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Midterm 10/20/2016

Overexpression When a cell produces too much protein. In oncogenes can cause cancer by flooding cells with the message to grow and divide.
Four major classes of infectious agents (1) Viruses (ex. rotavirus), (2) Bacteria (ex. cholera), (3) Protozoa (ex. parasites, cryptosporidium), (4) Worms (ex. hookworm)
Diarrhea The passage of 3 or more loose/liquid stools per day.
Treatment for diarrhea (4) (1) Rehydration with ORS; (2) Zinc supplementation; (3) Nutritious food; (4) Antibiotics
Recipe for ORS Oral Rehydration Solution - Clean water, sugar, salt
Types of Diarrhea (3) (1) Acute watery diarrhea; (2) Acute bloody diarrhea (dysentery); (3) Persistent diarrhea (lasts longer than 14 days)
Diarrhea Prevention Strategies (6) (1) Rotavirus vaccination; (2) Improved sanitation (sewage/human waste); (3) Access to safe drinking water; (4) Breastfeeding through 6 months; (5) Improved nutrition; (6) Personal/food hygiene (hand washing)
"El Tor" A strain of the Cholera bacteria believed to be responsible for the 7th pandemic of Cholera.
Early symptoms of As exposure (1) Skin lesions; (2) DM; (3) "Blackfoot" disease; (4) Neurocognitive deficit
Late symptoms of As exposure (1) Cancers (bladder, skin, liver, lung): (2) CVD
How much cancer death is attributable to avoidable environmental exposure? 60% - Schottenfield
What is cancer? A multistep process that blends internal factors (ex. genetics/gene mutations and obesity) with external exposures (environmental exposures)
What are the evidentiary lines of support for environmental exposures causing cancer? (1) time trends ; (2) Geographic variation; (3) Migration studies; (4) Occupational exposures; (5) Animal assays
Time Trends Increased exposure in population associated with increased incidence of cancer, example positive relationship between lung cancer and smoking rates in the US
Geographic Variation Specific forms of cancer are more prevalent in different parts of the world (example melanoma in Australia)
Migration Studies Migrants take on the rate of cancer in the place they migrate to (versus genetics only) example Japanese and increased rates of CRC cancer when they migrate to the US
Occupational exposures Certain occupations have increased exposures to certain toxic materials, rise in the incidence of related cancers in these groups. Example chemists are exposed to benzene and have inc rates of leukemia; miners exposed to radon, inc rates of lung cancer
Animal Bioassays We can't test exposures in humans, but we can in humans. Animal testing allows us to control for other factors including exposure to hazardous materials and observe cancer incidence.
hPylori A acid-loving bacteria often found in the stomach, increased ulceration and risk of gastric cancer (damage/repair cycle that leaves stomach cells vulnerable); inc use of antibiotics has dec prevalence of hP in stomach - dec stomach cancer
Estrogen Receptors and Breast Cancer Estrogen Receptor + BC - cancer cell has ER, when receives signal from estrogen, will grow. Hormonal treatment can block the receptor and stop growth. ER- BC does not have receptor, does not benefit from hormone therapy
Benzopyrene A polycyclic hydrocarbon found in cigarettes, when exposed, reactive metabolites might bind with nucleotides in the DNA - this "adduct" can cause errors in future DNA synthesis - DNA damage causes mutations that can lead to cancer
Aflatoxin A mycotoxin that grows on mold which is a potent carcinogen. Aflatoxin causes a mutation at gene p53 which is a tumor suppressor gene.
Toxicology The study of the adverse effects of chemical compounds on people and animals.
