pathpharm 2 week 1 Flashcards
Define Risk factor:
A characteristic, condition, or behavior, such as high blood pressure or smoking, that increases the possibility of disease or injury.
Define Relative risk:
the ratio of the chance of a disease developing among members of a population exposed to a factor compared with a similar population not exposed to the factor.
In many cases relative risk is modified by:
the duration or intensity of exposure to the causative factors
Define Proband:
A person serving as the starting point for the genetic study of a family (used esp. in medicine and psychiatry).
Define Polygenic:
A polygenic trait is one whose phenotype is influenced by more than one gene. Traits that display a continuous distribution, such as height or skin color, are polygenic.
Define Multifactorial:
Involving or dependent on a number of factors or causes.
T or F: In multifactoral gene expression, the loci act in concert in an additive fashion, each adding or detracting a small amount from the phenotype.
TRUE
T or F: The environment plays little part in producing the final phenotype.
FALSE. The environment interacts with the genotype to produce the final phenotype.
Define Liability distribution:
As the number of multifactorial genes for the trait increases, the liability for the disease increases.
Define Threshold of liability:
The point at which a combination of risk factors will result in development of disease (To be affected by a multifactoral disease, a person must have several factors that when added together meet/exceed the disease threshold)
Define Recurrence Risk:
When one child has already been born with a genetic disease the probability that subsequent children will also have the disease
Define empiric risk:
The chance that a disease will occur in a family, based on experience with the diagnosis, past history, and medical records rather than theory.
T or F: In multifactorial traits, the more severely affected the individual, the more genes he/she has to transmit, and the higher the recurrence risk.
TRUE
Define concordant trait (as it relates to twins):
A trait shared by both twins
Define discordant trait as it realtes to twins:
a trait not shared by both twins
Define congenital trait:
Traits/conditions that are present at birth, regardless of their causation.
Nature refers to:
heredity: the genetic makeup or “genotypes” an individual carries from the time of conception to death.
Nurture refers to:
various external or environmental factors to which an individual is exposed from conception to death.
The notion of ___________ refers to the biologically prescribed tendencies and capabilities individuals possess, which may unfold themselves throughout the course of life.
nature
T or F: Environmental factors usually do not involve several dimensions.
FALSE. Environmental factors include both physical environments (e.g., secondhand smoking and prenatal nutrition) and social environments (e.g., the media and peer pressure). They vary in their immediacy to the individual; they involve multiple layers of forces, ranging from most immediate (e.g., families, friends, and neighborhoods) to larger contexts (e.g., school systems and local governments) to macro factors (e.g., international politics and global warming).
List 5 environments that can cause disease:
Pesticides, chemicals, radiation, air pollution, and water pollution
List environmental factors for CAD:
Cigarette smoking, obesity/sedentary lifestyle, Infections from Chlamydia and H. Pylori
Familial hypercholesterolemia is an important cause of:
heart disease
The risk of colorectal cancer in people with one affected first-degree relative is:
2-3 times higher than in the general population
A person with at least one affected first degree relative is _____ times more likely to have CAD than the general population.
2 to 7
What 3 specific factors put a person at a higher familial risk of developing CAD?
- there are more than one affected relative, 2. the affected relative(s) is female (the less affected sex) 3. age of onset in the affected relative(s) is early
_____________________ Results in plasma cholesterol levels that are approx. twice as high as normal and is inherited as an autosomal dominant trait
Familial Hypercholesterolemia
Hypertension has a familial component because:
about 20%-40% of the variation in systolic and diastolic pressure is caused by genetic factors
Increased sodium intake, decreased physical activity, psychosocial stress, and obesity are the main environmental risk factors for:
hypertension
If a woman has one affected first-degree relative her risk of developing breast cancer ________.
