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Foundations of Health Services > HWD Final Exam > Flashcards

HWD Final Exam Flashcards

1
Q

What are five (5) points from 2015 Dietary Guidelines?

A
  1. Follow healthy eating pattern across lifespan
  2. Focus on (a) variety (b) nutrient density and (c) amount
  3. Limit calories from (a) added sugars (b) saturated fats (c) and reduce sodium
  4. Shift to healthier food and beverage choices
  5. Support healthy eating patterns for all people
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2
Q

What are five (5) points from 2015 Dietary Guidelines?

A
  1. Follow healthy eating pattern across lifespan
  2. Focus on (a) variety (b) nutrient density and (c) amount
  3. Limit calories from (a) added sugars (b) saturated fats (c) and reduce sodium
  4. Shift to healthier food and beverage choices
  5. Support healthy eating patterns for all people
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3
Q

What are three (3) dietary principles of healthy eating patterns?

A
  1. An eating pattern is totality of all foods and beverages consumed
  2. Nutritional needs should be met primarily from foods.
  3. Healthy eating patterns are adaptable.
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4
Q

What are five (5) groups of foods that constitute a diet with variety?

A
  1. Fruits [whole fruits]
  2. Grains [at least half whole grains]
  3. Fat-free or low-fat dairy
  4. Protein foods [sea food, lean meats, poultry, eggs]
  5. Oils
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5
Q

What is the specific limit on calories from added sugars?

A
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6
Q

What is the specific limit on calories from saturated fats?

A
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7
Q

What is the specific limit on sodium?

A
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8
Q

What are two measurements used for energy control?

A
  1. Nutrient density (mass per kcal)

2. Energy density (kcal per volume or mass)

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9
Q

What are five (5) groups of foods that constitute a diet with variety?

A
  1. Fruits [whole fruits]
  2. Grains [at least half whole grains]
  3. Fat-free or low-fat dairy
  4. Protein foods [sea food, lean meats, poultry, eggs]
  5. Oils
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10
Q

What is the specific limit on calories from added sugars?

A
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11
Q

What is the specific limit on calories from saturated fats?

A
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12
Q

What is the specific limit on sodium?

A
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13
Q

What are five (5) principles of diet planning?

A
  1. Adequacy
  2. Balance
  3. Moderation
  4. Variety
  5. Energy (calorie) control
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14
Q

What are two measurements used for energy control?

A
  1. Nutrient density (mass per kcal)

2. Energy density (kcal per volume or mass)

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15
Q

Define pharmacogenetics

A

Study of association between a single gene and drug effects

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16
Q

Define pharmacogenomics

A

Study focused on multiple genes contribution to drug effects

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17
Q

Define gene

A

DNA sequence that contains information to make a protein

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18
Q

Define locus

A

position on a chromosome where a gene resides.

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19
Q

Define genome

A

complete DNA sequence of an organism that contains all of its genetic information

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20
Q

Define proteome

A

Complete set of proteins encoded by genome of an organism

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21
Q

Define proteomics

A

Technology that analyzes the quantitative changes of the protein content of a cell, tissue or body fluid

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22
Q

Define autosomes

A

all of the chromosomes except sex chromosomes

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23
Q

Define sex chromosomes

A

X and Y chromosomes

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24
Q

Define allele

A

One of the variant forms of a gene at a particular location on a chromosome

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25
Q

What is the difference between a dominant and recessive allele?

A

Level of expression

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26
Q

Define homozygous

A

Having identical alleles at a given locus

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27
Q

Define heterozygous

A

Having different alleles at a given locus

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28
Q

Define genotype

A

Internally coded, heritable information (combination of all alleles)

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29
Q

Define phenotype

A

The observable manifestation of a genotype

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30
Q

Define haplotype

A

A set of alleles that tend to be inherited together as a unit

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31
Q

Describe structure of a nucleotide

A
  1. Purine or pyramidine (nitrogenous base)
  2. Sugar
  3. Phosphoric group
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32
Q

Define codon

A

A set of three consecutive nucleotides that provides genetic information to code of a specific amino acid

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33
Q

Define messenger RNA

A

RNA that serves as a template for protein synthesis

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34
Q

Define genomic DNA

A

All DNA from an individual person (both introns and exons)

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35
Q

Define complementary DNA

A

DNA that is synthesized from a messenger RNA using reverse transcriptase

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36
Q

Define transcription

A

The synthesis of a single-stranded RNA molecule from a double stranded DNA template in the cell nucleus

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37
Q

What enzyme catalyzes transcription?

