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Z Phase 1 Others > Week 8 > Flashcards

Week 8 Flashcards

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1
Q

How are the sections of the eat well plate divided?

A

Fruit & veg and Carbs/starchy foods take up two tirds and the final third is made up of protein, dairy and a very small amount of fat

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2
Q

Who does the eat well guide apply to?

A

Most people but those with dietary requirements should check with a medical professional about how they can adapt the guide

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3
Q

How does the guide apply to children?

A

Doesn’t apply to children below the age of 2, between 2 and 5 children should start to eat the same as their families

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4
Q

Should infants have fat in their diet?

A

None

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5
Q

What nutrients may you be deficient in if you don’t eat enough protein?

A

B vitamins,Vitamin E, iron, zinc and magnesium

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6
Q

What may happen if you are deficient in vitamin B12?

A

It affects the bodies ability to make red blood cells so can result in tiredness/weakness as the body has an impacted ability to transport oxygen

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7
Q

What may happen if you are deficient in Vitamin E?

A

Uncommon but can cause nerve and muscle damage that results in loss of feeling in limbs, loss of body movement control, weakness and vision problems. can also cause a weakened immune system

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8
Q

What may happen if you are deficient in iron?

A

Anaemia symptoms include general fatugue and weakness, pale skin, shortness of breath and diziness

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9
Q

What may happen if you are deficient in zinc?

A

Affects many different body systems so there is no distince set of symptoms. common symptoms include poor sense of smell and taste, poor wound healing, hair loss and deformed nails

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10
Q

What may happen if you are deficient in magnesium?

A

Can result in tremors, poor coordination, muscle spasms and appetite loss

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11
Q

What nutrients may you be deficient in if you don’t eat enough starchy foods?

A

Fiber, Calcium, iron and b vitamins

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12
Q

What may happen if you are deficient in fiber?

A

Increased risk of weight gain and heart disease. Symptoms include constipation, nausea, tiredness and in diabetics, blood sugar fluctuations

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13
Q

What may happen if you are deficient in calcium?

A

If not enough calcium is obtained through the diet the body starts taking it from the bones. This can lead to osteoparosis. Symptoms of calcium deficiency include muscle cramps, aches and spasms.

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14
Q

What nutrients may you be deficient in if you don’t eat enough dairy?

A

Vitamin A, Riboflavin, Niacin and calcium

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15
Q

What may happen if you are deficient in Vitamin A?

A

Impairs immunity and hematopoiesis and can cause rashes and vision issues like xerophthalmia

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16
Q

What is xerophthalmia?

A

Issues seeing in low light. Can lead to blindness if left untreated.

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17
Q

What may happen if you are deficient in riboflavin?

A

Essential for metabolic energy production. Long term deficiency causes anaemia. Symptoms include spre throat, lesions and conjunctivitis

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18
Q

What may happen if you are deficient in niacin?

A

Sever deficiency is known as pellagra. symptoms include rash when exposed to sunlight, swollen mouth, bright red tongue, and v&d

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19
Q

What nutrients may you be deficient in if you don’t eat enough fruit and veg?

A

potassium, vitamin C, folic acid and many more

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20
Q

What may happen if you are deficient in potassium?

A

Hypokalemia can make muscles feel weak,cramp,twitch or even become paralysed.

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21
Q

What may happen if you are deficient in vitamin C?

A

Can result in scurvy. Common symptoms include fatigue, depression and connective tissue defects

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22
Q

What may happen if you are deficient in folic acid?

A

can lead to anaemia

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23
Q

What are the key symptoms of bulimia nervosa?

A
  • recurrent episodes of overeating (eg once a week or more for at least a month) accompanied by compensatory behaviours
  • The individual is obsessed with their body image
  • they may have severe tooth decay, weakened muscles and in the long term, potential heart problems
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24
Q

How is Bulimia managed in adults?

