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OMS 1 > Exam Block 3 > Flashcards

Exam Block 3 Flashcards

1
Q

Essential dietary requirements

A

Amino acids, fats, vitamins, minerals

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2
Q

Excess fuel stored as

A

Carbohydrate (glycogen) and fat (triglycerides)
Process of anabolism
Animals don’t store protein for use in fasted state

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3
Q

Waste

A

Compounds generated by metabolism, foreign compounds taken in as food and drink that aren’t useful as fuel
Body has a echo sim to dispose of them

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4
Q

ATP

A

Chemical unit of energy used by cells for fuel
Dietary and stored fuel is oxidized to produce energy in the form of heat and ATP

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5
Q

2 mechanism to produce ATP

A

Substrate level phosphorylation
Oxidative phosphorylation

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6
Q

3 fuels oxidized to produce ATP

A

Carbohydrates fats and proteins
Process of catabolism

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7
Q

Branched metabolic pathways common

A

Different fuels from many sources enter similar metabolic pathways
Fates of metabolites are determined by an organisms energy status

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8
Q

Common substrate produced

A

Acetyl coA
Can be metabolized (completely when oxidized to CO2 and H2O
can be stored as fatty acids and triglycerides

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9
Q

Common substrates may produce different storage fuels such as

A

Glucose converted to glycogen and fat
Other metabolites can only become fat

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10
Q

Major dietary carbs

A

Starch (polysaccharide)
Simple sugars : glucose and fructose
Disaccharides lactose and sucrose

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11
Q

Dietary proteins

A

Polymeric chain of amino acids linked by peptide bonds
Digestion breaks them into amino acids and dipeptides for absorption

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12
Q

Dietary lipids (fat)

A

Triglyceride fats oils

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13
Q

Dietary alcohol

A

Ethanol

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14
Q

Energy content of food

A

1 kcal = 4.128 kj
Carbs and proteins 4 kcal/g
Fat 9 kcal/g
Alcohol 7kcal/g

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15
Q

Body stores fuel how

A

Fat - triglycerides stored in droplets in adipose tissue(85% of stored fuel, very efficient)
Carbohydrate - glycogen stored in cytosolic granules in liver and muscle cells (limited)
Protein - function as structural component of enzymes, can be used as fuel but may result in loss of function

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16
Q

ATP transfers phosphate to what in muscle

A

Creatine
Creatine phosphate generated by Creatine kinase from atp and Creatine to store atp equivalent

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17
Q

Daily energy expenditure

A

Basal metabolic rate (BMR) + physical activity + set induced thermogenesis + wound repair and growth

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18
Q

Measurements of body composition

A

Body fat %
BMI 704x(weight/height^2)

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19
Q

Effective weight loss

A

Calorie intake less than calorie expenditure
Change eating habits increase fiber and grains decrease fat
Increase exercise specifically low impact aerobic

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20
Q

Essential fatty acids

A

Linolenic acid - seeds, green leafy vegetables
Linoleic acid - vegetable oils
Eicosapentanoic acid (EPA) - cold water fatty fish, milk, yogurt
Docosahexaenoic acid (DHA) - cold water fatty fish, full fat milk, yogurt

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21
Q

Essential amino acids

A

PVT TIM HALL
phenylalanine, valine, threonine tryptophan, isoleucine, methionine, histidine, arginine lysine, leucine
Nitrogen balance - amino acids required for protein synthesis, excess proteins ingested not stored they’re removed as waste and carbon skeleton stored as fat or glycogen

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22
Q

Nitrogen balance

A

Positive - growing child, pregnant woman, body builders
Balanced - adult
Negative - illness, injury, stress
Kwashiorkor : protein deficit but not calorie deficit
Marasmus : protein and calorie deficit
Anorexia nervosa : eating disorder

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23
Q

Long term starvation leads to what illness

A

Kwashimiorkor and marasmus

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24
Q

Anabolic pathways

A

Synthesize molecules for fuel (glycogen, triglyceride, glucose)
Synthesize molecules for function (dna/rna, proteins, amino acids acids, membranes and extra cellular matrix)

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25
Q

Catabolic pathways

A

Breakdown of fuel molecules (digestion, glycolysis, amino acid metabolism)
Breakdown of functional molecules (nitrogen disposal, detoxification, endocytosis, apoptosis)

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26
Q

Physiological status controls metabolism how

A

Fed - body can use excess dietary intake to add to metabolic food stores
Fasted - body utilizes stored fuels during time of need, during starvation other fuels are produced or spare glucose is used

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27
Q

Glucose homeostatic levels

A

80-100 mg/dl

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28
Q

Hormone signals

A

Insulin = fed
Glucagon = fasting
Cortisol = fasting, trauma, infection, chronic stress
Epinephrine= fight or flight

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29
Q

Biomolecules regulating metabolism

A

Pancreatic hormones = insulin and glucagon
Glucocorticoids = cortisol
Catecholamines = epinephrine and norepinephrine

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30
Q

ATP aerobic vs anaerobic

A

Oxidative phosphorylation requires oxygen
Substrate level phosphorylation doesn’t require oxygen

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31
Q

Carb digestion

A

Hydrolyzed to 2 monoacylglycerols and free fatty acids in small intestine
Absorbed and resynthesized into standard triacylglycerols for secretion

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32
Q

Liver in fed state

A

Glucagon freely enters and leaves, excess glucose stored as glycogen and converted to fat, amino acids absorbed from proteins or converted to glucose and fat

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33
Q

Brain

A

Always use glucose and metabolize it completely to CO2 and water

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34
Q

Red blood cells

A

Use glucose only, metabolize it only to lactose or pyruvate

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35
Q

Insulin dependent absorption of glucose happens where

A

Muscle
Adipose tissue

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36
Q

No insulin effect on glucose transport happens where

A

Brain, red blood cells, liver

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37
Q

Muscle in fed state

A

Glucose absorbed when insulin permits its entry
Active aerobic = glucose to CO2
Active anaerobic = glucose to lactate
Inactive = glucose to glycogen

