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DUSON Spring '18 > Patho Week 1 > Flashcards

Patho Week 1 Flashcards

1
Q

Chromosomes

A

Organized packages of DNA in the nucleus. 23 pairs of chromosomes, 22 are autosomes, 2 are sex chromosomes.

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2
Q

DNA

A

In chromosomes

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3
Q

Genes

A

Functional parts of DNA

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4
Q

Somatic Cells

A 
Cells, organs, tissues
46 chromosomes in 23 pairs
Diploid
Formed by mitosis
Autosomes - 22 pairs are in autosomes, one pair of sex chromosomes
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5
Q

Gametes

A

Sperm and ovum
23 chromosomes
Haploid
Formed by meiosis

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6
Q

DNA nucleotides

A

A-T

C-G

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7
Q

RNA nucleotides

A

U-A

C-G

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8
Q

Helicase

A

Enzyme that breaks down hydrogen bonds between nucleotides leaving sing strands. “Unzipper”

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9
Q

Polymerase

A

Enzyme that travels on a single strand of DNA and adds the correct nucleotides. Proofreads to increase the accuracy of DNA replication

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10
Q

Mutations

A

When the consistent pairing does not happen correctly.

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11
Q

Mitosis

A

Replication of somatic cells.

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12
Q

Central Dogma

A

Genes direct the synthesis of proteins.

  1. Transcription
  2. Translation
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13
Q

Transcription

A

mRNA is synthesized from single stranded DNA template. Similar to replication, U replaces T. Makes mRNA, which leaves the nucleus and travels to cytoplasm.

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14
Q

Translation

A

mRna interacts w/ribosomes. Ribosomes read the sequence and build codons (units of 3). Multiple codons together leads to amino acids, which are the building blocks of proteins.

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15
Q

Protein functions (5)

A 
Structure
Antibodies
Enzymes
Messengers
Transport/Storage
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16
Q

Protein - Structure

A

Provides support for cells. (Elastin, collagen)

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17
Q

Protein - Antibodies

A

Bind to specific foreign particles (viruses & bacteria) to help protect the body. (immunotherapy aka immunoglobulin G)

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18
Q

Protein - Enzymes

A

Carry out almost all the chemical reactions that take place in cells. Assist with replication, transcription, translation. (Lactase)

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19
Q

Protein - Messengers

A

Transmit signals to coordinate biological processes. (Oxytocin, insulin)

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20
Q

Transport/Storage

A

Bind and carry atoms and small molecules within cells and throughout the body. (hemoglobin)

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21
Q

Modes of cell signaling (3, fastest to slowest)

A
  1. Direct contact via receptors (paracrine, autocrine)
  2. Signal protein moves from one cell to another via interstitial fluid (must be relatively close, ie neurotransmitter)
  3. Signal protein moves from one cell to another via the bloodstream (further apart, hormonal)
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22
Q

3 types of cell surface receptor proteins

A
  1. Ion channel
  2. Enzyme-linked receptor
  3. G-protein linked receptor
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23
Q

Ligand-gated ion channel

A

Receptor is on the cell surface. Ligand binds to the receptor and opens and closes so the ion can pass through. (Nicotinic receptors, Gaba receptors)

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24
Q

G-protein coupled receptors

A

“Second messenger”. Attaches, reactions to separate molecules, second messenger activated. The second messenger does the work in the cell, the G-protein receptor is on the cell membrane.

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25
Q

G-protein coupled receptor examples

A

Serotonin, histamines, opioid receptors

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26
Q

Enzyme-linked receptors

A

“Second messenger system”, pulls molecules together. (Growth hormone)

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27
Q

Signal Transduction

A

Activates a receptor on the cell surface. The activated cell receptor:

  • Relays the signal intracellularly
  • Amplifies the signal
  • Results in divergent intracellular responses
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28
Q

Functions of Signal Transduction (4)

A
  1. Regulate gene expression
  2. Regulate specific metabolic pathways
  3. Amplify signal
  4. Divergent - can do several of these things
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29
Q

Autonomic NS

A

Involuntary (homeostasis). Sympathetic and parasympathetic

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30
Q

Somatic NS

A

Voluntary (skeletal muscles)

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31
Q

Sympathetic NS

A

Fight or flight. Prepares the body for strenuous activity. Increased blood supply with Oxygen and nutrients. Functions over the entire system. Norepinephrine and Epinephrine.

