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A 19-year-old teenager was dancing in clogs in an ethnic street festival when she inverted her left foot bacteria pilorica buy 500mg famicef mastercard. She presents to antibiotics for acne in pregnancy cheap famicef 250 mg with mastercard your office the next day with a swollen foot antibiotics for uti and alcohol purchase famicef 500mg without a prescription, but mainly complains about tenderness on the lateral aspect of the foot along the plantar surface iv antibiotics for sinus infection generic famicef 500 mg on line. You carefully palpate her foot and determine that she has tenderness over the tuberosity of the fifth metatarsal bone. What muscle has avulsed from its insertion on to the tuberosity of the fifth metatarsal? Abductor digiti minimi Fibularis (Peroneus) brevis Fibularis (Peroneus) longus Tibialis anterior Tibialis posterior 489. The bone marked B in the lateral plain film of the right foot is which of the following? While some people continue to increase in height through their teenage years, most change very little in height for decades. However, many elderly men and women often lose height as a result of which of the following? A 27-year-old man is admitted for neurologic evaluation of a gunshot wound received 5 days previously. A 9-mm bullet had passed through both the medial and lateral heads of the gastrocnemius muscle. The exit wound on the lateral head of the muscle was somewhat deeper than the entrance wound in the medial head. The bullet did not strike bone or significant arteries although significant tissue damage, suppuration, and swelling were found around the exit wound. Neurologic examination reveals losses of dorsiflexion and eversion of the left foot. The patient cannot feel pinprick or touch on the dorsum of the left foot or anterolateral surface of the left leg. Sciatic nerve Femoral nerve Sural nerve Common fibular (peroneal) nerve Tibial nerve 492. In a presurgical patient, the great saphenous vein was cannulated in the vicinity of the ankle. During the procedure, the patient experienced severe pain that radiated along the medial border of the foot. Which of the following nerves was accidentally included in a ligature during this procedure? Medial femoral cutaneous nerve Saphenous nerve Superficial fibular nerve Sural cutaneous nerve Tibial nerve 582 Anatomy, Histology, and Cell Biology 493. A pulse in the dorsalis pedis artery may be palpated in which of the following ways? Between the tendons of the extensor digitorum longus and fibularis (peroneus) tertius muscles b. Between the tendons of the tibialis anterior and extensor hallucis longus muscles d. Because sacral hiatus is just anterior to anus which contains lots of bacteria, increasing the chances of unintentional contamination d. What pathological condition is illustrated in this plain film of the lumbosacral spine? Kyphosis Scoliosis Lordosis Spondylolisthesis 584 Anatomy, Histology, and Cell Biology 496. Which part of the vertebra would connect to the three other parts: the body, the lamina and the transverse process? Inferior articular facet (A in the image in question 495) Superior articular facet (B in the image in question 495) Lamina (C in the image in question 495) Pedicle (D in the image in question 495) Body (E in the image in question 495) 497. A 22-year-old man who belongs to a weekend football league was running with the ball when a defender tackled him mid-lower limb from the side.

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Membrane synthesis in the endoplasmic reticulum Membrane modification in the Golgi apparatus Presence of carbohydrates on the cytoplasmic surface the distribution of cholesterol Flipping proteins between the leaflets of the lipid bilayer Cell Biology: Membranes 101 36 antibiotic quality premium purchase 250 mg famicef fast delivery. When the MedAct unit arrives they find a patient with acute shortness of breath and audible wheezing antimicrobial bath mat purchase 250mg famicef with amex. Auscultation reveals decreased breath sounds with wheezing on inspiration and expiration antibiotic resistance hand sanitizer order famicef 500 mg with visa. The patient has taken her prescribed medications with no relief of symptoms prior to antibiotics bad for you cheap 500mg famicef free shipping her 911 call. They are arranged so that both the amino- and the carboxy-terminals are located intracellularly Cell Biology: Membranes Answers 30. It is responsible for the fundamental structure of the membrane and provides the barrier to water-soluble molecules in the external milieu. Other membrane functions are performed primarily by proteins that function as receptors, enzymes (catalysis of membrane-associated activities), and transporters (answers b, c, and d). Connection to the cytoskeleton (answer e) is performed by members of the spectrin family of proteins reinforcing the membrane on the cytosolic side. The membrane consists of a bilayer of phospholipids with the nonpolar, hydrophobic layer in the central portion of the membrane and the hydrophilic polar regions of the phospholipids in contact with the aqueous components at the intra- or extracellular surfaces of the membrane. The polar head groups of the lipid bilayer react with osmium to create the trilaminar appearance observed in electron micrographs of the plasma membrane. IgA functions in several ways, one of which is to coat pathogens with a negative charge that repels the polyanionic charge on the cell surface. In IgA deficiency, pathogens can more easily attach to the cell surface leading to persistent infections. The carbohydrate of biological membranes is found in the form of glycoproteins and glycolipids rather than as free saccharide groups (answer a). The polyanionic charge of the membrane is produced by the sugar side chains on the glycoproteins and glycolipids. Glycoproteins often terminate in sialic acid side chains, which impart a negative (polyanionic) charge