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38
Q

Adipose in fed state

A

Dietary fat delivered to chylomicra, fatty acids and glucose absorbed, insulin stimulates glucose uptake and triglyceride assembly

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39
Q

Adipose in fasted state

A

Hydrolyze triglycerides for fuel to free fatty acids and glycerol

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40
Q

Liver in early fasted state

A

Generate glucose by breaking down glycogen
Produces ketone bodies

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41
Q

Muscle in fasted state

A

Uses fatty acids and ketone bodies as fuel

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42
Q

As starvation progresses what happens

A

Body becomes more dependent on fat as fuel,produce more ketone bodies, brain uses ketones for fuel

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43
Q

Liver in starvation

A

Some gluconeogenesis

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44
Q

Adipose in starvation

A

Hydrolyze triacylglycerols to free fatty acids and glycerol

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45
Q

Muscle in starvation

A

Use fatty acids and ketones as fuel

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46
Q

Brain in starvation

A

Uses ketones for fuel

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47
Q

Metabolism of toxic waste

A

Nitrogenous waste disposed as water soluble metabolites
Liver plays important role in metabolism of waste

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48
Q

What happens to urea in starvation

A

Production decreases as starvation proceeds

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49
Q

Bacteria classifications

A

Eukaryotes - animals, plants, parasites, fungi, archaebacteria
Prokaryotes - eubacteria, cyanobacteria

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50
Q

Eubacteria classification

A

Family, genus, species

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51
Q

Classification scheme

A

Numerical taxonomy, nuclei acid homology
Traditional - gram and acid fast stains, cell morphology and arrangement, growth conditions biochemical reactions

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52
Q

General properties of bacteria

A

No nucleus, rigid cell wall, cell envelope, 70s ribosome, polycistronic mRNA (no introns)

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53
Q

Virulence

A

Relative capacity of a pathogen to overcome body defenses
Increases ability to cause infection
May be spread via mobile genetic elements
May be structural component, enzymes, or toxins released from the cell

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54
Q

Capsule or slime layer

A

Widespread occurrence, dispensable for growth, hydrated gel
Function - to protect from external environment, protect cell from uptake by phagocytosis, attachment

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55
Q

Biofilms

A

Important sources of infection
Form on or within indwelling devices
Bacteria and yeast have been identified as components of biofilms
Once bacteria reach a suitable surface they colonize, reach a significant level then cell detachment and emboli occur
Antimicrobial resistance effectively spreads
Duration of indwelling devices correlates with infection risk

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56
Q

Pili or fimbrae

A

Short thin
Only on gram negative
2 types somatic and sex

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57
Q

Flagella

A

Long thin wave appendage, H antigen, basal body, hook, filament ( rotates using 256 H per turn)
Chemotaxis - counter clockwise is swimming, clockwise is twiddle

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58
Q

Prokaryotic cell wall

A

Responsible for cell shape and structural rigidity
Composition - peptidoglycan polysaccharide backbone, repeating disaccharides, cross linked by tetrapeptide bridge composition and linkages vary among organisms

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59
Q

Gram positive cell wall

A

Thick peptidoglyan, lipoteichoic acids, teichoic acids

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60
Q

Gram negative cell structure

A

Surface protein layer, outer membrane, periplasmic space, peptioglycan thinner and less cross linked, cytoplasmic inner membrane

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61
Q

Outer membrane composition of gram negative bacteria

A

Lipopolysachrides (LPS), phospholipids, proteins

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62
Q

LPS structure of gram negative bacteria

A

Lipid A endotoxin, core region, polysaccharide side chains (O antigen)
Function is to protect the cell

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63
Q

Periplasmic space of gram negative bacteria

A

Gel like solution of proteins and binding proteins, degradative enzymes, detoxifying enzymes, peptidoglycan cell wall

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64
Q

Cytoplasmic membrane of gram negative bacteria

A

Similar in gram negative and positive, 30% phospholipids 70% proteins, small amount of carbs, no sterols, osmotically fragile, enzymatically active, osmotic barrier

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65
Q

Endospores

A

Resistant to killing, cryptobiotic, means of survival
Triggered by exhaustion of C/N source, accumulates a large amount of calcium and dipicolinic acid, very stable

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66
Q

Endospores structure

A

Core, spore wall, cortex, spore coat, exosporium

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67
Q

Endospores activation

A

Spontaneous

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68
Q

Endospores germination

A

(Water, amino acid, or simple sugars)
Cortex swells, hydrolysis begins, water uptake, loss of heat resistance, excretion of calcium and dipicolinic acid

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69
Q

Spore germination

A

Core enlarges, mRNA synthesis, protein synthesis, energy by simple glycolysis, spore wall thickens, spore coat ruptures, cell emerges

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70
Q

Bacterial growth

A

Binary fusion, 4 stages (lag, exponential and logarithmic growth, stationary, death)
Analog to infectious disease

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71
Q

During incubation what happens

A

Increase nucleosides, amino acids, trnas

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72
Q

Bacterial growth requirements

A

Energy source, carbon source, nitrogen source, essential minerals, other metabolites

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73
Q

Types of bacterial energy and carbon sources

A

Photoautotrophs (requires light and carbon dioxide)
Photoheterotrophs (light and organic compounds)
Chemoautotrophs (inorganic chemicals and carbon dioxide)
Chemoheterotrophs (organic compounds and carbon)

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74
Q

Types of bacterial growth required minerals

A

Nitrogen, sulfur, phosphorus, trace elements (magnesium, potassium, iron, zinc, copper, cobalt, molybdenum, selenium)

