Term
• Barometric pressure decreases with altitude
• 760 mm Hg = barometric pressure at Sea level
• 565 mm Hg = barometric pressure of a standard
commercial airline
• What is the PO2 at sea level and in the aircraft? |
|
Definition
Sea level PO2 = 760x0.21=160 mmHg
Airplane PO2 = 565x0.21=119 mmHg |
|
|
Term
If you breathe from a tank of 40% oxygen at sea level
( pressure 760 mm Hg) what is the partial pressure of
oxygen in the air you are breathing? |
|
Definition
Answer: PIO2
=
760 x0.4=
304 |
|
|
Term
If you breathe air of usual composition while in an airplane
(barometric pressure 560 mm Hg) what is the fractional
concentration of oxygen (FIO2)? What is the partial
pressure of oxygen in the air you are breathing? |
|
Definition
Answer: FIO2
= 0.21
PIO2 = 0.21=560x.21=118 mmHg |
|
|
Term
Which has more CO2 ? 1 L of gas with FCO2 0.40
500 ml of gas with FCO2 0.80 |
|
Definition
Answer: Neither, they are the same |
|
|
Term
|
Definition
alveolar volume + dead space
VT = VA + VD |
|
|
Term
Alveolar Ventilation
(VA) = |
|
Definition
|
|
Term
At body temperature ( 37 °) water vapor pressure =
|
|
Definition
|
|
Term
|
Definition
abnormal permanent enlargement of airways distal to terminal bronchioles with destruction of their walls
|
|
|
Term
|
Definition
productive cough for more than 3 months in 2 consecutive years (in the absence of an alternative diagnosis)
|
|
|
Term
Describe
pathogenic mechanisms
of COPD |
|
Definition
smoking-linked ↑ neutrophils
–Elastase
–Proteases
Genetic component: α1-antitrypsin deficiency
–Protease inhibitor
|
|
|
Term
What is a functional unit of the lung? Describe.
|
|
Definition
Acinus: That portion of the lung distal to the terminal bronchiole, i.e. respiratory bronchioles, alveolar ducts, alveolar sacs and alveoli
|
|
|
Term
COPD: Pathophysiologic impact? |
|
Definition
Pathophysiologic impact:
1.Loss of gas exchange area (alveoli)
2.Loss of pulmonary capillaries - matching of ventilation/perfusion and diffusion capacity
3.Impact on oxygen delivery & CO2 elimination
4.Loss of elastic fibres affecting lung recoil
a.Air trapping
b.Changes in lung volumes – “hyperinflation”
|
|
|
Term
| What is the criteria for spirometry testing? |
|
Definition
| Coughing, phlegm, short of breath with simple chores, wheezing at night, frequent and persistent colds |
|
|
Term
| What is the Gas exchange impact of COPD? |
|
Definition
Gas exchange impact:
Loss of gas exchange area
alveoli + pulmonary capillaries
= Mismatch ventilation to perfusion
= Reduced diffusion capacity for oxygen |
|
|
Term
| What value on the spirometry test represrents the baseline for airflow obstruction? |
|
Definition
|
|
Term
| What are the 4 primary functional components of the respiratory system? |
|
Definition
1. Mechanics: movement of gas into the lungs
2. Gas exchange
3. Control of breathing
4. Acid base balance |
|
|
Term
|
Definition
| Abnormal, permanent enlargement of airways distal to terminal bronchioles with destruction of their walls |
|
|
Term
| What is chronic bronchitis? |
|
Definition
| Productive cough for more than 3 months in 2 consecutive years in the absence of an alternate diagnosis |
