NR507 Final Exam Possible Questions A-Z / NR507 Final Study Guide (Latest-2022): Advanced, Exams of Nursing

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NR- 507 IStudy IGuide

Chapters I 1 - 5, I 11 - 14, I 16 - 20, I 21 - 25, I 27 - 3 - 33, I 34 - 39, I 40 - 47

1. GI Isymptoms Iresulting Iin Iheart Iburn( Ich I41, Ipg I 1429 - I1466) ➢ The Iclinical Imanifestations Iof I(GERD) Ireflux Iesophagitis Iare Iheartburn Ifrom Iacid Iregurgitation, Ichronic Icough, Iasthma Iattacks Iand Ilaryngitis. ➢ Heartburn Ialso Imay Ibe Iexperienced Ias Ichest Ipain, Iwhich Irequires Iruling Iout Icardiac Iischemia. ➢ Hiatal Ihernias Iare Ioften Iasymptomatic. IGenerally, Ia Iwide Ivariety Iof Isymptoms Idevelop Ilater Iin Ilife Iand Iare Iassociated Iwith Iother Igastrointestinal Idisorders, Iincluding IGERD. IManifestations Iof Ithe Ivarious Itypes Iof Ihiatal Ihernia Iare Idifficult Ito Idistinguish. ISymptoms Iinclude Iheartburn, Iregurgitation, Idysphagia, Iand Iepigastric Ipain ➢ Early Istages Iof Iesophageal Icarcinoma Iare Iasymptomatic. IThe Itwo Imain Imanifestations Iof Iesophageal Icarcinoma Iare chest Ipain Iand Idysphagia. IThe Imost Icommon Itype Iof Ipain Iis Iheartburn I(pyrosis). IIt Iis Iinitiated Iby Ieating Ispicy Ior Ihighly Iseasoned Ifoods Iand Iby Ilying Idown.
2. Complications Iof Igastric Iresection Isurgery I(c I41, Ipg I1439) ➢ Weight Iloss Ioften Ifollows Igastric Iresection Ibut Istabilizes Iwithin I 3 Imonths. IInadequate Ifood Iintake Iis Ia Icommon Icause Ibecause Imany Iindividuals Icannot Itolerate Ithe Iosmotic Ieffect Iof Icarbohydrates Ior Ia Inormal-size Imeal. IFoods Imay Ibe Ipoorly Iabsorbed Ibecause Ithe Istomach Iis Iless Iable Ito Imix, Ichurn, Iand Ibreak Idown Ifood Iparticles. IAbdominal Ipain, Ivomiting, Idiarrhea, Iand Imalabsorption Iof Ifats Ialso Icontribute Ito Iweight Iloss. IIn Ithe Icase Iof Ibariatric Isurgery Ifor Iextreme Iobesity, Iweight Iloss Iis Ithe Iintended Ioutcome.
3. Chicken Ipox I( Ic I46,pg I1659) ➢ an Iinfectious Iviral Idisease Ithat Iis Ispread Iby Idirect Icontact Ior Ithrough Ithe Iair Iby Icoughing Ior Isneezing; Iit Icauses Ia Iblister-like Irash Ithat Ifirst Iaffects Ithe Iface Iand Itrunk Iand Ithen Ican Ispread Iover Ithe Irest Iof Ithe Ibody; Isymptoms Iinclude Isevere Iitching, Ifatigue, Iand Ifever.
4. Skin Icancer I( Ich I 46 Ipg, I1641) ➢ Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma Iis Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom Iskin Icancer ➢ Chronic Iultraviolet I(UV) Iradiation Icauses Imost Iskin Icancers. IProtection Ifrom IUV Iradiation Ifrom Ithe Isun Iand Iartificial sources I(e.g., Itanning Ibeds), Iparticularly Iduring Ithe Ichildhood Iyears, Isignificantly Ireduces Ithe Irisk Iof Iskin Icancer Iin Ilater Iyears. IAreas Icommonly Iexposed Ito Ithe Isun’s Irays—face, Ineck, Iand Ihands—are Ihighly Ivulnerable Ifor Isuch Ilesions. IDark-skinned Ipersons Iand Ithose Iavoiding Isunlight Iare Isignificantly Iless Ilikely Ito Idevelop Ithese Imalignant Itumors. IIn Idark-skinned Ipersons, Ibasal Icells Icontain Ithe Ipigment Imelanin, Ia Iprotective Ifactor Iagainst Isun Iexposure ➢ Basal Icell Icarcinoma I ( Imost Icommon) Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated IbasalIor Igerminative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction. IThey Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically Iapparent. ➢ Squamous Icell Icarcinoma I(SCC) I is Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon human Icancer. Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasive. IAreas Iaffected Iare Ithe Ihead Iand Ineck I(75%) Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody.
5. Parts Iof Ithe Iheart Iin Iterms Iof Ifunction, Isuch Ias Ipericardium I( Ich I31, Ip I1085) ➢ The Iheart Iwall Ihas Ithree Ilayers—the Iepicardium, Imyocardium, Iand Iendocardium—and Iis Ienclosed Iin Ia Idouble-walled Imembranous Isac, Ithe I pericardium ➢ The I pericardial Isac I has Iseveral Ifunctions. IIt I(1) Iprevents Idisplacement Iof Ithe Iheart Iduring Igravitational Iacceleration Ior deceleration, I(2) Iacts Ias Ia Iphysical Ibarrier Ithat Iprotects Ithe Iheart Iagainst Iinfection Iand Iinflammation Ifrom Ithe Ilungs Iand Ipleural Ispace, Iand I(3) Icontains Ipain Ireceptors Iand Imechanoreceptors Ithat Ican Ielicit Ireflex Ichanges Iin Iblood Ipressure Iand Iheart Irate. ➢ the Iouter Ilayer Iof Ithe Ipericardium, Ithe I parietal Ipericardium , Iis Icomposed Iof Ia Isurface Ilayer Iof Imesothelium Iover Ia Ithin Ilayer Iof Iconnective Itissue. IThe I visceral Ipericardium , Ior I epicardium , Iis Ithe Iinner Ilayer Iof Ithe Ipericardium ➢ At Ione Ipoint Ithe Ivisceral Ipericardium Ifolds Iback Iand Ibecomes Icontinuous Iwith Ithe Iparietal Ipericardium, Iallowing Ithe large Ivessels Ito Ienter Iand Ileave Ithe Iheart Iwithout Ibreaching Ithe Ipericardial Ilayer ➢ The Iouter Ilayer Iof Ithe Iheart, Ithe Iepicardium, Iprovides Ia Ismooth Isurface Ithat Iallows Ithe Iheart Ito Icontract Iand Irelax Iwithin Ithe Ipericardium Iwith Ia Iminimal Iamount Iof Ifriction. ➢ the Iinternal Ilining Iof Ithe Imyocardium Iis Icomposed Iof Iconnective Itissue Iand Ia Ilayer Iof Isquamous Icells Icalled the I endocardium ➢ The Iendocardial Ilining Iof Ithe Iheart Iis Icontinuous Iwith Ithe Iendothelium Ithat Ilines Iall Ithe Iarteries, Iveins, Iand Icapillaries Iof Ithe Ibody, Icreating Ia Icontinuous, Iclosed Icirculatory Isystem
6. Congenital Iheart Idefects I(ch I33pg I1200)

