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todays questions Flashcards

1
Q

Both ALP and GGT are elevated

A

Bile duct disease, liver

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2
Q

Liver function biomarker most raised in post-hepatic jaundice

A

ALP

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3
Q

Reticulonodular shadowing in lower lobe

A

Mycoplasma

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4
Q

Muscles used in forced expiration

A

Internal intercostals

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5
Q

Stimulates action of central chemoreceptors

A

Hydrogen ions

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6
Q

Reduced levels of G6PD effect on rbcs

A

More susceptible to stress, more haemolysis

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7
Q

Franky starlingy lawwwwww

A

As EDV increases, SV increases

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8
Q

Axes of FS curve

A

Y SV and X EDV

Y Save Very much when you can eXpend on EDVentures

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9
Q

Normal ejection fraction

A

60%

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10
Q

GLP-1 affect on pancreas

A

Stimulates insulin synthesis from b cells

Increases somatostatin increase in D cells

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11
Q

GLP-1 and GLP-2 released from

A

Enteroendocrine L cells

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12
Q

Reversal drug for digoxin

A

Digibind

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13
Q

Electrolyte imbalance that exacerbates digoxin toxicity

A

Hypokalaemia

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14
Q

Reduced transient Ca(2+) in heart

A

Reduced contractile force

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15
Q

Left ventricular ejection =

A

SV / EDV

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16
Q

ACE inhibitors SEs

A

Cough obvs
Angioedema
Hypotension
Hyperkalaemia

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17
Q

Sudden decrease in perfusion triggers

A

Vasodilation

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18
Q

Furosemide

A

LOOP diuretic

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19
Q

How does fuosemide treat heart failure

A

Increased water excretion and salt by kidneys and peripheral vasodilation

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20
Q

Most common HAP causes

A

Pseudomonas aeruginosa, staph aureus and enterobacteria

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21
Q

Dullness to percussion

A

Pneumonia

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22
Q

Pleural rub

A

Pneumonia

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23
Q

Bronchial beathing

A

Pneumonia

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24
Q

Increased vocal resonance

A

Pneumonia

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25
Urine investigations in pneumonia
Legionella or pneumococcal
26
Cephalic phase of acid secretion
Vagal stimulation of chief, parietal and ECL cells
27
Inhibiting bile acid reuptake reduces
Rate of bile acid production by liver
28
Parietal cells action
In fundus and body of stomach, secrete HCL (gastric acid duh) using H+/K+ ATPase pump
29
PPIs inhibit
H+/K+ ATPase pump used by parietal cells
30
Profuse vomiting effect on ABGs
Metabolic Alkalosis
31
Your anus sphincter is under the control offffff
Somatic innervation
32
2 forms of vitamin K
Phylloquinone ( Diet) | Menaquinones ( Gut bacteria )
33
Clotting factor 2
Prothrombin
34
Trypsin responsible for
Protein digestion - released by pancreas will give you that one for free ;)
35
Brunner's gland
Provide alkaline mucous to neutralise chyme from stomach
36
Enterogastric reflex
Stimulated by distension of SI by presence of chyme - stops vagal stimulation and gastric acid secretion
37
Incretin ( GIP ) release triggered by
eating a meal containing glucose
38
Pernicious anaemia
Parietal cells undergo autoimmune destruction
39
Loop diuretics inhibit
Na -K-Cl cotransporters
40
Why does ramipril cause dry cough
Increases bradykinin levels
41
Amiodarone
Potassium-channel blocker, class III anti-arrhythmic
42
Amlodipine and amiodarone
Ones a CCB and ones a K channel blocker silly fresher
43
PPAR? receptor
Nuclear receptor that increases transcription of genes for lipoprotein lipase, increasing LDL uptake and reducing levels in blood
44
Fibrates action
decrease serum triglycerides
45
Statins mechanism of action
Competitive HMG-CoA reductase inhbitor
46
Process of atherosclerosis
1 - Endothelial destruction - altered NO synthesis 2 - Cell injury - adhesion molecules expressed 3 - Foam cell formation - LDL oxidised and taken up by macrophages - foam cells 4 - Foam cell fatty streak 5 - Smooth muscle proliferation and connective tissue deposition 6 - Plaque rupture
47
