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533 Cards in this Set

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What is pathology? ***
a branch of medicine that studies the characteristics, causes and effects of disease
What is disease? ***
the unhealthy state of a body part, a physiological system, or the body as a whole.

there is a disordered structure of function
What is a cause of many types of diseases? ***
abnormal growth patterns
What is hyperplasia? ***
an increased number of cells, resulting in tumor formation
What is hypoplasia? ***
incomplete development or underdevelopment of an organ or tissue

(e.g., a child with cerebral palsy that presents with an underdeveloped limb or muscle tissue)
What is aplasia? ***
the absence of a structure of tissue

(e.g., plastic anemia, where the bone marrow fails to produce erythrocytes, leukocytes, and platelets and the patient is unable to fight infection
What is metaplasia? ***
the conversion of normal tissue cells into an abnormal form following chronic stress or injury

(e.g., cancer)
What is dysplasia? ***
abnormal development of a structure

(e.g., congenital heart defect, or hip dysplasia in a dog)
What is etiology? ***
the study of the causes of diseases
What are the sources of infectious diseases? ***
- bacteria
- fungi
- parasites
- viruses
What is the source of hereditary diseases? ***
defective gene(s) or genetic disease
What is a congenital birth defect? ***
an error in development of the fetus
What can cause congenital birth defects? ***
- maternal infection during pregnancy (e.g., rubella)
- use of certain drugs or excessive alcohol intake during pregnancy
- industrial waste exposure during pregnancy
- accident at time of delivery (e.g., interference with oxygen supply
What types of environmental factors can cause disease? ***
- sun exposure (e.g.,, skin cancer)
- radiation exposure
- asbestos exposure
- chemical exposure
Diseases of malnutrition may be caused by: ***
- lack of adequate food supply
- patient's inability to digest properly/absorb nutrients properly
What are some degenerative causes of disease? ***
- arthritis
- normal aging
Name an endocrine disturbance that may cause disease. ***
altered thyroid function due to improper hormone secretion as seen in thyroid disease
Name a disease caused by obstruction of a hollow organ. ***
coronary artery disease
What is a neoplasm? ***
a new growth of cancer (actually, a new and abnormal growth of tissue in some part of the body, but especially as a characteristic of cancer)
List the various etiologies of disease. ***
- congenital birth defects
- hereditary disease
- environmental factors
- malnutrition
- infectious disease
- degenerative factors
- endocrine disturbances
- obstruction of hollow organs
- neoplasm
- trauma or injury
- idiopathic
The cause of disease is known as its ________. ***
etiology
What is a diagnosis? ***
the use of scientific and/or clinical methods to determine the nature of a disease
What factors are considered in making a diagnosis? ***
- signs
- symptoms
- lab tests
- diagnostic imaging (e.g., MRI, X-ray, etc.)
- patient history
As a PTA, why must you know how to report your patient's signs and symptoms? ***
you will need to know when even minute changes occur, to determine whether treatment should be discontinued or modified
What is a sign? ***
OBJECTIVE evidence of disease observed on physical examination

(e.g., fever, elevated pulse rate, pallor)
What is a symptom? ***
a SUBJECTIVE indication of disease perceived by the patient

(e.g., pain, dizziness, itching)
What is a syndrome? ***
certain signs and symptoms that tend to occur concurrently in some diseases
A skin rash is an example of a _____. ***
sign
What is a prognosis? ***
the predicted course and outcome of the disease, as made by a physician after examining all the signs and symptoms and deriving a diagnosis
The predicted outcome of a disease is its _______.
prognosis
A fever is an example of a:
sign
What disease type has a slow and long-lasting course?
chronic
The recurrence of a disease’s signs and symptoms is known as:
relapse
Normal health and non-disease conditions represent:
homeostasis
A chronic aftermath of an initial disease is known as:
sequela
Which of the following is not a disease?

tuberculosis
polio
common cold
fatigue
fatigue
The overall study of disease may be called:
pathology
What is the opposite of idiopathic?
etiology
An objective or measurable disease feature is called:
sign
Simultaneous signs and symptoms of a disease are called:
syndrome
The cause of a disease can be identified as idiopathic, which means unknown. (T/F)
true
A traumatized tissue has an abnormal gene. (T/F)
false
Homeostasis means the maintenance of the body in an unchanging state. (T/F)
false

(it is maintaining within normal limits, not completely unchanging)
The severe scars left after a serious burn injury represent a sequela. (T/F)
true
A syndrome is an inherited disease. (T/F)
false
An abnormally high red blood cell count is always a sign of a disease condition. (T/F)
false
Pathogenesis is the branch of medicine that studies the characteristics, causes, and effects of disease. (T/F)
false

(pathogenesis is the cause of the disease, together with its development;

pathology is the study of disease in general;

pathophysiology is the study of the physiological processes leading up to disease)
When a patient complains of pain in the chest and a feeling of dizziness, she is describing symptoms. (T/F)
true
Alternating periods of remission and exacerbation are characteristics of acute disease. (T/F)
false (this is characteristic of chronic disease)
Diseases always are the result of some infections agent such as bacteria, viruses, fungi, or parasites. (T/F)
false

(diseases can be infectious, but they can also be caused by:
- congenital birth defects
- heredity
- environmental factors
- malnutrition
- infection
- degenerative factors
- endocrine disturbances
- obstructions in hollow organs
- neoplasm
- trauma/injury
- idiopathic origin
Pallor means:
abnormal paleness
________ cannot be treated successfully by antibiotics.

Strep Throat
Tuberculosis
Influenza
Salmonella
influenza
A(n) ______ is reduced size or function of a tissue.
atrophy
When a diabetic patient experiences kidney failure, he has developed a(n)
complication
_________ refers to the permanent damage remaining after a disease has run its course.
sequela
Development of an increased number of cells in a tumor is called _______.
hyperplasia
During fetal development, the roof of the mouth (palate) sometimes fails to form completely. This is an example of __________.
hypoplasia
Prediction of the course of a disease is the ________.
prognosis
An area of abnormal tissue or function is called ________
lesion
Bacteria may develop their own ________ and thus resist antibiotics through multiple or constant exposure.
immunity
Unknown disease cause
idiopathic
A pimple is a representative form
lesion
Known cause of disease
etiology
Measurable disease observation
sign
Number of new disease cases in a population
incidence
Developmental cause of disease
pathogenesis
Predictable outcome for a disease
prognosis
Number of disease cases in a population
prevalence
Perceived criterion of disease
symptom
Follows diagnosis
treatment
What is inflammation? ***
a protective response to injury or invasion by disease-producing organisms
What are some causes of inflammation? ***
- foreign substances (e.g., splinter)
- allergies
- chemical agents (e.g., poison, venom)
- trauma or injury
- pathogenic organisms (e.g., bacteria, virus, fungus)
- physical agents (e.g., radiation, temperature extremes)
Are inflammation and infection the same thing? ***
no

you can have inflammation without infection (e.g., sunburn)
but you can't have infection without inflammation
What causes infection? ***
invading pathogenic organisms

