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MD2002 > MD2002 Week 8 > Flashcards

MD2002 Week 8 Flashcards

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1
Q

how are benign tumours different from malignant? (7)

A
  1. well circumscribed
  2. slow growth
  3. no necrosis
  4. non-invasive
  5. no metastasis
  6. resemble tissue of origin
  7. minimal nuclear pleomorphism
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2
Q

what can prostate tumour metastasize to?

A

this tumour can metastasize to bone

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3
Q

what can lung tumour metastasize to?

A

this tumour can metastasize to brain and adrenals

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4
Q

what can breast tumour metastasize to?

A

this tumour can metastasize to lung, liver, bone, brain

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5
Q

levels of grade classification of tumour

A

I - well differentiated
II - moderately differentiated
III - poorly differentiated
IV - nearly anaplastic

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6
Q

categories in stage classification of tumour

A

T: size
N: degree of lymph node involvement
M: extent of metastases

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7
Q

Dukes’ staging system for colorectal cancer

A

A: confined to bowel wall
B: through wall but no lymph node involvement
C: lymph node involvement
D: distant spread

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8
Q

adenoma

A

nomenclature for glandular cancer

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9
Q

teratoma

A

cancer containing elements of all three embryonic germ cell layers

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10
Q

what are the benign and malignant forms of teratoma?

A

benign: ovarian
malignant: testicular

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11
Q

by how much does a previous wrist fracture increase risk of a hip and vertebral fracture respectively?

A

this fracture doubles risk of hip fracture and triples risk of vertebral fracture

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12
Q

2 types of osteoporosis

A

type 1: post menopausal

type 2: age related in those > 75

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13
Q

what constitutes a fragility fracture according to WHO

A

“fall from a standing height or less”

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14
Q

common sites of osteoporotic fractures (5)

A
  1. proximal humerus
  2. distal radius
  3. spine
  4. femoral neck
  5. vertebral body
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15
Q

what is compared in DEXA T score?

A

this DEXA score compares a young adult of same gender w/ peak bone mass

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16
Q

what is compared in DEXA Z score?

A

this DEXA score compares a patient w/ same age/sex/size

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17
Q

what T-score indicates osteopenia (bone thinning?)

A

a T score of -1 to -2.5 indicates this

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18
Q

how do bisphosphonates work chemically?

A

this drug disrupts protein prenylation branch of mevalonate pathway

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19
Q

how are genes methylated?

A

C5 on CpG islands of promoter regions are methylated into 5-methylcytosine

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20
Q

how are methylated genes compacted?

A

methyl CpG binding proteins recognizes methylated CpGs and recruits histone deacetylases which removes acetyl groups, favouring compact chromatin

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21
Q

heterchromatin

A

highly condensed chromatin

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22
Q

when are heterochromatin replicated in S phase?

A

this chromatin is replicated late in S phase

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23
Q

position effect

A

effect where genes moved near condensed DNA are not expressed

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24
Q

how does Lyonization occur?

A

X-inactive-specific-transcript (Xist) are expressed from inactive X-chr and codes for an RNA

