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A.p bio 🧪 UNIT 1 CHEMISTRY OF LIFE — TEST CRAM Q&A 🟣 TOPIC 1: BIOLOGY REVIEW & STATISTICS Experimental Design Q: What is the independent variable? A: The variable the scientist changes/manipulates. Q: What is the dependent variable? A: The variable that is measured/observed. Q: Easy way to remember independent vs. dependent? A: Independent = I change it. Dependent = data I collect. Q: In an experiment, fertilizer concentration is changed and plant height is measured. What is the independent variable? A: Fertilizer concentration. Q: What is the dependent variable? A: Plant height. Q: What are constants? A: Things kept the same for every experimental group. Q: What is a control group? A: A group used as a comparison/baseline. Q: What is a positive control? A: A group that should produce a known positive result. Q: What is a negative control? A: A group that should produce no response/result. ⸻ Data & Statistics Q: What is qualitative data? A: Descriptive data that isn’t measured numerically. Example: color, texture, smell. Q: What is quantitative data? A: Numerical/measurable data. Example: 15 cm, 20°C, 5 grams. Q: What is the mean? A: The average: add all values and divide by the number of values. Q: What is the median? A: The middle value when data is arranged from least to greatest. Q: What is the mode? A: The value that occurs most often. Q: What is the range? A: Highest − lowest. Q: What does standard deviation tell you? A: How spread out the data is around the mean. Q: Small standard deviation means what? A: Data points are close together/consistent. Q: Large standard deviation means what? A: Data points are more spread out/variable. Q: If Group A and Group B have similar means, but Group A has a much smaller standard deviation, what does that mean? A: Group A’s data is more consistent and clustered around the mean. Q: What is SEM? A: Standard error of the mean; it estimates how accurately the sample mean represents the population mean. Q: What does a small SEM mean? A: The mean is more precise/reliable. Q: What do error bars show? A: The amount of variation or uncertainty around a mean, depending on what the graph specifies. Q: What should you look for when reading graphs? A: Specific data points, trends, patterns, increases/decreases, and relationships between variables. ⸻ 💧 TOPIC 2: STRUCTURE OF WATER & HYDROGEN BONDING Q: Why is water polar? A: Oxygen is more electronegative than hydrogen, so oxygen becomes partially negative and hydrogen becomes partially positive. Q: What does δ− mean? A: Partial negative charge. Q: What does δ+ mean? A: Partial positive charge. Q: What type of bond holds the H and O together inside one water molecule? A: Covalent bond. Q: What type of attraction occurs between different water molecules? A: Hydrogen bonds. Q: What causes water’s cohesion? A: Hydrogen bonding between water molecules. Q: What is cohesion? A: Water molecules sticking to other water molecules. Q: What is adhesion? A: Water sticking to other surfaces/materials. Q: What causes surface tension? A: Cohesion/hydrogen bonding between water molecules at the surface. Q: What is capillary action? A: Water moving upward through a narrow space because of cohesion + adhesion. Q: Why can water move upward through plants? A: Hydrogen bonding creates cohesion between water molecules, while adhesion helps water interact with the plant’s xylem walls, allowing capillary action. Q: Which interaction is primarily responsible for water cohesion? A: Hydrogen bonds. Q: What is a solute? A: The substance being dissolved. Q: What is a solvent? A: The substance that does the dissolving. Q: What is a solution? A: A solute + solvent mixture. ⭐ MUST KNOW: Polarity → hydrogen bonding → cohesion/adhesion → capillary action → water movement in plants ⸻ 🧬 TOPIC 2: ELEMENTS OF LIFE Q: Why is carbon so important to life? A: Carbon has 4 valence electrons, allowing it to form four stable covalent bonds and create many different structures. Q: Why can carbon create such a huge diversity of molecules? A: It can bond with itself and many other elements, creating chains, rings, branches, and complex structures. Q: What four major macromolecules are built from