Exam #1 Flashcards

Question

Aging and the cell/tissues

Answer 1

Every physiological processes can be shown to function less efficiently Effects of aging depends on how we care for ourselves and genetics - senescence (loss of cell's power of division and growth) causes loss of tissue-repair capacity - increase in stem cell exhaustion - peripheral vascular resistance increases Delayed emptying of stomach decreased immune response to T-dependent antigens -increased accumulation of proinflammatory tissue

Answer 2

Infants: - 75%-80% TBW - They have a high metabolic rate - Their kidneys are not mature enough to counter fluid losses. Older adults: - thirst sensation is diminished

Answer 3

- At the arterial end of capillaries, fluid moves from the intramuscular space into the interstitial space b/c capillary hydrostatic pressure (BP) is higher than the capillary on optic pressure - facilitates the outward movement of water from the capillary to the interstitial space and is mainly influenced by blood pressure.

Answer 4

Is heavily influenced by plasma proteins (albumin) - Low plasma albumin causes edema, especially in the lower extremities, as a result of a reduction in plasma oncotic pressure.

Answer 5

When circulating blood volume or BP is reduced, renin, an enzyme secreted by the juxtaglomerular cells of the kidney, is released in response to sympathetic nerve stimulation and decreased perfusion of the renal vasculature.

Answer 6

Hormonal regulation of sodium and potassium balance is influenced by aldosterone. - When circulating blood volume or blood pressure is reduced: Aldosterone causes Na+ and H2O resorption (hangs onto Na+ and H2O), and thus increases BP and blood volume. - However, sacrifices K+ by increasing excretion thus hypokalemia.

Answer 7

Causes: Hyperkalemia, hyponatremia, and fluid volume deficit

Answer 8

Causes: Hyperkalemia, hyponatremia, and fluid volume deficit

Answer 9

Secretion of ADH and the perception of thirst are stimulated by a decrease in plasma volume, increase in serum sodium, decreased BP (so decreased perfusion)

Answer 10

Hormones that include atrial natriuretic peptide (ANP) produced by the myocardial atria, brain natriuretic peptide (BNP) produced by the myocardial ventricles, and urodilatin within the kidney. - Natriuretic peptides decrease BP and increase NA+ and H2O excretion - Counteracts the RAAS- it is an Antagonist of the RAAS

Answer 11

Regulator of fluids, nerve impulse conduction, acid-base balance, cellular chemical reactions, and transport of substances across the cellular membrane

Answer 12

Associated w/ hypoaldosteronism - loss of sodium, inadequate intake, and some medications - Sodium depletion usually causes hypoosmolality with an associated movement of water into cells (cellular swelling with potential for rupture) and cellular function is altered. -Clinical manifestation are related to altered action potential in neuron and muscles so impaired nerve conduction and neurological changes - N/V with less severe hyponatremia -More severe: lethargy, seizures, coma = major cause of morbidity and mortality in ICU and older patients

Answer 13

CNS is most serious, and some are the same as hyponatremia such as coma and seizures

Answer 14

the major determinant of the resting membrane potential necessary for transmission of nerve impulses

Answer 15

Major determinants of the resting membrane potential, which is necessary for the transmission and conduction of nerve impulses, maintenance of normal cardiac rhythms, and skeletal and smooth muscle contraction

Answer 16

Think heart/cardiac functioning - also a HUGE contributor to acid-base balance Ex. An increase in hydrogen ions (acidosis) in the blood causes the body to shift hydrogen ions into the cell in exchange for potassium

Answer 17

Oliguiric kidney failure (little to no urine output) Addison’s disease (decreased production of aldosterone thus body holds onto K+)

Answer 18

- Hyperkalemia should be investigated when there is a history of renal disease, massive trauma, insulin deficiency, Addison disease, use of potassium salt substitutes, or metabolic acidosis

Answer 19

In states of acidosis, hydrogen ions shift into the cells in exchange for ICF potassium

Answer 20

- Decrease intake: starvation or anorexia nervous, inadequate replacement - Inadequate replacement - Increased renal loss: renal tubular failure, K+ losing diuretics, hyperaldosteronism, vomiting, diarrhea

Answer 21

From ECF to ICFL respiratory/metabolic alkalosis - insulin promotes cellular uptake of K+ Ex. When administering insulin in diabetic ketoacidosis (DKA), watch for decreased ECF potassium!!

