Pharmacology 2060A/B Lecture 12: Lecture 12

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2 Apr 2018

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Coronary heart disease: coronary heart disease occurs when coronary blood circulation fails to adequately supply the heart with blood, coronary heart disease is primarily caused by atherosclerosis. Atherosclerosis occurs when plaque builds up on the walls of the arteries. This causes the artery to narrow and results in decreased blood flow to the heart: the risk of developing coronary heart disease is directly related to the levels of cholesterol in the blood. Therefore people with high blood cholesterol are at risk of developing coronary heart disease. For this reason, large efforts have gone into designing drugs to lower blood levels of cholesterol. In canada, cardiovascular disease causes one third of all deaths. Cholesterol is an important molecule that supports many physiological roles. It is an essential component of cell membranes, a precursor of steroid hormones (i. e. testosterone and estrogen), and a precursor of bile salts (which helps us absorb dietary fats in our diet).

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Need 150 word response to the below discussion post

The heart is the most important muscle in your body. The heart is just like a pump that moves the blood throughout the body. This action is what keeps us alive. We are typically taught about the danger of a heart attack, and what we must change in our lives to prevent it; but just like many people, I am at a high risk for heart disease because of family history as well as because of my firefighter career, as heart disease is the number one killer of firefighters (Fire Engineering, 2012). According to the American Heart Association, âboth the risk of heart disease and risk factors for heart disease are strongly linked to family historyâ (American Heart Association, 2016). However, even though your family history provided a picture or marker for possible issues, it is up to us to lower the risk by making changes in our lifestyles.

Heart attacks are caused by blockage that stops blood flow to the heart. A heart attack is when there is damage or death to the heart muscle tissue due to loss of blood supply and this does not necessarily result in an individual's death. A heart attack can show symptoms, such as radiating chest pain or discomfort, dizziness or nausea, sweating, anxiety, stomach pain and shortness of breath. Women have the same symptoms, but they do show some difference in that they describe the pain in their stomach and shoulder blades. In the field we treat heart attack by treating the symptoms; we use IV fluids, baby aspirin, as well as nitroglycerin.

There is another silent killer that most people do not hear much about or they think it is the same thing as a heart attack. As a medic, I deal with this life and death situation all the time, and it interesting to see how many people are not aware of the difference of a heart attack and a sudden cardiac arrest. Sudden cardiac arrest is the abrupt loss of heart function in a person who may or may not have diagnosed heart disease. This can happen at any time, its unexpected and occurs instantly, or seconds after symptoms occur. Cardiac arrest is caused when the heartâs electrical system malfunctions. This causes the heart to go into and irregular heart rhythm (ventricular fibrillation). When this happens, the hearts lower chambers suddenly start quivering and this stops the pump of blood in the heart. The only thing that can reverse cardiac arrest is early defibrillation and CPR. Most people think that a defibrillator can be used on heart attack patients, but this is not the case. The defibrillator is used to shock the heart and restore the normal heart rhythm, if the heart stops, then CPR has to be performed.

Unlike a heart attack, sudden cardiac arrest can happen to anyone, no matter how health or fit they are. According to the American Heart Association âcardiac arrest is a leading cause of death, nearly 360,000 out-of-hospital cardiac arrest occur annually in the United Statesâ (American Heart Association, 2016).

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1. The risk of acquiring disease is measured by the

a. Incidence rate

b. Incidence rate times the average duration of the disease

c. Incidence rate divided by the prevalence rate

d. Prevalence rate

e. Prevalence rate times the average duration of the disease

2. The strength of an association between a factor and a disease is best measure by .

a. Incubation rate

b. Incidence of the disease in the total population

c. Prevalence of the factor

d. Attributable risk

e. Relative risk

3. Case fatality rate for a given disease refers to

a. The crude mortality rate per 100,000 population

b. Cause-specific mortality rate due to the disease

c. A fatal outcome of any disease

d. The percentage of deaths among cases of the disease

e. The proportion of deaths due to the disease among all deaths from all causes

4. An investigator is interested in etiology of neonatal jaundice. To study this condition, he selected 100 children who were diagnosed with this condition and 100 children born in the same period and in the same hospital who did not have a diagnosis of neonatal jaundice. He then reviewed the obstetrical and delivery records of their mothers to determine various prenatal and perinatal exposures. This is an example of a(n):

