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Question 1

ADH is released from where?

Answer 1

posterior pituitary !

Question 2

where in kidney nephron is most dilute?

Answer 2

most dilute: at start of distal tubule (~ 100 mOsmol) (lots of Na / Cl has been removed)

Question 3

which part of nephron controls blood pressure?

Answer 3

juxtaglomerular apparatus

Question 4

loop of henle is responsible for filtering what % of Na and H20, from urine -> blood?

Answer 4

20% Na

15% H20

Question 5

what would u use furosemide for? (2)

Answer 5

Furosemide removes excess water in the body: blocks NaKCC channel

indications:

• oedema
• resistant hypertension

Question 6

Diabetes insipidus is caused by what?

Answer 6

Diabetes insipidus; damage to the hypothalamus or posterior pituitary leading to loss of ADH secretion. Result high volume of dilute urine.

Question 7

how do thiazide diuretics work?
what is an AE of these?

Answer 7

Thiazide diuretics like bendroflumethiazide (Aprinox) inhibit reabsorption of sodium and chloride ions from the distal convoluted tubules in the kidneys by blocking a Na+/Cl− cotransporter.

One important adverse effect of long-term thiazide use is loss of potassium resulting in hypokalaemia.

Question 8

where do u find the cells that release ANP ? what stimulus do they cause

what is their effect? where does the effect occur!

Answer 8

Specialised muscle cells: right atrium and inferior vena cava.

In response to stretch (indicating increased preload) these cells release atrial natriuretic peptide (ANP)

ANP decreases Na+ reabsorption in the distal tubule and collecting duct of the kidney.

Question 9

what is the difference between osmoreceptors and baroreceptors?

Answer 9

• *Osmoreceptors** reside in hypothalamus and respond to changes of extracellular fluid (ECF) osmolality.
• *Baroreceptors** are mechanoreceptors that sense blood pressure in the vessel wall.

• Osmoreceptors respond to changes in osmotic pressure, which is the “pressure” of solutes in water trying to equalize their concentrations across a semipermeable barrier.*
• Baroreceptors respond to actual mechanical pressure, like when you touch or press on something, or when it touches or presses on you. They’re also found in the muscular walls of arteries where they sense the physical pressure of blood flowing through them.*

Question 10

what are Arteriovenous malformations?

Answer 10

Arteriovenous malformations (AVMs) happen when a group of blood vessels in your body forms incorrectly. In these malformations, arteries and veins are unusually tangled and form direct connections, bypassing normal tissues.

Question 11

* how do u calculate net filtration pressure? *

Answer 11

NFP = (HPc - HPif) - (OPc - OPif)

Question 12

what does this describe: ‘specialised pits that undergo endocytosis’

Answer 12

caveolae

Question 13

what is paracellular diffusion?

where does it occur? 1 example xo

Answer 13

Paracellular transport refers to the transfer of substances across an epithelium by passing through the intercellular space between the cells.

kidnyes

Question 14

what are two reasons for lympathic blockage?

Answer 14

primary: genetic cause
secondary: damage to lymphatic system (e.g. surgery, elephantiasis - worm infection, tissue injury)

Question 15

how do u subdivide different types of anaemia based on mean cell volume? (3)

how do u subdivide anaemia by production of rbc? (2)

Answer 15

based off mean cell volume (MVC)

• microcytic: MVC <80 fL (rbc are smaller than usual)
• normocytic: MVC 80 -100 fL (normal sized, but just less off them an expected)
• macrocytic: MVC > 100 fL (rbc are larger than usual)

//

increased destruction: high reticulocytes. due to bleeding or haemolysis

reduction production: low reticulocytes. anaemia of chronic disease, aplasia, cancers

Question 16

there are 5 leukocytes. name which ones are granular and agranular (5)

Answer 16

• *granular**: neutrophils, basophils, eosinophils
• *agrunular**: monocytes, lymphocytes

Question 17

what is the name of when neutrophils move through capillary cell wall?

Answer 17

diapedesis

Question 18

what are the following caused by?

• microcytic:
• normocytic:
• macrocytic:

Answer 18

• microcytic: iron deficiency, thalassaemia (an inherited blood disorder that causes your body to have less hemoglobin than normal)
• normocytic: acute blood loss, renal failure, SCA, leukaemia
• macrocytic: alchohol and liver disease

Question 19

what are eosinophils associated with? (3)

Answer 19

eosinophils: allergic reaction, parasitic infections & chronic inflammation

Question 20

where in a lymph node would you find:

a) B cells
b) T cells
c) immature B cells

Answer 20

The nodes are covered by a capsule of dense connective tissue, and have find lymphocytes

• cortex (under the capsule) - lymphoid follices: B cells
• deep cortex: T cells
• medulla: B cells (immature)

Question 21

how do u differentiate between B & T cells?

Answer 21

staining not useful - need to use immunohistochemistry (Immunohistochemistry (IHC) is the most common application of immunostaining. It involves the process of selectively identifying antigens (proteins) in cells of a tissue section by exploiting the principle of antibodies binding specifically to antigens in biological tissue

Question 22

what are distinguishing features of the spleen? (2)

Answer 22

red and white pulp (1)
no cortex and medulla (1)

Question 23

what do u find in red and white pulp in spleen?
which one makes up most of spleen?

Answer 23

white pulp: B and T cells, APCs and plasma cells

red pulp: old & damaged RBC, macrophages, lymphocytes

red pulp = 80%

Question 24

what are Epithelial reticular cells? where do u find?

Answer 24

Epithelial reticular cells, or epithelioreticular cells (ERC) are a structure in both the cortex and medulla of the thymus.

