b-adrenergic receptors(Allosteric?) Feedback/feed forward
inhibition vs competitive/non competitive vs.
reversible/nonreversibleCREBChaperone protein that is in a barrel.
keeps proteins in their shape before and afterLDH vs troponins I
and TLiver cell integrity - ALT to AST = settings[]; ALT > AST
in damage unless alcohol/cirrhosisBiliary excretory function of the
liver - ALP and GGT. ALP also in bone, so when both elevated, bile
duct obstruction/damage.ALP-1 bile duct = settings[]; ALP-2
bone.Serum alpha-amylase and pancreatic lipase - damage to the
pancreas. Lipase/amylase >2 for ethanol-inducedalpha fetoprotein
(AFP) for liver = settings[]; found in fetus instead of
albumin.
A patient is rushed to the ER with an aortic aneurysm. Long
limbs lenses of eyes dislocated. Connective tissue disorder.a.
Defect in the formation of cross-links between tropoelastin
moleculesb Lack of hydroxylated lysine and proline residuesc.
Mutation in fibrillin-1d. Defect in lysyl oxidase, which reduces
allysine residues
Klippel-FeilVACTERL2-mercaptoethanol and bME - break disulfide
bondsSDS - breaks hydrophobic interactionsUrea and salts break
hydrogen bondsAcids/bases break ionic bondsSpectrin and Ankyrin
Glutamic acid is mutated to valine in Sickle cell disease at
point six in the betal chain.Lysyl hydroxylase and prolyl
hydroxylase
Adrenergic-Adrenergic
GQactivationPLCbreakPIP2IP3 +DAG
PKCupregulationGSactivationACcAMPPKAupregulationHistologyPancreatic
cellsStriated duct, serous, mucousMacula adherensSatellite
cellsExudateTransudateMonoblast
Gallbladder - simple columnar
Vagus NerveBranches into the pharyngeal nerveStimulates parietal
cells to secrete intrinsic factor for Vitamin B12
absorption.Postganglionic parasympatheticPhrenic NerveSympathetic
to the diaphragm
2/109A 69 year old woman complains of weakness in her arm.
Muscle testing reveals weakness of the muscles in the extensor
compartment of her arm but all other muscles are normal. CT
angiography reveals atherosclerosis (narrowing) of the artery
supplying the extensor compartment. Which artery has become
occluded?A. SubclavianB. Deep brachialC. AxillaryD. BrachialE.
Ulnar
Answer: D
40/109A 58 year old female is diagnosed witha number ofsmall
growths in the posterior mediastinum. During surgery to resect
thegrowths the surgeon realises that one of themon the body of a
thoracic vertebra has involved one of therami communicans.If it is
a white ramus that is involved, which nerve fibres are at risk
oftrauma during the resection?A. Preganglionic sympatheticB.
Postganglionic sympatheticC. Preganglionic parasympatheticD.
Preganglionic sympathetic and visceral afferentE. Postganglionic
sympathetic and visceral afferent
Answer: D
45/109A59 year old man undergoes radiographic examination to
assess arthritic changes in his vertebral column. The radiologist
notes osteophytes (bony outgrowths) in some of his cervical
intervertebral foramina, especially theforamenbetweenC7 and T1.
Which spinal nerve will be impinged upon by the osteophytes in this
foramen?A. C5B. C6C. C7D .C8E. T1
Answer: D
59/109A quick way to identifytheindividual intercostal spaces is
to use the sternal angle (of Louis), which is located at thelevel
of the 2nd costal cartilages, and count down from there. The
sternal angle lies at the level of which intervertebral disc?A.
T1-2B. T2-3C. T3-4D. T4-5E. T5-6
Answer: C
101/109A neonate is born in a severely cyanotic state. Imaging
studies reveal that the patient is suffering from the most common
cause of congenital cyanotic heart disease. Whichis that cause?A.
Tetrology of FallowB. Transposition of the great arteriesC. Atrial
septal defectD. Ventricular septal defectE. Pulmonary stenosis
Answer: B
Describe in general the composition of the ECM related to
fibrous proteins (name two), specialized proteins and gel-forming
group. The ECM contains also the gel-forming group of
proteoglycans.Type I: skin, bone, and tendon, cornea Type II:
cartilage, inter-vertebral disk and vitreous body Type III: blood
vessels, and fetal skin Ehlers-Danlos syndromes is a heterogeneous
group of disorders due to hereditary defects of collagen synthesis.
