No Air
<3
Go Sip Girl
Big Brain
Crying in the Club
200

What are some triggers of asthma

- URTIs

- allergens (dust, house mites, pollen)

- smoke

- exercise

- weather

- pollution

- occupational exposures (SO2, print, flour, bleach)

- food stuffs (sulphites and salicylates)

- GERD 

- medications (NSAIDs and beta blockers)

200

What drugs are used to treat hypertension. Describe two of their mechanisms of action.

  • angiotensin converting enzyme (ACE) inhibitors 
  • angiotensin II receptor antagonists
  • calcium channel blocking agents
  • diuretics 
  • beta adrenoceptor antagonists (beta blockers)
200

What are the four mechanisms that control GFR

  • INTRINSIC (in kidney) - myogenic response + tubuloglomerular feedback
  • EXTRINSIC - sympathetic NS + RAAS


200

What drug do you administer during a paracetamol overdose and what is its effect?

  • acetylcysteine
  • restores glutathione levels and/or inactivates NABQI
200

What are the four dopamine pathways in the brain? Which nuclei do they orignate from?

  • tuberoinfundibular - arcuate nucleus
  • mesolimbic - ventral tegmental area
  • mesocortical - ventral tegmental area
  • nigrostriatal - substantia nigra
300

Describe the mechanism of action of salbutamol

  • beta2 receptor agonist 
  • stimulates B2 receptors on bronchiole smooth muscle and produces bronchodilation 
  • may also inhibit mediator release from mast cells and increase mucus clearance by acting on cilia 
300

Describe the ionic basis of pacemaker cell electrical activity

  1. funny voltage gated Na channels open --> Na influx (K channels are closed) --> depolarisation towards membrane threshold
  2. funny channels close at the same time voltage gated T-type Ca channels open --> Ca influx (gradual)
  3. voltage gated L type Ca channels open --> Ca influx (fast) --> AP 
  4. voltage gated K channels open --> K efflux, L type channels close --> repolarisation
300

Describe the difference between BPH and prostate cancer:

  • location
  • symptoms
  • feel of it
  • location - BPH is transitional, prostate cancer is peripheral
  • symptoms - both cause nocturia, double voiding and dribbling. prostate cancer tends to present with painless haematuria BUT BPH DOES NOT
  • feel of prostate - BPH is smooth, enlarged, firm and rubbery and maintain central sulcus. cancer is hard, assymetrical and irregular in shape 
300

What is non-declarative memory and where is it stored in the brain

  • memory that is subconsciously generated in response to events or stimuli that informs skills, habits and behaviours 
  • associative learning --> amygdala 
  • procedural memory --> basal ganglia, cerebellum and neocortex 
300

Outline the three main prefrontal syndromes (what you would see)

  • dorsolateral - metacognitive dysfunction (problem solving, planning)
  • orbitofrontal - personality change/emotional dysregulation, impuslive, poor social insight, no awareness of social cues, no empathy
  • medial - reduced motivation 
400

What important structures pass through the thoracic diaphragm? Where do they pass and why?

  • inferior vena cava - central tendon in caval opening (T8), contraction of diaphragm won't constrict it but will move IVC up and down to promote venous return 
  • esophagus - muscle in esophageal hiatus (T10), diaphragm acts as a sphincter to prevent reflux when the stomach is contracting, or the abdominal muscles are compressing the stomach. 
  • aorta - aortic hiatus (T12), osseoaponeurotic opening, meaning it is a gap formed by both bone and fibrous tissue
400

How does CO change with exercise?

  • exercise increases CO by increasing HR and SV
  • increase sympathetic activity and decrease parasympathetic activity leads to increase in HR (adrenaline acts on sinoatrial node to increase speed of firing)
  • increase in muscle contracting and resp rate leads to increase in venous return --> increase EDV and SV
  • adrenaline leads to increase contractility and venoconstriction
  • despite increase afterload from higher BP, overall CO increases

400

Describe the blood supply of the kidney

  • renal artery (anterior and posterior branches) --> segmental arteries --> interlobar arteries --> arcuate arteries --> interlobular arteries --> afferent arterioles --> peritubular cappilaries (cortex) or vasa recta (medulla)
  • rabbits sometimes ignore all invitations avoiding party venues 
400

Discuss the experience of a person with a lesion to the left side of their thoracic spinal cord putting their feet in the sand.
Would they be able to feel that the sand was cold through their feet? Why?

