GENERALITIES - ARRYTHMIAS Flashcards
The change in transmembrane voltage triggers the Na ion channels to open, which in turn causes the transmembrane voltage to be even higher. The mechanism in this is:
A. Open loop
B. Positive feedback
C. Servo mechanism
D. Negative feedback
B. Positive Feedback
POSITIVE FEEDBACK CYCLE - opens the Sodium channels.
Event that will cause rise in -70mv may cause many voltage-sodium channels to begin open, then results to rapid inflow of sodium ions.
Part of the nervous system that determines the response to stimuli
A. ANS
B. CNS
C. Sensory input portion
D. Motor output portion
B. CNS
The Central Nervous System composed of brain & spinal cord.
Brain - stores information, generates thoughts, creates ambition, and determines reaction that the body performs in response to sensations. Appropriate signals is transmitted through motor output portion of the nervous system
NOT TRUE regarding the fluid transport in the circulatory system
A. Liver stores absorbed stuff
B. Blood flows through the lungs at all times
C. Carbon dioxide is removed from the blood
D. Substances absorbed in the GIT will be used in its absorbed form
D. Substances absorbed in the GIT will be used in its absorbed form
ORIGIN OF NUTRIENT IN THE ECF
Respiratory System - provides oxygen for the body & remove CO2
GIT System - digest food and facilitate absorption of nutrients
Liver - change chemical composition of absorb substances to more usable form
Musculoskeletal system - protects internal organs and support the body
Protein channels have the ff characteristics
A. Impermeable
B. Open to engulf ions through endocytosis
C. Passage of water through pores
D. Voltage-gated channel release of Ach
D. Voltage-gated channel release of Ach
Protein Channels 2 important characteristics:
1. often selectively permeable to certain substance
2. many channels can be opened or closed by gates that regulates electrical signals (voltage-gated) or chemicals that bind to channel proteins (ligand-gated)
Differentiate Pinocytosis and Phagocytosis
A. Size of the substance engulfed
B. Action
C. Exocytosis occur at the end
A. Size of the substance engulfed
Pinocytosis VS. Phagocytosis
Pinocytosis:
1. intake of fluid
2. vesicles-invagination
3. Pinosomes release contents inside
4. May or may not be digest w/ help of lysosome
5. No exocytosis at the end
6. Size of vesicle - small (0.1-0.2)
Phagocytosis:
1. intake of solid
2. vesicles - evagination
3. Phagosomes do not directly release contents inside
4. Lysosomes combined to digest
5. exocytosis occur at the end
6. Size of vesicles - large (1-2)
Shared characteristic of simple and facilitated diffusion
A. Inhibition of Na-K pump
B. Carrier-mediated
C. Stereospecificity
D. Doesn’t need metabolic energy
D. Doesn’t need metabolic energy
SUMMARY OF MEMBRANE TRANSPORT
Simple diffusion - Passive, downhill; Carrier-mediated(NO); ATP use(NO); Na+ gradient dep. (NO)
Facilitated diffusion - Passive, downhill; YES; NO; NO
Primary Active Transport - Active; uphill; YES; YES, direct; NO
Cotransport Symport - Secondary Active; YES; YES, indirect; YES (move same direction)
Counter-transport symport - Secondary active; YES; YES, indirect; YES (moves in opposite direction)
Osmosis is primarily governed by:
A. Pressure difference
B. Degree of permeability
C. Molecular weights of solute & solvent
D. Concentration difference of solvent
D. Concentration difference of solvent
Difference of the water concentration across the cell membrane will cause to cell either shrink or swell depends on the direction of water movement.
The process of net movement of water caused by concentration difference of water is called OSMOSIS.
