Terms (Midterm 2) Flashcards
Substance Misuse
The use of a substance inconsistent with medical or legal guidelines.
Dependence
Frequent or consistent use of a drug or behaviour that makes it difficult for the person to function without it.
Substance Use Disorder
A cluster of symptoms involving cognitive, bodily, and social impairment related to the continued use of a substance. A single disorder measured on a continuum from mild to severe.
Pharmacy
The art of compounding drugs from various substances.
Pharmacology
The science and study of drugs.
Neurotransmitters
Brain chemicals that transmit nerve impulses.
High
The subjectively pleasing effects of a drug, usually felt quite soon after the drug is taken.
Placebo Effect
When a person receives an inert substance yet responds as if it were an active drug.
Opioids
Drugs that relieve pain, cause drowsiness, and induce euphoria.
Euphoria
An exaggerated feeling of well-being.
Naloxone
A drug that can temporarily reverse an opioid overdose.
Stigma
Negative attitudes, beliefs, or behaviours about or towards a group of people because of their situation in life. Includes discrimination, prejudice, judgment, and stereotypes.
Central Nervous System Depressants
Drugs that slow down the central nervous system.
Sedation
The induction of a calm, relaxed, often sleepy state.
Anaesthetics
Drugs that produce a loss of sensation with or without a loss of consciousness.
Central Nervous System Stimulants
Drugs that speed up the activity of the nervous or muscular system.
Psychosis
A severe mental disorder characterized by a distortion of reality. Symptoms might include delusions or hallucinations.
Depersonalization
A state in which a person loses the sense of reality or perceives their body as unreal.
Hallucinogens
Drugs that alter perceptions, feelings, and thoughts.
Altered States of Consciousness
Profound changes in mood, thinking, and perception.
Codependency
A relationship in which a partner or family member who does not abuse drugs or alcohol is controlled by the behaviour of the person with an addition.
Addictive Behaviours
Are habits that have gotten out of control resulting in negative effects on a person’s health.
Addiction
A chronic disease that disrupts the brain’s system of motivation, reward, and memory. Compulsive desire and increasing need for a substance or behaviour, causing harm to the individual and/or society.
Tolerance
A physical state in which the body adapts to a drug so that the initial dose no longer produces the original physical or psychological effects.
Reward Pathway Components
1) Ventral tegmental area (VTA).
2) Nucleus accumbens (NA).
3) Prefrontal cortex (PFC).
Withdrawal
A set of symptoms including anxiety, pain, irritability, sweating, tremors, vomiting, and insomnia.
Drugs
Are chemicals other than food that are intended to affect the structure or function of the body.
Psychoactive Drug
A drug which alters a person’s experiences or consciousness and is most often associated with abuse and addiction.
Intoxication
A short-term state in which sometimes unpredictable physical and emotional changes occur. The state of being mentally affected by a chemical (literally a state of being poisoned).
The Plenty Paradox
Overabundance is itself a stressor caused by the mismatch between our primitive wiring and our modern dopamine-rich ecosystem.
Psychological Set
Expectations about how one will react to the drug.
Common Opioids
1) Heroin
2) Opium
3) Morphine
4) Oxycodone
5) Codeine
6) Hydrocodone
7) Fentanyl
Naloxone Kits
Used to treat an overdose.
Common Central Nervous System Depressants (Sedatives)
1) Barbiturates
2) Benzodiazepines
3) Methaqualone
4) Gamma hydroxybutyrate
5) Alcohol
Federal Approach on Canada’s Opioid Crisis
1) Prevention
2) Treatment
3) Harm Reduction
4) Enforcement
Common Central Nervous System Stimulants
1) Amphetamine
2) Methamphetamine
3) Cocaine
4) Crack Cocaine
5) Ritalin (ADHD Drugs)
6) Caffeine
7) Nicotine
8) Ephedrine (used for weight loss)
Marijuana/Cannabis Products
1) Cannabis
2) Hashish
- Comes from the hemp plant Cannabis sativa.
- THC (tetrahydrocannabinol) is the main active ingredient (10-30%).
- Usually smoked but can also be ingested.
