Lääkikseen eli pänttäyskertomus: Orgaaniset reaktiot osa II

Jun 8, 2009

Orgaaniset reaktiot osa II

Diagnosis by Pikkis - reported on Monday, June 08, 2009

'
Orgaaniset reaktiot:
1. substituutioreaktiot (korvausreaktiot, funktionaalinen ryhmä vaihtuu, yleisin)
2. additioreaktiot (liittymisreaktiot)
- additioreaktioihin kuuluu tärkeä ryhmä pelkistysreaktiot (esim. vetymolekyyliin liittyminen!)
3. eliminaatioreaktiot (lohkaisureaktiot)
- eliminaatioreaktioihin kuuluu tärkeä ryhmä hapetusreaktiot (esim. vetymolekyylin poistuminen!)
4. muut orgaaniset reaktiot

Entsyymit ja kofaktorit mahdollistavat monen biologisen systeemin kemialliset reaktiot (esim. pelkistys- ja hapetusreaktiot!).

Orgaanisen kemian reaktioihin vaikuttavat lisäksi mm. reaktion suorituslämpötila ja erilaiset liuottimet. Selvitettävä minkälaisia biologisten järjestelmien reaktioissa?

Käsitteitä

additioreaktiot eli liittymisreaktiot
eliminaatioreaktiot eli lohkaisureaktiot
entsyymi
hapetusreaktiot
kofaktori
liuottimet
pelkistysreaktiot
R = reaktiossa muuttumaton alkyyliryhmä (hiilivetyryhmä, esim. etyyli, metyyli, propyyli)
R' = samassa yhdisteessä esiintyvä toinen alkyyliryhmä
reagenssi
reaktion suorituslämpötila
substituutioreaktiot eli korvausreaktiot

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Lääkisvitsejä

Four surgeons were sitting around discussing who they like to operate on. The first surgeon said: "I like operating on librarians. When you open them up everything is in alphabetical order." The second surgeon said: "I like operating on accountants. When you open them up everything is in numerical order." The third surgeon said: "I like operating on electricians. When you open them up everything is color coded." The fourth surgeon said: "I like operatingon lawyers." The other three surgeons looked at each other in disbelief. One of them asked: "Why?" The fourth surgeon replied: "Because they are heartless, gutless, spineless, and their ass and head are interchangeable."

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The doctor tells the patient he has very bad flu. The patient says he wants a second opinion. The doctor says: "OK, you're ugly too. "

"A doctor is the only man without a guaranteed cure for the cold." - Dominic Cleary

"The art of medicine consists in amusing the patient while Nature affects the cure." - Voltaire

"If a doctor treats your cold, it will go away in fourteen days. If you leave it alone, it will go away in two weeks." - Gloria Silverstein

A man walks into the pharmacy and asks the pharmacist: "Do you have any acetylsalicylic acid?" "Do you mean aspirin?", says the pharmacist. "That's it, I can never remember that word."

Dwayne is recovering from surgery in St Peter's, Chertsey, UK, having had a local anaesthetic when a nurse asks him how he's feeling. "I'm O.K. But I didn't like the four-letter-word the doctor used in surgery." "What did he say?", asks the nurse. "OOPS!"

From Medical Charts

* Patient has two teenage children, but no other abnormalities. * Patient has chest pain if she lies on her left side for over a year. * On the second day, the knee was better, and then on the third day it disappeared. * The patient is tearful and crying constantly. She also appears to be depressed. * The patient has been depressed since she began seeing me in 1993. * Discharge status: Alive, but without my permission. * Healthy-appearing decrepit 69-year old male, mentally alert but forgetful. * The patient refused autopsy. * The patient has no previous history of suicides. * Patient has left white blood cells at another hospital. * Patient's medical history has been remarkably insignificant with only a 40-pound weight gain in the last three days.* Patient had waffles for breakfast and anorexia for lunch. * Between you and me, we ought to be able to get this lady pregnant.* Since she can't get pregnant with her husband, I thought you might want to work her up.* She is numb from her toes down.* While in ER, she was examined, x-rated and sent home.* The skin was moist and dry. * Occasional, constant, infrequent headaches.* Patient was alert and unresponsive. * She stated that she had been constipated for most of her life until she got a divorce.* Rectal examination revealed a normal-size thyroid.* I saw your patient today, who is still under our car for physical therapy.* Both breasts are equal and reactive to light and accommodation.* Examination of genitalia reveals that he is circus-sized.* The lab test indicated abnormal lover function. * The patient was to have a bowel resection.* However, he took a job as a stockbroker instead. * Skin: somewhat pale but present.* The pelvic exam will be done later on the floor.* Patient was seen in consultation by Dr. ____, who felt we should sit on the abdomen and I agree. * Large brown stool ambulating in the hall. * She has no rigors or shaking chills, but her husband states she was hot in bed last night.* Patient was found in bed with her power mower.

As the doctor completed an examination of the patient, he said: "I can't find a cause for your complaint. Frankly, I think it's due to drinking." "In that case," said the patient, "I'll come back when you're sober."

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Jun 8, 2009

Orgaaniset reaktiot osa II

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