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Human Form and Funciton > Quiz 13 > Flashcards

Quiz 13 Flashcards

1
Q

Define pharmacokinetics

A

The actions of the body on the drug

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2
Q

Define pharmacodynamics

A

The actions of the drug on the body

Usually this means ‘how does the drug bind to the receptor’

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3
Q

Name four examples of pharmacokinetics

A

ADME

Absorption
Distribution
Metabolism
Elimination

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4
Q

Define what an agonist is

A

Drug or natural ligand that activates the receptor. Sometimes selective, sometimes not

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5
Q

What does the dose response curve look like for an agonist?

A

Sigmoidal

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6
Q

Define what an antagonist is

A

Binds to the receptor in the same location as the agonist would. However it does not activate a response. Thus it interferes with the agonist.

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7
Q

What happens to the dose response curve when you add an antagonist

A

It shifts the dose-response curve to the right. Slope and shape of the sigmoidal curve remains the same

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8
Q

If you have antagonist in solution, how do you overcome this to get a desired effect?

A

Increase the concentration of agonist

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9
Q

Define what an allosteric activator is

A

It binds to the receptor at a separate location from where the agonist binds and potentiates the effect.

(It changes the configuration of the receptor to better receive the agonist)

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10
Q

Describe the changes to the dose-response curve when an allosteric activator is added

A

The plateau (think Vmax) is raised. This means that the same concentration of agonist brings about a greater effect.

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11
Q

Describe what an allosteric inhibitor is

A

It binds to the receptor at a location separate from the agonist site, thus it is noncompetitive. Actions are often reversible.

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12
Q

Describe the dose-response curve change that occurs when an allosteric inhibitor is added

A

The plateau (think Vmax) is lowered. Meaning the same concentration of agonist is less effective at bringing about a response

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13
Q

True or false… receptors may be active, producing an effect, even in the absence of drug

A

True. Very small amounts however. “In the absence of drugs, the two isoforms of receptors are in equilibrium and Ri is favored”

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14
Q

True or false.. If a receptor is bound to drug, it must be in the active form

A

False. “Inactive receptors can exist, even if paired with MOST drugs”

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15
Q

Receptors are in equilibrium between the inactive and active forms. Without drug the ____ form is favored. With drug the ____ form is favored.

A

1) inactive

2) active

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16
Q

Define full agonist. Describe its dose-response curve

A

This agonist has a much higher affinity for the active receptor, thus the equilibrium favors the Ra-D form the most, resulting in the largest effect.

The curve has the highest plateau

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17
Q

Describe what a partial agonist is. Describe what the dose-response curve looks like

A

A partial agonist produces a lower response than full agonists because the agonist has intermediate affinity for both Ri and Ra. (Meaning the equilibrium is shifted more towards the Ri side, resulting in less of a response). The Ra-D complex is less stable.

This simply lowers the plateau on the curve

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18
Q

Describe what an inverse agonist is. What doe its dose-response curve look like?

A

this agonist has a greater affinity for Ri, thus equilibrium favors the Ri-D complex (very stable), resulting in a decrease of activity compared to the constitutive activity. Thus, inverse agonists can produce contrasting physiologic results.

The plateau shifts down, even below the constitutive activity

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19
Q

Describe what a conventional antagonist is and what its dose-response curve looks like

A

A conventional antagonist has equal affinity for the Ra and Ri, thus has NO CHANGE in constitutive activity.

The dose-response curve is flat, at the same level as constitutive activity.

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20
Q

What is EC50?

A

The concentration of agonist at which you get 50% of the effect

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21
Q

What is Kd?

A

The concentration of agonist in which half of the receptors are bound.

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22
Q

What is IC50?

A

This is the concentration of the ANTAGONIST in which you have 50% of the effect

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23
Q

True or false. EC50 = Kd

A

FfAaLlSsEe

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24
Q

What happens to EC50 when you add competitive antagonist to the solution?

A

The EC50 shifts to the right (think Km)

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25
Q

What happens to EC50 when you add noncompetitive antagonist (allosteric inhibitor) to the solution?

A

EC50 doesn’t change. However, the plateau shifts down (think Vmax)

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26
Q

Define threshold

A

The smallest dose possible that causes a measurable effect

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27
Q

What are spare receptors?

