ISSUES IN HEALTH FINAL

abortions utilizing, dilation and extraction (D&X) also referred to as partial birth abortion is typically performed when?

after 21 weeks of pregnancy

what is the current position of the ASRM regarding the status of human embryos?

an embryo, prior to the development of a neural streak, has a lesser status than adults and children and should be regarded as worthy or special respect but not the same rights as persons

which of the following is NOT true regarding the characteristics of the fetus at the end of the first trimester?

baby begins to hear and swallow **fetus is approx. 3 inches, movement has begun, heart is beating, fingers and toes have formed ARE

hemophilia A and B

bleeding disorders

which type of cancer is the most common cause of death in children (age 0-14) in the US?

brain cancer

apoptosis differs from cell death caused by injury because the apoptotic cells...

break into small fragments

what represents the type of cancer with the highest incidence in women in order?

breast, lung, colon, rectum

the current Highly Active Anti-Retroviral Therapy (HAART) primarily consists of?

combinations of multiple nucleoside and non-nucleoside reverse transcriptase inhibitors

this type of ethics seeks to determine which choice or decision would result in the greatest good

consequentialism

duties of the trainee in a successful mentor/trainee relationship do NOT include?

continually negotiating agreements established for authorship and ownership **doing assigned work in a conscientious way, respecting the authority of others working in the research setting, and following research regulations and research protocols ARE

according to the American Heart Association the type of CVD that accounts for the most number of deaths is?

coronary heart disease

the committee on bioethics from UNOS recommends what method as the best alternative for increasing organ donation in the US?

creating a required response

Prader Willi/Angelman syndromes

decreased motor skills, cognitive impairment, early death

the 5th case study illustrates the idea that...

demonstrates that complex and contradictory patents on research tools can hinder the development of new treatments

what department of the US government is primarily responsible for overseeing the nation's health?

department of health and human services

drug discovery

discovering and bringing one new drug to the public typically costs a pharmaceutical or biotechnology company nearly $1.8 billion and takes an average of 10-12 years

cystic fibrosis

disease of lung and pancreas resulting in thick mucous accumulations and chronic infections

preclinical technology

during the preclinical development of a drug, laboratory tests document the effect of the investigational drug in living organisms (in vivo) and in cells in the test tube (in vitro)

pregnancy is diagnosed clinically when?

elevated levels of hCG are detected and verified by ultrasound

alpha-1-antitrypsin deficiency

emphysema and liver disease

gaucher disease

enlarged liver and spleen, bone degeneration

hereditary hemochromatosis

excess iron storage disorder

as stated in class, most home diagnostic kits are designed to err by providing a ______ result

false-positive

tay-sachs disease

fatal neurological disease of early childhood; seizures; paralysis

chemical composition of marijuana

- 400+ chemicals ~60 fit into category known as cannabinoids - THC is active ingredient

genetic transfer

- conjugation (plasm transfer) - transformation (transfer of free DNA) - transduction (transfer by delivery)

can DNA be patented?

- patents have been used for over a century to protect a wide range of inventions including new medicines, new materials, and new machines - naturally-occurring phenomena such as electricity or wild species of plants or animals are not regarded as inventions, but as discoveries and are thus not eligible to be patented - in general, raw products of nature are not patentable, DNA products usually become patentable when they have been isolated, purified, or modified to produce a unique form not found in nature - over 3 million genome-related patent applications have been filed

phase II clinical studies

- phase II studies are designed to determine effectiveness and further study the safety of the candidate drug in humans - depending upon the type of of investigational drug and the condition it treats, this phase of development generally takes up from 6 months up to 3 years - testing is conducted with up to several hundred patients suffering from the condition the investigational drug is designed to treat - this testing determines safety and effectiveness of the drug in treating the condition and establishes the minimum and maximum effective dose - most phase II trials are randomized or randomly divided into groups, one of which receives the investigational drug, one of which gets a placebo containing no medication and sometimes a third that receives a current standard treatment to which the new investigational drug will be compared - in addition, most phase II studies are double-blinded, meaning that neither patients nor researchers evaluating the compound know who is receiving the investigational drug of placebo

phase IIIB/IV studies

- phase IIIB trials, which often begins before approval, may supplement or complete earlier trials by providing additional safety data or they may test the approved drug for additional conditions for which it may prove useful - phase IV studies expand testing of a proven drug to broader patient populations and compare the long-term effectiveness and/or cost of the drug to other marketed drugs available to treat the same condition

argument for why marijuana should be illegal

- physical effects - psychological effects - crime - use by minors - legalization of marijuana as tactic to legalize all drugs - legalization = increased use = increased levels of addiction

methods of weed delivery - ingesting

- physically ingest - alternative to smoking - does not expose other chemicals to lungs - stronger, longer lasting effects - THC enters bloodstream through stomach - carried to liver and then to body **other methods: topical agents, nasal sprays

safety

- the term safety is often used in a simplistic and misleading manner - safety depends on many particulars of the individual case - humans with vascular problems reduce risks of thrombosis by ingesting small amounts of rat poison (Warfarin)...large amounts would be deadly - dosage and condition are just 2 of the many factors that affect safety - increased potency = danger

what percentage of infertility cases are typically treated in vitro fertilization or similar treatments?

3%

which of the following are potential targets for the treatment of HIV?

ALL OF THE ABOVE: reverse transcriptase, fusion proteins, integrase

what is considered a risk factor for infertility?

