FunMed Flashcards

(73 cards)

1
Q

Define child poverty

A

When a child lives in a household with an income below 60% of the UK average

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2
Q

Barker hypothesis

A

Small size at birth is linked to an increased risk of developing certain diseases in later life such as CHD, diabetes, stroke and hypertension

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3
Q

Fraser guidelines

A

Can provide contraception confidentially to under 16s if:
They understand all aspects of the advice
They cannot be persuaded to tell their parents
They are likely to engage in sex with or without the treatment
Their physical or mental health could suffer without such treatment
It is in their best interests to receive such treatment or advice without parental knowledge

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4
Q

DLP mutation

A

Mutation in gene coding for dynamin like 1 protein

Dominant negative effect - mutant allele prevents functioning of wild type allele

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5
Q

DLP1

A

GTPase enzyme that regulates mitochondrial and peroxisomal fission
Involved in the scission of membranes late in replication

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6
Q

Roles of peroxisomes

A
Lipid metabolism 
Chemical detoxification 
Beta oxidation of fatty acids 
Neutralise free radicals and poisons 
Synthesis of plasmalogens
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7
Q

Stages of grief

A
Denial 
Anger 
Bargaining 
Depression 
Acceptance
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8
Q

Reasons for genetic counselling

A

Family history
Genetic condition themselves or known carrier
Abnormal test result
Previous child with genetic illness

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9
Q

Mutations in PWS

A

70% = deletion
20-30% = maternal uniparental disomy
Imprinting errors?

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10
Q

How does uniparental disomy arise?

A

Random even in meiosis II of gametogenesis

As a result of trisomy rescue

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11
Q

Symptoms of PWS

A
Severe hypotonia 
Feeding problems 
Developmental delay
Overeating 
Excessive sleeping
Hypogonadism
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12
Q

Complications of PWS

A

Obesity –> sleep apnoea, diabetes

Intolerance to pain

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13
Q

PWS treatments

A
Physical therapy to increase muscle mass
Speech therapy 
Occupational therapy 
Nutritional advice 
Regular physical exercise 
Growth hormone treatment --> increases muscle mass and lessens growth retardation and lessens weight gain
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14
Q

Angelman syndrome mutation

A

In UBE3A which is a ubiquitin protein involved in targeting proteins for degradation

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15
Q

Angelman syndrome symptoms

A
Developmental delay 
Speech impairment 
Learning difficulties
Seizures
Sleep disorders
Excessive laughing 
Movement and balance problems
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16
Q

Angelman syndrome treatments

A

Anti-seizure medication
Speech therapy
Physiotherapy for joints
Melatonin for sleep problems

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17
Q

Angelman vs PWS genetics

A
PWS = paternal allele absent and maternal silenced by imprinting
Angelman = maternal allele absent and paternal silenced by imprinting
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18
Q

Imprinting mechanisms

A

DNA methylation
Histone modifications
Small RNAs

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19
Q

Genetic conflict hypothesis

A

Fathers genes produce larger offspring compared to mothers whose is best if all survive to adulthood
Paternal imprinting favours larger offspring
Maternal imprinting favours smaller offspring

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20
Q

Causes of respiratory acidosis

A
Oversedation 
Brainstem trauma 
Respiratory muscle paralysis 
Pneumonia 
Emphysema 
Bronchitis
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21
Q