➢ Congenital Iheart Idisease Iis Ithe Ileading Icause Iof Ideath, Iexcluding Iprematurity, Iduring Ithe Ifirst Iyear Iof Ilife.^5 It Iis Iestimated Ithat Ias Imany Ias I35% Iof Ideaths Icaused Iby Icongenital Iheart Idefects Ioccur Iin Ithe Ifirst Iyear Iof Ilife Iand Ithat Ione Ithird Iof Ichildren Iborn Iwith Icongenital Iheart Idisease Iwill Idie Ias Ia Iresult Iof Itheir Icardiac Idisease ➢ The Ietiology Iof Imost Icongenital Iheart Idisease Iis Iunknown. ➢ As Imany Ias I50% Iof Iinfants Iwith Itrisomy I 21 Ihave Ia Icongenital Iheart Idefect, Ieither Ian IAV Icanal Idefect Ior Ia IVSD. IExtra Icardiac Idefects Iare Inoted Iin Ias Imany Ias I35% Iof Iinfants Iwith Icardiac Ilesions. IProspective Istudies Iusing Ichromosomal Ianalysis Ihave Isuggested Ithat Icongenital Icardiac Imalformations Imay Ibe Ithe Iresult Iof Ia Isingle Igene Idefect

7. Urinary Itract Iobstruction I(ch I37, Ipg I1340) ➢ Urinary Itract Iobstruction Iis Ian Iinterference Iwith Ithe Iflow Iof Iurine Iat Iany Isite Ialong Ithe Iurinary Itract. An Iobstruction Imay Ibe Ianatomic Ior Ifunctional. IIt Iimpedes Iflow Iproximal Ito Ithe Iobstruction, Idilates Istructures Idistal Ito Ithe Iobstruction, Iincreases Irisk Ifor Iinfection, Iand Icompromises Irenal Ifunction. IAnatomic Ichanges Iin Ithe Iurinary Isystem Icaused Iby Iobstruction Iare Ireferred Ito Ias I obstructive Iuropathy. IThe Iseverity Iof Ian Iobstructive Iuropathy Iis Idetermined Iby: I(1) Ithe Ilocation Iof Ithe Iobstructive Ilesion, I(2) Ithe Iinvolvement Iof Ione Ior Iboth Iupper Iurinary Itracts I(ureters Iand Irenal Ipelvis), I(3) Ithe Icompleteness Iof Ithe Iobstruction, I(4) Ithe Iduration Iof Ithe Iobstruction, Iand I(5) Ithe Inature Iof Ithe Iobstructive Ilesion. IObstructions Imay Ibe Irelieved Ior Ipartially Ialleviated Iby Icorrection Iof Ithe Iobstruction, Ialthough Ipermanent Iimpairments Ioccur Iif Ia Icomplete Ior Ipartial Iobstruction Ipersists Iover Iweeks Ito Imonths Ior Ilonger.
8. GI Isymptoms Iof Iconditions Isuch Ias Ipyloric Istenosis, Ihiatal Ihernia, Iulcerative Icolitis- I(ch I 41 Ipg I 148,1429,1440) ➢ Hiatal Ihernia Iis Ithe Iprotrusion Iof Ithe Iupper Ipart Iof Ithe Istomach Ithrough Ithe Ihiatus I(esophageal Iopening Iin ItheIdiaphragm) Iat Ithe Igastroesophageal Ijunction. IHiatal Ihernia Ican Ibe Isliding, Iparaesophageal, Ior Imixed. ➢ Ulcerative Icolitis Iis Ian Iinflammatory Ibowel Idisease Ithat Icauses Iulceration, Iabscess Iformation, Iand Inecrosis Iof Ithe colonic Iand Irectal Imucosa. ICramping Ipain, Ibleeding, Ifrequent Idiarrhea, Idehydration, Iand Iweight Iloss Iaccompany Isevere Iforms Iof Ithe Idisease. IA Icourse Iof Ifrequent Iremissions Iand Iexacerbations Iis Icommon ➢ Pyloric Istenosis Iis Ian Iobstruction Iof Ithe Ipyloric Isphincter Icaused Iby Ihypertrophy Iof Ithe Isphincter Imuscle. IIt Iis Ione Iof Ithe Imost Icommon Idisorders Iof Iearly Iinfancy Iand Iaffects Iinfants Ibetween Ithe Iages Iof Ieither I 1 Iand I 2 Iweeks Ior I 3 Iand I 4 Imonths
9. Skin Icancer Ilesions I( Ich I46, Ipg I1641) ➢ Basal Icell Icarcinoma Iand Isquamous Icell Icarcinoma Iare Ithe Imost Iprevalent Iforms Iof Icancer. IMalignant Imelanoma Iis Ithe Imost Iserious Iand Ithe Imost Icommon Icause Iof Ideath Ifrom Iskin Icancer ➢ Basal Icell Icarcinoma Iis Ia Isurface Iepithelial Itumor Iof Ithe Iskin Ioriginating Ifrom Iundifferentiated Ibasal Ior germinative Icells. IThe Itumors Igrow Iupward Iand Ilaterally Ior Idownward Ito Ithe Idermal-epidermal Ijunction. IThey Iusually Ihave Idepressed Icenters Iand Irolled Iborders. IEarly Itumors Iare Iso Ismall Ithat Ithey Iare Inot Iclinically Iapparent. ➢ Basal Icell Icarcinoma Iis Ithe Imost Icommon Itype Iof Iskin Icancer Iin Iwhites Iand Iis Ithought Ito Ibe Icaused Iby IUVIradiation Iexposure ➢ Squamous Icell Icarcinoma I(SCC) Iis Ia Itumor Iof Ithe Iepidermis Iand Ithe Isecond Imost Icommon Ihuman Icancer. ➢ Two Itypes Iare Icharacterized: Iin Isitu I(Bowen Idisease I[BD]) Iand Iinvasiv e. IAreas Iaffected Iare Ithe Ihead Iand Ineck I(75%) Iand Ithe Ihands I(15%), Iwith I10% Iof Isquamous Icell Icarcinomas Ioccurring Ielsewhere Ion Ithe Ibody. IThese Itumors Iare Imore Ipredominant Iin Icountries Iwhere Iarsenic Iis Ifound Iin Ihigher Irates Iin Idrinking Iwater. ➢ Cutaneous Imelanoma I is Ia Imalignant Itumor Iof Ithe Iskin Ioriginating Ifrom Imelanocytes, Ior Icells Ithat Isynthesize Ithe pigment Imelanin. IThe Iincidence Iof Imelanoma Iis Iincreasing, Iand Iyoung Ito Imiddle-age Iadults Iare Iat Ihighest Irisk. CHARACTERISTIC DESCRIPTION Lentigo IMalignant IMelanoma Frequency 4% Ito I15% Iof Icutaneous Imelanomas Age Iat Idiagnosis 50 Ito I 80 Iyears Iold, Imean Iage I 65 Iyears Primary Ilocation Head, Ineck, Idorsum Iof Ihands I(sun-exposed Iareas) Pigmentation Iaccording Ito Ithickness <1.5 Imm I(levels II Iand III) Tan Iand Ibrown >1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black >1.5 Imm I(levels IIV Iand IV) Nodule Iformation Superficial ISpreading IMelanomas Frequency 57% Ito I70% Iof Icutaneous Imelanomas Age Iat Idiagnosis 20 Ito I 60 Iyears Iold Primary Ilocation Legs Iof Ifemales; Iupper Iback Iof Iboth Igenders Pigmentation Iaccording Ito Ithickness <1.5 Imm I(levels II Iand III) Tan Iand Ibrown >1.5 Imm I(level IIII) Tan, Ibrown, Iand Iblue-black >1.5 Imm I(levels IIV Iand IV) Nodule Iformation Primary INodular IMelanoma

