Biochem High Yield Flashcards
What change to Histones Inc transcription? Dec?
Methylation decreases transciption, Acetylation increases transcription
Megaloblastic anemia that does not correct with Folate or Vit B12 administration
Orotic Aciduria Note: Deficiency in UMP Synthase–> increased orotic acid in urine and megaloblastic anemia (No hyperammonemia–>Ornithine Transcarbamolase Deficiency)
Intellectual Disability, Self Mutilation, Gout, dystonia
Lesch-Nyhan Syndrome Note: HGPRT deficiency, X-linked recessive
Removal of RNA Primer
DNA Pol I w/ 5’->3’ exonuclease activity
DNA proofreading
3’->5’ exonuclease activity Note: DNA Pol III and I;
Transition vs Transversion
Transition: Purine to Purine
Transversion: Purine to Pyrimidine
Xeroderma Pigmentosa
Defective Endonuclease repair of pyrimidine dimers Note: Increased risk for SqCC, Basal CC, Melanoma
Base Excision Repair Order of Enzymes
Glycosylase (removes altered base)
Endonuclease (5’) then Lyase (3’)
DNA Pol then DNA Ligase Note: repairs spontaneous/toxic deamination of bases
RNA Polymerase products
I: rRNA, II: mRNA, III:tRNA Note: Amantinin (mushroom toxin) inhibits RNA Pol II (mRNA synthesis–>hepatotoxic)
Nuclear modifications to mRNA
5’ Cap, 3’ Polyadenylation, Splicing Note: inital transcript is hnRNA (heterogenous nuclear RNA)
Cellular Structure that stores & Quality Controls mRNA
P-Bodies Note: contain exonucleases, decapping enzymes, and microRNAs
Antibodies to snRNPs in spliceosomes
Anti-Smith Ab – Lupus
Binds the AA on tRNA
CCA at 3’ end Note: Added as a post-translational modification, ATP used to charge the tRNA
tRNA structure
75-90 nucleotides, including Dihydrouricil and Pseudouridine Note: Dihydrouracil in D arm necessary for binding the correct aminoacyl-tRNA synthase
Mischarged tRNA outcome
Wrong AA at the correct codon
Energy for translocated derived from
GTP
Ribosome protein production
RER-secreted; free ribosomes-cytosolic/organellar Note: Mucus-secreting Goblet cells, Plasma cells, and Chief cells (stomach-pepsinogen) are rich in RER
Trafficing signal for Lysosomes
Mannose-6-Phosphate Note: Deficient in I cell disease–lysosomal proteins excreted, coarse facial features, clouded corneas, high plasma lysosomal enzymes, restricted joint movement, can be fatal
What does the Peroxisome catabolize
Very-long chain FA, Branch-chain FA, AA
Dynein Retrograde, Kinesin Anterograde
Dynein used by HSV for latency
Bronchiectasis/Recurrent Pulmonary infections, infertility, and Situs Inversus
Kartagener’s Disease Note: dynein arm defect in cilia
Level of what AA best reflects Collagen synthasis
Glycine (1/3 of collagen is glycine) Note: Gly-X-Y
Vitamin C deficiency effects collagen production where
RER Note: decreases hydroxylation of proline and lysine
Osteogenesis imperfecta where?
RER Note: Problems w/ formation of triple helix in RER (3 alpha chains)
Problems with Cross-linking in Ehlers Danlos, where?
