Chapter Summary 24: Genetics and Genomics

The emerging role genetics and genomics in medicine
Genetics is the study of trait transmission through DNA passed in sperm and egg cells from generation to generation. In genes, which are parts of chromosomes, encode proteins. The human genome consists of about 24,000 protein encoding genes plus many other sequences. Somatic cells are diploid; sex cells are haploid. Genomics considers many genes that interact with each other and the environment. Proteomics analyzes the spectrum of proteins that a particular cell type produces.

Modes of inheritance
1.Chromosomes and genes common pairs.
2.Chromosome charts are called karyotypes.
3.Chromosomes 1 through 22, number in decreasing size order, are autosomes.
4.Autosomes do not have genes that determine sex.
5.The X and Y Chromosomes are sex chromosomes.
6.Chromosomes and the genes they carry are paired.
7.An allele is an alternative form of a gene.
8.An individual can have two different alleles for a particular gene.
9.The gene itself can have many alleles, because a gene consists of many building blocks, any of which may be altered.
10.An individual with a pair of identical alleles for a particular gene is homozygous; if the alleles are different, the individual is heterozygous.
11.The combination of genes present in individuals cells constitutes the genotype; the appearance of the individual is its phenotype.
12.A wild type allele provides normal or the most common function.
13.A mutant allele causes disease or an unusual trait; it is a change from the wild type condition.

Dominant and recessive inheritance
1.In the heterozygous condition, an allele that is expressed when the other is not is dominant.
2.The masked allele is recessive.
3.Recessive and dominant genes may be autosomal or X-linked or Y- linked.
4.An autosomal recessive condition affects both sexes and may skip generations.
5.The homozygous dominant and heterozygotous individuals have normal phenotypes.
6.The homozygous recessive individual has the condition.
7.The heterozygote is a carrier.
8.An affected individual inherits one mutant allele from each parent.
9.And autosomal dominant condition affects both sexes and does not skip generations.
10.A person inherits an autosomal dominant condition from one parent, who is affected.
11.Pedigrees and Punnett squares are used to depict modes of inheritance.

Different dominance relationships.
1.In incomplete dominance, a heterozygote has a phenotype intermediate between those of both homozygotes.
2.In co-dominance, each of the alleles in the heterozygote is expressed.

Gene expression.
1.Penetrance expressivity.
2.A genotype is incompletely penetrant if not all individuals inheriting it express the phenotype.
3.A genotype is variably expressive if it is expressed to different degrees in different individuals.
4.A pleiotropic disorder has several symptoms, different subsets of which are expressed among individuals.
5.Pleiotropy reflects a gene product that is part of more than one biochemical reaction or is found in several organs or structures.
6.Genetic heterogeneity refers to a phenotype that can be caused by alterations in more than one gene. The same symptoms may result from alterations in genes whose products are enzymes in the same biochemical pathway.

Multifactorial traits.
1.A trait caused by the action of a single gene is monogenic, and by the action of more than one gene, is polygenic.
2.A trait caused by the action of one or more genes and the environment is multifactorial.
3.Height, skin color, eye color, and many common illnesses are multifactorial traits.
4.A frequency distribution for a polygenic trait forms a bell curve.

Matters of sex.
1.A female has two X chromosomes; a male has one X and one Y chromosome.
2.The X chromosome has many more genes than the Y.

Chromosome disorders.
1.Extra, missing, or rearrange chromosomes or parts of them can cause syndromes, because they either cause an imbalance of genetic material or disrupt a vital gene.
2.Polyploidy is an extra chromosome set.
3.Polyploidy results from fertilization involving a diploid gamete.
4.Human polyploids not survived beyond a few days of birth.
5.Aneuploidy: cells with an extra or missing chromosome are aneuploid.
6.Cells with the normal chromosome number are you euploid.
7.Aneuploidy results from non-disjunction, in which a chromosome pair does not separate, either in meiosis I or meiosis II, producing a gamete with a missing or extra chromosome.
8.At fertilization, a monosomic or trisomic zygote results.
9.A cell with an extra chromosome is trisomic.
10.A cell with a missing chromosome is monosomic.
11.Individuals with trisomies are more likely to survive to be born and those with monosomies.

Prenatal tests.
1.Ultrasound can detect large-scale structural abnormalities and assess growth.
2.Maternal serum marker test indirectly detect a small fetal liver which can indicate a trisomy.
3.Amniocentesis samples examines fetal chromosomes in amniotic fluid.
4.Chorionic villus samplings obtained and examine chorionic villus cells, which descend from the fertilized egg and therefore are presumed to be genetically identical to fetal cells.
5.Fetal cell sorting obtains and analyzes rare fetal cells in the maternal circulation.

Gene therapy.
1.Gene therapy corrects the genetic defect causing symptoms.
2.Heritable gene therapy alters all genes in an individual and therefore must be done on a gamete or fertilized egg.
3.Heritable gene therapy is not done in humans that is useful and other species.
4.Non-heritable gene therapy replaces or corrects defective genes in somatic cells, often those in which symptoms occur.

Chapter 24 Genetics and Genomics

Chapter 24

Genetics and Genomics

1. Discuss the relationship of DNA, genes, chromosomes, and the genome.
A gene is a nucleotide sequence of a DNA molecule with the information on how to construct a specific protein. Genes may also control other genes by turning them on or off. A chromosome is a set of proteins (histones) as well as a thread of DNA. Chromosomes appear as rod-shaped bodies in the nucleus when a cell divides. A genome consists of all the genes found in the cell.