The biochemical defect can be a mutation of the pro- chain gene,
most clinically important mutations are found in the gene for Type
III collagen which can lead to lethal vascular problems.The buffer
capacity is highest at the pKa.What happens to the -amino acid or a
modified -amino acid when it is used to form biological active
amines?
Biological active amines are formed by decarboxylation of the
carboxyl group.
[this process needs pyridoxal phosphate (PLP from vitamin B6) as
cofactor and patients with this vitamin deficiency show less
formation of biological active amines. PLP is needed for formation
e.g. of histamine, GABA, serotonin]Nitric oxide is formed from
arginine via nitric oxide synthase.1.8 DNA turns for histones11 nm
fiber - beads on a string.30 nm - chromatin fiber10 bases per turn
at 0.34 nm between bases = 3.4 nm per turn.B-Normal (right hand) =
settings[]; Z - Alternating purine/pyrimidine (left hand) =
settings[]; A - denydrated3.6 residues per turn for alpha
helicesWhat is the advantage to synthesize a larger precursor
protein for eventual formation of short peptide hormones?
Peptide hormones are very powerful. It is necessary that they
are only formed when needed and contain the correct amino acid
sequence. The process of synthesis of a larger protein precursor is
under genetic control and prevents formation of a faulty peptide
hormone. mannose/mannose 6-phosphate
HistologyErythrocytes - 43% of blood volume.Osteoblasts - Build
bone. Parathyroid hormone (PTH) increases bone resorption and
calcium release through osteoblasts (osteoclasts don't have
receptors for PTH).
Osteoclasts - Increase calcium content. Has calcitonin receptors
to inhibit activity.
Osteocytes - In lacunae.Ribosomes formed in the
nucleolus.Claudin - tight junctionZonula adherens - Cadherin,
Ca2+Desmosomes - Intermediate filaments, desmocollin,
desmogleinHemidesmosomes - IntegrinMyeloperoxidase -
neutrophilsBlood stem cell - pluripotentProerythroblast -->
basophilic erythroblast --> polychromatophilic erythroblast
--> orthochromatophilicerythroblast --> reticulocyte -->
mature red blood cellCilia - 9 + 2 doublets. Basal body - 9
triplets.
Myeloperoxidase is an enzyme most closely associated with:A.
NeutrophilsB. EosinophilsC. BasophilsD. LymphocytesE. Monocytes
ANSWER: A
The single type of stem cell in the bone marrow from which all
blood cells arise is called aA. Multipotential stem cellB.
Omnipotential stem cellC. Colony forming unit (CFU)D. Progenitor
(blast) cellE. Pluripotential stem cell
ANSWER: E
A shift to the left is a term used whenA. Eosinophil production
exceeds neutrophil production in the bone marrowB. Monocyte
production becomes greater than lymphocyte productionC. Very large
numbers of immature erythrocytes enter the circulating bloodD.
Large numbers of immature neutrophils (band cells) appear in the
circulating bloodE. The red marrow is converted to yellow
marrow
ANSWER: D
Which of the following pairs of hormones are mainly involved in
controlling pancreatic exocrinesecretions?A. Insulin and glucagonB.
Secretin and cholecystokininC. Somatostatin and gastrinD. Motilin
and serotoninE. Glucagon and somatostatinANSWER: B
Which of the following is not produced by an enteroendocrine
cell?A. ReninB. CholecystokininC. GastrinD. Vasoactive intestinal
polypeptideE. SecretinANSWER: A
94. Collagen is A. The most abundant protein in the body. B.
Assembled extracellularly. C. Composed of the amino acid, glycine,
which makes up about one third of its amino acids. D. altered in
patients with long term, low Vitamin C intake.
63. When comparing primary bone verses secondary bone A. Primary
bone has an irregular array of collagen fibers whereas secondary
bone has collagen fibers arranged in lamellae. B. Primary bone has
a lower proportion of osteocytes per unit area than secondary bone.
C. Primary bone has a higher mineral content than secondary bone.
D. Primary bone can be found only in embryos and not in adults:
secondary bone can be found in adults. E. All of the statements are
correct.
Answer: A
95. The lamina propria is a specialized type of A. Loose
connective tissue. B. Dense irregular connective tissue. C. Dense
regular connective tissue. D. Reticular connective tissue. E.
Mucoid connective tissue.
