Advanced Physiology and Pathophysiology

Advanced Physiology and Pathophysiology

Unit 1: Cellular Homeostasis

Unit Introduction – Cellular Homeostasis
Welcome to Unit 1 of the course! During Unit 1, you will be focusing on the fundamental concepts of cellular biology and deviations at the cellular and tissue levels. A solid grasp of basic cellular structure and function is crucial for advanced practice nurses to comprehend and apply principles related to cellular and tissue abnormalities. In this initial unit, your primary objective is to gain knowledge about the course and the advanced competencies required by advanced practice nurses who will be responsible for the care and education of patients across the entire lifespan, encompassing various pathologies.

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Unit Learning Objectives
1. Apply understanding of homeostatic mechanisms, including fluid and electrolyte balance, acid-base balance, and thermoregulation, to both normal physiology and pathophysiologic conditions.
2. Compare cellular damage and adaptation.
3. Differentiate between two prevailing theories of aging.
4. Employ the principles governing the movement of water within body compartments, considering the factors contributing to edema.
5. Evaluate the impact of specific hormones on fluid, electrolyte, and acid-base equilibrium.
6. Anticipate disturbances in fluid, electrolyte, and acid-base balance likely to occur in select pathophysiologic scenarios.

Learning Materials
Textbook
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
– Chapter 1, “Cellular Biology”
– Chapter 2, “Altered Cellular and Tissue Biology”
– Chapter 3, “The Cellular Environment: Fluids and Electrolytes, Acids, and Bases”

Note: Unless specified, all articles can be accessed through the University of St. Augustine Library.

Textbook PowerPoint(s)
McCance, K. L., & Huether, S. E. (2019). “Cellular Biology” [PowerPoint slides]. Elsevier.
McCance, K. L., & Huether, S. E. (2019). “Altered Cellular and Tissue Biology” [PowerPoint slides]. Elsevier.
McCance, K. L., & Huether, S. E. (2019). “The Cellular Environment: Fluids and Electrolytes, Acids, and Bases” [PowerPoint slides]. Elsevier.

Faculty Lecture(s)
Dunlap, J. (2020). NUR 7610 Chapter 2 – Altered Cellular and Tissue Biology.ppsx
Dunlap, J. (2020). NUR 7610 Chapter 2 – Altered Cellular and Tissue Biology – NonRecorded.pptx

Optional Resources
Articles
Xu, X., & Ren, J. (2012). Unmasking the Janus faces of autophagy in obesity-associated insulin resistance and cardiac dysfunction. Clinical & Experimental Pharmacology & Physiology, 39(2), 200–208.
– Retrieved from the University of St. Augustine Library database.

Guyenet, P. G., & Bayliss, D. A. (2015). Neural control of breathing and CO2 Homeostasis. Neuron, 87(5), 946–961.
– Retrieved from the University of St. Augustine Library database.

Hafycz, J. & Naidoo, N. (2019). Sleep, aging and cellular health: aged-related changes in sleep and protein homeostasis converge in neurodegenerative disease. Frontiers in Aging Neuroscience, 11.
– Hafycz library link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579877/pdf/fnagi-11-00140.pdf

Khan Academy. (n.d.). Homeostasis. Retrieved from https://www.khanacademy.org/science/biology/principles-of-physiology/body-structure-and-homeostasis/a/homeostasis

Tooze, S., and Zoncu, R. (2015). Control of cellular homeostasis: Organelles take the pilot’s seat. Molecular Biology of the Cell, 26(6), 1009–1010.
– Tooze article web link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357499/

Media
Alila Medical Media. (2017, October 17). Acid base balance, animation [Video]. YouTube.

Khan Academy. (n.d.). Unit: Cells [Video].

Khan Academy. (2015, July 30). Osmosis [Video]. YouTube.

Khan Academy. (2009, December 11). Krebs, citric acid cycle, cellular respiration, biology [Video]. YouTube.

Woodruff, D. (2014, January 10). Altered cellular biology [Video]. YouTube.

