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  1. Where is preproinsulin synthesized?
    in the Rough endoplasmic reticulum
  2. How is insulin synthesized?
    • 1. Preproinsulin is synthesized in the RER.
    • 2. Cleavage of "presignal"
    • 3. Proinsulin and C peptide is stored in secretory granules.
    • 4. Released equally via exocytosis.
  3. What prevents the hematogenous spread of Candida?
  4. How do we turn genes on?
    • De-methylate DNA
    • Histone acetylation
  5. How do we turn genes off?
    • Methylate DNA
    • De-acetylate histone
  6. What are the effects of histone acetylation on gene expression?
    Turns genes on
  7. What can be used to estimate GFR?
    Creatinine clearance
  8. What can be used to estimate RPF (renal plasma flow)?
    PAH (paraminohippuric acid)
  9. A deficiency of N-acetylglutamate results in? How does it present in neonates?
    • N-acetylglutamate is required as a cofactor for carbamoyl phosphatate synthetase I which converts CO2 + NH3 (ammonia) to carbamoyl phosphate.
    • Causes hyperammonemia.
    • Presents as poorly regulated respiration and body temperature.
    • Poor feeding
    • Developmental delay
    • Intellectual disability
  10. What is the function of carbamoyl phosphatate synthetase I?
    Converts CO2 + NH3 (ammonia) to carbamoyl phosphate I
  11. The left horn of the sinus venosus gives rise to?
    Coronary sinus
  12. Where is the coronary sinus derived from?
    Left horn of the sinus venosus
  13. What is the coronary sinus and what can cause it to dilate?
    • Collection of veins that collect deoxygenated blood from the heart muscle and delivers it to the right atrium.
    • The coronary sinus communicates freely with the right atrium and therefore can become dilated secondary to any factor that causes right atrial dilation eg Pulmonary hypertension.
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  14. Describe the blood flow in coronary artery disease in the presence of an MI.
    • In coronary artery disease, vessel occlusion can be passed by the natural existence of collateral vessels that help support blood flow.
    • In the presence of an MI, coronary arterioles vasodilate, diverting collateral blood flow to ischemic areas.
  15. What is coronary steal syndrome and what causes it?
    • Adenosine, Regadenoson (adenosine agonist) and dipyridamole cause coronary steal by vasodilating coronary arterioles in non-ischemic regions. 
    • This results in decreased perfusion pressure within the collateral suppying the ischemic myocardium.
    • May lead to hypoperfusion and worsening of the existing ischemia.
  16. Describe the facial anomalities of Potters syndrome.
    Image Upload 2
    • Low set ears
    • Retrognathia - abnormal displacement of the mandible
    • Suborbital creases
    • Depressed nasal tip
  17. What is the most common cause of Potters syndrome?
    • Bilateral renal agenesis
    • Lack of fetal urine causes oligohydramnios
  18. What structures are formed by the pronephros?
    It degenerates
  19. The mesonephros contributes to the development of which structures?
    Male genital system (Wolffian ducts)
  20. What happens to the mesonephros in females?
    It regresses and becomes the vestigial Gartners ducts.
  21. Which structures does the uteric bud give rise to?
    • Ureter
    • Major and minor calyces
    • Collecting ducts 
    • Renal pelvises 
  22. Where does the ureter arise from?
    Uteric bud
  23. Where does the major and minor calyces arise from?
    Uteric bud
  24. Where does the collecting ducts arise from?
    Uteric bud
  25. Where does the renal pelvises arise from?
    Uteric bud
  26. Which structures does the metanephric mesoderm (blastema) give rise to?
    • Glomeruli
    • Bowman's space
    • Proximal tubules
    • Loop of Henle
    • Distal convoluted tubules
  27. Where does the glomeruli arise from?
    Metanephric mesoderm (blastema)
  28. Where does the bowmans space arise from?
    Metanephric mesoderm (blastema)
  29. Where does the Proximal convoluted tubules arise from?
    Metanephric mesoderm (blastema)
  30. Where does the loop of Henle arise from?
    Metanephric mesoderm (blastema)
  31. Where does the distal convoluted tubules arise from?
    Metanephric mesoderm (blastema)
  32. Where is the uteric bud derived from?
    • Derived from the caudal end of the mesonephric duct.
    • Image Upload 3
  33. What forms the metanephric mesenchyme?
    Uteric bud penetrates into the sacral intermediate mesoderm to induce the formation of metanephric mesenchyme.