doubles
T or F: A woman’s risk for breast cancer increases if the age of onset in her affected relative is early and if the cancer is bilateral (both breasts)
TRUE
T or F: Some types of colorectal cancer are inherited as single-gene traits
TRUE
A high fat/low fiber diet is said to increase a person’s risk of developing____________
colorectal cancer
Siblings of affected individuals with diabetes have a substantial (elevation/lowering) in risk
Elevation (6% vs 0.3% in the general population)
Recurrence risk is elevated for type I diabetes when:
there is a diabetic parent (1%-3% for a diabetic mother and 4%-6% for a diabetic father)
T or F: Specific viral infections can contribute to Type I diabetes by activating an autoimmune response
TRUE
The two most important risk factors for type II diabetes are:
positive family history and obesity
The empirical recurrence risks for first-degree relatives of type 2 diabetes range from:
10%-15%
T or F: Adoption studies show that adopted children’s BMI more closely resembles their adoptive parents than their biological parents
FALSE. Adopted children’s BMI more closely resembled that of their biological parents regardless of environmental factors
T or F: There is a strong correlation between parents and children’s BMI’s
TRUE
Nutritional deficiencies can result from:
poor intake ( d/t environmental, physical, psychological reasons), altered absorption ( full faster; not feel like eating), impaired distribution by circulation - poor circulation in the GI tract effects absorption, inefficient uptake (not able to cross in the blood stream)
A lack of iron can lead to:
hemoglobin not able to carry oxygen
A lack of calcium will
affect bone density
Why do we need fatty acids and bile?
We need fatty acids for healing and repair, and we need bile to break down fat in our GI tract into fatty acids
The human body utilizes ______ amino acids, and ______must come from the diet because the body cannot synthesize or recombine them.
20, 9
_______________ causes a decrease in absorptive function
Protein deficiency
Protein deficiency leads to:
The integrity of the pancreas is affected leading to diminished exocrine secretion. ÿWith starvation lowered plasma proteins (albumin) cause fluid to move into the interstitium (edema).
Hyperlipidemia can lead to disease because:
Elevated concentrations of blood lipids, particularly LDL cholesterol, are a significant risk factor for atherosclerosis and coronary heart disease.
___________results in deposits of fat in the liver, heart, and muscle.
Hyperlipidemia
Hyperglycemia may lead to _____________ which is a risk factor for several other diseases.
obesity
What are the 3 types of regeneration?
Labile, stable, and fixed
Labile regeneration refers to which types of tissues?
mucosa & epithelia: always regenerating new tissue
Stable regeneration refers to what type of tissue?
bone-only regenerates when in growth phase (children) or when broken
Fixed regeneration refers to what types of tissues?
muscle, heart, nerve (nerve fibers grow but nerve cells don’t grow)-all can grow larger, but do not regenerate
What are the phases of tissue regeneration after an injury?
Inflammatory, proliferative/reconstructive, remodeling, resolution, and repair
This is the clean up phase of cell repair:
inflammatory
This phase lasts 2-3 days to 3 weeks, involves capillary buds, endothelial proliferation then granulation [tip of cell growth, pink/red tissue in wound, regrows outside, inside, recreate cell, close off, leaky (serous fluid) red-pink
proliferative/reconstructive phase
Scar tissue synthesis of collagen and breakdown of collagen occurs during:
the remodeling phase of tissue regeneration
The repair phase consists of:
regeneration of parenchymal, connective tissue repair
What three types of tissues are able to regenerate?
epithelial, mucosa, and liver
List some factors that affect healing:
nutrition, blood flow and oxygen, impaired inflammation and immune response, infection, wound separation, foreign bodies, age, hemorrhage, excessive fibrin-adhesions/keloids- too much scar tissue (etra collagen) can connect with other tissues which is bad, and predisposing factors (DM- pts have poor circulation _ poor healing, PVD- peripheral vascular disease)
What are the two major groups of local anaesthetics?
esters and amines
List 2 examples of Esters:
procaine (Novocaine), and tetracaine (Pontocaine)
List 2 examples of Amines:
lidocaine (Xylocaine) and bupivacaine (Marcaine)
Tissue adhesives are used in__________.
small lacerations
The time to close the wound is much faster using____________
tissue adhesives.
Before applying a tissue adhesive:
The wound must be cleansed carefully
T or F: In general, decontamination is far more important than antibiotics.
TRUE
Use of antibiotics should be individualized based on
the degree of bacterial contamination, the presence of infection-potentiating factors, such as soil, the mechanism of injury, and the presence or absence of host predisposition to infection.