carbon? A: Carbohydrates, proteins, lipids, and nucleic acids. Q: What element is especially important in amino acids and nitrogenous bases? A: Nitrogen. Q: What element is found in nucleic acids and certain lipids? A: Phosphorus. Functional Groups Q: What is a functional group? A: A group of atoms that gives an organic molecule specific chemical properties and behaviors. Q: What are the major functional groups you need to know? A: Hydroxyl, carbonyl, carboxyl, amino, and phosphate. Q: What is a hydroxyl group? A: –OH Q: What is a carboxyl group? A: –COOH Q: What is an amino group? A: –NH₂ Q: What is a phosphate group? A: –PO₄ group. Q: What is a carbonyl group? A: A carbon double-bonded to oxygen: C=O. Q: What is a hydrocarbon? A: A molecule made only of carbon and hydrogen. ⸻ 🔗 TOPIC 3: INTRODUCTION TO BIOLOGICAL MACROMOLECULES Q: What is a monomer? A: A small building block that can join with others. Q: What is a polymer? A: A large molecule made from repeating monomers. Q: What are the four major biological macromolecules? A: Carbohydrates, proteins, lipids, nucleic acids. Q: What is dehydration synthesis? A: A process that joins monomers by forming a covalent bond and removing H₂O. Q: What is hydrolysis? A: A process that breaks covalent bonds by adding H₂O. 🧠 REMEMBER: Dehydration = take water OUT → build Hydrolysis = add water → break Q: Which process joins monomers to form a polymer? A: Dehydration synthesis. Q: Which process breaks polymers apart? A: Hydrolysis. Q: What happens to water during dehydration synthesis? A: Water is removed/released. Q: What happens to water during hydrolysis? A: Water is added. ⸻ 🍞 TOPIC 4: PROPERTIES OF BIOLOGICAL MACROMOLECULES Carbohydrates Q: What is a monosaccharide? A: A single sugar monomer. Q: What is a polysaccharide? A: A carbohydrate polymer made of many sugar units. Q: What is starch used for? A: Energy storage in plants. Q: What is glycogen used for? A: Energy storage in animals. Q: What is cellulose used for? A: Structural support in plant cell walls. ⸻ Proteins Q: What are proteins made of? A: Amino acids. Q: What is the monomer of a protein? A: Amino acid. Q: What part of an amino acid varies between amino acids? A: The R group. Q: Why are R groups important? A: Their different properties affect how a protein folds and functions. ⸻ Lipids Q: Are lipids generally polar or nonpolar? A: Mostly nonpolar/hydrophobic. Q: What does hydrophobic mean? A: Water-fearing; doesn’t mix well with water. Q: What does hydrophilic mean? A: Water-loving; interacts with water. Q: What is the difference between saturated and unsaturated fatty acids? A: Saturated = no C=C double bonds. Unsaturated = one or more C=C double bonds. Q: Which fatty acid has more bends/kinks? A: Unsaturated fatty acid. Q: Why do unsaturated fatty acids have kinks? A: Their double bonds bend the carbon chain. ⸻ Phospholipids Q: What two types of regions does a phospholipid have? A: A polar hydrophilic head and nonpolar hydrophobic tails. Q: Why are phospholipids important in cells? A: They form the cell membrane bilayer. Q: Why do phospholipids form a bilayer? A: The hydrophilic heads face the watery environments while the hydrophobic tails face inward away from water. ⸻ Nucleic Acids Q: What do nucleic acids do? A: They store and transmit biological information. Q: What is the monomer of nucleic acids? A: Nucleotide. Q: What are nucleotides made of? A: A 5-carbon sugar + phosphate group + nitrogenous base. ⸻ 🧩 TOPIC 5: STRUCTURE & FUNCTION OF BIOLOGICAL MACROMOLECULES Protein Structure Q: What determines a protein’s primary structure? A: The sequence of amino acids. Q: What is secondary protein structure? A: Local folding into structures such as alpha helices and beta sheets, stabilized by hydrogen bonds. Q: What is tertiary structure? A: The overall 3D shape of one polypeptide. Q: What is quaternary structure? A: Multiple polypeptide chains/subunits working together. ⭐ KNOW THIS ORDER: Primary → Secondary → Tertiary → Quaternary Q: Why can changing one amino acid affect protein function? A: It can change interactions between amino acids, which can change the protein’s shape, potentially changing its function. Q: What is denaturation? A: When a protein loses its normal shape, causing