PATH120- Full Review Queens

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222 Terms

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Describe the structure of a neuron

  • cell body: containing the nucleus
  • dendrites: treelike features that extend from the cell body and contain receptors
  • axon: transmits outgoing signals away from the cell body
    -axon terminals: where neurotransmitters, where signals are transmitted to adjacent neurons
  • myelin sheath: fatty coating for axons, insulation for signals, speeds up transmission (not on all axons)
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What are 3 indigenous ways of experimental learning

  1. Observation
  2. Action
  3. Reflexion
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What is the definition of pathology

Study of disease, it's cause/effects, and process of planning a course of treatment

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What is etiology?

cause of disease

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What is pathogenesis?

how a disease develops (mechanisms of action)

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What is a biochemical change?

  • "lab test values"
  • build up of substances or loss of substances
  • ex: DNA sequencing, glucose levels, antigen testing, HDL+ LDL levels.
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What is a morphological change?

  • structural or tissue changes
  • changes to cellular level
  • "how it looks", blood smear, biopsy results
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What is a functional change?

  • symptoms
  • "how its working"
    ex: high blood pressure, loss of mobility
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What is a natural history?

  • the progression and projected outcome of the disease without medical intervention
  • likely outcome/ prognosis
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What is treatment?

Management/ care of patient

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What are complications?

  • New secondary or additional problems
  • Short an longterm effects
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What are 4 Indigenous ways to transmit knowledge to future generations.

  1. Through knowledge keepers
  2. Ceremonical speeches
  3. Storytelling
  4. Sharing circles
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What are 2 important Indigenous values?

  1. Relationality: Were all related (people+ nature+ spiritual world)
  2. Spirituality: Practices are sacred and secular.
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What are the 7 grand father values?

  1. Courage
  2. Love
  3. Honesty
  4. Wisdom
  5. Humility
  6. Truth
  7. Respect
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What are the 4 sections of the medicine wheel and describe what they mean?

Spiritual: cultural safety, strenght and resiliences
Physical: Capacities, mobility, comorbidity, awarnes and prevention
Mental: Housing, family, community and ceremony
Emotional: Casuality, access to equipment and services

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What is an ally?

A person who:

  • recognizes privilege
  • educated
  • takes responsibility for change
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role of nucleus

  • Stores DNA
  • where DNA replication occurs
  • Where DNA is transcribed to mRNA
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role of mitochondria

  • produces energy (ATP)
    where krebs cycle takes place
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Role of cytoplasm:

Liquid in the cell

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Role of cytoskeleton

  • dense network of specialized structure
  • moves cargo
  • generates motion
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Role of endoplasmic reticulum

  • where proteins are translated and processed
  • where lipids are made
  • helps transport of molecules around the cell
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Role of Golgi Apparatus

  • "post office" of the cell
  • packages proteins and sends to vesicles to be sent to final destination
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Role of lysosomes

-Digest waste (proteins lipids, nucleic acids to their base aka recycling)
-destroy viruses/ bacteria

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Role of endosomes

-store
-sort
-organize

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Role of peroxisomes

makes hydrogen peroxide in reaction to reactive oxygen species in body

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How are cells specialized

By gene expression

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What is a genetic muation

  • changes to DNA
  • proteins cannot be properly made
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What are the 5 steps of the cell cycle?

G0= phase where cells enter when they are not dividing
G1= cells are actively growing, they must pass checkpoint before they start division to ensure proper completion of the phase before the next
S= the entire genome is replicated
G2= last changes for cells to grow before they are divided
M= cell division/mitosis

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What are the 5 steps of mitosis?

  1. Prophase: Chromosomes become visible, nuclear envelope breaks down, microtubials grow from centrioles and move to opposite poles of the cell.
  2. Metaphase: chromosomes line up along the middle of the cell, microtubials attach themselves to sister chromatids.
  3. Anaphase: Sister chromatids are separated.
  4. Telophase: sister chromatids reach the ends of the cell
  5. Cytokinesis: The 2 cells divide.
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What is a stem cell?

a cell that can differentiate and become any type of human cell

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What is a progenitor cell?

a stem cell that becomes partially specialized through asymmetric division

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What is stem cell differentiation

A progenitor cell divides to replace a damaged or lost cell

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Causes of uncontrolled cell division

  • checkpoints dont work properly causing growth or cancer
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Causes of cell death.

apoptosis and necrosis

  • lack of ressources or release of harmful chemicals like ROS ( reactive oxygen species)
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What is cancer?

