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Main Concepts

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resexuwe's version from 2017-07-14 00:07

Clinical

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Babies be careful using oxygen supplementationOxygen suppresses EPO production
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Main Concepts

Question Answer
What electrolytes does the low volume state have? Increase total Na, Decrease serums Na & Cl & K & Ca2 (Bound to albumin)
What pH does low volume state have?Alkalotic(except diarrhea, Renal tubular Type II & DKA) because Aldo dumps H+
What pH does vomiters have?Alkalotic because you vomit out H+ -> low volume state
What pH does diarrhea have?Acidosis because stool has bicarb from pancreas
What happens if pulse increase greater than 10 on standing?Hypovolemic shock
What happens if pulse increase less than 10 on standing?Autonomic dysfunction
Symptoms of low energy state?CNS - MR, Dementia, Decreased activity / Cardiovascular - CHF, pericardial effusion / Muscle weakness - SOB, weakness, Impotence, distillation, urinary retention, constipation
Symptoms of low energy state in rapidly dividing cells?Dry skin, brittle nails, loss of hair, BM suppression, endothelial & endometrial & breast atrophy, lungs SOB with infection, Kidney PCT affected first, GI nausea vomiting & diarrhea, Urinary retention, azoospermia
Symptoms of low energy state with cancer?Skin, GI, Bone marrow Cancers
What are the most common SIGN of the low energy state?Tachypnea & Dyspnea
What are the most common SYMPTOM of the low energy state?Weakness & SOB
Most common infection of LESUTI & Respiratory
What is the most common cause of death in LESHeart Failure
Explain all restrictive lung diseaseInterstitial problem Decreased diffusion & perfusion / Small Stiff lungs( decrease VC ) / Trouble breathing FEV1/FVC ratio >80 / ABG - decrease pO2-> Increase RR -> Decrease pCO2 -> Increase ph
Restrictive lung disease CXR?Reticulonodular pattern, ground glass appearance -> DIE FROM Corpulmonale
Restrictive lung disease examplesNM diseases(breathing out is passive), drugs, autoimmune
Restrictive lung disease txPressure support on ventilator, Increase O2 & RR, Inspiratory time. Decrease in TV
Explain all obstructive lung diseaseObstructive airway problem(bacterial), big mucus filled lungs (Increase RV, Reid index ->Increase Airway thickness/airway lumen), Trouble breathing out FEV1/FVC <0.8, ABG -> Increase pCO2 -> Increase RR, Decrease pH
COPD die fromBronchiectasis. Tx - Manipulate rate on ventilator , Increase RR, Increase expiratory time & O2
What symptoms does a more likely to depolarize state have?Brain - Psychosis, seizures, jitterniess / Skeletal muscle - muscle spasms, cramps / SM - Diarrhea / Heart - Tachycardia, arrythemias
What symptoms does a less likely to have depolarize state have?Brain - Lethargy, mental status changes, depression / Skeletal muscle - Weakness, SOB / SM - Constipation / Heart - Hypotension, Bradycardia
What is the humoral immune responseB cells and Neutrophils patrol the blood looking for bacteria
What is the cell mediated immune response?T cells and Macrophages patrol the tissues looking for non-bacteria
What is karyolysisNucleus dissolves
What is karyohexxisNucleus Fragments
What is PyknosisNucleus turns in blobs "pick blobs"
What is apoptosisProgrammedcell death -> quiet no inflammation, nucleus guides it
What is necrosisNon-programmed cell death -> noisy inflammation, nucleus destroyed first
What does high GABA levels lead to?Bradycardia, lethargy, constipation, impotence, memory loss
What state does estrogen mimic?The neuromuscular disease state (estrogen muscle relaxant)
What is the CBC for every vasculitis?DECREASE RBC, Platelets, INCREASE WBC, Tcells, MP, schistocytes, ESR
What is the time line of inflammatory response?1HR- Swelling / DAY 1 - PMNs showup at 4hrs, predominate at 24 hrs / DAY 3 - PMNs peak / DAY 4 - Macrophages/t-cells / DAY 7 - Macrophages/T-cells peak, fibroblasts arrive / DAY 30 - Fibroblasts peak / MONTH 3-6 - Fibroblasts complete fibrosis
Blood macrophage?Monocytes
Brain macrophage?Microglia
Lung macrophage?T1 pneumocytes
Liver macrophage?Kupffer cells
Spleen macrophage?Raticulo Endothelial Cells
Lymph macrophage?Dendritic cells
Kidney macrophage?Mesangial cells, found in the macula densa, (renin found in juxtaglomerular cells)
Peyers Patch macrophage?M cells
Skin macrophage?Langerhans cells
Bone macrophage?Osteoclasts
CT of macrophages exampleHistiocytes, Giant cells, Epitheliod cells
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Biochemistry

Question Answer
What is the most common intracellular bufffer?Protein
What is the most common extracellular buffer?Bicarbonate
What is a Zwitterion?A melcule with one negative and one positive end
What is the isoelectric point?The pH at which there is no net charge?
