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208 Cards in this Set
- Front
- Back
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How are most physiological processes regulated?
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By negative feedback mechanisms
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What is homeostasis?
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The purposeful maintenance of a stable internal environment
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What is the general adaptation syndrome?
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A systemic reaction in response to a stressor in which coordinated physiological responses like adrenal hypertrophy, thymic atrophy, and gastric ulcers occur
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What causes thymic atrophy in the general adaptation syndrome?
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Thymic atrophy occurs because of the suppression of the immune system by cortisol. During stress, the hypothalamus secretes corticotrophin releasing factor which stimulates the release of adrenocorticotrophic hormone from the anterior pituitary gland which stimulates the release of cortisol from the adrenals. Cortisol is a major mediator of the stress response, but in high doses it suppresses immune function
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What causes gastric ulcer in stress?
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During GAS, the activity within the stomach is decreased which leads to increased acid production
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How do negative feedback mechanisms work?
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When a value falls below a specific set point, mechanisms respond to activate a specific response. When a value goes above the set point, the mechanism shuts off
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What are ANS (autonomic nervous system) responses to stress thought to be regulated by?
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The hypothalamus and the RAS (reticular activating system)
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What does the RAS do in reaction to stress?
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It modulates mental alertness, ANS activity, and skeletal muscle tone
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How do lymph nodes function?
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Lymph nodes filter foreign materials and antigens from the lymph before it reaches the bloodstream. They are also a major site for immune cell proliferation and immune response
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What are the two types of immune defenses?
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Innate (nonspecific) and Adaptive (specific)
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What is the function of the mitochondria?
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They are the "power plants" of the cell. They transform organic compounds from nutrients and convert it to energy in the presence of oxygen
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What is cellular respiration?
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The conversion of organic compounds to energy with oxygen by mitochondria
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What organelle contains its own DNA?
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Mitochondria
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What are the lysosomes responsible for within the cell?
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They are the digestive system of the cell. They contain digestive enzymes that break down worn out cell parts or foreign substances
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What is innate immunity?
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This is the natural resistance that people are born with.
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What is adaptive immunity?
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This form of immunity is acquired slowly, but is more efficient. It is the focused recognition of a specific antigen followed by an amplified response to that antigen
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What are the two types of adaptive immunity?
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Humoral immunity and cell-mediated immunity
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What is humoral immunity?
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This type of immunity is regulated by B cell lymphocytes within the blood and is used to target microbes, toxins, and viruses within the blood.
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What is cell-mediated immunity?
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This form of immunity is regulated by T lymphocytes and is targeted at intracellular microbes/viruses
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What part of an antigen makes it recognizable by a specific immunoglobulin receptor?
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The epitope or immunologically active "arm"
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What are the principal cells of the immune system?
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Lymphocytes, regulatory cells, effector cells, and antigen-presenting cells
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What is the cell coating on the cell surface called?
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Glycocalyx
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What is significant about the glycocalyx?
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It contains the tissue antigens that are important in cell-to-cell recognition
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What are lymphocytes?
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A type of WBC that recognizes and targets specific antigens to generate an immune response
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What are the two classifications of lymphocytes?
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B cell lymphocytes and T cell lymphocytes
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Where do most lymphocytes reside?
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99% reside in the lymph
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What are antigen-presenting cells?
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Macrophages and dendritic cells that engulf antigens and foreign material and present them for recognition by lymphocytes and subsequently, their activation in the immune response
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What are effector cells?
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Effector cells are immune cells that are specified for the destruction and removal of a foreign object or antigen. They include cytotoxic T cells, natural killer cells, phagocytes, and other leucocytes.
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Where do B cells mature?
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In the bone marrow
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What is catabolism?
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The process of breaking down stored nutrients and body tissues to produce energy
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What is anabolism?
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The process of using ATP to construct complex molecules
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Where does aerobic or cellular metabolism occur?
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Mitochondria
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What products are broken down during aerobic metabolism?
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Hydrogen and carbon from ingested fats, proteins, and carbohydrates
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What are the end products of aerobic metabolism?
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Water and carbon dioxide
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Where do T cells mature?
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In the thymus
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Briefly describe the process of aerobic metabolism
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Acetyl-CoA condenses with oxaloacetic acid through various enzyme-mediated steps. Hydrogen and carbon dioxide are produced. Hydrogen combines with NAD or FADH and undergoes oxidative metabolism to form ATP and H2O. Carbon dioxide converts to bicarbonate or is carried to the lungs and exhaled
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What is glycolysis?
