Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Principles of Disease > Drug Therapy and Disorders of Cell Growth > Flashcards

Drug Therapy and Disorders of Cell Growth Flashcards

1
Q

What are the main stages of a drug life cycle in the body?

A

Absorption
Distribution
Metabolism
Excretion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is meant by absorption?

A

The movement of a drug from the area of administration to the circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the definition of CMax?

A

Maximum concentration a drug can reach in the circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the definition of TMax?

A

The time it takes for a drug to reach CMax (maximum concentration in circulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some of the common sites of administration of a drug?

A 
Oral
sublingual
topical
IV
IM
pessary
suppository
inhalation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the therapeutic range of a drug?

A

The optimal dose at which a drug is effective without being toxic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which is a constant and which is variable, TMax or CMax, and why?

A

TMax is constant - increasing dose doesn’t speed up the absorption process
CMax variable - increasing dose increases concentration in circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the main factors affecting absorption of a drug?

A

physiological/membrane barriers
GI activity
food/alcohol
disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is bioavailability?

A

The amount of blood in circulation available for use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is first pass metabolism?

A

Metabolism of a drug before it reaches its target

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the biochemical properties that affect drug absorption?

A
  • lipid solubility
  • ionisation
  • particle size
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What determines the lipid solubility of a drug?

A

The lipid-water partition coefficient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What determines the degree of ionisation of a drug?

A

The Henderson-Hasselbalch equation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What causes different rates of drug absorption in children?

A

Different pH levels
Gastric emptying
Metabolic rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some advantages of IV drug administration?

A

bypass first pass metabolism
100% bioavailability
quick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some advantages of inhalation drug administration?

A

bypasses first pass metabolism
can be metabolised in lungs
avoid oral administration side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are some advantages of rectal drug administration?

A

slow absorption
avoid stomach irritation
bypass first pass metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some advantages of subcut/IM drug administation?

A

bypass first pass metabolism
only need small dose
effect can be modulated with formulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some advantages of transdermal drug administation?

A

bypass first pass metabolism

can be used for slow release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some advantages of sublingual drug administation?

A

bypass first pass metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the differences between pharmacokinetics and pharmacodynamics?

A

pharmacodynamics - drug mechanism of action

pharmacokinetics - drug movement in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the definition of drug distribution?

A

The ability of a drug to reach the target tissue from the circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the definition of volume of distribution?

A

It is the theoretical volume of plasma required to detect the total concentration of drug in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the definition of drug clearance?

A

The time it takes for a drug to be eliminated from the circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the main organs involved in drug clearance?

A

Kidneys

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the mechanisms of drug clearance from the kidneys?

A

Glomerular filtration rate
Active secretion
Distal reabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the biliary system?

A

It’s a mechanism used by the liver to expel drug into the intestine through bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What happens to a drug when it goes through the biliary system?

A

It is bound to a conjugate which renders it inactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the importance of plasma proteins in drug administration?

A

They bind drug molecules, only unbound drug is active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What half-life of drug is best used in acute situations and why?

A

Short half life.

Long half life takes longer to take effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What properties of a drug are associated with higher volume of distribution?

A

Drugs which are lipophilic and non ionised, crossing barriers quicker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What factors can affect how much drug is bound in the circulation?

A

OTHER DRUGS
pregnancy
kidney failure
hypoalbuminaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the definition of half life?

A

The length of time after which the concentration of a drug in the circulation has halved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What factors affect half life of a drug?

A

Volume of distribution

Clerance rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the mechanisms of excretion of drugs from the kidneys, and what types of drugs do they excrete?

A

GFR - most unbound drugs
active secretion - ionised drugs (acids/bases)
passive reabsorption - small non-ionised drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What properties of a drug affect its volume of distribution?

A

Ionisation

Lipid solubility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What happens to drugs metabolised in the liver?

A

Rendered polar and water soluble, then excreted in bile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

In which organs do drugs have to be actively transported across membranes?

A

BBB
ovaries
testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

In which organs do drugs tend to build up during distribution?

