NURS 314 Flashcards
Transription
First step of gene expression where DNA is copied
Translation
ribosomes create protiens
Protein production
The result of translation and transcription
Genes
Sequence of DNA that contains the instructions make protein
DNA Replication takes place where?
Nucleus
Where does DNA remain during replication?
Nucleus
The point where DNA is split and replicated
Replication Fork
RNA polynerase
Assists in transcription
Three types of RNA
1) mRNA - messenger RNA
2) tRNA - transfer RNA
3) rRNA - ribosome RNA
Which RNA carries the gene copy outside of the nucleus?
mRNA
rRNA is created where?
In the ribosomes
Known as mitochondrial DNA
Exons and Introns play what role in transcriptions?
Knows the type of the cell to create
The RNA type that is the glue that holds everything together.
rRNA
Telomeres
DNA sequence at the ends of the chromosomes
Result of telomeres continued replication.
Mutations or development of cancer cells
Daughter cell
germ line
Gametes
Mitosis results in the formation of gametes
False
Meiosis is the cell division that forms gametes
Crossing-over
chromosome pairs align and ends exchange
Two genes that are close together on the chromosome are called
Linkage
Ex. red hair and freckles
Punnet Square
Summarizes the genetic inheritance process.
Helps figure out the likelihood of dominant traits
Alleles
Copy of genes
Homozygous
If all your copies of a gene are alike
Heterozygous
If copied genes differ.
Carrier
If you are heterozygous for a recessive trait and do not show it
Hemizygous
If you only have one copy of a gene
Induction
Turns on a gene
Repression
Turns a gene off
Can socioeconomic status lead to induction or repression?
Yes
Polygenic
Many genes could affect one trait
Multifactorial
Both multiple genes and the environment could affect one trait
Epistasis
One gene could mask the effect of another
Complementary
One gene might depend on another
Two genes together might create a new phenotype
Collaborative
Gene mutation - Inherited
Present in all body cells; passed from parent to child through egg and sperm
Gene mutation - Spontaneous
Can occur in individual egg or sperm at time of conception. Can be passed to future generations
Gene Mutation - Acquired (somatic)
Occur in body cells other that egg of sperm. Changes in DNA that take place after conception.
Can somatic gene mutation be passed to offspring?
Yes
Autosomal dominant
Trait expressed with one copy of gene. Fifty percent chance of passing it on
brown eyes or Huntington’s disease
Autosomal recessive
Require two copies of the gene, one from each parent.
blue eyes or cystic fibrosis, sickle cell anemia, PKU
X-linked
Carried on the X chromosome
Passed from Mother to off-spring. Cannot be passed by father.
hemophilia, Duchenne muscular dystrophy
Mitochondrial DNA
Disorders can affect both male and female but only passed by females (in ova but not sperm)
In Mitochondria only
Multifactorial
Traits may cluster in families, but do not have characteristic pattern of inheritance
neural tube defects,
Teratogens
Environmental agents that produce birth defects during embryonic and/or fetal development
Three types of tetratogenics
1) Radiation
2) Drugs and chemical substances
3) Infectious agents
Fetal alcohol syndrome
refers to a host of cognitive, physical, and behavioral abnormalities that result from maternal alcohol consumption.
Cocaine’s affects on the fetal growth
preterm births, growth retardation, microcephaly, neurologic deficits, limb size reduction, hydronephrosis, and ambiguous genitalia. The higher the dose, the worse the manifestations
Folic acid is…
important for DNA synthesis and cell division
TORCH screening detects what?
Antibodies against teratogen microorganisms in infant serum
TORCH acronym:
- Toxoplasmosis-protozoa
- Other (varicella, TB, Epstein-Barr)
- Rubella
- Cytomegalovirus
- Herpes virus
Why is Genomics Important?
Plays a role in 9 of 10 leading causes of death
Health
- State of physical, mental, spiritual, and social functioning within developmental context
- Individual and societal responsibility
Disease
- Failure of adaptive mechanisms
- Results in functional or structural disturbances
Illness
-Subjective experience of individual and physical manifestation of disease
Function
- Levels reflected in terms or performance/social expectations; loss indicator of need for nursing intervention
Disability
Impairment that substantiates limits one or more major life activities
Wellness
An active process through which people become aware of, and make choices toward, a more successful existence
Healthy People 2020 - Overarching Goal #1
1) Attain high quality, longer lives free of preventable disease, disability, injury, and premature death
Healthy People 2020 - Overarching Goal #2
2) Achieve health equity, eliminate disparities, and improve good health of all groups
Healthy People 2020 - Overarching Goal #3
3) Create social and physical environments that promote good health for all
Healthy People 2020 - Overarching Goal #4
4) Promote quality of life, healthy development, and healthy behaviors across all stages of life
Six Dimensions of Wellness
- Occupational
- Physical
- Social
- spiritual
- Intellectual
- Emotional
Health promotion
The process of enabling people to increase control over, and to improve, their health.