it to lose or reduce its function. Q: What can cause protein denaturation? A: Things such as high temperature or extreme pH. ⸻ DNA Structure Q: What does antiparallel mean? A: The two DNA strands run in opposite directions: one 5’ → 3’ and the other 3’ → 5’. Q: Why is DNA directionality important? A: DNA strands have specific 5’ and 3’ ends, which determines how they are read and copied. ⸻ Carbohydrate Structure Q: Why can two carbohydrates made from similar sugar monomers have different functions? A: Their monomers can have different arrangements, bonding, branching, and structures, which changes their properties and functions. Q: Example of this? A: Starch and cellulose are both made from glucose, but their different bonding/arrangements give them different functions. ⸻ 🧬 TOPIC 6: NUCLEIC ACIDS Q: What are the three parts of a nucleotide? A: 5-carbon sugar + phosphate group + nitrogenous base. Q: What sugar is found in DNA? A: Deoxyribose. Q: What sugar is found in RNA? A: Ribose. Q: What nitrogenous base is found in DNA but not RNA? A: Thymine (T). Q: What nitrogenous base is found in RNA instead of thymine? A: Uracil (U). Q: Is DNA usually single- or double-stranded? A: Double-stranded. Q: Is RNA usually single- or double-stranded? A: Single-stranded. Q: What does DNA store? A: Genetic/biological information. Q: What connects nucleotides together? A: Covalent bonds form the sugar-phosphate backbone. ⸻ 🧬 Base Pairing Q: What does A pair with in DNA? A: T Q: What does T pair with? A: A Q: What does C pair with? A: G Q: What does G pair with? A: C RNA: A ↔ U C ↔ G Q: If one DNA strand is 5’-ACGTAC-3’, what is the complementary strand? A: 3’-TGCATG-5’ Q: Why is it written 3’ → 5’? A: Because DNA strands are antiparallel. ⸻ 🔥 UNIT 1 BIG CONNECTIONS — YOUR TEACHER WILL LOVE THESE Q: Explain the water connection. A: Water’s polarity causes hydrogen bonding, which produces properties like cohesion and adhesion that are important for biological functions such as water movement through plants. Q: Explain the carbon connection. A: Carbon’s four valence electrons allow it to form many covalent bonds, creating the huge diversity of biological molecules. Q: Explain the macromolecule connection. A: Monomers join → polymers/macromolecules form → their structure determines their properties and function. Q: Explain the protein connection. A: Amino acid sequence → protein shape → protein function. Q: Explain the DNA connection. A: Nucleotide sequence → biological/genetic information. Q: Explain the experiment connection. A: Experimental design → data → analysis → evidence → biological conclusion. ⸻ 🚨 15 QUESTIONS YOU SHOULD BE ABLE TO ANSWER WITHOUT LOOKING What is the independent variable? → What you change. What is the dependent variable? → What you measure. Small standard deviation means…? → Data is consistent/close together. Why is water polar? → Oxygen is more electronegative than hydrogen. What causes cohesion? → Hydrogen bonding. What causes capillary action? → Cohesion + adhesion. Why is carbon so versatile? → Four valence electrons. What joins monomers? → Dehydration synthesis. What breaks polymers? → Hydrolysis. Protein monomer? → Amino acid. Nucleic acid monomer? → Nucleotide. Unsaturated fatty acids have what? → Double bonds and kinks. What determines protein shape? → Amino acid sequence/interactions. DNA sugar/base? → Deoxyribose + thymine. DNA strands are…? → Double-stranded and antiparallel. 🧠 LAST-MINUTE MEMORY CHAIN Memorize this exact chain: Water: POLAR → H-BONDS → COHESION/ADHESION → CAPILLARY ACTION Macromolecules: MONOMER → DEHYDRATION → POLYMER Breaking: POLYMER → HYDROLYSIS → MONOMERS Protein: AMINO ACID SEQUENCE → SHAPE → FUNCTION DNA: NUCLEOTIDE SEQUENCE → INFORMATION Experiment: INDEPENDENT → DEPENDENT → DATA → EVIDENCE → CONCLUSION

