2a notes

Question 1

What are 3 diseases that involve amyloidosis?

Answer 1

myeloma
Alzheimer’s disease
carpal tunnel syndrome

Question 2

What is lymphoedema and how would you treat it?

Answer 2

chronic non-pitting oedema due to lymphatic insufficiency - normally affects the legs
TREAT: compression stockings, massage, long-term antibiotics to prevent cellulitis

Question 3

What is amyloidosis and how would you test for it?

Answer 3

deposition of amyloid (protein)

biopsy of rectal mucosa

Question 4

What are some causes of lymphoedema?

Answer 4

Primary = inheritied deficiency of lymphatic vessels 
secondary = obstruction of lymphatic vessels e.g. malingnacy after radiation

Question 5

What are some of the functions and types of lymphocytes?

Answer 5

B cells - produce antibodies
T cells
- CD4 (MHCII) stimulate B and CD8 cells
- CD8 (MHCI) directly kill pathogens via enzymes

Question 6

What is the purpose of alternative pathway and how does it do this?

Answer 6

It amplifies immune response of classical and lectin - C3 (b) from blood binds to pathogen
Factor B + D forms C3 convertase

Question 7

What is a granuloma?

Answer 7

aggregate of epithelial histocytes`

Question 8

What is the definition of a carcinoma?

Answer 8

malignant epithelial neoplasm

Question 9

What is an adenoma?

Answer 9

benign tumour of glandular epithelium

Question 10

What is the definition of carcinogenesis?

Answer 10

The transformation of normal cells to neoplastic cells through permanent genetic alterations or mutations

Question 11

What is the function of C3a and C5a?

Answer 11

They activate mast cells to produce histamine - increasing inflammation

Question 12

What type of hypersensitivity is inflammation?

Answer 12

Type IV - cell mediated

Question 13

What are the characterisitics of inflammation?

Answer 13

redness, heat, swelling, pain, loss of function

Question 14

What are the types of immunoglobulins and their function?

Answer 14

IgG - humoral immunity 
IgM - in blood, involved in complement 
IgA - mucosal surface and tears 
IgD - antigen recognition 
IgE - allergic response

Question 15

What is the classical complement cascade?

Answer 15

C1 binds to IgG or IgM - cleaves to C4 converting C4 to C4a and C4b
C4b binds to the pathogen and cleaves C2, converting C2 into C2a and C2b
C4bC2a is formed (C3 convertase) which converts C3 to C3a and C3b
This forms C5 convertase (C4bC2aC3b) which cleaves C5 to C5a and C5b

Question 16

What is the definition of a neoplasm?

Answer 16

a lesion resulting form the autonomous abnormal growth cells which persists still after the initiating stimulus has been removed

Question 17

What is the difference between lectin and classical pathways?

Answer 17

In lectin pathway - the lectin with mannose residues binding with polysaccharide cleaves C4 and C2 to C3 convertase
Classical it is C1 binding to IgM or IgG

Question 18

What are the fluid compartments?

Answer 18

Total (42 L) - 2/3 intracellular (28L)

1/3 extracellular - plasma (3L), interstital 11L), transcellular (1L)

Question 19

What is the window period in HIV?

Answer 19

the period between the virus being present in the body and it being present in the blood

Question 20

What type of bacterial are staphlococcus and streptococcus?

Answer 20

both gram + cocci
staph = clusters
streph = chains

Question 21

What bacterial can infection people taking antibiotics?

Answer 21

clostridium difficile

Question 22

Why can’t you diagnose TB with a gram stain and what do you use instead?

Answer 22

it’s an acid fast bacilli so has a high lipid content which is resistant to gram stain
use a ziehl-neelsen stain

Question 23

What are the effects of adrenoreceptors?

Answer 23

alpha 1 - vasoconstriction, pupil dilation, contraction of bladder
alpha 2 - decreases insulin
beta 1 - increases force, rate and contraction of heart, increases renin and therefore blood pressure
Beta 2 - bronchodilation, vasodilation, decreases GI motility
Beta 3 - increases lipolysis and relaxation of bladder

Question 24

What are the 5 types of malaria and their differences?

Answer 24

vivax - 48 hr cycles
ovale - 48 hr, can lay dormant in liver 
malariae - 72 hr cycles
falciparium - 48 hr cycles, cerebral malariae
knowlesi - 48 hr cycles

Question 25

How does HIV infect people?

Answer 25

CD4 receptors bind to HIV receptor = conformational change and the 2nd receptor binds
membranes fuse
viral genetics move into cell
matrix and capsule digested and the RNA is released
reverse transcriptase
integrase moves DNA to host chromosome
RNA transcriptase

Question 26

What is commensal?

Answer 26

when an organism colonises the host but does not cause disease in normal circumstances

Question 27

What are the stages of virus replication?

Answer 27

attachment 
cell entry 
interaction 
replication 
assembly 
release

Question 28

Where does the chickenpox virus lie dormant?

Answer 28

in dorsal root or cerebral ganglion

Question 29

What are the 6 key properties of a virus?

Answer 29

can only be seen under electron microscope
only grows in living cells
inert outside host, have enzymes that act inside cell
process DNA and RNA
no cell wall, has outer protein coat and sometimes a lipid envelope
protein receptor on virus surface allow attachment to susceptible host cells

Question 30

What does MIC in antibiotics mean?

Answer 30

minimal inhibitory concentration

- lowest concentration of antibiotic that will inhibit visible growth of microorganism after overnight incubation

Question 31

What are the 4 features of HIV that make it a very dangerous virus?

Answer 31

sexually transmitted
long latency period
attacks immune system
very good at replicating and mutating

Question 32

Name 5 modifiable diseases

Answer 32

mumps, measles, rubella, scarlet fever, hepatitis (a,b,c), anthrax, cholera, legionnaires, measles, meningitis, SARS, smallpox, rabies, whooping cough

Question 33

What colour are gram - bacteria and why?

Answer 33

they are pink - crystal violet stain fades but the fuchsin counterstain stays visible

Question 34

What are 2 things in antibiotics the can determine killing?

Answer 34

concentration dependant - how high the concentration is above MIC
Time dependant - time that the serum concentration is above MIC in dose interval

Question 35

What are the stages of bacterial growth?

Answer 35

lag
exponential/log
stationary

Question 36

What is the vector for malariae?

Answer 36

female anopheles mosquito

Question 37

What are the 2 stages of liver metabolism?

Answer 37

Phase 1: modification by oxidation, reduction or hydrolysis by cytochrome P450 enzymes
Phase 2: conjunction with glucaronic acid etc. to make drug more water soluble

Question 38

What is the difference between pharmokinetics and pharmodynamics?

Answer 38

kinetics - how body effects drug

dynamics - how drug effects body

Question 39

What are 5 types of adverse drug reactions?

Answer 39

Augmented: predictable extension of clinical effect
Bizzare: hypersensitivity
Chronic: occurs after long time of therapy
Delayed: occurs many years after use
End of use: withdrawal

Question 40

What is the difference between affinity and efficacy of drug?

Answer 40

affinity = how well ligand bind to receptor 
Efficacy = how well ligand activates receptor

Question 41

What are the 4 main targets of drugs?

Answer 41

receptors
enzymes
transporters
ion channels

Question 42

What is the definition of pain?

Answer 42

unpleasant sensory or emotional experience associated with actual or potential tissue damage