BECOM Exam #4 Flashcards
(324 cards)
1
Q
Pituitary part names
A
Ant: pars distalis Post: pars nervosa pas intermedia (in between ant and post) infundibular stalk pars tubulars (surrounds infundibular stalk)
2
Q
Posterior innervation and secretion (from hypothalamus)
A
paraventricular nucleus: oxytocin
supraoptic nucleus: ADH
3
Q
Anterior communication with hypothalamus
A
hypophyseal portal vein
4
Q
Hypophyseal pouch ectoderm forms
A
ant pituitary
5
Q
Neurohpoyseal pouch neuroectoderm forms
A
post pituitary
6
Q
anterior pituitary cells and function (acidophils and basophils)
A
- Acidophils – contain polypeptide hormones
- Somatotrophs – secrete growth hormone (GH, aka somatotropin)
- Mammotrophs (aka Lactotrophs) – secrete prolactin (PRL)
- Basophils – contain glycoprotein hormones
- Gonadotrophs – secretes follicle stimulating hormone (FSH) and luteinizing hormone (LH)
- Thyrotrophs – secrete thyrotropin (TSH)
- Corticotrophs – secrete adrenal corticotropin (ACTH) and lipotropin (LPH)
7
Q
Pars intermedia cell type
A
corticotrophs
chromotrophs
8
Q
Pars Tubularis cell type
A
gonadotrophs
9
Q
Pituitary adenomas types (cell types and hormone)
gigantism
loss of mensural cycle
Cushing disease
A
gigantism: somatotrohs -> GH
loss of mensural cycle: lactotrophs -> prolactin
Cushing disease: thyrotrophs -> hyperthyroidism
10
Q
Thyroid cell type and hormone
A
Follicular cell (thyocyte): thyroglobulin Parafollicular cells (c cells): calcitonin
11
Q
parathyroid cell type and hormone
A
principal cells: parathyroid hormone (PTH)
oxyphil cells: some PTH but mainly nonfunctional
12
Q
Adrenal Cortex layers and steroids
A
- capsule
- zona glomerulosa: mineralcoticoids (aldosterone)
- zona fasciculata: glucocorticoids (cortisol)
- zona recticularis: dehydroepiandrosterone DHEA a precursor to testosterone
- adrenal medulla: epinephrine and norepinephrine
13
Q
Addison’s disease
A
destruction of particular cell type of adrenal cortex
-KNOW layers and correlate to different symptoms of Addison’s disease
14
Q
Pineal Gland contents and release
A
corpus arenaceum (brain) sand: releases melatonin
15
Q
POMC
A
POMC is cleaved into
- ACTH and B-lipoprotein (B-LPS)
- ACTH contain alpha-MSH
16
Q
Pregnancy can cause infarction in the pituitary
A
d
17
Q
Serous inflammation
A
Excess watery fluid exudate…blisters
18
Q
Serofibrinous inflammation
A
Exudate rich in fibrin
19
Q
Catarrhal inflammation
A
Mild inflammation of mucous membrane with excess watery secretion
20
Q
acid fast pos. gastrointestinal protozoa
A
Cryptosporidia, Cyclospora
21
Q
Giardiasis
A
Causative agent: Giardia lamblia
Manisfestations: sulfurous belching/flatulence, fat-rich stools, diarrhea and vomiting
-#1 protozoan intestinal disease in US
-contaminated water, after someone goes camping (beavers)
22
Q
Cryptosporidium
A
Causative agent: Cryptosporidium parvum
Manisfestations: self-limiting watery diarrhea in immunocompetent hosts (AIDS) will run course in normal individual
-epidemic community diarrhea outbreaks
-ACID-FAST positive
23
Q
Cyclospora
A
Similar manifestations as cryptosporidium but larger histologically
-ACID-FAST positive
24
Q
Amebiasis
A
Causative agent: Entamoeba histolytica
Manisfestations: amoebic dysentery (traveler’s dysentery)
-histologically will contain RBCs within
25
toxoplasma gondii
CAT POOP parasite
- can also be found it uncooked meat or unwashed vegetables
- can affect pregnant women fetus
- lesion scattered across brain in immunocompromised individuals
26
Acanthamoeba
- effects eye usually through effected contacts
| - found in USA
27
Naegleria fowleri
Disease: Rapidly fatal primary amoebic meningoencephalitis by amoeba borrowing through cribriform plate into brain
Transmission: swimming in freshwater lake
Diagnosis: Amoebas in spinal fluid
-found in USA
28
trypansoma brucii
```
Disease: African Sleeping Sickness
Manifestation: characterized mainly by sleeping problems insomnia or sleepiness
Transmission: Tsetse fly (painful bite)
Diagnosis: Trypomastigote in blood smear
-AFRICA
```
29
plasmodium
P. falciparum
P. malariae (Anopheles mosquitoes)
P. vivax
P. ovale
30
plasmodium falciparum
Manifestation: cerebral hemorrhaging and blood in urine (lyses 10% of blood cells)
Diagnosis: produces banana shaped
31
babesiosis
Manifestation: fever and hemolytic anemia:
Transmission: US tickborne illness
Diagnosis: Maltese Cross on histological slide
32
Trichomonas vaginalis
Manifestation: foul-smelling greenish discharge
Transmission: sexual
Diagnosis: Motile ‘pear-shaped’ trophozoites and strawberry cervix
33
leishanosma spp
Disease: Visceral leishmaniasis (fatal) or Cutaneous leishmaniasis
Transmission: Sandfly
Diagnosis: Macrophages with amastigotes
34
trypanosma cruzi
Disease: cardiomegaly, megacolon, and megaesophagus (Chagas Disease) or unilateral periorbital swelling
Transmission: kissing bug
Diagnosis: Trypomastigote in blood smear
35
mites vs lice
mites, scabies, and chiggers: burrow
| lice: don't jump, close contact
36
17alpha hydroxylase def
- will have a decrease in hydroxylase not a complete loss of hydroxylase
- normal levels of aldosterone but decreased DHEA and cortisol
- low cortisol -> no neg feedback on ACTH -> increase pigmentation
37
21 hydroxylase (CYP21A2) def
- normal levels of DHEA and aldosterone but low cortisol levels
- KEY LOW 11-deoxycortisol
38
11 B hydroxylase (CYP11B1) def
- normal levels of DHEA and aldosterone but low cortisol levels
- KEY HIGH 11-deoxycortisol
39
aldosterone vs cortisol binding to albumin and CBG
cortisol has a higher affinity for CBG than aldosterone
| -inc cortisol will unbind aldosterone from CBG increasing blood aldosterone levels
40
Side effects of aldosterone excess
- High salt intake suppresses the angiotensin system and can lead to shrinkage of the zona glomerulosa
- high Na+
- alkalosis (H+ secretion)
- low K+
- Promote inflammation and fibrosis in cardiovascular system
- Systolic and diastolic dysfunction
- damaging effects on the cardiovascular system, baroreceptors and kidneys and can lead to worsening heart failure
41
Aldosterone escape
Aldosterone increase -> increase in Na+ retention -> transient increase in arterial BP -> pressure diuresis and increased ANP secretion (natriuresis)
42
Cortisol metabolic functions
- inc glucose
- dec insulin sensitiivity
- inc lypolysis
- dec protein synthesis (inc protein catabolism)
- Inhibit keratinocyte proliferation and collagen synthesis
- Promote osteoclast activity
- Postpartum cortisol is needed for initiation of lactation by PRL
43
Cushing Disease
- excessive glucocorticoids
- striae (stretch marks) - inhibition of collagen synthesis
- Osteoporosis - promotion of osteoclast activity
- Hypertension - alpha receptor epi and NE, NA+ retention
