how does the critic acid relate to the study of pathophysiology?

Billy was slipped a poison. This particular poison slows down the Na-K solute pump of neurons. If the solute pump slows down, what will happen to the neurons? Will the neurons become more excitable or less excitable or would it have no effect on depolarization potential?

1. pH 7.44 PaCO2 80 mm Hg HCO3- 30 mEq/L

   	a	metabolic acidosis with partial respiratory compensation
   	b	metabolic alkalosis with partial respiratory compensation
   	c	respiratory alkalosis with full renal compensation
   	d	metabolic alkalosis with full respiratory compensation

2. pH 7.25 PaCO2 40 mm Hg HCO3- 20 mEq/L

   	a	metabolic acidosis with no respiratory compensation
   	b	respiratory acidosis with no renal compensation
   	c	metabolic acidosis with partial respiratory compensation
   	d	respiratory acidosis with partial renal compensation

3. pH 7.31 PaCO2 55 mm Hg HCO3 28 mEq/L

   	a	respiratory acidosis with no renal compensation
   	b	respiratory acidosis with partial renal compensation
   	c	respiratory acidosis with full renal compensation
   	d	respiratory acidosis with no metabolic compensation

4. pH 7.50 PaCO2 35 mm Hg HCO3- 48 mEq/L

   	a	metabolic acidosis with partial respiratory compensation
   	b	metabolic alkalosis with partial respiratory compensation
   	c	metabolic alkalosis with no respiratory compensation
   	d	metabolic alkalosis with no renal compensation

5. pH 7.20 PaCO2 69 mm Hg HCO3 37 mEq/L

   	a	respiratory acidosis with partial renal compensation
   	b	metabolic acidosis with partial respiratory compensation
   	c	metabolic acidosis with no respiratory compensation
   	d	metabolic alkalosis with no renal compensation

Which bone(s) is/are located...

Anterior to the proximal end of the tibia?
Lateral to the superior end of the sternum?
Medial to the fibula?

Superior to the sacrum?

Medial to the proximal end of the femur?
lateral to the thoracic vertebrae?

Medial to the proximal end of the humerus?

Distal to the humerus?
Medial to the ilium?

A person was admitted to hospital for a car accident and sustained a fracture in his right arm and left leg with burns of total burn surface area of 68% and injury in his head and neck due to accident but with no fracture in them. He stayed in coma for 3 days to control his situation and the severity of brain injury is measured by the Glasgow Coma Scale and found to be 14. The patient had no previous medical or nutritional problems. The patient had a surgery for his leg (installation for hip joint), but all other problem were solved with no surgeries. An inflammation happened to his hip after the surgery where the physician delayed his discharge from the hospital. The patient weight upon his admission to hospital is 109 Kg and his height is 188 cm.

1-Discuss the metabolic response in this case describing phases, hormonal state, regulations? (Please notice that your answer not to exceed 300 words, and list the reference you have used).

2-If you are working in this hospital as a dietitian, explain the nutrition plan you will follow for this case, in each stage of his medical treatment plan, from his admission, ICU, before surgery, after surgery, at home, mention all nutrients to concentrate on, or to supply and method of feeding to use in each stage? (Please notice that your answer not to exceed 1 word page, with single space between lines, and no need for references).

-How to assess thyroid disorders medically and nutritionally?

(Please notice that your answer not to exceed 150 words for each point, and list the reference you have used).

Explain why the following scenarios would negatively impact neuronal functioning?

a) Severe damage to the myelin sheath caused by a viral infection.,

b) Degenerative condition that exclusively affects the oligodendrocytes. ,

c) Structural damage to the dendrites. ,

d) Extensive damage to the Nissl’s substance.

The volume of inhaled air where there is no exchange of gases with the pulmonary capillaries is called the:

A. Residual Volume
B. Functional Residual Capacity
C. Inspiratory Volume
D. Dead Space
E. Vital Capacity

Write and explain cardiac conduction system?

Please summarize these two passages from this article.