(e.g., bacteria, viruses, fungi, parasites)
How do invading organisms cause disease? ***
- by local infection
- by secretion of a toxin
- by initiating an allergic response
What vascular changes occur with inflammation? ***
- local blood vessels, arterioles, and capillaries dilate, resulting in increased blood flow
- increased blood flow causes heat and redness associated with the inflammatory process
- with increased blood flow, more leukocytes (WBCs) reach the injury or infection
- specialized WBCs called neutrophils or polymorphs line up within capillary walls
- damaged tissue releases histamine, which causes capillary walls to become more permeable
- increased permeability allows plasma and neutrophils to pass in and out of blood vessels easily
- phagocytic neutophils engulf and digest bacteria and cellular debris
- escaping plasma and WBCs comprise inflammatory exudate, which causes swelling associated with inflammation
- increased fluid in the tissues (edema) puts pressure on sensitive nerve endings, causing pain
What is hyperemia? ***
increased blood flow
What substance is released by damaged tissue, causing capillary walls to become more permeable? ***
histamine
What is inflammatory exudate? ***
a mixture of plasma and white blood cells that causes the swelling associated with inflammation
What is edema? ***
swelling
What is a phagocyte? ***
a cell that consumes and digests other cells
What are the signs and symptoms of inflammation? ***
- redness
- heat
- swelling
- pain
How is a scar formed? ***
- connective tissue cells called fibroblasts produce collagen fibers that contract and close the gap between cut edges of injured tissue

- scar tissue is the fibroblasts and their collagen fibers that heal the cut
What is a fibroblast? ***
a connective tissue cell that produces collagen fibers to aid in healing/scar formation
What is an adhesion? ***
occurs when connective tissue fibers anchor adjacent tissues together
What is a keloid? ***
occurs when connective tissue fibers are laid down in an irregular network
What is an antigen? ***
a foreign element that triggers an immune response
What substances are created by the body to fight against antigens and render them harmless? ***
antibodies and activated lymphocytes
What types of material normally comprise an antigen? ***
they are normally a protein or large polysaccharide (complex carbohydrate)
What is immunity? ***
the ability of the body to defend itself against infectious agents, foreign cells, and abnormal body cells
What two types of immunity do we have? ***
- innate immunity (nonspecific defenses), and
- acquired immunity (specific defenses)
What six elements comprise our innate immunity (nonspecific defenses)? ***
- Fever
- Interferon (group of substances that stimulate immune system)
- Physical or chemical barriers (skin & secretions)
- Phagocytosis
- Inflammation
- Natural killer cells (leukocyte that recognizes body cells with abnormal membranes)
FIPPIN
What are the two types of acquired immunity (specific defenses)? ***
- humoral immunity
- cell-mediated immunity
What is humoral immunity? ***
- circulating antibodies capable of destroying foreign invaders

[B lymphocytes, which comprise memory cells and plasma cells (immunoglobulins)]
What is the difference between an immunoglobulin and an antibody? ***
none, they mean the same thing
What is cell-mediated immunity? ***
activated lymphocytes responsible for resistance to infectious diseases caused by certain bacteria and viruses

(T lymphocytes, processed by the thymus gland into activated lymphocytes, comprise the cytotoxic, helper, and suppressor T lymphocytes)
What structures comprise the lymphatic system? ***
- lymph vessels
- lymph nodes
- spleen
- thymus gland
- tonsils
What is lymph and of what is it comprised? ***
it is the fluid within lymphatic vessels

it is comprised of water, WBCs, nutrients, hormones, salts, carbon dioxide, oxygen, and urea
Antibodies and lymphocytes (WBCs) are formed in the: ***
- lymph nodes
- spleen
- bone marrow
- tonsils
- adenoids
Lymph nodes and lymph tissue are strategically placed in the body to: ***
intercept invading organisms
What two types of lymphocytes provide immunity? ***
T lymphocytes
B lymphocytes
What are cytotoxic T cells? ***
- killer cells capable of killing invading organisms
- important in destroying cells invaded by viruses and cancer
- a.k.a. CD8 T lymphocytes
What do helper T cells do? ***
- they increase the activity of killer cells, B lymphocytes, and suppressor T cells by secreting lymphokines
- also activate macrophages that destroy invading organisms by phatocytosis
What do suppressor T cells do? ***
- they slow down the cytotoxic (CD8 T/killer) lymphocytes
- help stop the immune response (homeostasis--so the response doesn't go too far)
Some activated B lymphocytes are transformed into: ***
plasma cells which divide rapidly and produce a large number of cells that secrete antibodies into lymph
Some B lymphocytes do not become plasma cells and instead remain ______ ***
dormant until reactivated by the same antigen (memory cells)
What is a memory cell? ***
A B lymphocyte that remains dormant until reactivated by a subsequent exposure to the same antigen.
Why are booster shots so effective? ***
because memory cells produce a more potent and longer lasting antibody response
What is a retrovirus? ***
a virus that carries its genetic code on the RNA instead of teh DNA
Why is HIV infection so devastating? ***
it causes severe immunodeficiency of T-cell functions

it attacks helper (CD4) T lymphocytes and destroys their ability to fight infection and renders them incapable of stimulating the B-lymphocytes and cytotoxic (CD8/killer) T cells
What is Chronic Fatigue Syndrome? ***
- it manifests as an immune response consistent with a viral infection
- no known cause or cure
- generally affects young professionals ("Yuppie flu")
What are the signs and symptoms of Chronic Fatigue Syndrome? ***
- severe and persistent fatigue
- muscle and joint pain
- fever
- difficulty with concentration and memory/retention
What is immune tolerance? ***
the ability of the immune response to recognize the difference between the individual's own body cells and cells of an invading pathogen
What happens when immune tolerance fails? ***
autoimmune disease

activated T-cells and antibodies attack the body's own tissues
What are the four types of lupus? ***
- systemic lupus erythematosis (SLE)
- discoid/cutaneous lupus
- drug-induced lupus erythematosus
- neonatal lupus
Which is the most severe type of lupus? ***
systemic lupus erythematosis (SLE)
Why is systemic lupus erythematosis (SLE) so deadly? ***
autobodies against RNA and DNA can attack any body cell and threaten the organs, especially the heart, lungs, kidneys, liver, and blood
also can affect joints and muscle tissue
What are the signs and symptoms of systemic lupus erythematosis (SLE)? ***
- rash
- skin overly sensitive to sunlight
- joint and muscle pains
- hypertrophy of joints (appear similar to RA)
- fever
- enlarged lymph nodes and spleen
- fatigue
- Raynaud's phenomenon
- periods of exacerbation and remission
What is the typical treatment for discoid/cutaneous lupus? ***
NSAIDs/corticosteroids to relieve inflammation
What is the typical treatment for systemic lupus erythematosis (SLE)? ***
no specific treatment except corticosteroids to control inflammatory symptoms of redness, heat, swelling, and pain
What is the usual prognosis for systemic lupus erythematosis (SLE)? ***
fatal

usually due to organ (renal/heart) failure or pneumonia
What are the two types of artificial immunity? ***
- active immunity
- passive immunity
What is active immunity? ***
person is given a vaccine or toxoid as antigen, and he/she then forms antibodies to counter it
What is a vaccine? ***
a low dose of inactivated (dead) or attenuated (weakened) bacteria or viruses used to induce immunity
What is a toxoid? ***
a chemically altered poisonous material/toxin

