9 Flashcards

Question

Pathophysiology of septic shock

Answer 1

1. Bacterial LPS activates macrophages and neutrophils 2. Systemic release of cytokines (IL-1, TNF-alpha) 3. Activation of endothelial cells leading to systemic vasodilation and hypotension 4. Vascular leakage and oedema 5. Activation of complement

Answer 2

Transformation - Small fragments of DNA taken up by the cell. Transduction - Phage mediated transfer of non-phage DNA between bacteria. Conjugation - Bacteria having sex, pili join to create a channel. Transposons - Jumping genes, mobile genetic units integrate into genome.

Answer 3

1. Lag 2. Exponential - once they have enzyme, it moves quickly 3. Stationary - nutrient deficit 4. Death - lysing

Answer 4

1. Congestion - lung is oedematous and red - 1st 24hrs 2. Red hepatisation - extravasation of red cells into alveolar spaces and increased number of neutrophils 3. Grey hepatisation - red cells disintegrate and neutrophils persist 4. Resolution - complete recovery - exudate digested by enzymes and cleared up by macrophages - exudate liquefied and either coughed up in sputum or drained in the lymph

Answer 5

- Staphylococcus aureus - Staphylococcus epidermidis - Lactobacillus species

Answer 6

- Staphylococcus aureus - Staphylococcus epidermidis - Streptococcus pneumoniae - Haemophilus influenzae

Answer 7

- Blood - CSF - Urine

Answer 8

Normal flora that only cause disease when introduced to unprotected sites. Pseudomonas aeruginosa

Answer 9

Neisseria gonorrhoea only associated with human disease

Answer 10

Adhesins - pili, fimbriae, outer membrane protein Flagella - penetrate mucus Capsule Toxins

Answer 11

- Protein released extracellularly | - Protein destroyed by heat

Answer 12

Inactivated toxin useful as vaccine

Answer 13

- Gr+ - Rod - Facultatively anaerobic - Does not produce endospores Systemic infection initiated in GIT Food borne - pate, soft cheese, unpasteurised milk, deli meats Listeriosis is usually caught from eating food containing listeria bacteria

Answer 14

Obligate intracellular parasites Cannot make energy or proteins independent of host Genome either DNA or RNA Replication by self-assembly Prions do not contain any genetic information