Frequency 12% Ito I21% Iof Icutaneous Imelanomas Age Iat Idiagnosis 20 Ito I 60 Iyears Iold, Imean Iage I 53 Iyears Primary Ilocation Trunk, Ihead, Ior Ineck **Pigmentation Iaccording Ito Ithickness

1.5 Imm I(level IIII)** Small Inodule I(any Ihue) >1.5 Imm I(levels IIV Iand IV) Large Inodule I(any Ihue) Acral-Lentiginous IMelanoma Frequency 2% Ito I8% Iin Iwhites; I30% Ito I75% Iin Iblacks, IHispanics, IAsians Age Iat Idiagnosis 20 Ito I 60 Iyears Iold Primary Ilocation Palms, Isoles Iof Ifeet, Imucous Imembranes Pigmentation Iat Iany Ithickness Blue-black Iirregular Imacules, Ipapules, Ior Inodules

10. Gastroesophageal Ireflux Idisease- I(c I41, Ip I1439) ➢ Gastroesophageal Ireflux Idisease Iis Ithe Iregurgitation Iof Ichyme Ifrom Ithe Istomach Iinto Ithe Iesophagus, Icausing Iesophagitis Ifrom Irepeated Iexposure Ito Iacids Iand Ienzymes Iin Ithe Iregurgitated Igastric Icontents.
11. Congenital Iintrinsic Ifactor Ideficiency( Ich I28, I988) ➢ Deficiency Iin IIF Isecretion Imay Ibe Icongenital Ior, Imore Ioften, Ian Iautoimmune Iprocess Idirected Iagainst Igastric Iparietal Icells. ICongenital IIF Ideficiency Iis Ia Igenetic Idisorder Ithat Idemonstrates Ian Iautosomal Irecessive Iinheritance Ipattern. I The Iautoimmune Iform Iof Ithe Idisease Ialso Ihas Ia Igenetic Icomponent, Ias Ido Imost Iautoimmune Idiseases ➢ The Iprincipal Idisorder Iin IPA Iis Ian Iabsence Iof I intrinsic Ifactor I(IF) , Ia Itransporter Irequired Ifor Iabsorption Iof Idietary vitamin IB12, Iwhich Iis Iessential Ifor Inuclear Imaturation Iand IDNA Isynthesis Iin Ierythrocytes. IIF Iis Isecreted Iby Igastric Iparietal Icells Iand Icomplexes Iwith Idietary Ivitamin IB12 Iin Ithe Ismall Iintestine. IThe IB12-IF Icomplex Ibinds Ito Icell Isurface Ireceptors Iin Ithe Iileum Iand Iis Itransported Iacross Ithe Iintestinal Imucosa.
12. Types Iof Igastric Iulcers-signs Iand Isymptoms, Icharacteristics I( Ich I41, Ipg I 1437 - 1438) ➢ The Iclinical Imanifestations Iof Igastric Iulcers Iare Isimilar Ito Ithose Iof Iduodenal Iulcers I. IThe Ipattern Iof Ipain, Ifood, Iand Irelief Iis Icommon, Ibut Ithe Ipain Iof Igastric Iulcers Ialso Ioccurs Iimmediately Iafter Ieating. ➢ Gastric Iulcers I also Itend Ito Ibe Ichronic Irather Ithan Ialternate Ibetween Iperiods Iof Iremission Iand Iexacerbation Iand cause Imore Ianorexia, Ivomiting, Iand Iweight Iloss Ithan Iduodenal Iulcers. ➢ On Iset Iage I 50 Ito I 70 Iyears Iof Iage, Ifamily Ihistory- Iusually Inegative, Igender I– Iequal Iin Imen Iand Iwomen, Istress Ifactors- Iincreased I, Iulcerogenic Idrugs- Inormal Iuse, Icancer Irisk I– Iincreased , IPahtophysiology- I Helicobacter Ipylori Iincfection I– Ioften Ipresent I(6o% Ito I80%) Iabnormal Imucus- Imay Ibe Ipresent, Iparietal Icall Imass I– Inormal Ior Idecreased, Iacid Iproduction- Inormal Ior Idecreased, Iserum Igastrin I– Iincreased, Iserum Ipepsiogen I– Inormal I, Iassociated Igastritis I– Imore Icommon I , Iclinical Imanifestations I - Ipain I– Ilocated Iin Iupper Iabdomen, Iinttermittent, Ipain Iantacid-relief Ipattern, Ifood Ipain Ipattern, Iclinical Icourse- Ichronic Iulcer Iwithout Ipattern Iof Iremissionn Iand Iexacerbation
13. Bile Isalt Ideficiencies I( Ich I41,pg I1440) ➢ Conjugated Ibile Iacids I(bile Isalts) Iare Inecessary Ifor Ithe Idigestion Iand Iabsorption Iof Ifats. IBile Isalts Iare Iconjugated Iin Ithe Ibile Ithat Iis Isynthesized Ifrom Icholesterol Iand Isecreted Ifrom Ithe Iliver. IWhen Ibile Ienters Ithe Iduodenum, the Ibile Isalts Iaggregate Iwith Ifatty Iacids Iand Imonoglycerides Ito Iform Imicelles. IMicelle Iformation Imakes Ifat Imolecules Imore Isoluble Iand Iallows Ithem Ito Ipass Ithrough Ithe Iunstirred Ilayer Iat Ithe Ibrush Iborder Iof Ithe Ismall Iintestinal Ivilli ➢ Clinical Imanifestations Iof Ibile Isalt Ideficiency Iare Irelated Ito Ipoor Iintestinal Iabsorption Iof Ifat Iand Ifat-soluble Ivitamins I(A, D, IE, Iand IK). IIncreased Ifat Iin Ithe Istools I(steatorrhea) Ileads Ito Idiarrhea Iand Idecreased Iplasma Iproteins. IThe Ilosses Iof Ifat-soluble Ivitamins Iand Itheir Ieffects Iinclude Ithe Ifollowing:
    1. Vitamin IA Ideficiency Iresults Iin Inight Iblindness.
    2. Vitamin ID Ideficiency Iresults Iin Idecreased Icalcium Iabsorption Iwith Ibone Idemineralization I(osteoporosis), Ibone Ipain, Iand Ifractures.
    3. Vitamin IK Ideficiency Iprolongs Iprothrombin Itime, Ileading Ito Ispontaneous Idevelopment Iof Ipurpura I(bruising) Iand Ipetechiae.
    4. Vitamin IE Ideficiency Ihas Iuncertain Ieffects Ibut Imay Icause Itesticular Iatrophy Iand Ineurologic Idefects Iin Ichildren. IThe Imost Ieffective Itreatment Ifor Ifat-soluble Ivitamin Ideficiency Iis Ito Iincrease Ithe Iamount Iof Imedium- chain Itriglycerides Iin Ithe Idiet, Ifor Iexample, Iby Iusing Icoconut Ioil Ifor Icooking. IVitamins IA, ID, Iand IK Iare Igiven Iparenterally.
14. Clonal Iselection I(ch I12, Ipg373) ➢ This Iis Ireferred Ito Ias I clonal Iproliferation I or I clonal Iexpansion I. IAs Ia Iclone Iwith Ia Imutation Iproliferates, Iit Imay IbecomeIan Iearly Istage Itumor, Ifor Iexample, Ia Icarcinoma Iin Isitu Ior Ia Ibenign Icolonic Ipolyp. IAdditional Iheritable Ichanges Ican Ioccur Iin Ithese Iearly Ilesions Ithat Ipermit Iprogression Ito Imore Iadvanced Itumors. IThe Iprocess Iof Itumor Idevelopment Iis IaIform Iof Idarwinian Ievolution; Icells Iwith Ia Igenetic Ichange Ithat Iconfers Ia Isurvival Iadvantage Iout-