Make sure that no T cells are allowed to survive which could attack the body’s own cells

Question 25

what are hassals corpsucles? where find? function?

Answer 25

**hassals corpuscles:** concentric layers of flattened reticular epithelial cells filled with keratohyalin granules and keratin. **activate dendritic cells** **only found in thymus**

Question 28

where does the intercostal neurovascular bundle lie in relation to: 2) intercostal muscles

Answer 28

2) intercostal muscles: **between internal and innermost intercostal muscles**

Question 29

where does the right and left dome of the diaphragm reach to on the ribs?

Answer 29

right dome: upper border of 5th rib left dome: lower border of 5th rib

Question 30

what is the nerve supply to: visceral pleura? parietal pleura?

Answer 30

visceral pleura: **autonomic** parietal pleura: **somatic**

Question 31

what are the names and locations of the pleural recesses? [2]

Answer 31

1. **costadiaphragmatic**: located between the costal pleurae and diaphragmatic pleura 2. **costomedialstinal**: located betweeen the costal pleurae and the mediastinal pleurae, behind the sternum

Question 32

which structures contribute to the nasal septum? (3)

Answer 32

- septal cartilage - ethmoid - vomer

Question 33

what are the meatuses? why does your nose run when you cry?

Answer 33

meatuses: the spaces beneath the conchae are referred to as the superior, middle and inferior meatuses (singular: meatus). The nasolacrimal (tear) duct drains into the inferior meatus (which is why your nose runs when you cry).

Question 34

what are the 4 paranasal sinuses ? [4]

Answer 34

sinuses: - frontal - sphenoid - maxilla - ethmoid

Question 35

what does the eustachian tube connect?

Answer 35

**eustachian tube:** connects the middle ear cavity to the nasopharynx

Question 36

what is the function of nasal conchae? (2)

Answer 36

i) increase the surface area of these cavities, ii) rapid warming and humidification of air as it passes to the lungs.

Question 37

what do the vocal cords attach to i) anteriorly ii) posteriorly?

Answer 37

i) anteriorly: **thyroid catilage** ii) posteriorly: **artyenoids**

Question 38

what happens in arteries if hypoxia occurs?

Answer 38

arteries under hypoxia: will reform under hypoxic influence. If a tissue becomes hypoxic it will induce angiogenesis to allow arteries to grow and expand in hypoxic areas so areas that are deficient to have a blood supply (HIF1 causes VEGF ! )

Question 39

axillary artery branches? [3]

Answer 39

sends branches to **external chest wall** & **shoulder girdle** BUT: **_major branch = humeral circumflex_** -

Question 40

what arterial branches come off the ulnar artery? which is deeper out of ulna and radius?

Answer 40

ulnar artery -\> **common interosseous** (supplies the deep flexors and extensors of forearm) -\> **posterior & anterior interosseous arteries** **Ulnar is much deeper** than the radial, which is fairly superficial.

Question 41

which is the most common vein for venipuncture?

Answer 41

median cubital vein, across cubital fossa

Question 43

where does the abdomina aorta end? path from abdominal aorta -\> femoral artery? and at which vert levels are these?

Answer 43

**ends at L4 = top of iliac crest (pelvis)** abdominal artery -\> common iliac artery (S1), at sacroiliac joint -\> **internal iliac atery & external iliac artery**

Question 44

what does the internal iliac artery supply and branch? (3)

Answer 44

internal iliac supplies: pelvic walls & pelvic viscera, gluteal region interna iliac -\> **superior gluteal artery** & **inferior gluteal artery** -\> **obturator artery**: supplies head of femur and the medial muscle groups of the thigh

Question 45

describe pathway of obturator artery & what it supplies?

Answer 45

internal common iliac -\> obturator artery -\> (passes through the obturator foramen) **acetabular branch** ## Footnote **acetabular supplies the hip joint**

Question 46

what is peripheral vascular (arterial) disease? what can cause it?

Answer 46

Peripheral vascular disease is caused by Arterial narrowing. This will result in decreased blood flow, meaning there’s pain. Pain results from an imbalance between supply and demand. Lower limb has bigger oxygen demand for muscle, so atherosclerosis can cause pain due to ischaemia (imbalance between supply and demand of oxygen) Most common cause is Atherosclerosis, arteritis, aneurysm and embolism

Question 47

which patient population immediately gets access to hypertension drugs?

Answer 47

**Grade 1 hypertension with high risk for CVD immediately get drugs** but if low / moderate risk without CVD or renal disease, after 3-6 months of lifestyle intervention & BP still not controlled = drugs **- Grade 2: drugs - Grade 3: drugs**

Question 48

how do you managed treatment for hypertension depending on patient populations race and age?

Answer 48

under 55 = **ACE** black / afro carribean = **Ca2+ channel blockers**

Question 49

what are the three different reasons that RAAS system might be activated?

Answer 49

1. sympathetic nerve activation (via B-adrenoreceptors) 2. renal artery hypotension 3. decreased sodium delivery to the distal tubules of the kidney

Question 50

what are effects of RAAS system? [4]

Answer 50

_differing effects depending on where it binds:_ * *i) proximal tubule:** Increases Na+ reabsorbtion, which increases blood flow, which increases BP * *ii) adrenal cortex:** increases aldosterone, which causes increase Na+ reabsorbtion in distal tubule, increase bloodflow and BP * *iii) systemic arterioles:** binds to GPCR = artriolar vasoconstriction = increases BP * *iv) brain:** stimules release of ADH = increase Na reabsorbtion