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181 Cards in this Set
- Front
- Back
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T/F: Autonomic neurons have the same structure as CNS somatic neurons
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true
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T/F: actions of the parasympathetic and sympathetic nervous systems are mutually exclusive?
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FALSE!
each system is always acting - have a balance |
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Fill the blanks with SHORT or LONG
1. Sympathetic neurons have ___ pre-ganglionic fibres, and ___ post-ganlionic fibres 2. Parasympathetic neurons have ___ pre-ganglionic fibres, and ___ post-ganlionic fibres |
1. Sympathetic neurons have SHORT pre-ganglionic fibres, and LONG post-ganlionic fibres
2. Parasympathetic neurons have LONG pre-ganglionic fibres, and SHORT post-ganlionic fibres |
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T/F: pre-ganglionic ANS fibres are under control of brain structures higher than the medulla
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True
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The ANS commands all tissues and organs except what?
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Skeletal m.
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What responses would you see with SYMPATHETIC stimluation?
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"FIGHT OR FLIGHT"
Increased HR, BP Redirect blood flow to skeletal m., lungs Bronchodilation Pupil dilation Depressed digestive function Mobilised glucose reserves Orgasm Micturition (urine discharge) |
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Where are sympathetic pre-ganglionic cell bodies found?
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Lateral horn of spinal cord.
T1 to L2/3 |
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Where do pre-ganglionic sympathetic neurons synapse?
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1. Paravertebral ganglia (sympathetic trunk)
2. Prevertebral ganglia (aorta, organ of innervation) 3. Chromaffin cells (adrenal medulla) |
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What is the ganglion impar?
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Where the sympathetic trunk on either side of the spinal cord join together in front of the coccyx
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What are the prevertebral ganglia?
From where do they receieve input? |
Sympathetic ganglia in front of spinal cord.
They are a series of ganglia on surface of abdominal aorta, named for the artery they are next to: - Celiac ganglia - Superior mesenteric ganglion - Inferior mesenteric ganglion Receive input from splanchnic nn. and innervate organs of abdominal and pelvic region. |
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The lateral horn is also known as....?
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Intermediolateral grey matter (IML grey matter)
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T/F: the sympathetic paravertebral ganglia are associated with all vertebral levels
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true
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How many sympathetic cervical ganglia are there?
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three - superior, middle, inferior
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What is the stellate ganglion?
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The fusion of the inferior cervical ganglion and the first thoracic ganglion
[sympathetic] NB: can sometimes be just T1 |
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How do sympathetic fibres supply LOCAL structures? i.e. between T1-L2/3
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1. Pre-ganglionic fibres leave lateral horn and travel in ventral roots to join spinal n.
2. Enter sympathetic ganglion and SYNAPSE on post-gang neuron 3. Re-enter spinal nerve 4. Supply local structures via primary dorsal or ventral rami |
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How do sympathetic fibres supply DISTANT structures? i.e. above T1, below L2/3
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1. Pre-ganglionic fibres leave lateral horn and travel in ventral roots to join spinal n.
2. Enter sympathetic ganglion and DO NOT SYNAPSE 3. Traverse sympathetic chain in search for ganglion containing neurons that supply target structure then SYNAPSE on post-gang neuron 4. Re-enter spinal nerve (at new higher or lower level) 5. Supply distant structures via primary dorsal or ventral rami [alongside somatic motor fibres supplying same structure] |
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Sympathetic pre-ganglionic fibres supplying the HEAD would synapse in which ganglion?
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Superior cervical
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Sympathetic pre-ganglionic fibres supplying the FEET would synapse in which ganglion?
