Misc Questions pt 1 Flashcards
What does each of the following serum enzymes indicate:
- AST
- ALT
- ALP
- Amylase
- Aspartate aminotransferase: increased in MI. Confirmed with presence of serum Troponin T & I
- Alanine transaminase: indicates liver damage, bile duct problems, myopathy
- Alkaline phosphatase: indicates obstructed bile duct, Paget’s disease (it is a by product of osteoblast)
- High plasma amylase indicates pancreas damage
* ALT is elevated in both liver damage and bile duct problems. However, ALP is more specific indicator of bile duct obstruction
* * Problems in the tubular portion of the GIT don’t produce any distinctive serum enzyme patterns
The glutamate residue on factor II, X, IIV, IX must be converted to ……. in a reaction requiring …… for optimal activity
gamma-carboxyglutamate
Vit. K
* Vit K deficiency will lead to increase PT/INR
* Common in neonates (present with multiple hemorrhages)
What does each of the following contain
- Midbrain
- Pons
- Medulla
- Hypothalamus
- Micturition center
- pneumotaxic center
- respiratory center, vomiting, swallowing, coughing centers
- Thermal regulation, thirst, food intake
Removal of the ant. Pituitary gland may mitigate the hyperglycemia in DM type I. T/F??
True
The ant. pituitary secretes GH, ACTH, TSH, all which decrease peripheral sensitivity to insulin, and worsens hyperglycemia.
Each one of these defects leads to what?
- Aortic stenosis
- Aortic insufficiency
- Mitral stenosis
- Mitral insufficiency
- increases afterload, causing a pressure gradient between the ventricle and the aorta. Causes systolic murmur
- increases preload, produces retrograde flow from the aorta to the ventricle, leading to a diastolic murmur
- increases left-atrial volume and pressure, producing a diastolic murmur
- increases volume and pressure in the atrium and ventricle, producing a systolic murmur
Free thyroixe level test is used to ??
check the status of the thyroid gland.
* Increased levels of free thyroxine (non-TBG bound) indicates hyperthyroidism
Acute gastric stress ulcer may be caused by …… . The blood flow to the stomach is ……
weakened gastric epithelium, with high levels of pepsin & HCl
Blood flow to the stomach is compromised in stress ulcer (as blood provides O2, and HCO3 to protect from the harsh acidic environment of the stomach)
Drug induced impotency is caused by …… . While ejaculatory incompetence is caused by …..
inhibition of the NO synthase, which forms NO from Arginine.
- NO causes relaxation & vasodilation so the corpus cavernosa accommodates more blood
- The function of the synthase is maintained by androgens
- Low Oxytocin and prostaglandin (they have no effect on impotency)
Finasteride is a drug used to inhibit ……
the enzyme 5α-reductase
- This converts testosterone to DHT
- used to treat BPH & baldness
Which of the following substances cause a “stable” froth in urine when present in large amounts?
- Protein
- Ketone
- Bilirubin
- Protein would be the correct answer for “stable” froth
- no froth, only acetone like odor
- causes yellow foam
Blood flow is the same for different types of the blood vessels each minute. T/F??
True
* The velocity of flow is different, and usually depends on the cross section of the vessel. So, capillaries have the largest cross section, and the lowest velocity of blood.
What is relaxin?? and what are the functions?
It is a hormone, secreted by the corpus luteum (along with progesterone and estrogen). In pregnancy, it causes increased CO, renal blood flow.
- In the males, it enhances sperm motility
- It
What is the calorie content of each of the following
- Carbs
- proteins
- fats
- 3.4 kcal
- 4 kcal
- 9 kcal
- Central chemoreceptors are sensitive to arterial pH. T/F
2. Peripheral chemoreceptors are sensitive to arterial pH. T/F
- False. However they are sensitive to H from the dissociation of carbonic acid in the CSF
- True
Hypoventilation of central origin means …..
depression of the respiratory center in the pons and medulla by drugs
- Nicotinic receptors are non …….
- GABA receptors are ….
- Dopamin receptors are …..