A

Extra receptors that dont really make a difference. You can take away these receptors and see no change in the maximal effect

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28
Q

Why is it that if you add partial agonist with full agonist that you see a decrease in the maximal effect (plateau)?

A

The partial agonist is taking up some of the receptors, shifting the equilibrium more towards the Ri-D complex, thus lowering the maximum effect. Thus, the mixture of partial and full agonist will be intermediate between the full agonsit maximal effect and the partial agonist maximal effect

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29
Q

Describe what an additive drug-receptor interaction is

A

1+1=2. Drug effect equals the sum of individual effects.

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30
Q

Describe what a synergistic drug-receptor interaction is

A

1+1=5. The sum of the two drug effects is much greater than the sum of the individual parts.

(Deals with more than one drug at a time)

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31
Q

Describe what an antagonistic drug-receptor interaction is

A

1+1=0.5

A drug can block the effect of another

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32
Q

What is a chemical antagonist?

A

Does not involve receptor

For example: charge differences due to certain environments

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33
Q

What is a physiological antagonist?

A

Involves endogenous regulatory pathways mediated by different receptors

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34
Q

Define efficacy in regards to pharmacology

A

This is the number of receptors that must be activated to yield a maximum response. A drug with high efficacy only needs to activate a small amount of receptors.

(Think up and down) A drug with high efficacy will have a high plateau

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35
Q

Define potency

A

The relative concentrations of two or more drugs that produce the same drug effect. Usually refers to EC50

(Think side to side). A drug that is more potent with be shifted towards the left

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36
Q

Define affinity

A

A measure of the tightness that a drug binds to the receptor

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37
Q

The therapeutic index = ____. Which is better a high therapeutic index or a low therapeutic index?

A

TD50 (toxic dose)/ED50 (Therapeutic dose)

A high therapeutic index is favorable

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38
Q

When referring to the therapeutic range, The Y axis of the graph is ____ and the X axis is _____

A

Y axis = blood concentration

X axis = drug dosage

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39
Q

What is the margin of safety?

A

The amount of drug lethal to 1% divided by the amount of drug that causes a beneficial effect in 99%

You want this to be a high number

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40
Q

True or false… toxicity means leathal dose

A

False, it is defined for what you want it to be. It can be certain symptoms

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41
Q

The amount of drug that gets to the target is inversely proportional to what two things?

A

Distance of the site of administration to the target

Amount of tissue that the drug must pass through

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42
Q

What does parenteral mean?

A

Not by way of the GI tract

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43
Q

Name three examples of parenteral drug administration

A

Intravenous

Intramuscular

Subcutaneous

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44
Q

Which is faster absorption, intramuscular or subcutaneous injections?

A

Intramuscular (about 5 minutes). Large volumes are possible, sometimes painful

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45
Q

True or false… subcutaneous injections allow for larger volumes of drug to be administered in comparison to intramuscular injections

A

False… intramuscular injections allows for larger volumes to be administered

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46
Q

What does enteral mean? Give two examples of enteral drug administration

A

Enteral - by way of the GI tract

Oral - most common and convenient, effect takes about 30 minutes

Rectal - less first pass effect than oral

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47
Q

What is enteral drug administration less predictable than parenteral?

A

You dont know how much will be absorbed because it can change due to pH, food, etc.

side note: absorption occurs in duodenum. This is called first pass metabolism

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48
Q

The initial distribution of drug into the tissues is determined by ____

A

The rate of blood flow

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49
Q

The concentration of drug at a particular site is related to its ____

A

Affinity

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50
Q

What other two factors can play a role in drug distribution?

A

Plasma binding proteins

Gastric emptying time

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51
Q

Name three other methods of drug administration

A

Inhalation (very fast)

Topical

Transdermal (patches)

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52
Q

What is a loading dose?

A

The first big dose given to the patient to load the system with a high enough concentration to get the effects within the therapeutic range quickly. Then the effects are maintained within the therapeutic range by consecutive smaller doses

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53
Q

What is the difference between drug and medicine?

A

Drug - any substance that brings about a change in biological function through its chemical actions

Medicine - a subset of drugs used for selective, THERAPEUTIC effects

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54
Q

True or false… side effects are always negative effects

A

False. Side effects are just any unintended effects of the drug, may be positive

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55
Q

Define xenobiotic

A

Chemical not synthesized in the body

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56
Q

Absorption of the drug is affected by what four factors?

