Bio Final Exam Study Guide PDF

1 1 Bio final exam 1. What are examples of microorganisms (also known as microbes) a. Bacteria, viruses, fungi, Protozoa, algae 2. Defines a. acellular: non-living microbes...

1 1 Bio final exam 1. What are examples of microorganisms (also known as microbes) a. Bacteria, viruses, fungi, Protozoa, algae 2. Defines a. acellular: non-living microbes i. Infectious particles, Viruses, Prions (infectious protein molecules) b. Cellular: living i. Bacteria, Archaea, some algae, Protozoa, some fungi d. Pathogen: harmful infectious agents; only 3% are pathogenic e. Opportunistic pathogens: have potential if opportunity presents itself i. Weak immune system f. Nonpathogen: helpful microbial allies that may prevent growth of pathogens i. Indigenous microflora g. Decomposers (sprophytes): organisms live off dead organic matter i. Break down organic materials into nitrates, phosphates, and other chemicals needed for plant growth ii. Bioremediation h. Immunology: branch of microbiology that deals with PROTECTION from disease i. Once you get the disease, you won’t get it again i. Sterilization: heat, moisture, and pressure j. Bacteriology: study of bacteria k. Virology: study of viruses l. Commensalism: parasite gets benefit without causing harm to host m. Symbiosis: organelles live together or close association of 2 dissimilar organisms i. Commensalism, mutualism, parasitism n. Mutualism: both parasite and host benefit o. Parasitism: parasite benefits at the expense of host i. Host dies, dumb parasite p. Protozoology: study of Protozoa q. Amoeba: Protozoa found in soil and water r. Saphophyte: organism living on dead and decaying matter s. Pseudopods: move by false-feet in ameba t. Phycology: study of algae u. Virulent: bacteriophage causes lytic cycle & destroys bacterial cell, then escapes  2 v. Temperate: lay dormant due to lytic cycle being held off in a bacteriophage 3. Describe Infectious disease vs microbial intoxication: a. Infectious disease: pathogen colonizing in body i. TB or syphillis b. Microbial intoxification: pathogen produces toxin in vitro i. A person ingests a toxin that causes disease 1. A person eats lettuce and develops salmonella from microbes living on the lettuce 4. How can microbes be transferred? a. Healthcare provider to pt, Pt to pt, Pt to healthcare provider b. Contaminated clothes, dishes and food c. Contaminated mechanical devices, instruments, syringes 5. What can we do to limit the spread of disease? a. VACCINATE! b. Follow Standard precautions 6. In terms of microbes, what were the first to be observed by humans? a. Bacteria and Protozoa 7. List some Major breakthroughs in microbiology: a. Microscopes, bacterial staining b. Growing cultures in lab c. Etiology of infectious disease: specific microbes 8. Understand each pioneer: a. Anton Van Leeuwenhoek: first to discover microbes on teeth i. “little beasties” b. Pasteur: discovered anthrax and TB, discovered germ theory, rabies vaccine, and pasteurization i. Germ theory: specific microbes cause disease c. Koch: Koch’s postulates, added to gram staining i. Postulates: proves causation of bacterial diseases (etiology) 1. Microbe must be found in similarly ill individuals 2. Microbe gets isolated and grown in pure culture 3. Susceptible animal receives microbe and falls ill with original disease 4. Microbe reisolated from the experimentally ill animal ii. Postulates: do not apply to viral infections; only with bacterial infections d. Petri: invent glass petri dish e. Lister: started handwashing AND spray air and wipe surgical sites  3 f. Fleming: penicillin in petri dish g. Holmes and Semmelweis: wash hands for pregnant pts; babies were developing streptococcus pyogenes (child bed fever) from unwashed hands h. J. Cohn: discovered B. Anthraxes produces spores that resist adverse conditions i. Hans Christian Gram: developed gram staining process 9. How can microbes be controlled?: a. Disinfection, sterilization, antibiotics 10. What are cold sores known as? What causes them to appear? a. Latent; stress, sunlight 11. What is penicillin used to produce? a. Antibiotics 12. What is the virus that is no longer a known in the US thanks to vaccine a. Smallpox; lot of cases in Africa b. Poliomyelitis (polio) 13. What is the Bubonic Plague? a. Black Death in Europe (1348-1350) that killed 30-60% of population i. Left Europe in 19th century 14. T/F microbes were once believed to come from living organic matter a. False, they were believed to spawn from dead organic matter 15. T/F around 1,000 different bacteria species live in the oral cavity a. False, 300 16. T/F Lister was highly respected for beginning a handwashing routine a. False, it wasn’t until Holmes and Semmelweis came along until it gained respect 17. T/F mad cow disease is a virus. a. False, it is prion 18. T/F Protozoa and prions are cellular a. False, prions are acellular 19. T/F microbes produce more O2 than plants a. True 20. T/F bacteria are eukaryotes a. False, prokaryotes 21. T/F bacteria are virulent, but are not temperate. a. False, although bacteria are virulent, they are also temperate 22. T/F Protozoa are either saprophytic OR parasitic a. true 23. T/F prokaryotic cells have numerous membrane bound organelles and reproduce by binary fission  4 a. First statement is false. Prokaryotes have only one membrane which is the cell membrane. Second statement is true. 24. T/F prokaryotic cells contain flagella; flagella consist of protein threads called flagellin a. True and true 25. T/F capsules allow phagocytosis to occur much quicker than if a capsule was absent. a. False, capsules protect the bacteria from being engulfed by white blood cells 26. Does prokaryotic cells have ER and/or Golgi complex? a. Neither 27. How many chromosomes does a human have? Genes? a. 46 pairs of chromosomes and 20k-30k genes 28. What do these eukaryotic organelles do? a. ER: interconnected membrane system forms transport network of tubules b. Golgi complex: communicates with ER and known as packaging plant c. Lysosome: lysozyme breaks down foreign material by phagocytosis i. Can cause autolysis (destroy entire cell) d. Cell wall: provide rigidity, shape, and