Answer 15

Envelope and nucleocapsid

Answer 16

Nucleocapsid

Answer 17

``` H = hemagglutinin N = neuraminidase ```

Answer 18

- Spread through large droplets - Sensitive to detergents - Must stay wet to remain infectious E.g. Ebola, HIV, influenza

Answer 19

- More stable in environmental stress e.g. acid, temperature, drought - Spreads more easily - Survived gut - Norovirus and rotavirus

Answer 20

- Attach - Penetrate - Uncoat - Replicate - Assemble - Release

Answer 21

- Hep C - Polio - Dengue

Answer 22

- Measles - Mumps - Influenza - Rabies

Answer 23

gp120 binds to CD4 cells (CD4 T cells or macrophages) and then binds to a co-receptor CCR5 or CRCX4. gp41 - 6 folded helix. Then duplicates in each mitotic division.

Answer 24

Detected by thermoreceptors in the skin. Signals to cerebral cortex - voluntary actions and hypothalamus - activates sympathetic NS causing piloerection and adrenaline release which causes skin vasoconstriction. Also stimulates hypothalamus to produce TRH, causing pituitary to release TSH and then producing T3 and T4 = all increases BMR

Answer 25

- Opposite of cold - Also activates cholinergic system - sweating and other brain centres - RAAS system also contributes to concentration of urine

Answer 26

- Increase synthesis of sodium potassium ATPase pumps - increase ATP breakdown which increases heat - Cholesterol synthesis and lipolysis increase. - Protein synthesis increase. - Enhances effects of catecholamines by increasing beta receptor expression. - Increases BMR by stimulating use of oxygen to make ATP.

Answer 27

Rabies: lyssaviruses Malaria: mosquitoes Dengue fever: Aedes type mosquitoes West Nile Virus: mosquitoes Japanese encephalitis: mosquitoes, specifically those of the Culex Zika Virus: Aedes mosquitoes Chikungunya virus: Aedes albopictus and Aedes aegypti mosquitoes Yellow fever: Aedes aegypti mosquitoes (mainly) Tick-borne disease: many different types and pathogens

Answer 28

- Malaria: mosquito-borne infectious - Syphilis: Treponema pallidum - Brucellosis: unpasteurized milk - Hepatitis B (HBV) - Hepatitis C (HCV) - Human Immunodeficiency Virus (HIV)

Answer 29

From latent site in trigeminal ganglia and also pharynx Usually herpes simplex 1 Coldsore

Answer 30

HHV-1 (HSV1) - Herpes simplex virus 1 HHV-2 (HSV2) - Herpes simplex virus 2 HHV-3 (VZV) - Varicella zoster virus HHV-4 (EMV) - Epstein-Barr virus HHV-5 (CMV) - Cytomegalovirus HHV-8 (KSHV) - Kaposi’s sarcoma-associated virus

Answer 31

Reye syndrome is a rapidly progressive encephalopathy. Symptoms: - Vomiting - Personality changes - Confusion - Seizures - Loss of consciousness Even though liver toxicity typically occurs, jaundice usually does not. Death occurs in 20–40% of those affected and about a third of those who survive are left with a significant degree of brain damage. The cause of Reye syndrome is unknown. - It usually begins shortly after recovery from a viral infection, such as influenza or chickenpox. - ~90% of cases in children are associated with aspirin (salicylate) use. - Inborn errors of metabolism are also a risk factor. Changes on blood tests may include a high blood ammonia level, low blood sugar level, and prolonged prothrombin time.

Answer 32

Hyperpyrexia is malignant - over 40 degrees

Answer 33

Acute - mainly neutrophils | Chronic - mainly macrophages

Answer 34

Oedema Generation of inflammatory exudate May lead to pus

Answer 35

Cyclo-oxygenase - produces prostaglandins Lipo-oxygenase - produces leukotrienes

Answer 36

Platelets - serotonin Mast cells - histamine Inflammatory cells

Answer 37

- You get the infection - Naturally attenuated - Not fully virulent - Single dose - Cheaper than non-living - May return to virulence

Answer 38

- Kinins - Clotting cascade - Complement inflammation

Answer 39

Although traditionally their presence was associated with tuberculosis, they are not specific for tuberculosis or even for mycobacterial disease. In fact, they are found in nearly every form of granulomatous disease, regardless of aetiology.

Answer 40

Fusion of macrophages

Answer 41

Touton giant cells are a type of multinucleated giant cell seen in lesions with high lipid content such as fat necrosis, xanthoma, and xanthogranulomas. They are also found in dermatofibroma.

Answer 42

Induce a state of immunological readiness so that a first infection with a pathogen is recognised as though it were a second infection by the same pathogen

Answer 43

- Not as effective as living vaccine | - Multiple doses may be required

Answer 44

Transfer pre-formed immunological mediators into a normal individual e.g. IgG mother -> foetus or IgA in colostrum or snakebite venom

Answer 45

They are not well adapted to growth at 37 degrees Their enzymatic pathways function most efficiently at redox potentials found in non-living substrates Host defence mechanism effective at dealing with ingested/inhaled fungi

Answer 46

Because it produces a low immune response on its own Subunit: when you break apart an organism and vaccinate with part that is most likely to induce an immune response

Answer 47

- Eukaryote - Chitin cell wall - 80s ribosomes - Reproduction may be sexual or asexual - Has cell bound organelles

Answer 48

Formation of filaments - these are hyphae Entangled mass of hyphae form mycelium (network of white filaments)

Answer 49

Asexual - production of conidia which can develop within hyphae Sexual reproduction through sexual spores

Answer 50

Aspergillus

Answer 51

- Single-cell organisms - Round or ovoid - Reproduce by budding

Answer 52

Tinea (ringworm) Tinea pedis - dermatophyte infection of the soles of the feet and the interdigital spaces.

Answer 53

Malassezia furfur Malassezia furfur is a species of fungus that is naturally found on the skin surfaces of humans and is associated with seborrhoeic dermatitis

Answer 54

Keratin as they produce keratinase

Answer 55

It is a tropical and subtropical disease caused by leishmania and transmitted by the bite of sandflies. It affects either the skin or the internal organs. Can cause splenomegaly Forms skin sores which erupt weeks to months after the person is bitten by infected sand flies.

Answer 56

Exo-Erythrocytic (liver) cycle Erythrocytic cycle Sporogonic cycle

Answer 57

1. Mosquito is infected with malaria - can be found in salivary glands 2. Mosquito bites naive human skin, some parasite gets into the bloodstream - parasite sporozoite at this stage 3. Parasite goes in bloodstream to liver where it infects the hepatocytes 4. Then turns into a replicated structure called a schizont 5. Schizont then ruptures producing merozoites which are able to infect RBCs. 6. Ring stage trophozoites mature into schizonts which can then rupture and produce merozoites 7. Some ring stage trophozoites differentiate into sexual erythrocytic stages (gametocytes) 8. Microgametocyte (male) penetrate the macrogametocyte (female), forming a zygote 9. Zygote becomes motile and elongates - ookinetes 10. Ookinetes invade the midgut wall of the mosquito where they develop into oocytes 11. Oocytes grow and rupture releasing sporozoites, which go into mosquito salivary glands

Answer 58

Erythrocytic cycle

Answer 59

Chagas disease - megacolon

Answer 60

Proto-oncogenes - growth promoting Tumour suppressor genes - growth inhibiting Genes that control apoptosis Genes that repair DNA

Answer 61

Virus infects cervical epithelial cells where it produces viral proteins E1-E7 E6 and E7 bind to tumour suppressor genes Rb and p53 and causes a reduction in their levels, it promotes DNA synthesis and interrupts p53 mediated growth, arrest and apoptosis of the genetically altered cells

Answer 62

Faecal oral | Common in pets such as dogs

Answer 63

Penetrates the skin and migrates from the skin into the lungs into the trachea and then swallowed again

Answer 64

Haematogenous - mainly through veins as they are thinner and once in the venous system follow normal drainage so a lot of malignant cells deposited in liver and lungs Lymphatic - malignant cells can penetrate lymphatic vessels draining the primary site travelling to regional lymph nodes Transcoelomic - spread directly across coelomic spaces and surfaces e.g. peritoneal or pleural cavities. Common in ovarian cancers

Answer 65

They code for oncoprotein which positively regulate cell growth

Answer 66

- Variable differentiation from well differentiated to poorly - Many mitoses - abnormal forms - High nuclear:cytoplasmic ratio - Cellular and/or nuclear pleomorphism

Answer 67

Fluid filled peritoneal cavity due to immune responses in the liver changing our fluid dynamics The urinary tract or the intestines may be infected. Symptoms include abdominal pain, diarrhoea, bloody stool, or blood in the urine. Those who have been infected for a long time may experience liver damage, kidney failure, infertility, or bladder cance

Answer 68

Blocked lymphatics

Answer 69

Treatment is not always necessary as the infection usually resolves on its own. However, if the illness is acute or symptoms persist and medications are needed to treat it, a nitroimidazole medication is used such as metronidazole, tinidazole, secnidazole or ornidazole.

Answer 70

- Tapeworms - Flukes - Roundworms

Answer 71

Level of differentiation

Answer 72

T - primary tumour (T0-T4) N - lymph node status (N0-N3) M - metastasis (M0-M1)

Answer 73

Duke's staging Dukes A - limited to bowel wall Dukes B - beyond bowel wall Dukes C - nodal metastasis Dukes D - distant metastasis

Answer 74

Endocrine insufficiency - destruction of glands Endocrine elaboration - mainly in benign tumours e.g. hypercalcemia in parathyroid adenoma

Answer 75

Compression - e.g. of SVC in lung cancer Obstruction Intussusception - telescopes into itself Displacement - of trachea in thyroid cancer Ulceration

Answer 76

Less differentiated tend to be more aggressive neoplasms

Answer 77

Wasting syndrome - catabolic state resulting in profound loss of body fat and mass, weakness and anorexia

Answer 78

1. Self sufficiency in growth signals 2. Insensitivity to antigrowth signals 3. Evasion of apoptosis 4. Limitless replicative potential 5. Sustained angiogenesis 6. Tissue invasion and metastasis 7. Reprogramming of energy metabolism 8. Evasion of immune destruction

Answer 79

- Increase in cell contents | - Some cells arrest at this phase G0

Answer 80

- Replication of DNA | - Centrosome duplicates

Answer 81

Scans DNA and if there's a problem stops the cell cycle

Answer 82

Between metaphase and anaphase

Answer 83

Ensures DNA is completely replicated

Answer 84

p53 and Rb Their loss leads to excessive proliferation

Answer 85

Slow growing cancer that rarely metastasises

Answer 86

Presents in sun exposed areas with pearly papules which ulcerate in the middle as they lose their blood supply Telangiectatic blood vessel - cardinal sign

Answer 87

- Nodular - Morphoeic - Superficial

Answer 88

Cyclin-dependent kinase (CDK) inhibitor 1 0 Capable of inhibiting all cyclin/CDK complexes, though is primarily associated with inhibition of CDK2 - p21 represents a major target of p53 activity and thus is associated with linking DNA damage to cell cycle arrest.

Answer 89

Maintain genetic stability e.g. gene repair BRCA 1 and 2

Answer 90

Telomerase enzymes in stem cells and germ cells

Answer 91

Maintain telomere length so that they can continue replicating and acts as a primer which allows gaps to be filled by DNA polymerase Telomerase is activated in most human cancer cells - this is how they keep on proliferating

Answer 92

Small blister less than 5mm

Answer 93

A large blister greater than 5mm in diameter

Answer 94

Small, solid elevation of skin but bigger than 5mm (similar to a papule but bigger)

Answer 95

Small, solid elevation of skin (less than 5mm in diameter) (basically a small raised area of skin)

Answer 96

Radical when the melanoma grows horizontally within the epidermis Vertical - tumour grows downwards into deeper dermal layers

Answer 97

Visible collection of free pus in a blister

Answer 98

Nodule consisting of an epithelial-lined cavity filled with fluid

Answer 99

Flat mark on skin.

Answer 100

Palpable, plateau like elevation of abnormal skin - a group of papule may from a plaque (basically a big raised area of skin)

Answer 101

Basal cell carcinoma

Answer 102

If it gets into your brain - can go through the CSF

Answer 103

Accumulation of thickened stratum corneum in the form of readily detached fragments

Answer 104

Bleomycin - anticancer drug

Answer 105

Staphylococcus aureus

Answer 106

Staphylococcus aureus Streptococci

Answer 107

Atypical mole with varying colour and scalloped edges Major criteria - change in size, colour and shape Minor criteria - inflammation, bleeding, sensory change

Answer 108

Actinic keratosis Cutaneous horns of keratin Chronic ulcers Bowen's disease

Answer 109

Bacterial skin infection caused by S. aureus or S. pyogenes

Answer 110

A superficial form of cellulitis - involves upper dermis + superficial lymphatics Caused by Streptococcus pyogenes (also known as beta-hemolytic group A streptococci),

Answer 111

Irreversible cell damage

Answer 112

Initial stages are potentially reversible. After necrosis and inflammation, pathology irreversible.

Answer 113

Normal, pyknosis, karyolysis, karyorrhexis

Answer 114

Coagulative necrosi (can't happen in brain) Liquefactive necrosis (can happen in brain) Caseating necrosis (unusual form)

Answer 115

o Drugs: allergy, overdose, side effects o Radiation: inflammation, scarring, neoplasia o Blood transfusion: hepatitis, HIV o Complications: surgery, immobility

Answer 116

IL-1 | IL-6

Answer 117

Evaporation (sweating)

Answer 118

TRH - thyrotropin releasing hormone

Answer 119

TSH - thyroid stimulating hormone

Answer 120

Triiodothyronine

Answer 121

Stratum lucidum

Answer 122

After necrosis and inflammation pathology irreversible

Answer 123

Genetic or non-genetic Present from birth

Answer 124

IgG or IgM

Answer 125

Type 1 | Type 4

Answer 126

Cornified cells in the scontratum corneum

Answer 127

Cornified layer

Answer 128

- Lipids - Insoluble proteins (forms hydrophobic layer) - Strong filaments (linked by cell-cell junctions)

Answer 129

Keratinocytes

Answer 130

Produce keratin and lamellar granules (waterproof sealant)

Answer 131

Langerhans cells

Answer 132

In basal layer In associated w/ nerve fibres responsible for fine touch sensation

Answer 133

Imbalance between cell renewal and cell loss in the epidermis

Answer 134

Breakage of cell-cell junctions

Answer 135

Basal layer Stratum basale

Answer 136

Stratum spinosum

Answer 137

Blister, vesicle, bulla, pustule

Answer 138

Papule, plaque, nodule, wheal

Answer 139

Macule, patch, naevis, erythema

Answer 140

Loss of epidermis and papillary layer of dermis

Answer 141

Hyperplasia of epidermis following pressure or friction

Answer 142

Loss of superficial epidermis

Answer 143

