provided
The primary follicle becomes a follicle
45
Obstructive lung disease definition
Narrowing of the airway
46
Common obstructive diseases
Asthma COPD Cystic fibrosis
47
Two factors which decrease the internal diameter of the bronchioles
Mucus production
Inflammation
48
What does a peak flow test measure
Maximum speed of expiration
49
What two investigations are used in obstructive lung disease
Spirometry
Peak flow test
50
What does FEV1 and FVC measure
FEV1- forced expiatory in one second
FVC- total exhalation
51
What FEV1/FVC ratio is diagnostic of an obstructive airways condition
FEV1/FVC ratio less than 0.7
52
What is the neurotransmitter acting at muscarinic receptors
ACh
53
What is the agonist acting at beta 2 adrenergic receptors
Salbutamol
54
What neurotransmitter acts at the nicotinic receptors
ACh
55
What is the main function of the parasympathetic nervous system
Basic body functions
Decrease in heart rate
Constrict bronchioles
56
What is the main function of the parasympathetic nervous system
Fight or flight
Increased heart rate
Dilates bronchioles
57
Name two catecholamine neurotransmitters
Adrenaline and noradrenaline
58
Four things to ask people who are planning a pregnancy
Diet, exercise, smoking, alcohol intake, underlying health conditions
59
How long should methotrexate be stopped prior to conceiving
3 months
60
What is methotrexate used to treat
Rheumatoid arthritis
61
What is sodium valproate used to treat
Epilepsy
62
Name three complications when taking sodium valproate during pregnancy
Neural tube defects
Oral
Cardiac
Urogenital defects
63
Why are NSAIDS a danger in pregnancy
NSAIDS block the arachidonic pathway. This inhibits the production of PGE
PGE is used to keep the ductus arteriosus open during pregnancy
64
Name two complications of premature closing of the ductus arteriosus
Pulmonary hypertension
Organ and tissue oedema
65
Dosage of folic acid required in pregnancy
400 mcgms until week 12
66
Function of the ductus arteriosus
Connect the pulmonary artery to the aortic arch to allow oxygenated blood into the body but bypassing the lungs
67
Physical features of fetal alcohol syndrome
Thin upper lip
Low nasal bridge
Smooth Philtrum (bow)
68
Definition of diabetes
A condition in which the pancreas does not make enough insulin or none at all
69
Type 1 diabetes definition
Autoimmune disease
Immune system attacks insulin producing cells
70
Type two diabetes definition
Not enough insulin or no response to insulin
71
Symptoms of diabetes
Frequent urination
Excessive thirst
Blurred vision
Slow healing cuts
Weight loss
Fatigue
72
Investigations of diabetes
Blood glucose test
126-200> diabetes
73
Treatment of type 2 diabetes
Diet changes
Exercise
Stop smoking
74
Treatment of type 1 diabetes
Insulin therapy
75
Risk factors of type 2 diabetes
Obesity
Age
Family history of disease
Low socioeconomic status
Smoking
76
Hyperglycemia regulation
Beta cells release insulin from pancreas
Fat cells take in glucose
77
Hypoglycemia regulation
Alpha cells release glucagon in pancreas
Liver releases glucose into the blood
78
Virchows triad
Hyper coagulation
Venous stasis
Vascular injury
79
Risk factores for DVT
obesity
Immobilized in hospital
Previous VTE
family history
80
Epidemiology of DVT
1/1000 per annum
30% presents as sudden death
30% develop recurrent thrombosis
81
Physiology of DVT
often in lower limbs
Common arteries: splenic mesenteric, cerebral
82
Presentation of DVT
Unilateral
Pain
Swelling
Increased temperature of limb
83
Investigations of DVT
D-diner as a negative predictor
Venous ultrasonography of femoral or popliteal vein
Wells DVT score
84
Treatment of DVT and PE
Rapid initial anti coagulation
Extended therapy to prevent recurrent thrombosis
85
Clinical presentation of pulmonary embolism
Collapse, faintness
Pleuritic chest pain
Difficulty breathing
Haemoptysis
86
Investigations of pulmonary embolism
Chest X ray
ABG
V/Q scan
CT pulmonary angiogram
87
Complications of thrombosis
Embolism
Occlusion
88
Aneurysm definition
Artery dilates 1.5x it’s normal size
89
Six P’s of compartment syndrome
Pain
Pallor
Perishingly cold
Parasthesia
Pulseless
Paralysis
90
Symptoms of arterial claudicación
Reduced walking ability
Improves in rest
Sore leg at night
91
What can chronic claudicación lead to
Necrosis and gangrene
92
Two main features of COPD
Emphysema and chronic bronchitis
93
A 38 year-old woman with a strong family history of cardiovascular disease has tests to assess her cardiovascular risk.