- Disturbance in menstrual cycle
44
Tg time in the follicle
the longer in follicle more time for iodine to be added by TPO resulting in more T4, if in follicle for less time (during increase demand) less iodine added by TPO resulting in more T3
45
T3 vs T4
T3: active
T4: inactive
46
DIT and MIT
are recycled to Tyrosine and I- by iodotyrosine deiodinase (transported to the follicular lumen by Pendrin)
-Iodine def. without DIT and MIT cant reclycle iodine, a lot of iodine in urine
47
Selenodeionidases (D1 vs D2 vs D3)
D1: T4 -> T3 (liver, kidneys and thyroid tissue)
D2: T4 -> T3 (CNS)
D3: inactivates T3 to DIT and T4 to RT3
48
Goiter syndrome
-is an enlargement of the thyroid gland in the neck
Causes:
-low iodine -> low T3 -> no negative feedback
-
49
T3 function
- Stimulate the pituitary somatotrophs to express GH and increases IGF-1 in bones and muscles (INDIRECT)
- Direct stimulatory role on bones and muscle tissues (↑ synthesis of enzymatic and structural proteins) (DIRECT)
- inc BMR (increases oxidative respiration capacity, UCP-1)
- Inc B1 adrenergic receptors -> inc HR
- INC GLUCOCORTICOID INACTIVATION -> INC ACTH
50
T3 and T4 function (nuclear)
-Nuclear activation and non classical activation of membrane receptor (both T3 and T4) -> synthesis of new proteins
51
Giant Cell
multinucleated cells that form as a result of Granulomatous Inflammation
52
Caseating granuloma vs Noncaseating granulomas
Caseating: focus of activated macrophages (epithelioid cells), rimmed by fibroblasts, lymphocytes, histiocytes, occasional Langhans giant cells; central necrosis with amorphous granular debris; acid-fast bacilli
-central zone: necrotic, granular, “cheesy” appearance
Noncaseating: granulomas with abundant activated macrophages
-central zone: non-necrotic
53
vitamin D activation
Cholecalciferol -> 25-hydroxycholecalciferol --(PTH)--> 1,25-dihydroxycholecaliferol
high calcium or low PTH decrease 25-hydroxycholecalciferol -> 1,25-dihydroxycholecaliferol
54
Vitamin D actions
↑ intestinal calbindin ↑Ca++ absorption
↑ Ca++-dependent ATPase and alkaline phosphatase
↑ phosphate flux through the intestinal epithelium
↑ Ca++ and phosphate renal secretion (minimal effect)
55
b cells:
a cells:
d cells:
b cells: secrete amylin (dec gastric emptying, dec glucagon secretion) and insulin
a cells: secrete glucagon
d cells: secrete somatostatin
F cell: secrete pancreatic polypeptide (PP)
e cells: secrete gherlin
56
GLP-1, GIP and CCK (incretins)
- primes the b cells for the incoming hyperglycemia
- GLP-1 surpasses glucagon
- Dipeptidyl peptidase IV inhibitors increase GLP-1 and improve glucose tolerance
57
tyrosine-phosphatases (PTP)
terminates insulin receptor signaling
- ex. PTP1B and leucocyte antigen-related (LAR) phosphatase
- over expression in patients with insulin resistant diabetes
58
stress affect on ACTH
- stress increase CRH -> increases ACTH
- chronic stress can result in in constantly elevated threshold for the glucocorticoid negative-feedback mechanism (requires higher cortisol levels to decrease CRH and ACTH)
- HYPOGLYCEMIA is a stress signal which causes CRH release
59
Diurnal variation and ACTH
- CRH and ACTH are normally released in a pulsatile fashion
- CRH and ACTH will be higher earlier in the morning because of low levels glucose
- Lower levels of CRH and ACTH in the day time
60
Metabolic (direct) actions of GH
- metabolizes lipids, carbohydrates (inc FA oxidation)
- increase insulin resistance
- ↑ thyroid secretion
- ↑ fasting glucose levels by ↑ hepatic glycogenolysis and gluconeogenesis
- ↓ and amino acid protein catabolism and inc protein synthesis
61
Anabolic actions of GH
through IGF-I/somatomedin (INDIRECT)
- GH stimulated growth through IGF-1/somatomedin (INDIRECT)
- bone growth
- protein synthesis (muscle growth)
- form somatomedin C which has a longer half life than GH
62
IGF-1
- bone growth
- muscle growth (inc AA uptake and inc protein synth)
- cartilage growth
63
Gigantism
high GH before epiphyseal closure
64
Acromegaly
high GH after epiphyseal closure -> disproportionate growth
65
Symptoms and signs of GH excess
- Musculoskeletal (protruded mandible, enlarged forehead, pressure-induced osteoarthritis, large hands and feet with square fingers)
- Cardiovascular (Dilated cardiomyopathy, cardiomegaly, CHF)
- Metabolic (high glucose, dec insulin sensitivity (diabetes))
- Elevated IGF-I
66
High ADH (SIADHS)
- Hyponatremia (increase volume -> release ANP -> secrete Na+)
- Concentrated urine
- Elevated urinary Na
67
StAR
after cholesterol ester is cleaved by cholesterol esterase StAR is used to transport cholesterol across the mitochondrial membrane so steroidogenesis can occur
68
Zona glomerulosa
- lacks CYP17A1 (17a-hydroxylase) and cannot produce DHEA or glucocorticoids
- aldosterone production
69
Primary hyperaldosteronism vs Secondary hyperaldosteronism
Primary hyperaldosteronism: adrenal tumor
| Secondary hyperaldosteronism: high activity of the renin-angiotensin system
70
pregnancy effect on CBG
increase CBG which will increase total T3/T4 but normal T3/T4 blood levels
71
In long term cortisol excess
- increased adipocytes differentiation (centripetal obesity)
| - increase cortisol neg feedback threshold
72
oxytocin during development
cardiomyocytes and neural development
73
cortisol during development
Lung maturation
74
Dehydroepiandrosterone (DHEA)
-Responsible for adrenarche (early stage sexual maturation) before or around puberty in male and female
75
Dehydroepiandrosterone (DHEA) during pregnancy
In placenta, 16a-OH-DHEA is converted to 16a-OH-androstenedione and then to estriol (E3)
76
Adrenogenital syndrome
adult females
newborn females
prepubertal males
adult females: deep voice, large muscles, fascial hair, breast become smaller
newborn females: partially male-type external genitalia
prepubertal males: Precocious pseudopuberty
77
TPO activity is stimulated by
Stimulated
- TSH (which also increases NIS, follicular cell proliferation and Tg endocytosis)
- hCG of pregnancy
78
hCG
mimics TSH on follicular thyroid cells
79
T3 during development
neonatal brain development
80
Metabolic actions of thyroid hormones
↑Glucose absorption from the intestine
↑Glycolysis, gluconeogenesis and oxidative phosphorylation
↑Lipolysis, ↑ LDL ↓ plasma cholesterol
↑Protein synthesis and degradation (net effect is catabolic)
81
Thyroid actions on cardiovascular system
- inc cardiac output (also due to increased b adrenergic receptors
- inc pulse pressure
- inc a myosin heavy chain -> in the speed of cardiac contractions
- inc Sarcoplasmic reticulum Ca++ ATPase
82
JAK/STAT
GH and prolactin
83
somatomedin C
IGF-I
| longer half-life than GH
84
PC1/3
clips out of the c peptide (proinsulin -> insulin) and cleaves POMC????????????
