HWD Final Exam Flashcards
(122 cards)
1
Q
What are five (5) points from 2015 Dietary Guidelines?
A
- Follow healthy eating pattern across lifespan
- Focus on (a) variety (b) nutrient density and (c) amount
- Limit calories from (a) added sugars (b) saturated fats (c) and reduce sodium
- Shift to healthier food and beverage choices
- Support healthy eating patterns for all people
2
Q
What are five (5) points from 2015 Dietary Guidelines?
A
- Follow healthy eating pattern across lifespan
- Focus on (a) variety (b) nutrient density and (c) amount
- Limit calories from (a) added sugars (b) saturated fats (c) and reduce sodium
- Shift to healthier food and beverage choices
- Support healthy eating patterns for all people
3
Q
What are three (3) dietary principles of healthy eating patterns?
A
- An eating pattern is totality of all foods and beverages consumed
- Nutritional needs should be met primarily from foods.
- Healthy eating patterns are adaptable.
4
Q
What are five (5) groups of foods that constitute a diet with variety?
A
- Fruits [whole fruits]
- Grains [at least half whole grains]
- Fat-free or low-fat dairy
- Protein foods [sea food, lean meats, poultry, eggs]
- Oils
5
Q
What is the specific limit on calories from added sugars?
A
6
Q
What is the specific limit on calories from saturated fats?
A
7
Q
What is the specific limit on sodium?
A
8
Q
What are two measurements used for energy control?
A
- Nutrient density (mass per kcal)
2. Energy density (kcal per volume or mass)
9
Q
What are five (5) groups of foods that constitute a diet with variety?
A
- Fruits [whole fruits]
- Grains [at least half whole grains]
- Fat-free or low-fat dairy
- Protein foods [sea food, lean meats, poultry, eggs]
- Oils
10
Q
What is the specific limit on calories from added sugars?
A
11
Q
What is the specific limit on calories from saturated fats?
A
12
Q
What is the specific limit on sodium?
A
13
Q
What are five (5) principles of diet planning?
A
- Adequacy
- Balance
- Moderation
- Variety
- Energy (calorie) control
14
Q
What are two measurements used for energy control?
A
- Nutrient density (mass per kcal)
2. Energy density (kcal per volume or mass)
15
Q
Define pharmacogenetics
A
Study of association between a single gene and drug effects
16
Q
Define pharmacogenomics
A
Study focused on multiple genes contribution to drug effects
17
Q
Define gene
A
DNA sequence that contains information to make a protein
18
Q
Define locus
A
position on a chromosome where a gene resides.
19
Q
Define genome
A
complete DNA sequence of an organism that contains all of its genetic information
20
Q
Define proteome
A
Complete set of proteins encoded by genome of an organism
21
Q
Define proteomics
A
Technology that analyzes the quantitative changes of the protein content of a cell, tissue or body fluid
22
Q
Define autosomes
A
all of the chromosomes except sex chromosomes
23
Q
Define sex chromosomes
A
X and Y chromosomes
24
Q
Define allele
A
One of the variant forms of a gene at a particular location on a chromosome
25
What is the difference between a dominant and recessive allele?
Level of expression
26
Define homozygous
Having identical alleles at a given locus
27
Define heterozygous
Having different alleles at a given locus
28
Define genotype
Internally coded, heritable information (combination of all alleles)
29
Define phenotype
The observable manifestation of a genotype
30
Define haplotype
A set of alleles that tend to be inherited together as a unit
31
Describe structure of a nucleotide
1. Purine or pyramidine (nitrogenous base)
2. Sugar
3. Phosphoric group
32
Define codon
A set of three consecutive nucleotides that provides genetic information to code of a specific amino acid
33
Define messenger RNA
RNA that serves as a template for protein synthesis
34
Define genomic DNA
All DNA from an individual person (both introns and exons)
35
Define complementary DNA
DNA that is synthesized from a messenger RNA using reverse transcriptase
36
Define transcription
The synthesis of a single-stranded RNA molecule from a double stranded DNA template in the cell nucleus
37
What enzyme catalyzes transcription?
RNA polymerase
38
Define translation
Process of synthesizing a polypeptide from an RNA template
39
What are four (4) examples of genetic polymorphisms?
1. Nucleotide repeats (VNTR: Variable Number of Tandem Repeats)
2. Deletions
3. Insertions
4. Mutations (may be silent or not)
40
What are two types of sites in an intron?
