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Questions and Answers
Which of the following is NOT a risk factor for type 2 diabetes?
What is the term used for an individual who inherits two different versions of the same gene?
In autosomal recessive inheritance, when will a condition manifest?
Which genetic term describes the observable characteristics of an organism?
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What are alleles?
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What is the term for the volume of blood in the ventricles at the end of atrial contraction?
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Which complex on an electrocardiogram (ECG) is associated with isovolumetric contraction?
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During ventricular ejection, which valves are open and closed respectively?
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What affects stroke volume (SV) based on the provided factors?
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What is the initial site of action potential (AP) generation in the heart?
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What is the final product of carbohydrate digestion that can be absorbed by the intestinal cells?
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During the absorptive stage of metabolism, what primarily occurs in the body?
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What is a key function of ATP in cellular metabolism?
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What happens during the postabsorptive stage when the gastrointestinal tract is empty?
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Which of the following is NOT a function of lipids in metabolism?
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What best describes the role of essential amino acids?
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Which type of diabetes is characterized by autoimmune destruction of pancreatic islet cells?
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Which process describes the breakdown of complex molecules into simpler ones?
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What is the ratio of genotypes when considering cystic fibrosis and normal alleles?
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Which of the following is NOT a treatment for cystic fibrosis?
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What is the most common STI caused by a small intracellular bacterium?
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Which part of the ECG corresponds to atrial depolarization?
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During which phase of the cardiac cycle do the ventricles fill with blood?
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Endometriosis is characterized by which of the following?
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Which type of herpes is primarily transmitted through contact with lesions?
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What is the probability of an individual carrying the defective allele for cystic fibrosis?
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What condition is indicated by a pH of 7.31, paCO2 of 37, and HCO3 of 20?
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Which of the following values would indicate a metabolic alkalosis condition?
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What is the interpretation of a pH of 7.3, paCO2 of 30.8, and HCO3 of 13?
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In diagnosing respiratory acidosis, which of the following combinations would NOT indicate this condition?
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What condition is suggested by a pH of 7.42, paCO2 of 46, and HCO3 of 32?
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Study Notes
Carbohydrate Digestion
- Only monosaccharides can be absorbed by the body.
- Larger carbohydrate chains must be broken down into smaller units.
- Amylase in saliva and pancreatic juices break down large chains into disaccharides.
- Enzymes in the brush border of enterocytes break down disaccharides into monosaccharides.
- Monosaccharides, such as glucose, fructose, and galactose, are then absorbed by intestinal epithelial cells through active transport and diffusion.
Energy Production
- Cellular respiration captures energy from food to produce ATP in cells.
- Stored energy in glycogen and fats can be broken down when needed.
- Phosphorylation activates molecules by transferring high-energy phosphate groups from ATP.
Metabolism
- The body processes nutrients through digestion, absorption, and transport to tissues.
- Cells utilize absorbed nutrients for synthesis of lipids, proteins, and glycogen.
- Oxidative breakdown of intermediate products produces carbon dioxide, water, and ATP.
Metabolism Regulation
- The absorptive stage occurs for 4 hours after eating, characterized by anabolism exceeding catabolism.
- Excess nutrients are stored as fat.
- The postabsorptive stage occurs when the digestive tract is empty, relying on body reserves for energy. Catabolism exceeds anabolism.
Anabolism & Catabolism
- Anabolism: Synthesis of large molecules from smaller ones.
- Catabolism: Hydrolysis of complex structures into simpler ones.
Nutrient Utilization
- Glucose: Used for ATP production, stored as glycogen in the liver and muscles, and can be synthesized from other nutrients in the liver.
- Lipids: Used for ATP production, stored as triglycerides in adipose tissue, and can be synthesized from glucose.
- Proteins: Serve as building material, can be used for ATP, can be converted into fat for storage, and produce ammonia as a by-product which is converted into urea by the liver and excreted by the kidneys.
Amino Acids
- There are 20 different types of amino acids.
- They are the smallest building blocks of protein.
- Essential amino acids cannot be produced by the body and must be obtained from the diet.
Diabetes
- Characterized by the body's inability to maintain blood glucose levels.
- Can result from insulin deficiency or insulin resistance.
-
Types of diabetes:
- Type 1: Autoimmune destruction of pancreatic islet cells.
- Type 2: Insulin resistance, which may progress to type 1.
- Gestational: Occurs during pregnancy and is a risk factor for type 2.
- Type 2 Risk Factors: Obesity, metabolic syndrome, physical inactivity, unhealthy diet, tobacco smoking, and genetic factors.
Genetics
- Gene: A sequence of DNA containing information for a specific protein.
- Allele: Two versions of a gene, one inherited from each parent.
- Homozygous dominant: Inheriting two copies of the dominant allele (BB).
- Homozygous recessive: Inheriting two copies of the recessive allele (bb).
- Heterozygous: Inheriting one dominant and one recessive allele (Bb).
- Phenotype: Observable characteristics.
- Genotype: Unique sequence of DNA.
Autosomal Dominant Inheritance
- Example: Eye color, where Bb (Brown) is dominant over bb (blue).
