This document summarizes plasma proteins and their functions. It discusses the three major types of plasma proteins - albumin, globulins, and fibrinogen. Albumin provides colloidal osmotic pressure, globulins are responsible for immunity, and fibrinogen forms blood clots. The liver produces most plasma proteins at a high rate of up to 30g per day to replace losses. Conditions like burns or kidney disease that cause major protein losses can be compensated by the liver. Plasma proteins also act as carriers for hormones and provide a source of amino acids for tissues.
Factors responsible for erythropoiesis. Development and maturation of erythrocytes require mostly three types of factors
1. General factors 2. Maturation factors 3. Factors necessary for hemoglobin formation.
Factors responsible for erythropoiesis. Development and maturation of erythrocytes require mostly three types of factors
1. General factors 2. Maturation factors 3. Factors necessary for hemoglobin formation.
The nephron is the microscopic structural and functional unit of the kidney. It is composed of a renal corpuscle and a renal tubule. The renal corpuscle consists of a tuft of capillaries called a glomerulus and an encompassing Bowman's capsule. The renal tubule extends from the capsule.
The nephron is the microscopic structural and functional unit of the kidney. It is composed of a renal corpuscle and a renal tubule. The renal corpuscle consists of a tuft of capillaries called a glomerulus and an encompassing Bowman's capsule. The renal tubule extends from the capsule.
Hematology is a branch of medicine involving the study of blood and blood disorders. The common blood disorders are Anemia, leukemia, lymphoma, thalassemia and thrombocytopenia etc. This PPT is about blood physiolopgy and morphology. Blood is a body fluid that circulates in the body and transport essential material to the cells of body. This fluid is also called connective tissue as it contains cellular and extra cellular material. Cellular Material:
The cellular material of blood are RBCs, WBCs and platelets (fragments of cells).
Extracellular Material:
The plasma is extracellular material of blood. This makes the blood a unique connective tissue as it is fluid. The cellular elements of blood remain suspended in the extracellular part of blood (plasma) which is almost 90-92% water.
For further information, check next part of slide.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Last class questions??
Average number of RBC in males 5,20,000+/-
300,000
In women, 4,700,000 +/- 300,000
Why male and female difference???
Persons living at high altitudes have greater
number of RBC’s
Why ???
3. Learning objectives
List the major plasma proteins of the blood
Describe the functions of plasma proteins
Define plasmapheresis and its potential uses
4. Introduction
Major types of plasma proteins present in the
plasma are
1. Albumin – Provides colloidal osmotic pressure
in plasma which prevents plasma loss from
capillaries
2. Globulin – responsible for body’s natural and
acquired immunity
3. Fibrinogen- forms blood clots that help repair
leaks in the circulatory system
5. Formation of plasma proteins
All the albumin and fibrinogen of plasma
proteins and 50-80% of globulins, are formed in
the liver.
The remaining globulins are formed almost
entirely in the lymphoid tissues.
They are mainly gamma globulins that
constitute the antibodies used in immune
system.
6. Formation of plasma proteins
The rate at which plasma proteins formed by
the liver can be extremely high, as much as
30g/day.
Certain disease conditions cause rapid loss of
plasma proteins:
severe burns that denude large surface areas
of skin can cause loss of several liters of
plasma through denuded area each day.
7. Formation of plasma proteins
The rapid production of plasma proteins by
liver is valuable in preventing death in disease
states.
A person with severe renal disease loses as
much as 20g of plasma protein in urine each
day for months.
It is continuously replaced mainly by the liver
production of the required proteins.
8. Formation of plasma proteins
In cirrhosis of liver, large amounts of fibrous
tissue develop among the liver parenchymal
cells
Causes decrease in their ability to synthesize
plasma proteins.
Decrease in the plasma colloidal osmotic
pressure
Generalized edema
10. Fluid filtration across capillaries
Fluid shift hypothesis
Starling’s hypothesis
The hydrostatic pressure in the capillaries tends
to force the fluid and its dissolved substances
through the capillary pores into the interstitial
spaces (out driving force)
Conversely, C.O.P, tends to cause the fluid
movement by the osmosis from interstitial fluid
into the blood (In driving force)
11. Fluid filtration across capillaries
Four primary forces determine weather the fluid
moves out of the blood or into the blood.
