Foundations of Medicine Flashcards

1
Q

Describe the type of phospholipids on the outerleaflet of the membrane

A

Sphingomyelin & phosphatidylcholine

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2
Q

Describe a peripheral proteins vs an integral protein

A

Peripheral: Assoc. with cell membrane but are easily removed
Integral: Protruding from only one membrane surface or transmembrane-spanning throughout the membrane

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3
Q

What are the more common type of phospholipids found on the OUTER leaflet of the plasma membrane (applicable in RBC)

A

1.) Sphingomyelin (SM)
2.) Phosphatidylcholine (PC)

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4
Q

What are the more common type of phospholipids found on the INNER leaflet of the plasma membrane (applicable to RBC)

A

1.) phosphatidylserine (PS)
2.) Phosphatidylinositol (PI)
3.) phosphatidylethanolamine

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5
Q

THE COMPOSITION OF THE MEMBRANE LEAFLETS IS ACTIVELY Maintained BY A GROUP OF PROTEINS named:

A

Flippases and floppases

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6
Q

_____________ concentration is high in the plasma membrane compared to other cellular compartments

A

Cholesterol

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7
Q

Where is cholesterol synthesized in the cell?

A

ER

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8
Q

What are lipoproteins

A

round particles made of fat (lipids) and proteins that travel in your bloodstream to cells throughout your body. Cholesterol and triglycerides are two types of lipids found in lipoproteins.

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9
Q

Carbs occur on the outer membrane surface of the plasma membrane mainly as:
What is their purpose?

A
  • glycoproteins and glycolipids
  • Contribute to negative charge to membranes-immunity and barriers via repulsion
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10
Q

What is the purpose of the glycocalyx

A

Cell recognition
Adsorption of molecules on cell surface
Mechanical & chemical and protection

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11
Q

Glycoproteins can act as signaling molecules and can also:

A

Function as the surface receptors to which signaling molecules bind

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12
Q

G Protein coupled receptors are what type of protein

A

Integral protein

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13
Q

What is a peripheral protein

A

Anchored to only one side of the membrane

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14
Q

What type of protein is G-protein coupled receptor?

A

Integral protein

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15
Q

T/F: glycoproteins are only found in the cell membrane

A

False, some are found as hormones

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16
Q

T/F: Integral membranes may be transmembrane or anchored

A

True

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17
Q

Peripheral proteins are readily removed and compare to integral proteins. Give an example of each

A

They may be associated with integral proteins but are easily removed compared to integral proteins that require a detergent
I.e.
Integra: G protein coupled
Peripheral: G alpha subunit

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18
Q

Why does carrier mediated transport reach a saturation point while simple diffusion does not

A

Diffusion does not require any channel or carrier

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19
Q

All forms of carrier mediated transport share three features:

A

1.) Stereospecificity
2.) Saturation
3.) Competition

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20
Q

What feature of carrier mediated transport does this scenario represent: for some theraputics, single-enantiomer formulations can provide greater selectivity for their biological targets. Improved theraputid indices and/or better pharmacokinetics than a mixture of enatiomers

A

Competition

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21
Q

Varieties of molecules will act on one type of receptor with greater or lesser preference/concentration which indicates ______________ amongst these

A

Competition

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22
Q

What are the three major types of passive movement
What does Passive movement mean?

A

Simple
Facilitated diffusion
Osmosis
Movement from higher concentration to lower concentration

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23
Q

Channel mediated and carrier mediated diffusion are forms of _________________ ____________________ where movement of ions and molecules move down their concentration gradient known as:

A

Facilitated diffusion
Passive facilitated diffusion

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24
Q

How does channel mediated diffusion differ from carrier mediated?

A

Something has to bind and the carrier has to change conformation
Thus channels are faster at moving things inside our outside the cell

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25
Q

Channels vary from each other based on:

A

How they open

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26
Q

Movement across the membrane against the concentration gradient is

A

Active transport

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27
Q

Primary active transport

A

Pumps powered by ATP

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28
Q

Secondary active transport harnesses energy to move things against the concentration gradient by:

A

Gradient that is established by the primary active transport which used ATP to move things in and out of the cell

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29
Q

Receptor mediated cytosis may end up in the following results

A

Degradation

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30
Q

To maintain a constant intracellular environment, the cell membrane exhibits:

A

Selective permeability

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31
Q

Sphingomyelin is a molecule identified in a plasma membrane. What is its location

A

Outside leaflet

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32
Q

Describe how secondary active transport uses Na+/K+ ATPase

A

Starts with Na/K+ pump that moves sodium outside the cell and K+ in.
Na is already in high concentration OUTSIDE the cell and is now even HIGHER concentration outside the cell
This high concentration of Na+ drives the concentration gradient Na down into the cell taking glucose along with it

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33
Q

How does the intracellular Na+ concentration gradient change following inhibition of the Na+/K+ ATPase?

