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Disease and defense random > Unit II > Flashcards

Unit II Flashcards

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1
Q

Subclasses of tNSAIDs (5)

A
  1. salicylates
  2. pyrazalone derivatives
  3. acetic/carboxylic acids
  4. oxicam derivatives
  5. propionic acid derivatives
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2
Q

3 acetic/carboxylic acid drugs

A
  1. indomethacin (Indocin)
  2. ketorolac (toradol)
  3. nabumetone (Relafen)
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3
Q

Oxicam drug

A

meloxicam (Mobic)

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4
Q

3 propionic acid drugs

A
  1. ibuprofen (advil, motrin)
  2. naproxen (Aleve, Naprosyn)
  3. ketoprofen (orudis)
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5
Q

Characteristics of pyrazalone dereivatives

A

more potent and longer lasting than aspirin but serious toxicities with chronic use

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6
Q

use of indomethacin

A

generally limited to arthritic conditions that do not respond to safer agents

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7
Q

Treatment of dysmenorrhea

A

ibuprofen or naproxen via inhibition of synthesis of endometrial prostaglandin

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8
Q

Inhibitoin of COX-1 PGE->

Lowest risk with ___ highest risk with ___

A

dyspepsia and gastric ulceration

Low- ibuprofen
high- naproxen

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9
Q

Interfere with COX-1 thromboxane A2 synthesis->

A

promotion of bleeding

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10
Q

INhibition of COX-1 and COX-2 PGE synthesis->

Highest risk with ___ lowest risk with ____

A

reversible renal insufficiency: fluid retention

HIgh- ibuprofen
Low- naproxen

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11
Q

Celecoxib (Celebrex) is metabolized by

A

CYP2C9

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12
Q

Acetylsalicylic acid is hydrolyzed by ____ to _____

A

esterases

salicylate

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13
Q

Reversible changes following cell injury (4)

A
  1. Decreased ATP
  2. Decreased Na pump (cell swelling)
  3. increased glycolysis, decreased pH
  4. D protein synthesis
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14
Q

Irreversible changes following cell injury (3)

A
  1. activation of lysosomal enzymes
  2. DNA, protein degradation
  3. Increase Ca influx
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15
Q

3 injuries following hypoxia

A
  1. 02 therapy - high levels of 02 are needed acutely to keep the patient alive. However, high
    levels of 02 radicals are also produced and have toxic effects on cells - especially in the lung.
  2. Acute inflammation - PMNs have enzymes such as myeloperoxidase which produce oxygen
    radicals. Many hypoxic tissues are infiltrated with PMNs.
  3. Reperfusion - In hypoxia, xanthine dehydrogenase is proteolytically converted to xanthine
    oxidase. Once the hypoxia is corrected, the xanthine oxidase produces activated oxygen species.
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16
Q

