Sem1 Cholera and Microbes PDF

EBL semester 1 Zainab Marafie  Case 1: Cholera Vocab Centrifuges Cholera Epidemic/pandemic/endemic Mannitol Autoclave Pipettes Rehydration salts ILOs 1. What is Cholera? 2. What are Cholera’s effects on the body? -symptoms -side effects 3. How does it effect normal li...

EBL semester 1 Zainab Marafie  Case 1: Cholera Vocab Centrifuges Cholera Epidemic/pandemic/endemic Mannitol Autoclave Pipettes Rehydration salts ILOs 1. What is Cholera? 2. What are Cholera’s effects on the body? -symptoms -side effects 3. How does it effect normal life? 4. How does the sodium-glucose electrolyte balance work in a normal body? -how does the body deal with dehydration? -how does cholera cause dehydration? 5. Treatment for Cholera -Composition of rehydration salt -antibiotics -vaccine 6. Which demographics are effected by Cholera? -epidemiology of Cholera -mortality rates -how does it spread?  Case 1: Cholera Vocab Centrifuges: a device that uses gravitational force and spinning force to separate components of fluid (blood) Cholera: a bacterial infection that can cause severe diarrhea Epidemic: a widespread occurrence of an infectious disease in a community at a time Pandemic: epidemic of an infectious disease that has spread across a large region Endemic: disease found among particular people or a country Mannitol: type of sugar alcohol used as a sweetener and medication Autoclave: machine that uses steam under pressure to kill harmful bacteria, viruses, fungi on items that are placed inside a pressure vessel Pipettes: laboratory tool used to transport a measured volume of liquid Rehydration salts: a mixture of salts and sugars used to combat loss from dehydration 1. What is -An infection by Vibrio cholerae (gram Cholera? negative) bacteria that can cause diarrhoea. People get sick when they eat/ drink something with contaminated cholera bacteria. The bacteria releases an exotoxin called choleragen. -A bacteria is a gel-like matrix made of water, enzymes, nutrients, wastes, and gases. It contains cell structures. -facultative anaerobe: can live in aerobic or anaerobic conditions (respiratory and fermentative metabolism). 2. What are -Diarrhea, vomiting, leg cramps, loss of fluids (which leads to dehydration and shock) Cholera’s effects are all symptoms of Cholera. Death is a possibility if left untreated. on the body? Some long term effects: -symptoms - kidney failure because of dehydration -side effects - rapid heart rate. - loss of skin elasticity. - dry mucous membranes. - low blood pressure. So Cholera doesn’t cause these symptoms directly, it happens as a result of dehydration. 3. How does it -It leaves people sick and dehydrated which can lead to death. effect normal life? Cholera is an infectious bacteria that is caused from drinking or eating something that’s contaminated. If untreated, death can occur. Symptoms include diarrhea, vomiting, dehydration, cramps. Kidney failure and LBP are a long term effects caused by the dehydration. - 4. How does the -Fluids and cells in the body contain electrolytes (minerals) which regulate chemical sodium-glucose reactions and maintain the fluid balance of body. electrolyte balance Electrolytes: work in a normal Balance the amount of water in your body body? Balance your body's acid/base (pH) level Move nutrients into your cells Move wastes out of your cells Make sure that your nerves, muscles, the heart, and the brain work the way they should 3 hormones involved in regulating sodium and water balance by kidneys: -Hypothalamus in brain will tell pituitary gland to release ADH which is a hormone that causes the kidneys to absorb more water, decreasing the amount of urine produced. Aldosterone released from adrenal glands to promote Na reabsorption in kidneys. On the other hand, ANH from atrium acts on kidneys to promote sodium excretion to urine by providing actional potential needed for signaling of Na channels to open. -The kidneys maintain a balance of electrolytes by shifting sodium levels as the body requires. When the level of electrolytes in your body is too low or too high, an electrolyte imbalance occurs. -how does the body -By increasing the ADH and the aldosterone deal with dehydration? The body will attempt to deal with dehydration by first stimulating the thirst centres of the brain, which will prompt someone who is dehydrated to drink more fluid. However, if water intake cannot keep up with water loss, dehydration will become severe and the body will respond by doing things that decrease the loss of water, such as decreasing sweat and producing less urine. (The kidney will conserve water, Na and will secrete K) -how does cholera -The Vibrio Cholera colonizes the small intestine and produces exotoxins which cause dehydration? causes changes in electrolyte channels which then causes fluid and electrolyte loss (diarrhea). -toxin enters epithelial cells-> activates the G-protein -> this activates adenylate cyclase->breaks down ATP to cAMP->CAMP then binds to PKA-> increased secretion of Cl into lumen-> prevents channels that let Na and Cl back into cell-> lower water potential in lumen-> water moves from epithelial cells to lumen by osmosis->diarrhea. 3 hormones that regulate sodium and water reabsorption and excretion: ADH, aldosterone, and ANH. Cholera causes an electrolyte imbalance because of the rapid loss of fluids. The bacteria Vibrio Cholerae colonizes the small intestine which produces a toxin that enters cells and activates G-protein receptor. Then, adenylate cyclase is activated which turns ATP into cAMP which binds to PKA and increase the production of Cl into lumen and prevents the channels that let Na and Cl back into cell. This disrupts the osmotic balance in intestines. 5. Treatment for rehydration solution: orally or intravenously Cholera -Composition of 1. Anhydrous glucose (highest proportion) rehydration salt 2. trisodium citrate 3. potassium chloride 4. Sodium chloride Dissolved in 1 liter of clean drinking water. -antibiotics Antibiotics are used to lessen the illness, but rehydration is more important. -mostly given to children -Recovery time: within a week -Side effects: antibiotics can cause nausea and vomiting -vaccine A single dose vaccine to prevent Cholera exists for those who are traveling to an area of active transmission. Other prevention: sanitize hands, drink sterilized/boiled/sanitary food/water. 6. Which -Children and women are more susceptible to cholera than adults, especially those demographics children under the age of five years (they can take a Zinc medication to reduce are effected by diarrhea). Cholera? -Major outbreaks of cholera usually occur during the warmest part of the year. -epidemiology of -Symptoms of Cholera may appear from a couple of hrs to 5 days after eating/ Cholera drinking contaminated food/water. The symptoms of mild cases of cholera resolve on their own within 3-6 days. The bacteria usually disappear from the gastrointestinal system within 2 weeks. -mortality rates -A normal person can last 3 days without water, however, a person with Cholera may last less if untreated. -how does it spread? -Cholera spreads through fecal-oral route. The main treatment for Cholera is ORS or IVT which is a solution of sodium chloride, trisodium citrate, potassium chloride, and glucose mixed with water which is used for rehydration. Other treatments include antibiotics. Prevention: vaccine for traveling, maintaining sanitation. Spreads through fecal oral route. Children are more exposed to Cholera. Symptoms of Cholera should go away within a week and bacteria from the gastrointestinal system should go away in 2 weeks.  Case 2: microbes Vocab Flagellated cells Ciliated cells Microbes Motile Ecology ILOs 1. What are microbes? -cellular structure -difference between flagellated and ciliated 2. Staining of a microorganism -process 3. Presence of microbes in contaminated vs clean water 4. How do microbes contaminate water? -breeding ground 4. Filtration of water -Minerals in water -different methods of filtering water 5. Fluoridation process  Case 2: microbes Vocab Flagellated cells: are cells with one or more long, whip-like flagella in the appendage region. Ciliated cells: cells found in most types of eukaryotic cells and are covered in tiny hairs called cilia; they are used for cell movement and help move substances around. These cells use a sweeping motion to remove toxins from lungs. Microbes: small organisms found abundantly, they include bacteria, archaea, and eukaryotes. Motile: cells and organisms that can move. Ecology: study of the environment that helps us understand how organisms live with each other. 