Answer 22

Necessary ion for many fundamental metabolic processes - it is the major cation associated with the structure of bones and teeth. - It serves as an enzymatic cofactor for blood clotting and is required for hormone secretion and the function of cell receptors - Plasma membrane stability, permeability, and repair are directly related to calcium ions, as is the transmission of nerve impulses and the contraction of muscles.

Answer 23

- Inadequate intestinal absorption - massive blood administration - decreases in PTH and vitamin D levels; - nutritional deficiencies - elevated calcitonin levels - pancreatitis

Answer 24

- increased neuromuscular excitability, tetany - tingling, muscle spasms (particularly in hands, feet, and facial muscles) - intestinal cramping, hyperactive bowel sounds - osteoporosis and fractures - severe cases show convulsions and tetany - prolonged QT interval, cardiac arrest

Answer 25

Hyperparathyroidisms - bone metastases with calcium resorption from breast, prostate, renal, and cervical cancer - excess vitamin D - Many tumors that produce PTH - calcium-containing antacids

Answer 26

Many nonspecific; - fatigue, weakness, lethargy, nausea - anorexia, constipation - impaired renal function, kidney stones - heart: dysrhythmias, bradycardia, cardiac arrest - bone pain

Answer 27

Influenced by parathyroid hormone (PTH), calcitonin, and vitamin D

Answer 28

Think “energy” ATP (adenosine tri phosphate) and oxygen transport 2,3 DPG (2,3 diphosphoglycerate)

Answer 29

- Intestinal malabsorption related to vitamin D deficiency - long-term alcohol use disorder - increased renal excretion of phosphate associated with hyperparathyroidism

Answer 30

- Conditions r/t reduced capacity for oxygen transport by RBC and disturbed energy metabolism - Leukocyte and platelet dysfunction; deranged nerve and muscle function - severe cases: irritability , confusion, numbness, coma, convulsions - possible respiratory failure- b/c of muscle weakness -cardiomyopathies, bone resorption (leading to rickets or osteomalacia) same as hypercalcemia

Answer 31

- Acute or chronic renal failure with significant loss of glomerular filtration (kidneys main excretory organ for phosphate) - long-term use of laxatives or enemas containing phosphates - hypoparathyroidism

Answer 32

- Symptoms primarily t/t low serum calcium levels (caused by high phosphate levels) - similar to symptoms of hypocalcemia - when prolonged, calcification of soft tissues in lungs, kidneys, joints (same as hypocalcemia)

Answer 33

is a cofactor in intracellular enzymatic reactions, protein synthesis, and neuromuscular excitability. - Improves myocardial metabolism, reduces peripheral vascular resistance, and inhibits platelet function.

Answer 34

Malnutrition, malabsorption syndromes, alcohol use disorder, urinary losses (renal tubular dysfunction, loop diuretics)

Answer 35

- Behavioral changes, irritability, - increased reflexes, muscle cramps, ataxia, nystagmus, tetany, convulsions, - tachycardia

Answer 36

- Usually, renal insufficiency or kidney failure with little or NO urine output!! - (Mg+ excreted by kidneys and intestines); - also, excessive intake of magnesium-containing antacids

Answer 37

- Lethargy, drowsiness; nausea and vomiting - loss of deep tendon reflexes, muscle weakness - bradycardia, heart block, cardiac arrest - respiratory distress;

Answer 38

An acid-base imbalance is not a disorder in and of itself, it is a diagnostic sign. - In order to correct the imbalance, treatment is targeted at resolving the cause of the imbalance

Answer 39

7.40 – less than 7.40 is considered acidosis; - greater than 7.40 is alkalosis when evaluating pH during an exacerbation of a disease entity.

Answer 40

Examples below of poor ventilatory status (hypoventilation) that cause retention of carbon dioxide (CO2) thus unable to eliminate a powerful acid via the lungs!! ✓ Respiratory failure – hypoventilation UGH! ✓ Chronic respiratory disease (e.g., COPD) ✓ Barbiturate or sedative overdose ✓ Respiratory muscle weakness

Answer 41

- CO2 retention from hypoventilation - Compensatory response (lungs in trouble, kidneys try to help) is ↑ HCO3− retention by kidney, but this is not an immediate compensatory mechanism and does take some time to be effective. However, with chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD), kidneys are very effective. - Kidneys secrete hydrogen ions (H+). - Bicarbonate is regenerated by the kidneys.