85
PTH-related peptide
can be released by tumors and have nothing to do with the parathyroid causing hypercalemia
86
low dose Vitamin D vs high dose
Small quantities -> promotes bone calcification
| Extreme dose of Vit D -> bone resorption
87
paid PTH effect
slow PTH effect
other effect:
paid PTH effect:
-Ca2+ pump at osteolytic membrane (Ca2+ from bone to ECF)
slow PTH effect:
-inc RANKL and M-CSF secretion from osteoblasts that increases osteoclast
-suppress OPG which will dec osteoblast
other
- ↑ Ca++ reabsorption (TRPV5) at nephron
- ↑ phosphate loss
- ↑ the absorption of Mg++
- ↑ 1,25-dihdroxycolecalciferol which increases intestinal Ca2+ reabsorption
88
excessive Ca2+
decrease parathyroid size
-High Ca++ -> stimulation of Ca++ sensing receptor/CaSR (G-coupled protein) -> activation of IP3, DAG and intracellular Ca++ -> ↓ PTH secretion
89
Calcitonin
- produced by C cells of thyroid gland
- Secreted in response to increase in plasma Ca++ concentration
- Acts to lower plasma Ca++ levels by inhibiting activity of bone osteoclasts
90
PTH hypersecretion
- hypercalcemia (causes hyporeflexia and muscle weakness)
- hyperphosphaturia (bc osteoclast inc alkaline phosphatase)
- renal stones
- bone decalcification
91
PTH hyposecretion
-hypocalcemia (causes hyperreflexia and tetany)
-hyperphosphatemia
-
92
Vitamin D deficiency
soft bones (rickets and osteomalacia) bc getting Ca2+ from bones
93
amylin
- reduces gastric emptying (satiety)
| - inhibits glucagon
94
somatostatin
- inhibits secretion of insulin, glucagon, and pancreatic peptide
- stimulate glucose and amino acid ingestion
- reduce GI motility
95
sulfonylurea
blocks K+ channel on pancreatic B cells causing depolarization and insulin release
96
finsulin promotes
- glycogen synthesis
- glycolysis
- lipogenesis (dec ketone bodies)
- protein synthesis
- Increases GLUT4 expression
97
moderate exercise vs. intense exercise vs. stress
- moderate exercise: proportional glucose uptake and glucose production bc GLUT4 stimulated by exercise is equal to catecholamine lipid and glucose production
- intense exercise: more glucose production than glucose uptake (hyperglycemia) bc high catecholamine release (inc glucose and lipolysis) while also suppressing GLUT4 by inhibiting insulin secretion
stress: high glucose production and little glucose uptake (can cause insulin resistance diabetes) bc catecholamines are suppressing insulin secretion while increasing blood glucose
98
glucagon stimulated by and increases
Hypoglycemia
Increased amino acids
Norepinephrine
Epinephrine
↑ hepatic glycogenolysis
Gluconeogenesis
Lipolysis
99
how does oxytocin cause contraction
PLC and PKC cause inc Ca2+ -> contraction
100
Leydig cell function
release testosterone into blood vessels and seminiferous tubules
101
Sertoli cell function
- nourish germ cells
- movement of germ cells
- structural support
- blood testis barrier (immunological privileged site due to tight junctions)
- secrete androgen binding protein (binds testosterone in seminiferous tubule to allow spermatogenesis FSH DEPENDENT)
- secrete inhibit (inhibits FSH when testosterone levels are hit)
- phagocytize (residual bodies and degenerated cells)
102
Cryptorchidism
when the testis don't descend and temp is 37-38 which won't allow spermatogenesis to occur
103
Spermatogonial Phase
Type A dark: resident processor cell
Type A pale: divide into type B cell
Type B: differentiate into spermatocyte
104
Spermatocyte Phase
Primary spermatocyte: meiosis I, large cell
| Secondary spermatocyte: meiosis II, smaller cell
105
Spermiogenesis Phase
- Golgi Phase: form proacrosomal granules, centrioles migrate, axoneme formation (core of flagellum)
- Cap Phase: acrosomal cap formed
- Acrosome Phase: machete formed and mitochondria migrate posteriorly
- Maturation Phase: residual bodies formed
106
Chemical Mediators (PAMPs and corresponding receptors)
```
Endotoxin TLR4
Lipoproteins TLR1, 2, 6
Peptidoglycan NOD 1 & 2
Heat shock proteins TLR2 and 4
Bacterial DNA TLR9
Bacterial RNA TLR3, TLR7, TLR8
```
107
Chemical Mediators (DAMPS and corresponding receptors)
High Mobility Group box 1 RAGE, TLR2, TLR4, TLR7/8,TLR9, IL-1R, or CXCR4
Heat shock proteins TLR2, TLR4 in a CD14 dependent fashion
RNA and DNA TLR3, TLR7, TLR8, TLR9
Mitochondria TLR9
ATP varied, amplify effects LPS, IL-1b and IL-18
S100A8/S100A9 TLR3 trafficking and function
Heme induces TNF-a via NFkB pathway
108
Extravation
- leakage of leukocytes form capillaries into infected/damaged tissue
margination: leukocytes adhere to blood vessel wall (INTEGRINS on leukocytes and ICAM/SELECTIN on endothelial cell)
diapedesis: leukocytes squeeze between endothelial cells into tissue
109
IL-1B, IL-6, TNF-a
cytokines that signal for acute phase proteins (mainly IL-6), neutrophil mobilization, increase body temp
110
acute phase proteins and purpose
C-reactive protein (opsonization)
mannose-binding lectin
fibrinogen (clotting factor)
111
```
Chemokines attract what cell
CXCL8
CXCL7
CCL3
CCL5
CXCL-1
```
CXCL8: neutrophils, naive T cells
CXCL7: neutrophils
CCL3: monocytes, NK and T cells, basophils, dendritic cells
CCL5: monocytes, NK and T cells, basophils, eosinophils, dendritic cells
CXCL-1: neutrophils, naive T cells, fibroblasts
112
Transudate edema
extravascular fluid with low protein content
| -due to increase hydrostatic pressure
113
Exudate edema
mast of cells and fluid seeping out of blood vessels
| -due to increase vascular permeability
114
Suppurative (Purulent) vs Non-Suppurative
Suppurative: severe acute inflammation with pus
-pyogenic bacteria
-localized
Non-Suppurative: acute inflammation with less proteins
-Serous (blister)
-Serofibrinous (rich in fibrin)
-Catarrhal (irritation of mucous membrane plus watery secretion)
-Pseudomembranous inflammation (Diptheria and Shigella endotoxins)
-Hemorrhagic inflammation
-Necrotizing inflammation
-Allergic inflammation
115
mesonephric duct forms
f
116
Amoebic vs Bacterial Dysentery
Amoebic: Entamoeba histolytica
