McCance Huether Pathophysiology Test 1

Oxidative phosphorylation

Process by which adenosine diphosphate (ADP) is converted into adenosine triphosphate (ATP) and inorganic phosphate through reoxidation and phosphorylation of ADP

Hypocretins (orexins)

Produced in the hypothalamus and play a role in regulating wakefulness and food intake, energy consumption, pleasure or reward

Prevalence rate

Proportion of the population affected by a disease at a specific point in time

Lymphedema

Protein and fluid accumulation in the interstitial space from blockage (infection or tumor) or surgical removal

Receptors

Proteins that bind to hormones, neurotransmitters, antigens etc.

Osmotic pressure

Pulling- the amount of pressure or force that is exerted by solute molecules of a given compartment

30kHz-300GHz

RF-EMR frequency range

Ribosomes

RNA-protein complex involved in translation of RNA into protein

Bruxism

The habit of unconsciously gritting or grinding the teeth especially in situations of stress or during sleep

Translocations

The interchanging of material between non-homologous chromosomes

Capillary hydrostatic pressure (blood pressure)

The major force behind filtration

angiogenic factors

chemical signal that induces the development and growth of blood vessels *VEGF, PDFG, bFGF*

automatic regulation of breathing

chemoreceptors lung and chest wall receptors

CCL2

chemotactic factor commonly expressed by tumors

mutation of caretaker gene leads to

chromosome instability & increased rates of mutation

cerebral injuries ketoacidosis uremia drug overdose

chronic increased vasodilation and decreased thermoregulatory control

Atmospheric pressure

combined pressure of all gases in the air we breathe 14. 7 psi 760 mmhg

bones

common site for breast CA metastasis

spleen

common site for lymphoma metastasis

metencephalon

composed of cerebellum and pons

midbrain

composed of corpora quadrigemina (tectum), tegmentum, and basis pedunculi

peripheral nervous system (PNS)

composed of cranial nerves and spinal nerves also can be divided into somatic and autonomic nervous systems

hypopituitary decreased liver function malnutrition parkinson disease rheumatoid arthritis

conditions that diminish the ability to generate heat

spinal cord

conducts somatic and autonomic reflexes, provides motor pattern control centers, and serves as a sensory and motor modulation center

Nissl substances

consist of ER and ribosomes and are involved in protein synthesis

somatic nervous system

consist of motor and sensory pathways regulating voluntary motor control of skeletal muscle

Papez circuit

consists of amygdala, parahippocampal gyrus, hippocampus, fornix, mamillary body of the hypothalamus, thalamus, and cingulate gyrus

central nervous system (CNS)

consists of brain and spinal cord, enclosed within the cranial vault and vertebrae

autonomic nervous system

consists of motor and sensory components and is involved with regulation of the body's internal environment through involuntary control of organ systems -can be further divided into sympathetic and parasympathetic

diencephalon

consists of the epithalamus, thalamus, hypothalamus, and subthalamus

corpus striatum

consists of the lentiform nucleus, putamen,mglobus pallidus, and caudate nucleus

medulla oblongata

controls reflex activities such as HR, RR, BP, coughing, sneezing, swallowing, vomiting. Nuclei of CN IX- XII located here

dorsal neurons

deal with inspiration

ventral neurons

deal with inspiration and expiration

fissures

deeper grooves of the cerebrum

M1 (TNM staging)

demonstrable metastases

nuclei

dense, packed cell bodies in the CNS

efferent

descending pathways carrying sensory impulses from the CNS to effector organs

microvascular disease in DM

destruction of capillaries

heterogenous

different ca cells from same tumor can mets to different location because tumors are _______ in their cellular composition

reyes syndrome (stomach bleeding)

dont use aspirin in children because it can cause

hyperinsulinemia

increased free-floating fatty acids give rise to the amount of insulin in the blood

genomic instability

increased tendency of an organism's DNA to acquire mutations

anesthesia

induces hypothermia, reduces platelet function, impairs coagulation cascade

thermoreceptors

provide the hypothalamus with information about skin and core temperature

temporal

lobe which contains the primary auditory cortex. also involved in long-term memory and secondary functions such as balance, taste, and smell

therapeutic hyperthermia

local, regional, or whole-body induced hyperthermia used to destroy pathologic microorganisms or tumor cells by facilitating the host's natural immune process or tumor blood flow

phase II detoxification enzymes

located in the liver, protect against reactive intermediates & non-activated xenobiotics

axons

long, conductive projections from the cell body that carry nerve impulses away from the cell body

hypoglycemia unawareness

longstandind DM may not develop hypoglycemia w/o usual SNS manifestios

anaplasia

loss of cellular differentiation, irregularities of size & shape, loss of normal tissue structure

characteristics of ca cells

loss of contact inhibition, resistance to apoptosis & anchorage independence, anaplasia

BRCA1

loss of this tumor suppressor gene causes Breast Cancer

APC

loss of this tumor suppressor gene causes Familial Adenomatous Polyps

p16 (CDKN2A)

loss of this tumor suppressor gene causes Familial Melanoma

p53 (TP53)

loss of this tumor suppressor gene causes Li-Fraumeni syndrome

neurofibromin (NF1)

loss of this tumor suppressor gene causes Neurofibromatosis

RB1

loss of this tumor suppressor gene causes Retinoblastoma (childhood CA of eye)

Wt1

loss of this tumor suppressor gene causes Wilms tumor (childhood CA of kidney)

type IA, autoimmune DM

pancreatic beta cells are destroyed by autoreactive cytotoxic T lymphocytes

saltatory conduction

process by which ions can flow between segments rather than along the entire length of the membrane, resulting in increased velocity of neuronal conduction

transformation

process by which normal cell becomes ca cell

multiple mutations

progression from benign to malignant tumor requires _______ ________

cranial nerves

project from the brain and pass through foramina in the skull

spinal nerves

project from the spinal cord and pass through intervertebral foramina of the vertebrae

sleep promoting neurotransmitters

prostaglandin D2, l-tryptophan, serotonin, adenosine, meatonin, GABA, growth hormones

Prostate Specific Antigen

prostate tumors

ras protein

protein involved in growth signaling

oncogene

proto-oncogene that mutated in such way that proteins are inappropriately active accelerating cell proliferation

radon

radioactive gas found in basements & mines, can lead to lung cancer

circadian rhythm disorder

rapid time-zone changes; alternation in sleep schedule

function of telomerase

rebuilds & maintains telomeres for unlimited replication

tumor markers

substances like hormones, enzymes, genes, antigens, antibodies) found in ca cells & in blood, spinal fluid or urine

total lung capacity

sum of all volumes

M2 (TNM staging)

suspected metastases

fever tachycardia hypertension

symptoms of heat cramps

dehydration decreased plasma volume hypotension decreased cardiac output tachycardia nausea weakness dizziness faint

symptoms of heat exhaustion

vasoconstriction shivering coagulation ischemic tissue damage ice crystals on inside of cell

symptoms of hypothermia

acidosis tachycardia cardiac dysrhythmias hypotension decreased cardiac output cardiac arrest unconsciouness absent reflexes fixed pupils apnea

symptoms of malignant hyperthermia

increased resistance to airflow loud snoring gasping intervals lasting 10 to 30 seconds fragmented sleep daytime sleepiness

symptoms of obstructive sleep apnea

substantia nigra

synthesizes dopamine

limbic

system composed of Papez circuit, septal area, habenula, nucleus accumbens, other portions of the hypothalamus, and related autonomic nuclei.

Coup

Brain injury that occurs on the same side of a blunt force to the head; it results from the rapid acceleration and then deceleration of the brain as it hits the inside of the skull. Injury directly below the point of impact.

Transient ischemic attack

Brief episode of neurologic dysfunction, symptoms typically last less than 1 hour, no evidence of infarction

Contusion

Bruise produced by bleeding into the skin or underlying tissues from an insult that did not break the skin but did rupture blood vessels.

Multiple sclerosis

Chronic, *autoimmune*, *demyelinating* disease of the *CNS* that causes inflammation, axonal degeneration and scarring of myelin sheaths.

Subdural hematoma

Collection of blood between the *inner surface of the dura mater and the surface of the brain* caused by rupture of *veins*

Oncotic pressure

Colloid pressure keeps water inside the compartment, attracts water from interstitial space back into the capillary- losses or diminished albumin

Chromatin

Combination of DNA and proteins that make up the contents of the nucleus of a cell: packages DNA into a smaller volume

Adipose

Composed of animal fat.

Genotype

Composition of genes at a given locus

Osmolarity

Concentration of molecules per volume of solution

Osmolality

Concentration of molecules per weight of water

Peroxisomes

Contains the enzyme catalase and one or more oxidases.

Polysomnography

Continuous record during sleep of multiple physiological variables ( brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements during the study)

Heat cramps

Contraction of voluntary muscle usually as a result of vigorous exercise resulting from salt and water loss from sweating

Interstitial oncotic pressure

Created by large molecules such as plasma proteins that cannot penetrate the membrane

p16 gene

Cyclin-dependent kinase inhibitor 2a Associated tumor(s): Melanoma

common cause of kidney disease

DM

Transcription

DNA is used as a template to make messenger, transport, and ribosomal RNA

epigenetic silencing

DNA methylation & covalent histone modification can mimic mutation by heritably inactivating tumor suppressor genes

Genome

DNA representing all of the genes for a given species

ipsilateral

Damage to the cerebellum is characterized by ___________ loss of equilibrium, balance, and motor coordination.

Sudden Infant Death Syndrome

Death of an apparently healthy infant usually before one year of age that is of unknown cause and occurs especially during sleep

Metabolic acidosis

Decrease in pH caused by an increase in noncarbonic acids or a decrease in bicarbonate from lactic acidosis, renal failure or diabetic ketoacidosis

Lactic acidosis

Decrease in pH from muscle contraction during anaerobic glucose metabolism

Atrophy

Decrease or shrinkage in cell size

Hypovolemia

Decreased blood volume capable of causing hypotension, tachycardia, and decreased urine output.

Hypocalcemia

Decreased calcium from inadequate intestinal absoprtion, deposition into bone or soft tissue, decreases in parathyroid hormone or vitamin D

Hypochloremia

Decreased chlorine from hyponatremia, vomiting and loss of hydrochloric acid, cystic fibrosis, and sodium deficit related to diuretics or restricted intake

Hypomagnesemia

Decreased magnesium from malnutrition, malabsorption syndromes, alcoholism, renal tubular dysfunction, metabolic acidosis, diabetes mellitus, loop and thiazide diuretics

Respiratory acidosis

Decreased pH caused by elevated carbon dioxide (increased hydrogen and carbonic acid concentrations) secondary to alveolar hypoventilation.

Hypophosphatemia

Decreased phosphate from intestinal malabsorption, increased renal excretion, vitamin D deficiency, magnesium and aluminum caontaining anatacids (bind phosphate), long-term alcohol abuse, respiratory alkalosis and hyperparathyroidism

Tension headache

Headache caused by *emotional strain* or overwork that tends to be focused in the *occipital region* and can be continuous for months.

Cluster headache

Headache characterized by *unilateral* severe pain over the eye and forehead that lasts *30 minutes to 2 hours*, several attacks per day can occur over a period of days followed by long periods of remission

Migraine

Headache that usually begins in the *temporal* region *unilaterally* after vascular changes of cranial arteries and may cause irritability, nausea, vomiting, constipation or diarrhea, and photophobia.

Radiation

Heat loss through electromagnetic waves

Extradural Hematoma

Hemorrhaging usually from an *artery* most commonly associated with a skull fracture after a head injury

Desmosomes

Hold cells together with continuous bands, belts or button like points of contact

Hypernatremia

Increased sodium from acute gain in sodium (hypertonic saline solutions, hyperaldosteronism, Cushing syndrome) or a loss in water

Vitamin D

Increases absorption of calcium in the small intestine

Klinefelter syndrome

Individuals with at least two X chromosomes and one Y chromosome

Radiculitis

Inflammation of a spinal nerve root

Meningitis

Inflammation of the *membranes covering the brain* and *spinal cord* associated with an infection from bacteria, viruses, parasites or toxins

Encephalitis

Inflammation of the brain usually caused by a virus.

Fusiform aneurysm (giant aneurysm)

Large aneurysm that stretches to affect the entire circumference of the arterial wall.

