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Which cells contribute to the development of centriacinar emphysema?
Heavy smoing causes neutrophils and macrophages to release proteases: elastase, cathepsins, matrix metalloproteinases which destroys elastic fibers.
What is the function of Club/ Clara cells?
- 1. Secrete component of surfactant
- 2. Detoxify inhaled substances (eg tobacco smoke) by cytochrome P450 mechanism
Label the diagram
Which structures does the truncus arteriosus give rise to?
Ascending aorta and pulmonary trunk
What structure does the cardinal veins give rise to?
- Superior vena cava
- R.common and R.anterior cardinal vein
Which embryonic structure gives rise to the SVC?
R.common and R.anterior cardinal vein
Which embryonic structure gives rise to the ascending aorta?
Which embryonic structure gives rise to the pulmonary trunk?
Describe the presentation of obstructive sleep apnea
- Excessive daytime sleepiness (MCC)
- Bed partners kept awake (snoring)
- Morning headaches
What causes obstructive sleep apnea?
- In adults: excess parapharyngeal tissue
- In children: adenotonsillar hypertrophy
- Patient continues to contract the diaphragm in an attempt to breathe but airflow is impeded by upper airway obstruction
What is obesity hypoventilation syndrome (aka Pickwickian syndrome)?
- Obesity BMI>30 impeded the expansion of the chest and abdominal wall during breathing.
- Underventilation of lungs during all hours -> Chronically elevated PaCO2 during sleep and waking hours
- Decreased PaO2
What is central sleep apnea?
CNS injury/ toxicity- no drive to initiate breathing
The 47,XXY karyotype is diagnostic of?
- Klinefelter syndrome
- The extra chromosome is acquired due to meiotic nondisjunction.
45,XO karyotype is diagnostic of ?
Calcitonin is secreted by?
Parafollicular or C cells of the thyroid
What is the function of calcitonin?
Decreased bone resorption of calcium (osteoclast inhibition)
Describe the passage of a penetrating injury to the right ventricle.
- Penetrating injury at the left sternal boarder at the level of the 4th intercostal space
Describe the penetrating injury to the left ventricle.
Penetrating injury t the 4th
intercostal space in midclavicular line,
only after passing through a bulk of the lung
Describe the penetrating injury to the pulmonary trunk.
- Penetrating injury to 2nd intercostal space at left sternal boarder
At what level does the IVC penetrate the diaphragm?
How does HIV enter the target cell?
- 1. gp120 binds CD4 and CCR5 ( on macrophages (early infection))/ CXCR4 (on T cells (late infection))
- 2. The virus enters the cell by fusion with the cell membrane (gp41)
What role does the CCR5 coreceptor play in HIV infection?
gp120 binds CD4 as well as a coreceptor CCR5 on macrophages (early infection).
What role does CXCR4 play in HIV infection?
gp120 binds CD4 as well as coreceptor CXCR4 in T cells (late infection)
Deletion of both alleles of the gene that codes for CCR5 indicates?
Homozygous CCR5 mutation= immunity/ resistant to HIV
What happens if cells do not express the CCR5 protein on their membrane?
HIV binds CD4 but is unable to enter the cell.
What is the importance of fibronectin?
- High molecular weight glycoprotein that is synthesized in the liver and plays a role in wound healing.
- Component of cryoprecipitate used to treat coagulation deficiencies involving fibrinogen and factor 8
What are cadherins?
- Calcium dependent adhesion proteins responsible for cellular adhesion.
- Loss of E-cadherin promotes metastasis.
Downregulation in the gene that codes for E-cadherin is implicated in?
Cancer progression and metastasis
What are calcium-dependent adhesion proteins?
Cadherins- important for cellular adhesion
What are the effects of ethanol (alcohol) on gluconeogenesis?
- Ethanol metabolism increases the NADH/NAD ratio in the liver causing the conversion of:
- Oxaloaxetate to malate (prevents gluconeogenesis -> Fasting hypoglycemia)