Answer: A
101. The nuclear envelope A. Is made up of two unit membranes.
B. Is supported internally by intermediate filaments. C. Disappears
during metaphase. D. Is studded on the outside by polyribosomes. E.
Has all of the above features. Answer: E
103. Which of the following statements about intercellular
junctions is TRUE? A. The maculae adherens forms a band completely
surrounding the cell. B. The primary function of the gap junction
is structural support. C. Desmosomes allow for the passage of small
molecules between cells. D. Intracellular actin filaments insert
into attachment plaques at the zonula adherens. E. Cadherins are
primarily responsible for attaching cells to the extracelluar
matrix.
Answer: D
AnatomyKidneys develop from the sacral level62 spinal
nervesEndometrium conceptus - Decidua parietalisGranulosa cells of
cumulus oophoricus turns into the corona radiataMajor calyces
derived from the lower part of the dorsal mesogastrium
Histology:The thymus is composed of T cells, epithelial
reticular cells and some macrophages. The thymus consists of a
cortex and medulla with no germinal centers. Immature T cells
arefound at the edges of the cortex. As they mature, they migrate
deeper into the cortex and eventually leave as mature naive T-Cells
through the venules of the medulla. In the lymph node, the cortex
is made of primary follicles of resting B-cells and secondary
follicles with germinal centers. The germinal centers are where
B-cells are undergoing cloal expansion after binding antigen and
receiving T-cell help. Most T-cells are located deeper in the
cortex. Antigen-stimulated helper T-cells are formed when antigen
is presented to them by dendritic (and possibly macrophages), deep
in the cortex. B cells also bind their antigen in this region. B
cells entering the lymph node travel through the cortex to a
follicle. If they have bound antigen in the cortex, they attract
antigen-stimulated T helper cells to the follicle, where T-cell
help occurs. T-cell help in the spleen occurs in the periarteriolar
lymphatic sheath (PALS). Close to, if not touching, the PALS are
follicles of resting B-cells, a clone of which may give rise to a
germinal center upon proper stimulation.
What is the purpose of de novo fatty acid synthesis? Where in
the body does it take place? Where in the cell does it take place?
Is there a regulated step? What is special?The fatty acid de novo
synthesis takes place mainly in the liver and lactating mammary
gland. The synthesis takes place in the cytosol, mitochondria are
however needed to form citrate. There is a regulated step catalyzed
by acetyl CoA carboxylase. It is special that malonyl CoA is formed
in the regulated step and that many malonyl CoAs are then used by
the FA synthase complex. Free palmitate is released which needs to
be activated to palmitoyl CoA as palmitate itself has detergent
character.
Carnitine is a molecule derived from amino acids (lysyl residue
of a specific protein then methylation using S-adenosylmethionine,
SAM).
Please work on the last three objectives for these lectures on
your own. Prepare a concept map indicating the steps involved in
the generation of ketosis in starvation and uncontrolled type I
diabetes mellitus.Correlate laboratory data in ketoacidosis
(laboratory data in blood and urine) to the clinical signs in the
patient = settings[]; include hyperventilation.Explain the
biochemical basis of occurrence of hypoglycemia and hypoketosis in
the systemic fatty acid oxidation disorders [the liver gets back
most of the bile acids/salts, but it does not get back the
phosphatidylcholine. That is why in the liver, phosphatidylcholine
is not only synthesized using dietary choline, but is also formed
by 3x methylation of phosphatidylethanolamine using SAM]
How to differentiate components of nephroncorticomedullary vs
medullary extra vs intra vs JG cellshow to distinguish bronchi
section slidesnail bed / hair appendage??which lobes are clinically
relevant of prostate??layers of tunica vaginalis???male / female
epithelia???tunical albuginea??smooth muscle is coupled with
cuboidal epitheliumAlveolar duct to sac-> knobs THICK VS THIN
partschromophores- stem cellsmelanin lies on top of nucleusfine
touch in which layer?? layerdeep touch granulosum lamina bodies aka
membrane coating granules are in skin to give hydrophobic naturePeg
cell cilliated are present for fallopian tube. contrast ciliated vs
flat cell surfacespeg cell functions to nutrion to ovum, help
spermdo cilliated cells increase / decrease??PARS convoluta- mostly
PCT/DCTPCT is dirty lumen, less acidophilic PCT is microvilliPCT /
DCT is 6:1 at least in DCT is closely arranged
PARS recta
PCTis like desendingDCT is like thick asc
medulla divides where thin vs thickthick is cortex
COLUMN OF BERTINI?!?
