Pathophysiology Study guide for Exam 1
Pathophysiology Study guide for Exam 1 NURB 340
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This 11 page Study Guide was uploaded by Kelsey Forbeck on Thursday September 15, 2016. The Study Guide belongs to NURB 340 at University of Indianapolis taught by Moore in Fall 2016. Since its upload, it has received 136 views. For similar materials see Pathophysiology in NURSING at University of Indianapolis.
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Date Created: 09/15/16
NURB 340: Pathophysiology STUDY GUIDE EXAM ONE: Genetics Immunity Inflammation Hypersensitivity Infection 60 points Genetics: 1. Describe the composition and structure of DNA: 2. Identify the major chromosomal abnormalities and their clinical consequences: 3. What is the difference between genotype and phenotype? 4. What are some specific examples of risk factors associated with multifactorial inheritance? 5. What are the principles of multifactorial inheritance? 6. What is autosomal dominant? 7. What is autosomal recessive? 8. What is x linked recessive inheritance mode? 9. Why should we study genetics? 10.Who owns your genetic information? 11.What is the difference between (characteristic wise)Turner syndrome and Klinefelter’s syndrome? 12.What is a mutation? 13.What is euploid cell? 14.What is polyploidy 15.What is triploid? 16.What is tetra ploidy? 17.What is aneuploidy? 18.What is monosomy? 19.What is trisomy? 20.What is nondisjunction? 21.What are the implications of genetic evaluation and counseling? 22. What is the purpose of the human genome project? 23.What has the human genome project taught us? 24.Compare and contrast the autosomal and x-linked genetic disease. Immunity and Hypersensitivity: 1. What is the mechanism of action of the immune system? 2. What are the various types of hypersensitivity reactions? 3. What is concept of transplant rejection? 4. Which of the following terms describes the type of immunity that occurs when performed antibodies transfer from donor to recipient? a. Active PAGE 1 b. Passive c. Cellular d. Memory 5. Urushiol, a toxin found in poison ivy, is an example of an antigen that does not produce an immune reaction? a. True b. False 6. Define acquired immunity 7. What is the difference between innate and acquired immunity? 8. What is the difference between antigen, immunogens, and haptens? 9. What are the major functions of antibodies? 10.Why are cytokines important to the immune system? 11.What is the role of the T helper cell? 12.Why is anaphylactic shock considered an emergency? Inflammation and Infection: 1. What is the mechanism of infection? 2. What is the mechanism and phases of the inflammatory response? 3. What are the abnormal mechanisms of action of the inflammatory response? 4. What is communicability? 5. What is virulence? 6. Which virus undergoes yearly antigenic drift allowing for emergence of new strain? a. Influenza b. Streptococcus c. Staphylococcus d. Herpes simplex 7. Which vaccine contains live viruses that are weakened and attenuated? a. Hepatitis B b. Measles, mumps, and rubella (MMR) c. Diphtheria, tetanus, pertussis (DTaP) d. Hemophilic influenza type B (HIB) 8. What is the difference between and endotoxin and an exotoxin? 9. What are the benefits of inflammation? 10.What are the four steps in phagocytosis? 11.An injury to a vascularized tissue has occurred and activated an acute inflammatory response. Which of the following is TRUE regarding this response? It: a. Is nonspecific b. Is activated slowly PAGE 2 c. Is the third line of defense d. Relies on cellular components only 12.What are the lines of defense? ANSWERS: Genetics Answer: 1. The composition of DNA is it’s made up of molecules know as nucleotides. Each nucleotide includes a phosphate group, sugar group, and a nitrogen base. (adenine, thymine, guanine, and cytosine) These four bases are held together by WEAK hydrogen bonds. The structure of DNA is a spiraling double helix. It looks somewhat like a ladder. 2. The major chromosomal abnormalities are: a. Deletion (part deleted) i. Clinical manifestation: th 1. Cri-Du-Chat (deleted material on 5 chromosome) b. Duplication c. Inversion d. Insertion (take some from one and add to another) e. Translocation (Taking a piece from red and give to green and take from green and give to red) f. Fragile site (There is an indent that is easy to breakoff) i. Clinical Manifestations: 1. Fragile X syndrome (leads to mental retardation) PAGE 3 3. Genotype is genetic composition and phenotype is physical composition. EX: trisomy 21 (down syndrome) is genotype. Phenotype is low set ears etc. 4. Risk factors of multifactorial inheritance include: smoking, what you eat and put into your body, what’s going on in your family genetic wise, radiation, chemicals, etc. 5. Environmental factors, lifestyle choices and behaviors, family genetics, things that “run in the family”, and genetic predisposition. 6. Autosomal dominate is either expressed as AA or Aa. A indicates the dominance. The normal parent and affected parent will have a 50/50 chance to affect child. EX: Huntington’s disease, Marfan disease, and neurofibromatosis. 7. Autosomal recessive is expressed as aa. The disease is usually not expressed in the parents but both are carriers. 50% carrier 25% normal 25% affected. EX: PKU, sickle cell, and cystic fibrosis. 8. X-linked recessive inheritance mode is either dominate or recessive. Dominate is very rare and males are carriers. Recessive is more common and almost always MALE. If the father is affected, they will never pass it to their son but will always give the bad X to their daughter. Their daughter will be carriers but won’t actually be affected. 9. We study genetics to find cures. If we understand the problem, then we can fix it. We also can have a better understanding of what can actually be passed on. Also, this will help us nurses be a resource for our patients if we understand genetics. 10. You own your genetic information and you can do what you want with it. 11. Turner’s syndrome (45X, 0) characteristics include short stature, shield shaped thorax, widely spaced nipples, small finger nails, poor breast development, PAGE 4 constriction of aorta, elbow deformity, brown spots, underdeveloped gonadal structures, and no menstruation. Klinfelter’s syndrome (47.XXY) characteristics include tall stature with feminized physique, frontal baldness, poor beard growth, lose chest hair, breast development, female type pubic hair, and small testes. 