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75
Q

Bacterial growth factors

A

Any ,metabolite bacteria can’t make for themselves

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76
Q

Environmental factors for bacterial growth

A

Temperature, salt concentration, pH, water, osmotic conditions, oxygen requirements

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77
Q

Obligate anaerobes

A

Oxygen is toxic

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78
Q

Aerotolerant anaerobes

A

Only grow in anaerobic conditions but not killed by oxygen

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79
Q

Facultative

A

Grow in aerobic and anaerobic conditions

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80
Q

Obligate aerobes

A

Require oxygen

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81
Q

Microaerophiles

A

Grow best under low oxygen tension

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82
Q

Capnophile

A

Grow best in the presence of increased carbon dioxide

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83
Q

What happens to toxic oxygen (superoxide) during metabolism

A

Detoxified by superoxide dismutase, catalase, and peroxidase

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84
Q

Bacteria cell division

A

Cell division and dna replication tightly coordinated, cell mass determines initiation of replication, rapidly growing bacteria have multiple replication forks

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85
Q

Energy yielding degradative catabolic pathways

A

Fermentation (partial oxidation of organic compounds)
Respiration (complete oxidation of organic compounds)
ATP and glucose (central to fermentation, respiration, and bio synthetic processes)

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86
Q

Anabolic pathways

A

Energy consuming, biosynthetic

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87
Q

Amphibolic processes

A

Involves both degradative and biosynthetic processes

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88
Q

Fermentation

A

Partial oxidation of organic compounds
2 phases : oxidation of glucose (2 ATP) and reductive (reoxidation of NADH2 and NADPH2)

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89
Q

Phases of fermentation

A

Embden meyerhof - 2 ATP from substrate level phosphorylation (NAD reduced, PEP to pyruvate)
Reductive phase - maintain oxidation reduction balance
End products - lactic acid, alcohol, mixed acid, butanediol, butyric acid, propionic acid

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90
Q

Propagation methods

A

Solid media
Liquid media (defined or complex)

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91
Q

Hemolysis on blood ager

A

Differential media, identification based on phenotype, color difference most common

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92
Q

Selective media

A

Selects for growth of 1 type of bacteria and inhibits another

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93
Q

MacConkeys agar

A

Promotes gram negative growth
Bile salts inhibit gram positive growth
Used for wounds, cervix, sputum, urine, stool

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94
Q

CNA agar

A

Promotes gram positive growth
Colistn and nalidixic acid inhibit gram negative growth
Used for blood, genital, urine

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95
Q

3 main bacterial tests

A

Microbial identification by isolation and culture
Identification by specific microbial genes or products
Detection of pathogen specific antibodies or pathogen specific antigens

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96
Q

Common lab test

A

Catalase, coagulase, oxidase, quelling reaction, antibiotics (optochin, novobiocin, bacitracin)

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97
Q

Bacteria identified by

A

Simple characteristics, biochemical properties

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98
Q

Bacterial antibiotic susceptibility test

A

Qualitative, quantitative, with images

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99
Q

Common stains

A

Gram, giemsa, periodical acid schiff, Ziehl neelsen, India ink, silver

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100
Q

Agglutination

A

Specific antibodies coated onto latex beads, useful when patient has received antibiotics

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101
Q

Immunofluorescence

A

Specific antibodies bind to immunifluorescent tag and will react with organisms to allow visualization

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102
Q

ELISA

A

Enzymes linked immunosorbent assay
Detects pathogens, antigens, or host antibodies against pathogens
Direct - presence of antigen analyzed
Indirect - antigen bound by primary antibody which is detected and labeled with a second antibody

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103
Q

PCR

A

detects a single gene target

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104
Q

normal flora is associated with what

A

skin and mucous membranes

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105
Q

most normal flora are what

A

commensals

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106
Q

what happens at birth in regards to normal flora

A

born sterile then will colonize

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107
Q

benefits of normal flora

A

antagonism - prevent colonization of pathogens
immunologic imprinting - primes host to response quickly to pathogens
maintin GI peristalsis and intestinal integrity
convert dietary carcinogens and precarcinogens to noncarcinogens
synthesis of vitamin k and b complexes

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108
Q

detrimental effects of normal flora

A

opportunistic infections - all normal flora has the potential to cause disease
ecological disruption leading to overgrowht by indogenous bacteria
convert noncarcinogens to carcinogens

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109
Q

general maladies caused by normal flora

A

dental caries, periodontal disease, abcesses, endocarditis

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110
Q

true resident flora

A

relatively fixed, in particular anatomical sites, if removed come back

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111
Q

transient flora

A

nonindoginous, do not establish as permanent members of normal flora, may colonize skin and mucous membranes for hours days or months

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112
Q

skin normal flora has more organisms where

A

sites with partial occlusion (axilla, perineum, toe webs)

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113
Q

what is the most common infectious agent

A

viruses

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114
Q

what are the severity rankings of viruses

A

subclinical, mild disease, moderately sever, life threatening, chronic disease, cancer

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115
Q

virus properties

A

small, obligate intracellular parasite, highly organized, uses host biosynthetic machinery, key enzymes for genome replication virally encoded

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116
Q

virus classification

A

RNA or DNA then family genus species

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116
Q

virus structure

A

genome - ssRNA, dsRNA, ssDNA, dsDNA
capsid
nucleocapsid (capside and genome together)
envelope (around nucleocapsid of some)
virion (infectious particles)

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117
Q

virus DNA genomes

A

linear, circular, size varies, all genomes single molecule

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118
Q

virus RNA genomes

A

70% viruses, high mutation rate, minimal RNA viruses linear, can be several RNA fragments, ssRNA classified based on polarity (act as mRNA = +, must be transcribed = -)

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119
Q

capsid structure

A

protein shell, infectious particle in viruses that dont have envelope, protomers are viral structural protein that form the capsid (bind w noncovalent bonds)

