NEW #2 Final Human Health Diseases

Spring 2025 – Final Exam Study Guide General Questions

• African Americans have the greatest risk of maternal mortality and the highest rates of infant mortality.
• Know other groups that have high rates of other diseases.
• Know the leading causes of death discussed and their order.
• Be able to identify pictures of: famous people with diseases, structure of diseases in tissue/cells, people showing characteristics of diseases.
• Know how to draw a public health triangle and identify primary, secondary, and tertiary preventions.

Cardiovascular Heart

• Label the parts of the heart and know their functions.
• Lies close to the center of the thoracic (chest) cavity.
• Mostly composed of myocardium (cardiac muscle).
• Surrounded by pericardium.
• Divided into right and left side by the septum.
• Four chambers:
  • 2 atria (right atrium & left atrium).
  • 2 ventricles (right ventricle & left ventricle).
• 2 sets of valves: prevent blood from flowing backward.
  • Atrioventricular (tricuspid valve & mitral valve).
  • Semilunar (pulmonary valve & aortic valve).
• 6 main veins: 2 vena cava (superior and inferior) + 4 pulmonary veins.
  • Carry blood toward heart.
  • Walls have three layers:
    • Thin inner epithelium.
    • Middle smooth muscle.
    • Outer connective tissue.
  • Thinner than arteries.
  • Venules are small veins (Receive blood from capillaries).
  • May carry blood against gravity (Contain valves).
• 2 main arteries: Pulmonary artery + Aorta.
  • Carry blood away from heart (Artery = Away).
  • Walls have three layers (Thin inner epithelium, Thick smooth muscle, Outer connective tissue).
  • Arterioles are small arteries (Regulate blood pressure).
• Know the direction of blood flow + whether it’s deoxygenated or oxygenated:
  • Body → Superior and inferior vena cava (low oxygen) → Right atrium →tricuspid valve → Right ventricle →pulmonary semilunar valve →pulmonary arteries → lungs → pulmonary veins → Left atrium → mitral valve → Left ventricle → aortic semilunar valves → All body tissues
• Arteries, veins, and capillary beds: Label the parts of a capillary bed and surrounding vessels
• Know the function of these parts, whether they carry oxygenated or deoxygenated blood, which direction blood flows, how blood is moved, and what happens in various parts (movement of things like oxygen, carbon dioxide, nutrients, wastes, etc)

Blood Pressure

• Pressure against blood vessel wall.
  • Know systolic and diastolic + what they mean.
    • Highest during ventricular contraction (Systolic pressure).
    • Lowest when ventricles relax (Diastolic pressure).
  • What various blood pressure readings mean (you should know the cutoff for normal without a chart, otherwise, know how to read the chart).
  • Don’t confuse 120/80 with normal (hypertension stage one/ not normal/ has to be under).

Cardiovascular Diseases

• Matching causes and symptoms.

Coronary artery disease

• Cause: causes ischemia (lack of oxygen).
• Symptoms:
  • Chest pain (Occurs regularly after exercise + After eating).
  • Chest pain that varies in intensity or regularity may indicate myocardial infarction (heart attack).
    • Blood flow to heart muscle cut off.
    • Heart muscle tissue dies from lack of oxygen.
    • Ischemia can lead to ventricular arrhythmia → ventricular fibrillation.

Stroke

• Cause:
  • Ischemic (Blocking artery in the brain + Tissue downstream lacks oxygen, dies).
  • Hemorrhagic (Rupture of blood vessel + Bleeding into the brain or space around the brain).
• Symptoms: FAST (Facial droop, Arm weakness, Speech difficulty, Time to call emergency services).

Atherosclerosis

• Cause: “Hardening of the arteries” as they become less flexible due to buildup.
  • Narrowing of artery interior > Build up of plaque (fat, cholesterol, calcium, cellular waste products, and fibrin).
• Symptoms: Chest discomfort during exercise or emotional stress, leg cramps when walking, shortness of breath with light activity.