  34. What is linkage disequilibrium?
    Different inherited allele frequencies in a population.
  35. The presence of Koilocytes are characteristic of which infection?
  36. What type of cell is shown on the slide below? Describe it.
    Image Upload 4
    • Koilocyte
    • Immature squamous cells with a dense irregularly staining cytoplasm and perinuclear clearing (halo).
  37. Intraepithelial neoplasia of the cervix (CIN) and vulva are caused by which strains of the Human papilloma virus?
    16, 18, 31, 33, 35
  38. Genital warts (condylomata acuminatum) are associated with which strains of the human papilloma virus?
    6 & 11
  39. Skin warts (verruca vulgaris) are caused by which strains of HPV?
  40. What are the findings in the stool of latase deficient ppts?
    • Bacterial fermentation of undigested lactose produces short chain fatty aids and excess amounts of hydrogen peroxide acidifies the stool
    • ↓pH
    • Breath shows ↑ Hydrogen peroxide
    • ↑Stool osmotic gap
  41. Langerhans giant cells are characteristic of?
    • Granulomatous conditions, including the caseating granulomas associated with Mycobacterium tuberculosis infection.
    • Horse-shoe shaped.
  42. What is the cell type seen below?
    Image Upload 5
    • Langerhans giant cell (do not be confused with Langerhans cell)
    • Characteristic of granulomatous conditions.
    • They have multiple nuclei peripherally organized in the shape of a horse shoe.
  43. Which artery is most likely to be eroded by posterior duodenal ulcers?
    • Gastroduodenal artery
    • Image Upload 6
  44. How are the three proteins of the lac operon synthesized?
    • All three proteins of the lac operon (β-galactosidase, permease, transacetylase) are synthesized from a single mRNA molecule containing the z, y and a gene sequences, respectively. 
    • Polycistronic mRNA
  45. How do we calculate collapsing pressure?
    = 2 (surface tension)/ radius
  46. The majority of cases of Down syndrome occur due to?
    • Meiotic nondisjunction
    • Failure of chromosomes to separate during the first meiotic division of the ovum.
  47. What causes Robertsonian translocation?
    Occur due to a break near the centromere of chromosomes, with transfer of genetic material between chromosomes.
  48. What causes Cri-du-chat syndrome?
    Congenetal microdeletion of short arm of chromosome 5
  49. Where are chromaffin cells derived from and what is their function?
    • Neural crest cells
    • Secrete epinephrine and norepinephrine
  50. Which cells are located in the adrenal medulla and what are their functions?
    • Chromaffin cells
    • Secrete epinephrine and norepinephrine
  51. What secretes norepinephrine and epinephrine in the adrenals?
    Chromaffin cells- adrenal medulla
  52. What regulates chromaffin cells?
    Acetylcholine released by preganglionic sympathetic neurons.
  53. Acetylcholine from preganglionic sympathetic neurons regulates control of which type of cell in the adrenals?
    • Chromaffin cells
    • Secrete norepinephrine and epinephrine
  54. The image below is a cross section through an adrenal gland. The tissue indicated by the arrow A is most likely to contain cells activated by?
    Image Upload 7
    Adrenal medulla - Chromaffin cells- Activated by acetylcholine released by preganglionic sympathetic fibers- secrete norepinephrine and epinephrine
  55. Aldosterone secretion by the zona glomerulosa is regulated by?
    Angiotensin II and extracellular K+ levels
  56. Angiotensin II regulates control of secretion of which product from the adrenals?
    Zona glomerulosa- Aldosterone
  57. What is identification? Give an example.
    • Modeling behavior after another person who is more powerful (though not necessarily admired).
    • E.g. Parent who was abused as a child becomes an abusive parent.
  58. What is Reaction formation? Give an example.
    • Replacement of an unpleasant or unacceptable thought or desire with an emphasis on its opposite.
    • E.g. Person who is a homosexual has a lot of heterosexual affairs and publicly criticizes homosexuals to relieve inward anxiety about his/ her homosexual desires.
    • E.g. Person who has a strong desire to continue using heroin volunteers at public forums and visits places.
  59. What is Repression? Give an example.
    • Involuntarily withholding an idea or feeling from conscious awareness.
    • E.g. An adult who was abused as a child lacking awareness of the abuse until he/she sees a movie featuring child abuse.
