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Internal Medicine > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

-erol

A

-bronchodilation

Bronchodilators Adrenergic

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2
Q

Bronchodilators Xanthrine derivatives

A

-phylline
-bronchodilation

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3
Q

Cancer

A

large groups of diseases caused by uncontrolled cellular growth and spread of abnormal cells

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4
Q

What percentage of cancers are genetic?

A

5-10%

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5
Q

Differentiation

A

normal changes of cells with different physiologic functions

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6
Q

Malignant Cells

A

Become less recognizable from their parent cells

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7
Q

Anaplasic Cells

A

unrecognizable from parent cell, loss of differentiation, last level of metaplasia

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8
Q

Dysplasia

A

disorganization of cells that vary in size and shape

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9
Q

Metaplasia

A

1st level of dysplasia, reversible

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10
Q

Hyperplasia

A

increase in cell number

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11
Q

Neoplastic Hyperplasia

A

increase in abnormal cell mass

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12
Q

Tumor

A

Neoplasm, abnormal new tissue growth

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13
Q

Primary Tumor

A

tumor from local cells

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14
Q

Secondary Tumor

A

tumor from metastasized cells

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15
Q

Carcinoma in stitu

A

localized, pre-invasive, pre-malignant, epithelial tissue

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16
Q

-oma

A

benign

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17
Q

Epithelial tissue

A

carcinoma

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18
Q

Connective tissue

A

sarcoma, malignant

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19
Q

Hematopoietic tissue

A

leukemia, myeloma

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20
Q

Stage 0

A

carcinoma in stitu, pre-malignant

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21
Q

Stage I

A

Early, local

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22
Q

Stage II

A

increase risk of spread

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23
Q

Stage III

A

Spread but not to other regions

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24
Q

Stage IV

A

spread to other regions

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25
Q

T

A

Primary Tumor

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26
Q

T(x)

A

cant be assessed

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27
Q

T(o)

A

no evidence

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28
Q

T(is)

A

in stitu

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29
Q

T(1-4)

A

progressive increase

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30
Q

N

A

Regional lymph nodes

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31
Q

Nx

A

cant be assessed

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32
Q

N(o)

A

no metastasis

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33
Q

N(1-3)

A

increased lymph node involvement

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34
Q

M

A

distant metastasis

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35
Q

Mx

A

can be assessed

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36
Q

M(o)

A

No distant metastasis

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37
Q

M(1)

A

distant

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38
Q

Most common cancers

A

Lung, breast, colorectal

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39
Q

Endogenous causes of cancers

A

genetics (prostate, breast, ovarian, colorectal)

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40
Q

Exogenous causes of cancers

A

environment (50%)

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41
Q

Carcinogens

A

agents capable of inacting malignant transformation

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42
Q

Carcinogenesis

A

carcinogens can cause cells to undergo malignant transformation, 7-8 steps

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43
Q

Hayflick Limit

A

cells can divide 50x before dying

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44
Q

Theory of Dysfunctional Senescence

A

Failure to die after increased mutations

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45
Q

Somatic mutation theory

A

neoplasia originates from a single cell through chromosomal changes

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46
Q

Oncogenesis

A

cancer causing genes, in all genes but can become malignant individually when activated by carcinogens

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47
Q

Tumor Suppressor Genes

A

anti oncogenes, chromosomal deletions (-p53, apoptosis of cells, activated by cellular stress

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48
Q

Stem Cell Hypothesis

A

abnormal stem cells feed cancer, chemo resistant, hard to kill

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49
Q

Tumor Specific Antigens

A

uniquely expressed on tumor cells, recognized by T Cells (fusion proteins and viral proteins)

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50
Q

Fusion proteins

A

translocations of genes that combine and create new genes

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51
Q

Viral proteins

A

aid in the replication of viruses

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52
Q

Tumor Associated Antigens

A

on tumorous and normal cells

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53
Q

Tumor Evasions

A
  1. Loss of immunogenicity
  2. antigenic modulation
  3. induction of immune suppression (T Cells)
  4. Prevention of NK and T Cell Activation
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54
Q

Cancer Immunotherapy

A

Anti-body based therapy, adoptive cell therapy, cancer vaccines

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55
Q

Most common metastase sites

A

lymph nodes, liver,lungs,bone, and brain

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56
Q

Seed vs. Soil

A

some cancers favor certain sites, target soil not seed

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57
Q

Percentage of cancers that metastasize

A

30%

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58
Q

Tumor Angiogenesis

A

new BV from existing to grow tumor

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59
Q

Most Common Nutrient Rich sites

A

Pulmonary (most common), Hepatic, Skeletal system, CNS

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60
Q

Osteolytic

A

decreased bone density, leads to hypercalcemia

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61
Q

Osteoblastic

A

increase bone density, dense scarring

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62
Q

CNS Sites

A

Brain: from lungs
Spinal Cord: involves vertebrae

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63
Q

Opioids

A

pain management for cancer, (morphine, fentanyl, oxycodone)