BULGING NUCLEUS
VASA recta find out differentials
nephron goes from glomerulus to DCT
collecting duct is shared and makes up uniferous tubule
lobule is half of pars convoluta on both sideslobe is pyramid
plus cortex
True lumen in infundibulum of fallopian tube, can always trace
to center
FSH differentiates something primordial to primary oocytes (at
puberty)
VAS DEFFERENS: 3 well defined SMC layers inner long mid
circsmall lumen, epithelium is simple cuboidal
GIVES EJACULATORY FORCE
URETER has
mammary glandactive when minimal stroma lots of secretionfat in
both
B is in white pulp of spleen
OPEN CIRCRBC is disposed in white flex can squeeze throughold
stale / sickle get stuck / phagocytized
What is little/literal cells elongated epithelium
T is
Hassals corpusc- calcified ERC?? only in medulla
ENDOTHELIA-reticular cells
placenta tertiary layers??
21st day have tertiary??fertilzation
trophoblast has both layers mesosomething with fetus
where does HCG come from??
HCG maintains corpus leuteum to synthesize progesterone
until
placenta has well defined outter layer and internal blood
vessels with meso in betweenthis is tertiary dev of placenta'
thin skin looks like pseudostratisfied
pylosebaceous hair glandmyopithelium / arrector pilli musclehair
follicle
eccrine is straight to skin
stratified cuboidal is only going to be sweat glandapocrine
gland is not apocrine secretion, actually merocrineejects into
sweat gland
Only active after puberty that's why you start stinking
secretory portion is lighter
weird donuts rbc is tunica albugenea
tunica propria is
leydig are known is interstitilal cells between tunical
layers
ovum and follicular cells use glycoproteins to prevent
multi-sperm
glycocalyx of basement menbrane / podocytes will stain PAS
reticular fibers allow for volume accomodation
GERMINAL CENTERS (b cell)= secondary tissue, inner cortex
questions on
light colored area is sinus of medulla
thing that looks like glomerulus is actually mamary gland
stereocilia reabsorbs, it's much like microvilli
activin vs inhibin
FSH action on secondary oocytes / vs after ovulation
acts on fllicular cells
LH -> THeca internal cells??germinal epithelium is cuboidal,
functionlessCilliated pseuostratified with stereocilliaT cells are
perilymphatic sheethlitteral chords of ERC / eccrine sweat gland
has stratified cuboidal / columnarishdark / clear / myoeductal
portion exretory or apocrineparacortex T cell in viral
infectionhumoral outercortexLayers
renal corpuscleinternadensa??????? vera laminaexternadermischeck
out lymph tonsil pharyngeal has mix stratifiedno cryptslingual has
shallow crypts mucuspalatine crpyts have descimatedchief-
parathyroid, darkoxyphil- uknowinnreticular layer mostly type
Imerckels -stratum basalevibrationpusceles- vibration,
deeppapillary- loose for vascularity CHECK OUT PROSTATE
citrate acidlipidproteolyticwhiteprostate yellow sugar
mucouslipochromepilosebaceous unitphases of Uterus during cyclemid
40's slidessecretoryprogesteronelutealglycerophospho something to
mature sperm70false lumenactivated by testosteronechromophobes-
unknown or stem or dying reverts corneaABCDElunglymph
tissueslensFNH final review
1 Sertoli cells anndd continuous capillary2 B3 E4 D5 A E6
Afferent vessel capsular border subcapsular sinus intermediate
medullary sinus hillum efferent vesselDc7 C8 a9 b10 e11 b12 b13d14c
A15 b16 d A17 c18 b A19 b20 c E21 B 22 b C23 a24 Ciliary body
posterior pupil anterior body trabecular meshwork canal of schlemm
vesselse25 ENeuron axons in tangled formation are phosphorylated
Tau proteins
Bullous pemphigoid- hemidesmosomes
Pemphigous vulgarus- Full (desmoglian)
kartagener- bad motor proteins, can't use cillia, infertile
spermLymph
What stain best visualizes stromal fiber connective tissue of
lymph nodes?Silver nitrateIs silver nitrate silver stain, and is
this the optimal stain for reticular fibers, and are reticular
fibers main component of lymph nodesHow do lymphocytes enter lymph
nodes?What cells are unique to the thymus??What are epithelio-