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120
Q

types of capsid structure

A

helical - cylindrical, protomer is single protein
icosahedran - crystalline, an icosahedron
complex - symmetry hasnt been resolved

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121
Q

envelope structure

A

surrounds capsid of some viruses, derived from modified portion of cellular membrane, viruses with and envelope sensitive to lipid solvents

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122
Q

viral pathogensis

A

process that produces disease (entry, replication, cytopathology, spread, interaction with host system, overall outcome of infection)

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123
Q

virus entry

A

direct inocculation, respiratory tract, gastrointestinal tract, genitourinary tract, conjunctiva

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124
Q

primar infrection

A

location of initial virus infection prior to systemic spread, some visuses only produce primary infection

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125
Q

prodrome

A

early symptoms before main disease presentation

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126
Q

cell and organ tropism

A

influenced by host and viral factors

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127
Q

virus spread

A

local - only replicates at site of inocculation
subepithelium invasion and lymphatic spread
viremia - most efficient, primary = low virion in blood, secondary = high virion in blood

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128
Q

cell injury

A

oucome of virus infection stems from fate of infected cell
macromolecular synthesis inhibited, damage to organelles, general cell necrosis

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129
Q

host immune response

A

positive effects
increase pathogenesis of virus

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130
Q

overall outcome of virus

A

subclinical, acute infection, persistent infection, slow viral diseases, transformation (tumors)

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131
Q

virus lifecycle

A

attachment, penetration, uncoating, biochemical replication, assembly, release

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132
Q

mykoses

A

disease caused by fungus

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133
Q

fungus

A

eukaryotic, most aerobes, derive nutrients via absorption

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134
Q

saprobes

A

live on dead or decaying material

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135
Q

commensals

A

live with another deriving benefits from its host, host may or may not benefit but not harmed

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136
Q

parasites

A

benefits from host without contributing to relationship, pathogenic if it harms the host

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137
Q

fungal structure

A

membrane bound organelles and cytoskeleton, plasmalemma (phospholipids and sterols), cell wall, capsule

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138
Q

imidiazole

A

antidungal, inhibit synthesis of ergosterol

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139
Q

polyene antifungals

A

bing more tightly to ergosterols than cholesterol

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140
Q

fungal cell wall

A

antigenic, multilayered (polysacharrides and proteins), polysacharrides = chitin, glucan, mannan

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141
Q

fungal capsule

A

polysacharide, only in some fungi, antiphagocytic and a virulence factor

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142
Q

yeast

A

unicellular, reproduce with nuclear fission and budding

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143
Q

mold

A

molticellular, hyphae

144
Q

spores

A

conidia, asexual reproduction

145
Q

dimorphic

A

can grow in mold or yeast form under different conditions (mold in cold, yeast in beast)

146
Q

spores

A

function in reproduction of fungi, sexual and asexual reproduction

147
Q

labratory diagnosis of fungi

A

direct microscopic examination, culture, morphology or PCR, serology, molecular techniques

148
Q

dermatophycosis

A

infection of skin, hair, nails

149
Q

sporotrichosis

A

chronic infection of cutaneous, subcutaneous, lymph tissue (acquired through cutaneous inoculation)

150
Q

endemic mycoses

A

natural habitat restricted to specific geographic regions

151
Q

systemic mycoses

A

infection of healthy and immunosuppressed

152
Q

parasitic relationship

A

host is harmed
bacteria or fungi

153
Q

parasitic disease

A

caused by protozoa, helminths, ectoparasites

154
Q

host types

A

definitive - harbors adult stages of parasite
intermediate - harbors larval stages of parasite
paratenic - parasite infective to definitive host but doesnt undergo development

155
Q

many stages in parasite lifecycle

A

tropozoite, cyst, cercaria (free swimming larval stage), metacaria (infective larvae), miracidium (ciliated nonfeeding larva)

156
Q

appendages

A

proglottid, scolex

157
Q

antiparasitic agents

A

amphotericin B, chloroquine, metronidazole, mebendazole, praziquantes

158
Q

ectoparasites

A

live outside host

159
Q

endoparasites

A

live inside host

160
Q

most deadly animals

A

mosquitos, freshwater snails, assassin bugs, tsetse fly

161
Q

types of hosts

A

resevoire - natural habitat of infectious agent
vector - living carrier that transports infectious agent (mostly arthropods)
carrier - host harbors pathogen without symptoms

162
Q

classification of endoparasites

A

protozoa - single cell eukaryotes with movement (flagellates, sporozoans, microsporidians, ciliates
amebas - lumen dwelling, 2 stage lifecycle (trophozoite and cyst stages), use pseudopoda and protoplasmic flow to move
sporozoa - complex lifecycle, altrnate sexual and asexual reproduction

163
Q

helminths

A

parasitic worms, large multicellular parasites

164
Q

nematoda

A

roundworms

165
Q

cestodes

A

tapeworms

166
Q

termatodes

A

flukes and blood flukes

167
Q

ascaris

A

transmitted by consumption of fertilized eggs (roundworms) worms in stoolsch

168
Q

istosomiasis

A

blood flukes

169
Q

cysticercosis

A

tapeworms, parasitic tissue infection, must swallow eggs found in feces

170
Q

polio

A

acute systemic viral infection leading to wide range manifestations, transmitted by fecal oral route, small single stranded encapsulated RNA

171
Q

3 stereotypes of polio

A

1 (most infected), 2 (vaccine infection), 3 (wild type)

172
Q

poliomyelitis

A

due to polio, GI first then moves to lymph nodes then to spinal cord and brain stem, primary target is motor neurons

173
Q

post polio syndrome

A

polio survivors have progressive muscle weakness and disability (1/3 - 1/2 survivors)

174
Q

acute flaccid myelitis

A

acute motor weakness, nonpolio enterovirus infection (ventral spinal cord dies)