Fibronectin

Large glycoprotein- promotes cell adhesion and anchorage

Heat stroke

Life-threatening condition associated with high temperatures and humidity (rectal temperature above 106 degrees fahrenheit, peripheral vasodilation, thermoregulatory failure, hypovolemia)

limbic

system whose effects are believe to be involved with primitive behavioral response, visceral reaction to emotion, feeding, biologic rhythms, and sense of smell. A major function is consolidation of memory through a reverberating circuit

bronchial circulation

systemic circulation, delivers blood to and from the bronchi and bronchioles

Euvolemic Hypernatremia

total body water loss, usually from DI C.M. severe polyuria and mild hypernatremia, weight loss, weak pulses, tachycardia, postural hypotension, fever, restless

xenobiotics

toxic, mutagenic, and carcinogenic chemicals in food

interneurons

transmit impulses from neuron to neuron and are also involved in cognitive function

pons

transmits info from the cerebellum to the brainstem nuclei and relays motor info from the cerebral cortex to the contralateral cerebellar hemisphere

cannabinoid

transmitters that are released from postsynaptic neurons that modulate neurotransmitter release from presynaptic neurons

dilute salt solutions

treatment for heat cramps

sodium bicarobonate

treats acidosis

T2 (TNM staging)

tumor 2-5cm

T1 (TNM staging)

tumor <2cm

carcinoembryonic antigen (CEA)

tumor marker associated with GI, pancreas, lung, & breast tumors

alpha fetoprotein (AFP)

tumor marker associated with Liver & germ cell tumors

catecholamines

tumor marker associated with adrenal gland tumor

B-Human chorionic gonadotropin (B-hCG)

tumor marker associated with germ cell tumors

urinary bence jones protein

tumor marker associated with multiple myeloma

HVA/VMA (homovanillic acid/vanillylmandelic acid)

tumor marker associated with neuroblastoma

adrenocorticotropic hormone (ACTH)

tumor marker associated with pituitary adenoma

prostate specific antigen (PSA)

tumor marker associated with prostate tumors

dawn phenomenon

type I DM has higher blood glucose in early am than in middle of night

pluripotent cells (precursor cell or adults stem cell)

undifferentiated cells not committed to specific function

cretinism

untreated hypothyroidism

Procainamide

Used to treat cardiac dysrhythmias

-oma

benign tumor- lipoma

Expressivity

Variation in a phenotype associated with a particular genotype

germ cells & stem cells

besides CA cells, which cells have telomerase?

physical activity

best way to reduce risk for breast, colon, & endometrial CA

parietal

lobe of the brain which contains the major area for somatic sensory input

Cerebellar astrocytoma

*Brain tumor* of the right or left *cerebellar* hemisphere and cause symptoms on the same side as the tumor including head tilt, limb ataxia, and nystagmus.

Chronic paroxysmal hemicrania

*Cluster*-type headache that occurs with more *daily frequency* (4 to 12/day) but with shorter duration (20-120 minutes)

Classic cerebral concussion

*Diffuse* brain injury with cerebral disconnection from the brainstem reticular activating system and is a phenomenon of physiologic, neurologic dysfunction without substantial anatomic disruption. Immediate loss of consciousness for less than 6 hours with retrograde and anterograde amnesia.

Hemorrhagic stroke (intracranial hemorrhage)

*Hypertension* or *ruptured aneurysms* that result in bleeding in the brain, typically increases intracranial pressure and may lead to death.

Ependymoma

*Intracranial tumor* that is most commonly found in children and typically arises from the inner lining of the *4th ventricle* and the *spinal canal*.

Myasthenia gravis

*Neuromuscular disorder* caused by an *autoimmune* response in which antibodies to *acetylcholine receptors* impair neuromuscular transmission.

Neurogenic shock

*Sudden* loss of the *sympathetic* nervous system signals to the *smooth muscle* in vessel walls, causing vasodilation, hypotension, bradycardia and hypothermia

Mild concussion

*Temporary* axonal disturbances *without the loss of consciousness* in response to a violent blow, jarring, shaking, or other closed head injury.

anterior pituitary synthesize what hormone

- FSH - LSH - ACTH - TSH - Prolactin - GH

3 types of hyperthyroidism

- Grave's - Nodular thyroid - thyroid storm - oversecretion of T3 & T4 - decreased TSH, increased T3 & T4

primary hyperaldosteronism

- HTN - hypokalemia - increased pH - increased K urine - Na & H2O retention

pheochromocytoma

- HTN - tachycardia - palpitations - severe ha - diaphoresis - heat intolerance - wt loss - constipation - tumors of chromaffin cells of adrenal medulla - flushing - caused by tumor of adrenal glad - excess secretion of catecholamines - dx test: urine for catecholamines & CT scan

tx DKA

- IVF - insulin gtt - replace electrolytes

mineralocorticoid

- aldosterone - RAAS regulates secretion of aldosterone

hypothyroidism

- at birth, high birth wt, jaundice & hypothermia - lethargy - cold intolerance - hoarseness - nonpitting boggy edema around eyes - coarse hair - decreased body temp - underproduction & underseretion of thyroid - primary: loss of functional thyroid tissue & cells (radiation, tumor removal, etc) - secondary: dysfunction w/in pituitary or hypothalamus (lack of TSH) - increase TSH, decrease T3 & T4 - bradycardia - wt gain - tired - syncope - memory loss - depression - anemia - hypoventilation -hyperlipidemia - peripheral edema - puffy eyes & face

adrenal medulla hormones

- catecholamines - epi 10x more potent than norepi - both increase bp & HR, vasoconstrict - increase RR, increase cell metabolism - increase glucose

chronic complications of DM

- macroangiopathy: - PVD - CAD/MI - CV disease, TIA, stroke - microangiopathy: - retinopathy - nephropathy - neuropathies both peripheral & autonomic

panhypopituitarism

- necrosis or another problem in anterior pituitary - causing deficiency of all of its hormones with lack of GH, FSH, TSH & ACTH

Cushing disease

- caused by hypersecretion of ACTH from anterior pituitary - cortisol excess causes lipolysis & altered fat distribution - ACTH excess causes hyperpigmentation because excess MSH is formed as an alternative cleave product of same hormone precursor which stimulates production of melanin, a skin pigment - facial flush - moon face - supraclavicular fat pad - purple striae - pendulous abd - trunk obesity - thin extremities - easy bruising - excess cortisol - exogenous steroid, use prednisone - adrenal adenoma - increase glucose lead to type II - abnormal lipolysis - increase risk of clotting & infection - steroids inhibit arachinodinc pathway leading to water retention, edema & peptic ulcer - more common in men

anterior pituitary adenoma

- causes hypersecretion of hormone from adenoma itself - hyposecretion of hormones from surrounding pituitary cells

thyroid gland function

- cellular process - maintenance of cells & tissues

SIADH

- characterized by high levels of ADH in the absence of normal control mechanism - lethargy - decreased Na - sz - decreased plasma osmolality - concentrated urine - lung ca - fluid volume overload - increase urine Na - caused by pain

parathyroid gland hormone (PTH)

- controls Ca & Phos - stimulates osteoclasts (breakdown of bone to increase serum Ca & assist in production active form of Vit D - increase renal absorption of Ca

3 types of glucocorticoids

- cortisol - cortisone - corticosterone

thyroid storm

- crisis & severe - leads to death if not treated - triggered by surgery/trauma - agitation/restlessness/AMS/delirium - increase HR - HF - febrile - n/v/d

myedema coma indicates

- decrease LOC - emergent - hypotensive - hypoventilation leading to being intubated

deficiency of ACTH cause

- decrease aldosterone production - loss of functional maintenance of adrenals (lack of cortisol & lack of androgen production)

lack of FSH

- decrease estrogen in women - decrease production of sperm

RAAS system

- decrease perfusion to kidneys releasing renin converts to angiotensin I to angiotensin II which vasoconstrict & increase aldosterone - keep K and H2O

deficiency of LH cause

- decrease progesterone in women - decrease ovulation - decrease testosterone & testicular growth

hypoparathyroidism

- decreased PTH secretion - cause decrease Ca & increase Phos - phosphate prevents conversion of vit D to active form

type I DM

- deficit of insulin & amylin - severe insulin deficiency & excessive fat breakdown & make ketoacids faster than body can remove them - excess of glucagon - polydipsia (thirsty, s/sx of dehydration) - nocturia - polyuria - increased appetite - wt loss - hyperglycemia - glycosuria - increase urine osmolality - diuresis - gluconeogenesis (body needs energy making glucose from fat & protein to make ATP instead of going to Citric Cycle - keonuria - nutritional deficiency - hungry - go into dkA - dx before 30yo - common in whites - B cells destroyed by autoimmune - sugar spills into urine - lack of insulin production

type II DM

- dx mid age - family hx - more common in Hispanics, blacks, indian - insulin resistance dt receptors or unable to utilize correctly - not enough insulin

hypopituitarism

- dysfunction of anterior pituitary gland which deficiency of one or more anterior pituitary hormone - pituitary infarction - shock - Sheehan's syndrome - CNS infection - pituitary tumor removal - head trauma

goiter

- enlargement of thyroid gland - increased stimulation by TSH

dx of DM, one of 3 test positive

- fasting glucose =>126 - random glucose >200 in persons w/ sx - HgbA1C +>6.5, treatment aim <7

gastroparesis

- full filling after dinner - autonomic neuropathy which is a microvascular problem

hormones from adrenal cortex

- glucocorticoids - mineralocorticoids - gonadocorticoids (sex hormones)

HHNK

- glucose >600 - no acid or ketones - nlm serum CO2 - serum osmolality >320 - occur w/ type II DM - brought on by CV or renal disease - increased osmotic pressure - decreased blood volume

acromegaly

- hypersecretion of GH in adults - long bones already stopped growing - adults will develop enlarged jaw, forehead, tongue and large feet and hands - HTN - hyperglycemia - HF - edema - excessing sweating - enlarged tongue

gigantism

- hypersecretion of GH in kids & adolescents whose epiphyseal plates haven't closed yet so thin long bones are able to grow - kids

acute complications of DM

- hypoglycemia - DKA - HHNK

prolactin controlled by

- hypothalamus by secreting dopa thus meds that block dopa will have increase prolactin secretion - breast develop during pregnancy - milk production

neurogenic DI

- hypothalamus of posterior pituitary that decrease ADH release - centrally located lesion in hypothalamus & pituitary gland

fx of glucocorticoids

- immune system - promote vasoconstriction - cellular metabolism - gluconeogenesis in liver

thyroid nodules

- increase secretions of thyroid hormones dt hypertrophy of follicular cells

hyperthyroidism s&sx

- increase temp - loose stools - excessive sweating - increase HR - hair loss - anorexia - exopthalmus (bulging eyes)

2 basic components of patho of type 2 DM

- insulin resistance - pancreatic beta cell dysfunction

nephrogenic DI

- kidney causes insensitivity to ADH - renal tubules don't respond to ADH - polycystic kidneys - ongoing & can cause pyelonephritis which is reversible

lack of GH

- lack growth in kids - dwarfism - impaired tissue healing - osteoporosis - decrease muscle mass

DI

- polydipsia - nocturia - polyuria - hypernatremia - increased plasma osmolality - large volume of dilute urine - thirsty - decreased urine osmolality - increase plasma osmolality - increase Na - too much H2O intake - causing suppression of ADH - prone to dehydration

DKA

- polyuria - decreased LOC - Kussmaul breathing - acetone breath - hyperglycemia - decreased pH - ketonuria - glycosuria - more common in type I DM - insulin deficiency with liver producing more glucose - peripheral glucose utilization decreased - gluconeogenesis started - ketones in blood or urine causing metabolic acidosis - glucose >250 - HCO3 <18 - pH 7.3 - increased anion gap

malignant tumors

- poorly differentiated cell appearance - rapid growth rate - high mitotic index - no capsule - neovascularization through angiogenesis - invasive growth - can metastasize

primary hyperparathyroid

- predisposed to kidney stones - osteoporosis d/t PTH trying to fix low serum Ca breaking down bone - metabolic bone disease & kyphosis - increased Ca, decreased Phos - cause by adenoma - compensatory response to decrease Ca associated with decrease renal activitation of Vit D mainly in CKD

exophthalmus

- protruding eyes in Grave's disease - fibroblasts located behind eye have TSH receptors which is stimulated by TSI autoantibodies causing enlargement of ocular muscles and accumulation of fat and edema push eyeballs forward

hyperparathyroidism

- secondary: increase PTH & decrease Ca - most likely tumor, primary: decrease PTH & increased Ca

aldosterone causes kidneys

- secrete K - maintain Na

hypoglycemia

- tachycardia - diaphoresis - tremor - pallor - LOC/confusion - sz/coma - palpitations - anxiety - ha - dizzy - fatigue - visual changes - < 45 - 60 in adults/kids - < 35 for 1st 48 hrs in infants

decrease Ca levels s&sx

- tetany - confusion - hyperreflexia - bone deformities

tumor suppressor genes

- that act as inhibitors of growth factor stimulation - block specific phases of cell cycle - induce end stage (terminal) differentiation - stimulate cell senescence or death

tx SIADH

- treat underlying cause - free H2O restriction - hypertonic soln - can have Gatorade & juices

uses for tumor markers

- used to screen & identify individuals at high risk for ca - help diagnose specific types of tumors - follow clinical course of ca

adrenal adenoma causing hypersecretion of androgens in woman

- virilization - lack of breast development - hirsutism - increased muscle bulk

Addison disease

- weakness - fatigue - hypotension - hyperkalemia - hypoglycemia - elevated ACTH - decrease aldosterone & cortisol - disease of adrenal cortex & medulla - autoimmune disease that attacks the adrenal glands

benign tumors

- well differentiated cell appearance - slow rate of growth - low mitotic index - has a capsule - slight vascularization - expansile growth - cant metastasize

Graves disease

- wt loss with increase appetite - body temp elevated with increased HR - excessive thyroid hormones increase metabolic rate which increase heat production - involves autoantibodies against TSH receptors called thyroid stimulating immunoglobulins (TSIs) which stimulate TSH recepors on thyrocytes causing thyroid gland to secrete T3 & T4 - autoimmune hypothyroid - antibodies attach to thyroid & acts like TSH stimulating release of T3 & T4

asbestos

-a fibrous mineral that may be found in homes build prior to 1978 -can cause mesothelioma & lung CA

cachexia

-loss apetite, early satiety, weakness, inability to maintain wt, taste alterations, -leads to protein calorie malnutrition & progressive wasting

epithelial transition (EMT)