reticular cellsWhat constitutes red pulp of spleen?What constitutes
white pulp?What leukocytes are affected / abnormal in DiGeorge's /
thymic aplasia?T-cellsWhere is the blood thymic barrier? Solely the
coretex of the thymusWhat are germinal centers of lymph node?What
is a central organ of the lymph?What is a peripheral organ?What are
major immunoglobulins of B-lymphocytesHassall's
corpuscles??Supposedly no known functionWhich are not found ln the
Thymus??Lymph nodulesT lymphocytesHassall's
corpusclesCortexEpi-reticulo cellsHow does lmyph flow through a
node??Small many afferent lymph vesselsCapsuleSubcapsular
sinusintermediate sinusmedullary sinushillusCentral efferent
vessel(Thymus is the only lymph tissue that does not have afferent
vesselWhat is the mechanism for lymphocytes to re-enter blood from
lymph??Why is the blood-thymus barrier important??This barrier,
which is only in the cortex, protects or shields developing
t-lymphocytes from exposure to circulating (self-) antigensWhere
are B-lymphocytes not found? Probably where T- are madeThymusWhere
is the highest concentration of T cells in lymph??It is the inner
(para-) cortexWhere is the highest concentration of T cells in
spleen??Learn the spleenWhat is the open theory of circulation?It
probably has to do with how spleen has sinusoidal? capillaries
Would germinal centers with active carcinoma have the most abundant
oragnelles be??Microtublesrough ERperoxisomessecretory
granzlysosomesB-T barrier??Cortex
Q#24Congenital adrenal hyperplasias (CAH) are rare genetic
diseases due to overstimulation of the adrenal cortex by ACTH. What
is found in patients with CYP 17 deficiency?
Masculinization of femalesDeficiency of aldosteroneDeficiency of
cortisolStimulated estradiol synthesis Stimulated testosterone
synthesis
Q#25The most common of the rare diseases of CAH is the
deficiency of CYP 21. Which steroid hormone is less synthesized in
these patients in addition to less cortisol synthesis?
ProgesteroneDHEATestosteroneEstradiolAldosterone
Q#43What is special about medium-chain fatty acyl CoA
dehydrogenase? This enzymeneeds NAD+ as coenzymeis needed for the
complete oxidation of palmitoyl CoAacts only on dietary
medium-chain fatty acyl CoA is found in both, cytosol and
mitochondriacatalyzes the second oxidation step of -oxidation
Heparan sulfate binds lipoprotein lipase (activated by ApoC-II)
to endothelial cells.
Lysosomal storage diseases also include the group of
sphingolipidoses. Which enzyme is deficient in the sphingolipidoses
Tay Sachs, Fabry, Gaucher and Niemann-Pick Disease,
respectively?
Tay Sachs Disease: hexosaminidase AFabry Disease:
-galactosidaseGaucher Disease: glucocerebrosidaseNiemann Pick
Disease: acid sphingomyelinase
Which compounds accumulate in Tay Sachs, Gaucher, Fabry,
Niemann-Pick Disease, respectively?
Tay Sachs Disease: GM2 accumulateGaucher Disease :
glucocerebrosides accumulateFabry Disease: globosides (ceramide
trihexoside) accumulateNiemann-Pick Disease Type A and B:
sphingomyelin accumulates
What are key words for Tay Sachs, Gaucher, Fabry and
Niemann-Pick Disease, respectively? How are these patients
clinically described?
Tay Sachs: cherry-red macula and onion shell-like inclusions.
Patients have rapid, progressive fatal neurodegradation, blindness,
muscle weakness, seizures.
Gaucher: crumpled tissue paper appearance of cytoplasm. Patients
have hepatosplenomegaly and osteoporosis of long bones. Most common
LSD.
Fabry: reddish skin rash (bathing suit distribution). Patients
have kidney and heart failure, and burning pain in lower
extremities.
Niemann Pick: cherry-red macula and foamy appearing cells.
Patients have hepatosplenomegaly, and neurodegeneration in Type
A.
Describe the differences between Niemann-Pick Disease Type A and
Type B.
Niemann-Pick Disease Type A is the classic infantile form.
Patients have severe rapid neurodegeneration and severe mental
retardation. Life expectancy is to 2-3 years.
Niemann-Pick Disease Type B is the visceral chronic form.