A

Na concentration increases

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34
Q

What is the difference between phagocytosis and receptor-mediated endocytosis

A

Phagocytosis: endocytosis where vesicles are formed as particulate material external to the cell are engulfed by pseudopodia

Receptor-mediated endocytosis: endocytosis in which plasma membrane receptors first bind specific substances; receptor and bound substance are taken up by the cell

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35
Q

Na+ is a cation in high concentration outside the cell, what is an anion in high concentration here?

A

Chloride, Cl- or Phosphate, PO4

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36
Q

K+ is a cation in high concentration inside the cell, what is an anion in high concentration outside the cell?

A

Phosphate, PO4 or Chloride

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37
Q

In primary active transport of Na+/K+ transport what is the direction of Na+ and K+

A

3 Na+ OUT
2 K+ in

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38
Q

What is a class of drugs that inhibits Na+/K+ ATPase? Toxicity of these dugs could induce:

A

Cardiac glycosides, ouabain & Digitalis

Hyperkalemia

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39
Q

What factors can induce Hypokalemia by increasing Na-K-ATPase activity?
Describe the concentration of K+ in ECF and ICF in this scenario

A

T3, T4, B adrenergic stimulation, hyperinsulinemia

ECF: Lowered b/c K+ being pushed in
ICF: K+ concentration increased

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40
Q

Give an example of Ungated ion channels
How do they transport?

A

K+ leaky channels
Selectively permeable to certain substances that is determined by size, shape and charge of channel and ion

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41
Q

List the type of Gated channels

A

Voltage
Ligand/Chemical

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42
Q

Describe how voltage gated channels work
Give an example of

A

Apply a charge to the membrane which causes the channel to open
Voltage-gated Na+ channels

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43
Q

Describe how Ligand/chemical channels work
Give an example of one

A

A ligand or chemical will bind to the channel and will cause it to open
Nicotinic ACh receptor channels

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44
Q

What does mEq/L stand for

A

Miliequivalent per Liter

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45
Q

What is the concentration of K+ inside the cell?
What is the concentration of K+ OUTside the cell?

A

INSIDE: 140 mEq
OUTSIDE: 4 mEq

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46
Q

What is the concentration of Na+ INSIDE the cell?
What is the concentration of Na+ OUTSIDE the cell?

A

INSIDE: 14 mEq/L
OUTSIDE: 142 mEq/L

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47
Q

What is the ratio of K+ inside compared to outside? What about Na+ inside compared to out?

A

35 times greater inside the cell
10 times less inside the cell

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48
Q

What is a diffusion potential

A

The potential difference generated across a membrane when a charged solute diffuses down its concentration gradient
The charge left behind as an ion is traveling through a membrane

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49
Q

What is membrane potential?

A

Difference in voltage across cell membrane

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50
Q

Why are there different equilibrium potentials for different ions at rest?

A

The typical resting neuron will maintain differing concentration of ions across the membrane
The equilibrium potential represents the direction of membrane potential

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51
Q

What is resting membrane potential?

A

Voltage difference across the cell at rest

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52
Q

What would be a limitation of the membrane potential

A

If the membrane is NOT permeable to the ion in question, i.e. if a channel for a specific ion is closed, even if the concentration is raised, then the membrane potential cannot exist

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53
Q

Membrane potential depends on: (2)

A

Diffusion potential
Concentration gradient

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54
Q

What is resting potential of a normal cell

A

~ -70 mV

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55
Q

What is the electrostatic gradient?

A

The charge that is left behind by ion movement that pulls the ion in the opposite direction of the concentration gradient

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56
Q

The diffusion potential counters the concentration gradient. Explain why

A

Because the diffusion potential is the charge left behind as ions move
The concentration gradient is the flow of ions away from higher concentration gradient it creates its diffusion potential that is opposite the charged ion which creates “like charges attract”

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57
Q

When is equilibrium potential reached:

A

K out = Kin

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58
Q

What would a Equilbrium potential of K+ at -90 mV mean?

A

Potassium will move down its concentration gradient until -90 mV inside the cell is reached where the electrostatic gradient will keep it at an equilibrium point

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59
Q

How might the Nernst equation vary?

A

The constant 61 may be positive or negative depending on the ion in question

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60
Q

What is the Nernst equation mean?

A

It is the equilibrium potential
Calculates the voltage necessary to perfectly oppose the net movement of an ion DOWN its concentration gradient

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61
Q

What is the Nernst equation mean?

A

It is the equilibrium potential

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62
Q

What is the Nerst equation?

A

Ke = 61/z x Log Xin/Kout
where Z is the charge of an ion

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63
Q

What is the expected resting Vm?

A
  • 90 to -70 Vm
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64
Q

What does Vm stand for?

A

Membrane potential

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65
Q

In normal cells, why is Vm so close to Ek?
What do these two things mean?

A

The membrane is far more permeable to K+, since K+ leaks out of the cell, there more negative ICF and is more permeable to Na+
Vm is the membrane potential
Ek is the equilibrium potential of potassium, K+

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66
Q

What does the Goldman-Hodgkin-Katz Equation calculate?
What is another name for this equation?