  • uncontrolled cell division
  • spreads to other tissues
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What is a neoplasm?

Abnormal tissue forming when cells grow and divide

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What is a tumor?

  • mass/ swelling/ enlargement- can be benign or malignant
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Can benign tumour invade or spread?

No

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Can malignant tumour invade or spread?

Yes

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Can the size of a benign tumour impact the harm

No, they can grow up to 50kg without killing patient

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Can the size of a malignant tumour impact the harm

a malignant tumour can kill someone before even weighing 50g

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What does a benign tumour look like?

  • smooth/round
  • looks like a sea sponge
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What does a malignant tumour look like?

  • spiky contour
  • looks like a crab
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What is a carcinoma?

  • cancer of epithelial cells
  • solid tumour
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What is a sarcoma?

  • cancer of connective tissue
  • develops in fat, muscles, nerves, tendons, joints, blood vessels, lymph vessels, cartillage or bone
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What is lymphoma?

  • begins at lymohocytes, affecting cells of the immune system (glands, nodes and lymphoid tissues)
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What is a glioma?

  • cancer of the connective tissues of the brain
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What is leukemia?

cancer of the blood and bone marrow cells

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What is the etiology of cancer?

  • 50% prevalence in canada
  • caused by genetic mutation
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What are some risk factors of cancer?

  • Family history
  • Tobacco use
  • Age
  • HPV infection
    -UV radiation
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What happens to the body with the use of tobacco?

  1. Tobacco:
  • each inhale contains lots of toxic chemicals
  • the chemicals kill epiphelial cells
  • the tobacco lines the airways.
  1. Injury:
  • When epiphelial tissue dies, stem cells need to work harder and multiply more to fix the issue
  1. Repair:
  • Epiphelial layer is restored
  1. Resting state:
  • There is sucessful repair
  • stem cells can return to resting stage
  1. Persistent activation:
  • stem cells can mutate cuz they are overworked and not at rest.
  • smokers are often persistent putting their stem cells at more frequent risk of damage due to chemicals, risking more mutations
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Explain the steps of evolution and clonality of cancer

  1. Tranformation: A cell mutates from normal to mutated version
  2. Progression: The mutated cell 1 multiples and variates.
  3. Proliferation: More mutations can be made creating subclones of the cancer
  4. Tumour heterogeneity: The most "ideal" mutation will continue to replicate but there will be subclones of the mutation making it heterogenous
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What is a silent mutation?

alters a base but does not change the amino acid

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What is an oncogenic mutation?

A mutation directly contributing to the development of cancer

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What are 3 challenges to cancer treatment?

  1. Various types of tissues: different tissues respond to treatment differently.
  2. Continuous mutations: Some subclones of a mutation will respond to treatment better than others.
  3. Diversity: tumours can arise from the same cell and they can still be different from one another
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What can an oncogene do?

  • produce proteins with new or altered functions
  • act on growth factor receptor pathways
  • they are more known with sporadic cancers (cancer of a person with no family history)
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What are tumor suppressor genes?

genes that normally prevent cell division

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Common mutated genes in cancer

TP53
ERBB-1

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Discuss TP53

  • in almost all cancers
  • chromosome 17
  • gene is transcribed an translated to form 53 protein
  • affects G1 and S part of cell reproduciton
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What is the p53 protein?

  • determines whether a cell will survive or die
  • can stop cancer cells from surviving or can give them an advantage
  • activated when DNA is damaged, it is activatedm it binds ot DNA, stops cell reproduction in G1 cycle, induced repair by transcriptional regulation
  • when it is inactive, cells with DNA damage can form malignant tumours
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Discuss ERBB-1 gene

  • codes for EGFR (epidermal growth factor receptor)
  • chromosome 7
  • gene is transcribed and translated to for EGFR protein
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What is EGFR protein

  • detects ligands (extracellular signals)
  • tyrosine kinase (enzyme that transfers PO4 group to specific proteins)
  • broken down by lysosomes
  • common target for anti-cancer drugs
  • unaffected by chemo
  • antibodies is common treatment
  • kinase inhibitor are effective treatment
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Comparison of p53 and EGFR