protection e. Flagella: long, thin structures w microtubules that “swim” motive, typically one or more f. Cilia: organelles of locomotion that “beat” with movement g. Peroxisome: catalyzes (speeds up) breakdown of HP into water and oxygen h. Mitochondria: formation of ADP, energy from glucose that drive other cell functions (known as powerhouse) i. Ribosomes: protein synthesis; contains rRNA and mRNA(messenger) 29. When classifying microbes, what are the 6 considerations a. Size, shape, reproduction, nutrient needs, environmental needs, and disease producing power (if any) 30. Do prokaryotes contain microtubules? a. No 31. What is plasmodium Vivax? What is it’s process of infection? a. Malaria: an infected female mosquito bites someone 32. Which ER (rough or smooth) have ribosomes involved? a. Rough ER 33. Cell wall of fungi contains what? a. Polysaccharide chitin 34. How does ameba extend itself? a. Extends pseudopodium in direction it wants to go, then the rest of it follows 35. How does ameba eat food?  5 a. Phagocytosis 36. Does a Protozoa contain flagella and/or cilia? a. Flagella 37. What is the disease asymptomatic to females? How about males? What are these diseases categorized under? a. Trichomonas vaginalis is an STD asymptomatic in males b. N. Gonorrhaea is an STD asymptomatic in females 38. Color of gram + vs. gram – a. Pos: purple/blue; neg:red 39. Difference between gram + and – a. Pos: cell has a thicker peptidoglycan layer b. Neg: cell membrane and outer membrane are visible along sections of cell wall i. More resistant to antibiotics bc of the difficulty of penetration in thin cell wall 40. What do spores do? a. Enable bacteria to survive adverse conditions such as temp, disinfectants, lack of nutrients 41. When does germination occur? a. When spores come in contact with moisture 42. Examples of a spore: Bacillus and clostridium 43. What is the smallest microbe? What unit are they measured in? a. Viruses; nanometer nm (1/1,000,000mm) 44. Pili are what? a. Hairlike structures observed in gram – bacteria that allow bacteria to anchor to surfaces (tissues of host) i. Thinner than flagella and have a rigid structure, not mobile, ii. Piliated= disease causing 1. Unpiliated= unable to cause disease 45. What are the 2 types of acellular infectious materials? a. Viruses and prions 46. Virus can only be seen from what type of microscope? a. electron 47. Acellular microbe examples: a. Prion= mad cow disease b. Viroids 48. The order of microorganism classification Kingdom b. Class  6 c. Order d. Family e. Genus f. Species 49. How many membrane bound organelles does a prokaryotic cell contain? a. Zero! 50. What unit is used to measure bacteria? a. Micrometers µm(1/1000mm) i. Range from.2-10µm 51. HIV vs AIDS a. HIV: human immunodeficiency virus; i. Gains access through direct contact in blood stream; attacks T-cells 1. Intercourse, transfusions, needlestick, or break of skin b. Aids: acquired immunodeficiency syndrome i. What HIV ends up progressing into if left untreated 52. What beneficial activities does bacteria do? a. Fermentation and digestion 53. Why is gram staining important? a. It determines the type of bacteria and proper antibiotic prescription to effectively eradicate organism 54. What are the 3 shapes of bacteria? a. Cocci- spherical i. Streptococci pyogenes (strep throat) ii. Streptococcus mutants (tooth decay) iii. Streptococcus pneumoniae (bacterial pneumonia) iv. Staphylococci 1. Staphylococcus aureus: staph infection b. Bacillus- rod i. Blunt, rounded, pointed, or bifurcated ends ii. Clostridium retain (tetanus) iii. Clostridium botulinum (botulism) c. Spiral- spirochete i. Vibrio cholerae ii. Treponema pallidum is a species 55. Some Gram negative examples:  7 a. N. Gonorrhaea b. Chlamydias trachomatis (trachoma-eye disease) c. Heliobacter pylori (ulcers in stomach) d. Spirochetes 56. Some gram positive examples: a. Clostridium tetanus b. Bacillus thuringiensis (pesticide) c. Staphylococcus aureaus (boils) d. Streptococcus (strep, ear infections, meningitis) 57. Bacterial oxygen requirements: a. Aerobes: require O2 to live b. Anaerobes: live without O2 c. Facultative anaerobes: survive in either condition i. Exist, but do NOT thrive 58. Where in the body is best for bacterial growth? a. Digestive tract and oral cavity 59. How do pathogens cause disease? a. Capsules, pili, endotoxin b. Secrete exotoxin &or exoenzymes, destroying cells and tissue 60. 5 properties of a virus a. Either DNA or RNA b. Unable to replicate solo c. Do not reproduce via binary fission or mitosis/meiosis d. Lack genes and enzymes needed for energy production e. Depend on ribosomes, enzymes, and metabolites of host cell for protein/nucleic acid production 8  9 Prokaryotic cell - Eukaryotic cell acellular Acellular or cellular? or cellular? 1. What is the role of each of the following: pills, 1. Membrane bound organelles? capsule, spore 2. What is the role of the folllowing: flagella, 2. Membrane bound organelles? cilia 3. Reproduce how? 4. How does this cell 3. Reproduce how? move? 4. How does this cell move? 5. Microbe examples 5. Microbe examples 6. List 2 key differences from prokaryotes 6. List 2 key differences from a eukaryote 7. What microbe categories fall under eukaryotes? 7. What categories of microbes fall under prokaryotes?  10 61. Classifications of viruses: a. Type of genetic material (DNA/RNA) b. Shape & size of capsid c. # of capsomeres d. Is there an envelope? e. Host it’s infecting f. Type of disease it produces g. Targeting cells h. Immunologic or antigenic properties 62. Multiplication of animal virus and bacteriophage 1. Attachment (adsorption) phase – must come in contact and attach itself to the host cell; some viruses attach to only certain cells; ex. viruses that cause cold or flu attach to only the respiratory tract. 2. Penetration phase – penetrates host cell in a phagocytic-like fashion; a. Virus envelope interacts with host membrane; or b. Virus interacts with receptor sites on host cell surface  11 3. (ONLY ANIMAL VIRUS)—>Uncoating (Eclipse) phase – virus capsid is stripped off and only the genetic material (DNA or RNA) enters the cell; virus is still not detected at this stage. 