|
|
Term
| Describe panacinar/centrolobular emphysema |
|
Definition
Panacinar affects the lower lungs (distal alveoli)
Centrilobular affects the bronchioles |
|
|
Term
| COPD is the _ leading cause of death in Canada |
|
Definition
|
|
Term
| What are the 5 A's of smoking cessation? |
|
Definition
| Ask, Advise, Assess, Assist, Arrange |
|
|
Term
| What do B2-adrenergic agonists do to the airway smooth muscle? |
|
Definition
|
|
Term
| What does ACh do to airway smooth muscle? |
|
Definition
|
|
Term
| What do anticholinergics do to the airway smooth muscle? |
|
Definition
| Block ACh induced narrowing |
|
|
Term
| Describe treatments for mild AECOPD? |
|
Definition
| SABD or LAAC + SABD or LABA + SABD |
|
|
Term
| Describe treatments for moderate AECOPD? |
|
Definition
| LAAC/LABA + SABA or LAAC + LABA + SABA or LAAC ICS/LABA + SABA |
|
|
Term
| Describe treatments for severe AECOPD? |
|
Definition
| LAAC + ICS/LABA + SABA or LAAC + ICS/LABA + SABA + Theophylline |
|
|
Term
| Describe what happens during inspiration and changes in respiratory pressures |
|
Definition
1. Muscles contract, chest wall moves out
2. Diapragm descends
3. Intrapulmonic pressure becomes negative (usually less than atmosphere)
4. Intrapleural pressure becomes more negative |
|
|
Term
| Describe what happens during expiration and changes in repiratory pressures |
|
Definition
1. Muscles relax, chest wall moves inward
2. Diapragm ascends
3. Intrapulmonic pressure becomes positive (greater than atmosphere)
4. Intrapleural pressure remains negative |
|
|
Term
| Describe what a flow volume graph would depict for someone with emphysema. |
|
Definition
| They would show a reduced maximal expiratory flow compared to normal (flow limitation); No TLC or RV hyperinflation |
|
|
Term
|
Definition
| Means there is little or not expiratory flow reserve to breathe more quickly (can't increase expiratory flow) |
|
|
Term
| What are factors affecting dynamic compression in the lungs? |
|
Definition
1. ^ peripheral resistance, ^ pressure loss
2. Reduced lung recoil due to: low lung volumes, emphysema/loss of parenchyma
3. Airway structural stiffness |
|
|
Term
| What are the immunohistopathological features of asthma? |
|
Definition
| Inflammatory cell infiltration (eosinophils) |
|
|
Term
|
Definition
| Asthma is an inflammatory disorder of the airways characterized by paroxymal or persistent symptoms such as dyspnea, chest tightness, cough, sputum production and wheezing, associated with variable airflow limitation and a variable degree of hyperresponsiveness of airways to exo/endo stimuli |
|
|
Term
| What is a substance used for diagnosis of asthma and what does it do? |
|
Definition
| Methacholine; Airway hyperresponsive to methacholine...Severe asthma responds with FEV1 decrease with low concentrations of methacholine |
|
|
Term
| Important differences between asthma and COPD? |
|
Definition
| sputum production infrequent in asthma, clinical symptoms are variable, intermittent in asthma, airway inflammation (asthma: eosinophilic, COPD: neutrophilic) etc. |
