NEET MDS Lessons
Physiology
Cystic Fibrosis
→ Thick mucus coagulates in ducts, produces obstruction, Too thick for cilia to move
→ Major Systems Affected: Respiratory System, G. I. Tract,Reproductive Tract
→ Inherited, autosomal recessive gene, most common fatal genetic disorder
→ Major characteristic, Altered electrolyte composition (Saliva & sweat Na+, K+, Cl-)
→ Family history of Cystic Fibrosis
→ Respiratory Infections & G.I.Tract malabsorption
→ Predisposes lung to Secondary infection (Staphylococcus, Pseudomonas)
→ Damages Respiratory Bronchioles and Alveolar ducts, Produces Fibrosis of Lungs, Large cystic dilations)
Functions
Manufacture - blood proteins - albumen, clotting proteins , urea - nitrogenous waste from amino acid metabolism , bile - excretory for the bile pigments, emulsification of fats by bile salts
Storage - glycogen , iron - as hemosiderin and ferritin , fat soluble vitamins A, D, E, K
Detoxification -alcohol , drugs and medicines , environmental toxins
Protein metabolism -
- transamination - removing the amine from one amino acid and using it to produce a different amino acid. The body can produce all but the essential amino acids; these must be included in the diet.
- deamination - removal of the amine group in order to catabolize the remaining keto acid. The amine group enters the blood as urea which is excreted through the kidneys.
Glycemic Regulation - the management of blood glucose.
- glycogenesis - the conversion of glucose into glycogen.
- glycogenolysis - the breakdown of glycogen into glucose.
gluconeogenesis - the manufacture of glucose from non carbohydrate sources, mostly protein
Bile contains:
- bile acids. These amphiphilic steroids emulsify ingested fat. The hydrophobic portion of the steroid dissolves in the fat while the negatively-charged side chain interacts with water molecules. The mutual repulsion of these negatively-charged droplets keeps them from coalescing. Thus large globules of fat (liquid at body temperature) are emulsified into tiny droplets (about 1 µm in diameter) that can be more easily digested and absorbed.
- bile pigments. These are the products of the breakdown of hemoglobin removed by the liver from old red blood cells. The brownish color of the bile pigments imparts the characteristic brown color of the feces.
Serum Proteins
Proteins make up 6–8% of the blood. They are about equally divided between serum albumin and a great variety of serum globulins.
After blood is withdrawn from a vein and allowed to clot, the clot slowly shrinks. As it does so, a clear fluid called serum is squeezed out. Thus:
Serum is blood plasma without fibrinogen and other clotting factors.
The serum proteins can be separated by electrophoresis.
- The most prominent of these and the one that moves closest to the positive electrode is serum albumin.
- Serum albumin
- is made in the liver
- binds many small molecules for transport through the blood
- helps maintain the osmotic pressure of the blood
- The other proteins are the various serum globulins.
- alpha globulins (e.g., the proteins that transport thyroxine and retinol [vitamin A])
- beta globulins (e.g., the iron-transporting protein transferrin)
- gamma globulins.
- Gamma globulins are the least negatively-charged serum proteins. (They are so weakly charged, in fact, that some are swept in the flow of buffer back toward the negative electrode.)
- Most antibodies are gamma globulins.
- Therefore gamma globulins become more abundant following infections or immunizations.
Carbon Dioxide Transport
Carbon dioxide (CO2) combines with water forming carbonic acid, which dissociates into a hydrogen ion (H+) and a bicarbonate ions:
CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3−
95% of the CO2 generated in the tissues is carried in the red blood cells:
- It probably enters (and leaves) the cell by diffusing through transmembrane channels in the plasma membrane. (One of the proteins that forms the channel is the D antigen that is the most important factor in the Rh system of blood groups.)
- Once inside, about one-half of the CO2 is directly bound to hemoglobin (at a site different from the one that binds oxygen).
- The rest is converted — following the equation above — by the enzyme carbonic anhydrase into
- bicarbonate ions that diffuse back out into the plasma and
- hydrogen ions (H+) that bind to the protein portion of the hemoglobin (thus having no effect on pH).
Only about 5% of the CO2 generated in the tissues dissolves directly in the plasma. (A good thing, too: if all the CO2 we make were carried this way, the pH of the blood would drop from its normal 7.4 to an instantly-fatal 4.5!)
When the red cells reach the lungs, these reactions are reversed and CO2 is released to the air of the alveoli.
An anti-diruetic is a substance that decreases urine volume, and ADH is the primary example of it within the body. ADH is a hormone secreted from the posterior pituitary gland in response to increased plasma osmolarity (i.e., increased ion concentration in the blood), which is generally due to an increased concentration of ions relative to the volume of plasma, or decreased plasma volume.
The increased plasma osmolarity is sensed by osmoreceptors in the hypothalamus, which will stimulate the posterior pituitary gland to release ADH. ADH will then act on the nephrons of the kidneys to cause a decrease in plasma osmolarity and an increase in urine osmolarity.
ADH increases the permeability to water of the distal convoluted tubule and collecting duct, which are normally impermeable to water. This effect causes increased water reabsorption and retention and decreases the volume of urine produced relative to its ion content.
After ADH acts on the nephron to decrease plasma osmolarity (and leads to increased blood volume) and increase urine osmolarity, the osmoreceptors in the hypothalamus will inactivate, and ADH secretion will end. Due to this response, ADH secretion is considered to be a form of negative feedback.
The Posterior Lobe
The posterior lobe of the pituitary releases two hormones, both synthesized in the hypothalamus, into the circulation.
- Antidiuretic Hormone (ADH).
ADH is a peptide of 9 amino acids. It is also known as arginine vasopressin. ADH acts on the collecting ducts of the kidney to facilitate the reabsorption of water into the blood.- A deficiency of ADH
- leads to excessive loss of urine, a condition known as diabetes nsipidus.
- A deficiency of ADH
- Oxytocin
Oxytocin is a peptide of 9 amino acids. Its principal actions are:- stimulating contractions of the uterus at the time of birth
- stimulating release of milk when the baby begins to suckle