MSN 570 Week 1 DQ (GRADED A) | Cellular Biology and Case Study Discussion

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MSN 570 Week 1 DQ (GRADED A) Week 1 Cellular Biology and Case Study Discussion Humans are made up of trillions of cells; the basic unit of life. Within the field of biology, morphology of ... cells is the study of form, shape, size and arrangement of cells to determine their function, development and relationships between their structures. (Kamada et al., 2016) Different cell types vary from spherical to rod shape and carry out different roles in a living organism. In his article “Introduction to Mammalian Cell Culture”, Dr. Christopher Greb discusses three cell structures which includes fibroblastic-like cells, epithelial-like cells, and lymphoblast-like cells. According to Dr. Greb, “Fibroblastic-like cells are bipolar or multipolar and elongated in shape. Fibroblasts secrete the extracellular matrix and are part of the connective tissue which protects, support and insulate cells. Epithelial-like cells appear more regular in dimension, polygonal in shape and acts as a protective barrier for open orifices. Lymphoblast-like cells that are spherical in shape and does not attach to a surface in comparison to the first two structures. The most common example of this is a blood cell that delivers nutrients and oxygen to other organs of the body.” (2017) It is essential to understand the morphology of cells because it helps the clinician identify, classify and determine if a cell is functioning healthy or deteriorating, that can affect the health of the host. (Casares et al., 2019) Retinoblastoma Case Study A 2 two-year-old male presents with a retinal tumor and ultimately Retinoblastoma. Retinoblastoma is a rare type of pediatric cancer typically diagnosed before the age of five, affecting the retina of commonly one eye of the child but other times can be seen on both eyes. Most cases of Retinoblastoma are non-hereditary but if passed down through the genes it follows an autosomal dominant pattern. (National Institutes of Health, 2020b) The retinoblastoma gene (RB1) is classified as tumor suppressor that functions as cell growth regulator and slows cells from dividing rapidly. (Mallipatna et al., 2016) RB1 gene contains pRB protein that provides instructions on cell regulation, when RB1 gene mutations occur this protein is suppressed hence resulting to uncontrolled cell division that forms a cancerous tumor. (Mallipatna et al., 2016) Typically only one eye is affected because only one allele mutates; however, some instances where both alleles mutate or a second a second mutation of another RB1 gene happens then the child develops retinoblastoma in both eyes. (National Institutes of Health, 2020b) Germline mutation is a single gene such as autosome that is inherited form either parent while somatic mutation results from the failed process of meiosis and occurs spontaneously on somatic cells. (Ghassemi et al., 2014) Retinoblastoma can result from either a germline or somatic mutation because it can be hereditary and non-hereditary. (Dlugasch & Story, 2019) As mentioned above, pRB protein directs the pathway for cell growth regulation. Besides this, pRB protein initiates DNA replication which is essential to a cell survival, maturity and death. (National Institutes of Health, 2020a) Reference: Casares, D., Escriba, P., & Rossello, C. (2019). Membrane lipid composition: Effect on membrane and organelle structure, function and compartmentalization and therapeutic avenues. International Journal of Molecular Science, 20(9), 2167. doi: 10.3390/ijms20092167 Dlugasch, L., & Story, L. (2019). Applied pathophysiology for the advanced practice nurse. Burlington, MA: Jones & Bartlett Learning. Ghassemi, F., Chams, H., Sabour, S., Karkhaneh, R., Farzbod, F., Khodaparast, M., Vosough, P. (2014). Characteristics of germline and non-germline retinoblastomas. Journal of Ophthalmic & Vision Research, 9(2), 188-194. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181201/#:~:text=The%20term %20%E2%80%9Cgermline%20mutation%E2%80%9D%20in,of%20concern %20harbors%20the%20mutation. Greb, C. (2017, August 10). Introduction to mammalian cell culture. https://www.leica- microsystems.com/science-lab/introduction-to-mammalian-cell-culture/ Kamada, R., Tano, F., Kudoh, F., Kimura, N., Chuman, Y., Osawa, A., Namba, K., Tanino, K., & Sakaguchi, K. (2016). Effective cellular morphology analysis for differentiation process by a fluorescent 1,3a,6a-triazapentalene derivative probe in live cells. PLoS ONE, 11(8), 1-13. https://doi:10.1371/journal.pone.0160625 Mallipatna, A., Marino, M., Singh, A. (2016). Genetics of retinoblastoma. Asia-Pacific Journal of Ophthalmology, 5(4), 260-264. doi: 10.1097/APO.0000000000000219 National Institutes of Health. (2020, August 17). RB1 gene. https://ghr.nlm.nih.gov/gene/RB1#:~:text=Normal%20Function,or%20in%20an %20uncontrolled%20way. National Institutes of Health. (2020, August 17). Retinoblastoma. https://ghr.nlm.nih.gov/condition/retinoblastoma#genes Great discussion post Deborah! We listed the same processes of differential diagnosis used in the clinical setting which are pattern recognition and non-analytical diagnostic approach. Pattern recognition is where in the clinician relies on recognizing and grouping signs and symptoms that often appear together to make a disease diagnosis. A benefit to this model is there is rapid matching of disease pattern previously seen and diagnosed. A risk is without a keen and experienced clinician a sign or symptom might be missed that can result to a different diagnosis. (Yazdani, Hosseinzadeh & Hosseini, 2017) Differential diagnosis