A 45-year-old woman presents with a history of progressive weakness, fatigue, weight loss, nausea and increased skin pigmentation (especially of creases, pressure areas and nipples). Her blood pressure is 120/78 mmHg when supine and 105/52 mmHg when standing. LAboratory findings reveal serum sodium of 120 mEq/L (normal is 135 - 145 mEq/L); potassium level of 5.9 mEq/L (normal is 3.5 to 5 mEq/L); and low plasma cortisol and high ACTH levels.

A. What diagnosis would this woman's clinical features and laboratory findings suggest?

B. Would her diagnosis be classified as a primary or secondary endocrine disorder?

C. What is the significance of her darkened skin?

D. What type of treatment is indicated?

Explain the mechanism of neural control of respiration.

The idea is to find a new or novel advancement in medicine to do with Physiology only. That is I don't want advancements in other fields e.g. immunology, genetics, cancer, microbiology and so on.

So you discuss the problem or disease including initially normal physiology followed by a description of the disease. Then discuss the novel advancement and how it is helping patients to improve their lifestyles.  

The presentation should be between 5 - 6 minutes but not exceeding 6 minutes and 30 seconds.

QUESTION 59

1. Which, if any, of these is an example of an IPSP in a typical neuron?

   		a. a voltage change from 0 mV to +0.35 mV
   		b. a voltage change from -70 mV to -68 V
   		c. a voltage change from +35 mV to 0 mV
   		d. a voltage change from -70 mV to -72 mV
   		e. None of the above.

Anish was looking for a way to spend his summer break, so he decided to volunteer with a medical mission team going to staff a clinic in an impoverished rural region of India. At the briefing meeting, Anish and the other volunteers were warned that with the onset of the rainy season in August, they would be seeing patients with cholera, an acute diarrheal disease caused by the bacterium Vibrio cholera. Toxins from the cholera bacterium cause vomiting and massive volumes of watery diarrhea in people who consume contaminated food or water. Unless treated promptly, cholera can be fatal.

Cholera is endemic in parts of India, meaning that it occurs on a regular basis. A volunteer trained by the U.S. Centers for Disease control and prevention (CDC) spoke to the medical mission team about what to expect when treating patients and also about proper precautions for themselves. He explained that the oral cholera vaccine they had taken would protect against the O1 strains but the area they would be visiting also had the newer O139 strain not covered by the vaccine. Once in India, everything went well at the clinic initially. Then about five days into his trip, Anish has several bouts of copious and watery diarrhea. When he developed dizziness and a rapid heartbeat, he visited the medical officer for the team. There, he was diagnosed with dehydration from cholera-induced diarrhea.

Given Anish’s watery diarrhea, what would you expect his ECF volume to be?

Why was Anish experiencing a rapid heartbeat?

Esomeprazole is a proton pump inhibitor. For what symptom or condition might Anish have been taking this drug?

Why might taking a protein pump inhibitor like esomeprazole have increased Anish’s chances of contracting cholera?

Why would continuously open enterocyte CFTR channels cause secretory diarrhea and dehydration in humans?

Which type of IV solution would you select for Anish, and why? Your choices are normal (isotonic) saline, half-normal saline, and 5% dextrose in water (D-5-W).

Which of the following is composed of myosin protein?

Select one:

a. thick filaments

b. thin filaments

c. Z discs

d. all myofilaments

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This inherited degenerative disease of the muscular system is where the muscles weaken and atrophy and become replaced with fatty tissue.

Select one:

a. a strain

b. muscular dystrophy

c. tendenosis

d. fibromyalgia

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This chronic, non-progressive condition of pain in the muscles, tendons, and ligaments is called _______________.

Select one:

a. a strain

b. epicondylitis

c. fibromyalgia

d. repetitive motion disorder

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Blood is pumped through the heart by which type of muscle?

Select one:

a. skeletal

b. smooth

c. cardiac

d. visceral

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What is an example of a repetitive motion disorder?

Select one:

a. fibromyalgia

b. muscular dystrophy

c. multiple sclerosis

d. carpal tunnel syndrome

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Which of the following statements is not true?

Select one:

a. When infants are born, their muscular tissue is almost completely formed.

b. As the size of the fibers increase throughout growth, strength improves.

c. Growth of muscles in preschool years is relatively fast compared to the growth of infants and teens.

d. During adolescence, large muscles develop faster than small muscles, often resulting in decreased coordination.

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An important contribution to the homeostasis of the body by the muscular system is _______________.

Select one:

a. the ability of muscle to produce calcium for use by the bones

b. the ability of muscle tissue to insulate the body

c. the function of smooth muscle in moving the limbs and maintaining posture

d. the function of cardiac muscle to maintain a consistent heart beat

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While doing jumping jacks during an exercise class, your arms and legs move laterally away from the midline of your body. This motion is called _______________.

Select one:

a. extension

b. flexion

c. abduction

d. adduction

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Skeletal muscle produces body movement as well as maintains our _____as we sit.