4. Biosynthesis phase – virus takes over the metabolic activity of the host cell; directs it to synthesize enzymes required to manufacture new viral substances; viruses change the genetic code of the host cell; this can cause the host cell to become malignant or replicate itself. 5. Assembly phase – host cell produces nucleic acid and protein, and assembles them into new, infectious viruses. 6. Release phase – virus particle can leave the host in two ways: a. lysis – breakdown of host’s cell wall b. host cell remains intact while slowly excreting virus 63. Can viruses grown in a laboratory? a. No, they’re intracellular 64. Shape and structure of viruses a. Nucleocapsid i. RNA or DNA ii. Capsid (protein coat) iii. Capsomere (many small proteins) b. Envelope i. Lipids and polysaccharides c. Spikes 65. Overview of viral spread: a. Virus attaches to the cell with a nucleic acid b. Virus penetrates cell membrane and injects Nucleic acid c. Viral nucleic acid replicates using host cellular machinery d. New viral nucleic acids packaged into viral particles and released from cell. i. Host cell may be destroyed in this process 66. Virus shapes: a. Spiral b. Complex geometric c. Bacteriophage j. Viruses that infect bacteria ii. Are obligate intracellular pathogens  12 67. 68. Bacteria VS. virus  13 69. DNA virus examples: a. Papovavirus: warts b. Herpes virus: herpes, chicken pox(varicella), shingles(zoster), mononucleosis(Epstein-Barr) c. Adenovirus: respiratory infection d. Pox virus: small pox 70. RNA virus examples: a. Piconavirus: poliomyelitis, meningitis b. Togavirus: Rubivirus(rubella) c. Orthomyxovirus: influenza d. Rhabdovirus: rabies 71. T/F categories of viruses are determines by genome? a. True 72. What are some examples of latent virus infections? a. Herpes virus and shingles. 73. What are Antiviral agents? a. because antibiotics don’t work for viruses, antivirals have been developed to interfere with virus production 74:—— 75. What are oncogenic viruses? Give examples a. Viruses that cause cancer i. Epstein barr(mono)  14 1. Causes lymphomas ii. Herpes virus 8 1. Causes Kapoor sarcoma iii. HPV 1. Causes cervical and genital tract cancers 76. Infectious disease terminology a. Local – disease restricted to a confined area b. Focal – localized site of disease from which bacteria and their products are spread to other parts of the body. c. Systemic – disease in which microorganisms may infect any system of the body. Symptoms are primary symptoms. d. Secondary – infection by a microorganism that follows an initial (primary) infection by another kind of microorganism. e. Subclinical – disease that is so mild that it produces no symptoms f. Latent – disease or microorganism that appears dormant g. Bacteremia – presence of bacteria (not multiplying) in the blood h. Septicemia – systemic infection in which bacteria (multiplying) are present in the circulating blood stream, having spread from an infection in any part of the body. i. Pyemia – a form of septicemia caused by pus-forming microorganisms present in the blood j. Toxemia – bacterial toxins present in the bloodstream 77. What are the routes of entry? a. Skin, respiratory system, digestive tract, GI system, blood 78. More definitions: a. Enzyme: protein that speeds up a chemical reaction in a living organism b. Catalysis: speeding up of a rate of chemical reaction 79. Bacterial enzymes: a. Leukocidins – enzymes produced by some bacteria that can destroy neutrophils and macrophages, two types of white blood cells that perform phagocytosis. Both staphylococci and streptococci can secrete leukocidins. b. Hemolysins – cause the lysis of red blood cells; there are many different types of hemolysins; they are produced by staphylococci, streptococci, and Clostridium perfringens. c. Coagulases – bacterial enzymes that coagulate (clot) the fibrinogen in blood (fibrin – threads that form a blood clot; clots caused by coagulases may protect the bacterial cell from phagocytosis and other host defenses. Coagulases are produced by some members of the Staphylococcus genus.  15 d. Bacterial kinases – contribute to bacterial virulence by breaking down fibrin; the kinases dissolve blood clots formed by the body to isolate the infection. e. Hyaluronidase – secreted by certain bacteria such as streptococci and some species of Clostridium; it dissolves a type of polysaccharide that holds together cells of the connective tissue; this dissolving action produces the tissue blackening of infected wounds f. Collagenase – produced by several species of Clostridium, it facilitates the spread of gangrene. It breaks down the protein collagen, which forms the connective tissue of muscles and other body organs and tissues 80. ExoToxins a. Most potent poisons known to humans i. Produced by bacterial cell and released into host’s surrounding tissue during bacterial growth b. Mostly gram + organisms c. Botulism most powerful exotoxin – usually fatal i. Clostridium botulinum d. Escherichia coli – causes diarrhea i. Enterotoxins e. Some fungi produce Exotoxins f. Excreted by the bacteria into its surrounding medium. g. Usually unstable and sensitive to chemical, light, heat h. Diphtheria and tetanus 81. Endotoxins a. Contain in the organism’s cell and released when microbe dies b. Several gram – organisms c. Do not appear to have a role in human disease but can cease fever and vascular change when disease is already present d. Not liberated until the bacterium breaks do 82. Define: a. Anatomy: Study of the structure of the body b. Physiology: Study of the functioning of the body. c. Homeostasis: Ability of the body to maintain a constant internal environment. d. Pathophysiology: study of how disease & injuries cause abnormal changes in the body’s function 83. List & Describe 12 major organ systems\ a. Integumentary: skin b. Skeletal: bones for structure c. Muscular: the muscles enable the body to move about  16 d. Nervous: brain & spine e. Endocrine: hormones, pituitary gland, hypothalamus, pancreas f. Circulatory: blood, heart, blood vessels, arteries, capillaries g. Lymphatic: lymph, lymphatic vessels, and lymphatic tissues and organs, which are widely scattered