Colloquim Question.pdf

Colloqium Questions 1-What affects the buffer system? - pH is the acidity in the blood [HCO3−] is the concentration of bicarbonate in the blood, in mmol/L:gives basic medium. pCO2 is the partial pressure of carbon dioxide in the blood, in mmHg:carbon dioxide dissociates in blood and becomes carbonic...

Colloqium Questions 1-What affects the buffer system? - pH is the acidity in the blood [HCO3−] is the concentration of bicarbonate in the blood, in mmol/L:gives basic medium. pCO2 is the partial pressure of carbon dioxide in the blood, in mmHg:carbon dioxide dissociates in blood and becomes carbonic acid which is weak acid but increased concentrations give acidic medium. o the buffer system regulate the acid-base balance and it is controlled by kidneys and lungs. 2-What happens in case of acid-base disorders? Acid – Base Disorders Initial Changes Metabolic Acidosis [HCO3] decrease PH decrease Metabolic Alkalosis [HCO3] increase PH increase CO2 increase PH decrease Respiratory Acidosis Respiratory Alkalosis CO2 decrease PH increase Compensatory Changes Compensation by lungs by elimination of CO2 by hyperventilation The lungs keep CO2 by hypoventilation Kidneys eliminate H+ & retain HCO3Kidneys conserve H+ & excrete HCO3- 3-What are the diseases that are transmitted sexually? 1. 2. 3. 4. 5. 6. 7. 8. 9. Syphilis Chlamydia HIV/AIDS Gonorrhea Hepatitis (HBV,HCV) Herpes,Genital Human Papilloma Virus(HPV) Trichomoniasis Pelvic Inflammatory Disease(PID) By Joseph Badr Page 1 4-Which bacteria produce hydrogen sulfide?  Hydrogen sulfide(H2S) results from the bacterial break down of organic matter in the absence of oxygen.  Triple Sugar Iron(TSI) :a medium which contain ferrous sulfate for culturing Salmonella, Citrobacter, Edwardsiella, Arizona, Proteus, Providencia, Klebsiella, and Enterobacter. An agar medium has been devised which promotes growth and H(2)S production (generally within 6 hr) by Salmonella, Arizona, and Edwardsiella but which inhibits hydrogen sulfide production or growth of all other gram-negative organisms tested (including Citrobacter) or inhibits both. The use of this medium should facilitate the selection and identification of Salmonella. 5-Talk about cryoprecipitate. - Cryoprecipitate. (1) is a frozen blood product prepared from plasma. To acquire cryoprecipitate, thawed fresh frozen plasma should be centrifuged and the precipitate should be collected, and it is usually cloudy yellow color. - It contains specific proteins involved in clotting. Blood clotting proteins found in cryoprecipitate include :(1) a- Fibrinogen b- b- Factor VIII 8 (the protein missing in patients with Haemophilia A) c- c- Factor XIII 13 d- d- Von Willebrand factor (helps in getting the platelets to stick together) - Cryoprecipitate is a source of fibrinogen. Fibrinogen is vital to blood clotting. It is usually used in the treatment of patients with reduced levels of, or poorly functioning fibrinogen with clinical bleeding. 6-Talk about osmotic fragility test. - An osmotic fragility test is performed to diagnose two hereditary conditions: thalassemia and hereditary spherocytosis. To perform this test, you will give a blood sample. Your red blood cells will be tested to see how easily they break. If your red blood cells are more fragile than normal, the test is considered positive. To test the fragility of your red blood cells, they will be added into solutions with different salt concentrations (hypotonic solutions). Normal blood cells will be able to remain intact at lower salt concentrations than fragile blood cells. 7- Define cholesterol, triglyceride, chylomicrons, HDL & LDL. Molecules called lipoproteins carry cholesterol in the blood. Two important kinds of lipoproteins are low-density lipoprotein (LDL) and high-density lipoprotein (HDL). When checking LDL and HDL, doctors often include another type of fat called triglycerides. a- Total cholesterol is a measure of the total amount of cholesterol in your blood and is based on the HDL, LDL, and triglycerides numbers. By Joseph Badr Page 2 b- Triglycrides are a type of fat found in your blood that your body uses for energy. The combination of high levels of triglycerides with low HDL cholesterol or high LDL cholesterol can increase your risk for heart attack and stroke. c- Chylomicrons are lipoprotein particles that consist of triglycerides (85– 92%), phospholipids (6–12%), cholesterol (1–3%), and proteins (1–2%). They transport dietary lipids from the intestines to other locations in the body. Chylomicrons are one of the five major groups of lipoproteins (chylomicrons, VLDL, IDL, LDL, HDL) that enable fats and cholesterol to move within the water-based solution of the bloodstream. d- HDL cholesterol absorbs cholesterol and carries it back to the liver, which flushes it from the body. HDL is known as “good” cholesterol because having high levels can reduce the risk for heart disease and stroke. e- LDL cholesterol makes up the majority of the body’s cholesterol. LDL is known as “bad” cholesterol because having high levels can lead to plaque buildup in your arteries and result in heart disease and stroke. 