``` o Increased hydrostatic pressure o Decreased osmotic pressure o Lymphatic obstruction o Sodium retention o Inflammation ```

Answer 144

⁄ Increase in vascular volume/pressure ⁄ Decreases in plasma protein content ⁄ Changes in endothelial cell function

Answer 145

Formation of blood clot inside a blood vessel, obstructing flow of blood through circulatory system.

Answer 146

``` o Endothelial injury o Abnormal blood flow o Hypercoagulability (blood composition) ```

Answer 147

Impaired venous return causing local increased blood volume in a tissue; may occur systemically (HF) or locally (isolated venous obstruction); tissue cyanosed as deoxygenated haemoglobin accumulated.

Answer 148

Local vasodilation in response to ischaemia

Answer 149

Increased blood flow/vasodilation in response to period of activation (increased blood in skeletal muscle during exercise)

Answer 150

HF | It can lead to widespread oedema

Answer 151

COmpression of blood vessels

Answer 152

¥ Vessel wall integrity ¥ Osmolarity ¥ Maintenance of intravascular pressure

Answer 153

Extravasation across the vascular wall or Reduction of blood fluidity

Answer 154

movement of water (or blood) across the vascular wall

Answer 155

Lack of blood flow (systemic hypoperfusion) Leading to reduced nutrient delivery

Answer 156

``` Cardiogenic shock Hypovolemic shock Septic shock Neurogenic shock Anaphylactic shock ```

Answer 157

Macrophages, debris (lipids, calcium, fibrous connective tissue)

Answer 158

o Small haemorrhage (3-5mm), usually due to trauma or vasculitis.

Answer 159

Within blood vessel | Tunica intima and media

Answer 160

Arterial traumaI. E.I. use of artery for injection

Answer 161

Bacteria that have a complex nutritional requirement and will only grow when specific nutrients are available.

Answer 162

Conjugation A conjugative plasmid moves from one bacterium to another; requires cell-to-cell contact

Answer 163

Uptake of short DNA fragments by naturally transformable bacteria; most relevant for plasmids.

Answer 164

Transfer of DNA from 1 bacterium into another via bacteriophages (bacterial virus that contains DNA)

Answer 165

- Fluids: blood, CSF, urine | - Tissue/organs: muscles, glands, brain, inner ear…

Answer 166

Quantity of pathogen required to cause an infection or immunological response in a susceptible host.

Answer 167

H. influenza S. epidermidis S. aureus S. pneumoniae

Answer 168

S. epidermidis S. aureus Lactobacillus

Answer 169

The group of exotoxins that act on the small intestine

Answer 170

Proteins that are released extracellularly produced by certain Gr+ and Gr- species

Answer 171

C. difficile toxin A Cholera toxin E. coli toxins

Answer 172

LPS of Gr- bacteria

Answer 173

Exotoxins (destroyed by heat) Endotoxins heat stable because they aren't proteins (they are cell bound)

Answer 174

Gram+, cocci

Answer 175

factors which are secreted by bacterium directly into host cell, destroying the cell.

Answer 176

- Phagocytes – Macrophages, polymorphonuclear granulocytes | - Soluble factors – Complement, lysozyme

Answer 177

- Overt or strict pathogens (e.g. Neisseria gonorrhoeae, cholera) - Opportunistic pathogen (e.g. Pseudomonas aeruginosa) - Facultative pathogen (e.g. Bacillus anthracis – soil bacteria)

Answer 178

``` o Attachment and entry into body o Local or general spread in the body o Multiplication o Evasion of host defences o Shedding from body o Cause damage in host ```

Answer 179

o Adhesions: e.g. fimbriae, pili, outer membrane protein – specific molecules for specific receptors (to attach to host cell). o Flagella: for motility – to penetrate mucin. o Factors that help obtain essential nutrients: e.g. siderophores (produced by bacteria and have a high affinity to iron). o Toxins: these do direct damage to host. o Capsule: a sugar layer that helps the bacteria to evade the immune system. o Type III secreted molecules: factors which are secreted by bacterium directly into host cell, destroying the cell.

Answer 180

Extracelular

Answer 181

Difference between prokaryotic and eukaryotic cells

Answer 182

Metabolic analogues inhibit synthesis of nucleic acid precursors E.g. sulfonamides and trimethoprim

Answer 183

Peptidoglycan in both gram –ve and +ve bac (penicillin, cephalosporins) • Inhibit enzymes (PBPs) required for last step: transpeptidation.

Answer 184

Glycopeptides Because it can't cross cell wall of gram-ve

Answer 185

inhibit DNA replication ♣ Specifically, enzymes required to untangle DNA: gyrases; topoisomerases

Answer 186

Blocks mRNA synthesis ♣ E.g. ciprofloxacin ♣ Higher affinity to TMP for the bacterial enzyme than for the human enzyme.

Answer 187

70s (30s + 50s subunits)

Answer 188

80s (40s + 60s subunits)

Answer 189

Aminoglycosides Tetracyclines

Answer 190

Gentamycin

Answer 191

Oxazolidinones Lincosamides: - Clindamycin - Lincomycin - Pirlimycin Macrolide: - Azithromycin - Erythromycin - Clarithromycin - Spiramycin - Clindamycin

Answer 192

Puromycin, Mupirocin

Answer 193

Antimicrobial drugs which act like detergent on membrane. Mainly topical use due to neurotoxicity and nephrotoxicity in systemic use

Answer 194

Bactericidal (=kills) | Bacteriostatic (=inhibits growth)

Answer 195

Proteins in the cell breakdown when cellular liquid becomes acidified due to the disrupted blood flow. The tissue stays firm + cells hold their structure Ghost-like appearance

Answer 196

Due to inadequate blood supply. It's the most common type of necrosis

Answer 197

Can affect any tissue in the body except the brain. Commonly occurs in major organs like kidney, heart, liver - when oxygen deprived for certain amount of time.

Answer 198

Dead tissue softens + appears liquid-like + pus develops. Basically the result is a 'goo' of cell material wo/ shape

Answer 199

Enzyme imbalance that causes cell to digest itself/ Can be caused by bacterial or fungal infections + can occur in the brain

Answer 200

Cell's structure completely destroyed due to degradation by enzymes. The remaining tissue is white, soft, 'cheese-like'

Answer 201

Tuberculosis | Histoplasmosis

Answer 202

Biting insects

Answer 203

An acute febrile disease w/ greatest in the tropics.

Answer 204

Infect the skin + mucous membranes of humans. Some cause warts other can cause cancer. All HPV are transmitted by skin-to-skin contact + by inorganic objects.

Answer 205

Severe diarrhoea in young children It's caused by faecal-oral transmission

Answer 206

Human herpesvirus type 8 (HHV8) Kaposi sarcoma associated virus (KSHV)

Answer 207

Blood-stained vaginal discharge + abnormal cervical mass

Answer 208

Stomach cancer | also commonly causes gastric ulcers

Answer 209

Peptidoglycan cross-links in the bacterial cell wall --> rapid cellular death E.g. penicillin, cephalosporins

Answer 210

Aminoglycosides e.g. gentamycin, tobramycin Tetracyclines e.g. oxytetracycline

Answer 211

Macrolides

Answer 212

Bactericidal - Bacterial cell wall inhibition - Kill bacteria Bacteriostatic - Protein synthesis/reproduction - Help host defence take over-

Answer 213

Trimethoprim Sulfonamides

Answer 214

Cycloserine Vancomycin (glycopeptide - only works on gram +ve) Bacitracin ``` Beta lactams: Penicillins Cephalosporins Monobactams Carbapenems ```

Answer 215

DNA gyrase Inhibit enzymes topoisomerase II + IV (which are required for bacterial DNA replication, transcription, repair, stran supercoiling repair + recombination)

Answer 216

By self-assembly of individual components, including nucleic acid + capsid

Answer 217

HIV | Influenza virus

Answer 218

Bacteriophage | Plant viruses

Answer 219

Streptococcus pharyngitis

Answer 220

Post herpetic neuralgia Ophthalmic herpes zoster infection can cause blindness

Answer 221

Blood Semen Vaginal fluid Breast milk

Answer 222

HAART | Highly active anti-retroviral therapy

Answer 223

Indinavir, Ritonavir, Saquinavir, Lopinavir

Answer 224

80s | They are eukaryotes

Answer 225

Polyenes Azoles Allylamines

Answer 226

Interacts with ergosterol, punching holes in the cell membrane, causing cells to lose ions and small molecules. E.g. amphotericin B

Answer 227

Interfere with fungal enzymes, thereby preventing ergosterol production for the cell membrane. E.g. ketoconazole

Answer 228

Interferes with other fungal enzymes, preventing ergosterol production e.g. flunarizine

Answer 229

Doxycycline - cheapest Malarone - most expensive Mefloquine - combination med

Answer 230

Due to neuropsychiatric side-effects e.g. anxiety + hallucinations)

Answer 231

