Stasis Homies
Which two age populations generally have the hardest time maintaining homeostasis
Pediatrics and geriatrics
What three things do all cells have?
Cell membrane, nucleus, cytoplasm
Your patient complains of intense thirst and seems irritable. Is Na+ higher or lower?
Hypernatremia/Higher
Normal is 135-145 mEq/L
What part of Fick's Law is the most important for diffusion?
Ficks Law is
Rate of Diffusion=surface area x concentration gradient x membrane permeability
Most important is the concentration gradient
Rudolph Virchow said that "All diseases could be related to disturbance in _______ Function
Cell
What the body does to the drug is called?
What the drug does to the body is called?
Pharmokinetics
Pharmodynamics
Body's ability to maintain relatively stable and constant internal environment, despite changes (somewhere in this ballpark)
What are the four exchange systems in our body?
(Have openings to the external environment)
Respiratory
Digestive
Genitourinary
Integumentary
Is Ca++ higher or lower with stones, bones, groans, and psychic overtones?
Hypercalcemia/Higher
Normal is 8.5-10.5 mg/dL
What two fluid compartments does the cell membrane separate? Describe what selectively permeable means?
Separates the Intracellular fluid(ICF) and the interstitial fluid(ISF)
Selectively permeable means that only specific molecules are allowed to cross the barrier, thereby helping maintain internal conditions of cells
Which part of our VINDICATE'M mnemonic for common causes of disease is the MOST common
Vascular(Ischemia Hypoxia)
(Poor blood flow and low levels of O2)
After preclinical testing of a drug, there are four phases for FDA approval; at which phase do most drugs fail?
Phase 3, the double blind testing
Maintaining homeostasis requires communication between cells: What are the fastest and slowest forms of this communication
Cell to cell via gap junction is the fastest
Using the endocrine system to put a hormone in the blood stream to deliver it to a cell is the slowest and most diffuse.
DAILY DOUBLE
Name the 4 main macromolecules
For Double points: what is the function of the only macromolecule that is typically nonpolar
Carbohydrates-Polar
Lipids-Nonpolar
Proteins-Polar
Nucleic Acid-Polar
What ECG change might you see in a patient who has impaired renal excretion and is taking ACE inhibitors??
Is K+ higher or lower
Peaked narrow T waves are a symptom of hyperkalemia(higher)
What is the difference between passive transport and active transport? Give an example of each
Active transport uses ATP to move solutes across the membrane while passive transport has no direct energy expenditure.
The sodium-potassium pump is an example of primary active transport
Simple diffusion or osmosis are examples of passive transport
What are the two main types of cell deaths? Briefly describe them
Apoptosis: structured cell death/No inflammatory response, not necessarily pathologic(DNA + proteins damaged beyond repair)
Necrosis: Messy cell death/ inflammatory response, pathologic (ischemia, exposure to toxins, infection, trauma)
What is off label prescribing? Give an example
Legal prescription of a drug for a clinical use other than that directly approved by the FDA.
Verify example
What two fluids make up the ECF and what amount of TBW does it count for.
Interstitial fluid(ISF) and Plasma
About 1/3 of TBW or 14L
The characteristics of life are Organization, Metabolism, Responsiveness, Growth, Development, Reproduction, and Death*. Which of these characteristics would homeostasis fall under? AND which characteristic would differentiation and morphogenesis fall under?
Homeostasis goes with responsiveness
Differentiation and morphogenesis go with development
Excitable cells are the most susceptible to fluctuations in electrolyte concentration
Higher or lower than 5 types of excitable cells?
Name as many as you can
Lower(we're given 4 on the slides)
Neurons, skeletal muscle cells, cardiac muscle cells, smooth muscle cells
Which tonicity of an intravenous solution would you give somebody who was not dehydrated and it would restore their blood pressure.
Isotonic solution: adds fluid to the plasma and the ECF, but does not affect the ICF.
Fill in the missing steps for cellular swelling:
Cellular insult (such as hypoxia)-->Mitochondrial dysfunction--> ______ --> dysfunction of membrane pumps--> Accumulation of Na+(and Cl-) in cytosol -->______--> Cellular Swelling
Decreased ATP
Water follows Na+ and Cl- into cell
(Cellular swelling is the hallmark of cell injury!!!)
Drugs range from schedule 1-5, what schedule is this describing?