|
|
Term
| What laboratory result would be consistent with secondary hypothyroidism? |
|
Definition
| A reduced TSH and reduced thyroxine measurement |
|
|
Term
| What laboratory result would be consistent with primary hypothyroidism? |
|
Definition
| TSH levels are high and T4 and T3 (thyroxine) levels are low. |
|
|
Term
| Secondary amenorrhea may be caused by what? |
|
Definition
a. excessive exercise
b. fibroids
c. prolactin secreting tumour
d. inadequate nutrition |
|
|
Term
4. Choose the risk factor that does not apply to ovarian cancer.
a. Family history of breast cancer
b. Carrier of a BRCA1 or BRCA2 gene mutation
c. Regular ovulations without interruption by pregnancy
d. Increased age
e. Longstanding infertility due to lack of ovulation (anovulation) |
|
Definition
| e. Longstanding infertility due to lack of ovulation (anovulation) |
|
|
Term
| What stimulates thyroid hormone? |
|
Definition
|
|
Term
| What stimulates testosterone/progesterone? |
|
Definition
|
|
Term
| What stimulates cortisol? |
|
Definition
|
|
Term
1. Choose the one example that qualifies as negative feedback.
a. Thyroid stimulating hormone (TSH) on Thyroxine
b. Calcium’s effect on parathyroid hormone
c. Insulin’s effect on glucose
d. ACTH’s effect on Cortisol
e. Testosterone’s effect on prostate specific antigen |
|
Definition
| Calcium’s effect on parathyroid hormone |
|
|
Term
| What is the function of PTH? |
|
Definition
Increases Ca2+ in circulation which,
- increases release from bone (resorption)
- Increases absorption from kidneys
- increases absorption from intestines
(negative feedback keeps Ca2+ in normal range) |
|
|
Term
| What hormone/Ca2+ levels would be indicative of hyperthyroidism? |
|
Definition
|
|
Term
| What would elevated Ca++ and low PTH indicate? |
|
Definition
|
|
Term
| What cells of the pancreas produce insulin? |
|
Definition
|
|
Term
| What is difference between type 1 and type 2 diabetes? |
|
Definition
- Type 1: inadequate insulin production (low)
- Type 2: Normal or elevated insulin (insensitive to insulin) |
|
|
Term
| What do alpha cells of pancreas secrete? D cells? |
|
Definition
- alpha: secrete glucagon
- D: somatostatin |
|
|
Term
| Describe blood concentration (insulin-related) in a fed state. |
|
Definition
- ^ glucose oxidation
- ^ glycogen synthesis
- ^ fat synthesis
- ^ Protein synthesis |
|
|
Term
| Describe blood concentrations (insulin-related) in a faster state. |
|
Definition
glucagon dominates:
- ^ glycogenolysis
- ^ gluconeogenesis
- ^ ketogenesis |
|
|
Term
| What are some oral hypoglycemic drugs? |
|
Definition
- Sulfonylureas: stimulate B cells to release insulin (glyberide)
- Biguanides: Increase sensitivity to insulin, reduce glucose production/absorption (metformin)
- Glucovance: Combination of metformin and glyberide |
|
|
Term
| What would cause insulin induced-hypoglycemic shock? |
|
Definition
- skipping a meal
- exercise
- vomiting |
|
|
Term
|
Definition
|
|
Term
| Describe ion concentrations during ketoacidosis. |
|
Definition
|
|
Term
|
Definition
- Damage to retina vessels
- symptom of diabetes; leading cause of blindness |
|
|
Term
|
Definition
- Complication of diabetes
- microvascular damage to glomerulus caused by thickening of glomerular basement leading to increased permeability |
|
|
Term
| What are causes of diabetes insipidus? |
|
Definition
- Lack of ADH
- Resistance to ADH
- Excessive thirst |
|
|
Term
| Describe effects of Vitamin D and PO4 on calcium levels (in blood) |
|
Definition
Vitamin D: necessary for Ca ++ blood absorption
PO4: Inhibits Ca++ blood absorption |
|
|
Term
| Describe effects of calcitonin |
|
Definition
| Opposite of PTH; increases calcium in bone. Treatment for osteoporosis |
|
|
Term
|
Definition
- TSH, TRH
- ACTH (CRH)
- LH (GnRH)
- FSH (GnRH)
- GH, GHRH, GHRIH
-Prolactin, dopamine |
|
|
Term
|
Definition
| Hypopituitaryism following a vascular collapse from obstetrical hemmorhage |
|
|
Term
| Describe how a pituitary stalk transection and hormone levels |
|
Definition
- from blunt force trauma
- panhypopituitaryism except PROLACTIN elevated |
|
|