Faculty Lecture: Altered Cellular and Tissue Biology
Attached Files:
File Altered Cellular and Tissue Biology Transcript.pdf
File Altered Cellular and Tissue Biology Handout.pdf

Unit 1: Discussion/Introductions
To participate in your Introductions Discussion, click the above link and follow the instructions.
Take a moment to introduce yourself. Things to consider are: Where do you live? What area do you work in? Where would you like to work as an FNP? Feel free to share any other fun details about yourself.

Unit 1 & 2: Discussion Week 1 & 2
To participate in your Unit 1 and 2 combined discussion, click the above link to navigate to the discussion board. Then click “Create Thread” and follow the instructions.
The purpose of this combined Week 1 and 2 discussion is to examine how your body maintains homeostasis (Week 1 topics) as well as evaluate genetics and epigenetics (Week 2 topics). This Discussion is intended to allow you to show evidence of achieving the following Course Learning Outcomes (CLO):
CLO1: Apply concepts of pathophysiology at the cellular and systems levels for individuals and populations across the lifespan.
CLO2: Examine the impact of genetics and epigenetics on lifestyle and selected pathologies across the lifespan.
CLO3: Examine concepts of inflammation and immunity.
CLO6: Analyze the etiology and advanced pathophysiological alterations of selected body systems for common primary care diagnoses across the lifespan.

Discussion Scenario, choose one of the following:
1. Briefly explain how the body maintains homeostasis through fluid and electrolyte balance.
2. Briefly explain how the body maintains homeostasis though acid-base balance.
3. Compare and contrast Capillary hydrostatic pressure and Capillary oncotic pressure.
4. Compare and contrast Interstitial hydrostatic pressure and interstitial oncotic pressure.
5. Discuss the role of reactive oxygen species in cellular injury.
6. Compare and contrast DNA Hydroxymethylation and DNA Methylation.
7. Describe the pathophysiologic effects of alcohol exposure to a fetus? What are the long term implications?
8. Discuss the inheritance pattern of cystic fibrosis. What are the chances that a couple could transmit the condition to their offspring?

Initial Post:
– Include at least 2 scholarly, peer-reviewed sources (within 5 years) in your response.
– Writing should follow a professional format with appropriate APA citations and references.

Peer Post:
– Respond to at least 2 peers with different topics than your own.
– Include at least

1 scholarly, peer-reviewed source (within 5 years) in your response.
– Your response should either add to the content of the topic or ask additional questions based on research findings, and it should be at least 100 words excluding references.

Faculty Questions:
– Faculty will be present during the week on the discussion board. Respond to any questions posed directly by faculty during the week to meet the discussion expectations.

Initial post due date: Day 7 (Sunday) of Unit 1
Peer post and Faculty response to any faculty questions due date: Day 7 (Sunday) of Week 2

Please note: Avoid using non-academic information resources such as Wikipedia.com, Ask.com, Encarta.msn.com, Infoplease.com, etc., for graduate-level research. Avoid submitting attachments to the main forum unless instructed by the Instructor.

Unit 1: Check Your Knowledge Quiz
To complete the Check Your Knowledge Quiz for Unit 01, click the above link.
Check Your Knowledge Quizzes are due by Sunday of the week they are posted.

Unit 1 Respondus Practice Quiz (**Webcam**) – Requires Respondus LockDown Browser
The Purpose of the Respondus Practice Quiz is to validate the functionality of the Respondus browser on your personal device. You must first download the Respondus Browser to your device. Please see the link on the left-hand panel of the course title “Respondus Help” if you have not downloaded this already. Additionally, the quiz will collect information pertaining to the validation of your review of course materials.

Week 8 Assignment: Personal Philosophy of Teaching Part II

  • Unit Introduction – Cellular Homeostasis

    Welcome to Unit 1 of the course! During Unit 1, you will be focusing on the key concepts of cellular biology and alterations at the cellular and tissue level. It is essential that advanced practice nurses have a foundational understanding of basic cellular structure and function in order to understand and apply concepts of cellular and tissue alterations. Specifically, in this first unit, your focus is to learn about the course and the advanced knowledge and skills needed by advanced practice nurses who will be caring for and educating patients across the lifespan with many different pathologies.