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Lumbosacral vertebral bodies
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How do sympathetic fibres supply the HEART? ie. a deep structure
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1. Pre-ganglionic fibres leave lateral horn and travel with ventral roots to spinal nerve
2. Synapses in ganglion on post-ganglionic neuron --> NOW KNOWN AS A "CARDIAC NERVE" 3. Superior, middle and inferior cardiac nerves supply the cardiopulmonary plexus |
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How do sympathetic fibres supply the GUTS and GONADS? ie. deep structures
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1. Pre-ganglionic fibres leave lateral horn and travel with ventral roots to spinal nerve
2. Do NOT synapse in ganglion - instead, leaves ganglion as a SPLANCHNIC NERVE 3. Splanchnic n. travels towards prevertebral ganglia where it SYNAPSES 4. Post-ganglionic fibres from prevertebral ganglia will now supply target structure |
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What are some responses to parasympathetic stimulation?
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"REST AND DIGEST"
Slow HR, Fall in BP Incr. digestive function Promotes storage of glucose Stop sweating Bronchoconstriction Pupil constriction Genital erection Sexual arousal, lubrication |
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What are splanchnic nerves?
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Paired nerves that synapse on prevertebral ganglia - thus innervating viscera of abdominal and pelvic region
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T/F: Splanchnic nerves contain somatic sensory nerves from viscera, and autonomic nerves in search of abdominal aorta
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True
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What are the thoracic splanchnic nerves?
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Greater, lesser, least
Pierce the diaphragm and head toward prevertebral ganglia |
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T/F: splanchnic nerves only contain sympathetic fibres?
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FALSE.
The pelvic splanchnic nerve contains parasymp. fibres |
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Parasympathetic pre-ganglionic fibres originate from which locations?
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Brainstem (CN III, VII, IX, X)
Sacral spinal cord (S2, 3, 4) To remember - S2, 3, 4 keeps the penis off the floor! (because parasymp causes erection) |
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From which specific brainstem nuclei do parasympathetic fibres originate
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DMN of Vagus
NTS Nucleus ambiguus |
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What are the exceptions to the rule that parasympathetic ganglia lie near or within the organ?
What synapses in these 'exceptions'? |
The 4 paired parasympathetic ganglia of the head and neck (otic, ciliary, pterygopalatine, submandibular)
CN III, VII, IX synapse |
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T/F: CN X has no named ganglion.
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TRUE.
It just 'wanders' through the thorax and abdominal regions innervating structures SUPERIOR to splanchnic nerves (ie. heart, lungs, liver, stomach, reproductive organs,...) |
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What is the 'enteric motor system'?
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Parasympathetic fibres that regulate gut motility.
Fibres traverse the heart and look for ganglia on the gut surface (extremely short post-gang fibres) |
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Parasympathetic fibres that leave S2/3/4 go where?
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Travel in pelvic splanchnic nerve to pelvic region.
"S2,3,4 keep the penis off the floor" |
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What is 'circulatory shock' cf. 'progressive shock'
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Generalised inadequacy of blood flow throughout body to the extent that TISSUES ARE DAMAGED
Progressive shock when CV system itself is damaged - shock becomes progressively more severe |
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Shock is usually due to inadequate __ ?
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Cardiac output.
[occasionally due to abnormal perfusion pattern] |
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What are the 4 causes of circulatory shock?
Give e.g. of each |
1. HYPOVOLAEMIC SHOCK
-->Low BV -->Severe haemorrhage, vomiting, diarrhoea 2. CARDIOGENIC SHOCK -->decr. cardiac pumping capacity 3. VASOGENIC SHOCK -->something wrong with vessels -->septic shock, anaphylactic shock 4. NEUROGENIC SHOCK -->decr. sympathetic vasomotor activity |
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T/F: In response to shock, the body responds and initates compensatory mechanisms.
Firstly, hormonal responses and then neural responses |
FALSE.
Neural responses THEN hormonal (which reinforce neural reflexes) |
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What happens in acute haemorrhage that activates SNS?
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1. Decr. blood volume
2. Heart fills less 3. Decr. CO (Frank/Starling) 4. Decr. BP 5. Less stretch in arteries (detected by baroreceptors) 6. Activates SNS |
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What does the SNS innervate in order to increase BP in response to acute haemorrhage?
