Additional questions and answers

1. Xenical is a drug that inhibits pancreatic lipase. Explain how this drug might be effective in treating obesity.

2. People are give a glass of sugar water to drink at time 0.   Blood is withdrawn at every half hour and glucose levels are measured.   Results are plotted below.  Well, I haven't figured out the drawing programs here.  Levels of blood glucose in Person A rise quickly, then decrease back to baseline quickly.   In Person B, the baseline is higher.  Levels increase, but remain high and decrease more slowly.
A. Why does it take about an hour to get maximal levels of blood glucose.
B. What causes the rapid fall in blood glucose in person A?
C. What causes the blood to fall to baseline in Person B?
D. Which one of these people has diabetes mellitus?  A or B?

3. A certain drug is an alpha-1 receptor agonist (that is, it stimulates the receptor) whichcan be used to prevent the localized edema that occurs in the nasal passages during allergic responses.
A. This drug should increase/decrease/not affect the strength of heart contraction.   Explain briefly.
B. This drug should increase/decrease/not affect the flow of blood through the coronary arteries.  Explain briefly.
C. Describe the fluid changes that can cause edema, and how this drug prevents it.

4. Statins are drugs that inhibit HMG CoA reductase, the rate-limiting enzyme involved in synthesis of cholesterol.
A. In which organ is this enzyme most likely to be found?
B. Explain what occurs in this organ (on a molecular level) when cholesterol synthesis is inhibited.
C. Explain how this change makes these drugs useful in the prevention of atherosclerosis.

5. Choose the correct choice (a or b) and then explain the effect on blood flow, using at least one of the equations discussed in class.
A. Cardiac muscle is weak......blood flow in capillaries a) speeds up or b) slows down?
B. Arterioles constrict............blood flow in capillaries a) speeds up or b) slows down?
C. In part A, blood pressure is a) higher than or b) lower than normal?
In part B, blood pressure a) higher than or b) lower than normal?

6. The following types of drugs are used to lower blood pressure. Explain how each works to decrease blood pressure:
A. inhibits sympathetic innervation of the kidney
B. inhibits Na+ transport in the ascending limb of the loop of Henle

7. True/False. Correct if false.
A. Nitric oxide and acetylcholine both can act as vasoconstrictors.
B. Dietary triglycerides are delivered to the tissues by VLDL's.
C. End Diastolic Volume is normally larger than End Systolic Volume.
D. Cholecystokinin (CCK) stimulates pancreas to release digestive enzymes.
E. Epinephrine and glucagon have opposite effects on blood glucose levels.
F. The liver breaks down hemoglobin, and stores all the iron that is released.
G. Pepsin is secreted from parietal cells.

Answers

1. Function of lipase is to breakdown triglycerides to monoglycerides and free fatty acids, which is necessary before they can be absorbed.   If lipase is inhibited, no fat breakdown, no triglyceride absorption, fats exit in feces rather than going to adipose tissue for storage, less obesity.

2. A. The stomach is like a holding tank.  It slowly releases its contents to the small intestines, where absorption occurs as glucose combines with carriers in epithelial cell membranes.  It takes time for the ingested glucose to reach the intestines.
B. Insulin stimulates uptake of glucose by liver, adipose, muscle, so less is left in the blood.
C. Glucose in high concentration in blood produces high glucose concentration in the glomerular filtrate, which saturates the carriers there, so excess glucose is lost in the urine, lowering blood levels.
D. Person B

3. A. not affect.  Epinephrine receptors on heart muscle are beta-1, so shouldn't be affected.
B. Epinephrine receptors on coronary arteries are alpha and beta-2, so effect would depend on dose.  If there's sufficient alpha stimulation would decrease flow.  Drug wouldn't affect beta-2 receptors.
C. Fluid leaves capillaries when hydrostatic pressure outward from capillary is greater than osmotic pressure pulling fluid inward.  Hydrostatic presssure is dependent on blood pressure.  This drug will stimulate alpha receptors, causing vasoconstriction, which would slow the flow of blood to nasal passages, decreasing the pressure pushing fluid out, so preventing edema.

4. A. liver
B. decrease cholesterol in liver cells means less feedback inhibition of LDL receptor, so more LDL receptors.
C. Increased LDL Receptor means more LDL taken out of blood.  This delivers cholesterol to liver where it can be added to bile and excreted from the body.  Less LDL in blood means less LDL available to enter arteriolar walls and contribute to atherosclerosis.

5. A. b) slows down.   Decreased strength of contraction of heart means less pressure on the blood.
Flow = Pressure diff / Resistance, so decrease P ==> decrease F.   OR you could say:
BP = CO x R  and CO = EDV-ESV.  If decrease strength of contraction, then increase ESV and Decrease CO so Decrease P and P=FxR, so flow decreases.

B. b)slows down
R is proportional to 1/r 4, so decrease radius ==> increase R.  Flow = P/R, so the increased R means decreased Flow.

C. In A, BP is lower;  In B, BP is higher (pressure measured in arteries behind the constriction)

6. A. Sympathetic neurons innervate afferent arterioles to cause vasoconstriction, and decrease blood flow to glomerulus.  Without sympathetic innervation, will be vasodilation of afferent arteriole, causing pressure to increase in the glomerular capillaries, and increased GFR , increased urine formation, increased water lost in urine, decreased blood volume, decreased cardiac output, decreased blood pressure.
B. Less Na+ transported from the nephron means more Na+ in the filtrate, increases osmotic concentration so more water remains in filtrate, more water exits body, less water in body, lower blood volume, lower blood pressure.

7. A.  False.  vasodilators.  
B. False. ....by chylomicrons.
C. True
D. True
E. False. ...the same effects....
F. False.  stores some of the iron... 
G. False. Pepsin from chief cells.