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Survey of human disease -whole notes

by: CassRuss18

Survey of human disease -whole notes Bio 250

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WIttenberg University Bio 250 spring 2016 notes
survey of Human disease
Dr. Do Amaral
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Date Created: 07/25/16
1 Survey of human disease 1. Characteristics of disease a. Disease- disturbance of the body structure or function b. Lesion- well-defined characteristic structure changes in organs and tissues as a result of disease c. Changes you can see caused by di. i. Organic 1. Structural changes 2. Gross examination a. Blood pressure, temp 3. Histological exam. a. Pap-smear ii. Functional di. 1. No morphological abnormalities yet body functions are profoundly disturbed d. Pathology- study of di. i. Pathologist- physician who specialize in diagnosing and classifying di by studying the morphology of cells ii. Clinician- physician/ health care professional that cares for patients e. Symptoms- subjective manifestations such as weakness f. Signs- physical findings or objective manifestations such as swelling or redness g. Symptomatic di- w/ symptoms and/or signs h. Asymptomatic di- no signs or symptoms i. Early stages, usually asymptomatic ii. Progesses to symptomatic i. Etiology- study of diseases j. Etiological agent- responsible for causing disease k. Pathogenesis- process of development of disease l. Pathogen- any microorganism that causes disease 2. Classifications of disease a. Congenital and hereditary i. Developmental disturbances ii. Genetic abnormalities; chromosomes, intrauterine injury, genetic and environmental factors 1. Genetic- hemophilia 2. Chromosomes-down syndrome 3. Congenital- pregnant women getting rubella b. Inflammatory disease- body reacts to injury through an inflammatory process i. Bacteria/ microganism 1. Strep throat ii. Allergic reaction 1. Hay fever 2 c. Degenerative disease i. Tissue or organ degeneration as a result of aging or breakdown(pathogen) 1. Osteoarthritis- breakdown of cartilage between joints d. Metabolic disease- disturbance in metabolic process in body i. Diabetes e. Neoplastic disease- uncontrolled cell growth i. Benign: lipoma ii. Malignant: lung/ brain- cancer 3. Diagnostic test and procedures a. Clinical lab test- determine concentrations of substances in blood or urine frequently altered by di. i. Used to: 1. Determine con. Or activity of enzymes in the blood 2. Evaluate function of organs 3. Monitor response of cancer to treatment 4. Detect di-producing organisms 5. Res1ponse to antibiotics ii. evasive test- drawing blood iii. invasive test- pee sample from cup b. test of electrical activity- measure electrical impulses associated w/ bodily functions and activities i. ECG (EKG): measures serial change in EA of the heart in various phases of the cardiac cycle 1. Identify disturbances in heat rate, rhythm, abnormal impulses 2. Recognize heart muscle injury from ECG abnormalities ii. EEG: measures EA of brain; brain waves iii. EMG: measures EA of skeletal muscle during contraction and at rest c. Radioisotope (radionuclide studies)- evaluate organ function by determine rate of uptake and excretion of sub. Labeled w/ radioisotope 1. Injected or digested 2. Trace though body is it present or absent i. Used to find: 1. Anemia: B12 2. Hyperthyroidism: iodine 3. Pulmonary blood flow: albumin; find blood clots 4. Cancer spread: phosphorus; presence of tumor deposits in bone or spine 5. Heart muscle damage; evaluate blood flow d. Endoscopy i. examine interior of the body 3 ii. perform surgery formerly done through large abdominal incisions 1. bronchoscope 2. cystoscope- bladder 3. laparoscope- abdomen e. ultrasound-mapping echoes produced by high-frequency sound waves transmitted into body. Echoes reflect change in tissue density, producing images i. cheap and no radiation ii. used to look at many parts of the body including cardio vascular system f. x-rays- use low doses high-energy radiation to produce images i. Can penetrate through tissues at varying degrees depending on tissue density ii. The rays go on to a photographic film as they leave the body 1. Radiopaque: appears white in film; high density tissues, bone, absorb most of the rays 2. Radiolucent: appears dark on film; low density tissue, rays pass through iii. Can be harmful g. Computer tomographic (CT) scan- radiation detectors record amount of X-rays or ionizing radiation absorbed by the body and feeds data into a computer to reconstruct into an image i. High dose of radiation ii. Uses: 1. Scan for cancer in asymptomatic individuals (high genetic disposition) 2. Detect abnormalities of internal organs h. Magnetic resonance imaging (MRI)- hydrogen protons in water respond to magnetic field and computer is used to create images off that data. i. Usually used on brains, spinal cord ii. No ionizing radiation iii. Better then mammograms in finding breast cancer i. Positron emission