1. Microbes -cellular structure -difference Cilia: short haired, microscopic hair-like structure found in large numbers in between flagellated eukaryotic cells, organisms w cilia move faster (help cell move and moves and ciliated substances out of cell). They can be found in respiratory tract. Flagella: long hair like filamentous cytoplasmic structure present in small numbers in a specific part of cell (help cell move). Bacterium can have one flagella at the end of the cell, one or more flagella at both ends of the cell, or flagella distributed all around the cell. -Main types of microorganisms: viruses, bacteria, protozoa, and fungi. -Ciliated cells are short haired structures found abundantly in eukaryotic cells, they help w cell and substance movement. -Flagellated cells are long hair structures that exist in small numbers in a specific part of the cell and help w cell movement; they are most common in bacteria. 2. Staining of a -Gram staining is a technique used to differentiate two large groups of bacteria based microorganism on their different cell wall constituents. The Gram stain procedure distinguishes between Gram positive/Gram negative groups by coloring these cells red or violet. A bacteria with thicker peptidoglycan wall = gram positive because it retains the first stain and does not absorb the second one -> violet, these bacteria cause throat infections ex: streptococcus, mycobacterium tuberculosis. A bacteria w thinner peptidoglycan wall = gram negative bc it absorbs first stain, but is decolorized, and absorbs second stain. -Gram negative bacteria are -> red (these bacteria can cause diseases such as E. coli, Cholera); more resistant to antibiotics. -After applying crystal violet, followed by iodine, all bacteria are stained alike (violet). When a decolourizer like acetone is applied, the differentiation in gram + and - occurs. This removes the stain from gram - bacteria, but not from gram +. A red counter stain is then applied so that the decolonized gram - bacteria becomes red. -process Gram staining steps: 1. Applying primary stain = crystal violet stain 2. Add iodine (setting agent) 3. Decolorization with an alcohol ex: ethanol/acetone 4. Counterstaining with safranin (pink dye) 3. Presence of microbes in Clean water: contains non harmful organisms. contaminated vs Contaminated water: contains bacteria, algae, protozoans, archaea, and viruses. clean water 4. How do -contaminate as a result of human waste, domesticated animals, or wildlife. microbes -main origins of contamination of natural aquatic resources: discharges of water contaminate treatment plants, decontamination stations, hospitals, industries water? (conditions that help bacteria growth). -breeding ground -warmer, moister, protein rich environments w pH as neutral or little acidic (6.5-7.5). -growth increases as temp increases (breeding ground: 40-140 degrees F). -Gram staining is used to differentiate bet gram + and - bacteria. Thicker walls -> gram + -> violet Thinner walls -> gram - -> red -Gram staining: crystal violet stain, setting agent iodine, decolorization w alcohol, safranin counter stain. -Breeding ground of bacteria: warm moist environments with neutral/little acidic pH. 4. Filtration of -Minerals in water: calcium, magnesium, potassium, sodium. water You don’t want in water: iron, lead, copper. -Minerals in water -different methods 1. Boiling: high temp makes bacteria + viruses disappear, however dead organisms of filtering water settle at bottom of water (get rid of biological organisms, not chemicals). 2. Purifier: uses UV filtration which makes water pure. 3. Reverse Osmosis: forces water through a semipermeable membrane and removes contaminants to make water pure. 4. Chlorination: adding 5% Cl to water, quickly kills most microorganisms. 5. Distillation: collecting condensed water after evaporation, removes metals and microorganisms, not very effective. 6. Iodine Addition: adding iodine to kill organisms and remove chemicals, however adds unpleasant taste and can be fatal. 7. Water filter: kills bacteria, carbon gets rid of the chemicals and awful tastes while iodine coated screens can further remove viruses; expensive. 8. UV Radiation: exposing water to UV light that kills organisms, but without RO filter, it can’t remove impurities and metals. 5. Fluoridation -process of adding fluoride to drinking water to a level recommended for preventing process tooth decay. -Bad bacteria in mouth forms acid and plaque; these bacteria feed on sugars we consume and leave behind plaque: any bacteria attracted to sugar turns it into acid, which can lead to decay on the surface of your teeth and lead to plaque. -Fluoride prevents tooth decay by making the enamel (teeth cover) more resistant to the action of acids. It accelerates the buildup of healthy minerals in the enamel, further slowing the occurrence of decay - attracts calcium and phosphate ions to enamel to produce calcium phosphate which strengthens teeth. -Minerals present in water: potassium, magnesium, sodium, and calcium. -Common methods of filtration include: boiling, UV radiation, reverse osmosis, chlorination, adding iodine, UV filtration, and distillation. -Fluoride is added to water to prevent tooth decay as bad bacteria tends to feed on the sugars we consume on our teeth and turn it into acid, which can lead to plaque. Fluoride works by making the enamel more resistant to the acids.  Case 3: antibiotics Vocab 1. Penicillin 2. Tazocin 3. Anti-pseudomonal 4. piperacillin 5. Tazobactam 6. Broad spectrum 7. Antibiotic drugs ILOs 1. How are antibiotics classified? -What are the actions of the dif antibiotics (how do they attack?) -Types and Uses -mechanisms of action 2. History of antibiotics 3. What are the + and - side effects on the body? -how it treats bacteria? -anti-biotic resistance -methods of entering body 4. Preparation of antibiotics -doses/concentration -calculation of dosages 5. Treating infections -are there any alternative treatments? 6. Process of inflammation -symptoms of inflammation -body response 7. Process of wound healing -How does a wound lead to bacterial infection? -How do antibiotics lead to wound healing? 8. Process of fever -symptoms/treatment -how does a fever effect the body? -Body response and defense mechanism  Case 3: antibiotics Vocab 1. Antibiotics: used to treat or prevent some types of bacterial infection. They work by killing bacteria or preventing them from spreading. 2. Broad spectrum: antibiotic that works on two major bacterial groups: gram +/-, or any antibiotic that acts against many bacteria 3. Penicillin: B-lactam antibiotic used for treating bacterial infections; skin, chest, and urinary tract; it’s produced by mold, works by weakening the cell walls of bacteria. It allows holes to appear in the cell walls, which kills off the bacteria causing the infection. 4. Tazocin: combination of piperacillin and tazobactam that (piperacillin belongs to the penicillin group), its a broad spectrum antibiotic (works against many types of bacteria) given by drip to treat bacterial infections in dif parts of body. 5. Piperacillin: belongs to the penicillin group and is used as combination w tazobactam. It has a broad spectrum of antibacterial activity against most gram + and - aerobic bacteria and anaerobic bacteria including pseudomonas aeruginosa. 6. Anti-pseudomonal antibiotics: antimicrobal agents, which are used to treat pseudomonal infections, they have the activity of penicillins that treats gram - bacteria 7. Tazobactam: beta-lactamase inhibitor antibiotic that works by preventing bacteria from destroying piperacillin. 