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64
Q

Opioid Rotation

A

balance between analgesia and side effects

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65
Q

Paraneoplastic Syndrome

A

symptoms and signs at a distant site of a tumor

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66
Q

Anti-Neoplastic Treatment

A

management might be curative or palliative

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67
Q

Neoadjuvant Treatment

A

before surgical intervention, pair with chemo/radiation

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68
Q

Radiation Therapy

A

destroys h2 bonds in DNA strands, G2 most sensitive to radiation, done at different stages, G0 resistant

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69
Q

Cytotoxic Chemo Strategy

A

limit cell growth by killing

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70
Q

Growth Fraction

A

% of growing cells relative to neoplastic population, decrease as tumor grows

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71
Q

Cell Kill hypothesis

A

chemo kills 90%, never fully eliminate, 10% can be killed endogenously

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72
Q

Alkylating Agents Chemo

A

helix cant untwist for dna replication, initiates apoptosis

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73
Q

Features of Pancreas

A

sacroiliac joint and hip

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74
Q

Antimetabolites Chemo

A

endogenous metabolites, mimics other constituents that form nonfunctional genes or occupy enzymes, inhibit DNA synth.

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75
Q

Antibodies Chemo

A

antitumor antibiotics, cause DNA lysis or prevention of synthesis, form free radicals

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76
Q

Antimicrotubule Chemo

A

disrupt spindle formation

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77
Q

Topoisomerase Inhibitors Chemo

A

catalyzing cutting and re-ligating during unwinding/winding

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78
Q

Anticancer Hormones Chemo

A

mimic or block effects of sex hormones to treat hormone sensitive cancers, inhibit cancer cells

79
Q

Platinum Coordination Complexes Chemo

A

heavy metal compounds, cross links between DNA strands to prevent replication

80
Q

Target Cell Surface Glycoproteins Chemo

A

cell death, deliver chemicals and prevent cell growth

81
Q

Cytokines Chemo

A

increase immune mechanisms

82
Q

Adverse effects of Chemo

A

Alopecia, Gi toxicity, myelosuppression, fatigue, cardiotoxicity, pulmonary toxicity, renal toxicity, hepatic toxicity, neuropathies

83
Q

-azole

A

azole antifungals

84
Q

-avir

A

HIV protease inhibitors

85
Q

-cillin

A

penicillin antibodies, bacterial infections

86
Q

-cycline

A

tetracycline antibodies, bacterial infections

87
Q

-micin and -mycin

A

various antibacterials, bacterial infections

88
Q

Innate Immune System

A

1st response, limited specificity, internal and external defenses, inflammatory response (second)

89
Q

Adaptive Immune System

A

specifc and memory driven, B cells and T cells, antigen and antibody driven, active vs passive

90
Q

Neutrophils

A

1st response, short lived, polymorphonuclear cells, phagocyte and granulocyte, pus

91
Q

Monocytes/Macrophages

A

longest lived, mono= blood, macro= tissues, phagocytes. MCH 2, Antigen presenting

92
Q

Dendrites

A

main antigen presenting cell, MCH 2

93
Q

Eosinophils

A

allergic responses and parasites, granulocytes release histamine, cytokines, and heparin

94
Q

Basophils

A

granulocytes, allergic responses, increase blood volume

95
Q

Mast Cells

A

granulocytes, allergic responses, anaphylaxis, increase blood volume

96
Q

B Cells

A

produce antibodies, antigen presenting, mature in bone

97
Q

T Cells

A

mature in thymus, have helpers and cytotoxic

98
Q

Natural Killer Cells

A

kill cells with virus, don’t express antigens, interact with ligands, initiate apoptosis

99
Q

Major Histocompatibility Complex (MHC)

A

membrane proteins that present antigenic peptides for T cell recognition

100
Q

MCH I

A

bind proteins that have been synthesized in cytoplasm, recognized by cytotoxic CD4+ cells

101
Q

MCH II

A

bind fragments of previously phagocytized, pinocytosis, and endocised. Recognized by Helper CD+4 T cells

102
Q

External Defenses of Innate Immune System

A

physical, chemical, and mechanical

103
Q

Internal Defenses of Innate Immune System

A

soluble factors (complement system, cytokines, chemokines)
Cellular Response (neutrophils, mono/macrophages)

104
Q

Active Adaptive

A

usually permanent. Natural: contact with infection
Artificial: inoculation of antigen, vaccine