Hypertension

• Cause: High blood pressure
  • $~45$ of adults in the US have hypertension. Of these only $~24$ have it under control.
• Risk factors:
  • Modifiable: unhealthy diets (excessive salt, high in saturated & trans fats, low intake of fruits & vegetables), physical inactivity, tobacco and alcohol, being overweight or obese, air pollution.
  • Non-modifiable: family history of hypertension, > age 65, diabetes & kidney disease, race.
• Symptom: Headaches, vertigo, tinnitus, altered vision or fainting (can lead to atherosclerosis).

Hypertensive heart disease

• Cause: Heart disease caused by hypertension.
  • Different from ischemic heart disease BUT linked through atherosclerosis.
  • ie hypertension increases risk of atherosclerosis which increases risk of ischemic heart disease.
  • Hypertension makes it harder for the heart to pump blood.
  • The heart works harder, and gets larger.
    • Left ventricular hypertrophy.
  • Can lead to heart failure (can’t pump enough blood), arrhythmia, congestive heart failure.
• Symptom:

Diabetes

• Know the differences among the three types (Type I, Type II, Gestational).

Type 1 (“insulin dependent diabetes”)

• Body does not make (enough) insulin. Beta cells in pancreas that make insulin are destroyed by the immune system. Autoimmune.
• Cause:
  • Can occur at any age, but often, often early onset. About 5-10% of diabetes are Type 1 WITH two peaks: 4–7-year-olds; 10–14-year-olds.
  • No cure or prevention, treated with insulin injections + check sugar levels regularly.

Type 2 (“non-insulin dependent diabetes”)

• Body can’t use insulin properly (insulin resistance). When the need for insulin can not be met, the glucose level in the blood increases. Prediabetes --> diabetes. Metabolic
• Cause: Development of insulin resistance and prediabetes.
  • Poor diet leads to increased lipids in blood, fat cells.
    • Causes inflammation.
    • Causes insulin receptor activity to decrease (“resistant”).
    • Causes increased blood sugar.
    • Causes the need for more insulin.
  • About 90-95% of diabetes are Type 2.
    • Most common in adults (Becoming more common in children).
• Lifestyle changes (Eat a healthy diet, Exercise, Achieve/maintain a healthy weight).
• Medications: Several classes that work in different ways to lower blood sugar.
  • For example (FYI only):
    • Causing the pancreas to make and release more insulin.
    • Limiting the liver's ability to make and release sugar.
    • Blocking the action of enzymes in the intestines that break down carbohydrates, slowing how quickly cells take in carbohydrates.
    • Improving cells' sensitivity to insulin.
    • Limiting the kidneys' ability to take in sugar, which increases the amount of sugar that leaves the body in urine.
    • Slowing how quickly food moves through the stomach.

Gestational

• Body can’t properly use insulin during pregnancy. Usually resolves after pregnancy.
  • Affects about 3-8% of pregnancies Metabolic.

Respiratory system

• Label the parts of the upper and lower respiratory system, know their functions, and know their common names (for example, larynx = voicebox).

Upper respiratory tract

• Nasal cavity (Filtering; Warm, moisten; Odor receptors; Lacrimal glands drain into nasal cavities; Sinus headaches, inflammation).
• Pharynx (throat).
• Larynx ( voice box).
• Glottis
  • Located in the center of the larynx.
  • Contains vocal chords/ folds.
• Epiglottis: blocks the trachea when swallowing so food goes to the esophagus.