Peripheral membrane proteins function is primarily as:
A. Carrier for substances to pass through
B. Receptors for water soluble substance
C. Controllers of transport substances through the membrane
D. Second messengers allow communication between the interior to the environment
C. Controllers of transport substances through the membrane
Peripheral protein molecules - often attached to integral proteins. Its function almost entirely as enzymes or as controllers of transport of substances through cell membrane pores
Integral membrane proteins - serve as receptors for water-soluble chemicals (i.e peptide hormones)
Functional characteristics of Smooth Endoplasmic reticulum
A. Provides the enzyme for detoxifying substances
B. Budding off of transport vesicles for protein processing
C. Grows extensively to accommodate production of protein and lipid
D. Provides energy for the breakdown of glycogen during metabolism
A. Provides the enzyme for detoxifying substances
SIGNIFICANT FUNCTIONS OF ER, especially sER:
1. Provides enzyme that control glycogen breakdown when glycogen is to be used for energy
2. provides enzymes that are capable of detoxifying substances. Detoxification such as coagulation, oxidation, hydrolysis, & conjugation w/ glycuronic acid
Correct sequence of phagocytosis
A. Formation of phagocytic vesicle
B. Pinching off of the phagocytic vesicle
C. Inward pushing of the phagocytic vesicle
D. Cellular membrane attachment to the surface ligand of the particle
E. Contractile fibrils surround the phagocytic vesicle
D > A > E > C > B
PHAGOCYTOSIS STEPS:
1. Cell membrane receptor attached to the surface ligand of the particle
2. Formation of vesicle by evagination
3. Actin & contractile fibers surround the phagocytic vesicle
4. They contract, resulting to inward pushing of the phagocytic vesicle
5. Contractile protein pinch the vesicle for completely separation to cell membrane
Diffusion of positively charged ion outside the cell is increased
A. Pressure outside the cell
B. Negativity inside the cell
C. Positivity charged ions outside the cell
D. Concentration of substance inside the cell
B. Negativity inside the cell
Electrogenic Nature of Na+-K+ Pump
- 3 Na+ ions to the exterior every 2 K+ ions moved to the interior means a “net of one positive charge” to the “exterior”, results to “deficit of positive ion inside” the cell causes the “negativity” on the inside
Which transport mechanism DOES NOT require ATP?
A. Movement of sodium outside the cell
B. Movement of glucose to muscle cell
C. Movement of calcium to sarcoplasmic reticulum
D. Movement of ion to distal nephron
B. Movement of glucose to muscle cell
- facilitated diffusion
Movement of sodium outside cell
- primary active transport (Na,Ca,H,Cl)
What major mechanism directly contributes to resting membrane potential
A. Na K ATPase pump
B. Sodium leak channel
C. Potassium leak channel
D. Innate Nernst Potential of Na and K
C. Potassium leak channel
Leakage of Potassium Through the Nerve Cell Membrane
- may also leak sodium ions slight but MORE PERMEABLE to potassium, 100 times as permeable
- differential in permeability is a key factor in determining the level of the NORMAL RESTING MEMBRANE POTENTIAL
In a motor neuron, what will enter the pre-synaptic neuron after AP reaches its terminal?
A. Potassium
B. Sodium
C. Calcium
D. Chloride
C. Calcium
When AP spreads over the terminal, voltage-gated calcium channels open and allow calcium ions to diffuse from the synaptic space to the interior of the nerve terminal
Which of the ff statements regarding depolarization is TRUE?
A. Depolarization is the membrane potential in which occurrence of action potential is inevitable
B. Depolarization is the period in which a new AP can be elicited
C. Depolarization is the period in which a new action potential cannot be elicited
D. Depolarization is making the membrane potential less negative
D. Depolarization is making the membrane potential less negative
Depolarization Stage:
- the membrane becomes permeable to sodium ions (positively charged)
- The normal “polarized” state of -90mv is immediately neutralized by positively charge sodium ions, w/ potential rising rapidly in the positive direction
The myelin sheath of nerves is produced by supportive cells like oligodendrocytes in the CNS and Schwann cells in PNS. The ff is NOT a consequence of myelination of nerve fibers
A. Decrease in nonselective diffusion of ions across the axonal membrane
B. Increase in energy required to maintain ion gradients across the membrane
C. Increase in the velocity of nerve impulses along the axon
D. Generation of action potentials only at nodes of Ranvier only at the nodes
B. Increase in energy required to maintain ion gradients across the membrane
Saltatory Conduction is value for 2 reasons:
1. causing depolarization process to jump long intervals along nerve fibers
2. conserve energy
Which of the following statements best describes the adequate stimulus?