Answer 42

Examples below of increased elimination of carbon dioxide (CO2) - loss of too much acid from the body through the lungs (hyperventilation). - Hyperventilation – causes: hypoxia, anxiety, fear, pain, fever - Stimulated respiratory center (e.g., septicemia, stroke, meningitis, encephalitis, brain injury)

Answer 43

Compensatory response (lungs in trouble, kidneys try to help) is ↑ HCO3− excretion by kidney

Answer 44

Increased ACID load= elevated anion gap Increased hydrogen ion (H+) load Good way to remember: KILU

Answer 45

K= Ketoacidosis (diabetes myelitis) I= Ingestions (ethylene, glycol, salicaylates) L= Lactic acidosis (shock) U= Uremia

Answer 46

Diarrhea Renal failure

Answer 47

- Gain of fixed acid, inability to excrete acid or loss of base - Compensatory response (kidneys in trouble, lungs try to help) is ↑ CO2 excretion by lungs called Kussmaul respirations – the patient presents with increased rate and depth of respirations. Vomiting – trying to get rid of acid!

Answer 48

Vomiting – loss of acid (pH of stomach contents = 2) - Nasogastric suctioning - Diuretic therapy - Hypokalemia - Any condition that elevates aldosterone or mineralocorticoids (which enhance sodium [Na] reabsorption and potassium [K] and hydrogen ion [H +] excretion) can elevate HCO 3 −.

Answer 49

- Loss of strong acid or gain of base - Compensatory response (kidneys in trouble, lungs try to help) is ↑ CO2 retention by lungs

Answer 50

Identification of a specific genetic lesion can lead to effective prevention and support early screening. Presence of a genetic component can alter the course of disease through prevention and lowering risk factors. Also, a family history of a disease may mean that the person is more likely to develop the disease earlier in life: for example: a person with a first-degree relative with Alzheimer disease has double the risk.

Answer 51

1. Alleles are different forms of genes located at the same locus on the chromosome. 2. At any given locus in a somatic cell, an individual has two genes, one from each parent. An individual may be homozygous or heterozygous for a locus. 3. An individual's genotype is the person's genetic makeup, and 4. The phenotype reflects the interaction of genotype and environment.

Answer 52

is the extent of variation in phenotype associated with a particular genotype. If the expressivity of a disease is variable, the penetrance may be complete but the severity of the disease can vary greatly.

Answer 53

Genes are functional regions of DNA. -To serve as the basis of genetic inheritance, DNA must be able to provide a code for all the body's proteins. - DNA must be able to replicate itself accurately during cell division so that the genetic code can be preserved in subsequent cell generations. - A mutation is any inherited alteration of genetic material.

Answer 54

- unwinds the double helix, one holds the strands apart, and others perform different distinct functions. - The most important of these proteins - This enzyme travels along the single DNA strand, adding the correct nucleotides to the free end of the new strand. - Besides adding the new nucleotides, the DNA polymerase performs a proofreading procedure. -After the new nucleotide has been added to the chain, the DNA polymerase checks to make sure that its base is actually complementary to the template base. - If it is not, the incorrect nucleotide is excised and replaced with a correct one. This procedure, one of the mechanisms of DNA repair, substantially enhances the accuracy of DNA replication.

Answer 55

those that do not contain a multiple of 23 chromosomes. - Monosomy, the presence of only one copy of a given chromosome in a diploid cell, is the other common form of aneuploidy. - Monosomy of any chromosome is lethal. However, newborns with trisomy of chromosomes 13, 18, or 21 can survive. - This difference illustrates an important principle: loss of chromosome material has more serious consequences than duplication of chromosome material. - An aneuploid cell containing three copies of one chromosome is said to be trisomy (a condition termed trisomy).

Answer 56

in an autosome is trisomy of the twenty-first Chromosome: Down syndrome was formerly called mongolism, but this an inappropriate term and no longer used. - Individuals with this disease typically have intelligence quotients (IQs) between 25 and 70. The facial appearance is distinctive, with a low nasal bridge, protruding tongue, and flat, low-set ears.

Answer 57

For a recessive allele to be expressed, they must exist in a homozygous form. - The most common lethal autosomal recessive disease in white children is cystic fibrosis and is more common in females.

Answer 58

- If a male has the gene for cystic fibrosis, an autosomal recessive disorder, and the female has no gene, the child may still be a carrier. - Carriers do not usually show any phenotypic signs of the disease. - Because most recessive alleles are maintained in normal carriers, they are able to survive in the population from one generation to the next.

Answer 59

When one allele masks those of another they are in a heterozygote form. - At a heterozygous locus, the dominant gene masks those of a recessive gene.

