Question

1. My 8-month old son has a skin rash. The doctor prescribed hydrocortisone which is an anti-inflammatory drug that acts to stabilize the lysosome membranes. Explain why this effect reduces cell damage and inflammation. Why is this steroid hormone packaged in an oily based cream and applied topically (on the skin)?
2. An individual arrives at the hospital with a very rare disease. This disease is typified by the destruction of Ribosomes in the cells. Describe the immediate and long-term effects this would have on her physiology?
3. Three weeks ago, we were in the middle of a record heat wave. A number of elderly people visited their health care providers complaining of feel terrible. Most of the patients had cool and clammy skin and low blood pressure. What is their problem? What can be done to reverse it?
4. You are an athlete and running for 5 miles this morning. The new coaching intern was asked to fill the water bottles with Gatorade. He misread the printed instructions and filled them with water. Is this an acceptable predicament or not? Briefly explain why

Answer 1

Answer to first part of question

Hydrocortisone is an antiinflammatory drug.Its action is nonspecific and covers all components and stages of inflammation. This includes attenuation of—increased capillary permeability, local exudation, cellular infiltration, phagocytic activity and responses like capillary proliferation, collagen deposition, fibroblastic activity and ultimately scar formation. This action is direct and can be restricted to a site by local administration. The cardinal signs of inflammation—redness, heat, swelling and pain are suppressed.The most important mechanism is limitation of recruitment of inflammatory cells at the local site and production of proinflammatory mediators like prostaglandins and leukotrienes by inhibiting activity of phospholipase A2. This hydrocortisone is applied topically to allow the maximum concentration at the site. This also reduces the side-effects of orally prescribed corticosteroid.It comes as an oil based cream to increase its penetration as oil gives it a lipophilic medium that increases potency of the drug.

Answer to the second part of the question

These group of disorders are specifically called Ribosomopathies in which genetic abnormalities cause impaired ribosome biogenesis and function, resulting in specific clinical conditions. Congenital mutations in genes encoding ribosomal proteins cause Diamond-Blackfan anemia, a disorder characterized by hypoplastic, macrocytic anemia. Mutations in other genes required for normal ribosome biogenesis have been implicated in other rare congenital syndromes like Schwachman-Diamond syndrome, dyskeratosis congenita, cartilage hair hypoplasia, and Treacher Collins syndrome. Also the 5q− syndrome, a subtype of myelodysplastic syndrome, is caused by a somatically acquired deletion of chromosome 5q, which leads to insufficiency of the ribosomal protein and phenotype highly similar to Diamond-Blackfan anemia. Acquired abnormalities in ribosome function have been implicated more broadly in human malignancies. The p53 pathway provides a surveillance mechanism for protein translation as well as genome integrity and is activated by defects in ribosome biogenesis; this pathway appears to be a critical mediator of many of the clinical features of ribosomopathies.

Answer to the third part of the question

As you said there was a heat wave the classic triad of exposure to a heat stress, CNS dysfunction,i.e,the feeling experienced by elderly individuals in this case , and a core temperature >40.5°C helps establish the preliminary diagnosis of heat stroke.

Physiologically heat absorption by the body and dissipation of heat is balanced in normal individuals. But due to reducing reserve with increasing age they are more predisposed to heat related illness.

Treatment includes fluid resuscitation and rapid cooling which can be in form of evaporative cooling or immersive cooling.

Answer to fourth part of question

When you run you lose sweat that includes water and electrolytes thus after running simple water can't replace electrolytes in the body. Gatorade has electrolytes (sodium) that help replace the sodium lost as part of sweat. This is the explanation behind consuming specific thirst quencher rather than simple plain water after running.