throughout the body h. Immune: the defensive mechanisms that protect us from pathogens, foreign substances such as pollens, and cancer cells.; many parts that provide this protection i. Respiratory: lungs j. Digestive: mouth, pharynx, esophagus, stomach, small intestine, large intestine, rectum, and anus. i accessory organs: include the salivary glands, teeth, liver, gallbladder, and pancreas. k. Urinary: 2 kidneys, 1 ureter, bladder, urethra l. Reproductive: gonads, gametes, ovaries, testes… reproductive system 84. T/F and organ system is a group of organs that are independent in the body. They perform a particular function. a. False/True , an organ system is group of organs that help each other to perform a particular function b. T/F a molecule is the simplest level of organization in the body i. False, the atom is.  17 85. Periods/phases of infectious disease a. 1st, must enter i. Incubation: time between arrival and onset of symptoms ii. Prodromal period: pt feels like they’re “coming down with something 1. No actual symptoms yet iii. Period of illness: symptoms appear; acute or peak of symptoms 1. Communicable, mostly transmitted during this period iv. Convalescent period: recovery time for pt 1. Recovery can take a while (especially for resp infection 2. Permanent damage may occur - Brain damage after meningitis - Paralysis after poliomyelitis - Deafness after ear infection 86. Define:  18 a. Localized infection: one spot b. Systemic infection: pathogen carried to other parts of the body i. TB c. Acute disease: rapid onset and rapid recovery i. Measles, flu d. Chronic disease: slow onset and lasts long i. Syphilis, TB e. Subacute disease: can develop into long lasting disease i. Infective endocarditis f. Symptoms: evidence disease is perceived by pt g. Symptomatic disease: clinical disease where a pt has symptoms h. Asymptomatic disease: subclinical disease with no symptoms 84. Syphilis: a. Has 4 stages i. Primary stage: open lesions at 4-6 weeks after spirochete enters bloodstream ii. Secondary stage : rash, fever, mucous membrane lesions; disappears at weeks-12mo iii. Latent phase: weeks to years (sometimes lifetime) iv. Tertiary stage: spirochetes cause destruction to organs resulting in organ damage or death 85. What medication can help the herpes simplex I cold sores when triggered? a. Antiviral medication 86. Signs of disease: a. Objective evidence b. Abnormal vitals or scans c. Palpating and finding a lump 87. What are virulence factors? a. Characteristics that enable pathogen to cause disease i. Dictated by genotype b. To cause disease, must anchor to host cell after entering i. Not all can do this c. Receptors must match in order to penetrate and cause disease d. Faculative pathogens live within or outside of host cell 88. Direct communicable disease: a. Skin contact, mucous membrane contact 89. Indirect communicable disease: a. Airborne, respiratory, food, water, vectors(bugs), fomites, needles 90. Define in terms of disease:  19 a. Convalescent: can spread disease as long as microbe in the body b. Casual carrier: microbe in person only for a few days/weeks c. Chronic carrier: can remain infected their entire life d. Epidemic: people affected in a region/ community e. Endemic: regularly occurring within an area/ community f. Pandemic: widespread of disease occurring in a whole country or the world at a particular time g. Sporadic: occurs in-frequently, irregularly, & without a clear pattern in time h. Morbidity: rate of disease in a population i. Mortality: rate of death j. Chemotaxis: chemical released by injured cells signal/attract the WBC k. Edema: swelling l. Erythema: redness m. Pyrexia: fever n. 91. Defense lines a. 1: intact skin & mucous membranes i. Ex: taking too many antibiotics leading to thrush (candida albicans) b. 2: inflammation, fever phagocytosis (WBC) i. BOTH 1 and 2 lines of defense are “nonspecific” c. 3: immunity!!- antibodies and antigens (T-cells) i. “specific” because we’re dealing with antigens 92. Define a. Humoral immunity: always involves production of antibodies  20 b. Cell mediated immunity: involves many different cell types c. Antigens: stimulate production of antibodies; foreign substance d. Antigenic: substance capable of stimulating antibodies e. Antibodies: protein produced by WBC that respond to an antigen; protein produced by immune system 93. Where do immune responses to antigens initiated? a. In the spleen 94. Antibody groups (5 types) a. IgA: in colostrum and breast milk b. IgD: on B cells c. IgE: response to allergens, found on basophils & mast cells, found in tissues d. IgG: only one to cross placenta; i. “gee, thanks mom” e. IgM: longest (pentameter) and is the first antibody formed, providing protection in early stage of infection 95. Major roles of antibodies a. Neutralize toxins b. Prevent attachment of pathogen to host c. Prepare microbes for phagocytosis 96. When does Cell-medicated immunity occur? a. When antibodies are unable to enter cells i. T cells (remember HIV) 97. Allergic reactions: Antibodies formed to substances not usually recognized as foreign a. 2 types: i. Immediate and delayed 1. All types depend on T cell sensitized to antigen ii. Immediate: occurs within a few minutes-24hr 1. Type 1,2,3 - Involves IgE antibodies iii. Delayed: occurs after more than 24hrs-48hrs+ 1. Type 4 98. What is a severe allergic reaction called? a. Anaphylactic shock i. Convulsions can occur 99. Hypersensitivity types of allergic reactions: a. Type 1: anaphylaxis b. Type 2: cytotoxic; rh incompatibility c. Type 3:immune complex reaction; antibody with antigen  21 d. Type 4: delayed type; positive TB test i. Edema and inflammation occur ii. If severe, necrosis can occur iii. Antihistamine wont help 100. What is Graves’ disease? a. An autoimmune disease that causes hyperthyroidism 100. List the body’s level of organization from simplest to most complex: a. Atom, molecule, cells, tissues, organs, organ systems, human organism 101. What is the level of organization that is the unit of life? a. A cell 102. What is the anatomical position? a. Standing erect, facing forward, arms at sides, toes and palms directed forward, mirror image to viewers position 103. What are the terms of relative position? a. Superior/ inferior (above/below) b. Anterior/ posterior (front/back) c. Medial/ lateral (towards/ away from midline) d. Proximal/ distal (near/away from point of attachment) e. Superficial/ deep (near/ below surface) f. Center/ peripheral (center/ away from center) 104. How is the elbow both distal to the shoulder and proximal to the wrist? a. Elbow is close to the point of attachment that the wrist is. The wrist is proximal to the fingers and is closer to the trunk of the body that the fingers. The wrist is distal to elbow and fingers are distal to the wrist. 