(toxin--the poisonous material produced by a pathogenic organism)
Is active immunity long- or short-lived? ***
long-lived
What is passive immunity? ***
a situation where a person is given doses of “preformed antibodies” from the immune serum of an animal, usually a horse

it is used in situations where there is not time to vaccinate the patient and develop active immunity (e.g., snake bite--hospital administers antivenin)
Is passive immunity long- or short-lived? ***
short-lived
What is an allergic reaction? ***
a malfunction of the immune system in which it (over)reacts to one or more substances that do not bother most people
The immune reaction is ______ rather than defensive in the individual who is hypersensitive or allergic to an antigen. ***
destructive
What is the cause of the sensitivity in an allergic reaction? ***
abnormally formed antibodies

the system overproduces IgE immunoglobulins instead of IgG
What is the chain of events that produces an allergic reaction? ***
- body forms IgE vice IgG
- IgE attaches to mast cells containing histamine, heparin, serotonin, and bradykinin
- allergen binds with other end of IgE
- mast cells break down and release their chemical loads of histamine, etc.
- blood vessels dilate and release plasma into tissues
- tissues swell
How can allergic reactions be countered? ***
- allergy shots can desensitize
- oral antihistamines can relieve minor reactions
What are the steps the body goes through during anaphylactic shock? ***
- large quantities of antigens are introduced to the body when large numbers of antibodies are already present
- antigens and antibodies interact
- cellular damage triggers histamine release from mast cells and basophils throughout the body
- blood vessels dilate
- capillaries become more permeable and leak plasma into tissues
- blood pressure drops
- hypotension causes poor return of venous blood to the heart
- cardiac output is reduced
- blood pools in body instead of circulating
- person goes into shock
- smooth muscle contraction in respiratory tract can occur as well
What are some less-severe signs of anaphylactic shock? ***
- skin flush
- hives
- swelling of lips/tongue
- wheezing
- abdominal cramps
What are the signs and symptoms of life-threatening anaphylactic shock? ***
- profound weakness
- collapse due to low blood pressure
- decreased cardiac output
- inability to breathe or labored breathing
- seizures
The inflammatory response includes:

Histamine release
Dilation of blood vessels
Increased permeability of blood vessels
Answers 1 and 2
All of the above
all of the above
Which cells are associated with production of antibodies?
Plasma cells
Synonyms for antibodies include:

Immunoglobulins
Gamma globulins
Lymphokines
Answers 1 and 2 both are correct
All three of these choices are correct
answers 1 and 2 are both correct
Long-lived lymphocytes, which remain dormant until reactivated after an immune response are the:
memory cells
The secondary response to invasion by the same microbe will be:

Faster
Stronger
Longer-lasting
Answers 1 and 2
All of the above
all of the above
Passive immunity is achieved artificially by injection of:
preformed antibodies
Which are associated with humoral immunity?

T lymphocytes
B lymphocytes
Killer cells
Two of the above
All of the above
B lymphocytes
The most damaging aspect of AIDS is
suppression of the immune system
What type of allergic reaction creates the rash of poison ivy?

Bonding of ivy oil to IgE
Release of histamine from mast cells
Hypersensitive responses of the cellular immune system
Answers 1 and 2
All of the above
hypersensitive responses of the cellular immune system
Anaphylactic shock develops as a result of a:
systemic release of histamine, which drastically lowers blood pressure
The reaction of tissues to local injury, foreign invasion, or irritation is an infection. (T/F)
false
An inflammation is an undesirable reaction to injury. (T/F)
false
Cell-mediated immunity depends on the activities of B lymphocytes. (T/F)
false
Antibodies provide humoral immunity. (T/F)
true
Injection of toxoids produces a long-lived active type immunity. (T/F)
true
Failure of immune tolerance creates an autoimmune disease. (T/F)
true
Inflammation is another name for infection. (T/F)
false
The release of histamine increases the permeability of capillary walls. (T/F)
true
Anaphylactic shock is a moderately serious allergic reaction. (T/F)
false

(it is very serious)
Persons with severe allergy reactions to bee stings should carry a supply of epinephrine that can be self-injected during outdoor activities. (T/F)
true
Attraction of erythrocytes for a blood typing action is called ________.
agglutination
Bacteria that cause pus formation are called _______ bacteria.
pyogenic
Which defense cell contains heparin, histamine, and serotonin?

