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Flashcards in Block 1 Deck (268):
1

Study of disease. Especially changes in cells/tissues/organs that cause or are caused by disease

Pathology

2

Functional changes associated with disease

Pathophysiology

3

This is the where and when of disease. The disease occurrence and spread.

Epidemiology

4

Underlying cause of disease

Etiology

5

Disease comes from an infection

Infectious

6

You don't know what caused the disease

Idiopathic

7

Treatment of another disease caused the disease

Iatrogenic

8

Disease acquired from a hospital

Nosocomial

9

Something that you as a doctor measure

Sign

10

Things the patient tells you

Symptom

11

Rapid onset and short duration - not necessarily severe but some can turn chronic over time

Acute

12

Disease that lasts for a long duration - longer than 3 months

Chronic

13

___ of 10 chronic diseases we can prevent and cure

7

14

What type of diseases are the biggest killers in the U.S?

Chronic diseases

15

Poorly defined time between acute and chronic

Subacute

16

Things form the outside that attack and cause disease

Extrinsic factors

17

Micro organisms and parasites

Biological agents

18

Any chemical that can cause harm

Chemical agents

19

Mechanical injury, temperature extremes, electricity, radiation

Physical agents

20

Excess or deficiency type of extrinsic factor

Nutritional imbalances

21

Things from the inside of our bodies

Intrinsic factors

22

Inherited gene or chromosomal mutation
- Down's - trisomy 21 - non disjunction in meiosis

Genetic factor

23

Defects in embryological development

Congenital factors

24

Immune deficiency, misdirection, or autoimmunity

Immunological factors

25

Anxiety, strong or persistent psychological stress

Psychological factors

26

Genetic, congenital, immunological, psychological. These types of factors are called:

Intrinsic factors

27

Biological, chemical, physical, and nutritional imbalances. These types of factors are called:

Extrinsic factors

28

This is the phase of disease when no signs or symptoms are present. It is silent.

Latency

29

This stage of disease is when there are flu-like symptoms. It is hard to separate symptoms from other diseases

Prodrome

30

This is the phase of disease when there are very classical symptoms and it is more easily diagnosable.

Clinical symptoms

31

What is incomplete recovery from a disease?

Stuck with something chronic

32

What are the top chronic disease killers for Americans?

1. Heart Disease
2. Cancer
3. Stroke
4. Type 2 Diabetes
5. Obesity

33

Which 2 chronic diseases make up 46% of the top killers of Americans?

Heart disease and cancer

34

What are lifestyle factors that lead to chronic disease?

Lack of physical activity
Diet
Obesity
Stress
Pace of life
Alcohol consumption
Smoking and tobacco use

35

This is any chemical that can cause harm to the body. Airborne pollutants, contaminants in food/water, human waste products, heavy metals, fire

Chemical agents

36

These are any non-chemical, non-biological agents that cause disease. Outside the body that are denaturing or damaging. Electromagnetic radiation, vibration, heat stress, mechanical force

Physical agents

37

These are any foreign pathogenic organism. Bacteria, viruses, fungi, protozoan

Biological agents

38

The three categories of endogenous causes of disease are:
A. Microbiological, immunological, metabolic
B. Physical, vascular, metabolic
C. Metabolic, immunologic, vascular
D. Chemical, microbiological, vascular

C.

39

Study of factors affecting occurrence of chronic and infectious disease?

Epidemiology

40

How do you determine the rate of health-related events in a population?

Actual cases / potential cases

41

What are potential cases?

The people who are at risk for a particular disease. They DON'T already have it

42

What is horizontal transmission of disease?

Person to person, could be direct or indirect

43

What is vertical transmission of disease?

Type of direct transmission

To offspring in utero, during birth, through colostrum or suckled milk

44

To monitor and calculate expected frequency so that abrupt changes in frequency can be observed

Surveillance

45

The number of NEW cases of an infectious disease within a defined population over a defined period of time

Incidence

46

The number of ACTIVE cases at any given time

Prevalence

47

A disease that has a relatively stable and expected incidence and prevalence within a geography area

Endemic disease

48

And abrupt and unexpected increase in the incidence of disease over endemic rates

Epidemic

49

Spread of disease beyond continental boundaries

Pandemic

50

Death/illnesses

Mortality/morbidity

51

What happens if a new effective treatment is initiated?