- g protein coupled receptors. They are ligand gated ion channel receptors. Stimulation leads to Na influx & excitation
- same as nicotinic receptors, but excitation leads to Cl influx, stabilizing the membrane potential of the cell (inhibitory)
- G protein coupled receptors. Stimulation causes lowering of adenylate cyclase, and hence cAMP
What are the isoenzymes of creatine kinase??
- CK MM: found in skeletal muscles
- CK BB: found in brain
- CK MB: found in cardiac muscle
* Increased the level of these isoenzymes to the total CK indicates damage to the related organ.
* Example: an accident secondary to MI, will elevate CK MB / CK total
How to calculate the following volumes?
- ECF
- Plasma volume
- total body water
- measured by distribution of solute that diffuse through the capillaries, but not through the cell membrane. Like mannitol & inulin
- Measured by radioactive serum albumin or Evans blue dye (which binds to albumin)
- Measured by the volume of tritium, antipyrin or deterium
Explain why the Cardiac output increases in severe anemia?? And why there is GIT problems at the same time ?
- In severe anemia, there is tissue hypoxia, which causes the peripheral blood vessels to dilate. This allow more blood return to the heart.
- Viscosity is reduced in anemia, which lowers the peripheral vascular resistance to blood flow, allowing even more blood return to the heart.
- In severe anemia, blood is shunted away from the splanchnic vessels
What is the relation between PTH and magnesium??
Prolonged low serum magnesium (due to malnutrition with alcoholism) leads to decrease PTH release and efficiency.
- Acute decrease of Mg will increase PTH, but the chronic decrease in level lowers PTH
- Chronic low Mg will cause low Ca & high PO4 levels. This is called “functional hypothyroidism”
- Symptoms of low Ca are tremor, fasciculation, and seizures.
What is the C peptide?
it is a molecule that joins the alpha & beta chains of insulin. When insulin is released from beta cells, C peptide is also release in a 1 to 1 ratio.
* In case of insulin producing tumors, C peptide is also increased
Define glycated hemoglobin
a form of Hb that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time
- The fraction of glycosylated Hb is increased in hyperglycemia (i.e diabetes)
- Also called Hb A1C
What is the fate of the remaining monoglycerides from triglycerides metabolism?
In the adipose tissues and all cells, monoglyceride lipase removes the last fatty acid from the glycerol back bone.
* It acts in concert with hormone sensitive lipase.
Explain each of the following
- Moro reflex
- Babinski reflex
- Palmar reflex
- Tonic neck reflex
- startle reflex, the infant extends and abducts the arms, followed by flexion and adduction of the arms. Disappears at 6 months
- stroking of the sole or the lateral side fo the foot will cause great toe going up and the other toes fanning. Normal in infants up to 1 year, pathological in adults
- infant’s hand closing over an object that is placed in the palm
- extension of the ipsilateral leg and flexion of the contralateral arm and leg when the head is turned
After losing about 20% of the blood volume, normal atrial filling can be restored by …..
constriction of the veins and venules
* Mediated by the sympathetic nervous system
What is the effect of CCK, steroids & sympathetic stim. on the GIT movement?
They control the rate & amplitude of the frequency of the bowl movement, but not the frequency of the slow bowl movement itself
Increasing urine flow rate from 1 mL/min to 10 mL/min will significantly increase the clearance of …..
urea
- urine flow rate is controlled by ADH, and ADH control the reaborption of urea in the collecting duct.
- High urine flow means low ADH, and more urea excreted
For a person living at high altitude, the respiratory rate, HCO3 excretion & mitochondrial density would be …..
increased
The serum level of …… is increased in patient with nephrotic syndrome caused by membranous glomerulonephritis
cholesterol
- hyperlipidemia, due to increased hepatic fat synthesis and decreased fat catabolism
- triglycerides, and lipoproteins are found in serum in membranous glomerulonephritis, and these lipids also leak into the urine, producing lipiduria
The endometrial phase with small glands is …. while the one with the large glands is ….
proliferative phase
secretory phase
* estrogen and (progesterone) are responsible for the change from phase to another
When pulse rate increases, what happens to the systolic and diastolic times in the cardiac cycle?