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The liberation of energy from glucose when oxygen is not present or in the absence of mitochondria. It occurs during anaerobic metabolism
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What is glucose converted to during glycolysis?
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Pyruvate
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What product must be present for the conversion of glucose to pyruvate?
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NAD+
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What does NAD do during glycolysis?
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It carries hydrogen to an oxidative electron transport system
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What is pyruvate converted to in the absence of oxygen?
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Lactic acid
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How does lactic acid get reconverted and what is this called?
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The liver removes lactic acid from the bloodstream and converts it to glucose by way of gluconeogenesis
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When a macrophage or other effector cell engulfs an antigen, how do the lymphocytes distinguish the antigen-presenting complex from self vs. nonself?
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Major Histocompatibility Complex (MHC)
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What does active transport require?
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The expenditure of energy in the form of ATP
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"Cell drinking" is known as what?
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Pinocytosis
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Where are ingested particles transported to after phagocytosis?
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To a lysosome for digestion
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How do class I MHC molecules perform in the immune response?
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Class I MHC molecules are specific to antigen-presenting complexes that are targeted by CD8 (cytotoxic T cell lymphocytes).
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How do class II MHC molecules perform in the immune response?
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Class II MHC molecules are specific to antigen-presenting complexes targeted by CD4 (helper T cell lymphocytes)
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How do macrophages occur?
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They are the first line of defense. They engulf an antigen or foreign substance. They then release cytokines that triggers inflammation and signals other immune cells to either destroy the cell or trigger the production of antibodies
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What type of actions require humoral immunity or B lymphocytes?
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Elimination of bacterial invaders, neutralizaton of bacterial toxins, prevention of viral infection, and immediate allergic responses
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How are B lymphocytes identified?
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Presence of membrane immunoglobulins, complement, CD component, and class II MHC molecules
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What are immunoglobulins?
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Antibodies or proteins found in the bloodor on the cell surface of B cells. They function to recognize when a specific antigen is present and trigger a specialized immune response against that antigen
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What is atrophy?
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A decrease in cell size
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What are the five causes of atrophy?
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Disuse, denervation, ischemia, decreased endocrine stimulation, decreased nutrition
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What term is used to describe and increase in cell size?
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Hypertrophy
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What term describes an increase in the number of cells?
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Hyperplasia
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What is metaplasia?
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When one cell type is replaced by another
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What is deranged cell growth of a specific tissue called?
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Dysplasia
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What are the three categories of intracellualar accumulation?
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Normal body substances, abnormal endogenous products, and exogenous products
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Which immunoglobulin is the most abundent, present in all bodily fluids and is the only one to cross the placenta for transferral of immunity to the infant?
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IgG
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What abnormal endogenous accumulation occurs in alcoholism, starvation, and diabetes?
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Fatty acid accumulation in the liver
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What immunoglobulin protects mucous membranes?
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IgA
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This is the first antibody made by the newborn
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IgM
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What is the difference between dystropic calcification and metastatic calcification?
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Dystrophic occurs in dead or dying tissues whereas metastatic occurs in normal tissue secondary to increased serum calcium levels
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What are some examples of cellular injury from physical agents?
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Mechanical forces by impact, extreme temperatures, and electrical forces
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What cellular processes occur in extreme heat?
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Vascular injury, increased cell metabolism, inactivation of temperature sensitive enzymes, and disruption of cell membrane
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What cellular injuries occur in the presence of extreme cold?
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Increased blood viscosity, vasoconstriction, ischemia, and ice crystal formation
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What cellular injury occurs with electrical forces?
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Disruption of excitable tissues like neural/cardiac impulses
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What form of radiation is most devastating?
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Ionizing radiation
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What are some other causes of cellular injury besides physical and radiation?
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Chemical, biologic agents and nutritional imbalances
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What are the 3 mechanisms by which cellular injury occurs?
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Free radical injury, hypoxia and ATP depletion, and disruption of intracellular calcium homeostasis
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How is free radical formed?
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Free oxygen combines with H+ to form water, but small amounts combine to form free radicals like superoxide, hydrogen peroxide, and hydroxyl
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What are the three main injuries induced by free radicals?
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Lipid peroxidation (degrades cell membrane); oxidative modification of proteins (inactivates intricate enzyme systems); and DNA damage
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How does hypoxia and ATP depletion occur as a result of cell injury?
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When the cell is deprived of oxygen, aerobic metabolism stops the production of ATP which leads to failure of Na/K ATPase pumps and leads to acute cellular swelling
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Which immunoglobulin is required for B cell maturation?
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IgD
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What effects occur when homeostasis of calcium is disrupted?