compete Itheir

. IDevelopment Iis Irelated Ito Ithe Ioverall Ihealth Iof Ia Iwoman Iand Ilocal Idefense Imechanisms, neighbors. IThe Iprogressive Iaccumulation Iof Idistinct Iadvantageous I(from Ithe Ipoint Iof Iview Iof Ithe Icancer Icell, Inot Ithe Iindividual!) Imutations Ileads Ifrom Inormal Icells Ito Ifully Imalignant Icancers.

15. Obstructive Isleep Iapnea I(ch I16,pg I504) ➢ Obstructive Isleep Iapnea Isyndrome I(OSAS) I is Ia Idisorder Iof Ibreathing Iduring Isleep Irelated Ito Iupper Iairway Iobstruction Ithat Iis Iassociated Iwith Ireduced Iblood Ioxygen Isaturation Iand Ihypercapnia. IThe Itypical Iclassification Iof Ithe Iseverity Iof Ithis Idisease Iuses Ithe IApnea IHypopnea IIndex I(AHI). IThis Iindex Irepresents Ihow Imany Iapnea I(total Iairway Iclosure) Ior Ihypopnea I(partial Iairway Iclosure) Iepisodes Ioccur Iper Inight—the Inumber Iof Iwhich Iis Ithen Idivided Iby Ithe Inight’s Itotal Isleep Itime Ito Igive Ian Iaverage Inumber Iof Iapnea Ior Ihypopnea Iepisodes Iper Ihour.
16. Large Ibowel Iobstruction I(ch I41,pg I1431) ➢ Chronic Ior Ipartial Iobstructions Iare Imore Ioften Iassociated Iwith Itumors Ior Iinflammatory Idisorders, Iparticularly Iof the Ilarge Iintestine. IIntussusception Iis Irare Iin Iadults Icompared Iwith Ithe Imore Ifrequent Ioccurrence Iin Iinfants. IThe Imost Icommon Icauses Iof Ilarge Ibowel Iobstruction Iare Icolorectal Icancer, Ivolvulus I(twisting), Iand Istrictures Irelated Ito Idiverticulitis.
17. Vaginal Icandidiasis I(ch I24,pg I874) ➢ Vaginitis, Ior Ivaginal Iinfection, Iis Iusually Icaused Iby Isexually Itransmitted Ipathogens Ior I C. Ialbicans , Iwhich Icauses Icandidiasis particularly Ivaginal IpH. IVariables Isuch Ias Iantibiotics, Idouching, Isoaps, Ifeminine Ihygiene Isprays, Iand Ipregnancy Ialter Ivaginal IpH Ior Ithe Ibactericidal Inature Iof Isecretions Iand Ipredispose Ia Iwoman Ito Iinfection.
18. Folate Ideficiency I(ch I2,pg I67) ➢ Folic Iacid Ideficiency Iis Ia Icommon Iproblem Iin Ichronic Ialcoholic Ipopulations. IEthanol Ialters Ifolic Iacid I(folate) Ihomeostasis Iby Idecreasing Iintestinal Iabsorption Iof Ifolate, Iincreases Iliver Iretention Iof Ifolate, Iand Iincreases Ithe Iloss of Ifolate Ithrough Iurinary Iand Ifecal Iexcretion.Folic Iacid Ideficiency Ibecomes Iespecially Iserious Iin Ipregnant Iwomen Iwho Iconsume Ialcohol Iand Imay Icontribute Ito Ifetal Ialcohol Isyndrome ➢ A Ideficiency Iof Ifolate Ialso Iis Iimplicated Iin Ithe Idevelopment Iof Icancers, Ispecifically Icolorectal Icancers. ➢ Folate^ Ideficiency^ Iis^ Imore^ Icommon^ Ithan^ Ivitamin^ IB 12 I^ deficiency^ Iand^ Ioccurs^ Imore^ Irapidly.
19. Pancreatic Iinsufficiency I(ch I 41 Ipg I1439) ➢ Pancreatic Iinsufficiency I is Ithe Ideficient Iproduction Iof Ithese Ienzymes Iby Ithe Ipancreas. ICauses Iof Ipancreatic Iinsufficiency Iinclude Ichronic Ipancreatitis, Ipancreatic Icarcinoma, Ipancreatic Iresection, Iand Icystic Ifibrosis. ISignificant Idamage Ito Ior Iloss Iof Ipancreatic Itissue Imust Ioccur Ibefore Ienzyme Ilevels Idecrease Isufficiently Ito Icause Imaldigestion. IAlthough Ipancreatic Iinsufficiencycauses Ipoor Idigestion Iof Iall Inutrients, Ifat Imaldigestion Iis Ithe Ichief Iproblem.
20. Vitamin IB- 12 Itherapy I(ch Ich I28,pg I988) ➢ Replacement^ Iof^ Ivitamin^ IB 12 I(cobalamin)^ Iis^ Ithe^ Itreatment^ Iof^ Ichoice.^ IInitial^ Iinjections^ Iof^ Ivitamin^ IB 12 Iare Iadministered Iweekly Iuntil Ithe Ideficiency Iis Icorrected, Ifollowed Iby Imonthly Iinjections Ifor Ithe Iremainder Iof Ithe Iindividual’s Ilife. IThe Ieffectiveness Iof Icobalamin Ireplacement Itherapy Iis Idetermined Iby Ia Irising Ireticulocyte Icount. IWithin I 5 Ito I 6 Iweeks, Iblood Icounts Ireturn Ito Inormal. IPA Icannot Ibe Icured Iso Imaintenance Itherapy Iis Ilifelong. IConventional Iwisdom Iand Ipractice Iassumed Ithat Ioral Ipreparations Iwere Iineffective Ibecause Ithere Iwas Ino IIF Ito Ifacilitate Iabsorption of Ivitamin IB 12. IHowever, Irecent Iexperience Ihas Ishown Ithat Ihigher Idoses Iof Iorally Iadministered Ivitamin IB 12 I will Ibe Iabsorbed Iacross Ithe Ismall Ibowel Iand Iis Ibeneficial.
