Physiology and pharmacology Flashcards

1
Q

What are the four types of receptor

A

G - coupled receptor
Nuclear receptor
Ligand gated ion channel
Type 3 kinase receptors

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2
Q

What is an agonist for GABAaR

A

GABA, phenobarbitone

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3
Q

What is an antagonist for GABAaR

A

Picrotoxin

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4
Q

Is the Beta1 adrenoceptor inhibitory or excitatory

A

Excitatory

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5
Q

Is the Alpha 2 adrenoceptor inhibitory or excitatory

A

Inhibitory

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6
Q

What compound blocks the release of acetyl choline

A

Botulism

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7
Q

What type of nerve is the vagus nerve

A

Mixed nerve, cranial

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8
Q

List four targets of the vagus nerve

A

Liver, heart, lungs, tongue

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9
Q

What neurotransmitter is used at the vagal nerve endings

A

ACh

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10
Q

What effect is there from increase vagal output on the

  1. Heart rate
  2. Secretion from reproductive glands
  3. Most visceral blood vessels
  4. Bronchioles
  5. Sweat glands
A

Decreased, increased, vasodilation, constriction, none

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11
Q

What is the use of diazepam

A

A muscle relaxant

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12
Q

What is the use of cortisol hormone as a drug treatment

A

Reduces inflammation

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13
Q

How is the endocrine system co-ordinated

A

Hypothalamus secretes factors that act on the pituitary gland

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14
Q

What does the release of prolactin stimulate

A

Lactation

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15
Q

What does the release of growth hormone stimulate

A

chondrocytes in bone growth and uptake of amino acids

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16
Q

What are the differences between the two types of diabetes mellitus

A

Type 1 diabetes - Beta cells on the Islet of Langerhanns no longer present due to autoimmune disorder - leads to lack of insulin production and release - insulin no longer binds to peripheral cells to increase blood glucose absorption so blood glucose is high, but the body perceives it as being normal due to lack of beta cells so lipids and proteins are broken down further increasing blood glucose - causes excess glucose in urine (polyuria) and increased urinary output causing dehydration and fatigue etc

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17
Q

Type 2 diabetes?

A

Insulin levels are normal, however the peripheral cells don’t respond to it causing increased blood glucose levels

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18
Q

How is type 2 diabetes treated?

A

Metformin - Causes an increase of glucose uptake by muscles, reduces hepatic production of glucose,

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19
Q

What is Diabetes Insipidus

A

The posterior pituitary gland fails to produce ADH so excessive drinking and urination occurs

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20
Q

What does the thyroid hormone stimulate

A

protein synthesis, increased use of glucose and free fatty acids, increased lipolysis

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21
Q

What can too little thyroid stimulating hormone cause

A

Cretinism - Mentally immature - can’t hear or speak

bone growth retardation and sexually immature

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22
Q

What can too much thyroid stimulating hormone cause

A

Graves disease - Antibodies mimic TSH - pressure behind the eyes
Goiter - Usually attributed to low dietary intake of iodine

