For this assignment, you need to answer all 9 questions. The point value is listed for each question. The question/ question content was taken from Exam 1- so you should be somewhat familiar with the topics. This is open book, so you can use whatever resources you choose. You may not provide a quote or excerpt from a text or journal. This must be written in your own words, so we can assess your understanding. If it is not written in your own words, you will lose points for the question. Answers should be brief short answers. The response should be no more than 150 words (5-6 sentences) for each question. Please make sure you submit this by the posted due date. Late entries will not be accepted.

Question 1: (10 points)

Robert is a healthy 37-year-old male who was involved in a skiing accident suffering a complex fracture requiring an external fixation of his femur. Describe why Robert is at a higher risk of a surgical site infections. Explain how surgical site infections impair wound healing?

Question 2: (10 points)

Describe the acute inflammatory response associated with infection or injury. What clinical manifestations may the Advanced Nurse Practitioner expect to see in the acute-phase response?

Question 3: (10 points)

What role does Arachidonic Acid play in the inflammation response? Describe how it is synthesized. How do NSAIDs and Aspirin play into this pathway?

Question 4: (10 Points)

Jewel has been suffering from gastroenteritis with several days of severe vomiting. She now presents to the emergency department with confusion, hypotension, and a decreased respiratory rate. What Metabolic manifestation do you suspect? Describe the lab values you would expect to see for this diagnosis? Consider pH, PCO2, HCO3, Respiratory rate.

Question 5: (10 points)

Liz, a computer programmer, was on a trip to Tanzania to do some volunteer work with her church. Several of her friends were going to climb Mt. Kilimanjaro (19,340’) to the first camp Mti Mkubwa Camp at 9252’. On the way up the mountain, she all of a sudden started to feel lightheaded, sweaty, dizzy, and thought she felt palpitations in her chest. When her friend touched her cheek to look into her eyes, her face twitched.

1. What happened to Liz?
2. Why did it happen to her?

Question 6: (15 points)

Melissa is a 15-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. Melissa was too tired to get out of bed, and she said her head ached. On Monday morning, her mother took her to her primary care provider. Upon completing the physical exam, he told Melissa that the lymph nodes were enlarged in her neck, and she had a fever. He ordered blood tests and told Melissa he suspected she had mononucleosis, a viral infection.

1. Melissa’s illness is caused by a virus. Where are type I interferons produced, and how are they important in combating viral infections?
2. What is the difference between cell mediated immunity and humoral immunity.?

Question 7 (15 points)

Henry worked for 12 years as the groundskeeper for his local high school. He was really proud of the football team because they went to the state championship regularly, so Henry worked hard so the football stadium and the school grounds were perfect. Parents and patrons noted that the fields didn’t have any weeds and were mowed beautifully. Henry regularly used Roundup and other chemical fertilizers to ensure the beauty of his fields. 20 years later Grandpa Henry has developed Chronic Myelogenous Leukemia (CML). He is anorexic and lost a considerable amount of weight, so much that he had to buy new pants. His muscles are wasting, and he is weak. He tries to do his daily activities, but he gets tired easily and needs help from his family.

1. With frequent exposure to Roundup, DNA damage occurred. What are the three stages of carcinogenesis that occurred after his Roundup exposure?
2. Henry is normally a fit (BMI 23) and active man with a healthy appetite. Why would there be muscle wasting and weight loss now?

Question 8: (10 points)

Crohn’s disease involves inflammation and irritation of the intestinal lining. Which type of tissue

is most likely involved in the client's pathology? What are the effects of the chronic inflammation from Crohn’s disease?

There are 2 COVID 19 vaccines that use a new technology- m-RNA. It has been shown that the immunity from these vaccines decrease over time, so a booster is required. How does a booster decrease the risk of contracting COVID-19? Is this a primary or secondary response of the humoral immune system?