A4M Board Review Flashcards

Terms Definitions
Leptin (high serum leptin correlated with increased fat stores/weight gain; also seen in IR bec brain not responding to leptin signals so keep eating->wt gain)
hormone that suppresses appetite, produced in fat cells, epithelium and stomach, acts on receptors in hypothalamus to tell it "I'm full, stop eating", also stimulates gnRH, LH, FSH from ant. pituitary
lipolytic, activates triglyceride lipase in adipose tissue via cAMP, causes increased blood levels of fatty acids & glycerol
amount of daily energy expended while at rest, only enough energy is produced for vital organ functioning, as it increases, the # of mitochondria in the body increases as well
binds to and stimulates Sir2 sirtuin enzyme mimicking the effect of caloric restriction on longevity; it modulates insulin-mediated glucose uptake in muscles, it inhibits gene expression profiles associated with skeletal and cardiac mm aging
what inflammatory marker is inversely correlated to bone mineral density
T or F: in both men and women, GH reduces cortical osteocalcin; thus it increases trabecular and cortical bone content
This hormone affects immune function by increasing monocytes, increasing IGF1, incr B cells, incr T cell mitogenic response, incr cells expression of IL2 & IL3, thus fuctionally activating T lymphocytes; most abundant hormone in the body; inhibits breast cancer progression, prevents blood clots, decreases bone loss, increases memory, increases lean body mass; produced by cholesterol
only hormone that increases with age, involved in stress response, increases BP, BGlucose, suppresses immune function
inhibits release of GH and TSH, decreases gastric emptying, inhibits GI hormones
active mediator of FH
this mineral decreases BP, prevents MI, lowers risk of stroke, may help prevent DM 2 if taken with thiazide diuretic which causes its deficiency
this mineral important for strong bones and teeth, regulates mm contraction and relaxation, maintains acid/alkaline pH of body
acts as mild Ca-antagonist on vascular smooth muscle
false (not smoking or exercise)
True or False: Triglyceridemia commonly caused by diabetes, insulin resistance, smoking, obesity, exercise
True or false: Protein intake raises BP
Omega 9
neutral inflammatory, are MUFA that improve NO and decrease ROS; lowers LDL but does NOT raise HDL
PUFA or MUFA lower LDl and raise HDL?
Omega 3
anti-iflammatory, increases NO and improves insulin sensitivity, lowers BP, increases glucose uptake, increases glycogen storage, decreases plasma NE, directs fatty acids away from storage and to oxidation
Omega 6
are inflammatory because it increases arachadonic acid, does not decreases BP, but can prevent increase in BP induced by saturated fats
nutrient supplement that inhibits platelet aggregation, increases brain circulation; has anti-oxidant and cognitive benefits; improves CV function and decreases lipoprotein(a); prevents EPC senescence by increasing telomerase activity
increases intestinal bacteria to make pantothenic acid B5, which produces coenzyme involved in production of blood cells and protein metabolism
b6 pyridoxine
this vitamin metabolizes proteins, fats, carbs, is needed to make hemoglobin, formation of epinephrine and insulin
vitamin c
this vitamin aids in wound healing, formation & maintenance of collagen, is an anti-oxidant; massive doses then abruptly stopped can cause rebound scurvy
what nutrient inhibits glycation (wh is abnl protein metabolism where sugar binds to lipids/protein that increases permeability of arteries and makes it susceptible to atherosclerosis and cancer). inhibits AGEs (advanced glycation endproducts)
vitamin E
what vitamin impairs leukocyte and immune function; increases bleeding time
improves cardiac mm strength and promotes ability of body to withstand toxins, viruses and bacteria via anti-oxidant effects
b6 pyridoxine
can be used to treat homocysteinuria and has favorable effect on gestational diabetes
metformin (glucophage)
this drug improves insulin use prevents age-related onset of diabetes
acetyl L carnitine
transports fats into mitochondria (acetyl form best with brain, regular form best with body)
T or F: Epineph/NE, T3 & T4 are all secreted by endocrine tissues derived from ectoderm (adrenal medulla) and endoderm (thyroid)
what causes emotional detachment from pain, plays central role in controlling affective states, can bind to opiate receptors in the brain to cause sedation, analgesia & respiratory depression?
