Block 1

Front 1

Chemcial conditions in MI?

Back 1

High lactate, low pH, low PFK-1 = rate limiting enzyme ing lycolysis, olow ATP --> influx of Ca

Front 2

Why is low ATP in MI bad?

Back 2

Dysfuucntion of membrane pump --> influx of Dca --> cell death + lysis

Front 3

Name some pain mediators in MI

Back 3

Bradykinins, proostaglandins, serotonin, histamine, lactic acid

Front 4

Which torponins do we test for? When do they rise?for how long?

Back 4

T and I form muslce - prefred marker. Rises 3-12 hours after; stays for 7-10 day

Front 5

What do we look for with CK?

Back 5

Isoform MB; rises 4-8hours, delcines 12-24

Front 6

What do we look for with LDH?

Back 6

Isoform H4 >L2; rise 12-4, peak 2-3days

Front 7

Innervation of the pericardai?

Back 7

C3-C5 - phrenic nerve

Front 8

epicardial innervation?

Back 8

Autonomic from underlying part

Front 9

Heart innervation? Motor, sympa, parasympa

Back 9

Autonomic motor supply = Sym,pa T1-5; PSNS = X, slows rate no impact on contractility

Front 10

Thow specific are troponin tests?

Back 10

very

Front 11

What are the heart/muscle isoenzymes of CK?

Back 11

Heart CK-MB; sk m = CK-MM; Brain CK-BB.

Front 12

How good a test is CK?

Back 12

Sensitive >90%; but not specific - increased in trauma, exetion, post op, convulsions, etc.

Front 13

How is energy stored in striated muscle?

Back 13

CK stokes energy as creatine phosphate which maintains level of cellular ATP.

Front 14

How common are eating disorders? Most common age? RFs?

Back 14

Female 10:1 male; 50% 1st year realspe 90% overall relapse, death rate 1%/yr; lasts 5yrs average; most common 15-19; bulimia 20-24yo; Genes, personality, Sexual abuse, dysfuncitonal family

Front 15

Summarise biochem

Back 15

Glucose oxidised to pyruvate; enters citrica acid cycle, generates reduced NADH and FADH2, donate electrons to electron tranport chain. O2 acts as terminal electron acceptor. Electron flux powers H+ transport. This gradient drives ATP syntehsis via ATP syntahse across inner mito matrix

Front 16

Reccommended food proportions

Back 16

30% fat; 50% carb; 20% protien.

Front 17

How much stuff is produed in glycolysis / glucose molecul

Back 17

2 ATP net; 2 NADH formed

Front 18

What happens to pyruvate - 2 ways?

Back 18

1) oxidised to acteyl grou pof acetyl co A; OR reduced to lactate

Front 19

What isi the yield of the citric acid cycle?

Back 19

2ATP, 6 NADH, 2 FADH2, 4CO2 per glucose unit (hafl per pyruvate)

Front 20

What is oxidative phosphorylation?

Back 20

Generates more energy from NADH and FADH2, and regeerates NAD/FAD to continue cycle. This uses oxygen vi athe electron transport chian.

Front 21

What food do we aviod in PKU?

Back 21

Preotein - esp meat, fish, dairy

Front 22

What is PKU a disorder of?

Back 22

PAAH - required for Tyrosine synthesis.

Front 23

What amino acid accumulates in PKU?

Back 23

Phenylalanine

Front 24

What symptoms do we see in PKU?

Back 24

MAIN: Intellectual. ALSO: Tremor, Seizures, Parkinson-like, abnormalitie sof gait, behavioural problems, psychiatric disorde, tec

Front 25

Develop ment theroies

Back 25

Blah

Front 26

Developmnet stages

Back 26

Look over

Front 27

Stats on breast cancer?

Back 27

1 in 11; 85% with mutatnt BRAC1; 67% are ER+; 80% ductal, 20% lobular; familial 5-10%

Front 28

What percent of breat lumps are fibrocystic disease?

Back 28

40%

Front 29

Name 3 casues of a tender breast lump

Back 29

1) Abscess (breastfeeding esp) 2) Fibroadenosis (proliferative disease, not atypia 3) breast cyst; no nprolfierative)

Front 30

Name some breast cancer oncogens

Back 30

BRAC1 ch17; BRAC2 - chr13. These do not express ER or PR = harder to trea. ALOS p53 (50% all cancers); ER+ - 2/3 br ca - stimulates prolfieration. HRT will stimulate. Tamoxifen stops. HER-2 - 20-25%. Herceptin used to block

Front 31

Whats another word for anaplasia?

Back 31

Lack of differentiation

Front 32

Name 4 kinds of antibiotics which inhibit cell wall synthesis

Back 32

Beta lactans (inhibit petidoglycan yntehsis); Vancomyci (inhibits piptidoglycan cross linker); Bacitracin (disrups peptidoglycan precurse movement); Antimycobacterial - disrups mycloic acid

Front 33

Name 5 Abs which inhibit proteins ynthesis. What do they bind to?

