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99 Cards in this Set

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etiology
cause of disease
pathogenesis
mechanism of development of disease. It refers to the sequence of events in the response of cells or tissues to the etiologic agent from initial stimulus to expression of disease (Robbins p.4)
hyperplasia
abnormal increase in number of cells.
hypertrophy
Refers to an increase in the size of cells, resulting in an increase in the size of the organ. Can be physiologic or pathologic, and is caused by increased functional demand or by stimulation by hormones and growth factors. Result of increased production of cellular proteins. (Robbins, p. 6)
hypoplasia
underdevelopment of an organ or a tissue, usually resulting from the presence of a smaller-than-normal number of cells.
coagulative necrosis
A form of necrosis in which the architecture of dead tissues is preserved for a span of at least some days. Affected tissues exhibit a firm texture. The injury denatures not only structural proteins but also enzymes which can persist for weeks. Robbins p. 15
reactive oxygen species
ROS are chemically-reactive molecules containing oxygen, they form as a natural byproduct of the normal metabolism of oxygen and have important roles in cell signaling
ischemia-reperfusion injury
Ischemia refers to diminished blood flow to a section of body tissue. Ischemia-reperfusion injury is a counter-intuitive injury that results when blood flow is restored to the site that previously was blood-deficient. (the nutrients in the blood cause oxidative stress and inflammation)
dystrophic and metastatic calcification
Dystrophic calcification is encountered in areas of necrosis and in foci of enzymatic necrosis of fat. Calcification is almost always present in the atheromas of advanced atherosclerosis. It also commonly develops in aging or damaged heart valves (location = localized). Metastatic calcification may occur in normal tissues whenever there is hypercalcemia (Dystrophic = normal blood Calcium levels). Metastatic calcification may occur widely throughout the body but principally affects the interstitial tissues of the gastric mucosa, kidneys, lungs, systemic arteries, and pulmonary veins (location = diffuse). Though quite different in location, all of these tissues excrete acid and therefore have an internal alkaline compartment that predisposes them to metastatic calcification. (http://www.mdconsult.com/das/book/body/214802401-2/0/2060/18.html)
telomere
short, repeated sequences of DNA (TTAGGG) present at the linear ends of chromosomes that are important for ensuring complete replication of chromosomal ends and for protecting chromosomal termini from fusion and degradation. when each cell replicates a small section of the telomere is not replicated. (Robbins, pg 40)
chemotaxis
locomotion oriented along a chemical gradient
granuloma
focus of chronic inflammation consisting of a microscopic aggregation of macrophages that are transformed into epithelium-like cells surrounded by a collar of mononuclear leukocytes-principally lymphocytes and occasionally plasma cells (robbins p73)
leukocytosis and leukopenia
leukopenia: an abnormally low white cell count (usually resulting from reduced numbers of neutrophils, neutropenia). leukocytosis: an increase in the number of white cells in the blood (a common reaction to a variety of inflammatory states). (Robbins page 592-3)
regeneration
proliferation of cells and tissues to replace lost or damaged cells and tissues. normal structure is restored (vs repair where normal structure is altered.
repair
may restore some original structures but can cause structural derangements; most often consists of a combination of regeneration and scar formation by the deposition of collagen (Robbins 79)
adult stem cell (somatic stem cells)
in adult organisms, stems cell that are present in tissues that continuously divide such as the bone marrow, skin, and lining of the GI tract. Regardless of their proliferative activity, somatic stem cells generate rapidly dividing cells known as transit amplifying cells. These cells lose the capacity of self-perpetuation and give rise to cells with restricted developmental potential known as progenitor cells. -Robbins pg 84
extracellular matrix
Provides structural support to the cell as well as performs other various functions. This also refers to connective tissue such as collagen and elastin.
angiogenesis (neovascularization)
Neovascularization is the formation of functional microvascular networks with red blood cell perfusion. Neovascularization differs from angiogenesis in that angiogenesis is mainly characterized by the protrusion and outgrowth of capillary buds and sprouts from pre-existing blood vessels.
granulation tissue
A special type of tissue formed in the first 24-72 hours of the tissue repair process by fibroblast and vascular endothelial cell proliferation. It has a pink, soft, granular appearance on the wound surface and is the hallmark of tissue repair. Characteristic histological features are the presence of new small blood vessels and fibroblast proliferation. Robbins pg.102
keloid
A raised scar(hypertrophic scar) that grows beyond the boundaries of the original wound and does not regress; forms due to excess collagen deposition in the skin. Generally develops after thermal or traumatic injury. Excess collagen produced by myofibroblasts, which persist in the lesion through autocrine production of TGF-B and the establishment of focal lesions. More common in African Americans. More info: Robbins pg 106 -107.