A
  • bullimia focused guided self help
  • if this is unacceptable, CBT-ED
  • should be up to 20 sessions over 20 weeks focusing on normal eating behaviours
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25
How is bulimia managed in children?
-Bulimia nervosa focused family therapy (FT-BN) - should be 18-20 sessions over 6 months - if this is unacceptable consider CBT-ED
26
What is CBT?
Cognitive behavioural therapy. It aims to change the moods/feelings towards a certain situation or trigger
27
What are the key symptoms of binge eating disorder?
Frequent episodes of binge eating (eg once a week or more) without compensatory behaviours
28
How is binge eating charecterised?
-eating more quickly than normal -eating until uncomforatbly full -eating a lot when not hungry eating alone out of embarassment -feeling bad/guilty after eating
29
How is binge eating disorder managed?
-Binge eating disorder focused self help -CBT self help Adherance is especially important -if self help is unsuccesful offer group CBT-ED
30
What are the key symptoms of Anorexia nervosa?
A significantly low BMI Low weight with persistan pattern of behaviors to prevent weight gain Central to the patients negative perception of themself
31
How is anorexia managed in adults?
CBT-Ed should consist of up to 40 sessions over 40 weeks should aim to reduce risk to the patients health trying to establish healthy eating
32
What is a cough?
An explosive expiration that provides a normal protective mechanism for clearing the tracheobronchial tree of secretions and foreign material
33
What may initiate the cough reflex?
excessive amounts of foreign matter or other causes of irritation
34
What forms the afferent limb of the cough reflex?
receptors within the sensory distribution of the trigeminal, glossopharyngeal, superior laryngeal and vagus nerves
35
What forms the efferent limb of the cough reflex?
the recurrent laryngeal nerve and the spinal nerve
36
Describe that caught reflex?
about 2.5 litres of air is inspired epiglottis closes, vocal cords tightly shut to entrap the air within the lung abdominal muscles contract forcefully, pushing against the diaphragm internal intercostal muscles contract forcefully pressure in lungs rises to 100mmHg or more Markedly positive intrathoracic pressure causes narrowing of the trachea vocal cords and epiglottis suddenly open widely the large pressure difference between the airways and the atmosphere paired with tracheal narrowing produces rapid flow rates through the trachea
37
At what speed is air expelled from the lungs in a cough?
75-100mph
38
What are some factors that contribute to asthma?
environmental alleges viral respiratory tract infections exercise, hyperventilation gastro-oesophageal reflux disease chronic sinusitis aspirin or NSAID hypersensitivity beta blockers obesity occupational exposure emotional factors exposure to tobacco smoke
39
Describe the pathophysiology of asthma
It is complex and involves the following components; airway inflammation intermittent airflow obstruction bronchial hypersensitivity
40
Describe airway inflammation
varying degrees of mononuclear cell and eosinophil infiltration, mucous hyper secretion, desquamation of epithelium, smooth muscle hyperplasia and airway remodelling are present
41
What are the main cells thought to be involved in airway inflammation?
mast cells eosinophils epithelial cells macrophages activated T lymphocytes
42
What are the main cytokines thought to be involved in airway inflammation?
IL-4, IL5, IL-6, IL-9, IL-13
43
What is the theory about TL1 and TL2 lymphocytes?
loss of balance between the cells types. In asthma TL2 is favoured - perhaps due to lack of infection exposure?
44
What causes airflow obstruction in asthma?
acute bronchoconstriciton airway oedema chronic mucous plug formation airway remodelling
45
Describe the early asthmatic response
Response to aeroallergens IgE dependent mediator release leads to acute bronchoconstriciton
46
Describe the late asthmatic response
airway oedema 6-24 hours after allergen exposure
47
What causes chronic mucous plug formation?
exudate of serum proteins and cell debris
48
what causes airway remodelling?
long-standing inflammation - may reduce the reversibility of the obstruction
49
What does airway obstruction cause?
Increased resistance to airflow and decreased expiratory flow rates the changes lead to decreased ability to expel air and may result in hyperinflation
50
What does bronchial hyper responsiveness lead to?
bronchospasm and typical asthmatic symptoms such as wheezing, shortness of breath and coughing
51
What can bronchospasm be a response to?
allergens environmental irritants viruses cold air exercise
52
What are the non-pharmacological management options for asthma?
smoking cessation weight loss breathing exercises
53
What are the pharmacological management options for asthma?
inhaled corticosteroids long acting B2 agonist short acting B2 agonist
54
How is complete control of asthma defined?
no daytime symptoms no night time awakening due to asthma no need for rescue medication mo asthma attacks no limitations on activity normal lung function minimal side effects from medication
55
What are the histological differences in asthma?
increase mucous production and increase goblet cells increase eosinophils in mucous and cell tissue thickened basement membrane increased mast cells in lamina increased neutrophils and T cells smooth muscle hypertrophy
56
What does IgE do?
it forms a complex with mast cells The allergen binds to this and causes the release of histamine, prostaglandins and leukotrienes
