Nutrient Uptake and Metabolism

NUTRIENT UPTAKE AND METABOLISM

8. Examination questions

8.1. Human anatomy 1. Relationship between the structure and function of the intestine wall layers. 2. Structural components of the gastric mucosa and submucosal layer, and their structural relationship with the function of stomach. 3. Characterization of liver intraorganic blood circulation. 4. Structural and functional features of the bile ducts. 5. Structural components of the exocrine pancreas.

8.2. Physiology 1. Factors affecting secretion of hydrochloric acid in the stomach. Mechanisms of their action. 2. Phases of gastric juice secretion and their features. 3. Nervous and humoral regulation of secretion of pancreatic juice and bile. 4. Regulation of functions of small and large intestine. Defecation.

8.3. Human histology and embryology 1. Embryologic origin of digestive system, main stages of development. 2. Histological structure and development of teeth. 3. Similarities and differences of histological structure of small and large intestine. Types of epithelial cells in different parts of intestine. 4. Similarities and differences of histological structure of major salivary glands. 5. Histological structure of cardiac, fundic and pyloric parts of the stomach. Role of stomach fundic glands in digestive process. 6. Structure of classical hepatic lobule. Blood circulation in the lobule. Ultrastructure of hepatocytes, secretion of bile. 7. Structure of exocrine and endocrine part of the pancreas. 8. Elements of organism‘s immune defence system in digestive system. 9. Glands in different parts of digestive tract and their role in digestive process. 10. Structures of oral cavity: tongue, teeth, lip.

8.4. Pathological anatomy 1. Lipidosis, its kinds, causative factors, morphogenesis, morphology, outcome and signifficance. Lipidic tezaurismoses, local accumulation of cholesterol and cholesterol esters. 2. Pathological anatomy and complications of the obesity. 3. Disorders of bilirubin metabolism. Jaundice, its mechanisms of development. 4. Calculi (stones), its mechanisms of formation, localisation and morphology. Disorders of urates metabolism. 5. Cholelithiasis and cholecystitis, its morphology and complications. 6. Diabetes mellitus, its classification, pathogenesis, morphology, complications and causes of death. 7. Alcoholism, its pathogenesis, morphology, complications and causes of death. 8. Nonspecific immune responce, its morphogenesis, morphology, cursus, outcome and functional signifficance. 9. Pathogenesis, morphology and complications of appendicitis. 10. Pathogenesis, morphology and complications of peritonitis. 11. Pathogenesis, morphology and complications of ulcer disease. 12. Benign and malignant tumors of esophagus and stomach, its kind of growing, morphology, complications and causes of death. 13. Tumors of intestines, its morphology, complications and causes of death. 14. Tumors of liver, gallbladder, bile ducts and pancreas, its morphology, complications and causes of death.

8.5. Pathological physiology 1. Swallowing and digestion disorders, their etiology, pathogenesis, disorders of body functions. 2. Stomach digestion disorders and consequences of stomach resection. Their etiology, pathogenesis, disorders of body functions. 3. Gastric ulcer, etiology and disorders of body functions. 4. Duodenal ulcer, etiology and disorders of body functions. 5. Intestine digestion disorders, malabsorbtion syndrome, irritable bowel syndrome, their etiology, pathogenesis, disorders of body functions. 6. Jaundice, etiology, pathogenesis, disorders of body functions. 7. Gallblader stones, their etiology, pathogenesis, disorders of body functions. 8. Lipid metabolism disorders. Obesity, etiology, pathogenesis, disorders of body functions. 9. Carbohydrate metabolism disorders: hypoglycemia, hypoglycemic coma. 10. Diabetes mellitus, etiology, pathogenesis, types and disorders of body functions. Diabetic comas.