outside the fibroblasts
Copper Deficiency effect on Collagen
Menkes Disease Note: Copper is necessary cofactor for Lysyl oxidase–> Crosslinks collagen (extracellular)
Most common form of Osteogenesis Imperfecta
AutoDom, decreased production of otherwise normal collagen Note: Multiple fx w/ minimal trauma, blue Sclera (due to translucency of collagen over choroidal veins);
Hearing loss (abnormal ossicles), and dental imperfections
Ehlers Danlos
Faulty Collagen synethsis (6 types) Note: Can involve joint hypermobility, skin hyperextensability (Type 5 collagen)
Berry and Aortic Aneurysms (Type 3 collagen–blood vessels)
Blots
Southern: DNA; Northern: RNA; West: Protein Note: Southwestern: DNA-binding proteins
Pleotropy
One gene contributes to many phenotypic effects
Heteroplasmy
Presence of both normal and mutated mtDNA Note: Results in variable expression of mitochondrially-inherited disease between family members; Disease extent corrolates to the proportion of mutated DNA a person has
Pt has a recessive disease, only 1 parent is a carrier
Uniparental Disomy Note: Two copies of a chromosome from one parent and zero from the other; 25% of Prader Willi Syndrome–>
Difficulty releasing grib/doorknob, muscle wasting, frontal balding, cataracts, testicular atrophy
Myotonic Muscular Dystrophy Note: CTG trinucleotide repeats in DMPK gene; Distal Weakness in hands/feet; Type 1 fibers more affected
Macroorchidism, Large Jaw, large/everted ears, mitral valve prolapse, developmental delay
Fragile X Syndrome Note: X linked trinucleotide repeats affecting the METHYLATION of FMR1 gene (fragility only describes in vitro not in vivo);
Duchenne Muscular Dystrophy mutation
X-linked Frameshift mutation
Becker Muscular Dystrophy mutation
X-linked Point mutation
Rocker bottom feet, lowset ears, micrognathia
Edwards Note: Trisomy 18
Rocker bottom feet, cleft lip/palate, holoprosencephaly, polydactyly
Patau Note: Trisomy 13
Microcephaly, High pitched crying, epicanthal folds, severe intellectual disbility, VSD
Cri du chat Note: Chr 5 short arm deletion
Vitamin used to treat measles
Vitamin A Note: Deficiency causes night blindness and immune suppression
4 Enzymes that utilize Thiamine (B1)
Pyruvate Dehydrogenase, Transketolase, a-Ketoglutarate Dehydrogenase, Branched-chain Ketoacid Dehydrogenase Note: Deficiency in alcoholics Worsened if you give glucose w/o Thiamine (used for glucose metabolism)
Diagnosis of Deficiency: Increased Transketolase activity in RBC following Thiamine supplement
2 Things that cause Niacin deficiency (non-diet)
Hartnup disease (dec tryptophan/Neutral AA reabsorption), Carcinoid Syndrome Note: Pellegra-Dermatitis, Diarrhea, Dementia/Ataxia
3 Symptoms of Niacin Excess/Dyslipidemia use
Flushing (prostaglandin), Hyperglycemia, Hyperuricemia
Yellowing of the skin w/o scleral icterus
Vitamin A(Beta carotene) excess
Vitamin necessary for neurotransmitter synthesis
B6 Pyridoxal Phosphate Note: Serotonin, Dopamine, NE, Epinephrine, GABA; (DA to NE requires Vit C)
Rescue supplementation for Folate deficiency
Thymidine Note: Allows for continuation of DNA synthesis (bypasses thymidine synthase)–> stops RBC precursor apoptosis
Breastmilk is low in what 2 vitamins
D and K Note: Also low in iron
Vitamin that enhances the effects of warfarin
Vitamin E
Deficiency of what vitamin can be lethal in 1st week
Vitamin K Note: Neonatal Hemorrhage (high suspicion if birth not at a hospital– no Vitamin K shot)–same reason why Warfarin is not used in 3rd trimester despite what they said in class
Alcohol Dehydrogenase inhibitor? Acetaldehyde Dehydrogenase inhibitor
Alcohol: Fomepizole
Acetaldehydr: Disulfiram Note: Fomepizole used to prevent toxicity w/ ethylene glycol or methanol poisoning
Vitamin that has deficiency mimicking Friedrich Ataxia/B12 deficiency (posterior column and spinocerebellar demyelination)
Vitamin E Note: Also causes hemolytic anemia with ancanthocytosis
Disulfiram-like reactions
Metronidazole, Chlorpromazine (typical antipsychotic), 1st gen sulfonylureas, Griseofulvin, some cephalosporins
Glucose metabolism enzyme associated with maturity onset or gestational diabetes
Glucokinase Note: Glucokinase is key for glucose-sensing in the pancreatic Beta cell
Cofactors for Pyruvate dehydrogenase
Vit B1, B2, B3, B5, and Lipoic acid Note: Same Cofactors as alpha-Ketoglutarate Dehydrogenase
What cofactor of Pyruvate dehydrogenase does arsenic inhibit?