Term
| Drug to treat hyperprolactinemia? |
|
Definition
|
|
Term
| What does iodine do to T3/T4 |
|
Definition
| Decrease synthesis causing hypothyroidism |
|
|
Term
|
Definition
| neonatal hypothyroidism; iodine deficiency |
|
|
Term
|
Definition
| autoimmune; hyperthyroidism where antibodies stimulate TSH receptors |
|
|
Term
|
Definition
| Benign tumor that secretes norpinephrine and epinephrine |
|
|
Term
|
Definition
Excess glucocorticoids due to:
-ACTH secreting tumor
- Adrenal tumor
- Glucocorticoid treatment |
|
|
Term
| Describe effects of an adrenal tumour? |
|
Definition
| Increased cortisol, inhibits ACTH |
|
|
Term
| Effects of a pituitary tumor? |
|
Definition
| Increased ACTH, Increased cortisol |
|
|
Term
| Effects of ingested cortisol? |
|
Definition
| Inhibit ACTH, which in turn inhibits cortisol |
|
|
Term
|
Definition
Deficiency of adrenocortical hormones
- Primary: Glucocorticolids, mineralcorticoids, androgens
- secondary: just glucocorticoids |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Encapsulates the urethra and ejaculatory duct |
|
|
Term
|
Definition
density: 100 million/mL
Motility: 40%
morphology: 60% abnormal |
|
|
Term
|
Definition
| fibroid, benign tumour of the myometrium; causes amenorrhea |
|
|
Term
|
Definition
| Scarring of uterine lining; causes amenorrhea |
|
|
Term
| What female reproductive symptom does inhibition of GnRH cause? |
|
Definition
|
|
Term
| How does dopamine affect prolactin? |
|
Definition
| Suppression (bromocryptine a dopamine agonist used to treat increased PRL) |
|
|
Term
|
Definition
| Ectopic endometrium (endometrium outside uterine cavity) |
|
|
Term
| Benign prostatic hyperplasia? Treatment? |
|
Definition
| Enlargement of prostate, formation of nodules around the urethra. Treated with an anti-androgen or alpha adrenergic blocker |
|
|
Term
| How does cervical cancer begin? |
|
Definition
| Starts as dysplasia of squamous epithelial cells at columnar junction of the external os |
|
|
Term
| What STDS cause cervical cancer? |
|
Definition
| oncogenic stds (HPV, herpes type 2) |
|
|
Term
| Describe layers of colon from outside- in |
|
Definition
Smooth muscle:
- Longitudinal
- Myenteric ganglion
- Circular
Muscularis mucosa
Mucosa |
|
|
Term
| Which immune cells maintain mucosal integrity? |
|
Definition
| - Eosinophils, neutrophils, monocytes/macrophages, T cells, Mast calls (IH reaction) |
|
|
Term
|
Definition
Mucosa:
-epithelium
- Lamina propria
- Lymphatic tissue of lamina propria (Peyer's patches)
- Muscularis mucosa
Submucosa:
- Submucosal plexus
Muscularis externa:
-Inner circular layer
-outer longitudinal layer
-myenteric plexus
Serosa and Mesentery:
-Mesothelium |
|
|
Term
|
Definition
| Chronic or acute inflammatory response of stomach or intestines |
|
|
Term
|
Definition
|
|
Term
|
Definition
- Glottis closes
- LES relaxes
- Reverse peristaltic waves
- Abdominal muscles contract |
|
|
Term
| What nervous system controls GI sensory input? |
|
Definition
|
|
Term
| Types of bariatric surgery: |
|
Definition
- Roux-en-Y: Staples block food passage into stomach, travels through smaller esophagus to jeujenum
- Adjustable gastric banding: gastric band around fundus of stomach
- Sleeve gastrectomy: Staples and plastic banding constrict stomach opening |
|
|
Term
| Effect of enterogastrone? |
|
Definition
| Decreased gastric emptying |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Defect of sphrincter in neonate; no local inhibitory innervation |
|
|
Term
|
Definition
| Blockage of bile outflow causing jaundice, cirrhosis |
|
|
Term
|
Definition
-A: Infectious hep. Caused by water or environment; can be isolated cases or widespread
- B: Serum hep. from blood/secretions. It is from carrier or chronic
- C: Non-A, Non-B caused by blood, can be cured
- D: Needs Heb B to exist, caused by blood or environemnet
- E: Transmitted same as A, not common in US |
|
|
Term
| Describe effects of cirrhosis |
|
Definition
Loss of liver function due to fibrosis
Effect on blood flow:
- Fibrosis restricts flow; increased portal vein pressure
