unit 1 stuff Flashcards
(248 cards)
1
Q
illness vs disease
A
deviation from healthy state physically or mentally (is based on PERCEPTION)
vs
biologic/psychologic alteration (has OBJECTIVE data)
2
Q
the words “impairments”, “interventions”, “desired outcomes”, “functional limitations” are all part of what concept
A
ICF Framework
3
Q
what does ICF framework shift healthcare focus to
A
focus to life and human functioning as a whole, rather than just pathology
4
Q
depression, alcoholism, and schizophrenia are all examples of what type of diability
A
cognitive
5
Q
psychoneuroimmunology
A
the study of interactions among behavior, neural, endocrine, enteric, and immune functions
6
Q
the way people perceive reality is considered their ….
A
consciousness
7
Q
noncommunicable diseases
A
lifestyle diseases that are largely preventable
8
Q
primary, secondary, and tertiary medicine
A
primary = reducing risk factors
secondary = promotes early detection
tertiary = preventing severe disability (REHAB!!)
9
Q
what are 4 genome variation mechanisms that can occur
A
- single base pair changes
- insertions of base pairs
- deletions of base pairs
- structural rearrangement of chromosomes
10
Q
impairment vs disability vs handicap (and their levels)
A
functional loss (organ level)
activity limitations (person level)
social disadvantage (societal level)
11
Q
the upregulation or downregulation of genes based on environmental factors
A
epigenetics
12
Q
upregulation of DNA
A
adding methyl group and turning on gene expression
13
Q
downregulation of DNA
A
subtracting methyl group and turning off gene expression
14
Q
8 epigenetic factors that influence health
A
geographic
socioeconomic
health disparities/inequities
social
environmental
cultural
client variations
age
15
Q
what epigenetic factor is most adverse on a patient’s health
A
socioeconomic status
16
Q
cultural relativity
A
behavior is judges in relation to the context of the culture
(health = luck vs unhealth = punishment)
17
Q
what characteristic was disproved from being an epigenetic causation
A
race/ethnicity
18
Q
4 main client variations
A
- race/ethnicity
- gender
- sexual orientation
- generation
19
Q
what is the most important factor in changing a person’s epigenetics
A
nutrition
20
Q
enteric nervous system
A
basically how the gut is your second brain
microbiome!!
21
Q
food must have _______ in it to be considered a prebiotic
A
nondigestible fiber
22
Q
what vitamin reduces chronic pain
A
vitamin D
23
Q
what are the 3 theories of aging
A
- programmed-based
- damaged-based
- telomerase theory
24
Q
what are the 3 theories of programmed-based aging
A
- gene mutation theory
- genetic control theory
- planned obsolescence theory
25
what is the damage-based theory of aging
wear and tear over the years plus an accumulation of free radicals in the body
26
what is the telomerase theory of aging
telomeres are shortened with each cell division which leads to gradual damage to the chromosomes
27
where would a legion in the brain cause a decrease in executive function
the right hemisphere
28
who made the germ theory
louis pasteur
29
who discovered mitochondrial DNA
douglas wallace
30
when did the human genome project start and finish
1990-2003
31
supercenturians
people who live over 110 years old
32
pharmacotherapeutics
use of specific drugs to prevent, treat, or diagnose diseases
33
pharmacokinetics
how the body absorbs, distributes, and eliminates drugs
34
pharmacodynamics
the drug's MECHANISM in the body
35
toxicology
harmful effects of chemicals
36
what must be taken into consideration when dealing with pharmocotherapeutics
toxicology
37
pharmacogenetics
different reactions can occur due to differences in genetic makeup
38
what drug name system is nonproprietary and the most effective to use when communicating with a patient
genetic names
39
preclinical trial
testing pharmacokinetic and pharmacodynamic properties on animals
40
phase I clinical trial PLUS how many subjects are involved
pharmacological actions and toxic effects on humans
10-100 healthy VOLUNTEERS
41
phase II clinical trial PLUS how many subjects are involved
dosage range and effectiveness
side effects
50-500 people
42
phase III clinical trial PLUS how many subjects are involved
safety and effectiveness
100s-1000s of people tested
43
phase IV clinical trial PLUS how many subjects are involved
post marketing surveillance
FDA approved and watches market for new symptoms
44
how long do FDA trials typically last
7-9 years
45
orphan drugs
drugs for patients with rare disease
46
off-label prescribing
drug treats conditions other than what drug was approved for
47
schedule I drug + 2 examples
