T Flashcards
1
Q
Weil Felix test is used for
A
Test for rickettsial infections
2
Q
Which is not from an insect/flea bite
A
Q fever Cox burn
3
Q
Etiology of Q fever
A
Coxiella burnetii (can be in salivary gland) also CMV can be in salivary gland as well
4
Q
Patient has swelling of submandibular, tenderness. Patient is alcoholic. Radiographic-mass radiopaque (sialolith) - circumscribed, 1cm x 1cm, what is the reason for swelling
A
Bacteria infection
5
Q
Best method for bacteria to replicate and transfer most genetic information
A
Conjugation
6
Q
Action of the pili in organisms pathogenicity
A
Attachment and adherence to host cells
7
Q
Difference between staph and strep
A
Staph is catalase +
Strep is catalase -
8
Q
Lancefield grouping
A
It’s a serotype classification (that is, describing specific carbohydrates presen on the bacterial cell wall)
Lancefield is determined by C-carb composition of cell wall
9
Q
Streptomycin inhibits what
A
Protein production (translation)
10
Q
What aspect of staph is responsible for food poisoning
A
Enterotoxin
11
Q
MOA of staph aureus for drug resistance
A
Produces enzyme that breaks down penicillin, beta lactamase
12
Q
What bacteria causes endocarditis in IV drug user
A
Staph aureus
13
Q
Most common type of endocarditis
A
Streptococcus viridian
- alpha hemolytic strep
Acute —> staph
- subacute which is more common is viridans
14
Q
Which of the following diseases has janeway lesions
A
Infective endocarditis
15
Q
Which toxin produces scarlet fever
A
Erythogenic toxin (erythrogenic exotoxin)
16
Q
Rash for scarlet fever
A
Erythrogenic toxin of group A beta hemolytic s.pyogenes
17
Q
Strep mutans produces
A
Dextran which is glucose linked in alpha 1,6
18
Q
What enzyme do oral bacteria use to create dextran and participates in bacterial aggregation on teeth
A
Glucosyltransferase
19
Q
What enzyme primarily breaks down sucrose
A
Glucosyltransferase (dextran sucrase)
20
Q
Streptococcus breaks down sucrose into what products
A
Glucose and fructose
Glucans —> dextrans + mutans + levans
21
Q
Dextrans for polymers of
A
Glucose
Levans = polymers of fructose
22
Q
How is glucose and fructose associated with caries
A
Dextrans and levans
23
Q
Which of the following is not an oral bacterium and not found in dental plaque
A
Strep pyrogenes
24
Q
Which of the following does NOT cause pneumonia
- strep mutans
- H influenza
- S pneumoniae
A
Strep mutans
25
Most common bacteria on the dorsum of the tongue
S salivarius
26
Lipid A with a polysaccharide core is in which organism
Gram negative bacteria
27
Gram negative bacteria have LPS
What do gram positive bacteria have
Teichoic acids
28
N-muramic acid is part of
Bacterial cell wall
- it occurs naturally as N-acetylmuramic acid in peptidoglycan
- function is a structural component of bacterial cell walls. Chlamydia has none
29
Glycan binds what in bacterial cell wall
D-alanine
30
Rickettsia is a
Gram negative
Non spore forming
Highly pleomorphic bacteria
Responsible for typhus
31
Rickettsia diseases are destructive for/target?
Endothelial cells of capillaries
| - rickettsia are small gram negative, aerobic, coccobacillary bacteria
32
Which one needs Arthropoda vector (insects) or fleas?
Rickettsia except for cox burn
33
Weil Felix test is used for
Test for rickettsial infections
34
Which is not from an insect/flea bite
Q fever cox burn (not bite)
35
Etiology of Q fever
Coxiella burnetii (can be in salivary gland) also CMV can be in salivary gland as well
36
The toxin of the gas gangrene organism has what kind of enzymatic activity
(C. Perfringens)
| Lipase lecithinase
37
Clostridium tetani are all the following EXCEPT...
Gram positive
Anaerobic
Spores
Rod-shaped
No exception!!!!!
38
Mechanism of action of the tetanus toxin
Inhibition of neurotransmitter release (prevent release of GABA and glycine)
39
Over-treating with antibiotics, C. difficile, would should?
Pseudomembranous colitis
- clostridium difficile causes diarrhea and intestinal colitis
- CLINDAMYCIN
40
Spore forming bacteria
Clostridium (anaerobic) and bacillus (aerobic)
41
What ion is related to spores
Calcium dipicolinic (heat resistance of the endoscope)
42
Mycobacterium tuberculosis has mycolic acid that block antibiotics from penetrating
....
43
Legionnaires pneumophilia is mainly found in air-conditioning systems (prefer Aerosilized water)
....
44
An infection of the epithelial cells of the eye that can sometimes enter back into the nasopharynx
TRACHOMA due to chlamydia trachomatis
45
Blindness results from
Chlamydia trachomatis (trachoma and adult inclusion conjunctivitis)
46
Most common cause of non-gonococcal urethritis
Chlamydia
47
Bacillary dysentery (shigellosis) is caused by
Shigella
48
Which produces these toxins: protective antigen (PA), edema factor (EF), and lethal factor (LF)
Bacillus anthracis (causes anthrax)
49
Treponema palladium bacteria
Dark field microscopy
| - syphilis causes oral hard chancre, not painful, use wassermann test
50
Hutchinson’s teeth is a sign of
Congenital syphilis infection
51
What Protozoa are spread in cat feces
Toxoplasma gondii
52
How is arbovirus transmitted
Arthropoda
53
Which virus doesnt have a latent phase
Rhinovirus and poliovirus
These DO establish a latent infection
- EBV, HSV-1 and 2, VZV, CMV (all herpesvirus) HEH, CV
54
Herpes virus is the only virus that gets it cell wall from
Host nuclear membrane
- herpes virus —> dsDNA, enveloped, nuclear membrane, icosahedral nucleocapsid, establishes latent infection
55
Cytomegalovirus are associated with
Salivary glands (torches)
56
EBV and varicella zoster are members of
Herpesviridae
- EBV can cause burkitts lymphoma, nasopharyngeal carcinoma, B-cell lymphoma, hairy leukoplakia, and infectious mononucleosis
57
What happens with primary exposure to HSV1
Primary hermetic gingivostomatitis
58
What virus causes chicken pox
Varicella zoster virus
59
Epstein Barr virus is related to
Burkitts lymphoma
- EBC can cause burkitts lymphoma, nasopharyngeal carcinoma, b-cell lymphoma, hairy leukoplakia, infectious mononucleosis
60
Left back stab at L1-L2
KIDNEY
61
What cause influenza to change year to year
Antigenic capsule (gene reassortment)
- influenza virus is an orthomyxovirus with outer envelope has spikes (H and N) for attachment to host cells.
- treatment with amantadine —> inhibits viral attachment and uncoating
- the main mode of prevention is the vaccine, which consists of killed influenza A and B virus
62
What are the virulence factors of neisseria meningitis
Endotoxin LPS (gram negative)
WATERGHOUSE FRIDERISCHEN SYNDROME
63
Which is not associated with N.meningitis
Enterovirus (ex. Picornavirus)
64
What disease causing agents have a polysaccharide capsule
Even Some Super Killers Have Pretty Nice Capsules
- e. Coli
- s. Pneumonia
- salmonella
- k. Pneumonia
- H. Influenza
- p. Aeroginosa
- n. Meningitis
- c. Neoformans
65
Which virus can be transferred from mother to fetus and is associated with congenital abnormalities
rubella
TORCHES
- toxoplasmosis
- rubella
- CMV
- Herpes simplex
- syphillis
- lieseria through BLOOD not placenta crossing
66
Measles (rubeola) and mumps belong to which group of virus
Paramyxoviruses
- jump cause parotitis and sometimes in adults orhocitis
67
Kopliks spots
Measles
- ssRNA
- paramyxovirus
- transmitted by respiratory droplet
68
Hepatitis B virion
Dane particle
69
What has the longest incubation period
Hepatitis B
70
Hepatitis C virus is an RNA virus and is blood-borne (ssRNA, flavirius)
....