Incidence stays the same
Prevalence drops

52

What happens if a new effective vaccine gains widespread use?

Incidence drops
Prevalence drops

53

What happens if the number of deaths from the condition declines?

Incidence stays the same
Prevalence increases

54

What happens if recovery is more rapid than it was 1 year ago?

Incidence stays the same
Prevalence decreases

55

What is a cross sectional study and what does it measure?

It is the status of something at a snapshot

It measures disease prevalence

56

What is a case-control study? And what does it measure?

It compares a group of people with the disease to a group with disease

Looks for prior exposure or risk factor

Odds ratio

Starts with disease

57

What is a cohort study and what does it measure?

It looks to see if exposure affects the likelihood of disease

Starts with exposure

58

This is typically used in case-control studies. It is the chance that a group with the disease (cases) was exposed to a risk factor divided by the chance a group without the disease (controls) was exposed

Odds ratio

59

This is typically used in cohort studies. Risk of developing disease in the exposed group divided by the risk in the unexposed group

Relative risk

60

What does it mean for the odds ratio and relative risk if prevalence is LOW?

They are practically equal and interchangeable

61

Which measurements are about the DISEASE?

Sensitivity and Specificity

62

Which measurements are about the TEST?

Positive and negative predictive values

63

What does true positive mean?

Sick and test sick

64

What does false positive mean?

Healthy and test sick

65

What does true negative mean?

Healthy and test healthy

66

What does false negative mean?

Sick and test healthy

67

This is the likelihood that a sick person tests positive

Sensitivity


Think: Needs treatment b/c they are sick

68

This is the likelihood that a non-sick person tests negative.

Specificity

69

This is the likelihood that a positive test is found only in sick people

Positive predictive value

70

Likelihood that a negative test is found only in non-sick people

Negative predictive value

71

TP/(TP+FN)

Sensitivity

Everyone that is sick

72

TN/(TN+FP)

Specificity

Everyone that is healthy

73

TP/(TP+FP)

Positive predictive value

Everyone positive

74

TN/(FN+TN)

Negative predictive value

Everyone negative

75

Prevalence has a huge impact on _______?

Positive predictive value!

76

What does +/- 2 standard deviations cover?

It is a range that covers 95% of the healthy population

77

What does 1 standard deviation cover?

68% of the healthy population

78

As far as percentage of normal standard deviations, why is there an occasional test result from a healthy person that falls into the high or low side of normal?

Age
Gender
Geographical location

79

What 2 numbers have to be low to be considered anemic?

HGB (hemoglobin)
HCT (hematocrit - packed red blood cell volume)

80

Why would a person in Denver have higher HGB range than a person in dallas?

It higher b/c of elevation and less oxygen available

81

What does glucose/HgA1c levels tell you?

Diabetes

82

What do calcium levels tell you?

If they are increased without any other explanation - cancer (typically lung cancer)

83

What do electrolyte readings tell you?

Involved with blood pressure and metabolism

84

What do kidney tests (BUN/creatinine) tell you?

Renal function

85

What do ALT, AST, ALP, bilirubin levels tell you?

Injury vs. function of liver

86

What is the most specific test for heart injury?

Troponin

87

What is the threshold of FASTING levels for diabetes?

126 mg/dL or higher

88

What is the random blood sugar reading needed to diagnose diabetes?

200

89

What is the gold standard percentage for diagnosing diabetes?

Hemoglobin A1c of 6.5% or higher

90

What is normal hemoglobin A1c reading?

Less than 5.7%

91

What precedes diabetes?

Obesity

92

What is the best liver damage enzyme? And where is it found?

ALT! In the hepatocytes

Also AST is good too, but ALT is best

93

Which comes first, liver damage or loss of function?

Liver damage! Then loss of function

94

What is the best test for loss of liver function?

Bilirubin!

95

What are 2 things important for blood pressure?

Sodium and albumin

96

Identify the blood test that best supports liver failure?
A. Rising ALT and AST levels
B. Dropping ALT and AST levels
C. Rising Bilirubin levels
D. Dropping Bilirubin levels

C.

97

Which levels estimate glomerular filtration rate?

BUN and creatinine

98

What does doubling serum creatinine levels do?

Halves glomerular filtration rate (GFR)

99

If creatinine levels are 1, what is kidney function?

100%

100

If creatinine levels are 2, what is kidney function?

50%

101

If creatinine levels are 4, what is kidney function?