Art of interviewing In an interview, what factor do we need to consider? Social Economic Cultural How does the provider pick up on subtle ques? Shifts in body language in addition to spoken word Patients will tell you what is wrong with them if you ask the right questions Questions Open Ended OLDCARTS Don't use medical jargon Confrontation Watch for subtle ques "You look upset discussing _____, lets talk about it" Points out something striking about the patient's behavior or statement ○ Directs the patient's attention to something of which they may or may not be aware of ○ You look upset, you sound uncomfortable about that, Is there a reason you look away from me as you speak What does good communication improve? Health outcomes by resolving symptoms and reducing patient's psychogical distress and anxiety 85% of all malpractice lawsuits are based on poor communication skills What should we implement during an interview? ACTIVE LISTENING Watch their body language, tone, eye contact, speech and spoken word Understanding of what is being said, body language and other non verbal ques Symptom SUBJECTIVE ~What the patient feels ~Described by the patient Can be influenced by culture, intelligence and socioeconomic background Constitutional Symptom Fevers, Chills, Weight Gain, Weight Loss Effect all symptoms Sign OBJECTIVE What the observer finds on the assessment Crackles, dry skin, bruising What are the basic interviewing techniques? Questions Silence Facilitation Confrontation Interpretation Reflection Support Transitions Silence Silence is ok, but limit to 2 minutes or less If a patient is silent, you are silent Can restart the conversation with, "What are you thinking about?" Should never be used with the overtalkative patients ○ Can indicate interest and support ○ Don't allow more than 2 minutes of silence ○ Ok to ask: What are you thinking about? You were saying? These things are hard to think about Facilitation Keeps the conversation going "Tell me more about..." Encourages a patient to continue talking without controlling the direction of the conversation ○ Verbal and nonverbal communication that encourages the patient to keep talking ○ Go on, Tell me more, uh huh, And then Interpretation Based on inference "It sounds as if you are afraid...." Based on inference rather than observation ○ The provider interprets the patient's behavior, encouraging the patient to observe their own role in the problem. ○ You seem happy about that, Are you afraid you've done something wrong?, I wonder if your ____ is related to _____ Reflection Repeat part of the statement made by the patient Pt: "I haven't worked since 2016" APRN: "You haven't worked since 2016? Lets talk about that" A response that mirrors what the patient has just expressed ○ Patient: I am nervous about starting a new medication ■ Provider: Nervous about starting a new medication? Support Build a trusting relationship with the patient by using reassurance and empathy Shows an interest in or understanding of a patient ○ I understand ■ Reassurance ● A response that conveys to the patient that the interviewer understands what has been talked about ● That's great you were able to stop smoking, I am glad you came in today - we are going to help you ■ Empathy ● Response that recognizes a patient's feelings and does not criticize ● It's an understand, not an emotional state of sympathy ● I know it is not easy ______, I'm sure ______ has caused you a large amount of anxiety Transitions "Now I am going to ask you questions about..." Used as guides to allow the patient to better understand the logic of the interviewers questions in order to have a good flow to change the topic ○ I am now going to ask you questions about ______, Now let's talk about______ What does a past medical hx all include? General state of overall health Past Illnesses Hospitalizations Surgeries Prior injuries and accidents Allergies Current Medications Diet Sleep Patterns Immunizations Substance Abuse Complementary / Alternative Therapies What is sensitivity? How good a test is at identifying people who truly have the disease True Positive - Positive results are convincing RULE OUT = SnNout Sensitive test + Negative = disease OUT What is specificity How well a test does at correctly identifying people who are well True Negative - negative result is convincing RULE IN = SpPin Specific test + Positive = disease IN What is a functional capacity assessment? Asses geriatric patients abilities to perform activities of daily living (ADLs) -Self Care -Instrumental -Mobility -Timed Get Up and Go test Self Care ADLs Dressing Bathing Transferring from bed to chair Toileting Grooming Feeding oneself Instrumental