OMK key review points

1935

sulfanamide, it a antibacterial agent prontosil

1940's by Florey and Chain

Metchnikoff

created the cell theory of immunity

Paul Ehrlich

He created the magic bullet and He is the forerunern for antitoxins and compound 6060 which is used to treat syphilis

If right after performing the technique the patient feel better it is structure and function.

they are only in type II not in type one

• Extension dysfuction. E is equal and the problem facet is on the same side as the dysfunction.
• the problem facet is on the right side
• Ers means that ot wants to extends
• STUCK closed
• ERS right the right facet is stuck closed and does not want to open

• means that the left facet is stuck open That will cause it rotate and side-bend to the right side 
• STUCK OPEN

• it is a scoliosis 
• like side bend to the rigth and rotated to the left 
• you would feel ribs more posterior

Hard to see because it is such small sigments

• rate limiting step 
• it is actvated with fructose 2,6-bisphosphate F@^BP
• F2,6BP is a positive regulator

• activates protein kinase-1 which is used to adds a phosphate group
• Glucagin phosphorylates pyruvate kinase and thus inactivates it

• What determines and distributes health disease in human
• WHO what where when and why of any disease

• Ask michelle or preet
• Fructose-2,6-bisphosphate

oraganism multiply on or in the body and make the body infection to others directly or indirectly after developing a living vector

• West Nile 
• Malaria

low and constant level of disease in a population

level of infection found above that which is usually found in the population

AIDS, cholera (1980's), ZIKA ( 2016 ) COVID

only mammilian carriers od the infectious agent

The # of fatalities over the total cases

New cases/specific population over a specified time period

Total # of cases exiting in a given population

• human to human 
• respiratory droplets 
• The virus has ss RNA 
• very communicable
• MMR vaccination

• Pathogen Yersinia pestis 
• gram neg 
• from rats to fleas to humans 
• epidemic of the 1th centrury in Europe

Hospital acquired infections most commonly inolving opportunitistic organism

• A base linked to a sugar 
•  Side just got the SUGAR

• The heterosexual is always tight because they never express themselves
• Densely packed chromatin that does not express usually

DNA that has a start and a stop point that specifies a protein

• It is the most accurate 
• You have to put the back closest to the image detector.
• That way the X-ray passes from Anterior to posteror hence AP

Fibrin-1 protein mutation would lead to this aliment

The are competitive inhibitors that compete for thebinding of HMG CoA eductase

• When patient flexes the problem facet is stuck closed 
• and the vertebra rotate to the SAME SIDE 
• e.g. T4 ERS Right
• this means that the right facet is  stuck closed

Some Nuns Never really reach Sex

• silence
• Non verbal encouragment 
• neutral utterance
• Reflection
• Request 
• summarizing \

• Cut down
• Annoyed by people about you habit
• Guilty about your drinking 
• Eye-Opener- do you have a drink first thing in the morning

• found in prokaryotic cells
• places the RNA primer so DNA can be synthesized from 5' to 3' on a ss dna template

• Found in Prokaryotic DNA
• mainly to repair DNA.
• it also replaces RNA primer on the lagging strand and replacing them with DNA

• Prokaryotes need:
• DNA gyrase
• circular chromosome not sister chromatids 
• it is fast 
• large okazaki fragments 
• needs DNA polymerase I and II 
• single origin of replication 
• Dna replicates in the cytoplasm 
• circular and double stranded DNA

he used the pea plants to understand inheritance

That DNA is what makes up genes

She discovered that DNA is a double stranded helix

• Fibrous proteins 
• linking of GXY which is usually 
• Glycine, Proline, and Hydroxyproline or hydroxylysine

• DNA alpha
• DNA beta
• and OMEGa

• When primer is removed from the end of our DNA there is a gap because we can only add bases in the 5' to 3' directiojn 
• expressed in germ cell and  live forever because it prevents us from losing information at the end of our genes.
• usually when we replicate information we lose information at the end

• Repeats of GXY that create a alpha chain
• 3 alpha chains create collagen molecule
• collagen moelcules come together to make collagen fibrils \collagen fibrils come together to make a collagen fiber

• This is based on the sugar . 
• If the 2' carbon the sugar has an oxygen then it is RNA
• if not it is DNA because it does not have a Oxygen , hence deoxy.

• adenosine
• cytidine
• uridine
• guanosine
• thymidine

unwinds the DNA by breaking the hydrogen bonds that exist between the nitrogenous bases of each DNA strand.

dds a small primer to the existing DNA (since DNA polymerase is unable to start making DNA without a primer first).

seals the gap by building a bond between the phosphate group and the sugar.