Lower Respiratory Tract

• Trachea.
• Bronchi: 2 primary bronchi; Secondary bronchi; Tertiary bronchi.
• Bronchioles: lead to alveoli.
• Alveoli: contained in alveoli sacs, gas exchange.
• Right lung - 3 lobes.
• Left lung- 2 lobes (why only 2?).
• Bronchi
  • 2 primary bronchi.
  • Secondary bronchi.
  • Tertiary bronchi.
• Bronchioles: lead to alveoli.
• Know how breathing works.
• Know which parts are active vs passive (and what that means), know the role of the diaphragm and intercostal muscles, understand the role of volume and air pressure, know which direction the ribs move, etc.
• Inspiration (or inhalation): Active process, air moves into lungs.
  • The diaphragm contracts and flattens. Intercostal muscles contract and move the rib case upward/outward.
  • Volume of the thoracic cavity increases.
• Expiration (or exhalation): Usually passive process.
  • The diaphragm relaxes, rib cage moves downward/inward.
  • Volume of the thoracic cavity decreases.
  • Air pressure increases.
  • Air moves out of the lungs.
• Controlling breathing
  • Rate – 12 to 18 / min.
  • Nervous system control:
    • Medulla oblongata.
      • Sends signals through C3, C4, and C5 and into the diaphragm.
      • Sends signals through thoracic region and into the intercostal muscles.
    • Chemoreceptors also detect the presence of high $CO_2$ and high acids and will signal the brain to stimulate breathing.
    • Be able to describe:
      • Total Lung Capacity: Maximum volume of air the lungs can accommodate.
      • Tidal volume: Amount of air moved in and out during normal breathing at rest.
      • Inspiratory or Expiratory reserve volume: Amount of air that can be forcibly inhaled (or exhaled) after a normal tidal volume; Usually kept in reserve.
      • Vital capacity: Maximum volume that can be moved in and out in one breath.
      • Residual volume: Air remaining in lungs after maximum exhalation.
      • Know the causes and symptoms (to the extent discussed in class) of:

Pneumothorax

• Air in space between lungs and chest wall.
  • Causes lung to collapse.
  • Spontaneous, or caused by trauma.
  • Treated by removing trapped air, re-inflating lung.

Sinusitis

• (Upper resp. disease) - blockage of sinuses.

Otitis media

• (Upper resp. disease) – infection of the middle ear.

Tonsillitis

• (Upper resp. disease) – inflammation of the tonsils.

Laryngitis

• (Upper resp. disease) – infection of the larynx.

Pneumonia

• (Lower resp. disease) – infection of the lungs, thick fluid build-up (bacteria, viral, fungal, aspiration).

Tuberculosis

• (Lower resp. disease) – bacterial infection that leads to tubercles (capsules) ($Mycobacterium uberculosis$).

Pulmonary fibrosis

• (chronic lower resp. disease): the scarring of the lungs (disease that results from scarring of the lungs).
  • Restricts the ability to inhale air.
  • Secondary effect of a number of diseases (Asbestosis, silicosis, coal workers pneumoconiosis, cigarette smoking, radiation therapy, infections, gastrointestinal reflux disease, etc.).
  • Lung tissue inside and between alveoli damaged.
    • Healing results in scarring.
      • accumulation of connective tissue, called fibrosis.
      • Scarring results in less flexibility, space in alveoli.
      • Less air movement, less oxygen.
  • Symptoms:( Shortness of breath, dry hacking cough, fatigue, chest discomfort or pain).
  • Diagnosis: Chest X-ray, spirometry, biopsy.
  • Treatment: Scarring is permanent, Medication to slow scarring, inflammation, Oxygen supplementation, lung transplant, No cure.
  • Risk factors: Age, sex, smoking (vaping??), occupation, cancer treatments, genetics.
  • Complications: Collapsed lung, lung infections, respiratory failure, pulmonary hypertension, heart failure.

Chronic bronchitis

• Inflammation of the lining of the bronchi. Inflammation prevents good airflow into and out of the lungs and makes extra mucus.
  • Symptoms: Productive cough (wet cough) that lasts 3 or more months, Hypersecretion of mucus and mucins (thicken mucus).
  • Mucus narrows airways, limits airflow.
  • Cannot be completely cleared by ciliary beating.
  • Causes: Smoking, Air pollution, Genetics.
  • Treatment: Stop smoking, Inhaled bronchodilators, steroids, Oxygen therapy.

Emphysema

• Difficulty exhaling air from lungs.
  • Gradual thinning and destruction of alveoli.
    • Results in poor airflow, air trapping.
    • Poor gas exchange between lungs and bloodstream.
  • Symptoms: Chronic cough, usually productive, Shortness of breath, Producing a lot of mucus, Longer to breath out than in.
  • Cause: Smoking (80-90% of cases), Air pollution, Occupational exposure.
  • Diagnosis: Spirometry, X-ray, blood tests to rule out other diagnoses.
  • Treatment: No cure, delay progression, Reduce risk factors, treat current disease, Medications (Bronchodilators), Supplemental oxygen.

