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Flashcards in Quiz 13 Deck (215):
1

Define pharmacokinetics

The actions of the body on the drug

2

Define pharmacodynamics

The actions of the drug on the body

(Usually this means 'how does the drug bind to the receptor')

3

Name four examples of pharmacokinetics

ADME

Absorption
Distribution
Metabolism
Elimination

4

Define what an agonist is

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

5

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

Sigmoidal

6

Define what an antagonist is

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

7

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

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

8

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

Increase the concentration of agonist

9

Define what an allosteric activator is

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

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

10

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

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

11

Describe what an allosteric inhibitor is

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

12

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

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

13

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

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

14

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

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

15

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

1) inactive
2)active

16

Define full agonist. Describe its dose-response curve

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

The curve has the highest plateau

17

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

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

This simply lowers the plateau on the curve

18

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

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

The plateau shifts down, even below the constitutive activity

19

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

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

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

20

What is EC50?

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

21

What is Kd?

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

22

What is IC50?

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

23

True or false. EC50 = Kd

FfAaLlSsEe

24

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

The EC50 shifts to the right (think Km)

25

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

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

26

Define threshold

The smallest dose possible that causes a measurable effect

27

What are spare receptors?

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

28

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

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

29

Describe what an additive drug-receptor interaction is

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

30

Describe what a synergistic drug-receptor interaction is

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

(Deals with more than one drug at a time)

31

Describe what an antagonistic drug-receptor interaction is

1+1=0.5

A drug can block the effect of another

32

What is a chemical antagonist?

Does not involve receptor

For example: charge differences due to certain environments

33

What is a physiological antagonist?

Involves endogenous regulatory pathways mediated by different receptors

34

Define efficacy in regards to pharmacology

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

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

35

Define potency

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

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

36

Define affinity

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

37

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

TD50 (toxic dose)/ED50 (Therapeutic dose)

A high therapeutic index is favorable

38

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

Y axis = blood concentration

X axis = drug dosage

39

What is the margin of safety?

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

You want this to be a high number

40

True or false... toxicity means leathal dose

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

41

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

Distance of the site of administration to the target

Amount of tissue that the drug must pass through

42

What does parenteral mean?

Not by way of the GI tract

43

Name three examples of parenteral drug administration

Intravenous

Intramuscular

Subcutaneous

44

Which is faster absorption, intramuscular or subcutaneous injections?

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

45

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

False... intramuscular injections allows for larger volumes to be administered

46

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

Enteral - by way of the GI tract

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

Rectal - less first pass effect than oral

47

What is enteral drug administration less predictable than parenteral?

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

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

48

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

The rate of blood flow

49

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

Affinity

50

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

Plasma binding proteins

Gastric emptying time

51

Name three other methods of drug administration

Inhalation (very fast)

Topical

Transdermal (patches)

52

What is a loading dose?

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

53

What is the difference between drug and medicine?

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

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

54

True or false... side effects are always negative effects

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

55

Define xenobiotic

Chemical not synthesized in the body

56

Absorption of the drug is affected by what four factors?

Route of administration

Blood flow

Drug characteristics

Cell membrane characteristics (diffusion or active transport)

57

What are five drug characteristics to take into consideration?

Is it water soluble or lipid soluble?

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

Formulation

Concentration

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

58

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

Filtration - water soluble drugs small enough can go through aquaporins

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

59

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

True

60

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

Active transport

Facilitated diffusion

61

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

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

Affected by...
Dissolving of drug in GI tract

Destruction of drug by the liver

Intravenous = 100% bioavailability

62

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

Distribution and clearance

63

What is volume of distribution? What is its formula?

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

V= amount of drug in body/concentration of drug

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

64

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

100/33 = 3L

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

65

What are the three physiological compartments and their volumes?

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

66

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

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

Binding to tissue proteins (makes drug leave blood better)

Absorption into adipose tissue

Drug lipophilicity, hydrophilicity, MW

67

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

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

68

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

Higher

Extra-vascular

Vascular

69

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

Minimum possible

70

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

Small

Higher

71

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

Larger

72

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

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

73

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

T1/2 = 0.693 Vd/Cl

Cl = clearance rate

74

Clearance = ?