105. Imagine you are slicing a person in half using the plans of the body, describe how and what those cuts are. a. Sagittal plane: cutting someone down the midline, creating a left and right portion b. Frontal/coronal plane: cutting someone in the middle, but from the side of the body. Creating an anterior and posterior portion c. Transverse: cutting someone horizontally, creating a superior and inferior portion  22 106. Cavities of the body a. Ventral (2 divisions) i. Thoracic cavity: contains heart, part of esophagus, trachea, thymus, lungs 1 Divided by the mediastinum ii. Abdominopelvic cavity b. Dorsal cavity (posterior) i. Cranial and spinal cavities c. Abdominopelvic cavity: (upper and lower) 1 Upper: Abdominal cavity 2 Lower: pelvic cavity ii. Has 4 quadrants & 9 regions iii. Abdominal cavity: stomach, most of intestines, liver, gallbladder, pancreas, spleen, and kidneys iv. Pelvic cavity: rest of intestines, rectum, urinary bladder, internal parts of reproductive system  23 107. What are the 2 main sections of the skeletal system? a. Axial and appendicular 108. Explain the axial skeleton: a. It has 80 bones and is the skull, spinal cord, ribs, and sternum 109. Explain the appendicular skeleton a. It has 126 bones and are the appendages attached to the body, such as arms, legs, pelvic girth, shoulder girth 110. What is the skeletal system composed of? What are it’s functions? a. Bones, joints, cartilage, ligaments b. Supports body weight, protects soft organs, allows movement with muscle’s help, stores minerals (90% calcium and phosphorus), contains bone marrow that produces blood 111. How many types of body marrow are there? What are their significance? a. 2, yellow and red. i. Red: produced blood cells ii. Yellow: stores fat that can be used as energy 1 Can produce cartilage, fat, & bone 112. T/F the size and shape of a bone is related to it’s function a. True 113. T/F compact bone is found in long bones and contains osteocytes. a. True 114. List and explain the 2 types of ossification: a. Intramembranous: replacement of thin connective tissue membrane with bone i. In flat bones b. Endochondral: replacement of fetal cartilage skeleton with bone i. Long, irregular, and short bones 115. Where is intramembranous ossification found in a fetus. What is the rest of the other bones? a. Found in the flat bones of the skull; endochondral officiation 116. Where does growing in the bone take place? How does growth occur? a. At the epiphyseal disc i. Contains osteoblasts that invade cartilage in the disc ii. Mature into osteocytes and lay down bone b. Bones are affected by hormones (growth, estrogen, or testosterone) and thus causes growth. Osteoclasts and osteoblasts also play a role. Osteoclasts hollow out bone and osteoblasts deposit bone on the surface. This allows the bone is grow wider. 117. What do we call osteoclastic activity?  24 a. Resorption 118. What are the types of fractions? a. Simple, compound, green stick 119. Define terminology: a. Condye: large knob b. Epicondyle: enlargement near condyle c. Head: enlarges, rounded end d. Facet: small flattened surface e. Crest: ridge f. Spine: sharp projection g. Tuberosity: knob like projection h. Trochanter: large tuberosity (only on femur) i. Foramen: opening (for nerves, blood vessels, ligaments) j. Fossa: depression/ groove k. Meatus: tunnel or tubelike passage (ear) l. Sinus: hollow space; i. be able to identify 120. Skull:  25 a. How many facial bones? 14 b. How many cranial bones? 8 121. How many bones does the middle ear have? List them.. a. 3; malleus, incus, stapes 122. What are paranasal sinuses? How many do we have? List them.. a. Air filled cavities; we have 4: frontal, ethmoidal, sphenoidal, and maxillary Be able to identify bone structure: 123. What is the term for soft spots? Where are these located? What are their purpose? a. Fontanels which are located at the sutures of the skull. They allow cranial growth in infants. 124. What are the sections of the spine? a. Cervial, thoracic, lumbar, sacrum and coccyx 125. What spinal section is 1-7? Cervical 126. How many curves are there in the spine and what are they? a. 4: cervical, thoracic, lumbar, and sacral 127. What section is the largest and strongest? The 5 Lumbar vertebrae  26 128. T/F Axis is yes movement and atlas is no movement a. False, atlas is yes movement and no is axis 129. What are the 3 spinal disorders we talked about? Explain them. a. Scoliosis: lateral curve b. Kyphosis: hunchback c. Lordosis: swayback 130. How many ribs do we have? How many are true and how many are false? a. We have 12 ribs. Seven pairs are true and 5 pairs are false, which include the 2 pairs of floating ribs 131. Evaluate potential medical emergencies that could result from use of medication b. Contraindication from medication they already take & administered medication 132. Why do we go over health history? a. Identify emergencies that could arise b. Present disease & accomidations/ precautions to take (not PPE related) i. We used universal cautions ALWAYS c. Dosage questions d. Questions about time intervals PHARM 133. Define: a. Analgesic: pain relief b. Palliative: soothing, pain relief c. Prophylactic: prevention d. Curative: decreases advanced disease e. Antitussive: cough meds f. Nitroglycerin: vasodilator g. Decongestants: relieves blocked, stuffy nose by reducing swelling in blood vessels in nose 134. How are brand and generic medications recognized? a. Brand: caps & can be 2 names b. Generic: lowercase & 1 name 135. 