Definitions Flashcards
Organisation
Reorganising a tissue, the growth of capillaries and fibroblasts to change it from one thing to another, typically filling a cavity
Resolution
When the initiating factor is removed and the tissue is undamaged or able to regenerate
Repair
When the initiating factor is still present, the tissue is damaged and unable to regenerate
Healing by 1st intention
There is no gap between skin edges, the skin heals straight away and there is no infection
Healing by 2nd intention
There is a loss of tissue, you get granulation before a big scar forms
Stasis
A period of inactivity
An embolus
A mass of material in the vascular system. It can be lodged in a vessel and block it
Ischaemia
Lack of blood and reduction in blood flow
Infarction
When the cells have died from reduced blood flow
End artery supply
When only one artery supplies an organ
Congenital disorder
Disorders present at birth, could be developed in utero or inherited
Inherited disorder
Disorders caused by inherited genetic abnormality
Acquired disorders
Disorders caused by non-genetic environmental factors, they can be congenital (feral alcohol syndrome)
Hypertrophy
Increase in size of tissue caused by an increase in size of constituent cells
Hyperplasia
Increase in size of tissue caused by an increase in number of constituent cells
Atrophy
Decrease in size of tissue caused by a decrease in number or size of constituent cells
Metaplasia
Change in differentiation of a cell from one fully-differentiated type to a different fully-differentiated type
Dysplasia
Imprecise term for the morphological changes seen in cells in the progression to becoming cancer
Dermal elastosis
Wrinkles
Carcinoma in situ
A neoplasm that hasn’t broken through the basement membrane
Invasive carcinoma
A neoplasm that has broken through the basement membrane
Micro-invasive carcinoma
A neoplasm that has partly broken through the basement membrane
Tumour
Any abnormal swelling, including a neoplasm, inflammation, hyper trophy and hyperplasia
Neoplasm
A lesion resulting from the autonomous abnormal growth of cells, which persists after the initiating stimulus is removed. A new growth.
Screening
The process of identifying apparently healthy people who may be at an increased risk of a disease or condition
Sensitivity
How successful was the test at identifying all those with cancer in the group studied
Specificity
How well did the test identify all those without cancer in the group studied
Clonal selection hypothesis
The body that produces lots and lots of different types of B cells and it’s just luck that they fit with the bacteria
Primary lymphoid tissue
Where lymphocytes reach maturity (bone marrow/thymus). Also known as central lymphoid tissue
Secondary lymphoid tissue
Where lymphocytes are activated by antigens (spleen/lymph nodes). Also know as peripheral lymphoid tissue
Antimicrobial peptide
Secreted PRR that binds to the outside of a pathogen to make it easier for phagocytes to find
Lectins and collectins
Carbohydrate-containing proteins (secreted PRR) that bind to microbe walls, activate complement and improve phagocytosis by making the cell more obvious
Toll-like receptor
Cell associated (on the cell surface) PRR that binds to lipopolysaccharides and signals an immune response
Mannose receptor
Cell-associated PRR present on macrophages that detect fungi
Dectin-1
Cell associated PRR receptor present on phagocytes that detects fungi, it is more widespread that mannose receptor because it is on more cells
Nod-like receptor
Intracellular PRR that detects intracellular microbial pathogens
Hypersensitivity reaction
When an altered state of immunological responsiveness causes an inappropriate or excessive immune response
Rig-like receptor
Intracellular PRR that detects intracellular double-stranded viral RNA and DNA
PRR
Pathogen recognition receptor
PAMP
Pathogen associated molecular patterns
Natural killer cells
A lymphocyte (not phagocytic) that recognises ‘altered self’, kills unless they recognise a self-protein
Defensins
Positively charged peptides made by neutrophils. Insert into bacterial membranes and cause apoptosis of bacteria
Interferons
Produced by virally infected cells and T helper 1 cells. Combat viruses by interfering with cell replication and activated other immune responses
