unit 2 stuff Flashcards

1
Q

dysplasia

A

abnormal cells with different shape, size, and organization

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2
Q

metaplasia

A

abnormal cell changes but are benign and reversible

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3
Q

what is the term for early dysplasia

A

metaplasia

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4
Q

meta

A

change, alteration

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5
Q

plasia

A

cellular multiplication, growth

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6
Q

anaplasia

A

loss of cell differentiation

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7
Q

hyperplasia

A

increased number of cells in the tissue

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8
Q

neoplastic hyperplasia

A

abnormal increase of cell mass from tumor formation

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9
Q

plast

A

living substance, organelle, cell

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10
Q

carcinoma in situ

A

preinvasive epithelial tissue that has not penetrated the basement membrane

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11
Q

5 major neoplasm classifications

A
  1. epithelial
  2. connective
  3. nerve
  4. lymphoid
  5. hematopoietic
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12
Q

stage 0

A

carcinoma in situ (preinvasive)

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13
Q

stage 1

A

early, local stage cancer

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14
Q

stage 2

A

increased spread risk due to size

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15
Q

stage 3

A

spread but not disseminated to distant regions

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16
Q

stage 4

A

cancer spread and disseminated to other sites

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17
Q

what is “T” in the tumor classification

A

primary tumor

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18
Q

T(is)

A

carcinoma in situ

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19
Q

T1-4

A

progressive tumor size/local involvement

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20
Q

what is “N” in the tumor classification

A

regional lymph nodes

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21
Q

N(0)

A

no lymph node metastasis

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22
Q

N(1-3)

A

increasing lymph node involvement

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23
Q

what is “M” in the tumor classification

A

distant metastasis

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24
Q

M(0)

A

no distant metastasis

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25
Q

M(1)

A

signs of distant metastasis

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26
Q

3 most commonly diagnosed cancers

A
  1. lung
  2. breast
  3. colorectal
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27
Q

what is the world’s most prevalent cancer that has caused the most deaths

A

lung

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28
Q

somatic mutation theory

A

single cell mutation that causes cancer

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29
Q

translocation of genes

A

nucleotide bases from one chromosomal area go to another location

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30
Q

oncogenes

A

genes that can cause cancer from virus interaction or independently

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31
Q

tumor-initiating stem cells + why they are dangerous

A

stem cells that cause cancer
they are not susceptible to chemo and radiation

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32
Q

tumor-specific antigens (TSAs)

A

only expressed by tumors and recognized by T cells

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33
Q

why are tumor antigens not always spotted by the immune system

A

because they only slightly vary from self-antigens so they more easily escape the immune system

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34
Q

tumor-associated antigens (TAA)

A

expressed by tumor cells but also normal cells

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35
Q

3 main cells that fight cancer cells

A
  1. NK cells
  2. macrophages
  3. CD8+
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36
Q

5 most common cites of cancer metastasis

A
  1. lymph nodes
  2. liver
  3. lungs
  4. bone
  5. brain
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37
Q

is appendicular or axial skeleton more effected by cancer

A

axial

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38
Q

4 environmentally rich areas for cancer to grow

A
  1. pulmonary system
  2. hepatic system
  3. skeletal system
  4. central nervous system
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39
Q

