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Principles of Disease final
n/a
131
Pharmacology
Graduate
02/26/2011

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Term
Homozygous
Definition
identical alleles
Term
Heterozygous
Definition
two different alleles (one dominant, one recessive)
Term
Transmission Genetics
Definition
Transfer of genetic information from gene to the next generation.
Term
Population Genetics
Definition
Genetic diversity at individual, population, and species level.
Term
Quantitative Genetics
Definition
Gene results in distribution of phenotypic values.
Term
Penetrance
Definition
percent of individuals that carry an autosomal dominant gene and are expressing the trait.
Term
Variable expressivity
Definition
Variable expression of autosomal dominant trait in affected individuals.
Term
Genetic heterogenicity
Definition
production of given trait by different mutations at different loci.
Term
Pleiotropism
Definition
Multiple end effects of a single mutant gene.
Term
Polymorphism
Definition
Multiple allelic forms of a single gene.
Term
Germ cell mutations
Definition
Transmitted to progeny leading to hereditary diseases.
Term
Somatic cell mutations
Definition
Not transmitted to progeny and may lead to cancer or congenital malformations.
Term
Single base deletion
Definition
frame shift mutation
Term
point mutation
Definition
single base pair change
Term
Sickle Cell
Definition
Example of point mutation
Term
beta-thalassemia
Definition
example of point mutation
Term
three base deletion
Definition
Does not result in frameshift.
Term
Cystic Fibrosis
Definition
Example of three base deletion
Term
Four base insertion
Definition
alters the reading frame and may result in early termination.
Term
Tay Sachs
Definition
example of lipid storage disorder from four base insertion in gene for Hexosaminidase A.
Term
Multifactorial Disease
Definition
combined effects of two or more mutant genes combined with environmental factors.
Term
Translocation
Definition
transfer of one segment of chromosome to another
Term
Isochromosome
Definition
one arm is lost and other is duplicated
Term
Chromosomal inversion
Definition
rearrangement associated with two breaks, inversion, and reincorporation of broken part
Term
Ring chromosome
Definition
deletion affecting both ends, fusion of the damaged ends
Term
Triple repeat mutation
Definition
expansion of a long repeating sequence of three nucleotides.
Term
Fragile X Syndrome
Definition
X-linked disorder caused by triple repeat mutation within the 5'UTR of FMR-1 gene.
Term
Leber hereditary optic neuropathy
Definition
maternally inherited disorder caused by mutation in mitochondrial genes
Term
Prader Willi Syndrome
Definition
gene on maternal chromosome 15q12 is silenced and function is provided by paternal chromosome. This disease occurs when this paternal function is lost due to deletion.
Term
Angelman Syndrome
Definition
gene on paternal chromosome 15q12 is silenced and function is provided by maternal chromosome. This disease occurs when this maternal function is lost due to deletion.
Term
Gonadal mosaicism
Definition
results from mutations that occur postzygotically during embryonic development.
Term
Turner Syndrome
Definition
monosomy of X chromosome (45)
Term
Downs Syndrome
Definition
Trisomy 21 (47)
Term
Postnatal cytogenetic analysis
Definition
cytogenetic analysis performed on peripheral blood lymphocytes
Term
Prenatal cytogenetic analysis
Definition
cytogenetic analysis performed by amniocentesis or chorionic villi biopsy
Term
Fluorescence in Situ Hybridization (FISH)
Definition
DNA probes specifically recognize chromosome and are labeled with fluorescent dye wills hybridize to interphase nuclei at complementary sequence.
Term
Chromosome Painting
Definition
Entire chromosome is labeled with series of fluorescent probes and these will bind to multiple sites on chromosome.
Term
Direct Gene Diagnosis
Definition
involved detection of the mutant gene based on identifying qualitative differences in DNA sequences using restriction sites.
Term
Indirect gene diagnosis
Definition
Also known as Gene Tracking, involves detection of linkage of the disease gene with a harmless marker gene.
Term
Oligonucleotide probe analysis
Definition
used when point mutation producing abnormal gene does not alter any known restriction site. Involves hybridizing short sequences of nucleotides to both normal and abnormal to test the strength of hybridization. Strong- normal gene, weak- abnormal gene
Term
Neonatal
Definition
First four weeks
Term
Infancy
Definition
First year
Term
Early childhood
Definition
1-4 years
Term
Late childhood
Definition
4-14 years
Term
Fetal factors for Intrauterine Growth Retardation
Definition
chromosomal disorders, congenital anomalies, congenital infections
Term
Placental factors for Intrauterine Growth Retardation
Definition
Abruptio placentae, placenta previa, placental thrombosis, placental infections, umbilical-placental vascular anomalies, multiple gestations, confined placental mosaicism
Term
Maternal factors for Intrauterine Growth Retardation
Definition
toxemia of pregnancy, chronic hypertension, nutritional status, maternal narcotic abuse, alcohol intake, heavy cigarette smoking, intake of certain drugs
Term
immaturity of Lungs
Definition
Do not fully develop until 36 weeks. Immaturity can result in thick-walled alveolar septa that cause separation of the vascular supply from alveolar spaces, hindering oxygenation
Term
Immaturity of Kidneys
Definition
results in primitive glomeruli and tubules present in subcapsular zone, however deeper glomeruli and tubules are well fromed and function adequately.