25%

102

If GFR/clearance are less than 30 ml/min?

30% kidney function! See a nephrologist

103

If GRF/creatinine is less than 15 ml/min?

15% kidney function - dialysis or transplant!

104

Why are BUN levels not as reliable as creatinine?

BUN is impacted by diet so it fluctuates a lot

105

If you damage muscle, what is released?

Myoglobin!

106

What is one of the EARLIEST signs of heart attack?

Myoglobin levels high

107

What is the most specific test for heart attack?

Troponin - proteins found in heart muscle only

108

What is the goal level of total cholesterol?

Less than 200mg/dL

MUST be drawn fasting!

109

What is the max level of total cholesterol?

Over 240mg/dL - bad news, lipid lowering drugs

110

What is the high-density lipoprotein cholesterol (HDL-C)?

This is the good cholesterol - it transports cholesterol to liver (away from vessels)

111

What is the goal level for HDL-C?

Greater than 40mg/dL

112

What is low-density lipoprotein cholesterol (LDL-C)?

Bad cholesterol - deposits cholesterol into vascular walls

113

What is the goal level for LDL-C?

Less than 100mg/dL

114

Which lipid is NOT affected very much by fasting?

Cholesterols

115

Which lipid is hugely affected by fasting?

Triglycerides

116

What is the goal level for triglycerides?

Less than 150mg/dL

117

What is the high level of triglycerides (over 500 mg/dL) associated with?

Pancreatitis

118

What does the Comprehensive Metabolic Panel (CMP) have that the Basic Metabolic Panel (BMP) doesn't have?

CMP has liver function!

119

Where is ALP located?

Ducts of liver

120

Where is ALT and AST located and what do they measure?

In hepatocytes

Measure liver damage!

121

What does Bilirubin test for?

Liver FUNCTION!

122

What do hemoglobin (HBG) and Hematocrit (HCT) test for?

Best test for anemia!!

Both need to be low to diagnose though

123

After diagnosed with anemia, what is the primary test for what TYPE of anemia it is?

MCV - it determines how big the RBCs are

124

What is the ESR?

How fast RBCs settle out in a tube (mm per hour)

Normal is 20mm/hr or less

125

What do the ESR and CRP test for?

They are indicators of inflammation!

126

What do high ESRs suggest?

Inflammation!

127

What happens after inflammation?

IL-6 causes liver to produce fibrinogen. Fibrinogen sticks to RBCs and those precipitate out faster

NOT specific to disease - it detects any sort of inflammation

128

What are the vit. K dependent factors?

II, VII, IX, X

129

Which of the factors is ultra dependent on vitamin K?

VII!!

The others are only kinda dependent

130

What is the intrinsic pathway?

Activated by naked collagen

Factor IX!

131

What is the extrinsic pathway?

Cell explodes causing path to start

Factor VII!

132

What factor is the common pathway?

X!!

133

What factor does Warfarin (Coumadin) target?

Targets VII big time! Shuts it down

134

What factor does Heparin target?

X big time!! (Technically prevents Xa, not just X alone)

Also II, but not as big

135

What must happen in order to form a clot?

Fibrinogen must be converted to Fribrin

It must be tightly regulated for safety reasons

136

What does PTT monitor?

Heparin!!

137

What does PT monitor?

Coumadin!

Helps watch VII!

138

Why is VII affected by PT?

VII has a short half life which causes it to be affected

139

What is the most common bleeding disorder?
Which factor is absent?
What is used to monitor?

Hemophilia A

Factor VIII is absent!

Use PTT to monitor!

140

How is PT measured?

It is a ratio= patient clot time/average clot time

It monitors warfarin/Coumadin therapy and liver function

141

What is the target PT range for deep vein thrombosis prophylaxis?

2.0 - 3.0

142

What is the target PT range for mechanical heart valve?

2.5 - 3.5

143

The term for high WBC count is?

Leukocytosis

144

The term for low WBC count?

Leukopenia

145

What is happening if there is an elevation of WBC?

Infection

146

What type of infection causes high neutrophils?

Bacterial infection

147

What type of infection causes high lymphocytes?

Viral

148

What is the significance of PMNs, Segs, BANs, Myelos?

Add them all together to get total neutrophil count

149

What type of infection does eosinophilia suggest?

Allergies or worms

150

What is something that you should keep in mind if patient is either very high or very low WBC count?