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25
Rett Syndrome
dominant X-linked syndrome caused by mutation in gene encoding methyl-CpG binding protein 2 (MeCP2)
26
when does gene imprinting reset?
genomic imprinting resets on passage through germline
27
cause of PWS/AS
uniparental disomy of chr 15 causes loss of imprinted genes
28
issue with the population case-series
issue with this study is the Ecological Fallacy: associations found w/ aggregate data may not apply to individuals
29
example of case-control study
this study found ppl with lung cancer and looked at their history of smoking
30
cohort study
this study follows patients with different exposures for an extended time to find out outcome
31
RCT
this study gets a random pop divides them into groups that are put under different exposures
32
case series
analyzing a series of cases w/ same disease for any patterns
33
cross-sectional study
study that looks at population at a defined place and time
34
actions of gluteus maximus (2)
1. extends thigh | 2. assists in lateral rotation
35
actions of gluteus medius/minimus and tensor fasciae latae (2)
1. abduct thigh | 2. medially rotate thigh
36
attachments of tensor fasciae latae
this muscle attaches from ASIS to IT tract
37
origin of piriformis
this muscle attaches from the sacrum
38
attachments of superior/inferior gemelli and quadratus femoris
these muscles attach from ischium to greater trochanter (3)
39
what descends under piriformis medial to lateral?
inferior gluteal vessels/nerve and sciatic nerve
40
triceps coxae
superior/inferior gemelli and obturator internus make up this structure
41
attachments of biceps femoris
this muscle attaches from ischial tuberosity (long head) and lines aspera (short head) to head of fibula
42
pros/cons to transdermal drug route
this drug route has prolonged release, but skin is an effective barrier
43
pros/cons to intramuscular drug route
this drug route is rapid for aqueous, slow for oil. but is painful and requires personnel
44
bioavailability
fraction of unchanged drug that reaches systemic circulation
45
4 ways small molecules cross cell membrane
1. diffuse through lipid (likely) 2. aqueous pore 3. transmembrane carrier protein (likely) 4. pinocytosis
46
Henderson-Hasselbalch equation
pKa - pH = log10[BH+]/[B]
47
main drug properties that affect absorption (2)
1. lipophilicity | 2. ionisation
48
pH of gastric acid
pH of this body compartment is 1-3
49
pH of large intestine
pH of this body compartment is 8
50
pH of small intestine
pH of this body compartment is 5-6
51
pH of plasma
pH of this body compartment is 7.4
52
factors affecting drug distribution (6)
1. ionisation 2. lipophilicity 3. pH of compartments 4. cardiac output/blood flow 5. capillary permeability 6. plasma protein binding
53
define pharmacodynamics
what the drug does to the body
54
define pharmacokinetics
what the body does to the drug
55
what is generated from phase II metabolism?
hydrophilic, inactive compounds are generated from this phase of metabolism
56
how are hydrophobic drug molecules metabolized?
these drugs are conjugated into bile and then feces or hydrophilic metabolite then urine
57
cytochrome P450 enzyme
a mixed function monooxygenase mostly found in liver
58
functions of CP450 (2)
1. make steroids, fatty acids, and bile acids | 2. metabolism of substrates
59
what happens to paracetamol when glutathione levels are depleted?
CYP450 metabolizes this drug into a toxic metabolite, which is combined w/ hepatic proteins and causes hepatotoxicity
60
what drug decreases Warfarin effectiveness and how?
phenobarbital decreases effectiveness of this drug as it increases expression of CYP450 which metabolizes the drug
61
where in the body are lipophilic drugs eliminated more readily than hydrophilic drugs?
these types of drugs are more readily eliminated in the lungs
62
therapeutic window
concentration of drug that is effective and not toxic
63
at what concentration of drug would you mark as the onset of action?
concentration of drug just when it becomes effective
64
effect that a high absorption half life has on drug's duration of action
this size of a drug's absorption half life decreases duration of action as drug is getting metabolized for longer for being effective
65
what eventually happens to plasma drug concentration in IV infusion?
drug concentration eventually reaches "steady state" (rate of input equals rate of output)
66
locus
position of gene along Ch
67
missense mutation
mutation where one base pair is swapped
68
deletion (in frame) mutation
mutation where a a full codon is gone so rest of sequence is unaffected
69
triplet expansion mutation
mutation where a triplet is repeated
70
difference between Mendelian Inheritance and multifactorial diseases
the former is a disease caused by change in a single gene
71
relatives that share 25% of genes (3)
1. grandchildren 2. step sibling 3. niece/nephew
72
percentage of genes shared b/w cousins
percentage of genes shared b/w these relatives is 12.5%
73
percentage of genes shared b/w consanguineous cousins
percentage of genes shared b/w these cousins is 25%
74
allelic heterogeneity
different mutations in same gene cause same disease
75
locus heterogeneity
same disease can be caused by mutation in different genes
76
what type trait is often only seen in one generation
autosomal recessive traits are often only seen this often in a family tree
77
nonpenetrance
failure of a genotype to manifest
78
variable expression
term describing how family members may show different features of a disorder
79
Tinel's sign
test to detect irritated nerves by tapping over nerve to elicit tingling
80
Phalen's sign
test to detect carpal tunnel syndrome by flexing wrist for 30-60s to elicit tingling
81
how does aspirin work on cyclooxygenase?
this drug acetylates a-amino group of terminal serine of cylcooxygenase forming a covalent bond
82
chemical difference b/w COX1 and COX2
latter chemical structure has a side pocket
83
which COX is inducible and involved in inflammatory response?
characteristics of COX2
84
which prostaglandin comes from mast cells?
PGD2 comes from here
85
effects of prostaglandin on vessels? (2)
this eicosanoid vasodilates and increases post capillary venue permeability
86
how do prostaglandins cause fever?
bacterial endotoxins causes release of IL1 from macrophages, causing generation of PGEs
87
onset of action of salicylates
onset of action for this NSAID is 30min
88
Tmax of salicylates
Tmax for this NSAID is 1-2h
89
side effects of salicylates
1. bleeding, ulcers in stomach 2. nausea, tinnitus, vomiting dizziness 3. acid/base balance affected 4. lower blood coagulation 5. initial stimulation of CNS, then coma 6. renal insufficiency
90
how long do propionic acids last?
these NSAIDS last for 4-6h
91
Tmax of paracetamol
Tmax for this NSAID is 30min-1h
92
what nerve winds around fibular head from back of leg?
common peroneal nerve winds around this bone structure
93
what pharmacokinetic process affect half life of drug?
distribution, metabolism, and excretion affect this characteristic of drug
94
benign tumour of striated muscle
rhabdomyoma
95
benign tumour of smooth muscle
leiomyoma

MD2002 (11 decks)

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