135. What do we use reference books for?  27 a. We keep them in office to identify medications, their uses, how their used, contraindications, precautions, & doses i. Produced yearly 136. KNOW HOW TO WRITE PRESCRIPTION 137. What is the differences: a. FDA: determines drug marketing & sales. Regulates labeling that requires intensive testing to prove is safe & effective b. FTC: regulates trade practices of companies and prohibits false advertising c. DEA: under the dept of justice that regulates manufacture/distribution of substances w/ abuse potential i. DEA # required to write prescription for controlled drugs d. OBRA: requires pharmacy to dispense info and MAKES pharmacies counsel pt who has questions i. DUR is provided (“outside packaging that everyone just throws away”) 138. Controlled substance act of 1970: a. Administered by DEA and deals with drug abuse in the US i. Classifies drugs as I, II, III, IV, V 139. Controlled schedules: 1: high abuse potential; heroin, LSD, & marijuana 2: medically useful, but narcotic/ high abuse potential AND CANNOT BE REFILLED. Only WRITTEN prescription; condone 3: medically useful and has lower abuse chance than schedule 2. IS A CNS DEPRESSANT & relieves pain with no refills AFTER 6 months (limited to 5 refills); Tylenol #3, Vicodin i. Need new appointment to qualify for new rx of same med 4: medically useful with lower abuse potential than 3. DEPRESSES/ SLOWS body functions and has no refills after 6 months (and limited at 5) refills; diazepam, Librium i. Need new appointment to qualify for new rx of same med 5: medically useful, a few are OFC because they’re the least addictive. Must be 18 because it contains a limited quantity of narcotics; antitussive or anti diarrheal purposes 140. FDA pregnancy categories: a. A: possible fetal harm b. B: studies demonstrate NO fetal risk i. No evidence in later trimesters  28 c. C: adverse effects on fetus i. Only given if benefit outweighs the risks d. D: positive evidence of human fetal risks i. Does the benefit outweigh the risk? Depends on pt e. E: studies demonstrated fetal abnormalities f. X: absolutely contraindicated 1. Define a. Adverse drug effect: with each other, how they react with the body (meds)\ b. Due care: must have completed med hx & be knowledgeable about drug prescribed c. Curative: decreases advance of disease d. Antiemetic: decreases nausea/ vomiting e. Emetic: induces vomiting f. Local purpose: relief of hemorrhoids g. Elixir: clean, sweet flavored liquid used for medicinal purposes; taken orally h. Tincture: concentrated herbal extracts that are made using alcohol & chopped herbs i. Emulsion: a suspension of a salt of silver, platinum, etc. in gelatin or collodion; used to coat 2. Recognize these abbreviations: a. IV: intravenous b. IM: intramuscular c. SC, SQ: subcutaneous d. ID: intradermal e. IT: intrathecal 3. What are dietary supplements vs nutraceuticals? a. DS: OTC vitamins b. N: prescribed vitamin 4. Prophylactic means _______. Examples may be ________ a. Preventive; vax, anticoagulants, sedative, antianxiety drugs, anticonvulsant 5. Palliative means_______. An example is _______ a. Soothing, pain relief; antitussive (cough) 6. Analgesics control _____ like _______ a. Pain; headache 7. What helps angina? a. Nitroglycerin 8. What is a decongestant? a. Clears up sinuses & opens airway 9. Give an example of a curative medication a. Antibiotics, fungi/ yeast meds (BUT NEVER MEDS FOR VIRUS) 10. What are drug sources?  29 a. Plants, animals, minerals, synthetic 11. When is a pharmacopeia published? What is it’s purpose? a. Every 5 years; sets standards for strength & purity of drugs 12. Volume 1 vs volume 2 in pharmacopeia a. 1: for providers b. 2: for patients 13. How may copies are involved in ordering narcotics at a pharmacy? a. 3; to gets sent to pharmacy with pt, which one of them is sent to DEA for tracking. The last copy must be filed in the office narcotics record book 14. Narcotics require a written RX 15. LOOK OVER TOP 20 DRUGS WS 16. T/F: codeine & hydrocodone are the same thing a. False, they are chemically different via structure i. Metabolized differently 17. T/F: hydrocodone is more potent than codeine a. True; and more effective at reducing severe pain 18. ROUTES OF ADMINISTRATION 19. How does the route of administration affect the onset? a. It affects the onset of the action; all depends on how the body absorbs that medication 20. What do we do if asked to get drug out of storage? a. Read label carefully b. Check expiration date c. Ensure security of drug storage 21. How do we give a pt their medication? Do we have to stay with them when they take it? If so, why? a. We give a pt their meds in a cup. Yes, we stay with them to ensure they have taken the medication. 22. What do we always do when giving medication under dentist’s order? (hint: we do this after every visit…) a. Document!!!  30 23. T/F: medications given by IV are slower to have affect vs orally ingested medications a. False, IV is the most rapid response w/ immediate onset 24. What is a major disadvantage to enteral route of administration? a. The med is inactivated by stomach acids b. Can cause GI tract upset c. Cant use if pt is unconscious, nauseated, or has GI issues d. Some drugs aren’t properly absorbed 25. What are disadvantages with IV delivery? a. Allergy onset fast b. Side effects fast c. Drug irretrievable d. More $$$ and dangerous 26. Why is IM delivery effective? a. Due to high blood flow thru skeletal muscle tissue i. IM usually givin via deltoid/ gluteal 27. Where is SQ delivered: a. Just under the dermis with fast access to blood stream 28. Where is ID delivered? a. Into the epidermis of skin or mucosa 1. TB test & some LA 29. Where is IT delivered? a. Into the spine’s subarachnoid space 30. Where is the intraperitoneal route? a. In the abdomen i. Chemotherapy drugs can be given here 31. Understand the topical CAN be toxic 32. For inhalation, where does absorption take place? a. Via pulmonary endothelium into alveoli to gain access to circulation 33. What are forms of dosage? a. Tabs, caps, pills, lozenge/ troche, suppository, solution, elixir, syrup, tincture, spirit, suspension, emulsion, ointment, transdermal patch, aerosol, ID