``` Live attenuated Inactivated Subunit Toxoid Conjugate ```

Answer 232

Weakened version of living microbe that can't cause disease

Answer 233

Microbes killed w/ chemicals, heat or radiation

Answer 234

Include antigens (or epitopes) that best stimulate immune system

Answer 235

Formalin inactivated toxins used as vaccine

Answer 236

Specialised subunit vaccines where antigens are linked to polysaccharides

Answer 237

Mutation | Storage

Answer 238

Weaker immune response | Need boosters

Answer 239

Identifying specific antigen takes time

Answer 240

When main cause of illness is a bacterial toxin

Answer 241

Most effective for immature immune system of infants

Answer 242

Measles, mumps, rubella (MMR combined vaccine) Rotavirus Smallpox Chickenpox Yellow fever

Answer 243

H. influenzae type b | S. Pneumoniae

Answer 244

Influenza Hep A Polio Rabies Cholera

Answer 245

Meningococcal meningitis (Neisseria meningitidis) Meningococcal disease describes infections caused by the bacterium Neisseria meningitidis. It carries a high mortality rate if untreated but is a vaccine-preventable disease.

Answer 246

Yeast-like fungus of the genus Pneumocystis. The causative organism of Pneumocystis pneumonia, it is an important human pathogen, particularly among immunocompromised hosts.

Answer 247

Caused by Legionella Pneumophila, a bacterium usually found in streams, rivers and lakes. You can get them from hot tubs or air con Cause respiratory infection

Answer 248

Bacillus cereus Gram-positive, rod-shaped, aerobic, facultatively anaerobic, motile, beta hemolytic bacterium commonly found in soil and food.

Answer 249

Clostridium difficile Due to use of: cephalosporin, ciprofloxacin, co-amoxilclav, clindamycin Klebsiella oxytoca, Clostridium perfringens, Staphylococcus aureus, and Candida species might also contribute to AAD.

Answer 250

Interphase part, except cancer cells

Answer 251

Place where cell cycle is regulated. Apoptosis can occur if DNA is damaged

Answer 252

Mitosis will not occur is DNA is damaged or not replicated

Answer 253

Mitosis stops if chromosomes aren't properly aligned

Answer 254

So they can then bind to specific Cyclin dependent kinases and inhibit proteins that normally inhibit cell division

Answer 255

Proteins made at specific times: When active a phosphate group is added to a protein e.g. Rb Rb inhibits cell division but this phosphate group inactives it therefore cell division carries on

Answer 256

Always present but the majority of the time are inactive. Activated by specific cyclins

Answer 257

Because the tumour suppressor gene mutations tend to be recessive – both alleles need to be mutated in order to lead to the cancerous phenotype (first proposed when looking at cases of retinoblastoma)

Answer 258

Halt cell cycle and/or cause apoptosis

Answer 259

DNA repair proteins - recognise DNA damage + repair it or cause apoptosis Cell cycle repressors - inhibit proteins essential for the cell cycle

Answer 260

Genes that code for proteins that promote cell growth. They start as proto-oncogenes.

Answer 261

``` Src Ras Myc VEGR + EGFR BCR-Abl1 ```

Answer 262

A specific cytoplasmic tyrosine kinase and over activates it. Involved in sarcomas

Answer 263

GTPase which in turn turns on other genes which cause cell division. Involved in colorectal cancer

Answer 264

Transcription factor and is involved in Burkitt’s lymphoma

Answer 265

Receptor tyrosine kinases. Bind to tyrosine kinase receptors and switches them permanently on so cell is constantly dividing.

Answer 266

BCR-Abl1 It's a cytoplasmic tyrosine kinase. The coded protein is unregulated and signals for cell division. Involved in CML.

Answer 267

- Self-sufficiency in growth signals (oncogenes) - Insensitivity to antigrowth signals (tumour suppressors) - Evasion of apoptosis - Replicative immortality (telomerase) - Sustained angiogenesis - Tissue invasion + metastasis - Reprogramming of energy metabolism - Evasion of immune destruction - Underlain by genome instability and inflammation

Answer 268

The enzyme in a eukaryote that repairs the telomeres of the chromosomes so that they do not become progressively shorter during successive rounds of chromosome replication

Answer 269

The enlargement of an organ or tissue by the proliferation of cells of an abnormal type, as a developmental disorder or an early stage in the development of cancer. Cells have not invaded the basement membrane

Answer 270

New or abnormal growth of tissue which is irreversible

Answer 271

Tumours of the epithelial tissue

Answer 272

Tumuors of connective tissues

Answer 273

A tumour composed of tissues not normally present at the site (the site being typically in the gonads).

Answer 274

``` Prostrate Lung Bowel Bladder Non-Hodgkin lymphoma ```

Answer 275

``` Breast Lung Bowel Uterus Ovary ```

Answer 276

``` Lung Prostrate Bowel Oesophagus Pancreas ```

Answer 277

``` Lung Breast Bowel Pancreas Ovary ```

Answer 278

``` Leukaemia Brain and other central nervous system tumours Neuroblastoma Wilms tumour Lymphoma ```

Answer 279

Also called Wilms' tumor or nephroblastoma) Is a type of cancer that starts in the kidneys. It is the most common type of kidney cancer in children.

Answer 280

Cancer of the lymphatic system. There are 2 main types : - Hodgkin lymphoma - Non-Hodgkin lymphoma.

Answer 281

Lumps in lymph nodes, spleen, lower abdomen (MALT)

Answer 282

Difference between the 2 groups is due to the histology. Presence of Reed-Sternberg cells in Hodgkin No Reed-Sternberg cells in non-Hodgkin

Answer 283

Low grade = mature cell malignancy High grade = immature cell malignancy

Answer 284

Abnormal blood cells in peripheral blood

Answer 285

Acute lymphoid leukaemia (ALL) Acute myeloid leukaemia (AML) Chronic myeloid leukaemia (CML) - BCR-APL1 Chronic lymphoid leukaemia (CLL)

Answer 286

Acute = malignancy of immature cells (have less function so symptoms come on quicker) Acute more common in. children Chronic more common in adults Chronic = malignancy of mature cells (have more normal function so symptoms come on slower)

Answer 287

Everything other that B, T + NK cells. monocytes, macrophages, neutrophils, basophils, eosinophils, erythrocytes, dendritic cells, and megakaryocytes or platelets

Answer 288

Related to decreased function of bone marrow so anemia (fatigue, SOB), increased infection, bruising and nosebleeds

Answer 289

Myeloma is not a malignancy of a myeloid cell, it is a malignancy of B cells which is a lymphocyte cell Clonal proliferation of mature plasma cells that secrete immunoglobulins

Answer 290

Bone pain Hypercalcaemia Night sweats Weight loss Extreme fatigue Renal impairment

Answer 291

The cancer cells bind to stromal cells which activates osteoclast activity and therefore cause lytic lesions in bone, pathological fractures and hypercalcaemia (stones, moans, thrones, groans).