Term
Immaturity of Brain
Definition
external surface of brain is relatively smooth with absent convolutions. Poor demarcation of white and gray matter structures. cell migration and myelination are incomplete, so the brain is soft and gelatinous.
Term
Immaturity of Liver
Definition
Large relative to the size of the preterm infant. Extramedullary hematopoisis (blood cellular components occur outside of medulla of bone) is present.
Term
Intracranial hemorrhage
Definition
increase in intracranial pressure, damage to brain substances, and herniation of the medulla.
Term
Caput Succedaneum
Definition
accumulation of interstitial fluid in the soft tissue of the scalp resulting in circular area of edema
Term
Malformation
Definition
Error in morphogenesis that are intrinsic abnormalities that occur early in fetal development and may involve single or multiple organ systems.
Ex. Congenital heart defects, anencephaly
Term
Deformations
Definition
Error in morphogenesis that arises late in fetal life due to influence of mechanical factors. Usually in shape, form, or position of the body.
Term
Disruption
Definition
Error in morphogenesis that result from secondary destruction or interference with an organ or body region that was previously normal in development.
Ex. Amniotic Bands
Term
Amniotic bands
Definition
Type of disruption that can occur to fetus when amnion ruptures without injury to chorion, exposing the baby to fibrous sticky tissue and causing abnormalities.
Term
Sequence (Error of morphogenesis)
Definition
series of muliple congenital anomalies resulting from a single localized aberration in organogenesis leading to secondary effects to other organs.
Ex. oligohydramnios (decreased amniotic fluid)
Term
Syndrome (Error of morphogenesis)
Definition
several defects are present that are thought to be pathogenetically related.
Term
Agenesis
Definition
complete absence of an organ and its associated primordium (earliest recognizable stage of organ)
Term
Aplasia
Definition
Absence of an organ because of failure of the developmental anlage to develop.
Term
Atresia
Definition
Absence of an opening, usually of a hollow visceral organ, such as the trachea or intestine.
Term
Hypoplasia
Definition
Incomplete development or underdevelopment of an organ, with decreased number of cells.
Term
Hyperplasia
Definition
Overdevelopment of an organ associated with increased numbers of cells.
Term
Hypertrophy
Definition
Increa in organ size or function related to an increase in the size of individual cells.
Term
Hypotrophy
Definition
Decrease in organ size or function that related to a decrease in the size of individual cells.
Term
Dysplasia
Definition
Abnormal organization of individual cells.
Term
Cytomeglovirus
Definition
fetal infection usually in second trimester that affects the Central Nervous System and results in mental retardation, microcephaly, and deafness.
Term
Rubella
Definition
Fetal infection before 16 weeks gestation resulting in cataracts, heart defects and deafness.
Term
Thalidomide
Definition
Sleeping aid from 1950's given as antiemetic for morning sickness. Found later to be an angiogenesis inhibitor.
Term
13-cis-retinoic acid (Accutane)
Definition
Acne drug that binds to cytosolic building proteins and transports them to nucleus then reacts with retinoic acid receptors causing over-expression in heart development.
Term
Acyanotic heart defect
Definition
May be due to left-to-right shunting of blood in heart due to ASD or VSD causing volume overload in right atrium and right ventricle leading to to pulmonary hypertension.
May also be due to pulmonary stenosis, narrowing of of the pulmonary valve, and aortic stenosis.
Term
Cyanotic heart defects
Definition
Patient appears blue because there is diminished pulmonary blood flow and poorly oxygenated blood enters the systemic circulation. Due to right-to-left shunt.
Term
Tetralogy of Fallot
Definition
Involves four different heart malformations:
1. Ventricular septal defect (VSD)
2. pulmonary trunk stenosis (narrowing)
3. Right ventricle is more muscular than normal
4. Aorta is positioned over the VSD instead of left ventricle.
Term
Incidence of Infant Respiratory Distress Syndrome
Definition
60% incidence in infants born less than 28 weeks gestation.
<5% incidence in infants born at greater than 37 weeks gestation.