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32
Q

Parasympathetic NS

A

Rest and digest. Consume and store energy. Discrete organs. Acetylcholine.

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33
Q

Efferent pathways and ANS receptors

A

In both sympathetic and parasympathetic nervous systems. Travels from the hypothalamus to the SNS (short), which releases Ne that travels all over (long), which leads to shiver all over, not in a targeted area.

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34
Q

Types of ANS receptors

A

Cholingergic (Acetylcholine)

Adrenergic (Epi and NE)

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35
Q

Cholinergic receptors

A

Parasympathetic NS
Receive Acetylcholine.
Nicotinic
Muscarinic

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36
Q

Nicotinic receptors

A

Ligand-gated

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37
Q

Muscarinic receptors

A

G-protein

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38
Q

Adrenergic Receptors

A

Sympathetic NS
Receive Epi and NE
Alpha (1&2)
Beta (1&2)

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39
Q

Alpha and Beta receptors

A

G-proteins

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40
Q

Parasympathetic system receptors

A

Cholinergic! (Acetylcholine)

Nicotinic/Muscarinic

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41
Q

Sympathetic system receptors

A

Adrenergic! (Epi/NE)

Alpha/Beta

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42
Q

Agonist

A

Helper, works with

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43
Q

Antagonist

A

Blocker

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44
Q

Overall Homeostasis

A

Sensors -> CNS control center -> Effector

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45
Q

Heart SNS

A

B1, B2. Increase HR, force of contraction and rate of conduction

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46
Q

Heart PNS

A

Decrease HR and rate of conduction

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47
Q

Arterioles SNS

A

a1, constriction

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48
Q

Lungs SNS

A

B2, bronchodilation

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49
Q

Lungs PNS

A

Bronchoconstriction

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50
Q

Liver SNS

A

a1, B2, gluconeogenesis, gluconeolysis

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51
Q

Sweat glands SNS

A

M, a1, sweating

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52
Q

Stomach and Intestines SNS

A

a1, B2. Decreased molitity, contraction (a1)

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53
Q

Stomach and Intestines PNS

A

Increased motility, relaxation, stimulates secretions.

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54
Q

Pupils SNS

A

B1, Dilation

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55
Q

Pupils PNS

A

Constriction

56
Q

Salivary gland SNS

A

a1, constrict, small, thick saliva

57
Q

Salivary gland PNS

A

Dilate, large, thin saliva

58
Q

Bladder sphincter SNS

A

B2, contraction

59
Q

Bladder sphincter PNS

A

Relaxation

60
Q

Adrenal medulla SNS

A

N (nicotinic, with ACH), increased secretion of Epi and NE

61
Q

Three types of cell surface receptor proteins

A
  1. Ion channel-linked receptor
  2. Enzyme-linked receptor
  3. G-protein-linked receptor
62
Q

Pharmacokinetics

A

Drug with a site of administration. Gets in to the blood stream and is distributed in to the tissue.

Effects of the body on drugs.

63
Q

Pharmacodynamics

A

What a drug does once in the tissues.

Effects of drugs on the body.

64
Q

Plasma concentration vs time curve

A

Slope of the line = elimination rate of the drug. Generally eliminates at a constant rate.

65
Q

ADME (effects of body on the drug/PK)

A

Absorption
Distribution
Metabolism
Excretion

66
Q

Difference between IV administration and all other forms

A

IV bypasses absorption

67
Q

All 4 phases of PK involve….

A

…drug movement. Enter blood stream, leave vascular system, travel to sites of action, cross membranes to undergo metabolism and excretion.

68
Q

Do drugs pass through or between cells?

A

Drugs must pass THROUGH

69
Q

How do drugs cross cell membranes?

A
  1. Pores and channels
  2. Transport systems
  3. Direct membrane penetration
70
Q

Directe membrane penetration

A

Drug must be lipophilic (fat loving), allows for very rapid rate. (Fentanyl)

71
Q

Polar molecules

A

Have no net charge, but have an uneven distribution of charges (sometimes have a partial negative charge). H2O!

72
Q

Ions

A

Have a net electrical charge, either positive or negative. Are NOT able to cross membranes.

73
Q

Drugs cannot be absorbed once they are….

A

….ionized

74
Q

Ionization

A

Process for acid/base converting to a charged particle. Drugs cannot be absorbed once ionized!

75
Q

Weak acids are proton….