-responsible for permitting tumor cells to be transported to a distant site -driven by cytokines & chemokines

radiation therapy

-used to kill cancer cells while minimizing damage to normal structures -requires good local delivery of oxygen -produces slow changes in most cancers and irreversible changes in normal tissues as well.

gene silencing

-whole regions of chromosomes are shut off while the same regions in other cells remain active -Genes can be turned off by point mutations, deacetylation of histones or methylation of DNA

3 key genetic mechanisms of carcinogenesis

1) activation of proto-oncogenes resulting in hyperactivity of growth-related gene products called oncogenes 2) mutation of genes resulting in loss or inactivity of gene products that normally would inhibit growth (called tumor suppressor genes) 3) mutation of genes resulting in overexpression of products that prevent nml cell death, or apoptosis thus allowing continued growth of tumors

top 4 infections related to CA

1. HPV 2. helicobactor pylori 3. hep B 4. hep C

cancer causing HPV viruses (5)

1. HPV 16 2. HPV 18 3. HPV 31 4. HPV 33 5. HPV 45

TAMs (tumor-associated macrophage)

1. diminished cytotoxic response 2. block cytotoxic T-cell & NK cell functions 3. secrete cellular growth factors

routes of metastasis

1. direct invasion (lymphatics, veins) 2. epithelial-mesenchymal transition in carcinomas 3. local vs. distant metastasis

damage from IR occurs (3)

1. directly from biologic macromolecules 2. indirectly in the medium (organelles suspended in water) 3. irreversibly from ionization (attack by water based free radicals)

environmental factors related to melanoma

1. hx of 3 or more sunburns 2. periodic excessive sunlight exposure 3. long-term continous sunlight exposure 4. UV exposure @ tanning salons

factors that contribute to CA (7)

1. lifestyle choices (nutrition, smoking, etoh use) 2. environmental conditions (UV, radiation) 3. lack of physical exercise/obesity 4. sexual practices 5. prescribed & illicit medications 6. socioecomonic factors 7. carcinogenic substances

risk factors for melanoma

1. sunburn history 2. family history (genetic/phenotypic traits) 3. light hair, eyes, & skin 4. increasing age 5. presence of over 20 nevi;freckling

erv value

1200 ml

residual volume value

1200 ml

detoxification enzymes & antioxidant system

2 primary defense mechanisms that protect against xenobiotics that cause cell damage

sex-linked chromosomes

23rd pair of chromosomes

length to see hypothyroidism d/t stored thyroid hormone

3 months

IRV normal value

3000 ml

inspiratory capacity value

3600

Adhesion molecules

Also known as CAM (Cell Adhesion Molecule). Proteins that allow cells to hook together and form attachments to the cytoskeleton for maintaining cellular shape.

MATCHING Match the structure with its function. Answers may be used more than once. ______ A. Endoplasmic reticulum ______ B. Ribosome ______ C. Secretory vesicle ______ D. Lysosomes 44. Packages and transports proteins. 45. Fuses with the plasma membrane to release contents from the cell. 46. Synthesizes and transports lipids. 47. Provides energy to digest proteins into amino acids.

44. ANS: A PTS: 1 REF: Pages 5-6 MSC: The endoplasmic reticulum (endo = within; plasma = cytoplasm; reticulum = network) is a membrane factory that specializes in the synthesis and transport of the protein and lipid components of most of the cell's organelles. 45. ANS: C PTS: 1 REF: Pages 6-7 MSC: Proteins from the endoplasmic reticulum are processed and packaged into small membrane-bound sacs or vesicles called secretory vesicles that collect at the end of the membranous folds of the Golgi bodies. The secretory vesicles then break off from the Golgi complex and migrate to a variety of intracellular and extracellular destinations, including the plasma membrane. The vesicles fuse with the plasma membrane, and their contents are released from the cell. 46. ANS: A PTS: 1 REF: Pages 5-6 MSC: The endoplasmic reticulum (endo = within; plasma = cytoplasm; reticulum = network) is a membrane factory that specializes in the synthesis and transport of the protein and lipid components of most of the cell's organelles. 47. ANS: D PTS: 1 REF: Page 7 MSC: Lysosomes function as the intracellular digestive system (see Figure 1-6). Lysosomal enzymes are capable of digesting most cellular constituents down to their basic forms, such as amino acids, fatty acids, and sugars.

Match the structure with its function. Answers may be used more than once. ______ A. Passive-mediated transport ______ B. Active-mediated transport ______ C. Osmosis 48. Movement of water 49. Protein carrier 50. Facilitated diffusion

48. ANS: C PTS: 1 REF: Page 30 MSC: Osmosis is the movement of water down a concentration gradient; that is, across a semipermeable membrane from a region of higher water concentration to a lower water concentration. 49. ANS: B PTS: 1 REF: Page 32 MSC: In active-mediated transport, also called active transport, the protein transporter moves molecules against, or up, the concentration gradient. Unlike passive-mediated transport, active-mediated transport requires the expenditure of energy. 50. ANS: A PTS: 1 REF: Pages 31-32 MSC: In passive-mediated transport, also called facilitated diffusion, the protein transporter moves solute molecules through cellular membranes without expending metabolic energy.

vital capacity value

4800 ml

tidal volume normal value

500 ml

pH normal HCO3 normal PaCO2 normal

7.35-7.45 22-26 38-44

Spinal shock

A *complete loss* of *reflex function* in skeletal muscles, bladder, bowel, sexual function and automic control *below the level of the lesion*

Allele

Alternate version of a gene

neurotransmitter

A ________ is normally stored on one side of a synaptic cleft, and its receptors are on the other side

Fracture

A break, rupture, or crack, especially in bone or cartilage.

Autocrine

A cell secretes a hormone or chemical messenger that act on the same cell

Tetraploidy

A cell that has four copies of each chromosome

Polyploid

A cell that has more than the diploid number of chromosomes

Triploidy

A cell that has three copies of each chromosome

Trisomy

A cell with three copies of one chromosome

Anabolism

A cellular process that uses energy to synthesize complex molecules from simpler molecules.

Lead

A chemical agent that causes permanent effects on neurobehavior and intellectual performance.

Hematoma

A collection of blood in soft tissues or an enclosed space

Adenosine Triphosphate

A compound consisting of an adenosine molecule bonded to three phosphate groups, present in all living tissue. The breakage of one phosphate linkage (to form adenosine diphosphate, ADP) provides energy for physiological processes such as muscular contraction

Heat exhaustion

A condition characterized by faintness or fainting, palpitations, nausea, vomiting, headache, and profuse sweating and resulting from physical exertion in a hot environment

Syndrome of inappropriate secretion of Anti-Diuretic Hormone (ADH)

A condition in which the release of ADH is elevated relative to serum sodium levels, resulting in increased water reabsorption by the kidneys.

Heat cramps

A condition that is marked by sudden development of cramps in skeletal muscles and that results from prolonged work or exercise in high temperatures accompanied by profuse perspiration with loss of sodium chloride from the body

Monosomy

A diploid cell with only one copy of a chromosome

Osteomalacia

A disease in which vitamin D or calcium deficiency or excessive renal phosphate loss causes a softening of the bones with accompanying pain and weakness.

Aquaporins

A family of water channel proteins

Turner syndrome

A female with only one X chromosome (45 chromosomes total)

Trisomy X

A female with three X chromosomes

Cartilage

A flexible connective tissue composed of collagen fibers, ground substance rich in proteoglycan, and elastin fibers.

Microcephaly

A head with a small braincase

Heat stroke

A life-threatening condition marked especially by cessation of sweating, extremely high body temperature (greater than 40.5C and 104.9F), and collapse that results from prolonged exposure to high temperature; cerebral edema, renal tubular necrosis, organ failure, degeneration of CNS

Genotype

A map of ones specific genes

Renin-angiotensin-aldosterone system

A mechanism by which sodium and water levels are regulated in the body especially the actions on the kidney that increase water and sodium reabsorption.

Amphipathic

A molecule (especially a protein) having both hydrophilic and hydrophobic parts.

Urodilatin

A natriuretic peptide hormone that is synthesized in and released from the kidney and functions in the regulation of water and sodium.

Compensation

Adjustment of acid or base content in response to changes in pH; for example, a decrease in pH is accompanied by an increase in carbon dioxide removal by the lungs, causing pH to increase.

Citric acid cycle

Aerobic metabolism that includes a series of reactions in which acetyl CoA is oxidized into carbon dioxide, NADH and FADH.

Restless leg syndrome

A neurological disorder of uncertain pathophysiology that is characterized by aching, burning, crawling, or creeping sensations of the legs that occur especially at night usually when lying down (as before sleep) and cause a compelling urge to move the legs and that is often accompanied by difficulty in falling or staying asleep and by involuntary twitching of the legs during sleep; more common in women and people with iron deficiency

Calcitonin

A protein hormone produced in the thyroid gland that inhibits osteoclastic activity in bone.

Atrial and brain natriuretic peptide

A protein hormone synthesized and released from myocardial tissue in response to high sodium concentration, high extracellular fluid volume, or high blood volume and functions to promote sodium excretion and to cause vasodilation in the circulatory system.

Parathyroid hormone

A protein hormone that regulates calcium and phosphate levels in the body by promoting the absorption of calcium by the intestine, mobilizing calcium and phosphate from bones, and increasing the tendency of the kidney to reabsorb calcium and excrete phosphate.

Malignant hyperthermia

A rare inherited condition characterized by a rapid, extreme, and often fatal rise in body temperature following the administration of general anesthesia; increased myoplasmic calcium release and decreased calcium uptake with muscle contraction-intracellular calcium levels rise

Duplication

A repeated gene or gene sequence

Dantrolene sodium

A skeletal relaxant that inhibits calcium release during muscle contraction

Meningioma

A slow-growing, often encapsulated mass of cells derived from *arachnoid tissue* in the dural membrane that is usually *benign* but increases intracranial pressure.

Saccular aneurysm (berry aneurysm)

A slowly progressing aneurysm that affects *only a portion* of the circumference of the arterial wall and may be the result of congenital anomalies or degeneration.

Hypertonic

A solution of higher osmotic pressure

Hypotonic

A solution of lower osmotic pressure

Aneuploidy

A somatic cell that does not contain a multiple of 23 chromosomes

Cataplexy

A sudden loss of muscle control with retention of clear consciousness that follows a strong emotional stimulus (as elation, surprise, or anger) and is a characteristic symptom of narcolepsy

Autonomic hyperreflexia (dysreflexia)

A syndrome resulting from afferent stimuli which causes intense sympathetic discharge originating with spinal cord injury above the major splanchnic outflow characterized by hypertension, bradycardia, sweating of the forehead, severe headache, and piloerection on distention of the bladder and rectum.

Continuous positive airway pressure

A technique for relieving breathing problems (such as those associated with sleep apnea or congestive heart failure) by pumping a steady flow of air through the nose to prevent the narrowing or collapse of air passages or to help the lungs to expand

posterior pituitary doesn't synthesize hormones it only releases what hormones that are synthesized by hypothalamus

ADH oxytocin

Natriuretic hormones

ANP and BNP- released by heart- works opposite RAAS to decrease blood volume, promotes urinary excretion of Na and water

36. A muscle cell possesses which specialized function? a. Movement b. Conductivity c. Secretion d. Respiration

ANS: A A cell has the potential to differentiation and to gain the ability to perform one of eight specialized functions. Muscle cells can generate forces that produce motion. Nerves cells are capable of conductivity. Cells of the adrenal gland, testis, and ovary can secrete. Respiration is a function that all cells possess. PTS: 1 REF: Page 2

38. All cells are capable of what process? a. Excretion b. Movement c. Metabolic absorption d. Continuous division

ANS: A All cells have the capacity to excrete, thus allowing them to rid themselves of waste products resulting from the metabolic breakdown of nutrients. The remaining options are not functions possessed by all cells. PTS: 1 REF: Page 2

11. Which form of cell communication is used to communicate within the cell itself and with other cells in direct physical contact? a. Protein channel (gap junction) b. Plasma membrane-bound signaling molecules (involving receptors) c. Hormone secretion such as neurotransmitters d. Extracellular chemical messengers such as ligands

ANS: A Cells communicate by using hundreds of kinds of signal molecules, for example, insulin. Cells communicate in three main ways; they display plasma membrane-bound signaling molecules (receptors) that affect the cell itself and other cells in direct physical contact. The other options do not correctly describe this process. PTS: 1 REF: Page 20

32. The role of cytokines in cell reproduction is that they: a. Provide growth factor for tissue growth and development. b. Block progress of cell reproduction through the cell cycle. c. Restrain cell growth and development. d. Provide nutrients for cell growth and development.