fibrosis
Excessive deposition of collagen and other ECM components in a tissue. Fibrosis usually indicates the deposition of collagen in chronic diseases.
afferent vs efferent neuron
afferent neurons go from the muscle fibers to the CNS or spinal cord, they carry sensory information to be processed by the brain. efferent neurons go from the CNS to the muscle fibers, they carry motor information to cause the muscle to move
alpha and beta adrenoreceptors
Adrenoceptors are selective for norephinephrine and epinephrine. They are members of the G protein-coupled receptor superfamily. α receptors have the subtypes α1 (most α1 receptors signal via Gq-mediated pathways) and α2 (α2 adrenoceptors activate Gi, and inhibitory G protein). β receptors have the subtypes β1, β2 and β3 (all 3 beta subclasses activate a stimulatory G protein, Gs). ---- Golan p.132
antimetabolite
An antimetabolite is a chemical that inhibits the use of a metabolite, which is another chemical that is part of normal metabolism. Such substances are often similar in structure to the metabolite that they interfere with. The presence of antimetabolites can have toxic effects on cells, such as halting cell growth and cell division, so these compounds are used as chemotherapy for cancer.
antiplatelet vs anticoagulant agents
These are two of three classes of drugs developed to prevent and/or reverse thrombus formation. Antiplatelet agents do this by preventing platelet aggregation. (More specifically, by inhibiting platelet function to prevent localized platelet plug formation in response to endothelial injury, the first step in arterial thrombosis). Anticoagulants instead target various factors in the coagulation cascade, interrupting it to prevent the formation of a stable fibrin meshwork/secondary hemostatic plug.
catecholamine
The class of neurotransmitters derived from tyrosine via oxidation. Includes dopamine, norepinephrine, and epinephrine. Most synthesis occurs at the synaptic nerve ending. The catecholamines are removed from the synaptic cleft by re-uptake, enzymatic breakdown into metabolites or by diffusion from the synaptic cleft. These neurotransmitters modulate many vital para/sympathetic functions, and many drugs target the synthesis, storage, release, and reuptake of these neurotransmitters and their post-synaptic receptors.
noncompetitive (irreversible) active site antagonist
A type of chemical that prevents a substrate from interacting with the enzyme active site by covalently bonding to and changing the structure of the active site.
immunosuppression
Suppression of the body's immune system and its ability to fight infections and other diseases. Immunosuppression may be deliberately induced with drugs, as in preparation for bone marrow or other organ transplantation, to prevent rejection of the donor tissue. It may also result from certain diseases such as AIDS or lymphoma or from anticancer drugs.
loading dose vs. maintenance dose
"Loading dose is used to circumvent the process of drug distribution in body (lowering of drug plasma concentration) by providing a sufficient amount of drug to attain an appropriate therapeutic drug concentration in blood and tissues after only one or two doses.

A maintenance dose is given once a steady-state equilibrium is achieved between the drug concentration in tissues and plasma. Subsequent (maintenance) doses need only to replace amount of drug that is lost through metabolism and excretion. "
prodrug
an inactive compound that is metabolized by the body into its active, therapeutic form (Golan, 2nd ed., p 56)
selective vs nonselective agonist
agonists are molecules that, upon binding to their targets, cause a change in the activity of those targets. ***the following is not from the book (i couldn't seem to find a good explanation comparing the two, so i googled the following... feel free to update with better information*** selective agonists differ from nonselective agonists in that they are selective for a certain type of receptor
spare receptors
The phenomenon that results when a drug is able to exert its maximal antagonistic effect without binding 100% of the receptors available. These leftover, unoccupied receptors are called spare receptors. For example, if a drug can reach maximal effect by binding only 40 out of 50 available receptors, then there are 10 spare receptors present (those numbers are totally made up).
therapeutic index
a comparison of the amount of a therapeutic agent that causes the therapeutic effect to the amount that causes death. Quantitatively, it is the ratio given by the lethal dose divided by the therapeutic dose
morphologic changes
structural alterations in cells and tissues that are either characteristic of a disease or diagnostic of an etiologic process
atrophy
reduced size of an organ or tissue due to decreased size or number of cells
metaplasia
reversible change where one differentiated cells type is replaced by another
necrosis
cell death that resutls from severe damage to cell membranes, enzymatic destruction of cellular contents, and disruption of plasma membrane
Once phagocytised, what bacteria are able to escape the phagosome and enter the cytoplasm, where lysozymes are not present. How is this accomplished?
