current surge in numbers of overweight and obese individuals.....
.......treatments for obesity i.e. bariatric surgery, stomach stapling, liposuction, the newly
released OTC version of orlistat, "ALLI" .....
.......the effects of media hype on "thinness"

Describe how neurotransmitters are produced, transported, and released.

Patient Name: Jennifer Markus                                                                                                                                   MR#: 45879

Attending Physician: Katrina McKenzie, M.D.

Consulting Physician: Erik Anderson, M.D.                                                                                                            Date: 12/4/11

Subjective: Mrs. Markus is a 33-year-old woman with a PMH [past medical history] significant for depression, asthma, hiatal hernia, and migraine headaches. She presents complaining of waking with a pulsing headache on the left side of her head, with 1 day of prior increased sensitivity to light and to noises, as well as nausea, no emesis. The patient notes that work has been increasingly stressful over the past couple weeks and she’s had trouble sleeping. She took two tablets of ibuprofen last night in the hopes of avoiding a migraine, with minimal relief. She is currently taking sertraline for her depression.

She denies any history of seizure, cluster headaches, or tension headaches. She does smoke approximately one half pack of cigarettes daily. She notes that she’s been getting these headaches more frequently, as in two to three times per month. She would like something to decrease the duration of the headache, as well as some suggestions for prevention of future headaches.

Objective: VS: BP 134/80, HR 76, Temp 98.4, wt 155. Physical Exam. General: The patient is sitting with her eyes partially covered by her hands, otherwise, no acute distress. HEENT: Normocephalic/atraumatic, conjunctivae noninjected, pupils equal and round, reactive to light and accommodation (PERRLA), ears with normal cone of light reflex, nose with clear discharge, throat nonerythematous. Neck: No lymphadenopathy, thyroid smooth and symmetric, no nodularity palpated. Lungs: Clear to auscultation bilaterally. Heart: Regular rate and rhythm, no murmurs/grunts/rubs. Abdomen: Soft, nontender, nondistended, no abdominal bruits. Extremities: Warm and well perfused at distal extremities, no edema bilaterally. Musculoskeletal (MSK): Strength of upper and lower extremities equal and 5/5, no loss of sensation at extremities, normal patellar reflexes bilaterally.

Assessment: Patient is a 33 yo female with symptoms and physical exam consistent with migraine headache.

Plan: Migraine Headache Treatment. Begin the patient on a combination treatment of sumitriptan 85 mg and naproxen 500 mg, daily, for the duration of the headache.

Prevention: Continue with the sertraline, as it can have protective effects. Begin a smoking cessation regimen, because smoking can worsen headaches. Recommend some manner of stress-reduction practice, whether it be regular exercise, meditation practice, or relaxation practice.

Follow-up in 3 weeks to evaluate progress and number of headaches. At that time, will reevaluate with the possibility of adding a beta-blocker or calcium channel blocker. Patient was advised that if this headache worsens or fails to improve in the next 24–48 hours, she should call the clinic.

Erik Anderson, M.D.

Discussion Questions

2.     The format of this note is a SOAP note. Using an online search or other research method, describe what a SOAP note is and how it’s used.

Take a 20-minute walk or ride (or do anything that involves some movement) and think about the organ systems described in the lecture. Take a break from your activity, and note the following:

• Name 4 organ systems that you feel are working during your activity.

• What roles are 2 of these systems playing in your activity?

• What is one system that you know is working but you’re not feeling it work?

• Name 1 way that your body is maintaining “homeostasis” during your activity.

Describe the electrical activity of the heart to include the electrical activity of the noncontractile auto rhythmic cells (pacemaker cells) and the depolarization and repolarization of the myocardium.

Discuss age-related changes that occur in the remainder of the axial skeleton

Starting with a fatty acid located in the cytosol of the cell, explain “mechanistically” how an iron deficiency may result in reduced acetyl CoA production from beta oxidation of palmitic acid

Describe the social and public health (PH) challenges that need to be addressed to improve the health of women in low income countries

1. Describe the purpose of osteological landmarks (process, fossa, foramen). Identify 1-2 examples of each.

Which of the following statements is(are) true? (Check all that apply)

In eukaryotes, multiple genes can be expressed simultaneously by

A transcriptional regulator that activates expression of additional transcriptional regulators that induce production of a particular cell type or organ is called a

he control of a gene product’s levels or activity after transcription has taken place is called

compare and contrast the mucosa's between the esophagus and small intestine