Lipoic Acid Note: Causes vomiting, rice-water stools, and garlic-breath
TX for Pyruvate Dehydrogenase deficiency
Lysine and Leucine or high fat diet Note: only purely ketogenic amino acids
Cyanide and Carbon Monoxide inhibit what ETC complex
Complex 4 (Cytochrome C Oxidase) Note: Decrease protein gradient and block ATP synthesis
High dose aspirin, Dinitrophenol, and thermogenin have what effect on the ETC
Uncoupling agents Note: Allow H+ to pass through and consumes O2 w/o ATP synthesis–> heat generation
What Respiratory burst enzyme gives sputum its color
Myeloperoxidase Note: blue-green heme containing pigment
Glucose -6-Phosphate Dehydrogenase Deficiency has what 2 manifestations in RBC
Heinz Bodies: Oxidized/precipitated Hemoglobin
Bite cells: removal of HBs by splenic macrophages
Asymptomatic accumulation of fructose in blood/urine
Essential Fructosuria (Defect in Fructokinase)
Hypoglycemia, jaundice, cirrhosis, and vomiting in an infant after consuming juice/fruit
Fructose Intolerance Note: Deficiency of Aldolase B (Auto rec), accumulation of Fructose-1-p causes decreased phosphate, which inhibits glycogenolysis and gluconeogenesis
Urine dipsticks detect what sugar
Glucose Note: Negative in fructosuria/fructose intolerance–> test for reducing sugars (included fructose)
Supplementation w/ which sugar allows bipassing of the rate limiting step of glycolysis
Fructose Note: Fructose-1-P is converted by Aldolase B to DHAP and Glyceraldehyde (triose kinase to G3P)
Infantiile Cataracts and failure to track objects with galactose in blood/urine
Galactokinase Deficiency Note: accumulation of Galactitol due action of Aldolase reductase on galactose
Intellectual disability, jaundice, failure to thrive, hepatomegaly, and cataracts in an infant
Classic Galactosemia Note: Defect in Galactose-1-P Uridyltransferase–>accumulation of galactitol and depletion of phosphate
Classic Galactosemia is associated with what infection in neonate
E. coli Sepsis Note: Deficiency of Galactose-1-P Uridyltransferase
Cataracts, Retinopathy, and Peripheral Neuropathy are due to accumulation of sorbitol, what enzyme is lacking in these tissues?
Sorbitol Dehydrogenase
(Sorbitol to Fructose) Note: Glucose is converted to osmotically active sorbitol via Aldolase Reductase
Stool/Breath in Lactose tolerance test if intolerant
Decreased stool pH and increased breath Hydrogen Note: Osmotic diarrhea, bloating, flatulance
What two AA are enriched in histones
Arginine and Lysine Note: Basic AA that bind the negatively charged DNA–> Histidine is also basic
Which AA donates an NH2 group to form urea
Aspartate
What AA is actually split to form urea
Arginine Note: via Arginase (produces urea and reforms ornithine)
Excess NH3 in hepatic encephalopathy depletes what TCA intermediate, inhibiting the TCA cycle
Alpha Ketoglutarate Note: converted to Glutamate; Lactulose is used to remove excess NH4 (diarrheal that acidifies the GI)
Deficiency of N-acetylglutamate inhibits what Urea Cycle enzyme
Carbamoyl Phostphate Synthase I Note: Leads to hyperammonemia and Increased Ornithine
Hyperammonemia with excess orotic acid
Ornithine Transcarbamylase Deficiency Note: X-linked recessive, often evident in first few days of life: Increased Orotic Acid, Decreased BUN, Hyperamonemia symptoms (Kernicterus, somnolence, vomiting, cerebral edema
Excess orotic acid with Megaloblastic Anemia
Orotic Aciduria Note: deficiency of UMP Synthase, Megaloblastic anemia NOT treated with folate or vit B12 supplement
Phenylalanie Hydroxylase and Tyrosine Hydroxylase require what cofactor
Tetrahydrobiopterin
Intellectual disability, mousy.musty body odor, seizures, and eczema corrected with Tetrahydrobiopterin supplementation
Malignant PKU Note: Deficiency in Dihydrobiopterin Reductase;
What hormone may be elevated in malignant PKU
Prolactin Note: Tetrahydrobiopterin is also cofactor for Tyrosine hydroxylase–> decreased activity causes decreased DOPA, which causes decreased Dopamine, which removes inhibiton of prolactin secretion
Glutamate produces what neurotransmiter
GABA Note: requires pyridoxal phosphate (B6)
Arginine produces what 3 things
Nitric Oxide, Urea, Creatinine
Enzyme that converts NE to Epinephrine
PNMT Note: Requires cortisol and SAM
Tryptophan generates what 3 productes
Niacin, serotonin, Melatonin
NE/Epi breakdown product? Dopamine?
