Principles Of Disease Flashcards

1
Q

What is a gamma ray?

A

Occur due to radioactive decay of unstoppable isotopes. They have high energy and frequency.

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2
Q

Why is immunological tolerance important?

A

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.

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3
Q

Which types of immune response are antibody mediated?

A

Type I, II, III and (V)

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4
Q

What substances can modify drug action despite other drugs?

A

Food, smoking, alcohol and herbs

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5
Q

What are the benefits and risks of radiation?

A
Diagnosis
Management change
Treatment
Ionisation radiation
Risk of inducing fatal cancer
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6
Q

What is a tumour?

A

A tumour is an abnornmal uncoordinated growing mass of tissue which is irreversible.

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7
Q

What are cancer causing oncogenes?

A

Derived from proto-oncogenes with gain of function

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8
Q

When does inflammation become chronic?

A

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.

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9
Q

What is the difference between granulomas and granulomatous tissue?

A

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.

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10
Q

Where does a drug need to be distributed to for it to have an affect?

A

Target site of action

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11
Q

What is the definition of adverse drug reactions?

A

Any response to a drug which is noxious, unintended and occurs at doses used in normal reigimn.

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12
Q

What is first pass metabolism?

A

The metabolism of a drug before reaching systematic circulation

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13
Q

What can interactions of drugs in the GI tract cause changes in?

A

absorption rate

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14
Q

What is metaphase and prometaphase in DNA replication?

A

Metaphase - chromosomes DNA can be split in two easily

Prometaphase - Cannot be split in half perfectly

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15
Q

What are end of treatment reactions to drugs?

A

Adverse effects that occur when a drug treatment is stopped following long term use

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16
Q

What can a prolonged half-life cause?

A

increased toxicity.

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17
Q

What is acute inflammation?

A

A response to injury used to maintain the integrity of the organism. It is a series of protective changes occuring in living tissues.

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18
Q

What are the 4 factors in pharmokinetics?

A

Absorption
Distribution
Metabolism
Elimination

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19
Q

Where does excretion of a drug usually take place?

A

In the kidney

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20
Q

What are dispersions in drugs?

A

Coarse drug particles in a liquid phase, good for drugs which are insoluble and unpalatable.

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21
Q

What are the potential side effects of chemotherapy?

A
Alopecia
Nausea/vomiting
Renal failure
Diarrhoea
Sterility
They can be managed
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22
Q

What are tumour suppressor genes?

A

Genes that protect a cell from forming cancers
Mutation causes loss of function
e.g. retinoblastoma

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23
Q

What are the methods of cancer spread?

A

Local Spread
Lymphatic spread
Blood spread
Trans-coelomic spread (across body cavities)

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24
Q

Which grove on DNA interacts more with proteins? (major or minor)

A

Major groove

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25
Q

What is a teratoma?

A

tumours of germ cells

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26
Q

What is screening in cancer?

A

Diagnosis at an earlier stage before symptoms start. Allows cancer to be treated much easier and is most likely curable

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27
Q

What are the benefits of acute inflammation?

A

Rapid response
Cardinal signs and loss of function (prevent further injury)
Resolution and return to normal

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28
Q

What are the different types of adverse drug reactions?

A
Augmented
Bizarre
Chronic
Delayed
End of treatment
Failure of treatment
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29
Q

What can impair wound healing?

A

Dirty
Gaping wound
Poorly nourished
Inhibition of angiogenesis

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30
Q

What is a carcinoma?

A

malignant epithelial tumour

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31
Q

What is the area under a drug concentration-time graph?

A

Estimate amount of drug which reaches circulation

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32
Q

Where are unbound drugs filtered?

A

The glomerulus

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33
Q

What are failure of treatment reactions to drugs?

A

Failure of therapy and can be dose related or due to drug interactions

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34
Q

Where are drugs metabolised?

A

The liver, lining of the gut, kidneys and the lungs.

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35
Q

When is an intramuscular injection used?

A

To allow a more sustained duration of action up to months

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36
Q

What is angiogenesis?

A

Formation of new blood vessels

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37
Q

What is carcinogenesis?

A

The failure of cell cycle control. Occurs when the balance between proliferation and apoptosis is disrupted.

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38
Q

What are lymphocytes?

A

Cells that are part of the immune system
Small round cells with lots of subtypes
immune response and memory

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39
Q

What does drug therapy involve?

A

Get the drug into patient
Get the drug to the site of action
Produce the corrcet pharmacological effect
Produce the correct therapeutic effect

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40
Q

Why do cancer cells arise?