21. Cervical Iimmunoglobulin- I (ch I 23, Ipg I775) ➢ The Iexternal Icervical Ios Iis Ia Ivery Ismall Iopening Ithat Icontains Ithick, Isticky Imucus I(the I mucous Iplug ) Iduring Ithe Iluteal Iphase Iof Ithe Imenstrual Icycle Iand Iall Iof Ipregnancy. IDuring Iovulation Ithe Imucus Ichanges Iunder Ithe Iinfluence Iof Iestrogen Iand Iforms Iwatery Istrands, Ior Ispinnbarkeit Imucus, Ito Ifacilitate Ithe Itransport Iof Isperm Iinto Ithe Iuterus ➢ the Idownward Iflow Iof Icervical Isecretions Imoves Imicroorganisms Iaway Ifrom Ithe Icervix Iand Iuterus. IIn Iwomen Iof reproductive Iage, Ithe IpH Iof Ithese Isecretions Iis Iinhospitable Ito Imost Ibacteria. IFurthermore, Imucosal Isecretions Icontain Ienzymes Iand Iantibodies I(mostly Iimmunoglobulin IA) Iof Ithe Isecretory I(humoral) Iimmune Isystem ➢ These Idefenses Ido Inot Ialways Iprevent Iinfection, Ieven Iif Ithey Iare Iintact. IBesides Iinfection, Iuterine Ipathophysiology Iincludes Idisplacement Iof Ithe Iuterus Iwithin Ithe Ipelvis, Ibenign Igrowths I(fibroids) Iof Ithe Iuterine Iwall, Ihyperplasia Iof Ithe Iendometrium, Iendometriosis, Iand Icancer.
22. Congenital Imurmurs I( Ich I 32 Ipg I 1168 - 1170) ➢ Aortic Istenosis I– Icongenital Ibicuspid Ivalve, Idegenerative I(calcification) Ichanges Iwith Iaging, Irheumatic Ifever, Ileft Iventricular Ihypertrophy Ifollowed Iby Ileft Iheart Ifailure; Idecreased Iblood Iflow Iwith Imyocardial Iischemia, Ipulmonary

Iedema: Idyspnea Ion Iexertion, Isyncope Iespecially Ion Iexertion, Ipain- Iangina Ipectoris, Isystolic Imurmur Iheard Ibest Iat Ithe Iright Iparasternal Isecond Iintercostal Ispace Iand Iradiating Ito Ithe Ineck. ➢ Tricuspid Iregurgitation I– Icongenital, Iright Iheart Ifailure, Idyspnea, Ipalpitations, Imurmur Ithroughout Isystole Iheard best Iat Ithe Ileft Ilower Isternal Iborder.

23. Lactose Iintolerance I(CH I42,PG I1500)-

High Imitotic Iindex; Imany Idividing Icells Can Ispread Idistantly, Ioften Ithrough Iblood Ivessels Iand Ilymphatics Have Ia Ilow Imitotic Iindex; Idividing Icells Iare Irare Do Inot Imetastasize Grow Islowly Grow Irapidly Have Ia Iwell-defined Icapsule Are Inot Iencapsulated Are Inot Iinvasive Invade Ilocal Istructures Iand Itissues Are Iwell Idifferentiated; Ilook Ilike Ithe Itissue Ifrom Iwhich Ithey Iarose Are Ipoorly Idifferentiated; Imay Inot Ibe Iable Ito Idetermine Itissue Iof Iorigin BENIGN ITUMORS MALIGNANT ITUMORS ➢ Lactose Iintolerance I is Ithe Iinability Ito Idigest Ilactose I(milk Isugar). IIt Iis Icaused Iby Iinadequate Iproduction Iof Ilactase IandIis Ia Icommon Icause Iof Idiarrhea Iin Ichildren, Iparticularly Inonwhite Ichildren Iyounger Ithan I 7 Iyears Iof Iage. IThe Imalabsorption Iof Ilactose Iresults Iin Iosmotic Idiarrhea, Iin Iwhich Ifluids Imove Iby Iosmosis Ifrom Ithe Ivascular Icompartment Iinto Ithe Iintestinal Ilumen. IThe Iundigested Isugar Iis Iprocessed Iby Ithe Icolonic Ibacteria, Iand Iintestinal Igas Iis Iproduced. ➢ The Idiarrhea Iis Iaccompanied Iby Iabdominal Ipain, Ibloating, Iand Iflatulence. IDiagnosis Iincludes Ielimination Iof Idietary Ilactose Ior Ihydrogen Ibreath Itesting. ITreatment Iconsists Iof Iusing Ilactase-treated Idairy Iproducts Ior Ilactase Isupplements Ior Ireducing Idairy Iproduct Iconsumption. IOther Isources Iof Idietary Icalcium Ior Isupplements Ineed Ito Ibe provided Iif Idairy Iproducts Iare Ieliminated. ISome Ichildren Ican Itolerate Ilactose Iin Ifermented Iforms, Isuch Ias Icheese Iand Iyogurt ➢ a Icondition Icaused Iby Ilactase Ideficiency Iin Iwhich Ilactose Iis Inot Imetabolized, Imaking Iit Iimpossible Ifor Ithe Ismall Iintestine Ito Iabsorb Iit Iand Icausing Iexcessive Igas Iproduction Iand Idiarrhea Iwhen Iexposed Ito Ilactose-containing Ifoods.