2. Discuss the origin of the 46 chromosomes in a human zygote.
In a human, a cell contains 23 pairs of chromosomes (46 individual chromosomes). In human reproduction, a human zygote receives 46 chromosomes, however, 23 are supplied by the sperm and 23 from the egg.

3. Define homologous chromosomes.
Homologous chromosomes are chromosomes that are identical. In the human cell, there are 23 pairs of homologous chromosomes.

4. Distinguish between:
• homozygote and heterozygote
• autosome and sex chromosome
• mutant and wild type
• phenotype and genotype
• incomplete dominance and codominance
• haploid and diploid
• penetrance and expressivity
• germline and nongermline gene therapy
An individual who has two identical alleles of a gene is homozygous for that gene. A person with different
alleles for a gene is said to be heterozygous for it.
An autosome is a gene carried on a nonsex chromosome. A sex chromosome is the X or Y chromosome determining the sex of the zygote.
Wild-type refers to an allele of a phenotype that is either normal or the most common expression for a particular population. A mutant is an allele that is different from the wild-type producing an uncommon phenotype.
The combination of genes present in a person’s cell is its genotype. The appearance of the individual as a result of gene expression is his or her phenotype.
Incomplete dominance is a condition in which the heterozygous phenotype is intermediate between that of either homozygote. In other words, neither of the alleles of the gene is completely dominant over any other allele. This can be seen in sickle cell disease. In codominance, the different alleles are both expressed. This can be seen in ABO blood types.
The most drastic upset in chromosome number is an entire extra set, a condition called polyploidy. This results from formation of a diploid (rather than a normal haploid) gamete. For example, if a haploid sperm fertilizes a diploid egg, the fertilized egg is triploid, with three copies of each chromosome. Most human polyploids die as embryos or fetuses, but occasionally an infant survives for a few days, with defects in nearly all organs.
However, many agriculturally important plants are polyploids. Some organs normally have a few polyploidy cells, with no adverse effects on health. Liver cells, for example, may be tetraploid (4 chromosome sets) or even octaploid (8 chromosome sets).
Penetrance and expressivity
a. A genotype is incompletely penetrant if not all individuals inheriting it express the phenotype.
b. A genotype is variably expressive if it is expressed to different degrees in different individuals.
There are two basic types of gene therapy. Heritable gene therapy, also known germline gene therapy, introduces the genetic change into a sperm, egg, or fertilized egg, correcting each cell of the resulting individual. The change is repeated in the person’s gametes and potentially passed to the next generation.
In contrast is nonheritable gene therapy, also called somatic gene therapy, which targets only affected cells and therefore cannot be transmitted to the next generation. Nonheritable gene therapy provides a person with hemophilia genes that make possible secretion of functional clottting factors.

5. Explain how a gene can have many alleles.
Genes consist of hundreds of nucleotides in order to build its particular product. Any one of the different,
variant forms it can have is called an allele. Because the genes are paired, one allele on a gene may not
necessarily be the same on its partner.

6. Describe how cystic fibrosis is pleiotropic.
A pleiotropic disorder has several symptoms, different subsets of which are expressed among individuals.
Pleiotropy reflects a gene product that is part of more than one biochemical reaction or is found in several organs or structures.

7. Explain why the frequency distributions of different complex traits give very similar bell curves.
Although the expression of a polygenic trait is continuous, we can categorize individuals into classes and
calculate the frequencies of the classes. When we do this and plot the frequency for each phenotype class, a bell-shaped curve results. This curve indicating continuous variation of a polygenic trait is strikingly similar for different characteristics, such as fingerprint patterns, height, eye color, and skin color. Even when different numbers of genes are involved, the curve is the same shape.

8. Describe how the environment can influence gene expression.
Environmental factors can influence gene expression. For instance, nutrition affects height, and sun affects skin color.

9. Explain how genes and chromosomes determine gender.
There are two chromosomes that determine the gender of a human, X and Y. An egg cell carries only X
chromosomes and the sperm cell carries either an X or a Y chromosome. Thus, an individual who has an XX combination will be female, while an individual who has an XY combination will be male. It is the presence or absence of the Y chromosome that determines gender. On the Y chromosome, a gene called the SRY (sex-determining region of the Y) more specifically identifies whether a person will be male or female.

10. Explain why Y-linked genes are passed only from fathers to sons.
Genes on the sex chromosomes are inherited differently than those on autosomes because the sexes differ in sex chromosome constitution.
Y-linked genes are considered in three groups: those with counterparts on the X; those similar to genes on the X; and genes unique to the Y, many of which affect male fertility. Y-linked genes pass from fathers to sons.

11. Explain why the inheritance pattern of X-linked traits differs in males and females.
Males are hemizygous for x-linked traits; that is, they can have only one copy of a x-linked gene, because they have only one X chromosome.
Females can be heterozygous or homozygous for genes on the X chromosome, because they have two copies of it.
A male inherits an x-linked trait from a carrier mother. These traits are more common in males than in females.
A female inherits an x-linked mutant gene from her carrier mother, and/or from her father if the associated trait does not impair his ability to have children.