- Collaterals acquire increased pressure, affecting spleen and lower esophagus (varices)
- Ascites due to fluid shift into peritoneum |
|
|
Term
| What contents of intestinal lumen re sampled by the immune system? |
|
Definition
| Antigens, oral tolerance, secretory IGA, dendritic cells and M cells on Peyer's patches of gut associated lymphoid tissue |
|
|
Term
|
Definition
| Immune response causes damage to villi in upper GI = flat mucosa. Autoantibodies to gluten and transglutaminase-2 (deaminates gluten proteins) |
|
|
Term
| What ions are lost in diarrhea? |
|
Definition
|
|
Term
| Which e.coli are not in digestive tract naturally? |
|
Definition
| EHEC (enterohemorrhagic e.coli): 0157:H7 in cattle |
|
|
Term
|
Definition
| Telescoping of intestinal segment into adjacent region due to loose mucosa, common in young bowels |
|
|
Term
|
Definition
| Twist in loop of guy; failure of mesentery to retain organization |
|
|
Term
| Adhesion of the intestine |
|
Definition
| Mechanical obstruction where inapporpriate connection of adjacent intestinal segments |
|
|
Term
| Strangulation of intestine |
|
Definition
| Associatedwith herniation of abdominal muscle; intestine through hernia (ex. inguinal loop); entrapment causes constriction and obstruction |
|
|
Term
|
Definition
| Failure in development resulting in blind end of intestine, early Dx |
|
|
Term
| Congenital aganglionosis (Hirshprung's) |
|
Definition
| Non-propulsive region causing functional obstruction in infants; distended colon upstream of band; due to absence of intramural ganglia (no enteric neurons in segment) |
|
|
Term
|
Definition
| onset of failure of gut motility; loss of bowel sounds, risk of perforation and peritonitis |
|
|
Term
|
Definition
| A thin membrane that lines the abdominal and pelvic cavities and viscera |
|
|
Term
|
Definition
| Failure in propulsion and LES relaxation |
|
|
Term
|
Definition
|
|
Term
|
Definition
| (gastro-esophageal reflux disease): Acid reflux into lower esophagus causing inflammation due to lax LES, excessive acid, hiatal hernia (protrusion of upper stomach through diapragm) |
|
|
Term
| Endoscopic retrograde cholangiopancreatography |
|
Definition
| diagnostic enoscopy, interventional (gallstones removed, sphinterotomy (oddi)) |
|
|
Term
|
Definition
| Pressure recording in GI tract; diagnostic |
|
|
Term
| Tumours of ______ origin most common in GI tract |
|
Definition
| epithelial (liomyoma, mesothelioma rare) |
|
|
Term
|
Definition
| Venous pressure expands perianal rectal veins; internal (above anal sphincter), external (below) |
|
|
Term
|
Definition
| contractions of circular smooth muscle forming ring-like contractions |
|
|
Term
|
Definition
| Small out-pockets of the colonic wall caused by formation of diverticula |
|
|
Term
|
Definition
| pain + constipation/diarrhea |
|
|
Term
|
Definition
| Inflammation of GI caused by 2 diseases (Crohn's disease, and ulcerative colitis) |
|
|
Term
|
Definition
Typically terminal ileum
Skip lesions in ileum, cobblestoning of normal muscosa; surrounding tissue inflamed
Transmural: whole thickness of gut wall causing fistulae or sticturing (obstruction) |
|
|
Term
| Which vitamin is specifically absorbed in the ileum? |
|
Definition
|
|
Term
|
Definition
| Appears as mucosal ulcers in colon/rectum |
|
|
Term
|
Definition
| The end part of a long bone, initially growing separately from the shaft. |
|
|
Term
|
Definition
| the growing part of a long bone between the diaphysis and the epiphysis |
|
|
Term
|
Definition
| The shaft or central part of a long bone. |
|
|
Term
|
Definition
| Surrounds bone, entrance of blood vessels |
|
|
Term
|
Definition
| Lines medullary cavity, contains bone marrow (site of hematopoiesis) |
|
|
Term
|
Definition
| RANK ligand (+), osteoprotegerin (-) |
|
|
Term
| Effect of cortisol on bones |
|
Definition
|
|
Term
| GH effect on osteoblasts? |
|
Definition
|
|
Term
|
Definition
Chrondrocytes produce cartilage
Osteoblasts invade
Cartilage becomes calcified
Occurs at epiphyseal plate |
|
|
Term
|
Definition
| Wrist: distal radius fracture |
|
|
Term
|
Definition