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1. the HEART - increases contractility, rate of contraction (to incr. CO)
2. VEINS - vasoconstriction incr. venous return, increased heart filling and thus CO 3. ARTERIOLES - vasoconstriction incr. MAP and thus CO |
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What role does hydrostatic pressure play in response to acute haemorrhage?
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Lower BP in capillaries (-->decreased hydrostatic P)
Instead of leaking from vessel into interstitial space, fluid actually leaks back into the capillary Fluid reabsorption helps to incr. BV |
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What role does ADH play in response to acute haemorrhage?
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Released from pituitary in response to decr. BP/BV [detected by baroreceptors, atrial receptors]
Acts as potent vasoconstrictor Acts as anti-diuretic in kidney (promotes H2O reabsorption via aquaporin-2 channels) |
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What role does the renin-angiotensin-aldosterone system play in response to acute haemorrhage?
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1. Renin released from kidneys in response to decr. BV/BP
2. Renin converts angiotensinogen to angiotensin I 3. ACE (high concn in lungs) converts angiotensin I to angiotensin II 4. Angiotensin II acts on BVs, kidneys (incr. Na+ abs), brain (stims thirst), adrenal cortex (to produce aldosterone, which incr. Na+ abs) |
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Outlinesympathetic response to haemorrhage in the HEART and BRAIN
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Vasoconstriction does not occur in coronary or cerebral vessels. [sparse sympathetic innervation]
Instead, blood flow is AUTOREGULATED - controlled by local metabolic factors |
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Describe the autoregulation of blood flow to the heart and brain in response to acute haemorrhage
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1. Decr. perfusion pressure
2. Decr. coronary/cerebral blood flow 3. Imbalance b/w metabolic demand and nutrient supply 4. Decr local O2, incr local CO2 5. Vasodilation of arterioles 6. Restored coronary/cerebral blood flow |
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T/F: Blood supply to heart and brain does not fluctuate significantly with systemic BP fluctuations
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TRUE
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Outline the long term response to haemorrhage
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1. Loss of plasma compensated for (incr. hepatic synthesis)
2. Incr. RBC production to restore haematocrit 3. Incr. levels DPG causing Hb to release more O2 |
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Progressive shock occurs when BP falls below ___ ?
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50mmHg
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T/F: Autoregulation of brain/blood flow continues with progressive shock
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FALSE
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Outline the positive feedback loop of progressive
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Decr. CO --> Decr. BP
1. Decr coronary blood flow means lower HR and contractility 2. Decr. cerebral blood flow means less sympathetic activity 3. Decr. blood flow to other tissues leads to ischaemia and release of toxins (s.a. lactic acid) . This increases capillary permability and further reduces blood volume |
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In progressive shock, release of lactic acid has what consequences?
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Can depress heart m.
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How can progressive shock be considered a protective mechanism?
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Significant blood loss - may increase chance of survival if we decrease BP even further (won't lose as much blood).
The BP is maintained until it suddenly falls ("sympathoinhibition") |
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What are some other consequences of severe blood loss?
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- Acidosis
- Capillary hypoxia (structural damage and further permability) - GIT hypoxia - Generalised cell damage |
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T/F: acidosis increases likelihood of developing clots
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true
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What is the best treatment for haemorrhagic shock? What are some alternatives?
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Best treatment = blood transfusion.
Next best thing = plasma (main focus to restore CO) Next best thing = plasma substitute |
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Why is saline infusion not sufficient to treat haemorrhagic shock?
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Because it will probably just leak out of the vessels
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T/F: Vasodilator drugs in conjunction with transfusion can be an effective treatment of haemorrhagic shock .
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TRUE!
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What is Erikson's theory of personal development?
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Each stage is marked by a different CONFLICT that the person needs to overcome in order to progress to the next stage. If you don’t resolve that conflict, won’t move beyond that stage ...
[Adolescence is stage 5] |
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What are some of the tasks in Havighurst’s Developmental Task Theory relevant to adolescents?