• Makes initiator DNA attach to primer 
• this cause lagging strand synthese

Leading strand synthesis

Lagging strand repair

• increase in Cardiac Troponin I and T . 
• 2-4 hours to release and peaks after a day or two 
• CK-MB ( slower indicator)

some damage to the brain seeing that it is mostly found in the brain

CK-MB 

shows when cardiac muscle is damaged

shows when cardiac muscles and skeletal muscle is damaged.

• AAT 
• alpha 1 antitrypsin

• alanine aminotransferase and Aspartate aminotransferase 
• elevation in blood could mean liver damage

• Could mean cholestatsus
• elevation of this serum enzyme means that bile flow from the liver is blocked or slowed.

Also bones tumor , in the case of Rickets

• AST ALT : just like with the liver 
• creatine kinase 
• Aldolase

Amylase in blood indicative of pancrease damage

• made up of 4 subunits
• isofroms separated using chromatography and electrophoresis
• the subunit types are H (heart0 and m(muscle)

• Found in acute leukemia
• H3M
• H2M2

• The pure heart LDH 1 HHHH is in the myocardium
• Fasting moving 
• Heat Stable

HM3 HMMM is in the liver and muscle

• M4 MMMM Occur in muscle liver  
• anaerobic tissue in liver disease

• Km :increases 
• Vmax: stays the same

• Decrease in Apparent Vmax 
• Does not affect Km

[s]<<<km

[S] >>Km

found only in prokaryotes and sythesizes both lagging and leading strand

link nucleotide together in the Dna back bone

• in eurkaryotic cells.
• proteins that Dna wraps themselves around to organize itself

nucleosome - the unit of histones with  Dna wraps about it 2 times

This is the place where metyolation occurs in DNA

places where there are repeated CG's

The parent strand is usually methaylated for a time period that the new strand is not

• when the parent dna strand is methylated and the new strand is not
• This is to help with mismatch proofreading
• DAM methylase will know to repaire the new unmethylated strand then metylate at the A

make sure that the chromatin is accessible for replication

• only found in Prokaryotes
• quinones such as nalidixic acid and cirpoflocin inhibit DNA gyrase and will kill bacter gram -

• Glycine in the amino triple repeat in collagen G-X-Y has point mutation 
• results in pooor collagen packing 
• Fibril forming collagen type I

• mutation in collagen gene
• Firbril forming and Type I

• Type II 
• Under this is types 4,8,and 10

• fibril associated 
• interruption in triple helices 
• types 9 and 12

• formed in ER with N-glycosylated residue  and 3  alpha helicies twine to form pro collagen
• after N-residue is cleaved procollagen is offical collagen and stacks with other collagen to make collagen fibrils

form covalenbt cross links between collogen to make collagen fibrils

• This is where the cleavage of proalpha chain collagen is made
• if not down it result in faulty collagen or none

Vitamin C, Fe2+ and O2

• Ehlers Danlos Syndrome 
• defective collagen processing enxyme ( lysl oxidase)
• mutation in fibril forming colloagen
• type I II or V

• cysteines
• that form disulfide interchain
• links h

PDh pyruvate dehydrogenase

• an alpha-keto acid dehydrogenase
• Makes a 2 carbon product from a 3 carbon substrate
• There are 3 enzymes in PDH 
• - pyruvate dehydrogenase, Dihydrolipoyl transacetykase and Dihydrolipoyl dehydrogenase

• Loses Co2
• Oxidized by lipoic aicd 
• Acetyl group is transferred to coA

• 1. thamine Vitamin B1 pyrophosphate TPP : E1
• 2. Lipoic Acid E2
• 3. Coenzyme A E3
• 4. FAD E3
• NAD E3

• nonpolar residues 
• hyproxyproline
• dense hydrophobiv globules 
• rich in val pro gly
• crossed linked ( desmosine cross-link)
• lysly oxidase helps with cross linking
• when it is relaxed it is compressed

Elastin consists of Elastin and Glycoprotein micrfibrils ( Fribin 1, fibrin 2 etc.