A 
Eyes
bone
kidneys
lung
spleen
fat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why can drug metabolism cause toxicity?

A

Because drug breakdown products can be toxic metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the main changes that occur to a drug during metabolism, and why are they important?

A

drug made polar
drug mate water soluble
polar and watersoluble compunds can be excreted, whereas nonpolar and lipid soluble compounds are reabsorbed by circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the main steps involved in drug metabolism in the liver?

A

Phase 1 - oxidation, reduction, hydrolysis = make compound polar

Phase 2 - glucouronidation = make compound water soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the class of enzymes responsible for drug metabolism in the liver?

A

Cytochrome P450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the effects of enzyme inhibition on drug metabolism?

A

Drug metabolism slowed = higher level of drug in bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the effect of enzyme induction on drug metabolism?

A

Drug metabolised faster - lower levels of drug in bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which genetic modification of Cytochrome P450 causes a lack of response to codeine?

A

CYP2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Which types of Cytochrome P450 are the most important in drug metabolism?

A

CYP3A4
CYP2D6
CYP1A2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Which class of Cytochrome P450 is important in smokers and why?

A

CYP1A2 - metabolises theophylline, smoking induces enzyme so higher level of theophylline required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Which classes of Cytochrome P450 present genetic polymorphisms?

A

CYP2D6
CYP2C9
CYP2C19

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What factors can affect drug metabolism?

A 
Age
Pregnancy
Gender
Other drugs
Liver disease
Ethnicity 
Genetics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

In which phase of drug metabolism is a conjugate added to the drug, and what is this called?

A

Phase 2 - glucouridation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What are the different phenotypic types of metabolises?

A 
Poor metabolisers (PM
Intermediate metabolisers (IM)
Extensive metabolisers (EM)
Ultra rapid metabolisers (UM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

List some factors which induce drug metabolism

A

Alcohol
Smoking
Other drugs
Pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the main three considerations when deciding on a treatment regime?

A

Dosage of drug
Timing of administration
Frequency of administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the functions of enteric coating on tablets?

A

protect GI tract from drug

protect drug from GI acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are advantages of solutions and suspensions?

A

quick absorption
palatable (especially children)
easy for people with swallowing problems
can be given NG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are advantages of tables/pills?

A

easy to mass produce
easy to take
reproducible effect
reliable pharmacological effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are advantages to sustained release formulations?

A

Better compliance
less frequency of administration
maintains drug at therapeutic level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are some advantages of rectal formulations?

A

good for patients who can’t swallow

bypasses first pass metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are some of the advances in drug delivery methods?

A

nanoparticles
monoclonal antibodies
viral carriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the common factors considered for adverse drug reactions?

A

Onset and severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are the classifications of adverse drug reaction onset?

A

Acute (<60mins)
subacute (1-24 hours)
latent (>24hrs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the classifications of adverse drug reactions severity?

A

mild
moderate
severe

64
Q

What are the categories of adverse drug reactions and their main properties?

A

Augmented effect - predictable, primary or secondary
Bizarre effect - rare, non reversible, nonrelated
Chronic effect - after long term drug use (eg steroids)
Delayed effect - teratogenic/carcinogenic drugs
End of treatment effect - withdrawal/rebound symptoms
Failure of treatment effect - common, dose not high enough

65
Q

What is the mechanism used for reporting adverse reactions?

A

Yellow Card system

66
Q

What percentage of ADRs could potentially be avoided?

A

about 65%

67
Q

What percentage of hospitalised patients will develop an ADR?

A

10-20%

68
Q

What are some risk factors for ADR?

A 
Age
multiple conditions
multiple medications
kidney/liver disease
gender (women more likely)
genetics
prior history of ADR
69
Q

What percentage of ADRs leads to death in the UK?

A

up to 3%

70
Q

How common is death resulting from ADR in terms of leading causes?

A

4th leading cause

71
Q

What are the common mechanisms of drug interactions?

A

Pharmacodynamic

Pharmacokinetic

72
Q

In what way can drug interactions affect pharmacokinetics of other drugs?