NE/Epi: Vanillylmandelic Acid;
DA: Homovanillic acid Note: NE is first broken down to Normetanephrine, Epi to metanephrine by COMT
Effects of maternal PKU on infant w/o proper diet
Microcephaly, Mental and growth retardation, heart defects
Dark connective tissue, brown pigmented sclera, urine turns black w/ prolonged air exposure, Debilitating arthralgia
Alkaptonuria Note: Deficiency of Homogenisate oxidase–> accumulation of homogentisic acid and failure to breakdown tyrosine to Fumarate
Osteoporosis, Tall stature (marfanoid), kyphosis, lens subluxation (down and in), thrombosis/atherosclerosis w/ stroke and MI risk; Elevated Homocystine in urine
Homocystinuria Note: Due to Deficiency of either: MethionineCystathionine–>Cysteine
-Cystathionine Synthase –>supplement with inc cysteine, B6/pyridoxine, and dec methionine
-Homocysteine Methyltransferase (Methionine Synthase) Deficiency – inc methionine in diet
Renal Cystine stones (hexagonal)
Cystinuria Note: Hereditary defect in Renal Proximal tubule and intestinal reaborption of Cysteine, Ornithine, Lysine, and Arginine
Diagnosis of Cystinuria
Urinary Cyanide-Nitroprusside test turns purple
Severe retardation, disability, and sweet smelling urine
Maple Syrup Urine Disease Note: Deficiency in Alpha-Ketoacid Dehydrogenase (uses thiamine)–>blocks degradation of Branched amino acids (Valine, Leucine, Isoleucine); Isoleucine causes burnt sugar urine smell
What causes increased glycogen breakdown in muscle during exercise
Ca2+ directly activates Glycogen Phosphorylase Kinase
Glycogen storage disease causing cardiomyopathy
Pompe Disease (Type II) Note: Deficiency in Lysosomal a-1,4-glucosidase (acid maltase)
Glycogen storage disease causing painful muscle cramps, myoglobinuria, and arrhthmias
McArdle Disease (Type V) Note: Deficiency in Myophosphorylase (skeletal muscle glycogen phosphorylase)
Glycogen storage disease with hypoglycemia and accumulation of short outer Dextrin-like structures
Cori Disease (Type III) Note: Deficiency in Debranching enzyme (a-1,6-glucosidase)
Lysosomal Storage disease with Aseptic necrosis of the femur, pancytopenia, hepatosplenomegaly, and bone crisises
Gaucher’s Disease Note: Most common LSD, Gaucher cells (lipid-laden macrophages that look like crumpled paper)
Glucocerbrosidase deficiency–>accumulation of Glucocerebroside
What is present in Niemann Pick and absent in Tay Sachs
hepatosplenomegaly Note: both have neurodegeneration and cherry red spots on macula
Globoid cells
Krabbe Disease Note: Large macrophages filled with Galactocerebroside (Galactocerebrosidase deficiency)
LSD w/ ataxia, dementia, and cresyl violet stain +
Metachromatic Leukodystrophy Note: Arylsulfatase deficiency and accumulation of cerebroside sulfate
Hunters Syndrome vs Hurler’s Sydrome
Hunters is X linked, no corneal clouding, aggressive Note: both accumulate Heparan sulfate and dermatan sulfate, have gargoylism and developmental delay
Hypoketonic hypoglycemia (low glucose w/o inc ketones)
Carnitine Deficiency/Acyl-CoA Dehydrogenase deficiency Note: Carnitine is needed to transport Long Chain FA into the mitochondria
Urine test for ketones does not detect which one
B-Hydroxybutyrate
Protein and carboydrate generate how many kcal/g
4kcal/g Note: Fat generates 9kcal/g, alchohol 7kcal/g
How long until hepatic glycogen is gone
