Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

[ ESA 3- Infection and Immunity > Blood Bourne Viruses > Flashcards

Blood Bourne Viruses Flashcards

1
Q

What are viruses?

A

Obligate intracellular parasites without cellular structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do viruses consist of?

A

Molecule(s) of either DNA or RNA (but not both) surrounded by a protein coat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Do viruses have an envelope?

A

They may or may not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Where is the envelope of a virus derived from?

A

The plasma membrane of the host cell from which it is released

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do viruses reproduce?

A

They hijack the host’s mechanism for creating mRNA and production of proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens once viruses have reproduced in the host cells?

A

They can be released from the cell to infect other cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How can new viruses be released from the original cell?

A

Can often occur by death of the infected cell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How can viruses be classified?

A

In a variety of ways, based on their structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Give 7 examples of key viral classifications

A

Single-stranded, non-enveloped DNA viruses
Double-stranded, non-enveloped DNA viruses
Double-stranded, enveloped DNA viruses
Single-stranded, positive stand, icosahedral, non-enveloped RNA viruses
Single-stranded, positive strand, icosahedral or helical, enveloped RNA viruses
Single-stranded, negative strand, helical, enveloped RNA viruses
Double-stranded, icosahedral, non-enveloped RNA viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How many people does HIV infect per year around the world?

A

~2 million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How many new cases of HIV are there per year in the UK?

A

~6,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How many people in the world have HIV?

A

37million

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens if HIV is left untreated?

A

Most cases of HIV will progress to AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How many deaths worldwide did HIV cause in 2014?

A

1.2million deaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How many deaths did HIV cause in the UK in 2014?

A

320

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How many people with HIV are there in the UK?

A

103,000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What % of those infected with HIV in the UK are men?

A

67%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the HIV prevalence in Leicester, compared to the UK?

A

3.8/1,000 in Leicester, compared to 1.9/1000 in the UK

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What % of those infected with HIV are heterosexuals?

A

57%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What has happened regarding new diagnoses of HIV in heterosexuals since 2005?

A

It has decreased by 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How does the stage of diagnosis of HIV differ between heterosexuals and homosexuals?

A

> 50% of heterosexuals are diagnosed at a later stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the result of heterosexuals being diagnosed with HIV at a later stage?

A

Worse outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What % of those with HIV in the UK are black African?

A

50-60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the prevalence of HIV in IVDUs in the UK?

A

2/1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What % of sexual transmissions of HIV in the UK do MSM account for?

A

57%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is happening to the rate of sexual transmission of HIV by MSM?

A

It is increasing, whilst a decrease has been seen in every other group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What % of people living with HIV in the UK don’t know they have it?

A

17%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is HIV?

A

A retrovirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What does HIV do?

A

Infects and replicates within cells of the immune system, particularly CD4+ cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does HIV gain access to CD4 cells?

A

It binds to the receptors on the CD4 cells, and fuses with them to deposit their contents into them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What happens once HIV has deposited it’s contents into CD4 cells?

A

Single strands of viral RNA are then converted to double stranded DNA by reverse transcriptase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What happens once double stranded DNA has been produced from HIV RNA?

A

The viral DNA is combine with the cell’s down DNA by the integrase enzyme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the result of the combination of HIV DNA and the cells own DNA?

A

When the infected cell divides, the viral DNA is read and long chains of proteins are made

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What happens to the proteins produced as a result of HIV DNA integration?

A

Sets of these viral proteins come together and push out of the cell, taking some membrane with it to form an immature virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What happens to the immature HIV virus?

A

It breaks free of the cell and matures to form a working virus that can infect more cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the result of the use of CD4 cells as a host by HIV?

A

Causes death of CD4 cells and damages the immune system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the result of the damage to the immune system caused by HIV?

A

Patients present with opportunistic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Give 3 examples of opportunistic infections a patient with HIV might present with

A

Oral candidiasis
Kaposis’s sarcoma
PCP (pneumocystis pneumonia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What infections are HIV patients prone to in particular?

A

Infections from yeast, moulds, and protozoa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What happens to the levels of CD4 cells present when infected with HIV?

A

It alters the levels present, and this changes over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the result of the altered levels of CD4 found in HIV?

A

Leads to altered states of health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the stages in a HIV infection?

A

Stage 1 - acute infection/seroconversion
Stage 2 - Latent infection
Stage 3 - Symptomatic infection
Stage 4 - Severe infection/AIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What happens in the acute infection/seroconversion state of HIV?

A

The body mounts an unsuccessful immune response and causes a brief fall in CD4 count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

When does phase 1 of HIV infection occur?

A

2-3 months after exposure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What happens in the latent infection stage of HIV?

A

CD4 count remains high and the viral load is now

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How long does the latent infection stage of HIV last?