Systolic time is decreased but diastolic time has decreased more
* Under normal conditions, one third of the cardiac cycle is spent in systole and two thirds is spent in diastole
A patient experiencing pain postprandial of a fatty meal is due to ……
cholelithiasis
* Gall bladder contraction is stimulated by CCK
Motilin is ……
a hormone that regulates the migrating myoelectric complex, that occurs during fasting, clearing the stomach and small intestine of any residual food
- Migrating myoelectric complex helps trigger peristaltic waves, which facilitate transportation of indigestible substances to the colon
- Secreted by M cells, which are numerous in the crypts of the duodenum. (not the same M cells as the ones in Peyer’s patch)
Von willbrand factor forms a bridge between ……. & …….
exposed collagen at the injury site and circulating platelets stimulating platelet degranulation and initiating the clotting cascade
- Also, it binds platelets to the newly formed fibrin strands in a blood clot.
- Leads to increased PTT & BT
Increasing plasma concentration of phosphate will increase its urine clearance because ……..
it is reabsorbed by facilitated mechanism (Na-PO4 symport in the PCT)
* As the concentration of phosphate increases, the transporter saturates, leaving more phosphate available for excretion
Antibodies against the intrinsic factor producing cells in the stomach cause …..
pernicious anemia
Why aspirin administration may cause asthma?
Because aspirin inhibits cyclooxygenase pathway (which causes bronchodilation), while it doesn’t inhibit lipooxygenase (which form leukotrienes from arachidonic acid)
- Leukotrienes causes bronchoconstriction
- The ratio prostoglandins : leukotriens is decreased
Upper respiratory tract infection reduces the threshold of …….
respiratory mucosa to parasympathetic (vagal) stimulation and its bronchoconstrictor influence on the lungs
Nervous tissue maturation, ossification of bone, conversion of carotene to vitamin A is increased by ……. hormone
thyroid
* Also increases glucose absorption from the intestine
Cancer of ……. increases erythropoietin level
kidney
Why thrombin cleaves fibrinogen twice?
First cleavage causes polymerization of fibrin, the second causing it to branch
* Fibrin then activates factor XIII , which increases the strength of the clot by cross-linking the newly formed fibrin threads
Ach release from the presynaptic neuron is blocked by …..
Botulinus toxin
* treatment by anti-cholinesterase, such as nistigmine
Angiotensin-converting enzyme is present in ……
the endothelial cells of the alveolar capillary bed
In anemia, O2 carrying capacity is ……, this means that O2 contents is ……, but PO2 in the arterial blood is …..
decreased
decreased in blood
not affected (Hb saturation is independent from Hb concentration)
* Note that 2,3 DPG, H & Cardiac output will all be increased in anemia
* Note that venous PO2 will be decreased to lower than normal levels during rest and to very low levels whenever exercise is attempted.
Hormone replacement of ….. & …… is required (urgently) for patient who had a tumor removed next to the pituitary
glucocorticoids & thyroid
* it can be discontinued later if the function of the pituitary is not compromised
Mild CO poisoning causes …..
symptoms similar to flu, which delays its diagnosis
What is the function of:
- Type II fibers
- Type III fibers
- Touch and pressure sensation. Located in the dorsal column
- Temperature, pain and light touch. Located in the anterolateral system
An alcoholic man with Wernicke triad and Korsakoff syndrome can be treated with …..
B1 thiamine
* Wernicke triad (ophthalmoplegia, ataxia, and global confusion)
Secretin & GIP both …… gastric motility
decrease
If a person suffered a stoke that left them partially paralyzed on one side of the body, one would expect to see an increased number of …….
microglia (in the area of stroke)
If the level of thymosine production is reduced in the thymus, the result is ……..
decrease T lymphocyte
* If the lymphocytic stem cells remain in the bone marrow, they will differentiate into immature B cells and NK cells
Carotenemia (excessive intake of vitamin A) causes ……
yellowing of the skin, especially on the palms and soles
LDL are transported into cells by ……
receptor-mediated endocytosis
Most of the fluid reabsorbed by the kidney occurs in ………
PCT
Most of the muscles in the body can be classified as ……….
parallel muscles
* There is also: circular, convergent, pennate
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Neutralization of acids by saliva results mainly from ……
bicarbonate
