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Disease and defense random > Unit II > Flashcards

Unit II Flashcards

1
Q

Subclasses of tNSAIDs (5)

A
  1. salicylates
  2. pyrazalone derivatives
  3. acetic/carboxylic acids
  4. oxicam derivatives
  5. propionic acid derivatives
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2
Q

3 acetic/carboxylic acid drugs

A
  1. indomethacin (Indocin)
  2. ketorolac (toradol)
  3. nabumetone (Relafen)
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3
Q

Oxicam drug

A

meloxicam (Mobic)

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4
Q

3 propionic acid drugs

A
  1. ibuprofen (advil, motrin)
  2. naproxen (Aleve, Naprosyn)
  3. ketoprofen (orudis)
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5
Q

Characteristics of pyrazalone dereivatives

A

more potent and longer lasting than aspirin but serious toxicities with chronic use

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6
Q

use of indomethacin

A

generally limited to arthritic conditions that do not respond to safer agents

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7
Q

Treatment of dysmenorrhea

A

ibuprofen or naproxen via inhibition of synthesis of endometrial prostaglandin

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8
Q

Inhibitoin of COX-1 PGE->

Lowest risk with ___ highest risk with ___

A

dyspepsia and gastric ulceration

Low- ibuprofen
high- naproxen

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9
Q

Interfere with COX-1 thromboxane A2 synthesis->

A

promotion of bleeding

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10
Q

INhibition of COX-1 and COX-2 PGE synthesis->

Highest risk with ___ lowest risk with ____

A

reversible renal insufficiency: fluid retention

HIgh- ibuprofen
Low- naproxen

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11
Q

Celecoxib (Celebrex) is metabolized by

A

CYP2C9

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12
Q

Acetylsalicylic acid is hydrolyzed by ____ to _____

A

esterases

salicylate

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13
Q

Reversible changes following cell injury (4)

A
  1. Decreased ATP
  2. Decreased Na pump (cell swelling)
  3. increased glycolysis, decreased pH
  4. D protein synthesis
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14
Q

Irreversible changes following cell injury (3)

A
  1. activation of lysosomal enzymes
  2. DNA, protein degradation
  3. Increase Ca influx
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15
Q

3 injuries following hypoxia

A
  1. 02 therapy - high levels of 02 are needed acutely to keep the patient alive. However, high
    levels of 02 radicals are also produced and have toxic effects on cells - especially in the lung.
  2. Acute inflammation - PMNs have enzymes such as myeloperoxidase which produce oxygen
    radicals. Many hypoxic tissues are infiltrated with PMNs.
  3. Reperfusion - In hypoxia, xanthine dehydrogenase is proteolytically converted to xanthine
    oxidase. Once the hypoxia is corrected, the xanthine oxidase produces activated oxygen species.
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16
Q

2 •OH + 2 GSH->

A

2 H20 + GSSG

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17
Q

Endogenous pyrogens

A

IL-1 and TNF

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18
Q

Fibrinogen

A

Binds red blood cells causing them to form stacks that form sediments

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19
Q

Along with being endogenous pyrogens, what are other roles of TNF and IL-1

A
  1. Release leukocytes from the marrow

2. Stimulate E selectin

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20
Q

LTC4, LTD4, LTE4 cause

A

vascular permeability

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21
Q

growth factor secretion

A

macrophage

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22
Q

neovascularization

A

endothelial cell

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23
Q

collagen deposition

A

fibroblast/myofibroblast

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24
Q

collagen remodeling/retraction

A

fibroblast

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25
Q

re-epithelialization

A

epithelial cells/ hepatocytes

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26
Q

Granulation tissue composed of (4

A

fibroblasts
new capillaries
loose ECM
inflammatory cells (macrophages)

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27
Q

Initial scar

A

Collagen type III

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28
Q

sacr remodeling

A

Collagen type I

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29
Q

Prototypic hormone of GCs

A

cortisol

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30
Q

Prototypic hormone of MCs

A

aldosterone

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31
Q

3 categories of drugs used in the treatment of rheumatoid arthritis

A
  1. NSAIDs- control inflammation
  2. DMARDs- diagnosis is certain, suppress disease progression
  3. Low dose glucocorticoids- bridge until slower acting DMARDs take effect. also adjunctive therapy
32
Q