    Unit Learning Objectives

    • Apply knowledge of homeostatic mechanisms, such as fluid and electrolyte balance, acid-base balance, and theroregulation to normal physiology and pathophysiologic conditions. (CLO 1,6)
    • Compare cellular injury and adaptation. (CLO 1,6)
    • Contrast two general theories of aging. (CLO 1,6)
    • Apply the forces favoring and opposing the movement of water between body compartments to the different causes of edema. (CLO 1,6)
    • Analyze the effect of specific hormones of fluid, electrolyte, and acid-base balance. (CLO 1,6)
    • Predict fluid, electrolyte, and acid-base imbalances likely in select pathophysiologic conditions (CLO 1,6)
  • Learning Materials

    Textbook
    • McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
      • Chapter 1, “Cellular Biology”
      • Chapter 2, “Altered Cellular and Tissue Biology”
      • Chapter 3, “The Cellular Environment: Fluids and Electrolytes, Acids, and Bases”

      Note: Unless otherwise noted, all articles are available through the University of St. Augustine Library.

    Textbook PowerPoint(s)
    Faculty Lecture(s)
    Optional Resources
    Articles
    Media
  • Faculty Lecture: Altered Cellular and Tissue Biology

  • To participate in your Introductions Discussion, click the above link and follow the instructions.
    Take a moment to introduce yourself. Things to consider are: Where do you live? What area do you work in? Where would you like to work as an FNP? Feel free to share any other fun details about yourself.
  • To participate in your Unit 1 and 2 combined discussion, click the above link to navigate to the discussion board. Then click “Create Thread” and follow the instructions.
    The purpose of this combined Week 1 and 2 discussion is to examine how your body maintains homeostasis (Week 1 topics) as well as evaluate genetics and epigenetics (Week 2 topics). This Discussion is intended to allow you to show evidence of achieving the following Course Learning Outcomes (CLO):
    CLO1: Apply concepts of pathophysiology at the cellular and systems levels for individuals and populations across the lifespan (ILO 1; PLO 1,7; MSN Essential I)
    CLO2: Examine the impact of genetics and epigenetics on lifestyle and selected pathologies across the lifespan (ILO 1; PLO 1,7; MSN Essential I)
    CLO3: Examine concepts of inflammation and immunity  (ILO 1; PLO 1,7; MSN Essential I)
    CLO6: Analyze the etiology and advanced pathophysiological alterations of selected body systems for common primary care diagnoses across the lifespan  (ILO 1; PLO 1,7; MSN Essential I)
    Discussion Scenario, choose one of the following:
    1. Briefly explain how the body maintains homeostasis through fluid and electrolyte balance.
    2. Briefly explain how the body maintains homeostasis though acid-base balance.
    3. Compare and contrast Capillary hydrostatic pressure and Capillary oncotic pressure
    4. Compare and contrast Interstitial hydrostatic pressure and interstitial oncotic pressure
    5. Discuss the role of reactive oxygen species in cellular injury.
    6. Compare and contrast DNA Hydroxymethylation and DNA Methylation?
    7. Describe the pathophysiologic effects of alcohol exposure to a fetus? What are the long term implications?
    8. Discuss the inheritance pattern of cystic fibrosis. What are the chances that a couple could transmit the condition to their offspring?
    Initial Post:
    • Include at least 2 scholarly, peer reviewed, timely sources (within 5 years) in your response.
    • Writing should be in a professional format with APA appropriate citations and references.
    • Please note that on submission to the discussion board, Blackboard often alters the formatting of the post. This is taken into consideration when faculty grade the post.
    Peer Post:
    • Respond to at least 2 peers whose topics are different than your own.
    • Include at least 1 scholarly, peer reviewed, timely source (within 5 years) in your response.
    • Your response should either add to the content of the topic or based on research findings you include ask additional questions on the topic.
    • Response should be at least 100 words excluding references.
    Faculty Questions:
    • Faculty will be present during the week on the discussion board. It is expected that you will respond to any questions posed directly to you by faculty during the week. A failure to respond may result in a deduction of points as indicated in the Discussion Grading Rubric
    • Please refer to the grading rubric for further details on the content expectations. You can find this under “My Grades”, “Unit 1: Discussion”.
    Initial post due date: Day 7 (Sunday) of Unit 1
    Peer post and Faculty response to any faculty questions due date: Day 7 (Sunday) of Week 2
    Please note: Internet searches will often take you to non-academic information resources such as Wikipedia.com, Ask.com, Encarta.msn.com, Infoplease.com, etc. For a graduate-level course, you may not supplement your literature search with these sources because they do not come under a formal oversight or peer-review process.
    Please do not submit anything in the form of an attachment to the main forum (unless requested by the Instructor), since it is more likely to transmit viruses and becomes difficult to open.
  • To complete the Check Your Knowledge Quiz for Unit 01, click the above link.
    Check Your Knowledge Quizzes are due by Sunday of the week they are posted.
  • The Purpose of the Respondus Practice Quiz is to validate the functionality of the Respondus browser on your personal device. You must first download the Respondus Browser to your device. Please see link on the left hand panel of the course title “Respondus Help” if you have not downloaded this already. Additionally, the quiz will collect information pertaining to the validation of your review of course materials.