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23
Q

What makes up the intima of blood vessels

A

Basement membrane and epithelium

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24
Q

What makes up the media membrane

A

Elastic laminae or smooth muscular tissue

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25
What makes up the adventitia (external)
Collagen, vaso vasorum (blood vessels for the larger blood vessels), Nerves, lymphatics
26
What is the aorta
Elastic artery where most the smooth muscle of the media layer has been replaced with concentric layers of elastic tissue
27
What is arteriosclerosis
Thickening and toughening of arterial walls, focal calcification leads to a rigid wall
28
What is atherosclerosis
Vessel wall infiltrated by immune cells and fatty deposits | Plaque deposits on the vessel wall reduces vessel volume
29
What is a characteristic of arterioles and venules
Often found running alongside each other
30
What body system do arterioles regulate and how
Blood pressure through the angiotensin system Dehydration leads to decreased blood volume and pressure: Stimulates specialised cells in the glomerulus (macula densa) to produce renin - renin acts on angiotensinogen produced by the liver and cleaves part to form angiotensin I - Angiotensin converting enzyme produced by vascular endothelium (so mainly at the lungs) converts angiotensin I to angiotensin II which is the active form - This causes vasoconstriction increasing BP - also acts on the adrenal cortex causing production of aldosterone that causes salt and water reabsorption also increasing BP
31
What are ramipril and perindopril examples of
ACE inhibitors
32
What is a fenestrated capillary
Has gaps between its epithelial cells and very thin epithelia offering very little resistance
33
What vital role do capillaries have in the lymphatic system
Formation of tissue fluid
34
What are the different circuits of circulation
Systemic and pulmonary
35
What is in short term control of arterial BP
Baroreceptors When mean arterial BP is low it causes increased sympathetic activity on the heart raising both rate and force of contraction of the heart increasing cardiac output Also - increased sympathetic flow to blood vessels causes constriction increasing resistance in the vessels
36
what is phenylephrine
Sympathetic agonist to alpha 1 receptors causing increased vasoconstriction
37
What is dobutamine
A sympathetic agonist to beta 1 receptors causing increased cardiac output
38
What is digitalis
A sodium potassium pump inhibitor that causes excess sodium to be swapped with calcium causing greater contraction of the heart
39
What is prazosin
A sympathetic antagonist to alpha 1 receptors causing vasodilation
40
What is atenolol
sympathetic antagonist to beta 1 receptors causing decreased cadiac output
41
What is verapamil
A calcium channel blocker reducing force of muscle contraction
42
What are three normal variations in BP caused by
exercise, sleep, time of the year
43
What is an abnormal variation in BP caused by
Hyper or hypotension
44
What are the zones of the lungs
1: the conducting zone - No gas exchange in the upper airways - from nose to bronchial tree - function is to filter incoming air and to warm and humidify it 2: the respiratory zone - An increased surface area around 100m2 aids for rapid gas exchange
45
What three specialisations to epithelium of the lungs have
Ciliated - removal of bacteria Goblet cells - produce mucous to catch bacteria Sensory nerve endings - React to relevant stimulus to produce reflexes
46
Describe the alveoli
A sandwich created by flattened cytoplasm of type 1 pneumocytes and the capillary wall creates multiple barriers that have to be crossed for gas exchange over as small a distance as possible - large surface area
47
What is quiet inspiration
Only the primary muscles of inspiration involved (diaphragm and intercostal muscles) - diaphragm is pushed down to increase the thoracic and lung volume
48
What is forced inspiration
Recruits in accessory muscles (neck and back muscles as well as upper respiratory tract muscles)
49
What is quiet expiration
Passive process using elastic recoil, just the relaxation of the external intercostal muscles and recoil of the lungs
50
What is forced expiration
Accessory muscles recruited (internal intercostal muscles, abdominal muscles and neck and back muscles)
51
What is the pleura
A cavity filled with secretions lining the lungs preventing them from sticking to the chest wall - enables the free expansion and collapse of the lungs
52
What is the importance of balancing chest and lung elastic forces at rest
Maintains that the interpleural space is at a lower pressure than that of the atmosphere
53
What happens when a lung collapses
When the lung is punctured it releases air increasing the pressure within the pleural cavity causing the lung to collapse
54
What is compliance and how can it be measured
A measure of elasticity and is the change in volume/the change in pressure
55
What is low compliance