-variable fever
Bacterial: Shigella spp
-high fever
BOTH will have fecal leukocytes
117
Classical vs. Alternative Macrophage actions
Classical: Th1 produces IFN-y to activate macrophage resulting in the release of ROS, NO and lysosomal enzymes to kill infectious agent. Chemokines and cytokines are release to cause inflammation
Alternative: Th2 release IL-4/IL-13 which causes macrophage to release growth factors/TGF-B which will cause tissue repair/fibrosis and IL-10/TGF-B which will cause anti inflammation
118
Importance of LH surge
- Caused by high levels of E2
- High E2 stimulates Kiss peptide secreting hormones and anterior pituitary cells
- It causes increase in PA and other proteases -> inc collagenase
- Exits the egg from1st meiotic arrest (indirect)
- Induces smooth muscles contraction
- Within 2 h -> increased progesterone
- Hypertrophy of GC -> luteinization
- Increased prostaglandin and histamine in the dominant follicle -> hyperemia
119
NSAIDs effect on menstrual period?
cause heavier bleeding bc blood is thinner and prostaglandin is inhibited causing no uterine contractions (help expel blood and debri)
120
fibrinolysin
prevent menstrual blood from coagulating
| -Heavy menstrual cycle will have clots bc little fibrinolysin
121
collegenase
high during LH surge allowing ovulation of egg
122
cervical mucous (estrogen and progesterone)
- estrogen levels makes the mucous thin and watery
| - progesterone in the second half of the cycle causes the plug to be thick and impenetrable by the sperms
123
Menopause
- Hot flashes are caused by loss of vasomotor tone (temporary disturbances in hypothalamic thermoregulation)
- Elevated gonadotropins in blood (mainly FSH)
- Risk of osteoporosis and cardiovascular diseases increase after menopause
- Irritability, fatigue, anxiety and decreased strength are often associated with menopause
124
high androgens and infertility
- Testosterone is converted into DHT and DHT inhibits aromatase (no testosterone -> estrogen)
- No negative feed back by estrogen on GnRH so high LH and high testosterone loop
125
Female reproductive tract aids in sperm migration
- Contractions of myometrium propels the sperms toward the oviducts
- Progesterone relaxes the ovarian ducts -> allow the passage of the morula
- Upward contractions of oviduct smooth muscle
126
Zona reaction
Release of cortical oocyte granules causes oocyte membrane to become impenetrable to other sperm
127
Progesterone functions after fertilization
- Prime the uterus for implantation (decidualization)
- Inhibits myometrium contractions while estrogen stimulates the contractions
- Progesterone in fetus is converted to DHEAs which flows back to placenta to be converted to estriol (E3 weakest estrongen but large amount)
128
respiration rate during pregnancy and result
Icn bicarb in pregnant women urine bc inc CO2 exhalation causing respiratory alkalosis, kidney will secrete bicarb in response
129
Human Chorionic gonadotropin (hCG) (placenta hormone)
- Binds the same receptor as LH
- Sustains the corpus luteum during the first 6-7 weeks of pregnancy
- hCG also lowers the uterine contractility and support sexual development in male fetus
- hCG has TSH-like activity increases thyroid synthesis and albumin levels
130
Human chorionic somatomammotropin (placenta hormone)
- mix between GH and prolactin
- Increases the mother’s sugar level by promoting glycogenolysis and blocking glucose uptake (similar to GH actions) by reducing insulin sensitivity
131
Estrogen (Estriol/E3) (placenta hormone)
- The weakest estrogen
- Formed primarily from fetal DHEA
- Stimulates breast growth and duct growth (hyperplasia)
- Stimulates proliferation of uterine muscle cells, increases their oxytocin receptors and gap junctions
- uterine contraction
- Similar to aldosterone (inc Na+ reabsorption)
132
Progesterone (placenta hormone)
- inhibit the estrogen actions on the uterine smooth muscle contractions
- Inhibits the milk secretion
- Is converted into other steroids
- Towards the end of pregnancy, the fetal cortisol (and surfactant) causes more E3 to be made from this progesterone therefore favoring uterine contractions
133
Insulin (fetal hormone)
- Increased in response to excess maternal glucose
| - In uncontrolled diabetic mothers, increased insulin has anabolic effects on the fetus -> oversized newborn
134
androgen in regulating GnRH pulsatility
- inhibition of GnRH pulse frequency is antagonized by androgens
- dec LH and FSH
- Testosterone has a direct inhibition effect on GnRH
135
stress effect on GnRH
CRH, ADH, ACTH, endogenous opioid peptides (e.g., β-endorphin), and cortisol surpasses GnRH
136
what determines the half life of a hormone
amount of glycosylation
| -FSH has longer half-life in circulation than LH
137
closure of epiphyseal plates
testosterone indirectly closes the epiphyseal plates by converting to estrogen via aromatase
138
Testosterone actions reproductive system before birth
- Mediate differentiation of male genitalia, reproductive organs
- Differentiation of Wolffian’s ducts and testicular descent
139
Testosterone actions after birth
spermatogenesis, growth and maturation of reproductive system
140
Testosterone actions non-reproductive actions
Anabolic action on muscles, bones (growth and narrow pelvic outlet), BMR
Heart, erythropoietin, fusion of the epiphyseal plate (indirect)
141
Hypogonadism side effects
reduced steroidogenesis, spermatogenesis or both
142
Hypergonadotropic hypogonadism
high FSH and LH bc of a problem in their receptors leading to no negative feedback
- no response from gonads
- Klinefelter’s
143
Del Castillo syndrome
Sertoli cells but no spermatogonia cells
144
Pampiniform countercurrent heat exchanger
Pampiniform plexus is cooler than blood coming down so it will cool entering blood
145
AMH/MIF (anti-Müllerian hormone)
XY chromosomes then the embryonic testes will produce anti-Müllerian hormone. This causes the Müllerian (female) ducts to disappear
-secreted by sertoli cells