  • EGFR can be targeted from outside of cell
  • p53 has no extracellular component therefore drugs must enter the cell to be effective
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Present Aaliyah case (colorectal cancer case study)

  • she wasnt feeling well so visited Dr
  • blood tests show iron dificiency (anemia) which when in older men or post-menopausal women is a sign of gastrointestinal cancer
  • referred to gastroenterologist
  • got a upper endoscopy( camera into mouth, stomach and beginning of small intestine)
  • got colonoscopy where pass was found and biopsy was done
  • mass is cancerous
  • CT scan done to check for metastisis and there was none
  • hemicolectomy performer (part of large intestine removed)
  • genetic testing done to check for lynch syndrome which comes out positive
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What are the 5 steps of the development of colorectal cancer?

  1. hyperproliferation: A cell containes oncogenic mutations and divides and grows faster than normal
  2. Adenomatous polyp: Rapidly dividing cells move into intestinal lumen causing an adenoma/ colonic polyp
  3. Precancerous polyp: Precancerous polyps can be removed before they become cancerous. It can take 7-10 years for these growths to become malignant adenocarcinomas
  4. Adenocarcinoma: Polyps can become adenocarcinoma and cells can invade into adjacent tissue layers
  5. Advanced cancer: Polyps will continue to grow and invade deeper tissues, Cancer can enter the bloodstream and metastasize.
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what is the importance of screening for colorectal cancer

  • reduction risk of 77%
  • screening is done due to age or family history
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What are 2 common screenings done for colorectal cancer?

  1. fecal immunochemical test:
  • safe and painless
  • good for ppl age 50-74
  • done every 2 yrs
  • examines for blood in stool
  1. Colonoscopy
  • best for people at high risk
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What are the stages of cancer (prognosis)

T: depth
N: spread to lymph nodes
M: Metastisis

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What are the grades of cancer?

G1: low grade, still only found in glands, glands not very circular, hollow appearance
G2: medium grade, Some are still glands, still not very circular, cell shape is very different to G! or normal cell, center is filled with cells or debirs
G3: medium-high grade, barely looks like a glad ,cells vary in shape and size, only a few cells are still hollow
G4: high grade, no gland strucutre, no cells are hollow, cells do not have a specific structure.

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What is the difference between sporadic or familial colorectal cancer

Sporadic: spontaneous mutations in both allele of adenomatous polyposis coli gene (APC)
Familial: inherited mutation

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What is Lynch syndrome?

  • caused by a germline mutation (mutation of sperm or egg)
  • causes a higher risk of developping cancer
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What is the prognosis of colorectal cancer?

65% survival rate after 5 years

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What are factors that can cause colorectal cancer?

  • Age and health
  • Response to treatment
  • Stage and grade: Stage 1=90% survival vs stage 4=10%
  • Genetics
  • Access and compliance: access to screening and treatment and being voluntary to be treated
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Risk factors that put Indigenous people at higher risk of colorectal cancer

  • smoking
  • alcohol consumption
  • obesity
  • food insecurity
  • poverty
  • poor sanitation
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Describe Jorges case (Acute Myeloid leukemia)

  • 37 y/o male
  • symptoms: shortness of breath, low energy levels, nosebleeds, fever
  • blood test done to check for white and red blood cells, platelets and clotting factors
  • blood smear performed which shows blasts in his blood that are promylocytes
  • is diagnosed with acute myeloid leukemia
  • genetic testing shows PML- RARA translocation
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What is the impact of blood cancer in Canada

  • accoutns for 10% of all cancer in CA
  • 21000 new diagnoses in 2019
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What is hematopoiesis?

formation of blood cells from a stem cell to different specialized blood cells

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What is the classical blood cancer pathway?

  1. Differentiation block (tumour suppresor gene is lost in the HSCs leading to accumulation of immature blood cells (blasts)
  2. Enhanced proliferation: Proto-oncogens are mutated and proliferation increases
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What are the 4 types of blood cancer?

  1. Acute myeloid leukemia
  2. Acute lymphocytic leukemia
  3. Chronic myelogenous leukemia
  4. Chronic lymphocytic leukemia
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What are the main differences between acute and chronic blood cancers.