When should Prophylactic antibiotics be used?
n most human, dog, and cat bites, intraoral lacerations, open fractures, and exposed joints or tendons.
Why must we be conservative and careful with the use of antibiotics?
Bacteria can evolve and become resistant to medications after over use. This effects all people because even if a person has never used antibiotics if they contract a resistant strand of bacteria it still won’t be able to be treated
List common wound cleansing/irrigations:
NS, antiseptics, Darkin’s solution, hydrogen peroxide, Iodine, Debridement, wound dressings
What is Darkin’s solution?
(diluated bleach) Highly diluted, neutral antiseptic solution for cleansing wounds. Consists of sodium hypochlorite (0,45 % to 0,5 %) and boric acid (4 %). Its solvent action on dead cells hastens the separation of dead from living tissue. The solution is unstable and cannot be stored more than a few days. Developed during World War I.
Hydrogen peroxide is used to:
dissolves blood; can be difficult with some wounds and not used at hospitals
Debridment is used to:
stimulate new cells and getting rid of the old cells via sloughing
Papain/Urea Foam is a______________. It works by __________________, which helps improve the _____________________.
debriding agent; helping the breakdown of dead skin and pus; recovery time of open wounds
What is botox?
Botulinum toxin
What are the major uses of botox?
Cosmetic: treating wrinkles and facial lines that result from overactive pulling of the small muscles under the skin, medical: use for nerve damage ; to relax the muscle
The category I theory of aging states:
Aging is a Time dependent loss of structure and function, Appears to be the result of the accumulation of small, imperceptible injuries
Protein synthesis changes, mutations, free radicals would all be described as reasons for aging in which category?
Category I
The category II theory of aging states
Aging is the result of a genetically controlled development process
In category II, aging includes:
Programed life span, somatic mutations, catastrophic errors in transcription,Change in genetics due to viruses and chemicals
What signs of aging can be seen in the skin?
dryness -loss of water, wrinkles- loss of cells, dermis- loss causes strenght and elasticity to decrease,
Eccrine and sebaceous glands decrease in size and number,
changes in vascularity
This organ begins to atrophy in adolescence through the rest of a person’s life
thymus
Losing one’s ability to tell self from non-self can lead to:
cancer, infections and autoimmune diseases
What is important to note about T cells and aging?
as we age we make more T cells, but we cannot retrain them against new infections
What is one sign of aging in the musculoskeletal system?
bone mass reduction
Why can orthostatic hypotension be a sign of aging?
the heart muscles are compensation delayed
List one sign of aging in the pulmonary/respiratory system:
loss of alveolar sructure leading to less gas exchange
T or F: Decreasing levels of HCL, absorption hormones, and intrinsic factors are all signs of aging.
TRUE
Incontinence can be a sign of aging because:
smooth muscle and elastic tissue are replaced with fibrous connective tissue loss of bladder and sphincter tone
Aging will have what effect on pain thresholds?
Aging will cause the pain threshold to increase, meaning it may take an older person a longer time to feel pain compared to a young person
T or F: Tolerance is genetic.
FALSE. Tolerance is a learned subjective behavior-has nothing to do with the nervous system
Visual acuity decreases with age because:
the lens is more rigid
In the elderly these types of memory decrease:
short term and recall
Define apoptosis:
the active process by which cells self destruct in normal and pathologic tissues. Its an active process of cellular self destruction that is a programmed cell death.
Apoptosis is required to:
maintain a balance between cell death and proliferation.
decrease or shrinkage in cell volume, generation of pyknotic nucleus, condensation of the chromatin along the nuclear membrane, nuclear colapse, phagocytosis of intact apoptotic bodies that prevents release of cellular contents into the surrounding area and blocks any inflammatory response are all signs of:
apoptosis
Define necrosis:
unprogrammed chaotic process characterized by swelling and rupture rather than cellular shrinkage and the release of cellular contents that induce an inflammatory response in surrounding tissue.
Cells that die by___________release chemical factors that recruit phagocytes that quickly engulf the remains of the dead cell and reduce chances of inflammation.
apoptosis