146
Seminal vesicles
- Supply fructose for energy
- prostaglandins -> relax uterus/cervix, induce contraction
- Secrete fibrinogen (thickens sperm to stay around cervix)
147
Prostate gland
- alkaline fluid that neutralizes vaginal acidity
- clotting enzymes and fibrinolysin (liquefies sperm)
- Provides PSA, and fibrin-degrading enzyme (dissolve cervical mucus)
- prostasomes (adds Ca2+ channels to sperm)
148
esophageal achalasia
Loss of LES inhibition
| -closure of LES causing constant constriction of esophagus -> muscle deterioration
149
antral pump
leading contraction closes pyloric sphincter, trailing contraction squeezes food against sphincter causing retropulsion decreasing particle size
- gastin inc stimulation
- ach inc contraction strength
- NE and VIP dec contraction strength
150
types of gastric reservoir relaxation
receptive: swallowing food
adaptive: distention of stomach
feedback: relax when nutrients in SI
151
gastric emptying time
increase emptying: inc volume, isotonic
| decrease: low pH, large particles, inc fat/caloric content
152
migrating motor compelx
innervated by ENS
no MMC = bacteria growth
longer opening of depolarization gate = long reaching
153
haustration
contracting and receiving segments hold on to their status for a significant amount of time -> ↑ water absorption
154
interstitial cells of Cajal
pacemaker cells associated with the smooth musculature
| activate circular fibers
155
circular fibers vs longitudinal fibers
circular fibers: reduces the lumen diameter
-Pacemakers (Cajal) and excitatory musculomotor neurons activated
-Ca2+ via intracellular storage
longitudinal fibers: shortening the segment and expand the lumen
-Excitatory musculomotor neurons are main activators
-Ca2+ via influx
-both innervated by enteric nervous system (ENS)
156
stomach and intestine vs. esophagus and gallbladder contraction
- stomach and intestine contract spontaneously
| - esophagus and gallbladder do not contract spontaneously
157
Electomechanical coupling vs. Pharmacomechanical coupling
- Electomechanical coupling: in skeletal and GI smooth muscles: Depolarization -> opening of voltage-gated Ca++ channels -> Ca++ influx of Ca++ -> contraction
- Pharmacomechanical coupling: in smooth muscles only: Ligand activation of G-protein -> release of Ca++ from intracellular storages -> contraction without depolarization
158
L-Channels
are responsible for the rapid inward current depolarization phase during gastric action potential (L-type Ca++ channel blockers -> disruption in GI motility)
159
Sacral parasympathetics innervate the
distal half of the large intestine
160
Efferent vagal fibers synapse with neurons of ENS in the
esophagus, stomach, small intestine, upper colon, gal bladder and pancreas
161
paralytic ileus
no peristalsis in the GI tract
162
Gastrocolic
Enterogastric
Colonoileal
Reflexes
Gastrocolic: eating -> bathroom
Enterogastric: chyme from stomach -> SI tells stomach to slow down
Colonoileal: distention of the colon -> ileum slow down
gut to PARAVERTEBRAL ganglia and back to the gut
163
Reflexes from stomach and duodenum (vagovagal)
Pain reflexes
Defecation reflexes
Reflexes from stomach and duodenum (vagovagal)
Pain reflexes
Defecation reflexes
gut to spinal cord or brainstem and back to the gut
164
Vagovagal reflex
- Controls contraction in GI muscle layers in response to food stimuli
- Efferents synapse with ENS to musculature are both inhibitory and stimulatory; efferents to secretory are ONLY excitatory
165
Meyenteric plexus of Auerbach
- motor, between longitudinal and circular layers
| - Contains excitatory and inhibitory neurons
166
Submucosal /Meissner plexus
- Controls localized secretion and absorption
| - absent in esophagus
167
Afterhyperpolarization neurons
- Long-lasting hyperpolarization potential
- fulfill the role of interneurons
- majority in myenteric plexus
168
S-type neurons
- All have nicotinic fast EPSPs
| - Fast Na+ channels
169
tetradoxin
Na+ channel blocker
170
Excitatory secretomotor neurons release
ACh and VIP
171
main excitatory neurotransmitters
ACh and substance P
172
inhibitory neurotransmitters
ATP, VIP, nitric oxide and pituitary adenylate-cyclase
173
Blood flow is directly related to local activity vasodilators
CCK, VIP, gastrin, secretin, kinins, NO, adenosine (metabolic byproduct of ATP consumption)
174
shocks effect on villi
vasoconstriction of arteries bc of shock causes necrosis of villi resulting in decreases H2O absorption (loss of H2O)
175
slow EPSP (AH-type and S-type)
Metabotropic receptors
- AH-type cells is cAMP
- S-type cells IP3 & Ca++ (PLC activation)
- can be excite inhibitory/excitatory motor neurons resulting in prolonged contraction/secretion, contraction inhibition
176
fast EPSP
Ionotropic receptors associated with a ion channel
| -Most are mediated by ACh
177
Slow inhibitory postsynaptic potentials (substance that activate)
Hyperpolarizing synaptic potential surpassing excitability
- opioid peptide: constipation from opioids; diarrhea on naloxone treatment
- NE (alpha2 receptor): S-type neurons -> reduce secretion
- Galanin: slow IPSP in Auerbach’s plexus
- Adenosine (A1 receptor): dec cAMP
Coffee antagonizes A1 receptors -> inc motility
178
Presynaptic inhibition (mediators)
a neurotransmitter from one axon acts at receptors on 2nd axon to prevent the release of neurotransmitter from the 2nd axon
- Serotonin suppresses fast and slow EPSPs in myenteric plexus
- ACh negative feedback on self
- Histamine: at H3 presynaptic receptors to suppress fast EPSPs in ENS
179
Presynaptic facilitation
- Enhances the neurotransmitter release and the amplitude of fast EPSPs at the myenteric plexus of small intestine and gastric antrum
- NE inhibitory synapses at the submucosal plexus
- Prokinetic drugs utilize this mechanism
180
Metabotropic receptors bind slow EPSP
- neurotransmitters
- paracrine
- hormone
neurotransmitters: serotonin, Ach, substance P
paracrine: histamine
hormone: gastrin, CCK