A

Route of administration

Blood flow

Drug characteristics

Cell membrane characteristics (diffusion or active transport)

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57
Q

What are five drug characteristics to take into consideration?

A

Is it water soluble or lipid soluble?

Is the size of the molecule large or small? (Large molecules cant go to as many places and cant be absorbed as well as small molecules can)

Formulation

Concentration

Acidity (basic drugs are not well absorbed in the stomach)

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58
Q

What are the two mechanisms of drug passive transfer across biological membranes?

A

Filtration - water soluble drugs small enough can go through aquaporins

Simple diffusion - lipid soluble drugs can freely cross the cell membrane

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59
Q

True or false… only non-ionized drugs are soluble lipids

A

True

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60
Q

What are the two types of specialized transport across biological membranes for drug transfer?

A

Active transport

Facilitated diffusion

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61
Q

What is bioavailability? What two things affect bioavailability? What method of drug administration has the highest bioavailability?

A

The fraction of unchanged drug reaching the systemic circulation following administration by any route

Affected by…
Dissolving of drug in GI tract

Destruction of drug by the liver

Intravenous = 100% bioavailability

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62
Q

What are two important determinants for determining dose to be administered to patient?

A

Distribution and clearance

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63
Q

What is volume of distribution? What is its formula?

A

It is the measure of the apparent space in the body available to contain a drug.

V= amount of drug in body/concentration of drug

It can exceed any physical volume in the body because it is the volume apparently necessary to contain the amount of drug homogeneously at the concentration found in the blood/plasma/water.

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64
Q

If you give someone 100mg of a drug. Then take a plasma sample that is 33mg/l, what is the volume of distribution? What does it mean?

A

100/33 = 3L

3L means that the drug is restricted to the central compartment (blood)

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65
Q

What are the three physiological compartments and their volumes?

A

Plasma - 3L
Extracellular space - 14L
Total body water - 42L

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66
Q

What are four major variables affecting the volume of distribution (Vd)?

A

Binding to plasma proteins (makes drug stay in blood better)

Binding to tissue proteins (makes drug leave blood better)

Absorption into adipose tissue

Drug lipophilicity, hydrophilicity, MW

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67
Q

What does it mean if the volume of distribution is 300L?

A

This means that the drug is restricted to a smaller region of the body

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68
Q

Drugs with very high volumes of distribution have much ____ concentrations in _____ tissue than in the ______ tissue

A

Higher

Extra-vascular

Vascular

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69
Q

Drugs that are completely retained within the vascular compartment, have a ______ _____ volume of distribution equal to the blood component in which they are distributed.

A

Minimum possible

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70
Q

Drugs with a _____ volume of distribution are limited to certain areas within the body. Whereas those with a ____ volume of distribution penetrate extensible into tissues throughout the body.

A

Small

Higher

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71
Q

The larger the volume of distribution, the _____ a dose must be to achieve a desired target concentration

A

Larger

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72
Q

If a drug has a volume of distribution of 15-18L, what might you assume?

A

The distribution is limited to the extracellular fluid because this is the approximate volume of extracellular fluid

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73
Q

how is the volume of distribution used to calculate half life? What is the formula?

A

T1/2 = 0.693 Vd/Cl

Cl = clearance rate

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74
Q

Clearance = ?

A

Rate of elimination/concentration of the drug

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75
Q

Define clearance

A

It is the process of drug elimination from the body from a single organ without identifying the individual processes involved

May also be defined as the volume of fluid cleared of drug from the body per unit of time

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76
Q

Drugs are generally eliminated in the ___ but some in the ____

A

Urine

Feces, lungs (volatile compounds), salivary glands, sweat, and even hair

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77
Q

Does drug binding to plasma proteins increase or decrease the amount of drug filtered through the glomerulus?

A

Deecwease

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78
Q

Will a drug that is highly hydrophobic be more or less likely to be reabsorbed in the kidney tubules?

A

More likely

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79
Q

Name two examples of drug transporters

A

Solute carrier transporters

ATP binding cassette transporters

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80
Q

_____ transports drug molecules from cells back into the intestinal lumen for excretion

A

P-glycoprotein

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81
Q

What is the difference between zero order and first order kinetics of drug elimination?