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-Achieving new and more mature relations
-Masculine or femine social role -Accepting one’s physique -Emotional independence from parents and other adults -Preparing for marriage and family life -Career -Values and morals -Socially responsible behaviour |
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T/F: Piaget states that many adults never reach the final stage of development (i.e. capacity to use abstract thought, to think about theoretical notions)
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TRUE.
And while some adults do progress to this stage, they can often regress at times of emotional stress |
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T/F: risk-taking behaviour is strongly related to intergenerational dysfunction
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TRUE.
Early disruption to development and attachment can significantly impact on an individual, esp. during period of high-risk taking |
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T/F: Risk taking can be a POSITIVE thing in the transition from adolescence to adulthood
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TRUE.
People can get 'stuck' in adolescence longer |
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What is the Dual System Model of Risk Taking?
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An imbalance between cognition and emotions:
1. Adolescents’ cognitive skills have not fully matured, deeming them less likely to understand risks 2. Affective processes are well developed |
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T/F: in an emotional situation, adults and adolescents are likely to make the same decision.
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FALSE.
Adolescents simplify information in emotional situations, and will probably make a riskier decision |
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A study on Australian adolescents found that
1. ___% females had high to very high levels of psychological stress 2. ___% males had high to very high levels of psychological stress |
1. 19% females - and was linked to drinking behaviour
2. 12% males - not linked to drinking behaviour |
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The extra-cellular fluid accounts for:
1. What proportion of all body fluid? 2. What percentage of body weight? |
ECF accounts for
1/3 all body fluid 20% body weight |
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T/F: No cell is located more than 25-50um from capillary
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TRUE
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T/F: Physical and chemical composition of ECF effectively the same throughout entire body
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TRUE
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What is the difference between an intrinsic and an extrinsic control system?
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Intrinsic = built into organ which they regulate
Extrinsic = located outside organ being regulated. [permits control of several organs] |
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Outline process of metabolic autoregulation of blood flow to exercising muscle.
[is this intrinsic or extrinsic control?] |
1. Incr muscle metabolic activity
2. Incr consumption O2/production CO2 3. Decr local [O2]/Incr local [CO2] in ECF 4. Vasodilation of local arterioles 5. Incr local blood flow 6. Incr rate of supply of O2/removal of CO2 [intrinsic] |
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Adolescent parenthood is associated with what risk factors?
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- Low SES
- Low parental education - Family poverty - Single parenthood - Low occupational status - Job instability |
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What percentage of adolescents have a 'smooth transition' into adulthood?
What about the rest? |
25% smooth transition
[20% diagnosable psychopathology, the rest have developmental spurts alternating with periods of conflict] |
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T/F: perceived risk corellates negatively with risk involvement
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TRUE.
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Risk taking is influenced by ...
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1. Perceived susceptibility
2. Perceived severity 3. Perceived effectiveness of precaution 4. Perceived costs of precaution |
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What is the Frank-Starling Law?
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Increased force of contraction of cardiac m. in response to increased stretch
i.e. the heart able to adjust output in response to changes in input |
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Is cardiac output maintained with changing afterload?
What is 'afterload'? |
YES.
Afterload = Resistence that LV must work against to eject blood into the aorta during systole i.e. aortic P |
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Greater end-diastolic volume will result in:
A) Greater force of contraction B) Same force of contraction as before C) Reduced force of contraction |
A) Greater force of contraction (and thus SV)
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Outline the baroreceptor reflex
[Is it instrinsic or extrinsic control?] |
Barocreceptors are stretch-sensitive mechanoreceptors that aim to minimise DISTURBANCES of blood pressure.
The ANS elicit coordinated effects on the heart and blood vessels. [Extrinsic] |
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If baroreceptors were dysfunctional:
A) Decreased systolic BP B) MAP similuar but enormous fluctuations C) Normal BP - there are other mechanisms to control it |
B) MAP may be similar but you would see enormous fluctuations in BP
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T/F: Skin temperature receptors send the majority of fibres to the body temperature control centre
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False.
90% of fibres received by the control centre are from central temperature receptors (that detect core body temperature) |
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What are some homeostatic responses to incr. body temperature?