Unit 2: Genetics and Epigenetics

Unit Introduction – Genetics and Epigenetics
Genetics and Epigenetics are fundamental topics in the study of biological processes. Deoxyribonucleic acid (DNA) serves as the foundation for the genetic makeup of all living organisms. In the 20th century, Gregor Mendel’s work shed light on the significance of chromosomes and genes as the fundamental units of heredity. Since then, extensive research has been conducted, leading to the sequencing of DNA, which is a central component constituting genetic material. DNA serves as the blueprint for the genetic sequence and composition of an organism. Understanding genetics and the implications of genetic makeup is crucial when providing care to individuals across their entire lifespan. For instance, a significant proportion of pediatric patients experience some form of genetic disease. In Unit 2, the focus will be on key concepts related to genes, genetic diseases, gene-environment interactions, and common genetic disorders affecting individuals across their lifespan.

Unit Learning Objectives
1. Describe various aspects of inheritance, including autosomal, sex-linked, carrier, dominant, and recessive traits. (ILO 1; CLO 2, 6; MSN Essential I)
2. Evaluate pedigree charts to understand the inheritance patterns of genetic diseases. (ILO 1; CLO 2, 6; MSN Essential I)
3. Apply the principles of the Punnett square in understanding genetic inheritance. (ILO 1; CLO 2, 6; MSN Essential I)
4. Explore the concepts associated with genetics and epigenetics. (ILO 1; CLO 2, 6; MSN Essential I)
5. Discuss genetic abnormalities and the resulting clinical manifestations associated with selected genetic disorders. (ILO 1; CLO 2, 6; MSN Essential I)

Learning Materials
Textbook
– McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
– Chapter 4, “Genes and Genetic Diseases”
– Chapter 5, “Genes, Environment-Lifestyle, and Common Diseases”
– Chapter 6, “Epigenetics and Disease”

Textbook PowerPoint Presentations
– Chapter 4 – McCance, K. L., & Huether, S. E. (2019). Genes and Genetic Diseases [PowerPoint slides]. Elsevier.
– Chapter 5 – McCance, K. L., & Huether, S. E. (2019). Genes, Environment, Lifestyle, and Common Diseases [PowerPoint slides]. Elsevier.
– Chapter 6 – McCance, K. L., & Huether, S. E. (2019). Epigenetics and Disease [PowerPoint slides]. Elsevier.