1. How are Bactericidal antibiotics: kill bacteria antibiotics >by inhibiting cell wall synthesis ex: beta-lactam antibiotics such as penicillin classified? >by inhibiting bacteria enzymes or protein translation -What are the actions Bacteriostatic antibiotics: limit their growth and must work tog w immune system of the dif antibiotics to remove microorganisms (how do they attack?) >by interfering w bacterial protein production -Types and Uses >by interfering w DNA replication >by interfering w bacterial cellular metabolism Narrow spectrum antibiotics: target specific types of bacteria, such as gram + or -, less resistance can be developed Broad spectrum antibiotics: target wide range of bacteria, both gram +/- We have two main types of antibiotics in regards to the way the attack the bacteria: bactericidal and bacteriostatic. In regards to the specific types of bacteria antibiotics target we have: narrow and broad spectrum  Antibiotics that: bactericidal bacteria:streptomyces from grant aminocyclitol ring -mechanisms of aminoglycosides: sidoBoS ripoonone for gram-base end Itetracyclines: bacteristatic w/4 hydrocarbon rings we functional groups action Inhibit protein synthesis bind to go ribosome subunitcaminoacytown a mar originally isolated from streptomyces bacteria ↑ doxycyclinesbind macrolides: to bacteriostatic 50s ribosome subunit eXi · erythromycin lactone clarithromycin ring which · contain deoxy sugars , glycopeptides bactericidal Inhibit cell wall synthesis - B-lactam ex: penicillin:Blactam ring inhibitor given w/B-lactamase as Bacterial produce B-lactamase which ↑ resistance Inhibit folate (needed for DNA production) synthesis - sulfonamides bacteriostatic contains sulfonamide functional group synthetic Bactericidal Inhibit DNA replication · Fluoroquinolones: Broad spectrum notused now as much be of serious side effects 2. History of -first antibiotic discovered by Alexander Fleming in 1928 from substance in fungi antibiotics that killed microorganisms known as penicillin 3. What are the + + side effects: and - side effects on slows growth of bacteria, kill bacteria, prevent infection from occurring, fast- the body? acting and easy to take (most of them are oral) -how it treats bacteria? - side effects: vomiting, diarrhea, bloating, abdominal pain, thrush (yeast infection) Long term effects: body can build resistance 4 main mechanisms of action for antibiotics: inhibit protein synthesis (aminoglycosides, tetracyclines, doxycyclines, and macrolides), inhibit cell wall synthesis (b-lactam, glycopeptides), inhibit folate synthesis (sulfonamide), inhibit DNA replication (fluoroquinolones) Antibiotics are benefits bc they kill bacteria/slow their growth, however, they still possess - side effects which mostly are in the digestive system -anti-biotic -microbe develops a resistance toward an antibiotic caused by random mutation in the resistance DNA, the drug becomes ineffective, so other antibiotics should be administered. However, this might promote mutations which could lead to multiple drug resistance -they pass on their mutated DNA through vertical (to next generation) and horizontal (to bacteria next to them) transmission -methods of -Microbes occupy all of our body surfaces, including the skin, gut, and mucous entering body membranes. -Microorganisms capable of causing disease (pathogens) enter our bodies through the mouth, eyes, nose, or through wounds or bites that breach the skin barrier. Organisms can spread by several routes: Contact: direct contact w infected skin ex: cold sores, AIDS, indirect contact when an infected person touches a surface leaving microbes that are transferred to another person, droplets ex: influenza Contaminated food/water: ex E. Coli and Salmonella Vectors: fleas, mites, rats, dogs, snails ex: mosquito transmits malaria Airborne: residue of droplets containing pathogens in air 4. Preparation 3 methods of making antibiotics: of antibiotics Naturally: made by other organisms such as fungi, they are grown in colonies where active substance is then extracted Synthetic: made in lab Semisynthetic: method that takes naturally made antibiotic and adds amino acids in lab to enhance the antibiotic -doses/ 1 vial contains 2.25g of Tazocin: 2g Piperacillin and.25g Tazobactam concentration -calculation of In total you need 3.375g of Tazocin as a daily dosage dosages You need 1.5 vials of powder since the daily dosage is 3.375g So 2.25 + 2.25/2 = 3.375 For 1 vial, 10ml is needed to reconstitute the tazocin, so in order to prepare 3.375g of tazocin 15ml of sterile water is needed, however, you still need to reconstitute the 2 vials with 20ml and you just inject 15ml Antibiotic resistance is developed due to a random mutation in microbe DNA. This means a new antibiotic must be used, however, this might promote more mutations (multiple drug resistance) and the antibiotics won’t work. Microbes enter the body through contact, vectors, air, food/water. Antibiotics can be prepared naturally, synthetically, and semi-synthetically.  5. Treating bacteriophage therapy (it kills any bacteria it comes to and it might take a while infections to find the bacteria to kill), transition metals. Unfortunately, none have -are there any consistently demonstrated efficacy comparable to antibiotic treatment. alternative treatments? 6. Process of Inflammation is a process by which your body's white blood cells and the things inflammation they make protect you from infection from outside invaders. It’s basically your -symptoms of body’s immune system’s response. inflammation -Symptoms of inflammation include: heat, pain, redness, swelling, loss of function -body response -when inflammation happens, pro-inflammatory cytokines from white blood cells (mast cells-types of white blood cells that act like a line of defense for the body that is an auto immune response that release histamine and bradykinin. These cells cause inflammation and swelling of the tissues) enter blood to protect body from invaders which raises the blood flow to the area of infection and causes redness/warmth. Some of chemicals cause fluid to leak into tissues, resulting in swelling which may trigger nerves and cause pain. 7. Process of Wound healing is classically divided into 4 stages: (A) hemostasis, (B) inflammation, (C) wound healing proliferation, and (D) remodeling. (A) Hemostasis: process of stopping bleeding by clotting. During hemostasis, blood cells · start to clot, protecting the wound, preventing blood loss. Prostaglandins released from cut tissue signal platelets to form blood clot. Platelets release cytokines, vasoconstriction (B) inflammation: damaged tissue causes release of histamine which triggers vasodilation and increases permeability of blood vessels->increases WBC delivery (C) proliferation: fibroblasts infiltrate wound and secret collagen & extracellular matrix to less organized not build new tissue, scar is contracted (D) remodeling: As time passes, the new tissue strengthens (itching, stretching), but will -> maturation collagen to - never return to its original strength. Collagen is converted from type 3 to type 1. Water more organized reabsorbed-> collagen lies closer to each other->cross linking ->stronger wound -> collagen fibers -> collagen bundles Collagen -How does a wound -Bacteria occupy the open wound and start growing and increasing in number. They lead to bacterial form biofilms in the wound. They also secrete chemicals to inhibit any protective systems infection? of our skin. As the immune cells cannot clear the bacteria, the infection continues and -How do antibiotics new skin cell formation is paused. lead to wound -antibiotics kill/slow growth of microorganisms causing infection and prevent it from healing? worsening as wounds have microorganisms present and they may heal better if the microorganisms where slowed/decreased by antibiotics Inflammation is the body’s response to an infected wound and when the infection spreads the person develops a fever as a response to the infection 4 stages of wound healing hemostasis, inflammation, proliferation, and remodeling Bacteria occupy wounds, form biofilms, stop protective mechanisms -> no wound healing and infection occurs Antibiotics slow down growth/kill bacteria so that the body can heal itself  · 8. Process of fever -Symptoms: sweating, chills, headache, muscle aches, dehydration, loss of appetite -symptoms/treatment -Treatment: drink fluids, take medicine (ibuprofen and aspirin) that reduces fever -how does a fever effect -Your normal body temperature is approximately 37C. A fever is usually when your the body? body temperature is 37.8C or higher. A fever helps body fight infections by stimulating immune system, and when body temp is increases, it becomes harder for bacteria/virus -Body response and that cause infections to survive. defense mechanism -how fast a fever rises is the most dangerous, not how hot you are -Fevers are caused by chemicals called pyrogens (specifically interleukin-1) in the I bloodstream. Interleukin-1 goes to hypothalamus in the brain, which is in charge of regulating body temp. When pyrogens bind to certain receptors in the hypothalamus, the body temperature increases. -when u have an infection, macrophages secret interleukin-1 which will act on the anterior hypothalamus to secrete PGE and then that will regulate the thermostat (it will cause vessel constriction which will cause you to shiver to generate body heat) within the hypothalamus -Ibuprofen and aspirin will act on PGE to degrade it and get rid of it - Fevers (when body temp is over 37.8C) are a response to infections, and they are caused by chemicals specifically a pyrogen called interleukin 1. When interleukin 1 is secreted in blood by macrophages they migrate to anterior hypothalamus ->PGE secreted-> thermostat regulated Fever medications work by reducing PGE  Case 4: Blood Vocab 1. Haemocytometer 2. Drug dilution CCAs 3. Stethoscope 4. Dysentery 5. Differential count 6. Blood smear 7. Intravenous ILOs 1. Components of blood 2. Function of blood -blood clotting process -How it relates to dysentery 3. Blood Analysis -how do we prepare a blood smear? 