71
What version of hepatitis is chronic
Hepatitis C
72
Penicillin resistance comes from bacteria that contain what enzyme
Beta lactamase
73
MOA of amoxicillin
Disrupts cell wall and inhibits cross linking between peptidoglycan chains for gram (+)/(-)
74
Why doesnt amphotericin B work against bacteria
Ergosterol (fungi have in cell wall, bacteria don’t)
75
Polyene antifungal are specific to fungus because
It attacks the sterol that are present in fungi but not bacteria
76
Aminoglycosides MOA
binds to 30s ribosome and inhibits mRNA translation (protein synthesis, bactericidal)
77
Why dont you treat patients with penicillin and erythromycin
Penicillin only works on growing cells
78
Which one is the mechanism of action of fluorouracil
Suicide inhibitor of thymidylate synthase
- flurorouracil is a pyrimidine analog, anti-neoplastic, interferes with DNA synthesis by blocking thymidylate synthetase conversion of deoxyuridylic acid to thymidylic acid
79
Naproxen (alive) is a reversible non-selective COX inhibitor that is more potent than aspirin
...
80
What medication blocks prostaglandins
Aspirin
- aspirin irreversibly inhibits cocylooxgenase to decrease formation of precursor for thromboxane A2 (a platelet aggregator that is released by blood platelets) and prostaglandins
81
Lab test for warfarin
Prothrombin test (increases)
Warfarin = anticoagulant, inhibits vitamin K reductase —> affecting extrinsic pathways and prothrombin conversion so increase prothrombin time (normal ppt and bleeding time) HAEMOPHILA HAS INCREASED PPT
82
Sulfonamides compete with which molecule in their MOA
PABA to inhibit folic acid synthesis
Therefore cannot makes purines or pyrimidines
83
Sulfonamides block dihydrofolate and block what
Purine and pyrimidine synthesis
84
Detergent kills bacteria by interfering with the function of the cell membrane (destroy fat cell parts)
...
85
MOA of digoxin
Inhibition of Na.J ATPase that causes an increase in intracellular Na levels
86
What medication is a DNA gyrase inhibitor
Ciprofloxacin
| -fluoroquinolone, end in -oxacins
87
MOA of clindamycin
Inhibits 50s
88
Main side effect of clindamycin
Pseudomembranous colitis (diarrhea)
89
Rifampin works as a RNA synthesis inbhitor
- treatment of TB
- inhibits RNA dependent RNA polymerase which stops mRNA transcription
....
90
What is the most common bacteria vaccine given in the US
DTP (diptheria, tetanus, and pertussis)
91
Bordetella pertussis (whooping cough) vaccine is
Killed vaccine
92
Live attenuated vaccine (ex = polio Sabin vaccine) is an active immunity
Polio vaccines: Sabin (oral/attenuated/alive) versus SalK (injection of killed bacteria)
....
93
Antibiotic used for meningitis caused by haemophilus influenza
Ceftriaxone
94
MOA of viagra
Inhibits cGMP-specific phosphodiesterase type 5 (PDE-5), which regulates blood flow
95
All will depress respiration, EXCEPT
- general anesthesia
- nitrous oxide
- cocaine
Cocaine
96
Why is saliva hypotonic
Salivary duct cells reabsorbed Na and Cl- in exchange for K+ and HCO3
- saliva is hyposmolar because reabsorption of water by striated duct cells is less than reabsorption of Na
97
What nerve innervates the salivary glands of the palate
CN 7
98
Which salivary glands are only mucous secreting
Palatine salivary gland (in the submucosa)
Only serous glands = von ebner and parotid gland
99
How would the parotid differ from sublingual (staining/histology) or mucous/serous gland
Parotid
- serous
- more eosinophilia
Sublingual
- pale-stain due to mucous
- bubbly appearance (foamy dark nuclei)
100
Serous demilunes are in what gland
Sublingual gland
- serous demilunes are the serous cells at the distal end of mucous tubuloalveolar secretory unit of sublingual salivary glands. They secrete the proteins that contain lysozyme, which degrades the bacteria cell wells
101
What type of cells make up the demilunes of mucous something of sublingual glands
Serous cells
102
What is not derived from neural crest
Salivary glands and enamel
103
Epithelium of striated ducts of salivary ducts
Simple columnar epithelium
104
What parotid salivary glands resemble pancreatic ductal cells
Serous gland and intercalated ducts
105
Which salivary gland cell is more like proximal convoluted tubule in the kidney
Striated duct cell
106
What is in the parotid gland
FEAR
- facial nerve
- ECA
- auriculotemporal nerve
- retromandibular vein
107
Parotid gland duct (stensons duct) pierces the buccinator muscle and is located near maxillary 2nd molar
...
108
All of the primary ions are in saliva except
Calcium
109
What hormone stores glucose in adipose tissue
Insulin
110
Decreased insulin will result in
Increased gluconeogeneiss
111
What is phorphylated in an insulin receptor
Tyrosine
112
What needs a protein transporter to cross the cell membrane
Glucose through glut 4 FAC bidirectional transportation
113
Glucagon signals through
CAMP
- glucagon receptor is a 7-transmembrane receptor coupled to a g-protein and cAMP
114
Glucagon and epinephrine both have in common
Glycogenolysis and GLUCONEOGENESIS
115
Oxidative phosphorylation occurs in what enzyme
Pyruvate dehydrogenase
116
What enzyme is used for decarboxylation
Pyruvate decarboxylase
| Biotin = coenzyme
117
Rate limiting enzyme for glycolysis
PFK
118
Glucose-6-phosphate is not found in the muscles
...
119
Glucose is sequestered by which enzyme
Hexokinase
120
What is NOT true regarding hexokinase and glucokinase
They have the same KM
- glucokinase is higher, more affinity
- glucokinase is a isoform of hexokinase found only in the liver and only uses substrate glucose
121
UTP-glucose reacts with which of the following in glycogen synthesis
Glucose-1-phosphate
122
What steps restores oxaloacetate in TCA
Malate, malate dehydrogenase
123
What enzymes produce oxaloacetate
Pyruvate carboxylase (pyruvate —> oxaloacetate)
124
What is the main source of glycerol
Glucose/pyruvate
125
Where is phosphoenolpyruvate found
Liver
126
Tidal volume
Normal volume of air disabled between normal inhalation and exhalation when no extra effort is applied (500mg)
127
Vital capacity =
IRV + ERV + TV
128
Residual volume
Air remaining after max exhalation
129
Pressure on a mountain is 250mm Hg, what is the partial pressure of oxygen
50 mmHg
- oxygen = 20%
- nitrogen = 80% so 250 x 0.2 = 50mm Hg
130
Epithelium of respiratory tract
Pseudostratified ciliated columnar epithleium with goblet cells
131
Stretch receptors (hering-Breuer reflex) of the lung is carried by vagus nerve (CN 10) to prevent over-inflation
...
132
What produces mucous in lungs
Clara cells
| Nonciliated bronchiolar secretory cells that make GAGs to protect the bronchiole lining
133
Obstructive lunge disease —> compliance goes
UP
- obstructive lung disease is characterized by increased resistance to air flow (lower than normal expiration flow rates) and high lung volumes. Decreased elasticity, increases compliance
Ex: chronic bronchitis, emphysema, asthma
- restrictive lung disease is characterized by low lung volumes and slightly higher than normal expiration flow rate (increased lung elasticity). Decreased compliance.
Ex: interstitial fibrosis (lung hardening), asbestosis, and tuberculosis
134
In which can we see more squamous epithelium metaplasia
Bronchi
Another source said esophagus
135
Which organ most likely to undergo red infarction
Lung
- white infarct affect solid organs (ex: spleen, heart, kidney) while red infarction (hemorrhagic infarct) affects lungs and other loose organs like testis, ovary, SI due to loose tissues that allow RBC to collect in the infarcted zone
136
Emphysema can lead to
Respiratory acidosis
137
Hyperventilation can cause
Alkalosis
138
Metabolic acidosis —>
Hyperventilation
139
After metabolic or respiratory acidosis, which abnormality of electrolytes is more likely
Hyperkalemia
140
When is intrapleural pressure the most negative
End of expiration
141
When is alveoli pressure the most negative
Beginning of inhalation
142
What kind of epithelium is found in the nasopharynx region
Ciliated pseudostratified columnar epithelium
143
Infant has trouble breathing, what cells are causing problems
Type 2 pneumocytes
144
What describes oxygen transport
Bohr effect
145
What is true about myoglobin
Graph is hyperbolic (hemoglobin = sigmoidal)
146
Carotid body measures
Partial pressure of O2
147
Carbon monoxide decreases O2 content but pO2 is normal
...
