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Chapter 14, Problem 8CCS

10-Year-Old Boy with Spinal Injury

On arrival at Holyoke Hospital, Jimmy Chin, a 10–year-old boy, is immobilized on a rigid stretcher so that he is unable to move his head or trunk. The paramedics report that he was awake and alert after his accident at the skateboard park, but crying and complaining that he couldn't get up and that he had a “wicked headache." He has severe bruises on his upper back and head, and lacerations of his back and scalp. His blood pressure is low, body temperature is below normal, lower limbs are paralyzed, and he is insensitive to painful stimuli below the nipples. Although still alert on arrival, Jimmy soon begins to drift in and out of unconsciousness.

Chapter 14, Problem 8CCS, 10-Year-Old Boy with Spinal Injury On arrival at Holyoke Hospital, Jimmy Chin, a 10year-old boy, is

Jimmy is immediately scheduled for a CT scan, and an operating room is reserved.

Relative to Jimmy's condition:

Two days after his surgery, Jimmy is alert and his MRI scan shows no residual brain injury, but does show pronounced swelling and damage to the spinal cord at T4. On physical examination, Jimmy shows no reflex activity below the level of the spinal cord injury. His blood pressure is still low.

8. How does Jimmy’s excessively high blood pressure put him at risk?

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Imagine that you are a clinical geneticist. Your colleague is an oncologist who wants your help explaining the basics of genetics to their patient, who will be undergoing genetic testing in the coming weeks for possible acute myeloid leukemia (AML) induced by the radiation she had several years ago for breast cancer. Write a 1,050- to 1,225-word memo to your colleague. Include the following in your memo: An explanation of the molecular structure of DNA and RNA, highlighting both similarities and differences  A description of the processes of transcription and translation An explanation of the differences between leading and lagging strands and how the DNA is replicated in each strand Reponses to the following common questions patients might ask about this type of genetic testing and genetic disorder: Does AML run in families? What genes are tested for?
Respond to the following in a minimum of 175 words: What are some potential consequences that could result if the processes of replication, transcription, and translation don’t function correctly? Provide an example of how you might explain these consequences in terms that patients might understand.
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