Patient scenario

Mr. Singh is a 38-year old who practices power lifting 4 times per week. Usually Mr. Singh can “grip it and rip it” when performing 113 kg deadlifts but recently he has been having difficulty gripping the bar and experiencing fatigue and tingling in his hands. Mr. Singh’s trainer, Josephine, recommends he take a week off of working out before pushing his body any further. Dan returns to the gym a week later and attempts to bench press at a lighter weight to get warmed up. Josephine has to quickly spot him in a missed attempt. Mr. Singh becomes despondent and admits something might be wrong because he is still experiencing tingling, pain and weakness in his hands and now his feet as well.

Discussion Question:  Research Mr. Singh's symptoms and determine a differential diagnosis by listing at least two different possible conditions that match some or all of Mr. Singh's symptoms. Justify why you selected each of the conditions on your list.

Write a detailed answer to the discussion question. Your post must be at least 3-4 sentences per differential diagnosis

1. Cardiogenic shock results from a serious heart condition such as a myocardial infarction, slow or dangerous heart rhythms, or even ruptures to the valves or walls of the heart. Describe how cardiogenic shock would impact cardiac output and mean arterial pressure, then describe how the autonomic nervous system would respond to this. How could this response be potentially detrimental to both the heart and organs? You do not need to detail specific receptors and chemicals in the autonomic response.

7. Prolonged use of a specific class of anti-psychotic agents can lead to excessive release of the hormone prolactin from the pituitary gland. (This can actually lead to excess lactation, even in men). Prolactin has a negative feedback effect on GnRH in the hypothalamus. Describe the how these antipsychotics would impact ovulation in females and sperm production in men. Ensure you include chemicals and cell types where appropriate. (150-200 words; 10 marks)

When Mary began experiencing paresis and spasticity in her lower extremities, she knew that something was seriously wrong. She was finally diagnosed as having a form of relapsing remitting multiple sclerosis. An MRI performed during one of her more severe “episodes” revealed lesions (lower left) that appeared to improve after three months (lower right). Her neurologist explained that all of her previous episodes could be explained by the underlying cause of this disease. Mary learned that the progression of this disease is highly variable and was told that while many of the symptoms she reported are common, the combination of symptoms in her experience is very rare.

1) In the MRI images you can see the lesions as bright “white spots” on the brain. Using what you know about the structure of a neuron, explain what is causing this spot to appear on the MRI. 2) The brain has specific cells that are responsible for the improvement that you can see in the MRI images. What are these cells and what function to they perform?

3) How does this form of MS differ from other forms?

describe the anatomy of the arterial supply and venous drainage of the lower limb

What is the ATP yield from one molecule of glucose and how ATP is generated at each process:

a. Glycolysis

b. Kreb's cycle

c. Electron Transport chain

Please specify if any ATP are removed from the total yield as a result of these ATP being required to initialise the reaction

A patient taken to the emergency department after an episode of syncope. The nurse observed that she exhibits the following signs and symptoms: Polyuria, Ketosis, Polydipsia. The laboratory results of her routine urinalysis are as follows:

• COLOR: Yellow
• KETONES: 4+
• CLARITY: Clear
• BLOOD: Negative
• SP. GRAVITY: 1.015
• BILIRUBIN: Negative
• pH: 5.0
• PROTEIN: 2 mg/dL
• GLUCOSE: 186 mg/dL

Questions:

1. What would be the metabolic disorder associated with the patient? (1 point)
2. Explain the increase of ketone bodies in the urine. (2 points)
3. What test can be used to detect presence of Glucose in urine? Explain. (2 points)
4. What test can be used to detect presence of Protein in urine? Explain. (2 points)
5. How can you differentiate Diabetes Mellitus and Diabetes Insipidus? (3 points)

Which could result in fatigue by hindering the binding of Ca⁺⁺ to troponin?

Select one:

a. calcium

b. lactate

c. AMP

d. low pH

e. potassium

A 90 kg person is pedaling a Monark leg ergometer (distance = 6m) at a VO2 of 40 ml/kg/min. If their rpms are 70, what resistance are they pedaling against?