tomography (PET) i. Measures metabolism of biochemical compounds that are labeled with isotopes to measure organ function. glucose is common. ii. Expensive and not widely available iii. Uses: 1. Assess biochemical functions in brain 2. Determine metabolic activates of organ or tissue, specific site 3. Check blood flow in heart after a heart attack 4. Benign vs malignant tumors(increase glucose) 4 j. Cytological and histological i. Biopsy: tissue sample obtained for histological exam to determine abnormal structural and cellular patterns accompanying di. 4. Cells a. Organization of cells i. Cells  tissues  organs organ system  organism ii. Cell theory- all living things are made of cells, all cells come from other cells, cells are smallest form of life iii. Eukaryotic cell- membrane bound organelles, selectively permeable membrane b. Movement i. Diffusion- movement of sub from [high] to [low] ii. Osmosis- movement of water iii. Facilitated transport- movement of sub from [low] to [high] with the help of protein iv. Active transport- uses energy (ATP) and protein to move sub across membrane v. Endocytosis (lysomose, white blood cells)- cell eating vi. Exocytosis (golgi)- removing a substance from the cell 1. Movement of blood sugar c. Metabolic pathways i. Metabolism includes all chemical reactions that occur in cells 1. Most have reactants to get product 2. Positive and negative feedback d. Enzymes i. Proteins ii. Bind to active sites on specific substrates to lower AE and then sent back into cytoplasm iii. Degradation- a substrate is broken into smaller products iv. Synthesis- substrates are combined to produce larger products e. Cellular respiration i. Production of ATP, CO 2 H 2 and heat ii. Happens in the mitochondria iii. Has three parts: 1. Glycolysis 2. Citric acid cycle (krebs) 3. ETC iv. The reason the body needs oxygen f. Parts of the cell i. Lysosome- breakdown molecules and cellular compents ii. Nucleus- stores, copies and transmits genetic information 1. Central dogma- DNA  RNA Protein iii. Ribosomes- turn TRNA in to AA iv. SER- synthesis of lipids, detox drugs 5 1. Lots in liver v. Mitochondria- production of ATP 5. Tissue- a collection of cells of the same type that perform a common function. a. Epithelia i. Simple squamous- lining od lungs, blood vessels 1. Function- protection ii. Simple cuboidal- lining of kidneys, tubules, various glands 1. Function- absorbs molecules iii. Simple columnar- ling of small intestine, oviducts 1. Function- absorbs nutrients iv. Pseudostratified ciliated columnar- lining od trachea 1. Function- sweeps impurities toward throat b. Connective tissue i. Fibrous connective 1. Loose and dense a. Loose- supporting epithelium and internal organs. i. Adipose 2. Specializes connective a. Supportive i. Cartilage- cells in chambers (lacunae), matrix solid but flexible 1. Hyaline- find collagen fibers: nose, end of long bones, fetal skelton 2. Elastic- more elastic fibers then cartilage fibers: outer ear 3. Fibrocartilage- strong collagen fibers: disk between vertebra ii. Bone – cells in chambers (Lacunae), solid and rigid matrix made of collagen and calcium salts 1. Function: support, protection, movement 2. Compact- made of repeating circular units (osteons) which contain the hard matrix, living cells and blood vessels. Shafts of long bones 3. Spongy- open latticework w/ irregular spaces. Ends of long bones b. Fluid i. Blood- fluid matrix (plasma) and cellular components 1. Erythrocytes- carry oxygen 2. Leukocytes- fight infection 3. Thrombocytes- pieces of cells that colt blood ii. Lymph- matrix fluid, where white blood cells are made c. Muscle 6 i. Skeletal- 1. multi nuclei cells, striated 2. attached to skeleton (bone), 3. voluntary body movement ii. smooth 1. single nucleus, spindle-shaped 2. movement of substance in lumens of body 3. involuntary movement 4. blood vessel walls, walls of the digestive tract iii. cardiac 1. single nucleus, branching striated cells 2. wall of the heart 3. pumping blood 4. involuntary movement d. nervous tissue- communication between cells through sensory input, integration of data and motor output i. neurons ii. neuroglia- cells that support and nourish neurons 1. oligodendrocytes 2. astrocytes 3. microglia 6. Cell and tissues disease a. Cells will respond to changing conditions (changes in extracellular environment) in various ways to make cell more effective in area. b. Atrophy- cell size is reduced to minimize energy consumption. i. Atrophy of certain tissues provides energy for overall metabolism ii. Caused be: diminished function (zero-gravity), low levels of hormonal stimulation (beast size decrease after menopause), or low blood supply. c. Hypertrophy- increase in cell size d. Hyperplasia- increase in cell numbers to maintain proper function. i. As men age their prostate gland enlargers shrinking urethra size. e. Metaplasia- change from one cell type to another to better tolerate the adverse environmental conditions. i. Acid reflux- esophagus squamous