Patients have almost no neurodegeneration and life expectancy is to
early adulthood.Angiotensin II:A potent vasoconstrictor, stimulates
release of aldosterone and sodium retention through
aldosterone.Bradykinin:A stimulator of sensory pain endings, a
potent vasodilator that increases capillary permeability. This
peptide is involved in inflammation, causing pain and
edema.Endothelin:A powerful vasoconstrictor and stimulator of the
heart. It also contracts smooth muscles in different organs. This
polypeptide of 21 amino acid residues is produced by endothelial
and some other cells.Glucagon:A polypeptide of 29 amino acid
residues secreted by pancreatic cells. Glucagon stimulates the
breakdown of liver glycogen, gluconeogenesis in the liver, and
fatty acid mobilization from the adipose tissue.Oxytocin:A
nonapeptide synthesized in the hypothalamus and released into the
circulation through the posterior pituitary. It is a powerful
stimulator of uterine contraction and contraction of smooth muscle
in the myoepithelial cells of the mammary gland.Somatostatin:A
hormone produced by pancreatic d cells, hypothalamus, and certain
intestinal cells. This peptide of 14 amino acid residues inhibits
the secretion of insulin and glucagon by the
pancreas.Vasopressin:(antidiuretic hormone, ADH) Causes smooth
muscle contraction and antidiuretic effect through the increase of
water reabsorption in renal tubules.Classic salt wasting (SW)
congenital adrenal hyperplasia (CAH) is generally diagnosed during
infancy and is due to a mutation in the gene coding for P450c21. It
generally presents with hypokalemia, hyponatremia, hypotension,
hypovolemic shock, and hyperandrogenemia. The latter causes
masculinization, which degree can be severe if it goes untreated.
Rarely, masculinization can be complete, and one can have patients
that are so fully masculinize that they were actually drafted
during WW II. At least in one case, the patient had a menstrual
cycle, which presented as episodes of transurethral
bleeding.Mutations of the genes coding for P450c17and 3-HSD are
associated with ambiguous genitalia in males. However, deficiency
of P450c17is accompanied by hypertension, hypernatremia, and
hypokalemia. Whereas, deficiency of 3-HSD is characterized by
hypotension, hyponatremia, and hyperkalemia.The two most important
enzymes in the peripheral conversion of androgens are P450aromand
5-reductase which converts testosterone into 17-estradiol and
5-dihydrotestosterone (DHT), respectively. Estradiol is
responsible, at least in part, for the establishment of normal male
sexual behavior. In children, DHT is required to induce the
development of secondary sexual characteristics = settings[]; thus
the presence of a normal 5-reductase is essential. However, after
puberty, target tissues become sensitive to testosterone, thus
allowing for the development of secondary sexual characteristics
even in the absence of DHT.In the ovaries, lutropin (LH) has theca
cells P450sccfor its major stimulatory target, and its purpose is
to stimulate the production of androgens. Similarly, follitropin
(FSH) has granulosa cells P450aromas its major stimulatory target,
and the result is the stimulation of estrogen synthesis.62. NIDDM
(type 2) has each of the following characteristics (symptoms)
EXCEPT forA. HyperglycemiaB. ObesityC. Near normal insulin in
serumD. KetosisE. Polyuria
Show answerCorrect Answer: D
Feedback A: Types 1 and 2
Feedback B: Type 2
Feedback C: Type 2
Feedback D: Type 1
Feedback E: Types 1 and 2Anatomy:Pudendal nerve: S2, S3, S4
HistologyPalatine tonsil: Deep - dense fibrous connective
tissue. Deep tonsillar crypts. Stratified squamous,
non-keratinizedPharyngeal tonsil: Tonsillar pleats - incomplete
capsule with respiratory epithelium (nasal) + stratified squamous
non-keratinized (oral).Lingual tonsil: Thin connective tissue
capsule., stratified squamous non-keratinized. See lingual
glands.
Extracellular matrix: Scurvy - Poor hydroxylation of
tropocollagen for stable triple helix collagen fibrilsEhler Danlos
Type IV - Defect in collagen type III (reticular fibers).Marfan
Syndrome - Defect in fibrillin-1
Cholera - modifies Gs protein. Unable to hydrolyze GTP,
resulting in excessive cAMP amounts --> sodium loss via
diarrhea. Spherocytosis - Defective spectrin is unable to bind to
Band 4.1 protein to yield biconcave results in anemia due to
destruction.
