Bill S. is a longtime patient in your practice and has been in and out of rehabilitative treatment centers for the past 10 years for alcoholism. He tells you that he has been “on the wagon” for the past 3 months, and he is taking Antabuse. He also tells you that he is smoking more to deal with the stress of giving up alcohol. When you perform the intraoral and extraoral examinations, you notice that his parotid glands seem enlarged and that he has a red, beefy tongue with an ulcerated area on the lateral border of the left side. Once you start periodontal probing, the bleeding is excessive and continues long after it should have stopped.

2. Which factors could be responsible for the excessive bleeding?

a. Adverse reaction to the Antabuse

b. Poor oral hygiene

c. Liver failure caused by alcohol abuse

d. Squamous cell carcinoma

3. Which is the most likely cause of the ulcerated area on the lateral border of Bill’s tongue?

a. Trauma

b. Aphthous ulcer

c. Adverse reaction to the Antabuse

d. Squamous cell carcinoma

4. Noting that Bill is taking Antabuse, you use an alcohol-free pre-procedural rinse. Which would explain this use?

a. Fear of triggering alcohol cravings

b. Better efficacy than alcohol-based rinses

c. Adverse reaction to the Antabuse

d. Drying of oral mucosa with alcohol mouth rinses

5. Which modifications to the dose level of local anesthetic should be made for Bill’s dental treatment?

a. The dose should be reduced.

b. The dose should be increased.

c. No modification to the dose is necessary.

d. Local anesthetic is contraindicated completely.

You are watching your niece who is almost a year old and notice that she is unconscious on the floor with marbles around her. Breaths don’t go in.

Endurance training can make muscles more resistant to fatigue. What types of changes occur within the muscle to allow for this? Explain.

1. Describe the pH scale, and define the terms acid and base.

2. Explain how carbonic acid and bicarbonate are formed in the blood and the functions they serve.

3. Define the terms acidosis and alkalosis, and explain how they relate to hypoventilation and hyperventilation.

4. Explain how ventilation is adjusted to help maintain acid-base balance.

Place the correct word into the sentence to describe the muscles of respiration.
a. elevate

b. depress

c. flex

d. extend

1. The internal intercostals depress (wrong answer) the ribs and expand the thoracic cavity during inspiration.

2. The external intercostals elevate (wrong answer) the ribs causing a partial vaccuum effect resulting in an influx of air.

I put these answers in but they are wrong need help

1. Describe the axis of an ECG lead and the vector of electrical current.

2. Identify the waves, complexes, segments and intervals on an ECG.

3. Identify the limb, augmented limb, and precordial leads.

4. Identify the negative and positive electrodes for the different lead configurations.

5. Describe the process of analyzing an ECG strip or recording.

SHORT DISCUSSION QUESTIONS

1. Distinguish between Type I and Type II alveolar cells by explaining the role played by each in the lungs.

2. The alveoli of the lungs have a significant amount of elastic tissue as well as pores in their walls. Explain the specific role of each of these (elastic tissue and pores) in alveoli.

3. Explain Boyle's law then use it to explain why air enters the lungs during inspiration.

Know the origin/insertion/action of the following

a.Pectoralis major

b. Deltoid

c.Trapezius

d. Latissimus dorsi

Also locate the Linea alba

Know the origin/insertion/action of the following

: zygomaticus major, masseter

The Women’s Health Nurse Practitioner evaluated Sara, a 17-year old female. Sara has not had a menstrual period for 6 months. Her history reveals that menarche occurred at the age of 12 years, and her menses were regular at 28-day intervals until they became irregular 1 year ago. Sara is a member of her high school gymnastics team. She has been spending long hours training with the team, as she hopes to get a gymnastic scholarship at her “dream” university – the University of California, Los Angeles. In addition, she has ramped up her aerobic exercise program to strengthen her endurance. She states that she often does not have time to eat or is simply too tired to eat after training and getting her schoolwork done. She often relies on energy bars. She denies abdominal pain or bloating. Sara appears emaciated. She is 5 ft 4 in tall and weighs 88 lb; BMI is 15 kg/m2. Her pulse is 54/min, and blood pressure is 80/50 mm Hg. The rest of her physical exam is non-remarkable. Impression - The Nurse Practitioner suspects secondary amenorrhea(i.e., the absence of 3 to 12 consecutive menstrual periods after menarche). The secondary amenorrhea is most likely due to her exercise program, which has increased in intensity and duration over the last 6 months. It is also possible that Sara is not eating enough, given her high energy expenditure. To determine the cause of her amenorrhea, laboratory tests are ordered. Laboratory Test Results Pregnancy test negative LH Below normal FSH Below normal Estradiol Below normal Serum total calcium 7.8 mg/dl (normal range = 8.6-10.3 mg/dl) Serum ionized calcium 3.9 mg/dl (normal range = 4.4-5.2 mg/dl) Serum vitamin D, 25 hydroxy 25 ng/ml (normal range = 30-80 ng/ml) Serum PTH Increased above normal Follow Up Tests: Given that Sara’s serum calcium and vitamin D results were below normal, Sara had a bone density (DXA scan). Results revealed a Z score = -1 (lower than normal bone density). Given the low LH and FSH, Sara was tested with a priming dose of intravenous pulsatile GnRH (1-2 mg/90 minutes). Results showed normal levels of LH and FSH, in response to GnRH.

1. Considering Sara’s level of PTH, describe what adaptive response might be taking place within Sara’s bone (i.e., focus on the inter-relationship between the cells within the osteon)? How does this relate to her bone density results?

Trace the blood flow chamber, do not include heart valves
Start Pulmonary Capillary

End at right Kidney