NR507 Midterm Exam Study Guide i i i i i
Chapters
Chapter 1: Cellular Biology
i i i
Chapter 2: Altered Cellular and Tissue Biology
i i i i i i
Chapter 6: Epigenetics and Disease
i i i i i
Chapter 7: Innate Immunity: Inflammation
i i i i
Chapter 8: Adaptive Immunity
i i i i
Chapter 9: Alterations in Immunity and Inflammation
i i i i i i
Chapter 10: Infection
i i i
Chapter 12: Cancer Biology
i i i
i Chapter 13: Cancer Epidemiology
i i i
Chapter 14: Cancer in Children
i i i i i
Chapter 30: Alterations in Hematologic Function in Children
i i i i i i i
Chapter 34: Structure and Function of the Pulmonary System
i i i i i i i i i
Chapter 35: Alterations in Pulmonary Functions
i i i i i i
Chapter 36: Alterations in Pulmonary Function in Children
i i i i i i i
Chapter 37: Structure and Function of the Renal and Urologic Systems
i i i i i i i i i i
Chapter 38: Alterations of Renal and Urinary Tract Function
i i i i i i i i i
Chapter 39: Alterations of Renal and Urinary Tract Function in Children
i i i i i i i i i i
,Epigenetics (Note, Chapter 6 should be reviewed)
i i i i i i
Epigenetics and its role on human development
i i i i i i
Compare and contrast Prader-Willi syndrome and Angelman syndrome
i i i i i i i
Cellular Proliferation
i
the role of inactive MLH1 in the development of some forms of inherited colon
i i i i i i i i i i i i i
cancer (p. 1468-1470) p.186
i i i i
• MLH1 is a deoxyribonucleic acid (DNA) mismatch repair gene, essentially a
i i i i i i i i i i
tumor suppressor gene in this case. If MLH1 is inactive, repair is unable to be
i i i i i i i i i i i i i i i
made to the DNA mismatches and the hereditary factor of colon cancer (see
i i i i i i i i i i i i i
below) is able to proliferate.
i i i i i
• Progression from polyps to colon cancer (1) activation of proto-oncogenes i i i i i i i i i
(promote cell growth) (2) loss of tumor-suppressor gene activity (inhibit cell
i i i i i i i i i i
growth]); and (3) abnormalities in DNA mismatch repair (MMR) genes (fix
i i i i i i i i i i i
errors in DNA replication and recombination
i i i i i i
• Microsatellite instability = genetic hypermutability (predisposition to i i i i i i
mutation) that results from DNA MMR. Usually right sided colon proximal i i i i i i i i i i
to splenic flexure, associated with autosomal dominant hereditary polyposis
i i i i i i i i i
colorectal cancer.
i i
Inflammation as an etiology for cancer-note conditions in which this may occur (p.
i i i i i i i i i i i i
403)
i
• Chronic inflammation caused by infiltrating immune cells help to create a
i i i i i i i i i i
permissive tumor progressing environment. Also thought to precede and
i i i i i i i i i
initiate malignant change in many cancers (colon, liver, lung)
i i i i i i i i i
• Numerous environmentally-linked reasons for inflammation (tobacco i i i i i
smoke, exhaust, asbestos, fine particles in air) and can be linked to manycancers
i i i i i i i i i i i i i
(lung)
i
• Chronic inflammation and cancer development = continuous presence of
i i i i i i i i
cytokines (soluble factor that affects neighboring cell, can be pro- or anti-
i i i i i i i i i i i
inflammatory, interleukins or interferons)(p203-205), chemokines (low-
i i i i i i
molecular weight peptide that induce leukocyte chemotaxis or directional
i i i i i i i i i
movement of cells on a chemical gradient)(p203-205), reactive oxygen
i i i i i i i i i
species (free radical that damages cell membrane)(p59-60), oncogenes
i i i i i i i i
(mutant genes that in their normal nonmutant state direct synthesis of protein
i i i i i i i i i i i i
that positively regulate or accelerate proliferation), amongst others
i i i i i i i i
,Cancer
In terms of epigenetic modifications, the role of environmental stressors associated
i i i i i i i i i i
with development of cancer
i i i i
Defects in Mechanism of Defense i i i i
Hemolytic defects in the newborn i i i i
Understand the meaning of infectivity: Ability of the pathogen to establish an
i i i i i i i i i i i
infection. To invade the host and multiply.