Pulmonary ciliary dyskinesia + situs inversus ==
KartagenerAlzheimer - phosphorylation of tau proteinsAstrocytes -
glial cells for vascular support, blood-brain barrier, neuronal
migration. Contain glial fibrillary acidic proteins. Proliferation
after damage forms scars (multiple sclerosis). 80% of brain tumors
are astrocytomas.Hofbauer cells - phagocytic cells in
villiSyncytiotrophoblast - human chorionic
gonadotropinHutchinson-Gilford Progeria Syndrome - Defect in
laminin A (nuclear scaffold protein), resulting in accelerated
aging.Werner Syndrome - Defect in WRN gene for RecQ helicase,
resulting in accelerated aging.Growth hormone - inhibited by
somatostatin.Prolactin - inhibited by dopamine.Inhibin secreted by
Sertoli and granulosa cells inhibit FSH production.Calcitonin from
parafollicular/clear/c-cells directly inhibit osteoclast
activityChief cells from the parathyroid secrete parathyroid
hormone, which activate osteocytes to secrete osteoclast
stimulating factor - increases serum calcium, decreases serum
phosphate. Chief - darker vs oxyphil
Nipple:Lipid secretion via apocrine secretion.Protein secretion
via merocrine secretion.Desmosomes - cadherins and desmoplakins
Q#27The metabolism of HDL is still very much in discussion but
so far it is agreed upon that HDL2 delivers cholesteryl esters to
the liver in the reverse cholesterol transport. With which receptor
will HDL2 most likely interact?
A is correct: SR-B1.
[HDL2 interacts with SR-B1 and hepatic lipase which may cleave
some phospholipids of HDL]correctSR-A [is incorrect, SR-A acts as
scavenger receptors]LDL receptor [is incorrect, HDL do not contain
apo B-100 ]LDL-receptor related protein (LRP) [is incorrect, LRP
recognize apo E in remnants]CM remnant receptor [is incorrect,
specific for chylomicron remnants]
Q#17Which of the following injury markers in the blood is the
most specific for liver damage due to ethanol abuse? Increased
levels ofE is correct: serum GGT increases after ethanol
abuseAlanine aminotransferase [ is incorrect, it a marker for
general acute hepatocyte damage]Aspartate aminotransferase [is
incorrect, it a marker for general hepatocyte damage] AST/ALT ratio
smaller than 2 [is incorrect, AST/ALT larger than 2 is correct] d
Albumin [is incorrect, the levels are not increased, they can be
decreased in cirrhosis] e -glutamyl transpeptidase [is correct]
Q#41A 15 year old girl has been admitted to the Burns unit. She
has had severe burns when there was an accidental fire in the
house. She has been on fluid and electrolytes on admission and her
blood pressure has been stabilized. On the third day in the
hospital, which of the following metabolic changes would you
expect?D is correct: the change would be an increased rate of
muscle proteolysis.
A decrease in circulating cortisol[is incorrect, cortisol level
would be increased]An increase in ketone body production[ is
incorrect, ketone body production is not increased in patients with
trauma]Inhibition of hormone sensitive lipase in adipose tissue[is
incorrect, hormone sensitive lipase in fat cells will be
activated]correctA decrease in the metabolic rate[is incorrect, the
metabolic rate will be increased](Recapitulate the hormonal and
metabolic changes in the ebb phase, flow phase and anabolic phase
following trauma)
Hormone sensitive lipase is found only in the adipocytes. As a
results, lipolysis occurs only in the adipocytes.Asians glow due to
acetaldehyde buildup. Acetaldehyde dehydrogenase deficiency/low
activity
Neurological examination of a 66-year-old woman reveals a loss
of touch sensations on the left side of the face. Brainstem lesions
responsible for these sensory losses may be located in:
A. left pons and right midbrain
B. right pons and left midbrain
C. left and right pons and left midbrain
D. left and right pons and right midbrain
E. left and right pons and left and right midbrain
Answer Key:D
Physiology FinalRenalMaximum transport rates for glucose,
PAH?Glucose:Threshold: 200 mg/dLTransport maximum: 375
mg/minPAH:Threshold: 0 mg/dLTransport maximum: 80 mg/minK sparing
diuretisc inhibit function of H+ ATPase in principal cellsJ
receptors
NeuroscienceDistal nerve axotomyEphapses - Leakage of signal
into peripheral/adjacent junctions and activating them.Cerebellar
lesion:AtaxiaPostureIntention tremorDysmetria - Overshooting when
pointing. Wrong distanceDysarthriaDysdiadokinesiaTranscortical
Sensory vs. Transcortical Motor aphasiaHaloperidol - Dopamine
blocker?Haldol? - Antipsychotic? High affinity to D2 receptors
--> Tardive dyskinesiaReticular formation - two
branchesPhenothiazines - Block D2 receptorsReserpine - Depletes
dopamine storesMPTP - damages substantia nigra compactsParkinson
tremor - 5HzCN VII - AICA
Chromosome 1 - Presenilin 2 for AlzheimerChromosome 14 -
Presenilin 1 for AlzheimerChromosome 19 - ApoE for sporadic
Alzheimer
Cerebellum and hippocampal long term potentiation/depressionNMDA
receptors vs. AMPA receptorsWhere do metabotropic glutamate
receptors fit in?