Rate limiting enzyme in Glycolysis?PFK1
Rate limiting enzyme in Gluconeogenesis?Pyruvate carboxylase
Rate limiting enzyme in HMP shunt?G6pd
Rate limiting enzyme in Glycogenesis?Glycogen synthase
Rate limiting enzyme in Glycogenolysis?Glycogen Phosphorylase
Rate limiting enzyme in FA synthesisAcCoA carboxylase
Rate limiting enzyme in B-oxidation?CAT-1
Rate limiting enzyme in cholestrol synthesis?HMG CoA reductase
Rate limiting enzyme in Ketogenesis?Hmg CoA synthase
Rate limiting enzyme in Purine synthesisPRPP synthase
Rate limiting enzyme in Pyrimidine synthesisAsp transcarbamoylase
Rate limiting enzyme in TCA cycle?Isocitrate dehydrogenase
Rate limiting enzyme in Urea cycle?Carbamoyl Phosphate Synthetase I
Rate limiting enzyme in Heme synthesis?D-ALA synthase
What are the catabolic pathways that create energy?ABC AcetylCoA production, B-oxidation, Citric acid cycle
What are the anabolic pathways that store energy?EFGH ER, Fatty acid synthesis, Glycolysis, HMP shunt
What are the anabolic + catabolic pathways?HUG Hemesynthesis, Urea cycle, Gluconeogenesis
What does an Isomerase do?Creates an Isomer
What does and Epimerase do?Creates an epimer, which differs around 1 chiral carbon
What does a mutase do?Moves side chain from one substrate to another(interchain)
What does a transferase do?Moves sidechain from one substrate to another (interchain)
What does a kinase do?Phosphorylates using ATP
What does a phosphorylase do?Phosphorylates using Pi
What does a carboxylase do?Forms C-C bonds(w/ ATP and biotin using CO2)
What does a synthase do?Consumes 2 substrates equally
What does a Synthetase do?Consumes 2 substrates uses ATP
What does a Phosphatase do?Breaks phosphate bond
What does a Hydrolase do?Breaks a bond with water
What does a lyase do?Cuts C-C bonds w/ATP
What does a dehydrogenase do?Removes H with a cofactor
What does Thio do?Breaks S bonds
What is diffusion?From high to low concentration
What is Active transport?Goes agianst concentration grradient
What is Zero order kinetics?Metabolism independent of concentration
What is 1 st order Kinetics?Constant drug percentage metabolism over time depends on drug
What is efficacy?Max effect regardless of dose(lower w/ non-competitive antagonist)
What effects efficacy?Vmax
What is potency?Amount of drug needed to produce effect (lower w/ competitive anatagonist)
What affects Potency?Km
What is Kd?Concentration of drug that binds 50% of receptors
What is EC50?Concentration of drug that binds 50% of maximal response
What is Competitive inhibition?Fights for active site, no Vmax, potency decreases
What is Non-competitive inhibition?Binds to regulatory site, no Km, efficacy decreases, decrease Vmax
What is Endothermic Reaction?Consumes heat
What is Exothermic reaction?Gives off heat
What is the peak level?4hrs after dose (too high -> give less often)
What is trough level?2 hrs before dose (too high -> give less often)
What is t12?Half life, the time it takes for the body to use half of the drug ingested
What is Von Gierke?G-6Pase deficiency -> hypoglycemia, hepatosplenomegaly
What is Pompe?Cardiac a-1,4-gulcosidase deficiency -> Die early
What is Cori's?Debranching enzyme deficiency -> short branches of glycogen
What is Andersons?Branching enzyme deficiency -> Long chains of glycogen