ADLs Meal Preparation Managing Finances Use the phone Taking Meds Doing Housework Shopping Managing Transport Mobility ADLs Walking from room to room Climbing stairs Walking outdoors What is the timed get up and go test? Rise from chair, walk 10 feet, turn around, walk back to chair, turn and sit down Should be completed in 10 seconds or less If greater than 20 seconds, patient will need further evaluation What is the strongest predictor of future disability and death? Gait What should we be assessing in the elderly in relation to ADLs? # of falls in the last year Gender Identity One's internal sense of gender at a given time How a person feels and identifies themselves in terms of gender such as being a boy, girl or another gender Sexual Orientation The presence and/or object of a person's romantic, sexual, physical or spiritual attractions Who someone is attracted to or has romantic feeing towards ■ Same gender, different gender, more than one gender Alternative Medicine Systems Complete systems of health care that developed separately from Western/conventional medicine i. Traditional Chinese Medicine ii. Traditional Indigenous Healing Practices iii. Homeopathic Medicine Ayurvedic - translates to knowledge of life, origin = India Mind-Body Interventions Techniques that use the mind to help improve physical health and well-being Biofeedback Yoga / Meditation / Deep Breathing Prayer Tai Chi Biologically Based Therapies Natural substances or products from nature to improve health or treat illness Vitamins Herbal Products Probiotics Dietary Supplements Specialty Diets Manipulative and Body Physical movement, pressure, or hands-on techniques to help the body feel better or function better Chiropractic Osteopathy Reflexology / Massage Therapy Energy Therapies Energy fields in or around the body can be influenced to improve health or well-being Biofield therapy ~Intended to affect a patient's energy field for the purpose of healing by having a healer place their hands in or through them; the therapist's healing force restores the patient -Reiki -Therapeutic Touch Bioelectromagnetic based therapies ~Involve the unconventional use of electromagnetic fields. -Positioning external magnetic fields near or around the person, usually by placing magnets on the body, into clothing, or in mattresses Acupuncture -Traditional Chinese medicine in which thin needles are placed into the body to allow qi (energy) to flow unimpeded What is Yin & Yang? 2 opposite yet connected forces that exist in nature and the body They work together to maintain balance and harmony Yin Cooler Darker Quieter Slower Passive Associated with Rest Earth Moon Night Water Femininity Cold Yang Warmer Brighter Active Faster Masculinity Associated with Activity ■ Day, Heat, Light, Movement What is the goal of Yin & Yang? To Remain Healthy: ○ Maintaining a proper balance between yin and yang ○ Neither is considered completely good or bad ○ Both are necessary and work together What is the goal of Chinese Medicine? Not only cure disease, but keep people well Disease means failure in prevention of health care Health is a shared responsibility between the patient and provider Chinese medicine treats the patient as a whole rather than separate systems Preserving health, curing disease of mind, body and spirit The mind can help direct your body's energy toward healing and recovery Disharmony ■ Provides framework to help aid in healing ■ Ex: Patient doesn't catch the flu, develops disharmony. Abx, acupuncture or herbs can help to redevelop harmony What 2 techniques do the Chinese look at to diagnose? Tongue Pulse Assessment Tongue Assessment Believed to be a clear indicator of disharmony Color, Shape, Moisture, Coating, Thickness, Cracks & Texture of the tongue Pulse Assessment Disharmonies of the body have effects on the pulse ● Divided into 3 sections ○ Cun ■ Closest to the wrist ○ Guan ■ Second position ○ Chi ■ 3rd position, furthest from the wrist Left wrist (yin) ■ Heart, liver and kidney Right Wrist (yang) ■ Lungs, spleen and kidney Special Considerations for Peds: Head Palpable Anterior and Posterior Fontanelles Special Considerations for Peds: Eyes Inspecting for red reflex Special Considerations for Peds: Mouth Inspect for oral