A

they can affect Absorption, Distribution, metabolism and excretion

73
Q

How can drug-drug interactions affect drug absorption?

A

affect local pH
affect GI motility
affect gut flora
forming complexes with other molecules

74
Q

How can drug-drug interactions affect distribution of a drug?

A

affect plasma protein binding = alter bioavailability

75
Q

How can drug-drug interactions affect metabolism of a drug?

A

induce/inhibit cytochrome P450 function in the liver = increase/reduce drug metabolism and breakdown

76
Q

How can drug-drug interactions affect elimination of a drug?

A

can affect kidneys
can affect GFR
= slow down elimination

77
Q

What are the pharmacodynamic effects of drug interactions?

A

Direct/indirect effects
agonistic/synergistic effects
antagonistic effects

78
Q

What are examples of indirectly agonistic drug interactions?

A

warfarin + NSAIDS
benzo’s + alcohol/trycyclics
verapamil + atenolol

79
Q

What are examples of indirect antagonistic drug interactions?

A

NSAIDs + hypertensives/heart failure drugs

80
Q

which types of drugs are more likely to cause drug interactions?

A

drugs which are normally highly protein bound

drugs with a steep dose/response curve

81
Q

What is the best approach when dealing with drug interactions?

A
  1. try changing the frequency of the administration
  2. try alternative drug
  3. modify dose and monitor closely
82
Q

what are risk factors for drug interactions?

A 
being on many drugs
having multiple prescribers/self prescribing
age
diabetes
asthma
surgery
83
Q

what are the names given to a drug which is interacted with by another drug, and the drug causing the changes?

A

object drug

precipitant

84
Q

What is the incidence of drug interactions in hospital and primary care?

A

up to 30%

up to 70%

85
Q

What are common causes for medication errors?

A 
tiredness
depression
inexperience
heavy workload
unfamiliarity with drug
86
Q

What is meant by medication error?

A

potentially harming a patient as a result of wrong medication being given

87
Q

What is meant by prescription faults and errors?

A

faults - wrong decision on what drug to prescribe

error - mistake in writing up prescription

88
Q

When are medication errors most likely to occur?

A

on admission

on discharge

89
Q

What are the different classifications of errors in clinical practice?

A

error: wrong decision but not acted on
mistake: wrong decision, acted on
slip: task executed incorrectly
lapse: task executed correctly but omitted

90
Q

What are the 6 R’s to avoid prescription writing errors?

A 
Right patient
Right drug
Right dose
Right route
Right time
Right formulation
91
Q

are teratomas malignant or benign in ovaries?

A

benign

92
Q

are teratomas malignant or benign in testes?

A

malignant

93
Q

what is the leading type of cancer in men?

A

prostate cancer

94
Q

what is the leading type of cancer in women?

A

breast cancer

95
Q

what is the second most common type of cancer both men and women?

A

lung cancer

96
Q

what type of cancer is most common overall?

A

breast cancer

97
Q

what kind of cancers can occur in epithelial tissue?

A

glandular adenocarcinomas

squamous cell carcinomas

98
Q

what kind of cancers can occur in connective tissue?

A

osteosarcoma, liposarcoma, fibrosarcoma

99
Q

which cancers have the best, and worst, 5year survival rate?

A

best - melanoma

worst - lung cancer

100
Q

what are germ cell tumours known as?

A

teratomas

101
Q

what are the main two genetic mechanisms which contribute to cancer?

A

loss of tumour suppression genes

gain of oncogenes

102
Q

what are some of the main factors which promote tumour growth?

A

increased angiogenesis

reduced apoptosis

103
Q

how can cancer spread through the body?

A

via circulation
via lymphatics
local invasion
transcoelomic

104
Q

where is breast and prostate cancer likely to spread to?

A

bone

105
Q

where is ovarian cancer likely to spread to?

A

omentum

106
Q

what are some common sites for tumour metastasis?

A

liver
bone
lung
brain

107
Q

what are biomarkers and why are they useful?