PCBs Polychlorinated Biphenyls - a ubiquitous toxicant from liquid insulators and coolants; dose-response health effects such as skin disease, lowered immune function, menstrual disruption, cancer and intelligence issues; bioaccumulation
Bioaccumulation The process by which toxic substances accumulate in the tissues of living organisms - the food chain (plankton eat the sediment, eaten by larger and larger fish until eaten by humans. If can be metabolized, then will be excreted, if not then fat stores
Dose Response Change in health effect with change in dose
Hormesis When a little bit of exposure is better than none at all (in a sublinear dose-response curve)
ED50 The effective does -the dose at which 50% of animals develop tumors
Half Life The amount of time it takes for a compound's blood concentration to decrease by 50%; estimated by the elimination phase
Absorption The substance is in steady state in the blood stream
Elimination Blood is filtered through the kidneys, the substance is removed from the bloodstream
Distribution The substance is absorbed from the bloodstream to the surrounding tissue
Steady State The half-life of elimination dictates how long it takes to reach steady state
How long does it usually take to reach steady state? 4 half-lifes
Metabolism (toxicology) *Nearly* all toxicants can be metabolized; the process of chemical modification where substances are transformed so they can be secreted (ex. fat soluble to water soluble)
CY P450s Cytochrome P450s - the enzymes that enable us to metabolize toxicants (about 75% of metabolism), we have about 57 different kinds
Interindividual Variation Individuals have differing levels of CY P450s, this means the rate of metabolism/half-life can vary between individuals. This also means that there are individual differences in how prone/resilient individuals are to diseases caused by toxic exposure
CY P450 Inhibitor Ex. Grapefruit juice, causes a substance to have a longer half-life
CY P450 Inducer Ex. rifampin, causes a substance to have a shorter half-life
Acceptable concentration of lead in blood? 5 micrograms/dL
Genetic Causes of Obesity FTO genes - influences the number of beige cells; makeup of the gut microbiota can also cause individuals to burn more energy (twins and injected into mice)
How does Obesity lead to cancer? (1) fatty tissue leads to increased estrogen, breast cancer; (2) increase insulin and insulin growth factor in the blood; (3) increased hormones like leptin in the blood which leads to cell growth; (4) fat cells affect tumor growth regulators
Brown Fat Cell Converts energy into heat; protection from cold
Beige Fat Cell Cell found in white fat tissue that matures into a brown fat cell
White Fat Cell Usually found under the skin, in the abdominal area; stores energy (does not burn)
PAHs Polycyclic Aromatic Hydrocarbons - a type of endocrine disruptor
Endocrine Disruptors Mimic hormones, (ex. estrogen), increase adipose tissue, increased insulin interference
Wallerstein Effect If it's in front of you, you will eat it - you won't buy more than one, has lead to increase in serving sizes
Zika Infection Cycle Mosquito is infected when it bites an infected person, infects subsequent individuals it bites. Can also be transmitted from mother to fetus and through unprotected sexual contact.
Zika PH Interventions (1) Travel advisories; (2) Mosquito protection/control; (3) Reproductive health; (3) Screening and monitoring; (4) Research
Germ thoery Microbes cause infections; specific microbes cause specific diseases
Koch's Postulates (1) Bacteria present in all cases of the disease; (2) The bacteria must be grown in pure cultures; (3) The specific disease is reproduces when inoculated in a healthy susceptible; (4) Bacteria must be recovered from the sick and experiment host
How do microbes cause infection Microbe damages host (disruption in homeostasis, alters cell/tissue/organ functioning) through host factors (inflammatory response) or microbial factors
Sporadic infection isolated; a disease that occurs in a single case or scattered cases (ex. tetanus, pneumonia, food poisoning)
Incubation period the amount of time between infection and disease expression
TB Infection Determination (1) Bacterial load; (2) Environmental factors (enclosed spaces); (3) Duration of exposure; (4) Virulence of the organism
Antibiotics Derived from substances made by micro-organisms that kill/inhibit micro-organisms
Antibacterial resistance (1) By destroying the antibiotic; (2) by modifying the antibiotic; (3) Rapidly pumping out the antibiotic; (4) Mutate the bacteria's target structures (ex. receptors)
Community Acquired MRSA MRSA had been hospital based; is moving towards the community, among people who aren't immunocomprimised and in skin and soft tissue infection
Hershey Chase Experiment Discovered DNA as genetic material, injected phage DNA and protein with radioactive material, phage infected cells, knocked off the phage, the marked DNA was in the cell, the protein was not.