A

RNA polymerase

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38
Q

Define translation

A

Process of synthesizing a polypeptide from an RNA template

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39
Q

What are four (4) examples of genetic polymorphisms?

A
  1. Nucleotide repeats (VNTR: Variable Number of Tandem Repeats)
  2. Deletions
  3. Insertions
  4. Mutations (may be silent or not)
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40
Q

What are two types of sites in an intron?

A
  1. Regulatory regions

2. Splice sites

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41
Q

Define exon

A

The segment of DNA that is part of a gene and codes for amino acids, polypeptides or entire proteins

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42
Q

Define mutation

A

any permanent heritable change in the sequence of genomic DNA

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43
Q

Define Sequence Tagged Sites

A

any piece of DNA designed for PCR assay that can test DNA sample for its presence

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44
Q

Define genetic polymorphism

A

a condition in which one of two different but normal nucleotide sequences can exist at a particular site in DNA

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45
Q

What are four (4) examples of genetic polymorphisms?

A
  1. Nucleotide repeats (VNTR: Variable Number of Tandem Repeats)
  2. Deletions
  3. Insertions
  4. Mutations (may be silent or
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46
Q

What is the Polymerase Chain Reaction (PCR)?

A

Laboratory method for amplifying (

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47
Q

What are two types of DNA markers

A
  1. Expressed Sequence Tags

2. Sequence Tagged Sites

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48
Q

Define Expressed Sequence Tags

A

Short cDNA sequence used for identifying regions of DNA

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49
Q

What is an advantage and disadvantage of genotyping?

A

Adv: (1)Less expensive and (2) requires only a single sample
Dis: (1) Not sufficient for multifactorial conditions, and (2) data is complex.

50
Q

Define Single Nucleotide Polymorphisms (SNPs) (3 components)

A
  1. Single base subtitution
  2. Most common type of polymorphism
  3. Can be well-tolerated OR disease risk factor
51
Q

What is the goal of pharmacogenetics application?

A

Ability to identify polymorphisms that alter drug concentrations or response to medication

52
Q

Define phenotyping

A

Finding an observable biochemical measure that gives end results of pharmacogenetic differences between people.

53
Q

Define genotyping

A

Finding a specific genetic code that gives main reason for pharmacogentic differences between people.

54
Q

What are six benefits of pharmacogenomics?

A
  1. Improved medications (better targeting)
  2. Safer drugs (analyze patient profile)
  3. Improved determination of proper dose
  4. Advanced screening of disease
  5. Advancements in drug discovery
  6. Decreased health care cost (prevent ADR, decrease therapy duration, decrease # of failed trials)
55
Q

What are six (6) drug treatment protocols pharmacogenomics can impact?

A
  1. Oncology
  2. Cardiology
  3. Psychiatry diseases
  4. Asthma
  5. Cystic Fibrosis
  6. Diabetes
56
Q

What are three causes of inter-individual variation in drug treatment?

A
  1. Drug metabolism
  2. Drug targets
  3. Drug transporters
57
Q

What is an example of an adverse reaction caused by drug metabolism polymorphism?

A

Mercaptopurine toxicity can be linked to Thiopurine methyltransferase deficiency (TPMT)

58
Q

What is an example of an adverse drug reaction caused by drug target polymorphism?

A

Drug induced tardive dyskinesia can be linked to Dopamine D3 receptor polymorphism changing sensitivity.

59
Q

What role do drug transporters have in pharmacokinetics?