These forces are called “Starling forces” in
honor of the Physiologist Ernst Starling who first
demonstrated their importance
1. Capillary pressure (pc) – force fluid outward
through capillary membrane
2. Interstitial fluid pressure (Pif) – force the fluid
inward through capillary membrane
12. Fluid filtration across capillaries
Four primary forces determine weather the fluid
moves out of the blood or into the blood.
These forces are called “Starling forces” in
honor of the Physiologist Ernst Starling who first
demonstrated their importance
3. Capillary plasma colloidal osmotic pressure –
osmosis of the fluid inwards
4. Interstitial fluid colloidal osmotic pressure –
Osmosis of the fluid outwards
14. Fluid filtration across capillaries
If the sum of these forces – Net filtration
pressure (NFP) is positive, there will be a net
fluid filtration across the capillaries
If the sum of the starling forces is negative, there
will be a net fluid absorption, from interstitial
fluid into the capillaries.
NFP is slightly positive under normal conditions
Results net filtration of fluid into the interstitial
space
15. Capillary hydrostatic pressure
To estimate capillary hydrostatic pressure
1. Direct micropipette cannulation of the
capillaries, which has given an average mean
capillary pressure about 25 mmHg in some
tissues such as skeletal muscles and gut
2. Indirect functional measurement of capillary
pressure- which has given a capillary pressure
averaging about 17 mmHg in these tissues
16. Interstitial fluid hydrostatic pressure
In loose subcutaneous tissues – negative interstitial
fluid hydrostatic pressure
Kidneys – Positive (greater than atmospheric
pressure)
1. Direct micropipette cannulation of the tissues with
micropipette
2. Measurement of the pressure from implanted
perforated capsules
3. Measurement of the pressure from a cottonwick
inserted into the tissue
17. Plasma Colloidal osmotic pressure
Molecules or ions that can not pass through the pores of
a semi permeable membrane exert osmotic pressure
Proteins are the only dissolved constituents in the
plasma and interstitial fluids that do not readily pass
through capillary pores
It is the proteins of the plasma and interstitial fluids that
are responsible for osmotic pressures on the two sides of
the capillary membrane
The osmotic pressure exerted by plasma proteins is
called colloidal osmotic pressure or oncotic pressure
18. Plasma Colloidal osmotic pressure
The term “colloid” osmotic pressure is derived from
the fact that a protein solution resembles a colloidal
solution despite the fact that it is actually a true
molecular solution
The C.O.P of normal human plasma averages about
28 mmHg
19 mmHg of this is caused by molecular effects of
dissolved protein
9 mmHg by Donnan effect- extra osmotic pressure
caused by sodium, potassium and other cations held
in the plasma by the proteins.
