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biochemistry Flashcards

1
Q

what is the energy storage form of lipids

A

triglycerides

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2
Q

where are triglycerides stored

A

as fat droplets in adipose tissue

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3
Q

what happens to triglycerides when blood glucose is low

A

triglycerides are hydrolysed

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4
Q

what happens to triglycerides when fat is in excess

A

metabolised in the mitochondria to produce acetyl-CoA in TCA cycle

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5
Q

are triglycerides high or low energy per yield

A

high

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6
Q

what does cis mean

A

hydrogens are on the same side

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7
Q

what does trans mean

A

hydrogen are on opposite sides

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8
Q

what is budding

A

they recruit coat proteins and then can shed their coat leaving their receptor/ligand behind

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9
Q

what is targeting and trafficking meditated by

A

Rab proteins of GTPase

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10
Q

what is exocytosis

A

move out

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11
Q

what is endocytosis

A

move in

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12
Q

what is pinocytosis an example of

A

endocytosis

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13
Q

what is phagocytosis an example of

A

endocytosis

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14
Q

examples of energy

A

ATP

NADPH

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15
Q

what produces most energy in human diet

A
  • lipids

- polysaccharides

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16
Q

where does glycolysis occur

A

in cytosol

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17
Q

what does glycolysis produce

A

pyruvate

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18
Q

what is the product of anaerobic conditions

A

lactic acid

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19
Q

what happens to lactate

A

metabolised by the lier back into glucose by gluconeogensis

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20
Q

what is the regeneration of lactate called

A

cori cycle

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21
Q

what cycle does pyruvate enter under aerobic condition

A

TCA cycle

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22
Q

in TCA cycle what happens to pyruvate

A
  • decarboxylated to acetyl-CoA
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23
Q

what happens to acetyl-CoA in TCA cycle

A

joins with oxaloacetate to form citrate

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24
Q

how many reactions is TCA cycle

A

8

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25
Q

what is oxidative phosphorylation

A

movement of NADh and FADH2 through membranes to oxygen to produce water

energy released is used to efflux H+ set tun up a electrochemical gradient

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26
Q

what happens to the H+ electrochemical gradient

A

used for ATP synthesis through F0F1ATPase

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27
Q

what can failure to remove dysfunctional or misfiled proteins result in

A
  • alzhemiers

- dementia

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28
Q

what is a free radical

A

any atom or molecule that contains one or more unpaired electrons

making it more reactive

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29
Q

what are the major free radical species in the human body

A
  • hydroxy radical (OH)
  • superoxide radical (02-)
  • nitric oxide (NO)
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30
Q

what makes up total body water

A
  • intracellular fluid
  • extracellular
  • plasma
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31
Q

what is osmotic pressure

A

ability to hold water in the compartment

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32
Q

what does the intracellular fluid contain mainly

A

potassium

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33
Q

what does the extracellular compartment contain

A
  • sodium salt

- proteins

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34
Q

what is the capillary wall impermeable to

A

plasma proteins

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35
Q

what is the cell membrane impermeable to

A

sodium and potassium

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36
Q

what is the extracellular volume determine by

A

sodium concentration

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37
Q

what does a decreased extracellular volume do to cardiac output

A

decrease it

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38
Q

what filters most sodium

A

proximal tubule

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39
Q

what is responsible for day to day variation in sodium

A

aldosterone and ANP

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40
Q

what conditions cause sodium and water retention

A
  • cardiac failure
  • hepatic cirrhosis
  • hypoalbuminaemia
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41
Q

what does a high dose of mineralocoroitcoid initially increase

A

renal sodium retention so that extracellular volume is increased

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42
Q

what does spironolactone do

A

block mineralocorticoid

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43
Q

what does the release of cardiac ANP require

A

optimum sodium concentration at the site of its action

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44
Q

what are changes in plasma sodium and osmolarity sensed by

A

osmoreceptors

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45
Q

what do osmoreceptors influence

A

thirst and release of ADH (vasopressin)