Leukemia

151

What is the HGB x3 rule?

This formula tell you what the hematocrit level is

OR take HCT/3 to get HGB

152

What is a trademark of Polycythemia Vera?

High HCT, HGB, and high RBC count

153

What should the RBC be in anemic patients?

It's NOT always low! It could be normal or high

154

What is the HGB criteria for anemia in women?

Less than 12 g/dL

155

What is the HGB criteria for anemia in men?

Less than 13.5 g/dL

156

At what level should you start thinking about transfusing in anemia?

10 g/dL

157

What what level do you need to transfuse for anemia?

7 g/dL

158

What is MCV?

The mean corpuscular volume - the average RBC size - common anemia classification

159

What is microcytic anemia?

Most common in the world!

Iron-deficiency anemia - tiny RBCs but usually high or normal RBC count

MCV less than 80

160

What is macrocytic anemia?

Vitamin B12 deficiency and folic acid deficiency

Cell volume is huge but low RBC count

MCV greater than 110

161

What antigen/antibody indicates current or recent infection? (Acute)

IgM

162

What antigen/antibody indicates past infection?

IgG

163

What is the most common syphilis screen?

RPR
Also VDRL

It must be followed by either FTA-ABS or MHA-TP

Sensitive but NOT specific

Syphilis you can't culture it because it's too tiny to see on a gram stain

164

What does ANA screen for?

Autoimmune antibodies

Lupus erythematosus (SLE) - 95% of time

Scleroderma - 60-90% of time

165

If we suspect lupus what do we do?

Screen with ANA

Confirm with anti-dsDNA and Anti-Sm

166

What is the best test to run for UTI?

Leukocyte esterase

167

What are 3 things that show up in urinalysis with a UTI?

Blood, Nitrite, Protein

168

When interpreting a urinalysis, how will you know if someone is on a low carb diet?

Ketones in urine

Previous was a starvation marker, but burning fats = ketone spike

169

What will urinalysis look like for uncontrolled diabetes?

Glucose will be in urine

Uncontrolled diabetes causes blood glucose to go above kidneys ability to reabsorb it so it ends up in urine

170

How do you determine if liver function is improving, worsening, or staying the same?

If ALT/AST/BILI are going up, liver damage is worsening

If they go down it is improving

If they stay unchanged, it may mean the damage is unchanged

171

When do providers become concerned with fatigue?

If it is persistent fatigue - may include psychological or physical causes (depression, anxiety, substance abuse)

172

What is the virus that causes chronic fatigue?

Epstein Barr virus

173

When do clinicians become concerned about weight loss?

Unintentional - may indicate serious physical or psychological issues (depression, anorexia, bulemia, stress, anxiety)

174

What is the threshold for a low grade fever?

Less than 101

175

What is a moderate fever?

102

176

What is a high grade fever?

103 or higher - treatment! Proteins could start to denature

177

What is a high fever in newborns and infants?

99 or above

178

What are 2 proinflammatory cytokines that drive fever?

IL-1 and TNFalpha

179

What is the prostaglandin that drives fever?

PGE2

180

What is the ANTI inflammatory cytokines?

IL-4

181

What are the 3 criteria used to define fever of unknown origin (FUO)?

Illness at least 3 weeks in duration
Temp of 101 on several occasions
Failure to diagnose after 3 outpatient visits or 3 days of hospitalization

182

What are the top 3 causes of FUOs?

Infections (30-40%)
Neoplasms (20-30%)
Autoimmune disorders (10-20%)

183

Which of the causes of FUO will linger if not treated?

Autoimmune disorder - the others will eventually clear on their own and fever will go down if not diagnosed

184

Which headache alarms always indicate serious etiology?

Visual loss
Disequilibrium
Confusion or lethargy
New onset seizure

185

What is claudication?

Pain produced by a lack of blood flow - usually in the jaw

186

What is GCA?

Giant Cell Arteritis - Medium to large vessels that become inflamed and modular - cause claudication - usually in the jaw

187

What is thunderclap headache?

Sudden severe headache

188

What are migraines?

Pain that is throbbing or pulsing
Evolves - keeps getting worse
Typically last 4-72 hours!

189

Who is afflicted by migraines?

Young women (20-30 years old)

190

What is a tension head ache?

Band-like distribution with varying intensities

Occur late in the day on weekdays

Last 30 minutes to 1 week

191

Who is afflicted by tension headaches?