A

Vm when more than one ion is involved
Goldman Field Equation

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67
Q

The _________ membrane potential is closest to the equilibrium potential for the ion with the highest __________________

A

Resting
Charge

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68
Q

When using example of calculating the equilibrium potential Which fluid will change concentration, the outside or inside? Why

A

The extracellular fluid will change only
Because the inside of the cell will maintain homeostasis and not change

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69
Q

What effect does increasing K+ permeability have on Vm?

A
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70
Q

What effect does increasing Na+ on permeability on Vm

A
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71
Q

Why is resting membrane potential for RBC so close to 0?

A

Resting membrane permeability to sodium ions is high compared to most other cells

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72
Q

What is depolarization

A

When the membrane potential reaches closer to 0 mV

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73
Q

What is hyperpolarization

A

When the membrane potential becomes more negative to the resting membrane potential of a cell

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74
Q

What is excitability

A

How easy the cell to create an action potential

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75
Q

When hyperkalemia occurs what happens to the cell excitability

A

It increases and is closer to depolarization which makes it easer to generate action potentials and can induce cardiac arrythmias

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76
Q

Why does hypocalcemia cause tetany?

A

Lower Ca+ lowers the threshold so the Excitability increases as the sodium channels open due too the increase in vM

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77
Q

When a threshold is reached in a cell, what happens

A

All corresponding channels open

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78
Q

What determines resting membrane potential?
What determines cell threshold?

A

K+
Ca+

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79
Q

What does hypOkalemia do?

A

Increases hyperpolarization as K+ will want to move down its concentration gradient and OUT of the cell
Also will increase the duration of an action potential

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80
Q

How does hypocalcemia cause muscle tetany?

A

Low Ca in the plasma causes the Na channels to open
Ca+2 stabilizes Resting Membrane potential of cells
When there are fewer calcium ions, the threshold is lowered (Less + & more - ) so cells are more easily excitable

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81
Q

How does HyperKalemia induce cardiac arrythmias?

A

High K+ makes resting membrane potential less negative and closer to the threshold potiental

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82
Q

How can calcium reverse HypERkalemia?

A

1.) HyperKalemia makes the membrane potential less negative & and more likely to reach threshold
2.) Calcium stabilizes the resting membrane potential and increased Ca+ can raise the threshold to a more + number
3.) Thus administration of Ca can maintain the difference between membrane potential and threshold to prevent action potential

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83
Q

At rest, the cell is permeable to what ions?

A

Potassium only!

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84
Q

______________kalemia depolarizes the cell, ______________kalemia hyperpolarizes the cell.
Why?

A

Hyper
Hypo
In HypER: there is more K+ entering the cell which makes it more + and closer to the threshold & AP
In HyPO: there is less K+ entering the cell because the concentration gradient outside the cell is smaller, thus the cell is more remains more - and in a hyperpolarized state

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85
Q

Name the three surfaces of epithelial tissue

A

Apical
Lateral
Basal

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86
Q

Where is the apical surface of epithelial tissue?

A

On the top-most layer
Nearer the luminal surface

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87
Q

Where is the lateral surface of epithelial tissue?

A

On the sides
Laterally
Connects/touches to cells next to them

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88
Q

Where is the basal surface of epithelial tissue?

A

The bottom most layer
Nearer the attachment/basement membrane

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89
Q

In tissue, more specifically, epithelial tissue, what does stratified mean?

A

Layered

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90
Q

In epithelial tissue, which layer matters the most when determining what cell type is present?

A

The apical side (top most layer)

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91
Q

Which surface of epithelial tissue will have:
Axonemes–cilia & flagella
Microvilli

A

Apical surface

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92
Q

Why is the term stereocillia a misnomer?

A

Because they are more closely related to/similar to microvilli than cillia
All 3 are components of the apical surface of epithelial tissue & cytoskeleteon

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93
Q

Cilia are organized from cytoplasmic extensions known as:
______________________
These ______________ are formed by:
Thus cilia are made of:

A

Axonemes
Axonemes
Microtubules
Microtubules

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94
Q

Which are smaller cilia or microtubules?
Which are larger microtubules or microvilli?
Thus what can be inferred about size relationship between cilia and microvilli?

A

Microtubules = cilia!
Microvilli < microtubules
Microvilli < cilia

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95
Q

What are microvilli made of?

A

Microfilaments

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96
Q

What are the purpose of cilia?
What are the purpose of microvilli?
Cilia : ___________________ as microvilli : ____________________

A

Movement
Absorption
Cilia : movement as microvilli : absorption

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97
Q

What are the 5 types of connection junctions pertinent to the lateral surface of epithelial tissue?

A

1.) Gap junction
2.) Adhering junctions
3.) Desmosomes
4.) Hemidesmosomes
5.) Occluding junction AKA tight junction

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98
Q

What are the purpose of occluding junctions? Where are they found?

A

Found on lateral surface of epithelial tissue
Form tight junctions to prevent things from passing between cells
i.e. blood brain barrier

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99
Q

What are the purpose of adhering junctions? Where are they found?

A

Use actin to connect cells side by side to each other on the lateral surface of epithelial tissue

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100
Q

What are the purpose of gap junctions? Where are they found?