7- Acinetobacter infection. - Acinetobacter species are not motile and oxidase-negative, gram negative that grows well on macconckey, and occur in pairs under magnification. - Acinetobacter species are a key source of infection in debilitated patients in the hospital 8-Difference between iron deficiency anemia and minor thalassemia. Iron deficiency anemia Thalassemia RDW high RDW normal , RBC high Ferritin low Ferritin normal to high Iron low in blood Iron normal MCV low MCV low TIBC high HBA2>3.5 9-How is Multiple Myeloma confirmed? - It is confirmed by the presence of bence jones protein which is a light chain protein(monoclonal) and is characterized also by increase of IgM. - Bence Jones are light chain proteins in urine. WBC are produced in excess in urine of M.M patients. By Joseph Badr Page 3 10-In HIV, we look for what? What are the confirmatory tests? - We look for IgG and it is confirmed by ELISA & PCR 11-What is the indication for high white blood cell result? - A smear is made because maybe the high count is due to nucleated RBC which are read as WBC. After the smear, a corrected WBC count is done=WBC count*100/100+nucleated RBC number. But in general high WBC count indicates bacterial infections. 12-Difference between iron deficiency anemia and anemia of chronic disease. Iron Deficiency Anemia Anemia Of Chronic Disease Low serum irons Low serum irons Ferritin low Ferritin normal to high TIBC high TIBC normal to decreased(due to decreased production of transferrin) 13-Role of anti-diuretic hormone. - Conserve body water by reducing the loss of water in urine. High concentrations of antidiuretic hormone cause widespread constriction of arterioles, which leads to increased arterial pressure. Increases aldosterone which works on kidneys to reabsorb sodium and water. 14-Talk about renin–angiotensin–aldosterone system. - Renin–angiotensin–aldosterone system (RAAS) is a system that regulates blood pressure and fluid balance. When renal blood flow is reduced, juxtaglomerular cells in the kidneys convert the prorenin already present in the blood into renin and secrete it directly into the circulation. Plasma renin then carries out the conversion of angiotensinogen released by the liver to angiotensin I. Angiotensin I is subsequently converted to angiotensin II by the enzyme angiotensin-converting enzyme found in the lungs. Angiotensin II is a powerful vaso-active peptide that causes blood vessels to constrict, resulting in increased blood pressure. Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the tubules of the kidneys to increase the reabsorption of sodium and water into the blood. This increases the volume of extracellular fluid in the body, which also increases blood pressure. 15-Schilling Test principle and procedure. The Schilling test is a medical procedure used to determine whether or not you are absorbing vitamin B12 properly. A doctor may choose to order this test if you are suffering from vitamin B12 deficiency, also known as pernicious anemia. By Joseph Badr Page 4 Your doctor may recommend the Schilling test if you have a vitamin B12 deficiency in order to determine if your stomach is producing “intrinsic factor.” Intrinsic factor required for vitamin B12 absorption. Without it, your body will be unable to absorb vitamin B12, resulting in pernicious anemia. Procedure: consists of 4 stages: a- Stage one: You will be given two doses of a vitamin B12 supplement. The first dose will be in liquid form, which will contain a “radiolabelled” dye that can be detected in the urine and the second will be given as an injection one hour later. Then collect urine over the next 24 hours to measure the radio labeled vit B12. if concentration of radiolabeled>10% normal absorption if concentration 10% stomach unable to make intrinsic factor If concentration