24. Angiotensin-renin Isystem I( Ich I5, Ich I 37 Ipg I1327) ➢ Aldosterone Isynthesis Iand Isecretion Iare Iregulated Iprimarily Iby Ithe Irenin-angiotensin-aldosterone Isystem ➢ A Imajor Ihormonal Iregulator Iof Irenal Iblood Iflow Iis Ithe Irenin-angiotensin-aldosterone Isystem I(RAAS), Iwhich Ican Iincrease Isystemic Iarterial Ipressure Iand Iincrease Isodium Ireabsorption. IRenin Iis Ian Ienzyme Iformed Iand Istored IinIgranular Icells Iof Ithe Iafferent Iarterioles Iof Ithe IJGA ➢ The Irelease Iof Irenin Iis Iprincipally Itriggered Iby Idecreased Iblood Ipressure Iin Ithe Iafferent Iarterioles, Iwhich Ireduces stretch Iof Ithe Ijuxtaglomerular Icells; Idecreased Isodium Ichloride Iconcentrations Iin Ithe Idistal Iconvoluted Itubule; Isympathetic Inerve Istimulation Iof Iβ-adrenergic Ireceptors Ion Ithe Ijuxtaglomerular Icells; Iand Irelease Iof Iprostaglandin
25. Carcinoma I( Ich I 12 Ipg I 363 I)
26. Hormonal Iregulation Iof Icalcium I( Ich I 3 Ipg I 119 ) ➢ Calcium I(Ca++) I is Ia Inecessary Iion Ifor Imany Ifundamental Imetabolic Iprocesses. IIt Iis Ithe Imajor Ication Iassociated Iwith Ithe Istructure Iof Ibones Iand Iteeth. IIt Iserves Ias Ian Ienzymatic Icofactor Ifor Iblood Iclotting Iand Iis Irequired Ifor Ihormone Isecretion Iand Ithe Ifunction Iof Icell Ireceptors. IPlasma Imembrane Istability Iand Ipermeability Iare IdirectlyIrelated Ito Icalcium Iions, Ias Iis Ithe Itransmission Iof Inerve Iimpulses Iand Ithe Icontraction Iof Imuscles. Intracellular Icalcium Iis Ilocated Iprimarily Iin Ithe Imitochondria. ➢ Calcium Iand Iphosphate Ibalance Iis Iregulated Iby Ithree Ihormones: Iparathyroid Ihormone I(PTH), Ivitamin ID, Iand Icalcitonin ➢ The Iparathyroid Iglands Isecrete IPTH Iin Iresponse Ito Ilow Ilevels Iof Iserum Icalcium ➢ As Icalcium Ilevels Iincrease, Ian Iopposite Iadaptation Ioccurs, Ileading Ito Isuppression Iof IPTH Isecretion, Idecreased Irenal Ivitamin ID Iactivation, Idecreased Iintestinal Icalcium Iabsorption, Iand Iincreased Irenal Iphosphate Ireabsorption.
27. Glycoprotein I(ch I 8 I,pg I229) ➢ An I antibody , Ior Iimmunoglobulin, Iis Ia Iserum Iglycoprotein Iproduced Iby Iplasma Icells Iin Iresponse Ito Ia Ichallenge IbyIan Iimmunogen. IThe Iterm I immunoglobulin I is Iused Ito Idenote Iall Imolecules Ithat Iare Iknown Ito Ihave Ispecificity Ifor Iantigen, Iwhereas Ithe Iterm I antibody I is Igenerally Iused Ito Idenote Ione Iparticular Iset Iof Iimmunoglobulins Iwith Ispecificity Iagainst Ia Iknown Iantigen
28. Type I 2 Idiabetes I( Ich I22, Ipg I 739 ) ➢ a Icondition Iof Iglucose Iintolerance Ithat Inormally Iappears Ifirst Iin Iadulthood Iand Iis Iexacerbated Iby Iobesity Iand Ian Iinactive Ilifestyle. ➢ genes Ihave Ibeen Iidentified Ithat Iare Iassociated Iwith Itype I 2 Idiabetes, Iincluding Ithose Ithat Icode Ifor Ibeta-cell Imass, beta-cell Ifunction I(ability Ito Isense Iblood Iglucose Ilevels, Iinsulin Isynthesis, Iand Iinsulin Isecretion), Iproinsulin Iand Iinsulin Imolecular Istructure, Iinsulin Ireceptors, Ihepatic Isynthesis Iof Iglucose, Iglucagon Isynthesis, Iand Icellular

Iresponsiveness Ito Iinsulin Istimulation.

➢ Although Imany Iindividuals Iwith Irisk Ifactors Ifor Itype I 2 Idiabetes I(including Iobesity, Imetabolic Isyndrome, Iand Ihypertension) Iare Iinsulin Iresistant, Ionly Ithose Iindividuals Iwho Iare Igenetically Ipredisposed Ito Ibeta-cell Idysfunction I(and Itherefore Ia Irelative Ideficiency Iin Iinsulin) Iwill Idevelop Itype I 2 Idiabetes