• Mutationi n Fibrin-1 
• elongated limbs and skeltal deformation 
• hands and bodies are marfed

• in the lungs
• wall of arteries 
• elastic ligaments

• Elastin is all about me :
• MARFAN and Emphysema

• Alpha 1 antitrypsin is a protease inhbitor 
• preserve elastin 
• stop elastase 
• People with Emphysema are deficientin AAT or α1- antitrypsin   have their elastin in their lungs destroyed

• helps protease bind to AAT so that the protease can be =in hibited
• smoking oxidizes this enzyme

The visceral motor divison

the peripheal axon proesses

via the central process of the sensory axon

• cervial C1-C4
• Brachial C5-T1
• Intercostal n T1-T11
• subcostal T12 
• Lumbar L1 -L4
• Sacral plexus L5-S3

• Since there is not PDH to crease Acetyl CoA pyruvate becomes lactate and results in lactic acidosis 
• it is x-linked w. no treatment

• arsenic inhibits enzymes that require lipoic acid suc as PDH, α-ketoblutarate dehydrogenase 
• from complex with thio group on lipoic acid 
• affect brain

• oxidative decarboxylation to for Co2 and 2 NADH
• from Citrate to α-ketoglutarate

• oxidative and recreated oxa,oacetate 
• creates 1 NADH and 1 FADH2

Can I Keep selling sec for money, officer?

adding pressure to the surface of the body to determine size, shape, health, consistency, and motility beneath

• acetyl CoA + oxaloacetate =citrate 
•  through the use of citrate synthase 
• it is negative feedback 
• succinyl coa 
• NADH

• Aconitase 
• what a con first you take out the water then you add it back 
• Fe-S protein 
• inhibited by fluoroacetate

• Isocitrate dehydrogenase 
• oxidative decarboxylation 
• RATE LIMITING STEP 
• first NADH 
• release CO2

• ADP and 
• CA2+

• ATP
• NADH 
• sufficent energyu signals

• Cindy is kinky so she fuck more often 
• Citrate 
• Cindy And I Know Some Sexy Fucking Mothers! 
• Citrate synthase, Aconitase, Isocitrate dehydrogenase , α-ketoglutarate dehydrogenase, succinate thiokinase, Succinate dehydrogenase, Fumarase, and malate dehydrogenase

• oxidative decarboxylation 
• 2nd NADH 
• 2nd Co2 
• the productsuccinykt coA  contain a high energu bond

thamine, lipoic acid, CoA, FAD, NAd

ATP, GTP, NADH , and succinyl coA

CA2+  from muscle contraction

succinate thiokinase

• produces one GTp --> ATP 
• from the high ebergy bond of CoA 
• substrate level phosphorylation

• makes 1 FADh2 
• part of the ETC

• Fumarase 
• adde H2o to the doubel bond of the fumarate 
• reversible

• malate dehydrogenase 
• produces 3rd and final NADH

• 10 
• assuming 1NADH= 2.5 ATP
• 1FADH2=1.5ATP

• 3 NADH 
• 1FADH2

36 -38 from 1 molecule of glucose

• Step 1 
• step 3 
• Step 4

• Skin connective tissue 
• muscle and tendon 
• Visceral organs 
• BOne,ligament,and joints

• p- postion of comfort
• a- anatomy= study and visualize 
• l- level of tissue
• p- understanding the purpose behind feeling 
• a-ascertain movement 
• t- tweaking you feeling to see what feels better and what s better 
• e-evaluate what has changed

• 3 types 
• Hyaline
• Firbro cartilage
• Elastic Cartilage

hyaline lines the articular surface

• Firbous joint capsule 
• synovial membrane 9 produces synovial fluid)
• synovial fluid ( lubrication )
• Hyaline cartilage ( absorbs shock)

• 7 types 
• pivot 
• hinge
• ball and socket 
• plane
• Trochoginglymus 
• saddle 
• condyloid

Flex, extend, and rotate the knee

• condyloid 
• allows for flexion and extexion 
• abduction and adduction 
• circumduction

• saddle 
• allow movement in two different planes

Permit rotation like the atlas and the axis

activating muscle fibers that result in tension

isotonic -muscle length changes that create motion

• two types :
• Concentric and Eccentric

• shortening of the muscles
• like to concentrate is to make smaller
• overpowering gravity

• resisting gravity and controlling motion at a specific rate
• gravity overpower muscle 
• elongation of muscle s

• amino acids 
• fatty acids 
• Prophyrins 
• gluconeogenesis
• bases for nucleotide synthesis

• Pyruvate carboxylase 
• replensihes the intermediate of the TCA Cycle 
• contain Acetyl coA

• other than serving as an anaplerotic 
• it contain biotin and requires ATP and Mg2+

the first step of glucneogensis

Acetyl coA

amino acid degradation can create fumarate, oxaloacetate , a-ketoglutarate

• PDH deficiency
• PC deficency

vitamin B1 deficiency

5 coenzymes 

• Take Large cock and fuck Nathan
• thamine ( vitamin B1)
• Lipoic Acid 
• Coenzyme A
• FAD 
• NAD

