Medical Issues Flashcards
Bacteria vs Viruses
Bacterias
- 1-cell
- Good or Bad
- Reproduce
Bacteria vs Viruses
Viruses
- Microscopic
- Can’t survive without host cell
- Can trigger immune response
Lines of Defense
1st LoD
- Physical: skin
- Chemistry: ↓ pH, antimicrobial
- Biology: Microbiome
- Nonspecific/ innate
Lines of Defense
2nd LoD
order:
1. Macrophage
2. Leukocytes
3. Neutrophils
* Complement Sys: HAve proteins that kill infected cells
* Causes Histamine release ➠ Inflammation ➠ more WBCs
* Nonspecific/ innate
Lines of Defense
Interferons
Signal to other cells to increase antiviral protection
Lines of Defense
3rd LoD
- Kill and Remember antigen ⟹ causes response in B and T cells
Lines of Defense
B cells
- Bone Marrow Cells
- Sit in lymphatic system and wait until needed
- Tons of them but when matched, mitosis of proper one occurs
1. Plasma cells are created to make tons of antibodies
2. Memory cells are created - Resistance increases in waves based on number of exposures
Lines of Defense
T cells
- Immature B cells in Thymus
- Sit in lymphatic system and wait until needed
Lines of Defense
Process of Activating Immune Cells
- Antigen attaches to self protein on macrophage
- now = macrophage to antigen presenting cells
- Runs into T cells until proper one is found
- Binds to proper helper T cell
- That helper T cell divides further
- B cells and cytotoxic T cells are activated
Lines of Defense
Cytotoxic T cells
- Bind with an infected cell
- Uses perforin to poke holes in a cell and kill it
Lines of Defense
Antibodies
They:
1. Neutralize: Stop bacteria from working
2. Agglutinize: make them stick together
3. Precipitate dissolved antigens: Make antigens less useful and easier to destroy
4. Activate complement system which causes cell lysis
* First 3 enhance phagocytosis
* Last causes cell lysis
Immune System - EdPuzzle
Lymphatic System
Connects tissues with immune system using lymph nodes
Immune System - EdPuzzle
Macrophages
- Attack invading bacteria with “arms”
- can eat up 100s of bacteria
Immune System - EdPuzzle
Neutrophils
- 2nd LoD
- Suicide warriors that use deadily chemicals that damage heathy and non-healthy cells
- Will kill themselves after a while to not hurt healthy cells
Immune System - EdPuzzle
Inflammation
Swelling as fluid enters the damaged area to deliver complement proteins
Immune System - EdPuzzle
Dendritic Cell
- Immune System Intelligence Officer
- reports parst of bacteria to proper helper T cell
Immune System - EdPuzzle
Memory cells
- Remember antigens of bacteria and continues producing low amount of antibodies to provide resistance to future infection
Organ Transplants
Problem with Organ Transplants
Rejection
Organ Transplants
Tests for Transplant
- Blood Types: A, B, O, AB + Rh factors(+/-)
- HLA(MHC) Antigens: Tissue Matching
- 6 varieties of self proteins
- Must match most for success
- Sibs share more often than strangers
- Not as large of an issue because of immunosuppresant drugs
- Cross Matching Test
- Antibodies against donor
- Living donor is better than dead: Immediately decomposes after death
Organ Transplants
Transplant Rejection
- Hyperacute; Immediate rejection; Blood Type mismatch
- Acute; Weeks/ Months; Inflammation and Leukocyte infiltration: Most common
- Chronic; Months/ Years; Thickening and Fibrosis of vessels
Organ Transplants
Transplant Criteria
- Kidney: Time on List = Largest Waitlist
- Liver = MELD Score
- Creatinine = How well Liver is working
- Bilirubin = How well liver is cleaning bile
- INR-h = How well making clotting factors
- Serum Sodium level
- ☝︎ MELD = Worse state
Organ Transplants
Alternate Treatments
- Xenotransplants with Pigs
- Have to have huge pig farms
- Bioprinting
- Hard to replicate complex organs
Organ Transplant Talk : Will Chapman
Problems with Transplants
- Need»_space;> Amount
- 20% die every year on waiting list
- Organ allocation not equal and not considering all factors
Organ Transplant Talk : Will Chapman
Cadaver Donors
- Brain Death
- No cortical brainstem function
- Non-Heartbeating donors
Organ Transplant Talk : Will Chapman
Procurement Logistics
- Multiple teams
- Differnt cold ischemia times: heart → kidney
- Drop temp and use preservation fluid used
Organ Transplant Talk : Will Chapman
Prisoners = Donors?
- Yes: need more and dont need anymore for death row
- No: Coercion, viral transmission, become a high risk donor, security requirements for hospitals
Organ Transplant Talk : Coach Kinney
Emotional Toll of Donation
- ALA-60
- 5-14 years to live
- too many choices and long nights deciding
- Drug Study
- Transplant
- Nothing
- Had to grapple with thinking about others dying for his benefit
Viruses
What are Viruses?