epithelium because metaplastic columnar. f. Dysplasia- developmental and maturation of cells is disturbed and abnormal g. Increase enzyme synthesis- major biochemical changes (imbalance), stressful conditions i. Cell injury 1. Cell swelling- sodium diffuses into cell together w/ H2O causing cell to swell 7 a. Problem w/ NaK+ pump b. ATP synthesis changes 2. Fatty change- accumulation of adipose w/in the cytoplasm due to impairment of enzyme systems that metabolize fat. ii. Cell death 1. Necrosis- cell swells creates P.M damage, cell explodes and cytoplasmic contents are realized into extracellular space. a. Effects nearby cells b. Can to infection at the site 2. Apoptosis: programmed cell death- cell shrinks, P.M remains intact. Cellular contents are packaged into apoptotic bodies that are phagocytosed by other cells. 7. The immune system a. Responsible for recognizing the host cells from foreign matter i. Protects from infection ii. Isolates and removes foreign substance iii. Destroys cancer cells b. Leukocytes- 10 different kinds, tell difference by the shape of nucleus i. Derived from red bone marrow ii. In tissues and blood iii. Fight infection iv. Different types live for different lengthens of time. 1. Ones that make anti-bodies live for years v. There are two main types 1. Granular a. Neutrophils- phagocytizes pathogens and cell debris. b. Eosinophils- use granule contents to digest large pathogens and reduce inflammation. c. Basophils- promote blood flow to injured tissues and the inflammatory response. 2. Agranular a. Lymphocytes- responsible for specific immunity, B and T cells. b. Monocytes- become macrophages that phagocytize pathogens and cellular debris c. Nonspecific defense- recognize some general property marking the invader as foreign and they protect the body as the first line of defense i. Physical barriers- first line of defense against microbes are skin and antimicrobial secretions. ii. The inflammatory reaction- any agent that cause cell injury. There needs to be physical damage first. a. Agent- physical b. Chemical c. Microbiological 8 2. Local effects a. Capillary dilation- mast cell release histamines b. Increased capillary permeability  swelling i. Proteins leak out of capillaries, osmosis c. Attraction of leukocytes 3. Systemic effects: fever, increased number of leukocytes 4. Signs a. Heat and redness b. Swelling c. Tenderness and pain- irritation of nerve endings iii. The inflammatory process 1. Acute-neutrophile a. Phagocytic cells, mononuclear cells clean up tissue debris b. Mild- self-limiting, subsides w/ tissue resolution c. Severe i. Systemic effects ii. Bone marrow accelerates production of leukocytes iii. Liver produces acute phase proteins iv. Complement system 1. Plasma proteins that lyse foreign cells 2. 30 protein cascade membrane attack complex on surface of invading bacteria 3. The MAC raptures the bacterial membrane causing lysis of the bacteria and death 4. Uses osmosis 5. Chemotaxis- movement of cells, phagocytes, in a specific direction in response to a chemical stimulus. v. Interferons- cytokines 1. Protein messengers that inhibit viral replication inside host cells 2. Bind to cell receptors causing production of an antiviral protein that prevents viral replication in infected and non- infected cells. 8. Specific immune defense a. Lymphocytes recognize specific foreign molecules called antigens i. Antigen- any foreign molecule that can tiger a specific immune response against itself. 1. Protein coat of a virus b. B cells i. Made and matured in the bone marrow ii. Once mature goes to secondary lymphoid organs: tonsils, lymph nodes, spleen iii. Some live for hours, others years (antibody, memory) 9 iv. Turn into plasma cells with help of helper T cells which make antibodies v. Do not leave location c. T cells and helper T cells i. Cytotoxic T cells directly attack bad cells 1. Perforin enzymes punch hole in target cell 2. Granzymes trigger the cell to undergo apoptosis ii. Enter bloodstream and are directed to bad cells 1. T cells only recognize antigens that’s is bound to a macrophage 2. Attach antigen to class 1 MHC iii. Helper T cells need three steps to activate 1. Binding to antigen on class 2 MHC 2. Binding to non-antigen protein 3. Secretion of cytokines d. NK cells- lymphocytes that target virus infected cells and cancer cells i. Not antigen- specific ii. Secrete cytotoxic chemicals that cause cell death e. Antibodies i. Binds to specific antigen and leading to inactivation and destruction of foreign antigen ii. Neutralization- prevent foreign substance to binding to tissues. iii. Agglutination- 1 antibody binds to multiantigens preventing them from moving to other cells. iv. Opsonization- enhancement of phagocytosis v. Complement activation- bind to bacteria vi. Enhance natural killer cell activity f. Antibody structure i. Heavy chain- decided antibody type (immunoglobulins) ii. Short chain iii. Holds antigen iv. Antibodies are made from only 200 genes that react to different AA sequences g. Major Histocompatibility complex i. Class 1 MHC are expressed on the surface of all nucleated cells ii. Class 2 MHC are expressed on the surface of macrophages, activated B and T cells and thymus cells. iii. T cells have antigen receptors which recognize antigens only when they are associated w/ HMC molecules. 