8.6. Essentials of Medical Diagnostics

1. Clinical indications, the degree and the diagnostics of obesity. 2. Symptoms of illness in case of the diabetes mellitus. 3. Specimen of the tolerance to glucose. 4. Diagnostic signs of diabetes mellitus and the understanding of treatment. 5. Complications in case of diabetes mellitus. 6. Symptoms of illness in case of malfunctioning of digestive canal or liver. 7. Examination of stools. 8. Clinical biochemical analysis of liver enzymes. 9. Instrumental assays used in diagnose the diseases of digestive canal. 10. General clinical symptoms: acute and chronic stomach pain, dyspepsia, malabsorption, bleeding. 11. Jaundices 12. Comprehension of cirrhosis and liver malfunctioning caused by alcohol consumption.

8.7. Biochemistry 1. Digestion of polysaccharides, absorption of products of digestion. 2. Digestion of lipids (TAG, phospholipids, cholestrol esters), absorption of products of digestion. 3. Digestion of proteins, absorption of products of digestion. 4. Biosynthesis of hydrochloric acid in the stomach and its functions. Determination of acidity of gastric juice. 5. Structure of bile acids, role of bile in nutrient digestion. 6. Metabolism of hemoproteins. 7. Bile: main components; pigments and their metabolism. 8. Bile acids: origin, sites of produvtion, characterization of structure, importance of bile in digestion. 9. Reaction sequence of glycogen breakdown, enzymes, regulation, energy value, physiological significance. 10. Reaction sequence of glycogen synthesis, enzymes, regulation, physiological significance. 11. Metabolism of acetyl-CoA produced in beta-oxidation; ketogenesis (production of ketone bodies): substrates, reaction, enzymes, products, transportation and consumption of keton bodies. 12. Synthesis of triacylglycerols in tissues (tissue lipolysis) and its regulation. 13. Breakdown of triacylglycerols in tissues (tissue lipolysis) and its regulation. 14. Biological significance of cholesterol. Origin of cholesterol in human organism. The main stages of cholesterol synthesis. Regulation of cholesterol synthesis. 15. Approximate composition of chylomicrons, chylomicron formation and metabolism. 16. Approximate composition of very low density lipoproteins (VLDL), VLDL formation and metabolism. 17. Approximate composition of high density lipoproteins (HDL). HDL formation and metabolism. 18. General pathways of amino acid synthesis. Deamination of amino acids: ways of deamination, enzymes, their specificity, coenzymes, products and their metabolism. Diagnostic significance of aminotransferases. 19. Formation of ammonia and its detoxication in human organism. 20. Metabolism and elimination of xenobiotics. 21. Metabolism of ethanol. Mechanisms of ethanol toxicity. 22. Synthesis of insulin, secretion and its regulation in human organism. Target cells of insulin. Structure of insulin receptors, mechanism of intracellular signal transduction. Physiological effects of insulin. 23. Synthesis of glucagon, secretion and its regulation in human organism. Target cells of glucagons. Location of glucagons receptors, mechanism of intracellular signal transduction. Physiological effects of glucagon. 24. Mechanisms of regulation of glucose concentration in blood: implication of glucagon, glucocorticoids and insulin. 8.8 Pharmacology 1. Insulin preparations: classification (by origin and duration of action), relationship between pharmacokinetic properties and timing of administration. 2. Short-acting insulin preparations. 3. Intermediate-acting and long-acting insulin preparations. 4. Sulfonylureas and meglitinides. 5. Biguanides. 6. Thiazolidinediones and alpha-glucosidase inhibitors. 7. Undesirable effects of medicines used for the treatment of diabetes mellitus. Medicines used for the treatment of hypoglycemia. 8. Medicines used for the treatment of dyslipidemia: classification, mechanisms of action. 9. Statins: mechanism of action, indications, undesirable effects. 10. Undesirable effects of medicines used for the treatment of dyslipidemia.

8.9. Environmental and Occupational Medicine 1. Obesity; definition, distribution and causes. 2. Body mass index, its evaluation. 3. Evaluation of dietary composition: theoretical and in-fact caloricity calculation. 4. Principles of obesity prophylaxis. 5. Psychological, social and economical aspects of alcoholism. 6. Alcoholism and psychosocial injury of individual. 7. Alcoholism prophylaxis measures.