A

donators

76
Q

Weak bases are proton…

A

acceptors

77
Q

Oral drug administration

A

Most convenient and inexpensive. May have food interactions. Acidity may limit use. Many formulations. First-pass effect

78
Q

Rectal drug administration

A

Erratic absorption, hepatic first-pass effect (but less than oral)

79
Q

Sublingual/buccal drug administration

A

Bypasses hepatic first-pass, absorption into venous circulation, rapid onset.

80
Q

IV drug administration

A

Rapid onset, reliable, irreversible, bioavailability = 100%

81
Q

IM drug administration

A

Absorption is highly variable. Depo delivery possible (liquid injected in to muscle to be absorbed very slowly). Painful. Compared to IV can be faster due to placement.

82
Q

Subcutaneous drug administration

A

Smaller volume, slower onset vs IM

83
Q

Inhalation drug administration

A

Usually want delivery to lungs. Rapid onset, less systemic exposure, aka less makes it to the bloodstream

84
Q

Transdermal drug administration

A

Systemic. Simple, convenient, painless, but may be irritating to skin. Prolonged action, improved compliance.

85
Q

Other forms of drug administration

A

Topical (skin, vaginal, nasal, otic) have less systemic exposure

86
Q

Absorption definition

A

Drug moves from the site of administration to systemic circulation

87
Q

Factors that affect absorption

A 
Formulation (enteric coating)
% of drug that is uncharged
\+/- food
Blood flow
Characteristics of drug molecule
Concentration gradient
Surface area
Contact time (severe diarrhea eg)
First-pass effect
Multidrug reverse/efflux transporter
88
Q

First-pass effect

A

Oral drugs first pass through liver via portal circulation. Liver starts to metabolize drug before it gets in to systemic circulation.

89
Q

Bioavailability

A

% of drug that reaches systemic circulation. Quantity of drug that reaches systemic circulation divided by the quantity of the drug administered.

Affected by formulation, chemical characteristics, 1st pass effect, P-glycoprotein reverse transporter

90
Q

Distribution definition

A

Drug moves from systemic circulation to tissues. Affected by the drug characteristics, blood flow, capillary permeability, plasma protein binding (PPB), and patient/disease factors

91
Q

Blood brain barrier

A

Tight junctions, favors lipophilic, small molecule, low PPB. Drugs that aren’t lipophilic have a hard time getting to the brain.

92
Q

Plasma Protein Binding (PPB)

A

Drug binding proteins (ex Albumin), reversible. Bind to the drug in the blood stream, making it inactive. Only free drug in the blood stream can make it to the site of action. Binding is reversible. Affected by nutritional status and plasma protein levels, as well as possible drug-drug interactions.

93
Q

Elimination definition

A

Removal of drug from body. Includes metabolism and excretion, most a a combo of these two factors. Affected by renal/hepatic function, medications, age, pregnancy, disease, etc

94
Q

Metabolism definition

A

Biotransformation. Happens in the liver, GI tract, lungs, skin, kidneys, via enzymes (CYP450 Enzymes)

95
Q

CYP450 Enzymes

A

Large family of enzymes that catalyze oxidation reactions. 80% of all drug metabolism done by these enzymes. Drug interactions!

96
Q

Substrate

A

Substance (drug) that an enzyme acts on

97
Q

Metabolite

A

Product of biotransformation. Can be inactive or active. Can be toxic

98
Q

Pro-drug

A

Inactive drug that undergoes metabolism to an active form. Requires metabolism and activation before it does anything. No activity until it is metabolized in the body.

99
Q

Induction/Inhibition

A

Induction = rev it up, Inhibition = slow it down

100
Q

Factors affecting metabolism

A 
Age
Sex
Genetic variations
Diet (grapefruit, char grilled)
Smoking
Occupation
Other drugs
Liver disease etc
101
Q

Excretion definition

A

Removal of a drug or drug metabolites from body. Happens in the kidney, GI tract (bile), lungs, skin, breast milk. Affected by renal function and age.

102
Q

Renal excretion 3 steps

A
  1. Glomerular filtration (drugs from blood to urine)
  2. Passive tubular reabsorption (back to the body via passive diffusion, lipophilic back to blood stream, ions/polar compounds excreted in urine)
  3. Active secretion (of organic acids and bases)
103
Q

GFR

A

Glomerular filtration rate

104
Q

First order elimination

A

Constant fraction is eliminated, most drugs.