A. It is the minimum stimulus intensity that activates a sensory receptor
B. It is the specific form of stimulus that can generate an action potential in the sensory nerve
C. It is the only form of stimulus which can activate a sensory receptor
d. It is the form of energy to which a particular receptor has the lowest threshold
d. It is the form of energy to which a particular receptor has the lowest threshold
Adequate Stimulus
- particular form of energy to which a receptor is most sensitive; lower threshold
The resting membrane potential of the neuronal soma is primarily caused by:
Establishment of Resting Membrane Potentials under 3 conditions:
1. Potassium diffusion alone
2. Diffusion of both sodium and Potassium ions
3. Diffusion of both sodium and potassium ion plus pumping of both ions by Na+-K+ pump
The muscle end plate ACh, causes depolarization by which mechanism?
A. Opening of the voltage gated Na channel
B. Opening of the voltage gated Ca channel
C. Ca++ channel depolarization toward the Ca++ equilibrium potential
D. K+ channels depolarization toward the K+ equilibrium potential
A. Opening of the voltage gated Na channel
- Opening of ACETHYLCHOLINE-GATED CHANNEL allows large quantities of sodium ions to diffuse to interior causing a LOCAL DEPOLARIZATION that leads to the OPENING OF VOLTAGE-GATED SODIUM CHANNELS w/c initiates AP in the membrane
Which of the ff statements correctly describes Myofibrils?
1 - I bands contain only actin filaments
2 - A bands are isotropic to polarized light
3 - M line contain thick filaments linked by accessory proteins
4 - H zone are where thick and thin filaments overlap
A. 2&4 are correct
B. Only 1 is correct
C. All statements are incorrect
D. Only 1,2,3 are correct
E. 1&3 are correct
E. 1&3 are correct
1 - I bands contain only actin filaments
3 - M line contain thick filaments linked by accessory proteins
Light (I) bands - only actin filaments, they are “isotropic” to polarized light
Dark (A) bands - only myosin filaments & ends (overlapping) of actin filament; they are “anisotropic” to polarized light
Z line - where actin filaments anchored
M line - where myosin filaments anchored
H zone - contain only myosin filaments
Which of the ff achieves the side by side relationship bet actin and myosin filaments
A. Strong insertion of actin filaments into 2 discs by alpha actin
B. Large number of filamentous molecules of titin
C. Interaction of actin and myosin filaments through cross bridges
D. Absence of cross bridges in the very most center of myosin
B. Large number of filamentous molecules of titin
TITIN filaments molecules KEEP the MYOSIN and ACTIN filaments in place
- side by side relationship between myosin and actin filaments is maintained by a large number of filamentous molecule called titin
- It is “springy” due to its filamentous character
- spring titin act as framework that holds myosin and actin in place
Difference between 2 types of muscle fibers:
A. Fast fibers are rich in myoglobin to supply oxygen
B. Slow fibers have few mitochondria than fast fibers
C. Slow fibers have large amounts of glycolytic enzymes
D. Fast muscle fibers have less extensive blood supply
D. Fast muscle fibers have less extensive blood supply
Slow Fibers (Type 1, Red Muscle)
- smaller
- innervated by small nerve fibers
- more extensive blood vessel system & more capillaries ( > oxygen)
- increased in number of mitochondria; oxidative metabolism
- large amounts of myoglobin; red muscle
Fast Fibers (Type II, White Muscle)
- large
- extensive sarcoplasmic reticulum
- large amount glycolytic enzymes; glycolytic process
- less extensive blood supply
- fewer mitochondria, white muscle
Skeletal muscle contraction is termination by which action:
A. Removal of calcium from presynaptic terminal
B. Closure of Ach from the neuromuscular junction
C. Removal of Ach from the neuromuscular junction
D. Removal of intracellular calcium
A. Removal of calcium from presynaptic terminal
Removal of calcium ions from the myofibrils causes the muscle contraction to cease
Rigor mortis or post mortem rigidity results from which of the ff:
1 - Energy for muscle contraction is due to ATP from phosphocreatine and glycolytic metabolism
2 - calcium leaks from ECF and SR
3 - Binding of calcium to troponin uncovers actin binding sites
4 - Consumption of ATP disables myosin from detaching from actin
A. 1&3 are correct
B. 2&4 are correct
C. only 4 is correct
D. All are correct
C. only 4 is correct
Rigor Mortis
- muscle contract and become rigid , even w/out action potentials. Rigidity results from LOSS OF ALL THE ATP, which required to cause “separation of cross bridges from actin filaments”
- remain in rigor for 15-25hrs , until deteriorate from autolysis (enzyme released by lysosomes)
Low rate nerve impulse coming from the anterior motor neuron
Muscle tone
Skeletal Muscle Tone
- amount of tautness even the muscle at rest
- results from a low rate of nerve impulses coming from the spinal cord
Which of the ff enzymes dephosphorylates the myosin head to cause smooth muscle relaxation?