- High doses of marijuana can cause psychosis or panic.
Common Hallucinogens
1) LSD
2) Mescaline (peyote)
3) Psilocybin (magic mushrooms)
4) Ketamine
5) PCP
6) MDMA (ecstasy, can dangerously increase body temperature)
Synaesthesia
Cross over with sense ex. smelling colours and seeing sounds.
Treatment for Substance Use Disorders
1) Medication-assisted treatment.
- Methadone
- Buprenorphine
- Suboxone
2) Treatment centres.
3) Self-help groups and peer counselling.
4) Harm-reduction strategies.
Chain of Infection
Pathogen —> Reservoir —> Portal of Exit —> Means of Transmission —> Portal of Entry —> New Host
Pathogen
A microorganism that causes disease.
Toxins
Poisonous substances.
Reservoir
A natural environment in which a pathogen typically lives.
Portal of Exit
How the pathogen leaves the reservoir.
Vectors
Insects, rodents, or other organisms that carry and transmit a pathogen from one host to another.
Portal of Entry
How the pathogen enters the new host.
Systemic Infection
An invasion by a microorganism that spreads through the blood or lymphatic system to large portions of the body.
Immune System
The body’s collective physical and chemical defences against foreign organisms and pathogens.
Neutrophils
A type of white blood cell that engulfs foreign organisms and infected, damaged, or aged cells. Particularly prevalent during the inflammatory response.
Macrophages
Large phagocytic (cell-eating) cells that devour foreign particles.
Natural Killer Cells
A type of white blood cell that directly destroys virus-infected cells and cancer cells.
Dendritic Cells
Activates T and B cells and eats pathogens.
Lymphocytes
A type of white blood cell that works in both the bloodstream and the lymphatic system.
Lymph Nodes
Where macrophages and dendritic cells congregate and filter bacteria and other substances from the lymph.
T Cells
A type of lymphocyte that arises in bone marrow and matures in the thymus.
B Cells
A type of lymphocyte that matures in the bone marrow and produces antibodies.
Helper T Cells
Lymphocytes that help activate other T cells and may help B cells produce antibodies.
Killer T Cells
Lymphocytes that kill body cells that have been invaded by foreign organisms and can also kill cells that have turned cancerous.
Suppressor/Regulatory T Cells
Lymphocytes that inhibit the growth of other lymphocytes.
Antibodies
Specialized proteins produced by white blood cells that can recognize and neutralize specific microbes.
Memory T and B Cells
Lymphocytes generated during and initial infection that circulate in the body for years, remembering the specific antigens that caused the infection and quickly destroying them if they appear again.
Autoimmune Diseases
Diseases in which the immune system attacks the person’s own body.
Antigens
Markers on the surface of a foreign substance that immune system cells recognize as non-self and that trigger the immune response.
Histamine
A chemical responsible for the dilation and increased permeability of blood vessels in allergic reactions. Increases the inflammatory response and stimulates mucus production.
Pus
A collection of dead white blood cells and debris.
Cytokines
Chemical messengers produced by a variety of cell types that help regulate many cell functions. The immune system cells release this to help amplify and coordinate the immune response.
Immunity
Mechanisms that defend the body against infection. Specific defences against specific pathogens.
Acquired Immunity
The body’s ability to mobilize the cellular memory of an attack by a pathogen to throw off subsequent attacks. Acquired through vaccination and the normal immune response.
Incubation
The period when bacteria or viruses are actively multiplying inside the body’s cells. Usually a period without symptoms of illness. May be contagious.
Immunization
The process of conferring immunity to a pathogen by administering a vaccine.
Vaccine
A preparation of killed or weakened microorganisms, inactivated toxins, or components of microorganisms that is administered to stimulate an immune response, protects against future infection by the pathogen.
Allergies/Hypersensitivity
A disorder caused by the body’s exaggerated response to foreign chemicals and proteins.
Allergens
Substances that trigger an allergic reaction.
Anaphylaxis
A severe systemic hypersensitive reaction to an allergen characterized by difficulty breathing, low blood pressure, heart arrhythmia, seizure, and sometimes death.