4. Blood counts -range of values for white/red blood cells -differential counts: affected by infections 5. Infection -spreading -prevention 6. Health and Safety of handling blood -precautions  Case 4: Blood Vocab: 1. Hemocytometer: a specialized slide used for manual cell counting using a microscope 2. Drug dilution CCAs (OSCEs- clinical assessment): clinical assessment for diluting drugs 3. Stethoscope: medical device used for auscultation (listening to internal sounds of body) 4. Dysentery: bacterial/parasitic infection of intestines that causes diarrhea w blood/mucus 5. Differential count: test that measures % of each leukocyte (white blood cell) in your blood 6. Blood smear: blood test that gives info about the number/shape of red + white blood cells and platelets; usually done with CBC 7. Intravenous: giving medicines through a needle inserted into a vein 1. Components -contains red cells, white cells, and platelets (~45%) suspended in blood plasma (~55%) resea of blood Plasma: liquid component of blood, a mixture of water, sugar, fat, protein, and salts. The main job of the plasma is to transport blood cells throughout your body along with nutrients, waste products, antibodies, clotting proteins such as fibrinogen, chemical messengers such as hormones. Serum=plasma w out clotting factors Red blood cells: its a binocave disk with a flattened center and its the most abundant cell in the blood. It’s production is controlled by a hormone called erythropoietin, and they start as immature cells in bone marrow and after about 7 days they are released in blood. They contain a protein called hemoglobin that carries oxygen from lungs to body and returns carbon dioxide from body to lungs for exhalation. Antigens on RBS determine blood type. White blood cells: the make up about 1% of your blood, their main job is protection. Types and abundance: Never (neutrophils) Let (lymphocytes) Monkeys (monocytes) Eat (eosinophils) Bananas (basophils) 1. Neutrophil: is the first line of immune response, invades pathogens; phagocytes. It has a multilobed nucleus, releases cytokines ->inflammatory reactions · · 2. Lymphocyte: T lymphocytes (antigen specific) help regulate the function of other immune cells and directly attack infected cells and B lymphocytes (antibody specific)turn into plasma cells that produce antibodies. Lymphocytes have a spherical nucleus. 3. Monocytes: change into macrophages at site of infection, they’re phagocytes and resolve inflammation. It has a horseshoe nucleus. 4. Eosinophils: allergic response, parasitic infections, and pro-inflammatory mediators. They have a bilobed nucleus. 5. Basophils: defend body from allergens, and parasites, releases enzymes (histamine) to improve blood flow/inflammation and prevent blood clots, bean nucleus. & thrombocytes Platelets: small fragments of cells, help the blood clotting process (coagulation) by gathering at the site of an injury, sticking to the lining of the injured blood vessel, and forming a platform on which blood coagulation can occur. This results in the formation of a fibrin clot, which covers the wound and prevents blood from leaking.. They are also involved in haemostasis. Produced from megakaryocytes in bone marrow Blood is made up of ~55% plasma and ~45% RBC, WBC, and platelets. Plasma is the liquid part that transports blood cells with nutrients, waste, antibodies, clotting proteins, and hormones. RBCs start as immature cells in the bone marrow and get released when their matured. They contain hemoglobin. There are 5 dif types of WBCs that have dif functions and shapes. Platelets are fragments of cells that help in coagulation and are involved in haemostasis.  2. Function of blood key functions: blood -transports: oxygen: when breathing in, the air sacs in lungs fill w oxygen, and oxygen is moved into blood -blood clotting by passing through the thin walls of the air sacs and into capillaries which are small blood process vessels in lungs, the red blood cells then squeeze through capillaries, haemoglobin molecules in red blood cells carry oxygen and they travel in blood vessels from lungs to left side of heart where blood is pumped around the body hormones: hormones are secreted from glands into the blood and then carried to their target organs where they do their job. They carry instructions to cells all over the body. Once the hormones reach a target cell, they bind to receptors on the inside or the outside of the cell. By travelling in the blood, hormones can affect tissues and organs far away from where they were produced. nutrients: digested nutrients are absorbed into the blood through capillaries in the small intestine. They are then moved to the cells by blood around the body where they are needed. to the lungs and tissues throughout the body Waste: takes waste products such as carbon dioxide to kidneys + liver which filter blood Protection: carries white blood cells and antibodies which fight infection and form blood clots to prevent blood loss when their is a damage to a blood vessel. Regulating body temp and pH: maintaining homeostasis Process of blood clotting- haemostatis: 1) constriction of blood vessel: vasospasm ensues (narrowing of arteries to reduce blood flow) which leads to vasoconstriction in which the extracellular matrix/collagen becomes exposed to blood components (When blood vessel is injured, the walls of the vessel contract to limit the flow of blood to the damaged area preventing excessive loss of blood) 2) formation of a temporary platelet plug in 3 steps: Platelet adherence: The extracellular matrix releases cytokines and inflammatory markers that lead to adhesion of the platelets and their aggregation at that site which leads to the formation of a platelet plug and sealing of the defect. (Platelets cells stick to the injury site and spread along the surface of the blood vessel to stop the bleeding) Platelet activation: platelets that have adhered undergo specific changes. They release their cat cytoplasmic granules that include ADP, thromboxane A2, serotonin, and multiple other activation & - factors. They also undergo a transformation of their shape into a pseudopodal shape which in- turn leads to release reactions of various chemokines. Platelet aggregation: various platelets are activated, adhered to each other and the damaged endothelial surface leading to the formation of a primary platelet plug. (hormones produced by granules are particles - thatinvade platelets attract other cells to the area and make them clump together to form a platelet plug) microbes 3) activation of the coagulation cascade: involves the activation of clotting factors (factor X) which coagulation cascade are proteins that are involved in blood clotting. Factor X ->prothrombin- -> use Ca+ -> thrombin intrinsic Extrinsic 4) formation of the final clot (fibrin plug): 5oluble (most conversion of fibrinogen using thrombin -> fibrin insoluble monomers -> fibrin polymer (soluble Common s more efficient polymer); factor XIII completes the cross linking of fibrin polymers so that it is hardened which although longer) results in a fibrin mesh or clot over platelets which stops the bleeding The key functions of blood are: transportation of oxygen, waste, nutrients and hormones, protection from outside invaders, and regulation of temp and pH maintaining homeostatis. Haemostatis is the the process of blood clotting and it occurs in 4 main steps: constriction of blood vessels, formation of a temporary platelet plug, activation of coagulation cascade, and formation of the fibrin plug. -How it relates to -dysentery causes diarrhea containing blood dysentery 2 types of dysentery: -bacillary dysentery/shigellosis: caused by shigella bacteria -amoebic dysentry/amoebiasis: caused by an amoeba (parasite) called entamoeba histolytica 3. Blood Analysis -laboratory examination of a sample of blood used to gain information about its physical and chemical properties. Blood analysis is commonly carried out on a sample of blood drawn from the vein of the arm, the finger, or the earlobe. These tests can determine the number of erythrocytes and leukocytes in blood and hemoglobin concentration of red blood cells (blood count). -You can also determine the activity of enzymes or protein catalysts associated found in blood plasma -determine properties such as total volume, circulation time, viscosity, clotting time and clotting abnormalities, acidity (pH), levels of oxygen/carbon dioxide, and the clearance rate of various substances -how do we prepare a 1. Using lens paper, gently wipe two glass slides to remove any dust or glass fragments. blood smear? Place the glass slide on an even surface. 