is significant because it enables appropriate testing to rule out other medical condition and confirm a final diagnosis. (Stern, Cifu & Altkorn, 2019) An example of pattern recognition used in clinical setting is when a healthcare provider classifies that similar symptoms can appear in diseases like rheumatoid arthritis, Lyme disease and fibromyalgia but ultimately knows that the defining symptom for Lyme disease is a bull eye rash. Reference: Stern, S. D., Cifu, A. S., & Altkorn, D. (2019). Symptom to diagnosis an evidence based guide (4th ed.). McGraw Hill Professional. Yazdani, S., Hosseinzadeh, M., & Hosseini, F. (2017). Models of clinical reasoning with a focus on general practice: A critical review. Journal of advances in medical education & professionalism, 5(4), 177–184. Great discussion post Alyssa! Differential diagnosis is when a healthcare professional narrows a list of possible diseases that are causing a patient’s symptoms. Differential diagnosis is a process of recognizing and categorizing possible health condition based of patient’s reported symptoms, medical history, physical examination finding and diagnostic testing to reach a final diagnosis. (McCance and Huether, 2014) One process of differential diagnosis is analytical model, a clinical reasoning that is hypothesis driven. A benefit of this is within a few minutes of encounter with a healthcare clinician several diagnostic hypotheses is generated. A risk of this model is that it bypasses the traditional approach of first gathering thorough medical information and performing physical assessment prior to a diagnosis. (Yazdani, Hosseinzadeh & Hosseini, 2017) An example of hypothesis driven approach is when a pediatric patient comes in for a rash on his lower extremities an experience clinician knows that differential diagnosis for this symptom could include immune thrombocytopenic purpura, Henoch-Schonlein purpura and papular-purpuric gloves. Reference: McCance, K. L., & Huether, S. E. (2014). Pathophysiology: The biologic basis for disease in adults and children. Elsevier Health Sciences. Yazdani, S., Hosseinzadeh, M., & Hosseini, F. (2017). Models of clinical reasoning with a focus on general practice: A critical review. Journal of advances in medical education & professionalism, 5(4), 177–184. Great discussion post Aaron! Within the field of biology, morphology of cells is the study of form, shape, size and arrangement of cells to determine their function, development and relationships between their structures. (Kamada et al., 2016) In your chosen case study where the 15-year-old male patient who presents after ingesting windshield wiper fluid to get high. Advance nurse practitioners should know that windshield wiper fluid contains methanol that is poisonous when ingested and causes multiple organ failure. When this happens, the solvent methanol starts to move through the cell membrane to maintain the cell osmolarity. (Duglash & Story, 2021) Osmolarity is a measure of how concentrated a solvent is. Liver cells primarily metabolizes and detoxifies the blood from methanol and other harmful substance. (Duglash & Story, 2021) It is essential to understand the morphology of cells because it helps the clinician identify, classify and determine if a cell is functioning healthy or deteriorating, that can affect the health of the host. (Casares et al., 2019) Reference: Casares, D., Escriba, P., & Rossello, C. (2019). Membrane lipid composition: Effect on membrane and organelle structure, function and compartmentalization and therapeutic avenues. International Journal of Molecular Science, 20(9), 2167. doi: 10.3390/ijms20092167 Dlugash, L. & Story, L. (2021). Applied pathophysiology for the advanced practice nurse. Jones& Bartlett Learning. Kamada, R., Tano, F., Kudoh, F., Kimura, N., Chuman, Y., Osawa, A., Namba, K., Tanino, K., & Sakaguchi, K. (2016). Effective cellular morphology analysis for differentiation process by a fluorescent 1,3a,6a-triazapentalene derivative probe in live cells. PLoS ONE, 11(8), 1-13. https://doi:10.1371/journal.pone.0160625 Great discussion post Nicole! Humans are made up of trillions of cells; the basic unit of life. Within the field of biology, morphology of cells is the study of form, shape, size and arrangement of cells to determine their function, development and relationships between their structures. (Kamada et al., 2016) It is true that morphological aberrations in cells can result to neoplasia, metaplasia, atrophy, hypertrophy and neighboring mutations. In your chosen case study, an 18-year-old male presents with ADHD, small testes, learning disabilities and after a workup it is determined that he has a kerotype 47 XXY. The abnormality is caused by an error during cell division, wherein there is a maldistribution of X chromosome among developing reproductive cells. (Bonomi et al., 2016) Unfortunately most genetic diseases are irreversible but with new technology being tested such as gene therapy, researchers are finding a way to mediate DNA aberrations. Reference: Bonomi, M., Rochira, V., Pasquali, D., Balercia, G., Jannini, E. A., & Ferlin, A. (2016). Klinefelter syndrome (KS): genetics, clinical phenotype and hypogonadism. Journal of Endocrinological Investigation, 40(2), 123-134. https:/doi:10.1007/s40618-016- 0541-6 Kamada, R., Tano, F., Kudoh, F., Kimura, N., Chuman, Y., Osawa, A., Namba, K., Tanino, K., & Sakaguchi, K. (2016). Effective cellular morphology analysis for differentiation process by a fluorescent 1,3a,6a-triazapentalene derivative probe in live cells. PLoS ONE, 11(8), 1-13. https://doi:10.1371/journal.pone.0160625 [Show More]

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