Test 3 Flashcards
what are the 3 essential features of CA cells
immortality
altered behavior
altered morphology
what is the building blocks of cells that helps regulate cellular activity
proteins
What is the role of transcription factor
enables genes to be transcribed by RNA polymerase
what is the difference between proto oncogenes and oncogenes
proto oncogenes allow for cell growth. When a mutation occurs that causes them to enable unregulated proliferation, they become oncogenes
HER2/neu is an example of what and works at what point in cell synthesis
proto oncogene, works on growth factor receptors, common in breast CA
B-raf is an example of what and works at what point in cell synthesis
protooncogene, works on signal transduction, common in melanoma
Myb is an example of what and works at what point in cell synthesis
proto oncogene, works on transcription factor, common in leukemia
what are tumor supressor genes
genes that stop the proliferation of cells
Rb is an example of what and works at what point in cell synthesis
tumor supressor gene, works on cell cycle regulation, commonly dysregulated in neuroblastomas
APC is an example of what and works at what point in cell synthesis
tumor supressor gene, works on cell adhesion, commonly dysregulated in colon CA
what are 4 mechanisms of gene mutation
epigenetic modification, genomic modification, ribosomal alterations, viral transformation
what gene mutations are caused by chemicals and radiation
what gene mutations are caused by environmental factors changing the genome
genomic mutation
epigenetic modification
What carcinogenic chemical is found in overcooked meat and cigarette smoke and what does it do to dysregulate cell production
PAH, can activate estrogen receptors causing increased cell growth
what is angiogenesis
new blood vessel creation to continue supplying the tumor cells with enough O2 and nutrients
what do tumor cells secrete that helps them get past encapsulating barriers to metastasis
proteases
true or false: all cancer cells are capable of metastasising
false, only a small amount of CA cells that mutate enough to get past encapsulating barriers can metastasis
why may chemotherapy that is targeted to the primary tumor not work as well on metastasized cells
the metastasized cells have mutated to a point to allow them to move and therefore may not be as receptive to the treatment
what is a high mitotic index and when is it seen
a large proportion of cells in mitosis, seen in CA cells as they are constantly proliferating
what are 3 symptoms that are common to almost all CA
fatigue, cachexia, inflammation
cachexia is marked by _____
loss of body weight, anorexia, anemia
how is weight loss from cachexia different than weight loss from starvation
in starvation, it is mostly adipose tissue that is lost. In cachexia, equal amounts of adipose and muscle tissue are lost
what is the main driver of cachexia in CA
inflammation
what are the 3 classic classes of CA biomarkers
isoenzymes, antigens, ectopic hormones
isoenzymes can be used for progression or diagnosis
progression only, not specific enough for diagnosis
PSA is an example of what kind of biomarker
antigen
what are some examples of ectopic hormones that are measured as CA biomarkers
ACTH, ADH, MSH
What are the novel CA biomarkers
DNA methylation markers
microRNAs
SNPs
CA cells are usually (more or less) methylated than normal cells
more
what are micro RNAs
non coding RNA that regulates gene expression
what happens to micro RNAs in CA
certain CA’s with either increase or decrease certain micro RNAs
Micro RNAs can be used as (diagnostic, prognostic, or predictive)
Micro RNAs can be used as all 3
what does SNPs stand for
single nucleotide polymorphins
what is a SNP
sequence of DNA where there is a variation in one nucleotide
True or false: on top of testing susceptibility of getting CA, SNPs can also be used as prognostic and diagnostic
true
what are the stages of the cell cycle and what happens at each stage
G1 cell growth
S DNA synthesis
G2 cell growth and preparation for division
M mitosis
what happens during transcription
genes are read in DNE to produce mRNA
what happens in translation
mRNA transcripts are red to produce protein
what is contact inhibition
when normal cells come into contact with other cells they stop growing
what is the origin tissue of a carcinoma
epithelium (skin, organ lining, GI tract)
what is the origin tissue of a adenocarcinoma
organ or gland
what is the origin tissue of a sarcoma
supportive tissue (bone, tendon, cartilage, fat)
what is the origin tissue of a lymphoma
lymphatic system
what is the origin tissue of a glioma
connective tissue in the brain
what is the origin tissue of leukemia
bone marrow (affect RBC and WBC)
what is the origin tissue of a myeloma
plasma cells in bone marrow
what are the 3 stages of tumor growth
hyperplasia, dysplasia, anaplasia
what is hyperplasia
increase in cell number
what is hyperplasia
increase in cell number
what is dysplasia
regression of cells into less differentiated types
what is anaplasia
more irregularity of cells/lose original function
what are some carcinogenic viruses
HPV, Epstein Barr, Kaposi sarcoma herpe, HBV, HCV
what does TNM stand for and what is it
tumor, node, metastasis. Used for staging
list the different levels of T stages
TX: primary tumor cant be assessed