Causes of respiratory alkalosis

A

Mechanical ventilation
Stress
Liver disease
Septicaemia

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22
Q

Location of CFTR gene

A

7q31.2

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23
Q

Incidence of CF

A

1/25 carriers

1/2500 affected

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24
Q

Most common CF mutation

A

3 base deletion of Phe

Present in 70% of cases

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25
Heterozygote advantage of CFTR mutation
Protection against cholera, typhoid, TB
26
Function of CFTR channel
Transports chloride out of epithelial cells to decrease mucous viscosity Pumped chloride out of sweat back into the body
27
Symptoms of CF
``` Poor growth Weight loss Persistant cough Frequent chest infections Shortness of breath Infertility Insulin deficiency ```
28
Complications of CF
``` Lung remodelling Biofilm formation Superbug infection Autodigestion of the pancreas Infertility due to blocked sperm ducts Kidney toxicity and hearing problems due to excessive antibiotic intake Low bone mineral density Diabetes ```
29
Diagnosis of CF
``` Heel prick test Sweat test Lung function test - obstructive condition Chest X ray Genetic testing ```
30
Treatment of CF
``` Physiotherapy Pancreatic enzyme supplements Bronchodilators Steroids Mucolytics High calorie diets Oral and nebulised antibiotics Gene therapy ```
31
Therapeutic effects of benzodiazepines
``` Sedatives Anxiolytic Hypnotic - sleep inducing Anticonvulsant Muscle relaxant ```
32
Mode of action of benzodiazepines
Increase affinity of GABA to GABAa receptors to increase the frequency and duration of the channel opening Increased Cl- entry Increased hyperpolarisation Increased inhibitory effects
33
Side effects of benzodiazepines
Amnesia, sedation, ataxia, hypotension, respiratory depression, tachycardia, dizziness
34
Metabolism of diazepam
Diazepam --> desmethyldiazepam --> oxazepam by CYP3A4 Oxazepam conjugated with glucoronic acid Urinary excretion and some faecal
35
Diazepam half life
20-80 hours
36
Temazepam half life
3-13 hours
37
Metabolism of temazepam
Conjugation with glucoronic acid | Urinary excretion and some faecal
38
Why is temazepam safer for Edith?
Shorter half life so less likely to accumulate | Only phase II metabolism which is less affected by age
39
Compliance categories
``` Primary = not started Secondary = not finished Tertiary = not taken correctly ```
40
Reasons for non-compliance
``` Forgetfulness Symptoms gone Side effects Cost Effects not visible ```
41
Factors affecting drug metabolism
``` Pharmacogenetics Ethnicity Age Gender Diet and environment Drug interactions Disease ```
42
Microscopic evidence of coeliac disease
Villous atrophy Crypt hyperplasia Intra-epithelial lymphocytes
43
Macroscopic evidence of coeliac disease
Scalloping of mucosal folds Fewer mucosal folds Mucosal mosaic pattern Prominence of submucosal vessels
44
Function of tTG
Deamidation of gliadin Glutamine --> glutamic acid Increases affinity for HLA More immunogenic
45
Genotype of coeliacs
``` 95% = HLADQ2 5% = HLADQ8 ```
46
Symptoms of coeliac disease
``` All of malabsorption Anaemia Dehydration Diarrhoea Muscle wasting Foul smelling stools Weight loss ```
47
Problems with gluten free diet
Poor compliance Expensive Hidden extracts Contamination
48
Testicular cancer epidemiology
Most common cancer for men aged 25-49 1% of male cancers worldwide 2200 men diagnosed in the UK each year
49
Types of testicular cancer
Germ cell - seminoma (originate in seminiferous tubules), non-seminomas, mixed Lymphoma Stromal - Leydig or Sertoli cell tumours
50
Staging
I - no spread II - spread to abdominal lymph nodes III - spread to thoracic lymph nodes IV - spread to organs such as the brain, liver, lungs
51
Symptoms
``` Testicular mass Swelling or pain in scrotum Dull ache and heavy sensation in lower abdomen Gynecomastia Back pain ```
52
Risk factors for testicular cancer
``` Cryptorchidism - 11x Indirect inguinal hernia Gonadal agenesis - Klinefelter syndorme White Smoking Family history HIV positive Marijuana use ```
53
Treatment of testicular cancer
Orchiectomy Lymph node dissection Radiation Chemotherapy
54
Importance of testicle self exam
Become familiar with normal feel of testicles | Recognise any changes
55
Seminomas vs non-seminomas
Non-seminomas are faster growing and more aggressive compared to seminonas
56
Symptoms of meningitis
``` Fever Vomiting Photophobia Drowsiness Rapid breathing Non-blanching rash ```
57
Bacteria that can cause meningitis
``` Neiserria meningitides Group B strep Haemophillus influenzae B Streptococcus pneumonae Listeria monocytogenes ```
58
Viruses that can cause meningitis
``` VZV HSV HIV EBV Non-polio enteroviruses ```
59
Treatment for meningitis
Broad spectrum antibiotics - cephalosporins Steroids (dexamthosone) - reduce inflammation to reduce ICPa and thus brain damage and dampen immune system to prevent worsening of symptoms with antibiotics
60
Causes of reduced levels of consciousness
``` Diabetes Dehydration Head injury Drug overdose Alcohol intoxication Seizure Stroke Brain tumour Hypoxia Hypercapnia ```
61
How can bacteria reach the meninges?
Direct contract with the brain through the nasal cavity | In the blood stream
62
Vaccines that protect against meningitis
MenACWY, menB, menC, MMR, Hib, pneumococcal
63
Why are CF patients more prone to lung infections?
Mucous is viscous as lacks water Resists action of cilia Bacteria not swept out of the lungs Blockage of bronchi
64
MHC class I types
A, B, C
65
MHC class II types
DP, DQ, DR
66
Polygenic property of MHC
More than one type of both type I and II
67
Polymorphic property of MHC
Multiple alleles in the population meaning most individuals are heterozygous
68
Function of the lymphatic system
Removal of interstitial fluid from tissues Absorbs and transports fatty acids from the GI system Transports WBCs to and from lymph nodes to the bone Transports APCs from tissues to lymph nodes
69
Site of lumbar puncture
L3/4 | L4/5
70
What can be found out from a lumbar puncture?
Pressure determination Cell count Microbiology Levels of glucose, lactate, antibodies
71
Why is there increased stress in families with a child with chronic disease?
``` Less money Commitments at home Difficulty with holidays Less attention for other children Increased worry about child ```
72
CF physiotherapy problems
consuming Needs other family member Boring Exhausting
73
Requirements for informed consent?
Patient has capacity Patient offered adequate information Non-coerced into their decision