181
Trisomies
- Trisomy 21, 18, 13
- Only full autosomal trisomies that can occur in nonmosaic form and lead to viable offspring mainly because the are among the most gene poor chromosomes
- 21 > 18 > 13
182
Down Syndrome types
- Trisomy 21: Entire extra copy of 21st chromosome in each cell
- Robertsonian translocation: Translocation between 21q and the long arm of the other acrocentric chromosomes
- 21q21q translocation
- Partial trisomy 21: Only part of the long arm of chromosome 21 is present in triplicate
183
DiGeorge syndrome
deletion of segment of chromosome 22 resulting in craniofacial anomalies, intellectual disability, immunodeficiency and heart defects
-mediated by mishap in homologous recombination
184
DiGeorge syndrome
deletion of segment of chromosome 22 resulting in craniofacial anomalies, intellectual disability, immunodeficiency and heart defects
- mediated by mishap in homologous recombination
- TBX1 plays role in heart defect
185
Cri du chat syndrome
-Idiopathic Chromosomal Abnormality
-Hypertelorism (increased distance between eyes)
Epicanthus (skin fold of the upper eye lid)
Retrognathia (one jaw is set behind the other at longer distance than typical)
-larger deletion higher degree of intellectual disability
186
sympathetic vs parasympathetic stimulation of salivary glands
para: stimulation -> ↑salivation directly and by ↑ blood flow
sympathetic: stimulation -> short-lived, smaller increase in saliva (through b adrenergic receptors), saliva is more viscous than with parasympathetic activation
187
pyloric glands
Contain G cells (secrete gastrin) and mucous-secreting cells
188
oxyntic (gastric) glands
Contain parietal cells (HCl & IF), endocrine cells, chief cells (pepsinogen) and mucous neck cells
189
alkaline tide
from stomach
190
Pepsinogen
- secreted by chief cells
- activated to pepsin at low pH
- breaks down proteins to polypeptides
191
Intrinsic factor
bind B12 and is absorbed in the distal ileum
192
distal ileum direction will result in
- pernicous anemia bc no B12 absorption
| - trouble absorbing fat bc no recycling of bile
193
acid tide
from pancreas
194
Regulation of pancreatic secretion
Cephalic
Gastric
Intestinal
195
Regulation of pancreatic secretion
Ach
secretin
CCK
196
Brunner's gland Inhibited by sympathetic tone important why?
When an individual has high stress sympathetic stimulation will inhibit Brunner's gland resulting in no secretion of HCO3- and mucous -> ulcers
197
primary bile acids and how they are formed
chenodeoxycholic acid
cholic acid
cyt P450
198
Recycling mechanisms for bile salts
Diffusion
Carrier transport
Deconjugation, diffusion
Dehydroxylation
199
AZF region
on Y chromosome and contain genes that appear to be important in spermatogenesis
200
DAZ genes
deleted in azoospermia
201
XY gonadal dysgenesis
SRY mutation
DAX1 duplication
SOX9 mutation
NR5A1 mutation
202
Fragile X syndrome
FMR1 gene mutation (neural development disorder)
203
Beckwith-Wiedemann Syndrome
Somatic overgrowth
Predisposition to childhood embryonal malignancies
Increased size of internal organs
```
Cause:
Loss of maternal ICR2/Kcnq1 methylation
Gain of H19 methylation
Paternal UPD for Igf2 cluster
11P15.5 duplication including Igf2
Point mutation in CDKN1C
```
204
Silver-Russell syndrome
Growth retardation
Short stature
Cause:
Epimutation, loss of paternal ICR1 methylation
205
IGF2
| CDKN1C
IGF2: Over expression associated with cellular overgrowth
CDKN1C: Inhibitor of several G1 cyclin/cdk complexes
206
Presynaptic inhibition mediators
CCK, ATP, histamine, NE and ACh
207
Lower esophageal sphincter
Pyloric sphincter
Ileocolonic (ileocecal) sphincter
Internal anal sphincter
```
Lower esophageal sphincter: incompetence -> heartburn and Barrett metaplasia
esophageal achalasia (failure of smooth muscles to relax
```
Pyloric sphincter: incompetence -> bile reflux -> gastritis and ulcers
Ileocolonic (ileocecal) sphincter: incompetence -> bacterial overgrowth in S.I. -> bloating and abdominal pain
Internal anal sphincter: incompetence fecal incontinence
208
Primary peristalsis vs Secondary peristalsis
Primary peristalsis: start of swallowing, the entire esophagus acts as a peristaltic receiving segment all the way down to the GE junction
Secondary peristalsis: Triggered by failure of the 1ry peristalsis to transport food to the stomach stronger wave of propulsion
209
regulator of gastric motility
ach: inc plateau
gastrin: stimulate pyloric pump
NE and VIP: dec plateau
210
Receptive relaxation
Mechanoreceptors in pharynx during swallowing afferent vagal activation of efferent vagal inhibitory musculomotor neurons in gastric ENS
211
Adaptive relaxation
distension of gastric reservoir vagovagal feed back inhibitory musculomotor neurons in gastric ENS. (lost during diabetic neuropathy)
212
Feedback relaxation
The presence of nutrients in SI connections between receptors in SI and gastric ENS/or hormonal stimulation of the gastric ENS to gastric afferent vagal endings
213
gastric emptying time factors
```
Inc volume -> more rapid empyting
Larger particles -> slower
isotonic -> faster than hyper/hypo
more acidity -> slower
high fat (caloric count) -> slower
```
214
chyme colon storage location
transverse colon
215
dexamethasone
Synthetic glucocorticoids suppression of ACTH
216
11BHSD1 vs 11BHSD2
11BHSD1: cortisone -> cortisol
11BHSD2: cortisol -> cortisone
217
XIC
x inactivation center
218
Cognitive skills
Ability to think, learn and solve problems. In babies (< 1 year), this looks like curiosity. This is how your child explores the world with their eyes, ears and hands. In toddlers (1-3 years), it also includes learning to count, naming colors and learning new words
219
Social and emotional skills
Ability to relate to other people. Includes being able to express and control emotions. In babies, they smile at others and make sounds to communicate. In toddlers and preschoolers (3-5 years), they can ask for help, show and express feelings and get along with others.
