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Flashcards in Integrative Deck (51)
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1
Q

normal range ph

A

7.35 - 7.45

2
Q

how anion gap calculated

A

NaK - ClHCO3

3
Q

causes of metabolic acidosis with normal anion gap

A

diarrhoea, renal tubular necrosis

4
Q

how t1dm lead to shock

A

DKA causing dehydration

5
Q

what is patient safty incident, near miss, serious untoward incident, never event

A

PSI - unintended event leading to pt harm
near miss - potential for harm
serious untoward incident - incident which may have legal or media reprecussions
never event - serious and largely preventable

6
Q

how report clinical incident

A

datix reporting, inform key line managers

7
Q

where haemotpoeisis in fetus

A

0-2 mths - yolk sac
3-5 mths - liver and spleen
6+ - BM

8
Q

what is red an dyellow BM

A

red - haematopoeitic

yellow - fatty

9
Q

what is red and white pulp of spleen

A

red - sinuses lined by endothelial macrophages

white - like lymph follicles

10
Q

anatomy of lymph node. where are b and t cells found

A

see book
cortex - B cell
paracortex - t cell

11
Q

what causes splenomegaly

A

increased work load, congestion e.g. portal hypertension, infilatration by WBC eg. brucellosis

12
Q

causes of hyposplenism

A

coeliac and sickle cell

13
Q

wat is aplastic anaemia

A

pancytopenia with hypocellular BM

14
Q

what is ataxia telangiectasia. treat?

A

thymic hyperplasia leading to reduced B cells. treat with BM transplant

15
Q

what is myelodysplasia

A

BM failure - reduced mature blood cells and increased erythrocytes. Abrnomal RBCs in blood

16
Q

what are stellate cells of liver

A

secrete collagen scar tissue in damage

17
Q

how does diastolic and systolic heart failure occur

A

diastolic - hypertrophy leading to stiff ventricles, improper diastole
systolic - dilated cardiomyopathy

18
Q

what is clonus

A

3+ beats

19
Q

what is folate

A

vit b9

20
Q

what is hoffman reflex

A

tap middle or ring results in flexion of thumb. pathological if asymmetrical (UMNL)

21
Q

haemorrhagic stroke causes

A

hypertension, anti coag, blood abnormalities, tumoue

22
Q

symptoms of TACS

A

all of following - hemianopia. hemiparesis, hemisensory loss, cortical dysfunction - HHHC

23
Q

symptoms of PACS

A

2 of HHH or cortical dysfunction

24
Q

symptoms of anaemia and signs

A

symptoms - tired, dizzy, palpitations, headaches, SOB, weakness, angina, HF
signs - palor, tachycardia, systolic flow murmur

25
Q

microcytic anaemia causes

A

TAILS - thalassemia, anemia of chronic disease, iron, lead, sideroblastic anemia

26
Q

macrocytic anemia causes

A

alcoholism, b12 or folate deficiency, hypothyroidism

27
Q

normocytic anemia causes

A

Bm failure, anaemia of chronic, mixed Fe and B12 def, bleeding(?)

28
Q

name for increased neutrophils and causes

A

neutrophilia - smoking, infection, cancer, haemorrhage, inflammation,

29
Q

name for increased monocytes and causes

A

monocytosis - chronic inflamm, chronic infection (TB), leukaemia

30
Q

name for increased eosinophils and causes

A

eosinophilia - drug hypersens, allergic disease, parasite infection

31
Q

name for increased basophils and causes

A

basophilia - UC, RA

32
Q

what causes leukoerythroblastic anemia and result?

A

SOL in BM leads to immature blood cells in blood

33
Q

what tests extrinsic and instrinsic clotting

A

extrinsic - INR

intrinsic - APTT

34
Q

reduces platelet function?

A

uremia, NSIADs, hypergammaglobulinaemia

35
Q

haemophilia factors A and B?

A

A - eight

B - nine

36
Q

caues of non epileptic seizures

A

trauma, hypoglyc, hypoxia

37
Q

give type1-4 hypersensitivty pathology and examples

A

1 - IgE - asthma, anaphylaxis
2 - IgG against cell surface antigens - autoimmune haemolysis, blood transfusion reaction
3 - Ag/Ab complex deposited in tissues leading to inflammation - RA, lupus
4 - Th1 cells activate macrophages which damage - graft rejection, hashimoto, TB

38
Q

vit b12 drug?

A

hydroxocobalamin

39
Q

metabolic pathways in RBC?

A

NADPH and (glucose to lactate and ATP)

40
Q

tests for haemolysis

A

bilirubin, blood films, reticulocyte count, DCT, haptoglobin

41
Q

anemia test

A

ferritin levels

42
Q

explain anemia of chronic disease and how treat and test

A

inflammation goes to increased IL-6 which increases hepcidin which reduces ferroportin.
test - high ferritin with low % transferrin sat
treat - EPO

43
Q

fluid in body?

A

40% of TBW in ICF

20% of TBW in ECF - 20% in plasma and 80% in ISF

44
Q

how much g of solute in 5% solution

A

5g of solute in 100g of solution

45
Q

where is parotid fascia come from

A

investing layer of deep cervical fascia

46
Q

how is CSF circulated

A

help from ependymal cells in spinal cord

47
Q

name of segments in small bowel and large bowel? difference?

A

small - valvulae conniventies (go all the way)

large - Haustra only half way

48
Q

what happens to cells in hyperkalemia?

A

cell depolarised - Na channels inactivated. less AP

49
Q

give factors to identify biliary colic

A

fatty meal is worse. referred to back pain. R hypochondriac

50
Q

Diabetes type 2 management plan

A

lifestyle to metformin then sulphonylureas (above 7%) then TZD or insulin (above 7.5%)

51
Q

Define standardised mortality rate

A

taking into account confounders, death comparison