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Calcium rushes into the cell and out of ER and mitochondria. High intracellular calcium activates enzymes that lead to disruption of cellular membrane, cytoskeleton, and membrane proteins
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Cell destruction involves what two mechanisms?
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Apoptosis (removal of worn out cells and replacement with new ones) and necrosis
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What two patterns of cell injury are reversible?
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Cellular swelling and intracellular accumulation of fat
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Describe the process of DNA-directed control of cellular activity through synthesis of cellular proteins
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DNA makes a single strand copy via mRNA which travels to rRNA. tRNA brings the amino acids necessary for the synthesis of the proteins for the specific mRNA code. Protein synthesis occurs and so forth, control of cellular activity
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What does induction mean in terms of gene expression?
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The process by which gene expression is increased
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What is the process by which a regulatory gene acts to reduce or prevent another?
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Gene repression
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Accidental errors in duplication of DNA are called what?
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Mutations
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How many pairs of autosomal genes do we have?
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22
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What response is mediated by IgE immunoglobulin?
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Hypersensitivity/Allergic reactions
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What are alternate forms of a gene that come from each parent called?
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Allele
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How would you read XP22.2?
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X is x chromosome; P is region p; 22 is band 22, and 2 is region 2
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What is penetrance?
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The percentage of a population with a specific genotype that will have a recognized phenotype
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What is expressivity?
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How mild or severe a phenotype is?
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From whom do we get our mitochondria?
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Mother
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What are the characteristics of single-gene disorders?
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1. They are caused by a single defective or mutant gene 2. They follow Mendelian patterns of inheritance 3. They are characterized by their patterns of transmission
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What are the three types of single-gene disorders?
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Autosomal dominant, autosomal recessive, and x-linked recessive
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All sex-linked abnormalities are _____ linked.
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X
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Which single gene disorder is characterized by the transmission of a single mutant allele from an affected parent regardless of sex?
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Autosomal dominant
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What is autosomal recessive inheritance?
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When both parents pass on a mutant allele
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What are the functions of the T lymphocyte?
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They activate other T and B cells, control intracellular viral infections, reject foreign tissue grafts, and delayed hypersensitivity reactions
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How are natural killer cells different from cytotoxic T cells?
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Cytotoxic T cells need to recognize a specific antigen to perform targeted cell death. NK cells do not.
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What kind of disorder is fragile x syndrome?
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An x-linked disorder that affects 1 in 1000 males. 2nd most common cause of down syndrome
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What are some characteristics of multi-factorial inheritance disorders?
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1. They are caused by multiple genes and environmental factors 2. No clear-cut pattern of inheritance
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What is active immunity?
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Active immunity is immunity that develops as a result of exposure to a foreign substance or microbe. Examples would be immunizations or the development of antibodies after a disease course
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What is passive immunity?
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This form of immunity is the transfer of antibodies like when a mother passes her antibodies to her fetus
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What is a hypersensitive immune response?
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This is when the immune response damages the body's own tissues
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What type of hypersensitivity reaction is Type I and what cells mediate it?
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Anaphylactic or immediate immune response mediated by IgE from mast cells and basophils
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What makes neoplastic cells different from normal cells?
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They have unregulated growth and altered cell differentiation
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What is another phrase for tissue repair and renewal?
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Cell proliferation
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What is the process of cell specialization called?
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Cell differentiation
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What types of cells are well-diferentiated?
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Neural, cardiac, and skeletal cells
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What are the parent or progenitor cells?
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Blood, skin, and liver cells
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These types of cells can be triggered to enter a cell cycle to produce progenitor cells
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Undifferentiated stem cells
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What type of hypersensitivity reaction is involved with autoimmune and infectious disease? Who mediates?
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Type IV. T cells, monocytes, and macrophages
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What is paraneoplastic syndrome?
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A disease or symptom(s) that are the consequence of the presence of cancer in the body but not due to the LOCAL presence of cancer cells
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What must a malignent neoplasm have in order to penetrate the extracellular matrix to the bloodstream?
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The enzyme that is capable of degrading that matrix
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What steps occur in the transformation of a normal cell into a cancer cell?
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1. Initiation where cells are exposed to a carcinogenic agent 2. Promotion in which unregulated accelerated growth occurs 3. Progression in which tumor cells change in shape, spread, and growth
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What are 3 clinical manifestations of cancer?
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The breakdown of tissue integrity (bleeding, ulceration, necrosis); cancer cachexia (weight loss, anorexia, muscle wasting); and paraneoplastic syndromes (elaboration of hormones in sites unrelated to disease)
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What does CIDS stand for and what is affected?