• E:
• one promoter
• monocistronic mRNA 
• Pro:
• multiple genes controlled by the same promoter (e.g. lactose ; lac operon )
• poly cistronic MRna

becomes the sequence to make proteins

dna is transcripted to RNA

they turn rna on and off

eventually become the sequence to make proteins

they have secondary and primary structure

• copies Dna and turns it into RNA
• it does not have any repairing function- this is the reason why they mutate so often

most of the protein coding genes

ribosomal RNa

transfer Rnas, snrna and small Rna

• comes form the death cap mushroom 
• this enzyme binds to RNA pol II 
• can stop transcrition and replication in prokaryotes

• at the promoter around -25bp
• TATA box

at the promter at -35 -10 bp region

• they have transcription factors 
• Rna polymerase II ( Eukaryotes ) has 6 different transciption factors
• they all bind with Rna polymerase II

• Rna polymerase is made up of 4 different subunits ; the σ subunit recognizes the transcription start site
• sigma falls off of the promoter and then Rna polymerase continues transcritption

RHo dependent or rho independent

a hair bin loop ( areas of base homo logy ) where rho comes and dissociates the complex

• more common
• there is a  hair pin loop that is followed by a a series of u's are created and after that there are is AU and they form very weak hydrogen bonds that are not strong enough to hold
• A and U interaction there are only two hydrogen bonds that are not strong enough to hold and destablizes the  DNA and teseult sin termination

• are not regulated (e.g. RNa polymerase)
• we need to have it on all the time because we are constantly translating  DNA
• always turned on

BY activator and respressors

• code for proteins that allow cellt o use lactose as energy 
• LACZ
• LacY
• and LacA are

Lac I sit on the promter so that the lactose utilizing enzymes cannot be made and when lactose is present it binds to lac I that removes it from the promoter region

• Camp can bind cap and they can bind to sugar operons on the Cap site 
• It is necessary for Rna polymerase to bind to the promter 
• they untangle the promoter so transcription can take place

Catabolite activator protein

Glucose and lactose, respectively.

it can either weaken or strengthen it reaction with the mutation

• 5'capping
• 3’-polyadenylation
• Exonal splicing
• Abs to snRNPs very specific to SLE
• Abs to U1 RNP (MCTD)

a modified guanine residue is added and protect the rna from being degraded in the cell

a series of adenines that are added to the 3' end

• a disease that result from the mutation of an exons .
• there is a splice site made in an exon
• results in the removal or distruption of the gene that is used to make a cyotskeltal protein

remove exons from introns an but them together

help treat mixed contention tissue disease and SLE diseases because it stop snrps

rna molecules responsible for spliceosomes

• three main components:
• rRNA
• tRna
• mRNA

has three loops

30s and 50s which make 70s

starving and fasting

30s and 60s to make 80s

• holoenzyme ( 5 subunits)
• no transcriptoon factors
• polycitronis mrna
• promter at -35bp t -10 bp 
• no post transitional modification 
• coupled transcription and translation

• They need a start codon (AUG: methyanine) and a
• stop codon

• before the start codon is the ribosomal binding site and they move and wait for the first aug they encounter and this is the start 
• This rna binding site is also called the SHine-Dalgarno sequence

rRNa and protein

• has 3 loops and attached to it is the amino acid 
• on one end there is a section called the anticodon 
• on the other section is the amino acid
• carries the anticodon that corresponds to the codon from the mRNA

There are 64 and they are universal

creates a immature stop codon

3

• in ribosome that they have 3 site
• exits 
• peptid
• accept or site ) where a new TRNA is accepted

• create peptide bond between amino acids 
• it has the EPA sites 
• move one codon at a time
• there are initiation factors, elongation factor, and releae factors

• targets protein synthesis in prokaryotic 
• Aminoglycosides ( bind to 30 s leadin to misread mrna)
• Tetracyclines ( bind 30s)
• Macrolides: bind 50s 
• chloramphenicol ( bind 50s)

changing one condon to the other

• pneumoccous 
• lancet shapped diplococci

gram negative Legionella or Klebsiella

ecoli or S. typhi

• gonocossua 
• gram neg. 
• round shaped

• spirochetal bacterium 
• Treponema pallidium

chlamydophila  psittaci

cryptococcus neoformans

histoplasma capsulatum in yeast

Toxoplasma gondii

Cryptosporidium

• schitosomes
• type of helminths

salmonella

• lyme ticks 
• Lyme spirochetes (Borrelia )

in the word of the patient and is short and sweet

more structure and detailed with demogrphics

• Onset
• palliation/provoking
• Progression
• quality
• radiation 
• Severity/Site
• Timing