What is McArdles?Muscle phosphorylase deficiency -> muscle cramps w/exercise
What is Essential Fructosuria?Frucktokinase Deficiency -> Excrete fructose (still have hexokinase)
What is Fructosemia?Fructose Intolerance -> Aldolase B deficiency -> liver damage
What does a galactokinase deficiency cause?Cataracts
What does Galactosemia cause?Cataracts, MR, liver damage
What does the Citrate shuttle do?FA transport out of the mitochondria
What does the Carnitine shuttle do?FA transport into the mitochondria
What lysosomal diseases have cherry-red macula?Tay-sachs, Neimann Pick
What lysosomal diseases have a Gargoyle-face?Gauchers, Hurlers
What is Tay SachsHexominidase A deficiency -> Blindness, incoordination, dementia
What is Sandhoffs?Hexosaminidase A/B deficiency
What is Gauchers?Glucocerebrosidase deficiency -> wrinkled tissue MP, bone pain
What is Neiman-Pick?Sphingomyelinase deficiency -> zebra bodies
What is Fabrys?a-galactosidase deficiency -> corneal clouding, attacks babys kidneys, x-linked
What is Krabbes?B-galactosidase deficiency-> globoid bodies
What is Metachromaticleukodystrophy?Arylsulfatase deficiency -> childhood MS
What is Hunters?Iduronidase deficiency, milder form
What Hurlers?Iduronidase deficiency, worse form
What is Lesch-Nyan?HGPRT Deficiency -> gout, neuropathy, self-mutilation
What do white diaper crystals suggest?Excess orotic acid
What does biotin donate CO2 groups for?Carboxylation
What does THF donate methyl groups for?Nucleotides
What does SAM donate methyl groups for?All other reactions
What is the difference b/w Heterochromatin and Euchromatin?Heterchromatin -> Tightly coiled / Euchromatin -> Loose(10nmfibers)
What are the purines?Adenine, Guanine
What are the pyrimidines?Cytosine, Uridine, Thymidine
What is a silent mutation?Changes leave the same amino acid
What is a point mutation?Changes 1 base
What is a transtion?Changes 1 purine to another purine or pyrimidine to pyrimidine
What is transversion?Changes 1 purine to a pyrimidine or vice versa
What is a frame shift mutation?Insert or delete 1-2 bases
What is a missense mutation?Mistaken amino acid substitiution
What is a nonsense mutation?Early stop codon
What does a southern blot detect?DNA
What does a northern blot detect?RNA
What does a Western blot detect?Protein
What are the essential amino acids?PVT TIM HALL pHE, vAL, tRYP, tHR, iLE, mET, hIS, aRG, lYS, lEU
What are the essential fatty acids?Linolenic
What are the acidic amino acids?Aspartic acid, Glutamic acid
What are the basic amino acids?Lysine, Argenine
What are the sulfur containing amino acids?Cysteine, Methioine
What are the O bond amino acids?Serine, Threnine, Tyrosine
What are the N bond amino acids?Aspargine, Glutamine
What are the branched amino acids?Leucine, Ile, Valine
What are the aromatic amino acids?Phenyalnine, Tyrosine, Tryptophan
What is the smallest amino acid?Glycine
What are the ketogenic amino acids?Lysine, Leucine
What are the glucogenic + ketogenic amino acids?PITT pHENYALANINE, iSOLEUCINE, tHREONINE, tRYPTOPHAN
What are the glucogenic amino acidsAll the rest
What amino acids does Trypsin cut?Lysine, Arginine
What amino acids does B ME cut?Cysteien, Methionine
What amino acids does acid hydrolysis denature?Asn, Gln