A

Zero order
100, 80, 60, 40

A constant amount of drug is eliminated per unit time, independently of drug concentration

First order

100, 90, 81, 71.9,

The process that is directly proportional to the drug concnetration

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82
Q

true or false… phase 1 always precedes Phase 2 metabolism

A

False, it usually goes in that order but it can go either way

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83
Q

What usually occurs in drug metabolism?

A

Makes drugs more hydrophilic (thus more easily excreted)

usually makes substances less toxic

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84
Q

Where are microsomes derived from? Where are they derived if they have ribosomes in them? What do the smooth microsomes contain?

A

Purified liver endoplasmic reticulum?

Rough endoplasmic reticulum

Mixed function oxidases (monooxygenases)

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85
Q

Name two oxidases

A

NADPH-cyp450-oxidoreductase

cyp450

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86
Q

Describe phase 1 hepatic metabolism

A

Includes oxidation, reduction, and hydrolysis

Phase 1 metabolites that are hydrophilic are excreted. The other metabolites go on to phase 2 metabolism

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87
Q

What is cytochrome p450?

A

Heme-containing enzymes primarily found in liver hepatocytes and small intestine enterocytes

Key for drug metabolism (oxidation), biotransmoration, and detoxification

Each enzyme is referred to as an ISO form

88
Q

What are the two most common types of cytochrome p450s? Which is most abundant in human liver and intestines?

A

CYP3A4 and CYP2D6

CYP3A4 is most obundant in human liver and intestines

89
Q

Define substrate

A

A drug that is the target of a particular enzyme

90
Q

Define inducer

A

Increases the activity of a p450 enzyme thus increases metabolism and clearance of a drug

91
Q

Define inhibitor

A

Inhibits the activity of a particular p450 enzyme thus decreases metabolism and clearance of a drug

92
Q

Define phase 2 hepatic metabolism

A

Includes glucuronidation conjugation to make the drug more hydrophilic (utilizes glucuronic acid)

93
Q

Name four factors that can affect hepatic drug metabolism

A

Microsomes enzyme inhibiton (many drugs inhibit CYP450)

Microsomes enzyme induction

Liver disease

Plasma binding protein (drugs highly bound will not enter liver (also wont be filtered in the glomerulus) and thus have a longer half-life

94
Q

What percentage of blood returns to the venous system? The remaining fluid is taken up by _____

A

90%

they lymphatic system

95
Q

Explain the difference between the right lymphatic duct and the thoracic duct

A

The thoracic duct drains the left side and inferior portion of the body

The right lymphatic duct only drains the right head, and right arm

96
Q

What structure separates the superficial tissues and deep structures of the head and neck?

A

Deep cervical fascia

97
Q

Lymph can be drained from superficial tissues into…..

A

Regional nodes or deep cervical nodes

Regional nodes is more common

98
Q

Occipital lymph node

afferent: _____
efferent: _____

A

Afferent: back of scalp

Efferent: deep cervical lymph nodes

99
Q

Retro auricular lymph node

Afferent: ____

Efferent: ____

A

Afferent: strip of scalp above auricle, posterior external auditory meatus

Efferent: Superficial cervical nodes

100
Q

Superficial parotid lymph node

Afferent: ____

Efferent: ____

A

Afferent: strip of scalp above the parotid salivary gland, lateral surface of auricle, anterior wall of external auditory meatus, lateral part of the eyelid

Efferent: deep cervical node (Jugulodigastric)

101
Q

Deep parotid lymph nodes

Afferent: ____

Efferent: ____

A

Afferent: middle ear

Efferent: deep cervical node (jugulodigastric)

102
Q

About how many parotid lymph nodes are there?

A

5 to 6

103
Q

buccal lymph nodes

Afferent: ____

Efferent: ____

A

Afferent: lower eyelid, buccinator, facial vein

Efferent: submandibular lymph node… then to deep cervical.

***this one drains into a regional node before going to the deep cervical

104
Q

Submandibular lymph nodes

Afferent:

Efferent:

A

Afferent: a bunch of stuff… lips, nose, air sinuses, upper and lower teeth (except mandibular incisors), anterior 2/3 tongue (except tip), floor of mouth

Efferent: deep cervical nodes

105
Q

Submental lymph nodes

Afferent:

Efferent:

A

Afferent: tip of tongue, floor of mouth beneath tongue, incisors, central part of lower lip, skin over chin

Efferent: submandibular node oooorrrr deep cervical nodes (specifically the jugulo-omohyoid node)

106
Q

Where are the retropharyngeal lymph nodes located?

