NURS 3012 Review for Final Exam F 24

NURS 3012 REVIEW FOR FINAL EXAM

• Instructor: Keeta P. Wilborn, PhD, RN

CELLULAR REGULATION

• Key Topics:

  • Genetics

  • Neoplasia

AUTOSOMAL DOMINANT DISORDERS

• Inheritance through a single mutant allele from an affected parent

• Probability: 50% chance of transmission to offspring

• Unaffected relatives do not transmit the disorder

• Age of onset may be delayed

• Degree of Penetrance: Determines expression of inherited mutant gene

HUNTINGTON DISEASE

• Genetics: HD gene located on chromosome 4

• Type: Autosomal dominant disorder

• Symptoms Onset: 4th or 5th decade

• Pathophysiology: Death of brain cells primarily in the caudate nucleus and putamen

• Neurotransmitter effects:

  • Decreased GABA (inhibitory)

  • Imbalances in dopamine and acetylcholine (excitatory)

• Early Manifestations: Depression, personality changes, memory loss

• Later Manifestations: Dyskinesia, progressive rigidity, akinesia, dementia

AUTOSOMAL RECESSIVE DISORDERS

• Gene Requirement: Both alleles must be affected

• Probability: 25% chance of being affected; 25% chance normal; 50% chance of being a carrier

• Age of Onset: Usually occurs early in life

SICKLE CELL DISEASE

• Type: Autosomal recessive disorder

  • Sickle Cell Trait: Heterozygous with 1 HbS gene

  • Sickle Cell Disease: Homozygous with 2 HbS genes

• Mutation: Point mutation in the beta chain of hemoglobin

• Consequences:

  • Hemolytic anemia

  • Vascular occlusion leading to complications

• Manifestations: Pain, acute chest syndrome, stroke, increased infection risk

X-LINKED DISORDERS

• Mutation Location: X chromosome

• Female heterozygotes can be carriers without experiencing symptoms

• Transmission Probability: 50% for male offspring to be affected; 50% for daughters to be carriers

• If an affected male procreates, all daughters become carriers

HEMOPHILIA A

• Type: Sex-linked disorder primarily affecting males

• Pathophysiology: Insufficient factor VIII production

• Severity Levels:

  • Mild: 6-30% normal factor VIII activity

  • Moderate: 2-5% activity

  • Severe: 1% or less activity, severe bleeding

• Manifestations: Bleeding in soft tissues, joints, GI tract

DOWN SYNDROME

• Cause: Nondisjunction during meiosis leading to trisomy 21

• Risk Factors: Increases with maternal age

• Presentation: Physical characteristics and potential congenital defects

• Diagnosis: Prenatal screening

ONCOGENESIS

• Process:

  • Carcinogenic agents lead to DNA damage

  • Activation of oncogenes, inactivation of tumor-suppressor genes

  • Result: Unregulated cell differentiation and growth leading to malignant neoplasms

NEOPLASMS

• Benign Characteristics:

  • Well-differentiated cells, slow growth, encapsulated

• Malignant Characteristics:

  • Undifferentiated, rapid growth, invasive, capable of metastasis

PARANEOPLASTIC SYNDROMES

• Cancer cells can produce hormone-like proteins affecting the body:

  • Examples: ADH causing SIADH, ACTH causing Cushing syndrome, PTH-related causing hypercalcemia

• May also affect clotting mechanisms leading to disorders

GRADING VS STAGING OF CANCER

• Grading: Based on a microscopic examination of tumor cells (I-IV)

• Staging: Extent and spread of cancer using the TNM method

  • T: Tumor size (1-4)

  • N: Lymph node involvement (0-3)

  • M: Metastasis (0-1)

IMMUNE REGULATION

• Key Concepts: Anaphylaxis, HIV/AIDS, SLE

HIV/AIDS

• Transmission: Through sexual contact, blood-to-blood contact, or perinatally

• Phases of Infection:

  • Primary infection

  • Asymptomatic/latency

  • AIDS

ANTIRETROVIRAL DRUGS

• Characteristics:

  • Enter infected cells, interfere with nucleic acid synthesis

  • Can stimulate the immune system

  • Medications available

PERFUSION

• Key Concepts: Acute Coronary Syndromes, Heart Failure

HEART ANATOMY

• Main structures include: superior vena cava, right/left pulmonary arteries, valves, atria, ventricles, etc.

