Sunday, October 4, 2009

severe cutaneous atrophy in a dog with Cushing...Image via Wikipedia
  • Cushing syndrome is a disorder characterized by obesity due to hyper secretion of glucocorticoids.
  • Conn’s syndrome is primary aldosteronism.
  • Addison’s disease is chronic adrenal insuffiency.
  • Hormones of Adrenal medulla (Catecholamines) are
  • Pheochromocytoma is a condition in which there is excessive secretion of catecholamines.
  • Melatonin is secreted by parachymal cells of pineal gland, acts on gonads.
  • Severe stress can raise ACTH and cortisol level by 20 folds.
  • Fetal lung maturation depends on increased fetal Cortisol just before birth.
  • Human prolactin causes synthesis of milk in the female breast.
  • The half life of circulating growth hormone in humans is 20 to 30 minutes.
  • Blood is a connective tissue in fluid form.
  • Blood is 5 times viscous than water.
  • Blood cell count is greater in children than adult.
  • RBC is microcytic in iron defiency anaemia, prolonged forced breathing & increased osmotic pressure.
  • RBC is macrocytic in megaloblastic anaemia, muscular exercise & decreased osmotic pressure in blood.
  • Punctate basophlism is seen in lead poisoning.
  • Goblet ring is seen in certain types of anaemia like malaria.
  • Red cell vol. can be determined by radio isotope 51 Cr.
  • Cyanosis appears when the reduced Hb cone, of the blood in the capillaries is more than 5 gm/dl.
  • In vitro, coagulation is initiated by factor XII.
  • Life of RBC's in adult human body is 120 days.
  • Average life span of RBC in a newborn is 100 days.
  • Average life span of RBC in transfused blood is 90 days.
  • Life span of transfused platelets is 4 days.
  • Life span of platelets is 9-12 days.
  • Complete erythropoiesis occurs in 7 days.
  • Erythropoiesis occurs in
    • In first trimester RBC's are formed in Yolk sac. While in second trimester liver is the main organ. Third trimester in liver & bone marrow.  
    • Upto age of 5 – 6 yrs – red bone marrow of all bones.
    • 6 – 20 yrs – red bone marrow of all bones & all membranous bones.
    • After 20 yrs – all membranous bones & ends of long bone.
  • Hb starts appearing in intermediate normoblastic stage of erythropoiesis.
  • Nucleus disappears during late normoblastic stage.  
  • Factors needed for Erythropoiesis: erythropoietin, thyroxine, interleukins 3, 6, 11, stem cell factors, Vit B, C & D. (maturation factors Vit B12 & folic acid).
  • The iron remains in ferrous state.
  • The affinity of Hb for CO2 is 20 times more than for O2.
  • The affinity of Hb for CO is 200 times more than its affinity for O2.
  • Adult Hb consists of 2 alpha & 2 beta chains.
  • Fetal Hb consist of 2 alpha & 2 gamma chains.
  • In sickle cell anemia, the 2 alpha chains are normal but 2 beta chains are abnormal.
  • In Hb C, beta chains are abnormal.
  • Bilirubin is the final product formed from the destruction of Hb.
  • Total quantity of the iron in the body is 4gm.
  • 1 mg of iron is excreted every day through faeces. 
  • Normocytic normochromic anaemia is seen in aplastic aneamia.
  • Marcocytic normochromic anaemia seen in folate deficiency, Vit B12 & hypothyroidism.   
  • Pernicious anaemia or addsion's anaemia is marcocytic normochromic anaemia.
  • Microcytic hypochromic is seen in iron deficiency, thalassemia, heamoglobinopathies & heamolytic anaemia.
  • ESR decreases in allergic conditions, sickle cell anaemia, polycythemia & afibrinogenemia.
Male: 3 – 7 mm / hr
Female: 5 – 9 mm / hr
PCV (Packed cell volume)
Male: 40 – 45 %
Female: 38 – 42 %
MCV (Mean corpuscular volume)
90 cuµ (78 – 90 cuµ)
MCH (Mean corpuscular Hb)
30 pg (27 – 32pg)
MCHC (Mean corpuscular Hb Conc.)
30% (13 – 38%)
Colour index
1 (0.8 – 1.2)
4000 – 11,000 / cmm
50 – 70%
2 – 4 %
0 – 1 %
2 – 6%
20 – 30 %
Platelet count
2,50,000( 2 lakhs – 4 lakhs)
Bleeding time
3 – 6 min
Clotting time
3 – 8 min
Prothrombin time
12 sec
Activated partial thromboplastin time(APTT)
25 – 40 sec
Adult male
Adult female
4 – 5.5 millions / mm3
5 millions / mm3
4.5 millions / mm3
8 – 10 millions / mm3
Adult male
Adult female
New born
14 – 18 gm / dl
12 – 16 gm / dl
16 – 22 gm /dl
7.5 µ
Blood volume
5 liters
  • Granulocytes are neutrophils, eosinophils & basophils.
  • Agranulocytes are monocytes & lymphocytes.
  • Monocyte is the largest lymphocyte.