About 12-18 hrs, unless exercising (then less)
Glucose on starvation day 1-3 comes from
Liver Gluconeogenesis via peripheral lactate/alanine and adipose propionyl-CoA and glycerol
How long until brain can use ketone bodies
after day 3
Only apolipoprotein in LDL
ApoB-100 Note: binds LDL receptor
Hyperchylomicronemia (TG>2000 in kids) 1st presents as
Pancreatitis and abdominal pain Note: Deficiency in Lipoprotein lipase or ApoCII; No increased risk for Atherosclerosis
Pathognomonic lesion for Familial Hypercholesterolemia
Tendenous Xanthomas (Achilles) Note: AutoDom defect in LDL receptor; very accelerated atherosclerosis
Pyruvate Carboxylase is allosterically activated by:
Acetyl-CoA Note: converts pyruvate to oxaloacetate for gluconeogenesis
Insulin activates what intracellular enzyme
Protein Phosphatase 1 Note: Increases glycogen synthase and decreases glucose release
Elastin’s elasticity/recoil is due to
Interchain Crosslinks between lysine and Desmosine
DNA laddering by endonucleases in apoptosis yield what size DNA fragments
180bp fragments from internucleosome DNA
Neuron Swelling, displacement of nucleus to periphery, and dispersion of Nissl substance following Axon damage
Wallerian Degeneration
Fibrous Tissue formation in response to neoplasm
Desmoplasia Note: Ex Linitis Plastica in diffuse-type gastric adenocarcinoma
S-100 stain says what about cells
Neural Crest Note: Melanomas, schwannomas, Histocytosis
Hemoglobin has a sigmoid curve and therefore cannot have what type of kinetics
Michaelis Menton Note: To have Michaelis-Menton Kinetics, an enzyme must have a hyperbolic curve
Tetrahydrobiopterin is needed for what 3 enzymes in Neurotransmitter synthesis
Phenylalanine Hydroxylase, Tyrosine Hydroxylase, and Tryptophan Hydroxylase Note: Malignant PKU will decrease activity of all 3 due to deficient Dihydrobiopterin reductase
Gives rise to the smooth part (outflow tract) of the Left and right ventricles
Bulbis cordis
Why does HbF has a left shifted curve vs HbA
Less avid binding of 2,3 BPG
How is CFTR gated?
ATP
Homocysteinuria often responds to what supplementation
Vitamin B6/Pyridonine
Bilateral absence of the Vas Deferens
Cystic Fibrosis Note: Azoospermia
First breast milk given to an infant after birth
Colostrum Note: Contains IgA
Major regulator of iron absorption/excretion
Liver (hepatocytes) Note: Liver produces Hepcidin, which downregulates and inhibits ferroportin in intestinal epithelial cells
Alcohol effects what receptors
Downregulates GABA and upregulates NMDA Note: Predisposes to seizure w/ withdrawal due to decreased GABA (inhibitory) and increased NMDA (excitatory)
What senses low blood O2 to raise hematocrit in COPD/OSA
Kidney Note: Secretes EPO
Demyelination decreases the length constant for an axon
Signal strength decreases over a shorter distance
Hypoglycemia and low Ketone bodies, what enzyme deficient
Acyl-CoA Dehydrogenase Note: Deficiency of Beta oxidation, preventing ketone body formation w/ low glucose
Most important determinant of peak bone mass
Genetics
Marker of osteoblast activity
Bone ALP
Marker of osteoclast activity
Urine Deoxypyridinoline excretion Note: collagen cross linker
Hypothalamus produces what hormones
Supraoptic-ADH, Paraventricular-oxytocin
Hypothalamic nuclei causing hunger? Satiety?
