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1
Q

what are 5 cardinal signs of infection

A

-rubor (redness)
-dolor (pain)
-calor (heat)
-tumor (swelling)
-loss of function

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2
Q

3 stages of inflammation

A
  1. bradykinin + prostacyclin + NO mediate vasodilation
    2.fluid exudate- vessel becomes leaky and fluid forced out
    3.cellular exudate- neutrophils become abundant in exudate
  2. chemotaxis, more neutrophils move to inflammation site due to chemicals released
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3
Q

neutrophils in acute inflammation

A

-migrate to edge of BV
-adhesion together
-

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4
Q

what is the sequence of acute inflammation

A

-injury/infection
-neutrophils phagocytose and release enzymes
-macrophages phagocytose
-either, resolution OR progression to chronic inflammation

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5
Q

what are the 4 outcomes of acute inflammation

A

-resolution, normal
-suppuration, pus formation
-organisation, tissue replaced with granulation tissue in healing process
-progression to chronic inflammation

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6
Q

what are neutrophil polymorphs

A

-WBCs
-contain lysosomes for phagocytosis
-1st cells at site of inflammation
-lifespan= 2-3 days

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7
Q

what are macrophages

A

-phagocytose debris/bacteria
-transport material 2 lymph nodes + present it to lymphocytes 2 induce secondary immune response
-lifespan= months-years

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8
Q

what is the sequence of chronic inflammation

A

-no/very few neutrophils
-macrophages + lymphocytes
-fibroblasts arrive
-often ends w. repair + scar tissue

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9
Q

what are lymphocytes

A

-lifespan= years
- produce antibodies, B lymphocyte plasma cells
-immunological memory cells
-secondary defence mechanism

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10
Q

what are fibroblasts

A

produce collagenous connective tissue in scarring following some types of inflammation

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11
Q

what are granulomas

A

-particular type of chronic inflammation
-collections of macrophages/histiocytes surrounded by lymphocytes
-may be due to TB or leprosy
-may be seen around foreign material in tissue

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12
Q

2 reasons why blood clots don’t form all the time

A
  1. laminar flow
  2. non sticky endothelial cells
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13
Q

what is thrombosis

A

formation of a solid mass of blood from constituents in an intact vessel in a living person

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14
Q

what is the 1st stage of thrombosis

A

platelet aggregation, clotting cascade, + feedback loop causes formation of fibrin mesh which traps RBCs

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15
Q

3 factors that can cause thrombosis

A
  1. endothelial cell injury (changes vessel wall)
  2. change in blood flow
  3. change in blood constituents
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16
Q

thrombosis risk factors

A

-smoking, harmful chemicals
-diabetes
-hypertension
-lack of activity
-high cholesterol

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17
Q

what is an embolism

A

solid mass of blood is carried thru circulation until it becomes stuck + blocks a vessel

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18
Q

causes of an embolism

A

usually a thrombus
otherwise air, cholesterol crystals, amniotic fluid, fat

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19
Q

what is ischaemia

A

reduction of blood flow , therefore O2, to a tissue

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20
Q

what is an infarction

A

tissue necrosis due to inadequate blood flow to affected area

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21
Q

which organs are less susceptible to an infarction

A

dual arterial supply in:
liver, lung and brain

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22
Q

what is resolution

A

initiating factor removed
tissue undamaged/able to regenerate

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23
Q

what is repair

A

initiating factor still present
tissue damaged + unable to regenerate
- damaged tissue replaced by fibrous tissue
-collagen produced by fibroblasts

