Part 9 Flashcards by Daniel Ross

What are the symptoms of hepatitis B?

Similar to the symptoms of hepatitis A

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What is the incubation period of hepatitis B?

1-6 months

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How long does hepatitis B last?

90% of patients contract and recover in six months

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What is the mortality percentage of hepatitis B?

10%

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What percent of Americans are positive for Anti-HBs (i.e. they have had hepatitis)?

15%

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What are the different antigens in Hepatitis B?

HBcAg
HBsAg
HBeAg
HBxAg

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What does the HBsAg mean when present?

Marker of active replication and infection

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When do you see Anti HBc?

It persists during the acute phase of an illness

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When do you see Anti HBs?

Late. It usually indicates recovery.

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What does it mean when you see Anti HBe?

Reduced infectivity

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What does it mean when you see Anti HBx?

Ongoing replication of hepatitis B virus

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What is the incubation period of hepatitis C?

15–160 days

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What are the symptoms of hepatitis C?

Similar to hepatitis A and hepatitis B

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Is there a carrier state and hepatitis C?

A chronic carrier state is common

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What is the underlying cause in 1/3 of hepatocellular carcinoma’s?

Hepatitis C

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What is the most common reason for liver transplant?

Hepatitis C

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What is an extremely toxic substance for patients with hepatitis C?

Alcohol

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What are the treatments for hepatitis C?

Interferon and ribavirin

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What is the recommended diet for patients with Hepatitis C?

Low-fat, low protein and high carbohydrate. This helps like taking a load off of the liver

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What are the most common causes of decreased libido in women?

Hormones and/or stress

What are the common causes of dyspareunia?

Atrophy and vaginismus

What is the pathophysiology of sexual stimulation?

Sexual stimulation –> release of NO –> activates guanylate cyclase –> triggers formation of cyclic GMP –> generates local excitation response

Why are estrogen and testosterone important in the pathophysiology of sexual stimulation?

They promote the expression of nitric oxide synthase

What hormones promote sexual stimulation?

Dopamine and oxytocin

What hormone is inhibitory in sexual stimulation?

Serotonin

Name six cruciferous vegetables

Kale, cabbage, brussels sprouts, broccoli, cauliflower and bok choy

What are the chemicals in cruciferous vegetables

They are rich in glucosinolates which leads to isothiocyanates and indole-3-carbinol

What did one study show in relation to cruciferous vegetables and cancer risk?

It showed a 15% decreased risk for breast cancer

Name 11 foods with soluble fiber

Oatmeal, lentils, apples, oranges, pears, nuts, flaxseeds, blueberries, cucumbers, celery and carrots

Every 10 g/day increase in soluble fiber intake equals?

A reduced breast cancer risk by 26%

What is the beneficial chemical in Blackpepper?

Piperine

What are the beneficial effects of piperine?

It inhibits cellular mechanisms that are necessary for angiogenesis and it is anti-inflammatory

What is the definition of FVC?

It is the largest volume measured on complete expiration after full inspiration done as forcefully as possible

What is the definition of FEV1?

The volume of gas exhaled over one second during the performance of an FVC

What pathophysiologic pattern do you see in pulmonary fibrosis?

It is a restrictive pattern with decreased FEV1 and FVC

What causes the tissue destruction in pulmonary fibrosis?

Proteases (hydrolytic enzymes) that are released by inflammatory cells resulting in tissue necrosis which causes the release of intracellular enzymes. This can destroy RNA, ribosomal DNA and cell membranes

What causes the remodeling of the lung architecture in pulmonary fibrosis?

The digestion of the connective tissue (collagen and elastin) by these hydrolytic enzymes.

What is the difference in the aging lung before 60 and after 60?

Before 60 the lung increases sizes in three dimensions, after 60 the AP diameter increases more than height

What happens to lung function after age 55?

There is a progressive weakening of maximum inspiratory and expiratory pressures

What happens to the lungs between ages 24 to 78?

There is a progressive reduction in compliance (changing in volume/change in pressure)

True or false. After maturity expired airflow velocity increases with age (including FEV1)

False. Airflow velocity declines with age

Name 8 categories of substances that can cause asthma and bronchospasm

Mediators, cholinergic agonists, beta blockers, aspirin, allergens, air pollution, ingested substances and others

What are the mediators that can provoke asthma and bronchospasm?

Histamine, leukotriene C4 and prostaglandins D2 and F2

What is a neutrophils primary method of inducing death?

It's through NADPH oxidase which generates high levels of superoxide. This reacts nitric oxide to form peroxynitrite which is a potent ROS

Do neutrophils contain toll like receptors?

Yes

What are toll like receptors?

They are transmembrane pattern recognition receptors that recognize molecules that are broadly shared by pathogens but are distinguishable from host molecules. They play a key role in initiating an immune response

What are B cells?

They are antibody producing lymphocytes and make up approximately 5–15% of circulating lymphocytes

What antibodies do circulating peripheral B cells express on their service?

Most express both surface IgM or IgD antibodies. A smaller number express IgG, IgA or IgE antibodies