No currently accepted medical use in the U.S. High potential for abuse. Lack of accepted safety for use under medical supervision
Schedule 1
What solute can be found in both the plasma and the ICF, but not in the interstitial fluid? How does this solute affect the charge inside the cell
The anionic proteins(A-) are not in the ISF. They are negatively charged so they turn the inside of the cell negative.
List the 5 requirements for (most) life
Water, Nutrients, Oxygen, Heat, Pressure
Higher or Lower than 12 symptoms for hyponatremia
Name as many as you can
Higher
Headache, Nausea and Vomiting, confusion, stupor, lethargy and disorientation, possible seizures, coma, respiratory arrest
Muscle Weakness, muscle cramps, hyporeflexia, gait instability, ataxia
DAILY DOUBLE!!!
Describe how the sodium potassium pump works!!
Double points: What is the ratio of sodium: potassium across the membrane AND how much of our body's total ATP does this consume
After the ions have gone through the leak channels, the pump works to get sodium back into the ECF and potassium back into the cell. The pump opens to the inside of the cell where there are high affinity binding sites for 3 Na+. The pump then opens to the outside of the cell where the 3Na+ are released and 2K+ go into the pump to be put back into the cell. This process takes one ATP but this process as a whole uses 30% of the body's ATP.
Matching Game. Every odd number has an even match
1. Hypertrophy
2. Proliferation of differentiated cells
3.Metaplasia
4.attach Ubiquitin to proteins targeted for degradation
5.Hyperplasia
6.Involves reprogramming of stem cells
7.Atrophy
8. Caused either by increased functional demand or growth factor stimulation
1=8
2=5
3=6
4=7
Describe schedule II drugs and list at least 2
High Potential for abuse, accepted medical use with severe restrictions, abuse may lead to severe physical or psychological dependence.
Morphine, oxycodone(percocet), hydromorphone, Fentanyl, methadone, adderall, Ritalin, Cocaine
Describe both types of feedback used to maintain homeostasis and give a specific examples for both
Negative feedback: Response produced by the effector reverses the original stimulus
Example: (any example works as long as it's explained right) Body Temp Rises, Picked up by thermoreceptors which send signal to the brain via afferent pathway, signal arrives at the control center which sends signal to the sweat glands via the efferent pathway, we sweat which decreases body temp.
Positive Feedback: The response amplifies and reinforces the initial change.
Example: Childbirth: Uterine contractions, push baby against cervix causing cervical stretch which stimulates a gland to releases oxytocin which causes uterine contractions
DAILY DOUBLE
SEND MICUL A RR(Send Michael a railroad)
Name at least 10 of the 12 the systems using this mnemonic
Double Points: Pick a system and list what organs/structures it includes and it's function in the body
(S)keletal, (E)ndocrine, (N)ervous, (D)igestive, (M)uscular, (I)ntegumentary, (C)ardiovascular, (U)rinary, (L)ymphatic, (A)rticular, (R)espiratory, (R)eproductive
(Refer to organ system chart for double points)
Higher or lower than 12 elements that make up 99% of the human body
Name as many as you can
Lower (MgK COHN'S SPCl CaFe)
Magnesium, Potassium, Carbon, Hydrogen, Nitrogen, Sulfer, Sodium(Na), Phosphorus, Chlorine, Calcium, Iron
You look under a microscope and see a bunch of cells that have undergone crenation. In terms of osmosis and solutes, describe why this happened to these cells? What real life scenario could have caused this?
Someone might've lost a lot fluid through sweating or maybe being sick, so the extracellular fluid is very low meaning the solute concentration in the ECF is high. Water will then leave the cell(ICF) through the selectively permeable membrane and go into the ECF to balance out the solutes leaving the cell shrunk/shriveled from it's water loss.
Cellular Aging! Every even # has an Odd Match
1. Epigenetic Alterations
2. Can lead to mutations that impair cell function or cause cancer
3. Oxidative Stress and Free Radical Damage
4. Proteostasis
5.DNA Damage and Repair Deficiencies
6. Inflamm-aging
7. Release of specific cytokines lead to age-related diseases(cvd, diabetes, neurodegeneration)
8. Environmental changes alter the expression of genes
9. Decreased ability to breakdown misfolded proteins
10. Cumulative damage from highly reactive molecules overwhelms antioxidant defense systems
11. Telomere Shortening
12. Considered the mitotic clock of the cell
1=8
2=5
3=10
4=9
6=7
11=12
What does the PLLR require an drug label to include
Pregnancy risk, lactation risk, female/male reproductive potential