Cytokine
Small molecules secreted during an immune response that helps to signal and activate responding cells
Chemokines
Small molecules secreted during an immune response, these often signal cells to migrate to areas of inflammation
Perforin
Aids in delivering contents of cytotoxic T cell granules into the cytoplasm of target cell
Granzymes
Granules in cytotoxic T cells that are serine proteases, which activate apoptosis once in the cytoplasm of target cell
Granulysin
Granule in cytotoxic T cell that has anti-microbial actions and can induce apoptosis of target cell
Treg cells
T cells which can negatively regulate immune responses. High Treg count has bad patient prognosis
Natural Treg cells
Derived in the thymus, have CD4CD25 receptors
Adaptive Treg cells
Conventional T cells that are induced to turn into Treg cells in the periphery
Human leukocyte antigen
A group of proteins encoded within the MHC that the body uses to identify ‘self’
Cancer immunosurveillance
When the immune system can recognise and destroy nascent transformed cells all the time, normal control
Cancer immunoediting
Tumours tend to be genetically unstable, thus the immune system can kill and also induce changes in the tumour resulting in tumour escape and recurrence
Tumour escape
Immune responses change tumours such that the tumours will no longer be seen by the immune system
Tumour evasion
Tumours change the immune response by promoting immune suppressor cells
Immunotherapy
Learning how to harness the immune system to kill tumours
Adaptive immunotherapy
Inducing an immune response against the tumour that would discriminate between the tumour and normal cells
Active immunotherapy
Augmentation of host immunity to tumours with cytokines and co-stimulators or vaccinations
Passive immunotherapy
Adaptive cellular therapy (T cells) or anti-tumour antibodies
Allergy
Abnormal response to harmless foreign material
Atopy
A tendency to develop allergies
Tumour necrosis factor
Proinflammatory Cytokine with many functions, it causes death, mediates inflammation, maturation of dendritic cells, activation of T helper 1 cells
IL-6
An inflammatory cytokine, to function naked IL-6 requires gp130 and IL-6 receptor to be displayed on a cell
Pharmacokinetics
Describes how the body affects the drug
Pharmacodynamics
Describes how the drug affects the body
Potency
How well the drug works, described in EC50 (concentration that gives maximal response)
Full agonist
An agonist that gives maximal response
Partial agonist
An agonist that will never give you the full response. The Emax value describes the maximal response
Competitive agonist
Occurs when it can give maximal response is given by both the agonist and the antagonist
Non-competitive antagonist
When the maximal response of the agonist is reduced
Affinity
How well the ligand binds to the molecule, it is shown by agonists and antagonists.
Efficacy
How well the ligand activates a cell, it is just shown by agonists
Receptor reserve
A partial agonist has no receptor reserve, even with 100% occupancy maximal response is not seen. It varies from tissue to tissue
Signal transduction
Receptor is activated, other things (kinases etc.) get activated, lots of different steps leading to a response (transduction cascade)
Allosteric modulation
An allosteric ligand binds to the allosteric site on the agonist and affects the affinity in either a positive or negative way.
Drug tolerance
Reduction in drug effect over time. Needs continuous, repeated, high concentration drugs
Drug desensitisation
Receptors become uncoupled, internalised or degraded
Anti-pyretic
Reduce body temperature
Chimeric antibodies
Mostly human but Fab region is mouse antibody
Humanised antibodies
Almost all human but has 3 hypervariable mouse antibody sections
Compliance
The extent to which the patients behaviour coincides with medical or health advice (very professional based, not patient based)
Pain
Unpleasant sensory and emotional experience associated with actual or potential tissue damage
Invasins
Invade ileal and colonic epithelial cells causing local acute inflammatory response/tissue damage
Virulence determinants
A product or strategy that determines a bacteria virulence
CDT
Cytolethal distending toxin. Arrests cell cycle, target cells swell and lyse.