220
Speech and language skills
Ability to use and understand language. For babies, includes cooing and babbling. In older children, includes understanding what’s said and using words correctly that can be understood.
221
Fine and gross motor skills
Ability to use small muscles (fine motor, particularly in the hands), and large muscles (gross motor). Babies use fine motor skills to grasp objects. Toddlers and preschoolers use them to hold utensils, work with objects and draw. Babies use gross motor skills to sit-up, roll-over and begin to walk. Older children use them to do things like jump, run and climb stairs.
222
Activities of daily living
Ability to handle everyday tasks. For children, that includes eating, dressing and bathing themselves.
223
Pancreatic a-amylase
hydrolyzes starch and glycogen -> maltose
224
Disaccharidase deficiency
a
225
FA humans can't synthesize
omega 3/6
226
pancreatic lipase
only breaks down triglycerides -> 2 FA and 2-monoglyceride
227
Pancreatic colipase
(a peptide) binds to lipase and allows the lipase to the oil-water interphase, also counteracts the bile salt inhibition of lipase
228
Phospholipase A2
is the major pancreatic enzyme for digesting PL -> lysophospholipids (e.g. lysolecithin) and FAs
229
pancreatic cholesterol esterase
Cholesterol ester is hydrolyzed -> cholesterol and FA
230
bile salts
- Emulsification of fat droplets allows better digestion
| - Emulsification of lipid (FA) digestion products allows better absorption
231
Ezetimibe
Inhibit cholesterol importer causing no absorption of cholesterol
232
acyl-CoA cholesterol acyltransferase
adds ester to cholesterol
233
Poor fat absorption
deficiency in fat-soluble vitamins (A, D, E and K)
234
Abetalipoproteinemia (no Apo B)
fats are absorbed into enterocyte but inability to make chylomicrons and VLDLs -> accumulation of lipid droplets in the cytoplasm of the enterocytes
TAG loading requires microsomal triglyceride transfer protein (MTP) to dock with ApoB-48 orApo-B100.
Deficiency of MPT -> abetalipoproteinemia
235
Pepsin (endopeptidase)
proteins -> smaller polypeptides
236
Pancreatic endopeptidases
Trypsin
Chymotrypsin
Elastase
237
What can/not small intestine absorb
Di and tripeptides intestine can absorb but cant absorb disaccharides and triglycerides
238
Pancreatic exopeptidase
Carboxypeptidase A
| Carboxypeptidase B
239
closure action in intestine
Colostrum rapidly diminishes the leakiness of the fetal intestine not allowing intact proteins to be absorbed
240
Hartnup disease
| Cystinuria
Hartnup disease: defective carrier for neutral AA (e.g. tryptophan)involves Cystinuria: carrier for basic AA (e.g. Lys, Arg) and the sulfur-containing AA (e.g. cystine)
241
Vitamin A
where absorbed?
what happens with def.?
Retinol is the principle form
- passively absorbed in the entire intestine by CHYLOMICRON
- Vit A deficiency -> night blindness and skin lesions
242
Vitamin D
where absorbed?
what happens with def.?
- passively absorbed in the entire intestine by CHYLOMICRON
| - Def. -> rickets / osteomalacia
243
Vitamin E
where absorbed?
what happens with def.?
- Transported in association with LIPOPORTEINS and RBCs
| - Vit E deficiency -> fragile RBCs (antioxidant)
244
Vitamin K
where absorbed?
what happens with def.?
- Phyllaquinones is picked up by energy-dependent process in the PROXIMAL intestine and is incorporated into CHYLOMICRON
- Def. -> excessive bleeding disorder (won't have clotting factors
245
What also can use NIS in the follicular cell?
| What is pendrin used for?
NIS: Na+ I- symport
-bromide perchlorate thiocyanate
Cl- in exchange for I2
246
RANKL and M-CSF
secretion from osteoblasts that increases osteoclast
247
what is absorbed in the distal SI (ileum
B12, bile salts, and vitamin C
248
vitamin C
where?
def?
ileum
| scurvy
249
vitamin B1
where?
def?
jejunum
| beriberi
250
vitamin B2
where?
def?
proximal small intestine
| anorexia, impaired growth, nervous disorders
251
niacin
where?
def?
all small intestine
| Pellagra (dermatitis, dementia, and diarrhea) TRIPLE D
252
vitamin B6
where?
def?
all small intestine
| anemia, CNs disorder
253
biotin
where?
def?
all small intestine
| coenzyme for carboxylase enzymes -> def
254
folic acid
where?
def?
facilitated transport
| megablastic anemia, lesions, poor growth
255
vitamin B12
where?
def?
B12 + intrinsic factor at distal ileum
| pernicious anemia
256
CCK effect
contraction of gallbladder
release digestive enzyme from pancreas
slow motility of stomach -> slower release of gastric contents into the small intestine
257
jejunum vs ileum NaCl absorption
jejunum: Na+ in H+ out, Na+ in with aa or glucose
ileum: (Na+ in H+ out, HCO3- out Cl- in) Na+ and Cl- in
258
BK channel activaiton
- bacterial toxin inc adenyl cyclase -> inc BK channel
| - upstream diarrhea causes shear stress on intestine -> inc BK channels
259
Iron absorption (fast/slow)
Heme: fast
Non Heme: slow
Fe+ absorbed and bind/stored to apoferritin -> ferritin in enterocyte -> when to blood Fe+ passed to transferrin
260
H2O absorption hypertonic vs hypotonic
- hypertonic meal: water moves out to lumen first, then after the absorption of nutrients and electrolytes, water moves in (absorption in ileum and colon)
- hypotonic meals starts immediately (primarily in jejunum and ileum)
261
carnitine palmitoyltransferase-I
| translocase
carnitine palmitoyltransferase-I: acyl CoA + carnitine = acyl-canitine
- inhibited by malonyl CoA so not breaking down FA and building at same time
translocase: transfers acyl-canitine across mitochondrial membrane
262
ChREBP (carbohydrate response
| element binding protein)
a TAG synthesis regulator that when high carbs will be activated to transcribe genes involved in making FA
- long term
- acetyl coa carboxylase long term
263
secretin
in response to the low pH of the chyme entering the intestine causes the pancreas to release a solution rich in bicarbonate that helps neutralize the pH of the intestinal contents
264
Serotonin
suppresses fast and slow EPSPs in myenteric plexus
265
stimulation of parietal cells
gastrin, Ach, histamine
somatostatin and gastric inhibitory peptide inhibits
266
VIP
inhibits muscular contraction
| stimulates secretion -> increase diarrhea
267
Prokinetic drugs
presynaptic facilitation -> increase the probability of gate opening -> enhance propulsion
268
Bile acid-dependent and –independent bile canalicular flow