1. Introduction Vitamin D is the main hormone regulating calcium phosphate homeostasis and mineral bone metabolism.The discovery that a variety of tissues can express vitamin D receptor (VDR) has opened new ways of research related to vitamin D biological effects and molecular pathways [1–3]. There is evidence that vitamin D is implicated in the regulation of the immune system, the cardiovascular system, oncogenesis [4], and cognitive functions [5]. Loss of muscle mass and frailty are prevalent in many chronic diseases such as chronic obstructive pulmonary disease, cardiac insufficiency, cancer, and chronic kidney disease (CKD) [6]. Vitamin D deficiency is indeed extremely frequent in the above diseases. More than 3 decades ago, the clinical observation that patients with rickets and osteomalacia displayed proximal myopathy suggested a direct link between hypovitaminosis D and muscle function [7]. Recent evidence has confirmed that vitamin D may modulate muscle growth. In this review, we will specifically address the effect of vitamin D on skeletal muscles and its clinical implications, especially frailty and the risk of fall.

2. A Link between Vitamin D and Frailty? The term “frailty” is becoming more and more popular in geriatric medicine. However, its definition is vague. The Oxford dictionary defined it by “the condition of being weak and delicate.” A more precise definition is given by Fried who defined frailty as “a biologic syndrome of decrease reserve and resistance to stressors that results from cumulative declines across multiple physiologic systems and causes vulnerability to adverse outcomes [68].” Criteria of the frail phenotype have been described in order to translate the above theoretical definition into clinical indicators [68]. These are as follows: unintentional weight loss, self-reported exhaustion, weakness (grip strength), slow walking speed, and low physical activity. According to these clinical criteria, 3 phenotypes have been identified: robust: 0 criteria; prefrail: between 1 and 2 criteria; frail: 3 or more criteria. The majority of these criteria are related to locomotion and physical strength. Thus, it looks readily conceivable that hypovitaminosis D may lead to frailty, through negative effects on muscle strength and/or function. The association between vitamin D status and frailty has been studied in a number of observational studies. Data from an observational study from Hirani et al. which included 1659 community-dwelling men, with a 10% prevalence of frailty, showed that low vitamin D levels were independently associated with frailty [69]. A similar association was found by Tajar et al. in another cohort of elderly men. Subjects with vitamin D levels <50 nmol/L had an odd ratio of 2,37 of being classified into the “frail” versus the “robust” phenotype [70]. Using data from the third National Health and Nutrition Survey (NHANES), Wilhelm-Leen et al. found an association between frailty and a low vitamin D status in both elderly men and women, with overall 4-fold increase in the odd ratio of frailty [71]. Vitamin D not only is associated with frailty but also appears to be associated with an increased risk to develop frailty over time in women. In a prospective study including elderly women (age > 69 years), nonfrail women at baseline but displaying a vitamin D level of less than 50 nmol/L hada higher risk of becoming frail during the 4.5 years of followup than women with a higher level of vitamin D [72]. In a study from patients with cardiac insufficiency, Boxer et al. found an association between low vitamin D levels and the frail phenotype. In particular, vitamin D levels and the result of the 6-minute walking test were correlated [73]. In cardiac diseases, this functional test is known to predict survival [74]. Thus, low vitamin D is hypothesized to link with mortality in this setting. A prospective study including 4000 individuals (1943 men and 2788 women, mean age: 70), followed up to 12 years, indeed found a link between lower levels of vitamin D, frailty, and mortality. An assessment of vitamin D status and the physical phenotype (robust/prefrail/frail) were performed at baseline [75]. Mortality was positively associated with frailty. Frail individuals with a low vitamin D level were at increased risk (hazard ratio of 2.98) of death during the follow-up compared to robust individuals with a high level of vitamin D. Thus, overall, a clear association between vitamin D level and frailty has been demonstrated. Furthermore, interplays between vitamin D status, frailty, and mortality appear plausible. Whether vitamin D supplementation in frail subjects may reduce mortality is challenging and needs to be investigated in the future.

Please include a reference

Mr. F. was diagnosed with type 2 diabetes mellitus at age 46. At that time, he was overweight, enjoyed foods with high carbohydrate and fat content, and led a sedentary life. His family history indicated that his mother and his brother had diabetes. Weight loss, appropriate diet, and exercise were recommended to reduce blood glucose levels.