Social determinants of health
Shaped by the distribution of money, power, and resources throughout local communities, nations, and the world
Vulnerable populations
- More likely to develop health problems as a result of exposure to risk or,
- to have worse health outcomes from these health problems than the rest of the population
Risk
Probability of dying or developing a disease or its precursors influenced by environmental, social, and individual genetic and behavioral characteristics
Key features of Healthy People 2020
- Strategic framework.
- Data driven outcomes
- Stakeholders at all levels
- Research, program planning, and policy
- Accountability
Primary Preventive Care
- Within public health
- Incorporates clinical medicine for immunizations
Secondary Care
Screenings and management of disease
Tertiary Care
When prevention and secondary care fails
Private Sector types of Insurance
- HMO
- PPO
- Concierge
- Nursing managed
- Independent
Public sector health care delivery
- Medicare
- Medicaid; MCO
- CHIP
Health Maintenance Organizations (HMO)
- Group of providers contract with HMO’s
- Comprehensive care for paid fee: CAPITATION
- No coverage outside of network
Point of service (POS)
- Groups of providers contract with a POS plan
- Additional fee for providers outside of network
- Increases consumer choice
Preferred provider organizations (PPO)
- Contracted providers provide services for discounted price
- Additional consumer cost if non-PPO provider
- Largest networks of providers
Private sector health care delivery
- Independent practice: fee for service/choice of provider
- Nursing-managed centers
- Hospitalists: hired by hospitals
Health Savings Account
Annual account paid into by Pt for medical coverage or surgeries during the course of a year. Money put in is forfeited at the end of the year
Medicare
- Federal program
- Paid through taxes
- Finances medical care for people over 65, disabled persons, hospice, and end-stage renal disease
Medicaid
- Federal and state funded
- State-determined eligibility
- Costs up to 50% of some state budget
- Benefits vary by state
- Available to certain low-income individuals (138% federal poverty level), no age requirements, and families with children
Children’s Health Insurance Plans (CHIP)
- Provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid
- Works closely with Medicaid
- Eligible up to 2 times the poverty level
Health People 2020: Leading Health Indicators (LHI)
- Contains 42 topic areas with more than 1200 objectives
- Selected to communicate high-priority health issues
What parts of Medicaid overlap?
Inpatient care in hospitals, skilled nursing facilities, home health care, hospice. Part A
Supplementary voluntary coverage paid by patient. Part B
Pharmaceutical costs: multiple private plans available. Part D
PPACA
Patient Protection and Affordable Care Act. Also known as ACA
Genome
Complete set of genes
Proteome
Complete set of protiens
Genetics
The study of the genome
Proteomics
Study of the proteome
AA
Amino Acids
How many codons in one amino acid?
Triplet codes/codon
How many structural AA’s are there?
20
How many possible combinations of the four bases are there in codons?
64
rRNA forms how much of the ribosome?
60%
Whcih is the smallest RNA and what does it do?
tRNA
rRNA
mRNA
tRNA and it delivers the AA in the ribosome
Mitosis
Somatic cells and forms two daughter cells with diploid number of chromosomes
Meiosis
Forms cells with haploid number of chromosomes
How many chromosomes are located inside the haploid cell?
23
What happens when mutations occur
One nucleotide can be substituted for another, or nucleotides are rearranged
Chromosomal mutation
Generally random event during gamete formation
Differences in number or structure of chromosomes
Genetic mutation
Present in all cells and passed from parent to child through egg and sperm
Spontaneous mutation
Occurs in idividual egg or sperm at time of conception.
Can be passed to future generations.
Acquired (somatic) mutation
Occurs in body cells other than egg and sperm.
DNA changes after conception
Maybe passed onto off spring
Mendelian Inheritance
Autosomal dominant Autosomal recessive X-Linked Mitochondrial DNA Multi-factorial
Autosomal dominant
Trait expressed with one copy of gene.
Fifty percent chance of passing it on. Brown eyes or huntingtons disease
Autosomal recessive
Require two copies of the gene, one from each parent. Blue eyes or cystic fibrosis, sickle cell anemia, PKU
X-linked
Carried on the X chromosome. hemophilia, Duchenne muscular dystrophy
Mitochondrial DNA
Disorders can affect both male and female but only passed by females (in ova but not sperm)
Multifactorial
Caused by multiple genes and environmental factors
- Involve a single organ or tissue
- Siblings tend to have the same defect
- The higher the incidence the higher the risk in future offspring
Smoking, alcohol, drugs, infections, lack of vitamins
Example of Multifactorial
Neural tube defects
Neural tube defects
Birth defects of the brain, spine, or spinal cord. They happen in the first month of pregnancy, often before a woman even knows that she is pregnant.