thrush and geographic tongue Special Considerations for Peds: Genitalia Inspect for hypospadias (males), diaper dermatitis, vaginal yeast Special Considerations for Peds: Hip Dystocia Perform Barlow and Ortolani Maneuvers Assess for normal newborn primitive reflexes Special Considerations for teens Assess Tanner Stages for breast tissue and genitals Can ask parents to step out of the room for the exam to allow you to ask further personal questions. The parents can refuse, although most are happy to step out If the parent does agree, do not continue with further examination until another medical witness is in the room with you Additional questions for teens include social history, illegal drug use, sexuality, suicide/depression screening and safety at home Billing and Coding Current Procedure Terminology (CPT) International Classification of Disease (ICD) Current Procedure Terminology (CPT) -Codes used to document many of the medical procedures performed in a medical office -Services and procedures provided 1. Evaluation and Management 2. Performance and Measurement 3.Emerging Medical Terminology International Classification of Disease (ICD) Explains the reason for the services ○ Classifies diseases and injuries and is used to track mortality and morbidity statistics ○ Assigned to identify the diagnosis, system, condition, problem, complaint or other reason for the encounter Bias An unfair or one sided opinion that can influence how someone thinks or acts Implicit Bias Unconscious attitudes or beliefs about people that can affect how we treat or judge them without realizing it Explicit Bias Conscious and intentional opinions to beliefs about a person or group that can lead to unfair treatment Race Groups of people based on physical traits, national origin and ancestry ■ Skin color, different features Ancestery ○ People, families and backgrounds one comes from ○ Genealogic history, understanding of one's genetic heritage Racial Bias An unfair or one sided opinion/judgement about someone based on their race Racism Treating someone unfairly, badly, negatively because of their race Scientific Racism The false idea that science proves some races are better, smarter or more capable than others Belief of biological evidence of racial inferiority/superiority Example: Black people are biologically different and inferior to white people Dominant Narrative The main or most widely accepted story or viewpoint about a topic, interests or ideas in a dominant social group Spirituality A person's sense of connection to something bigger than themselves, such as nature, a higher power, or their own inner beliefs and values. A person's search for meaning and purpose in life, including how they connect with themselves, others, nature, the present moment, and what they consider meaningful or sacred Religion A set of beliefs, practices, and traditions that help people understand life, spirituality, and their connection to a higher power or something sacred Gender Expression How a person shows or expresses their gender through things like clothing, hairstyle, behavior, voice or appearance What is included with Telehealth? Telemedicine Remote Patient Monitoring Videoconferencing mHealth eConsults Patient education / Coaching Continuing Education for the provider Telemedicine Patient care / Consultation Patient Monitoring Mentoring Digital Imaging What is included in Telehealth Etiquite? Environment Performance Privacy Telehealth - Environment Visual- Provider appearance Room appearance Lighting Picture quality Auditory - Provider noises, background noise, audio quality Telehealth - Performance Provider appearance and communication Use of equipment Provider Preparation Telehealth - Privacy Privacy of sites Equipment privacy settings Consents Mastered (1) You've been getting these terms right! Select this one What is the main purpose of an interview? Gather pertinent information -Patient's illness and how well they are adapting to said illness Goal is to gather important information regarding patient's illness/condition and how they are coping with it Not studied (2) You haven't studied these terms yet! Select these 2 What is included in Chinese medicine? What happens if there is a disharmony between Yin & Yang?