Answer 292

Because immunoglobulins (called paraproteins deposit in the kidneys).

Answer 293

Basal cell carcinoma – can have for 10 + years without it causing too much damage Squamous cell carcinoma Malignant melanoma

Answer 294

Malignant tumour arising from basal keratinocytes of epidermis Most common form of skin cancer (typically on face of elderly) Slow-growing, locally invasive, rarely metastasises

Answer 295

Repeated UV exposure X-ray irradiation Chronic scarring Genetic Predisposition

Answer 296

An oncogene which when mutated is overactivated + constantly stimulates cellular division. Happens in BCC

Answer 297

1) Nodular: most common, skin coloured nodule, pearly edge – often central ulceration with adherent crust 2) Superficial (multifocal): flat, red plaque with irregular rim-like edge and light pigmentation – often many and most commonly on trunk 3) Morpheic: flat, thickened, whitish-yellow waxy plaque with indistinct edges, may have focal areas of ulceration

Answer 298

Surgical excision | Radiotherapy

Answer 299

Malignant tumour of epidermal keratinocytes Compared to BC:C which is malignant tumour arising from basal keratinocytes of epidermis

Answer 300

- Excessive UV exposure - Pre-malignant skin condition - Chronic inflammation - Immunosuppression

Answer 301

Keratotic (scaly and crusty), ill-defined nodule which can ulcerate

Answer 302

Surgical excision | Radiotherapy

Answer 303

Invasive malignant tumour of epidermal melanocytes, has potential to metastasise

Answer 304

Superficial spreading Lentigo Acral lentiginous Nodular

Answer 305

Nodular lesion arising in pre-existing lentigo maligna typically occurring in sun-damaged skin of face in elderly

Answer 306

Pigmented nodule that may grow rapidly + ulcerate - typically on trunks of males

Answer 307

Resembles lentigo but affects palms soles + nail beds

Answer 308

Flat tumour w/ variable pigmentation and irregular edges. Most common in lower leg

Answer 309

Surgical excision Radiotherapy Chemotherapy

Answer 310

Asymmetry, lump, skin changes (peau d’orange), inversion of nipple, discharge. Mets in bone, lung, liver, brain, hypercalcemia, enlarged lymph nodes…..

Answer 311

Based on what the cells look like under a microscope.

Answer 312

Based on cancer spread.

Answer 313

Autosomal dominant - Both are tumour suppressor genes responsible for production of proteins that repair DNA damage during cell reproduction.

Answer 314

Familial adenomatous polyposis

Answer 315

- Autosomal dominant - Inherit a ‘bad copy’ of the APC gene - Have one remaining ‘good copy’ of the gene, which is still liable for mutation, and when it does polyposis results - 90% of these people will develop colorectal cancer - Mainly left side colorectal cancer

Answer 316

Hereditary non-polyposis colorectal cancer

Answer 317

- Autosomal dominant - Early onset colorectal cancer (mid-forties) - Mainly right side colon cancer

Answer 318

Small bowel + gastric

Answer 319

Small growth, usually benign and with a stalk, protruding from a mucous membrane

Answer 320

An adenocarcinoma - arises from glandular cells in the mucosal lining of colon

Answer 321

high energy photons, electrons, protons, neutrons or alpha particles

Answer 322

High energy damages DNA in cancer cells so the cells can no longer replicate indefinitely

Answer 323

Tiredness, oedema, redness and mild burning. Chronic = infertility, increased risk of cancers in later life

Answer 324

Deplete tumour cells! Breaks between cycles give normal stem cells time to recover

Answer 325

Chemotherapy drug

Answer 326

Transfer an alkyl to the purine bases on cancer DNA and inhibit it Monofunctional = affect one base e.g. Dacarbazine Bifunctional = affect more than one base e.g. Nitrogen mustard, cyclophophamide

Answer 327

alkylating agents target all phases

Answer 328

Platinum compounds - Interrupt DNA double helix - E.g. Cisplatin Anthracyclines - Intercalate in DNA between base pairs and blocks DNA replication - E.g. Doxarubacin (cardiomyopathy so limited amount allowed in lifetime)

Answer 329

DNA strands from becoming tangled

Answer 330

These agents stop the topoisomerase enzyme from working therefore DNA becomes tangled and the cells can no longer replicate

Answer 331

Main constituent of the microtubules of living cells.

Answer 332

Vinca alkaloids Taxenes

Answer 333

Bind to tubulin and prevents the assembly of microfilaments so prevent cell division

Answer 334

E.g. Vincristine, Vinblastine

Answer 335

Topoisomerase I inhibitors = Topotecan, Irinotecan Topoisomerase II inhibitors = Etoperside, Teniposide

Answer 336

Binds to tubulin and prevents disassembly of it which also prevents cell division

Answer 337

E.g. Paclitaxal, Docetaxal, Eribulin (doesn’t cause hair loss)

Answer 338

Antifolates - E.g. Methotrexate Pyramidine analogues - E.g. 5-Fluorouracil, Gemcitabine Purine analogues - E.g. 6-mercaptopurine, 6-thioguanine

Answer 339

Bind to specific cell surface proteins expressed in the target tissue. This inhibits the normal activity of the receptor. Stops intracellular signals that drives processes like cell division and angiogenesis.

Answer 340

Bevacizumab (VEGF) = colorectal cancer Trastuzamab = breast cancer… only if the cells express the HER2 protein Rituximab = Hodgkin lymphoma (CD20)

Answer 341

Bind to intracellular domains of a specific cell surface receptor and prevents activation of the intracellular signals that drive cell processes

Answer 342

Imatinib = CML Erlotinib = non-small cell lung cancer Lapatinib = advanced breast cancer

Answer 343

``` ‘ab’ = monoclonal antibodies ‘ib’ = tyrosine kinase receptors ```

Answer 344

They bind to (alkylate) the nucleic acid bases of DNA and produce cellular death unless the damage is repaired

Answer 345

React with only one strand of DNA

Answer 346

React with an atom on both strands of DNA, producing a cross-link that covalently links the two strands of the DNA double helix.

Answer 347

They are enzymes that regulate DNA topology

Answer 348

They are essential for the integrity of the genetic material during transcription, replication, recombination processes.

Answer 349

Found in frontal lobe Involved in planning + programming og skilled movements

Answer 350

A tyrosine kinase inhibitor (TKI) inhibits tyrosine kinases. The proteins are activated by adding a phosphate group to the protein (phosphorylation), a step that TKIs inhibit. TKIs = anticancer drugs. E.g. used in CML

Answer 351

Used in Hodgkin's disease. It's an alkylating agent. An antineoplastic agent used primarily in combination with mechlorethamine, vincristine, and prednisone (the MOPP protocol) in the treatment of Hodgkin's disease.

Answer 352

Hypertrophy

Answer 353

Hyperplasia

Answer 354

Metaplasia

Answer 355

Mitochondria Plasma membrane Ionic channels in cell membranes Cytoskeleton

Answer 356

o Cellular level necrosis: normal, pyknosis, karyolysis, karyorrhexis o Tissue level necrosis: coagulative necrosis, colliquative necrosis, caseating necrosis (unusual form)

Answer 357

Dissolution of cell nucleus Especially during mitosis

Answer 358

Pyknosis, or karyopyknosis, is the irreversible condensation of chromatin in the nucleus of a cell undergoing necrosis or apoptosis.

Answer 359

Karyorrhexis is the destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. It is usually preceded by pyknosis and can occur as a result of either programmed cell death, senescence, or necrosis.

Answer 360

Type IV Cell-mediated Non-Autoimmune

Answer 361

Type III Immune-complex Autoimmune

Answer 362

Type I Anaphylactic Non-Autoimmune

Answer 363

Type II Cytotoxic Autoimmune

Answer 364

Type 2. and 3 Cytotoxic and immune-complex

Answer 365

Type 1 Anaphylactic Non-autoimmune

Answer 366

Type II Cytotoxic Autoimmune

Answer 367

Type IV Cell-mediated Non-Autoimmune

Answer 368

Type III Immune-complex Autoimmune

Answer 369

Mycobacterium | M. leprae

Answer 370

Bordetella B pertussis

Answer 371