All ages, both genders

192

What is a cluster headache?

Unilateral - orbital or temporal

Wake people up!!

Present with red eyes and/or nasal stuffiness

May cause transient or permanent ipsilateral Horner's syndrome!

Maybe abnormal pupil size

193

Who is afflicted by cluster headaches?

Middle aged men (30-50 years old)

194

What is temporal arteritis/GCA?

MEDICAL EMERGENCY!

Pain in temporal scalp area, jabbing neck pain, jaw claudication, and fever

Ischemic optic neuropathy may occur is not treated

195

What should you do if GCA is suspected?

Get on steroids (prednisone) immediately!!

196

Who is affected by GCA?

Patients over 60

197

Do brain tumors cause headaches?

Yes!
Occur in all ages
Interrupts sleep, causes nausea, vomiting, and visual changes - steadily becomes more severe

Tend to be worse in the morning

Likely to produce one or more physical symptoms and one or more neurological deficit - less that 1% don't do this

198

What does FAST mean?

Use tactic when you encounter someone with a STROKE!!

199

What does the F in FAST stand for?

Face - is face paralyzed - does their smile seem even or does one side droop

200

What does A in FAST stand for?

Arms - can they hold them both out and parallel to the ground or will one drop

201

What does S in FAST stand for?

Speech - is their speech slurred

202

What does T in FAST stand for?

Time - very critical get them to a hospital immediately

After 3 hours, they will have permanent damage

203

What are 4 mechanisms of cell injury?

Free radical formation, Hypoxia, disruption of intracellular Ca, and membrane damage

204

What is the role of free radical injury in diabetes-related complications?

Oxidative stress from free radicals results in modifications of proteins, which is the key to multiple diabetes related complications

205

What are the fat soluble vitamins?

D, A, K, E

206

How are free-radicals produced?

It is oxidative damage caused by glucose oxidizing

207

What causes glucose to oxidize?

Hyperglycemia (high blood sugar) via diabetes

208

What happens when proteins are oxidatively modified?

Immunologic component - trigger systemic inflammation

Structural component - impact normal function

209

Hypoxia (not enough oxygen for cells to work properly) causes a depletion of ATP. What are the effects?

Na+/K+ pump and protein synthesis disrupted

210

What does it mean if we see large amounts of lactic acid?

Significant damage to body - the body is under stress

211

What does the activation of ATPases, Phosphatases, proteases, and endonucleases cause?

Disrupts calcium homeostasis - causes cellular destruction

212

What does cytoskeleton damage, increased cytosolic Ca+, and reactive oxygen species cause?

Membrane damage

213

What are the five mechanisms that cause membrane damage?

Increased cytosolic Ca+
Loss of membrane phospholipids
Cytoskeleton damage
Reactive oxygen species
Lipid breakdown products

214

What is neoplasia?

Cancer - can't revert cells back to normal

215

This is shrinkage in the size of the cell

Atrophy

216

What is atrophy due to?

Lack of use, loss of innervation, diminished blood flow, inadequate nutrition, loss of endocrine stimulation, aging, pressure

217

This is when cells increase in size, but not in numbers.

Hypertrophy

218

What causes hypertrophy?

Increased functional demand or specific hormonal stimulation

Ex. Physiologic - body builders, breasts during pregnancy and lactation

Ex. Pathological - heart due to faulty valves

219

This is an increase in the number of cells, usually results in increased tissue volume

Hyperplasia

220

What is a physiologic example of hyperplasia?

Hormonal - uterine and breasts growth during pregnancy

Compensatory - connective tissue in wound healing

221

What is a pathologic example of hyperplasia?

Growth factors - benign prostatic hyperplasia - may give rise to cancerous proliferation

222

This is when one mature cell type is replaced by another mature cell type - it is REVERSIBLE

Metaplasia

223

This is the abnormal cell growth of a specific tissue that results in cells that vary in size, shape, and organization. It is strong implicated as a precursor of cancer

Dysplasia

224

What is cervix dysphasia most commonly caused by?

HPV! - its a concern because it can lead to neoplasia

225

Which image is least valuable for visualizing soft tissue?

X-ray

226

What is the most common precursor for cancer?

Dysplasia

227

What is the most toxic vitamin?

Vit. A!

Don't eat polar bear liver!

228

What vitamins are toxic but will just make you sick?

