1st MBBS SYLLABUS
https://drive.google.com/file/d/0Bw5V-SHiYOEZNHlOT3hoS3VfTnc/view?usp=sharing

Ventricular tissue action potential has a plateau phase. The ion causing the plateau is calcium. The plateau prevents the heart muscle to get tetanized.

Erythropoietin (Epo) is produced in the kidney (85%) and in the liver (15%).

Problem based learning (PBL) - diarhoea and dehydration

Muthu a 54 year old agriculture labourer travelled from his native village for 3 hours and reached the health centre. He was experiencing loose stools and vomiting for the past two days. He had ten to fifteen bouts of loose stools and around ten episodes of vomiting. Earlier, two days ago he had consumed food in a public place.

At the health centre his eyes were found to be sunken, he had a rapid thready pulse and his blood pressure was towards the lower side.

Vomiting was treated with an injection. Microscopic examination of his stool sample showed presence of diarhoea causing organisms. After the vomiting was controlled he was started on medicines for the bowel infection.

He was soon started on a solution which mainly was made up of clean water and sodium and glucose. After remaining in the health centre overnight he was started on a bland diet and sent home to his village.

Infection of the gastro intestinal tract caused diarhoea and vomiting. Not only was there a loss of fluid; there was also a lack of absorption from the intestines leading to shrinkage of body fluid compartments.

1.    Loose stools and vomiting brought Muthu to the health centre. Vomitus and stools belong to which body fluid compartment?

2.    List  the other body fluid compartments?

3.    Discuss the physiological basis for giving him sodium and glucose together.

4.    Trace in sequence the body fluid compartments that sodium and glucose enter.

5.    Mention the body fluid compartment of sodium.

6.    Mention the body fluid compartment of glucose.

7.    Rapid pulse indicates that the heart was responding and ensuring enough blood flow to the tissues. Adrenaline must have played a role here. Mention the adrenergic cell membrane protein involved.

8.    As adrenaline acts on the adrenergic cell membrane protein it is considered to be the first messenger. The second messenger has a role inside the cell. List three second messengers.

9.     Name the first second messenger to be discovered. Mention its mechanism of action.

ANSWER KEY WORDS

1.    Loose stools and vomiting brought Muthu to the health centre. Vomitus and stools belong to which body fluid compartment?

                              -transcellular fluid compartment

     

2.    List  the other body fluid compartments?

-      Intracellular fluid compartment

-      Intercellular fluid compartment or interstitial fluid or interstitium or I.F.

-      Intravascular compartment or vascular compartment or blood

-      Extra-cellular fluid compartment or extra-cellular fluid or ECF

3.    Discuss the physiological basis for giving him sodium and glucose.                          Sodium-glucose co-transporters (cell membrane protein) on the lumen side of the mucosal intestinal cells (enterocyte cells), one site for each sodium and glucose,configurational change of the carrier molecule, internalization of the two vital solute molecules.

4.    Trace in sequence the body fluid compartments that sodium and glucose enter.

   -transcellular fluid, intracellular fluid, interstitium, vascular compartment,

5.    Mention the body fluid compartment of sodium.

                                          ECF             (also transcellular fluid compartment)

6.    Mention the body fluid compartment of glucose.

                 -intracellular body fluid compartment

 7. Rapid pulse indicates that the heart was responding and ensuring enough blood

     flow to the tissues. Adrenaline must have played a role here. Mention the

     adrenergic cell membrane protein involved.

                      Adrenergic receptor

8.    As adrenaline acts on the adrenergic cell membrane protein it is considered to   

 be the first messenger. The second messenger has a role inside the cell. List

 three second messengers.

                               -cAMP

                               -IP₃

                               -Ca⁺⁺

                               -DAG

9.    Name the first second messenger to be discovered. Mention its mechanism of action.

              cAMP, altering cell function, increasing secretion, opening ion channels

Transport across capillaries

                   

                                      Transport across capillaries is specialized

Key words: Filtration slits, head (hydrostatic pressure) pressure from pumping of the heart, capillary circulation, colloid oncotic pressure from presence of albumin in the blood.

Capillary circulation

https://youtu.be/460AkgMRiB8

5.5 minute video on capillary circulation or capillary dynamics