148
Patient is on nitrous, best way to measure efficiency
Reserve minute volume
149
Mineral for coagulation
Zinc and Ca
150
What carries iron in the plasma
Transferrin
151
Prothrombin acts with which one to form thrombin
Ca
| - prothrombin and calcium/Pl/factor10a —> thrombin (liver)
152
What is the substrate of thrombin
Fibrinogen
153
If we put RBC in hypotonic solution
Hemolysis
154
Blood type: anti-A and anti-B both agglutinate. What blood type is it
AB
155
Which one of these helps in the retraction of the blood clots
Factor XIII
156
Boy bleeds during extraction, his maternal uncle and male cousin have same problem. What factor is involved
Factor VIII (hemophilia A and sex-linked)
- characterized by having prolong partial thromboplastin time (PTT) and normal PT/bleeding time
157
Hemophilia B (Christmas) disease is due to a factor __ deficiency
Factor 9
158
Hemophilia C is NOT sex linked and is due to a factor __ deficiency
11
159
Know cytochrome p450. Choose exception
- present in all tissues of the body and help with hormone synthesis/breakdown, cholesterol, synthesis, vitamin D metabolism
- metabolize toxic compounds, mostly in liver
....
160
Enzyme: competitive inhibitor versus non competitive
- increase K and Vmax stays the same
Non competitive inhibitors
- Km stays the same
- vmax decreases
161
In cells, N-glycosylation occurs in where?
RER (in all cells)
N-glycosylation is the attachment of sugar glycan to nitrogen (ex. Amide of asparagine)
162
Pyrimidine synthesis begins with what
Ribose 5-phosphate
- R5P = result of pentose phosphate pathway, makes ribose for nucleotide synthesis and NAPD for FA/steroid
163
What process makes NADPH
Pentose phosphate shunt
164
Primary molecule for reduction biosynthesis ?
NADPH
165
Purine metabolism intermediate and precursor of adenosine and guanine??
IMP (inosine monophosphate)
166
When taking away phosphate group from (named a nucleotide)?
Nucleoside
167
Whats the difference between thymidine and uracil?
Methyl group on thyme
168
Phosphodiesterase bonds — connect DNA I bond - connects 2 amino acids
...
169
Whats a small molecule that can’t elicit immune response on its own?
Hapten
- haptens are antigenic determinants, but are too small to elicit the formation of antibodies by themselves. They can elicit immune response when attached to bigger molecules
170
What elicits an immune response when bound to carrier protein?
Hapten
171
Alpha helix and beta sheets form (secondary protein structure) through hydrogen bonds
...
172
What is the main AA in the tertiary structure of protein?
Cysteine (disulfide bonds)
173
What kind of force holds proteins in the lipid bilayer?
Hydrophobic interaction
174
TRNA wobble is in the 3rd position of the codon
...
175
Which one plays an important role in detecting the starting codon (initation) for RNA transcription?
Sigma part
176
What determines protein turnover?
H-bonds and peptide bonds: breakdown and synthesis of proteins
177
Product of enzyme isocitrate dehydrogenase in TCA cycle
Alpha ketoglutarate
178
In the amino acid metabolism, what are they 2 primary acceptors of amine groups?
OAA and alpha-ketoglutarate
179
Phenylketonuria is a deficiency of?
Phenylalanine hydroxylase (PAH)
- phenylalanine hydroxylase is responsible for the conversion of phenylalanine AA —> tyrosine
180
What amino acid is associated with taste sensation of umami?
L-glutamate
181
What is the charge of glutamic acid at pH = 1?
+2
182
What are the keto genic amino acids?
Leucine and lysine
- ketogenic AA can be degraded directly into acetyl CoA, which is a precursor for ketone bodies
183
Nissl body is?
Rough ER
184
What residues are phosphorylated to activate/deactivate an enzyme (like glycogen synthase or glycogen phosphorylase)?
Serine
185
If patient is on a low carb diet, he/she wants low levels of?
Reduce production of insulin with low level of malonyl CoA
186
Apoptosis ? Hormone dependent physiologic involuted
...
187
What is the immune reactant in type 1 hypersensitivity? Antigen? Effector mechanism? Example of the hypersensitivity?
- IgE
- soluble antigen
- mast-cell activation
Allergic rhinitis, asthma, systemic anaphylaxis
188
What is the immune reactant in type 2 hypersensitivity? Antigen(s)? Effector mechanism(s)? Example of the hypersensitivity(s)?
- IgE
- cell or matrix associated antigen
- complement, FcR cells (phagocytes, NK cells)
- example = some drug allergies, penicillin
- IgE
- cell surface receptor
- antibody alters signaling
- example = chronic urticaria
189
What is the immune reactant in type 3 hypersensitivity? Antigen? Effector mechanism? Example of the hypersensitivity?
- IgG
- soluble antigen
- complement phagocytes
- example = serum sickness, Arthus reaction
190
What is the immune reactant in type 4 hypersensitivity? Antigen(s)? Effector mechanism(s)? Example of the hypersensitivity(s)?
- TH1 cells
- soluble antigen
- macrophage activation
- example = contact dermatitis, tuberculin reaction
- TH2 cells
- soluble antigen
- eosinophil activation
- example = chronic asthma, chronic allergic rhinitis
- CTL
- cell-associated antigen
- cytotoxicity
- example = contact dermatitis
191
Alternative complement pathway starts with?
C3a = need this to activation the other ones
C5 (C5a = chemoatrractant) = most potent
- alternative complement pathways starts with C3a. CD59, also known as protectin, which inhibits C9 polymerization during the formation of the membrane attack complex.
The classical pathway is inhibited by C1-inhibitor, which binds to C1 to prevent its activation
- Mannose binding lectin
192
Interferon gamma (IF-G) receptor complex produces dimerization of chains —> secreted by t-cells, anti-viral/tumor, part of class II neurons
- interferons are a group of signaling proteins made and released by host cells in response to the presence of pathogens, such as viruses, bacteria, parasites, or tumor cells. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten their anti-viral defenses
193
Cytotoxic T cells recognize?
Cytotoxic T cells (CD8) MHC1
CD4 cells = MH2
194
T- cell receptors (TCR) are similar to which one?
Fab
- fab (an Fc receptor is a protein found on the surface of certain cells — including, among others, B lymphocytes, follicular dendritic cells, natural killer cells, macrophages, neutrophils, eosinophils, basophils, and mast cells — that contribute to the protective functions of the immune system
195
Which of the following is for a delayed hypersensitivity/latent infection?
T cells and macrophages, lymphocytes
Type 4
196
Similarity between Type 1 and type 2 hypersensitivity
Both require previous sensitization
197
Where does the antigen for MHC I come from?
Virus and infected cells
198
Which of the following is used to phagocytize bacteria?
Gamma Fc receptor + C3b
Gamma Fc receptor + C3b (all of the Fcgamma receptors) belong to the immunoglobulin superfamily and are the most important Fc receptors for inducing phagocytosis of opsonized microbes
199
The predominant cell in acute inflammatory response and in abscesses ?
PMN (polymorphonuclearcytes)
200
What causes pus?
Neutrophils
201
What secrets TNF-alpha and IL-1
Activated macrophages
202
Which WBC is the most abundant?
Neutrophils
203
Which type of WBC shows the lowest in blood?
Basophils
Never Let Monkeys Eat Bananas
- neutrophil
- lymphocyte
- monocyte
- eosinophil
- basophils
204
CD4 cells recognize:
MH2
205
Postural reflex —>
Stretch reflex
206
Spasticity is defined as?