A

When cells have loss of their tumour suppression genes and gain function of oncogenes.

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41
Q

What do neutrophils do?

A

Recognise foreign antigen and move towards it.
Destroy the foreign antigen.
The neutrophils die once it has released its contents and produces puss.

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42
Q

How is iodine used in imaging?

A

given intravenously to demonstrate blood vessels or the vascularity of different tissues.

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43
Q

Which type of drug is absorbed the fastest?

A

Solution

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44
Q

What is phase 2 of metabolism?

A

Glucuronidation

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45
Q

What are the different forms of drugs?

A
Tablets or capsules
Solutions
Ointments and creams
Inhalation
Injections
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46
Q

What is involved in phase 2 of metabolism?

A

Conjugation which increases the water solubility and enhances excretion.
Attachment of glucuronic acid to the metabolite.
Usually results in inactivation

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47
Q

What is a poulation risk for genetics?

A

The risk that the person is the first person in their family to have the mutation and attain the disease

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48
Q

What does it mean if a tumour metastasises?

A

When the tumour spreads and grows at other sites within the body.

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49
Q

What negative effects can benign tumours have?

A

Cause pressure and obstruction

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50
Q

What negative effects can benign tumours have?

A

Cause pressure and obstruction

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51
Q

What is cellular and nuclear pleomorphism?

A

variation in size and shape of tumour cells where mitosis can present and often abnormal.

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52
Q

How are CT’s used in the testing and treating for cancer?

A

To monitor response to treatment, relapse and the progression of the disease.

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53
Q

What can metabolism of drugs lead to?

A

Loss of pharmacological activity, decrease or increase in metabolites activity and production of toxic metabolites

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54
Q

What is mRNA, tRNA and rRNA?

A

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.

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55
Q

What is the rate limiting step of absorption for tablets and capsules?

A

Tablets break down or dissolution

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56
Q

How is a drug delivery system chosen?

A

The dose of the drug
The frequency of administration
Timing of administration

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57
Q

What are some effects of inflammation?

A
Raised temperature
Feel unwell
Raised white blood cell count
Weight loss
anaemia
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58
Q

What is the granulation tissue mechanism and function?

A

Patches tissue defects
Replaces dead or necrotic tissue
Contracts and pulls together

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59
Q

What are natural killer cells?

A

Cells that destroy antigens and kill cells

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60
Q

What is proliferation of cells?

A

Growth of cells

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61
Q

What is tumour angiogenesis?

A

New blood vessel formation by tumours in order to sustain tumour growth. Can provide a route for tumour cells to enter circulation

62
Q

What is an astrocytoma?

A

A tumour of the central nervous system

63
Q

Why can granulomas cause a patient to feel no pain?

A

The granulomas attach to nerves

64
Q

What are common enzyme inducers?

A

Alcohol and smoking

65
Q

What is synergistic interactions in drugs?

A

These are interactions between drugs which produce the same effect

66
Q

What is barium sulphate used for in imaging and why is it used?

A

Used for oputlining the gastro-intestinal tract.

Used as barium absorbs more radiation than surrounding tissue which appears white.

67
Q

Why would a drug delivery system be formulated?

A

Allow selective targetting of a tissue site

Allow 24 hr action

68
Q

What is the body’s response for acute inflammation?

A

Transient arteriolar constriction
Local arteriolar dilation
Relaxation of vessel in smooth muscle
Flush, flare and wheal

69
Q

What is radiation carcinogenesis?

A

Purine and pyrimidine bases in DNA are targets for radiation damage
High-energy radiation is carcinogenic

70
Q

What is an antigen?

A

A molecule which is recognised by the immune system and is foreign to the body.

71
Q

What is absorption of a drug?

A

The process of movement of unchanged drug from the site of administration to the systematic circulation.

72
Q

What is combination treatment in cancer?

A

The use of multiple cancer treatments. Activity must balance and the combination should be chosen so that they have different mechanisms of action.

73
Q

What is an abscess?

A

A collection of puss which can discharge under pressure and heals once collapsed.

74
Q

What is autoimmune disease?

A

Antibodies are directed against its own cell and tissue component which damages or destroys organs, tissues, cells and cell components.

75
Q

What is phase 1 of metabolism?

A

Oxidation, Reduction and hydrolysis

76
Q

In a drug-drug interaction what is the drug affected called and what is the drug which induces the reaction called?

A

Affected - Object drug

induces the reaction - Precipitant

77
Q

What is the half life of a drug?

A

The time taken for the drug concentration in the blood to decline to half of the current value.