1. Part if the antigen presentation mechanisms iv. Unique to each individual and are known as HLA (Human Leukocyte antigens) 1. Mark self from non-self 2. Cells that do not match MHC are foreign and are responsible for tissue or organ rejection 10 h. How do we tolerate self? i. Clonal deletion- self-reactive T cells in the thymus and B cells in the Bone Marrow are induced to undergo apoptosis 1. Fetal stages, babies ii. Clonal anergy- Mature T and B cells in the circulation encounter self-antigen become non-responsive iii. Peripheral deletion- Mature t cells in circulation that encounter self-antigens undergo apoptosis. 9. Allergies- hypersensitivity a. IgE antibodies interacts w/ various “toxins” b. Histamine- Mast cells and Basophile c. Treated- IgA and Ig coat allergies when present i. Antihistamines ii. Epinephrine (adrenaline) iii. Allergy shots d. Environmental factors i. Not being exposed to infectious diseases ii. Living in areas of low level of pollution iii. Not having a cat or dog at a young age iv. Diet of mother when pregnant e. Anaphylaxis i. Fall in blood pressure ii. Spasm of smooth muscle in the airway 10. Autoimmune disease a. Three components i. Genetic- MHC ii. Being a woman iii. Recurring infections – getting sick alot b. Pathogenesis i. Alteration of patients own antigens causing them to become antigenic, provoking an immune reaction ii. Formation of cross-reacting antibodies against foreign antigens that also attack patient’s own antigens 1. They have similar proteins 2. Example- progressive inflammatory neuropathy a. Inhaling pig brain iii. Defective regulation of the immune response iv. Not well understood: damage to normal self-antigens so that they no longer identified as self and instead are identified as foreign c. Systemic lupus erythematosus i. 1 type that effects the whole body ii. Targets fibrous connective tissue, joints, heart, lungs and kidney iii. Signs: mostly a chronic 11 1. Butterfly (malar) rash 2. Oral ulcers 3. Joint pain and muscle fatigue 4. Possible renal failure 5. Precordium and pleura inflammation 6. No cure but can be treated at some level iv. Autoantibodies 1. The changed antibodies attack blood and nucleoproteins 2. The immune complexes are deposited in various tissues and trigger inflammation 3. Specific immune defenses are triggered against the self- antigens causing the organ damage d. Graves disease (Toxic goiter) i. Over stimulation of the thyroid gland: antithyroid antibody ii. Mimic effects of TSH but not subject to normal control mechanisms 1. The brain usually releases TSH through a negative mechanism iii. Treatments: 1. Antithyroid drugs- but can lead to under stimulation 2. Thyroidectomy- last resort 3. Radioactive iodine- kills thyroid cells iv. Symptoms 1. Enlarged gland 2. Inflammation of the eyes- can lead to blindness e. Rheumatoid arthritis- effects hands and toes i. Affects connective tissues, especially the joints ii. Produces chronic inflammation and thickening of synovial membrane iii. Rheumatoid factor: autoantibody in blood and synovial tissue; combines w/ antigen and triggers inflammation in joints iv. Tissue damaged caused by cytokines v. Can lead to dislocation from joint instability 12 Test 2 1. Pathogenic microorganism a. Prokaryotic cells- no membrane bound organelles b. Classified by four major characteristics i. Shapes and arrangement 1. Coccus- skin and nasal cavity a. Clusters, chains, pairs, Kidney shaped in pairs i. Pairs- Diplococcus (minigenits, ghonra) 2. Bacillus a. Square ends- anthrax (spores) b. Rounded ends- tuberculosis c. Club-shaped- diphelia (toxin) d. Fusiform- intestines (gingivitis) e. Comma-shaped- chloera 3. Spiral a. Tightly-coiled- syphilis b. Relaxed coil- Lyme disease ii. Gram staining 1. Gram-positive- resists red dye and retains purple stain a. Thick peptidoglycan cell wall b. Surface proteins 2. Gram-negative- stains red a. Thin peptidoglycan cell wall, thick periplasm wall b. Lipoprotein layer iii. Biochemical and growth 1. agar 2. Obligate and facultative organisms 3. Nutritional requirements a. Fastidious organisms b. Hardy organisms c. Biochemical profile iv. Antigen structure 1. Antigens in cell body 2. Capsule 3. Flagella 2. Treatment & prevention a. Vaccines b. Antitoxins c. Antibiotics i. Disrupt cell wall formation ii. Block protein metabolism iii. Nucleic acid disruption 1. Blocks DNA gyrase iv. Membrane disruption 1. Disrupts permeability 13 3. Disease a. Impetigo- staphylococcus aureus/ pyogenes i. Superficial skin patches caused by thin wall blisters ii. Beta hemolysis, fever, high blood pressure, glomerulonephritis (kidney inflammation) iii. Antibiotics b. Respiratory tract