ANS: A Growth factors, also called cytokines, are peptides that transmit signals within and among cells. They have a major role in the regulation of tissue growth and development (see Table 1-6). The remaining options do not correctly describe the role of cytokines in cell reproduction. PTS: 1 REF: Pages 38-39

22. The movement of fluid across the arterial end of capillary membranes into the interstitial fluid surrounding the capillary is an example of which fluid movement process? a. Hydrostatic pressure b. Osmosis c. Diffusion d. Active transport

ANS: A Hydrostatic pressure is the mechanical force of water pushing against cellular membranes. In the vascular system, hydrostatic pressure is the blood pressure generated in vessels by the contraction of the heart. Blood reaching the capillary bed has a hydrostatic pressure of 25 to 30 mm Hg, which is sufficient force to push water across the thin capillary membranes into the interstitial space. The remaining options do not correctly identify the process described. PTS: 1 REF: Pages 29-30

27. What occurs during exocytosis? a. Macromolecules can be secreted across eukaryotic cell membranes. b. All substances are secreted into the cellular matrix. c. No repairs in the plasma membrane can take place. d. Solute molecules flow freely into and out of the cell.

ANS: A In eukaryotic cells, secretion of macromolecules almost always occurs by exocytosis. The remaining options do not correctly describe exocytosis. PTS: 1 REF: Pages 35-36

10. The fluid mosaic model explains: a. How a cell membrane functions b. Why our bodies appear to be solid c. How tissue is differentiated d. How fluid moves between the intracellular and extracellular compartments

ANS: A The fluid mosaic model accounts for the flexibility of cellular membranes, their self-sealing properties, and their impermeability to many substances. The remaining options do not explain the mosaic model. PTS: 1 REF: Page 12 | What's New box

19. Passive transport is best described with which statement? a. Being driven by osmosis, hydrostatic pressure, and diffusion b. Involving receptors that can bind with substances being transported c. Being capable of transporting macromolecules d. Requiring energy generated by the cell

ANS: A Water and small electrically uncharged molecules move easily through pores in the plasma membrane's lipid bilayer. This process, called passive transport, naturally occurs through any semipermeable barrier. It is driven by osmosis, hydrostatic pressure, and diffusion, all of which depend on the laws of physics and do not require life. The other options do not correctly describe passive transport. PTS: 1 REF: Page 28

41. Which statements are true concerning the process of facilitated diffusion? (Select all that apply). a. Facilitated diffusion is also referred to as passive mediated transport. b. This process expends no metabolic energy. c. Moving solute molecules through cellular membranes are involved in this process. d. Movement up a concentration gradient is necessary. e. Facilitated diffusion is the primary means for water transport.

ANS: A, B, C In passive mediated transport, also called facilitated diffusion, the protein transporter moves solute molecules through cellular membranes without expending metabolic energy. Downward movement along a concentration gradient is necessary. Osmosis is the movement of water down a concentration gradient. PTS: 1 REF: Pages 31-32

42. Passive transport is dependent on: (Select all that apply.) a. Semipermeable barrier membrane b. The process of osmosis c. Diffusion as a driving force d. A living host e. Hydrostatic pressure

ANS: A, B, C, E Passive transport naturally occurs through any semipermeable barrier. It is driven by osmosis, hydrostatic pressure, and diffusion, all of which depend on the laws of physics and do not require life. PTS: 1 REF: Page 28

43. What is the primary function of proteins? (Select all that apply.) a. Proteins are binding units. b. Proteins are transport channels. c. Proteins are ribonucleoproteins. d. Proteins provide cell surface markers. e. Proteins are chemical reaction catalysts.

ANS: A, B, D, E Protein functions include (a) recognition and binding units (receptors) for substances moving in and out of the cell; (b) pores or transport channels; (c) enzymes that drive active pumps; (d) cell surface markers, such as glycoproteins; (e) cell adhesion molecules; and (f) catalysts of chemical reactions. PTS: 1 REF: Page 15

39. What are the major chemical components of the cell membranes? (Select all that apply.) a. Lipids b. Sodium ions c. Carbohydrates d. DNA e. Proteins

ANS: A, E The major chemical components of all cell membranes are lipids and proteins, but the percentage of each varies among different membranes. PTS: 1 REF: Page 12

17. Under anaerobic conditions, what process provides energy for the cell? a. Oxidative phosphorylation b. Glycolysis c. Lactolysis d. Passive transport

ANS: B Glycolysis produces a net of two molecules of ATP per glucose molecule through the process of oxidation or the removal and transfer of a pair of electrons. The other options do not correctly identify an anaerobic process that provides energy to the cell. PTS: 1 REF: Page 28

21. Which method of transport uses transmembrane proteins with receptors with a high degree of specificity for the substance being transported? a. Active b. Mediated c. Transmembranous d. Passive

ANS: B Mediated transport (passive and active) involves integral or transmembrane proteins with receptors having a high degree of specificity for the substance being transported. Inorganic anions and cations (e.g., Na+, K+, Ca++, chloride [Cl-], bicarbonate [HCO3-]) and charged and uncharged organic compounds (e.g., amino acids, sugars) require specific transport systems to facilitate movement through different cellular membranes. The remaining options do not correctly identify the process described. PTS: 1 REF: Page 31

3. Which component of the cell produces hydrogen peroxide (H2O2) by using oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction? a. Lysosomes b. Peroxisomes c. Ribosomes d. Oxyhydrosomes

ANS: B Peroxisomes are so named because they usually contain enzymes that use oxygen to remove hydrogen atoms from specific substrates in an oxidative reaction that produces H2O2, which is a powerful oxidant and potentially destructive if it accumulates or escapes from peroxisomes. Ribosomes are RNA-protein complexes (nucleoproteins) that are synthesized in the nucleolus and secreted into the cytoplasm through pores in the nuclear envelope called nuclear pore complexes. Lysosomes are saclike structures that originate from the Golgi complex and contain more than 40 digestive enzymes called hydrolases, which catalyze bonds in proteins, lipids, nucleic acids, and carbohydrates. Oxyhydrosomes are involved in enzyme production. PTS: 1 REF: Page 8

16. When a second message is necessary for extracellular communication to be activated, it is provided by which one? a. Guanosine triphosphate (GTP) b. Adenosine monophosphate (AMP) c. Adenosine triphosphate (ATP) d. Guanosine diphosphate (GDP)

ANS: B The two major second messenger pathways are cyclic AMP (cAMP) and calcium (Ca++).

8. Understanding the various steps of proteolytic cascades, such as caspase-mediated apoptosis and complement cascades, may be useful in designing drug therapy for which human diseases? a. Cardiac and vascular disorders b. Autoimmune and malignant disorders c. Gastrointestinal and renal disorders d. Endocrine and gastrointestinal disorders

ANS: B Understanding the various steps involved in this process is crucial for designing drug interventions. Dysregulation of proteases features prominently in many human diseases, including cancer, autoimmunity, and neurodegenerative disorders. The other options do not correctly describe this process. PTS: 1 REF: Page 15

30. What causes the rapid change in the resting membrane potential to initiate an action potential? a. Potassium gates open, and potassium rushes into the cell, changing the membrane potential from negative to positive. b. Sodium gates open, and sodium rushes into the cell, changing the membrane potential from negative to positive. c. Sodium gates close, allowing potassium into the cell to change the membrane potential from positive to negative. d. Potassium gates close, allowing sodium into the cell to change the membrane potential from positive to negative.

ANS: B When a resting cell is stimulated through voltage-regulated channels, the cell membranes become more permeable to Na+. A net Na+ moves into the cell, and the membrane potential decreases, or moves forward, from a negative value (in millivolts) to zero. The Na+ gates open, and Na+ rushes into the cell, causing the membrane potential to reduce to zero and then become positive (depolarization). The remaining options do not correctly describe the change that initiates an action potential. PTS: 1 REF: Page 36

40. Which cells lose their ability to replicate and divide? (Select all that apply.) a. Intestines b. Nerves c. Skin d. Lens of the eye e. Skeletal muscle

ANS: B, D, E All types of cells undergo mitosis during the formation of the embryo, but many adult cells, such as nerve cells, lens cells of the eye, and muscle cells, lose their ability to replicate and divide. Intestines and skin cells retain their ability to replicate and divide. PTS: 1 REF: Page 37

24. A patient who has diarrhea receives a 3% saline solution intravenously to replace the sodium and chloride lost in the stool. What effect will this fluid replacement have on cells? a. Become hydrated b. Swell or burst c. Shrink d. Divide

ANS: C A hypertonic solution has a concentration of greater than 285 to 294 mOsm/kg. An example of a hypertonic solution is 3% saline solution. Water can be pulled out of the cells by a hypertonic solution; therefore the cells shrink. The remaining options do not correctly describe the effect identified in the stem. PTS: 1 REF: Page 31

28. Why is it possible for potassium to diffuse easily into and out of cells? a. Potassium has a greater concentration in the intracellular fluid (ICF). b. Sodium has a greater concentration in the extracellular fluid (ECF). c. The resting plasma membrane is more permeable to potassium. d. An excess of anions are inside the cell.

ANS: C Because the resting plasma membrane is more permeable to K+ than to Na+, K+ can easily diffuse from its area of higher concentration in the ICF to its area of lower concentration in the ECF. Because Na+ and K+ are both cations, the net result is an excess of anions inside the cell, resulting in the resting membrane potential. The remaining options do not correctly identify the process that most easily diffuses K+. PTS: 1 REF: Page 36

33. What is the process of cellular reproduction? a. The process often takes months or years to complete. b. Cellular reproduction typically has a short interphase. c. Two diploid cells, called daughter cells, have been formed. d. The process involves the interaction of male and female cells.

ANS: C During telophase, the final stage, a new nuclear membrane is formed around each group of 46 chromosomes, the spindle fibers disappear, and the chromosomes begin to uncoil. Cytokinesis causes the cytoplasm to divide into roughly equal parts during this phase. At the end of telophase, two identical diploid cells, called daughter cells, have been formed from the original cell. PTS: 1 REF: Page 37

Chapter 1: Cellular Biology MULTIPLE CHOICE 1. Which statement best describes the cellular function of metabolic absorption? a. Cells can produce proteins. b. Cells can secrete digestive enzymes. c. Cells can take in and use nutrients. d. Cells can synthesize fats.

ANS: C In metabolic absorption, all cells take in and use nutrients and other substances from their surroundings. The remaining options are not inclusive in their descriptions of cellular metabolic absorption. PTS: 1 REF: Page 2

35. Which statement is true about phagocytosis? a. Phagocytosis is an example of exocytosis. b. Phagocytosis is dependent on small vesicles. c. Phagocytosis involves the ingestion of bacteria. d. Phagocytosis focuses on solute molecules.

ANS: C In phagocytosis, the large molecular substances are engulfed by the plasma membrane and enter the cell so that they can be isolated and destroyed by lysosomal enzymes. Two types of endocytosis are designated, based on the size of the vesicle formed. Pinocytosis (cell drinking) involves the ingestion of fluids and solute molecules through the formation of small vesicles, and phagocytosis (cell eating) involves the ingestion of large particles, such as bacteria, through formation of large vesicles (also called vacuoles). Phagocytosis in an example of endocytosis, not exocytosis. PTS: 1 REF: Pages 33-34

action potential

An ______ _______ in the presynaptic neuron causes the synaptic vesicles to release their neurotransmitters through the plasma membrane into the synaptic cleft

23. Why is osmolality preferred over osmolarity as the measurement of osmotic activity in the clinical assessment of individuals? a. Plasma contains sodium and chloride, which influence the volume of solution. b. Volume affects perfusion more than the weight of solutes. c. More of the weight of plasma is influenced by solutes, such as protein and glucose, rather than by water. d. Osmotic activity depends on the concentration of solutes present in plasma, such as proteins and glucose.

ANS: C In plasma, less of the plasma weight is water; therefore the overall concentration of particles is greater. The osmolality will be greater than the osmolarity because of the smaller proportion of water. Osmolality is thus the preferred measure of osmotic activity in clinical assessment of individuals. PTS: 1 REF: Page 30

18. What is the mechanism by which the energy produced from carbohydrates, proteins, and lipids is transferred to adenosine triphosphate (ATP)? a. Anaerobic glycolysis b. Oxidative cellular metabolism c. Oxidative phosphorylation d. Tricarboxylic acid phosphorylation

ANS: C Oxidative phosphorylation occurs in the mitochondria and is the mechanism by which the energy produced from carbohydrates, fats, and proteins is transferred to ATP. The other options do not correctly identify the mechanism described in the question. PTS: 1 REF: Pages 27-28

7. What organic compound facilitates transportation across cell membranes by acting as receptors, transport channels for electrolytes, and enzymes to drive active pumps? a. Lipids b. Proteases c. Proteins d. Carbohydrates

ANS: C Proteins act as (1) recognition and binding units (receptors) for substances moving in and out of the cell; (2) pores or transport channels for various electrically charged particles called ions or electrolytes and specific carriers for amino acids and monosaccharides; and (3) specific enzymes that drive active pumps that promote the concentration of certain ions, particularly potassium (K+), within the cell while keeping concentrations of other ions, for example, sodium (Na+), below the concentrations found in the extracellular environment. The other options do not correctly describe this process. PTS: 1 REF: Page 13 | Page 15

20. Active transport occurs across which type of membranes? a. Membranes that have a higher concentration of the solute on the outside of the cell b. Membranes that are semipermeable to water and small electrically uncharged molecules c. Membranes that have receptors that are capable of binding with the substances to be transported d. Membranes that have a cell membrane that is hydrophobic rather than hydrophilic

ANS: C Some molecules are moved into the cell by mechanisms of active transport, which require receptors that are capable of recognizing and binding with the substance to be transported. Diffusion is the movement of a solute molecule from an area of greater solute concentration to an area of lesser solute concentration. Hydrostatic pressure is the mechanical force of water pushing against cellular membranes. Osmosis is the movement of water down a concentration gradient; that is, across a semipermeable membrane from a region of higher water concentration to a lower water concentration PTS: 1 REF: Page 28

29. The cellular uptake of the nutrient cholesterol depends on which process? a. Receptor-mediated exocytosis b. Antiport system c. Receptor-mediated endocytosis d. Passive transport

ANS: C The cellular uptake of nutrients, such as cholesterol, for example, depends on receptor-mediated endocytosis. Nutrients are not transported via the other options.