12. Explain why a male cannot inherit a sex-linked trait from his father.
The Y chromosome does not carry any sex-linked traits. Therefore, all sex-linked traits come from the X chromosome of the mother in a male individual.

13. Explain why X-linked dominant traits are not seen in males.
Because of the severity of the disorders associated with X-linked dominant traits in males, they do not survive to be born. This condition is rare, but it does happen.

14. Discuss how a sex-limited trait and a sex-influenced trait differ from an X-linked trait.
Sex-limited traits affect structures or functions seen in only one sex and may be autosomal. Sex-influenced
traits are dominant in one sex and recessive in the other.

15. Explain how an individual with an extra set of chromosomes arises.
In meiosis, sometimes a gamete will be diploid instead of haploid. If this diploid pairs with a haploid, the result is a triploid zygote. This condition is called polyploidy and is nonviable.

16. Explain how nondisjunction leads to aneuploidy.
Nondisjunction occurs during either meiotic division when a pair of chromosomes fails to separate. The result is a gamete with either no chromosomes or both chromosomes. The resulting gamete is called an aneuploid. An extra chromosome is called trisomy, and a missing chromosome is called monosomy.

17. Distinguish among four types of prenatal diagnostic tests.
Prenatal tests
a. Maternal serum marker tests indirectly detect a small fetal liver, which can indicate a trisomy.
b. Amniocentesis samples and examines fetal chromosomes in amniotic fluid.
c. Chorionic villus sampling obtains and examines chorionic villus cells, which descend from the fertilized
egg and therefore are presumed to be genetically identical to fetal cells.
d. Fetal cell sorting obtains and analyzes rare fetal cells in the maternal circulation.

18. Describe why heritable gene therapy is impractical in humans.
Since heritable gene therapy involves a change in all of the cells in an organism, it must be accomplished at the fertilized egg stage. This is impractical in humans, and is not being attempted in them.

19. Explain how nonheritable gene therapy is being attempted in various human tissues.
Nonheritable gene therapy targets only specific cells. Bone marrow transplant is an example that has been
used for many years. First, all of the “old” cells must be destroyed. Then, donor marrow is injected in its place to correct the faults.

12 Times per Hour?

Hey Nutritional Foundations!

Did you know that we are all exposed, bombarded, assaulted 10 to 12 times per hour with junk food advertisements while we watch TV? Our children are most vulnerable. This may play a significant role in the cause of obesity in our Nation today.

Our Unit in Weight Management does a great job in delineating how exercise and diet are keys to health and well-being. However, it does not mention the overriding influence of the media and marketing in shaping our wants, desires and actions.

Most of us make decisions about food on an emotional basis and no amount of intellectualizing can overcome the power of emotions that go un examined. Let's talk nutrition!

Check out this link for more info:http://www.sciencedaily.com/releases/2008/11/081119120149.htm

Chapter 23: Growth and Development

Wow!

Today's lecture material was chock full of new words and concepts. Remember, if you understand the meaning and use of the new terms, it will be easier to successfully navigate this cumbersome material. I recommend making a list osf all the new terms and looking up the definitions of each of them. Here are a few that pop out at me:

Zygote
Morula,
Blastomere
Blastocyst
Trophoblast
Gastrula
Embryonic Disc
Ectoderm
Mesoderm
Endoderm
Allantois

Holy Cow! That's a great deal of new words and concepts and they appeared in the first 10 pages!!!!! I want each of you to be successful here at NAU-ZR and in your chosen careers, so please be diligent in your studies ... and yes, I know you have a life outside of school ... but this is a big investment and we want it to pay off.

Warmly,
Andrew

ps Matt found a cool picture that should help you study on this section. Thanks Matt!

Chapter 23 Pregnancy, Growth, and Development

Chapter 23

Pregnancy, Growth, and Development

1. Define growth and development.
Growth is an increase in size. Additionally, in the human, it entails an increase in cell numbers, followed by enlargement of the newly formed cells. Development is a continuous process by which an individual changes from one life phase to another.

2. Define pregnancy.
The presence of a developing offspring in the uterus.

3. Describe how sperm cells move within the female reproductive tract.
A sperm cell moves, by its tail lashing and muscular contraction in the female reproductive tract, into the uterine tube.

4. Describe the process of fertilization.
The sperm cell invades the follicular cells and penetrates the zona pellucida with the help of an enzyme (hyaluronidase), released by the acrosome of the sperm. It then passes through the egg cell membrane into the cytoplasm. During this process, the sperm cell loses its tail, and the nucleus in its head swells. The egg cell then divides unequally to form a relatively large cell and a tiny second polar body, which is expelled later. The nuclei of the egg cell and sperm cell come together in the center of the larger cell. Their nucleus membranes disappear and their chromosomes combine, thus completing the process of fertilization.

5. Describe the process of cleavage.
Cleavage occurs thirty hours after conception. The zygote begins to undergo mitosis, becoming many cells, with each division making the cells smaller and smaller.

6. Distinguish between a morula and a blastocyst.
A morula is a solid ball of sixteen cells that occurs after about three days. A blastocyst is the hollow ball that was formerly the morula, which the embryo is eventually developed from.

7. Describe the formation of the inner cell mass, and explain its significance.
The inner cell mass is a group of cells within the blastocyst that group together and eventually give rise to the embryo proper (the body of the developing offspring).