Term
Causes of Infant Respiratory Distress Syndrome
Definition
-Aspiration during birth of blood and amniotic fluid
-Brain injury with failure of central respiratory centers
-asphyxiating coils of umbilical cord around the neck of infant
-Excessive maternal sedation
-Idiopathic RDS (hyaline membrane disease)
Term
Pathogenesis of Infant Respiratory Distress Syndrome
Definition
Decreased surfactant results in increased alveolar surface tension with progressive atelectasis (lack of gas exchange) of alveoli and a higher inspiratory pressure required to expand the alveolus. Plasma leaks into alveolus and combine with fibrin and necrotic alveolar pneumocytes to form hyaline membranes.
Term
Hyaline membranes
Definition
Form when plasma leaks into alveolus and combines with fibrin and pneumocytes and fill air spaces and block gas exchange, causing more hypoxemia
Term
Erythroblastosis Fetalis
Definition
Hemolytic disease of the newborn due to antibodies from the mother attacking fetus's RBC.
Term
ABO imcompatability
Definition
Erythroblastosis Fetalis limited to babies with A or B antigens whose mothers have type O blood.
Term
Rh imcompatability
Definition
Erythroblastosis Fetalis which occurs in babies with RBC's having the Rh antigen (Rh +), and mother who do not have the Rh antigen (Rh -).
Term
Cause of Erythroblastosis Fetalis
Definition
Antibodies are formed after delivery of first child to child's RBC antigens. Rh + antigens can cross the placenta during the next pregnancy and destroy the fetus' RBC.
Term
Phenylketonuria (PKU)
Definition
Mutation to the phenylalanine hydroxylase gene cause deficiencies in the enzyme that converts phenylalanine to tyrosine.
Term
benign hyperphenylalaniemia
Definition
Only partial deficiency of phenylalanine hydroxylase therefore the patients do not suffer neurologic disorder.
Term
Cystic Fibrosis
Definition
Mutations to the CFTR (Cystic fibrosis transmembrane conductance regulator) protein serves as a chloride channel. Leads to increased water reabsorption from lumen, dehydration of the mucus layer, and ultimately accumulation of hyperconcentrated, viscid secretions that obstruct the airways.
Term
CFTR (Cystic fibrosis transmembrane conductance regulator) structure
Definition
Two transmembrane domains, two nucleotide-binding domains, and a regulatory domain (R-domain)with protein kinase phosphorylation sites.
Term
CFTR (Cystic fibrosis transmembrane conductance regulator) mechanism
Definition
Aceylcholine binds, increases cAMP, activates PKA which phosphorylates CFTR, leading to opening Cl- channels.
Term
Cystic Fibrosis Classification
Definition
Class I: defective protein synthesis - lack of CFTR at surface.
Class II: abnormal protein folding, processing, and trafficking - degraded before reaching surface.
Class III: defective regulation - prevent activation of CFTR by ATP hydrolysis.
Class IV: Decrease conductance - mutation in TM regions of CFTR leading to reduced function with normal expression.
Class V: Reduced abundance - mutations in intronic splice sites decrease protein expression.
Class VI: Altered regulation of separate ion channels.
Term
Sudden Infant Death Syndrome (SIDS)
Definition
The sudden death of an infant under 1.
Term
Neuroblastic tumors (Neuroblastoma)
Definition
tumors arise in the adrenal medulla or various ganglia.
Term
Wilms' Tumor
Definition
Between ages 2 and 5. Nephroblastoma, tumor of the kidney associated with deletion of WT-1 or WT-2 gene.
Term
Two basic components of all tumors
Definition
1. Proliferating neoplastic cells (parenchymal)
2. Supporting stroma
Term
Four characteristics of neoplasms
Definition
1. Differentiation and anaplasia
2. Rate of growth
3. Local invasion
4. Metastasis
Term
Differentiation of tumor cells
Definition
Extent to which tumor cells resemble comparable normal cells.
-benign tumors closely resemble (high differentiation)
-malignant tumors are less well differentiated.
Term
Anaplasia
Definition
Lack of differentiation
Malignant tumors
Term
Cytologic features that characterize anaplastic tumors
Definition
-Nuclear and cellular pleomorphism-wide variety in shape and size
-hyperchromatism- prominent nucleoli
-Nuclear-cytoplasm ratio- enlargement of nuclei
-abundant mitoses
-tumor giant cells
-loss of polarity
Term
Dysplasia
Definition
refers to disorderly but non-neoplastic growth
Term
Three categories of Hereditary forms of cancers
Definition
1. Inherited cancer syndromes
2. Familial cancers
3. Autosomal recessive syndromes of defective DNA repair
Term
Precancerous conditions
Definition
-cirrhosis of the liver-hepatocellular carcinoma
-atrophic gastritis of pernicous anemia-stomach cancer
-chronic ulcerative colitis-carcinoma of the colon
-leukoplakia of the oral and genital mucosa-squamous cell cancers
-solar keratosis of the skin
Term
Four classes of genes where mutations cause cancer.
