Explain why oxygen can easily cross a plasma membrane whereas sodium ions are unable to

cross a plasma membrane?

 Plasma membrane is primarily composed of lipids and proteins. Oxygen on the other
hand is classified as lipid soluble substance and is easily dissolve in the lipid bilayer while
sodium ions are water soluble substances and is not dissolve in the membrane.

Discuss why proteins and lipids in plasma are dynamic and asymmetrically distributed?

Describe the difference between mediated active transport and diffusion.

 Diffusion is characterized by movement of substances down in an electrochemical
gradient that does not require metabolic energy and is passive. Mediated active
transport is the complete opposite where the means of movement of substances occurs
against an electrochemical gradient that required direct input of metabolic energy and
therefore is active.

What is the difference between the absolute refractory period and the relative refractory
period of repolarization phase of impulse generation?

 Absolute and relative refractory period are two types of refractory periods that occur
after the generation of an action potential. Absolute refractory period refers to a time in
which a second action potential cannot be elicited even with a strong stimulus. On the
other hand, relative refractory period is the interval immediately after the absolute
refractory period and is capable of another action potential under a greater stimulus.
Ms. Jones has an annual Pap smear and gynecologic exam. Three years ago, immediately before
her third pregnancy, the pathology report of her Pap smear indicated she had hormonal
hyperplasia. Her current Pap smear indicates she has atypical hyperplasia or dysplasia. What is
the difference between these?
 Physiologic hyperplasia is due to the action of hormones that happens when there is a
need to increase functional capacity of certain organs. It is described as proliferation of
the glandular epithelium and is well illustrated by the proliferation of the glandular
epithelium of the female breast at puberty and during pregnancy, usually accompanied
by enlargement (hypertrophy) of the glandular epithelial cells. On the other hand,
atypical hyperplasia is caused by excessive or inappropriate actions of hormones or
growth factors acting on target cells. Atypical hyperplasia may serve as a risk factor in
which cancerous proliferations may eventually arise.

Mr. Smith is diagnosed with a cerebral embolus (stroke). Explain how the decrease in ATP
causes the intracellular ion balance to change.

Mr. Young has been smoking cigarettes for 20 years. Describe the cellular changes that have
occurred in his bronchial linings that now make him prone to upper respiratory infections?
 Cigarette smoking is one factor that causes a variety of diseases. The above patient
mentioned who’s a chronic smoker most likely will develop COPD. Long term exposure
to cigarette smoking will trigger lung epithelial cells to recruit inflammatory cells to the
lung. This will lead to oxidant-antioxidant imbalance and apoptosis. The ability of the
lung to replace damage airways will also be limited due to the impairment of the
function of macrophages in clearing apoptotic cells.

Explain changes that occur in a body in the first 48 hours following death.
 Presence of Rigor Mortis: in warm countries, rigor mortis sets in from 2-3 hours after
death. It is fully developed in the body after 12 hrs. It may last from 18 – 36 hours and
its disappearance is concomitant with the onset of putrefaction. Presence of post-
mortem lividity usually develops 3-6 hours after death. Appears as small petechia-like
red spots which later coalesce with each other to involve bigger areas in the most
dependent portions of the body. For the onset of decomposition, the average time is 24-
48 hours after death.
Mrs. Brown is an elderly woman with diabetes who was too ill to get out of bed for 2 days. She
has had a severe cough and has been unable to eat or drink during this time. On admission her
laboratory values show:
Sodium 156
Potassium 4
Chloride 115
Arterial blood gases: pH 7.30; PCO2 40; PO2 70; HCO3 20
a. What type of water and solute imbalance does Mrs. Brown have?
b. What symptoms would you expect to find?
c. What would be the treatment?
d. What do her ABG’s mean?

a. Mrs. Brown has hypernatremia and hyperchloremia. Starvation and diabetes can also
cause high anion gap metabolic acidosis.
b. Patients’ symptoms would range from shortness of breath, fatigue, tachycardia,
confusion and a fruity smelling breath.
c. The patient should be given IV fluids in order to rehydrate. We also need to check her
glucose levels as well. If an infection is obvious, then a proper course of antibiotic will be
helpful as well. We also need to raise the oxygen levels in the body.
d. Her ABG tell us that she has metabolic acidosis.

