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EBME201- Exam 3
not sure why i made this i'm gonna fail anyway lol
Terms in this set (37)
Which one of the following best represents the primary form in which iron is transported in the plasma...
True or False: Pluripotent hematopoietic stem cells are only committed to lymphoid stem cells
True or False: One neutrophil can engulf 3-20 bacteria whereas one macrophage can engulf ~100 bacteria.
A 20-year old man presents to the emergency department with a 2 week history of diarrhea after a trip out of the country. He is admitted to the hospital for dehydration. His stool specimen is positive for parasitic eggs. Which type of white blood cells would have elevated numbers?
Which of the following is true regarding white blood cells
Granulocytes are normally formed only in the bone marrow
In a normal, healthy person, which of the following blood components typically has the longest life span?
During an inflammatory response, which is the correct order for cellular events?
Activation of tissue macrophages,
infiltration of neutrophils from the blood,
infiltration of monocytes from the blood,
increased production of neutrophils and monocytes
Presentation of antigen to a B lymphocyte will result in
Production of antibodies
True or False: Regarding acquired immunity- Dormant lymphocytes -> Invasion of body by foreign antigen -> Phagocytosis by macrophages -> Presentation of antigen to lymphocytes which binds on surface antibodies (B-cell) or surface receptor protein (T-cell) -> activation of T and B-cells
Which are the professional antigen-presenting cells (APCs) of the body?
True or False: (in reference to opsonization) The Fc (constant) portion of the antibody binds to the antigen, whereas the Fab (variable) portion of the antibody binds to an Fab receptor on the phagocyte, facilitating phagocytosis.
Presentation of the antigen to a B lymphocyte will directly result in...
Production of antibodies
Where in the body are antigens typically presented for activation of the adaptive arm of the immune system?
Nearest draining lymph node
Briefly describe the OAB blood type system as well as the Rh blood type system. Describe the antigens present, alleles involved, and type of dominance. What are the differences between them?
OAB: A and B antigens; IA, IB, and IO alleles; IA and IB codominant over recessive IO
Rh: C, D, E, c, d, and e antigens; Type D most prevalent leads to Rh+ and Rh- alleles; Rh+ is dominant
Difference: Any agglutinins appearing in OAB blood system occur spontaneously while this is not so for the Rh system
He has type AB+ blood. Which blood types can he receive, and which types can he donate to?
Receive: O+, O-, A+, A-, B+, B-, AB+, AB-
Donate: AB+ only
What is the name of the disease that is characterized by agglutination and phagocytosis of the RBCs of a newborn or fetus? What role do the parent's Rh antigens play in the disease? How do doctors prevent this condition?
Erythroblastosis fetalis: mom is Rh-, dad is Rh+, fetus will inherit the Rh+ allele from dad, mom will start to make anti-Rh agglutinins which will diffuse through the placenta to fetus resulting in RBC agglutination
Prevention: anti-D antibody called Rh immunoglobulin globin.
When mismatched blood types are involved in a transfusion, which sample's RBCs are more likely to agglutinate? In your own words, explain why. What lethal condition may arise as a result of this?
RBCs of donor blood will likely agglutinate, plasma of donor blood is diluted by plasma of recipient, decreasing the agglutinins in it. But, the infused blood doesn't dilute recipient's plasma, so it can still agglutinate the donor cells. Acute kidney failure can occur.
Identify and describe the four different types of transplantations. Provide an example of each type.
Autografts: A transplant of a tissue or a whole organ from one point of the same animal to another point. (ex. skin graft)
Isografts: A transplant of a tissue or a whole organ from one identical twin to another. (ex. liver -but with reduced chance of incompatibility)
Allografts: A transplant of a tissue or a whole organ from one human to another, or from one animal to another of the same species. (ex. kidney transplant from one human to another)
Xenografts: A transplant of a tissue or a whole organ from an organism of one species to an organism of another species. (ex. human tumor cells into immunocompromised mice)
Which type of transplantation is the greatest concern in terms of graft rejection? Describe the relevance of the HLA antigen system in terms of graft rejection. In what scenario would graft rejection not occur?
-HLA antigens are the most important antigens for causing graft rejection. Only six antigens are present on tissue cell membranes in each person, but there are more than one trillion possible combinations, so it is nearly impossible for two people to have the exact same antigen combination
-Graft rejection would not occur if the immune system were completely suppressed
What will happen if you accidentally slightly injured a small capillary? What cell fragments are mainly responsible in this process and what are their functions?
●Formation of the platelet plug
○Change shape and adhere to collagen in the tissues and to a protein called von Willebrand factor that leaks into the traumatized tissue from the plasma
○secrete large quantities of ADP and their enzymes form thromboxane A2
○Activate other platelets to accumulate on the injured site and successfully block the blood loss
Describe three essential steps of blood clotting. What is the most important ion in the process and why?
1. Formation of the prothrombin activator
2. Prothrombin → Thrombin
3. Fibrinogen → Fibrin (to form the clot). Catalyzed by thrombin
Most important ion: Calcium
Reason: required for promotion or acceleration of all the blood-clotting reactions. Also important for the formation of thrombin in both intrinsic and extrinsic pathways
Describe heparin and what its role is in the body. What is its purpose in medical applications?
Highly negatively charged conjugated polysaccharide. Activated under certain physiological events to stop clotting. Used to prevent intravascular clotting.
What are the primary causes for the two types of hemophilia? Which case is far more common? What is the nickname for this disease and why?
Hemophilia A/classic hemophilia - abnormality or Factor VIII deficiency
Hemophilia B - Factor IX deficiency
Hemophilia A is more common
"Royal Disease" - Queen Victoria had it
You are a third year medical resident talking with one of your mentors when all of a sudden, a patient presents to the ER with lower intestinal bleeding. After further inquiry, you learn that the patient is a 57 year-old man who has previously suffered from recurrent deep vein thrombosis and has undergone successful anticoagulation treatment with warfarin. You note that the patient sought medical treatment for Pneumococcal pneumonia precisely 9 days ago and the doctor prescribed some ceftriaxone to treat the disease. However, he exhibits a prolonged prothrombin time. Propose an appropriate cause of the patient's intestinal bleeding and a possible therapy; explain in detail the relevance of the patient's pneumonia treatment to this scenario.
Antibiotic treatment for pneumonia can kill flora in the GI tract, whose flora is useful for vitamin K. Because of warfarin, clotting factor production is suppressed as well as vitamin K. Loss of anticoagulants in the system so want to treat with fresh frozen plasma and vitamin K. Should understand how vitamin K is crucial in the clotting process
Describe a common method to measure the clotting time and evaluate its limitations. Describe another indicator for coagulation time and its significance.
Method: collect blood in a chemically clean glass test tube and then tip the tube back and forth about every 30 seconds until the blood has clotted
Limitation: Cumbersome to operate, results vary and may not be accurate
Indicator: prothrombin time: evaluating the time of extrinsic pathway and common pathway coagulation. Standardized by international normalized ratio (INR)
Significance: Identify the risk of bleeding or clot formation
What are the five types of cells within the anterior pituitary gland? Describe the hormones produced by each and each hormone's physiological action.
-Somatotropes: growth hormone (GH/somatotropin), stimulates body growth, stimulates secretion of insulin-like growth factor-1; stimulates lipolysis; inhibits actions of insulin on carbohydrate and lipid metabolism
-Corticotropes: adrenocorticotropic hormone (ACTH/corticotropin), stimulates production of glucocorticoids and androgens by the adrenal cortex, maintains size of zona fasciculata and zona reticularis of cortex
-Thyrotropes: thyroid-stimulating hormone (TSH/thyrotropin), stimulates production of thyroid hormones by thyroid follicular cells, maintains size of follicular cells
-Gonadotropes: follicle stimulating hormone (FSH) stimulates development of ovarian follicles and regulates spermatogenesis in the testis; luteinizing hormone (LH) causes ovulation and formation of the corpus luteum in the ovary, stimulates production of estrogen and progesterone by the ovary, stimulates testosterone production by the testis
-Lactotropes (mammotropes): prolactin (PRL) stimulates milk secretion and production
Describe the metabolic effects of growth hormone. Elaborate on each of the main three effects.
