Jenny Higgins, a 27-year-old female, develops achy joints, disrupted bowel activity and skin rashes over the course of 7 months. Although mild at first, the symptoms get worse over this time period, and while her GP did not initially suspect an autoimmune disease, Jenny is eventually diagnosed with Systemic Lupus Erythematosus (SLE) a classic systemic autoimmune disease. Answer the following sub-questions separately.

1) Name some common autoantibody responses present in patients with SLE? (1 mark)

2) Briefly describe how these autoantibodies contribute to symptoms of the disease.

3) Patients with SLE often have delayed clearance of apoptotic cells. Explain why this delay may result in an increased risk of autoreactivity to internal cellular components such as the nucleus.

4) If self-proteins or tissue components in the joints are not targeted directly in SLE, why do patients develop inflammation of joints?

5) Briefly describe a 2 stage (2 different drugs, and why you have chosen these) anti- inflammatory treatment regime designed to quickly bring inflammation under control, but moving to long term treatment more readily tolerated by the patient.

1. Sympathetic innervation of the heart results in the following adaptations (check all that apply)

            a. Enhanced Heart Contractility

            b. Arterial Vasodilation

            c. Increased Ejection Fraction

            d. Increased Heart Rate

            e. Decreased Heart Rate

            f. Increased End-systolic Volume

            g. Increased End-distolic volume

2. What is the main Cardiovascular adaptation when someone goes from lying down to a standing position?

            a. Increase in stroke volume

            b. Vasodilation of vascular

            c. Increase in Heart Rate

            d. Decrease in Heart Rate

3. Gap Junctions

1. Allow the passage of blood to adjacent muscle cells
2. Allow the conduction of electrical signals to adjacent muscle cells
3. Allow the conduction of neurotransmitters to adjacent muscle cell
4. Active transporter, allowing the conduction of electrical signals to adjacent muscle cells

0. Ms Duffy is 28 years old and wears spectacles. Over the last three years her vision has been worsening even with spectacles. She was examined by an eye doctor and diagnosed to have thinner and steeper than normal corneas with vision impairment in both eyes but more in the left than right eye. Her corneal condition and vision were expected to continue to worsen without intervention. Thus, the eye doctor performed a negligibly invasive treatment procedure on her eyes, first in the left eye and six months later in the right eye. The treatment improved her vision in both eyes.

   Answer the following sub-questions separately.

   1. Which corneal disease did Ms Duffy develop? (1 mark)

   2. What could be the effect/s of this corneal disease on Ms Duffy’s vision and why? (1 mark)

   3. What are the two most common likely causes of this disease? (1 mark)

   4. From your understanding of the structure of the cornea, state primarily which part/s of the

      cornea is/are compromised in this disease? (1 mark)

   5. What are the main clinical and histopathological features of this disease?

   6. Which pathophysiological mechanisms are activated in this disease? Explain three of the

      mechanisms.

   7. Explain the basic principle underlying treatment of Ms Duffy’s disease. (1 mark)

1)The criteria to name muscles includes:
2) Classificate the vertebrae and their functions
3) whats the diploe bone function?

Pneumothorax is normally treated by insertion of a chest tube to draw air out of the pleural cavity. Explain why this would allow the collapsed lung to reinflate. Support your answer by drawing a diagram of the lungs, pleurae, and pleural cavity before and after inserting a chest tube. Label your diagram with the appropriate alveolar pressure and intrapleural pressure, assuming an atmospheric pressure of 760 mm Hg.

2.What recommendations could you make to the researchers to safeguard the ethical standards for research in the Tuskegee Syphilis Study? Consider each of the following ethical issues: informed consent; confidentiality; privacy; physical or mental distress; sponsored research; honest disclosure of results; scientific advocacy; protecting vulnerable clients; and withholding treatment for research purposes. Do you think the study could be done ethically at all? Support your conclusion.

Describe the cartilaginous structures of the respiratory system of cats.