Basis of genetic material Must be able to store information about itself and copy itself.
Balanced Polymorphism When heterozygotes have a survival advantage; ex. sickle cell anemia; when recessive mutations are common, it suggests some advantage.
Types of Breast Cancer Ductal Carcinoma in Situ (non-invasive, duct tissue); Invasive Ductal Carcinoma (invasive, duct tissue); Invasive Lobular Carcinoma (invasive, lobule tissue) - hard to detect with mammogram
Drawbacks to BC Screening Overdiagnosis; low specificity - half of women will have a false positive if they get tested every year for 10 years; low sensitivity in invasive forms of cancer
Cancer The uncontrolled growth of cells; cancer is clonal; requires mutations in multiple genes controlling growth
Rous' Chicken Virus attaches to somatic cell, penetrates its genetic materia; new RNA made from viral DNA; 1 RNA strand makes virus proteins the other gets packaged into newly formed virus - hijacks the cellular genes
Types of Cancer Genes (1) Oncogenes (promote cell growth); (2) inactivation/elimination of tumor suppressor genes
Retinoblastoma Usually Rb binds with E2F, where it prevents cells from growing unti lit receives signal. When Rb is inactivated/absent, E2F is always active and growth is uncontrollable.
BRCA 1 and BRCA 2 Normal function to repair genes when DNA is damaged. When BRCA 1 & 2 are inhibited/absent, the DNA is not repaired -> accumulate mutations -> cancer
Example of Oncogene src and myc
Example of Tumor Suppressor Gene Rb (retinoblastoma)
Type I Diabetes Caused by autoimmune function where the body attacks beta cells in the pancreas, insulin is not created; treated by insulin supplementation
Type II Diabetes Caused by inhibited reactivity to insulin. Increase adipose tissue leads to increased free fatty acid which leads to decreased insulin which leads to decreased glucose uptake by cells; supplementing insulin doesn't always work
Insulin A hormone produced by beta cells in the pancreas. Lowers blood glucose levels (triggers uptake of glucose into cells - via glucose transporters)
Glucagon A hormone produced by alpha cells in the pancrease. Increases blood glucose levels.
Malnutrition (1) protein-energy malnutrition which leads to wasting (marsmus) and stunting; (2) micronutrient deficiency
Causes of Hunger (1) Drought, (2) War and (3) Natural disaster which impact food production; (4) Distribution barriers, (5) insufficient agricultural infrastructure (which impacts how food gets from farms to population); (6) Poverty trap - too poor to buy produce food.
Green Revolution Creation of resilient crops that would help food insecure nations bolster food supply (ex. mexico, india). Ex mexico 1940s relied on wheat imports, 1950s was self-sufficient, 1960s was exporting a lot of wheat.
Fats/ Lipids Most energetic food; body breaks down slowly; becomes cell wall, myelin sheath, hormones; insulation - protects organs and body heat
Protein Broken down into amino acids, creates energy via the Krebs cycle.
Carbohydrates Our primary source of energy, involved in the production of ATP; complex carbs (polysaccharides) broken down into oligosaccharides broken down into disaccharides (lactose, sucrose) broken down into monosaccharides (fructose, glucose)
Glycolysis glucose becomes pyruvate becomes ATP
High Fructose Corn Syrup (1) When heated it loses sweetness, we use more; (2) does not stimulate insulin release; (3) double uptake into the liver, which is then coverted into FFA which
Evidentiary Support for Empirical Relationship between SES and Health (1) incremental; (2) above a threshold; (3) separate individual factors; (4) modifiable (USSR); (5) bi-directional - health can impact SES and vice versa
Created by: lars526



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