A
  1. Expressed predominantly in liver, intestines and kidney

2. Important determinants of drug absorption, distribution and excretion

60
Q

What are six benefits of pharmacogenomics?

A
  1. Improved medications (better targeting)
  2. Safer drugs (analyze patient profile)
  3. Improved determination of proper dose
  4. Advanced screening of disease
  5. Advancements in drug discovery
  6. Decreased health care cost (prevent ADR, decrease therapy duration, decrease # of failed trials)
61
Q

What are six (6) drug treatment protocols pharmacogenomics can impact?

A
  1. Oncology
  2. Cardiology
  3. Psychiatry diseases
  4. Asthma
  5. Cystic Fibrosis
  6. Diabetes
62
Q

What are four (4) functions of the immune system?

A
  1. Identifies self
  2. Protects body from antigenic, foreign substance
  3. Scavenges dead and dying body cells
  4. Destroys abnormal (cancerous) cells
63
Q

What are four (4) types of white blood cells

A
  1. Phagocytes
  2. Basophils/Mast cells
  3. Lymphocytes
  4. Monocytes
64
Q

What are two (2) types of lymphocytes and what is their function?

A
  1. B-cells (produce antibodies)

2. T-cells (attack antigens and control response with cytokines)

65
Q

Describe IgA antibody

A

protect body surfaces exposed to the environment

66
Q

Describe IgD antibody

A

generally found in small amounts in chest and abdomen linings

67
Q

Describe IgE antibody

A
  1. located in lungs, skin and mucus membranes
  2. reacts to foreign antigens (allergy)
  3. remembers prior exposures
68
Q

Describe IgG antibody

A
  1. smallest and most common

2. found in most body fluids

69
Q

Describe IgM antibody

A
  1. largest

2. found in blood and lymph

70
Q

What are three examples of autoimmune disorders?

A
  1. Multiple sclerosis
  2. Lupus
  3. Rheumatoid arthritis
71
Q

How do corticosteroids affect immune system?

A

They affect gene transcription.

72
Q

What are five (5) ways corticosteroids can interact with immune systems?

A
  1. Suppress T-Cells [interfere with cytokine production]
  2. Suppress B-Cells [interfere with binding of interleukins]
  3. Suppress Neutrophils [inhibit adhesion, chemotaxis, phagocytosis, release of mediators]
  4. Suppress Macrophages [down-regulate Fc expression; decrease activity on opsonized things]
  5. Reduce prostagalandin and leukotriene production [decrease production of pro-inflammatory metabolites]
73
Q

What are three (3) mechanisms to enhance the immune system?

A
  1. Vaccination (immunization) (immune system memory: activated B cells and sensitized T cells)
  2. Adjuvants (poorly understood mechanism: involves aluminum salts to increase local concentration and increase uptake by antigen-presenting cells)
  3. Probiotics
74
Q

What are seven (7) complications from an altered immune response?

A
  1. Immune deficiency diseases
  2. Hypersensitivity
  3. Anaphylaxis
  4. Autoimmune disease
  5. Serum sickness
  6. Transplant rejection
  7. Graft versus host disease
75
Q

Describe five (5) anaphylaxis side effects

A
  1. Difficulty breathing
  2. Lower blood pressure
  3. Swelling/hives
  4. Increased heart rate
  5. May lead to shock
76
Q

What are three examples of autoimmune disorders?

A
  1. Multiple sclerosis
  2. Lupus
  3. Rheumatoid arthritis
77
Q

What are three (3) differences between benign tumors and cancer?

A
  1. Cancer has persistent proliferation
  2. Its growth is invasive
  3. Metastasis
78
Q

What are two examples of genetic links to cancer?

A
  1. Germ-line mutations, e.g. BRCA1/BRCA2

2. Acquired mutations, e.g. primary or secondary tobacco smoke.

79
Q

What are checkpoints in the cell cycle?

A

Steps in the process that check to make sure a phase has properly occurred. Failure results in apoptosis

80
Q

What are five (5) phases of Cell cycle?