highest potential for abuse
restricted to research ONLY
LSD, heroin
48
schedule II drug + 2 examples
high potential for abuse/addiction
morphine, fentanyl
49
schedule III drug + 2 examples
mild-mod physical dependence + strong psychological dependence
anabolic steroids, amphetamines
50
schedule IV drug + 2 examples
limited possibility of physical/psychological dependence
stimulants, depressants
51
schedule V drug + 2 examples
lowest relative abuse potential
cough meds, antidiarrheals
52
potency
specific amplitude a dose produces
53
what is the difference between maximal effect and potency
potency measures how much of the drug is needed to make a reaction
maximal effect measures the max effects a drug is able to produce before the ceiling effect
54
ceiling effect
the maximal effect a drug can have no matter how big the dosages get
55
cumulative dose response curve
% of population that exhibits a specific response (NOT MAGNITUDE)
56
median effective dose (ED)
dose where 50% people respond to drug well
57
what is the other term for median effective dose
beneficial effect dose
58
median toxic dose
50% people get toxic effect from drug
59
therapeutic index definition AND equation
TI = TD / ED
indicates the drug's safety value
60
what does a high vs low therapeutic index mean
high = more safe
low = dangerous/toxic
61
3 enteral routes of drug administration
oral
sublingual/buccal
rectal
62
what drug administration route is most susceptible to the "first pass effect" and WHY
oral because the liver could filter the drug out of the system
63
4 parenteral routes of drug administration
inhalation
injection
topical
transdermal
64
how do local anesthesia, insulin, and hormones typically get administered
subcutaneous injection
65
what is the benefit of getting an intrathecal injection
the drug can bypass the blood/brain barrier + can get to the CNS
66
how do vaccines typically get administered?
intramuscular injection
67
what type of drug administration method does nasal spray, eyedrops, and eardrops fall under
topical
68
name 2 specific methods of transdermal administration
iontophoresis
phonophoresis
69
iontophoresis
electric current
70
phonophoresis
ultrasound waves
71
what are the 2 rules of transdermal administration categorization
1. must be able to penetrate skin
2. must not be degraded majorly by dermis enzymes
72
bioavalibility
% of drug that reaches bloodstream
73
are hydrophilic or hydrophobic molecules absorbed easier
hydrophobic
74
lipid rafts (what are they + what is the function)
lipid domains made of cholesterol + sphingolipids that move freely
cell signaling, endocytosis, ion channel functioning
75
a substance's ability to pass through pores depends on 3 characteristics
size
shape
electrical charge
76
passive rate of diffusion depends on 4 things
1. magnitude of gradient
2. size of substance
3. diffusion distance
4. temperature
77
t/f: there has to be a gradient for passive diffusion to occur
TRUE
78
active transport
carrier mediated transportation fueled by ATP
79
facilitated diffusion
carrier mediated with NO energy spent
80
difference between active transport and facilitated diffusion
both are carrier mediated but...
ACTIVE has a gradient + goes from low to high concentrations
FACILITATED doesn't have a gradient + goes from high to low like passive diffusion
81
what membrane transportation method (passive/active/facilitated) does glucose use to get into muscle cells
facilitated diffusion
82
what are the 4 ways molecules can transport through/across a membrane
passive diffusion
active transport
facilitated diffusion
endo/exocytosis
83
how does ionization impact diffusion
it decreased lipid solubility, making it harder to diffuse
84
what charge molecule (+ / - / 0) can diffuse the easiest
neutral (0)
85
weak acids can become __ charge in high pH environments
positively charged
86
what does it mean when drug volume distribution (Vd) is EQUAL to body water
uniform distribution of drug
(look for a normal, double digit number... 42 was the example given)
87
what does it mean when drug volume distribution (Vd) is GREATER THAN body water
drug is concentrated in tissues
(look for a HIGH NUMBER... 420 was the example given)
88
what does it mean when drug volume distribution (Vd) is LESS THAN body water
drug is in the plasma
(look for a LOW NUMBER... 8.4 was the example given)
89
bones store what 2 toxic agents from drugs
heavy metals (like lead) and tetracyclines
90
biotransformation
"drug metabolism"
chemical changes that take place after the drug is administered
91
metabolite
altered version of drug
92
oxidation
predominant biotransformation method