A

Between the pharynx and atlas

107
Q

Which is most superior, the jugulodigastric lymph node or the jugulo-omohyoid lymph node?

A

Jugulodigastric

108
Q

The gingiva is drained by _____

A

Submandibular lymph nodes

109
Q

The hard palate is drained by ____

A

Submandibular nodes and superior deep cervical nodes

110
Q

The soft palat is draine by ____

A

Retropharyngeal

111
Q

The floor of the mouth is drained by ____

A

Submandibular and submental nodes

112
Q

The teeth are drained by ____

A

Submandibular and deep cervical

Submental drains the mandibular incisors

113
Q

The tonsils are drained by ____

A

Jugulodigastric nodes

114
Q

The tip of the tongue is drained by ____

A

Submental node

115
Q

The anterior 2/3 of the tongue (excluding the tip) is drained by ____

A

Submandibular and deep cervical

116
Q

The posterior 1/3rd of the tongue is drained by ___

A

Jugulodigastric lymph nodes

117
Q

All of the paranasal air sinuses are drained by ____, except for _____ which is drained by _____

A

Submandibular nodes

Sphenoid sinus

Retropharyngeal nodes

118
Q

What is the only node that drains directly into the jugulo-omohyoid node?

A

Submental node

119
Q

Dorsal scapular nerve comes off of ____ and innervates ____

A

Root of C5

Innervates levator scapulae and rhomboids

120
Q

The suprascapular nerve comes off of ____ and innervates _____

A

Superior trunk

Supraspinatus and infraspinatus

121
Q

What structure separates the anterior and posterior divisions of the brachial plexus?

A

Axillary artery

122
Q

The brachial plexus is symmetrical except for what feature?

A

The anterior division of the middle trunk

123
Q

The nerve to subclavius branches off of ____ and innervates _____

A

Roots of C5 and C6

Innervates the subclavius muscle (duh)

124
Q

The long thoracic nerve branches off of ____ and innervates ____

A

C5, C6, and C7 roots

Serratus anterior

125
Q

The lateral pectoral nerve branches off of ____ and innervates ____

A

Lateral cord

Pectoralis major only

126
Q

The medial pectoral nerve branches off of ____ and innervates ____

A

The medial cord

Pec major and minor

127
Q

The upper subscapular nerve branches off of ___ and innervates ___

A

Posterior cord

Subscapularis

128
Q

The lower subscapular nerve branches off of ____ and innervates ____

A

The posterior cord

Subscapularis AND teres MAJOR MAJOR MAJOR

129
Q

The thoracodorsal nerve branches off of ____ and innervates ____

A

Posterior cord

Latisimus dorsi

130
Q

The medial brachial cutaneous and medial antebrachial cutenous branch off of ____ and innervate ____

A

Medial cord

Upper arm and muscles

Lower arm and muscles

131
Q

Which terminal nerves of the brachial plexus are involved in flexion?

A

Median

Ulnar

Musculocutaneous

132
Q

Which terminal nerves of the brachial plexus are involved in extension?

A

Radial

133
Q

What percentage of the U.S population has diabetes?

A

About 10%

134
Q

True or false… sucrose results in higher spikes of blood glucose and insulin. Eating lots of insulin can bring about insulin insensitivity

A

True

135
Q

Name four symptoms that are more severe in type one diabetes than type 2 diabetes

A

Polyuria and thirst
Weakness and fatigue
Polyphagia and weight loss

Nocturnal enuresis

136
Q

Name two symptoms that are more severe in type 2 diabetes than type 1

A

Blurred vision

Peripheral neuropathy

137
Q

What are three signs of diabetes?

A

Sweet tasting urine

Sweet smelling breath

Impaired wound healing

138
Q

The onset of type 1 diabetes usually occurs when? What hormone levels are elevated at onset?

A

Juvenile

Glucagon

139
Q

In type 1 diabetes, ____, ____, and ____ are dysregulated and released within the blood

A

Glucose, fats, amino acids

140
Q

Does improper fatty acid metabolism increase or decrease ketone body production and release?