Rate of elimination/concentration of the drug

75

Define clearance

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

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

76

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

Urine

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

77

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

Deecwease

78

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

More likely

79

Name two examples of drug transporters

Solute carrier transporters

ATP binding cassette transporters

80

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

P-glycoprotein

81

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

Zero order
100, 80, 60, 40

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

First order

100, 90, 81, 71.9,

The process that is directly proportional to the drug concnetration

82

true or false... phase 1 always precedes Phase 2 metabolism

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

83

What usually occurs in drug metabolism?

Makes drugs more hydrophilic (thus more easily excreted)

usually makes substances less toxic

84

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

Purified liver endoplasmic reticulum?

Rough endoplasmic reticulum

Mixed function oxidases (monooxygenases)

85

Name two oxidases

NADPH-cyp450-oxidoreductase

cyp450

86

Describe phase 1 hepatic metabolism

Includes oxidation, reduction, and hydrolysis

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

87

What is cytochrome p450?

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

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

Each enzyme is referred to as an ISO form

88

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

CYP3A4 and CYP2D6

CYP3A4 is most obundant in human liver and intestines


89

Define substrate

A drug that is the target of a particular enzyme

90

Define inducer

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

91

Define inhibitor

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

92

Define phase 2 hepatic metabolism

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

93

Name four factors that can affect hepatic drug metabolism

Microsomes enzyme inhibiton (many drugs inhibit CYP450)

Microsomes enzyme induction

Liver disease

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

94

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

90%

they lymphatic system

95

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

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

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

96

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

Deep cervical fascia

97

Lymph can be drained from superficial tissues into.....

Regional nodes or deep cervical nodes

Regional nodes is more common

98

Occipital lymph node

afferent: _____

efferent: _____

Afferent: back of scalp

Efferent: deep cervical lymph nodes

99

Retro auricular lymph node

Afferent: ____

Efferent: ____

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

Efferent: Superficial cervical nodes

100

Superficial parotid lymph node

Afferent: ____

Efferent: ____

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

Efferent: deep cervical node (Jugulodigastric)

101

Deep parotid lymph nodes

Afferent: ____

Efferent: ____

Afferent: middle ear

Efferent: deep cervical node (jugulodigastric)

102

About how many parotid lymph nodes are there?

5 to 6

103

buccal lymph nodes

Afferent: ____

Efferent: ____

Afferent: lower eyelid, buccinator, facial vein

Efferent: submandibular lymph node... then to deep cervical.

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

104

Submandibular lymph nodes

Afferent:

Efferent:

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

Efferent: deep cervical nodes

105

Submental lymph nodes

Afferent:

Efferent:

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

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

106

Where are the retropharyngeal lymph nodes located?

Between the pharynx and atlas

107

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

Jugulodigastric

108

The gingiva is drained by _____

Submandibular lymph nodes

109

The hard palate is drained by ____

Submandibular nodes and superior deep cervical nodes

110

The soft palat is draine by ____

Retropharyngeal

111

The floor of the mouth is drained by ____

Submandibular and submental nodes

112

The teeth are drained by ____

Submandibular and deep cervical

Submental drains the mandibular incisors

113

The tonsils are drained by ____

Jugulodigastric nodes

114

The tip of the tongue is drained by ____

Submental node

115

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

Submandibular and deep cervical

116

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

Jugulodigastric lymph nodes

117

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

Submandibular nodes

Sphenoid sinus

Retropharyngeal nodes

118

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

Submental node

119

Dorsal scapular nerve comes off of ____ and innervates ____

Root of C5

Innervates levator scapulae and rhomboids

120

The suprascapular nerve comes off of ____ and innervates _____

Superior trunk

Supraspinatus and infraspinatus

121

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

Axillary artery

122

The brachial plexus is symmetrical except for what feature?