a. Cross-sectional study

b. Case-control study

c. Cohort study

d. Clinical trial

e. Experiment

5. Which of the following statements describes the major advantages of a randomized clinical trial?

a. It avoids observer bias

b. It lends itself to ethical justification

c. It yields results replicable in other patients

d. It rules out self-selection of participants to the different treatment groups

d. It enrolls representative patients

6. A survey conducted in England revealed that of 224 families in which there had been a known case of poliomyelitis, 56 maintained parakeets as a family pet. In another British survey, 30 out of 99 poliomyelitis patients questioned kept parakeets. The inference that there is some relationship between the presence of a parakeet in a household and the occurrence of poliomyelitis among household members is

a. Correct b.

Incorrect because of failure to distinguish between incidence and prevalence

c. Incorrect because a proportionate ratio is used when a rate is required to support the inference

d. Incorrect because a failure to recognize a possible cohort phenomenon

e. Incorrect because there is no control or comparison group.

7. An investigator determines the correlation coefficient between triglyceride levels and degree of atherosclerosis in sampled blood vessels to be +1.67. On the basis of this you would conclude that:

a. Triglyceride level is a good predictor of atherosclerosis

b. Triglyceride level is not a good predictor of atherosclerosis

c. High triglyceride levels cause atherosclerosis

d. Atherosclerosis cause high triglyceride levels

e. The investigator has incorrectly determined the correlation coefficient

8. A screening test of known sensitivity and specificity is applied to two populations. The prevalence of the disease being screened for is 10% in population A and is 1% in population B. Which of the following is true?

a. The percent of all negative tests that have false-negative results is lower in population A than in population B.

b. Specificity is lower in population A than in population B.

c. Reliability is higher in population A than in population B.

d. The percent of all positive tests that have false-positive results is lower in population A than in population B.

e. Specificity is higher in population A than in population B.

9. Serum cholesterol levels are obtained for four healthy men. The probability that all will fall below the 10th percentile of the distribution of cholesterol for healthy males is:

a. 0.4

b. 1 â (0.1)4

c. (0.1)4

d. (0.9)4

e. Cannot be determined from these data

10. In a diabetes screening program, the screening level for a positive blood sugar level in test 1 is set at 160 mg/dl, and in test 2 at 130 mg/dl. The sensitivity is:

a. Greater in test 1

b. Greater in test 2

c. Equal in test 1 and 2

d. Dependent on the size of the population being evaluated

The human body is truly remarkable and is designed tofunction effectively. Organs are important structures composed ofdifferent tissues that facilitate specific functions within thebody. Organs function as part of an integrated group of structuresknown as organ systems. These organ systems form the organizationalunits that are responsible for crucial processes necessary forsustaining life.

Examples of organ systems include but are not limitedto the cardiovascular system, the digestive system, themusculoskeletal system, the nervous system, the excretory system,the endocrine system and the respiratory system. Even organ systemsdo not function alone. These systems work together, interactingwith other organs in a functional network that keeps the body inbalance. (Look up the term homeostasis in your text.) When homeostasis orthe normal functioning of organ systems is disrupted, disease maydevelop causing injury to the body, or even death. In thisassignment, you will explore organ systems, as well as associateddiseases or malfunctions.

Assignment details:

Take a look at the following casestudies that detail an outcome associated with a disease/organmalfunction. Select onestudy to investigate further for yourassignment.

Critically evaluate the information provided andcorrelate it with the organ systems that are affected in thescenario. Use the information that you have gathered to answer theassignment questions that follow the case study. For assistancewith your assignment, please use your text, the AIU Library, Webresources, and course materials.

Case Study 1:

Atherosclerosis isnarrowing of arteries caused by the accumulation of fatty depositson the arterial walls.

On June 22, 2002 the St. Louis Cardinals werepreparing for their upcoming baseball game against the Chicagocubs. Concern arose when their prized pitcher, 33-year old DarrylKile did not show up for practice. Soon after, he was found stillin his hotel room where he had suddenly died in his sleep (New YorkTimes, 2002). It was discovered that the cause of death was relatedto three of his coronary arteries being 80-90% blocked as a resultof atherosclerosis (New York Times, 2002), which ultimately causedhim to undergo a heart attack.