glycemic index
this is a measure of the effects of carbs on body's blood sugar levels. the lower the number, the slower the digestion, the less the spike in blood glucose post-prandially
this hormone upregulates p53 and p21 tumor suppressor genes and reduces the concentration of estrogen receptor alpha, which increases the risk of breast ca (v. estrogen receptor beta, wh decreases risk of breast ca)
what hormone inhibits breast cancer cells via androgen receptors?
this brain wave signals alertness, 12-16 hz
this brain wave signals sleep, 1-4 hz
this brain wave signals creativity, 8-12 hz
this brain wave signals drowsiness, 4-8 hz
Metabolic syndrome
what is the syndrome of IR, hyperinsulinemia, high FBS, high BP, high cholesterol and high free FA?
Insulin Resistance
aka pre-diabetes; it's when the pancreas is still working but its cells are resistant to insulin, see hyperinsulinemia and hyperglycemia
this brain lobe involved w/inability to *express* language (broca's aphasia)
this brain lobe involved with memory, inability to *understand* language (Wernicke's aphasia)
this brain lobe involves visual field cuts
this brain lobe involves calculations, reading & apraxia
brain region that involves coordination, ambulation, scanning speech, dizziness/vertigo and tremors
brain stem
brain region that involves breathing (wh is important for speech), swallowing difficulties, problems with movement and balance, sleep apnea
this lung PFT increases with levels of lutein, lycopene, Na, SE, vit C and beta carotene, folate, Mg and Fe
False (it INCREASES risk; involved in translation regulation & IGF1 signaling axis->premature aging)
T or F: Broca1 + Broca2 tumor suppressor gene mutation decreases the risk of breast, prostate, melanoma & pancreatic cancers
this nutrient is involved in over 100 enzymatic reactions and involved in production of thyroid hormone
vitamin c
long-term deficiency of this vitamin can lead to hyperplasia and hyperthryoidism
leading cause of blindness in people over 60. wet type has small deposits called DRUSEN that form under macula, dry type has abnl blood vessel formation under macula, leading to bulging & distortion and small hemorhages.
assoc with markers Ca27.29, CEA, PRL
assoc with markers CA19.9, CEA
assoc with markers PSA, PRL
assoc with marker CA125
T or F: cholesterol is needed to build cell membranes & bile salts, LDLs can't be utilized by the body although HDL can, cholesterol is found throughout the body even the brain, LDLs cause plaques
inward curving of spine that is over-exaggerated aka sway back
thinning of bone, risk factors include smoking, eating disorder, alcohol intake, corticosteroid meds, decreased calcium intake, older women, white/asian race, thin or petite frame, hyperthryoid which causes bone loss, positive family history
vertebral column change accomp by osteoporosis, osteoarthritis, may cause nerve compression and disc rupture
lateral curve of vertebral column
what muscle retracts scapula and elevates shoulders
pectoralis major
what muscle helps extend arm, horizontal flexion, abduction and internal rotation of arm?
latissimus dorsi
extends, adducts and internally rotates arm, helps extend shoulder backwards
deltoid anterior
what muscle abducts arm, helps extend the shoulder
hamstrings (biceps femoris, semitendinosus, semimembranosus))
what muscle group extends the hip and flexes the leg
quadriceps (vastus medialis/intermedius/lateralis, rectus femoris)
what muscle group flexes the hips and extends the leg
alpha lipoic acid
this skin agent interferes with production of pro-inflammatory cytokines, also excellent in decreasing wrinkles, is an antioxidant
topical application of this skin care agent enhances exfoliation and reinforces skin's ability to hold onto moisture, also increases epidermal thickness
stem cell potency that has limited ability differentiate (ie. adult stem cells, mesenchymal stem cells)
stem cell potency that allows complete differentiation into complete organism (does not apply to embryonic stem cells since they cannot produce an amniotic sac and umbilical cord)
stem cell potency that allows differentiation into a variety of cell types (ie. human cord blood which can differentiated into progenitor cells, wh then go on to become RBC, mast cells, monocytes, macrophage, osteocytes, neutrophils, plts, B + T lymphocytes, eosinophils
stem cell that can only differentiate into 1 cell type
skin care agent, analog of B vitamin (choline) and is a precursor to Ach; anti-wrinkling effects
endothelial progenitor cells
these cells are derived from stem cells, reside in adult bone marrow, circulate in blood, can predict occurrence of coronary arterosclerosis-related CV events depending on how many of these cells there are, their number & function are affected by hormones, esplly IGF1
this skin related process is characterized by matrix-metallo-proteinase expression (MMPs) via altered signal transduction pathways, occurs via superposition of solar damage on physiologic aging process-->damage produced in the tissue by single or repeated UV light exposure
this hormone plays a role in cognition, particularly information processing, plays role in cardiovasc fx, affects EPCs, has growth-promotin and metabolic effects
cholesterol to pregnenolone
what is rate limiting step in steroidgenesis?