| Ankle:fracture of distal fibula |
|
|
Term
|
Definition
Synarthroses (immovable, fibrous tissue)
Amphiarthroses (slightly movable, hyaline cartilage)
Diarthroses (freely movable, synovial) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Deformed position of the fingers, sign of rhematoid arthritis |
|
|
Term
| Differences of juvenile from adult rheumatoid arthritis |
|
Definition
Acute onset, sep. large joints
No RF
ANA (anti-neuclear antibodies often found) |
|
|
Term
|
Definition
uric acid crystals accumulate in synovial fluids
Tophi develop (white depositions)
Excess purine breakdown
Treatment: allopurinol, colchicine |
|
|
Term
|
Definition
| Insufficient bone mineralization due to vit. D deficieny |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What disease uses strontium ranelate as treatment? |
|
Definition
|
|
Term
| Alkalosis causes Ca++ to... |
|
Definition
| proteins bind more, so decrease |
|
|
Term
|
Definition
| Muscle spasm in arm and hand, limp position after pressure cuff applied |
|
|
Term
|
Definition
| Muscular dystrophy: X linked recessive, early onset/rapid progression |
|
|
Term
|
Definition
| Muscular dystrophy: delayed relaxation, autosomal dominant, slow progression |
|
|
Term
| Increased creatine kinase means? |
|
Definition
|
|
Term
|
Definition
| Dura mater, arachnoid, pia mater (inner) |
|
|
Term
| Subdivisions of the brain |
|
Definition
Forebrain = cerebrum (basal nuclei, cerebral cortex) + diencephalon (hypothalamus, thalamus)
Cerebellum |
|
|
Term
| What is part of the extrapyramidal system (coordinates skeletal muscle activity) |
|
Definition
|
|
Term
| Limbic system location/function |
|
Definition
| superior to brain stem, regulates emotions/feelings |
|
|
Term
|
Definition
| Internal carotid arteries and vertebral arteries |
|
|
Term
| What vessel supplies frontal lobe? |
|
Definition
|
|
Term
| What vessel supplies temporal/parietal lobes? |
|
Definition
|
|
Term
| Which vessels supply brainstem, cerebellum? basilar a |
|
Definition
|
|
Term
| Which vessels supply occipital lobe? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| charged, large, not lipid soluble |
|
|
Term
|
Definition
|
|
Term
| Mylenation in PNS vs. CNS |
|
Definition
PNS; schwann cells
CNS; oligodendrocytes |
|
|
Term
| Hormonal difference between sym/para? |
|
Definition
sym: noradrenaline (postganglionics)
para: ACh (pre/ para posts) |
|
|
Term
| Supratentorial vs. infratentorial lesions |
|
Definition
Supra: above tentorium cerebelli, discrete loss of specific function
Infra: below tentorium cerebelli, widespread impairment |
|
|
Term
| Expressive (motor) vs. receptive (sensory) aphasia |
|
Definition
Expressive: inability to write, speak (Broca's)
Receptive: inability to read, understand language (Wernicke's) |
|
|
Term
| Ipsylateral pupil fixed and dialated |
|
Definition
| Sign of intracranial pressure |
|
|
Term
| Which cells are brain tumours derived from? |
|
Definition
| Glial cells (astrocytomas) |
|
|
Term
|
Definition
| Bacterial infection of meninges |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Infection of parenchyma (connective brain tissue) |
|
|
Term
|
Definition
| Travels along peripheral nerves to CNS |
|
|
Term
|
Definition
| Viral infection associated with ASA |
|
|
Term
|
Definition
| Accumulation of CSF, compresses brain and blood vessels (2 types noncommunicating - obstuctive and communicating) |
|
|
Term
|
Definition
| Neural tube deficits, vit a or folate def., amnicentesis, |
|
|
Term
|
Definition
| Motor impairment caused by brain damage in perinatal periods: paralysis, dyskinetic, ataxic |
|
|
Term
|
Definition
dysfunction of extrapyramidal motor system, changes in basal ganglia
Gradual loss of striatal neurons
Neurons use dopamine as NT |
|
|
Term
|
Definition
| L-dopa, MAO-B and COMT inhibitors (reg. met. of dopamine) , Anticholinergics, fetal dopamine cell transplant |
|
|
Term
|
Definition
|
|
Term
|
Definition
| brain atrophy, degeneration of GABA neurons of basal and frontal |
|
|
Term
|
Definition
| Starts in entorhinal cortex to hippocampus, formation of amyloid plaques |
|
|