Cytokine Storm
An immune reaction in which the body releases large amounts of cytokine molecules into the bloodstream.
Infection
The invasion of the body by microorganisms.
Direct Transmission
Hand-to-hand, sexual contact, and/or contact with body fluids.
Indirect Transmission
Animals or insects, contaminated objects (fomites), and/or through air.
The Body’s Defence System
1) Physical Barriers
2) Chemical Barriers
3) The Immune System
Physical Barriers
1) First line of defence.
2) Intact skin.
3) Mucous membranes lining the respiratory, digestive, reproductive, and urinary tracts.
4) Nasal hairs.
5) Tears, saliva, and urine that physically flush out microbes.
6) Mechanical responses.
Chemical Barriers
1) Secretions of the oil glands.
2) Anti-microbial chemicals, such as the enzyme lysozyme found in saliva, tears, and sweat.
3) Acidic pH of the stomach and vagina.
The Immune System Components
1) Innate immune response. (No memory)
2) Adaptive immune response. (Memory)
3) Carried out by different types of white blood cells (leukocytes) produced in bone marrow.
Innate/Natural Response
1) Inflammatory response.
- Most cells release histamine.
- Dilation of blood vessels.
- Heat, swelling, and redness.
2) Neutrophils, dendritic cells, macrophages, and natural killer cells drawn to area.
- Destroy pathogens without any memory of past infections.
- Release cytokines as chemoattractants for more immune cells.
Phase 1
Macrophages and dendritic cells arrive, consume foreign cells, and relay information (ie. display antigens) to helper T cells, which rush to respond.
Phase 2
Helper T cells (CD4+) multiply rapidly and trigger production of killer T cells and B cells in the spleen and lymph nodes. Cytokines such as interleukins and interferons stimulate production of T cells, B cells, and antibodies.
Phase 3
Cell-mediated immune response: killer T cells (CD8+ cytotoxic T cells) destroy foreign cells and cells of the body that have been invaded and infected. Antibody-mediated (humoral) immune response: B cells produce antibody molecules that bind to antigen-bearing targets, thereby marking them for macrophages to consume. Antibodies only work against pathogens in the body NOT inside cells.
Phase 4
Suppressor T cells stop the immune response and restore balance. Dead cells are filtered and excreted.
Atherosclerosis
Build up of plaques in the arteries.
Prodromal Period
After incubation. Initial symptoms begin to appear. Highly contagious period.
Immunization Approaches
1) Weakened or inactivated virus.
2) Viral-vector vaccines.
3) Nucleic-acid vaccines.
4) Protein-based vaccines.
Immunoglobulin (IgE)
An antibody that causes allergic reactions.
Passive Immunity
Immunity that is passed down ex. breast milk.
Convolescent Blood
Blood that contains antibodies for a particular disease.
Bacteria
Single-celled prokaryotic organisms that can reproduce rapidly.
Pneumonia
Inflammation of the lungs caused by infection with bacteria, viruses, fungi, or by contact with chemical toxins or irritants.
Meningitis
Infection of the meninges (membranes covering the brain and spinal cord). Viral is mild, bacterial is life threatening.
Staphylococcal Infections
Spherical, clustered bacteria commonly found on skin or in nasal passage.
MRSA
Methicillin-resistant staphylococcus aureus.
Tuberculosis (TB)
Chronic bacterial infection that affects the lungs.
MDR TB
Multi-drug resistant tuberculosis.
XDR TB
Extensively drug resistant tuberculosis.
Tick-Borne Infections
Infections spread by ticks ex. lyme disease.
Antibiotics
Naturally occurring and synthetic substances. Interrupt the production of new bacteria by damaging some part of their reproductive cycle or by causing faulty parts of new bacteria to be made.
Antibiotic Resistance
Occurs when antibiotics are misused or overused and pathogens become resistant to their effects.
Bacteria Classification
1) Bacilli (rod shaped)
2) Cocci (spherical)
3) Spirochete (spiral shaped)
4) Vibrios (comma shaped)
Viruses
Small infectious agents composed of nucleic acid (DNA or RNA), proteins, and surrounded by glyco-protein coats. Lack an independent metabolism and reproduce only within a host cell. Lack all enzymes essential for energy production and protein synthesis in normal animal cells.