12. A mutation is permanent change in the structure of DNA. It is permanent because once replicated mutated, it will ALWAYS replicate mutated. 13. A euploid cell is a normal cell. 14. A polyploidy has more than needed 15. Triploid has three copies (23+23+23=69) 16. Tetra ploidy has four copies (23+23+23+23= 92) 17. Aneuploidy either has a missing ONE or extra ONE. 18. Monosomy only one exists and those who have this are incompatible with life. 19. Trisomy is an extra one typically one chromosome 21 also known as down syndrome. 20. Nondisjunction is failure of a pair of chromosomes to separate or divide normally. 21. The implications include reproduction and developmental history and for family history. During this situation you may use the Punnett squares. 22. The purpose of the human genome project was to focus and study all the locations on a human gene to gain better understanding of it. 23. It has taught about detailed information, organization, and function of human genes. It taught us that C and G comprised most of the concentrated areas on the human gene. PAGE 5 24. Autosomal dominant diseases Huntington’s disease(affected parent + unaffected parent will result in 50% chance of passing the disease on) autosomal recessive disease includes cystic fibrosis (Need two little a’s. If you have a big A then you are just a carrier) Immunity and Hypersensitivity Answers 1. The immune system’s mechanism of action is destruction of infectious microorganisms that are resistant to inflammation and protection against future exposure to the same microorganism. 2. The various types of hypersensitivity reactions include: a. Type 1: IgE mediated and is against environmental antigens (allergens) i. GI (n/v, diarrhea, abd. Pain) ii. Skin (urticarial (hives)) iii. Mucosa (conjunctivitis, rhinitis (runny nose), and asthma) iv. Lung (bronchospasm, edema, and thick secretions) b. Type 2: They are tissue specific and have five mechanisms: i. Cell is destroyed by antibodies and complement ii. Cell destruction through phagocytosis iii. Soluble antigen may enter the circulation and deposit on tissues; tissues destroyed by complement and neutrophil granules iv. Antibody-dependent cell-mediated cytotoxicity v. Target cell malfunction PAGE 6 c. Type 3: Immune complex mediated and is not organ specific. Serum sickness due to the deposit of serum in the blood vessels. And the Raynaud phenomenon where the extremities turn white. d. Type 4: Cell mediated and does NOT involve antibody. EX: graft rejections and allergic reactions to poison ivy. 3. Transplant rejection a. Hyper acute- immediate response which is rare because it has to have preexisting antibody to the antigen of the graft b. Acute- cell-mediated immune response against unmatched HLA antigens c. Chronic- result of week cell mediated reaction against minor HLA antigens 4. Passive 5. True 6. Acquired immunity is immunity that develops after you have been exposed EX: By an attack, disease or injection of antigens) 7. Innate immunity is an immunity you are born with and acquired immunity has to be developed by being exposed first. 8. Antigens bind with antibodies and have receptors on B and T cells. Immunogens induce production of antibodies (T and B cells). ALL IMMUNOGENS ARE ANTIGENS BUT ALL ANTIGENS ARE NOT IMMUNOGENS. Haptens are too small to be immunogens by themselves but become immunogenic after combining with larger molecules that function as carriers for the haptens. (Think about the poison ivy example) 9. The major function of antibodies: a. Direct PAGE 7 i. Neutralization- inactive or block the binding ii. Agglutination- Clumping iii. Precipitation- making a soluble antigen into an insoluble precipitate b. Indirect i. Inflammation ii. Phagocytosis iii. Compliment 10. Cytokines are important in the immune system because they’re responsible for activating other cells and regulating inflammatory response. 11. The role of the T helper cells is very important in adaptive immunity. They help activate B cells to secrete antibodies, and help activate cytotoxic T cells to kill infected target cells. 12. Anaphylactic shock is considered an emergency because it causes vasodilation, hypovolemia, decreased tissue perfusion, and impaired cellular metabolism. It can lead to death! There is a drop in blood pressure that can cause impaired mentation. Inflammation and Infection Answers 1. Infections mechanism is inflammatory response to presence of microorganism. 2. Acute inflammation results from vascular changes and corresponding leakage of circulating components into the tissue. Chronic inflammation results from unsuccessful acute response. PAGE 8 3. Abnormal mechanisms of action include 4. Communicability is the capability of being transmitted from an animal or person to another animal or person. Can be through direct or indirect. 5. Virulence is the degree of damage caused by a microbe to its host. 6. Influenza 7. Measles, mumps, and rubella (MMR) 8. Endotoxin is a toxin that is inside a bacterial cell and gets released once the cell disintegrates. Exotoxins are toxins that get released by a living bacterial cell into its surroundings. 9. The benefits of inflammation include: a. They limit and control the inflammatory process b. Prevent and limit infection and further damage c. Initiate adaptive immune response d. Initiate healing 10. The steps of phagocytosis: a. Adherence b. Engulfment c. Phagosome formation d. Fusion with lysosomal granules e. Destruction of the target. 11. Is nonspecific 12. The first line of defense is innate immunity. It includes the physical barriers such as skin, epithelial cell driven chemical barriers such as secretions of saliva, tears, earwax, and sweat, and normal microbiome. The second line of defense is the inflammatory PAGE 9 response and is the FIRST response to injury. It is nonspecific and is caused by a variety of material such as infection, trauma, and foreign bodies. PAGE 10
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