26. Potassium and sodium are transported across plasma membranes by: a. Passive electrolyte channels b. Coupled channels c. Adenosine triphosphatase (ATPase) enzyme d. Diffusion

ANS: C The exact mechanism for the transport of Na+ and K+ across the membrane is uncertain. One proposal is that ATPase enzyme induces the transporter protein to undergo several conformational changes, causing Na+ and K+ to move short distances (see Figure 1-29). The remaining options do not correctly describe the means by which K+ and Na+ are transported. PTS: 1 REF: Pages 32-33

2. Most of a cell's genetic information, including RNA and DNA, is contained in the: a. Mitochondria b. Ribosome c. Nucleolus d. Lysosome

ANS: C The nucleus contains the nucleolus, a small dense structure composed largely of RNA, most of the cellular DNA, and the DNA-binding proteins, such as the histones, which regulate its activity. The other options do not contain most of a cell's genetic information. PTS: 1 REF: Page 2

15. How do cells receive communication from the extracellular fluid surrounding them? a. Protein channel (gap junction) b. Plasma membrane-bound signaling molecules (involving receptors) c. Hormone secretion such as neurotransmitters d. Chemical messengers such as ligands

ANS: D Cellular communication can occur by the binding of a chemical massager (a ligand) to a specific membrane receptor that is closely associated with the channel (e.g., G proteins). The other options do not correctly describe how cells communicate. PTS: 1 REF: Pages 21-22

37. When a mucous gland cell creates a new substance from previously absorbed material, this process is known as which specialized cellular function? a. Excretion b. Metabolic absorption c. Reproduction d. Secretion

ANS: D Certain cells, such as mucous gland cells, can synthesize new substances from substances they absorb and then secrete the new substances to serve elsewhere as needed. The other options are not used to describe the function described in the stem. PTS: 1 REF: Page 2

25. The transport of glucose from the blood to the cell is accomplished by which process? a. Active-mediated transport (active transport) b. Active diffusion c. Passive osmosis d. Passive-mediated transport (facilitated diffusion)

ANS: D Facilitated diffusion is the means by which glucose is transported from the blood to the cells. The remaining options do not correctly identify this process. PTS: 1 REF: Pages 31-32

14. Neurotransmitters affect the postsynaptic membrane by binding to: a. Lipids b. Ribosomes c. Amphipathic lipids d. Receptors

ANS: D In each type of chemical signaling, the target cell receives the signal by first attaching to its receptors. The other options do not correctly describe this process. PTS: 1 REF: Page 17

9. Which structure prevents water-soluble molecules from entering cells across the plasma membrane? a. Carbohydrate chains b. Glycoprotein channels c. Membrane channel proteins d. Lipid Bilayer

ANS: D The bilayer's structure accounts for one of the essential functions of the plasma membrane. It is impermeable to most water-soluble molecules (molecules that dissolve in water) because the water-soluble molecules are insoluble in the oily core region. The bilayer serves as a barrier to the diffusion of water and hydrophilic substances while allowing lipid-soluble molecules, such as oxygen (O2) and carbon dioxide (CO2), to diffuse through it readily. The other options do not correctly describe this process. PTS: 1 REF: Pages 12-13

4. Which cell component is capable of cellular autodigestion when it is released during cell injury? a. Ribosome b. Golgi complex c. Smooth endoplasmic reticulum d. Lysosomes

ANS: D The lysosomal membrane acts as a protective shield between the powerful digestive enzymes within the lysosome and the cytoplasm, preventing their leakage into the cytoplasmic matrix. Disruption of the membrane by various treatments or cellular injury leads to a release of the lysosomal enzymes, which can then react with their specific substrates, causing cellular self-digestion. The other options do not correctly describe this process. PTS: 1 REF: Pages 7-8

Dysplasia

Abnormal changes in the size, shape and organization of mature cells

Pyrexia

Abnormal elevation of body temperature

Edema

Accumulation of fluid within the interstitial space- venous obstruction, Na and water retention C.M. can be localized or dependent, tightness of skin, facial swelling, rales, decreased wound healing, increased risk of pressure sores, weight gain

Renin Angiotensin Aldosterone System

Activated by low blood volume, triggers release of renin which converts angiotensinogen to angiotensin 1. ACE converts angiotensin 1 to angiotensin which causes arterial vasoconstriction and stimulates release of aldosterone. Aldosterone stimulates renal Na reabsorption and K+ excretion. Water is retained, less urine is produced, blood volume increases.

Guillain-Barre syndrome

Acute, inflammatory, *autoimmune* disease triggered by a preceding bacterial or viral infection that causes *demyelination* of *PNS* neurons resulting in denervation and atrophy of muscle with numbness, pain, parasthesis or weakness

Free radicals

An electrically uncharged atom or group of atoms having an unpaired electron capable of injurious chemical bond formation with proteins, lipids or carbohydrates

Partial trisomy

An extra portion of a chromosme is present in each cell

adiponectin, increasing

An increase in adipose tissue causes lower level of ________, that normally induces apoptosis, thus _______ cell proliferation

Hyperpolarization

An increase in the difference in electric potential across a cell membrane. Cell becomes more negative.

Enuresis

An involuntary discharge of urine: incontinence of urine

Rough endoplasmic reticulum

An organelle with ribosomes in the cytoplasm that synthesizes, processes, and transports proteins.

Mycotic aneurysm

Aneurysm that is caused by *bacterial* or *fungal* growth in the vessel wall or infection of an *arteriosclerotic aneurysm*.

Pseudostratified

Appears to consist of several layers but is actually a single layer

Cerebral infarction

Area of the brain loses blood supply because of vascular occlusion

Fragile sites

Areas on chromosomes that develop distinctive breaks or gaps when cells are cultured in a folate-deficient medium

Thrombotic stroke (cerebral thrombosis)

Arterial occlusions in vessels supplying the brain or intracranial vessels caused by *atherosclerosis* or *inflammation*.

Arteriovenous malformation

Arteries feed directly into veins through a vascular tangle of vessels

Antipyrogenic medications

Aspirin, acetaminophen, non-steroidal anti-inflammatory agents; use only if the fever is high enough to produce serious side effects

Dense connective tissue

Attaches structures to one another (tendons and ligaments)

post-transplant lymphoproliferation (PTLD)

B-cell lymphomas in persons with organ transplants

Phagocytosis

Bacteria and cell particulate are incorporated into large vesicles or vacuoles and digested.

h pylori

Bacteria most commonly responsible for stomach CA

Borrelia burgdorferi

Bacterial *spirochete* that causes *Lyme disease* transmitted by ticks

Oligodendroglioma

Benign nerve sheath tumor in the central nervous system

Neurofibroma or schwannoma

Benign nerve sheath tumor in the peripheral nervous system

Histone proteins

Bind DNA causing it to fold into chromosomes

Contusion

Bleeding into the skin or underlying tissues from a blow that squeezes or crushes soft tissues and rupyures blood vessels

Hydrostatic pressure

Blood pressure- pushes fluid outside of the vessels, the force of fluid against the walls of a compartment- venous obstruction, Na and water retention

Prostate ca metastasis

Bones (especially lumbar spine), liver

Codominance

Both alleles exhibit (blood type AB)

loss of heterozygosity

Both chromosome copies (alleles) of a gene are inactivated

Contrecoup

Brain injury resulting from the brain hitting the inside of the skull on the side *opposite* the site of blunt force trauma.

telomerase

CA cells reactivate this enzyme for unlimited replication

Glycolipids

Carbohydrate attached to a fat- basic component of the plasma membrane.

Carboxyhemoglobin

Carbon monoxide bound with hemoglobin

Facilitated diffusion

Carrier-mediated transport of solutes across the membrane down a concentration gradient and in the absence of energy expenditure.

Glycolysis

Catabolism of glucose or other monosaccharides to pyruvate and 2 molecules of ATP in the absence of oxygen or 34 molecules of ATP in the presence of oxygen.

Hydrolases

Catalyze bonds in lipids, proteins, carbohydrates and nucleic acids

Angiotensin II

Causes vasoconstriction and secretion of aldosterone

Respiration

Cells absorb oxygen and use it to transform nutrients (lipids and carbohydrates) into energy in the form of ATP

Paracrine

Cells secrete local chemical mediators that act on nearby cells

Cuboidal epithelium

Cells that are square in shape involved in absoprtion and secretion

Columnar epithelium

Cells that are taller than they are wide. Important in absorption and movement of mucus.

Euploid

Cells that have a multiple of the normal number of chromosomes (1 or 2 copies)

Catabolism

Cellular process that provides energy by breaking down complex molecules into simpler molecules.

Potocytosis

Cellular uptake of small molecules through caveolae

Reduction

Chemical reaction in which electrons are gained.

Oxidation

Chemical reaction in which electrons are lost.

Metaphase

Chromosomes are condensed and aligned along the equatorial plate for nuclear and cellular division.

Prophase

Chromosomes are condensed and visible.

Diploid

Chromosomes occur in pairs in somatic cells

Multifactorial trait

Variation in traits caused by genetic and environmental or lifestyle factors

Hypokalemia

Decreased potassium from potassium shifting from the extracellualr fluid to the intracellular fluid in respiratory or metabolic alkalosis or after administration of insulin, reduced intake, increased loss of potassium from laxatives abuse, diarrhea, vomiting and diuretics

Hyponatremia

Decreased sodium from diuretics, vomiting, diarrhea, gastrointestinal suctioning, burns, inadequate dietary intake, excess of total body water, IV 5% dextrose, renal failure, severe congestive heart failure or cirrhosis

Amyotrophic lateral sclerosis (ALS)

Degeneration of *UMNs* and *LMNs* in the cerebral cortex, brainstem, and spinal cord characterized by progressive muscle weakness leading to respiratory failure and death (*2 to 5 years *from symptom onset). Person has normal intellectual and sensory function until death

Neuropathy

Degeneration of the nervous system

Myelopathy

Degeneration of the spinal cord

Spondylolysis

Degenerative process of the vertebral column and associated soft tissue

Fluid volume deficit

Dehydration- intake is not enough for body's needs C.M. Poor skin turgor, dry mucous membranes, sunken eyes, sunken fontanelles, decreased urine output, fatigue

Lipid peroxidation

Destruction of unsaturated fatty acids

Capillary telangiectasis

Dilated capillaries with interspersed brain tissue deep in the brain

Cryogens or antipyretics

Diminish and control the febrile response by a negative feedback loop, arginine vasopressin, alpha-melanocyte stimulating hormone, corticotropin-releasing factor

Chemotaxis

Directional movement and attraction of microorganisms or phagocytes to substances released in the environment or tissues.