The anterior division of the middle trunk

123

The nerve to subclavius branches off of ____ and innervates _____

Roots of C5 and C6

Innervates the subclavius muscle (duh)

124

The long thoracic nerve branches off of ____ and innervates ____

C5, C6, and C7 roots

Serratus anterior

125

The lateral pectoral nerve branches off of ____ and innervates ____

Lateral cord

Pectoralis major only

126

The medial pectoral nerve branches off of ____ and innervates ____

The medial cord


Pec major and minor

127

The upper subscapular nerve branches off of ___ and innervates ___

Posterior cord

Subscapularis

128

The lower subscapular nerve branches off of ____ and innervates ____

The posterior cord

Subscapularis AND teres MAJOR MAJOR MAJOR

129

The thoracodorsal nerve branches off of ____ and innervates ____

Posterior cord


Latisimus dorsi

130

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

Medial cord

Upper arm and muscles

Lower arm and muscles

131

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

Median

Ulnar

Musculocutaneous

132

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

Radial

133

What percentage of the U.S population has diabetes?

About 10%

134

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

True

135

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

Polyuria and thirst
Weakness and fatigue
Polyphagia and weight loss

Nocturnal enuresis

136

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

Blurred vision

Peripheral neuropathy

137

What are three signs of diabetes?

Sweet tasting urine

Sweet smelling breath

Impaired wound healing

138

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

Juvenile

Glucagon

139

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

Glucose, fats, amino acids

140

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

Increase

141

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

Highly variable. Days to weeks to months to years

142

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

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

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

143

Reduced glucose uptake will result in what three things?

Elevated blood glucose

Fatty acid oxidation

Cellular energy deficiency

144

Fatty acid oxidation will lead to...

Increased liver gluconeogenesis (which contributes to elevated blood glucose)

Elevated blood ketone bodies

145

Elevated blood glucose and elevated blood ketone bodies contribute to ____

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

146

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

Decrease the pH (more acidic)

147

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

Insulin administration
Glucose monitoring
Diet (low carbs)

148

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

80 and 140 mg/dl

149

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

Injections

Pump

60-90

150

Define type two diabetes

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

151

Name the three possible mechanisms of insulin insensitivity

Adipokine signaling

Ectopic lipid storage and free fatty acids

Inflammatory signaling

152

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

Macrophage chemotaxis protein

Macrophages to break up fat and release it into blood

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

153

Type two diabetes is managed by what three approaches?

Lifestyle

Oral hypoglycemic drugs

Insulin

154

Name four common drugs for treating hyperglycemia

Sulfonylureas

Metformin

Peroxisome proliferator-activated receptor agonists - increases glut 4 expression

Alpha-glucosidase inhibitors
-prevents carb absorption

155

What are sulfonylureas?

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

156

What is metformin?

An oral hypoglycemic that reduces gluconeogenesis and lipogenesis

Involves the ampk signaling pathway

157

What are the five primary methods for detecting diabetes?

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

158

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

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

159

What are the signs of hypoglycemia?

Exhaustion
Dizziness
Loss of speech
Death

Increased heart rate
Sweating
Trembling

160

What are the causes of hypoglycemia?

Excess insulin
Physical activity
Insufficient food
Illness

161

What is the treatment for hypoglycemia?

Immediate sugar
Glucagon
Test blood sugar

162

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

Thirst, dry mouth
Excessive urination
Ketones

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

Insulin, oral hypoglycemic, physical activity, diet

163

What are the long-term diabetic complications for diabetes?

Cardiovascular disorders
Blindness
Kidney disease
Neurological complications
Impaired wound healing

164

Name the four fat soluble vitamins

Vitamin K
Vitamin A
Vitamin D
Vitamin E

165

Name the vitamins that have toxicity reported

Vitamin D
Vitamin A
Vitamin B3
Vitamin B6
Vitamin C

166

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

Folic acid

Ascorbic acid

167

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

Vitamin B12

168

Water soluble vitamins are absorbed by...

