Orgo 2, Ganley, Lecture 1 Chem 2110. Organic Chemistry 2. Ganley. Exam 5/Final Exam. Lecture 1. Includes: amino acid structure, amide bond/peptide synthesis, classifying side groups, protonation states, zwitterions, how to determine isoelectric point, purification by electrophoresis. Reaction mechanisms, steps, drawings, explanations, examples, etc.

Biochemistry Amino Acids Notes Quickly learn biochemistry topics with my concise and visually appealing notes! These notes cover the topics of types of amino acids, amino acid side chain classifications, the importance of cysteine, amino acid chirality, amino acid fischer projection rules, properties of amino acids, how to solve amino acid structure pH problems, zwitterions, isoelectric point (pI), and how to solve isoelectric point problems. These notes also include important definitions, beautiful digitally-drawn figures, helpful mnemonics and exam study-tips. I earned a 4.0 in biochemistry and so can you!

DNA, Genes, and Proteins Complete Notes This is a complete note set that contains 118 pages of notes about DNA, genes and proteins covering the following topics: Introduction to DNA 8 DNA - deoxyribonucleic acid 8 Central dogma of dna 8 DNA packaging 9 Genes 10 Genome 10 DNA structure 10 Pentose sugar 11 Nitrogenous bases 12 Purines 12 Pyrimidines 12 Nucleic acid nomenclature 13 Polynucleotide properties of DNA 13 DNA base pairing 13 Secondary structure of DNA 14 eukaryotic Cell cycle 15 DNA replication in eukaryotes 16 dna replication in prokaryotes 16 Mitosis and meiosis 18 chromosome structure 18 mitosis 19 Homologous chromosomes 20 meiosis 20 Meiosis I 21 Recombination 22 Meiosis II 22 Consequence of meiosis 23 Spermatogenesis 23 oogenesis 23 Dna repair and cancer 24 dna repair and integrity 24 DNA replication Stress 25 Replication machinery defects: mis-incorporation and proofreading 25 Tri-nucleotide repeat disorders 26 DNA damage response 26 Three outcomes 27 Senescence/Apoptosis 27 Cell cycle checkpoints 28 types of DNA repair 28 BAse excision repair 28 nucleotide excision repair 28 mismatch repair 29 non homologous end joining 29 Homology dependent double strand break repair 30 multi-step cancer model 32 Colorectal cancer 32 dna repair 32 intra-tumour heterogeneity 33 Clonal expansion and clinical resistance 34 synthetic lethality strategy 34 PARP inhibitors in clinical trials 34 protein structure 35 protein structure and function 35 amino acids 36 Protein Structure 38 The importance of amino acids 38 Isoelectric point of proteins 39 size of peptides and proteins 39 conjugated proteins 39 protein conformation 40 sequence affects alpha-helix stability 40 the extended conformation - beta strand 40 Tertiary structure 41 quaternary structure 42 Genotype, Phenotype, and Inheritance 43 gene expression 43 Inheritance 43 Co-dominance 44 pedigree analysis 44 inheritance patterns 45 Autosomal recessive 45 Autosomal dominant 46 X-Linked Recessive 47 X-linked dominant 47 y-linked 47 Mitochondrial 47 Monogenic or polygenic? 47 Polygenic 48 gene expression 49 introduction 49 what is a gene 49 transcription - Initiation 51 Transcription - Elongation 52 transcription - termination 53 RNA processing - 5’ Processing capping 53 RNA processing- Rna splicing 53 RNA Processing- 3’ processing cleavage and polyadenylation 54 Ribosomes 54 Types of RNA 55 The Genetic Code 55 Translation 56 Translation - initiation 56 Translation - Elongation 57 translation - termination 58 Mutations 59 Definition of mutation 59 Spontaneous Mutations 59 mutagenesis and mutation 60 Endogenous sources - transposons 60 Mutation 61 Single Nucleotide Polymorphisms - SNP 61 Single Nucleotide Changes 61 Sickle Cell Anaemia 62 Chromosomal Abnormalities 63 Robertsonian translocation 63 Numerical abnormalities - Polyploidy 64 Numerical abnormalities - Aneuploidy 64 Numerical abnormalities - Mosaicism 65 Cytogenetic Testing 66 Referral Reasons 66 Consequences of mutations 67 Reciprocal Translocation 67 Post-Translational processing of proteins: protein targeting 68 What is Post-Translational Modification? 