The two most common neural tube defects are spina bifida and anencephaly.
CYP450
Cytochrome P450 enzymes are essential for the metabolism of many medications.
Terotogen
environmental agents that produce birth defects during embryonic and/or fetal development
Teratogentic agents
Radiation
Drugs and chemical substances
Infectious agents
How are terotogenic agents introduced to the fetus?
These microorganisms cross the placenta, enter the fetal circulation, and produce hydrocephalus, microcephaly, mental retardation, etc.
Acquired infertility
Lifestyle factors
Occupational and environmental factors
Behavioral factors
STI’s
Industrial chemicals in food, water, air, and consumer products
Pharmacogenetics
How genes affect an individuals response to drugs
Recombinant DNA technology
Combination of DNA molecules that are found in nature
In inflammation; damaged cells release what and trigger what?
Damaged cells release inflammatory mediators which triggers either a local response or a systemic response
Local response to inflammation includes what type of responses?
Vascular and cellular
What occurs during the vascular response?
Prostaglandins and leukotrienes affect blood vessels
Arterioles and venules dilate to increase blood flow to the injured area and redness and warmth result
During vascular inflammation response; how do the capillaries respond?
The become more permeable allowing exudate to escape into the tissues resulting in swelling and pain
During the cellular local response; what occurs in this stage?
WBC enter injured tissue and destroys infective organisms, removes damaged cells, and releases more inflammatory mediators to control further inflammation and healing
Systemic response contains two responses:
WBC response and acute phase response
WBC response in systemic response includes what actions?
Release of inflammatory mediators that cause WBC production; WBC count rises; immature neutrophils release into blood
Acute phase of systemic response includes:
Leukocytes releasing interleukins and tumor necrosis factors which can lead to:
Fever
Lethargy
Skeletal muscle breakdown
What does the liver make during the Acute response phase?
Fibrogen and C-reactive protein
Fibrogen and C-reactive proteins do what?
Facilitates clotting
Binds to pathogens
Provides for a moderate inflammatory response
Colonization
Means microorganisms are multiplying in or on the host
Normal flora
Collection of microorganisms normally living in or on your body
Microbiome
Normal flora located in the gut, mucus openings, and skin
Opportunistic pathogens
Pathogens that take advantage of a compromised immune system
Innate Immunity
Always present
Attacks non-self microbes
Does not distinguish between different microbes
Innate immunity mechanisms
Epithelial barriers
Phagocytes
Plasma proteins
Cell messenger molecules
Adaptive immunity
Attacks specific microbes
Develops specific antigens after exposure
Adaptive immunity mechanisms
Humoral immunity and cell-mediated immunity
Humoral immunity
Antibody proteins in the blood that attack specific antigens
Cell-mediated immunity
Phagocytic cells that attack the specific antigen
Regulatory cells
T helper cells
T regulator cells
Antigen presenting cells
Effector cells
Carries out the attacks on the antigen
T cytotoxic cells (Killer T cells)
B cells
Leukocytes
What to B cells do?
Produces antibodies
Epitopes
Receptors on cell surface of MHC2 proteins
T helper cells are also known as
CD4+
MCH2 proteins attach to what?
CD4 receptors
T cytotoxic cells are known as
CD8+
CD8 receptors attach to which proteins?
MCH1
Plasma cells create what?
Antibodies; special proteins designed to attach to that antigen and destroy it
IgG
crosses placenta.
IgA
circulates in body fluids; pulls antigens together into clumps; acute illness phase
IgA: found in secretions on mucus membranes; prevents antigens from entering the body; found in colostrum
IgD
found on the surface of B cells; acts as an antigen receptor
IgE
Found on mast cells in tissues; starts an inflammation; associated with allergic response or parasite
IgM
acute illness phase
Vaccination produces what?
Primary immune response
Primary Immune response
Macrophage eats antigen –> presents to TH cells
TH cells –> activate B cells
Plasma antibody levels rise
Secondary immune response
B memory cells respond to antigen immediately
Plasma antibody levels rise withing days
Purpose of booster shots
To cause a secondary response so antibody levels elevate before a disease is encountered (flu shot)
ABX (antibiotics) kill bacteria how?
Cell wall synthesis
Protein synthesis
Nucleic acid synthesis
Bacterial metabolsim
How does bacteria fight back against ABX?
Inactivating antibiotics
Changing binding sites
Using different metabolic pathways
Changing their walls to keep antibiotics out
AV
Antivirals
AV kill viruses how?
Blocking viral RNA or DNA synthesis
Blocking viral binding sites to cells
Blocking production of the protein coats of new viruses
SE of amoxicillin
GI distress
Allergic reactions
Truvada
Prophalaxys and part of antiretroviral therapy for HIV
How does Truvada work?
Inhibits the activity of the HIV reverse transcriptase
Polymorphism
Common genetic variation
nucleotide