osteolytic cancer

A

cancer that decreases bone density

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40
Q

stage 4 symptoms

A

weakness, anemia, prexia

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41
Q

prexia

A

fever

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42
Q

pryo-

A

fire, heat, high temp

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43
Q

throbbing pain means

A

blood supply interference

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44
Q

sharp pain means

A

nerve pressure or displacement

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45
Q

what cancer is the most painful

A

bone

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46
Q

referred pain goes to were with pancreas/liver/spleen/gallbladder cancer

A

shoulder, mid/low back

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47
Q

sympathetic nervous system pain feels like and presents like

A

mild to moderate pain
tachycardia, hypertension, tachypnea

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48
Q

parasympathetic nervous system pain feels like and presents like

A

visceral/severe pain
hypotension, bradycardia, nausea, vomiting, weakness

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49
Q

paraneoplastic syndrome

A

tumor symptoms distant from the tumor itself

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50
Q

what causes paraneoplastic syndrome

A

typically ectopic hormone production by the tumor

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51
Q

secondary cancer prevention

A

early detection by screening

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52
Q

primary cancer prevention

A

epigenetic testing, nutrigenomics, and chemoprevention

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53
Q

curettage biopsy

A

pap smear

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54
Q

fluid aspiration biopsy

A

spinal tap

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55
Q

fine-needle aspiration biopsy

A

breast/thyroid

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56
Q

excisional biopsy

A

lumpectomy

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57
Q

core needle biopsy

A

tru-cuts

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58
Q

stereotactic biopsy

A

mammotome

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59
Q

PSA stands for

A

prostate specific antigen

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60
Q

CEA biomarker for what cancers

A

bowl
stomach
pancreas
lung
breast

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61
Q

neoadjuvant treatment

A
  1. chemo/radiation
  2. local control like surgery
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62
Q

adjuvant treatment

A
  1. surgery
  2. chemo/radiation
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63
Q

3 types of irradiation therapy

A
  1. external beam
  2. sealed source (x-ray/gamma)
  3. unsealed source (systemic therapy)
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64
Q

cell kill hypothesis

A

chemo reduces tumor to size that immune cells can take over

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65
Q

how can local cancer be cured

A

surgery

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66
Q

what cancer treatment is most popular for metastasized cancer

A

chemo

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67
Q

growth fraction

A

% of proliferating cells to the whole tumor

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68
Q

does growth fraction increase or decrease with tumor size and why

A

decrease because as the tumor grows, the blood can’t supply all the cells to replicate so some stay “dormant”

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69
Q

what circumstances does chemo work the best

A

when the tumor is small and a large proportion of the cells are dividing

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70
Q

alkylating chemo agent mechanism

A

prevents replication of DNA by stopping the untwisting

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71
Q

alkyl group

A

carbon/hydrogen chains (like methyl CH3)

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72
Q

antimetabolite chemo agent mechanism

A

interrupts cellular pathways that synthesize DNA/RNA

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73
Q

what are 2 ways antimetabolites interrupt DNA/RNA synthesis

A
  1. mimic active ingredients & makes fake, nonfunctional genetic product
  2. occupying enzymes needed for DNA/RNA synthesis
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74
Q

antibiotic chemo agent mechanism

A

inserts in between base pairs of DNA to prevent synthesis

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75
Q

antimicrotubular chemo agent mechanism

A

disrupts spindles and prevents cell division

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76
Q

topoisomerase inhibitor chemo agent mechanism

A

inhibits the unwinding/winding enzyme in DNA replication

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77
Q

anticancer hormone chemo agent mechanism

A

blocks hormones that fuel the cancer

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78
Q

platinum coordination complexes chemo agent mechanism

A

heavy metal compounds bind to DNA to distort the structure and prevent DNA translation/replication

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79
Q

agents that target cell surface receptors (chemo agent mechanism)

A

binds to receptors and triggers apoptosis (tyrosine kinase inhibitors)

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80
Q

cytokine chemo agent mechanism

A

stimulates immune system to fight so healthy cells aren’t harmed

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81
Q

alopecia

A

hair loss

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82
Q

anagen phase

A

actively growing hair

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83
Q

when does chemo induced nausea and vomiting occur, peak, and how long do effects last

A

occur: 1-2 hours
peaks: 4-10 hours
lasts: 12-24 hours

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84
Q

myelosuppression

A

bone marrow inhibition

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85
Q

neutropenia common infections

A

fungal
gram positive bacteria (most common)
gram negative bacteria (kills most)

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86
Q

tumor lysis syndrome

A

tumor is destroyed but metabolic byproducts are too much for the kidneys to handle

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87
Q

sinusoidal obstruction syndrome

A

liver veins are blocked

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88
Q

chemotherapy-induced peripheral neuropathy

A

less tendon reflexes
- less proprioception
- numbness, tingling, burning

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89
Q

CNS toxicity symptoms

A

chemo brain
stroke-like symptoms

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90
Q

autonomic neuropathy

A

hypotension
constipation
dysfunctional sexual organs/bladder

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91
Q

what cells mediate chemo and protect the body when neutrophils are low

A

granulocyte colony-stimulating factor
granulocyte-macrophage colony-stimulating factor

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92
Q

monoclonal antibodies

A

pharmacologically designed antibodies used in immunotherapy to attract NK cells which then kill the cell