A

proteins and molecules secreted by tumour cells

can be detected and used for diagnostic/prognostic and treatment purposes

108
Q

what are some types of biomarkers used clinically and for which cancer type?

A

alpha-feto protein (AFP) - testicular and liver cancer
oestrogen receptor - breast cancer
prostate specific antigen - prostate cancer
carcino-embryonic antigen (CAE) - colorectal cancer

109
Q

what is the difference between local invasion and transcoelomic spread?

A

transcoelomic spread moves through body cavities

it’s faster than local invasion

110
Q

what is a feature of cancer cells which allows them to form metastases?

A

loss of cell-cell adhesion

alteration of cell-matrix adhesion

111
Q

What can be some of the local effects of cancer?

A 
obstruction
pressure
pain
bleeding (anaemia/haemorrhage)
infection/ulceration
112
Q

What can be some of the systemic effects of cancer?

A 
weight loss (cachexia)
paraneoplastic syndromes (unexplained symptoms)
effects of treatment
hormone secretion ("normal" or abnormal)
113
Q

in what ways can cancer affect hormone secretion in terms of systemic effects?

A
  • normal: tumour cells induce higher levels of hormone from organs which normally secrete that hormone
  • abnormal: tumour cells induce production of hormone from the organ which doesn’t normally produce that hormone
114
Q

what are the stages of a cell life cycle during mitosis?

A 
G0 - cell not in active division
G1 - cell getting ready for DNA replication
S - DNA replication occurs
G2 - cell getting ready for mitosis
M - mitosis occurs
115
Q

what are the two different sets of factors which control cell division?

A

extrinsic - growth factors, hormones etc

intrinsic - checkpoints/restriction point

116
Q

What is the role of cyclin dependent kinases?

A

they area checkpoints during cell cycle, when cyclin is present

117
Q

What is pRb?

A

Retinoblastoma gene, tumor suppressor gene
target for CDKs, controls function of E2F transcription factor:
- hypophosphorylated –> active: inactivates E2F, so cell cycle stops
- phosphorylated –> inactive: E2F remains active, so no break applied to cell cycle

118
Q

What is E2F transcription factor?

A

a molecule which strongly induces cell cycle division

119
Q

What is the restriction point (P) during mitosis?

A

the checkpoint at G1 when the cell stops relying on external factors for progression of division process

120
Q

What is P53?

A

It’s a gene which is activated when there are errors in the cell cycle, to repair error or induce apoptosis through activation of p21

121
Q

What are the main genetic pathways which are disrupted during cancer?

A
  • P53 pathway

- Cyclin D –> pRb –> E2F pathway

122
Q

at which stage of cell cycles does cancer normally occur?

A

G1

123
Q

which are the main genes which become abnormal during cancer?

A

pRb
Cyclin D
CDK4
p16

124
Q

what are the mechanisms of chemical and radiation carcinogenesis?

A

chemical - nucleotides damaged, carcinogenic adducts bind to DNA
radiation - nucleotides damaged by radiation (xray, UV, gamma)

125
Q

what are the two versions possible in the “two hit hypothesis” of carcinogenesis, and what do they involve?

A

somatic - both copies of gene in same cell mutated over time
inherited - one gene in cell DNA already mutated, other one gets a somatic mutation later on
both lead to inactivation/loss of both genes in one cell, causing cancer

126
Q

what are proto-oncogenes, and how are they related to cancer development?

A

normal growth-promoting genes

structural or expression alteration can mutate them to become oncogenes

127
Q

how do oncogenes contribute to cancer?

A

they promote production of oncoproteins like growth factors and growth factor receptors

128
Q

what genetic changes normally lead to sporadic cancers?

A

several genetic mutations which occur over time

129
Q

what are the main three genetic causes of cancer?

A
  • chemical
  • physical (radiation)
  • viral
130
Q

what is PDL1 and what is its function in cancer?

A

checkpoint inhibitor

it binds to PD1 receptors on T cells, therefore “blinding” the T cells from recognising cancer cells as foreign

131
Q

how do barium studies show up on a scan?