infection- streptococcus pneumonia i. Coughing, purulent mucus discharge, difficulty breathing, fever ii. Pleurisy, septicemia, endocarditis, meningitis, septic arthritis iii.Antibiotics, pneumovax c. Dental caries (cavities)- streptococcus d. Cholera- vibrio cholera i. Severe diarrhea; loss 15% of body weight in hours, toxin causes water to pass from tissues ii. Older people can die from congestive heart failure iii. Drink fluids and electrolytes, vaccine (last for 6 months) e. Meningitis- Neisseria meningitides, streptococcus pneumoniae i. Headache, fever, stiff neck, nausea, purplish rash, 80% mortality rate if untreated. f. Hansen’s disease- mycobacterium leprea i. Large nerves (arms) become inflamed and painful ii. tuberculoid leprosy 1. Lesions on face and extremities. Can be self-limiting or progress iii. lepromatous leprosy 1. bacteria in the skin, can lead to disfigurement or blindness. iv. Antibiotics: dasosone, clorfazimine, rifampin. Can take 3- 5months and up to 2years to kill bacteria g. Lyme Disease- Borrelia Burgdorferi i. 3 stages 1. 10 days- flu like symptoms and circular lesion 2. Weeks-months- rashes, cardiac or neurological abnormalities, arthritis 3. Months-years- affect CNS, Behavioral changes and memory problems. ii. Antibiotics, cover up and use DEET when going into woods 4. Antibiotics a. Key findings: i. Effect on viral infection response ii. Effect on other infection responses iii. Mimicking the action of Bacterial signals iv. Some bacteria influence the immune response better the others b. Effects on the bacteria i. Cell wall inhibitors 14 1. Only effect a few types of bacteria 2. Can effect bacteria needed in the body 3. Block synthesis of cell wall ii. Cell membrane 1. Can effect self-cell membranes 2. Specific to lipid iii. DNA/RNA 1. Inhibits replication and transcription 2. Inhibits gyrase 3. Inhibits RNA polymerase iv. Protein synthesis inhibits acting on ribosomes 1. Different types for 50S and 30S ribosomes 2. Do not react with human ribosomes a. Sometimes react with mitochondria ribosomes v. Metabolic pathways and products 1. Folic acid is blocked c. Adverse effects of antibiotics i. Toxicity ii. Hypersensitivity 1. Allergic reaction iii. Alteration of normal bacterial flora iv. Can become resistant to antibiotic 1. Spontaneous mutations 2. Plasmid-acquired resistance v. Mechanisms for circumventing effects of antibiotics 1. Develop enzymes 2. Change cell wall structure 3. Change internal metabolic machinery 5. Vaccines a. Killed/ inactive whole cell vaccines i. Stimulates immunity but pathogen cannot multiply b. Live/ attenuated whole cell vaccines i. Viruses multiply and stimulate immunity w/o causing disease c. Vaccines from microbe parts i. Isolates antigen molecules used for vaccine ii. No pathogen present 6. DNA Viruses a. Non-cellular particles w/ definite shape, size & chemical composition b. Usually <.2um c. Only contain parts needed to invade & control host cell d. Have DNA or RNA but not both e. Lack enzymes and machinery needed for protein synthesis f. Structure of viruses i. Capsids- protein coat that protects DNA/RNA 1. Nucleocapsid- capsid & DNA/RNA 15 ii. Can have an envelope or be naked 1. Viral envelope a. On animal viruses b. Spikes- used to attached to host cell i. Exposed proteins outside the envelope g. Phases of multiplication i. Adsorption ii. Penetration iii. Uncoating- DNA/RNA is released from capsid iv. Synthesis v. Assembly vi. Release- exocytosis or cell lysis h. Damage to host cells i. Can lead to tumors and cancer ii. Cytopathic effects 1. Cell fussions- multinucleated cells 2. Cell lyis 3. Change DNA iii. Transformation- permeant change in genetic material resulting in cancer 1. Animal viruses iv. Oncoviruses- mammalian viruses that can initiate tumors v. Chronic infections- in tissue sample; slow rate of multiplication; mild or no symptoms vi. Latent infections- dormant phase 7. The herpesviruses a. Enveloped and double stranded DNA b. Replication w/in nucleus c. Herpes simplex viruses- i. Multiplies in sensory neurons, moves to ganglia ii. Trigged by: fever, UV radiation, stress, injury iii. New viruses migrate to body surface and produce lesions iv. HSV-1: lesions on the oropharynx, cold sores, fever blisters. 1. Occurs Intharly childhood 2. Enters 5 cranial nerve 3. Herpes labials- fever blisters, cold sores a. Usually Last 2-3 days 4. Herpetic gingivostomatitis- infection of oropharynax in young children a. Fever, sore throat, swollen lymph nodes 5. Herpetic keratitis- inflammation of eye 6. Encephalitis (inflammation of the brain)- rare complication but most common sporadic form of viral encephalitis in the U.S. v. HSV-2: lesions on the genitalia, oral 16 1. Ages 14-29 2. Can be spread w/o lesions 3. Enters lumbosacral spinal nerve trunk ganglia 4. Genital herpes- bilateral swelling and tenderness in the groin, clusters of vesicles on genitalia, perineum and butt. a. Recurrent with menstruation, stress and bacterial infection vi. Herpetic whitlow- penetrate a break