Summary McTimoney College of Chiropractic - Biomedical Sciences I
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Course
McTimoney - Biomedical Sciences
Institution
University Of Ulster
This is a full summary of all lecture notes and slide decks from Biomedical Sciences I. This summary can be purchased together with potential exam questions provided by the lecturer with my own answers for each question for the same price! The bundle will also include an overview of the important i...
,MAN Y2 2021 BMS1 McTimoney College of Chiropractic Michael Verouden
9.2.1 Hallmarks of malignant neoplastic cells............................................................................... 54
9.3 Carcinogenesis ............................................................................................................................ 54
9.3.1 Mutation .............................................................................................................................. 55
9.3.2 Growth & differentiation ..................................................................................................... 55
9.3.3 Local invasion ....................................................................................................................... 57
9.3.4 Metastasis ............................................................................................................................ 57
9.3.5 Summary .............................................................................................................................. 58
9.4 Clinical issues in cancer ............................................................................................................... 58
9.4.1 Cancer diagnosis .................................................................................................................. 59
9.4.2 Cancer grading & staging ..................................................................................................... 59
10 – Cancer chemotherapy ................................................................................................................... 60
10.1 Treatment approaches.............................................................................................................. 60
10.1.1 Radiotherapy ...................................................................................................................... 60
10.1.2 Chemotherapy (CRx) .......................................................................................................... 61
10.2 Principles of anti-neoplastic chemotherapy ............................................................................. 61
10.2.1 Kinetics of cancer treatment.............................................................................................. 62
10.2.2 Drug resistance .................................................................................................................. 63
10.3 Chemotherapy agents ............................................................................................................... 63
10.3.1 Traditional anti-neoplastic drugs (cytotoxic drugs) ........................................................... 63
10.3.2 Hormonal Rx....................................................................................................................... 64
10.3.3 Targeted Rx ........................................................................................................................ 64
10.3.4 Immunotherapy ................................................................................................................. 64
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, MAN Y2 2021 BMS1 McTimoney College of Chiropractic Michael Verouden
1 – What is disease
Basic features of disease & disease development
Factors involved in the cause of disease
Classification of disease, “official” & “unofficial”
Pathway to the diagnosis of disease
Role of pathology in disease diagnosis, monitoring & treatment
Disease = abnormality that negatively affects a structure/function of part/whole organ/organism.
• Medical conditions associated with symptoms & signs
• Occurs when cells are unable to adapt to changes in environment ➔ adaptation = health
• Health & disease are 2 extremes balanced by homeostasis
• Proximate causes & mechanisms ➔ infections, mutations, etc.
• Evolutionary causes ➔ influenced by modern problems
o Infection causes increased T cells to fight pathogens ➔ influenced by medicine
o Micro-organisms evolve faster than humans ➔ antibiotic resistance
o Allergies increase ➔ hypersensitive immune system to innocent agents
o Environmental changes
• Also influenced by age ➔ less response to environmental threats leads to increased
infections, emergence of dormant infections, and increased chronic diseases
• Also influenced by genes ➔ increased risk by having a certain gene – but can also have
beneficial influence
Diseases may differ in nature:
Structural disease (organic) Functional disease
Changes Lesions (= structural change) in Physiological/functional changes, no
cells/tissues lesions
Identifiable Molecular techniques identify Laboratory testing for biomarkers
protein & gene structure changes
Signs & symptoms Unreliable Reliable
Characteristics 3 groups: Results in structural changes over time ➔
Genetic/developmental more important
Acquired injury & inflammatory
Hyperplasia & neoplasia
Examples Tumours Excessive production (mucous, hormones)
Obstructions (asthma, GIT, vascular) Insufficient production (hormones)
Ruptures (perforations) Impaired function (muscle, nerve)
Healthy tissue loss (infarction)
1.1 Pathology
Pathology = science of causes & effects of disease.