A

Increase

141
Q

How long after the environmental trigger does type one diabetes form?

A

Highly variable. Days to weeks to months to years

142
Q

The lack of insulin will cause glucagon levels to (increase/decrease) and leptin levels to (increase/decrease).

A

Increase (this is like a positive feedback loop that will result in hyperglycemia)

Decrease (this leads to increased amount of eating, contributing to hyperglycemia)

143
Q

Reduced glucose uptake will result in what three things?

A

Elevated blood glucose

Fatty acid oxidation

Cellular energy deficiency

144
Q

Fatty acid oxidation will lead to…

A

Increased liver gluconeogenesis (which contributes to elevated blood glucose)

Elevated blood ketone bodies

145
Q

Elevated blood glucose and elevated blood ketone bodies contribute to ____

A

Osmotic diuresis (this is losing excessive amount of fluids through the kidneys)

146
Q

Do elevated blood ketone bodies increase or decrease the blood pH?

A

Decrease the pH (more acidic)

147
Q

Type 1 diabetes requires insulin replacement therapy. What are the three coordinated interventions?

A

Insulin administration
Glucose monitoring
Diet (low carbs)

148
Q

The goal of insulin administration is to maintain fasting blood glucose levels between ____ and ____

A

80 and 140 mg/dl

149
Q

What are the two approaches for insulin administration? What is the normal blood glucose range?

A

Injections

Pump

60-90

150
Q

Define type two diabetes

A

Progressive increase in fasting glucose due to reduced insulin sensitivity followed by a degeneration of insulin production

151
Q

Name the three possible mechanisms of insulin insensitivity

A

Adipokine signaling

Ectopic lipid storage and free fatty acids

Inflammatory signaling

152
Q

In type two diabetes, When adipocytes reach capacity, they secrete _____, which causes macrophages to ____, resulting in….

A

Macrophage chemotaxis protein

Macrophages to break up fat and release it into blood

This will interfere with the glucose channels, causing lipids to be used for energy instead of glucose

153
Q

Type two diabetes is managed by what three approaches?

A

Lifestyle

Oral hypoglycemic drugs

Insulin

154
Q

Name four common drugs for treating hyperglycemia

A

Sulfonylureas

Metformin

Peroxisome proliferator-activated receptor agonists - increases glut 4 expression

Alpha-glucosidase inhibitors
-prevents carb absorption

155
Q

What are sulfonylureas?

A

An oral hypoglycemic that serves to increase B cell insulin secretion. There types of this drug are glipizide, glyburide, and glimepiride

156
Q

What is metformin?

A

An oral hypoglycemic that reduces gluconeogenesis and lipogenesis

Involves the ampk signaling pathway

157
Q

What are the five primary methods for detecting diabetes?

A 
Urinalysis 
Glucose monitoring (tested over a long period of time) 
HBA1c
Glucose tolerance test (tested in a day)
C-peptide test
158
Q

What is the purpose of the C-peptide test? How does it work?

A

The C-peptide test differentiates between type one and type two diabetes. When proinsulin is cleaved to produce insulin, C-peptide is released. If C-peptide is present in the blood, it is type 2. If no C-peptide is present, it is type 1

159
Q

What are the signs of hypoglycemia?

A

Exhaustion
Dizziness
Loss of speech
Death

Increased heart rate
Sweating
Trembling

160
Q

What are the causes of hypoglycemia?

A

Excess insulin
Physical activity
Insufficient food
Illness

161
Q

What is the treatment for hypoglycemia?

A

Immediate sugar
Glucagon
Test blood sugar

162
Q

What are some symptoms in hyperglycemia, different from hypoglycemia? What causes it? What is the treatment?

A

Thirst, dry mouth
Excessive urination
Ketones

High blood sugar, lack of insulin, inactivity, excess food

Insulin, oral hypoglycemic, physical activity, diet

163
Q

What are the long-term diabetic complications for diabetes?

A 
Cardiovascular disorders
Blindness
Kidney disease
Neurological complications
Impaired wound healing
164
Q

Name the four fat soluble vitamins

A

Vitamin K
Vitamin A
Vitamin D
Vitamin E

165
Q

Name the vitamins that have toxicity reported

A 
Vitamin D
Vitamin A
Vitamin B3
Vitamin B6
Vitamin C
166
Q

What is the common name for vitamin B9? What about Vitamin C?