68 Protein Sorting 68 Functions of the Endoplasmic Reticulum 69 Disulphide Isomerase (PDI) 69 Protein Glycosylation 70 Synthesis of O-linked Oligosaccharides 70 Synthesis of N-linked Oligosaccharides 70 Protein Targeting for Secretion 71 Secretory Proteins: Translocation across the Er 72 The Signal Recognition Particle Cycle 73 Plasma Membrane Proteins 74 Type 1 Integral Membrane Proteins 74 Type II Membrane Proteins 74 Type IV Integral Membrane Proteins 75 Proteins of the Endoplasmic Reticulum 75 Lysosomal Proteins 76 Nuclear Proteins 76 What happens if there is misfolding? 77 Modifications in the Golgi Apparatus 77 Collagen - Function 79 Collagen Overview 79 Collagen - Summary of Synthesis and Modification in ER 80 Composition 81 Post Translational Modifications 81 Structure 82 Secretion and Aggregation 82 CRoss-Links 83 Regulation of Protein Function 84 Examples of Regulation 84 Regulation of Enzyme Activity 84 Substrate and Product Concentration 85 Allosteric Regulation 86 Allosteric Regulation of Phosphofructokinase 88 Covalent Modification of Proteins 89 Covalent Modification - Phosphorylation 89 Amplification by enzyme Cascades 90 Glycogen breakdown and synthesis are reciprocally regulated 91 Many Enzymes are Activated by Specific ProteoLytic Cleavage 91 Proteolytic Activation of Chymotrypsinogen 92 Zymogen Activation by Proteolytic Cleavage 92 Endogenous Inhibitors Regulate Protease Activity 94 Blood Clotting 95 The Cascade 95 Proteins of Blood Coagulation 96 Highlights of the Clotting Cascade 96 Modular Structure of Prothrombin 97 The Role of G-carboxyglutamate (Gla) Residues 98 Structure of Fibrinogen 98 Formation of a Fibrin Clot 99 Classic Haemophilia: A defect in Factor VIII 100 Stopping the Clotting Process 100 Fibrinolysis 102 Introduction to Molecular Techniques 103 Types of Molecular Techniques 103 Restriction Enzymes 103 DNA Gel Electrophoresis 104 Restriction Maps 105 Polymorphisms 105 DNA Cloning 106 complementary DNA library 107 Polymerase Chain Reaction (PCR) 107 DNA Sequencing - Chain Termination 109 Automated DNA sequencing 110 Nucleic Acid Hybridisation 110 Southern Blotting 111 Northern Blotting 111 In Situ Hybridisation 111 DNA Microarrays (DNA Chips) 112 Protein Gel Electrophoresis 112 SDS PAGE 113 Isoelectric focusing (IEF) 113 Two-Dimensional Gel Electrophoresis 114 Proteomics - protein identification 114 Antibodies 115 Immunocytochemistry 115 Enzyme-Linked Immunosorbent Assay (ELISA) 116 Measurement of Enzymes 117 Immuno (Western) Blotting 118 The files included in this download are original and copyright to myself, NotesbyMissChandhini. They are for your own personal use and should not be resold or redistributed. If you have any problems please don\'t hesitate to contact me. Contact me on: www.misstrendable.com @MissChandhini

Course 3 Chemistry Notes Notes made of the Chemistry lessons in Course 3. This is all the chemistry knowledge you need for the Knowledge and Theme tests. (Note that the Lewis Structures chapter is currently empty. Everything else is complete.) There are five questions about chemistry on the knowledge test of Course 3: - Acids & Bases (Buffer Calculation) - Calculating the Isoelectric Point - Salts & Separation - Drawing Lewis Structures (Orbitals) - Electrochemistry

NSG6001 Midterm Study Guide LATEST VERSION 2019 NSG6001 Midterm Study Guide LATEST VERSION 2019 NSG 6001 - ANP 1 – Study Guide for MIDTERMETT – Exercise Tolerance Testing – Stress Test1. Primary goal of ETTThe primary goal of the ETT is to increase workload incrementally to induce ischemia or until a predetermined workload is reached.2. A negative ETT (Exercise Tolerance Test) – this is the most common and east invasive test for CAD diagnosis and detection.a. Negative – if patient able to (A) exercise to at least 85% of the maximum heart rate without ischemia (B) means that there is no underlying heart problem present, or at least nothing serious.b. Positive – (A) if patient able to complete the exam without ischemia and (B) it means the test is inconclusive for CAD and but requires further diagnostic tests (C) chest pain is not indicative of CAD.3. Can ETT results correlate with the artery or arteries with CADRecent American College of Cardiology (ACC) guidelines give some guidance about noninvasive testing and markers for asymptomatic CAD based on an individual patient’s risk for CAD. ACC guidelines have as a class I recommendation (suggested) based on class B evidence (limited populations studied) that health care providers ascertain risk for cardiovascular disease in asymptomatic individuals by use of a global assessment such as the Framingham score. The ACC guidelines use the level of risk determined by these scores to evaluate the evidence and to classify recommendations for the use of various testing modalities in the investigation and determination of subclinical cardiovascular disease. For example, the ACC guidelines suggest that C-reactive protein can be used in asymptomatic men older than 50 years and women older than 60 years with low-density lipoprotein cholesterol < 160 mg/dL to determine if statin therapy is indicated and in asymptomatic intermediate-risk men older than 50 years and women older than 60 years to assess risk of cardiovascular disease. Anklebrachial index assessment is acceptable for intermediate-risk individuals to determine their risk for subclinical cardiovascular disease. And with risk factors of DM and HTN.4. How would the inability to exercise reduce the sensitivity and specificity of the routine ETT and understand the term: Sensitivity and an exercise echocardiography 2DEA. ETT’s lack of sensitivity is derived from the limitations of the surface electrocardiogram related to the spatial distribution of the electrical abnormalities that occur in ischemia. The ETT is more sensitive for the detection of severe disease.B. With an overall sensitivity of 67% and specificity of 72%, exercise stress testing can be a cost-effective strategy for evaluation of CAD.C. Because the interpretation of the test is based primarily on the development of characteristic ischemic ST-segment and T-wave changes, it is not surprising that resting ECG abnormalities can lead to a reduction in test sensitivity and specificity. The specificity of the routine ETT is reduced if the patient has had a prior myocardial infarction or if the patient has a resting bundle branch block conduction abnormality, paced rhythm, preexcitation syndromes, or inability to exercise because this produces persistent ST-segment and T-wave abnormalities.D. Ischemia that is confined to the posterior and or lateral segments of the left ventricle can be difficult to detect by ETT.E. The development of characteristic ischemic ST-segment and T-wave changes, it is not surprising that resting ECG abnormalities can lead to a reduction in test sensitivity and specificity. The specificity of the routine ETT is reduced if the patient has had a prior myocardial infarction or if the patient has a resting bundle branch block conduction abnormality, paced rhythm, preexcitation syndromes, or inability to exercise because this produces persistent ST-segment and T-wave abnormalities. A number of other factors can interfere with the sensitivity of the exercise test in detecting CAD. Because an increase in coronary blood flow is related to an increasing heart rate and systolic blood pressure, clearly the sensitivity of the test is effort dependent. The standard is the peak heart rate achieved during exercise.F. Although the 12-lead ECG is useful in localizing the region of myocardial ischemia, it is limited in both the sensitivity and the specificity and shows ischemic changes during or immediately after an ETT needed to distinguish the culprit coronary artery.5. Location of the J point in relation to the QRS after an exercise stress testThe ECG response of normal hearts is maintenance of an \\\"isoelectric\\\" ST segment during exercise and recovery. By standard criteria, a positive test result for CAD is defined by the development of horizontal or downsloping ST-segment depression of 1 mm measured 80 msec after the J point of the QRS complex (the junction between the QRS complex and the ST segment). ECG changes such as upsloping ST segment (elevation) or isolated T-wave downsloping (depression) have not demonstrated significant predictive value.In many healthy individuals, some degree of ST-segment elevation, especially in the precordial leads (V2 to V5), may be noted on the routine ECG. In most people, the degree of elevation is minimal; however, it can vary from 1 to 4 mm in height. This phenomenon has been attributed to early ventricular