Chronic: Proliferation of well differentiated cells, slow progression, can be monitored for some times before treatment is needed.
Acute: Proliferation of poorly differentiated cells, progresses rapidly, needs immediate treatment

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Factors affecting prognosis of AML

Age: poeple 65+ are at higher risk of death whereas childre 1-15 have a 90% survival rate.
Weight: underweight or overweight causes higher risk of death
Previous blood disorders: like hemophilia, anemia…
Genetics: certain mutations can make prognosis better or worse

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Name some AML related genes

AML1-ETO
CBFβ-SMMHC
PML-RARA!!! this ones important to know
FLT3
c-KIT
N-RAS, K-RAS
BCR-ABL
TEL-PDGFB

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What is immunotherapy?

  • using the bodys immune system to fight cancer
  • not useful for everyone
  • good for people with high immune response
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What are some cancer biomarkers?

  • Small chemical products
  • Enzymes
    -DNA
  • RNa
  • Cancer cells
  • Protein
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What are the 3 types of biomarkers

  1. Diagnostic biomarker: detects or confirms presence of disease
  2. Prognostic biomarker: indicates likelyhood of disease progression or reoccurrence
  3. Predictive biomarker: predicts response to a treatment
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What is metabolism?

  • total balance of energy requirements
  • process of converting macromolecules to energy
    Describes:
  • how we take macromolecu;es
  • how we store macromolecu;es
  • how we break them down
  • how we create new ones when needed
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What is an anabolic pathway?

A pathway where simple molecules are built up into more complex molecules. Requires energy.

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What is a catabolic pathway?

release energy by breaking down complex molecules into simpler compounds

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What are the 4 macromolecules?

carbohydrates: sugar, glycogen, fiber, starches *glucose=primary source of energy
lipids: fats (tryglycerides, oils, fats, cholesterol), associated with transporter proteins cuz theyre hydrophobic, part of adipose tissue
proteins: chains of amino acids, broken down for energy if starving
nucleic acids: DNA, RNA, critical for central dogma, not for energy but they make up ATP and GTP

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What are the factors that influence how our body stores energy?

  • Food intake
  • Food expenditure
  • Fat stores: how much fat you already have stored
  • CNS: basal metabolic rate (# of calories needed to keep your body functioning at rest.
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What is the bodys equilibrium?

Where the body ia at equal amount of anabolism and catabolism

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Why does our body do anabolism?

  • no exercises and high food intake means sugars and fats are stored a lot.
  • low exercise means adipose storage
  • high food intake means high blood sugar and low basal metabolic rate
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Why does our body do catabolism?

  • exercise and fasting causes more catabolic process
  • high exercise means adipose breakdown
  • low food intake means energy deficiency, low blood sugar and induced hunger
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What organ produces insulin?

Pancreas

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Explain insulin binding

Insulin binds to its receptor outside of the cell. The receptor is activated which signals an increase in anabolic activity

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Explain glucose transport

insulin sitmulates the movement of glucose transporters from endosomes in cells to the plasma membrane. Glucose can now enter the cell and be used for energy

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What happens if theres no insulin?

Glucose enters the cell but cannot be metabolized.

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What are plasmalipoproteins?

  • transporter of lipids in the blood stream
  • form spheres
  • their casing makes lipids watersoluble
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What is cholesterol?

  • made in the liver
  • travels through the bloodstream
  • cause of heart disease and stroke
  • 2 kinds: LDL (low density lipoprotein aka bad) and HDL (high density lipoproteins, carries LDL away from arteries back to the liver)
  • high trygliceride, low HDL and high LDL causes higher risk of heart disease
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What are the risk factors of metabolic disease?

Obesity:

  • accumulation of body fat
  • childhood obesity in canada has increase by 3x
  • in 2016 more ppl were obese than underweight
  • cause of T2 diabetes, heart disease, hypertension, cancer and arthritis
    Fat storage:
  • Subcutaneous fat:
    • counts for 80-90% of body fat
    • found under the skin
    • around abdomen, hips and thighs
    • higher rate in womens lower body
    • gives people a pear shape
  • Visceral fat:
    • counts for 10-20% of body fat
    • within the abdominal cavity
    • associated with the digestive tract
    • gives people an apple shape