Case 1: During her first visit to a Caribbean country, Margaret McKenzie, a 35 year-old woman, decided to try snorkeling over a local coral reef. Although she enjoyed the· fascinating plants and fishes, she found the taste of salt water unpleasant and was having trouble maintaining her orientation and position in the waves. Margaret lifted her head up and noticed that she was drifting further and further from shore. With a start, she realized that the tide was going out. She could hear her breath whistling through her snorkel, and she noticed that her breathing rate was fairly fast and getting faster. Shortly thereafter, she noticed that her heart had begun to pound. Margaret decided to swim in to shore. Although not usually a strong swimmer, Margaret found unexpected reserves of strength that enabled her to swim against the outgoing tide. When she arrived on the beach she was pale, breathing hard, and her heart was racing. Over the next few moments her color, and her heart and respiratory rates began to return to normal.

Case 2: Matthew was a first-year student in a medical illustration program. As part of his education, he was required to attend an autopsy with his class. This was to be his first experience viewing a dead human body, and he was apprehensive about it for days in advance. As he was attempting to sketch the great vessels of the heart, he noticed that his breathing rate was fast and getting faster. At the same time, he noticed that his heart had begun to race, that he was sweating despite the cool temperature, and that he was feeling lightheaded and nauseous. His professor, noticing that Matthew was pale and his pupils were dilated, led him to a chair outside the autopsy room. She handed Matthew a paper bag and recommended that he breathe into it for a few minutes. Soon Matthew's lightheadedness and nausea began to subside and his respiratory and heart rates began to return to-normal.

Guided questions for Case 1.

1. Describe the "Fight or Flight" reaction?

Phase 1: What general CNS structure is responsible for perception of fear and how are activating signals sent to the body (targets)?

Phase 2: Discuss neural and endocrine response to the activation of the fight or flight response.(bonus- Is there a difference in half-life of substances? If so, which one lasts longer?)

Phase 3. Describe effects on muscle, liver, heart and lungs. Bonus (what other changes may occur?

2. Describe mechanisms responsible for Margaret's circulatory changes e.g. cardiac and vascular; receptors and signaling pathway?

3. How can Margaret's increase in energy be explained?

4. What mechanisms caused Margaret's respiratory changes?

Guided Questions for Case 2:

5. Why was Matthew pale and sweating e.g. relate autonomics to control of cutaneous blood flow?

6. Why did Matthew feel lightheaded hint- breathing rate and CO2?

7. How did breathing into a paper bag relieve Matthew's symptoms?

1.a patient has been injured and is in need of a blood transfusion. when she arrives at the ER, doctors determine that she has type A+ blood. what antigens are present on her erythrocytes? what antibodies are present in her blood? what blood type(s) can she receive in her blood transfusion?

2. If an agglutination reaction only occurs when an anti-B antibody is applied, then the blood type must be typed ___(A/B) ___(+/-)

Compare and contrast how water volume and osmolality are regulated.

The IMA is ligated (occluded) when removing an aneurysm of the abdominal aorta. The IMA normally supplies arterial blood to the sigmoid colon and rectum. Uusualy, the sigmoid colon and rectum survive such a ligation. How do they survive? discuss the normal blood supply to the entire GI tract (in chart/table form, with names of arteries and names of corresponding structures), and then what occurs after the IMA is ligated to keep the sigmoid colon and rectum alive.

Kidney stones occur when solid material blocks the flow of urine in the renal system. Although there are many causes, Ca2+ is a common component of the stone itself. If left untreated, Kidney stones can lead to renal failure. You are a Nephrologist treating a patient who has already had one kidney removed. They report that they have experienced nausea, vomiting, and swelling of the extremities (edema.) An MRI shows a kidney stone which has completely blocked the ureter of the remaining kidney. Propose a mechanism whereby the kidney stone would explain the patient’s symptoms.

A 26-year old female patient (height 5 foot 6 inches tall) exhibits a forced expiratory volume in 1 second (FEV1) that is 1860 ml. Her VC = 3100 ml.

Describe what type of respiratory disease the woman may have. Explain how this disease may affect the resistance in her conducting zone. Would you also expect to see damage in the respiratory zone of the lungs? Explain.

Vital capacity decreases with age (say after age 20), but TLC does not decrease. What changes in the lung volumes (TV/ERV/IRV/RV) contribute to VC are most likely to change with age to make the preceding statement true?