Faculty Lectures
– Dunlap, J. (2020). NUR 7610 Chapter 5 – Genes, Environment-Lifestyle, and Common Diseases.ppsx
– Dunlap, J. (2020). NUR 7610 Chapter 5 – Genes, Environment-Lifestyle, and Common Diseases-NonRecorded.pptx
– Dunlap, J. (2021). NUR 7610 Chapter 6 – Epigenetics/methylation.ppsx
– Dunlap, J. (2021). NUR 7610 Chapter 6 – Epigenetics/demethylation-NonRecorded.pptx

Optional Resources
Articles
– Calzone, K., Kirk, M., Tonkin, E., Badzek, L., Benjamin, C., & Middleton, A. (2018). The global landscape of nursing and genomics. Journal of Nursing Scholarship, 50(3), 249–256. doi:10.1111/jnu.12380
– Godino, L., & Skirton, H. (2012). A systematic review of nurses’ knowledge of genetics. Journal of Nursing Education and Practice, 2(3), 173. doi:10.5430/jnep.v2n3p173
– Polli, A., Ickmans, K., Godderis, L., & Nijis, J. (2019). When environment meets genetics: A clinical review of the epigenetics of pain, psychological factors, and physical activity. Archives of Physical Medicine and Rehabilitation, 100(6), 1153–1161. doi:10.1016/j.apmr.2018.09.118
– Wayne, M., & Cheng, H. (2017). Genetics and epigenetics of autism: A review. Psychiatry and Clinical Neurosciences, 72, 228–244. doi:10.1111/pcn.12606

Media
– Beverly Biology. (2016, November 14). Autosomal recessive vs. autosomal dominance [Video]. YouTube.
– Garvan Institute of Medical Research. (2018, April 25). Epigenetics and cancer detection – Dr. Right Pidsley [Video]. YouTube.
– Garvan Institute of Medical Research. (2015, March 5). Epigenetics basics – Garvan Institute [Video]. YouTube.
– National Geographic. (2018, July 12). Genetics 101 [Video]. YouTube.
– Osmosis. (2017, July 3). Klinefelter syndrome – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube.
– Osmosis. (2018, January 8). Fragile X syndrome – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube.
– Stand Up to Cancer. (2018, April 3). Cancer treatment: Epigenetics [Video]. YouTube.
– The Children’s Hospital of Philadelphia. (2018, July 8). Introduction to Beckwith-Wiedemann Syndrome (BWS) [Video]. YouTube.
– Woodruff, D. (2014, January

20). Genetic alterations [Video]. YouTube.

Faculty Lecture: Epigenetics Processes
– Attached Files:
– Epigenetics Processes Transcript.pdf (31.319 KB)
– Epigenetics Processes Handout.pdf (153.239 MB)

Faculty Lecture: Chapter 5: Genes, Environment-Lifestyle, and Common Disease
– Attached Files:
– Chapter 5: Genes, Environment-Lifestyle, and Common Disease Transcript.pdf (50.962 KB)
– Chapter 5: Genes, Environment-Lifestyle, and Common Disease Handout.pdf (7.216 MB)

Unit 2: Check Your Knowledge Quiz
– To complete the Check Your Knowledge Quiz for Unit 02, click the above link.
– Check Your Knowledge Quizzes are due by Sunday of the week they are posted.

Unit 1 & 2: Discussion Week 1 & 2
– To participate in your Unit 1 and 2 combined discussions, click the above link to navigate to the discussion board. Then click “Create Thread” and follow the instructions.

These materials and objectives provide a comprehensive foundation for understanding genetics, epigenetics, and their clinical implications, which are essential for healthcare professionals caring for patients of all ages.

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Unit 2: Genetics and Epigenetics

  • Unit Introduction – Genetics and Epigenetics

    Deoxyribonucleic acid (DNA) underpins the genetic composition of all living things. In the 20th century, Gregory Mendel discovered the importance of chromosomes and genes as the basic units of inheritance. Since then, there has been sequencing of DNA, which is a primary constituent comprising DNA. DNA is the body’s blueprint for genetic sequencing and genetic composition. It is relevant to learn about genetics and the impact of genetic composition while caring for patients across the lifespan. For example, approximately one-third of pediatric patients have some degree of genetic disease. During Unit 2, you will focus on concepts related to genes and genetic disease, gene-environment interactions, and common genetic diseases impacting patients across the lifespan.