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93
Q

hematopoietic cell transplantation

A

type of immunotherapy where bone marrow is transplanted into patient

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94
Q

antiangiogenic therapy

A

blocks formation of new blood vessels

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95
Q

erol

A

Bronchodilators
(Adrenergic)

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96
Q

phylline

A

Bronchodilators
(xanthine derivatives)

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97
Q

fluorouracil

A

antimetabolite for chemo

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98
Q

cyclophosphamide

A

alkylating agent for chemo

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99
Q

selective estrogen receptor modifiers

A

blocks estrogen from stimulating tumor growth

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100
Q

palliative treatment

A

when cures are no longer possible or available

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101
Q

durable remission

A

if the response to treatment is maintained for a long period of time

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102
Q

no evidence of disease classification

A

0-5 years of no detectable disease

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103
Q

cured prognosis classification

A

5+ years of no disease

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104
Q

how long and how many times a week should a person be exercising mod-vigorously

A

30-60 min
5x/week

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105
Q

cancer is the 2nd leading cause of death in this age range

A

1-14 years old

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106
Q

what is the most common pediatric cancer

A

leukemia

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107
Q

what is the most common soft tissue cancer children get

A

rhabdomyosarcoma

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108
Q

what cancer is most common in adults

A

adenocarcinomas

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109
Q

what is the most common form of leukemia in children

A

acute lymphocytic leukemia (ALL)

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110
Q

what are the 2 age peaks of incidence in childhood cancer

A
  1. 2-5
  2. 15-19
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111
Q

what is the trade name for doxorubicin

A

Adriamycin

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112
Q

poiesis

A

making, formation

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113
Q

cells in the innate immune system

A

monocyctes
neutrophils
eosinophils
basophils
mast cells
NK cells

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114
Q

cells in the adaptive immune system

A

B cells
T cells

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115
Q

cells in both adaptive and innate immune system

A

macrophages
dendritic cells

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116
Q

first cells to respond in immune reaction

A

neutrophils

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117
Q

what cells fight against pus forming bacteria

A

neutrophils

118
Q

what cells filter out the neutrophil debris and other dead cells

A

monocytes/macrophages

119
Q

what cell helps in allergies and parasitic infection

A

eosinophils

120
Q

what are the 3 cells that are elevated with allergic reactions

A

eosinophils
basophils
mast cells

121
Q

what is the longest living immune cell type

122
Q

what cell is involved with allergies, anaphylaxis, and wound healing

A

mast cells

123
Q

what cells are involved with the movement and removal of antigens, antibodies, and compliment system

A

erythrocytes
thrombocytes

124
Q

what cell produces thrombosis and hemostasis

125
Q

3 types of T cells

A

helper
cytotoxic
suppressor

126
Q

what cell type has mature cells congregate in the blood and spleen

A

natural killer cells

127
Q

what cell is a mononuclear granulocyte

A

neutrophils

128
Q

what cell is a mononuclear phagocyte

129
Q

what 2 cells ingest pathogens and kills them

A

neutrophils
monocytes

130
Q

what 2 cells are limited in cancer patients that make them susceptible to infection

A

neutrophils
monocytes

131
Q

what are the 3 antigen presenting cells (APCs)

A

macrophages
dendritic cells
b cells

132
Q

what cells to APCs present their antigens to and what class of MHC

A

CD4+
MHC II

133
Q

MHC I involves what cell

134
Q

MHC II involves what cell

135
Q

soluble factors of internal defenses include

A

complement system
cytokines
chemokines

136
Q

where do B and T cells get trained

A

the lymphatic system

137
Q

what is the second line of defense in the immune system

A

the inflammatory response

138
Q

what is the first line of defense in the immune system

A

innate immunity

139
Q

what is the third line of defense in the immune system

A

specific immunity

140
Q

active natural immunity

A

natural antigen contact from the environment

141
Q

active artificial immunity

142
Q

passive natural immunity

A

natural contact through mother/fetus

143
Q

passive artificial immunity

A

injection of immune serum globulinhu

144
Q

what are the 2 parts of adaptive immunity

A

humoral
cell-mediated

145
Q

what is the humoral immunity mechanism

A

antibodies and B cells

146
Q

what is the cell-mediated immunity mechanism

147
Q

what region of the antibody determines the type of immunoglobulin it is

A

the heavy chain

148
Q

what region of the antibody binds to antigens

149
Q

what region of the immunoglobulin binds to the complement region

150
Q

what immunoglobulin is the first secreted

151
Q

which immunoglobulin is the main responder for primary immune responses

152
Q

which immunoglobulin is the main responder for most secondary immune responses

153
Q

which immunoglobulin is antiviral and antibacterial

154
Q

which immunoglobulin is involved with allergies

155
Q

which immunoglobulin defends the external body surface and is in serum/secretions

