unit 2 stuff Flashcards
(291 cards)
1
Q
dysplasia
A
abnormal cells with different shape, size, and organization
2
Q
metaplasia
A
abnormal cell changes but are benign and reversible
3
Q
what is the term for early dysplasia
A
metaplasia
4
Q
meta
A
change, alteration
5
Q
plasia
A
cellular multiplication, growth
6
Q
anaplasia
A
loss of cell differentiation
7
Q
hyperplasia
A
increased number of cells in the tissue
8
Q
neoplastic hyperplasia
A
abnormal increase of cell mass from tumor formation
9
Q
plast
A
living substance, organelle, cell
10
Q
carcinoma in situ
A
preinvasive epithelial tissue that has not penetrated the basement membrane
11
Q
5 major neoplasm classifications
A
- epithelial
- connective
- nerve
- lymphoid
- hematopoietic
12
Q
stage 0
A
carcinoma in situ (preinvasive)
13
Q
stage 1
A
early, local stage cancer
14
Q
stage 2
A
increased spread risk due to size
15
Q
stage 3
A
spread but not disseminated to distant regions
16
Q
stage 4
A
cancer spread and disseminated to other sites
17
Q
what is “T” in the tumor classification
A
primary tumor
18
Q
T(is)
A
carcinoma in situ
19
Q
T1-4
A
progressive tumor size/local involvement
20
Q
what is “N” in the tumor classification
A
regional lymph nodes
21
Q
N(0)
A
no lymph node metastasis
22
Q
N(1-3)
A
increasing lymph node involvement
23
Q
what is “M” in the tumor classification
A
distant metastasis
24
Q
M(0)
A
no distant metastasis
25
M(1)
signs of distant metastasis
26
3 most commonly diagnosed cancers
1. lung
2. breast
3. colorectal
27
what is the world's most prevalent cancer that has caused the most deaths
lung
28
somatic mutation theory
single cell mutation that causes cancer
29
translocation of genes
nucleotide bases from one chromosomal area go to another location
30
oncogenes
genes that can cause cancer from virus interaction or independently
31
tumor-initiating stem cells + why they are dangerous
stem cells that cause cancer
they are not susceptible to chemo and radiation
32
tumor-specific antigens (TSAs)
only expressed by tumors and recognized by T cells
33
why are tumor antigens not always spotted by the immune system
because they only slightly vary from self-antigens so they more easily escape the immune system
34
tumor-associated antigens (TAA)
expressed by tumor cells but also normal cells
35
3 main cells that fight cancer cells
1. NK cells
2. macrophages
3. CD8+
36
5 most common cites of cancer metastasis
1. lymph nodes
2. liver
3. lungs
4. bone
5. brain
37
is appendicular or axial skeleton more effected by cancer
axial
38
4 environmentally rich areas for cancer to grow
1. pulmonary system
2. hepatic system
3. skeletal system
4. central nervous system
39
osteolytic cancer
cancer that decreases bone density
40
stage 4 symptoms
weakness, anemia, prexia
41
prexia
fever
42
pryo-
fire, heat, high temp
43
throbbing pain means
blood supply interference
44
sharp pain means
nerve pressure or displacement
45
what cancer is the most painful
bone
46
referred pain goes to were with pancreas/liver/spleen/gallbladder cancer
shoulder, mid/low back
47
sympathetic nervous system pain feels like and presents like
mild to moderate pain
tachycardia, hypertension, tachypnea
48
parasympathetic nervous system pain feels like and presents like
visceral/severe pain
hypotension, bradycardia, nausea, vomiting, weakness
49
paraneoplastic syndrome
tumor symptoms distant from the tumor itself
50
what causes paraneoplastic syndrome
typically ectopic hormone production by the tumor
51
secondary cancer prevention
early detection by screening
52
primary cancer prevention
epigenetic testing, nutrigenomics, and chemoprevention
53
curettage biopsy
pap smear
54
fluid aspiration biopsy
spinal tap
55
fine-needle aspiration biopsy
breast/thyroid
56
excisional biopsy
lumpectomy
57
core needle biopsy
tru-cuts
58
stereotactic biopsy
mammotome
59
PSA stands for
prostate specific antigen
60
CEA biomarker for what cancers
bowl
stomach
pancreas
lung
breast
61
neoadjuvant treatment
1. chemo/radiation
2. local control like surgery
62
adjuvant treatment
1. surgery
2. chemo/radiation
63
3 types of irradiation therapy
1. external beam
2. sealed source (x-ray/gamma)
3. unsealed source (systemic therapy)
64
cell kill hypothesis
chemo reduces tumor to size that immune cells can take over
65
how can local cancer be cured
surgery
66
what cancer treatment is most popular for metastasized cancer
chemo
67
growth fraction
% of proliferating cells to the whole tumor
68
does growth fraction increase or decrease with tumor size and why
decrease because as the tumor grows, the blood can't supply all the cells to replicate so some stay "dormant"
69
what circumstances does chemo work the best
when the tumor is small and a large proportion of the cells are dividing
70
alkylating chemo agent mechanism
prevents replication of DNA by stopping the untwisting
71
alkyl group
carbon/hydrogen chains (like methyl CH3)
72
antimetabolite chemo agent mechanism
interrupts cellular pathways that synthesize DNA/RNA
73
what are 2 ways antimetabolites interrupt DNA/RNA synthesis
1. mimic active ingredients & makes fake, nonfunctional genetic product
2. occupying enzymes needed for DNA/RNA synthesis
74
antibiotic chemo agent mechanism
inserts in between base pairs of DNA to prevent synthesis
75
antimicrotubular chemo agent mechanism
disrupts spindles and prevents cell division
76
topoisomerase inhibitor chemo agent mechanism
inhibits the unwinding/winding enzyme in DNA replication
77
anticancer hormone chemo agent mechanism
blocks hormones that fuel the cancer
78
platinum coordination complexes chemo agent mechanism
heavy metal compounds bind to DNA to distort the structure and prevent DNA translation/replication
79
agents that target cell surface receptors (chemo agent mechanism)
binds to receptors and triggers apoptosis (tyrosine kinase inhibitors)
80
cytokine chemo agent mechanism
stimulates immune system to fight so healthy cells aren't harmed
81
alopecia
hair loss
82
anagen phase
actively growing hair
83
when does chemo induced nausea and vomiting occur, peak, and how long do effects last
occur: 1-2 hours
peaks: 4-10 hours
lasts: 12-24 hours
84
myelosuppression
bone marrow inhibition
85
neutropenia common infections
fungal
gram positive bacteria (most common)
gram negative bacteria (kills most)
86
tumor lysis syndrome
tumor is destroyed but metabolic byproducts are too much for the kidneys to handle
87
sinusoidal obstruction syndrome
liver veins are blocked
88
chemotherapy-induced peripheral neuropathy
less tendon reflexes
- less proprioception
- numbness, tingling, burning
89
CNS toxicity symptoms
chemo brain
stroke-like symptoms
90
autonomic neuropathy
hypotension
constipation
dysfunctional sexual organs/bladder
91
what cells mediate chemo and protect the body when neutrophils are low
granulocyte colony-stimulating factor
granulocyte-macrophage colony-stimulating factor
92
monoclonal antibodies
pharmacologically designed antibodies used in immunotherapy to attract NK cells which then kill the cell
93
hematopoietic cell transplantation
type of immunotherapy where bone marrow is transplanted into patient
94
antiangiogenic therapy
blocks formation of new blood vessels
95
erol
Bronchodilators
(Adrenergic)
96
phylline
Bronchodilators
(xanthine derivatives)
97
fluorouracil
antimetabolite for chemo
98
cyclophosphamide
alkylating agent for chemo
99
selective estrogen receptor modifiers
blocks estrogen from stimulating tumor growth
100
palliative treatment
when cures are no longer possible or available
101
durable remission
if the response to treatment is maintained for a long period of time
102
no evidence of disease classification
0-5 years of no detectable disease
103
cured prognosis classification
5+ years of no disease
104
how long and how many times a week should a person be exercising mod-vigorously
30-60 min
5x/week
105
cancer is the 2nd leading cause of death in this age range
1-14 years old
106
what is the most common pediatric cancer
leukemia
107
what is the most common soft tissue cancer children get
rhabdomyosarcoma
108
what cancer is most common in adults
adenocarcinomas
109
what is the most common form of leukemia in children
acute lymphocytic leukemia (ALL)
110
what are the 2 age peaks of incidence in childhood cancer
1. 2-5
2. 15-19
111
what is the trade name for doxorubicin
Adriamycin
112
poiesis
making, formation
113
cells in the innate immune system
monocyctes
neutrophils
eosinophils
basophils
mast cells
NK cells
114
cells in the adaptive immune system
B cells
T cells
115
cells in both adaptive and innate immune system
macrophages
dendritic cells
116
first cells to respond in immune reaction
neutrophils
117
what cells fight against pus forming bacteria
neutrophils
118
what cells filter out the neutrophil debris and other dead cells
monocytes/macrophages
119
what cell helps in allergies and parasitic infection
eosinophils
120
what are the 3 cells that are elevated with allergic reactions
eosinophils
basophils
mast cells
121
what is the longest living immune cell type
monocytes
122
what cell is involved with allergies, anaphylaxis, and wound healing
mast cells
123
what cells are involved with the movement and removal of antigens, antibodies, and compliment system
erythrocytes
thrombocytes
124
what cell produces thrombosis and hemostasis
platelets
125
3 types of T cells
helper
cytotoxic
suppressor
126
what cell type has mature cells congregate in the blood and spleen
natural killer cells
127
what cell is a mononuclear granulocyte
neutrophils
128
what cell is a mononuclear phagocyte
monocytes
129
what 2 cells ingest pathogens and kills them
neutrophils
monocytes
130
what 2 cells are limited in cancer patients that make them susceptible to infection
neutrophils
monocytes
131
what are the 3 antigen presenting cells (APCs)
macrophages
dendritic cells
b cells
132
what cells to APCs present their antigens to and what class of MHC
CD4+
MHC II
133
MHC I involves what cell
CD8+
134
MHC II involves what cell
CD4+
135
soluble factors of internal defenses include
complement system
cytokines
chemokines
136
where do B and T cells get trained
the lymphatic system
137
what is the second line of defense in the immune system
the inflammatory response
138
what is the first line of defense in the immune system
innate immunity
139
what is the third line of defense in the immune system
specific immunity
140
active natural immunity
natural antigen contact from the environment
141
active artificial immunity
vaccine
142
passive natural immunity
natural contact through mother/fetus
143
passive artificial immunity
injection of immune serum globulinhu
144
what are the 2 parts of adaptive immunity
humoral
cell-mediated
145
what is the humoral immunity mechanism
antibodies and B cells
146
what is the cell-mediated immunity mechanism
T cells
147
what region of the antibody determines the type of immunoglobulin it is
the heavy chain
148
what region of the antibody binds to antigens
Fab
149
what region of the immunoglobulin binds to the complement region
Fc
150
what immunoglobulin is the first secreted
IgM
151
which immunoglobulin is the main responder for primary immune responses
IgM
152
which immunoglobulin is the main responder for most secondary immune responses
IgG
153
which immunoglobulin is antiviral and antibacterial
IgG
154
which immunoglobulin is involved with allergies
IgE
155
which immunoglobulin defends the external body surface and is in serum/secretions
IgA
156
which immunoglobulin has the lowest blood levels and are found on naive B cells
IgD
157
4 functions of immunoglobulins
1. attacks antigens through agglutination
2. activates complement system
3. activates anaphylaxis through histamine
4. stimulates antibody-mediated hypersensitivity
158
gene rearrangement
DNA rearrangement B cells go through to create millions of antigen receptor types
159
what cell is responsible for the rejection of donor organs
T cells
160
what cells present to helper T cells to create an immune response
APCs
161
what cells present to cytotoxic T cells to create an immune response
infected cells
162
what t cell prevents inappropriate responses to "self" antigens
regulatory T cells
163
5 phases of immune system
1. recognition
2. amplification
3. effector
4. termination
5. memory
164
what immune system cells are most impacted by strenuous, high-intensity exercise
neutrophils
165
primary immunodeficiency
involves T cells, B cells, or lymphoid tissue
166
secondary immunodeficiency
results from underlying disease that stops immune response (AIDS)
167
HIV life cycle steps
binding
fusion
reverse transcription
integration
replication
assembly
budding
168
which HIV is most transmittable
HIV-1
169
4 clinical stages of HIV are based on the cell count of ___ in the body
CD4+
170
4 clinical stages of HIV
1. acute infection
2. asymptomatic
3. symptomatic
4. advanced
171
how many CD4+ cells are in advanced HIV
200
172
seroconvergence
HIV antibodies in the blood stream and test positive on HIV tests
173
what clinical stage of HIV is seroconvergence seen
asymptomatic
174
what is the hallmark symptom of having AIDS
kaposi sarcoma
175
Type I IgE-mediated reaction
allergies
176
Type II tissue-specific reaction
graves disease
myasthenia gravis
insulin-resistant diabetes
177
Type III immune complex-mediated reaction
lupus
178
Type IV cell-mediated reaction (T-cells)
contact sensitivity to poison ivy/metals
graft rejection
179
what is an example of complement-mediated lysis
ABO blood incompatibility: A+ blood cannot receive/give to B- blood
180
complement-mediated lysis and phagocytosis are both mechanisms of what hypersensitivity disorder
type II tissue specific
181
T cell mediated diseases
rheumatoid arthritis
multiple sclerosis
hashimoto thyroiditis
type I diabetes
IBS
182
3 types of autoimmune diseases
1. localized tissue damage from specific antibodies
2. localized organ lesion but antibodies are NOT organ specific
3. non-organ-specific diseases (antibodies and lesions all over)
183
self tolerance
unresponsiveness to one's own antigens
184
central tolerance
immature lymphocytes that recognize self-antigens are killed
185
discoid lupus
affects only the skin
186
systemic lupus
affects any organ in the body
presents different from each patient
187
symptoms of lupus
butterfly rash
lesions
CNS symptoms
Renal symptoms
188
isoimmune disease
organ/tissue transplant incompatibility of cell surface antigens
189
HLA matching
used to find donor organs to increase likelihood of host accepting the organ
190
what defines being at a carrier state for hepatitis
when the pathogen travels from the liver to the bloodstream
191
biggest external signs of infectious diseases
fever, chills, sweating, malaise, nausea, vomiting
192
internal physiological sign a patient has an infectious disease
increased # of leukocytes or a change in the types of leukocytes
193
what is the normal WBC count in the body
5k-10k
194
leukocytosis
elevated WBC count
195
leukopenia
decreased WBC count
196
what could cause leukopenia
bone marrow disease, radiation, or chemo
197
what could cause leukocytosis
infection or other inflammatory response
198
what is the most abundant WBC type
neutrophils
199
decrease in what kind of cell increases heath care-associated infection (HAI)
neutrophils
200
cytosis
increase in cells
201
what is the normal body temperature range
96.8-99.5*F
202
where is the temperature-regulating center of the brain
hypothalamus
203
pyrogens
protein substances and toxins that cause the hypothalamic thermostat to rise
204
how does infectious disease present in older adults
change in mental status
subnormal body temperature
brady/tachycardia
fatigue
lethargy
decreased appetite
205
examples of noninfectious causes of fever
drug reaction
pulmonary emboli
neoplasm
tissue necrosis
autoimmune diseases
206
intermittent fever
temperature returns to normal at least once every 24 hours
207
what are intermittent fevers typically associated with
sepsis
abscesses
infective endocarditis
208
remittent fever
temperature fluctuates but does not return to normal
209
what are remittent fevers associated with
viral upper respiratory infection
210
sustained/continuous fever
temperature remains above normal with minimal variations
211
recurrent/relapsing fever
episodic fevers lasting 1-3 days with 1 or more days of normal temps in between
212
what temperature threshold should be used for older adults when detecting fever
99-100*F
213
infectious disease definition
infection that causes obvious injury to the host and is accompanied by one or more clinical symptoms
214
incubation period
period between pathogen entering the host and the appearance of clinical symptoms
215
latent infection
after microorganism has replicated but stays inactive in the host (sometimes years)
216
period of communicability
time period when an organism can be shed
ex: respiratory route, GI
217
which is larger: fungus or bacteria
fungi are larger than bacteria
218
pathogenicity
ability of the organism to induce disease
219
virulence
the potency of the pathogen in producing severe disease
220
how is virulence measured
the # of people who die of the disease divided by the # of people who have the disease
221
opportunistic pathogens
they do not cause disease in people with intact host defenses but can cause devastating disease in immunocompromised individuals
222
an environment in which an organism can live and multiply
reservoir
223
where the parasite leaves the reservoir is called
portal of exit
224
what is essential for preventing the transmission of a pathogen
knowledge of the portal of exit
225
what are the 2 modes of contact transmission
1. direct contact
2. indirect contact
226
vector-borne transmission
involves insects and/or animals that act as intermediaries between two or more hosts
227
how small are airborne-transmitted particles
less than 5 um
228
how large are droplet-transmitted particles and how far can they travel
5um
3 feet
229
influenza is spread through what kind of transmission
droplet transmission
230
tuberculosis and chicken pox are spread through what kind of transmission
airborne transmission
231
salmonellosis is spread through what kind of transmission
vehicle transmission
232
vehicle transmission
pathogen is transmitted through a common source to many potential hosts
ex: contaminated food, water, IV
233
how a pathogen gets into a host
portal of entry
234
examples of safe waste
feces
urine
vomitus
tears
sweat
snot
235
health care-associated infection (HAI)
infections that develop in hospitalized person admitted to health care facility that were not present before being admitted
236
what are the most common HAIs
pneumonia
GI tract infection
surgical site infections (SSIs)
237
causes of HAI
frequent use of invasive devices
immunosuppressants and antibiotics
multidrug-resistant organisms
lack of hand hygiene
238
hospital interventions that can cause HAI
1. central line associated bloodstream infections
2. catheter associated urinary tract infections
3. ventilator associated pneumonia
4. surgical site infections
239
what is the #1 way to prevent HAIs
washing hands even when gloves are used
240
jewelry may sequester what type of pathogen
gram-negative organisms
241
artificial nails sequester what type of pathogen
coagulase-negative staphylococci
gram-negative rods
242
what position should the head of the bed be after a tracheostomy to prevent HAI pneumonia
30*
243
cocci shape
spherical
244
bacilli shape
rod-shaped
245
spirilla/spirochetes shape
spiral-shaped
246
bacteria cell walls contain
peptidoglycan
247
unicellular microorganisms with a rigid cell wall
bacteria
248
gram positive bacteria
purple stain
- thicker peptidoglycan wall
249
gram negative bacteria
pink stain
- small peptidoglycan wall with an additional bilipid membrane
250
CDI infection is associated with what type of symptoms and how is it transmitted
diarrhea and GI tract symptoms
fecal-oral route from contaminated hands
251
staphylococcal infection is associated with what type of symptoms and how is it transmitted
integumentary disease that produces skin lesions
252
streptococcal infections are associated with what type of symptoms and how is it transmitted
strep throat, typically through droplets
253
group B streptococcal infections
neonatal pneumonia
meningitis
sepsis
254
clostridial myonecrosis (gas gangrene) is caused by what classification of bacteria
anaerobic bacteria
they produce gas which breaks down tissue
255
pseudomonas effects which systems
integumentary
circulatory
respiratory
256
most common hospital and nursing home acquired pathogen
pseudomonas
257
bactericidal
drugs that typically kill or destroy bacteria
258
bacteriostatic
drugs that do not actually kill bacteria but limit their growth and proliferation
259
3 mechanistic steps of antibacterial drugs
1. inhibition of cell wall synthesis/function
2. inhibition of protein synthesis
3. inhibition of RNA/DNA synthesis
260
what are bacterial cell walls made of
peptidoglycans
261
what is the enzymatic cofactor in the synthesis of bacterial nucleic acids and EAAs
folic acid
262
what do drugs target to inhibit RNA/DNA synthesis
folic acid
263
antibiotic stewardship
being careful to not overuse antibiotics
264
what is a viruses composition
RNA or DNA
covered with proteins
capsule
265
3 DNA viruses
hepatitis b
herpes
chickenpox
266
nucleocapsid
nucleic acid core and the protein shell
267
4 steps of viral replication
1. absorption
2. penetration and uncoating
3. biosynthesis
4. maturation and release
268
what do antiviral drugs do
they slow down viral replication by interfering with one or more of the steps
269
75% of hepatitis c goes to...
chronic hepatitis c
270
approximately 70% of americans older than 12 years old have what virus
HSV-1
271
what virus is responsible for cold sores
HSV-1
272
what strain of herpes is most common through sexual contact
HSV-2
273
what part of the body does HSV1 primarily affect
mouth and oral cavity
274
what does varicella zoster virus (HHV-3) cause
chickenpox or shingles
275
what percent of the population gets shingles after chickenpox
10-20%
276
when is the period of communicability in varicella
first 1-2 days before the rash begins and then first 4-5 days after the lesions form crusts
277
Herpes virus 4 causes what infection
mononucleosis
278
Epstein-Barr virus causes what infection
mononucleosis
279
what % of people in the US between 35-40 have been infected with EBV
0.95
280
what % of the time do adolescents/young adults contract EBV and develop mononucleosis
35-50%
281
how is EBV transmitted
oral secretions
blood
transplanted organs
282
when can someone get back to sport after mono
1 month
283
what infections does respiratory syncytial virus cause
pneumonia
bronchiolitis
tracheobronchitis
284
what virus and infection is the main cause of hospitalizations in infants and young children
RSV
tracheobronchitis
285
how long do infants vs adults shed RSV
infants: 3-4 weeks
adults: 3-8 days
286
how long does influenza fever last
1-7 days (usually 3-5)
287
when would secondary bacterial pneumonia develop after influenza
5-10 days after onset of symptoms
288
endogenous substances that exert nonspecific antiviral activity
interferons
289
alpha and beta interferon type
type I
290
gamma interferon type
type II
291
lambda interferon type
type III