78
Q

What is a lymphoma?

A

malignant cancer of the lymphoid tissue

79
Q

What is a mild, moderate and severe reaction to drugs?

A

Mild - bothersome but requires no change in therapy
Moderate - Requires change in treatment, additional treatment and hospitalization.
Severe - Disabling or life-threatening

80
Q

What are some physiological barriers to drug absorption?

A

Passive diffusion
Filtration
Bulk flow
Active transport

81
Q

Why is DNA packaged with histone proteins?

A

The negatively charged DNA is neutralised by the positively charged histone proteins as well as taking up less space.

82
Q

How can inflammation become harmful?

A

When there is an inability to perfuse tissues and there is systematic release of chemical mediators from cells into the plasma

83
Q

When is a drug biologically active?

A

When a drug is unbound and not bound to a protein.

84
Q

What is mitochondrial inheritance?

A

genetics passed down through maternal inheritance (only females can pass it on) and has a high mutation rate

85
Q

What is drug distribution?

A

The reversible transfer of a drug between the blood and the extra vascular fluids and tissues of the body.

86
Q

What is a telomere?

A

The protective structures at the end of the chromosome (hundreds of repeated base sequences)

87
Q

How are autoimmune diseases caused?

A

Genetics - pre-disposistion to autoimmune disease

Environmental - Drugs, trauma, food and prior infection.

88
Q

What is immunotherapy?

A

The use of the patients own immune cells to treat their cancer.

89
Q

What are monoclonal antibodies?

A

Antibodies which act directly when binding to cancer specific antigen and produce an immunological response to cancer cells.

90
Q

What is immunological tolerance?

A

A state of unresponsiveness to a specific antigen which prevents adaptive responses that are damaging B cells and T cells.

91
Q

How can chronic inflammation be diagnosed?

A

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.

92
Q

What is the immediate reaction in an allergy and its effects?

A

The IgE effects;
vasodilation
Oedema
Vascular Congestion

93
Q

What conditions favour wound healing?

A

Cleanliness
Apposition of edges
Sound nutrition
Metabolic stability

94
Q

What are augmented reactions to drugs?

A

Normal and predictable reactions which are concentration dependant. Easily reversible by reducing or stopping the dose.

95
Q

When is the rectal route for drugs useful?

A

In young and old patients or if they are unable to swallow. Also allows the drug to treat local conditions.

96
Q

What is a drug-drug interactions?

A

The modification of a drugs effect by prior or concomitant administration of another drug, herb, foodstuff or drink

97
Q

What is leukaemia?

A

malignant cancer of the blood

98
Q

How is systematic chemo given?

A

orally or intravenously in regular cycles.

99
Q

What negative effects can malignant tumours have?

A
Tissue destruction
Infection
Bleeding (haemoorrhage)
Pain
Pressure
Obstruction
Weight loss
100
Q

How are oncogenes activated?

A

Chromosomal rearrangements

Over expression

101
Q

What is the state of drug metabolising enzymes in the foetus and very young children?

A

Defiient or inactive so build up to toxic levels quickly

102
Q

What is gametogenesis?

A

Egg formation

Sperm formation

103
Q

What do macrophages do?

A

Removes debris
Role in immune system
Take over from neutrophils

104
Q

What is direct antagonism?

A

Drug interactions between drugs that produce opposite effects

105
Q

How do immunotherapies work?

A

Macrophages and natural killer cells attack foreign cells

106
Q

How often should chemotherapy be given?

A

In stages as it also kills normal cells, however, if recovery is too long then the tumour cell population wil increase.

107
Q

What is a phenotype?

A

The outward, physical manifestation of an organism

108
Q

What is contained in chromosomes?

A

Many genes
Regulatory elements
other nucleotide sequences

109
Q

What is mitosis?

A

When the chromosome seperates then the cytoplasm seperates the two new daughter cells.

110
Q

What is a schwannoma?

A

tumour of the peripheral nervous system

111
Q

What is a benign tumour?

A

A tumour with a non-invasive growth pattern usually remaining in a single place. Rarely cause death

112
Q

Where do neutrophils and red blood cells go during acute inflammation?

A

Neutrophils move to the outside of the vessel.

Red blood cells congregate in the centre.

113
Q

What is drug metabolism?

A

A biochemical modification of pharmaceutical substances by living organisms usually through specialized enzymatic activity.

114
Q

What is a sarcoma?

A

malignant connective tissue tumour

115
Q

What is apoptosis in tumours?

A

Mechanism of programmed single cell death which regulates tumour growth

116
Q

What part of the cell contains the most genetic material?