``` Bacillus Clostridium Corynebacterium Mycobacterium Staphylococcus Streptococcus ```

Answer 372

Corynebacterium | C. diphtheriae

Answer 373

Acute respiratory tract infections, UTIs

Answer 374

Fingerprints and footpirints

Answer 375

- Increased hydrostatic pressure - Decreased osmotic pressure - Lymphatic obstruction - Sodium retention

Answer 376

Petechiae which is rash like in appearance

Answer 377

Bruises / Ecchymosis

Answer 378

Red blue/green Yelow/brown

Answer 379

Dislodged thrombi (thromboemobolism)

Answer 380

Excess blood in vessels

Answer 381

Congestion is passive Hyperaemia is active

Answer 382

- Aorta (especially abdominal) - Coronary arteries - Carotid - Cerebral - Leg arteries

Answer 383

Acid-fast organisms (mainly mycobacterium); e.g. mycobacterium tuberculosis. Acid-fastnes is a physical property of certain bacteria. They are resistant to decoloursation by acids during staning procedures due to large amounts of lipid substances within their cell walls called mycolic acids.

Answer 384

 Stain w/ crystal violet (CV); CV stain is retained upon washing w/ alcohol in Gr+ due to cell wall biochemistry.  CV washed out; Counterstain Gr- w/ fuchsin (pink)

Answer 385

Gr+ stain blue/purple, thick peptidoglycan layer, teichoic acid present, cytoplasmic membrane

Answer 386

Gr- stain pink/red, thin peptidoglycan layer (periplasm), LPS present, outer + cytoplasmic membrane

Answer 387

Bacteria that have a complex nutritional requirement + will only grow when specific nutrients are available

Answer 388

Transduction A horizontal gene transfer method

Answer 389

Transformation - A horizontal gene transer method

Answer 390

o A cell just needs to grow to twice its starting size + then split in 2 o But, to remain viable + competitive, a bacterium must divide at the right time, in the right place, + must provide each offspring w/ a complete copy of its essential genetic material o Doubling time depends on growth conditions (nutrients available) + vary w/ species o Growth limited by nutrients they need to growth

Answer 391

They are toxin producing pathogens, extracellular

Answer 392

Anti-metabolites that inhibit synthesis of nucleis acid precurors needed

Answer 393

Peptidoglycan in both gram negative and positivebacteria

Answer 394

Target gram +ve organisms because it can’t cross cell wall of gram-ve

Answer 395

Act like detergent on membrane Cytotoxic effects

Answer 396

 Mainly topical usage; upon systemic administration poor distribution in tissues, neurotoxicity + nephrotoxicity

Answer 397

DNA replication (quinolones) mRNA synthesis (rifamycins)

Answer 398

Bacterial 30s ribosome inhibitors Protein synthesis inhibitors

Answer 399

- Tetracyclines - Aminoglycosides - Nitrofurans - Spectinomycin - Streptomycin - Gentamicin

Answer 400

- Macrolides (erythromycin) - Chloramphenicol - Clindamycin - Lincomycin

Answer 401

Quinolones (nalidixic acid, ciprofloxacin) Novobiocin

Answer 402

Bacterial cell wall synthesis

Answer 403

Trimethroprim and Sulfonamides

Answer 404

Conduction/convection - 60% Radiation - 25% Evaporation - 15%

Answer 405

 More stable in the face of environmental stress (acid, temperature, drought)  Spreads more easily  Survives gut, poor water treatment (dehydration)  E.g. rotavirus, norovirus

Answer 406

 Envelop is derived from host membrane (budding)  Must stay wet to remain infectious  Very sensitive to detergents (membrane!)  Spreads through large droplets  Does not need to kill cell to spread (buds)  E.g. HIV, Ebola, influenza virus

Answer 407

HIV, ebola, influenza (enveloped) Rotavirus, norovirus (naked)

Answer 408

Influenza, mumps, measles, rabies, “Ebola”

Answer 409

Poliovirus, dengue, hepatitis C

Answer 410

Norovirus, rotavirus, hepatitis A + E

Answer 411

o Congenital infection: Cytomegalovirus, rubella, parvovirus, B19 o Perinatal: HIV, hepatitis B, herpes simplex

Answer 412

o Nucleotide reverse transcription inhibitors o Non-nucleotide reverse transcription inhibitors o Protease inhibitors o Integrase inhibitors

Answer 413

o KS is a mesenchymal tumour caused by a viral infection of: human herpesvirus 8 (HHV-8) Causes red or purpose patches of abnormal tissue (made of cancer cells, blood vessels, blood) to grow

Answer 414

o A parasitic disease caused by Toxoplasma gondii o In healthy people causes: systemic illness, w/ lymphadenopathy + fever o Immunocompromising people causes CNS infection, abscess, seizure, altered consciousness

Answer 415

Covalently bind to (alkylate) the nucleic acid bases of DNA and produce cellular death unless the damage is repaired

Answer 416

Monofunctional agents react with only one strand of DNA Bifunctional react with an atom on both strands of DNA, producing across-link that covalently links the 2 strands of the DNA double helix

Answer 417

Monofunctional alkylating agent

Answer 418

Topoisomerase inhibitors

Answer 419

Bifunctional alkylating agents

Answer 420

A flatworm, most commonly hostested in a fresh water snail making bathing dangerous in natural lakes.

Answer 421

What does Leishmania parasite cause and what is it mainly spread by?

Answer 422

What does Leishmania parasite cause and what is it mainly spread by?

Answer 423

Toxoplasma

Answer 424

Trichomoniasis is a sexually transmitted infection (STI) caused by a tiny parasite called Trichomonas vaginalis (TV). It's a protozoan

Answer 425

Cryptosporidiosis is a diarrheal disease caused by microscopic parasites, Cryptosporidium. It can live in the intestine of humans and animals and is passed in the stool of an infected person or animal.

Answer 426

Filariasis is a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding black flies and mosquitoes. This disease belongs to the group of diseases called helminthiases.

Answer 427

These are spread by blood-feeding black flies and mosquitoes. This disease belongs to the group of diseases called helminthiases.

Answer 428

An anaerobic parasitic amoebozoa, part of the genus Entamoeba.

Answer 429

Entamoeba histolytica, a protozoan parasite

Answer 430

African trypanosomiasis, also known as sleeping sickness, is an insect-borne parasitic disease of humans and other animals. It is caused by protozoa of the species Trypanosoma brucei.

Answer 431

Chagas disease, also known as American trypanosomiasis, is a tropical parasitic disease caused by the protist Trypanosoma cruzi.

Answer 432

Change of one cell type to another

Answer 433

Metaplasia

Answer 434

Hyperplasia Individual cells growing in size

Answer 435

The enlargement of an organ or tissue from the increase in size of its cells.

Answer 436

The collecting tubules

Answer 437

Controls aquaporins in the reabsorption of. water via V2 receptors.

Answer 438

Hyperplasia involves cell division, hypertrophy does not. Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number.