Left Foot

  • Yes
  • spinothalamic pathway carries temperature stimuli. it decussates in SC at level of spinal nerve, so the second order neuron would have already crossed to right side of SC before ascending past the lesion

 Right Foot

  • No
  • spinothalamic pathway from right foot would have decussated to left spinal cord where lesion is
400

What is generalised anxiety disorder according to the DSM5  

  • Excessive anxiety AND worry about everyday things
  • occurring most days for at least 6 months 
  • uncontrollable 
  • associated with at least three or more symptoms (same time frame): restlessness, easily fatigued, difficulty concentrating, irritability, muscle tension, sleep disturbance (C FIRST)
  • causes impairment to daily life (social, work, other)
500

Compare and contrast pulmonary and cardiac shunts (causes and presentation)

pulmonary shunt

  • perfusion without ventilation
  • caused by pneumonia, pulm edema, pulm embolism 
  • presents as dyspnea, cyanosis, pathology specific system

cardiac shunt

  • abnormal blood flow between heart chambers
  • caused by septal defects or patent ductus arteriosus
  • presents as cyanosis, clubbing, heart failure

both lead to hypoxemia but have diff underlying mechanisms and clin presentations

500

Summarise the baroreceptor reflex and control of MAP with reference to four effectors

  • decrease in MAP ---> decrease baroreceptor firing --> decrease parasympathetic activity and increased sympathetic activity

SA node

  • sympathetic nerve firing --> beta1 adrenergic receptors --> opens Na and Ca channels --> influx --> rate of depolarisation increases --> increase HR and CO 
  • increase HR

Myocardial cells

  • sympathetic activity --> increased ventricular contractility --> increased SV and CO 
  • beta 1 adrenergic receptors are G coupled proteins --> protein kinase activity 
  • protein kinase activity increases: Ca release from SR, Ca entry from ECF, myosin ATPase activity (all faster stronger contraction)
  • Ca reuptake to SR  (faster relaxation)
  • increase SV

Veins

  • veins store blood, constriction leads to increased venous return, EDV, SV and CO 
  • increase SV

Arterioles

  • arterioles provide resistance, constriction leads to increased TPR 
  • increase SV
  • Overall effect - negative feedback loop to increase MAP 
500

Describe actions of ADH on distal nephron

  • in presence of ADH, distal nephron becomes permeable to water (regulated reabsorption - if no ADH, no reabsorption)
  • ADH diffuses out of blood (peritubular capillaries) ---> binds to surface receptors on basolateral membrane of principal cells in distal nephron
  • acts via cAMP to trigger exocytosis of aquaporin vesicles
  • increases aquaporins in lumenal membrane (where filtrate is)
  • increases H20 reabsorption 
  • acts QUICK within 5-10 mins
500

Describe the pathophysiology of an ischaemic stroke

  • Reduced blood flow due to obstruction leads to reduced oxygen and glucose delivered --> reduced ATP production

  • ATP needed to maintain ATP dependent pumps --> ionic imbalances

  • Increase sodium leads to increase water retention -> oedema and lysis (necrosis)

  • Excitotoxity: excessive release of glutamate leads to overstimulation of neurons, resulting in calcium influx (release from intracellular stores) -> activates calcium dependent enzymes (lipase, nuclease, protease) -> cell death

  • alongside excitotoxcity there is oxidative stress which is exacerbated if blood is restored

500

Describe the four types of operant conditioning and provide an example for each one

Operant conditioning is learning of new association between behaviour and its consequence

- positive reinforcement

  • presentation of good stimulus after a [good] behaviour, making the behaviour more likely to occur in the future
  • e.g. verbal encouragement "well done"

- negative reinforcement

  • removal of aversive stimulus after [good] behaviour makes the behaviour more likely to occur in future
  • e.g. removing chores when kid does homework OR headache resolving when taking aspirin

- positive punishment

  • presentation of aversive stimuli after a behaviour, decreases likelihood of behaviour in future
  • e.g. speeding ticket

- negative punishment 

  • removal of pleasant stimuli after a behaviour, decreases likelihood of behaviour in future
  • e.g. removing screen time
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