2 drugs with minimal mineralcorticoid activity

A

dexamethasone

methylprednisolone

33
Q

Congestion

A

impaired outflow of venous blood

34
Q

color of congested tissue

A

red-blue due to accumulation of deoxygenated blood

35
Q

Oxygen at carbon atoms forms

36
Q

Metal vapors->

A

nasal and lung cancers

37
Q

arsenic exposure->

A

squamous carcinoma of skin

38
Q

Thorotrast->

A

liver cancer

39
Q

vinyl chloride

A

liver cancer

40
Q

asbestos->

A

mesothelioma

41
Q

benzene->

A

myeloid leukemia

42
Q

radon gas->

A

lung cancer (esp for smoker)

43
Q

Chromosomes of cancer cells

A
  • damaged

- aneuploid

44
Q

When you see jaundice in a pancreatic cancer patient, where is the tumor likely located

A

head of pancreas (blocking common bile duct)

45
Q

Where does colon cancer frequently metastasize to?

46
Q

Prostate cancer most common in ___ least common in ____

A

African americans

asians

47
Q

Problem with just looking at PSA levels in prostate cancer

A

sometimes elevated w/o cancer

EX: BPH

48
Q

Initial stage of prostate cancer

A

prostatic intraepithelial neoplasm (PIN)

49
Q

2 types of physiologic hyperplasia

A
  • Hormonal

- Compensatory (Liver)

50
Q

NETs are formed by

A

nuclei from neutrophils

51
Q

Granuloma in granulomatous tissue consists of

A

enlarged macrophages that form a nodule,, which is surrounded by lympocytes

52
Q

White blood cells and TNF/IL-1

A

more leukocytes are released from the bone marrow

53
Q

Increased hydrostatic pressure (4)

A
  • heart failure
  • fluid overload
  • venous obstruction or compression
  • arteriolar dilation
54
Q

Decreased oncotic pressure (2)

A
  • protein loss

- low protein production

55
Q

Lymphatic obstruction (3)

A
  • inflammation
  • neoplasm
  • post surgery or irradiation
56
Q

Neoplasia begins with

A

non-lethal genetic damage to cells

57
Q

4 mechanism of E-cadherin loss

A
  1. LOH
  2. Inactivating mutation (rare)
  3. hypermethylation of promotor
  4. Repressing transcription of E cadherin-> EMT
58
Q

Tfs that promote EMT (4)

A
  1. SNAIL
  2. TWIST.
  3. ZEB1/2
  4. SLUG
59
Q 
Changes in EMT: 
Downregulation of (3)
A
  1. E cadherin
  2. Cytokeratins
  3. Epithelial cell polarity
60
Q 
Changes in EMT:
Upregulation of (6)
A
  1. Vimentin
  2. Fibronectin
  3. N cadherin
  4. Motility
  5. Increased protein secretion
  6. Fibroblast-like morphology
61
Q

Prostatic cancer preferentially spreads to

62
Q

Bronchogenic carcinomas preferentially spread to

A

adrenals and brain

63
Q

Neuroblastomas preferentially spread to

A

liver and bones

64
Q

How do cancer cells make the metastatic site habitable

A

secrete cytokines, GFs, and ECM molecules that act on stromal cells, which make the environment more habitable

65
Q

Example of cancer cells making metastatic site more habitable

A

Breast cancer cells secrete parathyroid hormone related protein (PTHRP)-> osteoblasts make RANKL-> osteoclasts-> degrade matrix releasing IGF and TGF-B

66
Q

Paraneoplastic syndrome occurs in __% to __% of patients with cancer

67
Q

Example of alkylating agent

A

N-mustards

68
Q

Example of acylating agent

A

dimethylcarbamyl chloride

69
Q

Example of benign tumor overproducing harmful proteins

A

Overproduction of insulin by a benign islet cell adenoma of the pancrease-> hypoglycemia

70
Q

Cigarette smoke contains

A

carcinogens and tumor promoters

71
Q

Squamous cell lung carcinoma location

A

major branches of the bronchial tree “centrally”

72
Q

Pancreatic cancers often metastasize to _>

A

liver and lung, peri-gastric, periaorticm and omental lymph nodes

73
Q

Risk of colorectal cancer is high if polyp is greater than ___ cm

74
Q

Colorectal cancer metastasizes to

75
Q

Treatment of colorectal cancer

A

5-fluorouracil in compbination with other drugs (eribitux, EGFR inhibitor)

76
Q

Prostate cancer metastasizes to

77
Q

In cancer therapy, it is most important to kill which cell?

Disease and defense random (6 decks)

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