Hyper-responsive stretch reflect
- spasticity is a hypertonus state of the affected muscles due to a release of the tonic inhibition of the brainstem, facilitatory info which leads to gamma motor neuron excitation. Thus, hyperactivity of the gamma fibers
207
Where does this arise in the spinal cord: sympathetic preganglionic cervical ganglion (SCG)?
T1-T8
208
Where are the cell bodies of the preganglionic sympathetic nerves that innervate the head?
Interomediolateral horn of spine (T1-L2)
209
NE is a post-synaptic sympathetic neurotransmitter
....
210
What neurotransmitter is found in nerves that transfer pain?
Substance P
211
Endomysium versus endoneurium
Endomysium = areolar CT around each muscle FIBER
Endoneurium = CT around myelin sheath/neuron axon
212
CNS myelin sheath is formed by?
Oligodendrocytes
213
PNS myelin is formed by?
Schwann cells
214
An impulse can travel from one nerve to another in one direction because the SYNAPSE limits the direction of travel
...
215
What solute affects membrane resting potential?
K+
216
Resting potential is -70mV and extracellular K+ increases and comes our of nowhere?
No change
217
What happens when there is a decrease in extracellular K?
Hyperpolarization
Low extracellular K = hyperpolarization
High extracellular K = depolarization
218
Vitamin C —>
Hydroxylation of proline and lysine during collagen synthesis
219
In collagen synthesis, what part happens outside the cell?
Lysyl oxidase (LOX) for cross-linking collagen
220
Lysyl oxidase - what is the cofactor needed?
Cu - copper
221
What is the 3rd AA sequence in collagen?
Glycine-proline-lysine
(Glycine-proline-X or glycine-X-hydroxyproline)
Glycine is found at almost every 3rd residue
222
What AAs other than glycine is found in collagen?
Proline and lysine
Lysine is involved in crosslinking
223
What is present in collagen, that isnt in elastin?
Hydroxylysine
- tropocollagen is only found in collagen and reticular fibers, also has hydroxyproline and hydroxylysine
- elastin has glycine, alanine, proline, and hydroxproline. It also has tropoelastin
224
What is NOT needed for synthesis for collagen?
Vitamin K or folic acid
225
What is responsible for calcium regulation ?
Parathyroid hormone
- increase serum calcium
226
Main role of calcitonin?
Bone resorption
- its produced primarily by the parafollicular cells (also known as c-cells) of the thyroid.
- it acts to reduce blood calcium, opposing the effects of PTH
227
Osteoclasts —> monocytes
- mature monocytes and macrophages are capable of differentiation into osteoclasts
...
228
What is not in periosteum?
Osteocytes
229
What cytokines are found in osteoclastic bone ?
```
IL-1
IL-6
PGE2
TNF-alpha
MMPs
```
230
What are housed in howships lacunae?
Osteoclasts
- howships lacunae = groove/cavity usually contains osteoclasts that occurs in bone which is undergoing resorption
- trabecular bone is 1st resorbed by osteoclasts, creating a shallow resorption put (howships lacunae). Then, osteoblast deposit compact bone in the pit
231
Endosteum?
Thin layer of CT that lines the surface of body tissue that form the medullary cavity of long bones
232
What type of bone do you see after 2-3 years at the site of injury?
Compact bone
233
Which of the following is not found in compact bone?
Fibroblast
234
What is the chemical formula of the most common salt found in the bone?
HA: Ca10(PO4)6(OH)2
235
Vitamin D deficiency —>
```
Kids = rickets
Adults = osteomalacia
```
236
Vitamin D:
25 hydroxycholecalciferol gets converted to 1,25 dihydroxycalciferol where?
Kidney
237
Where do you get vitamin D from?
Skin, liver, kidney
238
Innervation of the thenar muscle (thumb)
Median nerve
239
What innervates the anterior wrist?
Median nerve
240
What part of the arm is most susceptible to ulnar nerve injury?
Elbow
241
Which muscle in the arm is innervated by the radial nerve (supplies upper limbs) —>
Triceps
242
What brachial nerve and muscle is for circumduction of the arm?
Axillary (because of deltoids)
243
Supination of the radio-ulnar joint?
Biceps brachii
244
What muscle adducts the scapula?
Rhomboids
Adducts = trapezius and rhomboids (major and minor)
Abducts = serratus anterior, pectoralis
Serratus anterior = long thoracic nerve innervation
245
Which one does not contribute to the posterior wall of the axilla?
Serratus anterior, humerus
- posterior wall = subscapularis, teres major, latissimus Doris, and scapula
Anterior border = pectoralis major and minor
- medial border = serratus anterior and thoracic wall
- lateral border = intertubecular sulcus
246
Innervation that causes rotation of the arm?
C5
| Doc says C5-C6
247
If a person can’t flex their wrist, what nerves are involved?
C6-C7 (ulnar nerve, flexor Carli ulnaris muscle)
248
What innervates the brachialis (biceps muscles)
Musculocutanous (C5-C7)
249
What is the most distal portion of the brachial plexus?
?
Branches
- musculocutanous, axillary, median, radial, and ulnar nerve
250
Axillary sheath surrounds the axillary vein, axillary artery, and 3 cords of the brachial plexus —>
NOT trunks/roots of branchial plexus
251
Where do the 4th, 5th, and 6th intercostal veins drain?
Accessory hemizygous (formed by the 4th-8th intercostal veins)
252
Right superior intercostal muscles drain into?
The right side azygous vein
253
Azygous vein leaves impression on right lung
...
254
What supplies the SA node ?
Right coronary artery
255
Where is atherosclerosis most common?
Abdominal aorta
256
What exits the thorax at 12?
Descending aorta
257
Thoracic duct is behind what?
Esophagus and aorta
258
Esophagus begins at what level?
Cricoid cartilage (C6), inferior to the cricothyroid
259
What is posterior to the aorta
- right kidney
- liver
- colon
Right kidney
Colon and pancreas are anterior to the abdominal aorta
260
What are the visceral Artie’s of the abdominal/descending aorta?
Celiac trunk and inferior mesenteric
- includes: celiac trunk, renal and superior/inferior mesenteric (not inferior phrenic)
261
Direct branch of the celiac trunk?
Splenic artery (also left gastric and common hepatic artery)
262
Hepatic portal vein contains blood from the?
Superior mesenteric and splenic vein
263
Hepatic sinusoid drain what?
Portal blood to central vein
264
What is not found in epithelium?
Meissner’s corpuscle (fine touch)
265
Meissners plexus —>
Only parasympathetic
266
Auerbach plexus —>
Both parasympathetic and sympathetic
| - motor innervation to both layers of tunica muscularis
267
Difference between lamina propria and dermis
Dermis has dense irregular CT
268
What type of cells are in stratum granulosum layer?
Keratohyalin
269
What is not present in an orthokeratinized layer?
Stratum lucidium
270
Floor of the mouth is non-keratinized stratified squamous epithelium
Soft tissues structures that are NONKERATINIZED = soft palate, buccal mucosa
...
271
Epithelium of palate?
Keratinized stratified squamous epithelium
- hard palate, attached gingiva, dorsum of tongue = keratinized SSE
272
What will cover the hard palate after an ulcer heals?
Parakaratinized stratum squamous epithelium
273
Most adundant papillae?
Filiform
274
Taste buds are involved in all papillae except?
Filiform
275
You only have minor amounts of this taste bud?
Circumvallate papilla
276
Antibody in mucosal surfaces?
IgA
277
Tongue moves to the right?
Right CNXII damage
| - damage/lesion to CN12 shows deviation towards paralyzed side when protruded because of weaker genioglossal muscle
278
What protrudes the tongue —>
Geniolgossus
279
What protrudes the mandible?
Lateral pterygoid
280
What protrudes the hyoid bone —>
Geniohyoid helps move tongue and hyoid anteriorly
281
What narrows the maxillary buccal vestibule when you open your mouth all the way?
Coronoid process
282
All of the following elevate the larynx except the sternothyoid
...