Answer 439

Leads to alveolar wall destruction

Answer 440

Bronchial dilation

Answer 441

Bronchiectasis

Answer 442

Alveolar filling due to consolidatoin

Answer 443

Facultative pathogen (.e.g Bacillus anthracis - soil bacteria)

Answer 444

Extracellular

Answer 445

C. botulinum C. tetani V. cholera E. coli O157:H7

Answer 446

Salmonella serovar Typhimurium Listeria monocytogenes

Answer 447

Endotoxin - LPS of gram negative bacteria Exotoxins - proteins that are released extracellularly produced by certain Gr+ + Gr- species Enterotoxin - group of exotoxins that act on the small intestine EXTRA* Toxoid - inactivated toxin used as a vaccine

Answer 448

Anti-metabolites

Answer 449

Trimethoprim

Answer 450

Peptidoglycan synthesis needed for bacteria cell walls (of gram positive and negative organisms)

Answer 451

Because they can't cross the cell wall of gram negative organisms

Answer 452

Polymyxins

Answer 453

Mainly topical useage because upon systemic administration they poorly distribute in tissues and leads to neuro- and nephro- toxicity.

Answer 454

Quinolones and rigamycins

Answer 455

DNA replication inhibition (quinolones) mRNA synthesis blocker (rifamycins)

Answer 456

80s (40s and 60s subunits)

Answer 457

70s (30s and 50s subunits)

Answer 458

30s inhibitors

Answer 459

Chloramphenicol Erythromycin (macrolide) Clindamycin Oxazolidinones

Answer 460

Puromycin | Mupirocin

Answer 461

- Resistance relates to sensitivity to antibacterial agent at a certain concentration

Answer 462

Resistant Intermediate Sensitive - Based on MIC (minimum inhibitory concentration of antibacterial agent which bacterial growth is not inhibited

Answer 463

Minimum inhibitory concentration Using strip with a gradient of concentration of drug soaked in it The lowest conc. of the drug where bacteria don't grow is the MIC

Answer 464

Methicillin resistant S. aureus Methicillin is a beta-lactam We use vancomycin to target S. aureus now but there is some vancomycin resistant S. aureus emerging

Answer 465

Temp of internal environment of body, inc. organs and blood

Answer 466

Pyrogens must be present for fever Other than that both are around 38-40 degrees

Answer 467

Hyperpyrexia is 40+ degrees and is life threatening Hyperthermia is 38-40 and not as life threatening

Answer 468

o Fevers are caused by pyrogens flowing in the bloodstream o Pyrogens  hypothalamus + bind to certain receptors in the hypothalamus o PGE2 is released + the set point is altered o PGE2 alters autonomic mechanisms of heat loss + retention to match the new set point o IL-1 (common pyrogen) – produced by macrophages when they come in contact w/ bacteria + viruses  IL-1 signals helper T cells into action

Answer 469

``` Infection Blood transfusion/iatrogenic pyrogens Inflammation Malignancy Hypothalamic insults ```

Answer 470

Altered set point

Answer 471

6am when metabolism is slowest It has a circadian rhythm

Answer 472

Eccrine sweat glands

Answer 473

Arteriolar vasodilation – allows increased blood flow through the artery, this redirects blood into the superficial capillaries in the skin increasing heat loss by convection + conduction

Answer 474

Few specific proteins (enzymes + capsid)

Answer 475

 More stable in the face of environmental stress (acid, temperature, drought)  Spreads more easily  Survives gut, poor water treatment (dehydration)  E.g. rotavirus, norovirus

Answer 476

 Envelop is derived from host membrane (budding)  Must stay wet to remain infectious  Very sensitive to detergents (membrane!)  Spreads through large droplets  Does not need to kill cell to spread (buds)  E.g. HIV, Ebola, influenza virus

Answer 477

The infective viral particle o For non-enveloped viruses (nucleocapsid = the virus particle = virion) o For enveloped viruses (virion = nucleocapsid plus envelope)

Answer 478

+strand mRNA

Answer 479

-mRNA strand (complementary sequence) or DNA

Answer 480

o Attachment = attachment inhibitors o Co-receptor binding = co-receptor inhibitors o Fusion = fusion inhibitors o Viral RNA transcribed to DNA (by RT) = reverse transcriptase inhibitors o Must be cleaned by viral protease enzyme = protease inhibitors

Answer 481

``` Attachment - to host cell Penetration - of host cell Uncoating - capsid falls apart Replication - copying genome and making new viral protein particles Assembly Release ```

Answer 482

Negative single strand RNA Positive single strand RNA Double stranded RNA

Answer 483

Hepadnaviruses have very small genomes of partially double-stranded, partially single stranded circular DNA. Hepadnaviruses replicate through an RNA intermediate (which they transcribe back into cDNA using reverse transcriptase).

Answer 484

Nucleoside analogues Protease inhibtors Fusion inhibitors

Answer 485

Synthetic analogues to block viral receptors (stops them from docking on host cells) Anti-HIV drugs called entry (fusion) inhibitors

Answer 486

Rotaviruses (gastroenteritis)

Answer 487

Poliovirus Dengue Hapatitis C

Answer 488

They are all enveloped | E.g. influenza. mumps, measles, radies, ebola

Answer 489

Aerosol (droplet)

Answer 490

Cytomegalovirus (CMV) | Epstein–Barr virus (EBV)

Answer 491

Cytomegalovirus (CMV) | Epstein–Barr virus (EBV)

Answer 492

Human papillomavirus (HPV)

Answer 493

Epstein–Barr virus (EBV)

Answer 494

Glandular fever | Pneumonia

Answer 495

(human) cytomegalovirus

Answer 496

HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised, such as HIV-infected persons, organ transplant recipients, or newborn infants

Answer 497

HCMV infection is typically unnoticed in healthy people, but can be life-threatening for the immunocompromised, such as HIV-infected persons, organ transplant recipients, or newborn infants

Answer 498

Enterically - ingestion

Answer 499

Norovirus, causes diarrhoea and vomiting, is one of the most common stomach bugs in the UK

Answer 500

Rotavirus - the most common cause of serious diarrhoea and vomiting in young children

Answer 501

HEV is a positive-sense, single-stranded, non enveloped, RNA icosahedral virus. HEV has a fecal-oral transmission route.

Answer 502

Varicella zoster virus - can cause chickenpox and shingles

Answer 503

Herpes simplex virus 1 = HHV-1 - Predominantly orofacial herpes Herpes simplex virus-2 = HHV=2 - Predominantly genital herpes Both stay latent in neurons Both are spread via close contact (oral or sexually transmitted)

Answer 504

HHV-1 = Herpes simplex virus-1 HHV-2 = Herpes simplex virus-1 HHV-3 = Varicella zoster virus HHV-4 = Epstein-Bar virus HHV-5 = Cytimegalovirus HHV-8 = Kaposi's sarcoma-associated herpes-virus

Answer 505

HIV, hepatitis B and C

Answer 506

Percutaneous

Answer 507

It is an informal name used to refer to any viruses that are transmitted by arthropod vectors The word arbovirus is an acronym (ARthropod-BOrne virus)

Answer 508

Type of cytokine (protein)

Answer 509

Viral infections | - they are produced by stimulation of fibroblasts and leukocytes by microbial products

Answer 510

Purulent exudate with dying cells and bacteria and antimicrobial products released by phagocytic cells

Answer 511

- Platelet aggregation + release - Bronchoconstriction + vasoconstriction [high] - Vasodilation + vascular permeability [low] - Increases leukocyte adhesion + chemotaxis - Increases leukocyte degradation / oxidative burst

Answer 512

Consolidation - Neutrophils and red cells enter alveolus - Fluid and cells srpread to adjacent alveoli leading to solidification

Answer 513

Live vaccines (naturally attenuated)

Answer 514

Oral polio, measles, mumps, rubella, yellow fever

Answer 515

Rabies | Influenza

Answer 516

DTP -diphtheria, pertussis (whooping cough), tetanus. | Experimental (malaria, HIV)

Answer 517

Living are cheaper than non-living which can be expensive

Answer 518

A retrovirus – single stranded RNA genome but reverse transcribed into DNA --> which is integrated into hosts genome

Answer 519

- HIV-1 shows typical behaviour of an RNA virus in having high mutation rate, single infections exhibiting the phenomenon of quasispecies (group of viruses related by a similar mutation) - HIV-2 = different HIV strain; it’s less prevalent + less pathogenic, found in West Africa

Answer 520

o KS is a mesenchymal tumour caused by a viral infection of: human herpesvirus 8 (HHV-8) ``` o Causes red or purpose patches of abnormal tissue (made of cancer cells, blood vessels, blood) to grow:  Under skin  In lining of mouth, nose, and throat  In lymph nodes  In other organs ```

