Principles Of Disease Flashcards
What is a gamma ray?
Occur due to radioactive decay of unstoppable isotopes. They have high energy and frequency.
Why is immunological tolerance important?
Allows us to understand how autoimmune diseases develop.
Intervenes with novel therapeutics based on immune tolerance
Replacement of long term immunosuppression with short term therapeutic stages.
Which types of immune response are antibody mediated?
Type I, II, III and (V)
What substances can modify drug action despite other drugs?
Food, smoking, alcohol and herbs
What are the benefits and risks of radiation?
Diagnosis Management change Treatment Ionisation radiation Risk of inducing fatal cancer
What is a tumour?
A tumour is an abnornmal uncoordinated growing mass of tissue which is irreversible.
What are cancer causing oncogenes?
Derived from proto-oncogenes with gain of function
When does inflammation become chronic?
When the cell population is especially lymphocytes, plasma cells and macrophages. It features tissue or organ damage and loss of function and can follow on from acute inflammation.
What is the difference between granulomas and granulomatous tissue?
Granulomas are aggregates of epithelioid macrophages in tissue which may surround dead material or lymphocytes and are a response to indigestible antigen.
Granulomatous tissue is inflammation charecterised by the presence of granulomas in tissues and organs.
Where does a drug need to be distributed to for it to have an affect?
Target site of action
What is the definition of adverse drug reactions?
Any response to a drug which is noxious, unintended and occurs at doses used in normal reigimn.
What is first pass metabolism?
The metabolism of a drug before reaching systematic circulation
What can interactions of drugs in the GI tract cause changes in?
absorption rate
What is metaphase and prometaphase in DNA replication?
Metaphase - chromosomes DNA can be split in two easily
Prometaphase - Cannot be split in half perfectly
What are end of treatment reactions to drugs?
Adverse effects that occur when a drug treatment is stopped following long term use
What can a prolonged half-life cause?
increased toxicity.
What is acute inflammation?
A response to injury used to maintain the integrity of the organism. It is a series of protective changes occuring in living tissues.
What are the 4 factors in pharmokinetics?
Absorption
Distribution
Metabolism
Elimination
Where does excretion of a drug usually take place?
In the kidney
What are dispersions in drugs?
Coarse drug particles in a liquid phase, good for drugs which are insoluble and unpalatable.
What are the potential side effects of chemotherapy?
Alopecia Nausea/vomiting Renal failure Diarrhoea Sterility They can be managed
What are tumour suppressor genes?
Genes that protect a cell from forming cancers
Mutation causes loss of function
e.g. retinoblastoma
What are the methods of cancer spread?
Local Spread
Lymphatic spread
Blood spread
Trans-coelomic spread (across body cavities)
Which grove on DNA interacts more with proteins? (major or minor)
Major groove
What is a teratoma?
tumours of germ cells
What is screening in cancer?
Diagnosis at an earlier stage before symptoms start. Allows cancer to be treated much easier and is most likely curable
What are the benefits of acute inflammation?
Rapid response
Cardinal signs and loss of function (prevent further injury)
Resolution and return to normal
What are the different types of adverse drug reactions?
Augmented Bizarre Chronic Delayed End of treatment Failure of treatment
What can impair wound healing?
Dirty
Gaping wound
Poorly nourished
Inhibition of angiogenesis
What is a carcinoma?
malignant epithelial tumour
What is the area under a drug concentration-time graph?
Estimate amount of drug which reaches circulation
Where are unbound drugs filtered?
The glomerulus
What are failure of treatment reactions to drugs?
Failure of therapy and can be dose related or due to drug interactions
Where are drugs metabolised?
The liver, lining of the gut, kidneys and the lungs.
When is an intramuscular injection used?
To allow a more sustained duration of action up to months
What is angiogenesis?
Formation of new blood vessels
What is carcinogenesis?
The failure of cell cycle control. Occurs when the balance between proliferation and apoptosis is disrupted.
What are lymphocytes?
Cells that are part of the immune system
Small round cells with lots of subtypes
immune response and memory
What does drug therapy involve?