A. Calcium-calmodulin-dependent protein kinase
B. Myosin Light Chain Kinase
C. Calsequestrin
D. Myosin Phosphatase
D. Myosin Phosphatase
- remove phosphate from the myosin light chain, causing detachment of the myosin head from the actin filament and relaxation of the smooth muscle
Correct sequence of skeletal muscle excitation to contraction
- AP arrives at neuromuscular junction
- Ach released and binds to receptors
- Na ion channel open
- Depolarization in sarcolemma
- AP travels along T-tubules
- Thick and Thin interaction = muscle contraction; muscle shorten
- Calcium is reabsorbed; relaxation begins
- Thick & Thin filaments relax = muscle lengthens & relax
What is true of Sarcoplasmic Reticulum in skeletal?
A. Network forms around muscle fiber
B. Tubular network forms at Z line
C. Tubular network w/ ribosome
D. Junctional at T-tubules
A. Network forms around muscle fiber
Action Potentials w/ plateau observed in smooth muscles is due to which of the ff?
A. All of the choices
B. Slow opening of voltage-gated potassium channels
C. Rapid depolarization due to increased sodium conductance
D. Prolonged opening of voltage-gated calcium channels
E. Closure of sodium channels w/ influx of chloride
D. Prolonged opening of voltage-gated calcium channels
- the calcium channels open many times more slowly than sodium channels, and they also remain open much longer.
Not true about smooth muscles;
Similar to skeletal muscles fibers, smooth muscle fibers are capable of only all-or-nothing twitches
All-Or-Nothing Principle
- depolarization process travels over the entire membrane, but it does not travel at all conditions are not right. it applies to all normal excitable tissue, all or none law is not applicable for whole skeletal muscle
The T tubules of Skeletal muscles are located
A. I band
B. I-A band
C. M band
D. H band
B. I-A band
T Tubules
- communicated w/ the outside of the cell membrane
- lies adjacent to the ends of longitudinal sarcoplasmic reticulum
In Skeletal muscle - 2 T tubules per sarcomere; located at I-A band
Stroke Volume factors except
A. Tension as the muscle contracts
B. Load exerted on the wall
C. Force according to length
D. Blood volume going back to the heart
D. Blood volume going back to the heart
STROKE VOLUME
-determined by preload, afterload, contractility
Preload - degree of tension in muscle when it begin to contract; end-diastolic volume
Contractility - “force” that the muscle can create at the given ‘length”
Afterload - load against which the muscles exerts its contractile force; end-systolic volume
At which phase of the cardiac cycle begins with the closure of the semilunar valves and end with the opening of AV valves?