175
Q

public health when considering infections (especially polio)

A

test persons of interest, wastewater surveillance, vaccination rates, vaccine derived polio possible

176
Q

duke trial on polio

A

use polio to treat glioblastomas, in phase 2

177
Q

ATP created by

A

fuel oxidation, can be used for mechanical transport and biochemical work

178
Q

energy provided by atp how

A

hydrolysis to adp

179
Q

atp high energy bonds

A

2 phosphoanhydride bonds (between phosphate groups)

180
Q

exergonic reaction

A

substrates have higher energy than products, release energy, -G

181
Q

endergonic reactions

A

products have more energy than substrates, absorb energy, +G

182
Q

thermodynamically favorable reactions

A

negative delta G, paired with unfavorable

183
Q

unfavorable reactions proceed if

A

substrate raised to high enough level, product concentration very low

184
Q

biochemical work of glycogen synthesis

A

2 energy harvesting reactions

185
Q

2 energy harvesting reactions

A

phosphoryl transfer reaction - phosphte from atp transferred
active intermediates - cleavage of intermediate provides energy (ATP, UTP, GTP, CTP)

186
Q

thermogenesis

A

energy expended for generating heat
shivering - increase ATP utilization and release heat
nonshivering - more fuel oxidized to ATP producing heat in brown fat

187
Q

fuel oxidation

A

energy transformed to reduction state of coenzymes which transfer elctrons to oxygen in ETC where the electrochemical gradient makes ATP

188
Q

oxidation reduction reactions

A

fuel donates electrons, NAD and FAD accept
oxidized in 3 ways - transfer of electrons as H or H-, direct addition of oxygen, direct donation electrons

189
Q

transfer as H or H-

A

nad accepts 2 electrons as hydride to form NADH and proton H
FAD accepts 2 electrons as 2 Hs donated separately to become FADH2

190
Q

oxidases

A

transfer electrons from substrate to oxygen which is reduced to water or hydrogen peroxide, not used in ATP generation

191
Q

glycolysis

A

central pathway producing ATP
aerobic and anaerobic
glucose converted to pyruvate generating ATP from substrate level phosphorylation

192
Q

aerobic glycolysis

A

pyruvate oxidized to CO2 in TCA cycle and ATP generated from electron transport chainto oxygen in oxidative phosphorylation

193
Q

anaerobic glycolysis

A

pyruvate and NADH converted to lactate and ATP generated via substrate level phosphorylation

194
Q

preparative phase of glycolysis

A

1 glucose to 2 G3P using 2 ATP

195
Q

ATP generating phase

A

2 G3P to 2 pyruvate
generates 2 NADH, 4 ATP
G3P oxidized by NAD and phosphorylated using inoganic phosphate
phosphates transfered to ATP (substate level phosphorylation)

196
Q

conversion of glucose to G6P

A

done by hexokinase
irreversible, commited to metabolism not necessarily glycolysis

197
Q

conversion G6P to fructose 6 phosphate

A

by phosphoglucose isomerase

198
Q

F6P to fructose 1,6-bisphosphate

A

by phosphofructokinast-1 (PFK-1)
first commited step of glycolysis

199
Q

conversion F1,6bisP to G3P

A

by aldolase creating 2 triose phosphates then triose phosphate isomerase creates G3P

200
Q

G3P to 1,3 biphosphoglycerate

A

by glyceraldehyde 3-P dehydrogenase
oxidizes G3P transfers electrons to NAD, forms high energy intermediate

201
Q

phosphoglycerate kinase

A

transfers phosphate of 1,3 biphosphoglycerate to ATP leaving 3 phosphoglycerate which is converted to 2 phosphoglycerate by phosphomutase and enolase removes water creating PEP

202
Q

pyruvate kinase

A

removes phosphate from PEP to ATP generating pyruvate

203
Q

oxidative fate of NADH

A

aerobic - shuttles transfer reducing equivalents across mitochondrial membrane to ETC and oxygen
anaerobic - reoxidized in cytosol by lactate dehydrogegnase

204
Q

oxidative fate of pyruvate

A

aerobic - shuttles, oxidized to acetyl coA and enter TCA cycle for complete oxidation
anaerobic - reduced to lactate by lactate dehydrogenase

205
Q

in aerobic glycolysis 2 shuttles regenerate NAD

A

glycerol 3 phosphate shuttle
malate aspartate shuttle

206
Q

regulation of glycolysis

A

by hexokinase
phosphofructokinase 1 (rate limiting)
pyruvate kinase in liver
pyruvate dehydrogenase in mitochondria

207
Q

2 paths of pluripotent stem cells

A

lymphoid prgenitor cells
myeloid progenitor cells

208
Q

cell mediators of immune system derived from

A

common stem cell
hematopoietic

209
Q

stem cells can

A

differentiate into other cell types

210
Q

hemaotpoeisis

A

formation and development of redand white blood cells

211
Q

cells involved in adaptive immune response

A

antigen specific lymphoctes, specialized accessory cells that participate in lymphocyte activation
effector cells that function to eliminate antigens

212
Q

lymphocytes

A

circulate continuously in blood and lymph
capable of migrating into tissue spaces and lymph organs
T and B cell (differentiate based on CD markers)
Natural killer cells (NK)

213
Q

t cell marker

A

CD4/8

214
Q

B cell marker

A

CD19

215
Q

b lymphocytes

A

bone marrow site of maturation, activation cause naive b cells to differentiate into effector (plasma) cells that secrete antibody and into memory b cells
they are membrane bound antibody as antigen receptor

216
Q

t lymphocytes

A

thymus maturation
only recognize antigen bound to major histocompatability complex (MHC) used for antigen presentation
t helper cells are CD4
t cytotoxic cells are CD8

217
Q

natural killer cells

A

large granular lymphocytes that are cytotoxic
part of innate immunity
lack antigen specific receptors