A
  1. G0 phase
  2. G1 phase
  3. S phase
  4. G2 Phase
  5. M phase
81
Q

What happens in G0 phase?

A

Cell receives growth signals or mitogens and start process of cell division, entering into G1 phase.

82
Q

What happens in S phase?

A

DNA is synthesized

83
Q

What happens in G2 phase?

A

Cell arranges and checks chromosomes

84
Q

What happens in M phase?

A

Spindles attach and chromosomes are drawn apart.

85
Q

What are checkpoints in the cell cycle?

A

Steps in the process that check to make sure a phase has properly occurred. Failure results in apoptosis

86
Q

What are three mechanistic classifications of anti-neoplastic agents?

A
  1. Cytotoxic agents
  2. Hormones
  3. Hormone antagonists
87
Q

What are six (6) challenges in treating cancer?

A
  1. Treatments are toxic to normal cells
  2. Fractional cell kill (same percentage, not same number)
  3. Failure to detect cancer early
  4. Delivering drug to tumor
  5. Drug resistance
  6. Optimal therapy duration is unclear
88
Q

What are four (4) responses to cancer treatment?

A
  1. Cure [entirely free of disease for 5 years]
  2. Complete response [no evidence of disease for at least 1 month]
  3. Partial response [50% tumor decrease for at least 1 month]
  4. Disease progression [25% tumor increase or new lesions during therapy]
89
Q

What are four (4) roles of pharmacist in cancer treatment?

A
  1. Multidisciplinary oncology team (dosing, chemotherapy preparation, personalized medicine).
  2. Education and drug information (to professions and to patients)
  3. Monitoring (outcomes, side effects, drug interactions)
  4. Prevention and early detection
90
Q

What is consolidation chemotherapy?

A

used to prolong remission duration and overall survival

91
Q

What is adjuvant chemotherapy?

A

used to treat multi-drug resistant cancers after definitive local therapy (surgery or radiation)

92
Q

What are four (4) principles of combination chemotherapies?

A
  1. Each drug should be active by itself
  2. Avoid resistance (inherent or acquired)
  3. Use drug with different mechanism or cell cycle activity
  4. Minimize overlapping toxicities
93
Q

What are six (6) challenges in treating cancer?

A
  1. Treatments are toxic to normal cells
  2. Fractional cell kill (same percentage, not same number)
  3. Failure to detect cancer early
  4. Delivering drug to tumor
  5. Drug resistance
  6. Optimal therapy duration is unclear
94
Q

What are four (4) responses to cancer treatment?

A
  1. Cure [entirely free of disease for 5 years]
  2. Complete response [no evidence of disease for at least 1 month]
  3. Partial response [50% tumor decrease for at least 1 month]
  4. Disease progression [25% tumor increase or new lesions during therapy]
95
Q

What are four (4) roles of pharmacist in cancer treatment?

A
  1. Multidisciplinary oncology team (dosing, chemotherapy preparation, personalized medicine).
  2. Education and drug information (to professions and to patients)
  3. Monitoring (outcomes, side effects, drug interactions)
  4. Prevention and early detection
96
Q

Describe the activity of the complement pathway (2 components)

A
  1. Begins proteolytic attack on pathogens

2. Signals other effectors

97
Q

What are four (4) important inflammation actions?

A
  1. Increased vascular permeability
  2. Leukocyte extravasation [movement into tissues]
  3. Chemotaxis
  4. Disposal of cell and cellular debris
98
Q

Describe chronic inflammation

A
  1. Lasts months or years

2. variety of diseases

99
Q

What are four (4) signs of inflammation?

A
  1. Redness
  2. Warmth
  3. Pain
  4. Swelling (edema)
100
Q

What are four steps in inflammatory cascade?

A
  1. Infection or perceived threat activate immune system
  2. Leukocyte and endothelial cells activated
  3. Inflammatory mediators are released
  4. Inflammation occurs
101
Q

What is the complement pathway?