• Injury mechanisms to cells/tissues + how body responds
• Includes:
o Basic structural & functional changes
o Pathophysiology = study of causes leading to changes
o Pathogenesis = events leading from changes to clinical manifestation of disease
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,MAN Y2 2021 BMS1 McTimoney College of Chiropractic Michael Verouden
For each disease the following characteristics should be known:
Epidemiology Incidence, prevalence & population distribution
Aetiology Cause
Pathogenesis Events in cells/tissues in response to cause
Morphology Structural changes in cells/tissues
Clinical significance Manifestation of changes giving rise to clinical picture
Complication/sequelae Secondary, systemic or remate consequences
Prognosis Anticipated course (cure, remission, fate)
Disease causes:
1) Genetic = inherited or pre-natal acquired gene defects (e.g. cystic fibrosis)
2) Environmental = no genetic components (e.g. traumatic head injury)
3) Multifactorial = interaction of genetic & environmental (e.g. diabetes)
1.1.1 Genetic factors
These factors are inherited or acquired (through conception/embryogenesis).
• Often associated with congenital metabolic abnormalities (cystic fibrosis) or structural
effects (Down’s & Turners syndrome)
• May predispose to tumours (retinoblastoma)
• May be acquired post-natally (cellular mutation)
o Neoplastic changes & tumour development are concealed by presence of larger
quantity normal cells
• Number of defective genes:
o Monogenic = single defective gene (majority)
o Polygenic = >1 defective genes at different places on chromosome (minority)
Inheritance models help show if a disease is autosomal or sex-linked and/or dominant or recessive.
• Dominant alleles already show effect with 1 copy of the allele (heterozygote)
• Recessive alleles only show effect with 2 copies of the allele (homozygote)
• Both dominant alleles = codominance
• Sex-linked disease has genes linked to X chromosome
o Males (XY) & female (XX)
o Boy inherits X chromosome from mother
o Girl inherits X chromosome from either mother or father
o Recessive sex-linked diseases show effect in females with 2 copies but in males
already with 1 copy ➔ more common in males
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, MAN Y2 2021 BMS1 McTimoney College of Chiropractic Michael Verouden
Non-neoplastic diseases with genetic defects:
• Abnormal chromosome number ➔ problems with gametogenesis & cellular division
o Down’s syndrome: 3x (trisomy) chromosome 21
• Fragile chromosomes = translocation of genetic material between chromosomes (rare)
o Similar to the carcinogenesis model and often associated with tumour development
• Single gene effects ➔ discrete biochemical or structural abnormalities (common)
o Adult structural defects = dominant
o Child biochemical defects = recessive
o Gene deletion, point mutation, insertion/deletion, gene fusion ➔ leading to
functional loss/gene or death
1.1.2 Environmental factors
Infections are the major cause of disease in all age groups internationally:
• Infective agents ➔ viruses, bacteria, fungi, yeasts, helminths, protozoa, prions
• Transmission
o Direct = contact with source
▪ Horizontal (person to person)
▪ Vertical (mother to foetus in-utero)
▪ Droplet spread (coughing, sneezing, talking)
o Indirect = contact with source via intermediate vehicle
▪ Vehicle borne ➔ contact with fomites = object that can transfer disease
when contaminated (food, water, biological products)
▪ Airborne (non-specific)
▪ Vectors borne (e.g. parasite carriers)
• Characteristics determined by host responses & infective agent properties
Non-infectious factors may contribute to disease by:
• Chemical influences
o Due to environmental pollutants, industrial & domestic materials, drugs, etc.
o Effects ➔ tissue corrosion, altered metabolic pathways, cell membrane injury,
allergic hypersensitivity reactions, neoplastic changes
o Smoking & alcohol biggest factor
o May have mutagenic effects changing chromosome structure:
▪ Teratogenic = affect embryogenesis & lead to malformations
▪ Carcinogenic = leads to tumorigenesis
• Physical influences
o Obvious & direct tissue damage depending on tissue integrity
o Effects ➔ mechanical, thermal, radiation
▪ Thermal damage is mostly localised (burns, frostbite) but also spread
(hypothermia)
▪ Thermal damage positively used as diathermy in surgery
▪ Radiation has wide spectrum of effects ➔ sunburn to melanoma
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