-95% of bile salts that enter the small intestines in bile are recycled and reabsorbed into the portal circulation by active transport mechanisms in the distal ileum.
Hepatocytes metabolise cholesterol to
-> cholic acid and chenodeoxycholic acid.
The total bile salt pool in a healthy adult is
-> approximately 5 g.
-> 20-30 mg of bile pigment is reabsorbed/day in a healthy adult.
Scarlet fever has an incubation period of
average 70kg adults at normal resting state:
-circulating volume would be approximately 5000ml.
-Approximately 15% of the blood is in the arterial system.
-venous system contains approximately 3000ml of blood.
- pulmonary circulation.25% (1250ml) of the blood volume is in the
The classical pathway is activated by
-> antibody-antigen complexes.
The MAC is formed on
->the surface of pathogenic bacterial cells as a result of the activation of the ALTERNATIVE pathway->transmembrane channels -> disrupt the phospholipid bilayer of target cells ->cell death.
An opsonin is a molecule that targets an
-> ANTIGEN for an immune response.
following are causes of eosinophilia:
Allergy e.g. asthma and hayfever
Parasitic infections e.g. filariasis, ascariasis and toxocariasis
Skin disease e.g. eczema and psoriasis
Aspirin is a non-competitive cyclo-oxygenase antagonist. It works by
-> covalently acetylating the cyclo-oxygenase active site in both COX-1 and COX-2.
At low doses (75 mg per day) aspirin only inhibits
-> COX-1, the enzyme responsible for making thromboxane A2, and therefore principally exhibits an anti-thrombotic effect.
At medium to high doses (500-5000 mg per day) aspirin inhibits
-> both COX-1 and COX-2. COX-2 is responsible for the production of prostaglandins and therefore has an anti-inflammatory effect at these doses.
The effects of a single dose of aspirin last
-> 7-10 days, the time required for the bone marrow to generate new platelets.
is classified as follows:
Severe < 30°C
-J waves may be seen between the QRS complex and the T wave. The statement is true.
-AF and bradycardias are the commonest rhythm disturbances seen on ECG.
-Defibrillation is appropriate at normal energy levels if VF or VT are present. If 3 shocks are unsuccessful then further shocks should be deferred until core the core temperature is > 30°C. Defibrillation is often ineffective below 30°C.
-> produced by the S-cells in the mucosa of the duodenum and jejunum
-> in response to increased acidity.
-> increases bicarbonate ion production and release from the exocrine pancreas, bile ducts and from the Brunner's glands in the duodenum-> bicarbonate ions act to neutralize the acid and establish a pH conducive to the action of other digestive enzymes.
Secretin stimulates the release of:
-> + myeloperoxidase and Sudan black , - negative for PAS.
Codeine phosphate and dihydrocodeine have
-> similar potencies.
At rest the blood in the coronary vein is
-> 25% saturated with oxygen.
Pain sensation is transmitted to the CNS via
-> small unmyelinated C fibres.
Wound healing is impaired by the following:
Poor blood supply
Superimposed wound infection
Foreign material in the wound
Nutrient deficiency e.g. vitamin C deficiency
Drugs e.g. corticosteroids
The common digital nerves are derived from
- median and ulnar nerves.
-They divide in the DISTAL palm -> paired volar branches.
-run with the digital vessels on either side of the flexor tendon sheath of each finger.
->part of the inferior boundary of the hypothalamus-> Regulatory hypophysiotropic hormones collect -> before entering the hypophyseal portal system->connects the hypothalamus with the anterior lobe of the pituitary gland.
management of anaphylaxis in an 6-12 year old
· IM adrenaline in 6-12 year olds is
· 300 mcg (0.3 ml of 1:1000).
· Crystalloid 20 ml/kg.
· IV Adrenaline 1 mcg/kg/min.
· IV Hydrocortisone in 6-12 year olds is 100 mg.
Platelets will be present in Whole blood but they will have lost function after
-> approximately 24 hours.
Fresh frozen plasma must be used within
-> 1 hour of thawing.
the neck of the femur:
-> Capsule->Anteriorly the capsule attaches at the intertrochanteric line, posteriorly the lateral half of the femoral neck is extracapsular.
- The intertrochanteric line -> anteriorly
- intertrochanteric crest ->posteriorly.
The descending colon passes
->along the lateral border of the left kidney.
Causes of cranial diabetes insipidus include:
Infiltrative processes e.g. sarcoidosis, histiocytosis X
U waves occur in
->hypokalaemia, hypercalcaemia, thyrotoxicosis, digitalis exposure, in patients taking anti-arrhythmics and in long QT syndrome.
Inverted U waves may represent
Lamellar corpuscles (Pacinian corpuscles)
->vibration and pressure sense.
Bulbous corpuscles (Ruffini's corpuscles)
Free nerve endings
-> pain sensation (nociception).
-> light touch.
-> glutamic acid ->is replaced by valine.
Ad fibres are
->velocity of approximately 20 m/sec.
-terminate in the upper laminae of the dorsal horn.
C fibres are
->velocity of approximately 2 m/sec.
- transmit temperature sensation.
Facultative anaerobic bacteria make ATP via aerobic respiration and are also capable of switching to fermentation. Examples include:
-half-life of 5-30 hours
-used as an adjunct in alcohol withdrawal. Diazepam is a suitable alternative and also commonly used.
-should be reduced in patients with renal impairment.
the only benzodiazepine with predictable intramuscular absorption.
following are the relations of the inguinal canal:
Anteriorly skin, Camper's fascia, Scarpa's fascia, aponeurosis of external oblique, superficial inguinal ring (medial 1/3 of canal)
Posteriorly transversalis fascia, conjoint tendon, deep inguinal ring (lateral 1/3 of canal)