i i i i i i i
Most effective treatment for HIV - Page 327 - Antiretroviral therapy (ART) in
i i i i i i i i i i i i
different combinations. In general, at least three drugs used as a cocktail (2 NRTIs
i i i i i i i i i i i i i i
and one from another class (NNRTI, PI, INSTI or CCR% antagonist). Death reduced
i i i i i i i i i i i i i
significantly with compliance. Without meds, death in 9 to 10 months.
i i i i i i i i i i i
No cure, just good response with decades of life. Even with success avoiding
i i i i i i i i i i i i
oportunistic infections, HIV patients at higher risk for comorbidities
i i i i i i i i i
(cardiovascular disease, renal disease, diabetes, liver disease). Development of
i i i i i i i i i
effective vaccine greatest hope in fight against AIDS. Providers recommend to
i i i i i i i i i i i
screen adults 15 – 65 for the disease. Those younger and older with increased risk
i i i i i i i i i i i i i i i
should be tested.
i i i
Defected cells of HIV i i i
Signs of T-Lymphocyte deficiency
i i i
Pulmonary Alterations i
Pulmonary function tests (see pages 1243-1243) i i i i i
Spirometry: measures volume and flow rate during forced expiration i i i i i i i i
Alveolar-arterial oxygen gradient: evaluates cause of hypoxia i i i i i i
Diffusing Capacity: a measure of the gas diffusion rate at the i i i i i i i i i i
alveolocapillary membrane
i i
Arterial blood gas: used to determine pH, oxygen, and CO2 concentrations
i i i i i i i i i i
Radiographic chest exams: evaluates air trapping, consolidation, cavity i i i i i i i
formation, or presence of tumors
i i i i i
• ABG used to determine pH and o2 and CO2 concentrations (most accurate).
i i i i i i i i i i i
, • Diffusing capacity measure of the gas diffusion rate at alveolocapillary i i i i i i i i i
membrane Ex. residual volume, total lung capacity, functional reserve
i i i i i i i i i
capacity. Determine cause of hypoxiua use alveolar-arterial oxygen
i i i i i i i i
gradient. i
• Chest xray views air trapping, consolidation, tumors, and cavity formation
i i i i i i i i i
Relationship of lung compliance and residual volume i i i i i i
Chest wall compliance decreases with age losing some of its ability to
i i i i i i i i i i i
expand, respiratory muscle strength and endurance decreases. These mechanical
i i i i i i i i i
changes in the lung and chest wall reduces ventilatory capacity in older adults. As
i i i i i i i i i i i i i i
vital capacity decreases, residual volume increases, but total lung capacity remains
i i i i i i i i i i i
the same. (see pages 1244-1245)
i i i i i
Relationship of lung compliance and residual volume: decreased lung i i i i i i i i
compliance=vital capacity decrease=residual volume increases Ex. as seen in
i i i i i i i i
normal aging
i i
Shifts in the oxyhemoglobin dissociation-pg. 1241-1242 (Pam Grant)
i i i i i i i
Shifts in the oxyhemoglobin dissociation: (process in which oxygen is released
i i i i i i i i i i
from hemoglobin occurring the body tissues at the cellular level), oxyhemoglobin
i i i i i i i i i i i
is when hemoglobin molecules wind with oxygen this occurs in the lungs and is
i i i i i i i i i i i i i i
called oxyhemoglobin association or hemoglobin saturation.
i i i i i i
• The shift occurs right or left on the curve. Right shift oxygen moved into the
i i i i i i i i i i i i i i
cells such as by acidosis and hypercapnia. A left shift means association in the
i i i i i i i i i i i i i i
lungs and dissociation in the tissues by alkalosis and hypocapnia..
i i i i i i i i i i
When hemoglobin saturation and desaturation are plotted on a graph, the result is a
i i i i i i i i i i i i i
distinctive S-shaped curve known as oxyhemoglobin dissociation curve. Several
i i i i i i i i i
factors can change the relationship between Pao2 and Sao2, causing the
i i i i i i i i i i i
oxyhemoglobin dissociation curve to shift to the right or left.
i i i i i i i i i i
• A shift to the right depicts hemoglobin's decreased affinity for oxygen or an
i i i i i i i i i i i i
increase in the ease with which oxyhemoglobin dissociates and oxygen
i i i i i i i i i i
moves into the cells. The curve is shifted right by acidosis (low pH) and
i i i i i i i i i i i i i i
hypercapnia (increased Paco2).