Definition
1. Growth-promoting protooncogenes
2. Growth-inhibiting tumor-suppressor genes
3. Genes that regulate apoptosis
4. Genes that regulate DNA repair
Term
Carcinogenesis
Definition
The attributes of malignancy are acquired in a stepwise fashion.
Also called Tumor progression
Term
Oncogenes
Definition
genes whose products are associated with neoplastic transformation or play a role in tumor progression.
Term
Protooncogenes
Definition
Normal cellular genes that affect growth and differentiation. They become oncogenes when mutated.
Term
Products of protooncogenes
Definition
Growth factors
Growth factor receptors
Signal-transducing proteins
Nuclear Transcription proteins
Cyclins and cyclin-dependent kinases (CDK)
Term
Cyclins and cyclin-dependent kinases
Definition
regulate the progression of cells through the cell cycle.
Term
D-type cyclins
Definition
facilitate the transistion from G1 to S phase of the cell cycle by activating CDK4 and CDK6. These CDK's phosphorylate retinoblastoma protein (pRB) which in turn releases E2F transcription factors for S-phase proteins.
Term
Three mechanisms that convert protooncogenes to oncogenes
Definition
1. Point mutations
2. Chromosomal rearrangements
3. Gene amplification
Term
Rb
Definition
functions in cell cycle regulation
Somatic mutations cause:Retinoblastoma, Osteoscarcoma, Breast, Colon and Lung Cancers
Inherited mutations cause: Retinoblastomas and Osteosarcomas
Term
p53
Definition
Functions in cell cycle regulation and Apoptosis in response to DNA damage.
Somatic mutations cause: Most human cancers
Inherited mutations cause: Various carcinomas and sarcomas
Term
WT-1
Definition
Functions in Transcription
Somatic mutations cause: Wilms Tumor
Inherited mutations cause: Wilms Tumor
Term
BRCA-1
Definition
Tumor suppressor
Inherited mutations cause: Breast and Ovarian cancer
Term
BRCA-2
Definition
Tumor suppressor
Inherited mutations cause: Breast Cancer
Term
p16
Definition
Functions in Cell Cycle Regulation
Somatic mutations cause: Pancreatic and Esophageal cancers
Inherited mutations cause: Malignant melanoma
Term
DMRG
Definition
DNA mismatch repair gene
can cause ALL cancers
Term
TGF-b receptor
Definition
Functions in cell growth inhibition
Somatic mutations cause: colon cancer
Inherited mutations cause: unknown
Term
E-cadherin
Definition
Functions in cell adhesion
Somatic mutations cause: Stomach and Breast cancer
Inherited mutations cause: Gastric cancer
Term
NF-1 and NF-2
Definition
Regulates RAS pathway of signal transduction, mutated version stays in GTP-bound state and continually signals to divide.
Somatic mutations cause: Schwannomas and Meningiomas
Inherited mutations cause: Schwannomas and Meningiomas
Term
Bcl-2
Definition
Control apoptosis by regulating the exit of cyrochrome c from the mitochondria which activates proteolytic enzyme caspase 9. Overexpression extends cell survival
Ex. B-cell lymphomas
Term
Three variables that influence the kinetics of tumor cell growth
Definition
1. Doubling time of tumor cells
2. Growth fraction - amt of cells in reproductive phase
3. Cell production and loss imbalance
Term
Tumor angiogenic factors
Definition
1. Vascular endothelial growth factors (VEGF)
2. Basic fibroblast growth factor (bFGF)
Term
Four steps in Invasion of Extracellullar Matrix
Definition
1. Detachment of tumor cells from each other
2. Attachment to matrix components
3. Degradation of extracellular matrix
Migration of tumor cells
Term
Cancer Cachexia
Definition
Loss of body fat, wasting, and profound weakness
Term
Paraneoplastic Syndrome
Definition
Symptoms not directly related to the spread of the tumor. Earliest clinical manifestations of a neoplasm and may mimic distant spread.
Term
Grading
Definition
Semi-quantitative estimate of gravity of tumor based on degree of differentiation and the number of mitoses within the tumor.
Term
Staging
Definition
Based on the anatomic extent of the tumor. Size of primary tumor and extent of local and distant spread.
Term
Five ways that cancer cells escape detection and killing
Definition
1. Drug resistance
2. Expresses immune cell inhibitors
3. Resistant to apoptosis even due to chemotherapy
4. Normal tissue specific gene expression is lost
5. Limited access
Term
Infection
Definition
colonization of the human host
Term
Carriage
Definition
Establishment of a long term harmless relationship between host and the bacteria
Term
Disease
Definition
Infections that result in pathology
Term
Pathogen
Definition
Microbe that can cause disease to host
Term
Virulence
Definition
relative capacity of a pathogen to cause disease
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