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46
Q

what does ADH play a role in

A

urinary concentration by increasing the water permeability

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47
Q

what does the absence of ADH do to water

A

means little water is reabsorbed in the collecting ducts

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48
Q

what are principal cells

A

have sodium and potassium channel in the apical membrane

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49
Q

what are intercalated cells

A

they do not transport sodium but have a role in hydrogen and bicarbonate handling

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50
Q

what is the name of water channels

A

aquaporins

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51
Q

what direction does water move in aquaporins

A

down an osmotic gradient

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52
Q

what happens to water channels when ADH has worn off

A

water channels are removed from the luminal membrane by endocytosis

53
Q

what does ingestion of water cause

A

decreased release of ADH

54
Q

what does a decrease in water reabsorption allow the water to go

A

excreted in dilute urine

55
Q

what does water loss via sweat cause a rise in

A

both plasma osmolarity and ADH secretion

56
Q

what disease can cause patients to become very thirsty

A

central diabetes insipidus

57
Q

what are patients with central diabetes insipidus have a decrease in

A

ADH

58
Q

when is a water load rapidly excreted

A

by inhibition of ADH release

59
Q

what is another occasion where ADH is released

A

stress e.g. surgery or trauma

60
Q

what does increased extracellular volume a result of

A

whole body salt retention

61
Q

what is peripheral oedema caused by

A

expansion of the extracellular volume by at least 2L

62
Q

where is peripheral oedema normal seen first

A

the ankles

63
Q

what is lipodermatosclerosis

A

the skin is tethered and cannot expand to accommodate the oedema

64
Q

when can oedema be noted in the face

A

in the morning

65
Q

where does oedema accumulate in a patient in bed

A

in the sacral area

66
Q

what other diseases does expansion of interstitial volume cause

A
  • pulmonary oedema
  • pleural effusion
  • pericardial effusion
  • ascites
67
Q

what does expansion of the blood volume do

A
  • raise JVP
  • cardiomegaly
  • added heart sounds
  • basal crackles
  • raised blood pressure
68
Q

what is extracellular volume expansion due to

A

sodium chloride retention

69
Q

what does reduction in cardiac output and a fail in effective circulatory volume to do RAAS

A

activates it

70
Q

why is there peripheral vasodilatation in hepatic cirrhosis

A

due to increased NO generation

71
Q

what is interstitial oedema a common clinical finding with

A

hypoalbuminaemia

72
Q

what do oestrogen cause for sodium

A

mild sodium retention due to weak aldosterone like effect

reason for weight gain in premenstrual phase

73
Q

what do mineralocorticoids and liquorice have

A

aldosterone like actions

74
Q

what do NSAIDs cause

A

sodium retention in the presence of activation of RAAS

75
Q

why may oedema result

A

from increased capillary pressure owing to relaxation of pre-capillary arterioles

76
Q

what drug has a side effect of peripheral oedema

A

dihydropiridine calcium channel blocker

77
Q

what drug can cure oedema

A

diuretics

but returns when they are stopped

78
Q

where does loop diuretics act

A

in ascending limb of loop of Henle

79
Q

examples of loop diuretics

A
  • furosemide

- bumetanide

80
Q

where does thiazide diuretic act

A

early distal convoluted tubule

81
Q

examples of thiazide diuretic

A
  • bendroflumethiazide

- metolazone

82
Q

what do loop diuretics stimulate excretion of

A

both sodium chloride and water by blocking the sodium-potassium-2-chloride (NKCC2)