Sodium cotransporters

169

What is the difference between a vitamin and a vitamer?

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

170

Vitamin A

Involved with vision

Deficiency leads to night blindness and skin problems

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

171

Vitamin B1

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

Chronic alcoholism and diabetes is associated with B1 deficiency

Thiamine

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

172

Vitamin B2

Essential for carbohydrate and lipid metabolism (forms FAD)

Riboflavin

173

Vitamin B3

Necessary for NAD+

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

174

Vitamin B5

Pantothenic acid

Coenzyme A synthesis

175

Vitamin B6

Forms PLP. Involved in amino acid metabolism and neurotransmitter synthesis

PLP - involved in amino-transferase reactions

Pyridoxine

176

Vitamin B7

Biotin

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

Produced by bacteria in the gut

177

Vitamin B9


What is the daily adequat intake?

Folic acid

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

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

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

Deficiency also associated with abnormal nucleated erythrocytes

TAking too much B9 cause it results in masking B12 deficiencies

178

Vitamin B12

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

Poorly absorbed in gut

Deficiency can result in irreverbable nerve damage

179

Vitamin C

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

Provides antioxidant activity, promotes collagen synthesis

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

180

Vitamin D

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

Sunlight exposure converts provitamins to vitamin D

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


181

Vitamin E

Involved in immune signaling, involves prostaglandin synthesis

Deficiency results in an impaired immune response

182

Vitamin K

Required for production of clotting factors

Deficiency results in bleeding and hemorrhaging, osteoporosis

183

Name the 13 essential vitamins

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

184

Name the two essential fatty acids

Linoleate and alpha-linolenate

185

Name the two pathways for nervous system control of organ system

Autonomic nervous system

Neuroendocrine system

186

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

Hypothalamus

It receives info from every organ in the body.

Directly controls the autonomic nervous system

Indirectly controls the neuroendocrine system

187

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

Epinephrine and norepinephrine

Acetylcholine

Epinephrine, acetylcholine, serotonin

188

What processes produces CO2?

Betaoxidation and carbohydrate metabolism

189

Chemoreceptors and baroreceptors feed back to the nucleus of ____

The solitary tract

190

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

Decreases

Increases


Decreased blood pressure does just the opposite

191

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

True

192

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

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

193

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

Eicosanoid

Used in the inflammatory response

194

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

Pentose phosphate

Lipid synthesis and dealing with free radicals

195

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

Glycolysis

Glycogenesis

Pentose phosphate pathway

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

196

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

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

197

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

Chylomicrons produced in the intestines

Albumin

198

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

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

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

199

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

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

200

What things inhibit a-cells from secreting glucagon?

When is glucagon constitutively released?

Insulin
Somatostatin

At low glucose levels

201

Insulin drives glucose ____, glycogen ____, and lipid _____

Uptake

Storage

Synthesis

202

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

Release

Breakdown

203

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

Oxaloacetate

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

204

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

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

Deep cervical nodes

205

Name 6 regional neck lymph nodes

Retropharyngeal
Paratracheal
Infrahyoid
Prelaryngeal
Pretracheal
Lingual

206

The paratracheal lymph nodes drain ____ and dumps into ____

Thyroid gland

Deep cervical

207

Name the three anterior cervical nodes

Infrahyoid
Prelaryngeal
Pretracheal

208

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

True

209

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

True

210

Name the supraclavicular nerves of the brachial plexus

Dorsal scapular
Nerve to subclavius
Long thoracic
Suprascapular

211

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

Acetone is toxic

Acetoacetate and B-hydroxybutyrate can be used as fuel

212

Fat soluble vitamins require ___ for uptake

Cholesterol esterase

213

Water soluble vitamins are absorbed by sodium trasnporters besides ____

B9 and b12

214

What enzyme directs genetic recombination? (Crossing over)?

Recombinases

215

What are the three classses of transposable elements?

DNA only transposons
Retroviral like retrotransposons
Nonretroviral retrotransposons