156
Q

which immunoglobulin has the lowest blood levels and are found on naive B cells

157
Q

4 functions of immunoglobulins

A
  1. attacks antigens through agglutination
  2. activates complement system
  3. activates anaphylaxis through histamine
  4. stimulates antibody-mediated hypersensitivity
158
Q

gene rearrangement

A

DNA rearrangement B cells go through to create millions of antigen receptor types

159
Q

what cell is responsible for the rejection of donor organs

160
Q

what cells present to helper T cells to create an immune response

161
Q

what cells present to cytotoxic T cells to create an immune response

A

infected cells

162
Q

what t cell prevents inappropriate responses to “self” antigens

A

regulatory T cells

163
Q

5 phases of immune system

A
  1. recognition
  2. amplification
  3. effector
  4. termination
  5. memory
164
Q

what immune system cells are most impacted by strenuous, high-intensity exercise

A

neutrophils

165
Q

primary immunodeficiency

A

involves T cells, B cells, or lymphoid tissue

166
Q

secondary immunodeficiency

A

results from underlying disease that stops immune response (AIDS)

167
Q

HIV life cycle steps

A

binding
fusion
reverse transcription
integration
replication
assembly
budding

168
Q

which HIV is most transmittable

169
Q

4 clinical stages of HIV are based on the cell count of ___ in the body

170
Q

4 clinical stages of HIV

A
  1. acute infection
  2. asymptomatic
  3. symptomatic
  4. advanced
171
Q

how many CD4+ cells are in advanced HIV

172
Q

seroconvergence

A

HIV antibodies in the blood stream and test positive on HIV tests

173
Q

what clinical stage of HIV is seroconvergence seen

A

asymptomatic

174
Q

what is the hallmark symptom of having AIDS

A

kaposi sarcoma

175
Q

Type I IgE-mediated reaction

176
Q

Type II tissue-specific reaction

A

graves disease
myasthenia gravis
insulin-resistant diabetes

177
Q

Type III immune complex-mediated reaction

178
Q

Type IV cell-mediated reaction (T-cells)

A

contact sensitivity to poison ivy/metals
graft rejection

179
Q

what is an example of complement-mediated lysis

A

ABO blood incompatibility: A+ blood cannot receive/give to B- blood

180
Q

complement-mediated lysis and phagocytosis are both mechanisms of what hypersensitivity disorder

A

type II tissue specific

181
Q

T cell mediated diseases

A

rheumatoid arthritis
multiple sclerosis
hashimoto thyroiditis
type I diabetes
IBS

182
Q

3 types of autoimmune diseases

A
  1. localized tissue damage from specific antibodies
  2. localized organ lesion but antibodies are NOT organ specific
  3. non-organ-specific diseases (antibodies and lesions all over)
183
Q

self tolerance

A

unresponsiveness to one’s own antigens

184
Q

central tolerance

A

immature lymphocytes that recognize self-antigens are killed

185
Q

discoid lupus

A

affects only the skin

186
Q

systemic lupus

A

affects any organ in the body
presents different from each patient

187
Q

symptoms of lupus

A

butterfly rash
lesions
CNS symptoms
Renal symptoms

188
Q

isoimmune disease

A

organ/tissue transplant incompatibility of cell surface antigens

189
Q

HLA matching

A

used to find donor organs to increase likelihood of host accepting the organ

190
Q

what defines being at a carrier state for hepatitis

A

when the pathogen travels from the liver to the bloodstream

191
Q

biggest external signs of infectious diseases

A

fever, chills, sweating, malaise, nausea, vomiting

192
Q

internal physiological sign a patient has an infectious disease

A

increased # of leukocytes or a change in the types of leukocytes

193
Q

what is the normal WBC count in the body

194
Q

leukocytosis

A

elevated WBC count

195
Q

leukopenia

A

decreased WBC count

196
Q

what could cause leukopenia

A

bone marrow disease, radiation, or chemo

197
Q

what could cause leukocytosis

A

infection or other inflammatory response

198
Q

what is the most abundant WBC type

A

neutrophils

199
Q

decrease in what kind of cell increases heath care-associated infection (HAI)

