NEET MDS Synopsis
ESSENTIAL FATTY ACIDS
Biochemistry
ESSENTIAL FATTY ACIDS (EFAs) Polyunsaturated FAs,such as Linoleic acid and g(gamma)- Linolenic acid, are ESSENTIAL FATTY ACIDS — we cannot make them, and we need them, so we must get them in our diets mostly from plant sources.
Regulation of PTH secretion
Biochemistry
Regulation of PTH secretion
Secretion of parathyroid hormone is controlled chiefly by serum [Ca2+] through negative feedback. Calcium-sensing receptors located on parathyroid cells are activated when [Ca2+] is low.
Hypomagnesemia inhibits PTH secretion and also causes resistance to PTH, leading to a form of hypoparathyroidism that is reversible.
Hypermagnesemia also results in inhibition of PTH secretion.
Stimulators of PTH includes decreased serum [Ca2+], mild decreases in serum [Mg2+], and an increase in serum phosphate.
Inhibitors include increased serum [Ca2+], severe decreases in serum [Mg2+], which also produces symptoms of hypoparathyroidism (such as hypocalcemia), and calcitriol.
Bile
PhysiologyBile 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.
Zinc Phoshate Cement
Dental Materials
Zinc Phoshate Cement
Uses. Zinc phosphate cement is used both as an intermediate base and as a cementing medium.
(1) Intermediate base. A thick mix is used under permanent metallic restoration. This layer of cement protects the pulp from sudden temperature changes that may be transmitted by the metallic restoration.
(2) Cementing medium. Zinc phosphate cement is used to permanently cement crowns, inlays, and fixed partial dentures upon the remaining tooth structure. A creamy mix of cement is used to seat the restoration or appliance completely into place. The cementing medium does not cement two objects together. Instead, the cement holds the objects together by mechanical interlocking, filling the space between the irregularities of the tooth preparation and the cemented restoration
c. Chemical Composition.
(1) Powder. primary ingredients - zinc oxide and magnesium oxide.
(2) Liquid. Phosphoric acid and water in the ratio of two parts acid to one part water. The solution may also contain aluminum phosphate and zinc phosphate Liquids exposed in open bottles will absorb moisture from the air in high humidity. The liquids will lose moisture if humidity is low. Water gain hastens setting; water loss lengthens setting time.
PROPERTIES OF ZINC PHOSPHATE CEMENT
a. Advantages. Some advantages of zinc phosphate cement as a cementing medium are:
o Inconspicuous appearance.
o Speed and ease of usage.
o Sufficient flow to form a thin layer for the cementing of closely adapted crowns, fixed partial dentures, and inlays.
o Low thermal conductivity beneath a metallic restoration.
b. Disadvantages. Some disadvantages of zinc phosphate cement as a cementing medium are:
o Low crushing strength that varies between 12,000 and 19,000 psi.
o Slight solubility in mouth fluids.
o Opaque material not suitable for visible surfaces.
c. Strength. The ratio of powder to liquid increases the strength of phosphate cements to a certain point. For this reason, the dental specialist must use as thick a mix as practical for the work being performed.
SETTING REACTIONS OF ZINC PHOSPHATE CEMENT
a. Chemical Reaction. The chemical reaction that takes place between the powder and liquid of setting phosphate cement produces heat. The amount of heat produced depends upon the rate of reaction, the size of the mix, and the amount of heat extracted by the mixing slab.
b. Powder to Liquid Ratio. The less powder used in ratio to the liquid, the longer the cement will take to harden. Good technique minimizes the rise in temperature and acidity of the setting cement that can injure the pulp. Generally, for increased strength, decreased shrinkage, and resistance to solubility, it is advisable to blend as much powder as possible to reach the desired consistencies.
c. Setting Time. The setting time of zinc phosphate cement is normally between 5 and 9 minutes.
Lower the temperature of the glass mixing slab to between 65° and 75° F (18° to 24° C), if the glass mixing slab is not already cooled below the temperature at which moisture will condense on it. → Blend the powder slowly. → Mix the powder over a large area of the cool slab. → Use a longer mixing time, within optimum limits.
Precautions. The following precautions should be observed.
o Prevent loss or gain of moisture in liquid cement by keeping bottles tightly stoppered.
o Dispense drops only when ready to mix.
o Use a cool, dry glass slab (65° to 75° F).
o Use the same brand of powder and liquid.
o Add increments of powder slowly.
o Use the maximum amount of powder to obtain the desired consistency.
(To incorporate the most powder, the material should be mixed with a moderate circular motion over a large area of the slab, turning the spatula often.)
Other coxibs
Pharmacology
Valdecoxib
used in the treatment of osteoarthritis, acute pain conditions, and dysmenorrhoea
Etoricoxib new COX-2 selective inhibitor
SHOCK
General Pathology
SHOCK
Definition. It is a clinical state of acute inadequacy of perfusion to tissues due to fall in effective circulating blood volume.
This inadequacy can be caused by :
Increased vascular capacity
Decreased blood volume
Altered distribution of available blood
Defective pumping system
Causes:
(1) Hypovolemic
Massive hamorrhage (external or internal).
Loss of plasma as in bums.
Dehydration due to severe vomiting, diarrhea diabetic coma.
Generalized capillary permeability as in anaphylaxis.
(2) Cardiogenic
Myocardial infarction.
Pulmonary embolism.
Cardiac tamponade
(3) Peripheral pooling:
Endotoxic shock.
Disseminated intravascular coagulation (DIC).
(4) Neurogenic:
Syncope.
Contributory factor in trauma, bums etc.
Metabolic changes in shock
Hyperglycaemia due to glycogenolysis.
Increased blood lactate and pyruvate due to anaerobic glycolysis. This results in metabolic acidosis.
Protein catabolism and increased blood urea.
Interference with enzyme systems.
Organs involved in shock
(1) Kidneys:
Renal tubular necrosis.
Cortical necrosis.
(2) Lungs:
Oedema, congestion and haemorrhage.
Microthrombi.
(3) G.I.T. :
Mucosal oedema.
Ulceration and haemorrhage
(4) Degeneration and focal necrosis in:
Heart.
Liver.
Adrenals
(5) Anoxic encephalopathy
Periodontium
Dental Anatomy
The periodontium, which is the supporting structure of a tooth, consists of the cementum, periodontal ligaments, gingiva, and alveolar bone. Cementum is the only one of these that is a part of a tooth. Alveolar bone surrounds the roots of teeth to provide support and creates what is commonly called a "socket". Periodontal ligaments connect the alveolar bone to the cementum, and the gingiva is the surrounding tissue visible in the mouth.
Periodontal ligaments
Histology of the Periodontal Ligament (PDL)
Embryogenesis of the periodontal ligament
The PDL forms from the dental follicle shortly after root development begins
The periodontal ligament is characterized by connective tissue. The thinnest portion is at the middle third of the root. Its width decreases with age. It is a tissue with a high turnover rate.
ISO-ENZYMES
Biochemistry
ISO-ENZYMES
Iso-enzymes are physically distinct forms of the same enzyme activity. Higher organisms have several physically distinct versions of a given enzyme, each of which catalyzes the same reaction. Isozymes arise through gene duplication and exhibit differences in properties such as sensitivity to particular regulatory factors or substrate affinity that adapts them to specific tissues or circumstances.
Isoforms of Lactate dehydrogenase is useful in diagnosis of myocardial infarction. While study of alkaline phosphatase isoforms are helpful in diagnosis of various bone disorder and obstructive liver diseases.