PHYSIOLOGY

 Each human kidney has about – 1- 1.3 million nephrons.

 MOA of NSAIDs induced renal failure – inhibition of the production of
prostaglandins.
 Action of ADH on the kidney - Increase water permeability of collecting ducts
(increasing urea absorption).
 Renal vasodilators – Dopamiane, Prostagladin’s, Ach, high protein diet.
 Endocrine functions of the kidney
1. Release of erythropoietin
2. Vitamin D conversion
3. Release of Renin
4. Release of Prostaglandins
 MOA of Angiotensin II – vasoconstriction of efferent arteriole.
 Form of bilirubin secreted by the kidney – urobilirubin.
 Form of bilirubin secreted in the feces – stercobilin.
 Glucose absorption occur at Duodenum and proximal Jejunum.
 Heme catabolism take place in the Reticuloendothelial System.
 Cholecystokinin (CCK) secreted by I cells of duodenum and jejunum.
 Secretin secreted by S cells of duodenum.
 Somatostatin secreted by D cells in pancreatic islets and GI mucosa.
 Somatostatin inhibits the release of gastrin and secretin.

Lung:
 Tidal volume – 500ml.
 Inspiratory Reserve Volume – 3300ml
 Expiratory Reserve Volume – 1000ml
 Residual Volume – 1200ml
 Vital Capacity – 4.8 litres in males , 3.2 litres in females .
 Physiological dead space in normal adult – 100ml
 Arterial CO2 level – 40mmhg
 Hering Bruer reflex – distention of lung causes slowing of respiratory rate , helps in
maintenance of tidal volume
 Bohr effect – affinity of oxygen for Hb decreases with fall in ph
 O2 – Hb dissociation curve is Sigmoid shape .
 Decompression sickness aka caisson sickness/divers/bender’s palsy is due to N2O
causing narcosis in descending phase and air embolism in ascending phase.
 First 150ml of inspiration fills anatomical dead space – this contributes only to total
ventilation but not alveolar ventilation.
CVS :
o CO = Stroke Volume X Heart Rate
o Mean arterial pressure = diastolic pressure plus + 1/3rd of pulse pressure.
o CO measured by – fick method, dye dilution, Doppler.
o Ejection fraction – ratio of stroke volume to end diastolic volume.
o Frank starling law – indicates relation between CO and left ventricular EDV.
o 2-3 DPG does not bind to HbF.
o Occulocardiac reflex – decrease in pulse rate associated with traction applied to
extra ocular muscles or compression of the eye ball.
Waves in JVP:
o A WAVE – ATRIAL SYSTOLE
o X WAVE – ATRIAL DIASTOLE
o C WAVE – ISOMETRIC CONTRACTION
o V WAVE – ISOMETRIC RELAXATION
o Y WAVE – OPENING OF A-V VALVE AND EMPTYING OF BLOOD IN
VENTRICLE.
GIT:
 Parietal cells are oxyntic cells – secrete HCl, ghrelin & intrinsic factor.
 Chief cells aka zymogen cells aka peptic cells – secrete pepsinogen and lipase
 Pancreatic enzymes – trypsin, chymotrypsin , carboxy peptidase are stable in
alkaline Ph
 Enterokinase – activates trypsin.
 GIP is produced by K cells in mucosa of duodenum and jejunum.
 1 gm of Hb is 35 mg of bilirubin.
 Steatorrhea termed as stool fat more than 7gms per day.
 Glycaemic index – measure of foods ability to elevate blood sugar level.
 Pain perception is by – parietal peritoneum.