  60. What is suppression? Give an example.
    • Intentionally withholding an idea or feeling from conscious awareness.
    • E.g. Student choosing to not worry about an upcoming examination.
  61. Which diseases are associated with HLA-B27?
    • Psoriatic arthritis
    • Ankylosing spondylitis
    • Inflammatory bowel disease (Chron disease and Ulcerative colitis)
    • Reactive arthritis (Reiter syndrome)
  62. What does the HLA-B27 gene code for?
    MHC class I
  63. Describe the presentation of Reactive arthritis (Reiter syndrome).
    • Can't see: Conjunctivitis, anterior uveitis 
    • Can't pee: Urethritis, cervicitis, prostatitis (painful urination, discharge)
    • Can't bend my knee: Arthritis, knee pain 
  64. Describe the process of Oogenesis.
    • 1. Primary oocytes arrest in Prophase of Meiosis I and remain there until puberty.
    • 2. At puberty, female becomes capeable of reproduction. FSH stimulation causes some oocytes to complete Meiosis I, forming secondary oocytes and Polar bodies (both 23, 2N)
    • 3. The secondary oocyte begins meiosis II but halts in metaphase II.
    • 4. At day 14 of the menstrual cycle, the secondary oocyte is released from the ovarian follicle in response to ↑estrogen and ↑LH.
    • 5. The secondary oocyte remains frozen in metaphase II until fertilization occurs.
    • 6. At fertilization, it divides into a mature oocyte and second polar body.
  65. An oocyte isolated from the fallopian tube soon after ovulation would be in which stage of gametogenesis?
    Prior to fertilization, secondary oocytes are arrested in metaphase of meiosis II
  66. At what stage of gametogenesis is the oocyte in before puberty?
    Primary oocytes arrest in prophase of meiosis I  and remain there until puberty
  67. What causes the release of ANP and BNP?
    Atrial/ A-type Natriuretic Peptide & B-type/ Brain Natriuretic Peptide- released from atrial (ANP) and ventricular (BNP) myocytes in response to ↑blood volume (e.g ventricular hypertrophy)
  68. What causes reperfusion injury?
    Damage by free radicals
  69. Leision to the ventromedial hypothalamic nuclei results in?
    Obesity, aggressive and savage behavior 
  70. What is the MMC of a lesion to the ventromedial nucleus of the hypothalamus?
  71. Lesion to the lateral area of the hypothalamus results in?
    • Adults → anorexia
    • Infants → failure to thrive
  72. Lesion to the posterior hypothalamus results in?
    Poikilothermia- inability to regulate body temperature (cold-blooded)
  73. What is the function of the anterior nucleus of the hypothalamus?
    • Cooling
    • Stimulates the parasympathetic nervous system to produce vasodilation and sweating.
  74. What is meta-analysis?
    Compiling data from several studies to increase the power of analysis
  75. What is the function of peroxisomes?
    Metabolism of very long-chain fatty acids, branched chain fatty acids, and amino acids.
  76. This structure is involved in the metabolism of very long-chain fatty acids.
  77. This structure is involved in the metabolism of branched-chain fatty acids.
  78. Abnormal functioning of this structure results in the presence of fatty acids with branched points at odd numbered carbons.
  79. What is Refsum disease?
    • Defect in peroxisomal alpha-oxidation (which metabolizes branched chain fatty acids). Results in accumulation of phytanic acid.
  80. Increased levels of phytanic acid are associated with which pathology?
    • Refsum disease
    • Defect in peroxisomal alpha-oxidation (which metabolizes branched chain fatty acids)
  81. What is Zellweger syndrome?
    • Infants are unable to properly form myelin in the CNS. 
    • Findings: hypotonia, seizures, hepatomegaly, retardation, early death.
  82. What is the function of the  DNaA protein?
    Acts at the repication fork to unwind the DNA; assists Helicase.
  83. Label the image below
    Image Upload 8
    • 1 = prostate
    • 2 = rectum
    • 3 = obturaaator internus
    • 4 = ischium
    • 5 = body of pubis
    • 6= pubic symphysis
    • 7 = femoral artery
    • 8 = femoral vein
  84. What are the effects of smoking during pregnancy?
    • Low birth weight ***
    • Preterm labour/ early delivery**
    • Placental problems***
    • Intrauterine growth retardation***
    • Attention deficit hyperactivity disorder**
  85. What causes low birth weight in infants?
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