Shigella
Rickettsiae
Listeria Monocytogenes
by destroying the phagosomal membrane
ischemia
the supply of oxygen and nutrients is decreased often because of reduced blood flow as a consequence of a mechanical obstruction in arterial system
hypoxia
deprivation of oxygen in tissues
mitochondrial permeability transition pore
high-conductance channels in mitochondrial membrane; form upon damage to mitochondria. leads to loss of mitochondrial membrane potential, resulting in failure of oxidative phospohrylation and progressive depletion of ATP
intrinsic pathway of apoptosis
This pathway is the result of increased mitochondrial permeability and release of pro-apoptotic molecules into the cytoplasm which initiates the suicide program of apoptosis; major mechanism of apoptosis
extrinsic pathway of apoptosis
This pathway is initiated by engagement of plasma membrane death receptors (members of TNF receptor family, most common is FAS which binds to FAS-L) on a variety of cell.
inflammation
response of vascularized living tissue to injury. complex reaction in tissues that consists mainly of responses of blood vessels and leukocytes. Can be acute or chronic
acute inflammation
early onset, short duration inflammation involving edema and neutrophil emigration
chronic inflammation
later onset, longer duration inflammation involving leukocytes and macrophages and inducing blood vessel proliferation and scarring
transudate
an extravascular fluid with low protein content and specific gravity below 1.012 that is an ultrafiltrate of blood plasma resulting from elevated fluid pressures or diminished osmotic forces in the plasma
edema
excuess fluid in interstitial tissue or body cavities; may be either exudate or transudate
transmigration (diapedesis)
movement of neutrophils mediated by homotypic interactions on leukocytes and endothelial cells
endothelial activation
first step in transmigration where mediators present at inflammatory sites increase the expression of E- and P-selectin by endothelial cells
phagocytosis
an endocytotic process used by phagocytes in which cells engulf solid particles
abscess
localized collections of purulent inflammatory tissues caused by suppuration buried in a tissue, an organ, or a confined space
purulent exudate (pus)
neutrophils, liquefactive necrosis, and edema fluid
acute-phase proteins
plasma proteins, mostly synthesized in the liver, whose plasma concentrations may increase several hundred fold as part of the response to inflammatory stimuli
differentiation
where a less specialized cell type turns into a more specialized cell type
embryonic stem cell
ES cells: pluripotent stem cells that can generate all tissues all of the tissues of the body. Come from the inner mass of blastocysts in early embryonic development which contains pluripotent stem cells known as ES cells
induced pluripotent stem cell
While niche cells (the cells of somatic stem cells' environment) are what transmit stimuli to regulate stem cell self-renewal and the generation of progeny cells, recent research shows that differentiated cells of rodents and humans can be reprogrammed into pluripotent cells by the transduction of genes encoding ES transcription factors
receptor-mediated signal transduction
a process activated by the binding of ligands such as growth factors, and cytokines to specific receptors
focal adhesion complex
structure caused by ligand binding to integrins causes clustering of the receptors in cell membranes
healing by primary union (first intention)
the simplest type of cutaneous wound repair is healing of a clean, uninfected surgical incision approximated by surgical sutures (leaves a small scar)
healing by secondary union (secondary intention)
a more intense inflammatory reaction, formation of granulation tissue, and extensive collagen deposition leading to formation of substantial scar, which generally contracts
adrenergic vs. cholinergic neurotransmission
neurotransmission mediated by catecholamines like NE, epinephrine, dopamine (former) or by ACh
agonist vs. antagonist
agonists bind to targets and cause a change in them through binding, antagonists inhibit the ability of targets to be activated/inactivated by agonists
alkylating agent
electrophilic molecules that are attacked by nucleophilic sites on DNA, resulting in the covalent attachment of an alkyl group to the nucleophilic site
anaphylaxis
A life-threatening hypersensitivity reaction caused by systemic mast cell degranulation after exposure to an allergen in a previously sensitized individual
autoimmunity
autoimmune diseases occur when the host immune system attacks its own tissues, mistaking self antigen for foreign
autoreceptor
receptors that regulate neurotransmitter release
bioavailability
the amount of drug available to the target organ
chelator
a multidentate structure with multiple binding sites (typically binds heavy metals such as lead, mercury, or cadmium, etc.) Binding of metal shifts the equilibrium constant in favor of metal ligation (which overrides the body)
chemotherapeutic agent
drugs that interfere with cell growth and division
combination antineoplastic therapy
drugs in a multidrug regimen can interact synergistically to enhance the antineoplastic therapy and can decrease likelihood that resistance will emerge.
