medical interventions unit 1

James Smith

41 years old, Sue's father, has three brothers

Judy Smith

42 years old, Sue's mother, has two brothers and two sisters

Mike Smith

16 years old, Sue's brother

Sue Smith

18 years old, plays soccer, freshman in college

Sue's medical history

Broken ankle (11 years old) and mild asthma (managed with in inhaler)

Antibody

An antigen-binding immunoglobulin, produced by B cells, that functions as the effector in an immune response

Antigen

A foreign macromolecule that does not belong to the host organism and elicits an immune response

Bioinformatics

The collection, classification, storage, and analysis of biochemical and biological information using computers especially as applied in molecular genetics and genomics

Concentration

The amount of a specified substance in a unit amount of another substance

ELISA (enzyme-linked immunosorbant assay)

A quantitative in vitro test for an antibody or antigen in which the test material is absorbed on a surface and exposed either to a complex of an enzyme linked to an antibody specific for the antigen or an enzyme linked to an anti-immunoglobulin specific for the antibody followed by a reaction of the enzyme with a substrate to yield a colored product corresponding to the concentration of the test material

Enzyme

A protein serving as a catalyst; a chemical agent that changes the rate of reaction without being consumed by the reaction

Genome

The complement of an organism's genes; an organism's genetic material

Medical intervention

Any measure whose purpose is to improve health or alter the course of a disease

Outbreak

A sudden rise in the incidence of a disease

Pathogen

A specific causative agent of disease

Primer

A molecule (short strand of RNA or DNA) whose presence is required for formation of another molecule (a longer chain of DNA)

Serial dilution

A stepwise dilution of a substance in a solution

Solute

A substance dissolved in another substance

Solution

A homogeneous mixture of two or more substances, which may be solids, liquids, or gases, or a combination of these

Solvent

A substance, usually a liquid, capable of dissolving another substance

Substrate

The reactant on which an enzyme works

Bacteria

Unicellular microorganisms that have no nucleus or membrane-bound organelles except ribosomes; Some are pathogenic and deadly but others are helpful; can be in shapes such as spherical, rod, or spiral

Virus

Latin for "poisonous/toxic," requires a host to survive, has genetic material surrounded by a protein, lipid, or glycoprotein coat; can be fought with vaccines or antivirals in the first three days of infection

Fungi

An infectious agent that is not a plant or animal, has no chlorophyll, no photosynthesis, has a cell wall like a plant, obtains food from decomposing soil

College infirmary

Where Sue Smith seeks medical attention in the Introduction of Activity 1.1.2

Chief investigator

Your job in Activity 1.1.2

Sue

Student who reported a constant headache and lethargy, had a temperature of 100.6 degrees, roommates and teammates with Jill, same floor and chemistry classmates with Maggie, lab partners and shares food/drinks with Marco in biology, visited a friend at another college, consumes excess caffeine to keep up with her busy schedule

Jill

Student who felt extremely run down, sore, and tight, temperature of 99.7 degrees, roommates and teammates with Sue, same floor/chemistry class with Maggie, sorority sisters with Wanda, smokes cigarettes

Anthony

Student who had a dry cough, felt tired, muscles ached, sinus issues, temperature of 100 degrees, same floor and works in the newspaper with Arnie, friends with Maria, spends time running through the woods across campus

Wanda

Student who had a fever, swollen glands, and a sore throat, sorority sisters with Jill, doesn't sleep a lot, has a boyfriend named Ray who took Tylenol instead of going to the doctor like he should have

Maggie

Student who had a scratchy throat, "heavy head," and poor temperature regulation, sings in a campus band, same chemistry class as Sue and Jill

Maria

Student who felt run down and had a fever of almost 103 degrees, lives on the same hall and shares food and drinks with Sue and Jill, Anthony's friend

Arnie

Student who had a cough and a runny nose, increased his vitamins, fever of 100.5 degrees, same floor and works with Anthony for the newspaper, has a girlfriend

Diagnostic laboratory tests

Why samples of Sue's blood, urine, and lymph were collected

Primers

Small segments of DNA which attach to key genes in bacteria and viruses and allow amplification and sequencing of the DNA; isolated in a pilot lab partnership between the college infirmary and the molecular biology department

Human Genome Project

In 1990, scientists working on this famous project embarked on a mission to map the human genome, the complete genetic layout of a human being. This project was completed in 2003, and since then, it has mapped the genomes of other species including mice, the fruit fly, and various bacteria.