adds oxygen OR removes hydrogen
93
reduction
removes oxygen or adds hydrogen
94
hydrolysis
drug is broken into several parts
95
conjugation
body hormone/chemical is added to the drug
96
phase I and phase II of biotransformation mechanisms
phase I modifies molecule to make it more polar (oxidation/reduction/hydrolysis)
phase II involves SYNTHESIS (endogenous substance added--> conjugation)
97
cytochrome P450 monooxygenase is responsible for what biotransformation mechanism
oxidation
98
enzyme induction and what does it lead to
enzymes adapt to metabolize drugs quicker which leads to TOLERANCE
99
metabolites must be _(polar/nonpolar)__ to be excreted
POLAR
100
what is drug clearance + what is its equation
CL = Q x [(ci-co) / ci]
ability to eliminate drug either systematically or single organ/tissue level
101
what does Q, ci, and co stand for in:
CL = Q x [(ci-co) / ci]
Q = blood flow to the organ
ci = drug entering
co = drug exiting
102
how is systematic clearance calculated
by adding clearance of each organ up
103
half-life
amount of time it takes for 50% of the drug to be eliminated
104
genetic polymorphisms
small genetic variants between people
(these are why some people get varying sickness symptoms or reactions to drugs)
105
acetylcholine receptor is an example of which kind of receptor
ion channel
106
how do acetylcholine receptors work
Ach molecules bind and open the channel for sodium (Na+) to go through
107
GABA receptor is an example of which kind of receptor
ion channel
108
insulin system uses what receptor system
receptors that directly activate enzymes
- insulin binding DIRECTLY INCREASES ACTIVATION which signals glucose uptake into the muscles
109
explain the secondary messenger system using stimulatory G proteins + adenylate cyclase
substrate binds to the receptor
G protein sends a signal to the enzyme adenylate cyclase
enzyme creates SECONDARY MESSENGER cAMP
cAMP activates protein kinase
110
what do regulator proteins do
change cell function
111
tyrosine kinase protein uses which receptor mechanism
receptors that directly activate enzymes
substrate binding directly causes phosphorylation to increase kinase activity
112
what is the largest group of surface receptors
G-proteins
113
where does a beta-I selective drug target? why?
heart
it has more beta-1 receptors than any other organs in the body
114
Agonist has both __________ and __________
affinity and efficacy
115
competitive antagonists
agonists/antagonists have equal opportunity to bind
agonist can knock off antagonist
116
noncompetitive antagonists
irreversible bonds
117
mixed agonist/antagonist example
estrogen agonist in bone but antagonist in breast tissue
118
desensitization
overstimulation of receptors cause decrease in function
negative feedback
119
down regulation
overstimulation of receptors causes # of receptors to diminish
negative feedback
120
super-sensitivity
prolonged periods without any receptor stimulation causes an increase in receptors
ex: parkinson's
121
chelating agents
binds to heavy metals to prevent toxicity
122
ischemia + what 2 things can cause it
lack of blood flow that causes cells to swell
thrombus or atherosclerosis
123
what is sepsis caused by
endotoxins
124
direct cytopathic effect of a virus
RNA virus goes into cell and destroys contents directly
125
indirect cytopathic effect of a virus
T lymphocytes detect foreign virus protein receptors on cell and destroy the cell
(uses the body's cells to destroy each other)
126
partial agonists
these do not evoke a maximal response EVEN IF all receptors are bound
127
inverse agonists
bind to the same receptor as an agonist but produces the opposite reaction
128
cross reactivity in immune reactions
foreign body + host antigen = attack on specialized cells
129
what is a granuloma + what disease commonly has these
aggregate of macrophages surrounded by lymphocytes
common in TB
130
example of direct and indirect chemical factors that cause cell injury
direct: heavy metals like mercury
indirect: metabolized into harmful substance like acetaminophen
131
kwashiorkor
protein malnutrition
132
marasmus
general malnutrition
133
what are the #1 causes of death in impoverished countries
1. marasmus
2. kwashiorkor
134
reactive oxygen species (ROS)
unstable molecules that "steal" electrons from healthy cells
135
oxygen toxicity
Hydrogen binds to Oxygen and creates harmful compounds that kill cells
136
positive uses of free radicals
1. fights inflammation
2. kills bacteria
3. regulates autonomic nervous system
137
oxidative stress leads to __% lifestyle-related diseases
90%
138
what is degenerated by free radicals in Parkinson's disease?
substantia nigra
139
antioxidants interaction with ROS
detoxify ROS and protects cells by giving electrons
can be endogenous and exogenous
140
nitric oxide (NO)
helpful free radical that protects heart, GI, blood vessels, blood clotting, fights common cold
141
how can you increase Nitric Oxide (NO) bioavailability
long-term aerobic training
142
metaplasia
change from one cell type to another
143
dysplasia
abnormal development or growth of cells, tissues, or organs
144
cell injury by intracellular accumulation (plus an example)
increased storage of lipids, proteins, carbs, pigments (like fatty liver)
145
leukopenia is a sign of
infection or sepsis
146
leukocytosis is a sign of
active inflammation
147
pyknosis
clumping of nucleus
148
karyorrhexis
fragmentation of nucleus
149
karyolysis
dissolution of nucleus
150
blebs
membranous lobes created as the cell membrane breaks up in cell death
151
5 types of necrosis
1. coagulative
2. caseous
3. liquefactive
4. fatty
5. fibrinoid
152
coagulative necrosis
Ischemia
nucleus phyknosis and karyolysis
Kidneys, heart, and adrenal glands
Protein denaturation
153
caseous necrosis
cell membrane explodes and debris looks like cheese
granuloma forms
154
liquefactive necrosis
neuron death causes liquification and abscess in brain
155
fatty necrosis
pancreatic lipases create calcium soaps (white + chalky appearance)
acute pancreatitis from abdominal trauma
156
fibrinoid necrosis
plasma proteins + cell debris accumulate from trauma to blood vessel wall
157
4 signs of inflammation
1. erythema (redness)
2. heat
3. edema (swelling)
4. pain
158
granulation
tiny red granules that are visible in the base of a healing wound
159
what cells make granulation + how
made by macrophages releasing GF with endothelial cells and fibroblasts
160
exudate
high protein + cellular debris that leaks due to vessel permeability
161
transudate
low protein composition that leaks due to osmosis, not vessel permeability
162
2 types of effusion
exudate
transudate
163
4 chronic inflammation cells
- granulation
- macrophages
- lymphocytes
- plasma cells
164
3 acute inflammation signs
- increased blood flow
- edema with leaking plasma proteins
- neutrophil + WBC emigration
165
6 mediators of blood flow
1. histamine
2. serotonin
3. bradykinins
4. anaphylatoxins
5. leukotrienes
6. prostaglandins
166
what are the different cells in acute vs chromic inflammation
acute: platelets + neutrophils
chronic: plasma cells + lymphocytes
167
5 inflammatory exudates
1. hemorrhagic/sanguineous
2. serosanguineous
3. serous
4. purulent
5. catarrhal
168
hemorrhagic (sanguineous) exudate
bright red and bloody
169
serosanguineous exudate
blood-tinged yellow/pink fluid
48-72 hours after injury
170
serous exudate
thin/watery exudate (think blisters)
indicates early inflammation
albumin and immunoglobulins
171
purulent exudate
cloudy pus
indicates bacterial infection
172
catarrhal exudate
thin, clear mucus
respiratory infection
173
stasis
slowing or stopping of the normal flow of a fluid, such as blood
174
margination
leukocytes accumulate in blood vessels
175
diapedesis
migration of WBC to injury site
176
chemotaxis
movement in response to chemical signals
177
chemotactic agent
attracts cells to injury site
178
how long do neutrophils live and what are they replaced by
24 hours
monocytic/macrophage
179
histamine function
vasodilation and bronchoconstriction
180
what cells produce histamine
mast cells, basophils, platelets (granuals)
181
endothelial contraction importance
it increases the permeability of the blood vessels
182
what does platelet activating factor (PAF) do
causes us to feel fever and pain
183
arachidonic acid
produces prostaglandins and leukotrienes
184
prostaglandins
a type of platelet activating factor that mediates pain and fever responses
185
what do corticosteroids to
suppresses inflammation by stopping phospholipase A2
186
what pathway does Aspirin stop
cyclooxygenase pathway
187
2 important cytokines with overlapping functions
IL-1 and TNF
188
what chemical mediator produces autocrine, paracrine, and hormonal inflammatory effects?
cytokines
189
IL-1
produces fever
190
TNF
induces IL-1
191
what are the phagocytic cells (3)
neutrophils, monocytes, macrophages
192
kinin enzymatic system
produces bradykinin
- causes dilation, produces pain
193
what are the 4 components of tissue healing
1. fibronectin
2. proteoglycan
3. elastin
4. collagen
194
Fibronectin function
forms scaffold, tensile strength, and "glues" other substances/cells together
- chemotactic for fibroblasts and macrophages
195
what secretes fibronectin
plasma proteins
196
proteoglycan function
stabilizes and hydrates the tissue
197
elastin function
forms fibrils by cross-links
198
what cell secretes proteoglycans
fibroblasts
199
what is the main extracellular component of tendons
collagen
200
type I collagen function
mature scarring
in all body tissues
(MOST COMMON TYPE)
201
type II collagen function
cartilaginous tissue
growth pates (physis)
3 month half-life
202
type III collagen function
thin filaments
disulfide bonds for bridges
found in babies
breakdown of this = wrinkles
203
type IV collagen function
in basement membranes
204
the glomeruli of kidney nephrons are made of what kind of collagen?
type IV
205
what collagen type helps develop capillaries
type III
206
what inhibits collagen
free radicals
207
what 4 cells produce growth factor
1. platelets
2. fibroblasts
3. endothelial cells
4. macrophages
208
platelet growth factor function
speeds up healing through inflammation, repair, and remodeling
209
fibroblast growth factor function
stimulates endothelial cells to form new blood vessels
210
what are the 4 phases of healing
1. hemostasis and degeneration
2. inflammation
3. proliferation and migration
4. remodeling and maturation
211
hemostasis and degeneration process
platelets release growth factor for inflammation
212
inflammation goals (3)
to inactivate injurious agent
to remove dead cells
to heal the tissue
213
what elements are needed for inflammation (5)
blood flow
circulating cells
connective tissue
chemical mediators
collagen
214
proliferation and migration goals
angiogenesis/neovascularization (new blood vessels)
granulation tissue
215
granulation tissue
endothelia and fibroblast cells make new blood vessels that look red and granular
216
contracture
excessive shrinking that limits mobility and organ functioning (like skin on burn victim)
217
anthrofibrosis
joint scarring caused by contracture
218
tissue contraction in remodeling
myofibroblasts shrink healing tissue
219
labile cells
divide constantly
GI/skin
220
stable cells
not normally dividing but can when stimulated
muscle cells
221
primary intention
wounds that heal under conditions of minimal tissue loss (surgery, small scar)
222
secondary intention
Wound healing where edges can't be easily approximated and wound fills with granulation (large scar)
223
tertiary intention
A wound with a large gap of missing tissue that has been contaminated and needs a drainage tube while healing (suture closed later)
224
can damaged lung cells fully regenerate?
yes, if the basement membrane stays normal
225
how often does the digestive tract regenerate
every 5 days
full turnover in 3-4 weeks
226
peripheral nerve healing
new axonal sprouts form withing 24 hours
227
wallerian degeneration
degeneration of a nerve distal to an injury
228
does a transection or contusion heal quicker in skeletal muscle
transection
229
contusion of muscle healing
loss of strength
incomplete
high rate of reinjury
230
what is the tissue structure of bone
80% cortical
20% cancellous
231
bone fracture healing steps
1. hematoma formation
2. soft callus (fibrocartilage)
3. bony callus (fibroosseous union)
4. remodeling and complete restoration of medullary canal
232
how long does the restoration of the medullary cannal take?
months to years
233
factors that can impact bone healing (6)
- type of bone
- site
- treatment
- complications
- comorbidities
- soft-tissue injury
234
what 2 cell types are needed for tendon/ligament healing
1. tenoblasts
2. fibroblast
235
when does the proliferative phase occur in tendon/ligament healing
2-3 weeks
236
prostaglandins mediate which tissue inflammation process
tendon/ligament
237
why are cartilage injuries not regenerative? (3 reasons)
cartilage is aneural, avascular, and alymphatic
238
4 types of cartilage
1. articular (hyline)
2. fibrocartilage
3. elastic
4. fibroelastic
239
articular cartilage examples (4)
joint surfaces
costal cartilage
bone apophyses
epiphyseal plates
240
fibrocartilage examples (4)
tendons
ligaments
meniscus
vertebral discs
241
1 elastic cartilage example
trachea
242
1 fibroelastic cartilage example
meniscus
243
synovial membrane
membrane lining the capsule of a joint
244
intimal layer
inner layer of synovial membrane next to the joint space
245
subintimal layer
outer layer of synovial membrane
supportive layer made of fibrous and adipose tissue
246
what 2 elements have high concentration in reversible cell injury
sodium and calcium
247
sequence (4) of WBC in inflammatory response
1. margination
2. adhesion
3. diapedesis
4. chemotaxis
248
how do myofibroblasts remodel and mature tissue?
through tissue contraction to shrink the healing tissue together with contractile proteins