Get the drug into patient
Get the drug to the site of action
Produce the corrcet pharmacological effect
Produce the correct therapeutic effect
Why do cancer cells arise?
When cells have loss of their tumour suppression genes and gain function of oncogenes.
What do neutrophils do?
Recognise foreign antigen and move towards it.
Destroy the foreign antigen.
The neutrophils die once it has released its contents and produces puss.
How is iodine used in imaging?
given intravenously to demonstrate blood vessels or the vascularity of different tissues.
Which type of drug is absorbed the fastest?
Solution
What is phase 2 of metabolism?
Glucuronidation
What are the different forms of drugs?
Tablets or capsules Solutions Ointments and creams Inhalation Injections
What is involved in phase 2 of metabolism?
Conjugation which increases the water solubility and enhances excretion.
Attachment of glucuronic acid to the metabolite.
Usually results in inactivation
What is a poulation risk for genetics?
The risk that the person is the first person in their family to have the mutation and attain the disease
What does it mean if a tumour metastasises?
When the tumour spreads and grows at other sites within the body.
What negative effects can benign tumours have?
Cause pressure and obstruction
What negative effects can benign tumours have?
Cause pressure and obstruction
What is cellular and nuclear pleomorphism?
variation in size and shape of tumour cells where mitosis can present and often abnormal.
How are CT’s used in the testing and treating for cancer?
To monitor response to treatment, relapse and the progression of the disease.
What can metabolism of drugs lead to?
Loss of pharmacological activity, decrease or increase in metabolites activity and production of toxic metabolites
What is mRNA, tRNA and rRNA?
mRNA - transcribed from DNA and carries information for protein synthesis
tRNA - to translate mRNA sequence into amino acid sequence
rRNA - component of ribosomes, produced in the nucleus.
What is the rate limiting step of absorption for tablets and capsules?
Tablets break down or dissolution
How is a drug delivery system chosen?
The dose of the drug
The frequency of administration
Timing of administration
What are some effects of inflammation?
Raised temperature Feel unwell Raised white blood cell count Weight loss anaemia
What is the granulation tissue mechanism and function?
Patches tissue defects
Replaces dead or necrotic tissue
Contracts and pulls together
What are natural killer cells?
Cells that destroy antigens and kill cells
What is proliferation of cells?
Growth of cells
What is tumour angiogenesis?
New blood vessel formation by tumours in order to sustain tumour growth. Can provide a route for tumour cells to enter circulation
What is an astrocytoma?
A tumour of the central nervous system
Why can granulomas cause a patient to feel no pain?
The granulomas attach to nerves
What are common enzyme inducers?
Alcohol and smoking
What is synergistic interactions in drugs?
These are interactions between drugs which produce the same effect
What is barium sulphate used for in imaging and why is it used?
Used for oputlining the gastro-intestinal tract.
Used as barium absorbs more radiation than surrounding tissue which appears white.
Why would a drug delivery system be formulated?
Allow selective targetting of a tissue site
Allow 24 hr action
What is the body’s response for acute inflammation?
Transient arteriolar constriction
Local arteriolar dilation
Relaxation of vessel in smooth muscle
Flush, flare and wheal
What is radiation carcinogenesis?
Purine and pyrimidine bases in DNA are targets for radiation damage
High-energy radiation is carcinogenic
What is an antigen?
A molecule which is recognised by the immune system and is foreign to the body.
What is absorption of a drug?
The process of movement of unchanged drug from the site of administration to the systematic circulation.
What is combination treatment in cancer?
The use of multiple cancer treatments. Activity must balance and the combination should be chosen so that they have different mechanisms of action.
What is an abscess?
A collection of puss which can discharge under pressure and heals once collapsed.
What is autoimmune disease?
Antibodies are directed against its own cell and tissue component which damages or destroys organs, tissues, cells and cell components.
What is phase 1 of metabolism?
Oxidation, Reduction and hydrolysis
In a drug-drug interaction what is the drug affected called and what is the drug which induces the reaction called?