i i i
• A shift to the left depicts hemoglobin's increased affinity for oxygen, which
i i i i i i i i i i i
promotes association in the lungs and inhibits dissociation in the tissues. The i i i i i i i i i i i
Chapters
Chapter 1: Cellular Biology
i i i
Chapter 2: Altered Cellular and Tissue Biology
i i i i i i
Chapter 6: Epigenetics and Disease
i i i i i
Chapter 7: Innate Immunity: Inflammation
i i i i
Chapter 8: Adaptive Immunity
i i i i
Chapter 9: Alterations in Immunity and Inflammation
i i i i i i
Chapter 10: Infection
i i i
Chapter 12: Cancer Biology
i i i
i Chapter 13: Cancer Epidemiology
i i i
Chapter 14: Cancer in Children
i i i i i
Chapter 30: Alterations in Hematologic Function in Children
i i i i i i i
Chapter 34: Structure and Function of the Pulmonary System
i i i i i i i i i
Chapter 35: Alterations in Pulmonary Functions
i i i i i i
Chapter 36: Alterations in Pulmonary Function in Children
i i i i i i i
Chapter 37: Structure and Function of the Renal and Urologic Systems
i i i i i i i i i i
Chapter 38: Alterations of Renal and Urinary Tract Function
i i i i i i i i i
Chapter 39: Alterations of Renal and Urinary Tract Function in Children
i i i i i i i i i i
,Epigenetics (Note, Chapter 6 should be reviewed)
i i i i i i
Epigenetics and its role on human development
i i i i i i
Compare and contrast Prader-Willi syndrome and Angelman syndrome
i i i i i i i
Cellular Proliferation
i
the role of inactive MLH1 in the development of some forms of inherited colon
i i i i i i i i i i i i i
cancer (p. 1468-1470) p.186
i i i i
• MLH1 is a deoxyribonucleic acid (DNA) mismatch repair gene, essentially a
i i i i i i i i i i
tumor suppressor gene in this case. If MLH1 is inactive, repair is unable to be
i i i i i i i i i i i i i i i
made to the DNA mismatches and the hereditary factor of colon cancer (see
i i i i i i i i i i i i i
below) is able to proliferate.
i i i i i
• Progression from polyps to colon cancer (1) activation of proto-oncogenes i i i i i i i i i
(promote cell growth) (2) loss of tumor-suppressor gene activity (inhibit cell
i i i i i i i i i i
growth]); and (3) abnormalities in DNA mismatch repair (MMR) genes (fix
i i i i i i i i i i i
errors in DNA replication and recombination
i i i i i i
• Microsatellite instability = genetic hypermutability (predisposition to i i i i i i
mutation) that results from DNA MMR. Usually right sided colon proximal i i i i i i i i i i
to splenic flexure, associated with autosomal dominant hereditary polyposis
i i i i i i i i i
colorectal cancer.
i i
Inflammation as an etiology for cancer-note conditions in which this may occur (p.
i i i i i i i i i i i i
403)
i
• Chronic inflammation caused by infiltrating immune cells help to create a
i i i i i i i i i i
permissive tumor progressing environment. Also thought to precede and
i i i i i i i i i
initiate malignant change in many cancers (colon, liver, lung)
i i i i i i i i i
• Numerous environmentally-linked reasons for inflammation (tobacco i i i i i
smoke, exhaust, asbestos, fine particles in air) and can be linked to manycancers
i i i i i i i i i i i i i
(lung)
i
• Chronic inflammation and cancer development = continuous presence of
i i i i i i i i
cytokines (soluble factor that affects neighboring cell, can be pro- or anti-
i i i i i i i i i i i
inflammatory, interleukins or interferons)(p203-205), chemokines (low-
i i i i i i
molecular weight peptide that induce leukocyte chemotaxis or directional
i i i i i i i i i
movement of cells on a chemical gradient)(p203-205), reactive oxygen
i i i i i i i i i
species (free radical that damages cell membrane)(p59-60), oncogenes
i i i i i i i i
(mutant genes that in their normal nonmutant state direct synthesis of protein
i i i i i i i i i i i i
that positively regulate or accelerate proliferation), amongst others
i i i i i i i i
,Cancer
In terms of epigenetic modifications, the role of environmental stressors associated
i i i i i i i i i i
with development of cancer
i i i i
Defects in Mechanism of Defense i i i i
Hemolytic defects in the newborn i i i i
Understand the meaning of infectivity: Ability of the pathogen to establish an
i i i i i i i i i i i
infection. To invade the host and multiply.