implant, micropump 34. Suppositories can have local or systemic effects 35. T/F: ointment is only used externally a. True!! 36. What is a micropump? a. Most commonly used is insulin. It goes subcutaneous and usually in the abdomen 37. Define tolerance: a. Builds up from repeated use; increasing doses necessary to get the same result 38. T/F: tolerance can cross over with drugs that have a similar chemical structure a. True  31 39. Toxic dose: severe damage to organs 40. Lethal dose: results in death 41. What is idiosyncrasy? a. Unusual drug reaction i. Is unexpected 42. Define: a. Additive effect: addition of a drug increases the action of another drug b. Secondary effect: indirect consequence of taking a drug c. Xerostomia: dry mouth d. Trigeminal neuralgia: sharp, stabbing pain, aching of mandibular teeth e. Habituation: psychological dependence; withdrawals not severe a. CAFFEINE f. Potency of drug: amount of drug required to produce a desired effect g. toxicity: excessive dose or regular dose w/ pt with impaired metabolism. h. Efficacy: maximum intensity of effect obtained when a sufficient dose is administered 43. T/F: placebo can have contraindications a. False 44. Cocaine is a (vasoconstrictor/ vasodilator) a. Vasoconstrictor 45. When the combo of CNS depressants and alcohol happen, what occurs? a. Can cause death 46. Stimulants are also known as? a. Uppers 47. Sedative hypnotics are known as? a. Downers; CNS depressant 48. Give some examples of opioids: a. Codeine b. Opium c. Morphine d. Heroin 49. Know: codeine can be given as an anti-diarrheal drug a. It acts on the intestinal wall to slow down muscle contractions 50. What does the combo of alcohol & marijuana cause? a. hallucinations 51. cannabinoids cause increased pulse & BP 52. what can liver problems cause in terms of medication? a. May impair drug metabolism 53. Alcohol & nicotine can cause an increase in oral cancer 54. Can be difficult to produce anesthesia or analgesia in pt addicted to narcotics , so it’s important for a pt to list their drug abuse of past OR present 55. If a pt complains about pain during a non painful proc, what could be existent? a. Drug abuse 56. What is the most common dosage formula used for children?  32 a. Clark’s rule 57. What is the preferred dosage for children? a. Surface area rule 58. What is indicated by Rx; tells pharmacist to take following drugs & dispense them to pt? a. subscription 59. The most potent drug takes the smallest dose to produce the effect 60. Understand the parts of a prescription: a. Subscription: # or amount of drug to be dispensed- “dis” i. Ex: “dis: 500ml” b. Inscription: body of prescription that contains drug, dosage, strength, & drug form i. Ex: Percocet 10 mg tabs c. Transcription/signature: specific instructions to pt on how to use the medication; may be preceded by word “label” i. Ex: “sig: one tab q6h” d. Refill info: NEVER leave blank e. Signature: dr signature & degree written in ink ONLY BY THE DR THEMSELVES f. DEA #: not pre printed on form g. Additional info: side effects & how long to take medication h. Carbon copy: attached to pt chart 61. Some issues with handling medications: a. Exposure to light b. Exposure to moisture c. Exposure to drastic temp changes d. Exposure to air 62. Dental caries are what microbe? a. Streptococcus mutans 63. Perio disease microbe: a. Actinobacillus actinomycetemcomitans 64. Define: a. Anti infective: substance that acts against infections b. Antimicrobial: substance that kills growth or suppresses multiplication of microbe c. Antibacterial: destroys or suppresses growth/ multiplication of bacteria d. Antibiotic: chemical substance produced by microbe that have capacity to destroy or suppress growth of organism e. Antiviral: substance destroys viruses f. Antifungal: substance destroys fungi g. Spectrum: i. Narrow: range of activity of a drug primarily effective against either gram + or - ii. Broad: acts against wide variety of organisms  33 h. Resistance: microbes unaffected by anti microbial i. Bactericidal: ability to kill bacteria j. Bacteriostatic: ability to inhibit bacteria growth k. Blood level: concentration of anti infective agent present in blood l. Superinfection: infection caused by proliferation of microbes different from those causing the OG infection; caused by flora disturbance m. Infection: invasion of body by pathogenic microbe & rx of tissues to their presence n. Culture: growth & ID of organism causing infection o. Sensitivity: testing those organisms to determine which anti infective agent helps 65. Factors in determining likelihood a microbe will cause infection: a. Virulence b. # of microbes present c. Resistance of host 66. What can oral anticoagulants cause when used with antibiotic? a. Increased bleeding 67. How do antibiotics affect oral contraceptives? a. Antagonist effect by reducing it’s effect 68. Anti- infective agents lower blood level of estrogen 69. T/F: antibiotics can cause GI upset a. True 70. What is used for pregnancy patients when in need of antibiotic? a. Penicillins & erythromycin 71. Sulfa drugs are _____ a. Bacteriostatic 72. If your allergic to penicillin, you’re allergic to amoxicillin 73. Penicillin works against gram + bacteria 74. Amoxicillin preferred because it requires less daily dosing 75. Penicillin: a. Low dose is bacteriostatic b. High dose is bactericidal c. Most common allergy: rash 76. What can cause bacteremia? a. Eating foods that cut the mouth, brushing/ flossing, chewing gum 77. When are antibiotic prophylaxis used in dentistry? a. When needing to prevent pt risk of infection; including during EXT, surgery, SRP, & prophy 78. Edentulous pt should not have ill-fitting dentures; cause ulcerations that can lead to bacteremia  34 79. Endocarditis requires what before a procedure? a. Penicillin tx/ pre-antibiotic 80. T/F: erythromycin is still used in offices today a. False; previous schedules much harder for pt compliance 81. What is used to treat TB and used with PCN to increases both medication effects a. Streptomycin 82. Tetracycline causes…. a. Potentially Permanent Discoloration of teeth (“endogenous staining”) & underdevelopment of enamel when baby is in womb; can only