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Bioethics > Medical Issues > Flashcards

Medical Issues Flashcards

1
Q

Bacteria vs Viruses

Bacterias

A
  1. 1-cell
  2. Good or Bad
  3. Reproduce
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2
Q

Bacteria vs Viruses

Viruses

A
  1. Microscopic
  2. Can’t survive without host cell
  3. Can trigger immune response
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3
Q

Lines of Defense

1st LoD

A
  • Physical: skin
  • Chemistry: ↓ pH, antimicrobial
  • Biology: Microbiome
  • Nonspecific/ innate
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4
Q

Lines of Defense

2nd LoD

A

order:
1. Macrophage
2. Leukocytes
3. Neutrophils
* Complement Sys: HAve proteins that kill infected cells
* Causes Histamine release ➠ Inflammation ➠ more WBCs
* Nonspecific/ innate

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5
Q

Lines of Defense

Interferons

A

Signal to other cells to increase antiviral protection

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6
Q

Lines of Defense

3rd LoD

A
  • Kill and Remember antigen ⟹ causes response in B and T cells
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7
Q

Lines of Defense

B cells

A
  • 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
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8
Q

Lines of Defense

T cells

A
  • Immature B cells in Thymus
  • Sit in lymphatic system and wait until needed
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9
Q

Lines of Defense

Process of Activating Immune Cells

A
  1. Antigen attaches to self protein on macrophage
    1. now = macrophage to antigen presenting cells
  2. Runs into T cells until proper one is found
  3. Binds to proper helper T cell
  4. That helper T cell divides further
  5. B cells and cytotoxic T cells are activated
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10
Q

Lines of Defense

Cytotoxic T cells

A
  • Bind with an infected cell
  • Uses perforin to poke holes in a cell and kill it
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11
Q

Lines of Defense

Antibodies

A

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

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12
Q

Immune System - EdPuzzle

Lymphatic System

A

Connects tissues with immune system using lymph nodes

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13
Q

Immune System - EdPuzzle

Macrophages

A
  • Attack invading bacteria with “arms”
  • can eat up 100s of bacteria
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14
Q

Immune System - EdPuzzle

Neutrophils

A
  • 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
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15
Q

Immune System - EdPuzzle

Inflammation

A

Swelling as fluid enters the damaged area to deliver complement proteins

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16
Q

Immune System - EdPuzzle

Dendritic Cell

A
  • Immune System Intelligence Officer
  • reports parst of bacteria to proper helper T cell
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17
Q

Immune System - EdPuzzle

Memory cells

A
  • Remember antigens of bacteria and continues producing low amount of antibodies to provide resistance to future infection
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18
Q

Organ Transplants

Problem with Organ Transplants

A

Rejection

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19
Q

Organ Transplants

Tests for Transplant

A
  1. Blood Types: A, B, O, AB + Rh factors(+/-)
  2. HLA(MHC) Antigens: Tissue Matching
    1. 6 varieties of self proteins
    2. Must match most for success
    3. Sibs share more often than strangers
    4. Not as large of an issue because of immunosuppresant drugs
  3. Cross Matching Test
    1. Antibodies against donor
  4. Living donor is better than dead: Immediately decomposes after death
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20
Q

Organ Transplants

Transplant Rejection

A
  1. Hyperacute; Immediate rejection; Blood Type mismatch
  2. Acute; Weeks/ Months; Inflammation and Leukocyte infiltration: Most common
  3. Chronic; Months/ Years; Thickening and Fibrosis of vessels
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21
Q

Organ Transplants

Transplant Criteria

A
  • Kidney: Time on List = Largest Waitlist
  • Liver = MELD Score
    1. Creatinine = How well Liver is working
    2. Bilirubin = How well liver is cleaning bile
    3. INR-h = How well making clotting factors
    4. Serum Sodium level
  • ☝︎ MELD = Worse state
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22
Q

Organ Transplants

Alternate Treatments

A
  • Xenotransplants with Pigs
    • Have to have huge pig farms
  • Bioprinting
    • Hard to replicate complex organs
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23
Q

Organ Transplant Talk : Will Chapman

Problems with Transplants

A
  • Need&raquo_space;> Amount
  • 20% die every year on waiting list
  • Organ allocation not equal and not considering all factors
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24
Q

Organ Transplant Talk : Will Chapman

Cadaver Donors

A
  • Brain Death
    • No cortical brainstem function
  • Non-Heartbeating donors
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25
Q

Organ Transplant Talk : Will Chapman

Procurement Logistics

A
  • Multiple teams
  • Differnt cold ischemia times: heart → kidney
  • Drop temp and use preservation fluid used
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26
Q

Organ Transplant Talk : Will Chapman

Prisoners = Donors?

A
  1. Yes: need more and dont need anymore for death row
  2. No: Coercion, viral transmission, become a high risk donor, security requirements for hospitals
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27
Q

Organ Transplant Talk : Coach Kinney

Emotional Toll of Donation

A
  • ALA-60
  • 5-14 years to live
  • too many choices and long nights deciding
    1. Drug Study
    2. Transplant
    3. Nothing
  • Had to grapple with thinking about others dying for his benefit
28
Q

Viruses

What are Viruses?