105
Q

Passive Adaptive

A

temporary. Natural: natural contact with antibody
Artificial: inoculation of antibody
Acquired: immune products between individual

106
Q

Antigen

A

molecule on cells used for recognition by T cells or antibodies. Epitope: immunologically active site on antigen

107
Q

Antibodies

A

produced by B Cells. Heavy Chains: determine type of antibody. Fab Fragment: portion that binds to antigen

108
Q

Immunoglobulins

A

directly attack antigens, stimulate anaphylaxis and hypersensitivity. IgM, IgG, IgA, IgE, IgD

109
Q

IgM

A

expressed on B cells, 1st secreted, predominant

110
Q

IgG

A

antibacteral and antiviral, secondary, gestation

111
Q

IgA

A

serum and secretory (breast milk, urine, saliva), defends external

112
Q

IgE

A

low levels in blood, high affinitty receptors for basophils and mast cells (allergies and histamines), allergEEE

113
Q

IgD

A

low levels in blood, antigen receptors on immature B cells

114
Q

Immunologic Tolerance

A

Positive and Negative Selection. Positive: TCR gene rearrangement makes self identify. Negative: delete cells that recognize self peptides

115
Q

Cytotoxic T Lymphocytes

A

CD8+, kills other cells, MCH I, kill virally affected cells and produce cytokines

116
Q

Helper T Cells (CD4+)

A
  1. Help B Cells make antibodies
  2. Activate macrophages
  3. Help CTLs
  4. Help NK
  5. Neutrophil Recruitment
  6. Downregulation of Adaptive Immune Response
117
Q

Regulatory T Cells (Tregs)

A

Prevent inappropriate responses against “self” antigen

118
Q

Humoral Immunity

A

mediated by antibodies, body fluids (not urine), B Cell Development

119
Q

Phases of Immune System

A

Recognition, Amplification, Effector, Termination, Memory

120
Q

Recognition Phase

A

receptors bind to pathogens

121
Q

Amplification Phase

A

complement cascades, cell recruitment, proliferation of B and T Cells

122
Q

Effector Phase

A

removal of antigens

123
Q

Termination Phase

A

decreased immune reactions after antigen clearance

124
Q

Memory Phase

A

long lived B and T Cells

125
Q

Neutrophil and macrophage clearance post-exercise

A

After 30min, 2-4 hours`

126
Q

NK Cells post exercise

A

increase from epinephrine, then falls below pre-exercise level

127
Q

Inaccurate Immune Responses

A

Immunodeficiency, hypersensitivity, transplantation, Autoimmunity

128
Q

Immunodeficiency

A

immune response is lacking or absent. Primary: depletion due to genetics
Secondary: pre-existing condititons

129
Q

AIDS

A

destruction of immune system, caused by human immunodeficiency virus

130
Q

HIV Virus

A

RNA retrovirus, reverse transcriptase from RNA to viral DNA. Affects CD4+ cells and macrophages

131
Q

Acute HIV Infection

A

1-6 weeks, tests negative

132
Q

Asymptomatic HIV

A

CD4+ 500+.1-20yrs, positive test. Seroconversion has occurred (emergence of HIV antibiotics)

133
Q

Symptomatic HIV

A

200-500 CD4+.

134
Q

Advanced HIV

A

CD4+ less 200. Kaposi Sarcoma

135
Q

Type I Hypersensitivity

A

Immunoglobulin IgE. Seasonal allergies (histamines), anaphylaxis. CD4+ cells.

136
Q

Antihistamines

A

competing with histamine receptors

137
Q

Type II Hypersensitivity

A

Immunoglobulin IgG and IgM. Tissue specifc. Macrophages. Hashimoto’s.

138
Q

Type III Hypersensitivity

A

Immunoglobulin IgG, IgM, and IgA. Immune complex mediated. Systemic. Neutrophils. Lupus

139
Q

Type IV Hypersensitivity

A

T Cell mediated. No antibodies Delayed reaction. Graft rejection

140
Q

Autoimmune Diseases

A

mechanisms directed against self-antigens. Localized tissue, lesions localized with distant antibodies, non-organ specifc

141
Q

Central Tolerance

A

loss of self-reflective T and B Cells. Immature recognize self-antigens, leads to apoptosis

142
Q

Peripheral Tolerance

A

mature lymphocytes that self-antigens become inactive or suppressed

143
Q

Systemic Lupus Erythematosus (SLE)

A

chronic inflammation. Discoid: face. Systemic: everywhere.