A

neutrophils

200
Q

cytosis

A

increase in cells

201
Q

what is the normal body temperature range

A

96.8-99.5*F

202
Q

where is the temperature-regulating center of the brain

A

hypothalamus

203
Q

pyrogens

A

protein substances and toxins that cause the hypothalamic thermostat to rise

204
Q

how does infectious disease present in older adults

A

change in mental status
subnormal body temperature
brady/tachycardia
fatigue
lethargy
decreased appetite

205
Q

examples of noninfectious causes of fever

A

drug reaction
pulmonary emboli
neoplasm
tissue necrosis
autoimmune diseases

206
Q

intermittent fever

A

temperature returns to normal at least once every 24 hours

207
Q

what are intermittent fevers typically associated with

A

sepsis
abscesses
infective endocarditis

208
Q

remittent fever

A

temperature fluctuates but does not return to normal

209
Q

what are remittent fevers associated with

A

viral upper respiratory infection

210
Q

sustained/continuous fever

A

temperature remains above normal with minimal variations

211
Q

recurrent/relapsing fever

A

episodic fevers lasting 1-3 days with 1 or more days of normal temps in between

212
Q

what temperature threshold should be used for older adults when detecting fever

213
Q

infectious disease definition

A

infection that causes obvious injury to the host and is accompanied by one or more clinical symptoms

214
Q

incubation period

A

period between pathogen entering the host and the appearance of clinical symptoms

215
Q

latent infection

A

after microorganism has replicated but stays inactive in the host (sometimes years)

216
Q

period of communicability

A

time period when an organism can be shed
ex: respiratory route, GI

217
Q

which is larger: fungus or bacteria

A

fungi are larger than bacteria

218
Q

pathogenicity

A

ability of the organism to induce disease

219
Q

virulence

A

the potency of the pathogen in producing severe disease

220
Q

how is virulence measured

A

the # of people who die of the disease divided by the # of people who have the disease

221
Q

opportunistic pathogens

A

they do not cause disease in people with intact host defenses but can cause devastating disease in immunocompromised individuals

222
Q

an environment in which an organism can live and multiply

223
Q

where the parasite leaves the reservoir is called

A

portal of exit

224
Q

what is essential for preventing the transmission of a pathogen

A

knowledge of the portal of exit

225
Q

what are the 2 modes of contact transmission

A
  1. direct contact
  2. indirect contact
226
Q

vector-borne transmission

A

involves insects and/or animals that act as intermediaries between two or more hosts

227
Q

how small are airborne-transmitted particles

A

less than 5 um

228
Q

how large are droplet-transmitted particles and how far can they travel

229
Q

influenza is spread through what kind of transmission

A

droplet transmission

230
Q

tuberculosis and chicken pox are spread through what kind of transmission

A

airborne transmission

231
Q

salmonellosis is spread through what kind of transmission

A

vehicle transmission

232
Q

vehicle transmission

A

pathogen is transmitted through a common source to many potential hosts
ex: contaminated food, water, IV

233
Q

how a pathogen gets into a host

A

portal of entry

234
Q

examples of safe waste

A

feces
urine
vomitus
tears
sweat
snot

235
Q

health care-associated infection (HAI)

A

infections that develop in hospitalized person admitted to health care facility that were not present before being admitted

236
Q

what are the most common HAIs

A

pneumonia
GI tract infection
surgical site infections (SSIs)

237
Q

causes of HAI

A

frequent use of invasive devices
immunosuppressants and antibiotics
multidrug-resistant organisms
lack of hand hygiene

238
Q

hospital interventions that can cause HAI

A
  1. central line associated bloodstream infections
  2. catheter associated urinary tract infections
  3. ventilator associated pneumonia
  4. surgical site infections
239
Q

what is the #1 way to prevent HAIs

A

washing hands even when gloves are used

240
Q

jewelry may sequester what type of pathogen

A

gram-negative organisms

241
Q

artificial nails sequester what type of pathogen

A

coagulase-negative staphylococci
gram-negative rods

242
Q

what position should the head of the bed be after a tracheostomy to prevent HAI pneumonia