ALL OF THE ABOVE: smoking, low body weight, overweight, sexually transmitted infections

the effects of cancer on an individual is dependent on?

ALL OF THE ABOVE: the stage of the disease, the type of treatment, the type of cancer

people with a mutation of what protein seem to have some protection against HIV infection?

CCR5

fanconi amenia, group C

anemia, leukemia, skeletal disformities

compared to the prevalence of obesity in children over the last 30-40 years, the prevalence over the last 10 years has...

continued to rise at a lower rate (plateau)

ataxia telangiectasia

progressive brain disorder resulting in loss of muscle control and cancers

HIV mutates rapidly because?

reverse transcriptase lacks proof-reading capability

HIV was first identified in the US in?

the early 1980s

what best represents the limit of viability?

time of gestation in which the likelihood of survival of the fetus is 50%

what is NOT a main function of apoptosis?

to prevent cells from becoming infected with a virus **to aid in development, to destroy cells infected with a virus, to remove immune cells in response to infection as the infection subsides ARE

neurological effects of marijuana

- cannabinoid receptors - effects: short-term memory, problem solving, learning, coordination (hippocampus, cerebellum, basal ganglia) - normal NT anandamide - group of chemicals called cannabinoids - THC is a cannabinoid - when present, THC binds to cannabinoid receptors (CB1 and CB2) in place of anandamide - interferes with normal neural pathway/activity

types/timing of testing

- carrier screening, which involves identifying unaffected individuals who carry one copy of a gene for a disease that requires 2 copies for the disease to be expressed - preimplantation genetic diagnosis - prenatal diagnostic testing - newborn screening - presymptomatic testing for predicting adult-onset disorders such as HD - presymptomatic testing for estimating the risk of developing adult-onset cancers and AD - confirmational diagnosis of a symptomatic individual - forensic/identity testing/parental - pharmacogenetics

physiological effects of marijuana

- complex CV response - Triphasic - relaxation, haziness, lightheadedness - red eyes, dilation - increased intensity of senses - paranoia, panic - problems with memory and learning - distorted perception - difficulty with thinking and problem solving - loss of coordination - dry mouth - increased appetite, thirst

cons to patenting

- discourages innovation - prevents or hinders development of new or improved medicines and treatments (secrecy issues) - limits access to healthcare by increasing the cost of diagnostic tests and treatment for certain diseases - exploits information and materials and inhibits their free exchange between researchers - extensive and costly legal battles - partial patients can penalize those discovering biological function/application - patenting a part of nature (one organism owns a part of all or another organism) - patenting before or instead of publishing

combating antibiotic resistance

- education of physicians and patients - more frequent hand-washing by health care workers - quick identification and isolation of patients with resistant strains (better tracking and surveillance) - improvements in sanitation in developing countries - government incentives for the development of new antibiotics - careful food preparation and analysis of agricultural use

identification of targets

- established (a previously known and extensively researched target for therapy like cholesterol, inflammation) - new (newly identified proteins or protein functions based on basic scientific research (sirtuins, caveolin)

GINA - Genetic Information Nondiscrimination Act (May 2008)

- forbids insurance companies from discriminating through reduced coverage or pricing and prohibits employers from making adverse employment decisions based on person's genetic code - in addition, insurers and employees are not allowed under the law to request or demand a genetic test

gene

- functional and physical unit of heredity - pieces/segments of DNA - contain information for making a specific protein - allele = variant of a specific gene that specifies a particular trait - humans have 25,000 genes

types of gene-related patents

- gene fragments (ESTs - expressed sequence tags) - SNPS (single nucleotide polymorphisms) - gene tests - proteins - stem cells

chromosomes

- package of genes/DNA - humans have 46 (23 pairs)

newborn screening

- state laws (mandatory for various tests in most states) - cost (who pays? cost/benefit analysis) - respect of human rights (mandatory tests not consistent with human rights, screening benefits the individual, not necessarily society (no imminent harm to others)

post-market studies

- test a marketed drug in new age groups or patient types - some studies focus on previously unknown side effects or related risk factors - as with all stages of drug development testing, the purpose is to ensure the safety and effectiveness of marketed drugs

rights to genetic information & gene patenting

- the individual researcher - the institution with whom they are affiliated - funding organization - individual(s) from whom genetic material was obtained

chemistry manufacturing and controls CMC/pharmaceutics

- the results of preclinical testing are used by experts in pharmaceutical methods to determine how to best formulate the drug for its intended clinical use - a drug that is intended to act on the sinuses may be formulated as a time-release capsule or as a nasal spray - regulatory agencies require testing that documents the characteristics - chemical composition, purity, quality and potency of the drug's active ingredient and of the formulated drug

Vioxx

- treats primarily arthritis - cyclooxgenase-2 (COX-2) selective inhibitor - withdrawn from market in 2004 - appear to increase the risk of CV effects - Merck initiated withdrawal - FDA currently supports the return of Vioxx to the market (benefits outweigh the risks for some patients)

tracking/surveillance for antibiotic resistance

- typically occurs on a local (hospital) level - 1996 National Antimicrobial Resistance Monitoring System

basic ethical stance on transgenic art

- use alternative whenever possible - legal requirement for documentation of a SEARCH for alternatives and an explanation for why these alternatives were incorporated into the experimental design

mechanisms of action of antibiotics

1. inhibition of nucleic acid synthesis 2. inhibition of protein synthesis 3. action on cell membrane 4. interference with enzyme system 5. action on cell wall

the median time between untreated HIV infection and the development of AIDS is?