Cor pulmonale

Disease of the heart characterized by hypertrophy and dilatation of the right ventricle and secondary to disease of the lungs or their blood vessels

Obstructive sleep apnea syndrome

Disorder of breathing during sleep related to upper airway obstruction

Dyssomnias

Disorders of getting to sleep or staying asleep or of excessive sleepiness

Gangrenous Necrosis

Dry- dark shriveled skin Wet- internal organs- can lead to death Gas- from clostridium- antitoxins and hyperbaric therapy

substantia nigra

Dysfunction of the ______ ______ is associated with Parkinson disease

Dysplasia

E. Cells change in size, shape, organization P. AKA atypical hyperplasia, a disorderly proliferation Physiologic: N/A Pathologic: squamous dysplasia of cervix from HPV

Atrophy

E. Cells decrease in size P. Still functional Physiologic: thymus gland in early childhood Pathological: disuse (muscle atrophy)

metabolic alkalosis

E. GI loss, diuretic use C.M. slow, shallow respirations, irritability, twitching, s/s of hypokalemia pH >7.4 HCO3 >26

Hyperplasia

E. Increase in cell number P. Increased cellular division Physiologic: liver regeneration Pathologic: endometrial- usually r/t hormones

Hypertrophy

E. Increase in cell size P. Increased workload Physiologic: weightlifting Pathologic: cardiomegaly from HTN

Rhabdomyolysis

E. cell hypoxia caused by severe muscle trauma, hyperthermia, crush injuries, or severe dehydration P. hypoxia leads to cell death, cellular contents are released in bloodstream. C.M. CK is 5x upper normal limit, muscle pain, weakness, dark, reddish-brown urine, hypercalcemia, renal failure

respiratory acidosis

E. cns depression, airway abnormalities C.M. restless, confused, seizures, tachycardia pH <7.4 PaCO2 >44

Gout

E. disturbances in serum urate levels. uncommon for < 30 years old. P. uric acid is deposited in the tissues of kidney, heart, earlobes, and joints. C.M. inflammation, painful joints. result of diuretic use or diet high in cream sauces, red wine, or red meat

Hypoxia injury

E. inadequate oxygenation of tissues P. decrease in mitochondrial function, decreased production of ATP increases anaerobic metabolism. eventual cell death. C.M. hypoxia, cyanosis, cognitive impairment, lethargy

metabolic acidosis

E. increased acid production, loss of bicarb, diminished renal excretion of hydrogen C.M hyperventilation (compensatory), h/a, n/v/d, dehydration, hypotension pH <7.4 HCO3 <22

Ethanol

E. mood altering drug, long term effects on liver and nutritional status P. metabolized by liver, generates free radicals C.M. CNS depression, nutrient deficiencies-Mag, Vit B6, thiamine, PO4, inflammation and fatty infiltration of liver, hepatomegaly, leads to liver failure irreversible

Free radical and ROS

E. normal byproduct of ATP production, will overwhelm the mitochondria- exhaust intracellular antioxidants P. lipid peroxidation, damage proteins, fragment DNA C.M. development in Alzheimer's, heart disease, Parkinson's disease, Amyotrophic Lateral Sclerosis

Metaplasia

E. one cell type replaced with another P. reprogramming of stem cells, reversible Physiologic: N/A Pathologic: stratified squamous cells in bronchial lining r/t cigarette smoke

respiratory alkalosis

E. usually anxiety, PE, chf, salicylate OD, illegal drugs C.M. light-headed, confused, tetany pH >7.4 PaCO2 <38

DNA polymerase

Enzyme that replicates DNA using one DNA strand as the template

RNA polymerase

Enzyme that transcribes DNA into RNA

Discordance

Expression of the disease in one family member but not a second

Concordance

Expression of the disease in two related family members

Transmembrane protein

Extends across the bilayer and is exposed to an aqueous environment on both sides of it.

Cilia

Hair like projections that propel mucus, pus, and dust particles out of the body: lining of the respiratory passages.

Nondisjunction

Failure of homologous chromosomes or sister chromatids to separate during meiosis or mitosis

Endogenous pyrogens

Fever-producing substance produced by phagocytic cells as they destroy microorganisms within the host, prostaglandin E, Interleukin 1 and 6, tumor necrosis factor, interferon-gamma; act on preoptic nucleus of hypothalamus

Elastin

Fibrous mucoprotein, similar to collagen capable of stretching and recoiling

Squamous epithelium

Flat, thin cells involved in absorption, exchange of materials, filtration and secretion

Golgi complex

Flattened, smooth vesicles stacked near the nucleus of a cell that process and package secretory proteins into vesicles and enzymes into lysosomes and modify proteins targeted to become part of cellular membranes.

Fluid volume excess

Fluid intake exceeds body's needs C.M. Edema, rales, HTN, weight gain, bounding pulses, intake> output, JVD, restlessness or anxiety

Interstitial fluid

Fluid present in the extracellular spaces of a tissue.

Dizygotic

Fraternal twins who developed from two fertilized ova

Carcinoembryonic Antigen

GI, pancreas, lung, breast tumors

Thyroid-stimulating hormone-releasing hormone

Hypothalamus responds to low body temperature by releasing

Homozygous

Identical alleles of a given gene

Monozygotic

Identical twins who developed from a single fertilized ovum

7x

In 2009, national council on radiation reported Americans were exposed to more than ___ as much IR from medical procedures compared to the 1980s

Melanoma metastasis

In transit lymphatics, lung, liver, brain, GI tract

Intravascular fluid compartment

In venous system- 20%

Insomnia

Inability to fall or stay asleep

Ischemia

Inadequate blood supply in the circulation and can cause a decrease in blood flow to local vessels that may result in hypoxia and subsequent cell injury or death.

Relative risk

Incidence rate of a disease among individuals exposed to a risk factor divided by the incidence rate of a disease among individuals not exposed to a risk factor

Respiratory alkalosis

Increase in pH caused by alveolar hyperventilation and decresaed plasma carbon dioxide (hypocapnia).

Metabolic alkalosis

Increase in pH caused by an increase in bicarbonate ions secondary to an increase in metabolic acid loss from prolonged vomiting, gastrointestinal suctioning, excessive bicarbonate intake, hyperladosteronism (with hypokalemia) and diuretics

Hyperplasia

Increase in the number of cells as a consequence of an increase in cell division.

Hypertrophy

Increase in the size of cells and the affected organ

Hypervolemia

Increased blood volume capable of causing hypertension and edema

Hypercalcemia

Increased calcium from hyperparathyroidism, bone metastases with calcium resorption from breast, prostate, cervical cancer or hematologic malignancy, sarcoidosis, and excess vitamin D

Hyperchloremia

Increased chlorine from hypernatremia or a bicarbonate deficit (metabolic acidosis)

Hypermagnesemia

Increased magnesium from intake of magnesium containing antacids

Hyperphosphatemia

Increased phosphate from long-term use of phosphate containing enemas or laxatives, hypoparathyroidism,

Hypertonic hyponatremia

Increased plasma lipids, proteins, or glucose displace water balance and thus decrease sodium concentration.

Hyperkalemia

Increased potassium from increased intake, shift from cells to extracellualr fluid or decreased renal excretion

Preoptic area

Inhibitory modulation (GABA) of multiple arousal systems that promotes sleep in the hypothalamus

Diffuse brain injury (diffuse axonal injury)

Injury to neuronal axons in many areas of the brain caused by stretching and shearing forces received during brain injury.

Frameshift mutation

Insertion or deletion of one or more nucleotides that changes the amino acid sequence of a protein

Cyclic adenosine monophosphate

Intracellular molecule that acts as a second messenger and mediates the effects of extracellular substances on cell activity.

Fasciculation(s)

Involuntary muscular *twitching*

insulin effect on K+

K+ enters cell with glucose transport. Monitor Type II DM for hypokalemia

Atony

Lack of normal muscle tone or tension; flaccidity.

Anoxia

Lack of oxygen caused by sudden vascular obstruction.

Cytoplasm

Liquid material of a cell enclosed within the plasma membrane.

Alpha Fetoprotein Origin

Liver and germ cell tumors

Head and neck ca metastasis

Liver, bones, lymphatics

Colorectal ca metastasis

Liver, lungs

Testicular ca metastasis

Liver, lungs, brain

Breast ca metastasis

Liver, lungs, brain, bones

Mechanisms of ca metastasis

Local invasion, followed by invasion of surrounding tissues. Cells then may invade blood and lymphatic vessels. They must survive in circulation, then enter and survive in a new location. Then the cells can multiply and form a new tumor.

Intraocular fluids

Located or occurring within the eye

Deletions

Loss of a sequence of DNA from a chromosome

Anorexia

Loss of appetite especially when prolonged

Sarcoma metastasis

Lungs

Nuclear envelope

Made of two membranes transports materials in and out of the nucleus

Collagen

Main protein component of connective tissue produced by mainly by fibroblasts.

Consanguinity

Mating of two related individuals that dramatically increases the recurrence risk of recessive disorders

Gametes

Mature reproductive cells (sperm and egg) that unite to form a new organism

Integral protein

Membrane protein that facilitates the attachment of a cell to the extracellular matrix and signal transduction from the extracellular matrix to the cell

Centrioles

Microtubules involved in the formation of the mitotic spindle during cell division.

Aldosterone

Mineralocorticoid that is synthesized and secreted by the adrenal cortex and acts to regulate sodium and potassium balance by altering reabsorption in the kidney.

Cytokines

Molecule produced by the immune system that mediates interactions between cells to kill bacteria during the inflammatory response.

Active transport

Movement of a substance across a membrane by a carrier protein that requires expenditure of energy

Filtration

Movement of water and solutes through a membrane because of a greate force applied to one side of the membrane

Lung ca metastasis

Multiple organs including brain

moderate hyponatremia

Na 120-125 C.M. agitation, disorientation, headache

mild hyponatremia

Na 125-135 C.M. anorexia, apathy, restless, nausea, lethargy, muscle cramps

severe hyponatremia

Na <120 C.M. seizures, coma, areflexia, incontinence, death

Oncosis

Na and H2O enter cell and cause swelling. Organ increases in weight, becomes distended and pale. Associated with high fever, hypocalcemia, certain infections

Stenosis

Narrowing or stricture of a passage or vessel

Action potential

Nerve or muscle cell receives a stimulus that exceeds the theshold potential.

Suprachiasmatic nucleus

Neuron clusters in the hypothalamus that receive photic input from the retina via the optic nerve and regulate the body's circadian rhythms

Telophase

New nuclear membrane is formed around the chromosomes, spindle fibers disappear, and the chromosomes begin to uncoil

Disjunction

Normal separation of chromosomes during cell division

Peripheral protein

Not embedded in the lipid bilayer (plasma membrane)

Mitosis

Nuclear division- two identical nuclei are produced after chromosomal replication.

Interphase

Nucleus is not undergoing division

Incidence rate

Number of new cases of a disease reported during a specific period (typically 1 year) divided by the number of individuals in the population

Hypopnea

Number of partial airway closure episodes per night (episodes/hour)

Apnea Hypopnea Index

Number of total airway closure episodes per night (episodes/hour)

Chromatids

One of two identical chromosomal strands that splits longitudinally before cell division

Haploid

Only one member of each chromosome pair occurs in gamete cells

Phenotype

Outward appearance of an individual

Allele

Paired genes on autosomal chromosomes

Osmosis

Passive- the movement of water from an area of low concentration of solute to one of higher concentration

Penetrance

Percentage of individuals with a specific genotype who also express the expected phenotype

Ovarian ca metastasis

Peritoneal surfaces, diaphragm, omentum, liver

Carrier

Person who has a diseased gene but is phenotypically normal

Absolute refractory period

Plasma membrane cannot respond to an additional stimulus.

Endocytosis

Plasma membrane invaginates forming vesicles

Intravascular fluid

Plasma present in the blood.

Pontine reticular formation

Plays a critcal role in the generation of REM sleep located in the pons and brainstem

Cholesterol

Polar lipid molecule that is part of plasma membrane (lipid bilayer)

Locus

Position in which a gene occupies on a chromosome

Locus

Position of a gene on a chromosome

Founder cells

Precursor cells that adhere to like cells and undergo mitosis to form tissues.

Venous angioma(s)

Primitive embryologic veins in a radial pattern feeding a central vein

Epinephrine

Released by the adrenal medulla in response to thyroxine (T4), causes vasoconstriction (improves thermal insulation), stimulates glycolysis, and increases metabolic rates, thus increasing heat production

Thyroid-stimulating hormone

Released by the pituatary gland in response to TSH-RH

Thyroxine

Released by the thyroid gland in response to TSH

Abrasion

Removal of superficial layers of skin

Excretion

Removal of waste products resulting from the metabolic breakdown of nutrients.

what determines the degree to which the lungs inflate/deflate

Respiratory pressures inflating the lungs compliance of the lungs airway resistance

Reperfusion injury

Restoration of oxygen and subsequent damage from superoxide and hydrogen peroxide in transplantation and myocardial, hepatic, intestinal, cerebral and renal ischemia

Metaplasia

Reversible replacement of one mature cell by another (sometimes less differentiated)

Chromosome

Rod or threadlike organelle of a cell that carries the DNA and genes

Lysosomes

Saclike structures containing hydrolases cleave bonds in proteins, lipids, nucleic acids, and carbohydrates.

Heat exhaustion

Salt and water loss produce hemoconcentration and hypovolemia (hypovolemia, weakness, nausea)

Antidiuretic hormone

Secreted by pituitary gland in response to water deficit, Na excess, or hypotension. Causes kidneys to reabsorb water, increasing plasma volume

Introns

Sequences of RNA (non-coding regions) that are removed by nuclear enzymes in eukaryoyes

Extrons

Sequences of RNA that are translated into proteins

Tight junctions

Serve as a barrier to diffusion, prevent the movement of substances through transport proteins and prevent the leakage of small molecules between the plasma membrane of adjacent cells.

Tetany

Severe, intermittent tonic contractions and muscular pain, due to abnormal calcium metabolism

Reticular connective tissue

Short branching fibers that form an inelastic network

Chromosome

Single piece of coiled DNA and protein containing many genes, regulatory elements and other nucleotide sequences.

Cavernous angioma(s)

Sinusoidal collections of blood vessels without interspersed brain tissue

Mitochondria

Site of oxidative phosphorylation that generates ATP

Smooth endoplasmic reticulum

Site of phospholipid synthesis, breakdown of toxins and carcinogens in the liver, the conversion of cholesterol into steroids in the gonads and adrenal glands, and the release of calcium ions in the muscles, causing muscle contraction.

Fragile X syndrome

Site on the long arm of the X chromosome that develops distinctive breaks or gaps resulting in mental retardation

microRNAs

Small single-strand RNA molecules that bind to mRNA molecules to block certain parts' expression

Microvilli

Small, fingerlike projections of the surface of an epithelial cell involved in aborption of water and nutrients.

Microtubules

Small, hollow, cylindrical, unbranched protein structures

Resting membrane potential

The difference in electrical charge across the membrane of an unstimulated cell that is accomplished by the unequal distribution of charged ions.