Answer 521

Kaposi's sarcoma (HHV-8) CNS toxoplasmosis CMV retinitis Pneumocystis jirovecii pneumonia

Answer 522

 Attacks interstitial, fibrous tissue of lung, marked thickening of alveolar septa + alveoli --> significant hypoxia --> fatal  Lactate dehydrogenase (coverts lactate to pyruvic acid + back) levels increase + gas exchange is compromised  Oxygen is less able to diffuse into the blood --> hypoxia  Hypoxia + high arterial CO2 levels, stimulates hyper-ventilatory effort, thereby causing dyspnea (breathlessness)

Answer 523

Yeast-like pneumocystic iroveii

Answer 524

Lung infection in people with a weak immune system Seehn especially in HIV/ADIS and cancer patients undergoing chemotherapy

Answer 525

o Common virus, asymptomatic usually o Becomes latent in retinal epithelium in immune compromised people and leads to necrosis + bleeding which leads to acute onset of blindness

Answer 526

Polyenes Azoles Echinocandins

Answer 527

Binds to sterols (fatty part) in fungal cell membranes

Answer 528

Nystatin (topical use only) | Amphotericin B - systemic use, very broad spectrum, significant toxicity (renal damage + chills)

Answer 529

Azoles - inhibit lanosterol demetylase which interrupts ergosterol biosynthesis Echinocandins - inhibit glucan synthase which inhibits cell wall synthesis

Answer 530

Older drugs belong to imidazole group - clotrimazole Newer drugs to triazole group = fluconazole

Answer 531

P. falciparum (most virulent), P. vivax, P. ovale, P. malariae.

Answer 532

Quinolones Antifolates Artemisinin compounds

Answer 533

Sporozoites

Answer 534

Quinolones

Answer 535

Anti-folates

Answer 536

Artemisinin compounds (new antimalarials)

Answer 537

African trypanomiasis

Answer 538

T. b. rhodesiense | T. b. gambiense

Answer 539

Tsetse fly

Answer 540

African trypanomiasis

Answer 541

South american = transmitted by a bug (triatomine - a.k.a kissing bug) African - tsetse fly

Answer 542

American trypanosomiasis, is a tropical parasitic disease caused by the protist Trypanosoma cruzi. It is spread mostly by insects known as Triatominae, or "kissing bugs"

Answer 543

Triatomine excretes the parasite in faeces, faeces enter human blood stream via: wound or conjunctiva (eye rubbed)

Answer 544

Cats (faeces) or we can eat cysts in undercooked meat

Answer 545

Pyrimethamine

Answer 546

Pregnant - causes congential toxxoplasmosis leading to abortion, hydrocephalus Mild lymphadenopathy in healthy adults Serious HIV-associated opportunistic infection

Answer 547

Amoebiasis which is often asymptomatic but can cause dysentery and invasive extra-intestinal disease

Answer 548

Tapeworms: cestodes Flukes: trematodes Round worms: nematodes

Answer 549

Mebendazole

Answer 550

Albendazole

Answer 551

Cancer - a disorder of cell cycle (enhancement of activity in any molecule promotes growth or a loss of one that inhibits it)

Answer 552

Cyclin-dependent kinases + their inhibitors

Answer 553

Proto-oncogenes Tumour suppressor genes Genes that control programmed apoptosis DNA repair genes

Answer 554

Proto-oncogenes (RAS, BRAG, KIT) - when they mutate that become oncogenes (e.g. EGFR) Tumour-suppressor genes (p53)

Answer 555

Most cancers are sporadic, a minority 2-3% are inherited

Answer 556

o Breast cancer - BRCA1/2 o Familial adenomatous polyposis - APC gene o Hereditary non-polyposis colorectal cancer (HNPCC) – mismatch repair genes

Answer 557

 Asbestos – lung cancer mesothelioma  Nitrosamines + amides (preservatives) – gastric cancer  Naturally occurring (Aflatoxin B1) – liver cancer  Aromatic amines + azo dyes – liver + bladder cancer

Answer 558

 UV rays – SCC, BCC, melanoma |  Ionising radiation (electromagnetic + particulate) – Leukaemia, Solid organ malignancies (thyroid)

Answer 559

HPV EBV HepB H. pylori

Answer 560

Burkitt lymphoma B-cell lymphoma (IC people) Nasopharyngeal carcinoma Hodgkin lymphoma

Answer 561

Oncogenic DNA virus that interacts with cell cycle proteins pRb and p53 (tumour suppressor genes)

Answer 562

Hepatitis B

Answer 563

Gastric lymphoma, Gastric carcinoma

Answer 564

Reversible transformation of one type of mature fully differentiated cell into a different fully differentiated cell type

Answer 565

Squamous metaplasia | Glandular metaplasia

Answer 566

Happens in ducts (salivary, pancreas – presence of stones) that are chronically inflamed

Answer 567

 In oesophagus, squamous-lined to columnar-lined w/ goblet cells (Barrett’s oesophagus)  Patients go through biopsies to catch early signs of cancer

Answer 568

o Disordered growth o Cells undergo morphological transformation o Loss of architectural relationship between cells o Increased cell division o Incomplete maturation (or loss of differentiation)

Answer 569

Tumour containing elements of all 3 embryological germ cell layers Gonads

Answer 570

Leukaemias

Answer 571

Chronic inflammatory itchy skin condition which has a genetic component

Answer 572

Basal epidermis

Answer 573

Deposit melanin from melanosomes over nuclei of basal cells The melanin forms a barrier over basal cell nuclei

Answer 574

Langerhans cells

Answer 575

Found in basal epidermis Store serotonin which they release from associated nerve endings in response to pressure

Answer 576

Impetigo, Boils, Cellulitis, Folliculitis

Answer 577

Throat + skin

Answer 578

Basal cell carcinoma - best to have Squamous cell carcinoma

Answer 579

* Asymmetrical shape* * Border irregularity * Colour irregularity* * Diameter >6mm * Evolution* (e.g. change in size/shape) * Symptoms (e.g. bleeding, itchy)

Answer 580

 UV sunlight – skin cancer (CC to TT pyrimidine dimers)  Aflatoxin B1 in diet – liver cancer (codon 249 AGG to AGT)  Benzo(a)pyrene in tobacco smoke – lung cancer (hotspot codons 157, 248, 273)

Answer 581

A. Scaling

Answer 582

C. Erosion

Answer 583

E. Bruising

Answer 584

1: Obligate aerobes need oxygen because they cannot ferment or respire anaerobically. 2: Obligate anaerobes are poisoned by oxygen. 3: Facultative anaerobes can grow with or without oxygen because they can metabolise energy aerobically or anaerobically. Aerobic respiration generates more ATP than either fermentation or anaerobic respiration. 4: Microaerophiles need oxygen because they cannot ferment or respire anaerobically. However, they are poisoned by high concentrations of oxygen. 5: Aerotolerant organisms do not require oxygen as they metabolise energy anaerobically. Unlike obligate anaerobes however, they are not poisoned by oxygen.

Answer 585

``` -ssRNA : My Mum Is Right Measles Mumps Influenza Rubella ``` +ssRNA: He Parked Diagonally Hep C Polio Dengue

Answer 586

Gram negative Endotoxin = the glycoproteins on the LPS Gram positive doesn't a have LPS

Answer 587

Staging is a way of describing or classifying a cancer based on the extent of cancer in the body. The stage is often based on the size of the tumour, whether the cancer has spread (metastasized) from where it started to other parts of the body and where it has spread. Stages are based on specific factors for each type of cancer. (TNM staging system – T = Tumor; N = node involvement and M = metastastic spread) Grading is a way of classifying cancer cells. The pathologist gives the cancer a grade based on how different they look from normal cells (differentiation), how quickly they are growing and dividing, and how likely they are to spread. (How aggressive is the cancer?)

Answer 588

Hib (Haemophilus influenzae type b) disease Hepatitis B HPV (Human papillomavirus) Whooping cough (part of the DTaP) Pneumococcal disease Meningococcal disease Shingles