Autosomal Recessive Inheritance
- The abnormal gene is recessive, and the condition only manifests with two recessive alleles.
- Example: Cystic fibrosis, where nn (cystic fibrosis) is recessive to N (Normal alleles).
Chromosomes
- Humans have 23 pairs of chromosomes.
- Chromosomes 1-22 are autosomal.
- Chromosome 23 is the sex chromosome.
DNA Structure and Function
- DNA is double-stranded, with one strand acting as a template for the other.
- A binds to T (Apples in Trees)
- C binds to G (Cars in Garage)
- Each gene is read in sets of three letters, each set coding for an amino acid.
Cystic Fibrosis
- Affects 1 in 2800 individuals and 1 in 25 are carriers.
- Treatment involves:
- Replacement of pancreatic enzymes.
- Treatment of mucus buildup in the lungs.
- Prophylactic antibiotics.
- Improvement of liver function.
STIs
- 70,000 reported cases in Australia.
- Reporting is not mandatory for all types.
- Preventable with barrier contraception.
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Types of STIs:
- Gonorrhea: Caused by microorganisms.
- Chlamydia: Caused by a small intracellular bacterium, the most common STI.
- Genital herpes: Two types, transmitted through contact with lesions or mucosal surfaces. The virus travels to the dorsal root ganglion and persists for life.
Endometriosis
- Functional endometrial tissue implants outside the uterus.
- Reacts to hormonal fluctuations of the menstrual cycle.
- Can cause infertility or pain.
ECG & Cardiac Cycle
- ECG: Records the electrical signal of the heart muscle during action potentials.
- P-wave: Atrial depolarization.
- P-R interval: From atrial depolarization to contraction.
- QRS complex: Ventricular depolarization.
- S-T segment: From ventricular depolarization to repolarization.
- T-wave: Ventricular repolarization.
Cardiac Cycle/Mechanical Events
-
Ventricular Filling (associated with P-wave):
- Heart in diastole (relaxed state).
- Ventricles fill with blood.
- Semilunar valves are closed.
- Atria contract, increasing ventricular pressure.
- End diastolic volume (EDV) is the amount of blood in ventricles at the end of atrial contraction.
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Isovolumetric Contraction (associated with QRS complex):
- Atrial diastole.
- Ventricular systole (contraction).
- AV valves close, all 4 valves are closed (Lub sound is heard).
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Ventricular Ejection:
- Ventricular systole.
- Semilunar valves open.
- AV valves remain closed.
- Blood is pumped out of the heart.
- Stroke volume (SV) is the blood pumped out per beat.
- End systolic volume (ESV) is the blood remaining in the heart after ejection.
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Isovolumetric Relaxation:
- Ventricular diastole.
- Semilunar valves close.
- AV valves remain closed.
- Blood volume remains constant, and atria fill with blood.
Heart Rate, Stroke Volume, and Cardiac Output
- Heart rate (HR): Average 72 beats per minute.
- Stroke volume (SV): Amount of blood pumped out per beat.
- Cardiac output (CO): Amount of blood pumped out by the heart per minute.
- CO = HR x SV
Factors Affecting Stroke Volume
- Preload: EDV is part of preload, influenced by venous return and ventricular filling time.
- Contractility: Force of contraction at a given EDV.
- Afterload: Aortic pressure.
The Intrinsic Pathway of Conduction
- Pacemaker cells in the SA node initiate action potential (AP).
- AP spreads to both atria.
- Atrial depolarization occurs, representing the P-wave on ECG.
- Atrial contraction follows.
- AP reaches the AV node, where it is delayed for 0.1 seconds (allowing complete atrial contraction).
- AP travels to the bundle of HIS, then to right and left branches, and finally to Purkinje fibers.
- Ventricular depolarization occurs, representing the QRS complex on ECG.
- Ventricular contraction follows.
- Ventricular repolarization occurs, representing the T-wave on ECG.
- Ventricles relax.
ABG Interpretation
-
Rules:
- Check pH.
- Check partial pressure of carbon dioxide (paCO2).
- Check bicarbonate levels (HCO3).
- Determine if compensation is present.
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Compensation:
- pH within normal range.
- Metabolic: HCO3 out of normal range.
- Respiratory: PaCO2 out of normal range.
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Normal Ranges:
- pH: 7.35-7.45 (acidosis < 7.35, alkalosis > 7.45)
- paCO2: 35-45 (alkalosis < 35, acidosis > 45)
- HCO3: 22-26 (acidosis < 22, alkalosis > 26)
ABG Interpretation Example
| Values | Acid | Normal | Alkaline | Interpretation |
|---|---|---|---|---|
| pH = 7.31 | pH | paCO2 | Metabolic acidosis with no compensation | |
| paCO2 = 37 | HCO3 | |||
| HCO3 = 20 | ||||
| pH = 7.3 | pH | paCO2 | Metabolic acidosis with partial compensation | |
| paCO2 = 30.8 | HCO3 | |||
| HCO3 = 13 | ||||
| pH = 7.42 | paCO2 | pH | HCO3 | Metabolic alkalosis with full compensation |
| paCO2 = 46 | ||||
| HCO3 = 32 |
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