A

Group of proteins found in blood, body fluids and on cells originally thought to complement innate immunity.

102
Q

Describe the activity of the complement pathway (2 components)

A
  1. Begins proteolytic attack on pathogens

2. Signals other effectors

103
Q

What are seven (7) drugs mechanisms for anti-inflammatory effects?

A
  1. NSAIDS
  2. Corticosteroids
  3. Disease-modifying anti-rheumatic drugs (DMARDs)
  4. Immune biologics
  5. Anti-histamines
  6. Mast cell stabilizers
  7. Leukotriene modifiers [cyclooxygenase (COX) inhibitor]
104
Q

Does acetaminophen have anti-inflammatory effects?

A

no

105
Q

What is the mechanism of Entanercept (brand name Enbrel)?

A
  1. Binds TNF (both alpha and beta) and blocks its interation with cell surface receptors.
  2. Reduces inflammatory response by decreasing serum cytokine levels.
106
Q

What is C-reactive protein?

A

Biomarker of inflammation produced by the liver in response to pro-inflammatory cytokines

107
Q

What are two (2) muscloskeletal diseases with inflammation basis?

A
  1. Rheumatoid arthritis/osteoarthritis [autoimmune]

2. Gout [metabolic disease]

108
Q

What are two (2) skin diseases with inflammation basis?

A
  1. Psoriasis [t-lymphocyte mediated with hereditary component]
  2. Atopic dermatitis [hereditary component]
109
Q

What is the mechanism of Prednisone (brand name Deltasone)

A
  1. Prodrug that is converted to methylpredinosone [corticosteroid]
  2. Supressess migration of leukocytes and decreases capillary permeability
  3. Reduces activity and volume of lympathic system, suppressing the immune system.
  4. Suppreses adrenal function at high doses.
110
Q

What is the mechanism of Celecoxib (brand name Celebrex)?

A
  1. Selective Cox-2 inhibitor

2. Decrease formation of prostaglandin precursors.

111
Q

What is the mechanism of Entanercept (brand name Enbrel)?

A
  1. Binds TNF and blocks its interation with cell surface receptors.
  2. Reduces inflammatory response by decreasing serum cytokine levels.
112
Q

What is the mechanism of Hydroxyzine (brand name Atarax)?

A
  1. 1st generation H1 antagonist.

2. Reduces inflammatory response by competing with histamine.

113
Q

What is the mechanism of Ibuprofen (brand name Advil)?

A
  1. Inhibits prostagalandin synthesis via cyclooxygenase 1 enzymes.
114
Q

What is the mechanism of Montelukast (brand name Singulair)?

A
  1. Leukotriene receptor antagonist.

2. Binds receptors found in smooth muscle cells of respiratory system.

115
Q

What is the mechanism of Prednisone (brand name Deltasone)

A
  1. Prodrug that is converted to methylpredinosone [corticosteroid]
  2. Supressess migration of leukocytes and decreases capillary permeability
  3. Reduces activity and volume of lympathic system, suppressing the immune system.
  4. Suppreses adrenal function at high doses.
116
Q

What is the mechanism of Celecoxib (brand name Celebrex)?

A
  1. Selective Cox-2 inhibitor

2. Decrease formation of prostaglandin precursors.

117
Q

Give an example of a calcineurin inhibitor

A

Tacrolimus

118
Q

Give an example of an interleukin inhibitor

A

Anakinra

119
Q

Give two (2) examples of TNF-alpha inhibitors

A
  1. Adalimumab

2. Entanercept [Enbrel]

120
Q

Give two (2) examples of selective inhibitors for immune suppression

A
  1. Fingolimod

2. Omalizumab

121
Q

Give two (2) examples of non-specific inhibitors for immune suppression

A
  1. Azathioprine

2. Methotrexate

122
Q

What is mechanism of azathioprine?

A
  1. immunosuppressive antimetabolite
  2. halts replication and blocks purine synthesis
  3. alters function of RNA and DNA
  4. suppresses cell-mediated activities

Foundations of Health Services (3 decks)

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