repolarization. It can be differentiated from the ST-segment elevation of an acute MI by the following: an upward concavity of the ST segment, an elevated takeoff of the ST segment at the J point (the junction of the end of the QRS complex and the beginning of the ST segment), and a distinct notching or slurring on the downstroke of the R wave.6. Physiological changes that occur during a routine ETTIn a stress test or ETT, patients are asked to perform incremental exercises that result in positive chronotropic (rate) and inotropic (strength of contraction) stimulation of the cardiovascular system, which in turn increases myocardial oxygen demand. Increases in oxygen demand obligate an increase in myocardial blood flow. The fundamental pathophysiologic change in CAD is a limitation of the ability of the coronary arterial circulation to vasodilate appropriately. As a result, the ability to increase coronary blood flow in the face of increased myocardial oxygen demand is limited, leading to an imbalance between oxygen supply and demand and resulting in myocardial ischemia.7. Significance of ischemic changes on the ECG during exerciseCirculatory beds in the body, the coronary circulation allows maximum oxygen extraction from the blood when the body is at rest. In a stress test or ETT, patients are asked to perform incremental exercises that result in positive chronotropic (rate) and inotropic (strength of contraction) stimulation of the cardiovascular system, which in turn increases myocardial oxygen demand. Increases in oxygen demand obligate an increase in myocardial blood flow. The healthy coronary circulation can increase flow approximately five times above the baseline level. The fundamental pathophysiologic change in CAD is a limitation of the ability of the coronary arterial circulation to vasodilate appropriately. A second important predictor of more advanced CAD is exercise-induced hypotension (i.e., a fall in systolic blood pressure of at least 20 mm Hg at any point during exercise).8. Test performed on a patient before recommending an exercise routine12-lead ECG and ECHO (Echocardiogram)9. The agent most commonly used to administer an ETTThe most widely available pharmacologic agents for stress testing are dipyridamole (Persantine), adenosine, regadenoson (Lexiscan), and dobutamine. However, the US Food and Drug Administration (FDA) warns against the use of adenosine and regadenoson in patients with signs or symptoms of unstable angina or cardiovascular instability.10. The meaning of an ST segment elevation during an exercise stress testAcute STEMI. STOP THE TEST!11. Changes that occur in an ECG that demonstrate ischemia late in the ischemic cascade.ST segment and T-wave changes that are central to demonstration of ischemia occur relatively late in the ischemic cascade.12. (A) The meaning of left ventricle wall thinning and there is some hyperkinesias of the ventricular wall during an echocardiogram exercise test and (B) define a positive exercise echocardiogramA positive exercise echocardiogram is defined by stress- induced decrease in regional wall motion, decreased wall thickening, or regional compensatory hyperkinesis. A limitation of the test is that it is dependent on the operator’s experience. Test results can also be altered by obesity, lung disease, and tachycardia.13. Stress-induced ischemiaMany of these women have evidence of stress-induced cardiac ischemia, which is likely to be related to endothelial dysfunction of the microvasculature.ECHO – Echocardiogram14. Difference of an echocardiogram exercise testing and a thallium stress testingThe 2DE evidence for ischemia includes an abnormal left ventricular ejection fraction (LVEF) response to exercise or the development of regional wall motion abnormalities.The exercise is performed with a bicycle or treadmill, and dobutamine is the most common pharmacologic agent used simultaneously with the echocardiography imaging. The image quality may be enhanced by the injection of echogenic microbubbles.As previously demonstrated in thallium imaging, the sensitivity of the 2DE technique for CAD detection is enhanced in patient subsets with multivessel CAD or prior myocardial infarction. In addition, the sensitivity