105
Q

Half life

A

Time to eliminate 50% of a drug from the body

106
Q

Absorption

A

How the drug is getting in the bloodstream (bypassed with IV admin)

107
Q

Distribution

A

How the drug gets to target tissues

108
Q

Schedule 1 drug

A

No medical benefit, recreation only

109
Q

Schedule 2 drug

A

Can be used in small doses. Opioids, morphine, fentanyl, cocaine, ie. Hand written prescription, 1 month supply at a time in North Carolina.

110
Q

Schedule 3 drug

A

Used in medical settings

111
Q

Drug development - Pre-clinical

A

1-5 years. In vitro/animal. After research that leads to learning about an enzyme associated with a disease process. After this investigational new drug application.

112
Q

Drug development - Clinical

A

4-6 years, can take much longer depending on the disease. Human trials. Testing safety, dose, effects and safety, and effectiveness. Phases 1-3. After this a new drug application.

113
Q

Drug development - Marketing

A

Post-marketing surveillance. Low incidence AEs. Phase 4

114
Q

Black box warning

A

Very important. So that patients understand that there are severe risks, but now SO many drugs have black box warnings.

115
Q

Prescribing Information Label (PI)

A

Off label use is very common. Often there is no pediatric data when drug comes out, give the drug anyways.

116
Q

Chemical name

A

Rarely used

117
Q

Generic name

A

Assigned by US adopted names council

118
Q

Brand name

A

Proprietary. Selected by pharmaceutical company, there are marketing considerations.

119
Q

Pharmacokinetics

A

How the body affects the drug. Absorption, distribution

120
Q

Pharmacodynamics

A

What is the actions of the drug on the body? Drug and receptor interactions, biological responses (therapeutic and adverse)

121
Q

Ligand

A

Molecule that binds to the receptor. Ligand often = the drug

122
Q

Receptor

A

Macromolecule, to which a drug (ligand) binds to produce an effect. Once bound drugs mimic or block naturally occurring ligands.

123
Q

4 primary families of receptors

A

Cell membrane-embedded enzyme
Ligand-gated ion channel
Transcription factors
G-protein coupled

124
Q

What is homeostasis?

A

Adaptations to physiologic demands or stress to maintain a steady state. Reversible. Structural or functional responses to normal (physiologic) and adverse (pathological) conditions.

125
Q

What is thermoregulation?

A

Balance of heat production, conservation, and loss. 96.2-99.4. Can vary by where temp is taken, menstrual cycle, or circadian rhythm (peak at 6pm).

126
Q

What regulates thermoregulation?

A

Hypothalamus. Signaled by peripheral thermoreceptors in the skin and central thermoreceptors in the hypothalamus, spinal cord, and abdominal organs.

127
Q

Effectors of heat production/conservation

A

Chemical thermogenesis, shivering, vasoconstriction, central shunting, voluntary measures (ie jacket, layers)

128
Q

Effectors of heat loss

A

Radiation, conduction, convection, vasodilation, evaporation, decreased muscle tone, increased respiration, voluntary measures, adaptation

129
Q

What is fever?

A

A temporary “resetting of hypothalamic thermostat” to a higher level. Returns to normal set point when fever “breaks”

130
Q

What are fevers in response to?

A

Prostaglandins - exogenous pyrogens or endogenous pyrogens. Pyrogens = things that cause heat.

131
Q

What are some benefits of fever?

A

Kills/slows growth of microorganisms.
Decreases serum levels of minerals that bacteria need to replicate
Auses lysosomal breakdown and auto-destruction of viral and infected cells
Increases lymphocytic transformation and motility of polymorphonuclear neutrophils, which facilitates he immune response
Enhances phagocytosis

132
Q

Fever in neonates and infants

A

Treat aggressively for lower fevers. Especially under 28 days!

133
Q

Fever in children

A

Higher temperatures than adults for relatively minor infections. Febrile seizures before age 5 are not uncommon.

134
Q

Fever in elderly

A

Show lower response to infection. High morbidity and mortality results from lack of beneficial aspects of fever.

135
Q

Hyperthermia

A

Elevation of body temperature with an increase in the hypothalamic set point. Heat stroke, heat exhaustion, malignant hyperthermia (rare muscle disorder)

136
Q

Hypothermia

A

Marked cooling of the core temperature. Examples: therapeutic, keep pt cool for a protective reason.

DUSON Spring '18 (7 decks)

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