• GU urinary disturances 
• GYn vaginal symptoms 
• MSK joint and muscle issues
• Neurologicl: dizziness, tremors, headaches, etc
• endocrine 
• Pscyh: Depressed/anxious concentration

obtain the age of the pesrons that have disease

• establish rapport 
• demonstrate empathy
• instill confidence
• use appropriate verbal communication
• elicit clearly and effectively

system of belief shared among memebers of a particular group p

• activate PKA
• protein kinase A
• it adds a phosphate group on the target
• the phosphate

• it is a necessary part of the catalysis of a reaction 
• proteins cannot work without their cofactors

• ASSES 
• Ask Q's
• Seek self awareness
• Suspend judgement 
• Express kindness and compassion
• Support safe space
• Start where the patient is

• the proton gradient is leaking out
• meaning that you proton gradient gets disrupted 
• proton gradient is used by complex 5. 
• respiration increase because we are trying to restore our proton gradient

• oxaloacetate is oxidized to malate via NADH when it get into the mitchodria the maladehydrogenase is reduces to oxaloacteate and the  NADH is remade 
• in the cell asparate and a-ketoglutarate made from oxaloacetate to get out of the mitochondria 
• no energy loss

• Atp will decrease
• proton gradient decreases

it can be called a coenzyme

• translation happen late in the cycle
• DNa-> RNa->Rna

has promoters because they promote transcription

any alteration of DNA (genetic material ); they will have little or no significant effect

chromosomal mutations are much larger

wild type if the most common

inherent disease

result in cancer

Induced and Spontaneous

• erros in DNa polymerase
• base tautomerization
• Ap sites ( ROS)
• deamination

• this is the most common:
• chemical 
• radiation 
• heat 
• - dimerization 9 two thymine residue bond)

• lost of a purine or pyridimine 
• adenine or guanine  or C or t (u)

• remove amino group like going from 
• cytosine to a uracil

• different ensomers get switched 
• instead of AT it would be AG  resulting in shift in

• alkylating agents 
• bromouracil 
• acridine orange 
• cisplatin

• point  ( transitio/ transversion)
• missense/nonsense
• insertions/deletion, frameshift
• inversion, translocation, and duplication

a base subsitutionm mutation 

• two type 
• transition ( the dna base is changed to the same base)
• transversion ( the dna base is changed to a different one )

• the gene no longer can make the protein 
• the gene can no longer be transcribed

mutation does not cause any change in the protein

• pyridimine get bonded by a covalent bond
• lethal because the polymerase can no longer copy the DNA

• MutSHL system this sis what remove the mismatch 
• recognizes himimethylated DNA 
•  this is to fix and bases that were miss matched
• it happens during G2 of the cell cycle

this will lead to Lynch syndrome which is a type of colorectal cancer ( hereditary)

• happens in G1 stage of cell cycle
• has a more diverse range of 
• it is resistant to UV radiation 
• pyridimine dimer

Xeroderma pigmentosum

• the proteins that exist in nucletotide excision repair
• they remove 10-12 bases total and dna polymerase fills the gap 
• mutation result in Xeroderma pigmentosum ( high susceptible to sun )

• happens throughout cell cycle 
• repair damaged bases
• ap sites and dss breaks

• typically ds breaks 
• seen in breast and ovarian tumars 
• uses BRCA1/BRCA2 require for this repair.
• use one chromosome to repair the other

• there is a ds break and no sister chromosome to copy and help to fix the break 
• error prone

• during replication the DNA polymerase skips the error 
• polymerase eta

• G- growth prepare for division
• s dna synthesis 
• G2 growth 
• M- mitosis

• tumor supressor gene
• control G1 to S phase

check point in the cell cycle to make sure that errors are addressed and are not replicated

they stop mitoses at prophase I at birth  and Meiosis II does not happen until fertilization

• chiasmata formation and crossing over 
• that way that genes can be recombinated and give rise to alot of diversity

• when chromsomes do not split properly leading to mutation
• in sex cells this can lead to downs syndrome

cultural competency + cultural humility

self examination and recognition of biases / paradoigm

impacts care though service delivery ; respectful and responsive to health belief practices and cultural needs

• health care seeking behavior 
• perceived causes of illness 
• understand of disease process 
• treatment decisions

pt's opinion of desirable behavioral helath beliefs that need to be thought out

• cultural:
• destructiveness
• Incapability
• Blindness
• precompetnece
• competence
• proficiency

inquiry into the nature of things

general instruction for action

• disease= when self maintence is overcome
• movement is fluids is essential 
• nervous system is essential in controlling the body
• somatic component are present and contribute to diseased state