Mast cell
Lymphocytes
Neutrophils
Eosinophils
mast cell
A substance that triggers an immune response is an _________.
antigen
_______ disease may result when the body’s immune tolerance fails.
autoimmune
Excess fluid within tissues puts pressure on sensory nerves to cause:
pain
________ are antigens responsible for causing allergies.
allergens
Allergic reactions occur in ________ individuals susceptible to the allergy-causing agent.
hypersensitive
_________ shock is a serious reaction that is potentially lethal.
anaphylactic
The _______ immunoglobulin spikes high in allergic reactions
E
(IgE)
Natural hormone and inhalant medication:
epinephrine
Pathogen invasion
infection
Stimulates vascular permeability
Histamine
allograft
Most common form of transplant
Hypersensitivity type II
blood incompatibility
Injection medication for Rh- mothers
RhoGam
Lupus and scleroderma
autoimmune diseases
A retrovirus (the only one we discussed)
HIV
Pus-forming reaction
suppurative
(by pyogenic bacteria)
Eating cell
phagocyte
What causes infectious disease? ***
invading pathogenic microorganisms
How are infectious diseases transmitted? ***
- human-to-human (contagious/communicable)
- by other elements in environment (e.g., rabies from rat bite, cholera from fouled water) (noncommunicable)
A disease that passes readily from human to human is: ***
contagious or communicable
A disease that is not directly transmitted by humans is: ***
noncommunicable
What are the causes/pathogens of infectious disease? ***
- bacteria
- viruses
- fungi
- helminths
- protozoa
- arthropods
- prions (proteinaceous infectious particle)
What are the characteristics of bacteria? ***
- microscopic single-celled organisms
- no nucleus or membranous organelles
- grow rapidly and split in half through binary fission (in as little as 30 minutes)
- some produce endospores
How do bacteria multiply? ***
they grow rapidly and split in half through binary fission (in as little as 30 minutes)
What are the five shapes of bacteria cells we discussed? ***
bacilli - rod-shaped
cocci - round/spherical
spirilla - spiral-shaped
spirochetes - corkscrew-shaped
vibrios - comma-shaped
What are the characteristics of a bacterial infection? ***
- swelling
- redness
- pain
- fever
- pus
What are endospores? ***
- basically, a stripped-down, dormant bacteria waiting for better conditions to reactivate
- contains genetic material of the cell/bacteria
- resistant to desiccation, acid, temperature extremes, radiation
- germinate and form growing cells
- contaminate food, water, wounds
What is a virus? ***
- infectious particles made of a core genetic material (either RNA or DNA)
- wrapped in a protein coat (capsid)
- may have a lipid membrane around the capsid
- may have spikes for attachment
- not a living organism; needs a host to grow and replicate
Certain viruses infect and grow in only: ***
certain types of cells
cold virus - respiratory epithelium
herpes virus - nervous tissue
HIV - T- cells
Some viruses, like HPV, may cause: ***
abnormal cell growth
cancer
What are protozoa? ***
single-celled microorganisms with complex internal structures (nucleus, organelles, etc.--eukaryotic)
Do most protozoa cause disease? ***
no
What are the four classes of protozoa? ***
- amoeboids
- flagellates
- sporozoans
- ciliates (very few are pathogens)
How do amoeboids move? ***
using cell membrane extensions called pseudopodia
What is caused by the amoeboid Entamoeba histolytica? ***
Amoebic dysentary--an intestinal infection from feces-contaminated food or water
How do flagellates move? ***
they swim by using their whiplike appendages (flagella)
What do the following flagellates cause: ***
Trypnosoma
Giardia
- African sleeping sickness
- giardiasis - an intestinal infection
What is one of the characteristics of the sporozoan? ***
non-mobile
What does the Plasmodium sporozoan cause? ***
malaria (transmitted by mosquito bite)
What are the characteristics of fungi? ***
- single- or multicelled
- can move easily
- readily infect damaged tissue (more so than healthy tissue)
- cause disease by producing toxins that interfere with normal organ structure/function or induce inflammation/allergy
- reproduce via spores (which are allergens)
What are some fungal diseases? ***
Candidiasis - yeast infection/thrush
Histoplasmosis - lung infection from bird/bat-dropping contaminated soil
Microsporum - causes ringworm
Trichophyton - athlete's foot
What are the characteristics of helminths? ***
- parasitic worms
- complex multicellular organisms (roundworms and flatworms)
- well developed reproductive systems
- complex lifecycles and infection strategies
What is an infection with helminths called? ***
an infestation
What are some common roundworms? ***
- ascaris
- pinworms (Enterobius vermicularis)
- hookworms (Necator americanus)
What are the two major types of helminths discussed? ***
- roundworms
- flatworms
What is the most common worm infection in the U.S.? ***
pinworms (Enterobius vermicularis)
What worm infection is a leading cause of anemia and protein malnutrition? ***
hookworms (Necator americanus)
How do helminths cause disease? ***
- using the host’s nutrients
- feeding on blood and causing anemia
- blocking or perforating the intestines
- inducing severe inflammatory responses
What are arthropods? ***
animals with jointed legs and hard exoskeletons
What are some examples of arthropods? ***
- ticks
- mites
- lice
- flies
- mosquitoes
- fleas
What is a vector? ***
transmitter of a pathogenic organism
(e.g., mosquito transmits Plasmodium when it feeds on humans)
What is a reservoir? ***
- the source of an infectious agent
- can be human, animal, insect, soil, water
Define incidence ***
the number of new cases of a disease in a population
Define prevalence ***
the number of existing cases of a disease in a population
Define endemic ***
when a disease is always present at low levels in a population
Define epidemic ***
when a disease occurs in unusually large numbers over a specific area
Define pandemic ***
when an epidemic has spread to include several large areas worldwide
Define outbreak ***
when a disease suddenly occurs in unexpected numbers in a limited area and then subsides
Define standard/universal precautions ***
- the precautions taken to prevent spread of disease
- assumption that all bodily fluids are contaminated
- use of any/all available protective equipment and procedures to prevent contact with such substances
What is epidemiology? ***
study of transmission, occurrence, distribution and control of disease
What is horizontal transmission? ***
transmission from infected human to uninfected human
What is vertical transmission? ***
transmission from one generation to the next
Upon what does effective treatment of infectious disease depend? ***
type of pathogen
How are bacterial infections treated? ***
antibiotics
(some act on the cell wall, especially in gram-positive bacteria; others target the cell membrane and cause lysis; others target the protein synthesis of the cell, interfere with metabolism, or DNA or RNA synthesis)
Are viruses susceptible to antibiotics? ***
no
How are viral infections treated? ***
antiviral drugs can interfere with
- replication, or
- attachment of virus to host
How are fungal infections treated? ***
- treatment includes antifungal drugs that attack cell walls and membranes

- they are difficult to treat because the cells are similar to human cells and both are often destroyed by the treatment (topical agents aren't as dangerous as systemic agents)
What are re-emerging infectious diseases? ***
infections once considered under control, but are again becoming health threats
What is causing re-emergence of some infectious diseases? ***
- increased antibiotic resistance
- changes in climate (alter arthropod vector breeding)
- urbanization/crowding
- rapid world travel
- disruption of social and governmental structure (e.g., war)
- human demographics and behavior
What are some of the re-emerging infectious diseases? ***
- tuberculosis
- cholera
- malaria
- mumps
- strep throat/impetigo
- pneumonia/meningitis
All diseases caused by microorganisms are properly called:
infectious
Examples of communicable diseases include:
measles, mumps, tuberculosis

(anything transmitted from human to human)
Animals that transmit an infectious microbe from one person to another are referred to as:
vectors
All bacteria have in common:
absence of a nucleus
Viruses are:

Smaller than bacteria
Basically micro-parasites
Probable infectious agents
All of the above
all of the above
Rod-shaped bacteria are called:
bacilli
Viruses are capable of reproducing in:
a specific host tissue
Some people in all parts of the world have the common cold at any one time. This is properly described as:
endemic
Vertical transmission of disease occurs in which of the following:

Influenza
Lyme disease
Syphilis
Pneumonia
syphilis
Contraction of an infection during a hospital stay would be:
a nosocomial infection
Epidemiology is the study of the cause of diseases. (T/F)
false

(epidemiology is the study of the transmission, occurrence, distribution, and control of disease)
Vaccines reduce or prevent bacterial or viral infections. (T/F)
true
The re-emergence of some diseases can be traced to changes in climate. (T/F)
true
Infectious disease mortality has decreased significantly in the past two decades. (T/F)
false
Having chicken pox is usually a prelude to having shingles. (T/F)
true
Yeast infections are routinely controlled by penicillin. (T/F)
false
Helminths include both roundworms and flatworms. (T/F)
true
Having a high susceptibility means less chance for infection. (T/F)
false
Antifungal drugs can cause serious side effects, since fungal cells have many similarities to human cells. (T/F)
true
Vaccination is injection of antibodies from a microorganism in order to provoke an immune response and prevent future infection by that microorganism. (T/F)
false

(injection of an ANTIGEN, not an antibody)
Normal flora live mainly in the ________ and on the _______.
intestines, skin
The simple act of _______ helps reduce infectious spread. It is the single most important means of preventing spread of infections.
hand washing
A chemical method to characterize bacteria is the _________.
gram stain
Ig__ helps keep body surfaces antiseptic.
D

(IgD)
An example of a vector is the:

Deer
Tick
Mouse
Bird
tick
Elephantiasis is caused by a:
roundworm
Bacillus forms of bacteria are shaped like ________.
rods
An organism that is a reservoir for disease is a(n):
animal
A worldwide outbreak of a disease is said to be ________.
a pandemic
A re-emerging disease with increased antibiotic resistance is:

Smallpox
Tuberculosis
Polio
Measles
tuberculosis
Local or regional spread of disease
epidemic
Transmitted from human to human
contagious
Mode of bacterial reproduction
binary fission
Round and flat worms like nematodes or tapeworms
helminths
Infectious disease harbored and transmitted by bats
rabies
Kills bacteria
antibiotic
One method of disease prevention
vaccination
One type of mosquito-borne disease
malaria
A simple fungus infection
yeast
thrush
Tick-borne infectious disease
Lyme disease
What is neoplasia? ***
new and abnormal formation of tissue
What are two classes of neoplasia? ***
- benign
- malignant
What are the characteristics of a benign neoplasm? ***
- not usually dangerous (but may grow to a size that impedes function)
- not spreading by metastasis or infiltration of tissue
- cells adhere together
- generally encapsulated, with clearly defined edges
- non-cancerous
- grow as a single mass within tissue
- can grow within an organ causing considerable damage (e.g., brain tumor)
What are the characteristics of a malignant neoplasm? ***
- grows worse
- metastasizes
- often recurs after attempts at surgical removal
- irregularly shaped
- harmful and usually life-threatening
- typically larger than benign neoplasia
Which class of tumors are growing worse, benign or malignant? ***
malignant
What are five types of benign tumors? ***
adenoma - glandular tumor
angioma - red birth mark (a.k.a. port wine stain)
lipoma - fatty tumor
nevus - mole
papilloma - wart
Which is commonly referred to as a wart? ***

papilloma
lipoma
adenoma
nevus
papilloma
What is the second leading cause of death in the U.S.? ***
malignant tumors
How do cancer cells spread (metastasize)? ***
via
lymph fluid (carcinoma) or
blood (sarcoma)
Which grow faster, benign or malignant neoplasms/tumors? ***
malignant
What are the three classifications of malignant tumors? ***
carcinoma
sarcoma
melanosarcoma
What is the most common type malignant neoplasm/tumor? ***
carcinoma
Where do carcinomas originate? ***
epithelial tissue
By which system do carcinomas spread? ***
lymphatic system
Where are the most common sites for carcinoma? ***
skin, mouth, lungs, breast tissue, stomach, colon, and uterus

(all of which open or are exposed to the outside of the body)
What is the second most common type of malignant neoplasm/tumor? ***
sarcoma
Where are sarcomas found? ***
in the connective tissues, bones, muscles, cartilage
How do sarcomas spread? ***
via blood circulation
Where is the most common site of metastases related to sarcoma? ***
lungs
(since all blood eventually goes through your lungs)
Where is melanosarcoma found? ***
skin
From what does melanosarcoma originate? ***
a nevus or melanoma
What are the characteristics of a Grade 1 tumor? ***
- high survival rate
- tumor tissue differentiated and closely resembles parent tissue
What are the characteristics of a Grade 2 or 3 tumor? ***
- moderate survival rate
- cells moderately or poorly differentiated
What are the characteristics of a Grade 4 tumor? ***
- low survival rate
- cells so undifferentiated that tissue origin not easily recognized
What are the three phases in development of a neoplasm? ***
- initiation
- promotion
- progression
What occurs during the initiation phase of neoplasm development? ***
the cell undergoes genetic changes due to altering of DNA by agents such as chemicals, radiation, or oncogenic viruses
What occurs during the promotion phase of neoplasm development? ***
the altered cells proliferate and look benign; the mass may:
- regress (immune system handles it), or
- evolve into cancer (it's possible to prevent at this stage)
What occurs during the progression phase of neoplasm development? ***
- a change from a precancerous lesion to a malignant lesion
- growth rate increased
- malignancy invades and metastasizes
List some types of carcinogenic agents. ***
- environmental agents (air/water/soil/food pollutants)
- radiation (X-ray, UV light)
- chemical carcinogens
- use of tobacco products (30% of all cancer)
- genetic predisposition
- hormonal imbalances (e.g., prostate cancer)
- viruses (invade cells and alter DNA)
What causes nearly a third (30%) of all cancers? ***
use of tobacco products
What important steps can one take to help prevent development of cancer? ***
- stop using tobacco products
- improve diet and nutrition
- decrease UV/sun exposure
- caution with chemical usage
- regular preventive health examinations
What are some signs and symptoms of cancer? ***
- pain at late stage or if infection is present
- abnormal bleeding or discharge
- blood in urine, stool, vomit or sputum
- unusual thickening or lumps
- persistent cough or hoarseness
- change in bowel or bladder habits
- increased healing time of cuts, lesions or ulcerations
- moles or skin discolorations that change color, darken, enlarge, or become raised, crusty, scaly, or itchy
- unexplained rapid weight loss
- severe anemia
What does the American Cancer Society's CAUTION acronym stand for? ***
- Change in bowel or bladder habits
- A sore that does not heal
- Unusual bleeding or discharge
- Thickening or lump in breast or elsewhere
- Indigestion or difficulty in swallowing
- Obvious change in wart or mole
- Nagging cough or hoarseness
What are some means used to diagnose cancer? ***
- X-ray - use of contrast dyes to show site of tumor/mass
- biopsy - small sample of suspected tissue collected and examined microscopically
- exfoliative cytology - microscopic examination of scrapings, washings, or secretions from suspected area
What are some means of treating cancer? ***
- surgery
- radiation therapy
- hormone therapy
- chemotherapy
How is surgery used to treat cancer, and for what types is it most effective? ***
abnormal tissue is removed, as well as some of the surrounding tissue

effective for early stages of breast and uterine cancer; radiation often follows
Increased healing time of cuts or lesions is: ***

sign of adenoma
symptom of grade 2 tumor
necessary to diagnose cancer
sign of possible cancer
sign of possible cancer
How is radiation used to treat cancer, and for what types is it most effective? ***
used for treatment of fast-growing, undifferentiated tumors

the destructive effects are greater on fast-growing cells than on normal cells

effective treatment for leukemia and Hodgkin's disease; usually combined with chemotherapy
How is hormone therapy used to treat cancer, and on what types of cancer is it most effective? ***
hormone therapy is a type of chemotherapy used to treat prostate cancer by either:
- removing the androgen source which stimulates the cancer growth, or
- administering estrogen to inhibit the growth of the tumor
Any new and abnormal growth is properly called:
a neoplasm
Within a tumor, development of changes that transform cells into cancer is:
progression
CAUTION is an acronym used for remembering the common:
warning signs of cancer


Change in bowel or bladder habits
A sore that does not heal
Unusual bleeding or discharge
Thickening or lump in the breast or any other part of the body
Indigestion or difficulty swallowing
Obvious change in a wart or mole
Nagging cough or hoarseness
A malignant growth of glandular tissue is named:
adenocarcinoma
Sarcomas are tumors involving what tissues?
bone and muscle
Benign growths are usually:

Encapsulated
Non-spreading
Removed by surgery
All of the above
all of the above
A malignant tumor:

May block the lumen of an organ
May have an ulcerated and bleeding surface
Is always fatal
Two of the above are true
two of the above are true
(not always fatal)
The development of a cancer begins with a genetic change in a cell, which may be caused by:

A chemical
Radiation
A virus
All of the above
all of the above
Which of the following is not a possible carcinogenic type of radiation?