Sample prep

Step one of the bacterial identification lab; the goal is to start with a "good" sample. Pick up a single colony of bacteria, drop it in a microcentrifuge tube, and dissolve the cell walls with enzymes

PCR amplification

Step two of the bacterial identification lab; the goal is to multiply the genetic material of the bacteria using PCR

PCR purification

Step three of the bacterial identification lab; the goal is to separate the 1,500 base-pair long 165rDNA from the other primers, nucleotides, and other small compounds

Sequencing prep

Step four of the bacterial identification lab; the goal is to create even more copies of the purified DNA with varied length

DNA sequencing

Step five of the bacterial identification lab; the goal is to use an automatic sequencer to "read" colors of the fluorescent markers in the gel electrophoresis and reconstruct the sequence

Sequence analysis

Step six of the bacterial identification lab; the goal is to search a database and identify the pathogen

Molecular database

Matches the DNA sequence to the pathogen; a form of bioinformatics; National Center for Biotechnology Information (NCBI) Basic Local Alignment Search Tool (BLAST) site

Neisseria meningititis

Strain B6116177; the pathogen in Sue's body found by the BLAST site

Marco

The student who came to the infirmary on Day 2 complaining of extreme fatigue and a headache, has a girlfriend (Elena), lab partners in biology and shares food and drinks with Sue, dorm neighbors with Alvin

Alvin

The student who came to the infirmary on Day 2 complaining of a headache and a sore throat, stays up late, plays guitar, dorm neighbors with Marco

Qualitative results

Results of the ELISA that indicate whether a patient is positive or negative for the presence of the antigen or antibody

Quantitative results

Results of the ELISA test that indicate how much of the detected substance is present (shown by the depth of the color change), can be used to propose a chain of infection

Cerebral spinal fluid

The type of body fluid that was taken from patients at Sue's school for the ELISA test

Bacterial meningitis

Disease that Sue, Jill, Maria, and Marco have; must be treated quickly; corticosteroids can reduce the swelling and edema, antibiotics fight the infection, IV fluids can be administered, and patients are usually treated in the ICU

Influenza B

Disease that Anthony, and Arnie have; can be treated with antivirals up to five days after onset (according to recent studies) but less than three days is ideal, symptom reduction methods include rest, fluids, damp cloths, humidifiers, and salt water gargles

Mono (human herpesvirus 4)

Disease that Wanda and Alvin (maybe) have; can be spread through body fluids, any accompanying bacterial infections can be treated with antibiotics, corticosteroids reduce swelling, patients must drink plenty of water and fruit juices, symptom reduction methods include acetaminophen and ibuprofen to reduce pain, and salt water gargles relieve sore throat

Strep throat

Disease that Maggie has; antibiotics reduce severity, duration, spread, and complications; ibuprofen and acetaminophen reduce fever and pain; symptom reduction methods include rest, drinking water, eating soothing foods, salt water gargles, humidifiers, and avoiding throat and lung irritants

Antibiotic

A substance produced by or derived from a microorganism and able in dilute solution to inhibit or kill another microorganism (it's a type of drug that kills bacteria)

Antibiotic resistance

Resistance to one or more antibiotics, usually due to additional genetic information

Conjugation

The one-way transfer of DNA between bacteria in cellular contact

Transduction

The transfer of genetic material from one organism (such as a bacterium) to another by a genetic vector

Transformation

The genetic modification of a bacterium by incorporation of free DNA from another ruptured bacterial cell

Nucleoid

Gel-like region within the cytoplasm containing the single, circular, double-stranded DNA molecule. This chromosomal DNA is supercoiled, meaning tightly packed into a twisted form. The DNA contains all of the genetic information necessary for normal functioning of the cell.

Plasmids

Circular double-stranded DNA molecules. They are typically 0.1% to 10% of the size of the chromosomal DNA and only carry a few to several hundred genes.

Ribosomes

Structures involved in protein synthesis; they facilitate the joining of amino acids

Cell wall

Rigid barrier that surrounds the cell, keeping the contents from bursting out

Peptidoglycan

The substance that provides the rigidity of the cell wall

Plasma membrane (also called the cytoplasmic membrane)

Semipermeable membrane that surrounds the cytoplasm of the cell; the phospholipid bilayer is embedded with proteins that act as a barrier between the cytoplasm and the outside environment

Capsule

A distinct and gelatinous layer, called glycocalyx, enveloping the cell; enables the bacterial cell to adhere to specific surfaces and sometimes protects the bacterial cell from human immune systems

Flagella

Protein appendages that are anchored in the membrane and protrude out from the surface; they spin like tiny propellers to move the bacterial cell forward

Pili

Filamentous appendages which are similar in structure to flagella, but function in a different manner

Fimbriae

Pili that enable the bacterial cell to attach to a specific surface

Sex pili

Pili involved in conjugation, a mechanism of DNA transfer from one bacterial cell to another

Endotoxins

Lipopolysaccharide molecules that make up the outer leaflet of the outer membrane of Gram negative bacteria.