2 •OH + 2 GSH->

A

2 H20 + GSSG

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17
Q

Endogenous pyrogens

A

IL-1 and TNF

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18
Q

Fibrinogen

A

Binds red blood cells causing them to form stacks that form sediments

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19
Q

Along with being endogenous pyrogens, what are other roles of TNF and IL-1

A
  1. Release leukocytes from the marrow

2. Stimulate E selectin

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20
Q

LTC4, LTD4, LTE4 cause

A

vascular permeability

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21
Q

growth factor secretion

A

macrophage

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22
Q

neovascularization

A

endothelial cell

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23
Q

collagen deposition

A

fibroblast/myofibroblast

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24
Q

collagen remodeling/retraction

A

fibroblast

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25
re-epithelialization
epithelial cells/ hepatocytes
26
Granulation tissue composed of (4
fibroblasts new capillaries loose ECM inflammatory cells (macrophages)
27
Initial scar
Collagen type III
28
sacr remodeling
Collagen type I
29
Prototypic hormone of GCs
cortisol
30
Prototypic hormone of MCs
aldosterone
31
3 categories of drugs used in the treatment of rheumatoid arthritis
1. NSAIDs- control inflammation 2. DMARDs- diagnosis is certain, suppress disease progression 3. Low dose glucocorticoids- bridge until slower acting DMARDs take effect. also adjunctive therapy
32
2 drugs with minimal mineralcorticoid activity
dexamethasone | methylprednisolone
33
Congestion
impaired outflow of venous blood
34
color of congested tissue
red-blue due to accumulation of deoxygenated blood
35
Oxygen at carbon atoms forms
epoxides
36
Metal vapors->
nasal and lung cancers
37
arsenic exposure->
squamous carcinoma of skin
38
Thorotrast->
liver cancer
39
vinyl chloride
liver cancer
40
asbestos->
mesothelioma
41
benzene->
myeloid leukemia
42
radon gas->
lung cancer (esp for smoker)
43
Chromosomes of cancer cells
- damaged | - aneuploid
44
When you see jaundice in a pancreatic cancer patient, where is the tumor likely located
head of pancreas (blocking common bile duct)
45
Where does colon cancer frequently metastasize to?
Liver
46
Prostate cancer most common in ___ least common in ____
African americans | asians
47
Problem with just looking at PSA levels in prostate cancer
sometimes elevated w/o cancer | EX: BPH
48
Initial stage of prostate cancer
prostatic intraepithelial neoplasm (PIN)
49
2 types of physiologic hyperplasia
- Hormonal | - Compensatory (Liver)
50
NETs are formed by
nuclei from neutrophils
51
Granuloma in granulomatous tissue consists of
enlarged macrophages that form a nodule,, which is surrounded by lympocytes
52
White blood cells and TNF/IL-1
more leukocytes are released from the bone marrow
53
Increased hydrostatic pressure (4)
- heart failure - fluid overload - venous obstruction or compression - arteriolar dilation
54
Decreased oncotic pressure (2)
- protein loss | - low protein production
55
Lymphatic obstruction (3)
- inflammation - neoplasm - post surgery or irradiation
56
Neoplasia begins with
non-lethal genetic damage to cells
57
4 mechanism of E-cadherin loss
1. LOH 2. Inactivating mutation (rare) 3. hypermethylation of promotor 4. Repressing transcription of E cadherin-> EMT
58
Tfs that promote EMT (4)
1. SNAIL 2. TWIST. 3. ZEB1/2 4. SLUG
59
``` Changes in EMT: Downregulation of (3) ```
1. E cadherin 2. Cytokeratins 3. Epithelial cell polarity
60
``` Changes in EMT: Upregulation of (6) ```
1. Vimentin 2. Fibronectin 3. N cadherin 4. Motility 5. Increased protein secretion 6. Fibroblast-like morphology
61
Prostatic cancer preferentially spreads to
Bone
62
Bronchogenic carcinomas preferentially spread to
adrenals and brain
63
Neuroblastomas preferentially spread to
liver and bones
64
How do cancer cells make the metastatic site habitable
secrete cytokines, GFs, and ECM molecules that act on stromal cells, which make the environment more habitable
65
Example of cancer cells making metastatic site more habitable
Breast cancer cells secrete parathyroid hormone related protein (PTHRP)-> osteoblasts make RANKL-> osteoclasts-> degrade matrix releasing IGF and TGF-B
66
Paraneoplastic syndrome occurs in __% to __% of patients with cancer
7-15%
67
Example of alkylating agent
N-mustards
68
Example of acylating agent
dimethylcarbamyl chloride
69
Example of benign tumor overproducing harmful proteins
Overproduction of insulin by a benign islet cell adenoma of the pancrease-> hypoglycemia
70
Cigarette smoke contains
carcinogens and tumor promoters
71
Squamous cell lung carcinoma location
major branches of the bronchial tree "centrally"
72
Pancreatic cancers often metastasize to _>
liver and lung, peri-gastric, periaorticm and omental lymph nodes
73
Risk of colorectal cancer is high if polyp is greater than ___ cm
3 cm
74
Colorectal cancer metastasizes to
liver
75
Treatment of colorectal cancer
5-fluorouracil in compbination with other drugs (eribitux, EGFR inhibitor)
76
Prostate cancer metastasizes to
Bone
77
In cancer therapy, it is most important to kill which cell?
Step cell

Disease and defense random (6 decks)

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