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Vasodilation
Sweating Panting |
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What are some homeostatic responses to decr. body temperature?
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Shivering
Skin vasoconstriction Piloerection |
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How do we maintain balance and control of eye movements?
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Vestibular, visual and somatic receptors input to brain control systems, which give output to cranial nerves III, IV, VI to control eye movements, and cranial nerve XI and vestibulospinal tract to control neck and trunk movement
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Difference between positive feedback and feedforward control?
Give e.g. of each |
Positive feedback = change in variable results in response that accentuates the change (e.g. nerve AP)
Feedforward control = anticipatory response (e.g. immediate incr. BP/RR before starting exercise due to central command from motor cortex --> hypothal/BS) |
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What is the "gain" of a control system?
How do you calculate gain? |
measure of the DEGREE OF EFFECTIVENESS with which a control system maintains constant conditions following a disturbance
GAIN = compensation / error |
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Body temp = 37deg
Outside temp incr. from 15 to 35. Body temp rises by 0.5 deg Calculate the gain. Is it high or low? |
Normal value variable = 37
Disturbance = 20 Actual value variable = 37.5 Error = 0.5 Compensation = -19.5 Gain = compensation/error Gain = -19.5-0.5 Gain = -39 This is high gain - have effectively controlled situation |
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What is the SET POINT of a control system?
Can it vary? |
Level around which the physiological variable is controlled.
Can vary according to physiological state (e.g. exercise - BP regulated around new levels) |
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What are the advantages and disadvantages of a high gain system?
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ADV:
better control, reduced likelihood of error DISADV: Requires more metabolic energy, more complex in terms of neuronal organisation |
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Define Diaphysis
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The shaft or central part of a long bone
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Define Metaphysis
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the growing part of a long bone between the diaphysis and the epiphysis
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Define Epiphysis
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The end part of a long bone, initially growing separately from the shaft (separated by growth plate)
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Define Endosteum
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vascular membrane that lines the inner surface of long bones
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Define Periosteum
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dense layer of vascular connective tissue enveloping the bones except at the surfaces of the joints
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What is "bone mineral" laid down as? Why ?
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Calcium and phosphate are laid down as HYDROXYAPATITE
--> gives bone COMPRESSIVE STRENGTH |
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What type of matrix is hydroxyapatite laid down on ?
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Type I collagen
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T/F:
Cortical bone fills the interior of a bone, whereas trabecular bone makes up the hard outer layer |
FALSE.
TRABECULAR bone fills the interior of a bone, whereas CORTICAL bone makes up the hard outer layer |
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T/F: Trabecular bone is made up of Haversian systems.
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FALSE.
Cortical bone is made up of Haversian systems |
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What is an osteon? What does it contain?
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OSTEON = STRUCTURAL UNIT OF COMPACT BONE
Microscopically, cortical bone made up of circular osteons. Within each osteon: - haversian canals (contain blood vessels, nerves) - lacunae (holes with osteocytes) - canaliculi so that osteocytes can access central haversian canal |
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T/F: each 'haversian system' is separated from another by woven interstitial bone
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TRUE
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In which configuration is collagen laid down in compact bone? Why?
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Parallel, concentric circles for mechanical strength
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T/F: Collagen is not laid down in parallel in trabecular bone
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FALSE.
Has parallel fibres but they are laid down differently to compact bone |
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Where do most osteoporotic fractures happen and why?
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Spine, wrists, femur/hip
--> high proportion of trabecular bone (not as strong) |
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T/F: Trabecular bone is highly vascular and often contains bone marrow
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TRUE
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Describe the nature of cancellous bone
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- High SA
- Porous - Parallel collagen fibres more loosely organised - Bone rods and plates joining up to each other with marrow in the middle |
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T/F: Osteocytes remove bone while osteoblasts lay down bone.
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FALSE
Osteoclasts remove bone Osteoblasts lay down bone |
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Estrogen acts to (INCREASE/DECREASE) the lifespan of an osteoclast
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Estrogen DECREASES osteoclast lifespan
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The activity of an osteoclast/osteoblast depends on what factors?