A

Communication junction, i.e. electrical synapses

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101
Q

What are the purpose of Desmosomes? Where are they found?

A

Use intermediate filaments to attach cells to the basal lamina

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102
Q

Tight junctions seals off the intercellular space to prevent toxins and bacteria from entering, the specific integral membrane protein ____________________________ is used to fuse two trilaminar plasma membranes of adjacent cells forming a pentalaminar structure

A

Occludins

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103
Q

________________ cell junctions are proximal to the basal surface on the lateral surface of epithelial tissue. This “belt” is formed by _____________, tropomyosin, α-actinin, and ____________ . These are attached to each other by transmembrane proteins known as: ___________________

A

Adhering junction
Myosin
vinculin
Cadherins

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104
Q

When thinking of gap junctions also think of ____________________. These are what form the the opening and bridge between cells for molecules to pass for intercellular coordination and connection

A

Connexons which form Connexins

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105
Q

Macula adherens aka _________________ are cell junctions of epithelial tissue. They are formed by desmo______________ and desmo_______. They help form cell-cell connection on the lateral surface via _________________ filaments.

A

Desmosomes
Desmoplakins
Desmogleins
Intermediate filament

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106
Q

Which cell junctions on the lateral surface of epithelial tissue do NOT form a barrier between cells

A

Gap junctions and desmosomes

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107
Q

Which are the strongest attachment cell junctions? What is distinct about them?

A

Hemidesmosomes
While most cell junctions of epithelial tissue are on the lateral surface, hemidesmosomes are on the basal surface to anchor cells to the basement membrane

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108
Q

What adaptor protein connects hemidesmosomes to intermediate filaments forming attachment to basement membrane and cell of epithelial tissue?

A

Integrins

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109
Q

What components form the basement membrane on the basal surface of epithelial tissue?

A

Basal lamina
Reticular lamina

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110
Q

What layers comprise the basal lamina of the basement membrane?

A

Lamina lucida and lamina densa

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111
Q

Of the following, which are most similar in terms of FUNCTION?
1.) Gap junction
2.) Adhering junctions
3.) Desmosomes
4.) Hemidesmosomes
5.) Occluding junction AKA tight junction
Why is this so? How do they differ in COMPOSITION?

A

Desmosomes and adhering junctions
Because they both aid in forming attachment between cells but differ in one uses actin containing microfilaments and the other uses intermediate filaments

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112
Q

What are the two main division of epithelial tissue?

A

Stratified (multilayer) and simple (single layer)

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113
Q

Name the “flat” shaped stratified epithelial and simple epithelial cell type

A

Simple squamous = simple
Stratified squamous (Keratinized and nonkeratinized)

114
Q
A
115
Q

Name the “cuboidal” shaped stratified epithelial and simple epithelial cell type

A

Simple cuboidal
Stratified cuboidal

116
Q

Name the “Columnar” shaped stratified epithelial and simple epithelial cell type

A

Simple columnar epithelium & Pseudostratified columnar epithelium = SIMPLE
Stratified columnar= STRATFIED

117
Q

Name the “Dome” shaped stratified epithelial and simple epithelial cell type

A

Simple: none which are dome shaped
Stratified: transitional epithelium (relaxed and distended)

118
Q

What cell type are mesothelium?
Where in the body can you generally find these?

A

Simple squamous epithelium
Lining the surface of body cavities including capillaries, cardiovascular system and respiratory tract

119
Q

What cell type are endothelium?

A

Simple squamous epithelium

120
Q

Why are simple squamous epithelium generally not pink, rather blue?

A

Because they are so flat their nucleus gets flattened as well

121
Q

Where might you find simple cuboidal epithelial cells?

A

Kidney

122
Q

Where might you find simple columnar epithelial cells?

A

Digestive tract, fallopian tubes and testis structures

123
Q

Where might you find pseudostratified columnar epithelial cells?

A

Respiratory tract

124
Q

Why do pseudostratified columnar epithelial cells have cilia while simple columnar and cuboidal epithelial cells have microvilli?

A

Their functions vary
Pseudostratified in respiratory tract, think moving phlegm out
Columnar and cuboidal are absorption, think GI tract and tubules of kidney

125
Q

What type of cells are the first two layers of skin?
What are two major function of these type of cells?

A

Keratinized stratified squamous epithelium
Resist friction (think thick skin) and are impermeable to water

126
Q

Where might one find NONkeratinized stratified squamous epithelium?

A

Esophagus, mouth, vagina

127
Q

How can one tell the difference between the keratinized and nonkeratinized squamous epithelial cells?
While they may differ, how is their shape similar?

A

Keratinized retain their nuclei
They are flatter appearing

128
Q

Where might stratified cuboidal epithelial cells be found?
What is special about their appearance?

A

Ducts
They are usually only ~2 layers with the basal layer appearing incomplete

129
Q

How can you tell the difference between stratified cuboidal and columnar cells?

A

Cuboidal: normally 2 layers
Columnar: normally 2-3 layers, the TOP most layer are COLUMNAR!