3. Signs Iof Ibreast Icancer I( Ich I24, Ipg I873) CLINICAL IMANIFESTATION PATHOPHYSIOLOGY Chest Ipain Metastasis Ito Ithe Ilung Dilated Iblood Ivessels Obstruction Iof Ivenous Ireturn Iby Ia Ifast-growing Itumor; Iobstruction Idilates Isuperficial veins Dimpling Iof Ithe Iskin Can Ioccur Iwith Iinvasion Iof Ithe Idermal Ilymphatics Ibecause Iof Iretraction Iof ICooper ligament Ior Iinvolvement Iof Ithe Ipectoralis Ifascia Edema Local Iinflammation Ior Ilymphatic Iobstruction Edema Iof Ithe Iarm Obstruction Iof Ilymphatic Idrainage Iin Ithe Iaxilla Hemorrhage Erosion Iof Iblood Ivessels Local Ipain Local Iobstruction Icaused Iby Ithe Itumor Nipple/areolar Ieczema Paget Idisease Nipple Idischarge Iin Ia Inonlactating Iwoman Spontaneous Iand Iintermittent Idischarge Icaused Iby Itumor Iobstruction Nipple Iretraction Shortening Iof Ithe Imammary Iducts Pitting Iof Ithe Iskin I(similar Ito Ithe Isurface Iof Ian Obstruction Iof Ithe Isubcutaneous Ilymphatics, Iresulting Iin Ithe Iaccumulation Iof Ifluid orange I[peau Id’orange]) Reddened Iskin, Ilocal Itenderness, Iand Iwarmth Inflammation Skin Iretraction Involvement Iof Ithe Isuspensory Iligaments Ulceration Tumor Inecrosis
4. Sympathetic/parasympathetic Inervous Isystem I( Ich I 11 Ipg I344) ➢ The Iparasympathetic Isystem Ibalances Ithe Isympathetic Inervous Isystem Iand, Ithus, Ialso Iinfluences Iadaptation Ior Imaladaptation Ito Istressful Ievents. IThe Iparasympathetic Isystem Ialso Ihas Ianti-inflammatory Ieffects. ➢ The Iparasympathetic Isystem Iopposes Ithe Isympathetic I(catecholamine) Iresponses, Ifor Iexample, Iby Islowing Ithe heart Irate. IResearchers Ievaluate Ithe Irelative Ibalance Iof Ithe Iparasympathetic Iand Isympathetic Inervous Isystems Iusing Ia Itechnique Iknown Ias Iheart Irate Ivariability I(the Imeasurement Iof IR Iwave Ivariability Ifrom Iheartbeat Ito Iheartbeat). ➢ Under Iconditions Iof Iallostatic Ioverload, Ithe Iparasympathetic Isystem Imay Idecrease Iits Irestraint Iof Ithe Isympathetic Isystem, Iresulting Iin Iincreased Ior Iprolonged Iinflammatory Iresponses
5. ACTH- I(c I11,pg I339) ➢ Adrenocorticotropic Ihormone; ➢ the Ihypothalamus Isecretes I corticotropin-releasing Ihormone I(CRH) , Iwhich Ibinds Ito Ispecific Ireceptors Ion Ipituitary Icells Ithat, Iin Iturn, Iproduce I adrenocorticotropic Ihormone I(ACTH). IACTH Iis Ithen Itransported Ithrough Ithe Iblood ItoIthe Iadrenal Iglands Ilocated Ion Ithe Itop Iof Ithe Ikidneys
6. Bartholin Iglands I(C24,pg I920) ➢ Bartholin Iglands]) Inear Ithe Iurethra Iand Ivagina Ialso Iare Icommon. IThe Iexternal Ifemale Igenitalia Iare Ithe ImonsIpubis, Ilabia Imajora, Ilabia Iminora, Iclitoris, Ivestibule I(urinary Iand Ivaginal Iopenings), IBartholin Iglands, Iand ISkene Iglands.
7. Gonococcal Idisease I(c I26,pg I919) ➢ a Isexually Itransmitted Idisease Icaused Iby Ithe Ibacteria Igonococci Ithat Iinvade Ithe Imucous Imembranes Iof Ithe Igenitals Iand Iurinary Itract Iand Iin Iwomen Ithe Icervix, Ifallopian Itubes, Iand Iovaries, Icausing Ichronic Ipelvic Ipain Ior Iinfertility.

➢ Gonorrhea I is Icaused Iby I gonococci I (singular, I gonococcus ), Iwhich Iare Imicroorganisms Iof Ithe Ispecies I Neisseria Igonorrhoeae. INeisser Ifirst Iidentified Igonococci Iin Istained Ismears Iof Ivaginal, Iurethral, Iand Iconjunctival Iexudate Iin I1879.