X-rays
The radiation from atomic bombs
UV radiation from the sun and tanning booths
All of the above are dangerous, carcinogenic types of radiation
all of the above are dangerous, carcinogenic types of radiation
What behavioral trait may cause lung, stomach, and colorectal cancer?

Eating a low-fat diet
Smoking
Drug abuse
Skipping breakfast
smoking
Cancer has a basic genetic foundation/origin. (T/F)
true
The key identifying characteristic of malignant tumors is metastasis. (T/F)
true
The edges of a malignant tumor are well defined. (T/F)
false
Benign tumors generally are encapsulated. (T/F)
true
Benign tumors, especially cranial ones, are as risky as malignant tumors. (T/F)
true
There are two types of neoplasms, malignant and benign. (T/F)
true
Living in a certain geographic area of a country may increase one’s chance of developing a particular type of cancer. (T/F)
true
Carcinoma and sarcoma are two names describing the same type of cancer. (T/F)
false
A tumor biopsy is a lengthy procedure performed well in advance of surgery. (T/F)
false
Tumor and cancer are synonymous. (T/F)
false
Past age 50, men are prone to _______ cancer.
prostate
Carcinoma spreads primarily using the _________ system.
lymphatic
A(n) ________ is a type of polyp.

Myoma
Adenoma
Papilloma
Angioma
papilloma
The virus causing _________ also seems to be the cause of uterine cervical cancer.
genital warts
__________ is a method of estimating how much a tumor has spread.
staging
Coughing up blood is a major sign of _______ cancer.
lung
Once carcinogenesis has reached the ______ stage, the development of a malignant tumor is a certainty.
progression
Cervical cancer is often attributed to the _______ virus.
human papilloma
Surgery is the initial primary treatment for most ______ cancers.
skin
Cancer develops when ______ are turned on.
oncogenes
Cancer of blood cells
leukemia
Bladder cancer symptom
change in urination control
Skin cancer symptom
sore that will not heal
Respiratory cancer symptom
nagging cough
Laryngeal cancer symptom
hoarseness
Colon cancer symptom
change in bowel habits
Melanoma symptom
black color in mole
Most adult tumors of the central nervous system are derived from:
glial cells
Uterine or cervical cancer symptom
bloody (non-menstrual) vaginal discharge
Hodgkin’s disease symptom
Reed-Sternberg cells
The steady state the body attempts to maintain is called ______.
homeostasis
A significant disturbance in the homeostasis of the body triggers a variety of responses that often produce _______.
disease
Disease can be defined as a state of _____ _______.
functional disequilibrium
( a change in function or structure considered to be abnormal)
The study of disease in general
pathology
The study of the physiological processes leading up to disease
pathophysiology
What factors are analyzed to create a diagnosis?
- patient history
- physical exam
- signs
- symptoms
- laboratory data
- diagnostic (imaging) tests
What characterizes an acute disease?
- sudden onset
- short duration
What characterizes a chronic disease?
- slower, less severe onset
- long duration
What is a remission?
a period of time in which the signs and symptoms of a disease subside
What is an exacerbation?
the period in which the signs and symptoms of a disease recur in all their severity
What is a relapse?
when a disease returns weeks or months after its apparent cessation
What is a complication?
a disease or other abnormal state that develops in a person already suffering from a disease
What is the aftermath of a disease called?
the sequela
How is the mortality of a disease defined?
as a measure of the number of deaths attributed to a disease in a given population over a given period of time
How is the morbidity of a disease defined?
as a measure of the disability and extent of illness caused by a disease
What is a lesion?
it could be
- a damaged gene or enzyme; or
- abnormal cells, tissues, or organs
At the root of most causes of disease is _______ of some sort.
a lesion
What are the (six) major causes of disease?
stress
heredity
inflammation/autoimmunity/allergy
neoplasm
infection
malnutrition
Treatment includes procedures for the ____ or ______ of disease.
- cure
- reduction of symptoms
Treatments designed to relieve and manage the symptoms of incurable diseases are called _____ or _____
- palliative
- symptomatic
Type of treatment depends on:
- nature of the disease
- characteristics of the patient
- goals of the patient and physician
Types of treatments include:
- medical (pharmacologic)
- surgical
- psychiatric/psychological
- combination of any/all of the above
What is the body's immunological first line of defense?
intact skin
What are the body's innate (nonspecific) chemical barriers?
tears
saliva
sweat
oil
mucus
How do natural killer cells work?
they recognize and destroy body cells with abnormal membranes
How is fever created?
when phagocytes find and destroy foreign invaders, they release substances that raise body temperature
How does fever aid the immune system?
it stimulates phagocytosis, increases metabolism, and inhibits multiplication of some organisms

fever is a sign of the normal interplay between the immune system and microorganisms
What is interferon?
a group of substances that stimulate the immune system by interfering with viral multiplication

virus-infected cells and other agents produce interferon

often used to treat infections and cancer
Inflammation is a _____ _____ ______ to injury or invasion.
protective tissue response
Hyperemia
increased blood flow to an inflamed area
What is a neutrophil?
a leukocyte (WBC) that defends the body against invading microorganisms and speeds healing by engulfing cell debris in injured tissues
What substance is released by injured tissue during the inflammatory response?
histamine
What does histamine do in the inflammatory reaction?
causes the cell walls to become more permeable

After histamine causes increased permeability of the capillary walls, what occurs next in the inflammatory response?
plasma and neutrophils move out of the blood vessels and into the tissues
What is chemotaxis?
the attraction of the WBCs to the site of inflammation
What is inflammatory exudate?
plasma and WBCs that escape from the capillaries to the site of inflammation
In the inflammatory process, what causes the:
redness and heat?
swelling and pain?
hyperemia
inflammatory exudate
To increase effectiveness of inflammatory and immune response, the ____ ____ and ____ _____ release very large quantities of leukocytes.
bone marrow
lymph nodes
How is the normal white cell range of 4,000 - 10,000 per cubic microliter of blood affected when infection or inflammation is present?
it may rise to 30,000 or more
The excessive production of white cells
leukocytosis
How is pus created?
the neutrophils die soon after ingesting the bacteria and toxins and release substances that liquefy the surrounding tissue
Of what is pus comprised?
liquefied tissue
dead neutrophils
inflammatory exudate
What other phagocytic cells are involved in the inflammatory process?
monocytes or macrophages
What is fibrin?
a plasma protein carried in the inflammatory exudate

helps create clots in damaged tissue and walls off infection to prevent its spread
Bacteria that cause pus formation
pyogenic
Inflammation associated with pus formation
suppurative inflammation
Examples of suppurative inflammation:
abscesses
boils
styes
By what two ways can wound healing occur?
regeneration
fibrosis
What is regeneration?
replacement of destroyed tissue with the same type of cells
What is fibrosis?
fibroblasts (a type of connective tissue cell) produce collagen fibers that contract and draw the cut surfaces together
What is scar tissue?
a meshwork of collagen fibers created from fibroblasts during fibrosis
What is keloid healing?
A scar that is raised and hard
it is actually a benign tumor
What happens when collagen fibers anchor together adjacent structures?
adhesions
How is lymph created?
due to high pressure of cardiovascular system, fluids leak from capillary beds into tissues