What amino acids does Chymotrypsin cut?Phe, Tyrosine, Tryptophan
What amino acid turns yellow on Nurhydrin reaction?Proline
What does Carboxypeptidase cut?Left of any amino acidon the carboxy terminal
What does Aminopeptidase cut?Right of N terminus
What does CNBr cut?Right of Met
What does Mercaptoethanol cut?Right of Cys, Met
What does Elastase cut?Right of Gly, Ala, Ser
What does Trypsin Cut?Arg, Lys
What does Chymotrypsin cut?Phe, Tyr, Trp
What does a1- AT do?Inhibits trypsin from getting loose
What is PKU?No Phenylanine->Tyrosine (viaphe hydroxylase) -> Nutrasweet sensitivity, mental retardation, pale, blond hair, blue eyes, musty odor
What is Albinism?No Tyrosine -> Melanin (via Tyrosinase)
What is Maple Syrup Urine Disease?Defective metabolism of branched AA leucine, Isoleucine, Valine -> aa leakout
What is Homocystinura?No Homocysteine -> Cys -> COLA STONES -> Cystine, Ornithine, Lysine, Arginine
What is Pellagra?Niacin deficiency -> Diarrhea, Dermatitis, Dementia, Death
What is Hartnups?No Trp -> Niacin+Serotonin. Presents like Pellagra, can mimic corn rich diet
What causes anterior leg bowing?Neonatal syphilis
What causes lateral leg bowing?Rickets
What are the names of the B vitamins?The Rich Never Lie about Panning Pyrite Filled Creeks Vit B1- Thiamine, Vit B2 Riboflavin, Vit B3 Niacin, Vit B4 Lipoic acid, Vit B5 Pantothenic acid, Vit B6 Pyridoxine, Vit B9 Folate, Vitamin b12 Cobalamin
What does Vit A do?Night vision, CSF production,cofactor for PTH
What does Vit B1 do?Dehydrogenases, transketolase, (PPP) cofactors
What does Vit B2 do?FAD cofactor
What does Vit B3 do?NAD cofactor or NADP
What does Vit B4 do?Glycolysis, no know disease
What does Vit B5 do?Part of Acetyl CoA, no known disease
What does Vit B6 do?Transaminase co factor, myelin integrity
What does Vit B9 do?Nuclear division
What does Vit B12 do?Cofactor for HMT and MMM
What does Vit C do?Collagen synthesis
What does Vit D do?Mineralization of bones and teeth
What does Vit K do?Clottingfactors
What does Bioting do?Carboxylation
What does Ca2 do?Neuronal function, atria depolarization, SM contractile
What does Cu2 do?Collagen synthesis
What does Fe2 do?Hb function, electron transport
What is Bronze pigmentation?Fe deposit in Skin
What is Bronze cirrhosis?Fe deposit in liver
What is Bronze diabetes?Fe deposit in pancreas
What is Hemosiderosis?Fe overload in bone marrow
What is Hemochromatosis?Fe deposit in organs
What does Mg2 do?PTH and kinase cofactor
What does Zn2 ZINC do?Taste buds, hair, sperm function
What does Cr Chromium do?Insulin function
What does Mb do?Purine breakdown (xantine oxidase)
What does Mn do?Gycolysis
What does Se do?Heart function -> Dilated cardiomyopathy
What does Sn do ?Hair
What is Kwashiokor?Malabsorption, big belly(Ascites), protein deficiency
What is Marasmus?Starvation, Skinny, Calorie deficiency
Where does the Pre Label send stuff to?RER
Where does the Pro label send stuff to?Golgi
Where does the Mannose-6-P send stuff to?Lysosome
Where does the N-terminal sequence send stuff to?Mitochondria
What are the 4 types of collagen?SCAB type I- Skin, bone / type II- Connective tissue, aqueous humor / type III- arteries / type IV- Basement membrane
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