BPSI 405

T/F? 3 O2 molecules bound to Hgb is 75% saturation.

True

T/F? Each Hgb protein can bind 4 O2 molecules.

True

T/F? Hgb is a protein that O2 can bind to.

True (Hgb)

T/F? O2 is transported by RBCs.

True

T/F? Each Hgb protein can bind to 1 O2 molecule.

False (O2)

What is the systolic BP for category 2 hypertension?

>140 mmHg

Fumaryl diketopiperazine (FDKP) is a proprietary _____ that is the primary component of Technosphere Microparticles.

excipient;

this is used to deliver insulin to the alveolus of the human lung

Technosphere Microparticles (2.25 micrometer diameter) self-assemble from FDKP. This is a key respirable range for a lung.

Particles must dissolve in lung fluid upon reaching it to release drug

Average serum insulin and FDKP concentrations versus time in healthy volunteers indicate that the lung surface allows

for excipient and drug to be absorbed into bloodstream, more and less respectively

Based on characteristics of lung physiology, the more rapid absorption of insulin from AFREZA to blood vs subcutaneous injections is due to

the largest surface area and vascular bed area of the lung

Due to the growth factor signaling PDFG/VEGF/FGF pulmonary fibrosis, nintedanib is administered to IPF patients

using oral dosage forms

Idopathic pulmonary fibrosis (IPF) has a strong link to

drugs, chronic inflammation, environment, lifestyle

Mode of action of nitedanib in the treatment of IPF is thought to occur via the _____ of _____

inhibition; receptors for profibrotic mediators

Where is the gut microbiome located in the body?

The large/small intestines and colon

How many microorganisms comprise the human microbiota?

100 trillion

What is dysbiosis?

an imbalance of microorganisms in the GI tract

T/F? The terms microbiota and microbiome can be used interchangeably as they define the same concept

False

What are some causes of dysbiosis?

Medication use, changes in diet, infections (for exam it will be all of the above)

What is the gut-brain connection?

nerve and neuron network, e.g. vagus nerve connecting CNS and digestive system

What are some scientifically proven ways to improve gut health?

Exercise, reduce stress, drugs (will be all of the above on exam)

Prevention of recurrence of C. difficile infection (CDI) in individuals >18 years of age

following antibacterial treatment for recurrent CDI has 2 approved drugs

T/F? Probiotic supplements can generally help improve the makeup of microbes in the gut microbiome

False

The orally administered microbiome related product (approved to treat certain types of CDI) contains

gut microbiome spores in a capsulated vehicle with glycerol and saline

Which foods in diet are supportive of the gut microbiome?

Probiotic rich foods

T/F? Rebyota is an oral microbiome-spore gel-capsule & Vowst is a 150mL volume rectal microbiome-live enema PEG3350 in saline

False 

NEJM 2018 article describes 2 pts. that got ill, one died, following experimental FMT, from same donor, triggered a

safety alert & screening of donors for infectious E. coli with beta-lactamase

In Ocusert ®, what precorneal nonproductive processes are most negated for pilocarpine?

Tear turnover (production and drainage)

T/F? VOWST and REBYOTA both have an established MOA and defined nonclinical toxicology data/info

False

A 1% ocular suspension of brinzolamide improves ocular PK by (select all)

• adding a dissolution step prior to corneal absorption

• inc. precorneal residence time via particle dissolution step

Timolol XE ® brand is a topical ______ gel forming solution (rxn with Na in tears)

in situ

For acyclovir, corneal herpes virus, an ocular ointment (select all)

• rapid release is expected due to solubility differences

• rapid precorneal clearance is also possible after release 

To estimate the contribution of the nasal vs conjunctival route to systemic exposure

punctal plug & intranasal dose can be compared to topical

What does a LEFT shift of Hgb O₂ dissociation curve indicate?

• Dec. temperature

• Dec. P_CO2

• Inc. pH

• Dec. 2,3-DPG

Is the Hgb/O₂ curve sigmoidal?

Yes

What does the x-axis on the Hgb/O₂ curve show?

P_O2

What does the y-axis on the Hgb/O₂ curve show?

Hgb saturation

What is the one difference in symptoms of a myocardial infarction between men and women?

Shoulder pain in women

What treats hypertension?