Affected - Object drug
induces the reaction - Precipitant
What is the half life of a drug?
The time taken for the drug concentration in the blood to decline to half of the current value.
What is a lymphoma?
malignant cancer of the lymphoid tissue
What is a mild, moderate and severe reaction to drugs?
Mild - bothersome but requires no change in therapy
Moderate - Requires change in treatment, additional treatment and hospitalization.
Severe - Disabling or life-threatening
What are some physiological barriers to drug absorption?
Passive diffusion
Filtration
Bulk flow
Active transport
Why is DNA packaged with histone proteins?
The negatively charged DNA is neutralised by the positively charged histone proteins as well as taking up less space.
How can inflammation become harmful?
When there is an inability to perfuse tissues and there is systematic release of chemical mediators from cells into the plasma
When is a drug biologically active?
When a drug is unbound and not bound to a protein.
What is mitochondrial inheritance?
genetics passed down through maternal inheritance (only females can pass it on) and has a high mutation rate
What is drug distribution?
The reversible transfer of a drug between the blood and the extra vascular fluids and tissues of the body.
What is a telomere?
The protective structures at the end of the chromosome (hundreds of repeated base sequences)
How are autoimmune diseases caused?
Genetics - pre-disposistion to autoimmune disease
Environmental - Drugs, trauma, food and prior infection.
What is immunotherapy?
The use of the patients own immune cells to treat their cancer.
What are monoclonal antibodies?
Antibodies which act directly when binding to cancer specific antigen and produce an immunological response to cancer cells.
What is immunological tolerance?
A state of unresponsiveness to a specific antigen which prevents adaptive responses that are damaging B cells and T cells.
How can chronic inflammation be diagnosed?
Presented as a sore bit but has other symptoms. Arises from acute inflammation and has a large volume of damage which it fails to resolve.
What is the immediate reaction in an allergy and its effects?
The IgE effects;
vasodilation
Oedema
Vascular Congestion
What conditions favour wound healing?
Cleanliness
Apposition of edges
Sound nutrition
Metabolic stability
What are augmented reactions to drugs?
Normal and predictable reactions which are concentration dependant. Easily reversible by reducing or stopping the dose.
When is the rectal route for drugs useful?
In young and old patients or if they are unable to swallow. Also allows the drug to treat local conditions.
What is a drug-drug interactions?
The modification of a drugs effect by prior or concomitant administration of another drug, herb, foodstuff or drink
What is leukaemia?
malignant cancer of the blood
How is systematic chemo given?
orally or intravenously in regular cycles.
What negative effects can malignant tumours have?
Tissue destruction Infection Bleeding (haemoorrhage) Pain Pressure Obstruction Weight loss
How are oncogenes activated?
Chromosomal rearrangements
Over expression
What is the state of drug metabolising enzymes in the foetus and very young children?
Defiient or inactive so build up to toxic levels quickly
What is gametogenesis?
Egg formation
Sperm formation
What do macrophages do?
Removes debris
Role in immune system
Take over from neutrophils
What is direct antagonism?
Drug interactions between drugs that produce opposite effects
How do immunotherapies work?
Macrophages and natural killer cells attack foreign cells
How often should chemotherapy be given?
In stages as it also kills normal cells, however, if recovery is too long then the tumour cell population wil increase.
What is a phenotype?
The outward, physical manifestation of an organism
What is contained in chromosomes?
Many genes
Regulatory elements
other nucleotide sequences
What is mitosis?
When the chromosome seperates then the cytoplasm seperates the two new daughter cells.
What is a schwannoma?
tumour of the peripheral nervous system
What is a benign tumour?
A tumour with a non-invasive growth pattern usually remaining in a single place. Rarely cause death
Where do neutrophils and red blood cells go during acute inflammation?
Neutrophils move to the outside of the vessel.
Red blood cells congregate in the centre.
What is drug metabolism?
A biochemical modification of pharmaceutical substances by living organisms usually through specialized enzymatic activity.
What is a sarcoma?
malignant connective tissue tumour
What is apoptosis in tumours?