283
What creates the laryngeal prominence —>
Thyroid cartilage
284
Most superior part of larynx?
Aryepiglottic fold (epiglottis)
285
What muscle constrict to produce sound?
Lateral and transverse cricoarytenoid
286
What is the only muscle to abduct (contract) the larynx (vocal fold)?
Posterior cricoarytenoid muscle
287
What innervates muscles below the vocal fold and most of the laryngeal muscles —>
Recurrent laryngeal nerve (of CN 10)
288
Internal laryngeal nerve innervates thyrohyoid membrane
...
289
What occurs during tracheostomy?
Reduced airway resistance, reduced dead space
290
Lumbar puncture
Between L3 and L4
291
Trachea bifurcation
Sternal angle
292
Thyroid hormone is stored in?
The colloid
293
Where does the inferior thyroid artery come from?
Thyrocervical trunk
294
The arteries that supply the thyroid gland are from the thyrocervical trunk and ECA (superior thyroid A)
...
295
Terminal branches of the external carotid artery?
Superficial temporal artery and maxillary artery
296
In the carotid triangle, what branch of the ECA wouldn’t you see?
Superficial temporal artery
297
What makes up the carotid triangle?
Anterior border of SCM
Posterior belly of digastric
Superior omohyoid
298
Submental triangle consists of?
Anterior digastric, hyoid bone, and mandible
299
What structure is posterior to the carotid that runs along the longus capitas muscle
Sympathetic chain ganglia
300
What is in the carotid sheath
Common carotid
Internal jugular
Vagus nerve (not ansa cervicalis or phrenic N)
301
What does the sigmoid sinus drain into?
Internal jugular vein
302
Where does deep facial vein drain into?
Pterygoid plexus
| - deep facial vein connects the anterior facial vein and the pterygoid plexus
303
What specific organs does the portal vein drain ?produce
Stomach (also drains spleen, pancreas, SI, and LI)
304
Which one is not a function of the spleen?
Produce plasma cells
305
The difference between the inferior vena cava and portal veins
Portal contain no valves
306
Most common cause of portal hypertension —>
Liver cirrhosis (can also lead to esophageal varices)
307
Esophageal varices commonly seen in what?
Alcoholics or portal hypertension from cirrhosis
308
Esophageal varices can cause
Hematemesis (vomiting blood)
309
Alcoholics and liver cirrhosis —>
Mallory bodies (inclusion found in the cytoplasm of liver cells, damaged intermediate filaments in the hepatocytes, usually found in people with alcoholic liver)
310
Most frequent form of varicosities/varicose veins?
Superficial veins in the legs
311
Veins —> thick tunica adventitia
Muscular arteries —> thick tunica media
...
312
Initial venous drainage of the jejunum
Superior mesenteric vein
313
Which endocrine gland is not essential for life?
Adrenal medulla
314
What organ is not stimulated by the anterior pituitary
Adrenal medulla
315
Which of the following is a cancer of the adrenal medulla
Pheochromocytoma
- cardinal sign is persistent or episodic hypertension, often benign and results in irregular secretions of epi/NE
316
Cell producing epinephrine and norepinephrine
Chromatic cells of adrenal medulla
317
Which one is the end organ of the sympathetic system ?
Adrenal medulla
318
B1 receptors
B2 receptors
Alpha 1 and alpha 2
Beta 1 = Heart, bronchoconstriction
Beta 2 = dilation, smooth muscle
Alpha 1 and 2 = NE
319
Where is cortisol produced? Where is androgens produced?
Cortisol is produced in zona fasciculate
Androgens are produced in zona reticularis
320
Female secreting endometrium, what cycle is she in?
Luteal
321
Which organ doesnt make estrogen?
- Graafian follicle
- corpus luteum
- adrenal medulla
- theca interna
Adrenal medulla
- Graafian follicle = after 1st meiotic division, 2N haploid stage
- corpus luteum = hCG stimulates corpus luteum to secrete estrogen
- adrenal medulla —> the adrenal CORTEX secretes estrogen, the medulla secretes catecholamine
322
Which is an intracellular receptor?
Estrogen
| - includes steroid, estrogen, progesterone, vitamin D derivatives
323
Which of the following acts as nuclear receptor?
Vitamin D
| - nuclear receptors include endogenous hormones, vitamin A and D
324
What hormone promotes spermatogenesis ?
FSH
- FSH promotes follicle development in female and stimulates serotli cells to produce androgen-binding protein, which stimulates spermatogenesis
- LH promotes testosterone production in males and estrogen production in females
325
Granuloma cells of females are similar to what cells found in males?
Serotoli cells
- Sertoli cells help with spermatogenesis in the seminiferous tubules, activated by FSH
326
Where is testosterone made?
Leydig cells
327
Which is not in seminiferous tubules?
Leydig cell
- found adjacent to seminiferous tubules in interesting tissues, regulated by LH
328
Sperm stored/matured in?
Epididymis
329
What sustain the corpus luteum after the 1st trimester ?
HCG
- human chorionic gonadotropin made by placenta, allows corpus luteum to maintain high progesterone
330
Immunoglobulin transfer from mother to fetus?
IgG through placenta
331
Cell cycle immediately after fertilization?
Meiosis II
332
What is not transcriptionally active?
Heterochromatin (highly condensed, still zipped up in chromosome)
333
What phase is most variable in duration of the cell cycle?
G1
334
What stage is DNA synthesis in the cell cycle?
S
335
Histones are synthesis in which phase of the cell cycle?
S phase
336
Hepatocytes from what embryonic tissues?
Endoderm
337
GI tract, respiratory tract, thyroid, thymus, endocrine glands and organs, auditory system, urinary system, liver, and pancreas
What embryonic tissue?
Endoderm
338
Epithelium of skin and nervous tissue
- what embryonic tissue?
Ectoderm
339
Connective tissue, bone, cartilage, blood cells, all muscles (cardiac, smooth, skeletal), body cavities and some cardiovascular and urinary systems
- what embryonic tissue?
Mesoderm
340
Ureter in kidney is from what embryonic tissue?
Mesoderm
341
What are symptoms of trisomy 21 (Down syndrome)?
Wide neck, flat nose, small mouth
342
Klinefelter syndrome —>
XXY
343
Turners syndrome —>
XO
344
What is the name of the cellular mass after fertilization but before implantation —>
Blastula
345
Which stage of the zygote does implantation on the uterus occur?
Blastocyst
346
The ligamentum arteriosum is a remnant of what embryological structure?
Fetal left ductus arteriosus
- ductus arteriosus connects the pulmonary artery to the descending aorta to bypass the fetal lungs, doesn’t disappear immediately after birth
347
What goes with ligamentum arteriosum?
Left recurrent laryngeal N
348
Ligamentum venosum comes from what?
Ductus venosus
- shunts left umbilical vein blood directly to the IVC, bypass liver
-ligamentum teres = remnant of umbilical vein on the liver
349
Structure present in fetal heart that allows blood to pass from right to left atrium?
Fossa ovalis (remnant of fetal foramen ovale)
350
Crista terminalis is located on?
Right atrium
- it is the infection between the sinus venosus and the heart in the embryo
351
Which term is the best for a carcinoma that doesn’t perforate basement membrane?
Dysplasia
- dysplasia is non-malignant cellular growth, but may precede malignant changes in the tissue. It is associated with chronic irritation of a tissue, tissue appears somewhat structure less and disorganized and may consist of atypical cells without invasion
352
Most indicative of cancer?
Anaplasia
353
Which term describes the lack of differentiation?
Anaplasia (found in more malignant tumors)
354
Metaplasia —> reversible replacement of one tissue type with another
...
355
Which of the following would you not expect with a neoplasm/ not a characteristics of malignancy?
Aplasia
356
Neoplasm differences:
Benign:
- well differentiated
- slow growth
- encapsulated/well circumscribed
- localized
- movable
Malignant
- less differentiated (anaplastic)
- rapid growth
- invasion/metastasis
- immovable
...