dependent: free bile exchanged for Na+ then conjugated to make bile salts
independent: Na+ exchanged for H+ leaving HCO3- in the cell to be added to bile
- + secretin
269
estrogen
inhibits bile production
270
scavenger-receptor B
receptor on liver that receives HDL
271
```
Apo A
Apo B (48)
Apo B (100)
Apo C
Apo E
```
Apo A: HDL -> LCAT
Apo B (48): chylomicron
Apo B (100): VLDL and LDL
Apo C: lipoprotein lipase (TAGs -> FA + glycerol)
Apo E: chylomicron binds to receptor on liver
272
Carcinomas
arise from epithelial cells
- Squamous cell carcinoma: protective epithelium
- Adenocarcinoma: glandular epithelium
273
Sarcomas
Sarcomas: begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue
274
Hematopoeitic
Leukemia: malignancy of leukocytes
Lymphoma: tumors of B & T lymphocytes
275
Neuroectodermal
arising from components of central and peripheral nervous system
276
common alpha chain
FSH/LH and TSH
277
Prolonged testosterone treatment
↓ GnRH receptors on gonadotrops
278
low/high frequency GnRH release
Low-frequency: FSH release
| high-frequency: LH release
279
follistatin
produce by Sertoli cells with inhibin to deactivate activin
280
prostaglandin during menstrual phase
- vasoconstriction of endometrial vessels -> death
| - myometrium contractions leading to the expulsion of blood and debris
281
contraception
prevent ovulation by suppressing the LH surge
| -thickening of cervical mucous
282
Day after pill
progesterone antagonist preventing implantation by not allowing good development of endometrium
283
Estrogens are bound to
| Progesterone binds to
- More estrogen bound to albumin but estrogen has a higher affinity for SHBG
- increase in SHBG result in a high ratio of estrogen to androgens
-corticosteroid-binding protein
284
Prostasome
linked to natural sperm activation
285
fallopian tube
fimbrae -> infundibulum -> ampulla -> isthmus -> intramural
286
Polyhydramnios
no closure of the esophagus due to higher than normal amniotic fluid
287
is food digested?
| is bile present?
before or after stomach
| before of after bile duct in duodenum
288
Annular pancreas
atresia or stenosis of duodenum because ventral and dorsal pancreatic buds encircle the duodenum
289
Congenital omphalocel
mesenchymal defect where umbilical ring doesn't close resulting in herniation of intestines
-similar to Gastroschisis
290
midgut non rotation
- small intestines sitting on the right side and large intestine on the left side
- volvulus can cause occlusion of SMA -> intestinal ischemia
291
mixed rotation and volvulus
- cecum just below pylorus, fixed to post wall
| - can cause duodenal obstruction
292
reversed rotation
SMA obstructs the transverse colon and can also cause reduced blood flow through SMA
293
Subhepatic cecum and appendix
cecum stuck to the inf surface of the liver resulting in the appendix being located in the upper right quadrant
294
internal hernia
intestinal loop passes through mesenteric defect, can cause strangulation/obstruction
295
midgut volvulus
large intestine twist over the duodenum
296
Omphaloenteric duct remnants
ductal remnants develop into cyst in the umbilicus or just below
- can have persistent vitelline artery
- sirenomelia
297
Ileal diverticulum
small out pouching of the ileum with a remnant of vitelline duct
-dark feces from upper GI bleeding
298
Hirschsprung disease
- aka congenital megacolon
- Neural crest cells don’t migrate properly during weeks 5-7 and the myenteric plexus doesn’t have autonomic ganglion cells
299
persistent cloaca
common outlet of intestinal, urinary, and reproductive tract
300
anorectal agenesis with rectovaginal fistula
rectum opens up into vagina
301
lesser omentum and falciform ligament are derived from
ventral mesentery
302
Primary retroperitoneals
```
Kidneys
Adrenal glands
Aorta
IVC
Caudal rectum
Anal canal
```
303
Forgot includes and blood supply
stomach, Duodenum to just distal to the bile duct opening, liver, biliary apparatus
celiac trunk
304
omphaloenteric duct is obliterated by this point
week 11
305
midgut includes and blood supply
distal half of the duodenum, jejunum, ileum, cecum, ascending colon, and the proximal half transverse colon
SMA
306
hindgut
½ of the transverse colon, the descending colon, sigmoid colon, rectum, and anal canal cranial to the pectinate line
IMA
307
painful vs non-painful Bright red vs dark blood from hemorrhoids
Internal hemorrhoids - no pain, dark blood
| External hemorrhoids - painful, bright red blood
308
HMG CoA reductase
rate limiting enzyme for cholesterol synthesis
309
SREBP
binds when low cholesterol to inc enzymes needed for cholesterol synthesis
310
Estradiol (E2) effects
- inhibit osteoclast -> osteoporosis
- inc metabolism -> fatigue
- Na+ and H2O retention
- vaginal cornification -> painful intercourse bc thin vaginal wall
- thin mucous (ferning)
- inc progesterone receptors
311
gastrin effect on bile
- directly inc bile in liver
| - indirect inc by dec pH causing release of secretin (secretin inc HCO3- production in bile)
312
lithocolic acid
secondary bile acid that cannot be absorbed
313
alc effect on acetaminophen metabolism
inc P450 pathway diverting from GSH pathway
| -inc in NAPQ1
314
zone I
| zone III
zone I: glycogen and plasma protein synthesis
| zone III: detox
315
MALE
mesospheric duct
urogenital sinus
mesospheric duct: epididymis, ductus deferens, seminal gland, efferent ductules
urogenital sinus: bladder, spongy urethra, bulbourethra, prostate (also mesenchyme)
316
FEMALE
paramesospheric duct
urogenital sinus
paramesospheric duct: uterus, uterine tubes
| urogenital sinus: urethra, paraurethra, greater vestibular gland
317
```
Hepatocyte
RER
SER
Gogli
peroxisomes
```
RER: synthesis of plasma proteins
SER: biotransformatio/detox
Gogli: plasma protein and bile components
peroxisomes: oxidize FA
318
Dark granules
| Light Granules
Dark granules: NE
| Light Granules: Epi
319
Liver deterioration
fatty liver -> steatohepatitis -> cirrhosis -> liver failure
320
Barrett's esophagus
stratified squamous -> simple columnar
321
Transitional zone
| Peripheral zone
Transitional zone: benign hyperplasia
| Peripheral zone: adenocarcinoma
322
OPG
osteoclast inhibiitor
323
Parotid
submandibular
sublingual
Parotid: serous acini cells
submandibular: serous acini cells and mucosal acini cells
sublingual: mucosal acini cells
324
Dentin
Enamel
Cementum
Dentin: odontoblast
Enamel: ameloblast
Cementum: cementoblast, anchors periodontal ligament to roots of tooth