HMG-coA reductase reductase
Catalyzes conversion of HMG to mevanolic acid (rate-limiting) Competitively inhibited by statins
48
Na-K-l cotransporters location
Thick ascending limb of the loop of henle
49
Digoxin
Increases vagal outflow and has a negative chronotropic effect on the heart
50
Inotropic
Force of contraction
51
Chronotropic
Change in rate
52
Cardiac glycosides
Inhibit Na/K ATPase pump, increasing intracellular sodium
53
Rhabdomyolysis
Breakdown of skeletal muscle
54
Foam cells
Macrophages that have absorbed LDL
55
Test that should be done before putting patient on a statin
LFTs
56
Asthma patients should not be prescribed
NON SELECTIVE beta blockers such as Propanolol
57
Aldosterone
Mineralocorticoid
58
Spironolactone
Mineralocorticoid antagonist
59
Mineralocorticoids produced in
zona glomerulosa of adrenal cortex
60
How much water is reabsorbed in SI?
90%
61
How much water is reabsorbed in Li
10%
62
Anterior structure to pancreas
Stomach
63
Erythema nodosum
Sarcoidosis and IBD and TB legit anything babes
64
Sheep exposure
Coxiella Burnetii
65
Small cell lung cancer produces
ADH and ACTH
66
Squamous cell lung cancer produces
PTH
67
Respiratory syncytial virus causes
Rotavirus
68
Why do you get increased mucus cell in chronic bronchitis?
Increased goblet cell numbers
69
Asthma pyramid
SABA - Inhaled steroid -Theophylline/Leukotriene antagonist/LABA - Oral steroid
70
Faecal calprotectin
A protein found in stool during intestinal intestinal inflammation
71
How can H pylori lead to duodenal ulceration?????
Well chronic antral gastritis cause hypergastrinaemia due to gastrin release from antral G cells
72
Peptic ulcer
Break in superficial epithelial cells penetrating down to muscularis mucosa
73
Diagnosis of H.Pylori
Stool antigen test/C-Urea breath test, patient shoulda had no PPIs for 2 weeks and nooo antibiotics for 4
74
5 receptors of the chemoreceptor trigger zone
5-HT, H1, Muscarinic, D2, Substance P
75
Causes of upper GI haemorrhage
G+D ulcers, haemorrhagic gastropathy and erosions, gastric and oesophageal varices, mallory-weiss, reflux oesophagitis, gastric carcinoma
76
Acute diarrhoea
Less than 14 days
77
Chronic diarrhoea
30 + days
78
Diagnosing IBS
Last 3 months, at last 1 day per week recurrent abdominal pain with 2 or more: - w/ pooping - change in frequency of stool - change in form of stool
79
Action of sodium cromoglicate
Prevents histamine release from mast cells
80
Dihydropiridine calcium channel antagonists
Amlodipine and nifedipine, act preferentially on vascular smooth muscle. Typically used as anti-hypertensive not antiarrhythmic
81
Dihydropiridine calcium channel antagonists
Amlodipine and nifedipine, act preferentially on vascular smooth muscle. Typically used as anti-hypertensive not antiarrhythmic
82
Verapamil
Phenylalkylamine + more active on calcium channels in cardiac tissue
83
Flecainide
Class I anti-arrhythmic
84
Funny (notsofunny) current
Mixed sodium and potassium current activated by hyperpolarisation
85
Central chemoreceptors dorsal or ventral medulla
Ventrl
86
PPI mechanism of action
Irreversibly blocks H+K+-ATPase in parietal cells
87
Acute abdomen pain
``` Observations Analysis Oxygen Fluids Nausea + pain - Bloods + amylase, ABGs, radiology, AXR and CXR, CT ```
88
Perianal disease
Crohn's
89
Stenosis formation
1. Endothelial dysfunction triggered by smoking, hypertension or hyperglycaemia. 2. Pro-inflammatory, pro-oxidant, proliferative changes in the endothelium. 3. Fatty infiltration of the subendothelial space by low-density lipoprotein (LDL). 4. Macrophages phagocytose oxidised low-density lipoprotein. 5. Smooth muscle proliferation and migration from the tunica media into the intima.
90
Secretory diarrhoea
Transformation of absorptive gut to secretive gut
91
Rhabdomyolysis
Breakdown of muscle due to direct or indirect muscle injury
92
Caseating granuloma
TB
93
Increased goblet cells
Crohns
94
Non-caseating granuloma
Crohn s
95
Endothelin
Potent vasoCONSTRICTOR
96
Mitral regurgitation 2-7 days post MI
Rupture of papillary muscle
97
Hypokalaemia riddle thing
You have no pot and no T but a long PR and a long QT
98
S4
Atria contracting forcefully in an effort to overcome an abnormally stiff ventricle
99
Hesselbach's triangle
Direct hernias pass through: | Superolateral - epigastric vessels, medial - lateral edge of rectus muscle and Inferiorly - Inguinal ligament
100
Cholecystitis vs cholangitis
``` Cholecystitis = Inflammation of gallbladder Cholangitis = Inflammation of bile duct system - charcot's - fever, jaundice and RUQ ```
101
Tetralogy of Fallot
Pulmonary stenosis, RVH, VSD and overriding aorta
102
AAA screening
Offered to men from 65th birthday, positive is d>3cm, 3-4.4 is annual surveillance and 4.5-5.4 is 3 monthly surveillance, 5.5+ urgent referral
103
Virchow's triad
Endothelial injury, hypercoagulability and blood stasis

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