A. Isovolumetric Relaxation
B. Isovolumetric Contraction
C. Diastasis
D. Period of Filling
A. Isovolumetric Relaxation
- AV open, SL close
Isovolumetric Contraction
- AV close, SL open
Physiologic splitting of second heart sound
Physiologic split
- occurs during “inspiration’ -> chest EXPANDS -> intrathoracic pressure become negative -> INC. VENOUS RETURN to “R” side -> DELAY closure of PV -> DEC. VENOUS RETURN -> HASTEN closure of AO VALVE
Strength of cardiac muscle contraction depends on which of the ff:
A. Concentration of extracellular Ca2+
B. Concentration of NA upstroke of cardiac AP
C. Tissue requirement for oxygen
D. Amount of ATP available
A. Concentration of extracellular Ca2+
Opening of T-tubules pass directly through the cardiac muscle membrane into extracellular spaces surrounding the cells, allowing ecf in cardiac muscle
During this phase of cardiac muscle contraction, closure of Ca++ channels and increased permeability of membrane for potassium ions
A. Phase 0
B. Phase 1
C. Phase 3
D. Phase 4
C. Phase 3
Phase 0 (Depolarization) : Fast Sodium channels open - rapid inflow of Na+ causing depolarized the membrane about +20mv
Phase 1 (Initial repolarization): Fast Sodium channel close - K+ leave cell through open K+ channels
Phase 2 (Plateau): Ca2+ channels open and Fast K+ channels close - increase Ca2+ permeability and decrease K+ permeability
Phase 3 (Rapid Polarization): Ca2+ channels close and Slow K+ Potassium Channels Open - increased K+ permeability, exit the cell rapidly, end of plateau and return to resting membrane level
Phase 4 (Resting Membrane Potential) - -80 to -90mv
Part of the graph period of rapid filling
4-1
Part of the graph where aortic valve opens
2
At which point of the graph represents EDV?
1
At what phase can you hear the 4th heart sound
Phase A - B
Heart Sounds:
First Heart Sound (S1)
- closure of A-V
- vibration of taut valves, adjacent walls of heart and major vessels of heart
- duration: 0.14sec
Second Heart Sound (S2)
- closure of semilunar valve
- elastic stretch recoils the blood back to the arteries causes short period of revibration
-duration: 0.11sec
Third Heart Sound (S3)
- begin at the middle third of diastole
-between walls of ventricles
- present in children, adolescents, and young adults
- systolic failure in older adults
Fourth Heart Sound (S4)
- atrial contraction
- often heard in older patients w/ left ventricular hypertrophy
V wave corresponds to
end of ventricular contraction; slow of blood flow into atria from vein
Chest pains after fighting with boyfriend, irregular heart sound
A. Barlow’s syndrome
B. Generally not life threatening, but elevated heart rates will cause appearance of symptoms
C. Caused by backward bulging of the mitral valve during ventricular contraction
D. All of the above
D. All of the above
Weak rumbling low pitched sound after 2nd heart sound. What caused the patient’s dyspnea?
A. Reinfarction
B. Systolic heart failure
C. Underlying pneumonia
D. Valvular disease
B. Systolic heart failure
S3 Third Heart Sound
- begin at middle 3rd of Diastole
- ventricles are not filled sufficiently causes reverberation of its walls
- vibration of blood between walls of ventricles as it rushes from atria
- WEAK, RUMBLING SOUND (20-30HZ)
Venous return curve plateau is caused by?