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1. No. of cells formed
2. Activity of cells 3. Lifespan of cells |
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Where are pre-osteoclasts derived from?
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Pre-osteoclast derived from haemopoietic stem cell
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What are osteoclasts and what do they do?
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Multinucleated giant cells.[as a result of fusion of pre-osteoclasts]
Latch tightly to bone. Secrete acid and proteolytic enzymes to dissolve mineral and degrade protein |
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When osteoclasts degrade bone, what is consequently released?
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Embedded growth factors
Ca2+ |
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Once osteoblasts have made new bone they have 2 options:
1. ____ 2. ____ |
1. Become OSTEOCYTES (embedded in matrix - make up 90% of bone)
2. Become less active LINING CELLS |
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Osteocytes sense what?
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Mechanical forces
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Describe bone matrix composition
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1. Collagen (type I)
2. Non-collagenous proteins (alkaline phosphatase, proteoglycans, growth factors) 3. Bone mineral (hydroxyapatite) |
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The embedded growth factors/Ca2+ that osteocytes release go and do what?
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Embedded growth factors released intact from chaperones and act as signals to recruit the osteoblasts to the area to start forming bone.
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Define "osteoid"
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New bone matrix, before it has been mineralised
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Difference between lamellar and woven bone?
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Lamellar = organised collagen laid down (mechanically strong)
Woven = disorganised collagen laid down (mechanically weak) |
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When might you see woven bone?
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Woven bone is produced when osteoblasts produce osteoid rapidly, which occurs:
- initially in all fetal bones - after fracture - in Paget's disease |
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Why have bone turnover?
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- To change shape of bone (eg for linear growth)
- To make bone changes in response to changing load - To repair microdamage |
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Osteoblasts are derived from which stem cells?
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Mesenchymal
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T/F: Need osteoblasts to produce osteoclasts
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TRUE
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How do osteoblasts control how many osteoclasts are formed?
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By producing OPG (osteoprotegerin).
OPG binds RANK-L and prevents it from interacting with pre-osteoclast |
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Which cell expresses RANK-L?
Which cell has the RANK-R? |
Osteoblast expresses RANK-L
Pre-osteoclast has RANK-R |
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Where does bone remodelling take place in compact bone?
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Compact bone - takes place in Haversian canal.
Osteoclasts dig out a "tunnel" (the cutting zone). Osteoblasts follow and lay down new bone (the closing zone) to form a new structural unit |
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What happens in Rickets?
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Less bone mineralisation cf. normal.
Bone does not have normal compressive strength and cannot withstand gravity. Legs bow. |
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Alveolar bone is laid down by which cells?
What is embedded in alveolar bone? |
Laid down by osteoblasts.
Has a tooth embedded. |
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What is dentine?
What cells make it? |
Calcified tissue, one of the components of teeth.
Made by ODONTOBLASTS |
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What is enamel?
What cells make it? |
Tightly packed crystals containing fluorine.
Very resistant to acid. Protects underlying dentine. Made by AMELOBLASTS before tooth erupts |
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T/F: Once tooth has erupted, enamel continues to be made by ameloblasts.
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False.
Once tooth has erupted - that's all the enamel you're going to get!! Ameloblasts do make enamel, but they only survive within the gum |
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How are orthodontic devices (such as braces, plates) able to move teeth?
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Rely on bone remodelling due to mechanical force.
Putting pressure on ALVEOLAR BONE --> osteoclasts resorb surface tooth is being pushed against --> osteoblasts form bone behind the tooth as it moves away |
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How do you assess bone mass?
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BMD - bone mineral density.
Very low dose X-ray to lumbar spine and hip |
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What is "caries"? What causes it?
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When the enamel disappears.
Bacteria are carbohydrate dependent. When they break down glucose in food, produce acid which adheres to enamel. Bacteria can also produce proteolytic enzymes |
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Why don't you take X-rays of the chest in BMD testing?