10-12 years

according to the reading "Are We Equal in Death?", which of the following is necessary for a diagnosis of brain death?

ALL OF THE ABOVE: absence of brainstem activity, absence of motor responses, a repeat evaluation in ~6 hours with no change in symptoms/diagnosis

which of the following would be an argument for the concept of presumed consent for organ donation?

ALL OF THE ABOVE: asking for consent from the family members may be difficult, individual choice can be respected, individuals owe society the effort to register their objection, increase organ donation

areas of consideration in responsible conduct of research include?

ALL OF THE ABOVE: protection of human subjects, animal welfare, conflict of interest, and data management

what was the first country in the world to offer medical marijuana to its patients?

Canada

true or false: if two individuals are both infected with HIV, then condom use is no longer necessary to prevent infection

FALSE

what is NOT one of the four principles of principlism in bioethics?

NONE OF THE ABOVE: autonomy, beneficence, non-maleficence, justice

what is NOT one of the shared values in the responsible conduct of research?

NONE OF THE ABOVE: honestly, accuracy, efficiency, objectivity

what state was the first to pass a law legalizing physician assisted suicide?

Oregon

true or false: one of the main mechanisms for the loss of uninfected CD4+ cells in individuals with HIV is apoptosis

TRUE

true or false: transcriptions of the viral DNA may be increased due to increased cytokine secretion in response to infections

TRUE

true or false: voluntary, passive euthanasia is legal in the US

TRUE

why "if it were legal I wouldn't do it" is false

- 1975 legalization of marijuana...1988 use by 12-17 yr olds = 2x's national avg. - netherlands: legalized from '84-'96, lifetime use in '84 = 15%, lifetime use in '96 = 44%

medical marijuana today

- 29 states with legalized medical marijuana use - 2015 affirmative defense law for CBD and THC-A oils for treatment of epilepsy passed in VA - 2017 of repeal of smoke a joint, lose your license - 2017 VA Crime Commission study (studying decriminalization)

trisomy

- 3 copies of a chromosome - down's syndrome (trisomy 21) - trisomy 13 (Patau)

crime, violence, and drug use go hand-in-hand

- 40% of adult males tested positive for marijuana at the time of their arrest - marijuana is the first illegal drug teens use - there have been increasing numbers of junior high students using it - "gateway drug"

diseases treated by marijuana

- AIDS - glaucoma - cancer - MS - epilepsy - chronic pain - arthritis, migraine, menstrual cramps, alcohol and opiate addiction, depression and mood disorders

what is NOT one of the genes discussed in the reading on gene patenting?

- CD4+ **BRCA1, CCR5, and MSP-1 ARE

american support for marijuana

- CNN/TIME poll on Nov. 4, 2002 found that 80% of Americans believed that adults should be allowed to use marijuana for medicinal purposes if their doctor prescribes it - 2004 Squibb Howard Texas poll reported 75% support - over decade support has been between 60-80%

genetic information in the public domain

- GenBank - PubMed - Human Genome Project Information

Investigational New Drug (IND)/Clinical Trial Exception (CTX)/Clinical Trial Authorization (CTA) applications

- INDs, CTXs, and CTAs are examples of requests submitted to appropriate regulatory authorities for permission to conduct investigational research - the research can include testing of a new dosage form or new use of a drug already approved to be marketed

new drug application (NDA)/marketing authorization application (MAA)

- NDAs, MAAs - such applications document safety and efficacy of the investigational drug and contain all the information collected during the drug development process - at the conclusion of successful preclinical and clinical testing, this series of documents is submitted to the FDA in the US or to the applicable regulatory authorities in other countries - the application must present substantial evidence that the drug will have the effect it is represented to have when people use it under the conditions for which it is prescribed, recommended, or suggested in the labeling - obtaining approval to market a new drug frequently takes between 6 months and 2 years

predictions for antibiotic resistance

- WHO = some diseases will have no effective therapies within the next 10 years - emergence of vancomycin resistant strains

transgenic art

- a new art form based on the use of genetic engineering to transfer natural or synthetic genes to an organism, to create unique living beings - "Alba" - the transgenic rabbit - cells express the gene for EGFP, an enhanced version (i.e. a synthetic mutation) of the original wild-type green fluorescent gene found in the jellyfish Aequorea Victoria

ethical issues with genetic testing

- accuracy of testing - privacy and confidentiality - uncertainties regarding decision-making - reproductive issues - discrimination - psychological impact - social stigmatization

chimera

- an organism, organ ,or part consisting of 2 or more tissues of different genetic composition, produced as a result of organ transplant, grafting or genetic engineering - a substance, such as an antibody, created from the proteins or genes or 2 different species - an individual who has received a transplant of genetically and immunologically different tissue - a fanciful mental illusion or fabrication

target prioritization/validation

- analysis and comparison of each drug target to others based on their association with a specific disease and their ability to regulate biological and chemical compounds in the body - tests are conducted to confirm that interactions with the drug target are associated with a desired change in the behavior of disease cells

ted slavin

- born a hemophiliac - exposed to hep B virus and later blood tests show extremely high concentrations of hep B antibodies - doctor informs Ted of the blood test and his blood's potential value - ted sells blood to pharmaceutical companies and partners with others to form a company - uncovers link between hep B and liver cancer and creates first hep B vaccine

diseases for potential treatment for medical marijuana

- glaucoma (eye pressure) - cancer and AIDS (nausea and appetite) - epilepsy (muscle spasm relief) - multiple sclerosis (muscle spasm relief) - OVERALL PAIN RELIEF

john moore

- hairy-cell leukemia that filled spleen with cancer cells - signed consent to have spleen removed and discarded by hospital - follow up appts for samples for 7 years - grew suspicious when asked to sign a consent form - Mo cell line and commercial interests showed contracts valuing ~$3.5 million with estimated market value at $3 billion - couldn't sell his own cells because it violated Golde's contract (cancer researcher) - sued and 7 years later final ruling by CA supreme court ruled that tissues removed with or without consent during treatment are considered waste but did cite the lack of informed consent

drug design vs. screening

- high throughput screening (large numbers of related chemical compounds are screened for their effect on a particular target) - natural products - virtual high throughput screening - ADME - Absorption, Distribution, Metabolism, Excretion (Toxicology)

overview of drug discovery

- identification or targets and candidates - synthesis - characterization - screening - therapuetic efficacy - drug development/clinical trials

psychological effects of marijuana

- impaired memory and learning - loss of concentration - loss of motivation - indecisiveness - euphoria - hallucinations - depersonalizations - paranoia

medical use of marijuana in the news

- in the US, the use of cannabis for medical purposes is legal in 29 states, plus the territories of Guam and PR, and DC as of April 2017 - public support for allowing the medical use of cannabis has remained strong since Gallup first polled the subject in '99, finding 73% in favor

mechanisms of antibiotic resistance

- inactivation or destruction - efflux

therapeutic efficacy

- increase activity against the chosen target - reduce activity against unrelated targets - improve the "drug-like" or ADME properties of the molecule

genetic testing

- information on various traits and characteristics - screen for future/potential health risks - predict how you'll respond to medication (pharmacogenetics) - information on ancestry - forensics

gene-probing study March 27, 2013

- largest gene-probing study ever done has fished out dozens of new genetic markers that flag a person's susceptibility to breast, ovarian, and prostate cancer - the 74 newly discovered genetic variants double the previously known number for these malignancies, all of which are driven by sex hormones - underscoring the sheer magnitude of the findings, they're contained in 15 scientific papers published simultaneously by 5 different journals

replacement

- lower species - computational/other models

methods of weed delivery - smoking

- most commonly smoked - cigarettes, joints, bongs, etc. - THC enters body through lungs - passes into blood stream (alveoli) - quickly learn to control dosage

is marijuana safe?

- no documented deaths from overdose - aspirin - NSAIDS - tylenol

accuracy of testing

- no regulations are in place for evaluating the accuracy and reliability of genetic testing - genetic testing falls under services regulation by the FDA is limited - companies overreach in their claims regarding the benefits of genetic testing - dubious genetic testing - alternative viewpoint = this represents a power struggle for control over a procedure

factors contributing to the spread of antibiotic resistance

- overuse - improper use - increased numbers of infections - increased numbers of immunocompromised patients - lack of research and development of new antibiotics - veterinary and agriculture antibiotic use - commercial use of antibiotics

patent claims

- patient types: product, process, use - gene sequence - protein product - method of detection, production, or manipulation of the gene/protein

reduction - minimizing numbers used

- performing pilot studies to determine some of the potential problems in an experiment before numerous animals are used - designing a study to utilize animals as their own controls - gathering maximum amount of information from each animal, perhaps gathering data for more than one experiment concurrently - consulting with a statistician to use only the numbers of animals required to achieve significance - minimizing variables such as disease, stress, diet, genetics, etc. that may affect experimental results - performing appropriate literature searches and consulting with colleagues to ensure that experiments are not duplicated - using the appropriate species of animals so that useful data is collected - REPLACEMENT whenever possible

after the FDA (or other regulatory agency for drugs marketed outside the US) approves a new drug...

- pharmaceutical companies may conduct additional studies, including phase IIIB and phase IV studies - late-stage drug development studies of approved, marketed drugs may continue for several months to several years

pharmacology/toxicology

- pharmacological testing determine effects of the candidate drug on the body - toxicology studies are conducted to identify potential risks to humans

phase I clinical studies

- phase I studies are designed to verify safety and tolerability of the candidate drug in humans and typically take 6-9 months - these are the first studies conducted in humans - a small number of subjects, usually from 20-100 healthy volunteers, take the investigational drug for short periods of time - testing includes observation and careful documentation of how the drug acts in the body - how it is absorbed, distributed, metabolized and excreted

antibiotic resistance

- process or state in which microbes previously susceptible to an antibiotic are no longer inhibited or destroyed by that antibiotic - mechanisms of resistance: natural selection (mutation/genetic transfer)

pros to patenting

- promotes investment - rewards routine discovery - protects inventions without secrecy - wasteful duplication of effort is prevented - research is forced into new, unexplored areas

phase III clinical trials

- provide expanded testing of effectiveness and safety of an investigational drug, usually in randomized and blinded clinical trials - depending upon the type of drug candidate and the condition it treats, this phase usually requires one to four years of testing - in phase III, safety and efficacy testing is conducted with several hundreds to thousands of volunteer patients suffering from the condition the investigational drug treats

can patients become addicts to marijuana?

- psychological and physiological effects of stopped usage - irritability, nervousness, depression, anxiety, and even anger - other symptoms are restlessness, severe changes in appetite, violent outbursts, interrupted sleep, insomnia - miss feelings of being high

telomere

- region of highly repetitive DNA at the end of the chromosome - telomere shortening = during each replication part of the DNA is lost/shortened **Hayflick limit = 52 replications - telomere reverse transcriptase (TERT)

4 main attributes of medical marijuana

- relieves nausea, increases appetite - reduces intraocular pressure - reduces muscle spasms - relief of chronic pain

key steps of drug discovery

- research & development (avg. 2-3 years) - pre-clinical testing (avg. 1 year) - clinical trial testing (involving human patients) (avg. 10 years) - regulatory approval (avg. 2 years)

physical side effects of marijuana

- respiratory infections - increased HR - anxiety and panic attacks - decreases immunity - physical dependence/addiction

argument that medicinal marijuana should be legal

- safest therapeutic active substance known - reduces symptoms of numerous diseases and treatments - marinol is a treatment of anorexia associated with AIDS, nausea and vomiting associated with chemotherapy but has NEGATIVE psychological effects and takes longer to work - american support for the legalization of medicinal marijuana - reduced enforcement of laws in regards to marijuana use

health risks of marijuana

- same risks as cigarette smokers - emphysema, bronchitis, bronchial asthma, increased risk of lung damage, cancer - males = linked to decreased testosterone levels, sperm production (reversible)

uncertainties regarding decision-making with genetic testing

- should testing be conducted? - diseases with multiple genetic components - diseases influenced by environment/gene interaction - diseases that have no cure - testing minors for diseases that manifest as adults

marijuana effects over time

- smoking, within seconds - eating, varies (dependent upon digestion) - initial effects wear off within 1-2 hours - THC's terminal half life = 20 hours to 10 days (stored in fat tissues) - all affected by potency, dosage, individual user - once metabolized, byproducts have little effect on body

refinement

1. identifying pain and distress and making plans for preventing or relieving it 2. setting the earliest possible ENDPOINT for the experiment (that is, if the necessary information can be gathered before the animal experiences any ill effects from the experiment, this should be defined as the endpoint and the animal subsequently euthanized) 3. receiving adequate training prior to performing a procedure 4. using proper handling techniques for animals 5. ensuring that drug doses are correct and that the drugs used are not expired 6. ensuring that procedures to be performed on the animal are reasonable for that species 7. using appropriate analgesics and anesthetics for potentially painful procedures 8. performing surgeries and procedures aseptically to prevent infection 9. performing only a single major survival surgery on any one animal, whenever possible 10. performing appropriate post-surgical care, including thermoregulation and fluid balance 11. there are several specific research techniques in common use that are not often criticized for their potential for causing pain or distress to animals

reasons given by eduardo kac for the creation of "alba"

1. ongoing dialogue between professionals of several disciplines and the public on cultural and ethical implications of genetic engineering 2. contestation of the alleged supremacy of DNA in life creation in favor of a more complex understanding of the intertwined relationship between genetics, organism, and environment 3. extension of the concepts of biodiversity and evolution to incorporate precise work at the genomic level 4. interspecies communication between humans and transgenic mammal 5. integration and presentation of "GFP Bunny" in a social and interactive context 6. examination of the notices of normalcy, heterogeneity, purity, hybridity, and otherness 7. consideration of a non-semiotic notion of communication as the sharing of genetic material across traditional species barriers 8. public respect and appreciation for the emotional and cognitive life of transgenic animals 9. expansion of the present practical and conceptual boundaries of artmaking to incorporate life invention

most (89%) abortions in the US occur by _______ of pregnancy

12 weeks

high blood pressure or HTN is clinically diagnosed when a person has consistent blood pressure readings of more than what value?

140/90 mmHg

according to statistics from the CDC, implanting _____ embryos results in the highest percentage of live births

2

medicinal marijuana

2 arguments: - marijuana should not be legal for any purpose - marijuana should be legal for medicinal use

obesity is considered a risk factor for CVD when percent body fat exceeds what threshold?

32% in women

implementation typically occurs when?

6-8 days after fertilization

about what percentage of people 75+ years of age have CVD in the US?

75%

what best represents the percentage of infertility cases treated by conventional medical therapies such as medication or surgery?

85%

the highest abortion ratio (# of abortions/1000 live births) in the US occurs in women aged _________

<15

what best represents the percentage of individuals who die each year while on the waiting list for a solid organ transplant?

<15%

what represents the threshold value for HDL cholesterol that is considered high risk for coronary heart disease?

<40 mg/dL

according to the report, which of the following is NOT called for?

ALL ARE CALLED FOR: increased international and national investment and support in research aimed specifically at improving coverage of health services within and between countries, closer collaboration between researchers and policymakers, i.e. research needs to be taken outside the academic institutions and into public health programs that are close to the supply of and demand for health services, and global and national research networks to coordinate research efforts by fostering collaboration and information exchange

based on the lecture, what is NOT true regarding ethics?

ALL ARE TRUE: it involves systematizing, defending, and recommending concepts of right and wrong conduct, it addresses questions of morality, understanding, and examining moral life, and it is a set of moral principles and a code for behavior that govern an individual's actions with other individuals and within society

which of the following is considered a type of advanced directive?

ALL OF THE ABOVE: a living will, health care proxy/medical power of attorney, do not resuscitate order

which of the following is one of the 5 strategic goals of OPTN/UNOS?

ALL OF THE ABOVE: increase the number of transplants, provide equity in access to transplants, improve waitlisted patient, living donor, and transplant recipient outcomes, and promote living donor and transplant recipient safety

which of the following are non-medical criteria for evaluating transplant candidacy?

ALL OF THE ABOVE: life expectancy, organ failure caused by behavior, compliance/adherence to medical regimen, repeat transplantation

according to the reading "Are We Equal in Death?", which of the following is one of the inconsistencies found among hospitals in determining brain death based on the AAN guidelines?

ALL OF THE ABOVE: paying attention to low body temperature, determining the presence of sedative or paralytic medicines, determining the presence of metabolic disorders

according to the ASRM which of the following are current methods available for pre-pregnancy and pre-birth sex selection?

ALL OF THE ABOVE: prefertilization separation of X-bearing and Y-bearing spermatozoa, preimplantation genetic diagnosis followed by sex selective transfer of embryos, prenatal genetic diagnosis and sex-selective abortion

what is the best interpretation of "ECPs are taken long before organogenesis starts so they should not have a teratogenic effect?

ECPs are taken long before organ development begins so they should not result in increased birth defects

true or false: an individual can become infected by contact with the saliva of an HIV infected person

FALSE

true or false: because mosquitos carry the blood of their victims, they can spread HIV by biting another individual

FALSE

true or false: dedifferentiating somatic cells back to totipotency, avoids the ethical problems associated with the use of embryonic stem cells

FALSE

true or false: nearly 6 in 10 unintended pregnancies end in abortion in the US

FALSE

true or false: unless treated, the viral load or viral burden remains high during the progression of HIV infection to AIDS

FALSE

amyotrophic lateral sclerosis (ALS)

Lou Gehrig's Disease, progressive motor function loss leading to paralysis and death

what is NOT one of the criteria from which the Healthy Diet Score is calculated?

NONE OF THE ABOVE **all include: keeping sodium intake below 1500 mg per day, eating at least 4.5 cups of fruit or vegetables per day, keeping saturated fats to less than 7% of the total calories consumed per day, keeping sugar-sweetened beverages to less than 36 oz per week

which of the following is NOT considered by the PCBE as potential purposes of cloning-to-produce children?

NONE OF THE ABOVE: allow infertile couples or others to have genetically-related children, enable a parent to keep a connection with a dead or dying child or spouse, enable individuals or society to try to "replicate" individuals of great talent or beauty

responsibilities of the reviewer in the peer review process include all of the following EXCEPT?

NONE OF THE ABOVE: assessing whether the research methods are appropriate, checking calculations and/or confirming the logic of important arguments, making sure the conclusions are supported by the evidence presented, and confirming that the relevant literature has been consulted and cited

which of the following is NOT one of the criteria of the above mentioned state's "Death with Dignity Act"?

NONE OF THE ABOVE: be at least 18 years old, be an in-state resident, have a terminal illness with less than 6 months to live, make 3 requests for a prescription (one written and two verbal) with at least 15 days between requests

which of the following is NOT a factor considered when evaluating a convicted criminal for organ transplant?

NONE OF THE ABOVE: increased exposure to infectious disease, psychosocial issues, logistics

which of the following is NOT a potential problem for providing financial incentives to organ donors?

NONE OF THE ABOVE: who pays the organ donor or donor family? how much money is paid for an organ? economic disparities result influencing decisions, potential for coercion

true or false: HIV infection can be detected from a sample of saliva/oral fluids

TRUE

true or false: according to the PRCH, minorities (blacks and hispanics) have a disproportionate number of abortions compared to their proportion of the population and this is due, in part, to a disproportionate number of unintended pregnancies

TRUE

true or false: according to the article by Trussell and Raymond, emergency contraception is a cost-effective approach to abortion

TRUE

true or false: apoptosis triggered by either internal or external signals involves activation of caspases

TRUE

true or false: current cloning techniques do not involve the destruction of an embryo during the first stage when the nucleus of a somatic cell is transferred to a donor egg

TRUE

true or false: in the paper that describes the cloning of dolly, the authors report having greater success producing cloned sheep from fetal fibroblast cells compared to the technique used to clone dolly

TRUE

true or false: inhibition of apoptosis is one potential cause of cancer

TRUE

true or false: oral contraceptive pills containing progestins other than levonorgestrel can be used as emergency contraception

TRUE

true or false: the cancer death rates for men and for women are highest among African Americans in the US

TRUE

true or false: the decision of whether to give a criminal on death row an organ transplant is ultimately left to the transplant team

TRUE

true or false: the third case study examines whether isolating the viral components of HCV is inventive and sufficient to claim rights to any vaccine developed using that sequence

TRUE

which criteria must be met for an HIV positive individual to be diagnosed with AIDS?

TWO OF THE ABOVE idk the 2 but there's 3 answers: a CD4+ helper lymphocyte blood count of <200 per mm3, a serious infection or cancer, significant weight loss

which of the following is true regarding the article "Are we equal in death?": the authors concluded that...

TWO OF THE ABOVE idk which 2 but there are 3 answers: few of the neurology and neurosurgery programs followed the AAN guidelines for brain death, testing for apnea (absence of breathing) was different among centers and suggested a need for standardization, programs varied in the attention paid to low body temperature, sedative or paralytic medicines, or the presence of severe diagnosis

in the response to the article on gender/sex selection, the authors argue that the ASRM's rationale for opposing sex selection based on the concept that one gender will be favored over another is unsound because?

TWO OF THE ABOVE idk which 2 but there are 3 answers: reducing the numbers of one gender will increase the power/influence/value of that gender, in the US, most couples would utilize sex selection to balance the genders of families, population control is necessary

the majority conclusion of the President's Council on Bioethics with regard to human cloning included which of the following?

a four-year moratorium on cloning-for-biomedical-research which has since passed

what is NOT addressed by the Nuremburg Code?

a systematic framework to evaluate bioethical issues **informed consent, the rights of research subjects, and the responsibilities of researchers ARE

based on the article Neuroimaging, Law, and the Vegetative State and the video in class using functional MRI to ask questions of patients in a coma-like state, continued reliance on outwardly observable behaviors to diagnose disorders of consciousness could overlook patients that are?

aware but behaviorally silent

sickle cell disease

blood cell disorder; chronic pain and infections

factor V-Leiden

blood-clotting disorder

pluripotent stem cells are best defined as?

cells that can develop into any cell in the body except the placenta

what was part of the video "if by chance we meet again" about the cloned bull, Second Chance?

chance was cloned by Texas A&M Unviersity because they needed to clone an older animal

based on the terminology used in the President's Council on Bioethics, somatic cell nuclear transfer for production human stem cells would be called?

cloning-for-biomedical-research

inherited breast and ovarian cancer

early-onset tumors of breasts and ovaries

hereditary nonpolyposis colon cancer

early-onset tumors of colon and sometimes other organs

what hormone has been shown to be protective against the development of CVD?

estrogen

the case study involving the patenting of the BRCA-1 gene sequence, mutations, and diagnostic tests...

examines whether a patent on a diagnostic test for a particular genetic disorder prevents other diagnostic tests from being developed even if the original patent is not clearly defined or sufficiently described

the case study involving the gene that codes for the CCR5 receptor...

examines whether patents should be granted for genetic sequences despite the fact that the utility or primary function/importance of that sequence has yet to be identified

what branch of the US government is responsible for implementing health policies?

executive

one mechanism in which apoptosis is triggered by external signals (death activators) is mediated by the...

expression of FasL

gram-positive and gram-negative bacteria

gram-negative do not take up violent stain, have an extra coating, also generally considered more harmful

according to the AHA statistics, which of the following ideal cardiovascular health goals has the highest percentage/prevalence of people not meeting the goal?

healthy diet score

difference between historical and current drug discovery

historical: identification of molecules in traditional therapies, accidental discovery current: identification of mechanisms of disease, targeted drug development

congenital adrenal hyperplasia

hormone deficiency; ambiguous genitalia and male pseudohemaphroditism

according to the world health report, which of the following is NOT one of the challenges cited for most countries?

how to manage the financial needs of defense and healthcare **how to expand health services to meet growing needs with limited resources, how to protect people from infectious diseases, and how to encourage optimum use of available resources ARE

during most of the disease course in the progression from HIV to AIDS the immune system is?

hyperactivated

fertilization normally occurs where?

in the fallopian tubes

which term is best defined as the # of new cases of a condition, symptom, death, or injury that develop during a specific time period, such as a year?

incidence

which of the following is NOT cited as a reason ECPs are "cost-effective"?

increased ECP availability would lead to more diligent use of oral contraceptives **ECPs are more cost-effective than the other type of emergency contraception, insertion of a Copper T IUD when used only in emergencies, ECPs are cost-effective whether they are provided when the emergency arises or as a routine preventative measure, ECPs would be cost effective because the average medical care cost of unintended births is likely to be greater than the average cost of all births ARE

spread of antibiotic resistance

increased use of antibiotics increases the prevalence of resistant strains simply by selection pressure

statistics from the CDC show that over the past 20 years the percentage of people dying at home has _______ and in the hospital has ________

increased, decreased

what best describes the concept of "preferred status" for organ donors?

individuals who opt-in as organ donors are preferred over those who have not

based on discussion in class, what is the most likely reason that Zika virus is one of the most prominent global health issues?

infectiousness

patenting criteria for genetic material

inventors must: 1. identify novel genetic sequences 2. specify the sequence's product 3. specify how the product functions in nature (its use) 4. enable one skilled in the field to use the sequences for its stated purpose

spinocerebellar ataxia, type 1

involuntary muscle movements, reflex disorders, explosive speech

what is TRUE regarding Dilation and Curettage?

involves scraping of the uterine lining

according to the WHO the leading causes of death worldwide in order are?

ischemic heart disease, stroke/cerebrovascular disease, lower respiratory infections, COPD

which of the following is NOT one of the criteria that the ASRM considers necessary for research on embryos to be ethically acceptable?

it is conducted only on embryos specifically produced for research **it is likely to provide significant new knowledge that will benefit human health, it is conducted in ways that accord the embryo respect, it is conducted only on embryos donated by couples who have given informed consent ARE

what organ transplant has the highest percentage of recipients surviving after 1 year?

kidney

adult polycystic kidney disease

kidney failure and liver disease

alzheimer's disease

late-onset variety of senile dementia

charcot-marie-tooth

loss of feeling in ends of limbs

according to the WHO organization what are the leading causes of death for low income countries in order?

lower respiratory infections, HIV/AIDS, diarrheal diseases, stroke

which of the following is NOT a potential harm for LD-PPW?

lower/reduced organ ischemic time **death caused by complications in the removal of organs, potential pain caused to the donor, problems properly identifying candidates as donors ARE

what represents the most common types of cancer-related deaths in men in order?

lung, prostate, colon, rectum

what represents the 3 most likely ways HIV is transmitted among males in the US in order?

male-to-male sexual contact, heterosexual contact, injection drug use

dolly, the sheep, was cloned from what cell type?

mammary epithelium

what is the lifetime probability for men and women of developing cancer?

men 1 in 2, women 1 in 3

neurofibromatosis type 1

multiple benign nervous system tumors that can be disfiguring; cancers

dystonia

muscle rigidity; repetitive twisting movements

which of the following is NOT true regarding the "morning after pill" or Plan B?

must be taken within 24 hours of unprotected sex **contains high doses of normal oral birth control pills, inhibits implantation ARE

which of the following is NOT true regarding medical abortions?

only works by blocking fertilization **may include the use of the drug mifepristone (RU486), can be taken within the first 9 weeks of pregnancy, typically contains high doses of estrogen, progesterone, or both ARE

which type of cancer has the lowest relative survival rate in the US?

pancreas

in class, what was discussed as the most likely reason the National Institute of Allergy and Infectious Diseases (NIAID) is among the highest funded institutes of the NIH?

potential for major outbreaks

what is true regarding the ASRM's recommendations concerning sex selection?

preimplantation genetic diagnosis (PGD) used for sex selection to prevent the transmission of serious genetic disease is ethically acceptable

based on the slides and class discussion, what would be the best description of a "vegetative state"?

presence of arousal, but not the ability to interact with the environment

what is NOT part of the decision making process, ADPIE?

prevention **assessment, diagnosis, evaluation ARE

what is true regarding the reading on the decline in CVD and mortality?

prevention through improvements in primary risk factors accounts for the initial decline

phenylketonuria (PKU)

progressive mental retardation due to missing enzyme; correctable by diet

myotonic dystrophy

progressive muscle weakness; most common form of adult muscular dystrophy

which type of cancer has the highest relative survival rate in the US?

prostrate

thalassemias

reduced RBC levels

what is NOT one of the ways exercise/regular physical activity helps prevent CVD?

reducing blood pressure **aiding in weight management, increasing HDL/lowering LDL cholesterol ARE

bioethical questions...

seek to determine whether biological phenomena should be examined

additional arguments presented in opposition to the ASRM's recommendations regarding sex selection include what?

sex selection is a choice paid for by the individual not by society/taxes

bacteria

single-celled organism found throughout nature and can be both harmful and beneficial to humans

according to the PRCH, which of the following is NOT one of the reasons reported for terminating an unwanted pregnancy in the US?

societal/peer pressure **cannot afford a baby now, baby would interfere with school/employment, having relationship problems, done with child rearing/bearing ARE

which of the following is NOT one of typically reported characteristics of cloned animals?

sterility **obesity, musculoskeletal abnormalities, aggressive behaviors ARE

which of the following is NOT classified as a major risk factor for heart disease (i.e. increases risk by 2-fold?)

stress **high cholesterol, HTN, physical inactivity, smoking ARE

virus

submicroscopic infectious agent consisting primarily of a protein coat surrounding a core of RNA or DNA which is only capable of replicating within living cells

antimicrobial

substance capable of inhibiting or killing a microorganism (bacteria, fungus, parasites, viruses)

antibiotic

substance produced by a microorganism capable of inhibiting or killing another microorganism

assisted reproductive technology (ART) includes:

techniques which involve manipulation/handling of the egg or embryo outside the body

cells making up a tumor in the brain that has metastasized from testicular cancer contains cells that are most like what type of cancer cells?

testicular

the readings evaluating the relationship between running and all-cause mortality suggest?

that running exhibits a j-shaped curve with respect to mortality risk such that running too much or too fast can increase mortality risk

what was NOT part of the Terri Shiavo story?

the legality of her advanced directive **removal of her feeding tube on multiple occasions, a florida state law called "terri's law", and a federal law signed by the president called "Palm Sunday Compromise" ARE

which of the following is NOT a criteria of "Death with Dignity Act"?

the patient must be at least 21 years old **the patient must have a terminal illness with less than 6 months to live, the patient must be an Oregon resident, the patient must make 3 requests for a prescription (one written and two verbal) with at least 15 days between requests, and the prescribing doctor and a consulting physician must confirm terminal diagnosis and prognosis ARE

when determining the timeline for the normal 40 week human gestation period, day 0 is considered to be?

the start of the last menstrual period

animal use & transgenic art

things to consider: - basic competition for resources - treatment of animal reflects moral behavior and potentially treatment of humans - simple balance of survival (survival of the fittest) **problems with unrestricted human exploitation - continuum of "moral value" **based on similarities to humans **evolution

what provides the best description of an angioplasty?

use a fluid filled balloon at the end of a catheter to push open a vessel clogged by plaque

what is DNA banking by governments for?

use for criminal justice, identification, health policy

huntington's disease

usually midlife onset; progressive; lethal, degenerative neurological disease

the distribution of AIDS diagnoses among racial/ethnic groups has changed since the beginning of the epidemic with the percentage of AIDS diagnoses among ________ decreasing and among ________ increasing

whites, blacks/African Americans

one of the main methods of evaluating the quality/importance of a scientific research article is to consider the ________ of the journal in which it is published

impact factor

duchenne muscular dystrophy/becker muscular dystrophy

severe to mild muscle wasting; deterioration; weakness

the death of Karen Ann Quinlan is cited historically for?

the first legal case validating advanced directives