of exercise echocardiography is decreased in patients with resting wall motion abnormalities.15. How does an echocardiogram enhance a standard ETTCurrent data suggest that adjunctive echocardiographic imaging enhances the sensitivity and specificity of CAD detection to an extent comparable to that provided by nuclear techniques.16. The effect of an ultrasound echocardiography on a morbidly obese patientNon-invasive cardiac imaging may suffer from poor image quality in morbidly obese individuals.Woman and heart disease (Coronary Artery Disease)17. Women and assessing by procedures for CADAlthough cardiovascular disease is the leading cause of death in women, this disorder often is not diagnosed expeditiously. Unfortunately, studies investigating women and cardiovascular disease are limited. Women are more likely to have nonobstructive or single-vessel disease compared with men, which decreases the diagnostic accuracy of stress testing.18. Women and limitations of certain tests for CADLimitations based on the size of the woman’s breasts and size of coronary arteries.Women are more likely to have nonobstructive or single-vessel disease compared with men, which decreases the diagnostic accuracy of stress testing. Single-photon emission CT imaging is technically limited in women because breast tissue and smaller coronary artery size.19. Women and symptoms of CADLeading cause of death (cardiovascular, heart disease including CAD in women) but a considerable body of research has demonstrated that women have different patterns of CAD and different responses to cardiac testing than their male counterparts do.20. Guidelines found from what source to support the prevention of future heart disease in a patient. All patients, even if asymptomatic, require risk stratification according to the Framingham risk score (low, intermediate, or high) to identify CAD risk equivalents. At present, the ACC/AHA guidelines do not recommend stress tests for asymptomatic patients, unless the patient (men 45 years or older, women 55 years or older) is sedentary and wishes to begin exercising aggressively. For women who are symptomatic and have known CAD, an abnormal resting ECG recording, questionable exercise tolerance, or coronary risk factors (e.g., diabetes, peripheral arterial disease), stress test imaging is recommended.21. Stress testing and women as compared to menWomen are more likely to have nonobstructive or single-vessel disease compared with men, which decreases the diagnostic accuracy of stress testing.Other22. A strategy to improve healthcare practices: Improvements in the delivery and management of healthcare are necessary if we are to improve the overall health of the nation’s population. Which of the following are identified in your readings as strategic in the movement to improve the healthcare system? Management of the population and healthcare practices.23. Term used for the encouragement of patients to be active in their own healthcareAutonomy, Ownership, Partnership, Self-management24. Medicare Part A, or \\\"hospital insurance,\\\" covers inpatient hospital services as well as some post-hospital nursing care and home health care. Part A is paid for through federal payroll taxes.25. Medicare will not reimburse NPs for services considered to be exclusive to nursing.26. Medicaid and the way it is delivered by each state, a federal program administered by each state, provides health care coverage to low-income families, to women and children and elders who qualify on the basis of poverty or age, and to those with short-term disabilities.27. Adherence to the principle of fidelity mandates that health care providers honor their commitments; adherence to veracity compels health care providers to tell the truth and not to be deceptive.28. Collaboration between patient and healthcare providerThe best part of collaboration is between the health care provider (i.e. nurse practitioner) and the patient because if the patient doesn’t have faith in the HCP/NP, the relationship is doomed and true collaboration will not take place.29. Chronic disease management statistics: according to the World Health Organization (WHO); know the statistics and percentage of preventable deaths and disabilities: 67%.