1. List the factors contributing to diabetes mellitus in this case.

At age 50, Mr. F. noticed that his vision was cloudy, particularly in one eye. Cataracts were removed from both eyes.

2. Describe a cataract, and explain how diabetes promotes cataract formation.

3. Glyburide (DiaBeta) was prescribed at this time. Describe the action of this drug.

At age 56, a blister developed on the heel of one foot, which did not heal. An ulcer formed and persisted. Finally the foot was placed in a cast for 13 weeks to promote healing.

4. Explain several factors contributing to the delayed healing in Mr. F.

5. Why was it necessary in this case to remove the cast and replace it each week?

Peripheral neuropathy with total loss of sensory function had developed in both feet. Motor function was not directly affected. Orthopedic shoes were ordered and arrangements made for a podiatrist to provide regular foot care.

6. Why is it essential that Mr. F. examine his feet carefully each day?

At this time body weight had again increased substantially and blood pressure was elevated. Fosinopril (Monopril) was prescribed, along with recommendations for weight loss and regular exercise.

7. Describe the usual manifestations of hypertension.

At age 60, routine monitoring during a workout at the health club indicated atrial fibrillation. During consultation, the cardiologist also noted his blood pressure was very high.

8. State the purpose of the following medications prescribed at this time (see Chapter 18): fosinopril (Monopril), atorvastatin (Lipitor), amlodipine (Norvasc), warfarin (Coumadin), and sotalol (Sotacor).

Since that time, continued regular exercise and dietary modification have maintained weight at recommended levels. Blood pressure is within normal range, HbA_1c is below 7, and atrial fibrillation is controlled.

9. What does this HbA_1c value mean?

10. Why does Mr. F. bruise easily? What precautions would be advisable at this time?

11. Briefly review the effects of diabetes over time in this case.

question is :rewrite the story completely in layman's terms or plain English so that someone without a medical or science background would be able to understand.
Your translation must be clear and easy to understand.

Part 1 – Jack and Jill

Two individuals, one with a significant amount of testosterone and one with a large amount of estrogen went for a walk together up a hill. The male had genitalia that enabled the passing of semen and urine through the urethra. Urethritis was not a problem as of late for this gentleman.

The female had been suffering from dysmenorrhea for so many years that it was feared that endometriosis might be the culprit. Also, here had been periods of oophoritis, mastitis, menometrorrhagia and PID. Their goal was to have a baby together but the odds seemed stacked against them.

The male was only able to take short walks due to hematuria, prostatitis and benign prostatic hyperplasia and was experiencing times of anuria and yet at other times he experienced increasing the frequency and urgency of urination. This friend had recently undergone an orchiectomy. Having babies seemed impossible now.

The two friends often talked about personal matters and common topics included impotence & erectile dysfunction, fibrocystic change in the breast, mastalgia, cervicitis and toxic shock syndrome.

As the male was fetching the pale of water at the top of the hill he fell down and broke his crown. This was due to a syncopal episode. He rolled down and suffered a cranial contusion. The female came tumbling after and yet managed to come to the rescue and call 911. Next time they have decided to outsource this job. They eventually adopted a child and all was well.

Part 2 – The Old Lady Who Lived in a Shoe

An elderly female who strangely ovulated frequently, underwent gestation on a regular basis subsequent to numerous fertilizations. She produced many zygotes in her day. Many babies abounded.

She lactated as much as she could with her high prolactin level but it was insufficient to feed her family thus she had to bottle feed many of her children. She had never experienced eclampsia, pre-eclampsia, placenta previa, abruptio placenta, salpingocyesis or breech presentation. She never required in vitro fertilization. The births always went quite smoothly.
She did receive excellent prenatal care all along including amniocentesis procedures, and chorionic villus samplings. All her babies were born healthy and happy.

She had required a hysteroscopy, and a salpingogram and her ovaries which were due for a bilateral oophorectomy. She thought that maybe she had enough babies now and it was time to retire and look for a new shoe down in sunny Florida.

