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NEET MDS Synopsis

CLASSIFICATION OF ENZYMES
Biochemistry

CLASSIFICATION OF ENZYMES

1. Oxidoreductases : Act on many chemical groupings to add or remove hydrogen atoms. e.g. Lactate dehydrogenase

2. Transferases Transfer functional groups between donor and acceptor molecules. Kinases are specialized transferases that regulate metabolism by transferring phosphate from ATP to other molecules. e.g. Aminotransferase.

3. Hydrolases Add water across a bond, hydrolyzing it. E.g. Acetyl choline esterase

4. Lyases Add water, ammonia or carbon dioxide across double bonds, or remove these elements to produce double bonds. e.g. Aldolase.

5. Isomerases Carry out many kinds of isomerization: L to D isomerizations, mutase reactions (shifts of chemical groups) and others. e.g. Triose phosphate isomerase

6. Ligases Catalyze reactions in which two chemical groups are joined (or ligated) with the use of energy from ATP. e.g. Acetyl CoA carboxylase

Erythromycin
Pharmacology

Erythromycin

used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including  mycoplasma. It is also used to treat outbreaks of chlamydia, syphilis, and gonorrhea.

Erythromycin is produced from a strain of the actinomyces Saccaropolyspora erythraea, formerly known as Streptomyces erythraeus.

Mechanism of action Erythromycin prevents bacteria from growing, by interfering with their protein synthesis. Erythromycin binds to the subunit 50S of the bacterial ribosome, and thus inhibits the translocation of peptides.

Erythromycin is easily inactivated by gastric acids, therefore all orally administered formulations are given as either enteric coated or as more stable salts or  esters. Erythromycin is very rapidly absorbed, and diffused into most tissues and  phagocytes. Due to the high concentration in phagocytes, erythromycin is actively transported to the site of infection, where during active phagocytosis, large concentrations of erythromycin are released.

Most of erythromycin is metabolised by demethylation in the liver. Its main route elimination route is in the bile, and a small portion in the urine.

Erythromycin's half-life is 1.5 hours.

Side-effects. More serious side-effects, such as reversible deafness are rare. Cholestatic jaundice, Stevens-Johnson syndrome and toxic epidermal necrosis are some other rare side effects that may occur.

Contraindications Earlier case reports on sudden death prompted a study on a large cohort that confirmed a link between erythromycin, ventricular tachycardia and sudden cardiac death in patients also taking drugs that prolong the metabolism of erythromycin (like verapamil or diltiazem)

erythromycin should not be administered in patients using these drugs, or drugs that also prolong the QT time.

Molecular techniques
General Pathology

Molecular techniques

Different molecular techniques such as fluorescent in situ hybridization, Southern blot, etc... can be used to detect genetic diseases.

BIOLOGICAL BUFFER SYSTEMS 
Biochemistry

BIOLOGICAL BUFFER SYSTEMS 

Cells and organisms maintain a specific and constant cytosolic pH, keeping biomolecules in their optimal ionic state, usually near pH 7. In multicelled organisms, the pH of the extracellular fluids (blood, for example) is also tightly regulated. Constancy of pH is achieved primarily by biological buffers : mixtures of weak acids and their conjugate bases 

Body fluids and their principal buffers


Body fluids                     Principal buffers

Extracellular fluids        {Biocarbonate buffer Protein buffer } 

Intracellular fluids         {Phosphate buffer, Protein }

Erythrocytes                 {Hemoglobin buffer}

Other coxibs
Pharmacology

Valdecoxib

used in the treatment of osteoarthritis, acute pain conditions, and dysmenorrhoea

Etoricoxib new  COX-2 selective inhibitor

Digital Radiology
Radiology

Digital Radiology

Advances in computer and X-ray technology now permit the use of systems that employ sensors in place of X-ray ?lms (with emulsion). The image is either directly or indirectly converted into a digital representation that is displayed on a computer screen. 

DIGITAL IMAGE RECEPTORS

- charged coupled device (CCD) used
- Pure silicon divided into pixels.
- Electromagnetic energy from visible light or X-rays interacts with pixels to create an electric charge that can be stored.
- Stored charges are transmitted electronically and create an analog output signal and displayed via digital converter (analog to digital converter). 

ADVANTAGES OF DIGITAL TECHNIQUE

Immediate display of images.

Enhancement of image (e.g., contrast, gray scale, brightness).

Radiation dose reduction up to 60%.

Major disadvantage: High initial cost of sensors. Decreased image resolution and contrast as compared to D speed ?lms.

DIRECT IMAGING

- CCD or complementary metal oxide semiconductor (CMOS) detector used that is sensitive to electromagnetic radiation.

- Performance is comparable to ?lm radiography for detection of periodontal lesions and proximal caries in noncavitated teeth.

INDIRECT IMAGING

- Radiographic ?lm is used as the image receiver (detector). 

- Image is digitized from signals created by a video device or scanner that views the radiograph.

 

Sensors

STORAGE PHOSPHOR IMAGING SYSTEMS

Phosphor screens are exposed to ionizing radiation which excites BaFBR:EU+2 crystals in the screen storing the image.

A computer-assisted laser then promotes the release of energy from the crystals in the form of blue light.

The blue light is scanned and the image is reconstructed digitally.

ELECTRONIC SENSOR SYSTEMS

X-rays are converted into light which is then read by an electronic sensor such as a CCD or CMOS.

Other systems convert the electromagnetic radiation directly into electrical impulses.

Digital image is created out of the electrical impulses. 

 

Functional Divisions of the Nervous System
Physiology

Functional Divisions of the Nervous System:

1) The Voluntary Nervous System - (ie. somatic division) control of willful control of effectors (skeletal muscles) and conscious perception. Mediates voluntary reflexes.

2) The Autonomic Nervous System - control of autonomic effectors - smooth muscles, cardiac muscle, glands. Responsible for "visceral" reflexes

Lithium carbonate
Pharmacology

Lithium carbonate: 1st choice (controls mania in bipolar disorders); delay before onset of therapeutic benefit; no psychotropic effects in normal humans

i. Mechanism: blocks enzymes in inositol phosphate signaling pathway; no consistent effects of lithium on NE, 5-HT, and DA
ii. Side effects: severe CNS (ataxia, delirium, coma, convulsions) and CV (cardiac dysrhythmias)

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