1. Increased rate of protein synthesis in most cells of the body, decreased breakdown of proteins
2. Increased mobilization of fatty acids from adipose tissue, increased free fatty acids in the blood, and increased use of fatty acids for energy
3. Decreased rate of glucose utilization throughout the body
What is the secretion pattern of growth hormone? How is growth hormone secretion regulated? Identify the 7 main regulation factors and how they regulate the secretion of growth hormone.
Secreted in increasing/decreasing pulsatile pattern
1. Starvation (protein deficiency) - stimulates
2. Blood free fatty acids (decrease stimulates, increase inhibits)
3. Exercise - stimulates
4. Excitement - stimulates
5. Trauma - stimulates
6. Ghrelin - stimulates
7. Deep sleep - stimulates
In a particular case, a patient's growth hormone-producing cells had become abnormally active very early in life. What is the name of this condition, and what are three common symptoms? If this condition developed post-adolescence, what would it instead be classified as?
-Abnormally tall, hyperglycemia, diabetes mellitus, or panhypopituitarism
What role does antidiuretic hormone play in the body? Identify and describe the 3 conditions that prompt the release of ADH. Include relevant neuronal receptors.
-Function: maintain homeostasis of water amount/retains water in the body
-Increased EC Fluid osmolarity, which is detected by osmoreceptors
-Low blood pressure, detected by baroreceptors in carotid, aortic, pulmonary arteries
-Low blood volume, detected by stretch receptors in atria.
What three cell types comprise the islets of Langerhans? Pick two of the three cell types and describe what substance they secrete.
Beta: insulin or amylin
Describe the process of why insulin is important in uptake of glucose.
Normal resting muscle membrane is not readily permeable to glucose but insulin makes cell membrane more permeable
In your own words, explain the two reasons why insulin increases fat storage. Knowing this, how would the concentrations of blood glucose, free fatty acids, and acetoacetic acid change if the pancreas was suddenly removed? Briefly describe in words the behavior of the concentrations over time.
1. Inhibits lipase
2. Promotes glucose uptake into fat cells as well
-Blood glucose increases and slowly levels off
-Free fatty acids rapidly increase and immediately level off
-Acetoacetic acid slowly and gradually increases
What are the risks of a person's blood glucose rising too high?
1. Glucose exerts large amount of osmotic pressure in extracellular fluid -> cause cellular dehydration
2. Cause loss of glucose in urine
3. Osmotic diuresis by kidney -> deplete body of fluids and electrolytes
4. Long term - damage to tissues and blood vessels. Increase risk of heart attack, stroke, end-stage renal disease, and blindness.
Describe how to diagnose diabetes. How do they work (ie what differences are there between a person w/o diabetes and a person with)?
-Normal person loses undetectable amounts of glucose
-Person w/ diabetes loses small to large amounts of glucose in urine
Which of the following statements is correct?
a. Most of the heat and humidity adjustment needed can be done via the nose
d. The nose serves as a resonating chamber for speech
e. The nose houses the olfactory receptors which are responsible for smelling
f. The nose partially filters the inspired air and cleans it of foreign matter
Which of the following statements is correct?
b. The area of your deep lungs is equivalent to the area of a tennis court
c. If you inhale large particles of dust, they will primarily deposit onto your throat
d. A large porous particle (20 μm) with very low density behaves aerodynamically as a small particle (4 μm) and therefore deposits into the deep lungs
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