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Combined Immunodeficiency Syndrome. T and B cell lymphocytes are deficient
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A diverse genetic mutation that leads to the absence of all immune function is called what?
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SCIDS
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What are the two patterns of inheritance related to SCIDS?
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X-linked and autosomal recessive
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What is the main treatment for SCIDS?
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BMT
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When does Graft vs. Host Disease occur?
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When an immunologically compromised host receives immunological active cells
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What are the 3 basic requirements necessary for GVHD to occur?
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1. The host must have an antigen that is recognized as "non-self" by the graft 2. The graft must contain immunologically active cells to attack the host
3. The host must have an immune function that is adequately suppressed to not fight the transplanted cells |
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How does a retrovirus replicate?
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A retrovirus uses reverse transcriptase to make an RNA copy of itself to DNA and get injected into the hosts' genome
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What are regulatory cells in immune function?
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These are cells (T lymphocytes) that regulate the immune response. They are "master regulators"
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How is energy from mitochondria stored?
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It is stored as high energy phosphate bonds in a compound called ATP
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What part of the mitochondria is responsible for lipid synthesis and fatty acid metabolism?
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The outer mitochondrial membrane
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What is the inner membrane of mitochondria responsible for?
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Synthesis of ATP
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Mitochondria have their own DNA and are self-replicating. True or False?
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True
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What part of the cell is generally considered the "digestive system"?
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The lysosomes
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What kind of environment do the enzymes within lysosomes require?
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Acidic
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Where does synthesis of lysosomal enzymes occur?
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In the rough ER (endoplasmic reticulum)
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What comprises the cell membrane?
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A lipid bilayer that separates the internal components of the cell from the external environment; receptors for cell communication; ion differentials for electrical events; aids in regulation of cell growth and proliferation
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What type of agents can penetrate the cell membrane?
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Lipid-soluble agents
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What kind of pressure is created by osmosis?
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Osmotic pressure
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What kind of message does mRNA carry out?
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Transcription-copies of DNA for protein synthesis; Translation-the mRNA "tells" rRNA how to build the protein
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What does rRNA do?
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It provides the machinery for protein synthesis and it is the site of protein synthesis
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What is the function of tRNA?
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It brings amino acids to rRNA and attaches them in the form of codons to the mRNA
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What is osmosis?
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The movement of water through a semipermeable membrane. It goes from a low concentration of solute to a high concentration of solute
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What is diffusion?
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The passive movement of molecules or particles from a higher concentration to a lower concentration
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How is energy from mitochondria stored?
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It is stored as high energy phosphate bonds in a compound called ATP
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What part of the mitochondria is responsible for lipid synthesis and fatty acid metabolism?
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The outer mitochondrial membrane
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What is the inner membrane of mitochondria responsible for?
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Synthesis of ATP
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Mitochondria have their own DNA and are self-replicating. True or False?
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True
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What part of the cell is generally considered the "digestive system"?
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The lysosomes
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What kind of environment do the enzymes within lysosomes require?
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Acidic
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Where does synthesis of lysosomal enzymes occur?
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In the rough ER (endoplasmic reticulum)
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What comprises the cell membrane?
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A lipid bilayer that separates the internal components of the cell from the external environment; receptors for cell communication; ion differentials for electrical events; aids in regulation of cell growth and proliferation
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What type of agents can penetrate the cell membrane?
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Lipid-soluble agents
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What kind of pressure is created by osmosis?
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Osmotic pressure
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What kind of message does mRNA carry out?
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Transcription-copies of DNA for protein synthesis; Translation-the mRNA "tells" rRNA how to build the protein
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What does rRNA do?
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It provides the machinery for protein synthesis and it is the site of protein synthesis
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What is the function of tRNA?
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It brings amino acids to rRNA and attaches them in the form of codons to the mRNA
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What is osmosis?
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The movement of water through a semipermeable membrane. It goes from a low concentration of solute to a high concentration of solute
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What is diffusion?
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The passive movement of molecules or particles from a higher concentration to a lower concentration
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What does facilitated diffusion require?
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A transport protein
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What is apoptosis?
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Programmed cell death or "suicide"
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What happens to ATP in mitochondria when it isn't used or stored?
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It is dissipated as heat to maintain body temperature
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Tay Sachs is an example of what kind of cellular disorder?
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Lysosomal storage disease
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How does nonionizing radiation damage cells?
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Vibration/rotation of the atoms to produce thermal energy
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Why are biologic agents so detrimental to cells?
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They have the ability to replicate and cause further injury
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What is genotype?
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The actual genetic information
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What is phenotype?