A

Can last from 2 to 10 years, with some individuals never progressing from this stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

When do symptoms start to show in HIV?

A

If the CD4 count falls below viral load

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the CD4 count in stage I HIV?

A

> 500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the CD4 count in stage II HIV?

A

<500

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the CD4 count in stage III HIV?

A

<350

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the CD4 count in stage IV HIV?

A

<200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Where do the symptoms of an acute HIV infection affect?

A 
Systemic
Central
Mouth and throat 
Nose
Muscles
Liver and spleen
Lymph nodes
Skin 
Gastric
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the systemic symptoms of an acute HIV infection?

A

Fever

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the mouth and throat symptoms of an acute HIV infection?

A

Pharyngitis
Sores
Thrush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the oesophageal symptoms of an acute HIV infection?

A

Sores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are the muscular symptoms of an acute HIV infection?

A

Myalgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What are the liver and spleen symptoms of an acute HIV infection?

A

Enlargement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are the central symptoms of an acute HIV infection?

A

Malaise
Headache
Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What are the lymph node symptoms of acute HIV infection?

A

Lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are the skin symptoms of an acute HIV infection?

A

Rash

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What are the gastric symptoms of an acute HIV infection?

A

Nausea

Vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Where do the symptoms of later HIV/AIDS affect?

A 
Brain
Eyes
Mouth and throat
Blood
Lungs
Bone
Heart
Liver
Stomach
Reproductive system
Body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What are the brain symptoms of later HIV/AIDS?

A

Cryptococcal meningitis
Toxo (toxoplasmosis)
AIDS dementia complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are the eye symptoms for later HIV/AIDS?

A

CMV (cytomegalovirus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are the mouth and throat symptoms for later HIV/AIDS?

A

Cold sores and ulcers

Thrush (oral candidiasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What are the blood symptoms for later HIV/AIDS?

A

Hyperglycaemia

Dyslipidaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is dyslipidaemia?

A

Abnormal amount of fat in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the lung symptoms of later HIV/AIDS?

A

Histoplasmosis
PCP
TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What are the bone symptoms of later HIV/AIDS?

A

Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the heart symptoms of later HIV/AIDS?

A

Heart disease

Stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the liver symptoms of later HIV/AIDS?

A

HCV (Hep C virus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What are the stomach symptoms of later HIV/AIDS?

A

CMV
Crypto (cryptosporidiosis)
MAC (mycobacterium avium complex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What are the reproductive system symptoms of later HIV/AIDS?

A 
Genital ulcers
HPV (human papillomavirus) and cervical cancer
Menstrual problems
PID (Pelvic inflammatory disease)
Vaginal yeast infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What are the body symptoms of later HIV/AIDS?

A

HIV wasting syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the cure for HIV?

A

There is none

76
Q

What is the prognosis of HIV?

A

Can be treated, and leads to a life of chronic infection

77
Q

How do the life expectancy and quality of life of someone with HIV differ from person without?

A

Very good- if detected early, is treated adherently and with a healthy lifestyle, life expectancy can be equal to those without disease

78
Q

What is the result of a late detection of HIV?

A

Worse prognosis

79
Q

How is HIV transmitted?

A

Sexual transmission
Sharing of injecting equipment
Vertical transmission
Medical procedures

80
Q

What are the methods of sexual transmission of HIV?

A

Vaginal
Anal
Oral

81
Q

How can HIV be transmitted vertically?

A

In utero
During childbirth
Breastfeeding

82
Q

What medical procedures can lead to HIV infection?

A

Using blood/blood-products
Skin grafts
Organ donation

83
Q

What is transmission of HIV affected by?

A 
Type of exposure
Viral level
Other STIs
Condom use
Breaks in skin or mucosa
84
Q

What is the risk of HIV transmission if the source is HIV positive with a one unit blood transfusion?

A

90-100%

85
Q

What is the risk of HIV transmission if the source is HIV positive with receptive anal intercourse?

A

1/90 (1.11%)

86
Q

What is the risk of HIV transmission if the source is HIV positive with sharing injecting equipment?

A

1/149 (0.67%)

87
Q

What is the risk of HIV transmission if the source is HIV positive with mucous membrane exposure?

A

1/159

88
Q

What is the risk of HIV transmission if the source is HIV positive with needlestick injury?

A

1/333

89
Q

What is the risk of HIV transmission if the source is HIV positive with receptive vaginal intercourse?

A

1/1000

90
Q

What is the risk of HIV transmission if the source is HIV positive with insertive vaginal intercourse?

A

1/1220

91
Q

What is the risk of HIV transmission if the source is HIV positive with insertive anal intercourse?

A

1/1667

92
Q

What are the diagnostic tests for HIV?

A

Blood tests

‘Rapid’ tests

93
Q

What is looked for in blood tests for HIV?