Exotoxins

Proteins synthesized by both Gram negative and Gram positive bacteria and function as potent toxins

Gram negative bacteria

Bacteria that appear reddish-pink when Gram-stained due to the thin layer of peptidoglycan in the cell wall; these bacteria have porins

Periplasm

The region between the plasma membrane and the outer membrane that is filled with a gel-like fluid and proteins involved in a variety of cellular activities

Gram positive bacteria

Bacteria that appear purple when Gram stained; cell wall contains a thick layer of peptidoglycan and teichoic acids; approximately 20 times more peptidoglycan than a Gram negative bacteria

Beta-lactam antibiotics (Penicillins)

Antibiotics that irreversibly inhibit enzymes involved in the final steps of cell wall synthesis; these drugs vary, some work well on Gram positive bacteria while others work well on Gram negative bacteria; BACTERICIDAL

Tetracyclines

Antibiotics that reversibly bind to 30S ribosomal subunit and as a result prevent protein synthesis; effective against certain Gram positive and Gram negative bacteria; BACTERIOSTATIC

Fluoroquinolones

Antibiotics that prevent the supercoiling of chromosomal DNA by inhibiting topoisomerase enzymes; effective against a wide variety of bacteria; BACTERICIDAL

Sulfonamides

Antibiotics that inhibit the growth of many Gram positive and Gram negative bacteria BACTERIOSTATIC

Ciprofloxacin

The antibiotic that is used to cure campylobacter infections; the bacteria are becoming resistant due to use in the farm industry

Mutation

A change in the DNA that can sometimes cause a change in the gene product; a biochemical mechanism of antimicrobial resistance; enzymes change shape so the antimicrobials cannot bind to them and affect the cell

Destruction (Inactivation)

Occurs when the bacterial cell produces enzymes that degrade or deactivate the antimicrobial before it reaches its target site; a method of antimicrobial resistance

Efflux

Occurs when the antimicrobial enters the cell through a porin but is pumped out by an efflux pump

Audiogram

A graphic representation of the relation of vibration frequency (pitch) and the minimum sound intensity (volume) for hearing

Cochlear implant

An electrical prosthetic device that enables patients with sensorineural hearing loss to recognize some sounds; consists of an external microphone, speech processor, and electrodes implanted in the cochlea where they stimulate the auditory nerve

Conductive hearing loss

Hearing loss or impairment resulting from interference with the transmission of sound waves to the cochlea (middle ear blocked or malformed)

Hearing aid

An electronic device usually worn by a person for amplifying sound before it reaches the receptor organs

Inner ear

The essential part of the vertebrate organ of hearing and equilibrium that includes the vestibule, the semicircular canals, and the cochlea

Middle ear

The middle portion of the ear containing a chain of three ossicles that extends from the tympanic membrane to the oval window and transmits vibrations to the inner ear

Outer ear

The outer visible portion of the ear that collects and directs sound waves toward the tympanic membrane by way of a canal which extends inward through the temporal bone

Sensorineural hearing loss

Hearing loss or impairment resulting from problems with the auditory nerves

Sound

Mechanical energy that is transmitted by longitudinal pressure waves in a medium (such as water and air)

Frequency

Refers to the number of sound waves that pass a certain point in a unit of time, pitch, Hertz (Hz)

Amplitude

refers to the height of the sound wave measured from its midpoint to its crest (or trough), volume, decibels (dB)

Wavelength

The distance between one crest or trough to the next crest or trough of a sound wave

Pinna

Part of the ear that gathers vibrations and directs the vibrations into the auditory canal

Auditory canal

Part of the ear that connects the pinna to the tympanic membrane, amplifies sound waves, acidic to prevent infections, secretes cerumen (earwax) to keep itself moist

Eustachian tube

Part of the ear that regulates air pressure inside and outside the tympanic mambrane and drains secretions of the middle ear

Malleus

The first ossicle, shaped like a hammer, delivers vibrations from the tympanic membrane to the incus

Incus

The second ossicle, shaped like an anvil, delivers vibrations from the malleus to the stapes

Stapes

The third ossicle, shaped like a stirrup, transmits vibrations from the incus to the oval window