PROBLEM 1: (8 points total)A) List the four leading causes of mortality in small children in both the developing and the developed world. (1/2 point each, must be in the correct order)Developing world: 1) Perinatal conditions; 2) Lower respiratory infections; 3) Diarrheal diseases; 4) MalariaC) Over 50 million women worldwide suffer from debilitating pregnancy-related conditions. Among them is obstetric fistula. Define obstetric fistula, and describe how this condition impacts a woman’s quality of life. How is it treated? (1 point each)PROBLEM 3: (13 points total)PROBLEM 4: (6 points total)BIOE 301/362 Name: Exam 1January 29, 2008The exam consists of 10 questions. Show all work to receive credit. Clearly organize your work and draw a box around your final answers. NEATNESS COUNTS! Good Luck!Problem 1 (8): Problem 2 (10): Problem 3 (13): Problem 4 (6): Problem 5 (8): Problem 6 (12): Problem 7 (4): Problem 8 (8): Problem 9: (12): Problem 10 (19): Total (100):PROBLEM 1: (8 points total)A) List the four leading causes of mortality in small children in both the developing and the developed world. (1/2 point each, must be in the correct order)- Developing world: 1) Perinatal conditions; 2) Lower respiratory infections; 3) Diarrheal diseases; 4) Malaria- Developed world: 1) Perinatal conditions; 2) Congenital anomalies; 3) Lower respiratory infections; 4) Unintentional injuries/accidentsB) Septicemia is a serious infection of the bloodstream that claims the lives of many children in the neonatal period. Two interventions, when used together, have been shownto drastically reduce the incidence of infection following childbirth in the developing world. What are they? (1 point each)- All births should have a skilled birth attendant present- Use safe delivery kits including a sterile razorC) Over 50 million women worldwide suffer from debilitating pregnancy-related conditions. Among them is obstetric fistula. Define obstetric fistula, and describe how this condition impacts a woman’s quality of life. How is it treated? (1 point each)- Obstetric fistula is an opening between the birth canal and either the bladderor rectum due to injuries received during childbirth. Women are unable to remain continent, and are often left by their husbands and outcast by society.- A simple and inexpensive surgery repairs the torn tissue.PROBLEM 2: (10 points total)Diarrheal illness is a leading cause of mortality in small children in the developing world.A) In class, we discussed 4 mechanisms of gastrointestinal disease that lead to diarrhea. Describe these 4 mechanisms, and list one potential cause of each. . (1 point each; half-credit given for correct mechanism but incorrect cause)- Osmotic: inadequate absorption of solutes (lactose intolerance, excess sorbitol ingestion)- Secretory: excess water secretion into the lumen (bacterial toxins such as cholera, ETEC)- Inflammatory: damage due to infection (bacteria, viruses, or parasites)- Motility: accelerated gastrointestinal transit time (diabetes, nerve problems)B) In the 1960s, a treatment for diarrhea was developed that was soon heralded as, “The most significant medical advance of the century.” What is this treatment, and how does itwork? Describe the mechanism in detail. (4 points)- Oral Rehydration Therapy consists of a solution of water, salt and sugar. When given to patients with secretory diarrhea, such as that caused by cholera toxin, it can prevent dehydration. ORT uses a newly discovered method of sodium transport which depends on glucose. This mechanism is not affected by bacteria which produce diarrhea. Thus, providing glucose can increase sodium transport and promote water absorption.C) Explain what is meant by the statement, “Malnutrition is an infectious disease.” (2 points)- Children in the developing world are repeatedly exposed to infectious agents (bacteria, viruses, parasites) that cause the intestinal villi to be blunted, thus reducing the intestinal surface area available for absorption. Over time, their ability to extract nutrients from food sources may be severely compromised.PROBLEM 3: (13 points total)A) Sketch a plot showing (1) the HIV viral load and (2) CD4+ T cell count, over the time course of the disease. Clearly label your two curves. On the plot identify the approximate time of the acute phase of the infection, the latent period, and opportunistic infections.(1 point for each curve, 1 point each for 3 correct labels; 5 points total)- For the two curves, full credit requires the changes associated with acute HIVsyndrome: spike in RNA and dip in CD4 count. Full credit also requires correct overall trends: decreasing CD4 count, increasing RNA copies, and correct labels for the two curves.B) Without intervention, an HIV-positive mother can transmit the virus to her baby 30-40% of the time. Describe the 3 routes by which she may transmit the virus to her baby. Then, list the 4 core interventions used to prevent mother to child transmission. What is the risk of the baby contracting HIV if all 4 measures are used correctly? (1/2 point per item, 4 points total)- 3 routes of transmission: Perenterally (during pregnancy); Perinatally (during delivery); Breast feeding (through milk)- 4 core interventions: HIV testing and counseling; antiretrovirals to reduce viral load at delivery; safer delivery practices; safer infant feeding (formula).- These interventions lower the risk to just 4-6%C) In class, we created a “larger than life” human T cell and HIV particle to illustrate the 8 sequential stages of the HIV life cycle. Identify which of these 8 phases are targets for three major classes of anti-retroviral therapy that have been approved for use. List the general class of antiretroviral drug that corresponds to each of these three phases.(1 point each)- Fusion – Fusion inhibitors- Reverse Transcription – Reverse transcriptase inhibitors- Integration – Integrase inhibitors- Assembly – Protease inhibitors(note: no credit will be given for Tat antagonists: they were not FDA-approved!)PROBLEM 4: (6 points total)A) Unintentional injuries are a leading cause of death in the 15-44 year old age group in both developing and developed countries. Most of these deaths are caused by traffic accidents. Beginning with Newton’s second law (F = ma), explain in words and equations how airbags work to save lives.(2
View Full Document
Unlocking...