- Core: Nucleic Acid with 4-1000 genes
- DNA or RNA
- Protein Coated
- Capsomeres
- Have envelope sometimes to hide within body proteins
Viruses
Viral Reproduction
- Bind to protein on Host
Viral Reproduction
Covid Receptor
ACE-2
* Different types vary risk in animals
Viral Reproduction
Theory of Covid evolution
- labs
- Bats to pangolins to humans eating them
Viral Reproduction
Lytic Cycle
- Reproduction of virus in host cell then burst
Viral Reproduction
HIV
- Retroviruses = Uses RNA(less stable but quicker mutator)
- Chimps got SIV from monkeys and Humans got HIV from Chimps(after eating them)
- Have proteins to reverse transcription: reverse transcriptase and integrase
- Use lysogenic cycle
- Attack Helper T cells
- Bind to CCR5 & CD4 receptors
HIV
AIDS
- Autoimmune deficiency syndrome
- when Helper T cells with CD4 too low and makes immune system very suceptible to infections by opportunisitic diseases
Viral Reproduction
opportunisitic diseases
- Thrush
- Fungal Lung Infection
- Kaposis Sarcoma; Skin Cancer
- TB
Vaccines
Vaccines goal
- ☝︎ immune system strength by ☝︎memory cells
Types of Vaccines
Live Attenuated
- put in chick embryos to change virus then reinject into humans and trigger immune response
- best at illiciting immune responce
- Bad because:
- Revert and cause disease
- Possible harm to immunocompromised
- less safe than inactivated vaccine
- less safe for immuno compromised
Types of Vaccines
Inactivated Vaccine
- Not good at infecting but good at triggering immune system
- Many need more than one dose
- Safer and more stable
- can give to immunocompromised
Types of Vaccines
Replicating & Non-Replicating Viral Vector Vaccine
- give virus with ☟spike proteins and ☟ outside
- If Replicating, can give less because will produce more, but more dangerous
- Non-rep, need to give more but less dangerous
Types of Vaccines
Subunit Vaccines and Biotechnology
- Make spike protein which triggers immune system
- grown in bacteria and yeast and only 1 subunit
- need to make multiple because the virus will mutate multiple times
Types of Vaccines
RNA vaccines
- Trick cells to make immune cells by creating spike protein to respond to
- Faster to dev
Types of Vaccines
Boosters
- Enhance immune system
- Covers mutations
Vaccines
Herd Immunity
- Reduces spread among non vax ppl with more herd immunity
- Without can lead to old diseases reappearing with force: Measles
Vaccines
Testing
- Phases
- Safety
- Safety & Immune System Activated
- Safe and Effective
- Caused fear in ppl when sped up for COVID vax(new tech that was safe and didn’t need to sep stage 1 and 2)
Vaccines
Refusal Reasons
- Religion
- Personal
- Misinformed
Diseases
Sporatic
- Infrequently or irregularly gotten
Diseases
Cluster
- Concentrated in geological region
- occurs in larger numbers even though the actual number or cause is uncertain
Diseases
Endemic
- Contant presence / usual prevalence of a disease in a geographic population
- Africa for Malaria
Diseases
Hyperendemic
- Persistent High levels of disease
Diseases
Epidemic
- Sudden unexpected increase in the number of cases
- suggests out of control disease
- actively spreading
Diseases
Pandemic
- Epidemic spread over several countries
Diseases
Spanish Flu
- 1918
- Got in war then spread at home
- Started in africa
Epidemiology
What is it?
Who and How diseases spread
Epidemiology
Incidence
How much added to community
Epidemiology
Prevalence
Fraction of cases in population
Epidemiology
Case Control
People with disease
Epidemiology
Cohort Studies
Suceptible populations
Epidemiology
SIR Model
- Suceptible
- Infectious
- Removed
Vaccinations- Smith
Best case for
- Public health
- Removing Deadly disease
- Herd Immunity
- Cost Effective
- Economic and want good workers for govt
Vaccinations - Smith
Best Case Against
- Infringe on Autonomy and Religious beliefs
- animal testing
- lowering trust in medical system and govt
- medical problems
Public Health
What is it?
The mental and physical wellbeing of a population
Public Health
Govt Implementation
- Mix of prevention and treatment
- Freedom / Bodily Autonomy
- Socrates: Can’t follow laws when it pleases you
Public Health
Americans with Disabilities Act
- 1990
- 43 mil Am disabled with subtantial discrim or prejud
- Make resonable accomodations for those facing major life activity effects
Public Health
Bragdon v. Abbott
- 1998
- HIV Abbott informs dentist Bragdon abt HIV status and needs to fill cavity
- Wants to do procedure at hospital and makes her pay more for it
- Sues based in ADA and wins because descrim against major life ability(sex)
Public Health
AIDS and Crime
- Nushawn Williams, Darnell McGee, Angela Harris
- having sex while knowing you have HIV = attempted murder? or reckless endangerment?
Public Health
Ebola
- Bleed from every pore
- Kaci Hickox worked in Af as nurse and forced to stay on NJ runway for 21 days as quarantine
- Sued and won
Public Health
Corona
- Cruise ship
- Quarantine and mask mandates