130
Q

Where might stratified columnar cells be found?

A

Eye glands, some exocrine glands

131
Q

What is transition epithelium? Is it simple or stratified?

A

Stratified
These cells can change shape, think of bladder cells and how they can stretch as the bladder fills with urine from “dome/umbrella” shaped to flattened

132
Q

Barretts syndrome is a complication of chronic GERD marked by ________________ of the _________________ ________________ epithelium of the distal esophagus into a ______________ _____________ _____________ with goblet cells as a response to prolonged reflux-induced injury

A

Metaplasia
stratified squamous
simple columnar epithelium

133
Q
A
134
Q

Where can you find connective tissue relative to epithelial tissue? I.e. skin layers

A

Epithelial tissue: epidermis
Connective tissue: dermis
Connective tissue is found abutting to the basement membrane of the epithelial tissue

135
Q

Name 2 embryonic connective tissue

A

Mesenchyme and mucous connective tissue

136
Q

Name the 2 largest branches of connective tissue

A

1.) Loose (AREOLAR) connective tissue
2.) Dense irregular &/or irregular connective tissue

137
Q

Name 3 structural properties of connective tissue

A

1.) Tensile strength
2.) Elasticity
3.) Volume

138
Q

What materials make up the Extracellular matrix (hint: think connective tissue)

A

Ground substance and connective tissue fibers

139
Q

Where is Type III connective tissue found?

A

Lymphatic system

140
Q

Elastin is a type of connective tissue, which properties are corresponding to

A

Confirms to stretching and elastic recoil

141
Q

In the ground substance of connective tissue, what can you infer if there is large presence of hyaluronan

A

Hydration

142
Q

Mucopolysaccharides

A
  • Glycosaminoglycans
  • Help build cartilage, tendons and cornea, skin
143
Q

What do fibroblasts do

A

Produce the matrix

144
Q

Fibroblasts, adipocytes, mast cells are all considered

A

Resident cells of connective tissue

145
Q

Where does connective tissue arise from during gastrulation?

A

Mesoderm

146
Q

What do fibroblasts produce?

A

Collagen and elastin

147
Q

If there is scar tissue needing to be formed, what cells might be activated

A

Fibroblasts

148
Q

What is stored in adipocytes?

A

Triglycerides

149
Q

Serine and Threonine have a tendency to:

A
  1. Be phosphorylated
  2. O-linked glycosylation
150
Q

Describe the side chain of Asn

A

Asparagine
- 4 carbon AA with Nitrogen and C=O group
- Involved in N-linked glycosylation

151
Q
  1. What 3 AA have a tendency to engage in phosphorylation?
  2. Which two ALSO participate in O-linked glycosylation?
A
  1. Serine, Threonine, Tyrosine
  2. Serine & Threonine
152
Q

What amino acids negatively charged at physiologic pH?

A

Acidic Amino Acid

153
Q

What is the typical pKa of R group on acidic amino acids?

A

Low

154
Q

What 3 amino acids are positively charged at physiologic pH?

A

Arginine (Arg)
Lysine (Lys)
Histadine (His)

155
Q

This amino acid has 3 nitrogens on its side chain, 5 carbons, and is + charged at physiologic pH

A

Arg

156
Q

An ____________________ is one of two stereoisomers that are mirror images of each other but non-superimposable

A

Enantiomer

157
Q

What is an enantiomer

A

One of two stereoisomers that are mirror images of each other but non-superimposable

158
Q

What are diasteromers?

A

Stereoisomers with more than one chirality center that are not-mirror images of one another
- Groups have different configurations

159
Q

How do you calculate the pI of basic amino acids?

A

(pKa2 + pKa3) / 2 = pI

160
Q

Which amino acids have 2 amines and one carboxyl group?

A

Basic

161
Q

How do you calculate the pI of Acidic amino acids?

A

(pKa1 + pKa 2) / 2 = pI

162
Q

Which Amino acids have 1 amine group and 2 carboxyl?

A

Acidic
Glu & Asp

163
Q

What amino acids are essential?

A

Phe
Val
Try
Thr
Iso
Met
His
Arg –children only
Leu
Lys

164
Q

Which amino acid is essentially for children only?

A

Arg

165
Q

The breakdown of ______________________ is essential to get certain amino acids in the body:

A

Proteins
PVT TIM HALL

166
Q

What causes Kwashiorkor?

A

Malnutrition and deficiency of essential amino acids

167
Q

Kwashiokor is caused by lack of essential amino acids from malnutrition. List 3 symptoms associated with the disorder:

A

1.) Hepatomegaly w/fatty infiltrates
2.) Edema
3.) Ulcerative dermatosis

168
Q

What is marasmus? How does it differ from Kwashiorkor?

A

There is overall calorie deprivation while Kwashiorkor is strictly deprivation of essential Amino acids

169
Q

At physiologic pH was is the normal charge of the carboxyl group and amine group?

A

Carboxyl: -
Amine: +

170
Q

These two uncharged polar side chains can lose a proton at an alkaline pH.