8. Describe the process of implantation.
At about the sixth day, the blastocyst begins to attach to the uterine lining. Proteolytic enzymes that digest a
portion of the endometrium aid this. The blastocyst sinks into the resulting depression. At the same time, the uterine lining is stimulated to thicken below the implanting blastocyst and the cells of the trophoblast begin to produce microvilli that grow into the endometrium.

9. List three functions of hCG.
a. It prevents the termination of pregnancy.
b. It maintains the corpus luteum.
c. It stimulates the synthesis of other hormones from the developing placenta.

10. Describe the formation of the placenta, and explain its functions.
The placenta is formed from the region of the chorion still in contact with the uterine wall. It functions to deliver nutrients to the developing fetus and carry wastes away from the developing fetus.

11. Explain the major hormonal changes that occur in the maternal body during pregnancy.
Human chorionic gonadotropin (HCG) is secreted at a high level for about two months, then declines to a relatively low level by the end of four months. Estrogen steadily rises throughout the nine months of pregnancy. Progesterone also rises throughout the entire pregnancy but in lesser amounts than estrogen.

12. Describe the major nonhormonal changes that occur in the maternal body during pregnancy.
Some of the changes in the maternal body include:
a. enlargement of the uterus.
b. displacement of the abdominal organs.
c. increase in blood volume, cardiac output, breathing rate, and urine production.
d. increasing food consumption.

13. Explain how the primary germ layers form.
The primary germ layers form from the inner cell mass, which form the embryonic disk. The primary germ layers are the outer ectoderm, an inner endoderm, and a middle layer known as the mesoderm.

14. List the structures derived from the primitive tissues of the ectoderm, mesoderm, and endoderm.
The ectoderm gives rise to the nervous system, portions of the special sensory organs, epidermis, hair, nails, glands of the skin, and linings of the mouth and anal canal.
Mesodermal tissue forms all types of muscle tissue, bone tissue, bone marrow, blood, blood vessels, lymphatic vessels, various connective tissue, internal reproductive organs, kidneys, and epithelial linings of the body cavities.
Endodermal cells produce the epithelial linings of the digestive tract, respiratory tract, urinary bladder, and urethra.

15. Define placental membrane.
The placental membrane is a thin membrane that separates the embryonic blood within the capillary of a chorionic villus from the maternal blood in a lacuna. It is through this membrane that exchanges take place between the maternal blood and embryonic blood.

16. Distinguish between the chorion and the amnion.
The chorion is the membrane that contains the chorionic villi and surrounds the developing embryo. The
amnion is another membrane that develops around the embryo about the second week and is filled with amniotic fluid.

17. Explain the function of amniotic fluid.
It provides a watery environment in which the embryo can move and grow freely without being compressed by surrounding tissues. It also serves as protection from being jarred by the mother’s body movements.

18. Describe the formation of the umbilical cord.
As the amnion encloses the embryo and subsequently surrounds it with amniotic fluid, it envelops the tissues on the underside of the embryo. This is attached to the chorion and developing placenta, which is the formation of the umbilical cord.

19. Explain how the yolk sac and allantois are related, and list the functions of each.
The yolk sac appears during the second week of development. It is attached to the underside of the embryonic disk. It forms blood cells in the early stages of development and gives rise to the cells that later become sex cells. The allantois forms during the third week as a tube extending from the early yolk sac into the connecting stalk of the embryo. It also forms blood cells and gives rise to the umbilical arteries and vein.

20. Explain why the embryonic period of development is so critical.
The embryonic period is the most critical of development. During this time the embryo implants within the uterine wall and all the essential external and internal body parts.

21. Define fetus.
The fetus is the name given to the developing offspring from the end of the eighth week until birth.

22. List the major changes that occur during the fetal stage of development.
In the third lunar month body growth is accelerated and the external reproductive organs appear as male or female. Ossification centers appear in most bones. In the fourth lunar month the skeleton continues to ossify and legs lengthen considerably. In the fifth lunar month, skeleton muscles become active so the mother may feel movements. Hair appears on the head and skin. The sixth lunar month is when the body gains a substantial amount of weight. The eyebrows and eyelashes appear. The seventh lunar month sees the eyes open. In the eighth lunar month, testes in males descend. In the ninth lunar month, the fetus reaches about forty-seven centimeters in length, and has smooth skin and chubby body. At the end of the tenth lunar month, the fetus is full term.

23. Describe a full-term fetus.
A full-term fetus is about 50 centimeters long and weighs 2.7 to 3.6 kilograms. The skin has lost its down hair but is coated with sebum and dead epidermal cells. This scalp is usually covered with hair, the fingers and toes have well-developed nails, and the skull bones are largely ossified.

24. Compare the properties of fetal hemoglobin with those of adult hemoglobin.
Fetal hemoglobin is present by 50 percent greater concentrations than adult hemoglobin. It also has a greater attraction for oxygen than adult hemoglobin. It can carry 20 to 30 percent more oxygen than adult hemoglobin.

25. Explain how the fetal circulatory system is adapted for intrauterine life.
Fetal blood has a greater oxygen-carrying capacity than adult blood. The umbilical vein carries oxygenated blood from the placenta to the fetus. The ductus venosus conducts about half the blood from the umbilical vein directly to the inferior vena cava, thus bypassing the liver. The foramen ovale conveys a large proportion of the blood entering the right atrium from the inferior vena cava, through the atrial septum, and into the left atrium, bypassing the lungs. The ductus arteriosus conducts some blood from the pulmonary trunk to the aorta, bypassing the lungs. The umbilical arteries carry the blood away from the internal iliac arteries to the placenta.