Back 33

Animoglycosides - irreveribly bindt o 30S ribosome; Tetracyclines: block tRNA binding to ribosome -mRNA complex (30S); Chloramphenical - blocks peptitadaal elongation (50S)); Macrolides - reversibly bind to block elongation (50S); Clindamycin block elongaito n)(50S) - NB: These are ALL bacteriostatic EXCEP Aminoglysodies

Front 34

Name 2 Abs which alter cell membrnaes

Back 34

Polyxmisins (catioinic detergent like); Bacitracin

Front 35

Name 24 Abs which inhibit NA synthesis

Back 35

DNA: quinolones inhibit supercoiling; Metronidazole (cytotoxic byproducts disrupt DNA); RNA: Rifampin - binds RNA polymerase; Bacitracin - inhibits rAN trasncription

Front 36

Name 3 Abs with antibmetaoblite activity

Back 36

Sulfonamides, dapsone - compet with PABA (folic acid) sytmethsis); Trimethoprim - inhibit dihydrofolate reductase

Front 37

Name and describe the 5 layer sof skin

Back 37

Basale, Spinosum, Granulosu, Lucdum (rare), Corneum

Front 38

RFs for UTI

Back 38

Pregnancy, female, foreing body, statsis, obstruction

Front 39

What is the most common agent causing UTI/

Back 39

85% UPEC - urpoatogenic E Coli (in young sexually active - staphyloccus saphrophyticus)

Front 40

What AB should not be used in prgegnancy?

Back 40

Tetracycline --> teet discolouration; Sulfa --> jaudncie;. ALSO: Isoniazid, rifampin, difluca, vaccines

Front 41

What are hter roles of E1,2,F1,2 prostaglandins?

Back 41

1) Increase vascular mpereability, cause inflammation, contract sm m

Front 42

What is ther ole fI2 (prostacycline)?

Back 42

Vasodilation, reduced platelet adhesion

Front 43

What is the role of TXA2?

Back 43

Incerease vascular permeability; procagulatn; vasoconstritor

Front 44

What releases leukotrienes?

Back 44

Mast cells when activated

Front 45

Name roles of leuktotrienes

Back 45

1) Sm m conraion ;2) increase vascular permeability 3) Attract neutrophils = macrophages

Front 46

What are the 3 patewasy that activate complement? Where do ethey converge?

Back 46

Alternative (bacteria walls); Classical (IgG or M --> 1,2,4); Lectin pathway (mannos binding proteins on bacteria/viruses) ---all converge at C3

Front 47

What is the active part of C3? What does it do?

Back 47

C3b - larger --> wall. 1) phagocytes recognise --> opsonisation 2) Triggers terminal sequence activation (C5-9) --> membrane attack omplex. C3a (smaller) --> infllmmation - mast cells, permeability, chemotaxis of neutrophils.

Front 48

Empriatcal treatment of UTI?

Back 48

nitrofurantoin, cephalex or amixcillin-clavulanic acid (augmentin)

Front 49

Which Ig protect the urogenital tract the most?

Back 49

IgA

Front 50

What cells mediate phagocytos si of extraclleular bacteria?

Back 50

Neutrophils

Front 51

Differentiate Th1 and Th2 - what do they target, what do they do to B cells

Back 51

Th1 = bactria. Activate macrophages, stimulate IgG21 --> opsoniations + actiation of phargocytic cells. Intracellular pathway. TH2- produce IgG,A,E; memroy cells. Stimulate eosinophils, mast cells --> parasites/worms

Front 52

Differentiate MHC1 and II

Back 52

I --> CD8; on all cells; binds endogenously syntehsised Ag from infected cell (HLA A-->C); II ---> CD4; on APCs (or cells induced to express by IFN-gamma);

Front 53

T/F Materanl IgG is in feotal blood?

Back 53

TRUE

Front 54

When does a baby produce its own IgG

Back 54

6 mths

Front 55

Give me some stats of TB

Back 55

infects 1/3 world population; 95% developing countries; 2nd biggest disease after HIV/AIDS

Front 56

What is the TBr eactivation risk?

Back 56

10% per yhear with HIV; 10% lifetime otherwise

Front 57

Describe the pathogenesis of TB

Back 57

1) inhalation --> alvoli 2) ingestion by macrpophage recognsiing mannose capped glycolipids --> 3) EVASION A) maturaiton arrest B) stops low pH in endosome C prevents fusion with lysosome --> replication 4) spread 5) Macrophages secrete IOL12 --> TH1 --> IFN gamma , Mo --> TNF. TNF + IFNg --> NOS, NO + ROI; TNF + PDGF --> fibrobalsts --> granuloma + recruiment of monocuytes; monocyte s--> epithelioid subtype --> granuloma

Front 58

Desribe a grnaumoma

Back 58

Caseus necrossis surrounded by epithelioiud granumoa monocytes surrounded by sensistsed T cells

Front 59

Chemokine that recuirst monocyts?

Back 59

TNF

Front 60

Stain for TB

Back 60

Ziehl Nielsen

Front 61

BcG vax?

Back 61

Live attendulated M Bovis; 55% chance of resisting

Front 62

Size of true matnoux +ve?

Back 62

+11cm

Front 63

Rx of TB?

Back 63

RIPE - Rifampicin, Isoniazid, Pyhrazinamide, Ethambutol