Life Cycle of a Virus
1) The virus penetrates the cell.
2) The protein coat is removed.
3) Genes replicate and proteins are made.
4) The new protein coat is assembled and genes are inserted.
5) Viruses exit the cell.
Influenza
Highly contagious. Strains change year to year due to changes in antigens on viral coat.
Antigenic Drift
Mutation in RNA within the virus that cause small changes in the hemagglutinin and neuraminidase antigens on the surface of the virus.
Antigenic Shift
Reassortment or genetic recombination between different strains or host species, completely new antigens.
Viral Encephalitis
Inflammation of brain tissue.
Viral Hepatitis
Inflammation of the liver.
Poliomyelitis
Affects the nervous system and can cause irreversible paralysis and death.
Rabies
A virus that causes infection of the central nervous system.
Human Papillomavirus (HPV)
A variety of types cause warts. Some types cause cervical cancer.
Hepatitis A Virus (HAV)
Mildest form. Transmitted by an infected person or food or water contaminated by sewage.
Hepatitis B Virus (HBV)
Transmitted sexually. 5-10% become chronic carriers (won’t go away).
Hepatitis C Virus (HCV)
Direct contact with infected blood via injection (ex. drug use). Can develop chronic liver disease, cirrhosis, or liver cancer. 85% become chronic carriers (won’t go away).
AZT
A reverse transcriptase inhibitor used in HIV treatment.
Fungus
An organism that absorbs food from organic matter. Can be multicellular (molds) or unicellular (yeasts). Causes infections in the skin, mucous membranes, and lungs. Can form spores (a resistant formant stage).
Candida albicans
The fungus that causes yeast infections.
Protozoa
Single-celled eukaryotic that often produce recurrent, cyclical attacks of disease ex. malaria, giardiasis (waterborne disease), and trichomoniasis (common vaginal infection).
Malaria
Caused by a protozoan of the genus Plasmodium. Recurrent attack of severe flu-like symptoms. Injected into bloodstream of host by mosquitos. One of the most prevalent infectious disease worldwide.
Parasitic Worms
The largest organisms that can enter the body to cause infection.
Pinworm
The most common worm infection in Canada.
Prions
Lack DNA or RNA and consist only of protein. Their presence in the body does not trigger an immune response. They have an abnormal shape and form deposits (holes) in the brain. May trigger normal proteins to change their structure to the abnormal, damaging form. Have been linked to cause fatal degenerative disorders of the central nervous system ex. Creutzfeldt-Jakob disease (humans), bovine spongiform encephalopathy (cattle-mad cow disease), and scrapie (sheep).
Hygiene Hypothesis
Using hookworms to treat people with allergies. Helps reduce hypersensitivity of the immune system.
Sporadic
Diseases that occur infrequently and randomly ex. rabies.
Endemic
The usual prevalence of a disease or infectious agent in a population in a given area ex. common cold and Lyme disease.
Outbreak
Greater than expected number of new cases of disease in a define area (ex. food-borne disease).
Epidemic
Greater than expected number of new cases of disease affecting a larger population or region (ex. Ebola).
Pandemic
An epidemic that spreads over several countries or continents at the same time ex. HIV/AIDS, influenza, and COVID-19.
Zoonosis
A disease or infection that is transmitted from vertebrate animals to humans or vice-versa ie. the animal is the primary reservoir.
Common-Source
Group of people all exposed to an infectious agent or toxin from the same source. Usually rapid rise and decline of incidence.
Propagated
Transmission from one person to another.
Emerging
Diseases that are newly appearing or that were previously confined to only certain regions or species ex. SARS-CoV, SARS-CoV2, Monkeypox, Mad Cow disease, Ebola Virus disease, and Zika Virus.
Re-Emerging
Known diseases from the past which are making a comeback ex. tuberculosis and cholera.
