The second midterm will be on November 5th, in 100 GPB, from 12 pm to 1pm. Please remember to bring a scantron (882-ES) and a pencil.
These are suggested learning objects for the second unit of MCB135E. As for the first midterm, if you can say a few sentences about each topic and understand the general concept, you should be in good shape. Remember, these learning objects are generated by your GSI and not Professor Timiras. In other words, there might be things on the test that are not directly mentioned here; likewise, there is more here than will show up on your test. Prioritize your lecture notes and use this guide as a study tool. The guide is organized by lecture and covers up to the lecture on 10/27.
NOTE: YOU ARE RESPONSIBLE FOR ALL LECTURES UP TO THE EXAM INCLUDING THE LECTURE BEFORE THE EXAM. YOU ARE ALSO RESPONSIBLE FOR THE LECTURE ON LACTATION THAT IS ON THE WEBSITE. Good luck!!
(10/4) HORMONES IN REPRODUCTION
Know the role of the following hormones in reproduction, including gestation and birth: FSH, LH, estrogen, testosterone, progesterone, hCG, hCS, thyroid hormone, insulin. Know the hormones produces by the adrenal cortex (glucocorticoids, mineralocorticoids, sex hormones) and their role in fetal development. Understand the hypothalamic-pituitary-end organ axes including gonads, adrenal cortex, thyroid gland. Understand the effect of maternal diabetes on fetal growth. Understand how the production of a number of steroid hormones during pregnancy is dependent on the interaction of the mother, placenta, and fetal unit (see your handout). Understand the function of aldosterone, when the fetus begins to produce it and why.
Understand the regulation of growth before and after birth and the role of growth hormone on postnatal growth competence. Know the relationship of cortisol to respiratory function. Understand the growth and possible fetal survival of the anencephalic baby and how this is achieved. Know the roles of GH and the 2 major somatemedins before and after birth. Know the definitions of paracrine and autocrine. Understand that fetal growth is primarily regulated by paracrine signals and why this is beneficial. Understand the role of insulin in growth. Understand why deficient glycogen storage puts the baby at risk during birth. Understand why urine estrogen and progesterone levels can be used to evaluate placental function.
Know the definition of prematurity. Know the roles of estrogen, oxytocin, prostaglandins, and relaxin in labor and where each of these is produced. Know the three theories of how labor is initiated as well as the theory of CRH and the placental clock presented in a subsequent lecture. Know the three stages of labor. Know the relationship of the mechanical stimulation produced by the engagement of the babyıs head to oxytocin release. Know the central and local mechanisms for stimulation of uterine contraction. Know the three types of uterine muscle.
Know the prevalence of birth defects and an example of severe and moderate birth defects. Understand that the effects of teratogens are dependent upon timing and dose and that different organ systems have different critical periods. Know the difference between and an example of a structural and a functional defect. Know two examples of ³reversible² mental retardation. Understand how the majority of BDs are multifactorial. Be familiar with the common defects mentioned in lecture (ASD, cleft palate, spina bifida, PKU, etc.) And be able to recognize those included on the handout. Understand what experimental teratology is. Know the difference between a selective and universal teratogen. Know some of the consequences of folic acid deficiency, thalidimie, DES, and O2 excess.
Review the role of oxytocin, relaxin, prostaglandins in labor. 2 new items to learn: connexins and the placental clock theory. Understand the possible relationship between oxytocin, CRH, and stress. Review the role of cortisol in fetal development. Know some of the rationals for c-section. Understand why the c-section baby is more vulnerable at birth (this is covered in subsequent lectures).
Know the definition of SIDS, associated factors, and prevention methods. Understand how some systems are reorganized after birth (e.g. cardiovascular and CNS) while others take on new functions or are newly activated (e.g. respiratory and GI). Know the major structures an components of the respiratory system including the medulla, accessory muscles, the conducting zone and respiratory zone. Know the two types of cells in the alveoli and their functions. Know the functions of the lungs. Remember that the lungs have a role in the renin-angiotensin system covered on 10/27. Understand how changes in pH and CO2 stimulate respiration. Know what apnea is. Know why surfactant is important.
Understand how the GI system develops after birth (e.g. stomach volume, intestinal length, mucosa:muscularis, teeth, increase in stomach acid). Understand the significance of infant surface:body mass. Know the sources of energy for fetal growth and metabolism. Review PKU. Know the major GI functions. Know the embryological benchmarks of GI development mentioned in lecture. Know the definitions of Kwashakior and Marasmus and the mechanism of edema in the former. Understand why maternal milk is the ³best food². Know the roles of prolactin and oxytocin in lactation.
Know the principle functions of the liver (e.g. formation of bile, urea, a form of vitamin D, plasma proteins, cholesterol metabolism, etc.). Know the components of the liver (hepatocytes, cannaliculi, etc.) How is liver function different before and after birth? Know about bile, where it is formed, collected, stored, what it does, etc. Understand bilirubin metabolism and excretion. What is hyperbilirubinemia? What causes it? What are the two types? Know the difference between benign jaundice of the newborn and hemolytic disease of the newborn. Understand how hemolytic disease can result from the interaction of an Rh- mother with an Rh+ fetus. Understand that detoxification capacity is immature in the newbrn and the consequences.
Know about the embryological development of the kidney from nephrogenic cord to metanephros. Know the postnatal functions of the kidney. Know the components of the urinary system (medulla, cortex, calyces, pelvis, ureters, bladder, urethra). Know the components of the nephron. Know filtrate/day, normal plasma volume, and normal urine output/day. Know that the newborn has a greater H2O composition and the consequences of this. Functions of the kidney are further described in the next two lectures.
Review functions of kidney. Understand how ADH works and where it comes from. Understand how thirst is triggered by low plasma volume or high osmolarity which are sensed by baroreceptors and osmoreceptors; angiotensin II levels and buccal mucosal dryness also have a role. Know that filtration results from a balance between hydrostatic pressure and osmotic pressure. Understand that body fluids are distributed in different compartments (extracellular and intracellular). Understand how fuid is exchanged between the intra and extracellular compartments. Understand that osmotic pressure is a function of plasma protein. Understand the basic role of the vasa recta and the increase of osmolarity in the interstitial tissues between the loop of henle and vasa recta. Know where and how water is resorbed in the nephron (proximal tubules, loop of henle, distal tubules) and that almost all filtered H2O is resorbed. Know the factors affecting the ability to concentrate urine. Understand the differences in the length of the loop and amount of urea production in the newborn and the consequences of these. Understand why malnourished children are particularly vulnerable to dehydration.
Review role of kidneys in water balance, the common demands-in-excess of childhood (e.g. diarrhea, fever), and the function of ADH. Know the definition of diabetes insipidus. Know the renin-angiotensin system. Understand that the lungs and kidneys have complementary function in the regulation of pH. Know the mechanisms of urine acidification (reabsorption HCO3, secretion H+, formation NH4).