1. Regulatory regions
| 2. Splice sites
41
Define exon
The segment of DNA that is part of a gene and codes for amino acids, polypeptides or entire proteins
42
Define mutation
any permanent heritable change in the sequence of genomic DNA
43
Define Sequence Tagged Sites
any piece of DNA designed for PCR assay that can test DNA sample for its presence
44
Define genetic polymorphism
a condition in which one of two different but normal nucleotide sequences can exist at a particular site in DNA
45
What are four (4) examples of genetic polymorphisms?
1. Nucleotide repeats (VNTR: Variable Number of Tandem Repeats)
2. Deletions
3. Insertions
4. Mutations (may be silent or
46
What is the Polymerase Chain Reaction (PCR)?
Laboratory method for amplifying (
47
What are two types of DNA markers
1. Expressed Sequence Tags
| 2. Sequence Tagged Sites
48
Define Expressed Sequence Tags
Short cDNA sequence used for identifying regions of DNA
49
What is an advantage and disadvantage of genotyping?
Adv: (1)Less expensive and (2) requires only a single sample
Dis: (1) Not sufficient for multifactorial conditions, and (2) data is complex.
50
Define Single Nucleotide Polymorphisms (SNPs) (3 components)
1. Single base subtitution
2. Most common type of polymorphism
3. Can be well-tolerated OR disease risk factor
51
What is the goal of pharmacogenetics application?
Ability to identify polymorphisms that alter drug concentrations or response to medication
52
Define phenotyping
Finding an observable biochemical measure that gives end results of pharmacogenetic differences between people.
53
Define genotyping
Finding a specific genetic code that gives main reason for pharmacogentic differences between people.
54
What are six benefits of pharmacogenomics?
1. Improved medications (better targeting)
2. Safer drugs (analyze patient profile)
3. Improved determination of proper dose
4. Advanced screening of disease
5. Advancements in drug discovery
6. Decreased health care cost (prevent ADR, decrease therapy duration, decrease # of failed trials)
55
What are six (6) drug treatment protocols pharmacogenomics can impact?
1. Oncology
2. Cardiology
3. Psychiatry diseases
4. Asthma
5. Cystic Fibrosis
6. Diabetes
56
What are three causes of inter-individual variation in drug treatment?
1. Drug metabolism
2. Drug targets
3. Drug transporters
57
What is an example of an adverse reaction caused by drug metabolism polymorphism?
Mercaptopurine toxicity can be linked to Thiopurine methyltransferase deficiency (TPMT)
58
What is an example of an adverse drug reaction caused by drug target polymorphism?
Drug induced tardive dyskinesia can be linked to Dopamine D3 receptor polymorphism changing sensitivity.
59
What role do drug transporters have in pharmacokinetics?
1. Expressed predominantly in liver, intestines and kidney
| 2. Important determinants of drug absorption, distribution and excretion
60
What are six benefits of pharmacogenomics?
1. Improved medications (better targeting)
2. Safer drugs (analyze patient profile)
3. Improved determination of proper dose
4. Advanced screening of disease
5. Advancements in drug discovery
6. Decreased health care cost (prevent ADR, decrease therapy duration, decrease # of failed trials)
61
What are six (6) drug treatment protocols pharmacogenomics can impact?
1. Oncology
2. Cardiology
3. Psychiatry diseases
4. Asthma
5. Cystic Fibrosis
6. Diabetes
62
What are four (4) functions of the immune system?
1. Identifies self
2. Protects body from antigenic, foreign substance
3. Scavenges dead and dying body cells
4. Destroys abnormal (cancerous) cells
63
What are four (4) types of white blood cells
1. Phagocytes
2. Basophils/Mast cells
3. Lymphocytes
4. Monocytes
64
What are two (2) types of lymphocytes and what is their function?
1. B-cells (produce antibodies)
| 2. T-cells (attack antigens and control response with cytokines)
65
Describe IgA antibody
protect body surfaces exposed to the environment
66
Describe IgD antibody
generally found in small amounts in chest and abdomen linings
67
Describe IgE antibody
1. located in lungs, skin and mucus membranes
2. reacts to foreign antigens (allergy)
3. remembers prior exposures
68
Describe IgG antibody
1. smallest and most common
| 2. found in most body fluids
69
Describe IgM antibody
1. largest
| 2. found in blood and lymph
70
What are three examples of autoimmune disorders?
1. Multiple sclerosis
2. Lupus
3. Rheumatoid arthritis
71
How do corticosteroids affect immune system?
They affect gene transcription.
72
What are five (5) ways corticosteroids can interact with immune systems?