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Might get false reading due to calcification in the aorta
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What t-score would indicate
1. normal bone mass? 2. low bone mass? 3. osteoporosis? |
NORMAL
up to -1 [i.e. 1 SD away from young mean for that sex] LOW BONE MASS -1 to -2.5 OSTEOPOROSIS -2.5 and below |
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How can you measure bone mass other than BMD?
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Bone biopsy - invasive
Ultrasound MRI to look at geometry Micro-CT - look at micro architecture of bone |
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What are factors that affect risk of alcohol dependence?
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1. Availability of alcohol
2. Sex 3. Year of birth 4. Smoking 5. Mental illness 6. Family Hx 7. Alcohol sensitivity 8. Genotype * * |
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Pre-operative assessment should aim to obtain what information?
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1. PHYSICAL STATUS
age, weight, BMI, etc CV and respiratory system Effort tolerance 2. MEDICAL STATUS Resus/shock status, current and previous Hx, pregnant, etc 3. DRUG STATUS Medications, self-prescribed drugs, allergies, response to previous anaesthetics 4. SURGICAL STATUS nature of surgery, site, need blood?, risk, consent 5. CLINICAL Ex Esp respiratory, CV, neuro 6. INVESTIGATIONS 7. PREPARATION risks, therapeutic options, fasting, prophylaxis, etc 8. CONSENT |
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What is a pathological fracture?
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If disease process weakens bone so that its strength is reduced and normal forces of movement/mm. activity not tolerated
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What are the 3 "first aid" steps for fractures and fracture healing
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1. Reduction - restore anatomical position if necessary
2. Immobilisation - maintain anatomical position if necessary [via external splint or internal fixation] 3. Restore patient to normal function |
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What is the general course of treatment for a fractured femoral shaft?
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Almost always surgery.
Most common procedure = closed reduction and insertion of intramedullary rod, which generally remains in bone for life |
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What factors contribute to variance in long-term disability?
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Age, SES, pre-injury health, whether compensation involved, social support
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T/F: Medical students are required to attend in an emergency if requested
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FALSE. they are NOT DOCTORS
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A study in the US last year found that what percentage of young males were alcohol dependent?
How does this percentage change upon reaching the 55+ age bracket? |
15% young males
1% males 55+ |
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What are the risk factors for alcohol dependence?
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1. Availability
2. Education level 3. Sex (males more common) 4. Year of birth 5. Family situation / drinking habits 6. Mental Illness 7. Genotype / Sensitivity [ALDH2 polymorphisms] |
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Polymorphisms of which gene is responsible for flushing syndrome?
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ALDH2 gene
Having the ALDH2*2 polymorphism --> poor metaboliser of acetaldehyde |
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What are linkage studies?
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Track a phenotype through pedigrees and look at its inheritance pattern
Try and identify co-inheritance of genetic marker/s and disease of interest |
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What types of errors can be made in genetic linkage studies?
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type I (miss a meaningful finding)
type II (wrongly identify a finding as meaningful) |
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An association study of alcoholism involves what?
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compare group of alcoholic subjects with a group of random controls and look to see if a certain genetic marker is more common in the alcoholic/disease group than in the control group
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Certain genotypes associated with WHICH GENE, other than ALDH2, are associated with alcohol dependence?
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ADH gene on chromosome 4
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High activity variants of the ADH protein are less common in which population of people?
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Those who are NOT ALCOHOL DEPENDENT have high active ADH
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T/F: Even if you have the genes that predispose you to being a heavy drinker, as well as the psychosocial factors to promote drinking, your risk of serious bodily damage is also linked to genes
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TRUE
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T/F: SPINKI gene significantly decreases your risk of getting pancreatitis
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FALSE.
SPINKI gene significantly INCREASES your risk of getting pancreatitis |
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What is the risk of becoming alcohol dependent if you have all the genes strongly associated with alcoholism?
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50%
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In July 2010, what replaced state and territory health professional boards?
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Australian Health Practitioner Registration Authority
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In NSW, doctors are required to maintain fitness to practise through...?