218
Q

monocytes and macrophages

A

activated by phagocytosed antigen and stimular, cells secrete cytokines inhancing activation
monocytes ciculate in blood
macrophages resident in tissues

219
Q

granulocytic cells

A

neutrophils, eosinophils, basophils

220
Q

neutrophils

A

50-70% circulating white blood cells
multilobed nucleus and granulated cytoplasm and polymorphonucleated
phagocytic (increase with acute bacteria infection)

221
Q

eosinophils

A

bilobed nucleus and granulated cytoplasm
phagocytic (parasitic infection and allergies)

222
Q

basophils

A

lobed nucelus and havily granulated cytoplasm
secreted substances play major role in certain allergic responses

223
Q

mast cells

A

release histamine necause allergen

224
Q

dendritic cells

A

antigen capture and presentation

225
Q

primary lymph organs

A

thymus, bone marrow

226
Q

secondary lymph organs

A

lymph nodes, spleen, mucosal associated lymphoid tissue, (adaptive immune response initiated)

227
Q

MALT

A

mucosal lining, tonsils, peyers patches, appendix

228
Q

lymph nodes

A

sites where immune response to lymph borne protein anitgens initiated

229
Q

spleen

A

response to blood borne antigens

230
Q

parts of lymph node

A

outer cortex with follicles, inner medulla and medullary sinus, hilum, efferent lymph vessels

231
Q

outer cortex

A

B cell area

232
Q

paracortex

A

tcell area

233
Q

inner medulla

A

has macrophages

234
Q

immune system

A

cells and molecules responsible for immunity

235
Q

immune response

A

coordinated response to intro of foreign substances

236
Q

antigen

A

antibody generating substance

237
Q

immunogen

A

immune response generating substance

238
Q

to be antigen

A

must be recognized as foreign, must have certain degree of clinical complexity, must have molecular weight of at least 5000-10000 kD

239
Q

innate immunity

A

less specific, early response
stimulated by structures common to groups of related microbes, epithelia, phagocytic cells (neutrophils, macrophages), NK cells, cytokines and blood proteins

240
Q

adaptive response

A

activated in antigen specific fashion to provide for elimination of antigen and lasting protection (memory)

241
Q

adaptive immunity

A

later response, specificity to remember and respond more vigorously to repeated exposure, generates diversity

242
Q

lymphocytes in adaptive immunity

A

stimulated by antigens which are specific pieces of foreign substances

243
Q

2 types of adaptive immunity

A

humoral - mediated by molecules in the blood (antibodies produced by B lymphoctes), antibodies recognize microbial antigens, neutralize infectivity, target microbes for elimination
cell mediated - mediated by T lymphocytes (specificity, diversity, memory, clonal expansion, specialization, contraction, homeostasis, nonreactivity to self

244
Q

generate receptor diversity

A

millions of idiotypes (variable portion of antibody), accomplished by set of rearrangements of DNA segments during maturation of lymphoid cells (3 gene segments VDJ)

245
Q

epitope (antigeneic determinant of immunogen)

A

portion of molecule with 3D complimentary idiotype
hapten - only 1 epitome, cant produce immune response

246
Q

drug allergies

A

drug itself works as hapten, becomes conjugated to body proteins and hapten carrier conjugate serves as imunnogen for ensuing allergic response

247
Q

innate immunity

A

bacteria breaches skin barrieer and activates innate response
phagocytosis (pseudopodia to engulf and trap, fuse phagosome to lysosome to form phagolysosome for digestion and exocytosis of digested contents)
opsonization - macrophages and neutrophils have membrane receptors for antibody and complementary components, antigen coated with these phagocytosed more

248
Q

innate and adaptive link

A

macrophage ingest antigens and present to t cell

249
Q

innate immunity major functions

A

physical and chemical barriers, recruit WBC to site of infection and inflammation using cytokines, identify and remove pathogens and debris using WBC, activate adaptive immune system, clear dead tissue and initiate repair

250
Q

when pathogen breaches barrier

A

sensors detect pathogen and initiate response mechanism
sensor receptors - pattern recognition receptors (PRRs) or toll like receptors (TLRs)
patterns on pathogen - pathogen associated molecule patterns (PAMPs)

251
Q

DAMPs

A

damage associated molecular patterns
endogenous danger molecules released from damaged or dying cells
activate innate immune response by interacting and promoting inflammation process

252
Q

intracellular killing

A

in phagocytosis respiratory (oxidative) burst
activates membrane bound oxidase that generates oxygen metabolites that are toxic to ingested microorganisms

253
Q

2 oxygen dependent intracellular digestion mechanisms activated

A
  1. NAPDH oxidase - reduces oxygen to superoxide which leads to hydroxyl and hyrdrogen peroxide
  2. myeloperoxidase - in lysosome it acts on hydrogen peroxide and chloride to produce hypochlorite
254
Q

lysosome contents of phagocytes have oxygen independent degradative materials

A

lysosome, defensins, lactoferrin, hydrolytic enzymes

255
Q

neutrophils

A

early in innate response

256
Q

macrophages

A

later in innate response

257
Q

macrophages

A

coordinate other cells and tissues to clear infections, produce cytokines

258
Q

cytokines

A

soluble proteins tat mediate immune and inflammatory reaction
communicate with interleukins
pyrogens induce fever

259
Q

accute inflammatory response

A
  1. activate vascular endothelium in breached epithelial layer
  2. cytokines released induce selectin type adhesion molecules
  3. neutrophils bind and extravasaate into tissues (peak within 6 hours)
  4. monocytes, macrophages, eosinophils arrive (5-6 hours later)
260
Q

leukocyte extravasation

A

migration of leukocytes from blood to sites of infection, stimulated by cytokines
endothelial activation, rolling, integrin activation of chemokines, stable adhesion, migration through endothelium