A

HIV antigen

HIV antibody

94
Q

Is the HIV antigen or antibody used in the current standard test for HIV?

A

Both

95
Q

How long after infection will blood tests be positive for HIV?

A

4-6 weeks

96
Q

How long does it take to get a result of a HIV blood test?

A

Same day

97
Q

Can you get a false negative result with HIV blood tests?

A

Yes

98
Q

What is the advantage of rapid HIV tests?

A

Low cost

<1 hr

99
Q

What are the types of rapid HIV tests?

A 
Blood test (finger-prick)
Oral (saliva)
100
Q

How can rapid HIV tests be administered?

A

In-home tests

Postal testing

101
Q

How accurate are ‘rapid’ HIV blood tests?

A

If negative, very accurate

May get false positives

102
Q

Who should be tested for HIV?

A

Everyone, but some groups have additional need

103
Q

What respiratory conditions would indicate a need for HIV testing?

A

Bacterial pneumonia

TB

104
Q

What neurological conditions would indicate a need for HIV testing?

A

Aseptic meningitis
Dementia
Neuropathy

105
Q

What dermatological conditions would indicate a need for HIV testing?

A

Severe psorasis
Seborrhoeic dematitis
Recurrent/multi-dermal shingles

106
Q

What GI conditions would indicate a need for HIV testing?

A 
Chronic diarrhoea
Weight loss with unknown cause
Salmonella
Shigella
Campylobacter
107
Q

What haemotological conditions would indicate a need for HIV testing?

A

Any unexplained blood dyscrasia

LN

108
Q

What oncological conditions would indicate a need for HIV testing?

A

Lymphoma
Anal cancer
Head and neck

109
Q

What gynaecological conditions would indicate a need for HIV testing?

A

CIN2+
VIN
Any STI/Hep B/ Hep C

110
Q

What is the treatment for HIV?

A

Anti-retroviral treatment

111
Q

When should antiretroviral treatment be started in HIV patients?

A

As soon as possible, regardless of CD4

112
Q

Why should antiretroviral treatment be started ASAP in HIV patients?

A

To increase outlook on morbidity and mortality

113
Q

What is the aim of anti-retroviral treatment?

A

Prevent viral replication

114
Q

How does anti-retroviral treatment prevent viral replication?

A

Inhibits reverse transcriptase
Inhibits integrase
Inhibits protease

115
Q

How many drugs are used in combination to treat HIV?

A

3

116
Q

Why are 3 drugs used in combination to treat HIV?

A

To combat resistance

117
Q

Why must resistance be combated in HIV?

A

Over a million viruses are made each day, so it mutates quickly

118
Q

What is the result of the treatment of HIV involving 3 viruses used in combination?

A

Makes it difficult for the virus to develop resistance to all of them

119
Q

What does HIV treatment aim to do?

A

Create an undue table viral load
Reconstitute the immune system
Normalise lifespan
Reduce risk of infection

120
Q

How many people does HBV infect around the world each year?

A

4 million

121
Q

How many new cases of HBV are reported in the UK per year?

A

500

122
Q

How many people in the world have the HBV virus?

A

400million (5-8% of population)

123
Q

How many deaths did HBV cause worldwide in 2014?

A

~1 million

124
Q

What is the prevalence of HBV in the UK?

A

1/1,000

125
Q

What can HBV lead to if untreated?

A

Liver cirrhosis and hepatocellular carcinoma

126
Q

What % of HBV cases lead to liver cirrhosis?

A

10%

127
Q

How is hepatitis B transmitted

A

Blood
Sexual transmission
Vertically
Long term household contacts

128
Q

How can HBV be transmitted in blood?

A

IVDU

HCW with needle stick injury

129
Q

What is the risk of a HCW contracting HBV if they get a needlestick injury with a contaminated needle?

A

1:3

130
Q

How can HBV be transmitted vertically?

A

Mother to child

Perinatal transmission in patients from high endemic areas

131
Q

What is the incubation period of HBV?

A

6 weeks to 6 months

132
Q

What can HBV progress too?

A

Chronic infection

133
Q

What are the symptoms of acute hepatitis B?

A 
Jaundice
Fatigue 
Abdominal pain 
Anorexia
Nausea
Vomiting
Arthralgia
134
Q

What is athralgia?

A

Pain in joints

135
Q

At what level is AST/ALTs in acute hepatitis B?

A

1000s

136
Q

What % of hepatitis B patients present with no/vague symptoms?

A

50%

137
Q

How long does it take for some people to clear the infection?

A

Within 6 months

138
Q

What may result from acute hepatitis B?

A

Fulminant hepatic failure

Becomes chronic

139
Q

In what % of acute hepatitis B cases result in fulminant hepatic failure?