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24
Q

look up in notes regeneration

A

and repair

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25
what is atherosclerosis
accumulation of fibrolipid plaques in systemic arteries -reduces blood flow
26
risk factors for atherosclerosis
-hypertension -hyperlipidaemia -cigarette smoking -poorly controlled diabetes
27
process of atherosclerosis
-endothelium damaged -ulceration of endothelium leads to development of atherosclerosis plaques
28
what can atherosclerosis cause
if plaque completely blocks artery- no blood flow to organ= infarction
29
what happens when pieces of plaque break off
pieces can travel downstream + block smaller vessels causing embolism/small infarcts
30
what is apoptosis
programmed cell death - prevents cells with genetic damage continuing to divide
31
which protein detects DNA damage within cells
p53
32
how does a cell apoptose
series of proteins, trigger a release of activated enzymes, auto digest cell
33
2 examples of apoptosis for healthy functioning
development, eg webs between fingers cell turnover, old cells replaced
34
2 examples of apoptosis in disease
-mutations in p53 gene p53 no longer detects DNA damage, no apoptosis of damaged cells -HIV virus induces apoptosis in CD4 helper cells = immunodeficient state
35
what is necrosis
destruction of large numbers of cells via an external factor
36
examples of necrosis
-infarction -frostbite -toxic venom -pancreatitis
37
what does congenital mean
disease is present at birth
38
what is acquired disease
caused by non-genetic environmental factors
39
why do older peoples skin cells divide less than younger people
shorter telomeres, cells can divide
40
what is the only definitive method of slowing down ageing
calorie restriction
41
effects of ageing on skin
wrinkles- dermal elastosis UV-B light causes cross-linking of proteins, particularly collagen in the dermis
42
effects of ageing on eyes
UV-B causes cross-linking of proteins, causes opacity
43
what is osteoporosis
loss of bone matrix- predominantly in women after menopause due to lack of oestrogen can be prevented via hormone replacement therapy + vit D supplements
44
types of dementia and their risk factors
alzheimer's- not fully understood pathogenesis, some genetic factors vascular dementia= similar risk factors to athersclerosis
45
what happens to muscle in ageing
loss of muscle- sarcopaenia might be caused by reduced levels of growth hormone + testosterone
46
what can causes deafness
hair cells in cochlear do not divide, If damaged by high volumes, they will. die and not be replaced
47
what is hypertrophy
an increase in the size of an organ due to an increase in the size of its constituent cells
48
in which types of cells does hypertrophy occur
in organs where cells cannot divide
49
examples of hypertrophy
skeletal muscle in bodybuilders
50
what is hyperplasia
increase in the size of an organ due to an increase in the number of its constituent cells
51
in which types of cells does hyperplasia occur
organs where cells can divide
52
examples of hyperplasia
benign prostatic hyperplasia, endometrial hyperplasia
53
what is mixed hypertrophy/hyperplasia
increase in the size of an organ due to an increase in size and number of its constituent cells
54
what cells does mixed hypertrophy/hyperplasia occur
cells that can divide
55
examples of mixed hypertrophy/hyperplasia
smooth muscle cells of the uterus during pregnancy
56
what is atrophy
decrease in the size of an organ due to a decrease in size OR number of constituent cells
57
examples of atrophy
Alzheimer's dementia, quadriceps muscle following knee injuries
58
what is metaplasia
change in cell differentiation from one fully differentiated type to another fully differentiated type
59
what usually causes metaplasia
a consistent change in the environment of an epithelial surface
60
examples of metaplasia
-bronchial epithelium from ciliated columnar epithelium to squamous epithelium, caused by cigarette smoke -oesophageal squamous epithelium to glandular epithelium, continued acid reflux (barrett's oesophagus) -uterine cervix from columnar epithelium to squamous epithelium @ puberty
61
what is dysplasia
increase in abnormal cell growth/development -precancerous but may be seen before procession to development of cancer- neoplasia
62
examples of dysplasia
bronchial epithelium in cigarette smokers turns from ciliated to squamous epithelium, then development of dysplasia in squamous epithelium
63
what is carcinogenesis
the transformation of normal cells to neoplastic cells through permanent genetic alterations or mutations -multistep process -applies to malignant neoplasms
64
what is a neoplasm
an abnormal growth of cells (tumour)
65
define carcinogenic
cancer causing
66
define oncogenic
tumour causing
67
problems identifying carcinogens
-interval from first explosion may last decades eg asbestos -complexity of environment -ethical constraints eg can't test carcinogens on humans
68
where is hepatocellular carcinoma common
areas with high incidences of hepatitis B/C and mycotoxins
69
what risk is lung cancer associated with
smoking
70
what risks is bladder cancer associated with
-working in aniline dye and rubber industries -β-naphthylamine
71
what risks is scrotal cancer associated with
chimney sweeping- hydrocarbons in chimneys
72
what experimental evidence is there for carcinogens
-incidence of tumours in laboratory animals -cell/tissue cultures -mutagenicity testing in bacterial cultures
73
cons of experimental evidence
animals/cultures may metabolise agents differently to humans
74
what are 4 classes of carcinogens
-chemical -viral -ionising and non-ionising radiation -hormones, parasites and mycotoxins
75
what chemical can caused gut cancer
nitrosamines
76
what can cause leukaemia
alkylating agents
77
percentage of cancers caused by viruses
10-15%
78
chemical carcinogens
-no common structural features -some act directly BUT most require metabolic conversion from pro-carcinogens to ultimate carcinogens
79
name 4 DNA viruses
-human herpes virus 8 -epstein barr virus -hepatitis B virus -HPV merkle cell polyomavirus
80
what cancer is Human herpes virus 8 (HHV8) associated with
kaposi sarcoma
81
what cancer is associated with Epstein Barr virus (EBV)
burrito lymphoma nasopharyngeal carcinoma
82
what cancer is hepatitis B virus (HBV) associated with
hepatocellular carcinoma
83
what cancer is human papillomavirus (HPV) associated with
squamous cell carcinomas of the cervix,penis,anus and head and neck
84
what cancer is merkle cell polyomavirus (MCV) associated with
merkle cell carcinoma
85
name 2 RNA viruses
-human T-lymphotrophic virus (HTLV-1) -Hepatitis C virus (HCV)
86
what cancer is HTLV-1 associated with
adult T-cell leukaemia
87
what cancer is hepatitis C associated with
hepatocellular carcinoma
88
what does exposure to UVA or UVB increase the risk of
increases risk of BCC, SCC and melanoma -people with xeroderma pigmentosum = more at risk
89
what can increase in oestrogen levels cause
increased risk of mammary/endometrial cancer
90
what do anabolic steroids increase the risk of
hepatocellular carcinoma
91
what does the mycotoxin , aflatoxin B1 increase the risk of
hepatocellular carcinoma
92
what does the parasite chlonorchis sinensis increase the risk of
cholangiocarcinoma
93
what does the parasite shistosoma increase the risk of
bladder cancer
94
5 host risk factors
-ethnicity -diet/lifestyle -constitutional factors eg age , gender etc -premalignant lesions -transplacental exposure
95

Phase 2a (12 decks)

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