Directions:

1.     Print your name on each page of the examination before you do anything else!
        Do it now, and do it neatly.
2.     You absolutely, positively MUST confine your answers to the spaces provided.
        Failure to do so may result in an inaccurate evaluation of your knowledge.
3.     Complete the exam using a PEN if you wish to retain the right to discussing your
        answers with Dr. K-I-A.
4.     You must include sign and/or units in all answers requiring them.

#1.     Why can someone with Type A blood receive a transfusion of Type O
           blood but not of Type AB blood?

Type O blood does not have either the A or B antigen (it is not antigenic) so the Anti B antibodies in the Type A blood will not cause a problem.  The Type AB blood has both the A and B antigens and thus the Anti B antibodies in Type A would attack the AB transfused blood.
 

#2.     Examine the axes (and the numbers on the axes!) below and carefully
          follow the directions given in questions a through e.

a.     Carefully and with complete accuracy, fill in the curve for normal adult
        hemoglobin.  Label it with an A. – see Fig 16.8 in your text – you must
        have the right curve, especially at 40 mmHg and 100 mm Hg
b.     Based on your curve above, what is the P50 value of Hb?   Between 20
        and 50 mmHg
c.     Now plot the curve for fetal Hb.  Label it with an F.     To the LEFT
d.     Myoglobin is a monomeric protein found in skeletal muscle.  Myoglobin
        binds and stores oxygen in the muscle.  Draw the curve for myoglobin: Label it M.
        Somewhere to the LEFT of A and almost vertical  (no subunits )
e.     List two things that would shift the curve for Hb A to the right:
       increased temperature, decreased pH (Or increased CO₂), increased 2,3 DPG
 

#3.     a.  Agent R increases blood pressure but does not alter heart rate.  Agent R is
             alpha 1 agonist
          b.  Agent T does not change heart rate and does not block the response of the
               intestine or the heart to ACh or NE.  It does induce a slight increase in BP
               and eliminates the response of the bronchioles to Epi.  Agent T is acting as
               beta 2 antagonist
          c.  Agent W does not change heart rate, decreases BP, and induces intestinal cramps.
               Agent W is            histamine

#4.     Dr. Harley Schmedlap, Jr., noted physiologist, 440 alumnus, and part-time UM snow shoveler, has discovered a new form of life burrowing under the snow piles on campus.  These furry little creatures feed on the blood of frustrated 440 students who fling themselves into the snow in frustration over not understanding pharmacology.  Schmedlap has named this creature Horrillibus higginsus and now requests your help in completing the analysis of the following data:
 
 

	[Ion]intracellular	[Ion]Extracellular	Relative Permeability
Na+	12 mM	141 mM	0.05
K+	125 mM	6 mM	1.0
Cl-	11mM	135 mM	0.1
Ca++	10 µM	10 mM	0.0

a.  The actual, accurate value of the membrane potential is    -61 (or -61.0) mV
b.  The equilibrium potential of Ca++ is                               - 92 (or –92.3) mV
c.  Increasing the conductance of which two ions will induce hyperpolarization?
                                                                                                      K⁺ and Cl^-
d.  Increasing the extracellular concentration of which ion will induce depolarization?
                                                                                                    Na⁺ and K⁺
e.  If Vm were equal to - 111 mV, would Cl- enter or leave the cell?  Leave
f.  The maximum height of an action potential on a nerve in this creature would be:
                                                                                             + 66 (or + 65.8) mV
g.  In fewer than 5 words:  what is responsible for the refractory period of a nerve?
                                                      Inactivation of (voltage gated) Na⁺ channels

Now Schmedlap recorded an action potential from the nerve cells of this creature and provides the data below.  Use this graph to answer questions h through ?.

According to this plot,

h.     what is the value of Vm?   h_(approx) – 75 mV

i.     According to this plot, what is the E of Na⁺ ?   i (approx) +50 mV

j.     According to this plot, what is the E of K⁺ ?  j approx – 85 to –100 mV

k.     How long do the voltage-gated Na⁺ channels remain open k  ~ 1 msec

l.     How long do the voltage-gated K⁺ channels remain open? L  ~1 msec
 

#5.     Predict the action of each of the following agents on each of the following QUANTITIES by using I, D, or No .
 

	ACh	Epi	propranolol	Nicotine	agonist	agonist	histamine	NE
ACh release from parasymp nerve terminal	No C	D	No C	No C or I	No C	D	No C	D
Ventricular muscle strength	No C	I	No C or D	No C	No C	No C	No C	I
Heart Rate	D	I	D	D	No C	No C	No C	I
Pupil diameter	D	I	D	D	I	No C	No C	I
Blood Flow to skeletal muscle	I	I	D or No C	No C	D	No C	I	D
Blood Flow to intestine	No C	D	No C	No C	D	No C	I	D
Flow of saliva	I	I	No C	I	I	No C	No C	I
Bronchiole diameter	D	I	D or No C	D	No C	No C	D	No C
Secretion of stomach acid	I	D	No C	I	No C	D	I	D

#6.   Each of the following can be answered in one to three words.  Do so:
a.     Why has myelin evolved in vertebrates?
                                                                                a_ Increase conduction velocity
b.     Where do the parasympathetic nerves exit
        the spinal column:                                                           b_ cranial and sacral
c.     Increasing the G of Na⁺ on a post-synaptic neuron would
        result in what specific event?                                                           c__epsp_
d.     Serotonin does what to blood vessels?
                                                                                                                 d_constrict
e.     What protein binds both collagen and platelets?
                                                                                                                    e_vWf
f.     As the hematocrit increases above normal levels,
       plasma EPO                                                                                              f _D
g.     As plasma [prostacyclin] increases, the rate of platelet plug
      formation would                                                                                        g _D
h.     As kidney function declines in a human subject, plasma
      total bilirubin levels                                                                                   h_I_
i.     As liver function decreases in an alcoholic subject, plasma
       free bilirubin                                                                                        i__I___
j.     As blood oxygen levels decrease, the number of circulating
       reticulocytes would soon                                                                 j___I_____
k.     The most numerous phagocytic polymorphonuclear
       granulocyte is                                                                                k neutrophils
l.     This circulating granulocyte cell releases both
        heparin and histamine                                                                      l_Basophils
m.    This white blood cell is monomorphonuclear and
        differentiates into an antibody producing cell          m_B lymphocyte (or B cell)
n.     As plasma levels of NO increase, platelet aggregation
        will                                                                                                                 n_D
o.     Aspirin (acetyl salicylic acid) works as a “blood thinner”
        by inhibiting the synthesis of which specific molecule? o_TXA 2 or thromboxane
p.     As plasma [histamine] increases, the work of breathing
                                                                                                                            p__I__
q.     As red blood cell [2,3 DPG] decreases, Hb P₅₀
                                                                                                                           q__D__
r.     As hypothermia progresses, O₂ delivery to cells
                                                                                                                  r__D_______
 

#7.     Atropine used to be prescribed as a treatment for ulcers.  List three prominent side effects of this drug:

#8.     Advise an Rh+ mother who learns that she is pregnant with an Rh – child.  Is there a problem?  Explain briefly.

No problem because the fetal rbc’s do not have an antigenic structure (so mom will not generate any immune response against child’s rbc’s)

#9.     Clotting Factor X was originally called the Stuart Factor after the unfortunate individual who was missing it.  Factor XII was similarly celled the Haegman Factor.  Who had the bigger problem, Stuart or Haegman?  Explain.

Absence of Haegman (Factor XII) will still leave the Extrinsic mechanism intact while absence of the Stuart Factor (X) means no clotting response is possible.  Hence you don’t want to be Stuart !!