Select one:

a. 1.8 kg

b. 3.9 kg

c. 3.2 kg

d. 2.6 kg

e. 4.2 kg

Chronic kidney disease can also cause respiratory disorders including pulmonary edema, which causes the alveoli to fill with fluid.

• How would the chronic kidney disease cause pulmonary edema? (Make sure to consider fluid balance by the kidney and include any hormones involved.)

• Explain how pulmonary edema would affect gas exchange. (Make sure to include respiratory volume terminology and lung compliance in your discussion of gas exchange.)

1.Which of the following characterizes a relative polycythemia? There may be more than one answer. Select one or more: a. A type of polycythemia that promotes erythropoiesis; therefore, increases the number of circulating erythrocytes above normal. b. A type of polycythemia that does not promote erythropoiesis but increases the number of circulating erythrocytes above normal. c. Hypovolemic shock d. Anemia e. High altitude

2.What is TRUE about diabetes? There may be more than one answer. Select one or more: a. Type I diabetes mellitus is insulin deficiency while Type II diabetes mellitus is insulin-resistant diabetes. b. Exercise and weight loss are therapies for both Type I and Type II diabetes mellitus. c. Diabetes insipidus is due to lack of anti-diuretic hormone that results in large production of "flat" urine. d. During fasting, a diabetic patient has a plasma glucose of 65-70mg/dL. e. Type I diabetes mellitus is a juvenile-onset diabetes that develops during childhood. f. Type I and Type II diabetes mellitus and diabetes insipidus will result in abnormally elevated blood glucose concentrations and will affect blood vessels, eyes, kidneys, and nervous system. g. Type I diabetes accounts for 90% of all cases of diabetes while Type II diabetes accounts for 10%. h. Insulin injection is a therapy for Type I diabetes mellitus. Type I promotes the production of ketone bodies and promote the production of "sweet" urine.

1. Which of the following describes an endocytosis? There may be more than one answer.

Select one or more:

a. A cell engulfs a bacterium by pushing its cell membrane around the bacterium forming a phagosome that will pinched off from the cell membrane and enter the cytoplasm.

b. Specific solutes accumulate along an indented cell membrane that will form into an endosome and it will pinch off from the cell membrane and enter the cytoplasm.

c. A process that transports molecules outside the cell via fusion of a vesicle with the plasma membrane.

d. A pinocytosis is an uptake of a non-selective materials, like the extracellular fluid, into a cell via endosome that pinches off from the plasma membrane into the intracellular fluid.

e. The process is initiated when an influx of Ca²⁺ interacts with rabs and snares in the intracellular fluid.

2.

What are the characteristics of the red blood cells (RBCs)? There may be more than one answer.

Select one or more:

a. RBCs are circular, flattened, and biconcave cells which transport oxygen from the tissues to the lungs and carbon dioxide from the lungs to the tissues.

b. RBCs lacked nucleus and organelles but contained glycolytic enzymes, carbonic anhydrase, and hemoglobin.

c. RBCs, leukocytes, and platelets are derived from uncommitted pluripotent hematopoietic stem cells.

d. Erythropoiesis in adult occurs in the liver, spleen, and all red bone marrow.

e. RBCs live for about 9 days.

1. During laser-tissue interaction, heat is generated. Heat produced will increase the temperature of the tissue. Different temperature stages will give different tissue reaction. Typically, the temperature ranges can be grouped into various stages. Describe the reactions of skin tissues for the following stage:

1. 42 - 45 °C,

2. 50 - 60 °C, and

3. Above 100 °C

estion 14

Which of the following factors would decrease (slow down) diffusion rates?

Please explain sitting on a chair and standing up on how biomechanically the following phases work

Standing-

Squating down -

Sitting down-

Standing up-

How does sitting on a chair and standing up work Mechanical and Anatomical? ( use anatomy)

Describe red blood cell count, percentage of reticulocytes, hemoglobin, hematocrit, mean corpuscular volume, and mean corpuscular hemoglobin concentration as it relates to the diagnosis of anemia.

• Discuss laboratory tests for red blood cells.