Lateral-hunger, Ventromedial-Satiety Note: Leptin inhibits the lateral area and stimulates the ventromedial area
Melatonin/circadian rhythym is controlled by
Suprachiasmatic nucleus Note: Helps to overcome jet-lag
Deep thalamic nuclei (lateral to Medial)
Dentate, Emboliform/Globose, Fastigial
Oocyte Stages
In Ovary: Prophase Meiosis I
After Ovulation: Metaphase Meiosis 2 Note: Primary Ooocyte, 2N 4C
Secondary Oocyte 1N 2C
Endpoint of Conducting Zone lung structures
Cartilage and Goblet cells: end of Bronchi
Pseudostratified ciliated cells:beginning of terminal bronchioles
Airway Smooth Muscle: End of terminal bronchioles
Biotin
Carboxylase reactions Note: Pyruvate carboxylase and conversion of Propionyl-CoA to methylmalonyl-CoA
Receptors that cause Extrinsic Apoptosis
FAS and TNF
P and E selectin on endothelial cells bind to
Sialyl-Lewis X on leukocytes
Test for Chronic Granulomatous Disease
Nitroblue Tetrazolium test Note: Tests for NADPH activity
Two mechanisms by which CD8+ T cells kill cells
Perforin/Granzyme & expression of FasL Note: IL-2 from TH1 cells is secondary signal
What are the two anti-fibrinolysis substances
alpha2-Antiplasmin: Inhibits plasmin
Aminocaproic acid: prevents plasminogen activation
What differentiates disorders of fibrinolysis from DIC
Disorders of fibrinolysis have normal platelet counts and No increased D-dimers Note: Fibrinogen split products are elevated (not D-dimers b/c there are no clots so no cross-linked fibrin;
PT,PTT, and bleeding time elevated in both
Iatrogenic cause of Disorder of Fibrinolysis
Radical prostatectomy Note: Leads to release of urokinase (activates plasmin); TX w/ aminocaproic acid
What is secreted by endothelial cells that causes thrombin to activate protein C
Thrombomodulin Note: Endothelial cells also block subendothelial collagen, release Prostacyclin, Heparin-like molecules, and tPA
Inherited point mutation in Prothrombin that increases gene expression and thrombosis
Prothrombin 20210A (point mutation)
First step of heme synthesis is conversion of glycine & Succinyl-CoA to ALA by ALAS, what vitamin is key
Vitamin B6/pyridoxine Note: B6 deficiency (nutrition or Isoniazid) or lead poisoning cause acquired sideroblastic anemia
Gene mutations in Thalassemia
Alpha: Gene Deletion
Beta: Point mutation in promoter or Splice Sites
Screen that causes cells w/ any HbS to sickle
metabisulfite Note: Positive in both SCD and SCTrait
Left shift is marked by increased immature neutrophils w/ what receptor decreased
CD16 (Fc receptor)
Bordetella pertussis is associated w/ increase in what cell type in blood
Lymphocytes Note: Lymphocytosis promoting factor; Viruses also increase lymphocytes
Stain specific to Acute Lymphoblastic Leukemia
Tdt Note: DNA polymerase
HFR to F- conjugation goes from what to what
OriT to tra Note: Genes closer to OriT get transferred more
A disporportionate number of people are lost from one study group as compared to the other
Selection bias (attrition bias/Loss to follow up)
Most common cause of death age 1-44
Unintentional injury Note: 65 heart disease
To calculate carrier rate of an AR gene
Sqrt(prevalence/4) Note: 1/4 kid gets disease, square root gives carrier rate
Cardiac path associated w/ fragile X
Mitral valve prolapse Note: Also long face, large/everted ears and huge balls
ACL on MRI
Superolateral to inferomedial (SLIM)
Fractional Excretion of Water equation
Urine Flow Rate/GFR (x100%)
25% of Prader-Willi cases are caused by this, in which two maternally imprinted copies are present