CARDIAC OUTPUT DETERMINANTS

• Factors affecting cardiac output: Heart Rate, Stroke Volume (Preload, Afterload, Contractility)

CAD TYPES AND PATHOGENESIS

• Pathogenesis: Atherosclerosis

  • Types of Angina: Stable, unstable, ACS (NSTEMI, STEMI)

ECG READINGS

• T-wave inversion indicates ischemia; ST segment changes indicate injury

  • ST elevation = transmural injury

  • Abnormal Q waves = transmural infarct

SERUM CARDIAC MARKERS

• Myoglobin, CK-MB, Troponin – key markers for myocardial infarction and their timelines

HEART FAILURE

• Types: Right Heart Failure, Left Heart Failure, and their symptoms

  • Features include congestion, decreased output, pulmonary congestion, and edema

DRUG TREATMENT OF HEART FAILURE

• Standard medications:

  • ACE inhibitors, Diuretics, Beta Blockers, Cardiac Glycosides, others

OXYGENATION

• Conditions: Asthma, Croup, Bronchiolitis, Tuberculosis, RDS, Cystic Fibrosis, Anemia, and ABG interpretations

ASTHMA TYPES

• Atopic: Type I hypersensitivity with acute and late-phase responses

• Non-atopic: Triggers include respiratory infections, exercise, inhaled irritants

CYSTIC FIBROSIS

• Pathophysiology: Abnormal chloride transport leading to thick secretions and airway obstruction

  • Complications: Nutritional malabsorption, pancreatic issues, male infertility

TUBERCULOSIS

• Caused by Mycobacterium tuberculosis; affects lungs primarily

  • Responses: Macrophage attacks and cell-mediated immunity

INTRACRANIAL REGULATION

• Intracranial Pressure (ICP): Normal ICP values and effects on brain function

  • Use of osmotic diuretics in management

TRAUMATIC BRAIN INJURY (TBI) ASSESSMENT

• Glasgow Coma Scale to assess consciousness and responses

  • Score interpretation for severity of injury

CEREBRAL VASCULAR ACCIDENT (CVA)

• Types: Ischemic and hemorrhagic strokes

  • Symptoms include contralateral hemiplegia, aphasia, cognitive function changes

SEIZURE CLASSIFICATION

• Types: Generalized vs Partial; different patterns of onset

  • Characteristics include loss of consciousness or not

MOBILITY DISORDERS

• Conditions: Spinal Cord Injury, MS, MG, ALS

SPINAL CORD INJURY

• Immediate and secondary injury effects

  • Definitions for central cord syndrome, anterior cord syndrome, and Brown-Sequard syndrome

MYASTHENIA GRAVIS

• Type: Autoimmune disorder affecting acetylcholine receptors

  • Symptoms: Gradual weakness; can lead to myasthenic crisis

PARKINSON’S DISEASE

• Pathophysiology: Degeneration of dopamine neurons

  • Key features include tremor, rigidity, bradykinesia

MULTIPLE SCLEROSIS

• Types: Relapsing-Remitting, Secondary-Progressive, Primary-Progressive, others

  • Symptoms can vary widely across different types

AMYOTROPHIC LATERAL SCLEROSIS (ALS)

• Involvement of upper and lower motor neurons; progressive weakness

• Possible glutamate toxicity leading to motor neuron degeneration

METABOLISM AND NUTRITION

• Focus on key conditions: Cirrhosis, Bowel obstruction, Hepatitis, Pancreatitis, Cholecystitis

BOWEL OBSTRUCTION

• Complications include fluid loss, ischemia, and potential necrosis

CIRRHOSIS

• Etiology: Includes biliary obstruction, drug-induced damage, and alcoholic liver disease

  • Early manifestations may be asymptomatic

V Zাক্তগর HEPATITIS

• Various types with differing modes of transmission and risk factors

  • Manifestations: Jaundice, malaise, abdominal discomfort

CHOLECYSTITIS

• Caused by gallstones and ischemia; common symptoms and complications

PANCREATITIS

• Pathogenesis: Due to activated enzymes digesting pancreatic tissue

  • Symptoms include severe abdominal pain, potential hemorrhage