PART 3 - The Renal Sub Journey

Smaller subs had taken similar voyages in years prior and they had been equipped with diuretics, which carried them smoothly through the renal system. This patient was known for his hydronephrosis and after an intravenous pyelogram was performed the way was cleared for the sub to travel to see what was the problem. This patient initially experienced oliguria which made it hard for the sub to pass through but finally enuresis was achieved! The team noted the presence of renal calculi, but the team had to be cautious that the patient was not undergoing a concurrent lithotripsy, which would crack the hull of the sub. The kidney was mildly irritated by the sub’s journey thus experiencing prerenal azotemia and pyelonephritis but thankfully no nephrosclerosis resulted.

Other good findings for the patient with the urinary sub included no ureterostenosis or interstitial cystitis so a cystoscopy was not recommended. There were rumors of nocturia and alas, everything was free flowing at midnight. The light at the end of the tunnel was seen again and happily there were no urethral strictures slowing this exit down. This mission yielded much valuable information for this patient and the team and its mission was heralded as a grand success!

1. A myocardial infarction (heart attack) occurs when a coronary artery is suddenly blocked, usually due to the rupture of a cholesterol plaque. Which coronary artery do you think would have the biggest effect on heart function when blocked? How are blockages of the coronary arteries treated medically? How are they treated surgically?

ase 2

Steve is a member of the West Coast Eagles football team. During practice, he suffered a high impact collided with a team-mate and injured the anterior compartment of his thigh. As a result of the collision, his quadriceps femoris muscle were compressed against the femur, resulting in quadriceps contusion or ‘cork thigh’.

1. Describe the gross anatomy of the [muscles, their attachments and actions and nerve supply] of the quadriceps [anterior] compartment of the thigh.

2. Explain what happens to the muscle compartment following such injuries. [3 marks]

3. Explain the signs and symptoms of such an injury.

4. If severe or left untreated left untreated, this type of injury can result in compartment syndrome. Explain what is meant by compartment syndrome and outline the consequences of this condition.

5. In severe injuries of this type, a condition known as myositis ossificans can occur. Explain the processes involved in the development of this condition, and the resulting consequences if left untreated.

6. using the APA 7 style of referencing. Start your list of end-text references on a new page. The list of references should be left aligned. Use a hanging indent for each reference and follow APA style format for all reference

...........................................................................................................................................................................................................................................................................................................................................................................................................................................................

Sample A is from a 35 year old male who visited his GP complaining of chest pain during exercise. An ECG taken at rest was normal but ischaemic changes developed on exercise. A family history revealed that his father died of a heart attack at the age of 45 years. The laboratory test results for his fasting blood sample were as follows:

Analyte                       Patient values                        Reference range for fasting

     blood sample

Sodium                                    139                              135-145 mmol/L

Potassium                                4.1                               3.0-5.0 mmol/L

Total protein                           69                                65-80 g/L

Albumin                                  35                                35-47 g/L

Calcium                                  9.3                               9.0-10.5 mg/dl

Lactate dehydrogenase           250                              90-190 IU/L

Creatine kinase                       129                              30-60 IU/L

Asparatate transaminase         70                                < 40 IU/L

Gamma glutamyl transferase 30                                < 50 IU/L

Total Bilirubin                        13                                0.4-15 μmol/L

Glucose                                   12                                3.5-5.5 mmol/L

Fructosamine                          351                              205-285 μmol/L

Cholesterol                             

            Total                            7.2                               <5.2mmol/L

            HDL                            1.4                               >1.5 mmol/L

            LDL                            ?                                  <3.5 mmol/L

Triglycerides                           2.95                             <1.7mmol/L

On the gradient gel electrophoresis, plasma sample for this patient showed the presence of small dense LDL particle.

1. Calculate and comment on the LDL cholesterol values. What does the presence of small dense LDL mean?
2. How many cardiovascular risk factors does this patient have?
3. Discuss the type of hyperlipidaemia this patient is likely to have.
4. What further tests and dietary/drug treatments would you recommend for this patient?