Background Flashcards
Wet AMD - Progression
Outer seg of PR»_space; Engulfed by RPE»_space; Drusen (accumulation of debris) »_space; Autophagy (debris-filled macrophages)»_space; Inflammation»_space; (Inc) VEGF»_space; Neovasc»_space; Leaky BVs (under RPE)
Type I - Hypersensitivity rxn
(Common) = Immediate / Anaphylactic - (Fast) - Few min / Initial exposure - B cells»_space; Produ IgE / Second exposure - IgE binds to mast cells, Antigen binds IgE, IgEs cross-link»_space; Mast cell degranulation, Histamine release (e.g. Hay fever, Asthma)
Type IV - Hypersensitivity rxn
(Common) = Cell-Mediated / Delayed - (Slow) 1-2 days - Antigen interacts w/ T cell»_space; Cytokine release (e.g. Contact dermatitis, Vernal conj)
[COX], [LOX] pathway
Linoleic acid (Dietary PUFA, omega-6 fatty acid - Corn oil»_space; livestock/ Dec by omega-3 - Fish oil) OR Cell membrane phospholipids»_space; (Phospholipase A2)»_space; Arachidonic acid»_space; LOX - Leukotrines / COX»_space; Insertion of O2»_space; Eicosanoids - Prostanoids (Thromboxane - TXA2, Prostaglandin, Prostacyclin - PGI2)
[COX-1]
Constituent (In all tissues, esp GI)»_space; Thromboxane (TXA2), Prostaglandins (PGD2, PGE2, PGF2), Prostacyclins (PGI2)
[COX-2]
Inducible (In kidney, GI, CNS, (vascular) endo»_space; Upreg during inflammation)»_space; Prostaglandins (PGE2), Prostacyclins (PGI2)
Why [COX-2]- inhibitors removed from market
(e.g. Refecoxib - Vioxx) - (Inhibit) prostacyclins (PGI2) inhibiting platelet aggregation that usually counteracts thromboxane (TXA2) that (inc) platelet aggregation»_space; Clogging BVs - Inc risk of MI, CVA
Thromboxane (TXA2)
Platelet aggregation, VC (Triggered by atherosclerosis)
Prostaglandin (PGD2)
(DP receptor) - (inc) cAMP, Ca - Allergic rxn, Sleep/wake cycle
Prostaglandin (PGE2)
(EP receptor) - (inc) cAMP - Uterine contractions during labor, VD, (dec) stomach acid, Renal homeostasis
Prostaglandin (PGF2)
(FP receptor) - Uterine contractions during labor
Prostacyclin (PGI2)
(IP receptor) - (inc) cAMP - (Inhibits) platelet aggregation, VD, Renal homeostasis
Nociceptive pain processing
Stimulus»_space; Factors/inflammation (PG, NO, Bradykinin, Nerve GF), Nt (Glutamate, Substance P)»_space; Afferent nerve fibers (A-delta) - Myelinated (sharp somatic pain) - (C) - Unmyelinated (dull visceral pain)»_space; CNS (Spinal cord) - Dorsal horn, (Brain) - Thalamus/reticular formation (sense pain), Cortex/limbic system (emo to pain)
Neg feedback (to nociceptive pain processing)
Serotonin, NE, Opioid»_space; Opioid receptor (Inhibitory G-protein)»_space; (dec) cAMP»_space; (dec) Ca influx, dec nt release»_space; (inc) K out, dec excitability
Opioid receptor subtypes
(w/ endogenous opioid affinity) - (u) - Endorphins, (k) - Dynorphins, (delta) - Enkephalins / (u) - Euphoria, (dec) respiration, (k) - Dysphoria, hallucinations, (u and k) - Sedation, Constipation, miosis, (u, k, and delta) - Analgesia
Empirical vs. Definitive vs. Prophylactic antibiotic use
Empirical - Initiate Tx prior to det Dx
Definitive - Tx after confirming Dx
Prophylactic - Preventative measure (for patients predisposed to condition)
Prokaryotic cell - Cell wall, Plasma (cytoplasmic) membrane, Nuclear membrane, Genome, Organelles, Ribosomes, Cell division
(Wall) - Proteins, peptidoglycan, lipids / NO sterols / NO nuclear membrane / Single, circular DNA in nucleoid / NO organelles / 70 S (50 S + 30 S subunits) / Binary fission
Human Eukaryotic cell - Cell wall, Plasma (cytoplasmic) membrane, Nuclear membrane, Genome, Organelles, Ribosomes, Cell division
NO wall / Sterols / nuclear membrane / Multiple DNA molecules / 80 S (60 S + 40 S subunits) / Mitosis, Meiosis
Design of antibacterial combo drugs
Diff MOA (One bacteriostatic, One bacteriocidal), Diff spectrum coverage (One for Gram +, One for Gram -)
Antibiotic resistance in US vs Europe
In US antibiotics are not filtered from water supply (but in Europe they are)
Bacteria’s diff mech to antibiotic resistance
(Inactivate) - via Enzyme modification of drug, (Dec uptake) - Porin prevents drug entry, (Alt target) - Drug can NOT bind to target, (Inc elim) - Pump ejects drug that entered / (VRSA) - Swap genetic material w/ another bacteria, (Staph) Beta-lacatamse - Penicillinase - Change beta-lactam structure
(e.g. Antibiotic/Methicillin/Vancomycin/Multidrug-resistant)
(Mycobacterium TB, Staph aureus (MRSA) - Leading cause of hospital-acquired infections (VRSA), Enterococci (VRE), Neisseria gonorrhoeae/Gram neg bacteria - K pneumoniae, E coli)