most fluid is reabsorbed, but about 3 liters per day stays in the tissues

this must be returned to the bloodstream or it will cause swelling and low blood volume
How does the lymphatic system function?
the lymph circulates through the lymph vessels and is filtered in the lymph nodes, where macrophages phagocytize bacteria, viruses, etc.
Lymphocyte
WBC produced by lymph nodes

responds to bacteria, viruses, and foreign material in lymph
_______ play a critical role in specific immunity
lymphocytes
What roles do B lymphocytes play in humoral immunity?
- some interact with antigens and become activated
- some are transformed into plasma cells which divide rapidly and produce large numbers of antibodies
What are antibodies?
plasma proteins which are
gamma globulins called immunoglobulins (Ig)
How do antibodies work?
they bind to antigens and tag them for destruction by the immune system
IgA
IgA - local protection at mucosal surfaces

found in mucosal secretions and colostrum
IgG
IgG - produced in primary and secondary immune responses; neutralizes toxins, bacteria, and viruses

found in blood plasma, crosses placenta
IgE
IgE - allergy

found in trace amounts in serum
secreted by sensitized plasma cells in tissues and locally attached to mast cells
IgM
IgM - protects newborns

bound to B lymphocytes in circulation
usually the first to increase in the immune response
IgD
IgD - activates B lymphocytes

found attached to B lymphocytes
Types of T lymphocytes
- cytotoxic (CD8 or killer) T lymphocytes
- helper (CD4) T lymphocytes
- suppressor T lymphocytes
How do cytotoxic (CD8 or killer) T lymphocytes work?
they have receptor proteins on their surfaces which bind tightly to cells or organisms that contain a specific antigen

once bound, they release poisonous substances into the attacked cell
Against what types of cells are cytotoxic (CD8 or killer) T lymphocytes particularly effective?
- cells invaded by viruses
- cancer cells
Memory T lymphocytes
some T lymphocytes that participate in an immune response remain as memory T lymphocytes that can rapidly mobilize should the same antigen be encountered again
Hypersensitivity diseases or allergic diseases may manifest themselves ______ or ______
locally (confined areas such as skin or mucous membranes)
systemically (anaphylaxis)
How do allergy shots work?
they cause an increase of IgG in the bloodstream
IgG coats the allergen in the blood, blocking it from binding to IgE in the tissues and reducing the amount of tissue damage
How is anaphylaxis treated/countered?
epinephrine
glucocorticoids
cortisone derivatives
Types of hypersensitivities:
Type I
allergic or anaphylactic hypersensitivity

triggered by allergen binding to IgE on mast cells, which produces either local severe or systemic severe inflammation
Types of hypersensitivities:
Type II
cytotoxic or cytolytic

involve IgM or IgG interacting with foreign cells to cause their destruction
What happens during an incompatible blood transfusion?
the RBCs agglutinate (clump together)

massive hemolysis (rupture) of RBCs occurs
Types of hypersensitivities:
Type III
immune complex

antigens combine with antibodies to form immune complexes which deposit in tissues and blood vessels and cause inflammation and tissue destruction

(e.g., glomerulonephritis after strep, or farmer's lung from inhaling mold spores)
Types I, II, and III hypersensitivities are all ______ hypersensitivities, which _________________
immediate
develop within about 30 minutes of exposure to antigens or allergens
Types of hypersensitivities:
Type IV
cell-mediated or delayed

initial exposure activates T lymphocyte-mediated immune response which is slow to develop

first exposure leads to sensitization, thereafter, the T lymphocytes will release cytokines that damage tissue at point of exposure (e.g., contact dermitits or TB test)
What organs can be transplanted?
heart
lung
kidney
liver
intestine
pancreas
autograft
tissue graft from one site to another in the same patient
isograft
tissues from identical twin
xenograft
tissues from different species
allograft
most common
from another donor not an identical twin
How are allografts matched?
blood type must match
cell membrane antigens must be at least 75% match
What type of hypersensitivity are tissue and organ rejections?
Type IV or delayed hypersensitivity
Scleroderma is an autoimmune disease of the:
connective tissue
Two classes of scleroderma
- localized (skin and underlying muscle)
- systemic (skin, tissues under skin, blood vessels, major organs)
Localized scleroderma types
morphea (local patches or generalized patches)
linear scleroderma (single line or band)
Types of systemic scleroderma
limited cutaneous scleroderma (gradual onset, mostly limbs)
diffuse cutaneous scleroderma (sudden onset, much of body)
Sjögren's is an autoimmune disease of
the glands and other tissues
Two types of Sjögren's
- primary (occurs alone)
- secondary (occurs with lupus, scleroderma, RA, etc.)
Sjögren's can affect
the entire body (kidneys, GI system, blood vessels, lungs, liver, pancreas, nervous system)
Sjögren's patients should be aware:
incidence of lymphoma (cancer of the lymph nodes) is significantly higher in Sjögren's patients
What portion of new HIV infections are heterosexual?
two-thirds
To move from HIV-positive to AIDS diagnosis requires:
- patient to have one of the AIDS indicator diseases, and
- helper (CD4) T-lymphocyte count less than 200
HAART
- highly active antiretroviral therapy
- targets HIV replication and can render the viral load almost undetectable
How does stress affect immunity?
- causes increased production of cortisol
- cortisol decreases production of antibodies and substances released by leukocytes that stimulate other immune system cells
Because of the reduction in antibody production in older people, vaccines _______
are less likely to produce immunity
What is a pathogen?
an infectious agent or disease-causing organism
What is a notifiable disease?
a disease under constant surveillance in the US

physicians are required to report cases to the CDC
What are some notifiable infectious diseases?
measles
mumps
polio
tuberculosis
tetanus
Legionnares' disease
chlamydia
What is microbiota?
the normal flora in and on our bodies that comprises about 100 trillion microorganisms
opportunistic pathogen
normal flora of the body that take advantage of an opportunity to become harmful

not a problem in a healthy person, but may cause disease if host is weakened or immunocompromised
What is a carrier?
one who harbors an infectious agent but does not have signs or symptoms of the disease
What is the easiest and most frequently used portal of entry for pathogens?
the respiratory tract
What are some other portals of entry for pathogens?
- gastrointestinal
- genitourinary
What is the parenteral route of entry for microorganisms?
through a puncture, injection, bite or surgery
What is transmission by direct contact?
individual is infected by contact with the reservoir

(e.g., touching/kissing/having sex with infected person;
bitten by animal/insect;
inhaling infectious respiratory droplets)
How does disease transmission by indirect contact occur?
when the pathogen can withstand the environment outside the host for a long period of time before infecting another individual
(e.g., airborne transmission - longer hang time than respiratory droplets, which are considered direct contact)
What is a fomite?
an inanimate object that is contaminated by direct contact with the reservoir
(e.g., used syringe, kleenex, ingesting contaminated food/water)
What is a prion?
- proteinaceous infectious particle