Uniparental Disomy
Lens Subluxation in Genetic Disorder
MARFAN: Upward and Temporally
Homocysteinuria: Inferior and nasally
What diuretic can be used to prevent uric acid kidney stones
Acetazolamide Note: Alkalyzes the urine, urate crystals only at acidic pH
Diagnosis of Thiamine deficiency
Increased RBC transketolase activity after B1 admin
Reaction in TCA that uses Riboflavin (B2)
Succinate Dehydrogenase
Two treatments that bind to and excrete NH3
Benzoate and phenylbutryate Note: used in hyperammonemia and urea cycle deficiencies to allow NH3 excretion
Excess NH3 depletes what in the cell to stop the TCA
Alpha-Ketoglutarate
Increased ornithine and hyperammonemia w/ normal functioning urea cycle enzymes
hereditary N-acetylglutamate deficiency Note: TX w/ carbamoyl glutamate, necessary corfactor for Carbamoyl Phosphate Synthase 1
Increased homocysteine in urine w/o megaloblastic anemia
Homocystinuria Note: Intellectual disability, osteoporosis, lens subluxation, tall, kyphosis, thrombosis/atherosclerosis
Shuttles for FA synthesis and breakdown
Synthesis: Citrate; Breakdown: Carnitine
Unique lipoprotein to chylomicrons
ApoB-48
Paracrine release of Interferons alpha and Beta activate:
RNAaseL and Protein Kinase Note: Shut down both viral and host cell protein synthesis to prevent bacteria spread.w/ dsRNA present
Helper T cells express what cell surface proteins
TCR, CD4, CD3, CD40L, CD28 Note: CD40L activates B cells and is not on CD8 Tcells
Cell markers on NK cells
CD16, CD56 Note: CD16 bings Fc region of IgG
Endotoxin receptor on macrophages
CD14
Effect of inotropes on CO and Right atrial P
Increase CO and decrease RAP Note: CO curve shifted up, venous return curve does not move
Effect of increased blood volume/decreased venous compliance on CO and RAP
Increased CO and increased RAP Note: CO curve does not move, VR curve shifted to the right
Effect of Increased TPR on CO and RAP
Decreased CO and no change in RAP Note: CO curve shifted down (due to inc afterload), VR curve Rotated counterclockwise (due to inc TPR)
Fasting is required for measure of what lipoprotein
LDL Note: LDL=CH-HDL-VLDL; VLDL is calculated as TG/5, so if not, fasting, TG will be high making LDL artificially low; If TG>400, LDL measured directly
Receptor types for Parietal Cell (stomach) mediators
Ach & Gastrin– Gq
Histamine–Gs
Prostaglandins and Somatostatin – Gi Note: Ca/IP3 and cAMP increase the H+/K+ ATPase on the luminal membrane
What transmitter that increases gastric acid release does not have a clinically useful inhibitor
Gastrin Note: Ach by Atropine; Histamine by Ranitidine/Cimetidine/Famotidine
Nuclei in the Striatem? Lentiform Nuclei?
Striatem- Putamen and Caudate
Lentiform- Putamen and Globus pallidus
Largest contributor of functional dead space in the lung
Apex
Lung volume for minimum pulmonary vascular resistance
Functional Residual Capacity
AV node location
In interatrial septum near the right AV orifice
Most bactial efflux pumps used for Abx resistance use what as the energy source to pump out the drug
H+ out of the cell (secondary active transport) Note: Adding H+ prevents bacterial efflux of drugs
Stain for cartilage
Safranin O
Axillary sweating is mediated by what
Cholinergic Postganglionic sympathetic fibers from the thoracic sympathetic trunk
What hormone increases in a Nephrogenic DI pt that was water deprived
Vasopressin Note: Vasopressin is high but the kidney cannot respond
Histology of endometrium in secretory/Luteal phase
NAME?