357
Multiple myeloma
Cancer of plasma cells in bone marrow
Punched our radiolusencies
358
Having bence jones protein in urine indicates —>
Multiple myeloma
- bence jones proteins
- russel bodies (IgE inclusion)
- punched out appearance
- increased susceptibility to infection
359
What are the lab results of a person that has prostate cancer?
- increased serum acid phosphatase and increase prostatic specific antigen
- prostate carcinoma with metastasis to the bone result in increased PTH, high alkaline phosphatase and increase in prostatic specific antigen
360
Man has bony exocytosis with anaplasia glandular epithelium, what it is?
Prostate carcinoma which metastasis
361
Most probably cause for prolonged bleeding time in a patient with leukemia
Decreased number of blood platelets
- leukemia is a disease of the reticuloendothelial system involving uncontrolled proliferation of WBC
- people with leukemia may have thrombocytopenia
362
Reed-Sternberg cells?
Hodgkin’s lymphoma
363
In addition to kaposis sarcoma, which other malignant neoplasm is often observed with AIDS?
Non-Hodgkin’s lymphoma
- HIV (retrovirus) is an oncogenic RNA virus
- non-Hodgkin’s lymphoma are cancers of lymphoid tissue with the involved tissue being enlarged and are accompanied by night sweats and fever
364
Patient has ulcers in the gingiva. Lab values are 1200 WBC, 98% lymphocyte, normal platelet/RBC. What does the patient have?
Chronic lymphocytic leukemia (CLL)
- ALL and CLL have high number of lymphocytes. The leukemia cells survive longer than normal cells and build up, crowding out normal cells in the bone marrow
365
What do you find in the sweat of a person with cystic fibrosis?
Increased sodium and chloride
366
Patient with rash on side of face, droopy eye lid, constriction of pupil, what nerve dysfunction?
Horners syndrome
- damage to sympathetic (superior cervical ganglion)
367
Tay Sachs disease is a deficiency in what enzyme
Hexosaminidase
- tay Sachs disease (hexosaminidase A deficiency) is an auto-immune autosomal recessive disorder causing deterioration of nerve cells due to accumulation of gangliosides (spinolipid) causing nerve death
368
Sphingomyelin/sphingophospholipid:
Know characteristics
- not responsible for RBC recognition
Sphingomyelin function
- plasma membrane constituent
- nerve tissue constituent (myelin sheath)
- lysosomes
Major constituent
- ceramide and choline, accumulation is neimann-pick disease
...
369
What diseases are lysosomal deficiency?
Newman-pick, gauchers, tay Sachs
370
Prions affect which organ
Brain
371
Mitral valve is messed up, what will you see?
Pulmonary edema
372
What does not cause edema?
High albumin
Or shock
373
Patient had a stroke. What common artery is occluded?
Middle cerebral artery
- stroke can be caused in infarct in the brain
374
Patient got epidural hemorrhage, which artery was severed?
Middle meningeal artery
375
Person has acute hemorrhage, what occurs?
Heart rate increased
| BP decreases
376
Myocardial infarction —>
- coagulative necrosis = ischemia, blood less, heart, kidney
- liquefactive necrosis = enzyme digestion, infection (CNS)
- gangrenous necrosis = large areas (lower extremities, bowel)
- fat/calcified necrosis = pancreas, breast, etc
377
Which one is autosomal dominant?
Gardners syndrome
378
X-linked —> agammaglobulinemia (lack of gamma globulin in the blood causing immune deficiency)
...
379
Atelectasis —> deflated/collapsed alveoli (reduction in gas exchange)
...
380
What disease blocks acetylcholine receptors at NMJ?
Myasthenia gravis
381
What tumor is associated with myasthenia gravis?
Thymoma
Tumor in the thymus gland, t-cell maturation
382
What would a tumor of the anterior pituitary cause?
Affected ACTH specifically
383
Excessive secretion of ACTH causes what syndrome?
Cushing’s syndrome
384
Acromegaly as a result of a tumor of what —>
Anterior pituitary (causing high levels of growth hormone)
385
Diabetes insipidus
Lack of ADH
386
How would you describe diabetes type 1?
Autoimmune and islet cells appear degenerated
387
What causes microanginema in diabetics?
Damage to small capillaries
388
What is responsible for polyuria in diabetes?
Capacity of the kidneys to reabsorbed glucose is surpassed, glucose is lost in the urine alone with water and electrolytes
389
Neurofibromatosis is characterized by?
Multiple large pigmented skin lesions
| - cafe-au-lait, light brown spots on the skin
390
Gastroesophageal reflex disease (GERD) - Barrett’s esophagus and is a premalignant metaplasia?
Adenocarcinoma
- replacement of normal epithleium lining of the esophagus with simple columnar epithelium and goblet cells (which are found in lower GI)
391
Where in the GI tract are you most likely to see achalasia?
Esophagus
| - affects ability to perform peristalsis, nerve related
392
Acute pyelonephritis
- Infection of the RENAL PELVIS (kidney and ureters)
- usually E.coli most often from a UTI or vesicoureteral reflux
- active infection and abscess can develop
- renal pelvis filled with pus (PMNs)
393
Chronic pyelonephritis
- implies recurrent kidney infections and can result in scarring of the renal parenchyma and impaired function
- especially due to obstruction (usually e.coli infection of the renal pelvis)
394
Acute glomerulonephritis
- inflammation of the glomeruli of the kidney
- present with Hematuria and proteinuria or acute or chronic renal failure
- primary cause are intrinsic to the kidney
395
What GI disease is characterized by non-caseating granulomas?
Crohn’s disease
396
GI carcinoma/malignancy caused by villous adenoma
...
397
What part of the colon has the most chance of an adenocarcinoma?
Rectum
- rectum/sigmoid: associated with villus adenoma, such as ulcerative colitis, Crohn’s disease, Gardner’s syndrome and familial polyposis (colorectal: villous polyps)
398
Positive anti-nuclear antibody test (ANA) and positive ant-smith antibody is specific for disease?
Lupus SLE
- RH+ factor suggested that the patient has SLE, also has joint problems (RA)
399
Which one is not an autoimmune disease?
- arthus reaction
- erythroblastosis fetalis
- SLE
- Multiple sclerosis
Erythroblastosis fetalis —> mom = rh (+)/baby rh (-), causes hemolytic anemia
400
Sick cell anemia HbS what happens? (HbS = hemoglobin S, abnormal beta-globin)
- agglutination and oxygenation
- agglutination and deoxygenation
- deglutinaton and deoxygenation
- deglutinatoin and oxygenation
Agglutination and deoxygenation
401
Sickle cell anemia —> what type of mutation ?
Missense mutation (single point mutation)
402
Pernicious anemia results from what?
Lack of vitamin B12
403
Megaloblastic anemia is due to a deficiency of?
Folic acid (B9)
404
Most common type of anemia?
Iron deficiency anemia
405
Chronic ulcer with chronic slow blood loss; what is the most likely complication?
Iron deficiency anemia
406
Chronic blood loss from duodenum leads to —>
Microcytic and hypochromatic anemia (iron deficiency anemia)
407
Chronic bleeding peptic ulcer, what is a sign/symptom?
Fecal occult (blood in stool)
408
What does NOT cause cancer —> anthracosis
Anthracosis is caused by chronic exposure to coal, polluted air or cigarettes.
Black pigment is deposited in lung parenchyma
409
Most common cancer of the lung —>
Adenocarcinoma
410
Most common site in the lung to have squamous cell carcinoma?
Center of the lung
411
Patient had dysphasia, dysphagia, weight loss, long term heavy smoker
Laryngeal carcinoma
412
Lacrimal gland innervated by —>
Superior salivatory nucleus
| - it synapses on the pterygopalatine ganglion
413
Pain from which tract?
Lateral spinothalamic tract
414
Patient is given topical to relieve what fibers:
A delta fibers
| - NT for A delta fibers = glutamate
415
Sensation on the face and teeth involved what nucleus?
Main sensory nucleus of V
416
What are the primary sensory neurons of termination involved in pain from the maxillary 2nd molar?