261
Q

neutrophils release chemoattractive factors that call in other neutrophils

A

IL8, C5a

262
Q

complement

A

proteins made by liver, coat surface of bacteria and extracellular virus particles

263
Q

IL2

A

survival, proliferation, differentiation of effector and regulatory T cells

264
Q

IL 4

A

b cell switching to IgE

265
Q

IL5

A

activation of eosinophils

266
Q

interferon gamma

A

activation macrophages

267
Q

TGF beta

A

inhibit t cell activation, differentiation of regulatory T cells

268
Q

initiation of T cell response requires multiple receptors on t cell recognition ligands on APCs

A
  1. TCR recognizes MHC associated peptide antigens, coreceptors recognize MHC molecules
  2. adhesion molecules strenthen binding of T cells to APCs
  3. receptors for costimulates recognize and send signals provided by APCs
269
Q

integrins

A

enhance T cell response
initially bind weakly before antigen recognition
if APC displays antigen T cell recognizes, the antigen recognition increases binding strength

270
Q

becoming effector cells

A

1st signal - antigen binding to antigen receptor and ensures specificity of subsequential immune response
2nd signal - provided by costimulators : B7-1 (CD80) binds CD28 and stimulates, B7-2 (CD86) binds CTLA4 and inhibits

271
Q

t cells secrete IL2 why

A

to keep up with rapidly dividing microbes

272
Q

CD4 T cells that have differentiated express

A

CD40L and secrete cytokines

273
Q

differentiating into effector cells

A

CD8 t cells - functional CTLs with ability to kill target cells that express MHC these T cells recognize

274
Q

cells killing by CTLs is antigen specific and contact dependent

A

pecificity of CTL effector function ensures normal cells not lysed by CTLs secreting against microbes

275
Q

CD4 cells differentiate into TH1 and TH2 cells

A

subsets defined by ability to produce different cytokines
TH1 produces TNF alpha and gamma
TH2 produce IL4 and 5
TH17 produce IL17 and 22 (extracellular bacteria and fungus)

276
Q

humoral immunity

A

antibodies neutralize and eliminate antigens that induced their formation

277
Q

primary humoral immunity

A

first isotype of immunoglobin is IgM (peentamer)
most effective at sponging up antigen, low affinity, high avidity

278
Q

secondary humoral resposne

A

next isotype is IgG
activates complemetn and transported across placenta (protects fetus)

279
Q

IgA

A

produced in submucosa

280
Q

IgE

A

mast cells, Fe receptors, allergies

281
Q

antibody responses

A

T dependent (protein antigens)
T independent (non protein antigen)

282
Q

peptide antigens from microbes bound by MHC molecule of antigen presenting cell

A

dendritic cell most effective
t cells tcr recognize peptide antigen this way

283
Q

MHC aka HLA

A

class 1 presents to CD8 (expressed on all nucleated cells)
class 2 presented to CD4 (expressed mainly on antigen presenting cells)

284
Q

b cell receptors

A

antibodies (membrane bound or secreted)

285
Q

t cell receptors

A

only 1 specificity
IgA - mucosal immunity
IgD - naive B cell antigen receptor
IgE - mast cell activation, defense for helminth parasites
IgG - opsonization, antigen specific cytotoxicity
IgM - naive B cell antigen receptor, complement activation

286
Q

cells that fail to express useful receptors

A

die by apoptosis

287
Q

thymus each MHC product loaded with normal self peptides and presented to developing lymphocyte

A

failut=re of positive selection means t cell wont mature
must not bind too strongly

288
Q

oxidative phosphoryaltion

A

ATP formed as a result of transfer of electrons from NADH or FADH2 to O2 by electron carriers
requires electron donor, acceptor, inact inner mitochondrial membrane, components of ETC, ATP synthase

289
Q

proton motive force

A

energy that pushes protons to reenter matrix to equilibriate

290
Q

complex 1

A

NADH and CoQ oxoreductase - NADH carries binding proteins (FMN accept 2 e from NADH and FE S center transsfers e to Co Q

291
Q

complex 2

A

succinate dehydrogenase - transfer e to coq (no proton pumping)

292
Q

coQ

A

accepts electrons, pumps protons, shuttles electrons, generate toxis ROS

293
Q

complex 3

A

cytochrome bc1

294
Q

complex 4

A

cytochrome a a3 bound Cu facilitate collection of oxygen and electrons to reduce to water

295
Q

congenital lactic acidosis

A

increase in lactate and pyruvate bc inhibition of ETC

296
Q

uncoupling

A

DNP carry protons across membrane
RAACCO
rotenone/amytal
antimycin C
CO and CN
oligomycin

297
Q

UDP glucose

A

glycosyl transferase rxns
oxidized to form UDP glucuronate which forms glucuranide derivatives

298
Q

glycotransferases

A

transfer sugar component of nucleotide sugar donor to acceptor

299
Q

glucuronides

A

increased solubility, more exretion

300
Q

degredation product of heme

A

bilirubin

301
Q

lactose synthesis

A

convert glucose to galactose (epimerization)
lactose synthesis from galactose (lactose synthase)

302
Q

enzyme that makes UDP glucose into UDP galactose

A

UDP glucose 4 epimerase

303
Q

I cell

A

deficiency UDP N acetylglucoseamine
complex carbs and fatty substances accumulate

304
Q

Tay sachs

A

hexosaminidase A deficiency
GM2 ganglioside accumulation

305
Q

TCA cycle

A

pyruvate via acetyl coA through cycle of reactions
in mitochondria
produce coenzymes
energy production and biosynthese

306
Q

acetyl coa to citrate by what

A

citrate synthase - regulated

307
Q

citrate to isocitrate by

A

aconitase

308
Q

isocitrate to alpha ketoglutarate by what

A

isocitrate dehydrogenase (produce NADH) - regulated

309
Q

alpha ketoglutarate to succinyl coa by

A

alpha ketoglutarate dehydrogenase (produce NADH) - regulated

310
Q

succinyl coa to succinate by

A

succinate thiokinase (make GTP)