    Unit Learning Objectives

    • Describe the following elements of inheritance: autosomal, sex-linked, carrier, dominant, and recessive.  (ILO 1; CLO 2,6; MSN Essential I)
    • Evaluate pedigree charts for the inheritance patterns of genetic diseases. (ILO 1; CLO 2,6; MSN Essential I)
    • Apply concepts of the Punnett square. (ILO 1; CLO 2,6; MSN Essential I)
    • Apply concepts associated with genetics and epigenetics.(ILO 1; CLO 2,6; MSN Essential I)
    • Discuss genetic abnormalities and resulting clinical abnormalities associated with selected genetic disorders. (ILO 1; CLO 2,6; MSN Essential I)
  • Learning Materials

    Textbook
    • McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
      • Chapter 4, “Genes and Genetic Diseases”
      • Chapter 5, “Genes, Environment-Lifestyle, and Common Diseases”
      • Chapter 6, “Epigenetics and Disease”
    Textbook PowerPoint(s)
    Faculty Lecture(s)
    Optional Resources
    Articles
    Media
  • Faculty Lecture: Epigenetics Processes

  • Faculty Lecture: Chapter 5: Genes, Environment-Lifestyle, and Common Disease

  • To complete the Check Your Knowledge Quiz for Unit 02, click the above link.
    Check Your Knowledge Quizzes are due by Sunday of the week they are posted.
  • To participate in your Unit 1 and 2 combined discussions, click the above link to navigate to the discussion board. Then click “Create Thread” and follow the instructions.

    Unit 3: Inflammation and Immunity

    • The components and processes of innate immunity and adaptive immunity are concepts essential to understanding the body’s response to inflammation and immunity. During Unit 3, you will focus specifically on the body’s innate lines of defense, the inflammatory process, local manifestations of inflammation, acute and chronic inflammatory processes, and active and passive immunity.

      Unit Learning Objectives

      • Summarize the process of types of immunity. (ILO 1; CLO 3, 6; MSN Essential I)
      • Classify examples as which of the four hypersensitivities (ILO 1; CLO 3, 6; MSN Essential I)
      • Differentiate between immediate and delayed hypersensitivities, and give examples of each. (ILO 1; CLO 3, 6; MSN Essential I)
      • Examine the likely causes of autoimmune disease. (ILO 1; CLO 3, 6; MSN Essential I)
      • Describe the factors that influence infection by a pathogen. (ILO 1; CLO 3, 6; MSN Essential I)
      • Characterize mechanisms pathogens use to circumvent host defenses. (ILO 1; CLO 3, 6; MSN Essential I)
      • Describe the cause and effect of common immune deficiencies.(ILO 1; CLO 3, 6; MSN Essential I)
      • Discuss common infectious diseases including infectious microorganisms and typical presentation. (ILO 1; CLO 3, 6; MSN Essential I)