144
Q

Latent Lupus

A

symptoms without actually being lupus

145
Q

Antiphospholipid Antibody Syndrome

A

immune, fetal loss, thrombosis

146
Q

Late Stage Lupus

A

chronic 5+ years

147
Q

Fibromyalgia (FMS)

A

chronic widespread pain of soft tissues, muscle/location specific

148
Q

Leukocytosis

A

increased WBC

149
Q

Leukopenia

A

Decreased WBC

150
Q

Normal White blood cell count

A

5,000-10,000

151
Q

Fever

A

96.8-98.6

152
Q

Hypothalamus

A

temp-regulation center. pyrogens and cytokines

153
Q

Intermittent Fever

A

temperature returns to normal in 24 hrs (sepsis)

154
Q

Remittent Fever

A

temperature fluctuates but does not return (upper respiratory infection)

155
Q

Sustained or Continuous Fever

A

temperature remains above normal with minimal variation

156
Q

Recurring or Relapsing Fever

A

episodic fevers lasting 1-3 days with 1+ days of normal temperature

157
Q

Signs and Symptoms of Infectious Diseases

A

Abscess, hypertension, rash, fever, red streaks, inflamed lymph nodes, joint effusion

158
Q

Immunosenescence

A

thymus ages and becomes less active

159
Q

Age related cell changes

A

Less naive T Cells, Increase memory T Cells, slower response to stimulus

160
Q

Infection

A

organism has a parasitic relationship with its host

161
Q

Infectious Disease

A

infection with 1+ clinical symptoms

162
Q

Incubation Period

A

period b/wn pathogen entering and clinicial symptoms

163
Q

Latent Infection

A

occurs after microorganism has replicated but remains dormant

164
Q

Colonization of organisms

A

microorganisms present in tissues but dont cause symptoms

165
Q

Period of Communicability

A

time when organism can be shed

166
Q

Chain of Transmission

A

Pathogen, reservoir, portal of exit, mode of transmission, portal of entry, host susceptibility

167
Q

Pathogen

A

organism with the ability to cause disease

168
Q

Pathogenicity

A

ability of an organism to produce disease

169
Q

Virulence

A

potency of pathogen in producing severe disease by fatality case rate

170
Q

opportunistic pathogens

A

do not cause disease in healthy host but can be deadly for those compromised

171
Q

Reservoir

A

an environment that an organism can live

172
Q

Portal of Exit

A

place the pathogen leaves the reservoir

173
Q

Mode of Transmission

A

Contact transmission (direct and indirect), airborne (small particles), droplet (large droplets), vehicle (food), vector-borne (animal)

174
Q

Standard Precautions of CDC

A

assume anyone can be contagious

175
Q

Healthcare-Associated Infections (HAI)

A

nonsocomial infections. develop from hostpitalizations. Pneumonia, GI, Surgical

176
Q

Bacteria

A

single celled organisms with well defined cell walls. Cocci: sphere. Bacilli: rod. Spiral: spirochetes

177
Q

Clostridiodies (c diff), clostridial myonecrosis (gangrene), pseudomonas

A

Bacteria

178
Q

Bactericidal

A

kill bacteria

179
Q

Bacteriostatic

A

limit growth and proliferation of bacteria

180
Q

Antibacterial Inhibition of Bacterial Cell Wall

A

drugs can punch holes in cell walls or act as deterrents to break apart bilayer

181
Q

Antibacterial Inhibition of Bacterial Protein Synthesis

A

bind to cell and bind to ribosomes, blocks protein synthesis

182
Q

Antibacterial Inhibition of bacterial DNA/RNA synthesis

A

folic acid not nucleic synthesis, drug stops folic acid production

183
Q

Viruses

A

subcellular organisms made up of RNA/DNA, smallest, dependent on host cells, lacks cellular components, only genetic material

184
Q

Viral Replications

A

exocytose genetic material into cell and lysis causes new viruses to release

185
Q

Herpesviruses

A

“to creep”, 8 kinds. HSV-1: cold sores. HSV-2: sti. Treated with acyclovir

186
Q

Varicella Zoster Virus

A

chickenpox or shingles

187
Q

Infectious mononucleosis (Herpesvirus 4)

A

epstein-barr. mono.

188
Q

Respiratory Syncytial virus

A

children, lung issues

189
Q

Interferons

A

endogenous substances that exert nonspecific viral activity

190
Q

Diaphragm Referral site

A

Shoulder, lumbar spine

191
Q

Heart referral site

A

Shoulder, neck, upper back, TMJ

192
Q

Urothelial tract referral site

A

Back, inguinal region, anterior thigh, genetalial

193
Q

Pancreas, liver, spleen, galbladder referral site

A

Shoulder, midthoracic, or low back

194
Q

Peritoneal or abdominal cavity referral site

A

Hip pain from abscess of psoas or obturator

Internal Medicine (4 decks)

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