Yes, DM I pts were breast fed less than 3 months
Does cow's milk (bovine albumin protein) vs breast milk have influence on diabetes?
VO2 max
in exercise, this is the point where subject sees no further increase in workload while exercising >3 min; its the maximum workload attained by the patient; may be one of earliest indicators of Insulin Resistance or DM; strongly correlated with insulin sensitivity and endothelial dysfunction; its the single best marker that correlates w/cardiopulmonary fitness or ability of subject to do work
T or F: Hypoglycemia may occur during exercise since exercise lowers blood glucose
shifts production of homocysteine to glutathione and methionine
how do B6, B12, and folate treat homocyteinemia?
T or F: soluble fiber raises blood glucose and cholesterol
Obstructive vs Restrictive? characterized by low FEV1, low FEV1/FVC ratio and normal FVC; emphysema, bronchitis, asthma
Obstructive vs Restrictive? characterized by low FEV1, low FVC and normal ration FEV1/FVC; pulmonary fibrosis, resp. mm weakness, chest wall injury, neurologic disorder like polio
connect bone to bone, maintain joint stability, limits ROM of joint
connect muscle to bone, very vascular, assist in maintaining joint stability
form articulating surface between moving bones and forms pad in joint capsule to separate and cushion bones; absorbs impact shock, provides structural support; NOT vascular so can't repair itself; pads of these are called menisci or articular discs
similar to tendons except they are arranged in sheets (continuous sheet of connective tissue that wraps and attaches to muscle to one another & structures)
fluid-filled sac, lined with synovial membranes that protect soft tissues and are usually found near joints
synovial membrane
thin tissues that surround freely moving joints or bursae; secretes synovial fluid nourishes cartilage and ligaments within the joint capsule
hayflick limit
replicative senescence theory says that there is a fixed number of divisions which determines an organism's lifespan (the number of telomeres determines this number)
this type of solar radiation is the #1 culprit for chronic skin damage assoc w/photoaging, causes genetic damage via ROS production and free radicals
this solar radiation is associ w/ skin cancers (BCC>SCC>melanoma); exposure usually occurs before 18yo, penetrates only the epidermis and produces erythema assoc w/sunburn; also produces pyrimidine dimers wh can cause genetic mutation
this solar radiation is largely blocked by ozone layer, no impact on skin
which tumor suppressor gene mutations are associated with 50% of all skin cancers and 90% of pts dxed w/xeroderma pigmentosa (defect in DNA repair)?
Fringe projection
This skin evaluation technique measures in 3D depth & breadth of wrinkles/fine lines
skin evaluation technique via high tech digital photos that use polarizing filters
laser scanning microscopy
skin evaluation via images of photodamaged skin, datat used to predict short & longterm damage
these are light-absorbing molecules below the skin surface responsible for coloration & overall appearance of skin (3 types are collagen, hemoglobin & melanin); play critical role in determining perceived age
most commonly used retinol that increases capacity of epidermis to hold h2o; increases collagen; may also retard or prevent further skin damage
this amino acid is a nitric oxide precursor, used to treat HTN and erectile dysfunction; combined w/exercise, has synergistic effects
Omega 3
what type of fish oils can modulate hippocampal activity, improve memory and via DHA promote differentiation ofnerual stem cells into neurons
Smoking, htn, lack of exercise
top 3 risk factors for death based on Epic-Norfolk study
No, CR and resveratrol do not alter SIRT1 levels, and CR but not resveratrol induces PGC-1α transcriptional targets
Does Resveratrol alter SIRT1 levels?