CRP
HDL
HOMOCYSTEINE
LDL
TOTAL CHOLESTEROL
Which of the following would be the most reassuring, regarding risks of cardiovascular disease, if it were raised?
HDL decrease the risk of CVD
94
An ultrasound scan of a pregnant woman reveals the presence of twins, each of which has its own amniotic cavity and its own chorionic cavity.
Which type of twining is this?
Moño amniótico twinning
95
Which one of the following is a common adverse effect of dihydropyridine calcium channel blockers (e.g. amlodipine) when used for the treatment of hypertension?
Ankle oedema flushing, headaches
96
A 25 years old person with Asthma present to hospital acutelt SOB. You perform an arterial blood gas and it shows the following:
•PO2 7.0 (12-15 kPa)
•PCO2 4.5 (4.4-6.1 kPa)
•H+ 45 (36-44 nmol/l)
•HCO3 27 (21-27.5mmol/l)
What does their blood gas show?
Type 1 respiratory failure
97
What terminology is used to describe the combination of a base and a sugar?
Nucleotide
98
Which of the following immune cells can undergo NETosis?
99
Name two primary lymphoid organs
Thymus and bone marrow
100
Which of the cytokines is produced by muscles during exercise and assist in immune system homeostasis?
IL-10
101
What regulates embryo growth
The growth hormone secreted by the pituitary
102
What determines sex of the embryo
The presence of Y chromosome (SRY gene)
103
Where is the SRY gene activated
In the somatic cells of the gonad
104
Name two transcription factors
Tryptophan receptor
LAC receptor
105
Tryp repressor + tryptophan= ?
No transcription
106
Lac represssor+ lactose=?
Transcription
107
What is chromatin made up of
DNA histones other proteins
108
What do transcription factors attract
Histone modification enzymes
ATP Dependent chromatin remodeling complexes
109
Define DNA methylation
Regulates gene expression by repressing unwanted genes
Inhibits transcription factors
Recruits histone modifying factors
110
One multi potent haematopoetic cell can differentiate into…
Many different types of cells found in the blood
111
Two types of lymphoid cells
T cells B cells
112
Two types of myeloid cells
Macrophages neutrophils
113
What cell signal controls haematopoesis
Stromal cell signals from the bone marrow
114
Three things which influence size
Cell growth division and death
115
What controls the final cell number
Proliferation and cell death
116
Describe the exogenous pathway of lipid absorption
Triglycerides are turned into mono glycerides by gastric and pancreatic lipase
These are absorbed into enterocytes and reassembled into triglycerides
Apoprotein c and LPL turns triglycerides into fatty acids which are taken up by the muscle cells
117
What lipoprotein decreases the risk of cardiovascular disease
HDL
118
Function of lipoproteins
To transport triglycerides and cholesterol around the body
119
Describe the process of atherosclerosis
Formation of fatty streaks
Collection of foam cells in arterial wall
Plaque formation
Necrosis of foam cells leave a cholesterol pool
Plaque rupture causes tissue ischemia
120
What is the function of statins
To reduce LDL
Inhibits HMB-COA reductase
121
High cholesterol causes a …. Risk of CVD
25%
122
Three signs of familial hyper cholesterolaemia
Tendon xanthoma, corneal arcus, xanthalasma
123
What blood tests are taken for high cholesterol
Total cholesterol
HDL
triglycerides
124
P wave abnormalities
Peaked tall
Notched broad
Peaked tall: right atrial hypertrophy
Notched broad: left atrial hypertrophy
125
QRS Complex abnormalities
Wide: Bundle branch block, Wolff Parkinson’s white syndrome
Narrow: left ventricular hypertrophy
126
ST Segment abnormalities
Raised
Depressed
Raised: acute MI, pericarditis
Depressed: ischemia
127
T wave abnormalities
Peaked: hyperkalaemia
Flat: hypokalemia
Inverted: ischemia, MI
128
Defenses against respiratory infection
Mucus
Coughing
Sneezing
Nasal hairs
Broncho constriction
Alveolar surfactant
Alveolar macrophages
129
What cell produces alveolar surfactant
Alveolar type 2 cells
130
Three factors which increase risk of infection
Weak immune system
Diabetes
Organ transplant
131
Causation of bacterial pneumonia
Streptococcus pneumoniae
132
Symptoms of pneumonia
Cough
Sputum
Fever
Breathlessness
Chest pain
Fluid in pleural space
Confusion
133
Investigations of pneumonia
Chest x ray- pneumonia has radiological evidence
In no evidence- chest infection
Blood test- U+E CRP ABG
134
Treatment of pneumonia
Oxygen
Fluids
Antibiotics
135
Presentation of TB
Bad cough
Chest pain
Sputum
Fatigue
Chills
Fever
Weight loss
136
Investigations of TB
Mantoux test
Chest x ray
Blood test
ABG
137
FEV1 and FVC in obstructive lung disease
In obstructive lung disease, FEV1 would be less than 80% of predicted, as the airway obstruction limits air flow and increases resistance during expiration. FVC can either remain normal or decrease. The reduction of FEV1 is more drastic than FVC, resulting in a reduced FEV1/FVC ratio of <0.7.