Emerging Infectious Diseases of Concern
1) Avian influenza (H5N1)
2) West Nile virus (can cause permanent brain damage and death)
3) SARS-CoV and SARS-CoV2 (COVID-19)
4) Rotavirus (causes intestinal inflammation ex. vomiting and diarrhea)
5) ESCHERICHIA COLI 0157:H7 (causes bloody diarrhea and kidney damage)
6) Hantavirus
7) Zika Virus
8) Monkeypox
9) Ebola Virus Disease
Aerosol Transmission
Exhaled respiratory units of ≤ 5 μm in diameter linger in the air for hours.
Droplet Transmission
Exhaled respiratory units of ≥ 5 μm in diameter fall to the ground within 1 to 2 metres.
Fomite Transmission
Respiratory units incident on an inert surface, touched by a potential host, who then transfers it to their own mucous membrane.
Urethritis
Inflammation of the tube that carries urine from the bladder to the outside opening.
Cervicitis
Inflammation of the cervix characterized by discharge and bleeding on contact.
Proctitis
Inflammation of the rectum characterized by anorectal pain, the sensation of incomplete bowel movements, and discharge.
Epididymitis
Inflammation of the small body of sperm-carrying ducts that rest on the testes.
Opportunistic (Secondary) Infections
Infections caused when organisms take the opportunity present by a primary (initial) infection to multiply and cause a new, different infection.
7 Major STIs
1) Chlamydia
2) Gonorrhea
3) Syphilis
4) Human papillomavirus (HPV)
5) Genital herpes (HSV 1 and HSV 2)
6) HIV/AIDS
7) Hepatitis B (HBV)
Chlamydia
Caused by bacterium chlamydia trachomatis. Most prevalent bacterial STI in Canada. Can be asymptomatic. Women are at risk for pelvic inflammatory disease (PID) and infertility. Men may experience epidiymitis (inflammation of the testicles) or urethritis. Infants can acquire infection from mothers. Antibiotics can usually cure the infection in one dose.
Pelvic Inflammatory Disease (PID)
Abnormal vaginal bleeding with pain, fever, chills, and nausea. Treatment is antibiotics. Infection goes up into the reproductive track.
Human Papillomavirus Infection (HPV)
Thought to be one of the most common STIs in Canada. Can lead to common warts, genital warts, and genital cancers. Can be persistent and incurable. Can be spread by oral sex.
Types 6 and 11
Low-risk HPV. Causes genital warts.
Types 16 and 18
High-risk HPV. Can lead to cancer.
E6
Tags an important tumor suppressor for destruction.
E7
Inhibits a protein that normally puts the brakes on progression through the cell cycle.
HIV
A chronic disease that progressively damages the body’s immune system. Attacks and invades CD4 T-cells (helper T cells), monocytes, and macrophages, essential elements of the immune system. Enters a human cell and converts its own genetic material, RNA, into DNA which is inserted into chromosomes of the host cell. Viral DNA takes over the CD4 cell, causing it to produce new copies of HIV and makes CD4 cells incapable of performing immune functions. Lives only within cells and bodily fluids. It is transmitted by blood and blood products, semen, vaginal and cervical secretions, and breast milk.
Primary/Acute Infection Phase
Occurs in the first weeks after being infected and can produce flu-like symptoms. There is a lot of HIV in the system, making the individual much more infectious. Most people are unaware they are infected and tests (based on antibodies) are often negative at this stage.
Chronic Asymptomatic (Symptom-Free) Stage
Can last from 2-20 years. The virus progressively infects and destroys the cells of the immune system.
Chronic Symptomatic Stage
Further depletion of CD4 cells and a severely damaged immune system.
Kaposi’s Sarcoma
Rare skin cancer caused by a virus.
Tuberculosis
Respiratory infection caused by Mycobacterium tuberculosis.
Candida
A common fungus that causes yeast infections.
Pneumocystis carinii Pneumonia (PCP)
Lung infection caused by a fungus.
Treatment and the HIV Life Cycle
1) Binding Inhibitors (prevents the binding of HIV).
2) Fusion Inhibitors (prevents fusion of HIV to the cell).
3) Reverse Transcriptase Inhibitors (inhibits the reverse transcriptase enzyme from HIV).