A

Cys & Tyr

171
Q

At physiologic pH the side chains of these amino acids are fully ionized & contain a negatively charged carboxylate group.

A

Acidic amino acids
Asp & Glu

172
Q

Acidic amino acids are considered ______________

A

Proton donors

173
Q

The side chains of the basic amino acids accept protons. At physiologic pH, the R groups of __________ and ____________ are fully ionized and positively charged. In contrast, the free amino acid ___________ is weakly basic and largely uncharged at physiologic pH

A

Lysine
Arginine
Histidine

174
Q

Describe the charge of Lys, Arg, and His at physiologic pH

A

The side chains of the basic amino acids accept protons.
At physiologic pH, the R groups of lysine and arginine are fully ionized and positively charged.
In contrast, the free amino acid histidine is weakly basic and largely uncharged at physiologic pH

175
Q

Among 3 ionizable groups, which pKa is the most important used to differentiate an amino acid?

A

pKa 2

176
Q

High HCO-3 is most often the result of compensating for:

A

High CO2

177
Q

High CO2 indicates:

A

Acidosis

178
Q

Low HCO3- indicates:

A

Acidosis

179
Q

Low CO2 indicates:

A

Alkalosis

180
Q
A
181
Q

Describe why patients with Myasthenia gravis feel better in the morning and tired towards the end of the day

A
  • Exercises exhaust their acetylcholine reserves
  • MG have antibodies against Ach Receptors
182
Q

Explain why patients with Lambert-Eaton Myasthenia improve their muscle strength with exercise

A
  • They have antibodies against voltage-sensitive Ca+ channels
  • Towards the end of the day they have repeated nervous stimulation that will keep calcium levels in the axon high
183
Q

What is contained in the buffy coat?

A

Platelets and leukocytes

184
Q

Normally, what are the most abundant leukocytes?

A

Neutrophils

185
Q

What are the least common leukocytes?

A

Basophils

186
Q

What are the 2 main components of blood?

A

Erythrocytes
Plasma

187
Q

What is the difference between serum and plasma?

A
  • Serum does not have fibrinogens and clotting factors
  • Plasma has Fibrinogens and clotting factors
188
Q
  • What is Polycythemia? AKA erythrocytosis?
  • Why is this bad?
A

1.) Too many RBC
2.) Too many RBC can change hemodynamics

189
Q

What is anemia?

A

EITHER: overall TOTAL decrease of RBC
or
Same RBC levels that are lacking Hemoglobin

190
Q

What is Leukocytosis?

A

Too many WBC

191
Q

What does the suffix “-cytosis” mean?

A

Increase in quantity of cells

192
Q

What is Leukopenia?

A

Low WBC

193
Q

What is Thrombocytosis?

A

High platelet count

194
Q

What does the suffix “-penia”

A

Lack or deficiency

195
Q

What does the prefix “Thrombo-“ mean?

A

Platelet

196
Q

Define pancytopenia

A

Shortage of all blood cell types

197
Q

In H&E staining, ___________ components stain blue/purple.
________________ components stain pink

A

Basophilic (Basic liking)
Acidophilic

198
Q

What is the lifespan of Erythrocytes?
Where do they go for degradation?

A

120 days
- Degradation occurs in the spleen, liver, and bone marrow

199
Q

What is Hemolytic jaundice caused by?

A

When RBC break down, bilirubin is formed.
Too much bilirubin = jaundice

200
Q

What does hypochromic refer to?
Why does it occur?

A
  • Less color
  • When RBC do not have enough Hemoglobin
201
Q

What is anisocytosis?

A

Variation in Red blood cell size
- Normally RBC should all be same/similar size

202
Q

What is Poiklocytosis?

A

Variation in RBC SHAPE

203
Q

What does Microcytic RBC indicate?

A

RBC are abnormally small

204
Q

What does Macrocytic RBC indicate?

A

RBC are abnormally large

205
Q

What is Schistocytes?

A

Damaged RBC
- can indicate a life threatening condition is present

206
Q

What are reticulocytes?

A
  • Precursor to RBC
  • They kick out their nucleus but still have nucleic contents including RNA, polyribosomes, mitochondria
  • Reticulocyte enters blood circulation to become RBC
207
Q

Define megaloblastic

A
  • Unusually large, structurally abnormal blood cells resulting from impaired DNA synthesis
  • Hypersegmented neutrophils usually present as well
208
Q

______________________ indicates unusually large abnormal blood cells resulting from impaired DNA synthesis

A

Megaloblastic

209
Q

Define Nonmegaloblastic

A
  • RBCs are also large but not due to mechanisms involving DNA
  • Absence of hypersegmented neutrophils
210
Q

What is another word for platelets?

A

Thrombocytes

211
Q

Compare and contrast megaloblastic vs nonmegaloblastic

A

Both involve structurally abnormal blood cells
Megaloblastic is due to impaired DNA synthesis mechanisms while nonmegaloblastic is NOT due to DNA synthesis

212
Q

T/F: Platelets have nuclei while thrombocytes do not

A

False, Platelets = thrombocytes and they do NOT have nucleus

213
Q

Gray platelet syndrome is caused by:

A

Absence of α-granules in thrombocytes so there is bleeding disorder

214
Q

Reduced delta granules in thrombocytes can lead to:

A

Platelets lack Delta granules which allows for prolonged nosebleeds

215
Q

What do thrombocytes do when there is damage to vascular endothelium?