1. Suppress T-Cells [interfere with cytokine production]
2. Suppress B-Cells [interfere with binding of interleukins]
3. Suppress Neutrophils [inhibit adhesion, chemotaxis, phagocytosis, release of mediators]
4. Suppress Macrophages [down-regulate Fc expression; decrease activity on opsonized things]
5. Reduce prostagalandin and leukotriene production [decrease production of pro-inflammatory metabolites]
73
What are three (3) mechanisms to enhance the immune system?
1. Vaccination (immunization) (immune system memory: activated B cells and sensitized T cells)
2. Adjuvants (poorly understood mechanism: involves aluminum salts to increase local concentration and increase uptake by antigen-presenting cells)
3. Probiotics
74
What are seven (7) complications from an altered immune response?
1. Immune deficiency diseases
2. Hypersensitivity
3. Anaphylaxis
4. Autoimmune disease
5. Serum sickness
6. Transplant rejection
7. Graft versus host disease
75
Describe five (5) anaphylaxis side effects
1. Difficulty breathing
2. Lower blood pressure
3. Swelling/hives
4. Increased heart rate
5. May lead to shock
76
What are three examples of autoimmune disorders?
1. Multiple sclerosis
2. Lupus
3. Rheumatoid arthritis
77
What are three (3) differences between benign tumors and cancer?
1. Cancer has persistent proliferation
2. Its growth is invasive
3. Metastasis
78
What are two examples of genetic links to cancer?
1. Germ-line mutations, e.g. BRCA1/BRCA2
| 2. Acquired mutations, e.g. primary or secondary tobacco smoke.
79
What are checkpoints in the cell cycle?
Steps in the process that check to make sure a phase has properly occurred. Failure results in apoptosis
80
What are five (5) phases of Cell cycle?
1. G0 phase
2. G1 phase
2. S phase
3. G2 Phase
4. M phase
81
What happens in G0 phase?
Cell receives growth signals or mitogens and start process of cell division, entering into G1 phase.
82
What happens in S phase?
DNA is synthesized
83
What happens in G2 phase?
Cell arranges and checks chromosomes
84
What happens in M phase?
Spindles attach and chromosomes are drawn apart.
85
What are checkpoints in the cell cycle?
Steps in the process that check to make sure a phase has properly occurred. Failure results in apoptosis
86
What are three mechanistic classifications of anti-neoplastic agents?
1. Cytotoxic agents
2. Hormones
3. Hormone antagonists
87
What are six (6) challenges in treating cancer?
1. Treatments are toxic to normal cells
2. Fractional cell kill (same percentage, not same number)
3. Failure to detect cancer early
4. Delivering drug to tumor
5. Drug resistance
6. Optimal therapy duration is unclear
88
What are four (4) responses to cancer treatment?
1. Cure [entirely free of disease for 5 years]
2. Complete response [no evidence of disease for at least 1 month]
3. Partial response [50% tumor decrease for at least 1 month]
4. Disease progression [25% tumor increase or new lesions during therapy]
89
What are four (4) roles of pharmacist in cancer treatment?
1. Multidisciplinary oncology team (dosing, chemotherapy preparation, personalized medicine).
2. Education and drug information (to professions and to patients)
3. Monitoring (outcomes, side effects, drug interactions)
4. Prevention and early detection
90
What is consolidation chemotherapy?
used to prolong remission duration and overall survival
91
What is adjuvant chemotherapy?
used to treat multi-drug resistant cancers after definitive local therapy (surgery or radiation)
92
What are four (4) principles of combination chemotherapies?
1. Each drug should be active by itself
2. Avoid resistance (inherent or acquired)
3. Use drug with different mechanism or cell cycle activity
4. Minimize overlapping toxicities
93
What are six (6) challenges in treating cancer?
1. Treatments are toxic to normal cells
2. Fractional cell kill (same percentage, not same number)
3. Failure to detect cancer early
4. Delivering drug to tumor
5. Drug resistance
6. Optimal therapy duration is unclear
94
What are four (4) responses to cancer treatment?
1. Cure [entirely free of disease for 5 years]
2. Complete response [no evidence of disease for at least 1 month]
3. Partial response [50% tumor decrease for at least 1 month]
4. Disease progression [25% tumor increase or new lesions during therapy]
95
What are four (4) roles of pharmacist in cancer treatment?