Diuretics, beta blockers, ARBs

T/F? MI and cardiac arrest are both medical emergencies and are the same thing.

False

Cardiac arrest and MI are because of an issue with what?

MI —> circulation issue

CA —> electrical issue

What is Phase 0 in action potentials?

Rapid depolarization

What is Phase II in action potentials?

Plateau phase

What is Phase III?

Repolarization

What is Phase IV?

Resting membrane potential (not in pacemaker cells though)

What cells are FUNNY channels found in?

Pacemaker cells

Pacemaker cells have which Phases?

IV, 0, III

Gas exchange happens in alveoli and blood of…

Pulmonary capillaries

Do PCs have a refractory period?

No, only contractile cells do

What is the threshold for PCs?

-40mV

What is the threshold for CCs?

-70mV

How much time does it take for the CC to contract?

~200 milliseconds

What is the rising phase of action potentials called?

Depolarization

Do PCs have a resting potential?

No, the FUNNY channel makes it so that there is a continuous influx of charge; i.e. it is always moving towards threshold

Electrical signals in the heart go from ___ to the ___.

SA node → AV node

What ions are responsible for action potentials?

Na+, Ca++, K+

When are cardiac muscles at work?

All the time

Types of cell-cell junctions?

Desmosomes, fasciae adherent, and gap junctions

Where are B and T cells kept?

Bone marrow and thymus; they end up in lymphatic nodes

Where are B cells found?

Cortex of lymph nodes

Where are T cells found?

Medulla of lymph nodes

How many efferent lymphatic vessels are there?

One (lymphatic)

Where are MALT membranes found?

Tonsils, adenoids, bronchus, gut-associated

What is the function of the lymphatic system?

Immune, filtration, and water balance

What causes edema?

Lymphatic system is not absorbing water and it stays in interstitial area

What collects interstitial fluid?

Lymphatic capillaries

Name the 2 ducts.

thoracic and right lymphatic ducts

What way do lymphatic vessels travel?

One direction (no backwards travel)

What moves lymph?

Muscle contraction

What is lymphoma?

Cancer of the lymphatic system

Can the CYP3A4 enzyme be affected by genetic polymorphism?

No (polymorphism)

Gluconeogenesis

Glucose from non-carbohydrate sources

Glucogenolysis

Glycogen → glucose

How many lobules in the liver?

100,000 lobules

How many hepatocytes are there?

1,000,000 hepatocytes

What does biotransformation do for excretion of stuff?

Makes stuff go from nonpolar → polar to increase excretion

What % of glucose is reabsorbed by the proximal convoluted tubule?

100% glucose

After how much loss of kidney function is dialysis required?

Once 85-95% function is lost

Does the left or right kidney sit lower in the body?

The right sits lower

Are the efferent or afferent arterioles wider?

Afferent arterioles

What is the name of the capillary that runs length of nephrons?

Peritubular capillary

How many nephrons are there?

100M nephrons

What % of filtrate is reabsorbed at proximal convoluted tubule?

65% filtrate

What is the rest of this equation? excreted =

filtered - reabsorbed + secreted

What is ACE produced in?

It is produced in the lungs

Where is the hormone ADH held in?

Posterior pituitary gland

Is the contraction of skeletal muscles voluntary?

Yes, all movement of the skeletal muscles is voluntary

Which muscles are striated?

All but smooth muscles

Of actin and myosin, which is thick and which is thin?

Actin is thin and myosin is thick

For ATP produced, which filament does it bind to?

It binds to myosin

Is the action potential of the skeletal muscles the same as in the rest of the body?

No, it is not the same

How are signals passed in skeletal muscles?

Electrical → chemical → electrical

What chemical messenger is released from synapse to terminal?

ACh is released

Which band in filaments is dark?

The A band

Tropomyosin is considered the…

the bike chain

Toponin is considered the…

the lock

What releases the lock (troponin)?

Ca++ ions from sarcoplasmic reticulum

What is another name for the CNS?

Neuroaxis

Where do the peripheral nerves of the autonomic nervous system end?

Target organs, not muscle

Is the autonomic nervous sympathetic or parasympathetic?

They are both sympathetic and parasympathetic

Where are first order neurons?

Brainstem and spinal cord