T0: no primary tumor
T1: invades submucosa
T2: invades musculature
T3: through musculature into perirectal tissue
T4: perforates peritoneum and invades other structures
list the different levels of N stages
NX: node cannot be assessed
N0: no nodal involvement
N1: metastatis in 1-3 nodes
N2: metastasis in 4 or more nodes
list the different levels of M stages
Mx: metastasis could not be assessed
M0: no metastasis
M1: distant metastasis
what would be the TNM stage of a patient with a primary breast tumor that has invaded the muscles with local 2 local lymph nodes involved but no distant metastasis
T2N1M0
what is the MOA of mercaptopurine and what is it used for
CA therapy, inhibits DNA synthesis
what is the MOA of methotrexate when used in CA therapy
inhibits DNA synthesis
what is the MOA of cytochalasin and what is it used for
CA therapy, inhibits DNA replication
what is the MOA of vincristine and what is it used for
CA therapy, inhibits DNA replication
what is the MOA of doxorubicin and what is it used for
CA therapy, inhibits DNA function
what is the MOA of cisplatin and what is it used for
CA therapy, inhibits DNA function
what class if Tamoxifen and raloxifen, what are they used for
CA therapies, selective estrogen receptor modulators
Gleeve is what class of medication, how does it work and what is it used for
signal transduction modifier, is inhibits cell growth and causes apoptosis, CA therapy
Herceptin is what class of medication, how does it work and what is it used for
anti-cancer antibody, inhibits HER2, CA therapy
what is endostatin
angiogenesis inhibitor used in CA therapy
what is the MDR1 protein, what does it do and why is it important in CA
creates resistance to cytotoxic and targeted chemotherapy by pumping chemotherapies out of the cell before they can reach therapeutic levels
what is telomerase and when is there a increase in it
an enzyme which keeps adding telomeres back onto the ends of chromosones, CA cells have high telomerase activity, allowing them to continue replicating
how do aromatase inhibitors decrease estrogen
aromatase converts androgens to estrogen
in glaucoma, the distinguishing factor is peripheral or central vision loss
peripheral
true or false: if a presents with glaucoma symptoms with eye pain it is a medical emergency
true
is vision loss associated with glaucoma reversible? why or why not
no, due to death of optic nerve
what excitatory substance is toxic and found at elevated levels in glaucoma
glutamate
what is lantaprost and what is it used for
prostaglandin agonist, used for treatment of glaucoma
what are the 3 classes of medication used to treat glaucoma
prostoglandin agonist, beta adrenergic blocker, cholinergic agonist
how do beta adrenergiv agonists treat glaucoma
decrease fluid production
what is timolo and what is it used for
beta adrenergic agonist to treat glaucoma
what are some serious side effects of beta adrenergic blockers
cardiac failure, heart block, bronchospasm
how do cholinergic agonists treat glaucoma
improve trabecular outlfow
pilocarpine and carbachol are what kind of medication and used to treat what
cholindergic agonists to treat glaucoma
what are some serious side effects of cholinergic agonists
miosis, brow ache, decreased vision
what is blepharitis
inflammation of eyelid
what is a non pharmacological treatment for inflammation of the eyelid
diluted shampoo/baby shampoo
when would it be appropriate to use acidified ear drops
treatment of mild otitis externa
what is the most common bacterial cause of AOM
S. Pneumoniae
increased pressure in the endolymphatic system is characteristic of what disease
menieres
what is the main differentiating factor between menieres disease and BPPV
Menieres disease has hearing loss
true or false: children under the age of 6 months should not have empiric treatment for AOM when symptomatic
false, should treat all children under the age of 6 months with abx
what cranial nerve is implicated in bells palsy
7 - facial
what is the treatmetn for moderate to severe bells palsy
antivirals and steroids
what disease can mimic bells palsy and what is the distiguishing factor
ramsay hunt - RH has a herpatic rash that follows a dermatone usually on ears or in mouth
what are the 3 most common bacterial pathogens in ear infections
S. pneumoniea
haemophilus influenza
moraxella catarrhalis
Swimmers ear is also called
diffuse otitis externa
what ear infection is usually associated with a hair follicle
acute localized otitis externa
what ear infection involved deeper tissues and is more prevalent in immunocompromised patients
necrotizing otitis externa
what is otomycosis
otitis externa caused by fungal agent
what is the role of cerumen in the ear
anti infective, moisturized, maintains acidic environment to reduce colonization
what helps move cerumen further out of the ear canal
chewing and swallowing
true or false: older men tend to have more cerumen than other population groups
true
true or false: vaccinations decrease incidence of AOM
true, indirectly by reducing URTI
when might an ear exam reveal a red and swollen canal with lots of debris and foul smelling discharge
otitis media with effusion
true or false: debris in ear with OME should not be removed
false, should gently remove with suction or dry cotton swab
what is auralgon and what is it used for? when is it not used?