Answer the following assignmentquestions:

Why would atherosclerosis result in a heart attack?Provide a brief explanation based on how the heart functions.
How are arteries different from veins andcapillaries? Describe the functions of both arteries andveins.
Vertebrates and some invertebrates have a closedcirculatory system. Explain the advantage of having a closedcirculatory system over an open circulatory system?
Briefly explain how the lymphatic system isassociated with the circulatory system?
Describe one disease that affects the lymphaticvessels similarly to the way that atherosclerosis affects thearteries?

Case Study 2:

Cigarette smoking remainsthe leading preventable cause of death in the United States,causing an estimated 438,000 deaths - or about 1 out of every 5 -each year (National Cancer Institute, 2008).

Mr. Amos is now 57 years old and has been smoking forthe past 30 years of his life. A recent doctor's visit reveals thatMr. Amos has stage 3 lung cancer, characterized by his symptoms ofnagging chest pain, fatigue, coughing up blood, substantial weightloss, and increased carbon dioxide levels in his blood. The doctorinformed Mr. Amos that had he quit his smoking habit several yearsago, he would have reduced his risk for developing lung cancerlater in life. Mr. Amos immediately begins treatment for the lungcancer that has metastasized to his lymph nodes.

Answer the following assignmentquestions:

What main components in cigarettes affect therespiratory system? Explain their effects on specific organs, cellsand/or processes in the respiratory system.
There are alternate mechanisms of transportingcarbon dioxide (CO2) and oxygen (O2 ) in the blood. Explain howsmoking might lead to increased levels of carbon dioxide in theblood.
Can smoking affect other organ systems of the body?Give specific examples and briefly explain your answer.
How can you correlate cellular respiration with therespiratory system?
Does smokeless tobacco present a reduced risk forlung cancer and other smoking associated diseases? Provide evidencefor your answer.

Case Study 3:

Gigantism is abnormallylarge growth during childhood caused by excess growth hormonesecreted by the anterior pituitary gland.

Robert Wadlow, born on February 22, 1918, weighed anormal eight pounds, six ounces. However, by the time Robertreached the age of six months old, he weighed 30 pounds (Hamilton,1993). Within only a year, his weight rose to 62 pounds, more thandouble the normal weight of a baby at 18 months. Aside from hisweight, Robert continued to grow at an astounding rate, reachingsix feet, two inches and 195 pounds by the time he was eight yearsold. Robert's unique size was attributed to an over activepituitary gland, which produced much higher than normal levels ofgrowth hormone. At the time of his death in July 1940 at the age of22, Robert had reached a height of 8 feet 11.1 inches and weighed485 pounds (Hamilton, 1993).

Answer the following assignmentquestions:

How does growth hormone regulate various bodyfunctions in adults, and what could cause the excess secretion ofgrowth hormone?
Discuss the relationship between growth hormone andinsulin, and are there complications associated with theirinteraction?
Why is gigantism usually more difficult to treatthan dwarfism?
Give examples of two other hormones secreted by thepituitary, and briefly describe how they specifically affect otherorgan systems of the body?
Some athletes have resorted to the illegal use ofanabolic steroids to increase strength and muscle size. How areanabolic steroids different from growth hormone? Briefly explainyour answer.

References

Hamilton, S. (1993). Looking backand up: At Robert Pershing Wadlow, the gentle giant. Alton,IL: Alton Museum of History and Art.

National Cancer Institute. (2008). Tobacco statistics snapshot. Retrieved fromhttp://www.cancer.gov/cancertopics/tobacco/statisticssnapshot#0_references

The New York Times. (2002, July 17). Baseball: Coroner verifies the cause of Kile's death asnatural. Retrieved fromhttp://www.nytimes.com/2002/07/17/sports/baseball-coroner-verifies-the-cause-of-kile-s-death-as-natural.html?ref=darryl_kile

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Pharmacology 2060A/B Lecture 12: Lecture 12

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