in skin and cause localized infection, usually 1 finger, painful and itchy vii. Obtained by direct contact with secretions containing the virus viii. Herpes of newborns 1. Can be fatal- 80% death rate 2. Infant can be contaminated before or during birth 3. Infection of mouth, skin, eyes and CNS 4. Should be delivered by C-section if outbreak at time of birth ix. Treatment: topical medication 8. The Adenoviruses a. Non-enveloped double stranded DNA b. 30 different types associated with human disease c. Lymphoid tissue, respiratory and intestinal epithelia and conjunctiva d. Oncogenic in animals but not humans e. Spread by respiratory and ocular secreations f. Treatment: severe- interferon; inactivated polyvalent vaccine 9. Human papillomavirus a. Papillomavirus- squamous epithelia growth, wart or verruca b. 100 different strains c. Transmission- direct contact of contaminated surfaces d. Incubation- 2 weeks  over a year e. Many ways to remove warts, but they can recur f. Types of warts: i. Common seed warts ii. Plantar warts iii. Genital warts: STD g. 9 types of HPV can lead to reproduction cancer i. 2 types account for 70% of metastatic tumors ii. Pap smears can detect HPV iii. Two vaccines 10.RNA Viruses a. 12 families: envelope, capsid, nature of RNA genome i. Mumps (Epidemic parotitis): painful swelling of parotid salivary gland; Paramyxoviruses 1. Self-limited: 40% are subclinical. Get long term immunity 2. Incubation:2-3 3. Three stages: 17 a. Viremia- virus in blood b. Viuria- virus in pee c. Meningitis, swelling of testes, 1/3 systematic 4. In adults w/o symptoms 20-30% of males get epididymis and infected testes 5. Treat symptoms 6. MMR vaccine- live attenuated ii. SARS: fever, body aches, malaise, possible respiratory problems; coronaviruses 1. Transmitted though droplet of direct contact iii. Rubella (German Measeles); Rubivirus (Togavirus) 1. Single stranded RNA 2. Affects adolescents and young adults mostly 3. Transmitted by contact w/ respiratory secretions 4. MMR vaccine- live attenuated 5. Postnatal Rubella- last 3days; fever, sore throat, lymphadenopathy, mild rash 6. Congenital rubella- if no miscarriage, can lead to birth defects: cardiac, ocular lesions, deafness, mental and physical retardation b. Poliomyelitis (polio)- acute enteroviral infection of the spinal cord that can cause neuromuscular paralysis i. Poliovirus- naked capsid (picornavirus) 1. Resistant to: acid (high PH), bile and detergents 2. Fecal-oral transmission 3. Start in throat, move to intestines to multiply 4. Most infections are short-term and mild a. Severe Viremia- spreads to spinal cord and brain i. Invades motor neurons b. Post-polio syndrome- progressive muscle deterioration i. 25-50% of adults that where infected as children c. A septic meningitis- inflammation of nervous system i. <1%, usually in children ii. Destroys motor nerves ii. Treatment 1. Support pain and suffering 2. Vaccination a. Inactivated polio vaccine- salk vaccine b. Oral polio vaccine- sabin vaccine i. No longer in U.S gives polio like side affects ii. Used in poor countries. c. Reoviruses- double- stranded RNA genome i. Reovirus- cold-like upper respiratory infection, enteritis (small intestine), diarrhea 18 ii. Rotavirus- oral-fecal transmission, highest child mortality rate (virus), diarrhea 11. Prions and spongiform encéphalopathies a. Prions- proteinaceous infections particles. i. Resistant to everything ii. Can be obtained through Cabalism iii. Transmissible spongiform encéphalopathies 1. Neurodegenerative disease w/ long incubation periods 2. In human and animals b. Creutzfeldt-jakob disease (CJD)- genetic i. Alteration in PrP protein 1. Abnormal PrP turns normal PrP 2. Nerve cell death, loss in brain function, Impaired senses, change in behavior, uncontrollable muscle contraction 3. Can be transmitted through contact w/ brain tissue or CSf ii. cow disease is a stain of CJD called TSE 12. Fungi: mold, yeast a. Only 300 species are linked to animal disease b. Human mycoses- caused by true fungal pathogens and opportunistic pathogens i. True fungal pathogens can grow in any host i.e. healthy 1. Spores germinate in lungs 2. Can become systemic 3. Histoplasmosis: Ohio valley fever a. Can lead to pneumonitis 4. Cutaneous mycoses – ringworm (tinea) a. Genus i. Trichophyton- scalp, body, bread, nails and athlete’s foot ii. Microsporum- scalp and skin iii. Epidermophyton- groin and nails (human to human) b. Anti-fungal medicine ii. Opportunistic fungal pathogens can only grow in host with weak immune systems 1. Candida albicans- yeast a. Thrush- mouth and throat b. Vulvovaginal yeast infection- painful inflammation of female genital c. Cutaneous candidiasis- moist areas of skin and burn patients iii. Portal of entry 1. Primary mycoses- respiratory 2. Subcutaneous- skin, cut 3. Cutaneous and s uperficial- contamination of skin surface 13. Apicomplexan Parasites a. Have asexual and sexual phases 19 b. Plasmodium – Malaria i. Obligate intracellular disease ii. P. malariae, p. vivax, p. falciparum, p. ovale iii. 300-500 million new cases a year; 2 million deaths a year iv. Asexual phase- humans 1. Injected w/ sporazoite, become merozoites in liver which then enter blood stream and then enter RBC. In the RBC the merozoites turn into trophozoites which multiply and make RBC lyse turning into merozoites aging then gametes. v. Sexual phase- mosquito 1. Mosquito draws up RBC and gametes which fertilize and become sporazoites. Sporazoites enter misquito salivary glands to enter human host. vi. Symptoms 1. Start 7/+ days after infected 2. First symptoms- fever, headache, chills and vomtiting, needs to be treated in first 24 hours 3. 