A. Increased intrathoracic pressure
B. Drop of atrial pressure to 0mmHg
C. Zero pressure gradient between psf and RA
D. Collapse of large veins
D. Collapse of large veins
Plateau in Venous Return Curve at Negative Atrial Pressure:
- caused by collapsed of the large veins
- R.A pressure falls below zero
- at below atmospheric pressure -> increase in venous return
- R.A pressure falls to -2mm Hg -> venous return reach plateau - causes collapse of the veins entering the chest
Causes a shift to the right in the cardiac output venous return curve
A. Moderate Exercise
B. Blood Transfusion
C. Hemodialysis in AV fistula
D. Surgery
B. Blood Transfusion
Infusion -> increase Psf to 16mmHg -> shifts the venous return curve to the right
Increased Blood Volume -> reduce resistance of BV -> reduce resistance to venous return -> rotates curve upward
Not true regarding atrial repolarization
A. Occurs 0.15 after P wave
B. Presented at atrial T wave which is often not visible because it is buried in QRS
c. Atrial T wave is normally negative rather than positive in the three standard bipolar limb
D. Atrial repolarization vector is the backwards of the vector depolarization
c. Atrial T wave is normally negative rather than positive in the three standard bipolar limb
Atrial Repolarization
- follows about 0.15 secs after atrial P wave
- atrial T wave is normally positive negative
- atrial T wave appears same time with QRS
- obscured by larger QRS complex, seldom to observed in ECG
The ECG waveform is considered normal in which lead
A. Lead III
B. v2
C. aVR
D. V5
C. aVR
A healthy 24-year old 80kg male, w/ BMI of 24kg/m2 and body surface area of 2 square meters, with a cardiac output of 5.6 L/min has a cardiac index of:
A. 3 L/min/m2
B. 2.5 L/min/m2
C. 2.3 L/min/m2
D. 2.8 L/min/m2
D. 2.8 L/min/m2
Cardiac Index = CO/sq.BSA = 5.6/2 = 2.8
When impulse travels from AV node to the ventricles, which of the ventricles get depolarized first?
A. The left endocardial surface of septum
B. Endocardial surface of the right ventricular free wall
C. Epicardial surface of apex
D. Endocardial surface of the later LV free wall
c. Atrial T wave is normally negative rather than positive in the three standard bipolar limb
The ff condition can produce a decrease in the ECG voltage, Except
A. Pulmonary Emphysema
B. Left ventricular Hypertrophy
C. Pericardial effusion
D. Pleural effusion
B. Left ventricular Hypertrophy
The ff ECG shows biphasic t wave which is characteristic of:
A. Myocardial ischemia
B. Digitalis toxicity
C. BBb
D. None of the above
B. Digitalis toxicity
Ventricular repolarization is represented by what ECG wave?
A. P wave
B. R wave
C. T wave
D. U wave
C. T wave
- ventricular repolarization; muscle begin to relax; before end of ventricular contraction
The ECG Dropped beat
A. 1st degree av block
B. 2nd degree of mobitz type 1
C. 2nd degree of mobitz type 2
D. 3rd degree av block
B. 2nd degree of mobitz type 1
- progressive prolongation of P-R interval until a ventricular beat is dropped followed by resetting of the P-R interval and repeating abnormal cycle
- benign
A patient with no cardiac symptoms had palpitations, when palpating the patient’s radial pulse, what will you feel?
A. Pulse deficit
B. Strong pulse
C. Hyperdynamic pulse
B. Strong pulse
70 year old man complained of chest pounding (w/ ecg)
A. Electrical alternans
B. Premature ventricular contraction in bigemny
C. Premature atrial contraction
A. Electrical alternans
Chest pounding is an letricalalternans manifestation
Pac. eletrical impulse comes from
A. Right atrium
B. Left atrium
C. AV node
D. Coronary sinus
C. AV node
The 2 vitamins needed for RBC maturation
Cyanocobalamin (Vit.12) & Folic Acid
Site of RBC production during the last stage of gestation
A. yolk sac
B. Bone marrow
C. Liver
D. Spleen
B. Bone marrow
Production of RBC:
Yolk sac -early weeks of embryonic life
Liver - middle trimester of gestation; main organ for RBC production
Bone marrow - last month and after birth
Vertebrae (Ilium) - after 20 yrs of age
A 12 y/o child sought consultation w/ a pediatrician due to pallor and occasional dyspnea. Based on physical assessment and laboratory exam results, the child was diagnosed to have pernicious anemia. Which of the ff statements is TRUE?