Asthma

• Inflammation and narrowing of airways.
  • Tend to be sensitive to certain inhaled substances.
    • React, muscles in airways tighten, restricting the airway further.
    • The airway may get more swollen, make more mucus, further narrowing.
  • Symptoms: Wheezing, Coughing, Shortness of breath, Sleeplessness, Daytime fatigue, Lower activity levels, Absenteeism in work/school.
  • Diagnosis: Spirometry.
  • Treatment: No cure, Manage symptoms( Medications, Lifestyle modifications, Oxygen supplementation).
  • Risk factors:
    • Modifiable: Smoking, exposure to pollutants, exposure to chemicals, overweight.
    • Non-modifiable: Family history, allergic conditions such as atopic dermatitis.
  • Most common chronic respiratory disease in children under diagnosed and under treated.
  • Over 80% of asthma deaths occur in low/middle-income countries (lower respiratory need to know more details cause and symptoms + the other one only one word answer wtv that means?).

Cancer

• Understand the various risk factors.

Genetic

• Tests are available that can detect mutations associated with a number of types of cancers.
  • BRCA1 gene mutation (breast cancer), RET gene mutation (thyroid cancer), p16 gene mutation (melanoma).
• Positive results do not indicate cancer will definitely occur, just increased risk.
• Individuals with positive results may:
  • Have more frequent screenings.
  • Decrease environmental risks.
  • Undergo prophylactic surgery.

Age

• More than half of all cancers are related to modifiable health behaviors: Tobacco use, Diet, Physical activity, Sun exposure, Failure to get cancer screenings, Others (obesity).
• In cancer the role of:

Apoptosis

• programmed cell death / self-destruct.

Proto-oncogenes

• Oncogene is mutated version that doesn’t “turn off”.
  • Proto-oncogenes promote cell cycle, prevent cell death.
  • HER2/neu (human epidermal growth factor receptor 2).

Tumor suppressor genes

• Inhibit cell division, repair damaged DNA, tell cells when to die (apoptosis).
  • When mutated, cell division occurs more frequently, out of control.
  • Double-hit, or Two-Hit, theory (both copies in a cell need to be mutated).
  • BRCA1, BRCA2 (inherit one mutated copy on every cell).
• Different cancers, different genes mutated.
• Know which parts of the body are associated with which types of cancers.

Carcinomas

• (Epithelial tissues): Include skin, breast, liver, pancreas, intestines, lung, prostrate, thyroid.

Sarcomas

• (Muscle, connective tissues): Bone, cartilage, etc.

Leukemias

• blood.

Lymphomas

• Lymphatic tissues.

Blastoma

• Composed of immature cells.
• Know some statistics that were discussed (most common cancers overall, in men, in women, in certain age groups, which ones are increasing, etc.).
  • 1 in 3 people will get cancer in their lifetime.
  • 1 in 6 people will die from cancer.
  • Some cancers are increasing in subgroups:
    • Colorectal cancer in people under 55 (men).
    • Liver cancer in women.
    • Oral cancers associated with HPV.
    • Cervical cancers in women ages 30-44.
    • ADD MOREEEE.
• Know the difference between a malignant and a benign tumor. Know the details of each that were discussed in class.

Benign

• Localized to one area.
  • Usually encapsulated.
  • The tumor may continue to grow.
    • Can be deadly. Why?

Malignant

• Cells leave the primary tumor, move through blood or lymph.
  • Start secondary tumors in other locations.
  • Requires systemic treatment once metastasis occurs.
• Be able to identify primary, secondary, and tertiary preventions.