- causes spongiform encephalopathies (holes in the brain) by inducing abnormal folding of brain proteins
What is a latent infection?
viruses insert themselves in cells and do not reproduce

later, a trigger, such as stress, infection with another pathogen, or weakened immunity allows the virus to activate (e.g., herpes infection)
What is a glycocalyx?
a sticky sugar coat on a bacteria
What is a capsule? What does it do?
a glycocalyx that is organized and firmly attached to the cell wall of a bacteria

capable of protecting bacteria from phagocytosis
What is a slime layer? What does it do?
a glycocalyx that is unorganized and loosely attached to the cell wall of a bacteria

helps bacteria attach to surfaces
What are fimbrae? What do they do?
short, hair-like appendages that help bacteria attach to surfaces
What are pili? What do they do?
longer (than fimbrae) hair-like appendage bacteria use to join together to transfer DNA from one cell to another (sex pili)

most bacteria only have one or two
Transfer of DNA between bacteria can aid in ______ ______
antibiotic resistance
What is an endotoxin? What damage can it cause?
a toxin released into tissues when gram-negative cells die

causes life-threatening shock
What is a plasmid? What do they do?
small, circular, double-stranded DNA molecule contained in many bacteria along with the bacterial chromosome

they replicate independently of the bacterial chromosome and contain genetic information for antibiotic resistance, production of toxins, tolerance to toxic metals, and synthesis of enzymes
How are protozoa infectious?
most do not cause disease, however, they may invade and destroy certain tissues or provoke damaging inflammatory responses
What is chitin?
a special polysaccharide contained in the cell walls of fungi
What are mycelia?
specialized filaments fungi use to absorb nutrients from their surroundings
What are mycoses?
another term for fungal infection
Sources of microorganisms that cause nosocomial infections:
- patient's normal flora
- contact with healthcare staff
- contaminated instruments/needles
- healthcare environment
What are the principle routes of transmission of nosocomial infections?
- direct contact transmission from healthcare staff to patient
- indirect contact transmission through fomites and hospital's ventilation system
How are infections with protozoa treated?
with drugs that interfere with protein synthesis and metabolism

some antibiotics are used to treat protozoal infections
How are helminth infestations treated?
they are susceptible to drugs that
paralyze their muscles or
interfere with their carbohydrate metabolism
What is the best choice for long-term control of certain diseases? Why?
preventive measures
because treatment can result in
- resistant microorganisms
- toxic side effects
- allergies
What are emerging infectious diseases?
- outbreaks of previously unknown diseases
- known diseases whose incidence in humans has significantly increased in the past two decades

(emerging diseases have been identified at the unprecedented rate of one or more per year since the 1970s)
Measles is caused by:
Mumps is caused by:
German measles is caused by:
the rubeola virus
the paramyxovirus
the rubella virus
What are Koplik spots?
grayish spots that develop in the mouth before the rash of measles appears
What is orchitis?
inflammation of the testicles
What are parotid glands?
the largest of the salivary glands, and the ones that swell in the case of the mumps
What is the leading cause of death worldwide?
cancer
What four factors regulate cell growth?
- growth factors
- growth inhibitors
- cell cycle proteins (cyclins)
- programmed cell death (apoptosis)
What is apoptosis?
programmed cell death
Carcinogenesis is a multistep process that involves a complex sequence of _____ _______
genetic mutations
A mutation is:
a change in the biochemistry of a gene, resulting in the production of abnormal cells
Most invasive cancers develop only when:
several genes are mutated
Generally, mutations in three classes of genes are responsible for the development of cancer:
- oncogenes
- tumor suppressor genes
- DNA repair genes
What is an oncogene?
a gene that when mutated or expressed at abnormally high levels contributes to converting a normal cell into a cancer cell
Oncogenes are derived from:
protooncogenes, or growth-promoting genes and are activated genetic alterations induced by retroviruses
Normally oncogenes encode for proteins that regulate:
cell growth,
differentiation, and
apoptosis
Activation or overproduction of an oncogene leads to:
dysregulation of cell growth,
increased proliferation,
loss of apoptosis
Transformation of a normal cell to a malignant cell takes place not only by activation of oncogenes, but also:
by inactivation or deletion of tumor suppressor genes
Inactivation or loss of tumor suppressor genes by mutation or deletion leads to:
loss of function,
reduced restrictions on cell growth and division,
genetic instability,
loss of apoptosis, and
enhanced possibility of malignant behavior
DNA repair genes are also called:
caretaker genes
DNA repair genes are responsible for:
repair of errors in normal DNA replication
Mutations in DNA repair genes result in:
persistent DNA damage and
consequent further mutations and genetic instability

this may result in loss of tumor repair genes and conversion of a protooncogene to an oncogene and an increased susceptibility to cancer
In vitro
in the laboratory
Endogenous etiology of cancer
genetic makeup (sex, heredity, hormones, immunity, etc.)
The major cause of cancer throughout the world:
smoking
Most common causes of occupational cancer:
asbestos exposure (mesothelioma)

radon

chemical compounds such as benzene, benzidine, arsenic, soot, coal tars, wood dust
Exposure to ionizing radiation can cause:

Exposure to UV radiation can cause:
leukemia (cancer of WBCs)
breast cancer
thyroid cancer

skin cancer
Second largest contributor to cancer deaths after smoking:
diet and obesity
Cancer-causing chronic infections:
hepatitis B/C
HPV
HIV
Helicobacter pylori bacteria
Most common malignant disease worldwide:
lung cancer
Two types of lung cancer:
non-small cell lung cancer
small cell lung cancer
Most common type of lung cancer
adenocarcinoma
Most frequently diagnosed cancer in women
breast cancer
Fourth most common malignancy in the world:
stomach cancer
Second most commonly involved organ in metastasis, after the lymph nodes:
liver
What is ascites?
accumulation of fluid in abdominal cavity
Second most common cancer in women
cervical
Metrorragia
uterine bleeding
Dysuria
difficult urination
Dysphagia
difficulty speaking
Leading risk factor for prostate cancer:
age
Cryptorchidism
undescended testes
Hematuria
blood in the urine
Lymphoma is a heterogeneous group of neoplasms of:
lymphoid tissue
Lymphomas are classified as either ________ or ________
Hodgkin's disease or
non-Hodgkin's lymphoma
Hodgkin's is linked to the _____ ______ virus.
Epstein-Barr (EBV)
Hodgkin's disease is distinguished from non-Hodgkin's lymphoma by the presence of:
Reed-Sternberg cells
What are the risk factors for developing non-Hodgkin's lymphoma?
HIV/AIDS
immunosuppresive therapy
viral infections with HTLV1 or Epstein-Barr virus (EBV)
Helicobacter pylori infection (gastric lymphoma)
Indolent
slow-growing
Leukemia causes:
massive proliferation of immature forms of WBCs
Leukemia is classified on the basis of malignancy involving either _____ or _____ cells
lymphoid (B cells or T cells in lymph tissue)

myeloid (bone marrow cells)
Melanocyte
pigment-producing cell
Erythrocytosis
elevated RBC count
Paresis
slight paralysis
Meninges
membranes covering the brain
Cancer is the ____ leading cause of death in children.
second
The majority of childhood cancers are _______
leukemia