A

Platelets adhere to the vessel wall, release granules which aggregate and strop the bleeding

216
Q

_______________ are small, lens-shaped fragments of cells. They do not have nuclei, contain microtubules, microfilaments, mitochondria, and several types of granules.

A

Thrombocytes aka Platelets

217
Q

What is diapedesis?

A

The mechanism by which leukocytes can exit capillaries to enter the surrounding connective tissue in response to infection or inflammation

218
Q

What are mononucelar leukocytes?

A
  • AKA Agranulocytes
  • Immune cell with round nucleus
  • Can have granules but their granules lack specificity
219
Q

Why is Agranulocyte a misnomer?

A

These immune cells may still have granules

220
Q

______________________ small-medium sized cells with a large round nucleus

A

Lymphocytes

221
Q

Where do lymphocytes come from? Where do they go?

A

Come from bone marrow & thymus
Circulate throughout the body & lymph system

222
Q

What are three classifications of Lymphocytes?

A

T lymphocytes
B lymphocytes
Null cells

223
Q

B lymphocytes are responsible for ________________ immune response.

A

Humoral immunity

224
Q

T lymphocytes are responsible for _____________________ immune response.

A

Cellular immunity

225
Q

What are null cells?

A

A type of lymphocyte known as Natural Killer cells

226
Q

What is characteristic about a monocyte nucleus?

A

Horseshoe or kidney shaped large nucleus

227
Q

In connective tissue this type of cell becomes a macrophage. Kupffer cell when in the liver. Microglia in the nervous system. And osteoclasts in bone.

A

Monocytes

228
Q

What are azurophilic granules?

A

Granules found in monocytes which are NONspecific granules and are named for their tendency to take up blue dye during staining

229
Q

Lymphocytes and monocytes are both types of:

A

Agranulocytes

230
Q

Neutrophils, eosinophils, and basophils are all _________________ ______________.

A

Polymorphic leukocytes

231
Q

Polymorphonuclear lymphocytes AKA granlulocytes are:

A

A type of immune cell that has granules with enzymes that are released during infection, allergic reaction, and asthma

232
Q

T/F: Agranulocytes contain azurophilic granules while granulocytes contain specific granules

A

False, granulocytes contain both azurophilic granules & secondary/specific granules

233
Q

Describe the nucleus of a neutrophil

A

Multilobed

234
Q

Neutrophils play a primary role in ____________ & _________ infections.

A

Bacterial & fungal

235
Q

Persons with myeloperoxidase deficiency have frequent and prolonged bacterial and fungal infections. Why?

A

There is NADPH oxidase defect which prevents production of superoxides in neutrophils and other cells

236
Q

What makes neutrophils primary components in bacterial and fungal infections?

A

Their secondary/specific granules have antibacterial compounds

237
Q

Eosinophils have ____________________ granules and azurophil granules. The first type of granules contain: hydrolases, peroxidases, histaminase, basic protein, and _________________ _______________ proteins which have anti_______________ properties.

A

Specific
Eosinophilic cationic proteins
Anthelminthic properties

238
Q

How do eosinophils limit inflammation?

A

They selectively ingest and degrade antigen-antibody complexes and degrade histamine

239
Q

When would you expect to see increase eosinophil levels?
When would you expect to see decreased eosinophil levels?

A

Increased: parasite infection and allergic reaction
Decrease: during corticosteroid treatment

240
Q

Why are basophils normally in low count in a CBC?

A

Their job is to bring neutrophils & eosinophils to the infection site and then die

241
Q

What component of basophils attract eosinophils & neutrophils?

A

Eosinophil and neutrophil chemotactic factors

242
Q

______________ contain specific granules with heparin, histamine, peroxidase and eosinophil and neutrophil chemotactic factors

A

Basophils

243
Q

_______________ contain histaminase and _______________ contain histamine

A

Eosinophils contain histaminase
Basophils contain histamine

244
Q

_____________ & ____________ contribute to allergic reactions and are secreted by basophils

A

Histamine and heparin

245
Q

What is MCV?
If low, what might it indicate?

A

Mean corpuscular volume-the average size of RBC
- Anemia either microcytic or macrocytic

246
Q

What is RDW?

A

Red cell distribution width
- measure of how varied the size of cells are
- Reflected in the degree of anisocytosis on blood smear

247
Q

What is MCH?

A

Mean corpuscular hemoglobin
- The average hemoglobin mass content of a RBC

248
Q

What might a low MCH indicate?

A
  • Iron deficiency or disorders of globin synthesis
249
Q

What is MCHC?

A

Mean corpuscular hemoglobin concentration
- Average hemoglobin MASS per RBC volume
- Density of Hb in volume of RBC

250
Q

What is Hematocrit?