Isotonic

Solutions with equal osmotic pressures

Centromere

Spindle fiber attachment site where the two chromatids are held together

Metastasis

Spread of cancer to other parts of the body

Spondylolisthesis

Stress factor allowing the vertebra to slide forward I relation to the vertebra below

Baroreceptors

Stretch-sensitive mechanoreceptors located in the heart, aortic arch, and carotid sinuses that respond to changes in blood pressure and volume.

Embolic stroke

Stroke caused by blockage of cerebral vessels.

Lacunar stroke

Strokes caused by the *occlusion* (microinfarct) of a *small branch* of a larger blood vessel associated with *smoking, diabetes and hypertension*

Relative refractory period

Stronger than normal stimuli can produce an additional action potential while the cell is repolarizing

Hypothermia

Subnormal temperature of the body; temperature less than 35C an 95F

Silent mutation

Substitution of one nucleotide for another that does not result in a change in an amino acid

Missense mutation

Substitution of one nucleotide for another that results in a change of a single amino acid

Nonsense mutation

Substitution of one nucleotide for another that results in the addition or deletion of a stop codon

Interstitial fluid compartment

Surrounds the cells and bathes them in nutrients- 20%

TNM staging system

T= tumor size >/= correlates with metastatic ability N= whether lymph nodes are involved M= extra nodal involvement (liver, lungs)

hormone secrete prolactin

TRH

lab value for decomp HF

TSH

Laceration

Tear or rip resulting when the tensile strength of the skin or tissue is exceeded. Edges are jagged and irregular.

broca speech area

The ___ ___ ___ is responsible for the MOTOR aspects of speech, causing inability to form words (expressive aphasia or dysphasia) when damaged

wernicke area

The ____ ____ is responsible for reception and interpretation of speech. Damage results in receptive aphasia or dysphagia.

Effective arterial blood volume

The amount of blood within the arterial space- ECF changes will cause changes in the EABV in the same direction

Phospholipids

The basic component of the plasma membrane.

Diabetic ketoacidosis

The buildup of byproducts of fat metabolism that occurs when glucose is not available as a fuel source for the body because of insulin deficiency.

Repolarization

The closing of sodium channels and the opening of potassium channels (efflux of potassium).

Cytokinesis

The cytoplasm of a parent cell is divided into two identical cells after mitosis.

Anion gap

The difference between unmeasured plasma cations and anions that is used to distinguish different causes of metabolic acidosis.

Osmolality

The measure of solute concentration in a fluid. 280-295 mOsm

Threshold potential

The membrane potential that must be reached in order for an action potential to be generated and the impulse to be propagated to another cell.

Simple diffusion

The movement of a solute moecule form an area of greater solute concentration to an area of lesser solute concentration. Does not require energy.

Phenotype

The observable, detectable, or outward appearance of the genetics of an organism

Depolarization

The opening of sodium channels (sodium influx)

Hypercapnia

The presence of an excess of carbon dioxide in the blood

Hydroxyapatite

The principal storage form of calcium and phosphorus in bone that provides compressional strength

Recurrence risk

The probability that parents of a child with a genetic disease will have yet another child with the same disease

Secretion

The process involved in producing and releasing a substance from the cell

Meiosis

The process of gamete formation with two cell divisions resulting in a haploid number of chromosomes

Somnolence

The quality or state of being drowsy

Hematocrit

The ratio of the volume of red blood cells to a given volume of blood (percentage)

Anaphase

Third phase of mitosis during which centromeres are separated and sister chromatids are moved to opposite poles.

Down syndrome

Three copies (trisomy) of chromosome 21

Polygenic

Variation in traits caused by the effects of multiple genes

Telomere

The segment of DNA that occurs at the ends of chromosomes

Ring chromosome

The telomere of each chromosome arm is deleted and the broken arms are joined

vital capacity

The total volume of air that can be exhaled after maximal inhalation.

Conduction

The transfer of heat through matter by communication of kinetic energy from particle to particle with no net displacement of the particles

Convection

The transfer of heat thru gases or liquids (wind and fans)

8 12 5 5 1

There are __ cervical, __thoracic, __lumbar, __ sacral and __ coccygeal levels of the spinal cord.

Lyme disease

Tick-borne *spirochete* bacterial (*Borrelia burgdorferi*) infection that is characterized by a rash in the area of the bite, headache, neck stiffness, chills, fever, myalgia, arthralgia, malaise, fatigue, and possible development of arthritis in large joints.

Recessive

Trait not seen in phenotype

Dominant

Trait seen in phenotype

Quantitative traits

Traits that are measured on a continuous numeric scale

Pinocytosis

Transport of fluid into a cell by means of local infoldings by the cell membrane so that a tiny vesicle

Chromosome mosaics

Trisomy in only some cells of an organism

TNM

Tumor (size & extent of tumor) Nodes (lymph node involvement) Metastases (extent of distant metastases)

Extramedullary tumor(s)

Tumor originating from tissues outside the spinal cord including the meninges, epidura tissue or vertebral structures

Intramedullary tumors

Tumor originating within neural tissue

TNM staging

Tumor size, lymph Node involvement, extent of Metastases

Gap junctions

Tunnel or connexon that joins two adjacent cells and allows for the passage of molecules and electrical signals between the cells.

Autosomes

Twenty-two chromosome pairs that are homologous in males and females

Inversions

Two breaks on a chromosome with a reversal in order during reattachment

Heterozygous

Two different alleles of a given gene

Homozygous

Two dominant or recessive alleles

Polymorphism

Two or more alleles of a gene that occur with appreciable frequency in a population

Polymorphic

Two or more alleles which occur with an appreciable frequency in a population

Stratified epithelium

Two or more layers that are involved in protection

Osmosis

Water passes through a semipermeable membrane into a solution where the solvent concentration is higher

calcium and albumin

When blood levels of albumin are low, serum calcium levels will also be low as there is less protein available for binding

Heterozygous

When both a dominant and a recessive allele are present

HPV -6, -11, -16, -18,

Which HPV viruses have existing vaccines?

point mutation of ras

changes ras from proto-oncogene to oncogene *pancreatic & colorectal cancer*

Intracellular fluid compartment

Within the cells- 40% uk

1/3

___ of all cancers have an activating mutation of RAS

larger

_________axons transmit impulses at a faster rate

endoneurium

a delicate connective tissue around each axon in the PNS

Schwann cell

a glial cell that wraps around and covers axons in the PNS. Forms and maintains the myelin sheath

reticular formation

a large network of connective tissue nuclei within the brainstem that regulate vital reflexes. Essential for maintaining wakefulness

thalamus

a major integrating center for afferent impulses to the cerebral cortex; serves as a relay center for sensory aspects of motor information from the basal ganglia and cerebellum to appropriate cortical motor areas

red nucleus

a major motor output center influenced by the cerebellum

corpus callosum

a massive white matter pathway that connects the two cerebral hemispheres and is essential in coordination of activities between hemispheres

vermis

a midline structure connecting the anterior and posterior lobes of the two cerebellar hemispheres

cauda equina

a nerve bundle consisting of spinal nerves after the end of the spinal cord

astrocyte

a neuroglial cell that fills spaces between neurons and surrounds blood vessels in the CNS

oligodendrocyte

a neuroglial cell that functions to deposit myelin within the CNS; the CNS counterpart of the Schwann cells

plasticity

a principle of the CNS meaning that it is capable of change. the ability of the CNS to do this decreases with age

internal capsule

a thick white-matter region in which afferent and efferent pathways to and from the cerebral cortex pass through the center of the cerebral hemispheres

t(9;22)

a.k.a Philadelphia chromosome results in BCR-ABL protein *chronic myeloid leukemia*

divergence

ability of branching axons to influence many different neurons

tumor

abnormal growth results from uncontrolled proliferation

macrovascular disease in DM

accelerated atherosclerosis

dystrophic calcification

accumulation of Ca in dead or dying tissues calcium salt clump and harden- interfere with cellular structure and function r/t pulmonary TB, atherosclerosis, injured heart valves, chronic pancreatitis

metastatic calcification

accumulation of Ca in normal tissue result of hypercalcemia r/t hyperparathyroidism, hyperthyroidism, toxic levels of Vit D. Can also r/t hyperphosphatemia in renal failure

calcium and ionized calcium

acidosis increases ionized Ca+ alkalosis decreases ionized Ca+ and may cause symptoms of hypocalcemia

highly proliferative cells

acute IR especially damages organ systems with ____ _______ ____, such as the hematopoietic system, the skin, & GI system

methylation

addition of a methyl group, a biochemical process that influences behavior by suppressing gene activity and expression

acetylation

addition of acetyl group, of DNA and histones causes nucleosomes to loosen and spread apart

hypervolemic hypernatremia

administration of hypertonic saline C.M. volume overload, edema, chf, htn, pulmonary edema

Parasymp. stimulation on the lungs

airway constriction blood vessel dilation and increased secretions

symp. stimulation on the lungs

airway dilation blood vessel constriction decrease secretions

Adrenergic agents effect on K+

albuterol, beta blockers, and alpha adrenergic antagonists cause K+ movement into the cell. Alpha adrenergic receptors shift K+ out of the cell

hormone of Na regulation

aldosterone

point mutation

alteration of one or a few nucleotide base pairs

functional residual capacity

amount of air that remains in the lungs following normal expiration rv + erv

B cell hormone decrease in Type I & Type II DM

amylin

myelin

an insulating substance made of a segmented layer of lipid material

plasticity

an organisms development is contingent on its environment

50mSv

annual allowable occupation exposure of radiation in the US

hypersecretion of GH caused by

anterior pituitary adenoma

Cushing syndrome

any condition involving chronic exposure to excessive cortisol

premotor

area involved in programming of motor movements

prefrontal

area responsible for goal-oriented behavior, short-term memory, and elaboration of though and inhibition of emotion

anemia

associated w/ ca usually occurs because of malnutrition, resultant iron deficiency, chemotherapy, radiation & malignancies in blood forming organs

pain

associated w/ late stage ca caused by pressure, obstruction, invasion of structure sensitive to pain, stretching, tissue destruction & inflammation

lipoma

benign tumor of fat cells

rhabdomyoma

benign tumor of skeletal muscle

leimyoma

benign tumor of smooth muscle

oncogene activation

biologic response of radiation-induced cancer

antimetabolite chemo

blocks normal growth pathways in cells

convergence

branches of numerous neurons converging on and influencing one or a few nuerons

Fat Necrosis

breast, pancreas, abdominal structures- creates soaps

fascicles

bundles of axons in large nerves

autocrine stimulation

ca cell that secretes growth factor that stimulate its own growth engages in _________ _________

leukemia

ca of blood forming cells

stage 1

cancer confined to organ of origin

stage 4

cancer has spread to distant sites; bone, liver, lungs, brain

stage 3

cancer has spread to regional structures; lymph nodes

stage 2

cancer is locally invasive

somatic, germline

cancer predisposing genetic events that occur in _______ cells are not inherited but those that occur in ________ cell are inherited

cancer stem cell model

cancer stem cells in tumor survive cytotoxic chemo, tumor is likely to regrow

warburg effect

cancers consume large quantities of glucose via aerobic glycolysis to make cellular building blocks

cerebral aqueduct

carries CSF. obstruction of this causes hydrocephalus

spinothalamic tract

carries nerve impulses from the spinal cord to the thalamus in the diencephalon

hpv-18

cause of 80% of all anal CA

secondary insomnia

caused by drug or alcohol abuse, chronic pain disorders, chronic depression, obesity, aging

Kaposi sarcoma

caused by infection w/ HHV 8 or member of Herpesviridea family

primary endocrine disorder

caused by problem in gland that secretes hormone whose action is directed toward other tissues rather than another gland

secondary endocrine disorder

caused by problem with gland that secretes hormone whose target tissues are another gland that it stimulates or suppresses

UV radiation

causes basal-cell carcinoma, squamous cell & melanoma

t (8;14)

causes burkitt lymphoma alters control of myc protein->excessive proliferation of B lymphocytes

gray matter

cell bodies and dendrites of neurons. Organized into columns perpendicular to the surface that receive, integrate, store, and transmit info

stem cell & cancer cells

cells that are able to divide indefinitely because they make enzyme telomerase

Exercise effect on K+

cellular ATP is diminished, opening K+ channels and allowing K+ to leave cell

pleura

double layered serous membrane that lines the thoracic cavity

thyrotoxic crisis

effects of dangerously high levels of thyroid hormone w/ high fever, extreme tachycardia & potential death from HF or cardiac dysrythmias

hyperthermia

elevation of temperature without an increase in the hypothalamic set point

proto-oncogenes

encode growth factors (PDGF0 growth factor receptors (HER2) signal transducers (RAS) nuclear growth-promoting proteins (MYC)

tumor suppressor gene

encodes proteins that inhibit proliferation & prevent or repair mutations

adipokine leptin

enhances the production of inflammatory factors & TNF-a

glutathion-S transferases

enzyme housekeepers involved in metabolism of environmental carcinogens & ROS -those who lack this enzyme may be at higher risk for CA

phase I activation enzymes

enzymes that activate xenobiotics represented by the CYP 450 family

dipsogenic DI

excessive H2O intake that decreases osmolality by overwhelming ADH mechanisms

hypersomnia

excessive daytime sleepiness

Kidneys effect on K+

excretion and absorption of K+ is regulated by tubule system

forced expiratory volume

expiratory volume in a given period fev1

dendrites

extensions that carry nerve impulses toward the cell body

basal ganglia system

extrapyramidal system - eferrent pathways outside the pyramids of the medulla oblongata

survival of malignant tumors is

facilitated by tumor-associated macrophages that secrete cytokines & other factors that assist ca cell survival & proliferation

pituitary disease

failure of hypothalamus to secrete its usual hormones

clinical manifestations of ca

fatigue pain cachexia anemia leukopenia thrombocytopenia infection

38.5-41C 100-105.8

fever temperature range

Autosomal chromosomes

first 22 of 23 chromosomes

N2 (TNM staging)

fixed nodes involved

induction chemo

for shrinkage or disappearance of tumors

neuroglial cells

found in the CNS and PNS and can provide structural support and nutrition for neurons, remove debris, increase speed of nerve impulses, and play a role in memory

dx SIADH, best treatment

free H2O restriction

hypovolemic hypernatremia

from GI losses or diuretics C.M. Volume depletion, orthostatic hypotension, tachycardia, lack of organ perfusion