Vit E and D

229

Which vitamin will cause kidney stones?

Vit C

230

What is a Xanthoma?

Yellow translucent growth caused by CHOLESTEROL accumulations

231

What type of product is a xanthoma?

Endogenous

232

What is the buildup of substances that cells cannot immediately use or dispose of?

Intracellular accumulations

233

What are the 2 categories of intracellular accumulations?

Endogenous products or exogenous products

234

These are normal body substances present in abnormally large amounts? (Lipids, proteins, carbs, bilirubin)

They are also abnormal products from the inside of the body (inborn errors of metabolism)

Endogenous products

235

These are environmental agents and pigments (eat too many carrots get orange tint to skin)

Exogenous products

236

What is hepatitis?

LIVER inflammation

Bilirubin concentration increases

Jaundice in all body tissues

Protein production stops

237

What can be induced by acetaminophen?

Hepatitis!!

Symptoms include jaundice

Acetaminophen is toxic to the liver at high doses

238

What is Wilson's disease?

Damage to the liver - the copper binding protein is NOT produced.

It often present with psychiatric episodes and Kayser-Fleischer rings

Give zinc to remove excess copper

239

What is the earliest sign of Wilson's disease?

Kayser-fleischer rings

Accumulates copper in Descemet's around the iris

240

Is Wilson's disease endogenous or exogenous?

Endogenous!

241

What is an example of exogenous accumulations?

Argyria! From ionic silver in high doses

242

What is Argyria?

Permanent blue discoloration of the skin due to ionic silver

243

What is necrosis?

UNCONTROLLED! The messy lysis of dead cells

HUGE inflammation!

244

When you perform surgery, which type of cell death do you NOT want?

Necrosis - it inhibits healing

245

What is apoptosis?

PROGRAMMED cell death

NO inflammation!

The cytoplasmic membrane blebs

Pyknotic - shrinking, clumping, and pinching off

246

Which cell death involves cell shrinking?

Apoptosis

247

Which cell death involves cells swelling?

Necrosis

248

Why are CKMB and troponin levels elevated following an MI?

The cells are bursting (necrosis)

249

What happens to the organelles in Apoptosis?

They shrink and stay intact until phagocitized

250

What happens to the organelles in Necrosis?

They swell and blow apart with everything else inside the cell

251

This is when necrosis produces inflammation, and inflamed vessels leak fluid and cells making pus.

Exudates

252

What is the protein concentration of an exudate?

The protein levels are very high!

They appear cloudy in a tube because of lots of protein precipitate

253

This is when fluid is pushed through capillaries due to high pressure.

Transudate

It just forces out the fluid, the proteins stay trapped inside

254

Predict the protein concentration of a transudate.

Protein levels are very low

The tube would be clear - no precipitate

255

In acute inflammation, what are the fundamental cells involved?

Neutrophils! TONS involved because of the inflammation


Also but less important, mast cells, platelets, basophils

256

In chronic inflammation, what are the fundamental cells involved?

B and T lymphocytes
Macrophages

Plasma cells and antibodies

257

What are granulomas a sign of?

Chronic inflammation!

258

What are granulomas?

A core made of dead material and macrophages (epithelioid cells) surrounded by a rim of lymphocytes just one cell thick!

259

What are epithelioid cells?

Active macrophages at the center of a granulomas

260

What are the first apparent cellular changes in apoptosis?

Shrinking

261

What are the first apparent cellular changes in necrosis?

Swelling

262

What are the cell membrane changes in apoptosis vs necrosis?

Apoptosis:
Surface protrusions resulting in blebs

Necrosis:
Membrane smoothing, lysis, causing inflammation

263

What are the nuclear changes in apoptosis vs. necrosis?

Apoptosis: condensation, segmentation, DNA fragmentation

Necrosis:
None

264

What are mitochondrial changes in apoptosis vs. necrosis?

Apoptosis:
None

Necrosis:
Swelling

265

What are cellular mechanisms of aging?

Cross-linking DNA and proteins

Telomere shortening - end piece of genetic cells - our biological clock

266

What is Werner's Syndrome?
What is another name for them?

It is early signs of aging.
Also called Pangeria

267

What are other aging changes?

Dementia
Loss of lens elasticity - opacity - vision

268

What are negative factors that affect aging?

Stress, infections, diseases, malnutrition, accidents, toxins