Growth Hormone
what hormone stimulates protein synthesis, decreases urea production and improve nitrogen balance?
is a pro-hormone produced from cholesterol by the adrenal glands, gonads, adipose tissue, brain and skin
synthesized from cholesterol & is involved in steroidogenesis of progesterone, glucocorticoids, and estrogens
T or F: bovine casein-derived peptides and whey protein-derived peptides do NOT exhibit ACE-I activity
T or F: coq10 has ACE-I effect
Breast and Prostate
What 2 cancers share benefit from low circulating sex steroids, express PSA found in no other tumors, and share gene alteration in the AR gene
what mutation carriers affect overall NON-cancer life expectancy by increasing hazard of mortality between age 61-80, have reduced life expectancy overall, and are involved in translation regulation and IGF signaling axis which contribute to premature aging?
which of the following estrogen metabolite shows PROTECTION against breast cancer by blocking ER-alpha? 16-alpha OHE (16 alpha-hydroxyestrone), 2-OHE (2 hydroxy estrone), E1 (hydroxylated estrone), E2 (hydroxlated estradiol)?
symptoms of this mineral deficiency include white spots/bands/opaque white fingernails, loss of taste smell or appetite, and poor wound healing
in treating dyslipidemia, it is recommended to consume ____ servings of fruits, veg, whole grains, mixed & insoluble fibers
1.5 - 1.8
in treating dyslipidemia, it is recomm to consume ____ g/kg of protein daily
in treating dyslipidemia, it is recomm to exercise ____ minutes daily with aerobic AND resistance training
is an essential trace element involved in protein synthesis and numerous functions incl maintenance of cardiovascular functioning. Studies have shown that supplementation reduces risks of cancers, incl prostate, colorectal & lung
ergocalciferol (or calcitriol)
vitamin d is aka
False (Exaggerated response)
Increased oxidative stress is due to increased generation of ROS with a suppressed response to ROS
a reduced antioxidant reserve results from low intracellular, extracellular, enzymatic and non enzymatic antioxidants
arachadonic metabolites do not contribute to increased levels of ROS
this hormone blocks estrogen-receptor-alpha; THUS by occupying estrogen receptor, it bocks estrogen stimulation of breast cancer
estrogen (Estrogen-dominant symptoms reflect EP ratio > E20:1P)
too much of this hormone or over-replacement w/HRT can cause: vaginal bleeding, acquired clitoromegaly, endometrial hyperplasia if given w/o progesterone or given in continuous not-monthly cycles, breast cancer (16-OH estrogen metabolites)
DIM (diindolylmethane)
___ & I3C (indole-3-carbino) must be given w/HRT inorder to favor conversion of estrogens to the 2-OH metabolites (vs 16-OH wh is assoc w/breast cancer)
high (intracell. use of cholesterol to make steroids is decreased, wh leads to back-up of cholesterol)
hypothyroidism is associated with ___ cholesterol levels
challenge (urine GH levels are good diagnostic screening test for GHD)
___ tests are gold standard in diagnosis of Growth Hormone Deficiency: Insulin-induced hypglycemia (ITT), GHRH + Arginine & GHRH w/GH secretagogue GH-releaseing hexapeptide
Insulin Resistance
Too much GH therapy can cause ___ ____ & hyperglycemia due to overwhelming lipolysis. Avoid by using low dose GH.