Secondary (Screening)

• Skin cancer (melanoma)
  • ABCDE test
    • Asymmetry
    • Border that is irregular
    • Color inconsistent
    • Diameter greater than 6mm
    • Elevated and evolving
• Breast cancer
  • Self-check
    • Mammograms
    • Self exams, clinical breast exam (CBE).
    • Mammograms
• Testicular cancer: Self-check
• Colorectal: Fecal occult blood test (FOBT), colonoscopy
• Cervical: Pap test, HPV DNA test
• Prostate: Digital rectal exam, PSA test (prostate-specific antigen)
• Other
  • Not done routinely
    • When issue/difference noted
      • Diagnosed by X-ray, CAT scan, MRI, blood tests

Tertiary (Treatment)

• Localized: Surgery, Radiation
• Systemic
  • Chemotherapy
    • Kills cells in cell division or DNA replication with different methods.
    • Includes hair, GI tract, bone marrow cells
    • Nitrogen mustard (from mustard gas) first chemotherapeutic agent
    • Combination chemotherapy
  • Hormonal therapy
    • Breast and prostate cancers
  • Immunotherapy
    • Monoclonal antibodies
    • Keytruda (for various cancers)
    • Personalized vaccines
    • ProvengeTM!
      • personalized immunotherapy that activates the immune system to help fight advanced prostate cancer
  • Targeted therapy
    • Growth-signal inhibitors (prevent growth)
    • Angiogenesis inhibitors (prevent the formation of new blood vessels)
    • Apoptosis-inducing drugs (promote cell death)
• Know the difference between descriptive and analytic epidemiology

Descriptive epidemiology

• Refers to epidemiologic studies concerned with characterizing the amount and distribution of health and disease within a population.
  • WHO is getting sick? (ex. sex, age, race/ethnicity)
  • WHERE are they getting sick? (ex. country, rural/urban, near factory)
  • WHEN are they getting sick? (over a day, year, decade, seasonally)
  • HOW MANY are getting sick? (ex. proportion of population or subgroup)

Analytic epidemiology

• Examines causal (etiologic) hypotheses regarding the association between exposures and health conditions.
  • WHAT is making them sick? (ex. virus, pollution, radiation, stress)
• Be able to identify examples of:
  • Distribution of cancer (the facts, go out and collect without knowing causes): pattern (who, what, where & when) and frequency (how many) of health events
  • Determinants of cancer (know the cause of cancers): causes (why and how) of health-related events
• Know some famous people/agencies in cancer epidemiology and what they did

Neuro

Brain Regions

• Label the four main brain regions (cerebrum, cerebellum, diencephalon, and brainstem) and know their functions (matching, general idea)
• Understand the parts and functions of the nervous system.

Functions of Nervous System

• Receive information from surroundings
• Process and integrate information
• Send information and instruction to the body
• Divided into CNS and Peripheral Nervous System

Central Nervous System (CNS)

• Brain (protected by skull): Including cranial nerves
• Spinal cord (protected by vertebral column): Including spinal nerves
• Contains the same gray and white matter as the brain
• Relays information between the brain and other parts of the body
• Signals sweat glands to produce sweat and cool the body
• Coordinates reflexes

Peripheral Nervous System

• Afferent (sensory) nerves – carry sensory information into the CNS
  • Somatic (signals from skin, muscles, joints, special senses)
  • Visceral (signals from organs)
• Efferent (motor) nerves – carry motor information from CNS to effectors
  • Somatic (signals to skeletal muscles) - voluntary
  • Autonomic (signals to smooth muscles, cardiac muscles, glands) - involuntary
    • Sympathetic (fight or flight)
    • Parasympathetic (rest and digest)
• Understand which direction information travels, which type of information is transmitted, etc.
• Label the parts of a neuron and know the function of each part
• Neurons – contain three distinct structures
  • Cell body: Contains nucleus and other organelles
  • Dendrites: Short extension that receive signals from sensory receptors or other neurons
  • Axon
    • Portion that conducts nerve impulses
• Nerve fibers – individual axons
• Nerve – collection of nerve fibers
• Often covered by myelin sheath
  • Usually found on long axons, White matter
  • Insulates nerves
  • Helps regenerate damaged nerves
    • Gaps between are called nodes of Ranvier

Nervous Tissue

• Neurons: Transmit nerve impulses
• Neuroglia (neuroglial cells or glial cells): Support and nourish neurons
• Neurons – three types
  • Sensory neurons – take nerve signals from a sensory receptor to the CNS
    • Sensory receptors – detect changes in the environment
  • Interneurons - lies within the CNS
    • Receives input from sensory neurons, process information, communicates with motor neurons
  • Motor neurons - Transmit nerve impulses away from CNS to an effector
    • The effector – muscle fiber, organ, or gland that carries out our responses to environmental changes
• Collecting and passing information