19. Plasma Colloidal osmotic pressure
Albumin (4.5 grams/Deciliter) – contributes 21.8
mmHg of C.O.P
Globulin (2.5 grams/Deciliter) – contributes 6.0
mmHg of C.O.P
Fibrinogen (0.3 grams/Deciliter) – contributes 0.2
mmHg of C.O.P
Total (7.3 grams/Deciliter) – contributes 28.0
mmHg of C.O.P
20. Plasma Colloidal osmotic pressure
About 80% of total C.O.P of the plasma results
from the albumin fraction
20% from globulins
Almost none from fibrinogen
Albumin is important
21. Interstitial fluid Colloidal osmotic
pressure
The size of capillary pores are smaller than the
molecular size of plasma proteins
Not true for all capillary pores
Small amounts of plasma proteins do leak
through pores and transcytosis in small vesicles
22. Filtration at the arterial end
Forces tending to move the fluid outward
1. Capillary hydrostatic pressure = 30 mmHg
2. Negative interstitial free fluid pressure = 3 mmHg
3. Interstitial fluid colloidal osmotic pressure =8 mmHg
4. Total out driving force is 41 mmHg
Forces tending to move the fluid inward
1. Plasma colloidal osmotic pressure = 28 mmHg
Net outward force = 41-28 =13 mmHg
23. Filtration at the arterial end
This 13 mmHg filtration pressure causes an
average about, 1/200 of the plasma in the flowing
blood to filter out of the capillary at the arterial
end of the capillaries into the interstitial space
each time the blood pass through the capillaries
24. Filtration at the venous end
Forces tending to move the fluid outward
1. Capillary hydrostatic pressure = 10 mmHg
2. Negative interstitial free fluid pressure = 3 mmHg
3. Interstitial fluid colloidal osmotic pressure =8 mmHg
4. Total out driving force is 21 mmHg
Forces tending to move the fluid inward
1. Plasma colloidal osmotic pressure = 28 mmHg
Net inward force = 28-21 =7 mmHg
25. Filtration at the venous end
In driving force is more than outdriving force
The difference 7 mmHg is the net reabsorption
pressure
Causes about 9/10th of the fluid that has filtered
out at the arterial end of the capillaries to be
reabsorbed at the venous end
The remaining 1/10th of the fluid flows into the
lymphatic vessels and returns to the circulating
blood (Formation of Lymph).
26. Plasma proteins as carrier proteins
Some plasma proteins acts as carriers for water
insoluble substances (lipophilic)
Albumin acts as a carrier for steroid hormones, fatty
acids and thyroid hormones
Other specific carrier proteins in the blood also
important in transporting lipophilic hormones to the
target cells
Sex hormone binding globulin (SHBG) that binds
estradiol and testosterone
Corticosteroid binding globulin (CBG)
Thyroxine binding globulin (TBG)
27. Plasma proteins- source of amino acids
When tissues are depleted of proteins
Plasma proteins can act as a source of rapid
replacement
Plasma proteins acts as a labile protein storage
medium
Readily available source of amino acids
whenever a particular tissue require them
28. Reversible equilibrium between tissue
proteins and plasma proteins
Constant state of equilibrium between plasma proteins,
amino acids of plasma and tissue proteins
Radio active tracer studies demonstrated that about 400
grams of body protein is synthesized and degraded each
day as a part of continuous state of flux of amino acids
Reversible exchange of amino acids among different
proteins of body
Even during starvation or severe debilitating disease, the
ratio of total tissue proteins to total plasma proteins in
the body remains relatively constant (3:1)
29.
30. Reversible equilibrium between tissue
proteins and plasma proteins
Because of this reversible equilibrium between
plasma proteins and other proteins of the body
One of the most effective therapies for severe,
acute whole body protein deficiency is
intravenous transfusion of plasma protein
With in few days, or sometimes within few hours,
the amino acids of administered protein are
distributed throughout the cells of the body to
form new proteins as needed
31. Plasmapheresis
Plasma can be removed from the blood without removing
RBC
Blood is drawn from the patient and plasma separated
from it
The RBC’s are returned to the body of the patient such
that there is no loss of these cells
Yet some plasma was removed
The process is used on patients who have excess of
plasma proteins in their blood, making it viscous
Also can be used on those who have certain antibodies
present in their blood
32. Whipple’s experiment
George Hoyt Whipple, an American Physician and
Biomedical researcher (Nobel Prize winner)
Dog was bled and the cells were separated from
plasma
Cells were re injected being suspended in Ringer-
Locke’s solution (protein free fluid)
Plasma pheresis
Continued several weeks until protein concentration
decreased to less than 4gm%
Exhaustion of plasma protein reserves
33. Whipple’s experiment
When plasma protein levels lowered to 4-5 gm%,
after a duration about half an hour, reserve labile
proteins are mobilized in circulation and
physiological level of plasma proteins is achieved in
a period of 2-7 days, if balanced diet with adequate
protein is supplemented during this period.
If the protein levels decreased less than 4 gm%, the
protein store of the body gets exhausted
The decrease in the protein store less than 2 gm%,
leads to shock and death of animal