26. Trace the pathway of blood from the placenta to the fetus and back to the placenta.
See figure 23.21, page 912.

27. Describe the role of progesterone in initiating the birth process.
During pregnancy, progesterone is present in large concentrations. As the placenta ages, the levels decrease and this may cause an increase in prostaglandin, which will cause uterine contractions.

28. Discuss the events that occur during the birth process.
Labor is the period where the contents of the uterus are forced downwards. This thins the cervix to where it is able to be completely dilated. Following birth of the fetus, the placenta is expelled by uterine contractions through the birth canal usually within ten to fifteen minutes. This is commonly referred to as afterbirth.

29. Explain the roles of prolactin and oxytocin in milk production and secretion.
Prolactin stimulates the mammary glands to secrete large quantities of milk. This effect doesn’t occur for two or three days following birth, and during this time the glands secrete a thin, watery fluid called colostrum.
Oxytocin stimulates the myoepithelial cells of the ductile system to contract, ejecting the milk into a suckling infant’s mouth.

30. Distinguish between a newborn and an infant.
A baby is considered a newborn from birth until the end of the fourth week after birth. A baby is considered an infant from the end of the fourth week of age until age one year.

31. Explain why a newborn's first breath must be particularly forceful.
The first breath must be particularly forceful because the newborn’s lungs are collapsed and the airways are
small, offering considerable resistance to air movement. Surface tension also tends to hold the moist membranes of the lungs together. Surfactant secreted by the lungs of a full-term infant reduces this surface tension.

32. List some of the factors that stimulate the first breath.
a. Increasing concentration of carbon dioxide.
b. Decreasing pH.
c. Low oxygen concentration.
d. Drop in body temperature.
e. Mechanical stimulation that occurs during and after birth.

33. Explain why newborns tend to develop water and electrolyte imbalances.
The newborn’s kidneys are unable to produce concentrated urine, so they excrete a relatively dilute fluid. This is the reason that the newborn may develop a water and electrolyte imbalance.

34. Describe the cardiovascular changes that occur in the newborn.
See figure 23.25, page 900.

35. Describe the characteristics of an infant.
Infants have a high growth rate. The teeth begin to erupt. The muscular and nervous systems mature so that coordinated activities are possible. The child begins to communicate.

36. Distinguish between a child and an adolescent.
A child is defined as an individual one-year-old until the first year of puberty. An adolescent is a child who has reached puberty and extends until adulthood.

37. Define adulthood.
Adulthood extends from adolescence to old age.

38. List some of the degenerative changes that begin during adulthood.
a. Skeletal muscles lose strength.
b. The circulatory system becomes less efficient.
c. The skin loses its elasticity.
d. The capacity to produce sex cells declines.

39. Define senescence.
Senescence is the process of growing old.

40. List some of the factors that seem to promote senescence.
Disease processes that interfere with vital functions can accelerate senescence. Diseases of any major body
system can also accelerate senescence.

41. Cite evidence of passive aging and active aging.
Passive aging entails the breakdown of structures and the slowing of functions. Active aging entails new activities or the appearance of new substances such as the lipofucin granules and autoimmunity attacking healthy cells.

Nutritional Foundations Notes

SC 1201: Nutritional Foundations
Dr. Andrew S. Bonci
National American University, Zona Rosa

Chapter 13 Community Food Supply and Health

The health of the community largely depends on the safety of its available food and water supply. This chapter explores the factors that influence the safety of food. America's bountiful food supply is accompanied by certain hazards. Potential health problems related to the food supply can arise from several sources, such as lack of sanitation, food borne disease, and poverty.

1.The FDA is the primary governing body of the American food supply, with the exception of meat and poultry.
2.The USDA Food Safety and Inspection Service is responsible for food safety of both domestic and imported meat and poultry.
3.The National Marine Fisheries Service governs the safety of seafood and fisheries.
4.The Environmental Protection Agency regulates the use of pesticides and other chemicals and ensures the safety of public drinking water.
5.Regulation of advertising and truthful marketing of food products is a large job and is the duty of the Federal Trade Commission.
6.The CDC monitors and investigates cases of food-borne illness and is proactive in education and prevention.
7.The FDA is a law enforcement agency charged by the U.S. Congress to ensure, among other things, that America's food supply is safe, pure, and wholesome.
8.The FDA's method of enforcement are recall, seizure, injunction, and prosecution.
9.The FDA's division of consumer education conducts an active program of protection through consumer education and general public information.
10.In the mid-19th century the FDA established “truth in packaging” regulations that dealt mainly with food standards.
11.The basic standard identity requires that labels on foods not having an established reference standard must list all the ingredients in the order of amount found in the product.
12.Information about nutrients and food constituents that consumer groups believe it should be listed on the labels included the amount of macronutrients and their total energy value, key micronutrients, sodium, cholesterol, trans fats, and saturated fat.
13.The FDA set 2000 calories as the reference amount for calculating the %DV, although individuals may vary greatly in their specific needs.
14.Health claims that link nutrients or four groups with risk for disease are strictly for let regulated.
15.To make an association between a food product a specific disease, the FDA must approve the claim, the food must meet the criteria set forth for that specific claim, and the wording used on the package must be approved.
16.The agricultural and food processing industries have developed various chemicals to increase and preserve the food supply.
17.Critics voice concerns about how these changes have affected food safety and the overall environment.
18.Large American agricultural corporations as well as individual farmers use a number of chemicals to improve crop yields.
19.Problems with pesticide use have developed in four main areas: pesticide residues on foods, gradual leaching of the chemicals into the groundwater and surrounding wells, increased exposure of farm workers to be strong chemicals, and increased amounts of chemicals necessary as insects develop tolerance.
20.Organic plant foods are grown without synthetic pesticides, fertilizers, sewerage sludge, bioengineering, or ionizing radiation.
21.Organic meat, poultry, eggs, and dairy products are from animals raised without antibiotics or growth hormones.
22.All foods produced organically are not required to use the organic label; it is a voluntary program.
23.Certified organic foods are not recognized as being more safe or nutritious than conventionally produced foods. (Your course instructor disagrees with this)
24.organic farmers can still use natural pesticides and fertilizers and therefore are not producing pesticide free foods.
25.The food safety and inspection service of the USDA a does not approve the terms hormone free or antibiotic free.
26.The phrase is raised without added hormones and raised without added antibiotics are allowed, provided that the producer is able to supply an affidavit attesting to the production practices used to support the claim.
27.One important note about the use of hormones is that they are approved for use only in beef cattle and lamb production.
28.Organic farming is safer for the soil, water, agricultural workers, and birds.
29.When compared with conventional farming, organic farming is less efficient.
30.In the United States, 87% of soybean crop acreage, and a steadily increasing percentage of corn crops, are GM herbicide tolerant varieties. (remember GM means genetically modified)
31.GM crops are extensively tested regarding composition, safety, and environmental effects. (Your course instructor vehemently disagrees with this point)
32.Genetically modified crops remains controversial around the world.
33.GM corn that expresses a specific protein ultimately serves as its own insecticide.
34.The European Union has effectively outlawed the use of genetically modified crops.
35.The European Union prevents the importation of genetically modified organisms.
36.Regarding genetically modified organisms current testing procedures are unable to determine potential problems for long-term use, such as carcinogenicity or neurotoxicity.
37.Irradiation can kill bacteria and parasites on the food after harvest.
38.The use of irradiation is not a new science; wheat flour and white potatoes were approved for irradiation in the early 1960s.
39.Irradiation can be used to increase the shelf life of produce.
40.Foods that are here radiated: have essentially on altered nutritional value, are not radioactive, have no harmful substances introduced as a result of irradiation, but may take slightly different.
41.The FDA requires all here radiated foods to be appropriately labeled with either the radura symbol for radiation or by a written description stating the food has been exposed to radiation.
42.Irradiation introduces trans-fats in meat, and known health risk.
43.Consumer rejection in the United States and around the world mainly is the result of altered taste and fear of unknown long-term effects on human health.
44.The use of food additives, chemicals intentionally added to foods to prevent spoilage and extend shelf life, is not new to the food industry.
45.The two most common additives are sugar and salt, although consumers often do not recognize these basic ingredients as food additives.
46.A number of micro nutrients and antioxidants are used as additives in processed foods, not for their ability to increase nutrient content, but for their technical effects during processing or the final product.
47.Many disease bearing organisms inhabit the environment and can contaminate food and water.
48.The public health service estimates 76 million Americans become sick from foodborne illnesses annually, with a resulting 325,000 hospitalizations.
49.Control of foodborne disease focuses on strict sanitation measures and rigid personal hygiene.
50.The food itself should be of good quality and not defective or diseased.
51.Dry or cold storage protected from deterioration or decay, which is especially important for products such as refrigerated convenience foods, the fastest-growing segment of the convenience food market and the potentially most dangerous because they are not sterile.
52.Food safety depends on the following critical actions: cleanliness, separation, cooking, and refrigeration.
53.All food preparation areas must be scrupulously clean, and foods must be washed or cleaned well.
54.Cooking procedures and temperatures must be followed as directed.
55.All utensils, dishes, and anything else that comes in contact with food must be clean. Leftover food should be stored and receded appropriately or discarded.
56.Garbage must be contained and disposed of and a sanitary manner.
57.All persons handling food, especially those working in public food services, should follow strict measures to prevent contamination.
58.Simple handwashing and clean clothing and aprons are imperative.
59.Persons with infectious disease should have limited access to direct food handling.
60.Foodborne illnesses usually present themselves as flulike symptoms but can advance to a lethal illness.
61.Not all bacteria found in food or harmful.
62.Bacteria that are harmful to people are referred to as pathogens.
63.Hunger, even famine and death, exist in many countries of the world today.
64.Lack of sanitation, cultural inequality, overpopulation, and economic and political structures that do not appropriately use resources are all factors that may contribute to malnutrition.
65.The most common deficiencies in the world today are protein energy malnutrition, vitamin A deficiency, iodine deficiency, and iron deficiency.
66.Hunger does not stop at the US border.
67.More than 11 million households in the United States have food insecurity.
68.Food insecurity is defined as quote limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire acceptable foods in socially acceptable ways.”
69.Individuals at highest risk of food insecurity within the United States are African-Americans, Hispanics, single mothers, and households in central cities and not metropolitan areas.
70.Many people United States experience hunger every day.
71.In situations of economic stress and natural disasters, individuals and families need financial help.
72.WIC provides nutrition supplementation, education, and counseling in addition to referrals for healthcare and social services to women who are pregnant or postpartum and to their infants and children younger than five years.
73.Food marketing is big business, and producers compete for prize placement in shelf space.