A. There is poor Vit. B12 absorption from the GIT due to lack of intrinsic factor thus causing RBC maturation failure
B. Vit. B12 and Vit. K are needed in patients w/ pernicious anemia
C. Lack of intrinsic factor increases the availability of Vit. B12
D. Intrinsic factors binds loosely w/ Vit b12 thus it can be digested by the GIT secretions
A. There is poor Vit. B12 absorption from the GIT due to lack of intrinsic factor thus causing RBC maturation failure
-Maturation Failure Anemia caused by Poor Absorption of Vit.B12 from the GIT - occurs in Pernicious Anemia
An area with no rbc production after 20 y/o
A. Ribs
B. Sternum
C. Proximal Humerus
D. Vertebrae
marrow in long bones; exception the proximal humerus and tibiae
Agglutinates with anti-A
A+ blood type ; A agglutinogen (antigens) and B agglutinins (antibodies)
Blood types and Agglutinogens, Agglutinins
OO - O - (-) - anti-A and Anti-B (universal donor)
OA or AA - A - A - Anti-B
OB or BB - B - B - Anti-A
Ab - AB - A and B - (-) (universal recepient)
Fatal effect of transfusion reaction
A. Kernicturus
B. Kidney failure
C. Hemolytic disease of new born
D. Hyperbilirubinemia
B. Kidney failure
Acute Kidney failure after Transfusion reactions, begin w/ few mins to few hrs and continue until person dies of acute renal failure
A preterm infant was delivered via Cesarean section secondary to nonreassuring fetal heart rate pattern. On the 2nd hospital day, generalized jaundice was observed and laboratory exams were taken. The infant was then diagnosed w/ erythroblastosis fetalis. Which of the ff statements is CORRECT?
1 - The mother is Rh positive and father is Rh negative
2 - There is a rapid production of RBC including the nucleated blastic forms which are passed in the infants circulation
3 - the incidence decreases progressively w/ subsequent pregnancies
4 - The anti-Rh agglutinin will circulate in the infant’s blood for another 1-2 months after birth causing destruction of more RBCs
A. 1,2,3 correct
B. only 4 is correct
C. 2 and 4 correct
D. 1 and 3 correct
C. 2 and 4 correct
A 5 y/o child is playing in the playground and fell into the ground. He hit the ground w/ his right wrist causing an inflammation to the wrist
A. Vasoconstriction of the blood vessel
B. decrease permeability of the capiillaries
C. clotting of fluid in the interstitial spaces
D. increase of granulocytes in the area
C. clotting of fluid in the interstitial spaces
Inflammation characterized by:
- vasodilation of BV; increased blood f;ow
- increased permeability of capillaries; allows leakage of large amount of fluid in Interstitial space
- clotting of the fluid in interstitial space because of increase fibrinogen and leaking in capillaries
- migration of large numbers of granulocytes and monocytes in tissue
- swelling of tissue cell
An 8 y/o child came in to the clinic due to headache, dizzines, and shortness of breath. Its been 3 days since he started to experience these symptoms but there were bouts of head ache and dizzines few months ago. Patient is diagnosed case of Polycythemia vera. Which statement does not describe the case of the patient?
A. RBC count may reach 7-8 millions/mm3 and hematocrit may be 60-70 percent
B. Blood flow through the peripheral blood vessels is often rapid
C. There is an increased blood viscosity w/c decreases the rate of venous return to the heart
D. The quantity of blood in the skin subpapillary venous plexus is greatly increased
B. Blood flow through the peripheral blood vessels is often rapid
Polycythemia vera - due to increase in viscosity of the blood, blood flow is often slow
Based on the case in # 67 about Polycythemia vera.
1- RBC count may reach 7-8 millions/mm3 and hematocrit may be 60-70 percent
2. Blood flow through the peripheral blood vessels is often rapid
3 - There is an increased blood viscosity w/c decreases the rate of venous return to the heart
4 - The quantity of blood in the skin subpapillary venous plexus is greatly decreased
A. 1 and 3
B. only 4
C. 2 and 4
D. 1,2,and 3
C. 2 and 4
- Blood flow through the peripheral blood vessels is often rapid
4 - The quantity of blood in the skin subpapillary venous plexus is greatly decreased
Not part of reticuloendothelial system
A. Neutrophils
B. Mobile macrophages
C. In spleen
D. Monocyte
A. Neutrophils
reticuloendothelial systems
- monocyte
- mobile macrophages
- fixed tissue macrophages
- specialize endothelial cells in the bone marrow , spleen and lymph nodes
In an adhesion molecule that is found on the surface of endothelial cells in the capillaries that react with the integrin molecules in the neutrophils causing margination of the neutrophils
A. Leukotrienes
B. Tumor necrosis factor
C. interleukin 1
D. ICAm-1
D. ICAm-1
A 4 y/o child complained of pruritic maculopapular lesions on the extremities after eating egg and chicken. What could be the possible cause of the symptoms of the patient?