A

1%

140
Q

What % of acute hepatitis B cases become chronic?

A

6-10% of adults (more if from infancy)

141
Q

What is classified as chronic hepatitis B?

A

Persistence of HBsAg after 6 months

142
Q

What may result from chronic hepatitis B?

A

Cirrhosis

Hepatocellular carcinoma

143
Q

What % of chronic hepatitis B infections lead to cirrhosis?

A

25%

144
Q

What % of chronic hepatitis B infections lead to hepatocellular carcinoma?

A

~5%

145
Q

How is hepatitis B diagnosed?

A

Serology

146
Q

What is detected for in serology diagnosing hepatitis B?

A

Antigens and antibodies

147
Q

When will surface antigen (HbsAg) be found in hepatitis B?

A

Acute infection

Chronic infection

148
Q

When will surface antigen not be found in hepatitis B infection?

A

Past (cleared) infection

Never infected, vaccinated

149
Q

When will core antibody (HbcAb) be found in hepatitis B infection?

A

Acute infection
Past (cleared) infection
Chronic infection

150
Q

What core antibody will be found in acute hepatitis B infection?

A

IgM

151
Q

What core antibody will be found in past (cleared) hepatitis B infection?

A

IgG

152
Q

What core antibody will be found in chronic hepatitis B infection?

A

IgG

153
Q

When will core antibody not be found in hepatitis B infection?

A

Never infected, vaccinated

154
Q

When will surface antigen (HbsAb) be found in hepatitis B infection?

A

May or may not be in acute infection
Past (cleared) infection
Never infected, vaccinated

155
Q

When will surface antibody (HbsAb) not be found in hepatitis B infection?

A

Chronic infection

156
Q

What is the cure for hepatitis B?

A

None

157
Q

What is the treatment for hepatitis B?

A

Life-long anti-virals to suppress viral replication

158
Q

Are life-long antivirals required for everyone with hepatitis B?

A

No

159
Q

Who will not require life-long antiviral treatment for hepatitis B?

A

‘Inactive’ carrier

160
Q

How is someone determined to be an inactive carrier of hepatitis B?

A

Low viral load
Normal LFTs
Mild fibrosis

161
Q

What is the vaccine for hepatitis B?

A

Genetically engineered surface antigen

162
Q

How is the hepatitis B vaccine given? /

A

3 doses + boosters if required

163
Q

How effective is the hepatitis B vaccination?

A

Effective in most people

164
Q

How does the hepatitis B vaccine convey protection?

A

Produces surface antibody response

165
Q

What surface antibody response is adequate to provide protecting in hepatitis B?

A

> 10

166
Q

What surface antibody response provides long-term protection in hepatitis B?

A

> 100

167
Q

How many people are infected with HCV per year around the world?

A

Unknown

168
Q

Why is the number of people infected with HCV around the world unknown?

A

Many are not tested

169
Q

How many people in the world have the HCV virus?

A

Around 200 million (3% of the population)

170
Q

What is the prevalence of HCV in the UK population?

A

1 in 200 (most of them untested)

171
Q

How many deaths from HCV were there in the UK in 2014?

A

424

172
Q

What can HCV lead to if untreated?

A

Liver cirrhosis and hepatocellular carcinoma

173
Q

In what % of untreated HCV infections does liver cirrhosis result?

A

80% of cases

174
Q

Who is at risk of HCV infection?

A 
IVDU/crack or heroin smokers 
Blood transfusion patients prior to 1991
Infants born to HCV positive mothers
Sexual contact 
Needle stick injuries to HCW
175
Q

How is the risk of getting HCV from sexual contact increased?

A

If HIV infected

176
Q

What is the risk of healthcare workers getting HCV from a needlestick injury with a contaminated needle?

A

1:30

177
Q

What % of patients with HCV become chronically infected?

A

80%

178
Q

What does chronic liver disease and cirrhosis in patients who develop it as a result of HCV result in?

A

Decompensated liver disease
Hepatoma
Transplant
Death

179
Q

What % of people with HCV have no symptoms?

A

80%

180
Q

What are the symptoms of HCV?

A 
Fatigue
Anorexia
Dark urine
Nausea
Abdominal pain
181
Q

Can hepatitis C be cured?

A

Yes

182
Q

What is the cure for hepatitis C?

A

Directly acting antiviral drug combination

183
Q

How long is the course of treatment for hepatitis C?

A

8-12 weeks

184
Q

What is the chance of cure for hepatitis C?

A

> 90%

185
Q

How much does a course of hepatitis B treatment cost?

A

£50,000-£80,000

186
Q

Can someone treated and cured of hepatitis C get reinfected?

A

Yes

187
Q

Is there a vaccine for hepatitis C?

A

No

[ ESA 3- Infection and Immunity (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions