F222 Growth development and Disease ocr

Created by: charles lynch
Created on: 22-03-13 13:38

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Growth development and Disease
- Developing cell
  - DNA; Purines A,G; Pyrimidines C,T; AT has 2 hydogen bonds GC 3.
  - Apoptosis; programmed cell death
    - Normal development
      - Syndactyly; where fingers are webbed together because apoptosis has not occured in the cells between them.
      - endometrium shedding in the uterus during menstration
      - forming of synapses in the brain requires death of surrounfing cells
    - DNA damage or infection
    - the cell shrinks
      - the DNA and protein in the nucleus breaks down.
        The mitochondria break down.
        A types of phospholipid called phosphatiylserine usually on the inner surface of the plasma membrane goes on the outside. Phagocytes (ie. macrophages) have receptors for this and engulf fragments of the membrane.
  - Meiosis
    - Independant assortment
    - Meiosis 1: Homologous pairs line up
      - DNA Crossing over at chiasmata
      - Independant assortment
      - Meiosis 2: Chromatids seperate. Gametes produced (haploid)
  - Cell cycle
    - Mitosis
      - Prophase: Metaphase; Anaphase; Telophase:(cytokinesis)
        MIcrotubules are small hollow protein (tubulin) rods. They form the cytoskeleten and can assembled as needed.
    - G2
      - Cell organells divide and grow
    - G1
      - Protiens are made organells and cytoplasm built up. CDK 2/4 control movment to S
        P53 expresses P21.
        P21 competes with cyclins D&E for CDKs 2&4
        (Cyclin D binds to CDK4) (Cyclin E with CDK 2)
        
        As cyclin CDK complexes build up, they will phosphorylat RB - retino-blastoma proteins.
        Kinases add a phosphate group to proteins.
        
        RB inhibits G1 -> S phase progression until phosphorolated.
- Stem cells
  - Totipotency; can differentiate into any type of cell and is capable of making a whole new organism. Eg; zygote
  - Pluripotecy; can become any cell type but not a whole new organism. embryonic stem cells a pluripotent.
  - Multipotency;can form several but not all cell types. Adult stem cells are multipotent.
  - Unspecialised cells that have the ability to self renew by mitosis and differentiate into new cell types.
  - Potential uses; Treat many medicalconditions; Test the effect of experimental drugs; Improve knowledge on how diseases develop.
  - Concerns; Embryonic stem cells are taken from embyos with the potential for human life. Viruses may be passed on unintentionally; mabey stem cells could become cancerous; stemm cells are cultured using nutrients from animals - disease could pass though that.
  - Haemocytoblasts are multipotent stem cells that give rise to all the blood cells
- Disease
  - Infectious
    - Tuberculosis
      - Antibiotics
        Inhibit proper synthesis of cycle wall.
        
        Inhibit enzymes that produce folic acid in bacteria.
        
        Interfere with protein synthesis at the ribosomes.
        
        Target bacterial DNA replication.
        
        bacteria may build up resistance as mutated strains may be less susceptible to the affects. Thus, more likely to survive.
        XDR-TB
        Tuberculosis
        Antibiotics
        Inhibit proper synthesis of cycle wall.
        
        Inhibit enzymes that produce folic acid in bacteria.
        
        Interfere with protein synthesis at the ribosomes.
        
        Target bacterial DNA replication.
        
        bacteria may build up resistance as mutated strains may be less susceptible to the affects. Thus, more likely to survive.
        XDR-TB
        
        Spread by airborne mucus droplets, drinking unpasteurised milk from infected cows.
        
        Can infect most organs but usually the lungs. (it may spread).
        
        Diagnosed via xrays and sputum.
      - Spread by airborne mucus droplets, drinking unpasteurised milk from infected cows.
      - Can infect most organs but usually the lungs. (it may spread).
      - Diagnosed via xrays and sputum.
    - HIV
      - Replicate only inside a living cell - obligate intracellular parasites.
        A retrovirus; its gentic code is in RNA which, using Reverse Transriptase is made into DNA.
        The enzyme intergrase inserts the viral DNA into the hosts genome giving a provirus.
        The host cell then expresses the viral genes and ultimately gives rise to new viruses. (see animation on HIV tab).
        
        CD4 T-helper cells and macrophages.
    - MRSA
      - Reducing spread;
        Alcohol based hand rub between patient contact.
        
        Isolate MRSA patients.
        
        Wards cleaned thoroughly.
        
        Visitors use alcohol hand rub.
        
        All equipment cleaned thoroughly between patients.
        
        Wear disposable plastic apron when exposed to bodily fluids.
      - Dianosed by blod, sputum, tissue or urine culture.
      - Skin can have boils and abscesses. Also severe flu symptoms
    - Pathogens
      - Bacteria
      - Fungi
      - Viruses
      - Protoctists
      - Immune response
        Vaccine
        Clinical trials
        Phase 3: Compare the new treatment with ones in current use. Involves a lot more people from many hospitals possibly internationally.
        Phase 3 may be randomised to give a good cross section of patients.
        
        Phase 2:Finds out if the drug works well enough to be better than of equal to current treatment nd taken to phase 3. Best dose , side effects (~50 people). For cancer drugs find out what cancers it is effective with.
        
        Phase 4: Doctors can now prescribe it. Find out further side effects and about long term use. Lots of people now using it.
        
        Phase 1: Small numbers of people (<30). Find safe dose range, side effects, how the body copes. The dosage levels are gradually increased from very small amounts.
        
        Placeboes that appear exactly the same as the real drug are there to control for phsycological rather than physiological responses.
        Can be blind trails where the patient is not told whether they are being given the drug or the placebo or double blind where the doctor doesnt know either.
        
        It is considered unethical to cancer patients a placebo when their last hope is with the drug.
        Can be blind trails where the patient is not told whether they are being given the drug or the placebo or double blind where the doctor doesnt know either.
        
        It is considered unethical to cancer patients a placebo when their last hope is with the drug.
        
        NICE: The national Instituete of health and Clinical Ecellenc; analyses the effectivness of drugs and provides guidelines for the NHS.
        
        Live vaccines; contain an attenuated strain that is no longer ocapable of producing the full blown disease
        
        Dead micro-organisms; even though its dead it still has the antigens on it to generate a response
        
        A fragment of a pathogen; like a viral coat protien.
        
        Herd immunity; if eniough people are vaccinated it makes it too hard for the disease to spread through the population. % differs with disease.
        
        Overview video playlist
        
        Non-Specific Response
        1st line (External)
        Skin cannot normallly be penetrated by bacteria and viruses.
        
        Sebaceous glands release sebum that has weak anti-microbial properties.
        
        Sweat keeps the skin at a low ph (3-5) that inhibits the growth of many pathogens.
        
        Skin cells shed off (desquamation)
        
        Competeing unpathogenic microbes crowd out pathogens
        
        Tears and other bodily ssecretions contian lysosomes and phospholipases which hydrolise cell wall and membranes respectivly
        
        The stomach secretses gastric fluid that is acidic inhibiting microbial growth and access to the gastrointestinal tract.
        
        Mucus membranes line the respiratory, digestive and genital tracts.
        Mucus traps pathogens and contains lyzosome. Cilia sweeps the mucus away to the oropharanx where it is coughed or swallowed.
        
        2nd Line (Internal)
        Inflammatory Response
        Symptomes; Redness, swelling, pain, swelling.
        
        Chemokines releseased by damaged cells
        Damaged Mast cells release histamine when activated
        Histamine reaches endothelial cells and cause vasodialation.
        
        Phagocytes; (neutrophil, macrophages) squeeze through the gaps in the dilated cappilery (Diapedesis).
        Phagocytose pathogens.
        
        Phagocytes
        Pathogens give of chemecals that the phagocyte detects and moves towards via chemotaxis
        It engulf the pathogen to for a phagosome.
        This fuses with a lysosome that has enzymes which digest it.
        Indigestable material is discharged.
        
        Fever
        Macrophages responding to pathogens release interluekin-1
        Interleukin-1 hinduces the hypothalamus to produce prostaglandins; reseting the the bodies thermostat higher.
        Blood vesel constiction; shivering; higher metabolic rate.
        Chill phase; Body temp remians high untill there is no more interleukin-1
        Crisis phase is where the body goes back to 37; sweating and vasodialation.
        
        Specific Response (3rd line)
  - Non-infectious
    - Cancer
      - cancer is abnormal growth of cells that is invading other tissues (metastasis)
        Caused by mutations to the genetic code.
        Proto-oncogenes can code for receptor proteins on the membrane that bind to growth factors or the growth factors themselves (CDKs, Cyclins)
        Example - RAS oncogene; its receptor triggers cell growth even with no growth factor bound to it.
        
        (Cyclin D binds to CDK4) (Cyclin E with CDK 2)
        
        Mutagenes can change the DNA
        Carcinogens are mutagens that lead to cancer.
        Chemicals; BPDE (smoking), arsenic.
        BPDE is a risk factor for P53 mutations
        P53 expresses P21.
        P21 competes with cyclins D&E for CDKs 2&4
        As cyclin CDK complexes build up, they will phosphorylat RB - retino-blastoma proteins.
        Kinases add a phosphate group to proteins.
        
        RB inhibits G1 -> S phase progression until phosphorolated.
        
