Midterm 10/20/2016
Quiz yourself by thinking what should be in
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| Overexpression | When a cell produces too much protein. In oncogenes can cause cancer by flooding cells with the message to grow and divide.
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| Four major classes of infectious agents | (1) Viruses (ex. rotavirus), (2) Bacteria (ex. cholera), (3) Protozoa (ex. parasites, cryptosporidium), (4) Worms (ex. hookworm)
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| Diarrhea | The passage of 3 or more loose/liquid stools per day.
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| Treatment for diarrhea (4) | (1) Rehydration with ORS; (2) Zinc supplementation; (3) Nutritious food; (4) Antibiotics
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| Recipe for ORS | Oral Rehydration Solution - Clean water, sugar, salt
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| Types of Diarrhea (3) | (1) Acute watery diarrhea; (2) Acute bloody diarrhea (dysentery); (3) Persistent diarrhea (lasts longer than 14 days)
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| 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)
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| "El Tor" | A strain of the Cholera bacteria believed to be responsible for the 7th pandemic of Cholera.
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| Early symptoms of As exposure | (1) Skin lesions; (2) DM; (3) "Blackfoot" disease; (4) Neurocognitive deficit
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| Late symptoms of As exposure | (1) Cancers (bladder, skin, liver, lung): (2) CVD
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| How much cancer death is attributable to avoidable environmental exposure? | 60% - Schottenfield
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| What is cancer? | A multistep process that blends internal factors (ex. genetics/gene mutations and obesity) with external exposures (environmental exposures)
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| 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
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| Time Trends | Increased exposure in population associated with increased incidence of cancer, example positive relationship between lung cancer and smoking rates in the US
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| Geographic Variation | Specific forms of cancer are more prevalent in different parts of the world (example melanoma in Australia)
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| 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
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| 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
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| 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.
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| 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
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| 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
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| 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
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| 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.
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| Toxicology | The study of the adverse effects of chemical compounds on people and animals.
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| 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
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| 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
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| Dose Response | Change in health effect with change in dose
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| Hormesis | When a little bit of exposure is better than none at all (in a sublinear dose-response curve)
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| ED50 | The effective does -the dose at which 50% of animals develop tumors
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| Half Life | The amount of time it takes for a compound's blood concentration to decrease by 50%; estimated by the elimination phase
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| Absorption | The substance is in steady state in the blood stream
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| Elimination | Blood is filtered through the kidneys, the substance is removed from the bloodstream
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| Distribution | The substance is absorbed from the bloodstream to the surrounding tissue
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| Steady State | The half-life of elimination dictates how long it takes to reach steady state
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| How long does it usually take to reach steady state? | 4 half-lifes
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| 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)
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| CY P450s | Cytochrome P450s - the enzymes that enable us to metabolize toxicants (about 75% of metabolism), we have about 57 different kinds
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| 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
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| CY P450 Inhibitor | Ex. Grapefruit juice, causes a substance to have a longer half-life
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| CY P450 Inducer | Ex. rifampin, causes a substance to have a shorter half-life
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| Acceptable concentration of lead in blood? | 5 micrograms/dL
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| 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)
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| 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
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| Brown Fat Cell | Converts energy into heat; protection from cold
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| Beige Fat Cell | Cell found in white fat tissue that matures into a brown fat cell
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| White Fat Cell | Usually found under the skin, in the abdominal area; stores energy (does not burn)
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| PAHs | Polycyclic Aromatic Hydrocarbons - a type of endocrine disruptor
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| Endocrine Disruptors | Mimic hormones, (ex. estrogen), increase adipose tissue, increased insulin interference
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| 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
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| 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.
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| Zika PH Interventions | (1) Travel advisories; (2) Mosquito protection/control; (3) Reproductive health; (3) Screening and monitoring; (4) Research
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| Germ thoery | Microbes cause infections; specific microbes cause specific diseases
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| 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
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| How do microbes cause infection | Microbe damages host (disruption in homeostasis, alters cell/tissue/organ functioning) through host factors (inflammatory response) or microbial factors
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| Sporadic infection | isolated; a disease that occurs in a single case or scattered cases (ex. tetanus, pneumonia, food poisoning)
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| Incubation period | the amount of time between infection and disease expression
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| TB Infection Determination | (1) Bacterial load; (2) Environmental factors (enclosed spaces); (3) Duration of exposure; (4) Virulence of the organism
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| Antibiotics | Derived from substances made by micro-organisms that kill/inhibit micro-organisms
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| 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)
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| 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
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| 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.
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| Basis of genetic material | Must be able to store information about itself and copy itself.
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| Balanced Polymorphism | When heterozygotes have a survival advantage; ex. sickle cell anemia; when recessive mutations are common, it suggests some advantage.
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| 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
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| 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
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| Cancer | The uncontrolled growth of cells; cancer is clonal; requires mutations in multiple genes controlling growth
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| 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
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| Types of Cancer Genes | (1) Oncogenes (promote cell growth); (2) inactivation/elimination of tumor suppressor genes
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| 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.
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| 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
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| Example of Oncogene | src and myc
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| Example of Tumor Suppressor Gene | Rb (retinoblastoma)
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| Type I Diabetes | Caused by autoimmune function where the body attacks beta cells in the pancreas, insulin is not created; treated by insulin supplementation
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| 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
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| Insulin | A hormone produced by beta cells in the pancreas. Lowers blood glucose levels (triggers uptake of glucose into cells - via glucose transporters)
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| Glucagon | A hormone produced by alpha cells in the pancrease. Increases blood glucose levels.
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| Malnutrition | (1) protein-energy malnutrition which leads to wasting (marsmus) and stunting; (2) micronutrient deficiency
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| 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.
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| 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.
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| Fats/ Lipids | Most energetic food; body breaks down slowly; becomes cell wall, myelin sheath, hormones; insulation - protects organs and body heat
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| Protein | Broken down into amino acids, creates energy via the Krebs cycle.
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| 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)
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| Glycolysis | glucose becomes pyruvate becomes ATP
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| 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
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| 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
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