2. Mix blood thoroughly (if not a fresh sample). Place a small drop of blood on one end of one glass slide. Hold the bottom (frosted edge) of the slide with the thumb of your non-dominant hand. 3. Using your dominant hand, place the edge of the other slide at an approximately 35-45⁰ angle on the first glass slide, in front of the blood drop. Using gentle pressure, gently pull the second slide back into the blood drop and allow the blood to spread to the edge of the slide. 4. To spread the blood, rapidly but gently push the top slide forward through the remainder of the smear. It is important to keep gentle, equal pressure throughout the whole process, and do not lift the top slide before it reaches the edge of the bottom slide. A feathered edge should be present. 5. After preparation, the smear should be labeled and dried. The 2 types of dysentry are bacillary dysentry (caused by shigella bacteria) and amoebic dysentry (caused by amoeba called entamoeba histolytica). Blood analysis determines the number of erythrocytes and leukocytes in the blood. Blood smear prep: clean the slides w lens paper, mix blood and place a small drop on the end of one slide, take another slide and place it on an angle to the first slide and pull second slide into the blood drop. Then, spread the blood by pushing the top slide through the rest of smear. Finally, smear should be labeled and dried. 4. Blood count -CBC (complete blood count): blood test used to evaluate your overall health and detect disorders like anemia, infection, and leukemia. It measures components of blood such as red blood cells (if too low=anemia), white blood cells (a lot of them may be a sign of inflammation/infection), platelets, hemoglobin, mean cell volume MCV (average size of red blood cells), packaged cell volume PVC/haemotocrit (proportion of blood that is RBC) -range of values White blood cells: 4-11 x 10^9 cells/L for white/red Red blood cells: 4.5-6.5 x 10^12 cells/L blood cells (not Hemoglobin: 115-180 g/L imp) Mean corpuscular volume: 82-98 Platelets: 150-400 x 10^9 platelets/L PCV/hematocrit: 0.4 to 0.5 -differential -differential count tests can help diagnose: infections, autoimmune diseases, counts: affected inflammatory diseases, and leukemia (cancer of blood cells) by infections -for white blood cells and their percentages only -a high white blood cell count may mean you have an infection, an immune disorder, leukemia, or an allergic reaction. A low count may be caused by bone marrow problems, reactions to medicines, or cancer. 5. Infection -spread by air as air droplets, contact (direct/indirect), faecal-oral spread (pathogens -spreading in fecal particles pass from one person to another person’s mouth), blood/body fluids, -prevention sharing of injections -we can prevent infectious diseases from spreading by: immunizing against infectious diseases, washing hands, cover mouth when coughing/sneeezing, cleaning surfaces, ventilating 6. Health and -immunization for lab staff, PPE Safety of -Take all necessary precautions to prevent puncture wounds and cuts in the handling blood presence of blood and body fluids. -precautions -Avoid use of sharps, when possible, and discard sharps directly into the sharps container immediately after use, and at the point of use. CBC measures the amount of RBC, WBC, platelets, hemoglobin, MCV, and PCV. Differential counts measure the amount of WBC in blood and can help diagnose infections and inflammatory diseases. Spreading of infections can happen in dif ways: contact, air, faecal-oral, sharing of injections, or through body fluids. Prevention techniques: washing hands, immunizing, covering mouth when sneezing/coughing, and cleaning surfaces regularly. Precautions of handling blood include wearing PPE, sterilizing, immunizing against diseases, and discarding sharps properly.  Case 5: Malaria Vocab 1. Venepuncture 2. Malaria 3. Ebola ILOs 1. What is Malaria? -structure of plasmodium -lifecycle -classification 2. Spread of Malaria -environment -methods of transmission 3. Symptoms and treatment -complications -long-term effects -prevention -treatment 4. Demographics and susceptibility 5. Pathology of Malaria -microscopic diagnosis 6. Methods of drawing blood 7. Ebola  Case 5: malaria Vocab 1. Venepuncture: puncturing of a vein to withdraw blood for diagnostic purposes or to monitor levels of blood components/drugs. It is also used for drug administration. A hollow needle is inserted through the skin into a superficial vein. 2. Malaria: serious disease caused by parasite that infects a type of mosquito that feeds on humans. 3. Ebola: Zaire ebolavirus is a deadly disease with outbreaks that occur on the African continent caused by an infection within the ebolavirus genus 1. What is -mosquito bites dont cause malaria, they just spread it by biting humans. The Malaria? protozoan plasmodium causes it. -five kinds of malaria plasmodiums infect humans: 2 most common: Plasmodium falciparum (most violent, found in Africa), P. vivax (most common outside of African countries) -P. Malarie, P. Ovale, P. Knowlesi -parasitic protozoa host involves 2 hosts: female anopheles mosquito and humans Plasmodium inFemale Anopheles Mosquito bite, Humans the infected bite spreads (parasite) * Malaria -structure of -eukaryotic single-celled protists consist of nucleus, mitochondria, microtubules and Plasmodium apicoplast (unique to single-celled parasites helps for the invasion against the host cells) -covered in various proteins that are needed for the binding to the target cells Malaria is a disease caused by the protozoa plasmodium that enters the human body when the female anopheles mosquito bites. The 2 most common types of plasmodium: P Falciparum and P Vivax.  -lifecycle * 1) it starts w an infected mosquito biting a human, which transfers the malarial parasite into the body: the female anopheles mosquito secrets her saliva into the bloodstream to prevent blood coagulation. The plasmodium gets transferred from mosquitos to humans in the form of sporozoites. 2) Exoerythrocytic schizogony (stage name): Parasites, through the bloodstream, in liver-- enter the liver to grow and multiply (through asexual reproduction for 7-10 days causing no symptoms) and attack the liver cells. 3) Then, they burst out the liver cells to get released into the bloodstream (in the form of merozoites) 4) Erythrocytic schizogony: these merozoites target the RBCs (fever is caused when in RBC en RBCs burst) and develop into the Trophozoite (ring like structure). 5) 2 pathways: A. Most of Trophozoites then begin asexual reproduction creating new merozoites and when their numbers increase, they burst out of the RBCs and attack new RBCs. B. Gametogony: some of the Trophozoites enter the sexual cycle and produce 2 Gametocytes (germs cells of plasmodium), and when a mosquito comes to bite an infected human, these gametocytes enter the mosquito body w sucked blood. The 2 fuse to mature sex cells gametes female and male gametocytes in the mosquito fuse to create a zygote in the create - mosquito’s gut. As a result, an oocyst develops and crosses the gut wall to reach the salivary glands. The oocyst then releases sporozoites. When a female anopheles mosquito bites again, these sporozoites are released and the cycle continues. a sexual" merozoites Sporozoites liver -> merozoites -> tropozoite - -> sexual- 2 gametocytes -> mosquito. Zygote - royst.sporozoites < fever occurs when RBCS burst The life cycle of plasmodium starts with the female anopheles mosquito biting the human. It releases the plasmodium in the form of sporozoites which go through the bloodstream to the liver. The stage in which sporozoites grow and multiply in the liver is called exoerythrocytic schizogony. Then, merozoites burst from the liver and attack RBC. The stage in which the merozoites target the RBCs is called erythrocytic schizogony. From here, merozoites develop into trophozoites which undergo sexual or asexual reproduction. In asexual, trophozoites form merozoites that burst from RBC to attack others. In sexual, 2 gametocytes are formed and they enter the mosquito when it bites the human and fuse to create a zygote in the mosquito’s gut which develops into an oocyst which crosses the gut wall and enters the salivary glands and releases sporozoites. When the mosquito bites again, sporozoites enter bloodstream.  -classification Malaria is usually classified as asymptomatic, uncomplicated or severe. 1) Asymptomatic malaria can be caused by all Plasmodium species; the patient has circulating parasites but no symptoms. 2) Uncomplicated malaria can be caused by all Plasmodium species. Symptoms generally occur 7-10 days after the initial mosquito bite. Symptoms are non- specific and can include fever, chills, sweating, headache, nausea, vomiting, diarrhoea and anaemia. 3) Severe malaria is usually caused by infection with Plasmodium falciparum. Complications include severe anaemia and end-organ damage, including coma (cerebral malaria), pulmonary complications, and hypoglycaemia or acute kidney cose injury. Severe malaria is often associated with hyperparasitaemia and is associated * with increased mortality. a n 5. RBC infected 2. spread of Where malaria is found depends mainly on climatic factors such as temperature, Malaria humidity, and rainfall. Malaria is transmitted in tropical and subtropical areas, where -environment Anopheles mosquitoes can survive and multiply, and Malaria parasites can complete their growth cycle in the mosquitoes At low temperatures, Plasmodium falciparum (which causes severe malaria) cannot complete its growth cycle in the Anopheles mosquito, and thus cannot be transmitted. Generally, in warmer regions closer to the equator Transmission will be more intense, and Malaria is transmitted year-round. -methods of -From mother to unborn child transmission -Through blood transfusions -By sharing needles used to inject drugs -organ transplants (not transmitted human to human directly) Malaria -can be classified as asymptomatic, uncomplicated, or severe. -found in more tropical areas where the mosquito can survive and the life cycle of the plasmodium can be completed. -can be transmitted from mother to unborn child, through blood transfusions, by sharing of needles, and by organ transplants. 3. Symptoms and Malaria deaths are usually related to one or more serious complications, including: treatment -complications Cerebral malaria. If parasite-filled blood cells block small blood vessels to your brain (cerebral malaria), swelling of your brain or brain damage may occur. Cerebral malaria may cause seizures and coma. Breathing problems from accumulated fluid in your lungs Organ failure. Malaria can damage the kidneys or liver or cause the spleen to rupture. Anemia. Malaria may result in not having enough RBCs for an adequate supply of oxygen to your body's tissues. Low blood sugar. Can result in coma or death. -long-term effects -anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. If not treated well, the infection can become severe and may cause kidney failure, seizures, mental confusion, coma, and death. -prevention -take steps to avoid mosquito bites: cover skin, apply insect repellent to clothing and skin, sleep under bed net. Some drugs might be taken for protection when traveling to infected country: -Vaccine RTS,S/ASO1 is recommended for children in infected countries, acts against Plasmodium falciparum -gene therapy -eradication: eradicating specific mosquitoes to prevent the parasite from producing in the mosquito -treatment The most common antimalarial drugs: Chloroquine phosphate: most preferred. In many parts of the world, parasites are resistant to chloroquine, and the drug is less effective. Doxycycline: can be used in combination with another medicine for treatment, or alone as prevention. Symptoms: cerebral malaria, anemia, low blood sugar, organ failure, and breathing problems Long term effects: anemia, jaundice, kidney failure, coma, and death Prevention: preventative drugs, vaccine RTS,S/ASO1, gene therapy, eradication Treatment: chloroquine and doxycycline 4. Demographics -young children in sub-Saharan Africa and pregnant women are the groups most and susceptibility affected + HIV/AIDS positive people -Individuals with blood group “A” have been found to be highly susceptible to falciparum malaria -people with sickle cell (hemoglobin is low, RBC looses its shape and become sticky and stick with blood vessels to cause a clog); carriers are immune to malaria -tropical areas are most affected due to the mosquito and weather -highest transmission is found in Africa and in parts of Oceania 5. Pathology of Malaria can be identified by examining patient’s blood smear under the microscope, Malaria on a microscope slide. Prior to examination, the specimen is stained (with the -microscopic Giemsa stain--> stains the nucleic acid of parasite) to give the parasites a distinctive diagnosis appearance. 6. Methods of -venepuncture sampling: to draw blood from adult patients from a superficial vein in drawing blood the upper limp, can be inconvenient, has risk of storage, transportation and contamination of blood samples -fingerstick sampling: taking small amount of blood from end of finger -arterial sampling: commonly takes place in a hospital, used in identification of metabolic, respiratory and acid-base disorders, and can be painful for the patient and increases the risks of bleeding complications 7. Ebola -Ebola Virus Disease (EVD) is a rare and deadly disease in people and nonhuman primates -viruses that cause EVD are located mainly in sub-Saharan Africa -People can get EVD through direct contact with an infected animal or a sick/dead person infected with Ebola virus (first from infected animal then from person to person) -people with malaria are more likely to survive ebola -dif bet Ebola and malaria: malaria can only be spread by insects (not human to human) however, ebola can be spread bet animal and human and human to human Children and women are most susceptible to Malaria, and transmission is most common in Africa and tropical areas. Microscopic analysis is the identification of Malaria under a microscope, and this is done by staining the blood smear with the Giemsa stain (which stains the nucleic acids of the parasite). Methods of drawing blood include Venepuncture (drawing blood from a superficial vein in the upper limb), fingerstick sampling, and arterial sampling. Ebola (EVD) is a deadly virus that is spread in humans and animals through direct contact.  Case 6: nutrition Vocab 1. Pre-albumin 2. Anaemic 3. Hypocalcaemic 4. Rachitic rosary 5. Folate 6. Ferritin ILOs Day 1 1. What is the digestive system? -anatomy/physiology (enzymes) -Why is digestion important? -how does it work on a cellular level? -absorption of nutrients and vitamins 2. Vitamins -importance -functions 3. Minerals -importance -functions 4. What is a healthy diet? -micro/macro nutrients 5. Normal ranges -growth chart -calories -BMI Day 2 1. How to feed a child? -breastfeeding -introduction of solid foods -ethics 2. What is malnutrition? -causes -long term effects -treatment 3. What is rickets? -causes -effects -treatments 4. Types of diets 5. X-rays -how do X-rays work? -how are X-rays performed? -DEXA (body density scan)  Case 6: nutrition Vocab: 1. Pre-albumin: protein found in the blood that is produced by liver, helps carry thyroid hormones and vit A through bloodstream and helps control how your body uses energy. Low prealbumin is a sign of malnutrition. 2. Anaemic: condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body's tissues; refers to low hemoglobin. 3. Hypocalcaemia: condition where calcium levels are too low, caused by abnormal levels of parathyroid hormone or vit D. 4. Rachitic rosary: expansion of anterior rib ends at the costochondral junctions (seen in rickets as modularity at the costochondral junctions), due to calcium deficiency 5. Folate: also known as vit B9, necessary to make RBCs and WBCs in bone marrow, DNA and RNA, and transform carbs into energy. 