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1. Qualifications and experience (registration)
2. Health (impairment) 3. Professionalism (performance and conduct) |
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What can be viewed as a simple indicator of positive professional behaviour?
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participation in Continuing Professional Development (CPD)
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What is the single largest cause of death in people < 45 yo
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Road accidents
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For every fatal accident;
1. How many others require hospitalisation? 2. How many others are left with permanent disability? |
For every fatal accident.
1. 20 others require hospitalisation 2. 2 others left with permanent disability |
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what are the 3 principles of first aid in trauma setting?
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1. assume the worst
2. do no further harm 3. immediately apply prioritised sequence of assessment |
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T/F: unless haemorrhage is so severe as to cause progressive shock, compensatory mechanisms will act to restore BV and CO and person gradually recovers
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true
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For the average 70kg adult, what percentage of body mass is fluid?
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60%
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If average 70kg adult has 40L fluid, how is it divided between:
Intracellular Interstitial Blood plasma |
Intracellular = 25L
Interstitial = 12L Blood plasma = 3L |
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Resistance of a system of vessels depends on what?
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1. Whether in series or parallel
2. Diameter of individual vessels |
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T/F: in systemic circulation, total resistance mostly attributed to arteries
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FALSE - arterioles
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In systemic circulation, what does perfusion pressure =
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Perf. P = MAP - Venous P
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For normal streamlined flow, blood flow =
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Blood flow = Perfusion P / Resistance
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T/F: build up of metabolites causes direct relaxation of local arterioles
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TRUE
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Which age/gender group are most likely to binge drink?
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Males 20-29yrs
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What proportion of persons >14 reported alcohol use that put them at SHORT TERM risk of harm?
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1 in 3
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What proporption of MVAs involve at least one motorist with illegal BAC
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> 1 in 3
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Men account for what proportion of drivers KILLED with illegal BAC?
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80%
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What are some physical problems associated with acute alcohol intoxication?
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Reflux of gastric contents, severe vomiting can tear mucosal lining, heart palpatations, memory loss, coma, inhalation of vomit, death from respiratory depression
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What proportion of persons >14 reported alcohol use that put them at LONG TERM risk of harm?
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1 in 10
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T/F: in non-dependent and non-treatment seeking excessive drinkers, brief interventions by GPs have shown to be ineffective
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FALSE -effective
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What are the components of GP interve ntion of excessive drinkers?
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"FLAGS"
1. FEEDING - evidence of current alcohol related harm, benefits of cutting down, risks if don't 2. LISTEN TO RESPONSE readiness to change, have they tried 3. ADVICE TO CHANGE explicit verbal or written, cut down if not dependent, abstinence if dependent 4. GOALS 5. STRATEGIES TO ACHIEVE GOALS |
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T/F: In an emergency, it is a doctors legal requirement to extend duty of care to those who have never been a patient
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TRUE
[NSW Medical Practitioners Act] |
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In an emergency situation, if a doctor is REQUESTED to attend is there a legal duty of care?
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YES - required to attend themselves, or arrange another registered doctor
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When does the "Doctrine of Necessity" apply?
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When person unable to consent, but it is necessary for Dr to treat person (eg going to die, lose limb)
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What is the Good Samaritan Legislation?
When does protection not exist? |
Compassionate actions of a person to another in an emergency (in good faith).
No protection if: - intentional or negligible act caused injury - samaritan impaired (eg alcohol) - samaritan impersonating health/police officer |
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T/F: A student who performs a clinical activity beyond their level of skill is judged by the same standard as that used to judge a registered practitioner
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TRUE
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What is a closed/simple fracture?
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Overlying tissue intact
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What is a compound fracture?
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Site communicates with skin surface
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What is a comminuted fracture?
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Splintered bone
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What is a displaced fracture?
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Broken ends of bone not aligned
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Outline timeline of bone healing
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HAEMATOMA (1 week)
SOFT CALLUS/PROCALLUS (1 week) HARD CALLUS (3-4 weeks) RESORPTION AND REMODELLING (>4 weeks) |