  • In hemophilia clotting time is prolonged in presence of normal bleeding time.
  • Christmas disease occurs due to deficiency of factor IX.
  • Clotting factors
Factor I
Factor II
Factor III
Factor IV
Factor V
Pro accelerin (labile factor)
Factor VI
No such factor
Factor VII
Stable factor
Factor VIII
Anti hemophilic
Factor IX
Factor X
Factor XI
Plasma thrombplastin antecedent
Factor XII
Hegman (Conduct)
Factor XIII
Fibrin stabilizing factor (Fibrinase)
  • Blood group:
Antigen in RBC
Antibody in serum
Anti – B (β)
Anti – α
A & B
No anti body
No antigen
Anti A & Anti B
  • Universal recipient are Blood Group 'AB because it does not contain either Anti A ab or anti B ab.
  • Universal donor is Blood Group "()" because it docs not contain either A or B agglutinogen (antigen).
  • Commonest blood group is O.
  • Diseases associated with blood groups:
    • Group A – C.A stomach
    • Group O – duodenal ulcer
  • Normal basic acid output is 5-10 mmol/hour.
  • Blood is stored in the blood bank at 40C.
  • The number of iron Heme in one Hb molecule is 4.
  • The number of O2 molecules carried by one Hb molecule is 4.
  • Mean corpuscular diameter is 7.5 nm.
  • Maximum concentration of Hb normally found in RBC's is 34%.
  • In arterial blood, saturated Hb with 02 is 97%.
  • Thromboxane A2 is synthesized by platelets and promotes vasoconstriction and platelet aggregation.
  • In sickle cell anemia, valine is substituted for glutamic acid.
  • Platelets are derived from megakaryocytes.
  • Pus contains — Dead neutrophils, macrophages and necrotic tissues.
  • Cardiac output in anemia is above normal while in polycythemia is about normal.
  • Agglutinins are either IgM or IgG.
  • In Erythroblastosis fetalis, mother is Rh-, father is Rh+, foetus is Rh positive.
  • Hapatoglobin is a plasma protein responsible for carrying free Haemoglobin.
  • Usual anticoagulant used for transfusion is a citrate salt.
  • Earliest feature of iron deficiency anemia is decreased serum ferritin.
  • Arneth count is used in the determination of the percentage distribution of different types of neutrophils on the basis of no: nuclear lobes.
  • Wilson’s disease is due to decrease in caeruloplasmin.
  • Hormones secreted by kidney are erythropoietin, thrombopoitein, renin & 1, 25 dihydroxy cholecalciferol.
  • 1 kidney contains about 1 – 1.3 millions nephrons.
  • Ratio of corical nephrons to Juxtamedullary nephrons 85: 15.  
  • The GFR of average sized normal man is approximately 125 ml / minute or 180 liters / day.
  • At the rate of 125 ml/min, the kidneys filter an amount of fluid equal to 4 times the TBV, 15 times the ECF vol. and 60 times the plasma volume.
  • 1 – 1.5 liters of urine formed / day.
  • Urine osmolality in diabetes insipidus is 300 mmol/L.
  • Normal protein excretion is 50 -150 mg%.
  • The quantity of water lost as sweat per day is 600-800 C.C
  • Normal urea clearance is 44 ml/min.
  • Renal blood flow is 25% of cardiac output (1300 ml blood/min).
  • Total length of distal convoluted tubule is 5 mm.
  • Glomerulus membrane permits the passage of substances upto 4 nm and almost totally excludes substance with size greater than 8 nm.
  • Each glomerulus is a net work of approximately 50 parallel capillaries.
  • Urinary osmolality in diabetes insipidus is 300 m mol/Lit.
  • Glucose and amino acid are absorbed in proximal convoluted tubules by secondary active transport or sodium Co-transport.
  • Descending limb of thin segment of loop of Henle is freely permeable to water.                                                                   
  • Areas impermeable to water — ascending limb of thin segment thick segment of loop of Henle. Proximal half of convoluted tubule.
  • Areas impermeable to urea — Distal convoluted tubule & cortical portion of collecting tubules.
  • Substances completely reabsorbed in PCT — Glucose, proteins, amino acids, vitamins, acetoacetate.
  • Substances partially absorbed in PCT—Na. K, Cl (7/8 reabsorbed in PCT).
  • Substances secreted in PCT — H+, PAH (para amino hippurate). creatinine.
  • H+ are actively secreted in proximal tubules, distal tubules, collecting ducts.
  • Hyperosmilality in the interstitum is the prerequisite for excretion of concentrated urine.
  • Urea is reabsorbed from inner meduallary collecting ducts only in presence of ADH.
  • K+ is actively secreted in Late Distal tubules and Collecting ducts.
  • Macula densa is the epithelial cells of the distal tubule that comes to contact with the arterioles.
  • Juxtaglomerular cells produce renin.
  • Renin acts on angiotensinogen & convert it into angiotensin I. 
  • Renal threshold for glucose is reduced in renal glycosuria.
  • Creatinine clearance represents GFR.