6. Ferritin: protein that stores iron in cells, found in liver 1. What is the -made of gastrointestinal tract (series of hollow organs joined in a long tube from digestive system? mouth to anus): mouth, esophagus, stomach, small intestine, large intestine, and -anatomy/physiology rectum (enzymes) -accessory organs: liver, pancreas, gallbladder, salivary glands -small intestine components: duodenum (1st part), jejunum (mid part), and ileum (end) -large intestine components: appendix, cecum (1st part), colon (2nd part), and rectum (end) connection bet. SIB LI -digestion breaks nutrients into smaller parts for body to absorb and use, one of the most -Why is digestion energy consuming processes important? Proteins —> amino acids Fats —> FAs and glycerol Carbs —> glucose Bstomach (same but w/outv illi) ↳ cecum (connects 11 itransverSansse to SI) - colon Digestive system is made up of gastrointestinal tract and accessory organs Layers of gut lining: mucosa, submucosa, muscularis externa, and serosa. Small intestine has villi that is lined w epithelial cells that have microvilli -how does it work on a cellular level? -food moves through GI tract by peristalsis (series of muscle contractions) as the hollow organs have a layer of muscle that enables their walls to move (this movement pushes the food/liquid through the GI and mixes the contents within each organ) Muscles behind food contract to squeeze the food forward, muscles in front food relaxes to allow food to move ->antagonistic 1) Mouth: it starts when you eat and swallow, your tongue pushes the food down your throat. Epiglottis (flap of tissue) folds over your windpipe to prevent chocking and the food passes into your esophagus. 2) Esophagus: when you swallow, your brain signals the muscles of esophagus and peristalsis begins. Contains upper and lower esophageal sphincters. -Lower esophageal sphincter: When food reaches the end of your esophagus, the lower esophageal sphincter (ring like muscle) relaxes and lets food pass into your stomach. This sphincter usually stays closed to keep what’s in your stomach from flowing back into your esophagus. 4) Stomach: muscles mix food and liquid with digestive juices, and stomach empties the contents as a creamy paste called chyme into small intestine through pyloric sphincter. 5) Small intestine: muscles of the small intestine mix food with digestive juices from the pancreas, liver, and intestine, and push the mixture forward for further digestion. Walls of the small intestine absorb water and the digested nutrients into your bloodstream. As peristalsis continues, the waste products of the digestive process move into the large intestine. 6) large intestine: waste products from digestive products include undigested food, fluid, older cells from GI. The large intestine absorbs water and changes the waste from liquid into stool. Peristalsis helps move the stool into your rectum. 7) rectum: stores stool until it pushes it out of anus during bowel movement. Chewing in mouth turns food into bolus and epiglottis folds over windpipe, then food enters esophagus and peristalsis begins. Esophagus has upper and lower sphincters. Food moves into stomach and w contractions it is turned into chyme. Pyloric sphincter opens and chyme is secreted in duodenum. Absorption of nutrients in jejunum and ileum then undigested food enters large intestine. Water is absorbed creating stool->rectum-> anus  -breaking down of -when you chew, your salivary glands make saliva (0.75-1.5L/day) which moistens the food so it food: mouth can move down esophagus to stomach, tongue forms the food into a bolus and helps push food down esophagus -saliva secretes an enzyme called salivary amylase which breaks down starches ->maltose -lingual lipase is activated by stomach acid, breaks down fats -breaking down of -nerves in esophageal tissue sense bolus going down and trigger peristalsis. Peristalsis pushes the food: esophagus food down your esophagus into stomach. -consists of upper esophageal sphincter (prevents reflux of food into airways and entry of air into digestive tract) and lower esophageal sphincter (prevents the stomach contents from refluxing back into the oesophagus causing ‘heart burn’) -breaking down of -glands in stomach lining make gastric juice and enzymes that break down food into chunks food: stomach -lingual lipase fully activated What happens: Specific cells within the gastric lining, known as chief cells, release pepsin in an inactive form (zymogen) called pepsinogen. By doing so, the stomach prevents the auto- digestion of protective proteins in the lining of the digestive tract. Since chief cells release pepsin as a zymogen, activation by an acidic environment is necessary. Hydrochloric acid (HCl) plays a crucial role in creating the pH required for pepsin activity. Parietal cells produce HCl by secreting hydrogen and chloride ions. When pepsinogen and hydrochloric acid exist together in the gastric juice, pepsin is created in its active form. Pepsin (endopeptidase) breaks down proteins into peptides and amino acids, that can be easily absorbed in the small intestine. Through the actions of pepsin and the squeezing properties of the stomach, the food bolus enters the intestines as a liquidy mixture of partially digested food particles, called chyme. -Most signals that increase stomach activity get the job done by increasing the secretion of gastrin (chewing->G cells->gastrin->gastric glands) which stimulates gastric juice and stomach- muscle activity. Gobletcells chief cells parietal Gastric juice: mucus, HCl, pepsinogen, and intrinsic factor inded for vitBi absorption which is vital for a production Tangrams -> - -Secretin hormone secreted when food enters duodenum which tells pancreas to secrete pancreatic juices -breaking down of -The pancreas is unique in that it's both an endocrine and exocrine gland. In other words, the food: pancreas pancreas has the dual function of secreting hormones into blood (endocrine) and secreting digestive juices through ducts (exocrine). The duodenum in SI receives the pancreatic juice. -CCK hormone causes the pancreas to grow and produce enzymes of pancreatic juice and causes galbladder to empty the bile into duodenum Enzymes endopeptidase -Trypsin: produced in pancreas for first part of small intestine, activated by enterokinase, and - chymotrypsin -Carboxypeptidases: exopeptidase and dipeptidases/aminopeptidases Mouth secretes salivary amylase to break down starch, lingual lipase is activated by stomach. Peristalsis pushes food down esophagus into stomach. Gastric juice (pepsinogen, mucus, HCl, intrinsic factor) mixes w food in stomach and w contractions food turns into chyme. G cells in stomach secrete gastrin. Pancreas is stimulated by CCK and secretin to secrete enzymes and juice into duodenum.  -breaking down of -produces bile; used to breakdown large fat globules into small fat droplets food: liver -without bile, fats will only be partially digested -bile ducts carry bile from liver to gallbladder for small intestine to use -breaking down of -Stores bile between meals and releases it to SI for fat absorption. Absorbs electrolytes food: galbladder and water. When you eat, it transfers bile through bile ducts to small intestine. -breaking down of -chyme moves to small intestine and bile is secreted into duodenum; food slurry coming from food: small intestine stomach is mixed with bile and pancreatic juices in this part Proteins —> amino acids. Enzyme: trypsin, chymotrypsin, Carboxypeptidases, exo/dipeptidases Fats —> FAs and glycerol. Enzyme: lipases &border enzymes Carbs —> glucose Enzyme: maltase, lactase, amylase - -all breakdown of products of carbs, fat, proteins and vitamins, minerals, and water are absorbed brush border enzymes through the SI into blood -Absorption features: jejunem and ileum are coated in villi, which increases SA to maximize absorption and transfer nutrients to bloodstream -+stomach stimulates -> gastric glands to release gastric juice - -> stimulates pancreatic enzymes bile + - stimulates -> pancreatic juice Pancreatic hormones: endocrine role glucose) cells in pancreas increases glucose in blood (hydrolysis of glycogen -> Glucagon a - · to blood stimulates Hexolinase convert glucose glycogen) -> · Insulin B cells in pancreas-decreases glucose in cells in pancrease universal inhibitor (inhibits many hormones) somatostatin - · regulates secretion of glucagon insulin + -breaking down -absorbs water and electrolytes, bacteria also produce vit K and B which is absorbed of food: large -leftover fiber, water, and dead cells goes to large intestine intestine/colon -remaining fluid is drained through intestinal wall creating stool; formation and storage of faeces -stool is squeezed into rectum (as peristalsis continues), nerves sense it expanding, and tell the body to expel the waste through the anus -absorption of nutrients -4 ways digestive products are absorbed: active transport, diffusion, facilitated diffusion, and vitamins and endocytosis -enzymes -Amylase produced in mouth and pancreas. Pepsin produced in stomach. Trypsin produced in pancreas. Pancreatic lipase produced in pancreas. Lingual lipase in mouth. Liver produces bile and transfers it through bile ducts to gallbladder for storage. Food is mixed w bile and pancreatic juices in duodenum. Jejunum and ileum are coated w villi which increases SA. Large intestine absorbs water and electrolytes creating stool which is expelled from rectum. Hormones: gastrin, secretin, CCK, glucagon, insulin, somatostatin. Digestive products are absorbed through active transport, diffusion, facilitated diffusion, endocytosis.  & -summary pic 2. Vitamins -vitamins help you resist infections, keep nerves healthy, help body get energy from -importance food, and help in blood clotting Vitamins are grouped into two categories: Fat-soluble vitamins are stored in the body's liver, fatty tissue, and muscles. The four fat-soluble vitamins are vitamins A, D, E, and K. These vitamins are absorbed more easily by the body in the presence of dietary fat. Their role is to: Build bones Protect vision- Vitamin A helps keep cells healthy and protects your vision Interact favorably- Without vitamin E, your body would have difficulty absorbing and storing vitamin A Protect the body- Vitamin E also acts as an antioxidant Water-soluble vitamins are not stored in the body. The nine water-soluble vitamins are vitamin C and all the B vitamins. They have to be consumed on a regular basis to prevent deficiencies in the body. There role is to: Release energy- Several B vitamins are key components of certain coenzymes that help release energy from food. Vitamins are divided into fat soluble and water soluble Fat soluble: stored in fatty tissue, liver, muscles and they are A, D, E, K Water soluble: not stored so need to be consumed regularly and they are C and B vitamins  Produce energy- Thiamine, riboflavin, niacin, pantothenic acid, and biotin engage in energy production. Build proteins and cells- Vitamins B6, B12, and folic acid metabolize amino acids and help cells multiply. Make collagen- One of many roles played by vitamin C is to help make collagen, which knits together wounds, supports blood vessel walls, and forms a base for teeth and bones. -functions -sources (not imp) ↳ from cartene B1: cereal, beans and lentil, flaxseed and seeds, milk, nuts, oats, beef, rice, wheat B12: liver, dairy products, fish Folate: dark green leafy veges, ' haemoglobin beans, peanuts, fruits, whole grains, sunflower seeds, liver, seafood D: sunlight, eggs, seafood, milk, oranges K: dark green leafy veges, sunflower oil B3 How does skin absorb vitamin D? -When your skin is exposed to sunlight, it manufactures vitamin D. The sun's ultraviolet B (UVB) rays interact with a protein called 7-DHC (7-dehydrocholesterol) in the skin, converting it into vitamin D3, the active form of vitamin D. ·rotein sy. ⑭ - intrinsic factor needed for absorption by SI Vitamins have dif functions Vit D needs to be made into active form: UVB rays interact w 7-HHC protein to create vit D3 which is active form 3. Minerals -minerals are imp for building strong bones and teeth, controlling body fluids inside/ -importance outside cells, and turning food to energy -functions -grouped into 2 main groups: macro minerals: minerals needed in larger amounts micro minerals (trace elements): minerals needed in smaller amounts I neededthe most) * thyroid hormone production * -sources Calcium: dairy, beans, nuts, leafy greens, sardines, salmon w bones Magnesium: legumes (beans, lentils, peas), dark green leafy veges, nuts, seeds, fish, beef Macro minerals are minerals needed in large amounts like calcium (bone and teeth, muscle contraction) and phosphorus (bone and teeth) Micro minerals are minerals needed in small amounts like iron 4. What is a Macronutrients: nutritive components of food body needs for energy and to maintain healthy diet? the body’s structure and systems -micro/macro -include carbohydrates, fats, and proteins nutrients Proteins: provides structure to tissue, involved in metabolic, hormonal, and enzyme systems, and help maintain acid-base balance. Fats: energy reserve, insulation and protection of organs, and absorption and transport of vitamins. Only unsaturated fats are needed. Component of plasma mem. Carbs: body’s fuel; provides energy for muscles and central nervous system during movement, best eaten as polysaccharides and not monosaccharides (sugars) Micronutrients: vitamins and minerals needed by the body in very small amounts 6 essential micronutrients: 1) Iron- critical for motor and cognitive development, iron deficiency is a cause of anemia (low hemoglobin concentration) 2) Vitamin A- eyesight and immune system, children w vitamin A deficiency have increased risk of blindness and death from infections 3) Vitamin D- from sunlight, builds strong bones by helping body absorb calcium, helps immune system resist bacteria/viruses, required for muscle and nerve functions 4) Iodine- required during pregnancy for infant’s growth and cognitive development 5) Folate (vit B9)- fetal growth and development of brain and spine 6) Zinc- promotes immune functions and helps resist infectious diseases 5. Normal ranges Vitamin D ranges: between 50-175 nmol/L -adult Vitamin B12 ranges: between 120-700 pmol/L (160 to 950 pg/ml) Vitamin B1 ranges: 50 – 220 nmol/L Vitamin K ranges: 0.2-3.2 ng/mL Calcium ranges: 8.5 to 10 mg/dL (2.10 to 2.6 millimol/L) Magnesium ranges: 1.7 to 2.2 mg/dL (0.85 to 1.10 mmol/L) A healthy diet consists of protein (cell structure), fats (energy, organ insulation and protection, component of cell membrane), and carbs (energy for muscles) -growth chart -percentiles are measurements that show where a child is compared to other kids -When doctors plot a child's weight and height on the chart, they see which percentile line those measurements land on: The higher the percentile number, the bigger a child is compared with other kids of the same age and gender. The lower the percentile number, the smaller the child is. -If a child is malnourished, the curve won’t be consistent and there won’t be any progress (the curve will drop dramatically). If you’re on a lower percentile, it doesn’t mean your too small, the most imp thing is that the curve grows with time and doesn’t stay on the same pt. -calories Female children: 1200-1600kcal/d Male children: 1400-1800kcal/d Female teenager: 2200-2460kcal/d Male teenager: 2400-3150kcal/d Female adult: 2000kcal/d Male adult: 2500kcal/d -BMI -Body mass index: derived from mass and height of person Growth chart assesses where a child is in comparison to other children. If child is malnourished, the curve will drop significantly. However, if a child is on a low percentile it doesn’t mean that they are malnourished, the most imp thing is that the curve is increasing w time. Female adults needs 2000 kcal/d and male adults need 2500 kcal/d. BMI: take from mass and heigh of person. 1. How to feed a -the ideal food for infants is breast milk because it contains antibodies that will child? protect child from common childhood illnesses, provide all energy and nutrients -breastfeeding needed, and provide up to half or more of a child’s nutritional needed during the -introduction of solid second half of their first yr, and up to one third during their second yr foods -breastfed children perform better on tests, and are less likely to be overweight or -ethics have diabetes -WHO/UNICEF recommend that children are breastfed within the 1st hr of birth and for 6 months without food or water. From the age of 6 months, children should begin eating complementary foods like single veges and fruits without sugar/salt while continuing to breastfeed up to 2 yrs -intro of cows milk after 1 yr, not before -vit D should be supplemented to children bc the amount in breast milk is insufficient 2. What is -malnutrition: lack of nutrients from poor diet or problems absorbing nutrients malnutrition ? -includes micro nutrient deficiencies -causes -health conditions, medicines, physical and social factors might lead to malnutrition Health conditions: long term conditions that cause loss of appetite and feeling sick, mental health conditions, digestion illnesses, dementia, and eating disorders (anorexia) Medicine: side effects that make you feel sick Physical and social factors: teeth in poor condition, physical disability, limited knowledge of nutrition, living alone, alcohol, poverty -In children, malnutrition is caused by long term health conditions that lead to loss of appetite, disrupt digestion, and increase the body’s demand for energy -long term effects -changes in mood (depression and lethargy), poor concentration, decreased productivity, poor growth in children (malnutrition affects brain development), increased risk of infection, longer recovery and poor wound healing A healthy diet for a child includes breast milk bc it contai