243
Q

cocci shape

244
Q

bacilli shape

A

rod-shaped

245
Q

spirilla/spirochetes shape

A

spiral-shaped

246
Q

bacteria cell walls contain

A

peptidoglycan

247
Q

unicellular microorganisms with a rigid cell wall

248
Q

gram positive bacteria

A

purple stain
- thicker peptidoglycan wall

249
Q

gram negative bacteria

A

pink stain
- small peptidoglycan wall with an additional bilipid membrane

250
Q

CDI infection is associated with what type of symptoms and how is it transmitted

A

diarrhea and GI tract symptoms
fecal-oral route from contaminated hands

251
Q

staphylococcal infection is associated with what type of symptoms and how is it transmitted

A

integumentary disease that produces skin lesions

252
Q

streptococcal infections are associated with what type of symptoms and how is it transmitted

A

strep throat, typically through droplets

253
Q

group B streptococcal infections

A

neonatal pneumonia
meningitis
sepsis

254
Q

clostridial myonecrosis (gas gangrene) is caused by what classification of bacteria

A

anaerobic bacteria
they produce gas which breaks down tissue

255
Q

pseudomonas effects which systems

A

integumentary
circulatory
respiratory

256
Q

most common hospital and nursing home acquired pathogen

A

pseudomonas

257
Q

bactericidal

A

drugs that typically kill or destroy bacteria

258
Q

bacteriostatic

A

drugs that do not actually kill bacteria but limit their growth and proliferation

259
Q

3 mechanistic steps of antibacterial drugs

A
  1. inhibition of cell wall synthesis/function
  2. inhibition of protein synthesis
  3. inhibition of RNA/DNA synthesis
260
Q

what are bacterial cell walls made of

A

peptidoglycans

261
Q

what is the enzymatic cofactor in the synthesis of bacterial nucleic acids and EAAs

A

folic acid

262
Q

what do drugs target to inhibit RNA/DNA synthesis

A

folic acid

263
Q

antibiotic stewardship

A

being careful to not overuse antibiotics

264
Q

what is a viruses composition

A

RNA or DNA
covered with proteins
capsule

265
Q

3 DNA viruses

A

hepatitis b
herpes
chickenpox

266
Q

nucleocapsid

A

nucleic acid core and the protein shell

267
Q

4 steps of viral replication

A
  1. absorption
  2. penetration and uncoating
  3. biosynthesis
  4. maturation and release
268
Q

what do antiviral drugs do

A

they slow down viral replication by interfering with one or more of the steps

269
Q

75% of hepatitis c goes to…

A

chronic hepatitis c

270
Q

approximately 70% of americans older than 12 years old have what virus

271
Q

what virus is responsible for cold sores

272
Q

what strain of herpes is most common through sexual contact

273
Q

what part of the body does HSV1 primarily affect

A

mouth and oral cavity

274
Q

what does varicella zoster virus (HHV-3) cause

A

chickenpox or shingles

275
Q

what percent of the population gets shingles after chickenpox

276
Q

when is the period of communicability in varicella

A

first 1-2 days before the rash begins and then first 4-5 days after the lesions form crusts

277
Q

Herpes virus 4 causes what infection

A

mononucleosis

278
Q

Epstein-Barr virus causes what infection

A

mononucleosis

279
Q

what % of people in the US between 35-40 have been infected with EBV

280
Q

what % of the time do adolescents/young adults contract EBV and develop mononucleosis

281
Q

how is EBV transmitted

A

oral secretions
blood
transplanted organs

282
Q

when can someone get back to sport after mono

283
Q

what infections does respiratory syncytial virus cause

A

pneumonia
bronchiolitis
tracheobronchitis

284
Q

what virus and infection is the main cause of hospitalizations in infants and young children

A

RSV
tracheobronchitis

285
Q

how long do infants vs adults shed RSV

A

infants: 3-4 weeks
adults: 3-8 days

286
Q

how long does influenza fever last

A

1-7 days (usually 3-5)

287
Q

when would secondary bacterial pneumonia develop after influenza

A

5-10 days after onset of symptoms

288
Q

endogenous substances that exert nonspecific antiviral activity

A

interferons

289
Q

alpha and beta interferon type

290
Q

gamma interferon type

291
Q

lambda interferon type