Spinal nucleus of V
417
Mesencephalic nucleus
Propioception of face, jaw-jerk reflex
418
Main sensory nucleus
Light touch
419
Spinal trigeminal nucleus
Pain and temperature
420
Which subnucleus of the spinal nucleus of V is responsible for pain sensation
Pars interpolaris
421
Subnucleus oralis
- subnucleus oralis = transmission of discriminative (fine) tactile sense from the orofacial region
422
Subnucleus Caudalis
Transmission of nocicpetion and thermal sensations from the head
423
Pain from face goes to?
VPM = ventral posteromedially nucleus
Body pain = ventral posterolateral nucleus
424
Branchiomeric nerves come from where?
CN 5, 7, 9, 10
425
What nerve is involved in blinking?
CN V1 and CN7
426
What nerve innervates the skin above the upper lip?
Infraorbital N
427
Patient complains about burning sensation in the mandibular anterior?
Mental nerve
428
What innervates the posterior hard palate? Anterior hard palate?
Posterior hard palate = greater palatine nerve
Anterior hard palate = nasopalatine N
429
Which nerve innervate soft palate?
Lesser palatine nerve (CN V2)
430
Which is part of the cavernous sinus?
CN 3, 4, 6, V1, V2 (mnemonic = O TOM CAT)
431
What parasympathetic nerve runs through the foramen lacerum?
Greater petrosal nerve
432
What foramen transmits preganglionic parasympathetic fibers?
- foramen ovale for the lesser petrosal nerve
433
Before synapsing in the submandibular ganglion, pre-parasympathetic travel to which nerve?
Chorda tympani
434
What action of the lingual nerve stays with the nerve through its course?
Sensory to anterior 2/3 of tongue
435
Which nerve does not transmit taste fibers from the tongue?
- V
- VII
- X
V
436
What is the position of the lingual nerve in respect to the inferior alveolar nerve?
Anterior and medial
437
What ganglion does the postsympathetic for the submandibular ganglion?
Superior cervical ganglion
438
Intraoral approach to get to the submandibular ganglion —>
Cut through mucous membrane ONLY
439
If someone has motor loss underneath their right zygomatic, what nerve is damaged?
CN7 when existing the stylomastoid foramen
440
If you cut the nerve for the stylomastoid foramen, what do you lose innervation to?
Orbicularis muscle (oculus and oris)
441
CN 7 and 8 goes through?
Internal acoustic meatus
442
What nerve brings preganglionic parasympathetic nerve fibers to the otic ganglion, then eventually to the parotid gland?
Lesser petrosal nerve through CN 9
443
What goes between the superior pharyngeal constrictor and middle pharyngeal constrictor?
- stylopharyngeus muscle
| - glossopharyngeal nerve
444
What runs between the middle and inferior constrictor muscles?
Internal laryngeal branch of the superior laryngeal nerve
Superior laryngeal artery from the superior thyroid artery
445
What nerve goes between the palatoglossus and palatopharyngeus ?
Tonsillitis branch of CN9
446
Circumvallate papilla are innervated by what nerve?
CN9
447
What cranial nerve innervates levator Levi palatini?
CN X (pharyngeal branch)
448
What nerve does not come out of the jugular foramen ?
- CN9
- CN10
- CN11
- CN12
CN 12 — goes through hypoglossal canal
449
Gag reflex —> sensory limb (afferent) is mediated by?
CN 9
Motor efferent = CN 10
450
What is not innervated by the hypoglossal nerve?
Palatoglossal — innervated by CN X
451
Muscles inneravated by ansa cervicalis (C1-C3) include?
Infrahyoid muscles
452
What is the primary sensory relay station of the brain (conduit)?
Thalamus
453
What part of the brain controls hunger?
Hypothalamus
454
The swallowing center: 2nd stage of deglutinatoin is located?
Medulla
455
Sectioning of infundibular stalk of hypothalamus with normal hypophyseal tract leads to a decrease in what hormones?
ADH
Infundibular stalk = connection between hypothalamus and posterior pituitary
456
What divides the diencephalon into 2?
3rd ventricle
457
What lines the ventricle of the brain?
Ependymal cells
458
What makes up the blood-brain barrier?
Astroytes, endothelial cells in capillaries connected by tight junction, water/lipids pass or selective transport
459
Largest paranasal sinus?
Maxillary sinus
460
Where does the maxillary sinus drain into?
Semilunar hiatus of the middle meatus
461
Where does the nasolacrimal drain into?
Inferior concha
462
Right maxillary sinus is infected, where does it spread to next?
Right ethmoid sinus
463
What is the outer edge of the lateral wall of the ethmoid sinus?frontal
Orbit
464
Anterior cerebral artery supplies what lobes?
Frontal and parietal lobes (medial surfaces of both)
465
Arachnoid villa and granulation transport CSF from subarachnoid space to venous system
...
466
Increase in CSF pressure causes what?
Brain herniation
467
Vertebral artery pass through what foramen?
Magnum
468
What is not part of the circle of willis?
Basilar artery
469
Branches of the maxillary artery go through all of the following foramen except?
Foramen lacerum
470
Maxillary vein and superior temporal veins drain into?
Retromandibular vein
471
Each of the following structures lie between the hyoglossus and mylohyoid muscle expect one? Lingual artery (passes deep to hyoglossus m)
...
472
What makes up the sphenoid bone?
Body
2 greater wings
2 lesser wings
Pterygoid process
473
What forms the superior orbital fissure?
Greater and lesser wing of the sphenoid
474
Foramen ovale is located in?
Greater wing of the sphenoid
475
Medial border of the infratemporal fossa?
pterygomaxillary fissure
```
Lateral = ramus of mandible
Medial = lateral pterygoid plate of the sphenoid
Anterior = posterior surface of the maxilla
Posterior = carotid sheath
```
```
Floor = medial pterygoid muscle
Roof = greater wing of the sphenoid bone
```
476
Guy shot in the back of the head, bullet exits above eyebrows. Which bone is least likely to get damaged?
Maxillary
477
All of the following pass through th medial and lateral pterygoid except?
Buccal nerve — passes through lateral pterygoid heads
478
What is anterior to the pharyngeal tonsils?
Palatoglossal fold
479
Where is synovial fluid produced?
Internal synovial layer of the fibrous capsule (joint capsule)
480
What cells are responsible for production of synovial fluid?
Type B synoviocytes
481
What organ is found by the right kidney?
Colon
482
All of the following are in the kidney medulla EXCEPT?
Glomerulus (cortex)
483
In a healthy kidney, what does not get passed through?
Albumin and glucose
Clearance = 0mg/mL
484
Most kidney reabsorption and ATP used in the nephron of the kidney?
Proximal convoluted tubule
| - contain truncated pyramidal cells
485
Where is the highest osmolality?
Loop of henle in the medulla
486
Macula densa - location and function?
- distal convoluted tubule
- they sense NaCl concentration in thick ascending limb, can signal afferent arterioles to vasodilator and increase renin released from JG complex
487
What would increase GFR?
Dilation of afferent arterioles in kidney
488
Kidney substance filtered and secreted. The clearance rate is
- = to inulin
- greater inulin
- less inulin
Greater inulin
489
What is the para-aminohippurate (PAH) test used for?
Measure renal plasma flow
- PAH —> freely filtered and secreted by the kidney = renal plasma flow
490
Aldosterone is produced in the zona glomerulosa and affected DCT
...
491
If you inhibit ACE, what hormone is decreased?
Aldosterone
492
ADH is produced where?
Supraoptic nucleus of hypothalamus
493
ADH increases water permeability/resorption at DCT by inserts aquaporin-2 channels into the DCT and collecting duct epithelial cells
...
494
Deficiency of ADH —>
Dilute urine
495
What are the primary stones in gout?
Urate crystals (uric acid)
496
What do you want to inhibit in a person with gout?
Xanthine oxidase
| - uric acid is an end product of purine metabolism, specifically through xanthine metabolism
497
You could decrease plasma osmolality by injecting serum?
ADH
498
What type of enzyme is fumerase?
Isoenzyme
499
Ornithine is an intermediate of the urea cycle in mitochondria?
...
500
Fumerase/fumarate connects urea cycle through?
TCA cycle
| - hydration reaction
501
In the urea cycle, where does the nitrogen come from?