Mechanism of programmed single cell death which regulates tumour growth
What part of the cell contains the most genetic material?
Nucleus
What is dysplasia 1 and 2 in cancer?
dysplasia 1 - pre-malignant stage, earliest stage of malignancy
Dysplasia 2 - identified in epithelium, no invasion but can progress to cancer
What is meiosis?
Cell division in germ cells
How is acute inflammation caused?
micro-organisms (bacteria, fungi, viruses and parasites) which cause infection. Arises by injury even sterile injuries.
Why does early detection of cancer benefit?
Reduce patient mortality/morbidity
Detection before pre-invasive stage
What are chronic reactions to drugs?
Reactions related to the duration of treatment as well as the dose and is semi-predictable.
What are some cancer treatments?
Surgery Radiotherapy Hormonal therapy Chemotherapy Immunotherapy
What is the Mt genome?
A mutational hotspot due to a lack of efficient DNA repair system and lack of protective proteins.
What is radiotherapy?
Role in palliation Radio sensitive repair re-population re-oxygenation re-assortment can be combined with chemo
What are bizarre reactions to drugs?
Unpredictable and rare reactions which can cause serious illness or death and are not easily reversible.
What are proto-ocogenes?
Normal genes coding for normal growth regulating proteins
What is wound healing?
Process of repair of tissue damage
Phase of acute inflammation
Granulation tissue formation
Scar formation
What is the T-cell mechanisms?
Produce cytokines
Damages and kills other cells and destroys antigen
What types of immune response are T cell mediated?
Type IV
What do MRI’s allow for?
Excellent bone and soft tissue detail Vessels can be demonstrated Brain, spine and musculoskeletal abdomen and pelvis Cardiac imaging
How can a patient become septic?
Acute inflammation spreading to the bloodstream
What is the volume of distribution of a drug?
The volume of plasma that would be necessary to account for the total number of drug in a patients body.
Why does the chance of developing cancer increase over time?
mutations accumulating over time and activation of several oncogenes and loss if anti-oncogenes occurs
What are autoimmune diseases?
Typically chronic long-term disorders which patients tend not to die from. Treatments are limited to dealing with the symptoms rather than curing the disease.
When are intravenous injections useful?
Providing fast systematic effects and in unconscious patients.
What is a genotype?
The full hereditary information of an organism
What is the clearance of a drug?
The volume from which a drug is completely removed over a period of time. measured in ml/min
How does DNA fold to take up less volume?
DNA wraps around 8 histone proteins to form a nucleosome which then folds up to produce a fibre.
What is the fitness of an organism?
Its relative ability of an organism to survive long enough to pass on their genes.
What is the pathogenesis of acute inflammation?
Changes in vessel radius - flow
Change in permeability of vessel wall - exudation
Movement of neutophils from the vessel to extracellular wall.
What factors affect drug metabolism?
Other drugs, herbals and natural substances Genetics Diseases (liver) Age Sex Pregnancy
What are some gastrointestinal factors of drug absorption?
Speed of gastric absorption
food
illness
What are the signs of accute inflammation?
Redness Heat Swelling Pain Loss of function
In what patients could minor drug interactions cause severe reactions?
Those with; Liver disease Renal impairment Diabetes Epilepsy Asthma
What is a polysome?
Several ribosomes translating mRNA at one time.
What is a hypersensitivity response?
A hyper response from the immune system and harmful responses can cause tissue injury and cause serious disease.
What are delayed reactions to drugs?
These reactions occur after a long time
What are sublingual tablets?
small and dissolve slowly under the tongue
What are transdermal drugs?
Adhesive patches applied to skin which goes into systematic circulation.
What is enteric coating of a drug?
Delays breakdown of the tablet until it reaches the small intestine.
What is a malignant tissue?
A tumour with an invasive growth pattern and abnormal cells. There is a loss of function, spread of the cancer and frequently cause death.
What are the properties of an ideal isotope?
A half life similar to examination time
Be a gamma emitter
Be readily available
Easily bound to pharmaceutical component.