competitive (reversible) antagonist
binds to the same site as the agonist without producing the effect; blocks receptor response produced by agonist
dose-response relationships
Assume the response to a drug is proportional to the concentration of receptors that are bound by the drug  relation between dose (concentration) and patients response to that drug
down-regulation of receptor
In this phenomenon, prolonged receptor stimulation by ligand induces the cell to endocytose and sequester receptors in endocytic vesicles
drug clearance
A pharmokinetic parameter that most significantly limits the time course of drug action at the target organ
drug-drug interactions
how different drugs interact with each other
elimination half-life
Equivalent to biological half-life. Pertains to the amount of time it takes a substance (metabolite, drug, signaling molecule, radioactive nuclide, etc.) to lose half of its pharmacologic, physiologic, or radiologic activity. Medically it can indicate the amount of time it takes a substance in the plasma to halve its steady-state
drug metabolism or biotransformation
process by which biochemical reactions alter drugs within the body
enteral vs. parenteral drug administration
enteral is by mouth, parenteral is across barrier defenses like skin (only enteral must survive first-pass metabolism in the liver)
enzyme induction or inhibition
enzyme induction is Increase in the expression of the enzyme through increased transcription, increased translation, or decreased degradation. Inhibition is the opposite.
first order vs. zero order kinetics
first order is the amount of drug that is metabolized/excreted in a given unit of time is directly proportional to concentration of drug in systemic circulation. Zero order is when clearance rate remains the same despite increasing plasma drug level.
first-pass effect
The liver is the main organ of drug metabolism; orally administered drugs are often absorbed unchanged by GI tract and transported right to the Liver. The liver has first shot at metabolizing the drugs before entering the systemic circulation. Must take this into account when dosing in case Liver metabolizes a lot of it
graded vs. quantal dose-response curves
graded curves show the effect of a drug as a measure of its concentration. quantal curves show average effect of a drug as a function of its concentration in a population of individuals
hyperreactivity vs. hypersensitivity
Hyperreactivity describes an upward shift, while hypersensitivity shifts a stimulus-response curve to the left.
ionotropic vs. metabotropic receptors
ionotropic receptors are transmembrane ion channels which facilitate fast signal transduction (ligand-gated ion channels). metabotropic receptors are membrane-bound receptors which facilitate slow signal transduction through the activation of second messengers (G protein-coupled receptors)
median effective dose (ED50) vs. median lethal dose (LD50)
ED50 is dose at which 50% of subjects exhibit a therapeutic response to a drug, LD50 is dose at which 50% of subjects die
MDR transporters
These receptors pump hydrophobic compounds out of the brain and back into the blood vessel lumen (only certain hydrophilic nutrients allowed in); present in many cell types and play imp role in processes such as resistance of tumor cells to chemotherapeutic agents
muscarinic vs. nicotinic cholinergic receptors
muscarinic (end organs of ANS; G-protein)
nicotinic direct ligand-gated conductance; Acetylcholine bind to nAChR
partial agonist
molecule that binds to a receptor at its active site but produces only a PARTIAL response, even when all of the receptors are occupied (bound) by the agonist. A partial agonist can reduce the response produced by a full agonist, and in this way acts as a competitive antagonist
pH trapping
Net diffusion of acidic and basic drugs across lipid bilayer membranes is affected by pH trapping. The extent of drug trapping on one side of the membrane is determine by the drug’s acid dissociation constant (pKa) and by pH gradient across membrane.
pharmacodynamic vs. pharmacokinetic tolerance
pharmacodynamic is the most important mechanism of tolerance, results from changes in the drug-receptor interaction. pharmacokinetic tolerance is develops when the ability to metabolize or excrete the drug increases over time
physical (physiologic) vs. psychological dependence
physical is the need for the drug to be present to maintain “normal” functioning. If drug is not present, adaptations that produced the tolerance are unmasked. The hallmark of physical dependence is manifestations of WITHDRAWAL symptoms in absence of drug.]. psychological Deals with release of dopamine (reward NT) in synapses within the nucleus accumbens
potency (EC50) vs. efficacy (Emax)
EC50 is the concentration at which the drug elicits 50% of its maximal response. Emax is the maximal response produced by the drug
selective vs. nonselective antagonist
Selective antagonists bind to a specific receptor where as nonselective antagonist do not.
steady-state drug concentration
(Fraction Absorbed X Maintenance dose) divided by (Dosing Interval X Clearance)
sympathomimetic vs. sympatholytic drug
sympathomimetic is Drugs that mimic the effects of the sympathetic nervous system, such as catecholamines, epinephrine, norepinephrine, dopamine, etc. Such drugs are used to treat cardiac arrest, low blood pressure, or even delay premature labor, among other things. sympatholytic is treat hypertension via two major mechanisms; reduction of systemic vascular resistance and/or reduction of cardiac output
tachyphylaxis
rapidly decreasing response to a drug or physiologically active agent after administration of a few doses
thrombolytic agent
Used to lyse already-formed clots and therby restore the patency of an obstructed vessel before distal tissue necrosis occurs. Act by converting plasminogen to plasmin.
Xenobiotic
foreign substances that are not naturally found in the body. Most drugs are xenobiotics that are used to modulate bodily functions for therapeutic ends