University of the Visayas

Cebu City, Philippines

College of Nursing – Graduate Studies

PSYCHOPATHOPHYSIOLOGY IN MS
(CHRONIC DISORDERS)
FINALS

SUBMITTED BY: NINA HAMILI G. PIAO BSN RN

SUBMITTED TO: DR. BETTY GARINGO

 University of the Visayas
Cebu City, Philippines
College of Nursing – Graduate Studies

Nsg. 514

FINAL EXAM

I. ESSAY: Briefly discuss the following:

1. Share related cases and situation encountered in your field of practice the following chronic
diseases.
a. Neurological disorder
I was assigned to the Private Ward. We had a patient who was suffering from Multiple
Sclerosis. She was 29 years old, married and had 2 kids. She was admitted with continuous
ambubagging since our hospital had no mechanical ventilator. Fortunately, she was
breathing well but need ed assistance. That’s because her paralysis has already ascended
and breathing spontaneously is no longer possible. After a few days, she had acquired
Pulmonary Tuberculosis due to her low immune system and the doctors had to attach a
Open Chest Tube to drain the water and blood from her lungs due to pulmonary effusion.
After a few more weeks tracheostomy was done since oral airway is just temporary and she
need a permanent airway. It went well and we had to do tracheal care every shift.

b. EENT
I had a patient with Ménière's disease -a disorder of the inner ear that causes severe
dizziness (vertigo), ringing in the ears (tinnitus), hearing loss, and a feeling of fullness or
congestion in the ear. Ménière's disease usually affects only one ear. It was so severe that
the patient had to be hospitalized. She was in her 40’s and we administered antivertigo
meds on time to prevent the recurrence of signs and symptoms.

c. Musculoskeletal
I had a patient with gout is a type of arthritis that causes inflammation, usually in one joint,
that begins suddenly. Gouty arthritis is caused by the deposition of crystals of uric acid in a
joint. Gout can cause symptoms and signs such as. It was so severe that there were
deformities that you can see and appreciate. The patient had to take pain relievers to
relieve the pain caused by gout. I also made sure that the patient understood the
importance of having a low purine diet.

2. Give a latest update on chronic disease under the alternation in Inflammatory and Immunologic
and Cellular.
(please see attached page)
 University of the Visayas
Cebu City, Philippines
College of Nursing – Graduate Studies

Immune System Targets Diverse Viruses Using the Same Small Peptide
A single receptor on natural killer cells recognizes an amino acid sequence conserved across
Zika, dengue, and related pathogens.

Reference: M.M. Naiyer, “KIR2DS2 recognizes conserved peptides derived from viral helicases in
the context of HLA-C,” Science Immunology, 2:eaal5296, 2017.

Killing machines
Natural killer (NK) cells help fight viral infections as part of the body’s innate immune response.
Activation of these cells depends partly on a set of NK cell-surface proteins called activating
killer cell immunoglobulin-like receptors (KIRs). But how activating KIRs recognize pathogens is
poorly understood.

Searching for a match

While screening for viral peptides that stimulate one receptor, KIR2DS2, hepatologist Salim
Khakoo’s group at the University of Southampton, U.K., stumbled across an amino acid
sequence that appears highly conserved across multiple flaviviruses, from Zika to Japanese
encephalitis. “There are about 63 different flaviviruses, and they almost all have this five-amino-
acid sequence,” says Khakoo. “We were absolutely astonished.”

One size fits all

Using human cell lines, the team showed that major histocompatibility complex proteins—
important components of the vertebrate immune system—on virus-infected cells present this
sequence to KIR2DS2, which then activates NK cells to inhibit viral replication. The fact that
multiple viruses stimulate the same receptor suggests the possibility of developing broadly
antiviral therapeutics, Khakoo says. “We’re working on ways of using this knowledge to activate
natural killer cells, and develop a natural killer cell–based vaccine strategy.”

Out of lines
KIR researcher Marcus Altfeld of the Leibniz Institute for Experimental Virology in Germany says
he’s impressed by the study’s description of KIR2DS2’s mechanism of action. However, he notes,
“cell lines create a bit of an artificial system. . . . The next challenge will be to see whether these
responses can be seen in cells from a patient.”