8. Small Ipatent Iductus Iarteriosus I( Ich I33, Ipg I1202) ➢ The I patent Iductus Iarteriosus I(PDA) I is Ia Ivessel Ilocated Ibetween Ithe Ijunction Iof Ithe Imain Iand Ileft IpulmonaryIarteries Iand Ithe Ilesser Icurvature Iof Ithe Idescending Iaorta, Iusually Ijust Idistal Ito Ithe Ileft Isubclavian Iartery ➢ PDA Iclosure Iin Iasymptomatic Ichildren Iwith Ia Imurmur Iis Irecommended Iby I 2 Iyears Iof Iage Ibecause Iof Ithe Irisk Iof subacute Ibacterial Iendocarditis. INo Itreatment Iis Irecommended Ifor Ismall IPDA Iin Ithe Iabsence Iof Ia Imurmur Ior Iother Icardiac Iconditions
9. Chronic Iinflammatory Ijoint Idisease I( Ich I44, Ipg I 1568 - 1578) ➢ Rheumatoid Iarthritis I(RA) I is Ia Ichronic, Isystemic Iinflammatory Iautoimmune Idisease Idistinguished Iby Ijointswelling Iand Itenderness Iand Idestruction Iof Isynovial Ijoints, Ileading Ito Idisability Iand Ipremature Ideath ➢ Ankylosing Ispondylitis I(AS) I is Ithe Imost Icommon Iof Ia Igroup Iof Iinflammatory Iarthropathies Iknown Ias spondyloarthropathies. IIt Iis Ia Ichronic Iinflammatory Ijoint Idisease Icharacterized Iby Istiffening Iand Ifusion I(ankylosis) Iof Ithe Ispine Iand Isacroiliac Ijoints
10. Male Iand Ifemale Isex Ihormone Iproduction I( Ich I 23 Ipg I 726 - 791) ➢ The Imale Isex Ihormones Iare Iandrogens Iand I testosterone I is Ithe Iprimary Imale Isex Ihormone. ILeydig Icells Iof ItheItestes Iand, Ito Ia Ilesser Idegree, Ithe Iadrenal Iglands Iproduce Itestosterone Iand Iother Iandrogens. IIn Imen, Isex Ihormone Iproduction Iis Irelatively Iconstant Iwith Isome Idiurnal Ivariation ➢ The Isex Ihormones Iare Iall Isteroid Ihormones Iand Iare Isynthesized Ifrom Icholesterol IMale Iand Ifemale Isex Ihormones are Ipresent Iin Iall Iadults. IHowever, Ithe Ifemale Ibody Icontains Ilow Ilevels Iof Itestosterone Iand Iother Iandrogens, Iand Ithe Imale Ibody Icontains Ilow Ilevels Iof Iestrogen. IIndividual Ieffects Iof Isex Ihormones Idepend Ion Itheir Iamount Iand Iconcentration Iin Ithe Iblood. ➢ The Idominant Ifemale Isex Ihormones, Iestrogen Iand Iprogesterone, Iare Iproduced Iprimarily Iby Ithe Iovaries. IDuring Ifetal Idevelopment, Iinfancy, Iand Ichildhood, Isex Ihormone Iproduction Iis Ilow.
11. Genital Iwarts- I (ch I26, Ipg I934) a. Condylomata Iacuminata I are Isoft, Iskin-colored, Iwhitish Ipink Ito Ireddish Ibrown Idiscrete Igrowths. IThey Imay Ioccur Isingly Ior Iin Iclusters Iand Imay Ibe Ibroad Ibased Ior Ipedunculated Iand Ifeathery Ior Ismooth ISometimes Ithe Iwarts Ienlarge Ito Iform Icauliflower-like Imasses Ion Ithe Imale Ifrenulum, Iglans, Iforeskin, Iurinary Imeatus, shaft, Iscrotum, Ior Ianus Iand Ion Ithe Ifemale Ilabia, Iclitoris, Iperineum, Ivagina, Ior Ianus. IAlthough Ithe Ilesions Iare Iusually Inot Ipainful, Ithey Imay Icause Idyspareunia I(painful Iintercourse) Iand Imay Ibe Ifriable Iand Ibleed Ieasily. b. Genital Iwarts Iare Ivery Icontagious, Iwith Itransmission Irates Iamong Iindividuals Iestimated Ito Ibe Ibetween I38% Iand I95%. ISuch Ia Iwide Irange Iis Iattributable Ito Ithe Isubclinical Inature Iof Isome Iinfections Iand Ivarious Iinfluencing Ifactors Ithat Iinclude Inumber Iof Iexposures, IHPV Itype, Ilocation Iof Ilesions, Iand Icellular Iimmunity Iresponse. IInfants Iand Ichildren Ialso Ihave Ibeen Iidentified Ias Ibeing Iinfected Iwith IHPV. IInfants Ican Ibe Iinfected Iin Iutero Iand Iby Ipassage Ithrough Ian Iinfected Ibirth Icanal. IHPV Iinfection Iin Ichildren Ihas Ibeen Itraced Ito Ichild Isexual Iabuse; Ihowever, Ireports Ivary Iin Imaking Ithis Iconnection.
12. Pancreatic Ienzymes I( Ic I40,pg I1415) ➢ pancreatic Ienzymes I hydrolyze Iproteins I(proteases), Icarbohydrates I(amylases), Iand Ifats I(lipases). IThe IproteasesIinclude Itrypsin, Ichymotrypsin, Icarboxypeptidase, Iand Ielastase. IThese Ienzymes Iare Isecreted Iin Itheir Iinactive Iforms—that Iis, Ias Itrypsinogen, Ichymotrypsinogen, Iand Iprocarboxypeptidase—to Iprotect Ithe Ipancreas Ifrom ItheIdigestive Ieffects Iof Iits Iown Ienzymes. ➢ pancreatic Ienzymes I(proteases, Iamylase, Iand Ilipase), Iand Ibile Isalts Iact Iin Ithe Ismall Iintestine Ito Idigest Iproteins, Icarbohydrates, Iand Ifats.
13. Process Iof Imuscle Icontraction( Ic I43,pg I1533) ➢ Muscle Icontraction Iis Ia Ifour-step Iprocess: Iexcitation, Icoupling, Icontraction, Iand Irelaxation. IThe initial Icontraction Iprocess Iis Ithe Iexcitation-contraction Icoupling I(ECC) Iseries, Iwhich Iinvolves Ithe Ielectrical Iproperties Iof Iall Icells Iand Ithe Imovement Iof Iions Iacross Ithe Iplasma Imembrane ➢ Excitation , Ithe Ifirst Istep Iof Imuscle Icontraction, Ibegins Iwith Ithe Ispread Iof Ian Iaction Ipotential Ifrom Ithe Inerve Iterminal Ito Ithe Ineuromuscular Ijunction. ➢ Following Idepolarization Iof Ithe IT-tubules, Ithe Isecond Istage, I coupling , Ioccurs. IThis Istage Iconsists Iof Ithe migration Iof Icalcium Iions Ito Ithe Imyofilaments. ICalcium Iaffects Itroponin Iand Itropomyosin, Imuscleproteins Ithat Ibind Iwith Iactin Iwhen Ithe Imuscle Iis Iat Irest. ➢ Contraction I begins Ias Ithe Icalcium Iions Icombine Iwith Itroponin, Ia Ireaction Ithat Iovercomes Ithe Iinhibitory Ifunction Iof Ithe Itroponin-tropomyosin Isystem. IThe Ithin Ifilament I actin I then Islides Itoward Ithe Ithick Ifilament I myosin.

➢ Relaxation , Ibegins Ias Ithe Isarcoplasmic Ireticulum Iabsorbs Ithe Icalcium Imolecules, Iremoving Ithem Ifrom Iinteraction Iwith Itroponin. ICalcium Iis Ipumped Iback Iinto Ithe Isarcoplasmic Ireticulum Iby Imeans Iof Ian Iactive Itransport Iprocess. IThe Icross-bridges Idetach, Iand Ithe Isarcomere Ilengthens.

14. Cervical Idysplasia I(C I24,pg I825) ➢ Cervical Idysplasia I(cervical Iintraepithelial Ineoplasia I[CIN]) a Icondition Icharacterized Iby Ithe Iappearance Iof Iabnormal Icervical Icells Ithat Iare Iconsidered Iprecancerous. ➢ It Iis Iestablished Ithat Icervical Icancer Iis Ialmost Iexclusively Icaused Iby Icervical Ihuman Ipapillomavirus I(HPV) Iinfection. IInfection Iwith I“high-risk” I(oncogenic) Itypes Iof IHPV I(predominantly I 16 Iand I18) Iis Ia Inecessary Iprecursor Ito Idevelopment Iof Ithe Iprecancerous Icell Ichanges, Iknown Ias Idysplasia, Iof Ithe Icervix Ithat Ileads Ito Iinvasive Icancer ➢ these Icell Ichanges Ican Ibe Idetected Inoninvasively Ithrough Iexamination Iof Ithe Icervical Icells. IThe Icells Ican Ibe Idestroyed to Iprevent Icancer Idevelopment Iif Idysplasia Ican Ibe Idetected Iearly.
15. Consanguinity- I(c4,pg I156) ➢ Consanguinity Iis Isometimes Ipresent Iin Ifamilies Iwith Iautosomal Irecessive Idiseases, Iand Iit Ibecomes Imore Iprevalent Iwith Irarer Irecessive Idiseases. ➢ Consanguinity Iand I inbreeding I are Irelated Iconcepts. I Consanguinity I refers Ito Ithe Imating Iof Itwo Irelated Iindividuals, and Ithe Ioffspring Iof Isuch Imating Iare Isaid Ito Ibe I inbred****. I Consanguinity Iis Ioften Ian Iimportant Icharacteristic Iof Ipedigrees Ifor Irecessive Idiseases Ibecause Irelatives Ishare Ia Icertain Iproportion Iof Igenes Ireceived Ifrom Ia Icommon Iancestor. IThe Iproportion Iof Ishared Igenes Idepends Ion Ithe Icloseness Iof Itheir Ibiologic Irelationship. IFor Iexample,Isiblings Ishare Ione Ihalf Iof Itheir IDNA, Ion Iaverage, Ibecause Iof Itheir Idescent Ifrom Ithe Isame Iparents.