  • Clearance test for renal function includes inulin clearance, creatinine clearance & PAHA test.
  • PAHA test is performed to assess renal blood flow.
  • Micturition is primarily a spinal reflex.
  • Thick ascending loop of  henle is impermeable to water. 
  • Majority of sodium absorption occur  in the proximal tubule.  
4. 5 – 6
1000 – 1500 ml / day
Specific gravity
1.010 – 1.025
  • Average pH of semen is 7.5. 
  • Life span of spermatozoa within the female genital tract is upto 24 hours.
  • Speed of human sperm in female genital tract is about 3 mm/min.
  • Male sex hormones are called the androgens (secreted by leydig cells); testosterone, dihydro testosterone & androstenedione.
  • Mullerian ducts gives rise to female accessory sex organs such as vagina, uterus & fallopian tube.
  • Wolffian duct gives rise to male accessory sex organs such as epididymis, vas deferens & seminal vesicles.
  • Fetal testes begin to secrete the testosterone at about 2nd to 4th month of embryonic life.
  • The secretion from seminal vesicles contains fructose, phophorylcholine, fibrinogen, ascorbic acid, citric acid, pepsinogen, acid phosphatase & prostaglandin.
  • Fructose & citrate acts as fuel for the spermatozoa.
  • Prostatic secretion is rich in enzymes, fructose & citrate.
  • Androgen appears to be essential for spermatogenesis. Whereas FSH is required for spermatic maturation.
  • Testes do not produce fructose.(seminal vesicle)
  • Sertoli cells provide nutrition to the developing sperm; secrete oestrogen & hormone binding proteins.
  • Testosterone is synthesized from pregnanolone.
  • Testosterone stimulates the process of spermatogenesis, also necessary for the formation of secondary spermatocyte from primary spermatocyte.
  • Growth hormone is essential for the general metabolic processes in testis.
  • Male sex hormone is secreted mainly by interstitial cells of Leydig.
  • Development of male sex organ in fetal life depends on testosterone produced under the influence of HCG.
  • Testosterone circulates in Combination with Gonadal steroid binding globulin.
  • Hormone used for treating osteoporosis in old age — Testosterone.
  • In males FSH promotes spermatogenesis by enhancing the transport of Testosterone to seminiferous tubules and androgen binding protein synthesis from sertoli cells.
  • During menstrual period, upto 20 gm of protein may be lost.
  • Quantity of blood expelled during normal menstral cycle is 40 ml (approx) & serous – 35 mls.
  • FSH level is high in post menopausal women.
  • Ovarian hormones are estrogen and progesterone
  • Ovulation occurs on the 14th day of menstrual cycle in a normal cycle of 28 days.
  • Oxytocin causes contraction of smooth muscles of uterus & enhances labour.
  • Hormones secreted are HCG, Oestrogen, progesterone & human chorionic somato mammo tropin.
  • Relaxin is a hormone secreted from the maternal ovary during the later periods of pregnancy.
  • Biological test for Pregnancy can be performed only after 2 – 3 weeks of conception. 
  • LH is concerned with follicle maturation and ovulation.
  • Menopausal hot flushes are due to LH surge.
  • Estrogen increases the secretion and ciliary beating in fallopian tubes.
  • Estrogen changes the cuboidal lining of vagina to stratified.
  • Estrogen changes the break down of glycogen into lactate in vagina.
  • Estrogen initiates breast development.
  • Estrogen causes early epiphyseal closure.
  • Estrogen causes water retention.
  • Important function of progesterone is to promote secretory changes in endometrium.
  • Progesterone is the hormone for maintenance of pregnancy.
  • Progesterone inhibits ovulation.
  • The most important function of progesterone is to promote secretory changes in endometrium.
  • In human beings the total body water varies from 45 – 75 % of body weight.
  • Total water in the body is about 40 liters. (ICF forms 55% & ECF forms 45%).
  • The volume of interstial fluid is about 12 liters.
  • The volume of plasma is about 2.75 liters.
  • Osmolality is the measure of a fluid’s capability to create osmotic pressure, also called as osmotic conc. of a solution.
  • Osmolarity is the no: of particles / per liter of solution.
  • Isotonic solutions are having same effective osmolality as body fluids. Eg: 0.9% Nacl solution & 5% glucose solution.
  • The insensible water loss from the body is about 600 to 800 ml. per day.
  • The quantity of water lost as sweat per day is 600 – 800 C.C.
  • The normal pH of plasma is 7.4
  • Acidosis is pH  below 7.38
  • Alkalosis is pH above 7.42
  • Respiratory acidosis: primary excess of carbonic acid
    • Due to hypoventilation as in respiratory diseases & neural diseases.
  • Metabolic acidosis: primary deficiency of bicarbonate
    • As in lactic acidosis, diabetic ketoacidosis, uremic acidosis & diarrhea.
  • Respiratory alkalosis: primary deficiency of carbonic acid
    • Due to hyperventilation as in hypoxia, neural diseases & psychological conditions.
  • Metabolic alkalosis: primary excess of bicarbonate
    • As in vomiting & treatment with diuretics.

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