to the membrane. Similarly, the glycolipids (also called glycosphingolipids), particularly 102 Cell Biology: Membranes Answers 103 the gangliosides, terminate in sialic acid residues with a strong negative charge. Cholesterol (answer c) alters membrane fluidity (see figure below and question 34) and is amphipathic (hydrophilic and hydrophobic properties). Peripheral membrane proteins (answer d) are found primarily on the cytosolic leaflet of the membrane bilayer. A = Integral membrane protein, B = Glycoprotein, C = Peripheral membrane protein (more abundant on cytosolic surface), D = sugar, E = cholesterol, F = hydrophobic fatty acid chains (hydrophilic polar head groups are not labeled), G = glycolipid 32. Freeze fracture is a procedure in which the tissue is rapidly frozen and fractured with a knife. The fracture plane occurs through the hydrophobic central plane of membranes, which is the plane of least resistance to the cleavage force. They are described as the extracellular face (E face) and the protoplasmic face (P face). The cytoplasm is the backing for the P face, which in general contains numerous intramembranous particles (mostly protein). The E face is backed by the extracellular space 104 Anatomy, Histology, and Cell Biology and in general contains a paucity of intramembranous particles (see upper part of figure) compared with the P face (labeled with asterisks). In the absence of band 3 protein, the bicarbonate buffering of the blood is reduced, leading to acidosis or lowering of blood pH. In addition to its functional, bidirectional anion exchanger role, band 3 plays a key membrane structural role, since the cytoplasmic domain of the protein interacts with spectrin through an ankyrin bridge. The result of a null mutation in band 3 is the formation of erythrocytes that are small and round instead of biconcave (spherocytosis). Spherocytes are osmotically fragile because of their decreased surface area per unit volume (answer a). The accelerated hemolysis leads to increased bile production (answer c) and jaundice. Binding of an antibody to a cell surface receptor results in lateral diffusion of protein in the lipid bilayer, resulting in increased membrane fluidity-patching and capping. Rotational and lateral movements of both proteins and lipids contribute to membrane fluidity.

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It often occurs in the evenings or night-time and appearstobemorefrequentintheelderly antibiotic ear drops for ear infection purchase famicef 250mg on line. Therelativelyuniformworldwide prevalence suggests that a single environmental agent is not responsible antibiotic resistance new drugs generic 500mg famicef fast delivery. Environmentalfactors Epidemiological studies consistently show a small increased risk with rural living and drinking well water treatment for dogs with diarrhea imodium discount famicef 250 mg with visa. Prodromalpre-motorsymptoms Patients develop a variety of non-specific non-motor symptoms during the approximately 7 years antimicrobial vitamin list buy generic famicef 250 mg,sometimeslonger,beforethemotorsymptomsbecomemanifest. Akinesia Poverty/slowing of movement (also called bradykinesia) is the cardinal clinical feature of Parkinsonism and the main cause of disability. What distinguishes it from slowness of movementfromothercausesisaprogressivefatiguinganddecrementinamplitudeandspeed ofrepetitivemovements,suchasopeningandclosingthehandorfingertapping. Theupperlimbisusuallyaffectedfirstandisalmost always unilateral for the first years. Rapid dexterous movements are impaired, causing difficultywriting(micrographia)anddoingupbuttonsandzips,forexample. It is often described as pill-rolling because the patient appears to be rolling something between thumb and forefinger. Drooling may be an embarrassing problem and swallowing difficultyis a late feature that may eventually lead to aspiration pneumonia as a terminalevent. Visual hallucinations on treatment, and psychosis are not uncommon, and may herald evolving cognitive decline. Responsetodopaminergic drugsisneverlostbuttreatment-relatedfluctuationsmaydevelop(seebelow),whichcanbe limiting, especially for patients with early age at onset. Eventually, usually by the midseventies, late-stage, treatment-unresponsive features, such as cognitive impairment, swallowingdifficulty,lossofposturalstabilityandfalls,starttoemerge. Management Education about the condition is necessary and physical activity is beneficial and should be encouraged. Dopamine replacement with levodopa or a dopamine agonist improves motor symptomsandisthebasisofpharmacologicaltherapy. Treatmentofnon-motorsymptoms,such as depression, constipation, pain and sleep disorders, is also necessary and significantly improvesqualityoflife. Deepbrainstimulation Stereotacticinsertionofelectrodesintothebrainhasprovedtobeamajortherapeuticadvance in selected patients(usuallyunder age 70)withdisablingdyskinesiasandmotorfluctuations notadequatelycontrolledwithmedicaltherapy. Levodopaintestinalgelinfusion Continuous infusion of this gel into the small intestine via a jejunostomy using a patientoperatedpumpiseffectiveforselectedpatientswithseveremotorcomplications. Tissuetransplantation Transplantationofembryonicmesencephalicdopaminergiccellsdirectlyintotheputamenhas produced mixed results but is potentially promising; research is ongoing to refine the technique. Thesedisordersarerelentlesslyprogressive;althoughtheysometimesrespondtolevodopa, they usually cause death within a decade. Essentialtremor Thiscommoncondition,ofteninheritedasanautosomaldominanttrait,causesabilateral,fast, low-amplitude tremor, mainly in the upper limbs. Smallamountsofalcohol,betablockers (propranolol), primidone or gabapentin may help. Treatment is of the underlying cause but dopamine-blocking drugs, such as phenothiazines. Thisresultsintranslation of an expanded polyglutamine repeat sequence in huntingtin, the protein gene product, the functionofwhichisunclear.