brain made up of 3 develptal segments: R-complex (reptilian autonomic responses); mid-brain (integrates environment w/R-complex via 5 senses) and ____ which integrates words and meaning into emotional and physiologic responses
3AA (3 alpha androstanediol) & allopragnanolone are neurosteroids that are powerful ___receptor modulators (sedative/hypnotic, anticonvulsant & anxiolytic properties)
DOC (deoxycorticosterone)
one of the neurosteroid hormones produced by adrenal gland that possesses mineralocorticoid activity by acting as precursor to aldosterone; thought to enhance GABA-medicated chloride currents
DHEAS (orally ingested DHEA converted to sulfate when passing thru intestines & liver)
sulfated form of DHEA, shows no diurnal variation so better measurement since most DHEA is found as this (300 times higher than free DHEA)
Zinc citrate
___ ____ supplement helps prevent testosterone from being converted to estradiol, thus reduce incidence of gynecomastia in TRT
TRT improves visual-spatial AND ___ memory in males; TRT also improves cognitive fx in women
ERT improves ___ memory in females by its effects on hippocampal synaptogenesis & fx; BUT did not see improved working memory in women
Diabetes type ___ (assoc w/antibodies formed vs pancreas), increased age and free radical damage all contribute to Beta cell dysfunction * pancreatic "poop out"
C-peptide assay (DM2=high; DM 1 or 1.5 have low)
measures endogenous insulin, or the insulin that your body produces on its own (not injected); is the DEFINITIVE TEST to distinguish betwe DM1 vs DM2
(greater than) 10:1
what should the ratio of fasting blood glucose:insulin be? This gives you the best picture telling you whether your pancreas is in overdrive & pumping out too much insulin.
activates glycolysis (insulin directs glucose to be broken down to lactic acid, ATP, pyruvate wh enters into Krebs cycle)
how does INSULIN play role in Kreb's cycle? hint: early step in IR devlpt is dysfx in mitochondrial anion transport wh. is reulated by insulin, thus see lowered VO2max
F (insulin causes VASODILATION and increases NO; it's only when you become IR that you get vasoconstriction__>incr risk for MI)
T/F: Insulin is fat-storing, anabolic, anti-lypolytic, anti-inflammatory (keeps the fat stored, only FREE fatty acids in blood cause inflammation) & is promotes vasoconstriction.
Insulin Resistance
hyper-insulinemia is a marker for ______. The high insulin in blood is NOT the problem, it just signals the underlying problems going on w/overworked pancreas &, what's happening in the mm & fat & eventually the liver.
High (becomes catabolic when insulin levels are low, so breaks down fat & leaks out FFAs into blood)
Cortisol is anabolic at level of the fat cells when insulin levels are ____ (it builds & stores fat). Can have nl serum cortisol but at level of fat cells, see INCR cortisol activity
hyaline cartilage
during remodeling & rebuilding of bone following a fracture, a special type of connective tissue ____ _____ forms over the bone at the fracture site and creates a callus. Callus serves as model for new bone growth.
this mm plantar flexes foot & flexes lower leg (knee stays straight)
this mm plantar flexes foot w/knee bent
this mm group elevates & upwardly rotates scapula, retracts & depresses the scapula, raises arm
Beta-agonist drugs treat bronchoconstriction by increasing this ________ hormone, wh. allows broncho-dilation in asthma & copd.
_____ this hormone causes bronchoconstriction, so anticholinergic drugs are used to block constriction in asthma (fd to be even superior to beta-agonists in treating COPD)
collagen, melanin, hemoglobin
3 types of chromophores (light-absorbing molecules below skin surface, responsible for coloration & overall appearance of skin, critical role in determining "perceived age")
Fp (papillary; fibroblasts exhibit replicative senescence, limited capacity to divide, ie Hayflick limit)
Skin article: which dermal fibroblasts found to be altered in skin photo-aging? Fr (reticular, from deeper dermal layer) or Fp (papillary, from superficial dermis)
NF-kb (nuclear factor kappa beta)
what is the center piece (cytokine) of inflammation that decreases EPC function? It is turned on by inflamm. cytokines and also turns on inflamm. cytokines of its own
___ cancer marker CA15-3, CEA
___ marker predicts risk for acute MI
Smoking, HTN, low exercise, hi glucose, low HDL, hi salt
what are 6 top-ranking risk factors for mortality/death?
A fasting blood glucose of ____-_____ is considered PRE-DIABETIC
BASESFCC (beta cryptoxanthin, Vit ACE,Selenium, Fe, Cl Chlride)
Which serum nutrients INCREASE FEV1?
high K, Na
Which serum nutrients DECREASE FEV1?
b5 (pantothenic acid)
which vitamin is needed in production of Ach?
b12 (cobalamin)
which vitamin is needed in production of RBC, WBC?
___ year difference in mortality fd in EPIC Norfolk Study due to lifestyle changes in smoking, exercise, alcohol consumption & increased fruit/veg intake.
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