A
  1. Core: Nucleic Acid with 4-1000 genes
  2. DNA or RNA
  3. Protein Coated
  4. Capsomeres
  5. Have envelope sometimes to hide within body proteins
29
Q

Viruses

Viral Reproduction

A
  • Bind to protein on Host
30
Q

Viral Reproduction

Covid Receptor

A

ACE-2
* Different types vary risk in animals

31
Q

Viral Reproduction

Theory of Covid evolution

A
  • labs
  • Bats to pangolins to humans eating them
32
Q

Viral Reproduction

Lytic Cycle

A
  • Reproduction of virus in host cell then burst
33
Q

Viral Reproduction

HIV

A
  • 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
34
Q

HIV

AIDS

A
  • Autoimmune deficiency syndrome
  • when Helper T cells with CD4 too low and makes immune system very suceptible to infections by opportunisitic diseases
35
Q

Viral Reproduction

opportunisitic diseases

A
  • Thrush
  • Fungal Lung Infection
  • Kaposis Sarcoma; Skin Cancer
  • TB
36
Q

Vaccines

Vaccines goal

A
  • ☝︎ immune system strength by ☝︎memory cells
37
Q

Types of Vaccines

Live Attenuated

A
  • 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
38
Q

Types of Vaccines

Inactivated Vaccine

A
  • Not good at infecting but good at triggering immune system
  • Many need more than one dose
  • Safer and more stable
  • can give to immunocompromised
39
Q

Types of Vaccines

Replicating & Non-Replicating Viral Vector Vaccine

A
  • 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
40
Q

Types of Vaccines

Subunit Vaccines and Biotechnology

A
  • 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
41
Q

Types of Vaccines

RNA vaccines

A
  • Trick cells to make immune cells by creating spike protein to respond to
  • Faster to dev
42
Q

Types of Vaccines

Boosters

A
  • Enhance immune system
  • Covers mutations
43
Q

Vaccines

Herd Immunity

A
  • Reduces spread among non vax ppl with more herd immunity
  • Without can lead to old diseases reappearing with force: Measles
44
Q

Vaccines

Testing

A
  • Phases
    1. Safety
    2. Safety & Immune System Activated
    3. 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)
45
Q

Vaccines

Refusal Reasons

A
  • Religion
  • Personal
  • Misinformed
46
Q

Diseases

Sporatic

A
  • Infrequently or irregularly gotten
47
Q

Diseases

Cluster

A
  • Concentrated in geological region
  • occurs in larger numbers even though the actual number or cause is uncertain
48
Q

Diseases

Endemic

A
  • Contant presence / usual prevalence of a disease in a geographic population
  • Africa for Malaria
49
Q

Diseases

Hyperendemic

A
  • Persistent High levels of disease
50
Q

Diseases

Epidemic

A
  • Sudden unexpected increase in the number of cases
  • suggests out of control disease
  • actively spreading
51
Q

Diseases

Pandemic

A
  • Epidemic spread over several countries
52
Q

Diseases

Spanish Flu

A
  • 1918
  • Got in war then spread at home
  • Started in africa
53
Q

Epidemiology

What is it?

A

Who and How diseases spread

54
Q

Epidemiology

Incidence

A

How much added to community

55
Q

Epidemiology

Prevalence

A

Fraction of cases in population

56
Q

Epidemiology

Case Control

A

People with disease

57
Q

Epidemiology

Cohort Studies

A

Suceptible populations

58
Q

Epidemiology

SIR Model

A
  1. Suceptible
  2. Infectious
  3. Removed
59
Q

Vaccinations- Smith

Best case for

A
  • Public health
  • Removing Deadly disease
  • Herd Immunity
  • Cost Effective
  • Economic and want good workers for govt
60
Q

Vaccinations - Smith

Best Case Against

A
  • Infringe on Autonomy and Religious beliefs
  • animal testing
  • lowering trust in medical system and govt
  • medical problems
61
Q

Public Health

What is it?

A

The mental and physical wellbeing of a population

62
Q

Public Health

Govt Implementation

A
  • Mix of prevention and treatment
  • Freedom / Bodily Autonomy
  • Socrates: Can’t follow laws when it pleases you
63
Q

Public Health

Americans with Disabilities Act

A
  • 1990
  • 43 mil Am disabled with subtantial discrim or prejud
  • Make resonable accomodations for those facing major life activity effects
64
Q

Public Health

Bragdon v. Abbott

A
  • 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)
65
Q

Public Health

AIDS and Crime

A
  • Nushawn Williams, Darnell McGee, Angela Harris
  • having sex while knowing you have HIV = attempted murder? or reckless endangerment?
66
Q

Public Health

Ebola

A
  • 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
67
Q

Public Health

Corona

A
  • Cruise ship
  • Quarantine and mask mandates

Bioethics (12 decks)

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