Collecting Information

• Info collected by receptors
• Passed down axon as electrical signal
• Passed between neurons at synapses

Synapses

• Electrical signal arrives at tip of axon
• Releases neurotransmitters into synapse
• Neurotransmitters cross synapse, bind to receptor on postsynaptic cell membrane
• Cause or inhibit signal in postsynaptic cell
• Know what was discussed about multiple sclerosis (causes, symptoms, etc)

Multiple Sclerosis

• Autoimmune disease
  • The immune system attacks the myelin sheath in the CNS
• Leaves lesions or scars (“multiple scars”)
• Nerve cells die faster than usual

Risk Factors

• Autoimmune disorders (thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease)
• Infectious agents (Epstein-Barr virus)
• Environmental factors (smoking, vitamin D deficiency, current or childhood obesity)
• Genetic factors (family history)
• Sex (female 2-3xmore likely)
• Age (usually 20-40 years old)

Common Early Symptoms

• Blurred/double vision, red-green color distortion, pain/vision loss due to optic nerve swelling
• Trouble walking and difficulty with balance
• Numbness, prickling, or pins and needles (paresthesia)

Later Symptoms

• Muscle weakness in the arms and legs
• Trouble with coordination
• Partial or complete paralysis
• Muscle stiffness and spasms
• Fatigue
• Loss of feeling
• Speech problems
• Tremor
• Dizziness
• Hearing loss
• Bowel and bladder problems
• Depression
• Changes in sexual function
• Cognitive problems (focus, attention, memory, judgement)

Stress

Causes

• External vs internal
• Social-psychological
• Physical
• Stressors can be “good” or “bad”

Cortisol

• Steroid hormone produced by adrenal cortex
• Also called hydrocortisone when used as a medication
• Released in response to stress
• An acute stressor triggers the release of cortisol
• If the stressor goes away, cortisol returns to normal levels
• Cortisol binds to glucocorticoid receptors (GR) in most tissues and can affect multiple things
• Increases blood sugar levels
• Prevents inflammation

Body Response to Stressor

• Two systems respond to stress
  • Sympathetic nervous system
  • HPA axis (hypothalamic-pituitary-adrenal axis)
• Nervous System
  • Central nervous system: Brain and spinal cord
  • Peripheral nervous system
    • Sensory
    • Motor
      • Somatic
      • Autonomic
        • Sympathetic
          • “fight or flight”
        • Parasympathetic
          • “rest and digest”
• Sympathetic Nervous System
  • Innervates many organs
  • Releases epinephrine /norepinephrine
    • Hormones or neurotransmitters
  • Fast acting
• HPA Axis
  • Major neuroendocrine system
  • Composed of three components: Hypothalamus → pituitary → adrenal cortex
    • Information from amygdala, hippocampus, and prefrontal cortex feed into the hypothalamus
      • Amygdala: emotional responses, including fear, anxiety, and aggression; also memory
      • Hippocampus: consolidation of short-term to long-term memory
      • Prefrontal cortex: planning, personality, decision-making, executive function
    • Regulates many homeostatic systems
      • Metabolic, cardiovascular, immune, reproductive
    • Integrates physical and psychosocial influences to allow the organism to adapt to the environment
    • Complex set of interactions and feedback influences among three components
    • Composed of:
      • Hypothalamus: Releases CRH (corticotropin releasing hormone), which stimulates
      • Pituitary gland: To release ACTH (adrenocorticotropic hormone), which stimulates
      • Adrenal cortex: To release cortisol

Mental Health Disorders

• Be able to identify examples of mood disorders, anxiety disorders, psychotic disorders, impulse control disorders, neurocognitive disorders, and neurodevelopment disorders.
• Know the symptoms of the mental health disorders that were discussed in class.