Chapter 15 Weight Management

Currently 66% of adults ages 20 to 74 years in United States are overweight, with 32% meeting the criteria for obese. This chapter examines the problem of weight management and seeks a more positive and realistic health model that recognizes personal needs and sound weight goals.

1.obesity develops from many interwoven factors including personal physical psychological and genetic it is difficult to define.
2.Overweight denotes a bodyweight above a population weight for height standard.
3.Obesity is a more specific term that refers to the degree of fatness, which is the real health problem.
4.The increase in persons meeting the criteria for clinical obesity (B M. I of 30 or greater) has increased even more dramatically, from 13.3% of the population in 1960 to 32.1% in 2004.
5.BM I is a reliable method of predicting the relative risk of becoming an overweight adult based on the presence or absence of excess weight at various times during childhood.
6.Body mass index is a measure of body weight in kilograms divided by the square of height in meters.
7.Body composition measurements provide a better evaluation of overall health relative to wait
8.height weight tables are tools, or general population guides, and should be regarded only as such.
9.A person's ideal weight depends on many factors, including gender, age, body shape, metabolic rate, genetics, and physical activity.
10.Somebody that is essential for survival.
11.Some women dropping below the critical body fat percentage experienced amenorrhea because of the decrease in hormone levels.
12.Obesity increases the risk to the individual for the development of hypertension, type II diabetes, heart disease, sleep apnea, gallbladder disease, stroke, osteoarthritis, and breast and endometrial and colon cancers.
13.Amenorrhea is the absence of a menstrual period and a woman of reproductive age.
14.Although some persons have congenital obesity, a major cause of obesity in Americans is a lack of physical activity.
15.Regular exercise alone has a significant effect on increasing lean body mass and reducing risk of chronic diseases associated with obesity.
16.The overall energy imbalance is the primary cause for excess weight.
17.A genetic influences the predisposing factor for obesity, not the determining factor of obesity.
18.The daily life, environment, and habits of person chooses to influence the expression of this genetic trait. In other words, the genetic predisposition may exist but cannot express itself without an environment that supports it.
19.Studies show that the greatest risk for overweight is a history of being overweight.
20.In addition to genetic influence, families also exert social pressure and teach children habits and attitudes toward food. The amount of body fat a person carries is related to the number and size of fat cells in the body.
21.Work, family, and social environments may cultivate emotional stress, which many persons respond to by eating for comfort.
22.Environmental factors in the United States that contribute to obesity include the following: increase in food availability, fast and convenient foods, increase in portion size, decrease in food preparation time and skills, decrease in physical activity, increase in screen time, and decreased physical requirements of household chores.
23.Desperate attempts to lose weight may drive people to extreme measures, which sometimes worsen health risks.
24.Fad diets and supplements often are nutritionally inadequate.
25.No shortcuts to successful weight control exist.
26.Weight loss requires hard work and strong individual motivation.
27.Weight management must be a personalized program that focuses on changing food and exercise behaviors and stress and relaxation habits.
28.By understanding behaviors and changing associations with undesirable habits, individuals can plan constructive actions to meet personal health goals.
29.Adequate behavior modification requires you to specifically define the problem behavior in the desired behavior outcome.
30.Adequate behavior modification requires that you record eating and exercise behavior and carefully analyze it.
31.Adequate behavior modification requires you set up controls of the external environment involving the situational forces related to each behavior.
32.In dealing with behavioral cues minimizes many cues for the problem behavior is possible.
33.In dealing with behavioral cues suppress the cues that cannot be entirely eliminated.
34.In dealing with behavioral cues strengthen cues for desired behaviors.
35.In fostering new eating habits and patterns it is recommended to slow the pace of eating and to savor the food.
36.The central dietary approach and a weight management program that could achieve a degree of lasting success must be based on the following five characteristics: set realistic goals, reduce caloric intake, provide nutritionally adequate foods, ensure the cultural appeal of the foods, readjust your energy needs to maintain weight.
37.The two sides of energy balance our energy intake, in the form of food and energy output, in the form of metabolic work in physical activity.
38.Encourage patients to experiment with various activities until they find one they enjoy and can maintain long-term.
39.To help manage body weight and prevent gradual, on healthy body weight gain in adulthood one should engage in approximately 60 minutes of moderate intensity to vigorous activity on most days of the week while not exceeding caloric intake requirements.
40.To sustain weight loss in adulthood one should participate in at least 60 to 90 minutes of daily moderate intensity physical activity while not exceeding caloric intake requirements.
41.For a person who normally consumes 2000 kcal per day, the ideal scenario is a deficit of approximately 500 kcal per day.
42.The total caloric deficit should not all come from the diet.
43.The ideal weight loss program should combine a restriction in energy intake and increase in energy expenditure as represented in a 50-50 split.
44.Spreading food fairly evenly throughout the day helps meet energy needs.
45.Hunger usually peaks every 4 to 5 hours.
46.The most positive work with weight management is aimed at prevention.
47.A major culprit in this health epidemic is physical inactivity.
48.Support for young parents and children before obesity develops can help prevent many problems later in adulthood.
49.Food fads are scientifically unsubstantiated beliefs about certain foods that may persist for a short time in a given community or society.
50.In medicine, nutrition, and allied health fields, a quack is a fraudulent pretender who claims to have skill, knowledge, or qualifications that he or she does not possess.
51.People must develop intelligent concerns and rational approaches to meet their nutritional needs.
52.Desperately ill and lonely persons are easy prey for cruel hoaxes.
53.Figure conscious girls and muscle minded boys may respond to crash programs and claims offering the perfect body.
54.Obese persons face a constant barrage of propaganda that pushes diets, pills, candies, wafers, formulas, and devices.
55.Know the nutritional products being pushed and the people or company behind.
56.Know how human physiology and biochemistry really work.
57.Know the scientific method of problem solving.
58.Consider the emotional needs of food and food rituals help fulfill.
59.Use any opportunity that arises to present sound nutrition and health information, formally or informally.
60.A person who is more than 10% below the average weight for height and age is considered underweight.
61.A severely underweight person has their resistance to infection lowered general health is poor and their strength is reduced.
62.The three most common eating disorders or anorexia nervosa, bulimia nervosa, and binge eating disorder.