A

Folic acid

Ascorbic acid

167
Q

What is the only water soluble vitamin that is stored for long periods of time?

A

Vitamin B12

168
Q

Water soluble vitamins are absorbed by…

A

Sodium cotransporters

169
Q

What is the difference between a vitamin and a vitamer?

A

Vitamers are grouped under the umbrella group of vitamins. The vitamers for a type of vitamin can do the same things, but have slightly different structures

170
Q

Vitamin A

A

Involved with vision

Deficiency leads to night blindness and skin problems

Used to treat acne (accutane), except if you take while pregnant it can result in abnormalities in the baby

171
Q

Vitamin B1

A

Deficiency can result in wernicke karsakoff syndrome, memory problems, weight loss. Berrieberrie- peripheral neuropathy (caused impaired sensory and motor)

Chronic alcoholism and diabetes is associated with B1 deficiency

Thiamine

B1 is an essential coenzyme for the pyruvate bridge (TPP will help convert pyruvate to acetyl coA)

172
Q

Vitamin B2

A

Essential for carbohydrate and lipid metabolism (forms FAD)

Riboflavin

173
Q

Vitamin B3

A

Necessary for NAD+

Deficiency results in PELLAGRA (dermatitis, diarrhea, inflamed mucus membranes, delusions)

174
Q

Vitamin B5

A

Pantothenic acid

Coenzyme A synthesis

175
Q

Vitamin B6

A

Forms PLP. Involved in amino acid metabolism and neurotransmitter synthesis

PLP - involved in amino-transferase reactions

Pyridoxine

176
Q

Vitamin B7

A

Biotin

Involved in fatty acid synthesis (acetyl coA carboxylase) and amino acid catabolism

Produced by bacteria in the gut

177
Q

Vitamin B9

What is the daily adequat intake?

A

Folic acid

Forms tetrahydrofolate, essential for amino acid metabolism (forms methionine)

Daily adequate intake: 400 ug/day, 600 ug/day for pregnant women

Deficiency during pregnancy increases the risk of neural tube defects in baby

Deficiency also associated with abnormal nucleated erythrocytes

TAking too much B9 cause it results in masking B12 deficiencies

178
Q

Vitamin B12

A

B9 (folic acid) intake should not exceed 1 mg per day because it will mask the megoblasic anemia (abnormally nuculeated erythrocytes)affects of B12 without correcting neurological deficits leading to persistent deficiency and nerve damage.

Poorly absorbed in gut

Deficiency can result in irreverbable nerve damage

179
Q

Vitamin C

A

Deficiency results in Scurvy (fatigue, malaise, progressive weakening of CT, joint pain)

Provides antioxidant activity, promotes collagen synthesis

Excessive vitamin C is toxic and can result in goute and kidney failure.

180
Q

Vitamin D

A

Interacts with receptors to exert hormonal control of calcium and phosphate metabolism integration into bone

Sunlight exposure converts provitamins to vitamin D

Deficiency can result in rickets (bone softness) or osteomalacia (bone weakness), or muscle weakness

181
Q

Vitamin E

A

Involved in immune signaling, involves prostaglandin synthesis

Deficiency results in an impaired immune response

182
Q

Vitamin K

A

Required for production of clotting factors

Deficiency results in bleeding and hemorrhaging, osteoporosis

183
Q

Name the 13 essential vitamins

A 
A
B1,2,3,5,6,7,9,12
C
D
E
K
184
Q

Name the two essential fatty acids

A

Linoleate and alpha-linolenate

185
Q

Name the two pathways for nervous system control of organ system

A

Autonomic nervous system

Neuroendocrine system

186
Q

What structure in the brain is responsible for regulating all organ function in the body? Describe the two pathways of control

A

Hypothalamus

It receives info from every organ in the body.

Directly controls the autonomic nervous system

Indirectly controls the neuroendocrine system

187
Q

What neurotransmitter is involved in the sympathetic nervous system? What about parasympathetic?
What about enteric?

A

Epinephrine and norepinephrine

Acetylcholine

Epinephrine, acetylcholine, serotonin

188
Q

What processes produces CO2?