A. IgA has a special propensity to become attached to the mast cells and basophils during allergic reactions
B. Monocytes collect in the skin after an allergic reaction
C. The mast cells and basophils release histamine and bradykinin
D. Eosinophils are strong phagocytes and they exhibit chemotaxis and play a role in allergic reactions
C. The mast cells and basophils release histamine and bradykinin
What is the use of the cytoplasmic enzymes of the RBC?
1- Maintain pliability of the cell membrane
2 - maintain membrane transport ions
3 - prevent oxidation of the proteins in the RBCs
4. Keep the iron of the cells hemoglobin in the ferric form
A. 1 & 3
B. 2&4
C. 1,2,3
D. AOTA
C. 1,2,3
1- Maintain pliability of the cell membrane
2 - maintain membrane transport ions
3 - prevent oxidation of the proteins in the RBCs
True about antigen-presenting cells:
A. T lymphocytes respond to antigen only when they are bound to MHC proteins on the surface of antigen-presenting cells of Is in the lymphoid tissue
B. The B lymphocytes are the most potent of the antigen-presenting cells
C. The role of B lymphocytes is to present antigens to T cells
D. AOTA
A. T lymphocytes respond to antigen only when they are bound to MHC proteins on the surface of antigen-presenting cells of Is in the lymphoid tissue
Live attenuated vaccine?
1 - MMR
2 - hepa B
3 - varicella
4 - Oral polio
1 - MMR
3 - varicella
Which of the ff shows failure of the tolerance mechanism?
A. Myasthenia gravis
B.Rheumatic fever
C. Multiple sclerosis
D. Leukemia
A. B, C
A. Myasthenia gravis
B.Rheumatic fever
C. Multiple sclerosis
++ systemic lupus erythematosus , glomerulonephritis
The ff statement is correct on T cells:
A. Helper t cells compromised 75% of the total T cell
B. Cytotoxic T cell is the major regulator of virtually all immune function
C. Regulatory T cells contain perforins which they use in attacking other cells
D. AOTA
A. Helper t cells compromised 75% of the total T cell
A 5 y/o child is complaining of pruritic urticaria located at the upper and lower extremities. Mother gave an oral antihistamines to alleviate the symptoms. Which statement best explains the urticaria of the patient?
A. Histamine is released locally to cause vasoconstriction that induces the red flare
B. There is widespread allergic reaction that occurs throughtout the vascular system
C. there is an increase local permeability of the capillaries that lead to the swelling of the skin
D. Leukotrienes are released to cause spasm of the smooth muscle of the bronchioles eliciting an asthma-like attack
C. there is an increase local permeability of the capillaries that lead to the swelling of the skin
Urticaria
entering specific skin areas -> localized anaphylactoid reaction
Histamine
1. vasodilation -> red flare
2. increased local permeability -> swelling of the skin
Which is considered as the rate of limiting factor in blood coagulation?
A. Polymerization of fibrinogen molecules into fibrin fibers by thrombin
B. Formation of prothrombin activator
C. Conversion of prothrombin to thrombin
D. release of tissue factor
B. Formation of prothrombin activator
It is a procoagulant substance release by the platelet during clot retraction which causes more and more cross linking bonds between adjacent fibrin fibers:
Fibrin-stabilizing factor (TF XIII)
Vitamin K dependent clotting factors
Prothrombin, factor VII, Factor IX, factor X
The ff is not included in the intrinsic pathway for initiating clotting:
A. Activation of Factor XI by Factor XIIa
B. Activation of Factor XI by Factor XIIa
C. Activation of factor IX by Factor Xa
D. Formation of Prothrombin activator by Factor Xa and Factor V
C. Activation of factor IX by Factor Xa