A

Volume of RBC compared to the whole blood

251
Q

What would a high MCV indicate?
What would a low MCV indicate?

A

RBCs are large in size
RBCs are small in size

252
Q

What is RDW?

A

The Rec Cell Distribution

253
Q

What are reticulocytes?
What do they indicate?

A
  • Immature RBC
  • Accelerated erythrocyte production
254
Q

What might a reticulocyte count help indicate?

A

Early indicator or screening for iron deficiency

255
Q

What is reticulocytosis?

A

Increased circulating reticulocytes

256
Q

T/F: Hemophilia is due to low platelets

A

False, Hemophilia is a genetic disorder related to clotting factor problems. Platelets are still present in this condition

257
Q

T/F: Abnormal WBC are normally due to low neutrophil counts

A

True, since neutrophils are the most abundant WBC. If there are reduced neutrophils it will bring the WBC per microL of blood down

258
Q

What might a low WBC indicate?

A

Infection, bone marrow disorder, splenomegaly, and autoimmune disorders

259
Q

What are “band” neutrophils?

A

Immature neutrophils that are released from the marrow into peripheral blood

260
Q

What is hemolytic anemia?
What test might be ordered to determine if this is occuring?

A

When RBCs are destroyed faster than they are made
- Peripheral blood smear

261
Q

T/F: An increase in one type of WBC can cause a decrease in the percentage of other types of WBC

A

True

262
Q

High white blood cell counts may be due to inflammation, immune response, or __________________

A

blood diseases such as leukemia

263
Q

Abnormal or immature WBC may indiate:

A

Leukemia or bone marrow invasion by cancer or infection

264
Q

Where does Hematopoiesis occur?

A

In bone marrow

265
Q

All blood cells originate from a common pluripotential hemopoietic stem cell. But each cell type has its own lineage of cell generation comited to proliferate. what are these cells called?

A

Colony-forming cells or units

266
Q

Mast cells are similar to:
Why?

A

Basophils
- Mast cells play a role in immediate hypersensitivity and chronic allergic reaction
Basophils are fast to react to allergies and recruit eosinophils and neutrophils

267
Q

List the following in order:
Platelet
Thrombocyte
Megakaryoblast
Megakaryocyte

A

1ST: Megakaryoblast
2nd Megakaryocyte
3rd Platelet = thrombocyte

268
Q

What do demarcation membranes do?

A

They differentiate the cytoplasm of megakaryocytes to subdivide it into platelet zones

269
Q

Why do Thrombocytes need demarcation membranes?

A

When they are developing the megakaryoblasts do not have complete division of nuclei or cytoplasm so they are large with more chromosomes and the demarcation membranes subdivide the cytoplasm into platelet zones

270
Q

This is the order of Erythropoiesis:
1.) Progenitor cell (CFC-Es)
2.) __________________________ large cell, with large active nucleus and nucleoli
3.) 2 basophilic erythroblasts
4.) 2 polychromatophilic erythroblasts
5.) Orthochromatophilic erythroblasts: __________ ______________________ _______________
From here, the orthochromoatophilic erythroblasts, aka normoblasts, do not divide anymore. Rather they ____________________.
5a.) ___________________
5b.) mature Erythrocyte

A

2.) Proerythroblast
5.) Hemoglobin concentration rises to mature level
5a.) Differentiate
5b.) Reticulocyte

271
Q

This stage of erythropoiesis is termed:
When ribosomes are diluted by cell division and the hemoglobin concentration rises to near mature level

A

Orthochromatophilic AKA normoblast

272
Q

This stage of erythropoiesis is termed:
When the nucleus is extruded and only a few organelles (polyribosomes and mitochondria) remain in the cytoplasm

A

Reticulocyte

273
Q

Monocyte formation occurs in 3 stages:

A

1.) Monoblast
2.) Promonocyte
3.) Monocyte

274
Q

What do monocytes do?

A

Circulate for 3-4 days and then migrate into tissues. They are motile and highly phagocytic. They may mature in tissues into resident macrophages

275
Q

The second stage of monocyte formation is termed promonocytes formation. Describe what occurs here

A

Monoblast mature with the developments of cytoplasmic granules and start to have a frosted glass appearance in their cytoplasm

276
Q

Promyelocytes vary in size and are produced by the division of ___________________.

A

Myeloblasts

277
Q

Promyleocyte have abundant primary granules AKA:

A

Azurophilic granules

278
Q

What is another name for specific granules?
What is another name for nonspecific granules?

A

Specific: secondary granules
Nonspecific: Primary or Azurophilic

279
Q

The order of granulocyte formation:
1.)
2.) Promyelocytes
3.) Myelocytes
4.) Meta myeloctyes
5.) ________________ ____________

A

1.) Myeloblasts
2.) Band cells/ Band forms

280
Q

At what stage of granulocytopoiesis are nucleoli present?

A

Before and during promyelocyte stage
the second stage

281
Q

At what stage are specific granules first present in granulocytopoiesis?

A

Myleocyte stage, 3rd stage of granulocyte formation

282
Q
A