Depression

• Major depressive disorder (Dysthymia)
  • At least two weeks of depressed mood across all situations
    • Frequently associated with: Diminished interest or pleasure, Insomnia or hypersomnia, Significant change in appetite, Psychomotor agitation or retardation, Fatigue, Feelings of worthlessness, inappropriate guilt, Diminished ability to think or concentrate, Recurrent thoughts of death or suicide
    • Differentiated from sadness or grief
    • Diagnostic and Statistical Manual of Mental Disorders, 5th Edition

Schizophrenia

• Age of onset usually between 16 and 30

Symptom Categories

• Three categories of symptoms: positive, negative, cognitive
  • Positive = psychotic behaviors not present in health people (Hallucinations, delusions, thought disorders, movement disorders)
  • Negative = associated with disruptions to normal emotions/behaviors (“flat” affect, reduced feelings of pleasure in everyday life, difficulty beginning or sustaining activities)
  • Cognitive = not needed for diagnosis (Poor “executive functioning,” trouble focusing or paying attention, problems with working memory)
• Most people with schizophrenia report experiencing rejection, avoidance, other forms of interpersonal and social stigma
• Stigma – negative attitudes about members of a minority group, often lead to social exclusion, discrimination, other forms of marginalization

Synaptic Pruning

• Know what synaptic pruning is and why it is important
• Natural process that occurs in the brain between early childhood and young adulthood
• The brain eliminates extra synapses that are no longer needed
• Allows our brain to be more efficient
• Possible link between synaptic pruning and certain mental health disorders

Addiction

Drug Addiction

• Most drugs affect the reward circuit
• Cause an increase in dopamine
• Results in a feeling of pleasure
• Pleasurable reward motivates repetition of behavior
• Repeated drug use causes tolerance
• Brain produces less dopamine
• More drug is needed to achieve the same result
• Less pleasure from normal activities

Alcohol

• Risk factors: Genetic and environmental, High stress levels, anxiety, easy accessibility
• Affects both stimulatory and inhibitory neurotransmitters
• Increases dopamine
• Decreases glutamate
• Decreased glutamate slows thoughts, speech, and movement
• Increases GABA (Gamma-aminobutyric acid)
• GABA slows down your brain by blocking specific signals to your CNS
• Promotes CNS depression, sedation
• Heavy consumption desensitizes and down-regulates receptors
• Causes physical dependence

Withdrawal

• Uncontrolled synapse firing due to loss of depressant (alcohol)
• Symptoms: Seizures, anxiety uncontrolled shaking, hallucinations, possibly heart failure

Nicotine

• Nicotine binds to nicotinic acetylcholine receptors in the CNS
• Increases dopamine release: Pleasure, reward
• Increases norepinephrine release: Alertness, arousal
• Increases serotonin release: Increased mood
• Activates the autonomic nervous system: Increased heart rate, blood pressure, respiration

Opioids

• Resin or sap of opium poppy plant and semi-synthetic derivatives(Morphine, heroin, codeine, fentanyl, hydrocodone, oxycodone, methadone, etc.)
• Bind receptors meant for endorphins
• Blocks pain, slows breathing, general calming and anti-depressing effect
• Causes the release of dopamine, produces a euphoric effect
• Repeated use results in a decrease in endorphin production
• Tolerance develops, need increased doses to feel “normal”
• Prescribed for pain
• Stress and Opioid Addiction
• Stress triggers HPA (hypothalamic-pituitary-adrenal) axis
• Opioids suppress HPA axis
• Reduce feelings of stress
• Affects cardiovascular system, immune system, metabolic system, decreases adrenaline secretion

Opioid Withdrawal

• Withdrawal causes HPA to rebound
• Symptoms: Agitation, anxiety, insomnia, nausea, vomiting, dilated pupils
• Can be relieved by methadone: Long-term maintenance medicine for opioid dependence

Opioid Overdose

• Symptoms: Loss of consciousness, Unresponsive to outside stimulus, Awake but unable to talk, Slow shallow breathing, erratic breathing or breathing has stopped, Vomiting, Pulse is slow, erratic, or not present
• Naloxone (Narcan): Opioid antagonist, counters the effects of opioids, Blocks the receptors, Wears off in 20 – 90 minutes - some statistics ???