Urease
Hydrolyses urea to generate ammonia in order to buffer gastric acid
Protein A
A defensive protein, binds the Fc part of antibody so it can’t bind to immunological cells
Haemagglutinin
A sticky protein, sticking RBCs together and also to the epithelium
Pyogenic
Puss-forming
Cytotoxin
Several proteins that form a ring structure on cell membrane, causing a hole to form
Streptokinase
An enzyme released by strep. pyogenes, it breaks down clots that would walk off infection
Pre-patent period
The interval between infection of worms and the appearance of eggs in the stool
Nematodes
Roundworms
Trematodes
Flatworms, flukes
Cestodes
Tapeworms
Infectivity
The ability to become established in host, can involve adherence and immune escape
Virulence
The ability to cause a disease once established in a host
Invasiveness
The capacity of a pathogen to penetrate mucosal surfaces to reach normally sterile sites
Microbiome
Describes the totality of micro-organisms, their genetic element and their environmental interactions in an environment
Metagenomomics
Uses the genetic approach to describe the diversity of the microorganisms in an environment
Adhesins
Help bacteria binds to mucosal surfaces
Biofilms
Bacteria can stick together on a surface by secreting an extracellular polymeric substance of protein, polysaccharides and DNA
Superantigens
Bacteria and viruses can produce antigens that bind outside the peptide groove of the T-cell receptor, stimulating large numbers of T cells
Prophylaxis
Preventative healthcare
Kernig’s sign
As you straighten out the leg you pull the meninges and it’s very painful if the patient has meningitis
Brudzinski’s neck sign
When you lift the head and the patient reflexively lifts the knees to stop the meninges stretching if the patient has meningitis
Septicaemia
When an infection is found in the circulating blood this is septicaemia a.k.a. Blood poisoning
Antimicrobial
Agents produced by microorganisms that kill or inhibit the growth of other microbes in high dilution
ROTI
Related organ or tissue impairment
End of life care
If you are likely to die in the next year
Medical ethics
Critical evaluations of assumptions and arguments
Clinical truth
Clinical truth is contextual, personal and circumstantial. The cannot ignore objective truth but it mustn’t be relegated to it either
Deontology
Based on the belief that we have a duty of care to others. People are never treated as a mean to an end, they are the end. Tell the whole truth ignoring consequences. What would happen if everyone did this?
Consequentialism
Consequences are the most important thing, the way you get there isn’t important
Virtue ethics
A good person will act in a good way
Cardiac failure
Failure to transport blood out of the heart
Absolute risk
The risk of developing or dying from a condition over a specific period of time
Relative risk
A comparison between different risk levels
Attributable risk
Proportion of total risk that is due to a particular factor
Number needed to treat
The number of patients who need to take the treatment for one person to benefit from it
BME
An umbrella term used to describe people form minority social groups who share the common experience of discrimination of inequality because of their ethnic origin, language, culture or religion
Population attributable fraction (PAF)
The proportion of the incidence of a disease in the exposed and non-exposed population that is due to the exposure
Psychosocial factors
Factors influencing psychological responses to the social environment and pathophysiological changes
LVSD
Heart failure due to left ventricle systolic dysfunction
HFPEF
Heart failure with preserved ejection fraction (diastolic failure)
Syncope
Passing out
Spirometry
Fill lung as much as possible, blow the air out as fast and for as long as possible
Obstructive lung disease
Airways diseases, long time to exhale, FEV1/FVC
Restrictive lung disease
Interstitial or chest wall diseases. Lung volume is small so FEV1/FVC >80%
Transfer co-efficient
Measure of ability of oxygen to diffuse across the alveolar membrane
Occupational medicine
Branch of medicine concerned with the interaction of work and health
Epidemiology
The study of how often and why
Outbreaks
2 or more linked cases
Epidemic
More cases in the region/country
Pandemic
Epidemics that span international boundaries
Mast cell degranulation
Release of granule contents out of the cell. They release pre-formed mediators (histamine and enzymes) and newly synthesised mediators (cysteinyl leukotrienes and prostaglandin D2)
Epithelial degranulation
Losing epithelium (in asthma due to toxic proteins, major basic protein and eosinophil cationic protein)
