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1 - PBLs > Met > Flashcards

Met Flashcards

1
Q

Ferritin

A

Intracellular protein that acts as a buffer store of iron

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2
Q

ALP function

A

Can cause mobilisation of calcium and phosphate stores in bone to increase serum levels

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3
Q

Zonulin functions

A

Loosens tight junctions between epithelial cells of the gut lining is response to the presence of gliadin

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4
Q

Bacteria in Whipple disease

A

Tropheryma whipplei

Gram positive

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5
Q

Whipple disease pathophysiology

A

Lesions in intestinal walls
Damages billi
Also affects joints, CNS and CV systems

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6
Q

Diagnosis of Whipple disease

A

Duodenal biopsy
PAS positive staining macrophages
Pale yellow mucosa
Thickened mucosal folds

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7
Q

Whipple disease treatment

A

Penicillin, ampicillin, tetracycline, doxycycline

Vitamin supplements

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8
Q

Cholera toxin actions

A

Binds to enterocyte surface and taken up by endocytosis
Acvtiates a G protein that activates adenylyl cyclase
Increase IC cAMP levels
Overactivation of PKA
Phosphorylation of CFTR channel to open it
Large efflux of chloride ions
Water, sodium, potassium and bicarbonate follow
Rapid fluid loss leading to dehydration and diarrhoea

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9
Q

Define diarrhoea

A

Increased frequency of bowel evacuation with abnormally soft or liquid faeces with a volume of greater than 250g

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10
Q

Osmotic diarrhoea

A

Where the presence of unabsorbable products in the small intestine means that water remains in the intestines and is not absorbed
E.g. lactose intolerance

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11
Q

Secretory diarrhoea

A

Where substances are actviely trasnported into the gut lumen causing the secretion of water
E.g. cholera, salmonella

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12
Q

Inflammatory diarrhoea

A

Where bowel inflammation means the bowel is less able to absorb the products of digestion and water effectively
E.g. Crohn’s disease, ulcerative colitis

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13
Q

Complications of diarrhoea

A

Dehydration –> kidney failure, seizures, cerebral oedema, shrivelled skin, delirium, unconsciousness
Acid base imbalance - metabolic acidosis due to excessive bicarbonate loss
Malnutrition
Weight loss

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14
Q

Treatment of diarrhoea

A

ORS - glucose and sodium chloride
Diet - low fat, high fibre
Opiates (imodium) - slow transit time and increases anal sphincter tone
Bile acid sequesterants - prevents bile acids having an osmotic effect

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15
Q

Dietary water intake

A

2000-3000ml/day

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16
Q

Salivary secretions per day

A

1000-2000ml/day

17
Q

Gastric juices per day

A

1000-2000ml/day

18
Q

Bile secretions per day

A

500-1000ml/day

19
Q

Pancreatic secretions per day

A

1000-2000ml/day

20
Q

Intestinal secretions per day

A

1000-2000ml/day

21
Q

How much water enters the colon per day?

A

1500ml/day

22
Q

How much water is lost in faeces per day?

A

100-200ml/day

23
Q

Why is water needed in the gut?

A

Hydrolysis reactions
Allows substances to be brought into close contact with intestinal walls
Mixes with mucin to make mucous
Propulsion of gut contents by peristalsis

24
Q

How is gastric reflex prevented?

A

LOS tone
Acute angel where oesophagus enters stomach
Terminal oesophagus being within the abdominal cavity –> pressure collapses it
Contraction of the crural diaphragm exerts a pinch cock action on the oesophagus

25
Q

Pathophysiology of heartburn

A

Acid entering the oesophagus can get through the epithelium
Activates spinal and vagal afferents
Travel to the CNS
Give the sensation of pain

26
Q

Causes of heartburn

A 
TLOSRs
Weakened oesophageal epithelium 
Hypersensitivty to pain 
Hiatus hernia 
Increased intra-gastric pressure such as in obesity 
Decreased intra-abdominal pressure
Shortened oesophagus
27
Q

Risk factors for heart burn

A 
Obesity 
Fatty foods 
Cabonated and caffeinated drinks
Pregnancy 
Hiatus hernia 
Gastroparesis 
CCBs - relax LOS 
NSAIDs, SSRIs, bisphosphates, corticosteroids - irritation
28
Q

Diagnosis of heartburn

A 
Barium meal and x ray for obstructions 
Endoscopy for oesophagitis and masses
Biopsy for Barret's oesophagus 
Ambulatory acid probe test 
Manometry
29
Q

Treatment of heartburn/GORD

A

Actacids - neutralise stomach acid
PPIs - reduce action of H+/K+ ATPase in the parietal cells
H2 receptor antagonists - prevent binding of histamine to H2 receptors on parietal cells to decrease adenylyl cylase activation, cAMP production and therefore proton pump activation
Alginates - raft on stomach content surface
Baclofen - reduce TLOSRs
Macrolides - increase gastric motility
Surgery - fundoplication - creation of LOS with stomach

30
Q

Tests for H. pylori

A

Urea breath test
Blood antibodies
Stool antibodies
Stomach biopsy

31
Q

How does the urea breath test work?

A 
Drink containing urea 
Breath into bag 
Air tested for CO2 levels 
Higher than normal CO2 = positive 
This is because the bacteria convert the urea into ammonia and carbon dioxide
32
Q

Effects of hypoxia on EPO production

A

Decreased renal perfusion in hypoxia
Causes release of EPO from kidney
Causes increased RBC production in bone marrow

33
Q

HIF-1 in hypoxia

A

Alpha subunits not degraded in hypoxia
HIF-1 can bind to promote regions of genes to promote their transcription
Upregulation of genes involved in glycogen breakdown and glycolysis
Suppression of mitochondrial fission and promotion of autophagy to reduce oxidative stress
Upregulation of VEGF to promote angiogenesis to increase tissue perfusion

34
Q

Changes in glycogen breakdown in exercise

A

Calcium binds to calmodulin subunit of phosphorylase kinase
Activation of glycogen phosphorylase to increase glycogen breakdown
AMP also allosterically activates glycogen phosphorylase

35
Q

Entry into TCA cycle in exercise

A

Controlled by PDC

PDC unregulated by calcium and ADP

36
Q

Actions of AMP

A

Increases GLUT4 activity in muscles
Increases glycogen phosphorylase activity
Increases PFK-1 activity by activating AMPK which increases PFK2 action
Activates AMPK that inactivates ACC to prevent lipogenesis and promote fatty acid break down

1 - PBLs (8 decks)

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