24-72 hours- fever and chills, anemia, organ enlargement, sometimes death vii. Becoming drug resistant, chloroquine, mefloquine c. Tapeworm/ flatworm i. Taenia saginate 1. From uncooked beef a. Lava- killed by heat 2. Can become up to 2,000 proglottids 3. Human only host a. Few symptoms: abdominal pain and nausea b. In small intestine ii. Taenia solium 1. From uncooked pork 2. 800 proglottids 3. Can live for 25 years 14. Communicable Disease a. Transmitted person to person b. Endemic: small number of cases are always present in population c. Epidemic: communicable disease concurrently affecting large numbers of the population d. Direct transmission i. Physical contact ii. Droplet spread e. Indirect transmission i. Contaminated food and water ii. Insects (malaria) f. Syphilis- Treponema pallidum 20 i. Transmission: sexual or congenital ii. Cannot live long outside human host iii. 3 stage of syphilis a. Primary: 3-4week incubation period i. Chancre-small and painless lesion full of bacteria at site of infection that last 4-6 weeks 1. Highly contagious ii. Enters blood stream at 6 weeks iii. Does not produce toxins so immune system is not activated b. Secondary i. Spirochete is multiplying in blood 1. Need blood test to find ii. Purple rash that last 3-6 weeks; other symptoms, fever, headache, sore throat c. Tertiary syphilis- can show up as late as 20 years after secondary i. Damage to tissues and organs ii. Gummas- break down of tissue near major arteries. Made of WBC and connective tissue iv. Neurosyphilis – lack of blood supply to brain and spinal cord 1. Convulsions, blindness, pupils stop reacting to light v. Congenital syphilis 1. Nasal discharge, skin eruptions, bone deformation and nervous system abnormalities g. Chlamydia – Chlamydia trachomatis i. Gram-negative obligate intercellular parasite ii. Elementary Bodies- infections form; enters the body iii. Reticulate body- causes infection iv. Mostly asymptomatic inflammations v. Also congenital 1. Conjunctivitis 2. Pneumonia 15. Hereditary and congenital disease a. Hereditary/ Genetic- resulting from a chromosome abnormality or defective gene i. Autosomal recessive disorder- must be homozygous recessive (aa) a. Affect males and females equally b. Unaffected parents can have affected offspring c. Affected parent will have affected offspring 2. Cystic Fibrosis- chromosome 7 21 a. Cl ions do not pass though cell membrane due to malfunction of channel i. Many reasons for malfunction: production of proteins, stricture of membrane or stability of membrane b. Affects; sinuses, lungs, skin, liver, pancreas, intestines and reproductive organs i. Buildup of mucus ii. Males are infertile; 20% of women stile c. Life expectancy:37 years; immune to cholera ii. Autosomal dominant disorder- can be homozygous(AA) or heterozygous(Aa) 1. Marfan syndrome- chromosome 15 a. Effects production of fibrillin (makes elastic tissues and provides support). Not enough fibrillin is made b. People are abnormally tall c. Have normal life expectancy but usually die from heart failure iii. Codominance- heterozygote 1. Sickle hemoglobin- some cells become sickle-shaped other stay normal a. Hemoglobin subunit beta mutation b. RBC carry less oxygen and can cause blockage in blood vessels c. Helps make people immune to Malaria iv. X-linked recessive disorders 1. More males affected 2. For females both parents must be affected with gene 3. Skip generations 4. If female has disorder all sons will have disorder 5. Common disorders: red-green color blindness, hemophilia b. Congenital – intrauterine injury to embryo or fetus i. Causes: 1. drugs and chemical a. thalidomide- limb malformation, was a morning sickness medicine 2. radiation 3. maternal infections a. congenital toxplasmosis- Toxoplasmas gondiia i. parasite from cat feces ii. can cause: 1. premature birth 2. mental retardation or learning disabilities 3. visual and hearing impairments 22 TEST 3 1. Neoplastic Disease a. Benign vs malignant i. Benign tumors 1. Slow growth rate 2. Grows by expanding 3. The tumor does not spread 4. The tumor cells are well differentiated ii. Malignant tumors 1. Rapid growth rate 2. Grows by infiltrating other cells 3. The tumor spreads in the blood stream or by lymphatic channels 4. The tumor cells are not well defined b. The 3 phases of development of cancer cells