A

Betaoxidation and carbohydrate metabolism

189
Q

Chemoreceptors and baroreceptors feed back to the nucleus of ____

A

The solitary tract

190
Q

Increased blood pressure ____ tonic sympathetic activity and ____ vagal parasymphatic activity

A

Decreases

Increases

Decreased blood pressure does just the opposite

191
Q

True or false… very small amounts of releasing hormones are needed to stimulate the pituitary. Nanograms of hypothalamus releasing hormones signal the pituitary gland to secret micrograms of hormone to stimulate the adrenal gland to secrete milligrams of final hormone

A

True

192
Q

True or false… sympathetic nerves innervate the adrenal medulla to secrete epinephrine and norepinephrine.

A

True. And the sympathetics release ACH to allow this to happen

193
Q

PGE1 (prostaglandin E1) is an example of what class of hormone? What is it used for?

A

Eicosanoid

Used in the inflammatory response

194
Q

NADPH is produced in the ____ cycle and is involved in….

A

Pentose phosphate

Lipid synthesis and dealing with free radicals

195
Q

What are the four fates of glucose 6 phosphate in the liver?

A

Glycolysis

Glycogenesis

Pentose phosphate pathway

Converted to glucose by glucose 6 phosphatase and released into the blood

196
Q

Why is the nitrogen produced from amino acid catabolism transferred through alanine from muscle cells to the liver instead of glutamine?

A

It prevents a-ketogluterate from leaving the muscle (which is used in the citric acid cycle)

197
Q

How do fatty acids get from the diet to the liver? How do fatty acids get to the liver from adipose tissue?

A

Chylomicrons produced in the intestines

Albumin

198
Q

When adipose tissue reaches capacity, it releases leptin. What does leptin do?

A

Eat less, catabolize fatty acids, inhibits fatty acid synthesis.

Also it inhibits the pathway that causes you to eat more, synthesize fatty acids

199
Q

Explain how increased levels of glucose will cause B cells to secrete insulin

A

Glucose enters b cells via GLUT 2, this produces ATP. The increase of ATP will inhibit ATP-gated K channels. This causes depolarization, which will open voltage gated calcium channels to allow the influx of calcium. The influx of calcium will cause insulin granules to be exocytosed.

200
Q

What things inhibit a-cells from secreting glucagon?

When is glucagon constitutively released?

A

Insulin
Somatostatin

At low glucose levels

201
Q

Insulin drives glucose ____, glycogen ____, and lipid _____

A

Uptake

Storage

Synthesis

202
Q

Glucagon drives glucose ____, amino acid and fatty acid ____.

A

Release

Breakdown

203
Q

During starvation, you create more ketone bodies due to a lack of ____

A

Oxaloacetate

Without oxaloacetate, acetyl coa cannot enter the citric acid cycle and acetyl coa accumulates. The excess acetyl coa are converted into ketone bodies

204
Q

the superficial cervical lymph nodes drain the ____ and feeds into the ____

A

Skin over the angle of the jaw, and skin over apex of parotid gland and lobule of the auricle

Deep cervical nodes

205
Q

Name 6 regional neck lymph nodes

A 
Retropharyngeal 
Paratracheal
Infrahyoid 
Prelaryngeal 
Pretracheal 
Lingual
206
Q

The paratracheal lymph nodes drain ____ and dumps into ____

A

Thyroid gland

Deep cervical

207
Q

Name the three anterior cervical nodes

A

Infrahyoid
Prelaryngeal
Pretracheal

208
Q

True or false… the teeth can be drained directly by deep cervical nodes

A

True

209
Q

True or false… the anterior 2/3 of the tongue can drain directly into the deep cervical nodes

A

True

210
Q

Name the supraclavicular nerves of the brachial plexus

A

Dorsal scapular
Nerve to subclavius
Long thoracic
Suprascapular

211
Q

of the three ketone bodies, which can be used as fuel, which is toxic?

A

Acetone is toxic

Acetoacetate and B-hydroxybutyrate can be used as fuel

212
Q

Fat soluble vitamins require ___ for uptake

A

Cholesterol esterase

213
Q

Water soluble vitamins are absorbed by sodium trasnporters besides ____

A

B9 and b12

214
Q

What enzyme directs genetic recombination? (Crossing over)?

A

Recombinases

215
Q

What are the three classses of transposable elements?

A

DNA only transposons
Retroviral like retrotransposons
Nonretroviral retrotransposons

Human Form and Funciton (15 decks)

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