A

Nucleus

117
Q

What is dysplasia 1 and 2 in cancer?

A

dysplasia 1 - pre-malignant stage, earliest stage of malignancy
Dysplasia 2 - identified in epithelium, no invasion but can progress to cancer

118
Q

What is meiosis?

A

Cell division in germ cells

119
Q

How is acute inflammation caused?

A

micro-organisms (bacteria, fungi, viruses and parasites) which cause infection. Arises by injury even sterile injuries.

120
Q

Why does early detection of cancer benefit?

A

Reduce patient mortality/morbidity

Detection before pre-invasive stage

121
Q

What are chronic reactions to drugs?

A

Reactions related to the duration of treatment as well as the dose and is semi-predictable.

122
Q

What are some cancer treatments?

A
Surgery
Radiotherapy
Hormonal therapy
Chemotherapy
Immunotherapy
123
Q

What is the Mt genome?

A

A mutational hotspot due to a lack of efficient DNA repair system and lack of protective proteins.

124
Q

What is radiotherapy?

A
Role in palliation
Radio sensitive
repair
re-population
re-oxygenation
re-assortment
can be combined with chemo
125
Q

What are bizarre reactions to drugs?

A

Unpredictable and rare reactions which can cause serious illness or death and are not easily reversible.

126
Q

What are proto-ocogenes?

A

Normal genes coding for normal growth regulating proteins

127
Q

What is wound healing?

A

Process of repair of tissue damage
Phase of acute inflammation
Granulation tissue formation
Scar formation

128
Q

What is the T-cell mechanisms?

A

Produce cytokines

Damages and kills other cells and destroys antigen

129
Q

What types of immune response are T cell mediated?

A

Type IV

130
Q

What do MRI’s allow for?

A
Excellent bone and soft tissue detail
Vessels can be demonstrated
Brain, spine and musculoskeletal
abdomen and pelvis
Cardiac imaging
131
Q

How can a patient become septic?

A

Acute inflammation spreading to the bloodstream

132
Q

What is the volume of distribution of a drug?

A

The volume of plasma that would be necessary to account for the total number of drug in a patients body.

133
Q

Why does the chance of developing cancer increase over time?

A

mutations accumulating over time and activation of several oncogenes and loss if anti-oncogenes occurs

134
Q

What are autoimmune diseases?

A

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.

135
Q

When are intravenous injections useful?

A

Providing fast systematic effects and in unconscious patients.

136
Q

What is a genotype?

A

The full hereditary information of an organism

137
Q

What is the clearance of a drug?

A

The volume from which a drug is completely removed over a period of time. measured in ml/min

138
Q

How does DNA fold to take up less volume?

A

DNA wraps around 8 histone proteins to form a nucleosome which then folds up to produce a fibre.

139
Q

What is the fitness of an organism?

A

Its relative ability of an organism to survive long enough to pass on their genes.

140
Q

What is the pathogenesis of acute inflammation?

A

Changes in vessel radius - flow
Change in permeability of vessel wall - exudation
Movement of neutophils from the vessel to extracellular wall.

141
Q

What factors affect drug metabolism?

A
Other drugs, herbals and natural substances
Genetics
Diseases (liver)
Age
Sex
Pregnancy
142
Q

What are some gastrointestinal factors of drug absorption?

A

Speed of gastric absorption
food
illness

143
Q

What are the signs of accute inflammation?

A
Redness
Heat
Swelling
Pain
Loss of function
144
Q

In what patients could minor drug interactions cause severe reactions?

A
Those with;
Liver disease
Renal impairment
Diabetes
Epilepsy
Asthma
145
Q

What is a polysome?

A

Several ribosomes translating mRNA at one time.

146
Q

What is a hypersensitivity response?

A

A hyper response from the immune system and harmful responses can cause tissue injury and cause serious disease.

147
Q

What are delayed reactions to drugs?

A

These reactions occur after a long time

148
Q

What are sublingual tablets?

A

small and dissolve slowly under the tongue

149
Q

What are transdermal drugs?

A

Adhesive patches applied to skin which goes into systematic circulation.

150
Q

What is enteric coating of a drug?

A

Delays breakdown of the tablet until it reaches the small intestine.

151
Q

What is a malignant tissue?

A

A tumour with an invasive growth pattern and abnormal cells. There is a loss of function, spread of the cancer and frequently cause death.

152
Q

What are the properties of an ideal isotope?

A

A half life similar to examination time
Be a gamma emitter
Be readily available
Easily bound to pharmaceutical component.