        Ionising radiation; UV, Xray, Gamma.
        
        Certian viruses.
        Viruses; Human papilloma virus, Rous sarcoma virus
        Infectious
        HIV
        Replicate only inside a living cell - obligate intracellular parasites.
        A retrovirus; its gentic code is in RNA which, using Reverse Transriptase is made into DNA.
        The enzyme intergrase inserts the viral DNA into the hosts genome giving a provirus.
        The host cell then expresses the viral genes and ultimately gives rise to new viruses. (see animation on HIV tab).
        
        CD4 T-helper cells and macrophages.
        
        MRSA
        Reducing spread;
        Alcohol based hand rub between patient contact.
        
        Isolate MRSA patients.
        
        Wards cleaned thoroughly.
        
        Visitors use alcohol hand rub.
        
        All equipment cleaned thoroughly between patients.
        
        Wear disposable plastic apron when exposed to bodily fluids.
        
        Dianosed by blod, sputum, tissue or urine culture.
        
        Skin can have boils and abscesses. Also severe flu symptoms
        
        Pathogens
        Bacteria
        
        Fungi
        
        Viruses
        
        Protoctists
        
        Immune response
        Vaccine
        Clinical trials
        Phase 3: Compare the new treatment with ones in current use. Involves a lot more people from many hospitals possibly internationally.
        Phase 3 may be randomised to give a good cross section of patients.
        
        Phase 2:Finds out if the drug works well enough to be better than of equal to current treatment nd taken to phase 3. Best dose , side effects (~50 people). For cancer drugs find out what cancers it is effective with.
        
        Phase 4: Doctors can now prescribe it. Find out further side effects and about long term use. Lots of people now using it.
        
        Phase 1: Small numbers of people (<30). Find safe dose range, side effects, how the body copes. The dosage levels are gradually increased from very small amounts.
        
        Placeboes that appear exactly the same as the real drug are there to control for phsycological rather than physiological responses.
        
        NICE: The national Instituete of health and Clinical Ecellenc; analyses the effectivness of drugs and provides guidelines for the NHS.
        
        Live vaccines; contain an attenuated strain that is no longer ocapable of producing the full blown disease
        
        Dead micro-organisms; even though its dead it still has the antigens on it to generate a response
        
        A fragment of a pathogen; like a viral coat protien.
        
        Herd immunity; if eniough people are vaccinated it makes it too hard for the disease to spread through the population. % differs with disease.
        
        Overview video playlist
        
        Non-Specific Response
        1st line (External)
        Skin cannot normallly be penetrated by bacteria and viruses.
        
        Sebaceous glands release sebum that has weak anti-microbial properties.
        
        Sweat keeps the skin at a low ph (3-5) that inhibits the growth of many pathogens.
        
        Skin cells shed off (desquamation)
        
        Competeing unpathogenic microbes crowd out pathogens
        
        Tears and other bodily ssecretions contian lysosomes and phospholipases which hydrolise cell wall and membranes respectivly
        
        The stomach secretses gastric fluid that is acidic inhibiting microbial growth and access to the gastrointestinal tract.
        
        Mucus membranes line the respiratory, digestive and genital tracts.
        Mucus traps pathogens and contains lyzosome. Cilia sweeps the mucus away to the oropharanx where it is coughed or swallowed.
        
        2nd Line (Internal)
        Inflammatory Response
        Symptomes; Redness, swelling, pain, swelling.
        
        Chemokines releseased by damaged cells
        Damaged Mast cells release histamine when activated
        Histamine reaches endothelial cells and cause vasodialation.
        
        Phagocytes; (neutrophil, macrophages) squeeze through the gaps in the dilated cappilery (Diapedesis).
        Phagocytose pathogens.
        
        Phagocytes
        Pathogens give of chemecals that the phagocyte detects and moves towards via chemotaxis
        It engulf the pathogen to for a phagosome.
        This fuses with a lysosome that has enzymes which digest it.
        Indigestable material is discharged.
        
        Fever
        Macrophages responding to pathogens release interluekin-1
        Interleukin-1 hinduces the hypothalamus to produce prostaglandins; reseting the the bodies thermostat higher.
        Blood vesel constiction; shivering; higher metabolic rate.
        Chill phase; Body temp remians high untill there is no more interleukin-1
        Crisis phase is where the body goes back to 37; sweating and vasodialation.
        
        Specific Response (3rd line)
        
        As you age mutations build up. These can eventually combine to form cancer.
        