        Unit Introduction – Inflammation and Immunity

    • Learning Materials

      Textbook
      • McCance, K. L., & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Elsevier.
        • Chapter 7, “Innate immunity: Inflammation”
        • Chapter 8, “Adaptive Immunity”
        • Chapter 9, “Alterations in Immunity and Inflammation”
        • Chapter 10, “Infection”
      Textbook PowerPoint(s)
      Faculty Lecture(s)
      Optional Resources
      Articles
      Media
    • Attached Files:
    • The Purpose of this combined Unit 3 & 4 Case Study assignment is to further evaluate the physiology and pathophysiology of inflammation and immunity in the body as well as cancer. This case study assignment is intended to allow you to show evidence of achieving the following Course Learning Outcome (CLOs):
      CLO3: Examine concepts of inflammation and immunity  (ILO 1; PLO 1,7; MSN Essential I)
      CLO4: Describe common microorganisms and resulting infectious processes  (ILO 1; PLO 1,7; MSN Essential I)
      CLO5: Examine relevant issues with regard to cancer biology and cancer epidemiology across the lifespan  (ILO 1; PLO 1,7; MSN Essential I)
      CLO6: Analyze the etiology and advanced pathophysiological alterations of selected body systems for common primary care diagnoses across the lifespan  (ILO 1; PLO 1,7; MSN Essential I)
      Directions:
      Choose one of the following case studies to develop for your assignment submission.Based on this case develop an APA formatted paper addressing the following:
      • Include an introduction and a conclusion
      • Use headers to identify the portions of your paper
      • Paper should be in APA format including a title page and reference page.
      • Use headers to separate the topic areas
      • Include at least 3 scholarly, peer reviewed research articles
      • All sources should be timely and within 5 years
      • Web sites used should be noncommercial (e.g., gov, edu, org) website’s. Remember that website’s are not considered scholarly but may have very useful information.
      • Refer to Case Study grading rubric, found under “My Grades” for further details about how this assignment will be graded.
      • This assignment will be run through the Safe Assign similarity checker to determine if there are areas of your paper that match other sources. You are responsible for checking this report to determine if any revisions are needed for your final submission.
      Case Study Choice 1 (choose only 1)
      Tonya is a 16-year-old high school student. Over the last week, she had been feeling tired and found it difficult to stay awake in class. By the time the weekend had arrived, she developed a sore throat that made it difficult to eat and even drink. On Monday morning, her mother took her to her doctor. Upon completing the physical exam, the nurse practitioner (NP) told Tonya and her mother that the lymph nodes were enlarged in her neck and she had a fever. The NP ordered blood tests and told Tonya she had mononucleosis, a viral infection requiring bed rest.
       Based on the scenario above, answer the following questions in your APA formatted paper:
      1. Innate and adaptive immune defenses work collectively in destroying invasive microorganisms. What is the interaction between macrophages and T lymphocytes during the presentation of antigen in this scenario?
      2. Tonya’s illness is caused by a virus. Where are type I interferons produced, and why are they important in combating viral infections?
      3. Humoral immunity involves the activation of B lymphocytes and production of antibodies. What are the general mechanisms of action that make antibodies a key component of an immune response?
      4. Discuss the pathophysiology of the spleen involvement with this condition? What precautions if any should this patient take?
      Case Study Choice 2 (choose only 1)
      Patient Susan is a 60-year-old female who is presenting to her women health visit with her nurse practitioner. This is for her annual exam. Her last pap smear and mammogram were normal. Today, while performing her breast exam, her nurse practitioner notices dimpling in the left breast as the patient raises her arms over her head. When the NP mentions it to Susan she is surprised and denies noticing it before today. A firm, non-tender, immobile nodule is palpated in the upper quadrant of her breast. She reports no recent or abnormal drainage from her nipple. Further examination reveals palpable axillary lymph nodes.
      Susan is about 30 pounds overweight. She reports drinking a glass of white wine before bed each night. She denies any history of tobacco use. She reports use of a combination birth control pill on and off for 25 years until she reached menopause. She is not currently taking any prescription medications. She had menarche at age 10 and menopause at age 55. Further serological testing reveals the presence of a BRCA-1 gene mutation.
      Based on the scenario above, answer the following questions in your APA formatted paper:
      1. What is the significance of the BRCA1 mutation and how does this contribute to the development of breast cancer (How does is lead to the development of breast cancer? Consider the pathophysiology of this process.
      2. What risk factors are presented in this case study that may contribute to the development of breast cancer besides the BRCA1 mutation? Why do these contribute to the risk?
      3. What are the likely locations of metastasis of this type of cancer? Why? How does metastasis occur?
      4. Describe the conversation you would have with this patient as the NP provider to tell her she has breast cancer?
      Due Date: The Week 3 and 4 combinded case study is due Sunday of Week 4 to the assignment link in Unit 3.
    • To complete the Check Your Knowledge Quiz for Unit 03, click the above link.
      Check Your Knowledge Quizzes are due by Sunday of the week they are posted.

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