LH induces testosterone production where in female
Theca Interna Note: NOT in Theca Externa (structural support only)
Hypothalamus hormone that Stimulates Prolactin release
TRH Note: Primary/Secondary hypothyroidism can cause galactorrhea
Two mechanisms of cellular Atrophy
Polyubiquitination and Autophagy
Clotting factor involved in Coagulation, Fibrinolysis, Kinin/Kallikrein, and Complement
Hageman Factor (Factor XII)
First Step of Primary Hemostasis
Transiet Vasoconstriction of damaged vessel
If platelet count not given, does petechiae indicate quantitative or qualitative platelet disorder
Quantitative
Immune thrombocyopenic pupura is mediated by what cells
Plasma cells in the spleen Note: Increased mature megakaryocytes on BM biopsy
Failure of PTT to rise w/ heparin tx
Antithrombin III deficiency Note: Genetic or Nephrotic Syndrome
Alpha Thalassemia tetramers
3 deletions: HbH (Beta tetramer); 4- HbBarts (gamma tetramer)
Types of error that reduce precision? Accuracy?
Precison-Random error; Accuracy-Systematic error
What aspect of the DNA code allows for the 3’ wobble
Degeneracy
Isoniazid can cause deficiency of what two vitamins
B6/Pyridoxine and B3/Niacin Note: B6 is necessary for Niacin synthesis
What GI ligament is pinched to control bleeding of the portal vein
Hepatoduodenal Note: Contains the portal triad–Portal vein, hepatic artery, common bile duct
Which gastric arteries have poor anastomoses if blocked
Short Gastric Note: supply the fundus of stomach off splenic artery
The femoral sheath does not contain what structure
femoral nerve
Cremaster muscle is derived from what structure
Internal oblique
What two structures form the kidney
Metanephric Mesenchyme
Ureteric Bud (from mesonephric duct) Note: –>Glomerulus to distal tubule
–>Collecting duct to Ureter
Most common location of obstruction causing hydronephrosis
Uretopelvic junction Note: Last to canalize
Modified smooth muscle cells in the afferent arteriole
Juxtaglomerular apparatus Note: Release renin in response to B1 stimulus, low renal perfusion, and low NaCl to macula densa
What receptor subtype is effected in Parkinsons
D2 Note: GiPCR
What does DA in the Tuberoinfundibular tract lead to
Decreased prolactin
What does DA in the CTZ lead to
Emesis
What effect of Parkinson’s does anticholinergic TX not fix
Bradykinesia
How do Nitrates cause vasodilation
Form Nitrous Oxide which activates guanalyl cylase, which increases cGMP Note: Increased cGMP causes dephosphorylation of myosin light chain kinase
What does Thrombin time test
Fibrinogen deficiency/abnormality or Factor 13
Effects of estrogen on lipids
Increase: TG and HDL; Decrease: LDL
Acidic AA, Basic AA
Acidic: Aspartate and Glutamate
Basic: Arginine, Lysine, and Histidine Note: Arginine and Lysine are enriched in histones (bind negatively charged DNA)
One of the two NH3 in urea comes from what AA
Aspartate
Three nutrition deficiencies that result in poor wound healing
Vit C, Copper, Zinc Note: Vit C- Proline/Lysine Hydroxylase; Copper- Lysyl Oxidase; Zinc- Collagenase (type 3 to 1)
When can enzyme studies be done to confirm G6PD deficiency
Weeks after a hemolytic episode Note: Otherwise only cells w/ the enzyme will be left (need cells beyond G6PD’s half life)
Eyelid muscle innervation
Superior Tarsal–sympathetic (lost in Horner’s)
Levator Palpebrae–parasympathetic
Almost all skin below the umbilicus drains to the Superficial inguinal lymph nodes, what areas drain to the Popliteal nodes?
Posterior calf and Dorsolateral foot
Hormone that influences LDL receptor expression
Thyroid Hormone Note: Hypothyroidism–>Hypercholesterolemia due to decreased LDL receptors
Hyperthyroidism–>Hypocholesterolemia due to increased LDL receptors
Connection between the second Branchial pouch and second branchial cleft
Congenital Pharyngo-cutaneous fistula Note: fistula between the tonsillar area and lateral neck
1st arch neural crest fails to migrate
Treacher-Collins syndrome Note: mandibular hypoplasia and facial abnormalities