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The physical expression of a gene
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What are the common pathways of metastasis?
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Lymphatic and hematogenic
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Carcinomas usually spread through which pathway?
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Lymphatic
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What organ is a common site of metastasis from the GI tract?
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Liver
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A benign tumor of glandular origin is called what?
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Adenoma
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A benign tumor of bone tissue is called what?
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Osteoma
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What term is used for tumors of malignent epithelial origin?
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Carcinoma
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What term is used for tumors of malignent mesynchymal origin?
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Sarcoma
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Do benign tumors grow fast or slow?
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Slow
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Are benign tumors well-differentiated?
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Yes
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How do benign tumors grow?
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By expansion
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When do tumors of benign origin cause death?
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When they interfere with vital functions
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Malignent neoplasms grow rapidly. True or False?
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True
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What are two categories of malignent neoplasms?
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Solid and hematologic
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How do you get metastasis from a solid malignent tumor?
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As the tumor grows, it sheds cells from the mass and travels through the bloodstream
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What are tumor markers?
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Antigens expressed on a tumor cell or substances released by normal cells in the presence of a tumor
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What is oncofetal protein?
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A tumor marker produced during fetal development that can reappear later in life in the presence of neoplasms
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What cells are affected by HIV?
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CD4 T lymphocytes
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What is the pathophysiology of HIV?
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HIV infects CD4 T helper lymphocytes, immune response is impaired and unable to recognize foreign antigens or activate antibody-producing B lymphocytes. The body becomes susceptible to opportunistic infections
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Which HIV test is the most important and accurate?
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The Western Blot
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What HIV test is performed first and inexpensive and associated with false positives?
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The ELISA
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What are the signs and symptoms of acute leukemia?
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Pallor, weight loss, bruising, bleeding, fatigue, repeated infections
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What conditions lead to sickling of hemoglobin?
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Cold, stress, physical exertion, infection, hypoxia, dehydration, acidosis
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What are the first cells to arrive at site of infection?
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Neutrophils
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What does a lot of bands mean?
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Infection because you are trying to make more neutrophils?
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What effects does cocaine have on fetal development?
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Decreased uteroplacental blood flow causes preterm birth and various neurologic abnormalities. Maternal HTN causes abruptio placentae. Fetal vasoconstriction causes fetal anomolies
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What are the 3 stages of the general adaptation syndrome?
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Alarm stage, Resistance stage, and Exhaustion stage
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What is RBC production driven by?
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Low oxygen tension
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Where does RBC production occur in the adult?
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Vertebrae, sternum, ribs, and pelvis
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How would one measure RBC production?
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Reticulocyte count
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Where does erythropoetin bind?
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To receptors on stem cells
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What does ATP produce during glycolysis?
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2,3 DPG
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What does 2,3 DPG do?
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It binds to hemoglobin and reduces the affinity of hemoglobin to oxygen so that O2 can be released to your tissues
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Why is oxygen delivery impaired to tissues when you give banked blood?
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Banked blood is missing 2,3 DPG
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What is neutropenia?
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An abnormal decrease in the number of circulating neutrophils
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What is hemostasis?
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The stoppage of blood flow
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During the first stage of production of a clot, vessel spasm, what products are released?
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Thromboxane A2 and prostacyclin
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What does Thromboxane A2 do?
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It is a potent prostaglandin released from platelets that causes platelet aggregation so that a plug can be formed
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What does prostacyclin do?
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It produces profound vasodilation to prevent occlusion of the vessel from the clot
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What causes adhesion of platelets to the vessel wall?
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Von Willebrand factor
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Once a clot is formed, it requires stability. What process is activated and stabilizes the clot?
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Clotting cascade
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During the common pathway of the clotting cascade, what process occurs?
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Factor X is activated to factor Xa. Xa converts prothrombin II to thrombin IIa. IIa activates fibrinogen I to fibrin Ia
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How does Antithrombin III work?
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It binds to thrombin IIa to stop clotting cascade
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What product degrades a clot?
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Plasmin
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What is thrombocytopenia?
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A decrease in the number of circulating platelets
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DIC is characterized by what?
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Massive activation of coagulation, micro-thrombi, MOF, exhaustion of factors which eventually lead to bleeding
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What kind of hereditary transmission is Hemophilia A?
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X-linked
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What treatment is used for Hemophilia A?
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Factor VIII
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What is bilirubin?
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The destroyed heme unit in old/destroyed RBC's
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How does Aspirin prevent blood clotting?
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It inhibits cyclooxygenase, consequently the synthesis of prostaglandin thromboxane A so you inhibit platelet aggregation
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