Fundamentals of Medicine Flashcards
Carcinoma
Malignant tumour of epithelial cell origin
Adenocarcinoma
Malignant tumour of epithelial cell origin with a glandular growth pattern
Squamous cell carcinoma
Malignant tumour of squamous epithelial cell origin
Sarcoma
Malignant tumour of mesenchymal tissue
Chondrosarcoma
Malignant tumour of cartilage
Fibrosarcoma
Malignant tumour of fibrous tissue
Osteosarcoma
Malignant tumour of bone
Leiomyosarcoma
Malignant tumour of smooth muscle
Rhabdomyosarcoma
Malignant tumour of striated muscle
What cancer does alcohol cause?
Hepatocellular carcinoma
What cancer does smoking cause?
Lung carcinoma
What cancer does soot cause?
Squamous cell carcinoma
What cancer does asbestos cause?
Lung methothelioma
What cancer does HIV cause?
Kaposi sarcoma
What cancer does EBV cause?
Burkitt’s lymphoma
What cancer does HPV cause?
Cervical cancer
What cancer does hepatitis C cause?
Hepatocellular carcinoma
What cancer does H. pylori cause?
Gastric cancer
Errors in nucleotide excision repair can lead to what condition?
Xeroderma pigmentosum
Errors in DNA mismatch repair can lead to what condition?
Colon cancer
Errors in homologous end joining can lead to what condition?
BRCA2
Breast and ovarian cancer
Paraneoplastic syndrome
Non-metastatic systemic effects accompanying malignant disease
Endocrine - Cushing’s disease hypo/hyperglycaemia
Neurological - Lambert-Eaton myastenic syndrome
Musculocutaneous - acnthosis nigricans
Haematological = granulocytosis
Characteristics of anaplastic tissue
Abnormal and prominent nuclei Hyperchromasia High nuclear-cytoplasmic ratio Chromatin clumping Loss of polarity
Overall cancer incidences
NMSC, breast, lung, colorectal, prostate
Children cancer incidence
Leukaemia, brain tumour, lymphoma
Cancer mortality
Lung, colorectal, breast, prostate, pancreatic
Death %
Pancreatic, lung, brain, stomach, oesophagus
Where do T cells develop?
Thymus
What interleukin promotes T cell clonal expansion?
IL-2
What do Th1 T cells release?
IL-2, IFN,g, TNFa
What do Th2 T cells release?
IL4, IL5, IL3, IL13
What causes Th0–>Th1?
IL-12, IL-23
What causes Th0–>Th2?
IL-4
What causes Th0–>Th17?
IL-6, IL-21, TGFb
What do Th17 cells release?
IL-17
What causes Th0–>T-reg?
TGFb
Inflammatory cytokines
IL-1, TNFa, IL-6
Anti-inflammatory cytokines
IL-10, TGFb
Which chemokine drives neutrophil recruitment?
CXCL8
Which cytokine increases endothelial stickiness?
TNFa
What enzymes do CD8 cells release?
Perforins and granzymes
Where do B cells develop?
Bone marrow
What does the Fc portion of the antibody dictate?
Function
What does the Fab portion of the antibody dictate?
Which antigen the antibody can bind to
Which antibody exists as a pentamer?
IgM
Functions of antibodies
Agglutination Opsonization Antibody-dependant killing Neutralisation Activation of complement
Secondary lymphoid tissues
Spleen Tonsils Lymph nodes Liver Peyer's patches Appendix
What does TLR4 recognise?
LPS
What does TLR5 recognise?
Flagellum
What does TLR9 recognise?
CpG DNA
What does TRL7 recognise?
Double stranded viral NRA
Which antibody is made first?
IgM
Which is the most commonly found antibody in the blood?
IgG
Which is the second most commonly found antibody in the blood?
IgA
MHC class I
Present on all cells
Presents endogenous ligands
Presents to CD8 T cells
MHC class II
Present only on APCs
Presents exogenous ligands
Presents to CD4 T cells
Polygenic
More than one type of each MHC class molecule
Polymorphic
There are multiple alleles within the population meaning most individuals are heterozygous
MHC class I types
A, B, C
MHC class II tupes
DR, DP, DQ
EC50
Half of the maximum response
Effect of competitive antagonism on EC50
High EC50
Effect of non-competitive antagonism on EC50
EC50 the same
Maximum response reduced
Intrathecal route of administration
Into CSF
Epidural route of administration
Outside dura
How does hepatic elimination work?
Through bile
Drugs with zero order elimination
Aspirin, phenytoin, ethanol
Which phase of reactions is more affected by age?
Phase I reactions
Volume of distribution formula
Amount of drug in body / plasma concentration
Tachyphylaxis
Reduced drug effect on a short time scale
Glycopeptides
Gram positive cell walls
Beta lactams
Gram positive and negative but depends on the drug itself
Target cell wall synthesis
Aminoglycosides
Gram positive and negative
Target 30s ribosome
Tetracyclines
Gram positive and negative
Target 30s ribosome
Macrolides and linsosamines
Target 50s ribosome
Quinolones
Target DNA gyrase and topisomerase
Broad spectrum
Rifampicin
Targets RNA polymerase
Polymyxin
Targets bacterial cell wall
Mechanisms of antibiotic resistnace
Target modification Efflux pump Degrading enzyme Impermeability Resistance genes
Amantidine, rimantidine
Antivirals
Inhibit M2 protein
Prevent hydrogen ion influx
Inhibit uncoating and coating of new virions
Ribavarin
Guanine analogue
Neuraminidase inhibitor
Prevents cleavage of sialic acids
Prevents release from membrane
Influenza specific adherance
Haemagluttinin
Sialic acid
E. coli specific adherance
Haemagluttinin
Mannose
S. aureus stealth mechanism
Binds antibody in wrong orientation
Functions of exotoxins
Facilitate pathogenic spread
Lyse cells
Block protein synthesis
Prokaryotes
Bacteria
Archaea
Eukaryotes
Fungi Protozoa Algae Helminths Arthropods
Gram positive cell wall
Thick peptidoglycan layer with no outer membrane
Gram negative cell wall
Thinner peptidoglycan layer with an outer membrane
Shapes of bacteria
Spherical = cocci Cylindrical = bacilli Spirals = spirochaetes
Groups of bacteria shapes
Ball = staphylo- Chain = strepto- Pair = diplo-
Catalase test
Divides gram positive cocci
Staphylococci = catalase positive
Streptococci = catalase negative
Staphylococci divisions
Coagulase positive = S. aureus
Coagulase negative
Streptococci divisions
Alpha, beta, non haemolytic
Cellulitis pathogen
Streptococcus pyogenes
Erysipelas pathogen
Group A strep
Scarlet fever pathogen
Group A strep
Impetigo pathogen
Staphylococci or streptococci
Enterobacteriaceae divisons
Lactose fermenters (pink) - E. coli Lactose non-fermenter (colourless) - pseudomons, salmonella
Glandular fever pathogen
EBV
Chicken pox pathogen
VZV
Nucleocapsid structure
Aggregations of capsomeres to produce the capsid
Capsid associated with viral nucleic acid
Diseases of the nucelus
Laminopathies
Emery Dreifuss muscular dystrophy
Hutchinson-Gilford progeria syndrome
RER function
Protein synthesis
Glycosylation
SER function
Synthesis of lipids and carbohydrates
Storage of calcium
Detoxification of drug toxins