i. Initiation- a cells undergoes a mutation and divides repeatedly ii. Promotion- a tumor(mass of cells) develops and the cells start to mutate iii. Progression- a cell mutates in a way that it can invade surrounding tissue c. Terms to know i. Angiogenesis- the formation of new blood vessels that go to the tumor to give it nutrients and oxygen ii. Metastasis- when cancer cells move into the blood stream or lymphatic vessels to form new tumors away from primary tumor d. The genetics of cancer 1. Proto-oncogenes-proteins that promotes the cell cycle and prevents apoptosis 2. Oncogenes- proto-oncogenes that have mutated 3. Needs mutation in 1 allele ii. Tumor suppressor genes (TSG)- proteins that inhibit the cell cycle and promote apoptosis 1. Needs mutation in both alleles 2. P53- paired with MDM; when stress occurs the two break apart and genes are turned on or off iii. Types of mutations 1. Point mutation 2. Translocation 3. Amplification e. Types of cancer i. Oncology-the study cancer 1. Carcinomas-epithelial tissue 2. Adenocarcinomas-glandular epithelial tissue 3. Sarcomas-muscle and connective tissues 23 4. Leukemia-blood 5. Lymphomas–lymphatic tissues ii. Causes of cancer 1. Genetics 2. Environmental carcinogens a. Radiation- UV light and X-rays b. Viruses i. Hepatitis B and C ii. Epstein-Barr virus iii. Human papillomavirus c. Environmental carcinogens (smoke, pollution) 2. Types of cancer a. Acute myelogenous Leukemia i. Acute adult leukemia ii. Results from chromosome translocation iii. Proliferation of malignant myeloid cells iv. Bleeding, anemia and infection- need blood transfusion b. Breast cancer i. 14% of new cancer cases, 89% 5/+ year survival ii. Many types- infiltrating ductal carcinoma is the common type iii. Metastasize in bones, lungs and liver iv. Slow developing- 10 years v. BRAC1 #17 or BRAC2 #13 vi. Swelling, pain, nipple discharge, redness c. Prostate cancer- males only i. 13% of new cancer cases, 99% 5/+ survival rate ii. Glandular cells in prostate proliferate iii. Problems urinating, blood in urine d. Lung Cancer i. 13% of new cancer cases, 17% 5/+ survival rate ii. Only 10% curable iii. Adenocarcinoma, squamous cell carcinoma, large cell, small-cell iv. P53 gene and RB gene (90% of cases are altered). v. Persistent cough, chest pain, coughing blood e. Skin cancers i. Basal cell, squamous cell, melanoma ii. 4.5% of new cancer cases(melanoma), 91.5% 5/+ survival rate iii. P16 mutations- develop melanoma in 20’s/30’s 1. Allow cells to proliferate f. Colon cancer i. 8% of new cancer cases, 65% 5/+ survival rate ii. Need seven mutations 1. 2 APC, 1 KRAS, 2SMAD, 2 p53 iii. Polyps- benign tumors, that rarely turn into cancer (<1%) 3. Prevention and testing a. Screenings/ test 24 i. Self-exams ii. Colonoscopy iii. Mammogram iv. Pap test v. ABCDE- skin cancer (melanoma) vi. Tumor marker test 1. Blood test for tumor antigens/antibodies vii. Genetic 1. Mutations in proto-oncogenes and TSG viii. Biopsy b. Treatments i. Surgery- small tumors ii. Radiation therapy- localized therapy that causes chromosomal breakage and disrupts cell cycle iii. Chemotherapy- kill cancer by damaging DNA or interfering with DNA synthesis iv. Bone marrow transplant v. Immunotherapy- immune cell injections that bear tumors antigens vi. Passive immunotherapy- injections antibodies connected to RI or chemotherapeutic drugs vii. P53 gene therapy viii. Angiogenesis inhibition c. Prevention of cancer i. Use common sense 1. Sunscreen 2. Don’t smoke 3. Get test at right age 4. Get vaccinated 5. Have a healthy diet 6. Drink in moderation 4. Respiratory system i. Oxygenates blood and removes carbon dioxide ii. Connected with the circulatory system that transports gases In the blood stream 1. External and internal respiration iii. Upper tract iv. Lower tract b. Disease of the respiratory system i. Upper respiratory tract infection (sinusitis) 1. Inflammation of nose, sinuses, throat or larynx 25 a. Blocked drainage 2. Caused by the common cold and the flu 3. Usually followed by secondary bacterial infection ii. Pneumonia 1. Exudate spreads through lungs, fills alveoli and the area of the ling becomes solid-ish 2. Exudate may reach pleural surface 3. Many causes 4. 3 main types a. Bronchopneumonia b. Lobar c. Interstitial or primary atypical pneumonia i. Caused by virus or mycoplasma 5. Factors that can lead to infection a. Poor lung ventilation b. Postop accumulation of mucous c. Aspiration in lungs d. Obstruction of bronchioles 6. Symptoms a. Fever, cough, purulent sputum, pain with breathing, shortness of breath iii. Tuberculosis 1. Mycobacterium tuberculosis- produces no toxins and does not trigger immune response 2. Virulence factors- waxes and cords that prevent destruction 3. 1/3 of world population and 15 million Americans carry bacteria but only 5-10% of people get disease 4. Primary TB, secondary TB and Extrapulmonary TB 5. Skin test, x-rays, sample 6. Take 2 drugs and Rifater cocktail drug


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