1. Multidisciplinary oncology team (dosing, chemotherapy preparation, personalized medicine).
2. Education and drug information (to professions and to patients)
3. Monitoring (outcomes, side effects, drug interactions)
4. Prevention and early detection
96
Describe the activity of the complement pathway (2 components)
1. Begins proteolytic attack on pathogens
| 2. Signals other effectors
97
What are four (4) important inflammation actions?
1. Increased vascular permeability
2. Leukocyte extravasation [movement into tissues]
3. Chemotaxis
4. Disposal of cell and cellular debris
98
Describe chronic inflammation
1. Lasts months or years
| 2. variety of diseases
99
What are four (4) signs of inflammation?
1. Redness
2. Warmth
3. Pain
4. Swelling (edema)
100
What are four steps in inflammatory cascade?
1. Infection or perceived threat activate immune system
2. Leukocyte and endothelial cells activated
3. Inflammatory mediators are released
4. Inflammation occurs
101
What is the complement pathway?
Group of proteins found in blood, body fluids and on cells originally thought to complement innate immunity.
102
Describe the activity of the complement pathway (2 components)
1. Begins proteolytic attack on pathogens
| 2. Signals other effectors
103
What are seven (7) drugs mechanisms for anti-inflammatory effects?
1. NSAIDS
2. Corticosteroids
3. Disease-modifying anti-rheumatic drugs (DMARDs)
4. Immune biologics
5. Anti-histamines
6. Mast cell stabilizers
7. Leukotriene modifiers [cyclooxygenase (COX) inhibitor]
104
Does acetaminophen have anti-inflammatory effects?
no
105
What is the mechanism of Entanercept (brand name Enbrel)?
1. Binds TNF (both alpha and beta) and blocks its interation with cell surface receptors.
2. Reduces inflammatory response by decreasing serum cytokine levels.
106
What is C-reactive protein?
Biomarker of inflammation produced by the liver in response to pro-inflammatory cytokines
107
What are two (2) muscloskeletal diseases with inflammation basis?
1. Rheumatoid arthritis/osteoarthritis [autoimmune]
| 2. Gout [metabolic disease]
108
What are two (2) skin diseases with inflammation basis?
1. Psoriasis [t-lymphocyte mediated with hereditary component]
2. Atopic dermatitis [hereditary component]
109
What is the mechanism of Prednisone (brand name Deltasone)
1. Prodrug that is converted to methylpredinosone [corticosteroid]
2. Supressess migration of leukocytes and decreases capillary permeability
2. Reduces activity and volume of lympathic system, suppressing the immune system.
3. Suppreses adrenal function at high doses.
110
What is the mechanism of Celecoxib (brand name Celebrex)?
1. Selective Cox-2 inhibitor
| 2. Decrease formation of prostaglandin precursors.
111
What is the mechanism of Entanercept (brand name Enbrel)?
1. Binds TNF and blocks its interation with cell surface receptors.
2. Reduces inflammatory response by decreasing serum cytokine levels.
112
What is the mechanism of Hydroxyzine (brand name Atarax)?
1. 1st generation H1 antagonist.
| 2. Reduces inflammatory response by competing with histamine.
113
What is the mechanism of Ibuprofen (brand name Advil)?
1. Inhibits prostagalandin synthesis via cyclooxygenase 1 enzymes.
114
What is the mechanism of Montelukast (brand name Singulair)?
1. Leukotriene receptor antagonist.
| 2. Binds receptors found in smooth muscle cells of respiratory system.
115
What is the mechanism of Prednisone (brand name Deltasone)
1. Prodrug that is converted to methylpredinosone [corticosteroid]
2. Supressess migration of leukocytes and decreases capillary permeability
2. Reduces activity and volume of lympathic system, suppressing the immune system.
3. Suppreses adrenal function at high doses.
116
What is the mechanism of Celecoxib (brand name Celebrex)?
1. Selective Cox-2 inhibitor
| 2. Decrease formation of prostaglandin precursors.
117
Give an example of a calcineurin inhibitor
Tacrolimus
118
Give an example of an interleukin inhibitor
Anakinra
119
Give two (2) examples of TNF-alpha inhibitors
1. Adalimumab
| 2. Entanercept [Enbrel]
120
Give two (2) examples of selective inhibitors for immune suppression
1. Fingolimod
| 2. Omalizumab
121
Give two (2) examples of non-specific inhibitors for immune suppression
1. Azathioprine
| 2. Methotrexate
122
What is mechanism of azathioprine?
1. immunosuppressive antimetabolite
2. halts replication and blocks purine synthesis
3. alters function of RNA and DNA
4. suppresses cell-mediated activities