57
Describe intravenous administration
rapid onset by-passes liver permits titration drawbacks - increased adverse effects, requires IV access, infection, pain
58
Describe intramuscular admisnistration
absorption depending on blood flow by-passes liver rapid onset and shorter in duration drawbacks - neuromuscular damage, bleeding, pain, infection, delayed absorption in shock
59
Describe subcutaneous administration
absorption depending on blood flow constant and slow absorption prolonged effect by-passes lover drawbacks - pain, infection, delayed absorption in shock
60
Describe oral or rectal administration
convenient safest cheapest slowest onset, prolonged by less potent action drug passes through liver Drawbacks - absorption rate can be highly variable, absorption influenced by stomach contents, gastric acid can interfere with absorption, uncooperative patients may not take them.
61
What is bioavailability?
fraction of the administered drug dose that reaches the systemic circulation expressed as F
62
What factors may affect bioavailability?
drug factors - molecular weight, ionisation absorption - gastric pH / health of GI tract first pass metabolism (hepatic)
63
When does F=1?
for IV drugs
64
What is the volume of distribution?
apparent volume into which a known amount of drug must be dispersed to give the measured plasma concentration
65
What does volume of distribution depend on?
plasma protein and tissue binding molecular weight lipid solubility
66
What is volume distribution used to determine?
loading dose amount elimination half-life, dosage interval
67
What is the loading dose?
target concentration X volume
68
What is clearance?
theoretical volume of plasma "cleared" of drug per unit time
69
What is half-life?
the time required for serum plasma concentrations to decrease by half
70
What is half life determined by?
clearance and volume of distribution proportional to VD/CL
71
How many half-lives does it take to clear a drug?
4-5
72
When is a loading dose required?
drugs with a long half-life
73
What is meant by steady state?
the amount of drug administered is equal to the amount of drug eliminated within one dosing interval
74
How long does it take to reach steady state?
4-5 half lives
75
Describe type I hypersensitivity
immediate IgE, mast cells - release of histamine and other inflammatory factors
76
What is type II hypersensitivity?
antibody-mediated
77
What is type III hypersensitivity?
immune complex -mediated
78
What is type IV hypersensitivity?
T cell - mediated
79
Describe transplant rejection
T cells activated against donor transplantation antigens stimulation in peripheral lymphoid tissues Both CD4+ and CD8+ T cells also macrophages, neutrophils, B cells, NK cells Antigen production, compliment activation
80
Describe public health
responds to societal health concerns informed by a worldview prevailing at the time - science, ethics, aesthetic led in different eras by different types of leaders and organisational forms
81
Describe the first wave of health improvement in the UK
1830-1900 classical public health interventions (water and sanitation), emerging civil and social order social reformers municipal authorites
82
Describe the second wave of health improvements in the UK
1890-1950 science rationalism provides breakthroughs in many fields
83
Describe the third wave of health improvements in the UK
1940-1980 the welfare state and post-war consensus saw the emergence of the NHS, social security, social housing and universal education
84
Describe the forth wave of health improvements in the UK
1960-2000 effective health care interventions prolong life. Risk factors and lifestyle become a central concern in public health
85
Name some health concerns we face today
health inequalities obesity population growth and ageing demographic Human impacts of planet's life support system climate change
86
describe ion-channel linked receptors
also called transmitter-gate ion channels hydrophilic pores mediate passive transport show selectivity
87
Describe the mechanism of ion channel linked receptors
ligand (e.g. ACh) binds to multimeric receptor opens channel ions diffuse according to concentration gradient terminated by removal of ligand
88
Explain signal transduction via RTKs
RTK monomers are single-pass transmembrane molecules cytoplasmic domain has tyrosine kinase activity extracellular ligand induces dimerisation of RTK monomers Dimer undergoes autophosphorylation creates phosphotyrosine residues on cytoplasmic domain "docking sites" for intracellular proteins - scaffolds and substrates Simultaneous activation of downstream pathways RTK signalling often culminates in activation of enzyme or transcription factor
89
Give an example of an RTK pathway
mitogen activated protein kinase (MAPK) - features ras, a monomeric g protein
90
Describe G proteins
can bind to GTP G proteins are GTPases- can hydrolyse GTP to GDP G proteins may be monomeric or trimeric Ras is a monomeric G proteins (in RTK pathway) For G protein receptor coupled signalling must be trimeric G proteins
91
Describe the mechanism of G protein coupled receptors
also called serpentine receptors no intrinsic enzymatic activity binding of ligand causes the receptor to undergo a conformational change This lets a G protein bind to it The binding of the receptor to the G protein phosphorylates the bound GDP to GTP Alpha subunit with bound GTP activates effector enzyme G protein then hydrolyses GTP back to GDP and protein is no longer needed so diffuses away

Z Phase 1 Others (11 decks)

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