ABSITE KILLER PLUS Flashcards
Type I error
Reject null hypothesis incorrectly (aka it is false but you said it was true)
Type II Error
Accept null hypothesis error – aka false negative!
Type III error
Conclusions not supported by data
Prospective cohort study
Non random assignment to tx group
ANOVA is a t-test for ..
> 2 samples of QUANTITATIVE data (continuous variables)
Non parametric stats are used for what kind of data analysis?
Qualitative data analysis
Source of fever in atelectasis
Alveolar macrophages
Where is the TCA cycle located?
Inner matrix membrane of mitochondria
Nucleus has outer membrane that is continuous with..
Rough ER
Where are ribosomes made?
Nucleolus (remember – no membrane!)
Rough ER makes protein for..
Export!
Smooth ER is for..
Cytoplasmic proteins
Typical protein/lipid content of plasma membrane
60% protein
40% lipids
Increasing cholesterol content of plasma membrane does what for proteins?
Increases mobility of proteins
First sign of malignant hyperthermia
Increased end tidal CO2
Lymphatics lack what?
Basement membrane
Rate limiting step in cholesterol formation
HMG CoA Reductase
Steroid hormones go to nucleus AFTER binding where?
In the cytoplasm of the target cell
Krebs cycle generates how much ATP from 1 glucose
38
Anaerobic glycolysis generates how much ATP
2 ATP and lactate
What produces renin and why?
Macula densa senses low NaCl and produces renin
What does renin do
Converts angiotensinogen to angiotensin I
MOA of angiotensin II
ATII is a vasoconstrictor and increases aldosterone which keeps Na, loses K/H in urine
Describe how renal osteodystrophy leads to secondary hyper PTH
Kidney loses Ca, keeps PO4
Decreased vit D-1 hydroxylation
L vagus nerve gives off what branch?
Hepatic branch
LARP (anterior!)
R vagus nerve gives off what two branches
Celiac branch and criminal nerve of Grassi which if undivided can keep elevated acid levels post vagotomy
Parietal cells produce …
H+ and intrinsic factor which binds B12 and absorbed in TI
3 main stimuli for H+ production
ACh, gastrin, and histamine
How do we increase HCl production?
ACH and gastrin activate PIP, DAG to inc Ca, activate protein kinase C which incr Hal production
How does histamine increase HCl production
Acts on parietal cells via cAMP to incr HCl production
Think Happy cAMPer
Gastrin produced by what
Astral G cells
Gastrin inhibited by
H+ in duodenum
Gastrin stimulated by
amino acids, ACH
MOA of omeprazole
Blocks H/K ATPase of parietal cell
Somatostatin inhibits…
Gastrin, insulin, secretin, ACh
Decreases pancreatic and biliary output
Somatostatin stimulated by
Acid in duodenum
Proximal vagotomy abolishes ??
RECEPTIVE relaxation which increases liquid emptying. No change in solids.
Most common sx post-vagotomy
Diarrhea
Dumping syndrome occurs post-vagotomy in how many?
10%
Early dumping syndrome is due to
Hyper osmotic load, fluid shift
Late dumping syndrome is due to ..
Increased insulin with decreased glucose
How often does dumping syndrome fail to respond to dietary measures
1%
Enterokinase activates ..
Trypsinogen, which becomes trypsin – > activates other enzymes of digestion
CCK from intestinal mucosa acts to… (3 things)
Contract GB
Relax sphincter of odds
Incr pancreatic enzyme secretion
Primary stimulus of pancreatic bicarb secretion
Secretin
After small bowel resection, what hormone is increased
Enteroglucagon (small bowel mucosal hypertrophy)
Peptid YY is released from TI when?
With a mixed meal. It inhibits acid secretion
Bile is composed of ..
80% bile salts, 15% lecithin, 5% cholesterol
How does gallbladder concentrate bile
Active resorption of NaCl, H2O then follows.
Bile pool is approx how many grams?
5g. Gets recirculated q4h, we lose about 0.5g daily (aka 10%)
Stones form in which 3 situations
Increased cholesterol
Decreased bile salts
Decreased lecithin
2 Primary bile acids
Chalice acid
Chenodeoxycholic acid
2 Secondary bile acids
Formed by intestinal bacteria
Deoxycholic acid
Lithocholic acid
MMC
Interdigestive motility.
90 minute cycles
Starts in stomach, goes to TI
Phase I (gastric)
Quiescence
Phase II
Gallbladder contraction
Phase III
Peristalsis
Phase IV
subsiding electric activity
Key stimulatory hormone of digestion
Motilin
What part of small bowel absorbs most Na and H2O?
Jejunum. Much more permeable than ileum
Intrinsic pathway assoc with PTT or PT?
PTT
Which tissue factor common to both intrinsic and extrinsic
X
Which tissue factor crosslinks fibrin to form plug?
XIII
What is single best test to evaluate synthetic function of liver
PT
Banked blood is low in what?
2,3 DPG which increases Hgb affinity for O2 (left shift)
Cryo contains what ?
Fibrinogen
VWF-VIII
Protein C degrades which factors
Active V and VIII
Only factor not made in liver
Factor VIII (made by reticuloendothelial system!)
Von Willebrand’s effect on PTT, bleeding time etc
Long PTT
Long bleeding time
+ristocetin test
Type I and III VW disease have what problem with VWF
Low AMOUNTS. They’ll respond to DDAVP
Type II VW disease has what problem with VWF
Poor quality vWF
Only inherited coagulopathy with long bleeding time?
von willebrands
Inheritance of von willebrands
Autosomal dominant
ddAVP is useful in…
von willebrands, pts on ASA or w/uremic plt
Glanzmann thrombasthenia deficinecy in ..
IIb/IIIa receptor deficiency, causing decreased platelet aggregation
Bernard Soulier deficiency in..
Ib deficiency causing decreased adherence to exposed collagen
VII deficiency causes what PT/PTT effects?
Long PT, normal PTT
Hemophilia A causes what PT/PTT effects?
Normal PT, long PTT
Hemophilia B is a deficiency in?
IX
Levels of factor VIII should be replaced to what amount pre op in hemophilia A
100%
Levels of factor IX should be replaced to what amount pre op in hemophilia B
50%
Tx of hemophiliac joint
Do not aspirate! Give ice, ROM therapy, give factor VIII