Orthodromic impulses
Impulses in the correct direction
Chvostek’s sign
Tapping over the facial nerve in the region of the parotid gland causes twitching of the ipsilateral facial muscles
Trousseau’s sign
Carpopedal spasm induced by inflation of the sphygmomanometer cuff to a level about systolic blood pressure
Kussmaul’s respiration
Deep rapid breathing
Tinnel’s sign
Tapping on the carpal tunnel may reproduce the pain of carpal tunnel syndrome
There is progressive onset of limb weakness that reaches its nadir within 4 weeks. Reflexes are lost early in the illness. There are often sensory symptoms, parasthesiae. Disability ranges from mild to very severe, with involvement of the respiratory and facial muscles. Autonomic features, such as postural hypotension, cardiac arrhythmias, ileus and bladder atony are sometimes seen
Guillian-barre syndrome
Fatiguability of muscle on sustained or repeated activity that improves after rest. The ocular muscles are the first to be involved in about 65% of patients. The extraocular progression of weakness usually from top down leading to difficulty in talking, chewing, swallowing and respiratory difficulties
Myasthenia gravis
Erythema in the involved area, with poorly demarcated margins, swelling, warmth and tenderness. There may be a low-grade fever. In erysipelas the area is raised and erythematous and sharply demarcated from normal skin
Cellulitis
Muscle necrosis with sever pain and tissue swelling, gas production and sepsis with rapid progression to shock
Gas gangrene
Blackheads, whiteheads, inflammatory papules and pustules. Maybe hypertrophic or keloidal scarring and hyperpigmentation, which occurs predominantly in patients with darker complexions
Acne
Well-demarcated, salmon-pink silvery scaling lesions occur on the extensor surfaces of the limbs, particularly the elbows and knees. Scalp involvement is common
Chronic plaque psoriasis
Red glazed non-scaly plaques confined to flexures such as the groin, natal cleft and sub-mammary areas
Flexural psoriasis
Psoriasis occurs most commonly in children and young adults. An explosive eruption of very small circular or oval plaques appears over the trunk about 2 weeks after a strep throat infection
Guttate
Itchy, erythematous scaly patches, especially in the flexures such as in front of the elbows and ankles, behind the knees and around the neck. Scratching can produce excoriations and repeated rubbing produces skin thickening with exaggerated skin markings
Atopic eczema
An unusual pattern of rash with clear-cut demarcation or odd-shaped areas or erythema and scaling.
Exogenous eczema
A shiny pearly nodule which may go on to ulcerate.
Basal cell carcinoma
Ill-defined nodules that ulcerate and grow rapidly.
Squamous cell carcinoma
Keratoconjunctivitis sicca
Dry eyes
Xerostomia
Dry mouth
Hydronephrosis
Dilation of the renal pelvis or calyces
Obstructive uropathy
Functional or anatomic obstruction of urine flow at any level of the urinary tract
Supravesical obstruction
Above the level of the bladder
Infravesical obstruction
Below the level of the bladder
Bacteriuria
The presence of bacteria in the urine, can be symptomatic or asymptomatic
Pyruria
Presence of leukocytes in the urine, associated with infection.
Define epileptic seizure
Paroxysmal event in which changes of behaviours, sensation or cognitive processes are caused by excessive, hypersynchronous neuronal discharges in the brain
Define syncope
Paroxysmal event in which changes in behaviour, sensation and cognitive processes are caused by an insufficient blood or oxygen supply to the brain
Define a non-epileptic seizure
Paroxysmal event in which changes in behaviour, sensation and cognitive function caused by mental process associated with psychosocial distress occurs
Spondylolisthesis
Slippage of one vertebrae over the one below
Spondylosis
Degenerative disc disease
Myelopathy
Spinal cord disease
Radiculopathy
Spinal nerve root disease
What is autoinflammatory?
Describes a group of conditions with heritable systemic inflammation syndromes without circulating autoantibodies
What is base excess?
The amount of acid or base required to return 1 litre of blood to ‘normal’ mean standard bicarbonate of 22.9mEq/L
Puberty
The process of physical changes through which a child’s body matured into an adult body capable of sexual reproduction to enable fertilisation
Adrenarche
Adrenal maturation with increased adrenal androgens
Gonadarche
Gonadal maturation secondary to increased GnRH activity
Pubarche
The development of pubic hair
Thelarche
The development of breasts
Precocious puberty
Early puberty, girls before 8, boys before 9
Delayed puberty
Girls after 13, boys after 14