topical otic analgesic for painful ear disorders but is not effective in otitis externa
what is preffered for impacted cerumen: water or oil based products
water based
what are defensins and where are they found
antibacterial peptides that coat the conjunctiva
what is the main differentiating factor between bacterial vs viral or allergic etiology of red eye
bacterial usually starts in one eye and then may spread to other eye later, viral and allergic affects both eyes
what is a possible prodrome of herpes zoster opthalamicus
tingling sensation
what may cause a vesicular rash that crusts of the eye
herpes zoster opthalamicus
what are the recommendations for treating herpes zoster opthalamicus
treat within 72 hours of onset with an antiviral
what are some complications of herpes zoster opthalamicus
corneal scarring
glaucoma
cataracts
post herpatic neuralgia
how is post herpatic neuralgia treated
gabapentin or tricyclic antidepressants
what are some risk factors for gluacoma
increased IOP, family history, migraines, obesity, HTN
Open angle or closed angle gluacoma is a medical emergency
closed angle glaucoma
what are vision floaters
small clusters of cells or proteins lodged in vitreous humor
what are common symptoms of bells palsy
droopy eyelid, facial paralysis, twitching, weakness
what is a possible prodrom of bells palsy
postauricular pain
bells palsy is usually caused by a: virus or bacteria
virus
what are risk factors for bells palsy
elderly
diabetes
3rd trimester pregnancy
compromised immune system
what are steroid eye drops only rx by an opthamologist
risk of glaucoma and cataracts
when might an opthamlogist prescribe steroid drops
allergic conjunctivitis (severe)
keratitis
corneal injuries
when are opthalmic vasoconstrictors used? when are they contraindicated
for short term treatment of red eye. Contraindicated in narrow angle glaucoma and viral infections
what are 2 oral treatment options for dry eye syndrome
doxycycline, omega 3 fatty acid supplements
what is the treatment for bells palsy
corticosteroids with or without antivirals and lubricating eye drops
what condition may cause a vesciular rash on the ears or in the mouth
ramsay hunt
what is the typical viral pathogen that causes bells palsy
herpes zoster
what are some treatment options for tinnitus once serious etiology has been ruled out
misoprostol, benzodiazepines, low dose carbamazapine, intratympanic dexamethasone
what is the classic triad of menieres disease
episodic vertigo
tinnitus
hearing loss
Abx ending in “mycin” are part of what class
aminoglycosides
abx with ceph in the name are part of what class
cephalosporins
abx with “cycline” in the name are part of what class
tetracyclines
abx with “floxacin” in the name are part of what class
fluroqionolones
abx with “thromycin” in the name are part of what class
macrolides
what class of abx is erythromycin
macrolide
what are macrolides typically used to treat
wide range including URTI, otitis, ulcers
is E. colie gram negative or postive
negative
H. influenzae and H. pylori are gram negative or positive
negative
staph, strep, c. diff and chlamdia are gram negative or postivie
positive
why are gram negative more likely to cause fever
lipopolysacharide is a potent inducer of fever
pseudomonas is gram negative or positive
negative
what abx should not be taken with dairy
tetracyclines
what abx can cause teeth discoloration
tetracyclines
what is rifampin usually used to treat
TB
what abx inhibits folate metabolism
septra
what organism usually causes BV
T. vaginalis
what are the main treatments for CAP
doxy, amox, azithro, amox/clav
another name for pertussis is
whooping cough
what abx is used to treat pertussis
erythromycin
terbinafine is a ____
antifungal
what class are medications ending in “azole”
antifungals
what is 1st line treatment for MRSA
doxycycline
what abx is associated with tendinopathy
ciprofloxacin (fluroqionolones)
is malaria caused by a bacteria, virus, or protozoan
protozoan
how is malaria transmitted
mosquito bites
what causes the cycle of fever and chills in malaria
RBC getting infected and popping
true or false: doxycycline is a propylactic tx for malaria
true
what diseases can be spread by contaminated water
cholera, hepatitis
what is dukoral
oral vaccine that prevents cholera
what medication contains inactivated virbrio cholera and when is it used
dukoral, oral vaccine for cholera prevention
true or false: there is a yellow fever vaccine available in canada
true
true or false: there is a denge fever vaccine available in canada
false
true or false: there is a malaria vaccine available in canada
false
what class of medication can be used for weight loss off label
biguanides (metformin)
what is tenuate and what is it used for
sympathomimetic used for weight loss
what is pondimin and what is it used for
serotonin reuptake inhibitor used for weight loss
what is orlistat and what is it used for
lipase inhibitor used for weight loss
true or false: amphetamines like adderal can be used for weight loss
true
most vaccines are active or passive
active
what is the difference between active and passive vaccines
active is when body creates the antibodies, passive is giving the body the antibodies already made
what diseases require passive immunization
rabies, hep A
what 2 vaccines contain live virus
MMR and zoster
a vaccine containing attenuated virus is an active or passive vaccine
active
what brands used mRNA COVID vaccine
pfizer and moderna
protease inhibitors are found in what treatment for COVID
Paxlovid