Uncal herniation:Right uncal herniation due to right
intracerebral hypertensive hemorrhage:Left extensor plantar
response?!Melatonin output supraoptic nucleus MelanopsinCerebellar
tractsCerebellar cognitice affective disorder (CCAS) - Posterior
cerebellum: Emotional blunting, depression, disinhibition,
psychotic features (Dysmetria of thought).
PhysiologyEndocrineGeneral (central/peripheral) thyroid
resistance:1. Increased T3 and T4.2. Inappropriately low thyroid
stimulating hormone3. Euthyroid (normal thyroid) or
hypothyroidism.
Thyroid hormone synthesis:1. Uptake of I-2. Oxidation: I- -->
I23. Iodination of tyrosyl residues on thyroglobulin molecule4.
Coupling of iodotyrosines to form
iodothyroninesRenalConstrict/dilate afferent = effect on GFR and
renal blood/plasma flow
Constrict/dilate efferent = effect on GFR and renal blood/plasma
flowIncreased efferent arteriolar resistance --> Decreased
peritubular capillary hydrostatic pressureDecreased efferent
arteriolar resistance --> Increased peritubular capillary
hydrostatic pressurePhosphate reabsorption - Motocan Question
Number 226 for Renal
BEHS 640Piaget's2. Preoperational (pre-logical) stage: 2 - 7
years.Ability to pretendEgocentric - can only see the world through
their eyesLack of compensation - Notices only one feature instead
of multiple features: height and width for area.3. Concrete
operational (logical) stage: 7 - 12 years.Logical thoughts; mental
manipulation of objects and processesYes compensation --> yes
conservation4. Formal operational (abstract) stage: 12 -
adultAbstract thinking/hypothesizingHigher
order:SynthesizeAnalyzeEvaluate
Kohlberg's Theory of Moral ReasoningLevel I: Pre-conventional -
Personal benefitStage 1. Punishment orientationStage 2. Reward
orientationLevel II: Conventional - Normal
thoughts/expectationsStage 3. Good boy/girl - Avoid
disapprovalStage 4. Authority orientation - Uphold social
rulesLevel III: Post-conventional - Personal principlesStage 5.
Social contract orientation - Own thoughts, acts within social
restraints with attempts to changeStage 6. Ethical principle
orientation - Principles are the greatest priority. Acceptable to
transgress.
Erikson's theory of psychosocial development65 years: Integrity
vs. despair - Wisdom
DevelopmentNewborn:Abnormal/absent primitive reflexes at
birth:RootingSuckingPalmar graspMoro reflex - disappears at 3
monthsBabinski - 1 to 1.5 years.Persistent fisting at 3 months -
neuromotor deficitsAbsent smile at 3 months - visual, attachment,
maternal depression, child abuse/neglectFailure to reach for
objects at 6 months - motor, visual, cognitiveAbsent babbling at 6
months - hearingStranger anxiety - 8 - 9 monthsSeparation anxiety -
6 - 9 months.Persistent mouthing at 12 months - cognitiveAdvanced
non-communicative speech at 1.5 years - developmental,
cognitiveRegression/lack of normal development
Childhood: 3 - 12 yearsEarly: 3 - 6 yearsInjury to
traumaCommunicable diseases
Middle: 6 - 12 yearsBy age 7 - 90% brain mass, handednessChronic
medical conditionsInjuryLearning/attention disorderAdolescence: 12
- 19 yearsBecoming independent
Mortality - U.S.