Chapter 17 Nutrition Care

People face acute illness or chronic disease and treatment in a variety of settings: the hospital, extended care facility, clinic, and home. This chapter focuses on the comprehensive care of the patient's nutrition needs as provided by the registered dietitian. Nurses are intimately involved in the care process and often identify nutrition needs within the nursing diagnosis. An effective care plan involves all healthcare members as well as the patient, family, and support system.

1.Nutrition care must be based on individual needs and the person centered.
2.Needs must constantly be updated with the patient's status.
3.Despite all methods, tools, and technologies described in this text and elsewhere, remember this basic fact: therapeutic use of self is the most healing tool a person will ever use.
4.In the area of nutrition care, the registered dietitian carries the major responsibility of medical nutrition therapy.
5.Of all the health care team members, nurses are in the closest continuous contact with patients and their families.
6.Nursing diagnosis is a statement about the health of the client based on information gathered during the nursing assessment.
7.The nurse and dietitian form an important team for providing nutrition care.
8.The dietitian determines nutrition needs, plans and manages nutrition therapy, evaluates plan of care, and records results.
9.Successful care depends on the close teamwork of the dietitian and nurse.
10.When necessary, the nurse also may serve as an essential coordinator, advocate, interpreter, teacher, or counselor.
11.Nurses work more closely with patients than do any other practitioner.
12.Nurses are able to best coordinate the patient's special services and treatments and consults and referred as needed.
13.Unfortunately, malnutrition is common in hospital settings.
14.The nurse can help reduce a patient's anxiety by careful, brief, easily understood explanations about various treatments and plans of care.
15.Basic teaching and counseling skills are essential in nursing.
16.ADA has developed a standardized nutrition care process for registered dietitians.
17.The nutrition care process is composed of the following four distinct and interrelated nutrition steps: assessment, diagnosis, intervention, and monitoring and evaluation.
18.Appropriate care considers the patient's nutrition status, food habits, and living situation as well as his or her needs, desires, and goals.
19.The ABCD approach to nutrition assessment includes anthropometric data, biochemical tests, clinical observations, and dietary evaluations.
20.A nutrition diagnosis is identification and labeling an actual occurrence risk of more potential for developing a nutrition problem that dietetics professionals are responsible for treating independently.
21.The nutrition diagnosis will change as the patient's nutrition needs change.
22.The nutrition diagnosis statement helps identify nutrition problems, which may include nutrient deficiencies or underlying disease requiring a special modified diet.
23.Correctly identifying the cause is the only way to design intervention plan adequately.
24.Signs and symptoms of nutrition problems already cumulation of subjective and objective changes in the patient's health status that indicate a nutrition problem in our results of the identified etiology.
25.Objectives of the health care plan or design to meet identified needs of the patient.
26.Psychological and emotional problems can weigh heavily on the overall outcome of a patient's prognosis and well-being.
27.By considering the patient's personal goals and needs, the healthcare team and patient can help establish priorities for immediate and long-term care.
28.The primary principle of diet therapy is that it is based on a patient's normal nutrition requirements and is only modified as individual's specific condition requires.
29.Successful nutrition therapy can occur only when the diet is personalized.
30.When a patient cannot eat, but the remaining portions of the G.I. Tract can be used, and alternate form of enteral feeding by tube provides nutrition support.
31. If the patient cannot tolerate food or formula through the G.I. Tract, intravenous feeding is necessary.
32.Compared with tube feeding, parenteral feedings are more invasive and expensive and introduce more risk.
33.The nurse should be particularly familiar with food drug interactions because he or she is most commonly administering both items to patients.
34.Interactions in which food increases or decreases the effect of a drug can adversely influence the health of the patient.
35.Certain foods may affect the absorption, distribution, metabolism, or elimination of a drug thus altering the intended dose response.
36.Drug nutrient interactions primarily refer to reactions that occur when medications are taken in combination with over-the-counter vitamin and mineral supplements.
37.Drug nutrient interactions may result in a depletion of a nutrient, or the vitamin may induce a change in the rate of metabolism of the drug.
38.Interactions involving prescription drugs and herbs are the least well-defined drug interactions.