        Tumor suppressor genes; code for proteins that stop the cell cycle and usually cause apoptosis when DNA mutates.
        P53 (involved in half of all cancers), P21, Rb.
      - Cancer detection
        Thermography
        
        X rays
        
        Ultrasound
        
        MRI
        
        CAT scans
        
        Mammography
        
        PET
      - Treatment
        Surgery
        
        Chemotherapy
        
        Radiotherapy
        
        Hormone therapy
        Tamoxifen; prevents oestrogen getting to breast cancer cells by blocking oestrogen receptors.
        
        Immunotherapy
        
        Complementry therapies
    - Coranary heart disease
      - Atheroslerosis
        Endothelium damaged by irritant; smoking chemicals, high blood pressure, high lipid levels.
        Lipids build up in tunica intima
        phagocytes/ macrophages accumalate the lipids in the area becoming foam cells.
        Fiberous connective tissue is form over the affected area by smooth muscle cells from the tunica media
        A thrombus starts to form.
        Abit of this may break off (embolus) and get lodge in a norrower place down stream.
        This can cuase a heart attack (myocardial infaction) where cardiac cells die as they are starved of oxygen and glucose.
        Severe chest pain; Severe sweating;; irregular pulse; Cold skin, Blue lips; felling faint/ nauseaus.
        
        The patient may be given asprin. Asprin reduce the ability of platlets tocuase blood clots.
        
        If coranary arteries become narrowed by an athroma glucose and oxygen supply may be to small.
        This can cuase angina pectoris a pain in the chest.
      - Cardiac arrest can be caused by myocarial infarction. And is where the heart no longer beats well enough to pump blood around the body.
        This is treated by cardio-pulmonary resuscitation (CPR).
        
        Defibrilators deliver a powerful electric shock to the heart.
      - Risk factors; Diets high in salt increas blood pressure, high in fat increase blood cholestrol levels. (anti-oxidants reduce CHD risk). High blood pressure. Exercise lowers blood pressure and cholestrol level and stops obesity. Smoking raises blood pressure and increases the risk of atheromas developing. Genome, some people are genetically inclined to have high blood pressure/ cholestrol levels.
      - Angioplasties; inserting a thin flexible hollow tube called a catheter into the groin or arm and pushing it to the coranary artery. It is then expanded to squash the athroma and may leave a stent.
      - Coranary bypass surgery; a peice of vein is taken from else where in the bodyand used to bypass the old artery. If this cannot be done a whole heart transplant may be needed.
    - Lung disease
      - Smoking; CO bind with heamoglobin to form carcoxyhaemoglobin. Tar gets deposited throughout the lungs.
      - Coughing can scar the lungs. which makes diffusion less efficient and norrows airways.
      - Cilia become paralized. Can't move mucus. More prone to lung infections.
      - COPD - chronnic obstructive pulmonary diease.
        Emphysema
        Alviolar phagocytes in an attempt to reach the irritating mucus release elastase to get through tissue in their way.
        This breaks down the elastin in the alvioli walls and reduces surface area.
        The patient breathes deeply to compenste byt this over streches the elastin fibres remainin, making the lungs even less efficient
        
        Chronic Bronchitis.
        Build up of mucus in the lungs. Breathlessness, ongoing cough.
        
        Cilia become paralized. Can't move mucus. More prone to lung infections.
    - Asthma
      - 90% allergic asthma (younger people)
      - Intrinsic asthma; not to do with allergies
      - Excersise-induced asthma; loss of moisture from the lungs.
      - Membranes in airways release mucus and bronchoconstriction occurs.
      - Treatments; steriods (reduce inflamation), Beta-agonists (act as bronchodilators).
    - Diabetes
      - Type 1 - the immune system attacks the insulin producing cells in the pancreas.
        Given insulin injection to manage blood sugar levels.
      - Type 2 - more common than type 1 - someone becomes desensitised to the affects of insulin.
        Risk factors; old age, obesity, diet high in sugar, high blood pressure, physical inactivity.
        Treatment; good diet and excersise. Eat more complex carbohydrates as they take longer to break down so release sugar more evenly.
      - In a healthy person blood sugar levels are 4-8mmols dm^-3.
        Biosensors have enzymes that convert glucose to gluconolacton this produce a small electric current that is measure by the device.
      - Glucose tolerance test; Fast for 12 hours - have a glucose drink - measure glucose levels every 30 min for 3 hours.
  - Epidimiology
    - Endemic : An infectious disease that is always present within a certain population or region.
    - Pandemic a large spread/rise of incidence of a disease on global proportions
    - Epidemic: large increase in incidence of a disease in a localised area
    - morbidity rate; Incidence per population per year.
    - Mortality rate deaths per population per year.
- Fetal growth
  - Bi-peritiel curcumfrence
  - Crown rump lentgth
Given insulin injection to manage blood sugar levels.

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F222 Growth development and Disease ocr

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