1. Now that you see what happens with oxygen consumption, cardiac output, and stroke volume, create your own scenario where two subjects would have different numbers (for example so don’t use this one – someone with COPD vs. healthy person). Explain what you expect your findings to be and why.

go through every system (i.e. nervous, cardiac, respiratory, urinary, metabolism) and tell me the differences that are happening in someone running an endurance event compared to someone at rest. This should be separated into sections with headings, written in sentences, and should be 1.5-2 pages. For example, how might my respiratory rate change and why? Cardiac Output? Insulin levels? Glucose levels??

Describe the basics of nervous control of ventilation relative to the brain and 3 main kinds of lung receptors.

In tubular secretion from the peritubular capillary,

-what substances are secreted?

-if penicillin is found in the filtrate, why is it not filtered at the renal corpuscle?

-what is creatinine? is it secreted by the nephrons?

-where in the nephron does most secretion occur?

1. Henry is a 60 year-old, white college man who woke due to intense and worsening pain in his right flank this morning. He came to your emergency room in a state of distress, with diaphoresis (sweating) and pallor (pale appearance). He was unable to sit still or become comfortable in the ER cot, groaning and stating that he was nauseated. His past medical history includes diabetes, gout, and controlled hypertension. He takes medications for his diabetes, gout, and hypertension; he reports no difficulties in affording his medications and does not have difficulties in taking them as prescribed. His vital signs are as follows: temperature mildly elevated at 99.5℉, BP mildly elevated at 138/85, heart rate increased at 110, Respiratory rate normal at 20. His height is 5’9”, and his weight is 205 pounds; his BMI is 30.3

   • What two main diagnoses do you suspect for Henry? Provide supporting evidence using his clinical manifestations.
   • What risk factors does Henry have for the diagnoses you have chosen? List two risk factors for each diagnosis, and briefly explain how that increases an individual’s risk for that disease.
   • What tests do you suspect will be ordered to confirm Henry’s diagnosis, and what value do they add to confirming or excluding your chosen diagnoses? Include at least three tests.

There is the conventional dental crown making process. However, recently, new crown-making methods have been originated. Explain and compare the various crown making processes.

Case Study – Diabetes Mellitus Mohinder, a 28 year old male, had been diagnosed with diabetes mellitus when he was 12 years old. He started experiencing polydipsia, polyuria and polyphagia and his parents noticed that he was very lethargic and seemed continuously fatigued. They would occasionally detect the sweet, “fruity” smell of acetone on his breath. Their PA informed them that this was a sign of ketoacidosis associated with the diabetes. At the time, high fasting glucose levels and islet cell antibodies (ICA) had been detected in his blood. His doctors had him carry out a regimen to control his fluctuations in blood glucose which included diet, exercise and administration of exogenous insulin. At first he was administering insulin 1-3 times a day as indicated by measuring the glucose concentrations in small blood samples obtained from pricking his finger. When he was 22, he got a small battery-powered infusion pump that continuously infused insulin subcutaneously. Now he is considering an experimental treatment that involves implantation of beta-cells derived from donated pancreases. These cells implant in the liver and produce insulin in response to blood glucose levels.

1. Is Mohinder suffering from Type I or Type II diabetes mellitus? How can you tell?

2. What are polydipsia, polyuria and polyphagia? Why are these symptoms of diabetes?

3. What is ketoacidosis? Why is it a consequence of diabetes mellitus?

3. What do the ICA suggest about the etiology of his condition?

4. Why is an insulin infusion pump superior to periodic insulin injections? Why would donated beta-cells be superior to the infusion pump if they can be successfully implanted? (Think about the negative feedback loops for control of blood glucose as you answer this question. How do the concepts of sensitivity, gain and lag time relate to this question?)

5. What are the drawbacks to donated pancreas cells? How might embryonic stem cells be used to avoid these problems?