Pharmacology 2060A/B Lecture Notes - Lecture 12: Apolipoprotein B, Coronary Artery Disease, Low-Density Lipoprotein

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20 Nov 2017

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Module 12: drugs to lower blood cholesterol and triglycerides. 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 in the walls of the in arteries. This causes the artery to narrow and results 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: blood cholesterol levels are directly proportional with your risk of developing coronary heart disease. In canada, cardiovascular disease causes one third of all deaths. 12. 2 cholesterol: cholesterol is an important molecule that supports many physiological roles. The basic structure of lipoproteins is shown in the figure.

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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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16. All of the following are true about ear infections EXCEPT:

Middle ear infections (otitis media) often produce a puslike exudate (referred to as otitis media with effusion) due to infection by genera of Streptococcus, Haemophilus, or various species of anaerobes.

External auditory canal (otitis externa) infections are typically caused by Staphylococcus aureus or Pseudomonas aeruginosa.

After successful treatment of middle ear infections with antibiotics, sometimes tubes are inserted to prevent fluid accumulation, repeated infections, and hearing loss.

Pseudomonad infections are common in swimmers because these organisms are able to produce a soluble greenish-blue pigment.

Repeated ear infections in children often decrease markedly because as the child ages and the Eustachian tube changes shape and develops an angle that prevents most organisms from reaching the middle ear.

17. Why are colds difficult to treat and prevent?

Different cold viruses predominate during different seasons.

Because there are so many different types of rhino- and coronaviruses, each with different antigens, development and administration of vaccines are currently prohibitive.

Although some human interferons have been shown to block or limit rhinovirus infections, delivery to infection sites is difficult, and unwanted side effects can occur.

All of the above.

Both a and c.

18. Which of the following is NOT true about parainfluenza viruses?

Most infants by the age of 6 months have been exposed to and develop antibodies against all 4 parainfluenza viruses.

They cause rhinitis characterized by nasal, pharyngeal, and bronchial inflammation, primarily in children.

Parainfluenza virus infection can be prevented by vaccination.

They can cause noisy respiration (stridor) and acute obstruction of the larynx called croup.

The viruses are spread by direct contact or by large droplets.

19. In whooping cough, patients experience violent coughing episodes during the _________ stage and can have bluing of the skin or _________ due to lack of oxygen from massive mucus and bacterial airway blockage.

Paroxysmal; cyanosis

Catarrhal; pigmentation

Convalescent; osmosis

Pneumotic; hydrolysis

Primary; emesis

20. Penicillins have no effect on Mycoplasma pneumoniae because:

Mycoplasmas are viruses

Mycoplasmas possess beta lactamases

Mycoplasmas are too small

Mycoplasmas are eukaryotes

Mycoplasmas lack cell walls

21. How many cases of tuberculosis are reported globally each year?

10,000

100,000

3 million

10 million

22. Mycobacteria are difficult to Gram stain, and are termed âacid-fastâ due to their:

Ability to survive in acidic conditions

Resistance to drying

Thick, waxy cell walls

Resistance to sunlight

Lack of a peptidoglycan layer

23. Which of the following is true about pathogenic mycobacteria?

They have a long generation time of 12 to 18 hours.

They are obligate anaerobes sensitive to small amounts of oxygen.

They are highly resistant to drying and can remain viable in dried sputum 6 to 8 months later.

Both a and b.

Both a and c.

24. Clinical symptoms of tuberculosis are primarily due to:

Host inflammatory response

Mycotoxins

Endotoxin

Mucus production

Exotoxin

25. What characteristic of Coxiella burnetii, the causative agent of Q fever, allows it to survive for up to 2 years?

Metachromatic granule

Exotoxin

Endospore

Hemagglutinin

Cilia

26. The normal microflora of the heart includes species of:

Gram-positive bacteria

Gram-negative bacteria

Fungi

Viruses

None of these

27. Which of the following is commonly directly responsible for causing septic shock today?

Bacterial hemagglutinins

Bacterial endotoxins

Bacterial exotoxins

Fungal aflatoxins

Bacterial neurotoxins

28. All of the following are symptoms of septic shock EXCEPT

Shock

Lymphangitis

Chills

Fever

Collapsed blood vessels

29. What is the most likely explanation of how Streptococcus pyogenes causes rheumatic fever?

Strep throat infections migrate down to the heart.

Endotoxin production causes septicemia.

Vegetation followed by fibrin deposition.

Cross-reactivity of an antibody for a Streptococcus pyogenes antigen to a heart cell antigen.

It is an opportunistic infection triggered by coronary artery disease and atherosclerosis.

30. Bacterial endocarditis is an infection and inflammation of the lining and valves of the heart and occurs as a result of transient bacteria attaching to fibrin from exposed collagen fibers of damaged valvular surfaces. True or false?

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Pharmacology 2060A/B Lecture Notes - Lecture 12: Apolipoprotein B, Coronary Artery Disease, Low-Density Lipoprotein

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