i i i i i i i
Most effective treatment for HIV - Page 327 - Antiretroviral therapy (ART) in
i i i i i i i i i i i i
different combinations. In general, at least three drugs used as a cocktail (2 NRTIs
i i i i i i i i i i i i i i
and one from another class (NNRTI, PI, INSTI or CCR% antagonist). Death reduced
i i i i i i i i i i i i i
significantly with compliance. Without meds, death in 9 to 10 months.
i i i i i i i i i i i
No cure, just good response with decades of life. Even with success avoiding
i i i i i i i i i i i i
oportunistic infections, HIV patients at higher risk for comorbidities
i i i i i i i i i
(cardiovascular disease, renal disease, diabetes, liver disease). Development of
i i i i i i i i i
effective vaccine greatest hope in fight against AIDS. Providers recommend to
i i i i i i i i i i i
screen adults 15 – 65 for the disease. Those younger and older with increased risk
i i i i i i i i i i i i i i i
should be tested.
i i i
Defected cells of HIV i i i
Signs of T-Lymphocyte deficiency
i i i
Pulmonary Alterations i
Pulmonary function tests (see pages 1243-1243) i i i i i
Spirometry: measures volume and flow rate during forced expiration i i i i i i i i
Alveolar-arterial oxygen gradient: evaluates cause of hypoxia i i i i i i
Diffusing Capacity: a measure of the gas diffusion rate at the i i i i i i i i i i
alveolocapillary membrane
i i
Arterial blood gas: used to determine pH, oxygen, and CO2 concentrations
i i i i i i i i i i
Radiographic chest exams: evaluates air trapping, consolidation, cavity i i i i i i i
formation, or presence of tumors
i i i i i
• ABG used to determine pH and o2 and CO2 concentrations (most accurate).
i i i i i i i i i i i
, • Diffusing capacity measure of the gas diffusion rate at alveolocapillary i i i i i i i i i
membrane Ex. residual volume, total lung capacity, functional reserve
i i i i i i i i i
capacity. Determine cause of hypoxiua use alveolar-arterial oxygen
i i i i i i i i
gradient. i
• Chest xray views air trapping, consolidation, tumors, and cavity formation
i i i i i i i i i
Relationship of lung compliance and residual volume i i i i i i
Chest wall compliance decreases with age losing some of its ability to
i i i i i i i i i i i
expand, respiratory muscle strength and endurance decreases. These mechanical
i i i i i i i i i
changes in the lung and chest wall reduces ventilatory capacity in older adults. As
i i i i i i i i i i i i i i
vital capacity decreases, residual volume increases, but total lung capacity remains
i i i i i i i i i i i
the same. (see pages 1244-1245)
i i i i i
Relationship of lung compliance and residual volume: decreased lung i i i i i i i i
compliance=vital capacity decrease=residual volume increases Ex. as seen in
i i i i i i i i
normal aging
i i
Shifts in the oxyhemoglobin dissociation-pg. 1241-1242 (Pam Grant)
i i i i i i i
Shifts in the oxyhemoglobin dissociation: (process in which oxygen is released
i i i i i i i i i i
from hemoglobin occurring the body tissues at the cellular level), oxyhemoglobin
i i i i i i i i i i i
is when hemoglobin molecules wind with oxygen this occurs in the lungs and is
i i i i i i i i i i i i i i
called oxyhemoglobin association or hemoglobin saturation.
i i i i i i
• The shift occurs right or left on the curve. Right shift oxygen moved into the
i i i i i i i i i i i i i i
cells such as by acidosis and hypercapnia. A left shift means association in the
i i i i i i i i i i i i i i
lungs and dissociation in the tissues by alkalosis and hypocapnia..
i i i i i i i i i i
When hemoglobin saturation and desaturation are plotted on a graph, the result is a
i i i i i i i i i i i i i
distinctive S-shaped curve known as oxyhemoglobin dissociation curve. Several
i i i i i i i i i
factors can change the relationship between Pao2 and Sao2, causing the
i i i i i i i i i i i
oxyhemoglobin dissociation curve to shift to the right or left.
i i i i i i i i i i
• A shift to the right depicts hemoglobin's decreased affinity for oxygen or an
i i i i i i i i i i i i
increase in the ease with which oxyhemoglobin dissociates and oxygen
i i i i i i i i i i
moves into the cells. The curve is shifted right by acidosis (low pH) and
i i i i i i i i i i i i i i
hypercapnia (increased Paco2).
i i i
• A shift to the left depicts hemoglobin's increased affinity for oxygen, which
i i i i i i i i i i i
promotes association in the lungs and inhibits dissociation in the tissues. The i i i i i i i i i i i
