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Foundations of Medicine > FOM Week 3 > Flashcards

FOM Week 3 Flashcards

(88 cards)

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1
Q

Explain the Effects of Buspirone and Erythromyosin When Taken Together

A

Both of the drugs get metabolized by the same enzyme, CYP3A4, in the liver. These two act as competitive inhibitors to each other thus slowing down the metabolism of them and causing side effects

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2
Q

Pharmocodynamic Interactions

A

The capability of one drug to affect another drugs response directly
Can be beneficial or harmful

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3
Q

What is the main form of lipids in our diet

A

Even carbon triglycerols

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4
Q

Two Essential FAs of Human Diet

A

Omega 3 and Omega 6

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5
Q

Where are lipids stored in the body

A

White adipose tissue

Liver

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6
Q

Where in the cell does beta oxidation occur

A

The matrix of mitochondria

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7
Q

What is the activating step of beta oxidation

A

The fatty acid gets converted into fatty acyl CoA
This turns ATP into AMP
Occurs in the cytosol of cell

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8
Q

How does fatty acyl CoA cross the inner membrane of mitochondria

A

It uses the Carnitine Transport Protein

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9
Q

Explain how malonyl CoA regulates beta oxidation

A

Malonyl CoA is produced by glucose metabolism in lipogenesis. This inhibits the carnitine transferase so no FAs are metabolized
When you are using glucose to make lipids there is no need to metabolize FA (occurs after consuming lots of sugar)

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10
Q

Explain what happens when you eat lots of fatty acids

A

Acyl CoA inhibits lipogenesis of from glucose occuring

If you just consumed lots of lipids, you dont want to be making them

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11
Q

Explain the oxidation of even saturated FAs

A

1) Activate them by turning them to acyl CoA
2) Oxidize and create FADH2
3) Hydrolyze
4) Oxidize to create NADH
5) Cleave using CoASH to create acetyl CoA and a 2C shorter acyl CoA

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12
Q

Explain the difference of beta oxidation in unsaturated fatty acids

A

Since there is already a double bond present you skip the first oxidizing step so no FADH2 is created

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13
Q

Explain the difference of beta oxidation in uneven fatty acids

A

Proponiol CoA is formed instead of acetyl CoA and then converted into succinyl CoA

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14
Q

Ketonegenesis vs Ketogenolysis

A

Occurs in the liver
Occurs in the muscle and brain during starvation
Byproduct is acetone which leads to ketoacidosis

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15
Q

Cartilage consists of

A

Chondrocytes

Matrix (ground substance + fibers)

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16
Q

How does cartilage get nutrition and oxygen

A

Through diffusion

It lacks blood vessels

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17
Q

Characteristics of Bone

A

It has a hard compact outside
It has a soft spongy inside
On the inside there are lots of neurons and vessels
It is constantly being remodeled

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18
Q

Diaphysis vs Metaphysis vs Epiphysis

A

Diaphysis is the long shaft bone
Metaphysis is near the edge of the bone
Epiphysis is the edge of the bone where it rounds

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19
Q

Types of Cells in the Bone

A

Osteoprogenitor cells- create osteoblasts
Osteoblasts- synthesis collagen type 1 and alkaline phosphotase
Osteoctyes- Osteoblasts that are surrounded by calcium
Osteoclasts- giant multinucleated cells derived from monocytes that have a ruffled border. They secrete acid to resorb bone

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20
Q

Osteiod

A

Only type 1 collagen and proteoglycans

They are unmatured and uncalcified

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21
Q

ARF Cycle

A 
They cycle bone goes through once it gets damaged
Activation
Resorbtion
Reversal
Formation
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22
Q

Effects of PTH

A

It works to increase Ca in the blood
Binds to osteoblasts which will then secrete RANK-L. This will then bind to RANK on the osteoclasts and activate them which results in calcium being released

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23
Q

Denosumab and Osteoprotegerin

A

They both bind to RANK-L to prevent osteoclasts from binding to it and therefore prevent its activation

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24
Q

Biphosphonates

A

Used to treat osteoperosis

Work by causing the osteoclasts to undergo apoptosis

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25
3 Types of Cartilage
Hyaline- smooth and made up of collagen type 2. Found in the bone Elastic- has elastic fibers that make it not smooth. Made up of collagen type 2 and found in ear and larynx Fibrocartilage- made up of collagen type 1 and 2. Found in the vertebrae disks
26
Where does substrate from the TCA cycle come from
Acetyl CoA from glycolytic pyruvate Acetly CoA from beta oxidation Succinyl CoA from beta oxidation Amino acid catabolism
27
How does pyruvate get into the mitochondria
It freely passes the outer membrane but gets into the matrix from a carboxylic acid transporter in the inner membrane
28
Ways to Generate Oxaloacetate if None is Present
PEP Pyruvate Malate can all be used to make oxaloacete TCA will not occur unless oxaloacetate is present
29
Function of Thiamine
Cleaves C-C bonds
30
Function of Riboflavin
Involved in redox rxns of FAD
31
Function of Niacin
Involved in redox rxns of NAD
32
Products of the TCA Cycle
CO2 | NADH and FADH2 for the ETC
33
Explain How Cytosol NADH Enter Matix
Malate aspartate shuttle--> NADH | Glycerophosphate shuttle--> FADH2
34
Effects of Azide and CO on ETC
They bind to heme group and prevent oxygen from getting to tissues. Since oxygen is the final electron acceptor the ETC would stop and this would cause a build up of lactate
35
Delta G Naught vs Delta G
G naught is when the rxn is in equilibrium (G=0) | G is a snapshot of the rxn and must be negative for a rxn to occur
36
Importance of Free Energy Being a State Function
This means it is independent of its path Because of this we can use free energy to do work such as couple with unfavorable rxns and make them occur How enzymes work
37
Creatine Kinase and Phosphocreatine
They serve as a buffer system in the muscle
38
Explain How Mutated Proteins Affect G Naught
Mutations in proteins generally change the equilibrium of the folded state Mutated proteins have a higher G Naught which means the reaction is less favorable
39
Useful Ways Our Body Uses ROS
Signaling Immunity Energy Production
40
Explain How NO Effects Vessels
NO is produced by NO synthase and binds to guanyl cyclase in the smooth muscle causing them to relax which serves as a vasodilator
41
Nitroglycerin vs Viagra
Nitrogylcerin causes more NO to be produced | Viagra makes the NO signal last longer
42
ROS In ETC
1-4% of electrons leak off and can bind with O2 to form superoxides Is thought to serve as a signal to tell cell the current metabolic state
43
Ways to Prevent ROS Formation in ETC
Add more ADP Slow down the TCA Produce uncoupler proteins
44
How do metals affect ROS
Metals serve as a catalyst to forming ROS | H2O2 can bind to metals to form very toxic ROS
45
Ways ROS can attack our cells
They can cause mutations in DNA They can cross link amino acids making them not able to be degraded The can decrease the amount of unsaturated FAs in the membrane and thus depleting fluidity
46
Enzymatic Ways to Control ROS
They are located all throughout the cell Dismutase takes superoxide and converts it to H202 Catalase then take H2O2 and converts it to oxygen and water
47
Non Enzymatic Ways to Control ROS
These are vitamins that accept the electrons and by doing so they become radical species They are just more stable because of resonance Some will also bind to metals to prevent less radicals from forming
48
Importance of Physical Exam
The MH interview allows you to get an idea of the diagnoses. The physical exam is a way to confirm it
49
``` "Normal" Vital Signs for: Heart Rate Respiratory Rate Blood Pressure Temp ```
60-100. Anything below is bradycardia. Anything above is tachycardia 12-20 respirations per minutes 120/80 36-38 degrees celcius
50
Which parts go under each of the SOAP categories
S- All of patient interview O- Physical exam and vitals A- Assessment of everything. What you think it is P- Plan. What you are going to do to treat it
51
4 Reasons Why Documentation is Important
Billing Legal record Memory Aid Communication with other professionals
52
2x2 Table
Exposure is on the Top | Disease is on the right side
53
What measures can we establish in cohort study
Cumulative incidence, incidence rate, hazard, risk ratio, relative risk, absolute risk
54
What measures can we establish in a case study
Odds ratio
55
Odds Ratio Formula
AD/BC If it equals 1 there is no correlation If it is greater than 1, exposure is a risk factor If it is less than 1, exposure is a protective factor
56
Risk Ratio Formula
(A/A+C) / (B/B+D) or Risk in exposed/Risk in unexposed
57
Relative Risk Difference
1 - Risk Ratio (If protective) Risk Ratio - 1 (If risk factor) Normally used if exposure is a protective faster Converts it into numbers that patient will get
58
Absolute Risk Increase
If exposure is protective: Risk in unexposed - Risk in exposed If exposure is harmful: Risk in exposed - Risk in unexposed *It will always be a positive number
59
Number Needed to Treat
1/ARR | You want this number to be low
60
Number Needed to Harm
1/Absolute Risk Increase | You want this number to be high
61
Attributable Risk
Risk in Exposed - Risk in Unexposed | Same as Absolute Risk Increase
62
Population Attributable Risk
Risk in Population - Risk in Unexposed
63
Tertiary Prevention
The disease has been ongoing | We are working to prevent it from getting worse
64
Secondary Prevention
The disease is relatively new | We catch it at the right time to prevent real damage
65
Primary Prevention
Preventing disease from happening in first place
66
Which region in KS has worst health outcomes
SouthEast | Wyandotte
67
Where are the largest % of hispanics in KS
SouthWest | This also has the lowest number of PCP
68
``` What filament do each motor protein bind to and which direction do each go: Myosin 1 Myosin 2 Kinesin Dynein ```
Actin and moves towards plus end Actin and moves towards plus end MT and moves towards plus end (periphery) MT and moves towards minus end (body)
69
Gliding
When the motor proteins are anchored to a membrane or something. They can be used to move the filaments themselves to different parts of cell
70
Lamellipodium
The front part of the cell that has actin extending which causes the cell to move forward in its direction
71
Explain the Importance of Focal Adhesions in Cell Movement
Focal adhesions hold the cell down to the substrate In order for the cell to move, the FA in the back have to get disassembled and then reform in the front This is done by the assembly/disassembly of MT
72
Matrix MetalloProteases
They are proteins that degrade the BM and connective tissue. Very important in melanoma becoming invasive
73
TIMP-2
Required for MMP 1 to be active Inhibits MMP 2 An example of moonlighting
74
How Touch Influences Cilia Movement
Cilia cells have mechanoreceptors that open upon touch. This causes an influx of Ca which makes the cilia move more rapid. The calcium also spreads to other cells via gap junctions
75
What tissues use glycolysis
All tissues but most occurs in the brain
76
Where does glucose come from
Diet (glucose/fructose/galactose) Glycogen Storage in liver Gluconeogenesis from amino acids
77
Explain the Steps in Glycolysis
1) Phosphorylate glucose to activate it 2) 2 rxns that attempt to make it symmetrical 3) 2 rxns that cleave and isomerize 4) 2 rxns that harness energy 5) 3 rxns that isomerize into pyruvate
78
What cofactors are used in glycolysis
ATP NAD Mg K
79
What pathway products are produced by glycolysis
NADH 2 ATP 2 Pyruvate
80
What happens if no O2 is present
The ETC stops and thus no NAD+ is regenerated This causes a back up in all the processes that require NAD+ (glycolysis/beta oxidation) In order to regenerate NAD+ anaerobic respiration occurs
81
How is glycolsis and gluconeogenesis regulate
By enzyme inhibitors and free energy | Rxns that have a very low G are considered regulatory steps because they are irreversible (HK, PFK, PK)
82
Inhibitors and Activators of PFK
Inhibited by ATP and Citrate | Activated by AMP and F-2,6P
83
Inhibitors and Activators of FBPase
Inhibited by AMP and F-2,6P | Activated by ATP and Citrate
84
Goal of the Geriatric Comprehensive Assessment
To maintain function and well being | Focuses on quality of life rather than quantity
85
10 Parts to the Geriatric Assessment
``` AGING GAMES Audio/Visual Gait/Movement/Falling Insomnia Nutrition GI GU ADL Mood/Memory Environment Sexuality ```
86
DETERMINE for Nutritional Assessmenet
``` Disease Eating Poorly Tooth Loss Economic Hardship Reduction in Social Contact Medicines Involuntary Weight Loss Need for Assistance Elderly ```
87
Activities of Daily Living
``` DEATH Dressing Eating Ambulating Toileting Hygeine ```
88
Instrumental Activities of Daily Living
``` The first to go in dementia patients SHAFFT Shopping Housework Accounting Food Prep Transportation Telephone ```

Foundations of Medicine (5 decks)

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