Mr. Appel has severe chronic obstructive pulmonary disease (COPD). He is admitted to the
hospital with the complaint of increasing dyspnea, increased sputum, anxiety and diaphoresis.
He states he feels weak and tired. He routinely takes a diuretic (furosemide) and his pulmonary
medication. The following laboratory values are obtained:
Arterial blood gases: pH 7.25; PO2 60; PCO2 78; HCO3 30
Sodium 140
Potassium 2
Chloride 105
a. What type of imbalance does Mr. Appel have?
b. Interpret his ABG’s.
c. What would be the treatment.
a. Mr. Appel has hypokalemia.
b. The ABG is consistent with respiratory acidosis.
 c. First we have to correct the low PO2 levels by hooking the patient to a supplemental
oxygen. We can also consider giving bronchodilators and corticosteroids to relieve some
degree of obstruction. Other studies also suggests that a CPAP is successful in treating
episodes of hypoventilation thus correcting the respiratory acidosis as well.

Why are very young and very old people at higher risk for dehydration than other ages?

 Very young people have high requirement for water because of their large ratio of
surface area to volume and their inability to communicate their thirst, on the other
hand, very old people have a reduced total body water and a blunted thirst sensation.
Diuretics are more likely used by the elderly increasing the risk for dehydration.

Jim has received a 50% full-thickness burn to his body. Explain why he is now at increased risk
for bacterial invasion.

 Full thickness burns or third-degree burns will carry an increased risk of infection since
the affected tissue is most likely coagulated and sometimes frankly necrotic. A variable
degree of vasoconstriction as well as ischemia will be the main mitigating factors in
providing a suitable environment for opportunistic pathogens.

Explain the characteristics of antigens that enable them to cause an immune response.

 The certain antigenic characteristics which triggers immune response include size,
chemical composition, foreignness and interaction with MHC molecules. At least 10,000
molecular weight is needed in order to be recognized by the immune system. The
heavier they are, the better antigens they would be. Chemical composition is
characterized by having a vague molecular capacity. Antigens made up of proteins and
polysaccharides are more likely to elicit an immune response considering that their
external structure is made up of more complex branching units making it easier for B
cells to attach to. Third characteristic is foreignness. The body is efficient in identifying
self from non-self and the latter is eliminated normally. The more distant taxonomically
the source of antigen is, the greater the stimulus. Lastly, for an antigen to elicit an
immune response, it must be subject to antigen processing, which involves enzymatic
digestion to create small peptides or pieces that can be complexed to MHC molecules to
present to responsive lymphocytes. If a macromolecule can’t be degraded and
presented with MHC molecules, then it would be a poor immunogen.
The patients in room 234 both had appendectomies. The patient in bed 1 is 22 years old. The
patient in bed 2 is 66 years old. Which one is at risk for poor wound healing? Why?

 The patient at risk for a poor wound healing would be the older one. Most surgeons
believe that aging contributes to intrinsic physiologic changes that impairs wound
healing. Probable factors might include diseases or illnesses as well as drugs that may
impede tissue repair. There are also studies that suggest an increase amount of total
protein in younger individuals which is believed to help in the mechanical properties of
scarring.

Explain how macrophages assist in wound healing.

 The dominant cells in most chronic inflammatory reactions are macrophages, which
contribute to the reaction by secreting cytokines and growth factors that act on various
cells, by destroying foreign invaders and tissues, and by activating other cells, notably T
lymphocytes. Macrophages are professional phagocytes that act as filters for particulate
matter, microbes, and senescent cells. They also function as effector cells that eliminate
microbes in cellular and humoral immune responses.

Explain what physiologic actions catecholamines and cortisol have in common and in what ways
they differ in their actions.

You are caring for a 29-year-old female who is married with two small children. 1 and 3 years
old, at home. She is recuperating from a left lower lobectomy for bronchogenic carcinoma.
Although her chest x-rays show full lung expansion, she has a persistent air leak. Therefore she
continues to need a chest tube to suction and must remain hospitalized. Six days after surgery
she is sad, depressed and not eating. She stated that she does not feel she will ever get better
or go home. How would you use your knowledge of the coping process to help her?