More work required to inspire - pulmonary fibrosis - lung parenchyma are more rigid
56
What is high compliance
Often involves difficulty in expiring - Loss of elastic recoil - emphysema
57
What is surface tension
The recoil due to tension generated at the air - fluid interface - The initial phase of inspiration is to overcome the surface tension to open the airways
58
How do surfactants work
Decreases density of water molecules and has a hydrophobic tail that pulls the surfactant molecule upward so its vector is minimal
59
Where is surfactant produced
Type two pneumocytes
60
What controls are in place on bronchial smooth muscle
Parasympathetic - ACh released from the vagus nerve acts on muscarinic receptors leading to constriction Sympathetic - Release of norepinephrine acts as a weak agonist leading to dilation (epinephrine is a better dilator)
61
What two categories of lung disease are there
Obstructive - reduction in flow through airways and Restrictive - reduction in lung capacity (both reduce ventilation)
62
Narrowing of airways could be due to?
Excess secretions, bronchoconstriction (Asthma) and inflammation
63
What to obstructive lung diseases cause in an individuals FEV1 and flow volume loops and vital capacity
FEV1 is greatly reduced, the flow volume shows a reduction in flow rate and the vital capacity remains the same but takes longer to get to
64
Examples of obstructive lung disease
Chronic bronchitis - excess mucous Astchma - inflammatory disease COPD - Structural changes due to inflammation Emphysema - loss of elastin
65
What is a treatment for asthma
Short acting B2 adrenoreceptor agonists salbutamol causes relaxation of smooth muscle - bronchodilation Long acting - Glucocorticoids change gene expression reducing effect of inflammatory response
66
What symptoms are there of restrictive lung diseases
VC is reduced, reduction in volume of air moved and potential reduction of peak flow
67
What is asbestosis
Small particles build up in the alveoli - fibrous tissue builds up around the unremovable particles leading to loss of compliance
68
How is the basic rhythm of respiration controlled
By centres in the medulla
69
What groups are involved in the quiet inspiratory output
The dorsal respiratory group primarily for quiet inspiration
70
What group is involved in forced inspiration
Ventral respiratory groups
71
What controls the basic breathing pattern
The pre botzinger complex in the ventral respiratory group
72
What groups are involved in forced expiration
The ventral respiratory group
73
Why are no groups responsible for quiet expiration
Because it is passive and requires only elastic recoil
74
What controls the depth of breath
How long the dorsal respiratory group fires action potentials for
75
What two centres in the pons have respiratory functions
The pneumotaxic centre - increases the rate by shortening inspirations, inhibits the inspiratory centre and the apneustic centre - increases depth of breaths by stimulating the inspiratory centres
76
What are the role of chemoreceptors
Central chemoreceptors detect pH and CO2 changes in the CSF, if raised so is ventilation Peripheral chemoreceptors do the same in the blood at the aortic arch
77
What occurs at the proximal tubule
Bulk reabsorption - 70% of both sodium and water, 100% of glucose and amino acids, 90% of carbonates for blood pH level regulation
78
What protein channel is responsible for sodium and glucose cotransport
SGLT1 and SGLT2 - SGLT2 mutation leads to glycosuria
79
What protein is responsible for sodium and phosphate co transport
NaPiII - knockout in mouse leads to bone density problems early on but older mice are able to compensate for the loss of phosphates in urine
80
What protein is responsible for the movement of sodium in and hydrogen ions out into the lumen of the proximal tubule
NHE3 - uses the driving force of sodium in to pump H ions out against there concentration gradient - H ions then bind to carbonates formed at the glomerulus to form carbonic acid - carbonic anhydrase then causes CO2 and water formation which moves into the cell and they reform, H ions then dissacotiate and move back out whereas carbonates are reabsorbed into the blood stream for pH modulation
81
What occurs in the thin descending limb of the loop of henle
Water reabsorption - not permeable to sodium or chloride
82
What occurs in both the think and thin ascending limb of the loop of henle
Reabsorption of sodium and chloride ions
83
What protein is responsible for sodium potassium and chloride reabsorption
NKCC2
84
What protein channel allows chloride to be reabsorbed into the interstitial fluid
CLCK with the help of accessory protein Barttin
85
How do loop diuretics work
Blocks NKCC2 leads to salt and water retention so greater urinary output leading to reduced BP
86
What two cell types compose the late distal, connecting tubules and collecting duct
Principle - sodium and water reabsorption, potassium and H secretion Intercalated - alpha and beta: H secretion and phosphate reabsorption - opposite