Answer 60

- Genes responsible for this form of breast cancer have been mapped to chromosomes 17 (BRCA1) and 13 (BRCA2). - Women who inherit a mutation in BRCA1 or BRCA2 experience a 50% to 80% lifetime risk of developing breast cancer. - Breast cancer aggregates strongly in families. If a woman has one affected first-degree relative, her risk of developing breast cancer doubles.

Answer 61

Alzheimer disease (AD). - Later onset AD is rapidly increasing in the United States. - AD before the age of 65 is usually associated with an autosomal dominant mode of transmission.

Answer 62

- Some conditions are caused by genes located on the sex chromosomes, and that mode of inheritance is referred to as sex-linked. - The Y chromosome contains only a few dozen genes, so most sex-linked traits are located on the X chromosome and are said to be X-linked.

Answer 63

- Females receive two X chromosomes, one from the father and one from the mother, so they can be homozygous for a disease allele at a given locus, homozygous for the normal allele at the locus, or heterozygous.

Answer 64

- A male who inherits a recessive disease allele on the X chromosome will be affected by the disease because the Y chromosome does not carry a normal allele to counteract the effects of the disease-causing allele. - Consequently, males are more frequently affected by X-linked recessive diseases, with the difference becoming more pronounced as the disease becomes rarer.

Answer 65

the presence of a single X chromosome and no homologous X or Y chromosome, resulting in a total of 45 chromosomes; and it causes a set of symptoms known as Turner syndrome.

Answer 66

- Because they have no Y chromosome, persons with Turner syndrome are always female. - They are usually sterile, however, and have gonadal streaks rather than ovaries.

Answer 67

-short stature, webbing of the neck in about half of cases, widely spaced nipples, coarctation (narrowing) of the aorta (in 15% to 20% of cases), edema of the feet in newborns, and sparse body hair. - Their IQs are typically in the normal range, however intellectual abilities can be affected especially with impairment of spatial and mathematical reasoning ability. - Teenagers with Turner syndrome are typically treated with estrogen to promote the development of secondary sexual characteristics.

Answer 68

- the number of new cases of a disease reported during a specific period (typically 1 year) divided by the number of individuals in the population. - For example, during COVID, incidence rate was calculated on a weekly basis (number of new cases of COVID in one week)

Answer 69

a common measure of the effect of a specific risk factor. - It is expressed as a ratio of the incidence rate of the disease among individuals exposed to a risk factor divided by the incidence of the disease among individuals not exposed to a risk factor. Example: The incidence of death from lung cancer is 1.66 in heavy smokers (more than 25 cigarettes daily), but only 0.07 nonsmokers. - The ratio of these two incidence rates is 1.66/0.07, which yields a relative risk of 23.7 deaths. - Thus, it is concluded that the relative risk of dying from lung cancer increased by about 24-fold in heavy smokers compared with nonsmokers.

Answer 70

1) If the expression of the disease is more severe RR is higher. 2) Recurrence risk becomes higher if more than one family member is affected. For example, the sibling recurrence risk for a ventricular septal defect (VSD, a type of congenital heart defect) is 3% if one sibling has been affected by a VSD but increases to approximately 10% if two siblings have been diagnosed with VSDs. 3) The recurrence risk for the disease usually decreases rapidly in more remotely related relatives. 4) Many genes and environmental factors contribute to multifactorial diseases.

Answer 71

bridges DNA information and function by modifying gene expression without any alteration in DNA sequence. - "Epi-"means on or above in Greek, and "epigenetic" describes factors beyond the genetic code. - Epigenetic changes are modifications to DNA that regulate whether genes are turned on or off. - These modifications are attached to DNA and do not change the sequence of DNA building blocks

Answer 72

Epigenetic modification can cause individuals with the same DNA (IDENTICAL TWINS) to have different disease profiles – For example the occurrence of asthma in only one of a pair of identical twins. • As twins age, they demonstrate increasing differences in methylation patterns of their DNA sequences, causing increasing numbers of phenotypic differences.

Answer 73

Environmental factors, such as diet and exposure to certain chemicals, may cause epigenetic modification.

Answer 74

• Epigenetic factors are behaviors and environmental factors that can change how genes work, turning them "on" or "off". These factors can include: • Exposure to toxins: Air pollution, diesel exhaust, cigarette smoke, plastics, BPA, heavy metals like lead or cadmium • Substances: Alcohol, tobacco, recreational drugs, and certain prescription medications • Lifestyle: Foods, physical activity, stress levels, relationships, social interactions, community support, and access to healthcare • Epigenetic changes can occur throughout life, both as part of normal development and aging, and due to exposure to environmental factors. These changes can affect health in different ways.

Exam #1 Flashcards

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