He similarities and differences between autosomal recessive and sex-linked recessive conditions - Essay Example

By using suitable examples with rationale, discuss the similarities and differences between autosomal recessive and sex-linked recessive conditions. Autosomal recessive conditions manifest themselves only when an individual is homozygous for the affected allele that causes a certain condition. The alleles that cause these conditions are not found on the sex genes (the X or Y chromosomes), and the affects are generally masked in the heterozygous parents who possess both a normal, dominant allele and the affected recessive allele. Only offspring with both recessive alleles, meaning both parents are heterozygous carriers of the recessive genes will be affected. These disorders are present in only about 2.5 per 1000 live births, and will not be manifested is the offspring receives a dominant allele from either parent. Sex-linked recessive conditions are found on the sex chromosomes. Females, who have two X chromosomes will only show the condition if, like autosomal recessive conditions, they inherit a recessive allele from both parents. Males, having only one X chromosome, are always affected by X-linked recessive alleles because they have no other dominant allele to mask the affects of the single affected X chromosome (Kumar and Clark 2009, p. 43). The primary difference between autosomal recessive and sex-linked recessive is how males and females are likely to be affected, and how likely each are to inherit, a condition. Examples of autosomal recessive conditions include cystic fibrosis and sickle cell disease. Examples of sex-linked recessive conditions include hemophilia and red-green color blindness. 2. By using suitable named examples with rationale, discuss the similarities and differences between autosomal dominant and autosomal recessive conditions. Autosomal dominant conditions occur in diploid cells that possess at least one affected allele, meaning that only one parent needs to be affected for the offspring to show symptoms of the disease. If an individual has an autosomal dominant condition, then that individual must have had at least one parent with the condition though if the parent was heterozygous for the condition it may not be passes along to all offspring—only to those that receive the dominant allele. Autosomal recessive conditions however require that both alleles be affected by the condition in order to be expressed. This means that heterozygous parents may be carriers for certain conditions. Only if both parents pass the recessive allele onto the offspring will the offspring express the condition. This results in the chance that two heterozygous parents pass on an autosomal recessive condition of only 25%, whereas there is a 50% chance that a single heterozygous parents will pass on the condition to the offspring (Kumar and Clark 2009, p. 42-43). Examples of autosomal dominant conditions include Huntington’s disease. 3. Describe the differences seen between benign and malignant tumours. Use appropriate examples, with rationale, to support your points. Tumors arise from changes in a single cell that proliferate to affect areas of the body or even the whole body. Oncogenesis is a multistep process in which the malignant phenotype is expressed, which may occur due to both genetic and environmental factors. Anaplasia and metastatis are characteristics of malignant tumors, but no benign tumors. Anaplasia refers to the reversion of cellular differentiation and often includes an increased ability to multiply without differentiation. Metastatsis refers to the capacity of malignant tumor cells to spread across the body to adjacent and non-adjacent organs, often but not always through the bloodstream (Kumar and Clark 2009, p. 49). Benign tumors are nonprogressive and do not metastatis to other areas of the body. Some common examples of benign tumors include the common mole. Moles may sometimes develop malignancy over the course of an individual’s lifetime, however, so regular examinations by a physician are recommended. 4. Define with suitable examples, the following terms: aetiology, acute, chronic, diagnosis, prognosis, iatrogenic and idiopathic. Aetiology is the establishment of the origin or the cause of some condition. In medicine it usually refers to the cause of a certain disease. For instance, there is much debate over the aetiology of cancer, meaning that there is debate over whether the cuase of cancer is environmental or genetic (Kumar and Clark 2009, p.51). Acute conditions are temporary or non-permanent, such as acute respiratory illnesses such at those caused by the common cold virus. The body will almost always be able to eliminate this infection and the causative agent in a short period of time (Kumar and Clark 2009, p.89). Chronic conditions are those that are ongoing or recurrent, as in the case of chronic bronchitis or urinary infections that are caused by ongoing conditions, such as urinary retention in the case of chronic urinary infections (Kumar and Clark 2009, p.89). Diagnosis is the identification of the nature or cause, normally made by a medical professional such as a physician. Proper clinical diagnosis and therapeutic management are essential in patient care (Kumar and Clark 2009, p.3). Prognosis is the expected outcome of an illness or condition. In the case of genetic conditions, it is important that the prognosis be discussed early and freely so that patients can make informed decisions about their health (Kumar and Clark 2009, p.45). Iatrogenic affects are negative effects that follow from medical advice or treatment given by physicians or other healthcare professionals. Post-surgical complications are one example, though more subtle examples include psychological issues or drug-interactions (Kumar and Clark 2009, p.377). Idiopathic conditions are those that seem to arise spontaneously, or from a root cause that is unknown. Idiopathic irritation in the gastrointestinal tract is one example that may be caused by a large variety of factors, many of which are difficult to identify (Kumar and Clark 2009, p.247). 5. Differentiate, with appropriate examples, between the terms acute inflammatory response and acute immune response. An acute inflammatory response is a natural biological process that involves the reaction of macrophages and monocytes to irritants, such as endotoxins and toxins. These irritants may be of biological or another nature. Acute inflammation is the body’s first to harmful stimuli, and its is characterized by increased movement of leukocytes and plasma from the blood into injured tissue, resulting in heat, redness, and swelling that are often visible. This is followed by a biochemical cascade that propogates into the full inflammatory response. Acute infection however involves the response of the immune system to invading pathogens, such as viruses or bacteria. An example of an acute immune response is an acute viral infection response wherein the body mobilizes the immune system to generate pyrogenesis (fever) and other immune responses, such as those of the active immune system (Kumar and Clark 2009, p.86-87). 6. Define and illustrate with suitable examples what is meant by an infection being labelled as epidemic, endemic, pandemic and opportunistic. Epidemics are widespread infections that spread in waves through a community, affecting those that have no active immunity to the infection. The bubonic plague is a historical example of an epidemic infection spread by the fleas on rats (Kumar and Clark 2009, p.83). Endemics are infections that are maintained in the populations without the need for external inputs for the infection. An example is dengue, which is a common arthropod-borne viral infection in humans that occurs by endemic (Kumar and Clark 2009, p.114-115). Pandemics are widespread epidemics that spread across populations over large geographic regions, even continenets. HIV is an example of a pandemic that affects human populations (Kumar and Clark 2009, p.143-145). Opportunistic infections are those caused by pathogens that will normally not cause disease if the host is healthy, but may actively take advantage of weakness in the host, such as a weakened immune system. The herpes viral infection is an example of an opportunistic infection that affects humans (Kumar and Clark 2009, p.70). 7. Describe the pathological differences seen between benign and malignant tumours. Use appropriate examples, with rationale, to support the differences seen. Benign tumors have some signs of differentiation with small-shaped organization, while malignant tumors show large-shaped organization with many differences in the shape and size of cells. Benign tumors no or few regions of nuclear fission, whereas malignant tumors have many, pathological areas of nuclear fission (demonstrating that malignant tumors are growing more). The growth rate of sample cells for benign tumors is slow, whereas malignant tumors have varying rates of growth that are often much faster. In benign tumors the growth mode is on that demonstrates clear boundaries, whereas malignant tumors are invasive and exogenous, with no envelope defining the boundary between the tumor and surrounding tissue. Malignant tumors often demonstrate necrosis and bleeding, as well as the formation of ulcers. Malignant tumors often play a more threatening role to surrounding bodily organs (ALTH 2011, p.1). 8. Differentiate between the terms thrombosis, embolism, gangrene and ischaemia. Use appropriate examples to explain/support your points. Thrombosis is the formation of a blood clot inside of the blood vessels, which then obscures the flow of blood (Kumar and Clark 2009, p.224). Embolism is when a thrombosis breaks free of the local blood vessel and travels within the circulatory system, where it may cause blockage or damage to other areas (Kumar and Clark 2009, p.224). Gangrene is a condition where a large amount of tissue dies, or experience necrosis, which can impact circulation and other bodily functions. The primary cause is injury or illness that reduces blood supply to the tissue, resulting in cell death. Gas gangrene is one specific example caused by deep tissue infection, commonly seen in battlefield wounds that go untreated (Kumar and Clark 2009, p.125). Ischaemia is restriction of blood flow to an area, which may result in damage to the tissue. The restriction of blood flow may be caused by a number of factors, including thrombosis and embolism, but normally involves factors that affect blood flow through the blood vessels. Intestinal ischemia results from failure of arterial or venous flow, and is one example that commonly occurs in humans (Kumar and Clark 2009, p.283). 9. Differentiate, with appropriate examples, between the four types of hypersensitivity reactions seen. Type I hypersensitivity is also known as immediate or anaphylactic hypersensitivity, and is mediated by IgE. The mast cell, or basophil, is the primary component in this response and the mechanism involve preferential production of IgE in response to certain antigens (called allergens). The effects are normally quick after exposure to an antigen and may range from minor inconvenience to death (Ghaffer 2011, p.1). Type II hypersensitivity is also known as cytotoxic hypersensitivity and it may affect many different bodily organs and tissues. The antigens that cause this reaction are normally endogenous to the body, and this reaction is normally mediated by antibodies of the IgM or IgG classes though phagocytes and K may also be involves. Severity varies and treatment normally involves anti-inflammatory or immunosuppressive agents (Ghaffer 2011, p.1). Type III hypersensitivity is also known as immune complex hypersensitivity. The reaction may take three to ten hours after exposure to the antigen. These reactions are mediated by soluble immune complexes, mostly of the IgG class though IgM may also be involved. The antigen may be exogenous such as chronic bacterial, parasitic or viral infections or it may be endogenous such as non-organ specific autoimmunity, for example systemic lupus erythematosus (Ghaffer 2011, p.1). Type IV hypersensitivity is also known as cell mediated or delayed type hypersensitivity. Type IV hypersensitivity is involved in the pathogenesis of many distinct autoimmune and infectious diseases such as tuberculosis, leprosy, blastomycosis, histoplasmosis, toxoplasmosis, leishmaniasis as well as granulomas due to infections and foreign antigens (Ghaffer 2011, p.1). 10. Differentiate, and illustrate with suitable examples, they way bacteria are classified according to shape. The three primary forms of bacteria are cocci (spherical), bacilli (rod shaped), and spiral (coiled or spring-like). Cocci are spherical bacteria classified by the division of their planes into one, two, three, or random planes. An example is Staphylococcus aureus. Bacilli are rod-shaped bacteria that all divide in one plane producing a bacillus, streptobacillus, or coccobacillus arrangement. An example is Escherichia coli. Spirals come in one of three forms, a vibrio, a spirillum, or a spirochete. An example is Treponema pallidum (Bio 141, 2011, p.1). 11. What is meant by the term Virchow’s Triad? Use appropriate examples to explain/support each point shown. Virchow's triad describes the three categories of different factors that contribute to thrombosis: hypercoagulability, hemodynamic changes (stasis, turbulence), and endothelial injury/dysfunction. It is named for the German physician Rudolf Virchow (1821-1902). Virchow’s triad is a classical view of how thrombosis occurs, demonstrating that alterations in normal blood flow, injuries to the vascular endothelium, and alterations in blood constitution all play a role in thrombosis formation. When the blood flow changes, stasis, mitral stenosis, turbulence, and varicose veins may form. Injuries to the vascular endothelium may be caused by shear stresses applied to viens under hypertension. Hypercoagubility may be a consequence of risk factors such as hyperviscosity, deficiency of antithrombin III, changes that occur after bodily trauma, cancer onset, certain stages of pregnancy, nephrotic syndrome, and delivery, race, age, smoking, and obesity (Wang et al. 2008, p. 396). 12. With the use of suitable examples, show the differences between the terms ‘pathological features’ and ‘clinical features’. Pathological features are the physical impacts of a disease or disorder that may be sea upon examining a tissue directly. Clinical features, which are most commonly used to diagnose diseases, are those signs or symptoms that are exhibited by the patient, often see during normal physicals or other examination procedures. For instance, the clinical features of autosomal recessive disorders may be seen to impact an individual during the first few years of life, even though the pathological features have been present all along (Kumar and Clark 2009, p.43). 13. There are four types of hypersensitivity reaction seen. Identify the four types and describe why the process leading to an anaphylactic hypersensitivity reaction can only take place on second exposure. The four types of hypersensitivity of defined in question number 9. During the first exposure to an allergen, the immune system will stimulate B cells. These then synthesizes IgE that will migrate throughout the body and insert into Mast cells. When second exposure occurs, the allergen will then bind to the IgE, causing the Mast cells to then degranulate. This causes the dumping of a collectionof different substances called the mediators of inflammation, causing a violent, and even sometimes life-threatening, reaction (Ghaffer 2011, p.1). 14. Differentiate between the terms septicaemia, bacteraemia and viraemia. Septicaemia is commonly referred to as blood-poisoning. It is a potentially life-threatening condition wherein the whole body enters an inflammatory state (systemic inflammatory response), normally caused by an infection. Because delay in treatment can be deadly, treatment is normally started on an empirical basis (Kumar and Clark 2009, p.89). Bacteraemia is the presence of bacteria or pathogens in the blood, which is normally a sterile environment free of foreign organisms. Antibiotic chemoprophylaxis is one treatment that can result in the onset of bacteraemia by introducing pathogens into the blood (Kumar and Clark 2009, p.92). Viraemia is similar to bacteraemia, however it is viruses instead of bacteria that enter the bloodstream and thus gain access to other remote areas of the body. The level of viraemia can be used to represent the levels of replication of certain viruses that enter the bloodstream (Kumar and Clark 2009, p.140). 1. In terms of pharmacology, using appropriate examples differentiate between the terms of pharmacokinetics and pharmacodynamics. Pharmokinetics is the study of the fate of a drug once it enters the body, which includes how a drug is absorbed, how it is distributed, the bioactivity of the drug, the duration and intensity of the drugs effect, the chemical changes to the drug metabolism, and removal of the drug from the body. Pharmacodynamics is the study of the biochemical and physiological effect that a drug has on both the body and pathogens such as microorganisms or parasites. This includes the mechanism of action of the drug and the relationship between concentration and the drug’s effect. The traditional example of this is the drug-receptor interaction modeled by many biochemists as ligand-attachment site models (Lees et al, 2004, p.397-398) 2. With regard to musculoskeletal disorders, in terms of aetiology differentiate between osteoarthritis and rheumatoid arthritis. Osteoarthritis is related to the aging process. Over time, the water content in cartilaginous tissue increases and the protein makeup degenerates, leaving the tissue vulnerable to mechanical creep and failure. This starts by the formation of cracks and flakes, and eventually may result in a total loss of cartilaginous tissue. Rheumatoid arthritis is a condition wherein immune cells attack various body tissues, such as the joints. There is no clear cause, though evidence has been shown that both environment and genetics play a role in the onset of this condition (MedicineNet 2011, p.1). 3. With regard to musculoskeletal disorders, discuss why osteoarthritis is best termed osteoarthrosis. Osteoarthritis is a degenerative condition, making it more appropriately termed an arthropathies (arthroses) because the initial disease process is not centered in the interstitium and capillary bed of the synovium and is not being driven from its outset by mediators of inflammation. Also joint fluid is normal and the joint is not related to systemic or even local soft tissue disease process (Carlson 2001, p.1). 4. Discuss, with rationale, the clinical features seen in a urinary tract infection. What advice would you give to someone who is suffering from a urinary tract infection? Urinary tract infections may show clinical features such as painful urination, frequent urge to urinate, discharge from the urethra, cloudy or bloody urine, or a sense of bloatedness in the lower abdomen (especially in women), though symptoms may be different varying by age and gender. In newborns and the elderly symptoms can be hard to see until general pain, lethargy, or jaundice occurs. Increased fluid intake and increased Vitamin C intake (to increase urine acidity) may help to relieve mild cased of UTI. For severe cases IV fluid and hospitalization may be required. Most mild cases are easily cleared by oral antibiotics (MedicineNet 2011, p.1). 5. With respect to cardiovascular disease, show how the terms modifiable, partially modifiable and non-modifiable risk factors are associated with hypertension. Non-modifiable risk factors are those that cannot be changes, such as age, race, ethnicity, gender, and family history. Modifiable risk factors are those that a patient or those in his or her surroundings are able to change, such as weight, grooming, nutrition, physical inactivity, and smoking. Partially modifiable risk factors include those that may be changed indirectly or partially, such as metabolism rate or blood glucose levels (DiabetesPro 2011, p.1). 6. Discuss, with rationale the differences seen between Insulin Dependent Diabetes Mellitus (IDDM) and Non-Insulin Dependent Diabetes (NIDDM). Insulin-dependent diabetes is also called Diabetes mellitus Type I, or formerly known as juvenile diabetes because of its time of onset. The condition is autoimmune in origin, where the body attacks the beta cells of the pancreas that produce insulin. The lack of insulin leads to increased blood glucose, responsible for a number of side effects that are commonly fatal if not treated regularly with insulin injections or other insulin treatments. The condition is often diagnosed by that appearance of hyperglycemia and other symptoms between birth and ten years of age, but modern techniques allow early diagnosis based on analysis of autoantibodies, primarily islet cell autoantibodies, autoantibodies targeting the 65 kDa isoform of glutamic acid decarboxylase (GAD), insulin autoantibodies, and the autoantibodies that target the phosphatase-related IA-2 molecules. Non-insulin dependent diabetes, also known as diabetes Type II or adult-onset diabetes, is a condition in which the metabolism of an individual is affected. The disorder is characterized by levels of high blood glucose, insulin resistance, and/or insulin deficiency. The disorder is sometimes linked to weight gain, or other modifiable factors, and often can be treated in the early stages by increased exercise, changes nutrition, and dietary modification, though sever cases normally require medical insulin injections or oral medication treatment. Insulin-dependent diabetes is an autoimmune disorder, whereas non-insulin dependent diabetes is of metabolic origin. The former can be treated only with insulin treatments (or some experimental procedures that seek to replace destroyed beta cells surgically), whereas the latter can be treated based on severity by lifestyle changes or medical treatment (‘Diabetes Blue Circle Symbol’ 2011). 7. A patient consults you following a recent diagnosis of Chronic Obstructive Pulmonary Disease (COPD) and has been prescribed inhalers. The patient asks you to explain what is meant by bronchodilators and corticosteroids. With reference to the pathophysiology of COPD, explain how these drugs act. Chronic obstructive pulmonary disease is one of the most common lung diseases and is normally of two types. The first is chronic bronchitis, where cough and mucus buildup in the lungs lasts over a long period of time or even permanent, and the second is emphysema, where the lung tissue is actually destroyed. Most people who suffer from COPD have some signs of both types. The condition results in inflamed bronchial tubes, which correspondingly produce more mucus than normal and are more difficult to clear, leading to common bacterial infections, lowered oxygen levels in the blood, and difficulty clearing pooled mucus from the lungs. Often inhalers, such as ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), or formoterol (Foradil) are used to open up the airways by expanding the bronchial tubes in the lungs, or bronchodilation. This can be explained to a patient using the analogy of plumbing pipes, demonstrating that larger pipes can more easily let water flow to the home—and more easily allow ‘junk’ in the pipes to be flushed out. Basically, bronchodilators increase the size of the patients air ‘pipes’ so that air can get in and mucus can get out. Corticosteriods mimic the steroids naturally produced in the adrenal cortex and act to reduce inflammation, preventing further damage and obstruction due to COPD or its symptoms. In the case of COPD, the goal is to allow greater airflow, remove obstructing mucus (thus preventing other bacterial infection and complications), and prevent additional damage from occurring to lung tissue ('Chronic obstructive pulmonary disease' 2009). 8. In terms of pharmacology, using appropriate examples differentiate between the terms bioavailability, first pass effect and compliance. Bioavailability is the amount of a drug that reaches systemic circulation. When a drug is injected intravenously, it has 100% bioavliability; however, other administration routes such as oral, sublingual, and topical have lower bioavailability because part of the drug may not enter the body or may be metabolized into an inactive form before it reaches systemic circulation. The first pass effect is most significant with oral administration of drugs. Drugs administered orally enter the digestive system and then are absorbed from the small intestine. From here they enter the hepatic portal system and shortly reach the liver, where a large percentage of most drugs are metabolized before ever reaching systemic circulation. Compliance, in medicine, generally refers to the level at which a patient follows medical advice. Because drug absorption and metabolism, and thus bioavailability of the drug to the target, may be affected by eating, drinking, consuming alcohol, taking other medications, not taking entire doses f medication, taking more medication than prescribed, and other actions that the patient may take, compliance plays an important role in the actual bioavailability of a drug (Griffin 2009). 9. With respect to cardiovascular disease, describe the pathological features seen in the blood vessel wall in atherosclerosis. In atherosclerosis the walls of arterial blood vessels thicken due to accumulated fatty plaques, often cholesterols. The walls of affected vessels both thicken and harden, which is often asymptomatic though blood flow becomes increasingly restricted. The accumulation of fatty plaques along the arterial blood vessel walls are generally encouraged by macrophages (white blood cells) and by low-density lipoproteins (plasma proteins that carry cholesterol and triglycerides) when there is not adequate removal of of fats and cholesterol from such macrophages by functional high density lipoproteins (HDL). Atherosclerotic plaques may be either stable, normally asymptomatic, or unstable, each having very different pathophysiology. Stable plaques contain high levels of extracellular matrix and smooth muscle cells, whereas unstable plaques contain many more macrophages and foam cells. Additionally, in unstable plaques, the fibrous cap, or the extracellular matrix that separates the lesion from the arterial lumen, is weak and may rupture without warning, giving way to thrombogenic materials into circulation (Maton 1993). 10. Discuss, with rationale the risk factors leading to the development of Non-Insulin Dependent Diabetes (NIDDM). The onset of NIDDM is complex, and many factors may affect the onset of the condition. In over 80% of cases, the affected individual has no family history of NIDDM. There is a genetic component to risk for NIDDM, and the genes that confer susceptibility to IDDM are found in the HLA region of the sixth human chromosome, which explains the very different risks bases on race and ethnicity, with occurrence being high for Caucasians and much lower for ethnicities from East Asia. Weight, hypertension, maternal age, stress, birth order, nutrition, seasonal changes, and socioeconomic status all are risk factors for NIDDM, though both genders have been demonstrated to have the same risk levels for developing the condition (though with different ages of onset). Because NIDDM is a metabolic disorder, risk factors that change metabolism drastically such as weight gain or growth spurts are the most common times for symptoms to manifest, though they may do so at any time (Dorman et al. 2010). 11. A patient consults you following a recent diagnosis of Asthma and has been prescribed inhalers. The patient asks you to explain what is meant by bronchodilators and corticosteroids. With reference to the pathophysiology of Asthma, explain how these drugs act. Asthma is a chronic inflammatory condition of the lungs where airways experience reversible obstruction, often through bronchospasm. During bronchospasm the muscles that surround the airways of the lungs, or bronchioles, constrict suddenly under the influence of substances released from mast cells (basophils) generally initiated by anaphylatoxins. The constriction of the airway in asthma can be mild to life-threatening, and often inhalers, such as the short-acting beta-2 agonist Salbutamol, are prescribed. Corticosteroids, particularly glucocorticoids, are commonly prescribed for long-term control of asthma in order to reduce inflammation and muscular constriction in the lungs. For treating asthma symptoms, the three types of bronchodilators are: beta-agonists, anticholinergics, and theophylline. Each acts to open airways, clear mucous, and relieve immediate symptoms of airway constriction (WebMD 2011). 12. With respect to cardiovascular diseases, differentiate between the modifiable, partially modifiable and non-modifiable risk factors associated with coronary heart disease. Coronary heart disease refers to the failure of the coronary arteries to supply blood to the heart itself and surrounding tissues, often with complex etiology. Non-modifiable risk factors for coronary heart disease include age (with 83% of deaths due to the condition occurring in those 65 or older), male gender, and race/ethnicity (with highest occurrence being higher among those of African descent over Caucasian decent). Modifiable risk factors include tobacco smoke, physical inactivity, obesity or weight gain, and proper nutrition. Partially modifiable risk factors, or those that may be indirectly affected, include stress levels, adult-onset diabetes, blood cholesterol levels, and high blood pressure, each of which may be impacted by factors that are within the patient’s control such as nutrition and physical activity (AHA 2011). 13. Asthma can be considered as a chronic disorder. Describe the pathological changes seen in the respiratory passages during an acute asthmatic attack. Acute asthma attacks are often triggered by something in the environment, such as allergens, and can be recognized by the visible symptoms of wheezing, rapid shallow breathing, tightening of neck and chest muscles, confusion, bluing of extremities (such as fingertips or lips), and difficulty speaking. These symptoms are caused by the sudden constriction of the muscles surrounding the bronchioles due degranulation of mast cells upon exposure to anaphylatoxins, causing the airways to become smaller and inflamed. Mucus plugs may also form if not treated, further impairing breathing (Asthma Symptoms 2011). 14. Discuss the advice you would give to someone with a history of renal calculi to prevent a reoccurrence. Renal calculi are stones made up of tiny crystals that form in the kidney or the ureter, and are often pass naturally through the excretory system and are expelled along with the urine. Many people who get kidney stones are at risk for recurrence, especially among men. The most common risk factor is dehydration, so the best advice to prevent recurrence is to encourage the patient to drink more water (6-8 glasses per day) throughout the day on an ongoing basis in order to ensure proper urine volume. There are several types of kidney stones that normally form, the most common being calcium stones, though cystine, struvite, and uric acid stones also occur in some cases. Based on the patient’s diet, calcium can combine with oxalates, or other substances such as carbonate or phosphate, to form stones, and consultation with a dietician or other nutritional professional may be necessary in order to modify the patient’s diet to limit recurrence. In some cases prescription of mediations such allopurinol (for uric acid stones), antibiotics (for struvite stones), diuretics, phosphate solutions, or sodium bicarbonate or sodium citrate (responsible for increased urine alkalinity) maybe necessary in order to prevent renal calculi recurrence ('Kidney Stones' 2011). References Kumar and Clark, 2009, Clinical Medicine, Saunders-Elsevier, Spain. 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'Chronic obstructive pulmonary disease', 2009, PubMed Health, accessed online July 2 2011 at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001153/ Griffin, J.P, 2009, The Textbook of Pharmaceutical Medicine (6th Ed.), New Jersey, BMJ Books. Maton, Anthea, Roshan L. Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright, 1993, Human Biology and Health, Englewood Cliffs, New Jersey, Prentice Hall. Dorman, James; McCarthy, Bridget; O'Leary, Leslie; and Koehler, Anita, 2010, 'Risk Factors for Insulin-Dependent Diabetes', Diabetes in America, accessed online July 2 2011 at http://diabetes-in-america.s-3.com/adobe/chpt8.pdf WebMD, 2011, 'Bronchodilators and Asthma' accessed online July 2 2011 at http://www.webmd.com/asthma/guide/asthma_inhalers_bronchodilators AHA, 2011, 'Risk Factors and Coronary Heart Disease' American Heart Association, accessed online July 2 2011 at http://www.americanheart.org/presenter.jhtml?identifier=4726 Asthma Symptoms, 2011, 'What is an Acute Asthma Attack?', accessed online July 2 2011 at http://www.asthmasymptom.org/acute-asthma.html 'Kidney Stones', 2011, NIH, accessed online July 2 2011 at http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001493/ Read More