be removed via bleaching in less severity i. Pregnant women do not take this medication 83. What is tetracycline used for? a. Acne, pulmonary infections, travelers diarrhea, perio disease 84. Bacitracin is often used as part of dressing over soft tissue lacerations/ abrasions a. Administered topically in ointment or perio dressing form 85. DO NOT prescribe cephalosporins to a pt with immediate hypersensitivity to PCN a. Chemically related 86. Anti fungal agents: used to treat fungal infections a. Nystatin administered PO as suspension to be held in mouth for some time before swallowing 87. T/F: in dentistry, antiviral agents can be used for herpes outbreaks a. True  35 88. T/F: CNS depressants are used frequently in dentistry a. False 89. Amphetamines are classified as? a. CNS stimulants 90. T/F: anticonvulsant properties stem from some CNS depressants a. True 91. Chloral hydrate has a short duration of action 92. We do NOT write large amounts of CNS depressants for risks of addiction & suicide 93. Sedatives do not provide analgesia 94. What is known as psychosedation a. Nitrous oxide- oxygen sedation 95. T/F: DA can monitor but not administer nitrous oxide a. True 96. How long do we want a pt to be breathing oxygen after tx before leaving? a. 5 min 97. What are nitrous contraindications? a. Nasal obstruction b. COPD c. Acute respiratory infections d. Severe psychiatric disorders e. Drug addiction f. 1 trimester in pregnancy g. Person unable to communicate 98. What can too much nitrous cause? a. Nausea/ vomiting 99. Colors of containers: a. Nitrous oxide: blue b. Oxygen: green 100. Define: a. Scavenging system: ensures that operatory using proper nitrous ventilation i. scavenging masks supplied in a variety of sizes so mask always fits comfortably & secure of pt nose & face ii. induction time: time from injection to effective conduction blockage iii. duration: time from induction until reversal iv. paresthesia: persistent anesthesia caused by nerve sheath trauma, hemorrhage around or into nerve sheath, OR contaminated anesthesia 101. List the indications for nitrous oxide: a. Anxiety b. Gags easily c. History of asthma/ cardiac issues d. Mentally challenged e. Allergic to LA  36 f. Low pain threshold g. Cant tolerate long appts 102. T/F: it is never appropriate to supplement nitrous oxide for GA a. False, it is acceptable in some cases, especially in the OR 103. Advantages to nitrous use: a. Rapid onset b. Minimal effects c. Rapid recovery d. Easy administration i. DA can monitor IF CERTIFIED 104. “The hoses: one attaches to tanks to deliver gas and one is hooked to the HVE to remove the gas so the pat breathes inhales gas and exhales into the HVE or operators are not feeling the effects of the nitrous as well as the patient” 105. Corticosteroids: normally secreted by adrenal cortex a. Can cause more harm than good i. May cause adrenal cortex to stop producing steroids on its own, leading to atrophy of gland b. Contraindicated w pts: i. Diabetes ii. Hypertension iii. Peptic ulcers iv. TB v. Viral infections 106. What is rule of two? a. Pertaining to adrenocorticosteroids, during a stressful situation the adrenal gland is unable to respond if pt is take these agents; therefore, steroid supplement may be indicated 107. What is the most frequently used drug in dentistry? a. LA i. Amides: metabolized in liver 1. Xylocaine, lidocaine(names typically have 2 Is) ii. Esters: metabolized in bloodstream (higher risk of allergies) 1. Novocaine (no longer used), procaine, cocaine 108. What does LA do to Na & K? a. Inhibits their movement 109. T/F: all LA produce vasoactivity  37 a. True; counteracted by addition of vasoconstrictors 110. What is the only LA that produces consistent vasoconstriction? a. Cocaine 111. What do vasoconstrictors do in terms of blood? a. Acts as a hemostatic and reduces blood flow to site 112. The slower the injection the ____ painful; the higher the vascularity of the area the ____ the systemic effect a. less, higher 113. Adverse rx for pt: a. High weight: slower absorption b. Liver disease: slower metabolism leading to amide accumulation c. Kidney disease: lower excretion leading to amide & ester accumulation 114. LA can cause ____ if given too much a. Excitement, tremors, and eventually convulsions 115. Most common side effect is: a. Fainting 116. Allergies: a. Esters > amides 117. How long does paresthesia typically last? a. It resolves within 8 weeks 118. Types of injections: a. Periodontal ligament injection: solution injected under pressure into perio ligament usually with a special syringe b. Intraosseous injection: injection directly into bone 119. Topical has a ____ concentration than injectables a. Higher 120. What is topical’s optimal effectiveness? a. 2-5 minutes i. Has a shorter duration 121. What is ethyl chloride topical? a. Temporarily freezes area where it is applied 122. T/F: benzocaine can be injected a. False, it is poorly soluble 123. What is oraquix a. Lidocaine & prilocaine periodontal gel that is designed for SRP i. Deposited directly into perio pocket via blunt instrument & the liquid turns into gel at body temp 1. Onset is 30 seconds with a 20 min duration 124. Identify: a. NSAID: ibuprofen b. ASA: aspirin c. Analgesic & antipyretic: Tylenol 125. What is a substitute for aspirin if contraindicated? a. Tylenol  38 126. T/F: Tylenol offers a significant anti inflammatory effect a. False, only antipyretic 127. What is hepatotoxicity? a. Liver damage due to Overdose of Tylenol i. Leads to death 128. Overdose signs: a. Respiratory depression & pinpoint pupils (miosis) 129. Gel form hemostat: promotes clot formation 130. Absorbable hemostats can be moistened w thrombin solution to control capillary bleeding 131. Direct pressure is the best hemostatic 132. Gingival hyperplasia seen in _____ of pts taking Dilantin, in areas of natural teeth a. 30-50% 133. T/F: there is a lower range of drug interactions w/ anticonvulsants than w/ any other drug group a. False, it’s actually the widest range 134. Monitor gingival hyperplasia for epileptic pts 135. What medication contains antagonist to control abuse withdrawal symptoms a. Talwin i. This drug is ALSO addictive