A

white

132
Q

what types of barium studies are used for which types of cancer?

A

barium meal/swallow - upper GI/duodenum

barium enema - lower GI/large bowel

133
Q

what is the radiation for barium meal and barium enema?

A

barium meal - 1.5mSv

barium enema - 7mSv

134
Q

what is the difference between a pixel and a voxel?

A

pixel is 2D (x-rays)

voxel is 3D (CT)

135
Q

how do CT scans reconstruct the image?

A

analysing how many photons are sent back (not absorbed)

uses the Hounsfield attenuation coefficient

136
Q

What is the Hounsfield attenuation coefficient?

A

a measure which compares the attenuation level of tissues with that of water

137
Q

what are the radiation doses for chest, abdomen and pelvic CT scans?

A

chest - 8mSv
abdomen - 10mSv
pelvis - 10mSv

138
Q

What is the principle of ALARA?

A

as low as reasonably possible

only schedule CT scans when really necessary to avoid unnecessary radiation

139
Q

how do MRIs form an image?

A

magnetic frequency to align H+ protons

building image from how long it takes for them to return to normal alignment

140
Q

what should be the main properties of cancer screening?

A
  • early detection to allow for treatment
  • test shouldn’t cause harm
  • test should have reasonable cost/benefit ratio
  • test should be sensitive and specific
141
Q

what are the main classes of chemotherapy drugs?

A

antimetabolites
antimitotic antibiotics
alkylating agents
vinca alkaloids/taxanes

142
Q

what is an example of an alkylating agent in chemotherapy, and how does it work?

A

cisplatin

activated when added to water, it impairs DNA replication

143
Q

how do cancer cells resist alkylating agents?

A
  • alter its entry/exit into and out of the cell
  • inactivate it with enzymes once it enters
  • repair DNA that has been affected by drug
144
Q

what is the mechanism of action of anti-metabolites in chemotherapy, and what is an example of one?

A

methotrexate

mimic metabolites and bind to cell structures to stop DNA synthesis (S) in cell cycle

145
Q

what is the mechanism of action of vinca alkaloids and taxanes in chemotherapy?

A
  • vinca alkaloids prevent spindle formation prior to mitosis

- taxanes promote spindle formation but cycle goes no further

146
Q

what is the mechanism of action of antimitotic antibiotics in chemotherapy, and what is an example of them?

A

anthracyclines and non-anthracyclines

act in different ways at mitotic stage to stop it from happening

147
Q

What are the considerations of multidrug therapy for chemotherapy?

A
  • prevent resistance
  • synergistic action to increase response
  • different mechanisms to increase chance of response
  • different side effects to prevent neurotoxicity
148
Q

how do chemotherapy drugs cause nausea and vomiting?

A

through activation of the enterochromaffin cells, which release serotonin, causing nausea

149
Q

what is the basis PDL1 and Chimeric Antigen Receptor therapies in cancer immunotherapy?

A

PD1/PDL1 - unblinding T cells so they recognise cancer cells as foreign
CAR - modifying own T cells so they attack cancer cells)

150
Q

what are some other types of chemotherapy drugs apart from the cytotoxic agents and immunotherapy?

A

hormonal drugs

drugs targeting growth factors

151
Q

what are the systemic treatment options for cancer used?

A

chemotherapy
immunotherapy
targeted therapy
hormonal therapy

152
Q

what are the principles of adjuvant and neoadjuvant therapy in cancer?

A

neoadjuvant - prior to surgery, maximise surgical success

adjuvant - post surgery

153
Q

what are the benefits of radiotherapy?

A
  • can treat inoperable tumours
  • can reduce size of tumour to make it operable
  • can maintain structure/function of organ
  • responsible for 40% of cured cancers
154
Q

what are the prevention mechanisms for cancer?

A 
behavioural/environment change
diet change
screening
vaccination/prophylactic treatment
genetics
155
Q

what is the percentage of cancers treated with chemotherapy?

A

3%

Principles of Disease (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions