A client has been diagnosed with gram-negative pneumonia of the lower lobe
Knowing that gram-negative bacteria have a lipopolysaccharide endotoxin on their outer cell membrane, the health care provider should be assessing the client for which pathophysiological end result?
A) Damage to cellular mitochondria
B) Increased ATP levels
C) Activation of the p53 protein
D) Apoptosis
Ans: D
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The extrinsic pathway of apoptosis involves extracellular signaling proteins that bind to cell surface molecules called death receptors and trigger apoptosis. The end result includes activation of endonucleases that cause fragmentation of DNA and cell death. In addition to TNF and Fas ligand, primary signaling molecules known to activate the extrinsic pathway include TNF-related apoptosis-inducing ligand (TRAIL); the cytokine interleukin-1 (IL-1); and lipopolysaccharide (LPS), the endotoxin found in the outer cell membrane of gram-negative bacteria. DNA damage, activation of the p53 protein, and decreased ATP levels are associated with the intrinsic pathway.
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