-blastoma

from blasts or immature cells- neuroblastoma

Sarco-

from connective tissue- chondrosarcoma

Carcino-

from epithelial tissue- renal cell carcinoma

forced vital capacity

full inspiration followed by forceful max expiration

hypothalamus

function includes maintenance of constant internal environment and implementation of behavioral patterns. Exerts its influence through the endocrine system and neural pathways

Pulmonary circulation

gas exchange for lungs

TP53

gene where resistance to apoptosis occurs

transgenerational effect

genetic effects arise in distant progeny

Beta Human Chorionic gonadotropin origin

germ cell tumors

adjuvant chemo

given after surgical excision to eliminate micrometastasis after surgery

neo-adjuvant chemo

given before localized (surgical or radiation) treatment of cancer. may shrink tumor to make localized treatment easier or more effective

uncontrolled release of ROS

important contributor to skin carcinogenesis

immune system

important in protecting against ca caused by specific viral infection

prolactin secreting tumors

in anterior pituitary called prolactinomas in woman and normally cause galactorrhea

sulci

grooves between adjacent gyri

ganglia

groups of cells bodies in the PNS

thyrotoxicosis

having too much thyroid hormone as seen w/ hyperthyroidism

pleomorphic

having variable size & shape

stimulates the adrenal cortex increase in skeletal muscle tone initiates the shivering response produces vasoconstriction

heat conservation (sympathetic nervous system)

TSH-RH pathway is shut down sympathetic pathway is decreased produces vasodilation decreased muscle tone increased sweat production increased pulmonary ventilation

heat loss

adipokines

hormones secreted by adipose tissue that play an important role in energy balance and metabolism

10-20 years

how long does it take for HPV infection to cause CA?

acid base balance effect on K+

hydrogen enters cell, allowing potassium to escape during acidosis, visa versa for alkalosis

Osmolality effect on K+

hyperosmolality causes water to shift out of cell via osmosis. K+ will also shift out, causing hyperkalemia.

awake promoting neurotransmitters

hypocretin, acetylcholine, somatostatin, glutamate, cortisol

pituitary gland located in body

hypothalamus

myxedema

hypothyroidism can develop nonpitting boggy edema.

occipital

lobe containing the primary visual cortex

nodes of Ranvier

interruptions in the neurilemma and myelin sheath

Cell lysis effect on K+

intracellular K+ is released into bloodstream

Fatty Infiltration

intracellular accumulation of lipids in the liver liver fails to metabolize lipids. usually from ETOH or high fat diet. can lead to cirrhosis

calcium and phosphorus relationship

inverse relationship- if one increases= other one decreases, rehulated by PTH, Vit D, calcitonin

inferior colliculi

involved with voluntary and involuntary auditory motor movements, such as turning the head to improve hearing

superior colliculi

involved with voluntary and involuntary visual motor movements, such as ability of eyes to track moving objects

development of ca

involves both inactivation of tumor suppressor genes usually by loss of heterzygosity or by silencing & activation of oncogenes

Coagulative Necrosis

kidneys, heart, adrenals- secondary to hypoxia

deficiency of TSH cause

lack of thyroid hormone

thalamus

largest component of the diencephalon

5-10 years

latent period of radiation induced CA

white matter

lies beneath the cerebral cortex and is composed of myelinated nerve fibers which send messages to neurons

Caseous Necrosis

lung disease- usually TB- tissue looks like clumped cheese

isotonic hyponatremia

mOsm 280-295- not true hypovolemia- from elevated triglycerides or serum proteins

hypotonic hyponatremia

mOsm <280 and urine Na >100- fluid excess r/t intake or renal impairment

hypertonic hyponatremia

mOsm >295- from solutes other than Na- osmotic pressure leads to fluid shift from intracellular to extracellular

microtubules

made of protein and believed to be involved in transport of cellular products

basis pedunculi

made up of efferent fibers of the corticospinal, corticobulbar, and corticopontocerebellar tracts

brainstem

made up of the midbrain, medulla oblongata, and the pons

magnesium and potassium

mag inhibits the potassium channels, keeping balance. when mag is low, more K+ exits the call, and is excreted via the kidneys.

ozone

main ingredient in smog air pollution

Role of the respiratory system

make oxygen available for tissues for metabolism and remove byproducts- co2. barrier immunity synthesis and metabolism of various substances

osteogenic sarcoma

malignant bone tumor

sacroma

malignant tumor arising from connective tissue

carcinoma

malignant tumor arising from epithelial tissue

liposarcoma

malignant tumor of fat cells

adenocarcinoma

malignant tumor of glandular epithelium

melanoma

malignant tumor of pigmented cells in the skin

rhabdomyosarcoma

malignant tumor of skeletal muscle

liver

malignant tumors in intestines commonly mets to ____

inspiratory reserve volume

max amount of air that can be inhaled from a point of normal inspiration

expiratory reserve volume

max volume of air that can be exhaled from point of normal expiration

infection

may cause by leukopenia, immunosuppressed or debility associated w/ advanced disease

BCR-ABL protein

misregulated protein tyrosine kinase that promotes growth of myeloid cells

N1 (TNM staging)

mobile nodes involved

primary insomnia

more common in women; may last only a few days due to acute stress, traveling or disrupted sleep schedule

fatigue

most frequently reported symptom of ca

cigarette smoking

most important cause of CA

neuroglia

most numerous type of CNS cell

voluntary regulation of breathing is controlled by

motor and premotor cortex.

structural component of conducting airways

mucous layer smooth muscle layer supporting connective tissue layer

Liquefactive Necrosis

nerve cells- brain- accumulation of pus

ependymal

neuroglial cell that lines the CSF-filled cavities in the CNS

unipolar

neurons have one process that branches shortly after leaving the cell body.

multipolar

neurons that are the most common and have multiple dendrites and a single axon; example: most motor neurons

sensory

neurons that carry im,pulses from peripheral sensory receptors to the CNS

pseudounipolar

neurons that have one process that has its dendritic portion extending away from the CNS and its axon portion projecting into the CNS -typical of sensory neurons in cranial and spinal nerves

bipolar

neurons that have two distinct processes arising from the cell body; example: neuron connecting rod and cone cells of the retina

postsynaptic

neurons that relay impulses away from the synapse

presynaptic

neurons that relay impulses toward the synapse

motor

neurons that transmit impulses away from the CNS to an effector organ

neoplasm

new growth

N0 (TNM staging)

no axillary nodes involved

M0 (TNM staging)

no metastases

T0 (TNM staging)

no tumor

bystander effect

non-irradiated tissue shows genetic effects in nearby cells

OXPHOS, glycolysis

normal cells metabolize by ______ & ca cells metabolize it by _________

proto-oncogene

normal gene that codes for proteins that stimulate cell proliferation appropriately

36.2-37.7C 97.2-99.9F

normal temperature range

gyri

numerous convolutions on the surface of the cerebrum

febrile seizures

occur at temperatures greater than 39C or 102.2; predominant in boys under 5; brief and self-limiting; prolonged episodes are assocaited with the development of temporal lobe epilepsy in children

decreased

older adults have a _____ fever response to infections

erbB2

oncogene amplified in 20% of breast cancer

N-myc

oncogene amplified in 25% of childhood Neuroblastoma cases

Cancers linked to alcohol

oral cavity, larynx, pharynx, hypopharynx, esophagus, & liver

afferent

pathways that carry sensory impulses toward the CNS

central hypoventilation syndrome

patients are asleep, cannot breathe can be congenital or due to head truma or tumor in medulla, pons sleep apnea is mild form of this

contralateral control

phenomenon meaning that cerebral impulses control function on the opposite side of the body

prolactinoma

pituitary tumors that secrete prolactin

pacemaker action of respiration

pneumotaxic center in upper pons. expiratory center and inhibits inspiratory apneustic center in lower pons inspiratory center

myc protein

positive signal for cell proliferation

Sheehan's syndrome

postpartum pituitary infarction

dopamine

precursor of norepinephrine

chronic inflammation

predisposes to develop ca

Carcinoma in situ

preinvasive epithelial malignant tumors of glandular or squamous cells- cervix

hepatocellular carcinoma

primary liver ca

sunlight

principle source of UV radiation

differentiation

process by which cell develops specialized organization & function

CIS

refers to preinvasive epithelial tumors of glandular or squamous cell origin

synapse

region between adjacent neurons

microglia

remove debris through phagocytosis in the CNS

alveolar macrophages

removed inhaled particulate matter from alveoli

antioxidant, oxidant

repeated CT scanning can alter the balance between _______ and _____ systems & increase the number of ROS

breathing is controlled by

respiratory center- pons and medulla

caretaker genes

responsible for maintaining genomic integrity inherited mutations can disrupts caretaker genes & cause chromosome instability

leukopenia

result of chemo which is toxic to bone marrow or radiation

reticular activating system

reticular formation + cerebral cortex

5 years

secondary CA from IR treatment usually occurs within _ ____ for leukemia patients

protease & protease activators

secreted by metastatic cells to digest the extracellular matrix and basement membrane, enabling cells to move

pineal body

secretes melatonin. Located in the epithalamus

type 2 alveolar cells

secretory cells; produce pulmonary surfacing; reduces surface tension and prevents collapse of alveoli

longitudinal fissure

separates the two cerebral hemispheres

chronic obstructive pulmonary disease

significantly lowered oxygen tension and increases in carbon dioxide retention during sleep

T3 (TNM staging)

skin and/or chest wall involved by invasion

urate accumulation

sodium urate crystals are deposited in tissues- group of disorders collectively called gout- acute arthritis, chronic gouty arthritis, tophus, nephritis

TP53

squamous cell carcinoma involves mutation of this gene

43C 109.4

temperature that causes death

41C 105.8F

temperature that produces convulsions in the adult

4-7 specific hits

the accumulation of ___ ________ ____ over time is required to cause full-blown cancer

Tidal volume

the amount of air moves in and out of the lungs with normal breathing

inspiratory capacity

the amount of air that can be inhaled from normal expiratory level to the max amount

spatial summation

the combined effects of impulses from a number of neurons on a single synapse at the same time

Ventilation

the conducting airways movement of air between atmosphere and lungs

conus medullaris

the cone shaped end of the spinal cord

axon hillock

the cone-shaped, organelle-free area where the axon leaves the cell body

facilitation

the effect of excitatory postsynaptic potentials on the plasma membrane potential

temporal summation

the effects of successive, rapid impulses received from a single neuron on the same synapse

medulla oblongata

the lowest portion of the brainstem

summation

the number and frequency of potentials the postsynaptic neuron receives

dendritic zone

the receptive portion of a neuron that receives a stimulus and continues further conduction

wallerian degeneration

the sequence of events that occur when an axon is severed

L1-L2

the spinal cord terminates at ____ - ____

law of partial pressure of gases

the total pressure of a mixture of gases is equal to the sum of partial pressures of the different gases in the mixture.

Type 1 alveolar cells

thin squamous cells with a thin cytoplasm and nucleus

T3 & T4 stored as

throglobulin

Three processes involved in respiration

ventilation perfusion diffusion

HTLV-1 (human T-cell lymphotropic virus)

viruses associated with Adult T-cell Leukemia/Lymphoma

epstein-barr (EBV or HHV4)

viruses associated with Burkitt lymphoma, non-Hodgkin lymphoma, nasopharyngeal carcinoma

HPV

viruses associated with Cervical & Anogenital cancers

Hep B & Hep C

viruses associated with Hepatocellular carcinoma

KSHV/HHV8 (herpes virus)

viruses associated with Kaposi sarcoma

dx SIADH monitor for

volume overload

residual volume

volume that remains in the lungs after max expiration

paraneoplastic syndrome

when a tumor marker has biologic activity and causes symptoms (pheochromocytoma)

head & neck

where does basal cell carcinoma typically occur?

HPV & hep B

which 2 vaccines are cancer preventive vaccines?

HPV -16, -18

which HPV types cause the majority of cancers?

HPV -16, -18, -31, -45

which HPV viruses are associated with the highest risk for cervical CA?

metastatic prostate CA

which cancer has a treatment vaccine available?

men who work outdoors

which patient population is most likely to develop squamous cell carcinoma?