311
Q

succinate to fumarate

A

succinate dehydrogenase (NADH)

312
Q

fumarate to malate

A

fumarase

313
Q

malate to OAA

A

malate dehydrogenase (NADH) - regulated

314
Q

alphaketoglutarate dehydrogenase complex

A

thiamine pyrophosphate
lipoate
FAD

315
Q

pyruvate converted to acetyl coa how

A

pyruvate dehydrogenase complex (IMPORTANT bc convert ketone bodies to energy)
phosphorylation inactivates
dephosphorylation activates

316
Q

reactive oxygen species

A

highly reactive free radical or rapidly converted into oxygen free radicals

317
Q

haber weiss rxn

A

oxygen and hydrogen peroxide to oxygen, water, hydroxyl

318
Q

fenten rxn

A

waater to hydroxyl and hydroxide using iron

319
Q

hydrogen peroxide is a precursor to what

A

hypochlorous acid in phagocytic cells

320
Q

what is a major source of free radicals

A

cytochrome P450

321
Q

ionizing radiation does what

A

split water into hydroxyl radicals and hydrogen

322
Q

chain reactions do what

A

form lipid free radicals and lipid peroxides, major contribution to ROS induced injury

323
Q

blood and urine indicator of ROS

A

malondialdehyde

324
Q

what terminate chain reactions

A

lipid soluble antioxidants

325
Q

what is the major cellular defense against ROS

A

glutathione

326
Q

DNA damage by free radicals

A

break backbone
convert guanine to 8 hydroxyguanine

327
Q

nitric oxide

A

synthesized from arginine and nitric oxide synthase
attack ETC complex 3 and hemoglobin

328
Q

phagocytic cells form free radicals how

A

NADPH oxidase - e from NADPH forming superoxide
superoxide dismutase - forms hydrogen peroxide
myeloperoxidase - heme containing, forms hypochlorous acid

329
Q

cellular defense against oxygen toxicity

A

antioxidant scavenging enzymes - superoxidase dismutase, catalase, glutathione peroxidase, gluthione reductase
dietary antioxidants - vit E, asorbic acid, carotenoids, free radical scavengers, flavonoids
endogenous antioxidants - uric acid, melatonin

330
Q

gluconeogenesis differences

A

glucose 6 phosphatase - glucose from G6P
fructose 1,6 biphosphatase - fructose 1,6 biphosphate to fructose 6 phosphate
PEP carboxylase and pyruvate carboxylase - pyruvate to PEP

331
Q

substrates for gluconeogenesis

A

lactate, glycerol, amino acids

332
Q

what is converted into pyruvate

A

alanine (alanine aminotransferase)
lactate (lactate dehydrogenase)

333
Q

glycogen phosphorylase is what when phosphorylated

A

activated (degrades)

334
Q

glycogen synthase is what when dephosphorylated

A

activated (makes)

335
Q

pyruvate to PEP in liver

A

pyruvate in mitochondria converted to OAA and given to malate aspartate shuttle
OAA reformed in cytoplasm
PEPCK convert OAA to PEP

336
Q

glycogenolysis break glycogen)

A

glycogen to G1P to G6P to glycolysis in blood or to glucose in liver

337
Q

glycogen synthesis

A

glucose to G6P to G1P to glycogen
glycogen synthase and branching enzyme regulated step

338
Q

pentose phosphate pathway

A

generate ribose 5 phosphate and NADPH from G6P in oxidative and nonoxidative step

339
Q

nonoxidative

A

reversible, produce 2 fructose 6P and 1 G3P

340
Q

G6PD deficiency

A

hemolysis

341
Q

galactose ingested primarily as what

A

lactose which is converted to galactose then glucose

342
Q

galactosemia

A

deficiency in GALT which leads to acumulation of G1P

343
Q

essential fructosuria

A

fructokinase deficiency

344
Q

hereditary frustose intolerance

A

deficiency of fructose 1 P cleavage by aldolase B (rae limiting enzyme)

345
Q

insulin

A

uptake of glucose and storage of glycogen

346
Q

glucagon

A

release glycogen, make glucose

347
Q

somatostatin

A

secreted by pancrease, CNS, gastroduodenal cells
inhibit insulin, growth hormone, TSH

348
Q

growth hormone path

A

GHRH stimulate release GH

349
Q

epinephrine

A

increase metabolism of fuels

350
Q

glucocorticoids

A

cortisol
protect against insulin induced hypoglycemia

351
Q

cortisol secretion

A

CRH stimulates ACTH, stimulates cortisol release

352
Q

thyroid hormone

A

basal metabolic rate
TRH stimulates TRH releases T3/4

353
Q

ethanol metabolized how

A

alcohol dehydrogenase and acetaldehyde dehydrogenase
microsomal ethanol oxidizing system

354
Q

ADH and ALDH

A

ADH oxidize ethanol to acetaldehyde with reduction of NAD to NADH in cytosol and ALDH oxidize aldehyde to acetate in mitochondria
ALDH2 in liver

355
Q

microsomal ethanol oxidizing system

A

CYP2E1
increased expression with increased consumption
aldehyde can be produced faster than its metabolized injuring liver

356
Q

effects of ethanol metabolism

A

decreased NAD impairs flux of glucose in glycolysis
increase lactate production bc increased NADH

357
Q

alcohol induced liver disease forms

A

fibrosis
sclerosis
cirrhosis

358
Q

acetaldehyde adduct formation does what

A

decrease hypatic protein synthesis, decrease protection agains hydrogen peroxide and lipid peroxidation, portal hypertension, lipid reoxidation, decreased fatty acid oxidation

OMS 1 (8 decks)

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