Select one:

a. strength

b. vasodilation

c. vasoconstriction

d. posture

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Which of the following is not a function of the muscular system that helps the body maintain homeostasis?

Select one:

a. homatopoiesis

b. production of movement

c. stabilization of joints

d. generation of heat

The patient’s lung volumes/capacities: Expiratory Reserve Volume: 1100 ml Inspiratory Reserve Volume: 1000 ml Inspiratory Capacity: 1400 ml Total Lung Capacity: 4.2 L Solve for: Tidal Volume, Expiratory Capacity, Vital Capacity, Functional Residual Capacity, and Residual Volume.

Lung functions: volumes, and capacity measures TV = 300ml IRV = 1900ml IC = 2200ml FRC = 2300ml TLC = 5325ml The total lung capacity is normal Questions: Does the inspiratory capacity fall within normal values? What is the expiratory reserve volume of the patient? What is the vital capacity of the patient? Does the vital capacity fall within normal range? What condition does the patient suffer from?

Tight junctions:

a. allow communication between cells and an exchange of ions

b. cause cell membranes to tightly fuse together

c. extend around the cell like a belt

d. connect adjacent cells and their cytoskeleton

e. all of the above

When we study the effects of chronic stress on human health, most of our chronic stress is imaginary, meaning, it's made up by our imagination and conscious thought, created by the Frontal lobe. Discuss, why frogs and lizards cannot experience chronic stress like that? In 100 words or more.

Kim needs to learn about absorption of food in her digestive system, what do you tell her?

Describe a muscle contraction, be sure to include all the players (example – sarcoplasmic reticulum, actin, myosin…) and aslo expalin the responsiveness of skeletal,cardiac, and smooth muscle

You have a new client that wants to begin an endurance cycling program under your guidance. They start by giving you the following information while filling out their Health screening questionnaire.  

• 45 yrs old and Female
• Weighs 65 kg and is 162 cm tall
• Smoker
• Recreational cyclist (30 min of cycling 4x per week)
• No current diagnosis of cardiovascular, pulmonary or metabolic disease
• No major signs or symptoms of cardiovascular, pulmonary, or metabolic disease
• No orthopedic limitations to exercise
• Her father died of a heart attack at 65 yrs old, but her mother is still living at the age of 70.  

She also brings you a blood profile and blood pressure from a visit to a physician last week. The results are below:

• BP = 135/95 mmHg
• HDL=50 mg/dL
• LDL=149 mg/dL
• Total cholesterol = 199 mg/dL
• Fasting blood glucose = 80 mg/dL

She would like for you to assess maximal exercise capacity (VO_2max) AND begin participating in high intensity cycling in order to train for an upcoming race in 8 weeks. Answer the following: (7pts)

1. List her risk factors for CVD
2. Classify/stratify her as low, moderate or high risk for CVD
3. Can you perform a VO2 max test on her? Explain why or why not
4. Can she safely begin a high-intensity exercise training program? Explain why or why not.

A 78 year-old man gets up too quickly from his Lazyboy and nearly falls to the floor after experiencing light-headedness, but luckily falls backward into the chair.

a. Briefly, what are the essential components of a visceral reflex?

b. What is the cardiovascular response to this drop in blood pressure?

c. What location in the central nervous system coordinates this response?

What is wrong?

6. Phytates are found in meat.

7. Ceruloplasmin transports iron.

8. There is an increased excretion of zinc during stress and high carbohydrate intake.

9. Copper is needed to need to change thyroxine (T4) to triiodothyronine (T4).

10. A deficiency of molybdenum resembles Parkinson’s disease.

1. Which of the following is not a function of the endocrine system?

   1. Regulates metabolism

   2. Regulates the chemical composition and volume of the body’s internal environment

   3. Controls growth and development

   4. Quickly responds to stimuli by way of action potentials

   5. Regulates operation of the reproductive system

2. Which of the following sets of hormones are antagonists?

   1. Calcitonin and parathyroid hormone

   2. Glucagon and insulin

   3. GHRH and GHIH

   4. All of the above

   5. none of the above

3. ___ are attached to transport proteins within the bloodstream.

   1. Releasing hormones

   2. Pancreatic hormones

   3. Water-soluble hormones

   4. Lipid-soluble hormones

   5. All of the above

4. The adrenal medulla secretes ___

   1. Mineralocorticoids

   2. Glucocorticoids

   3. Androgens

   4. Adrenalins

   5. All of the above

5. The main link between the nervous and endocrine systems is the ___

   1. Thalamus

   2. Hypothalamus

   3. Pituitary gland

   4. Thyroid gland

   5. Adrenal gland

6. The primary target for antidiuretic hormone is the ___

   1. Kidney

   2. Hypothalamus

   3. Uterus

   4. Adrenal gland

   5. Pituitary gland

7. The hormone released in response to low blood calcium levels is ___

   1. Calcitonin

   2. Glucagon

   3. Thyroxine

   4. Parathyroid hormone

   5. cortisol