83
Q

side effects of loop diuretics

A
  • urate retention
  • hypokalaemia
  • decreased glucose tolerance
84
Q

are thiazide diuretics more or less potent than loop diuretics

A

less potent

85
Q

how do thiazide diuretics act

A

by blocking a sodium chloride channel in the distal convoluted tubule

86
Q

example of aldosterone antagonist

A

spironolactone

87
Q

when is spironolactone used

A

in patients with heart failure

88
Q

do you need to administer lots of loop diuretic to work

A

yes

89
Q

what causes decreased extracellular volume

A

loss of salt and water in a variety of ways

90
Q

examples of how a patient may lose salt and water

A
  • blood loss in haemorrhage
  • vomiting
  • diarrhoea
  • fluid shift in sepsis
91
Q

what can decrease extracellular fluid lead to

A

postural hypotension

92
Q

symptoms of decreased extracellular water

A
  • thirst
  • muscle cramps
  • nausea
  • vomiting
  • postural dizziness
  • confusion
  • coma
93
Q

what does loss of interstitial fluid lead to

A

loss of skin elasticity

94
Q

what does loss of circulating volume lead to

A

decreased pressure in the venous and arterial compartments

95
Q

where is the fluid volume of the body controlled

A

kidneys

96
Q

what does water follow

A

salt by osmosis

97
Q

what is salt retention controlled by

A

RAAS

98
Q

what happens if too much salt and water is retained

A

oedema

99
Q

what is the best way to monitor volume status

A

measure their weight over a period of days

100
Q

what is the osmolarity of the blood controlled by

A

kidneys

101
Q

what does ADH react to

A

retain free water which dilutes the blood

102
Q

what is the bodys sodium concentration determined by

A

the amount of free water

103
Q

what is a decrease in conc of H+ termed

rise in blood pH

A

alkalaemia

104
Q

what is an increase in the conc of H+ termed

decrease in pH

A

acidaemia

105
Q

where is excess sulphate excreted

A

in the urine

106
Q

what 3 cell types does the collecting duct have

A
  • principal cell
  • alpha-intercalated cell
  • beta-intercalate cell
107
Q

what do principle cells do under the influence of aldosterone

A

reabsorb Na+ and water and secrete K+

108
Q

what is the primary source of ammonia

A

glutamine

109
Q

what is deamination of ammonia catalysed by

A

glutaminase

110
Q

what does deamination result in

A

alpha-ketogluutaric acid and ammonia

111
Q

what is abnormal CO2 removal in the lungs termed

A

respiratory acidosis and alkalosis

112
Q

what is the abnormality in the regulation of bicarbonate termed

A

metabolic acidosis and alkalosis

113
Q

what does metabolic acidosis cause

A

hyperventilation leading to increased removal of CO2 in the lungs and partial compensation for the acidosis

114
Q

what is respiratory acidosis accompanied by

A

renal bicarbonate retention

115
Q

what are the ABG results in respiratory acidosis

A 
pH = decreased 
PaCO2 = increased 
HCO3 = increased for compensated

opposite direction to pH

116
Q

ABG results for respiratory alkalosis

A 
pH = increased
PaCO2 = decreased 
HCO3 = decreased

opposite direction to pH

117
Q

ABG results for metabolic acidosis

A 
pH = decreased 
PaCO2 = decreased 
HCO3 = decreased

same direction to pH

118
Q

ABG results for metabolic alkalosis

A 
pH = increased 
PaCO2 = increased 
HCO3 = increased

same direction to pH

119
Q

what is respiratory acidosis caused by

A

retention of CO2

120
Q

example of respiratory acidosis

A

COPD

121
Q

what is respiratory alkalosis

A

increased removal of CO2

122
Q

what causes respiratory alkalosis

A

hyperventilation

123
Q

what is metabolic acidosis due to

A

accumulation of any acid other than carbonic acid

124
Q

what disorders can lead to metabolic acidosis

A
  • lactic acidosis during shock

- impaired acid excretion

125
Q

what is chronic acidosis a risk factor for

A

muscle wasting in renal failure

126
Q

where is ammonia and H+ excreted

A

in the urine

127
Q

what can tubular disease cause

A

bicarbonate wasting

128
Q

when does ketoacidosis occur

A

in starvation and after alcohol overdose

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