138
Tidal volume definition and normal measurement
Tidal volume (TV): the volume of air inhaled and exhaled during a normal quiet breath, normal TV: 500mL.
139
Which class of anti-hypertensive drug can be used as an alternative to an ACE-inhibitor, if they are not tolerated?
Angiotensin receptor blocker
140
What blood tests are indicated in a patient with signs and symptoms of heart failure?
BNP as a negative predictor
FBC to exclude reversible causes of hf
U+E set baseline before diuretics
Glucose and lipids for CVD risk
141
What are the causes of pulmonary oedema?
Right ventricular failure
Calcium channel blockers
Pulmonary embolism
142
What are some of the common adverse effects of Beta blockers?
Bradycardia
Hypotension
Fatigue
Dizziness
143
FEV1 and FVC in restrictive lung disease
In restrictive lung disease, both FEV1 and FVC decrease
but the reduction of FVC is more drastic than FEV1, due to the limited lung expansion,
resulting in a normal or increased FEV1/FVC ratio.
144
Topic: Hypertension Question: Malignant Hypertension Definition
Malignant hypertension is a syndrome involving severe elevation of arterial blood pressure, resulting in end-organ damage.
145
What makes a good screening test
Cheap, reliable, minimally invasive, fast, easy access
146
Name three common health screening tests
Prostate cancer
Diabetic eye
Hyper lipidaemia
CVD risk
Cervical cancer
Bowel cancer
147
What are two risks of screening
Unreliable- under or over diagnosis
Follow up complications
148
Name four risk factors for breast cancer
Family history
Obesity
Excess alcohol intake
Inactivity
Hormone replacement therapy
Pregnancy
149
Breast cancer presentation
Breast mass
Skin changes
Metastatic disease
150
Treatment of breast cancer
Hormone therapy
Chemotherapy
Surgery
Radiotherapy
Targeted therapy
151
All cancers are treated with ______
Surgery
152
What week of gestation does the heart and vascular system develop
Week 3
153
What days does the embryo heat beat
Days 21-23 week 3/4
154
What week does blood flow to the embryo
Week 4
155
Define gastrulation
The process by which the single layered blastocyst turns into a multi layered structure
156
What forms the myocardium
Myocardial progenitor cells
157
Function of the cardiac jelly
Separates the myocardium from the cardiac tube
158
Vitelline veins function in fetus
Returning poorly oxygenated blood from the yolk sac
159
Umbilical veins function in fetus
Carrying oxygenated blood from the chorionic sac
160
What is the function of common cardinal veins
Returns poorly oxygenated blood from the embryo to the heart
161
What is the function of the Inter ventricular septum? When does this form
Forms at week 8 to separate the right and left ventricles
162
Why does fetal blood go straight from RA to LA
Since the lungs are not yet functional oxygen rich blood flows from the placenta into the RA and goes directly to the LA
163
What is the most common form of hole in the heart
Patent foramen ovale- abnormal resorption of septum primum
164
Name two rare congenital heart defects
Truncus arteriosus- pulmonary artery and aorta remain as one single vessel
Transposition of great arteries- pulmonary artery and aorta are swapped