Ammonia and aspartate
502
What is an intermediate in the urea and precursor for ornithine?
Arginine
503
What is around a myofibril?
Endomysium - surrounds a myofibril
Note:
- epimysium: around entire muscle
- perimysium: surrounds the muscle bundles (fascicles)
504
What is the perimysium?
Surrounds the muscle bundles (fascicles)
505
What is the epimysium?
Surrounds the entire muscle
506
During muscle contraction when an AP reaches the NMJ, what is released?
Acetylcholine is released
507
What is the function of calmodulin
Regulates smooth muscle contraction
-calmodulin activates the MLC-kinase: contraction is SLOW and prolonged
508
When does cardiac muscles start to contract?
When there is an influx of calcium from the outside
509
Parasympathetic nerves from vagus nerve have what effect on the heart?
LOWERS heart rate
- note: the parasympathetic nerves from the vagus lowers heart RATE
510
Regulation of the contraction in smooth muscle?
Calmodulin
511
When calcium binds to calmodulin, it activates what?
MLC-kinase
512
What controls the ATPase activity for smooth muscle?
Myosin
- controls the ATPase activity
- no t-tubules, poor SR, no troponin — so myosin is always ready to react and can hold long contractions
513
What modulates smooth muscle action potential?
Acetylcholine
514
What does acetylcholine cause the arrector pili to do?
Increase calcium entering the cell to erects the muscle
— if there is an increase in intracellular calcium —> greater activation of contractile proteins mult
515
The skeletal muscles are what type of cells?
Multinucleated
516
How many nuclei do cardiac and smooth muscle have?
Both have only 1 while skeletal has multiple
517
Direct source of energy for skeletal muscle?
ATP —> ADP + phosphate
518
How does ATP get transported out of the mitochondrial membrane?
ATP-ADP translocase ?
519
Sarcolemma/sarcomere is only in what type of muscle?
Striated muscles
- only skeletal and cardiac muscles are striated
520
During isotonic muscle contraction, which bands would get shorter?
H and I band gets shorter
Note
- H band = light band that bisects the A band, shortens during contraction
- I band = light band containing actin, shortens during contraction
521
Increasing the load of muscles does what to velocity ?
Slows it down
522
Gamma efferent motor fibers (gamma-motor) function?
Regulate change in muscle length and tone for stretch receptors (muscle spindles)
523
Inorganic phosphate is released from ADP in myosin for?
POWERSTROKE
| - myosin head pivots, pulling the actin filament toward the center (M-line)
524
What is responsible for dissociation of phosphate group during muscle contraction?
Cocking action
- cocking of the myosin head occurs, an ATP is plait into ADP + P
525
Myosin has ATPase action that turns ATP —> ADP + phosphate. Release of the phosphate group causes the
Myosin power stroke
526
Which one is not a glycoprotein hormone?
- GH
- Mucins
- Immunoglobulins
- TSH
- HCG
GH (somatrophin, peptide hormone) —> inhibits insulin
HCG and TSH is a glycoprotein hormone
527
Somatmedins function?
Promote cell growth
- somatomedins aka somatotropin or GH found in the anterior pituitary
528
alpha cells of the pancreas secrete what? Beta cells of the pancreas secrete what?
```
Alpha = glucagon
Beta = insulin
```
529
Growth hormone stimulated chondrogenesis indirectly by using what?
Somatomedins
| - they are a group of hormones that promote cell growth and division in response to stimulation by GH
530
Vitamin K
Blood clotting
531
What is biotin used for?
Pyruvate carboxylase, acetyl CoA (cofactor)
- any carboxylase needs biotin cofactor
532
What reaction requires thiamine (B1)?
Pyruvate decarboxylase
533
B1 is a coenzyme for?
Decarboxylase reactions
534
B2 is a coenzyme for?
FAD and FMN
535
B3 is a coenzyme for?
B3 = niacin
Coenzyme for NAD
- deficiency = pellagra
536
B6 coenzyme for?
Transamination reaction (amino acid and nucleic acid metabolism)
537
What is the cofactor involved in transamination?
PLP vitamin B6
538
Deficiency of B6
Peripheral neuropathy and dermatitis
539
B12 is needed for what?
intrinsic factor absorption (cobalamin)
540
Lumbar puncture
L3/L4
541
Phosphatidylcholine
Lecithin
542
Which does NOT cause vasoconstriction?
Histamine
543
Muscarinic AcH receptors effects?
Sweating and salivation
544
What hormone is responsible for milk secretion postpartum?
Oxytocin
- oxytocin ejects breast milk produced in the paraventricular nucleus of the hypothalamus and stored in the posterior pituitary
545
Advantage of using dry heat sterilization over autoclaving?
No dulling, it keeps instruments sharp
546
Best method to sterilize instruments without corrosion?
Dry heat
547
Ethylene oxide for sterilization is good for?
Heat labile tools
548
If unable to use heat, what method should be used to sterilize instruments?
Ethylene oxide
549
Whats a way to measure human basal energy?
Temperature
550
What enzymes are not involved in making cDNA?
- telomerase
The enzymes used to make cDNA are:
- reverse transcriptase
- RNA-dependent DNA-polymerase
551
DNA fingerprinting?
Restriction site
552
Which of the following types of blotting can be used to ID DNA restriction fragments?
Southern blotting
- restriction endonuclease are used to cut DNA
```
Northern = RNA
Southern = DNA
Western = proteins
```
553
What are the 5 steps of PCR? What is PCR used for?
1. Initialization
2. Denature
3. Annealing
4. Extension
5. Final elongation
Used to amplify and make more copies of DNA
554
What is PCR step initialization?
- DNA polymerase that need heat activation
555
What is the PCR step denaturing?
Heat reaction for 20-30 seconds so DNA melts, disrupts H-bonds to yield ssDNA
556
What is the PCR step annealing?
Reaction T is lowered for hybridization of primer to strain
557
What is the PCR step extension?e
DNA polymerase added to synthesize new DNA complement, x2 DNA
558
What is the PCR step final elongation?isoelectric put
Ensure all DNA strands have elongated
559
When does pH = pKa?
Isoelectric point
560
Mechanism of fluoride?
Enolase inhibitor (inhibits glycolysis)
561
Regulation of F —> bone/urine
...
562
What innervates the erector spinae muscles?
Dorsal branch of the spinal N
563
Which lymph nodes are along the external vein?
Deep cervical lymph nodes
564
Which structure has both afferent and efferent vessels?
Lymph nodes
565
Tetrodotoxin (pufferfish) is a channel blocker for voltage gated Na channels, what happens to action potential?
NO action potential
566
Which viruses do NOT have a latent phase?
Rhinovirus and poliovirus
567
Which viruses do have a latent phase?
EBV, HSV-1 and 2, VZV, CMV, HEH, CV all herpes
568
Herpes virus is the only virus that gets it cell wall from?
Host nuclear membrane
Herpes virus
- dsDNA
- enveloped
- nuclear membrane
- icosahedral
- nucleocapsid
- establishes latent infection
569
CMV is associated with?
- salivary glands
- intestinal glands
- chicken pox
- mononucleosis
Salivary gland
570
Which diseases cross the placenta?
TORCHES
571
EBV and varicella zoster are members of?
Herpesviridae
EBV can cause burkitts lymphoma, nasopharyngeal carcinoma, b-cell lymphoma, hairy leukoplakia (lateral borders of tongue), infectious mononucleosis
572
What causes influenza to change year to year?
Antigenic capsule (gene reassortment)
- influenza virus is an orthomyxovirus with outer envelope has spikes (H and N) for attachment to host cells
- treatment with amantidine —> inhibits viral attachment and uncoating
- the main mode of prevention is the vaccine, which consists of killed influenza A and B virus
573
What are the virulence factors of neisseria meningitis?
Endotoxin, LPS (gram negative)
N. Meningitis is an ENDOTOXIN (LPS) WATERHOUSE FRIDERISCHEN SYNDROME
574
What is not associated with N.meningitis?
- endotoxin
- capsule
- enterovirus
- aerobic
Enterovirus