Na-K-ATPase Pump:
 Na K ATPase pump is an active, electrogenic pump moving 3 Na ions outside and in
place 2 K ions inside utilizing ATP. It helps in intrusion of K+.
 Resting membrane potential of a skeletal muscle is -90mV
 Resting membrane potential of a smooth muscle is -50 to -75 mV
 Resting membrane potential of a cardiac muscle is -85 to -95mV
 the resting membrane potential in the rods is -40mV
 Resting membrane potential of inner ear is -60mV
 Resting membrane potential is due to : K+
 Resting membrane potential is close to isoelectric potential of : Cl-
 Nerve impulse travels in the direction only at synapse.
 RMP is close to - isoelectric potential of Chloride
 RMP is due to - Pottasium

Blood Brain Barrier:

 Function of phospholipid is transduction of signals and enzyme activation.
 Lipids and Proteins in cell membrane interact by Hydrogen bonds.
 Water moves freely across the BBB.
 MANNITOL an osmotically active substance that doesn’t normally cross the BBB,
because a sustained decrease in brain water content and is often used to decrease
brain volume.
 BBB may be disrupted by severe Hypertension, tumours, trauma, stroke, infection,
marked hypercapnia, hypoxia and sustained seizure activity.

CELL MEMBRANE:
 Signal transduction and enzyme activation are the functions of Phospholipid part.
 The Fluidity of the cell membrane is increased by Poly unsaturated fatty acids.
 RBC membrane is specially having spectrin (maintains integrity) and glycophyrin.
 Lipid bilayer is most permeable to urea.
 Protein : lipid ratio is 2:1
 Synthesis of lipids occurs in Agranular Endoplasmic Reticulum.
 Synthesis of proteins occurs in Rough ER.

1. Mildly decreased UDPGT- Gilberts

2. Absent UTPGT -Criglar Najar
3. Grossly black liver -Dubin Johnson
4. oxytocin produced by paraventricular nucleus of hypothalamus oxytocin
5. Corpus luteum is maintained by – luteinizing hormone.
6. Sertoli cells in the testis have receptors for – follicle stimulating hormone.
7. Ovarian reserve is best indicated by – follicle stimulating hormone.
8. Sertoli cells play a key role in - spermatogenesis.
9. Capacitance of sperms takes place in – uterus.
10. Malphigian corpsucles are seen in kidney.
11. Faecal mass is mainly derived from undigested food.
12. In proximal convulated tubule H+ is exchanged for sodium.
13. Adrenaline does not have any intracellular receptor
14. Cyclic GMP act on Atrial natriuretic peptide.
15. Cyclic GMP is the second messenger of insulin.
16. Maximum postprandial motility is seen in sigmoid colon.
17. Macula densa in kidney is located in – distal convoluted tubule.
18. Pain sensation is not relayed to post central gyrus
19. Receptor for inverse stretch reflex golgi tendon.
20. Righting reflexes are mediated by – mid brain.
21. Basal ganglia – thalamus is not included.
22. Blood brain barrier is formed by endothelial cells and foot processes.
23. Mean pulmonary artery pressure – 16mmhg
24. Lowest threshold potential in a motor nerve fiber is at axon hillock.
25. Calmodulin activates Muscle phosphorylase
26. Lewis triple Response is mediated by histamine.
27. Membrane integrity of RBC is due to spectrin.
28. Clathrin proteins is used in Receptor mediated endocytosis of LDL.
29. D2O (Deuterium oxide) is used to measure volume of total body water.
30. Agranular endoplasmic reticulum is involved in the synthesis of - lipids
31. Depolarization phase of the action potential in a nerve is due to – sodium influx
32. Burning pain is carried by - C type of fibres
33. Best prognosis in nerve injury - neuro
34. Conduction velocity (m/s) of nerve fibers carrying fast pain is about – 30m/s
35. Fine, irregular contraction of individual fibers called fibrillation.
36. Sarcolemmal proteins
a. a.Sarcoglycan
b. b.Dystrophin
c. c.Dystroglycan
37. Best method to increase, the muscle strength is isotonic exercise.
38. Gibbs donnan membrane equilibrium – The concentration of various ionic solution
is different across the cell membrane (ecf & icf).
39. Nernst equation – determines equilibrium potential across the cell membrane based
on asymmetrical distribution of ions.