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The mechanism for tube formation as occurs during development of the neural tube could best be explained by which of the following? Contraction of microfilament bundles associated with the zonula adherens Increased condensation of the transmembrane linkers of the desmosomes Expansion of the sealing strands in the zonulae occludentes Condensation of the gap junctions Contraction of tonofilaments associated with desmosomes Epithelium 155 75 oral antibiotics for dogs hot spots buy generic famicef 500 mg on line. In the figure below treatment for glaucoma dogs effective famicef 250mg, A is a transmission electron micrograph antimicrobial for dogs cheap famicef 250 mg line, and B is a freeze-fracture preparation of a specific cellular structure antibiotics not helping uti famicef 250 mg sale. Mutations in the proteins that constitute the intramembranous particles labeled in the freeze-fracture image below occur in humans. Which of the following would one expect to occur in the presence of such mutations? Faster conduction of nerve impulses Increased peristalsis in the small intestine Cardiac arrhythmias More rapid mobilization of glycogen to glucose in response to low blood sugar levels Decreased adherence of epithelial cells to the basement membrane 76. Molecular filtering Contractility Excitability Modification of secreted protein Active ion transport 156 Anatomy, Histology, and Cell Biology 77. In which specific layer of the accompanying electron micrograph would you expect to see the disruption? A 54-year-old woman presents to the oral surgeon on referral by her general dentist. Her dentist observes a firm mass in the anterior right side of the floor of the mouth. Her dentures were made by a denturist to save money and her general dentist indicates they fit very poorly. The calcification blocks the submandibular duct leading to atrophy of the acini and ducts with reduced secretory function. One would expect which of the following functional changes to occur in association with the basal folds of the striated duct cells? Per-Lennart Westesson and Xiang Liu, University of Rochester, Case #98. Increased lipid transport Increased absorption of carbohydrate Decreased active transport Decreased secretion of the primary saliva Decreased lysosomal activity 158 Anatomy, Histology, and Cell Biology 80. In the electron micrograph below, the structure labeled D primarily does which of the following? Forms a spot weld between cells Interacts with actin in the cytoplasm of the apical cytosol Facilitates communication between adjacent cells Seals membranes between cells Moves microvilli Epithelium 159 81. An 11-year-old boy presents with ciliary dyskinesia, sinusitis, and bronchiectasis. In the cross-section of the cilium shown below, which of the following is primarily affected in this disorder? The conversion of sliding to bending in the cilium is accomplished by which of the following? Restriction of movement by dynein binding of the central microtubules to each other b. Restriction of the microtubule doublets by radial spokes, nexin, and basal bodies 160 Anatomy, Histology, and Cell Biology 83. The structure responsible for the linkage of the intermediate filament network of cells to the basal lamina is which of the following? Macula adherens Zonula adherens Hemidesmosomes Focal contacts Zonula occludens 84. A 42-year-old woman, of Mediterranean descent, presents with multiple oral blisters (see photograph), which she says have been present for several months, and a few cutaneous blisters on her back and buttocks that she just noticed over the past week. The bullae are fairly superficial, with the site of skin disruption clearly in the epidermis. Analysis of her sera indicates autoantibodies to a subfamily of cadherins with the distribution shown in the immunofluorescence image (see photomicrograph). Hemidesmosome Zonula adherens Macula adherens Gap junctions Lamina densa of the basal lamina 85.

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