4) Integrase Inhibitors (inhibits the integrase enzyme from HIV that is responsible for altering the DNA).
5) Protease Inhibitors (an HIV enzyme, protease, that makes the HIV virus mature).
Types of Symptoms
1) Severe
2) Unusual
3) Persistent
4) Recurrent
Signs of Stroke
FACE (is it drooping?)
ARMS (can you raise both?)
SPEECH (is it slurred or jumbled?)
TIME (to call 911 ASAP)
Scientific Method
1) Ask a question.
2) Do background research.
3) Construct a hypothesis.
4) Test your hypothesis by doing an experiment.
5) Analyze your data and draw a conclusion.
6) Report your results.
Health Literacy
The skills to access, understand, and use information regarding health.
Vulnerable Populations Regarding Health Literacy
1) Seniors
2) Immigrants
3) Unemployed
Evidence-Based Medicine
A systematic approach to clinical problem solving that allows the best available research evidence with clinical expertise and patient values.
The Evidence-Based Medicine Triad
1) Individual Clinical Expertise
2) Best External Evidence
3) Patient Values and Expectations
Evidence-Based Practice
The practice of health care in which the practitioner systematically finds, appraises, and uses the most current and valid research findings as the basis for health-related decisions.
Hierarchy of Evidence Pyramid
Top
Systematic Reviews
Randomized Controlled Trials
Cohort Studies
Case-Control Studies
Case Series, Case Reports
Editorials, Expert Opinion
Bottom
Cohort Studies
Seeing the outcomes based on risk factors.
Case-Control Studies
Looking back in time to determine risk factors.
Case Series/Case Reports
Reporting on a single or group of people with new symptoms.
Complementary and Alternative Medicine (CAM)
Therapies and practices that do not form part of conventional or mainstream health care and medical practices as taught in most Canadian medical schools and offered in most Canadian hospitals. Examples, relaxation techniques, herbal medicine, massage, and chiropractic.
Traditional Chinese Medicine (TCM)
Based on highly abstract concepts. A sophisticated set of techniques and methods and individualized diagnosis, treatment, and prevention.
Qi
The life force contained in all living things.
Meridians
Pathways through which qi is believed to flow.
Acupuncture
The insertion of thin needles into the skin at points along meridians.
Acupressure
Applies pressure on points along meridians.
Homeopathy
Treats illnesses by giving very small doses of drugs that in larger doses would produce symptoms like those of the illness (like cures like).
Hypnosis
State of deep relaxation in which an individual is more suggestible.
Manual Healing
Based on the idea that misalignment or dysfunction in one part of the body can cause pain or dysfunction in that or another part. Correcting these misalignments can bring the body back to optimal health.
Chiropractic Medicine
Focuses on the relationship between structure, primarily of joints and muscles, and function, primarily of the nervous system, to maintain and restore health. Manipulation of joints, particularly those of the spinal column. Accepted by health-care and insurance providers to a far greater extent than other CAM therapies.
Energy Therapies
Forms of treatment that use energy originating either within the body (biofields) or from other sources (electromagnetic fields).
Qigong
TCM combines movement, mediation, and breathing to enhance flow of qi.
Empirical
Are based on the evidence of the senses and on objective and systematic observation, often carried out under carefully controlled conditions. They must be capable of verification by others.
Rational
They follow the rules of logic and are consistent with known facts.
Testable
Either they are verifiable through direct observation of they lead to predictions about what should occur under conditions not yet observed.
Parsimonious
They explain phenomena by using the fewest number of causes.
General
They have broad explanatory power.
Rigorously Evaluated
They are constantly evaluated for consistency with the evidence and known principles, for parsimony, and for generality.
Tentative
Scientists are willing to entertain the possibility that their explanations are faulty, based on new, better, or connected evidence.
The 5 Domains of CAM Practices
1) Alternative medical systems.
2) Mind-body interventions.
3) Biologically based therapies.
4) Manipulative and body-based methods.
5) Energy therapies.
Medicare
Canada’s National Health Insurance Program.
Tommy Douglas
Father of Medicare. Created Canada’s National Health Insurance Program.
