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• Most solutions can't be copy-pasted out of your notes, workbook, textbooks, or the web. Actually, we're intentionally asking questions that make you mirror on and piece collectively info you've got learnt all through the semester. To get full marks, you'll need to obviously display that you just understood the training materials and are in a position to apply the acquired information. When marking, we're on the lookout for connections to be clearly said, unambiguously written, and well-reasoned. We count on high-quality and convincing writing, the place the which means is obvious, related terminology is used, and which displays engagement with the unit. Don't be afraid of utilizing dot factors wherever you'll be able to; succinct and clear writing is way superior to a phrase salad or to a number of paragraphs with out essence.
Hints/suggestions from earlier semesters
• Take care that your solutions have the anticipated degree of depth—it is not going to be sufficient, for instance, to state that ‘drug X decreases blood stress’; we count on you to clarify the mechanism of and describe the chain of occasions resulting in the specified/recognized results.
• As an try to attempt to cover blatant plagiarism, some college students had simply merely changed sure phrases of their textual content they copied from the web/textbooks. This isn't paraphrasing however dishonest (i.e., plagiarism). As well as, the ‘alternative’ phrases have a tendency to change the which means and/or could also be inappropriate within the context of the reply.
• Any type of educational misconduct (e.g., plagiarism, collusion, or sloppy paraphrasing) can be topic to vigorous educational misconduct investigations leading to mark deductions, cancellation of the evaluation activity, and/or disciplinary hearings.
• We're significantly eager on seeing proof of your crucial considering abilities—i.e., you might be presupposed to assess all info you receive from numerous dependable sources (textbooks, lecture materials, journal articles). Please remember that simply because Google suggests a solution, it doesn't imply that it's appropriate. Case Examine 1 (30 marks complete)
Cheryl is a 55-year-old girl, who works lengthy hours for a publishing firm. She likes to have a few drinks when she will get house from work each night time with the take-away meals she picks up on her means house. She loves her job as an editor, however finds it very aggravating, and so, has taken to smoking cigarettes to assist her loosen up. What began as a pair on a regular basis has now grow to be a packet a day. She has additionally elevated her alcohol consumption to four glasses of vodka each night time as she has observed that she not will get the identical pleasurable emotions from a few glasses. Her mates have observed that she stumbles very often, forgets issues, is moody and is flushed within the face nearly on a regular basis. When questioned in regards to the quantity she drinks, she denies extreme use.
Within the final couple months, Cheryl has misplaced curiosity in lots of issues she as soon as loved; dancing, going to the flicks, and artwork class. She finds that she cries on the drop of a hat. She finds it tough falling asleep at night time, and so has began to drink increasingly till she passes out. She has no vitality to rise up for work and needs to remain in mattress all day. Her sister is frightened she is relying too closely on alcohol, and fears that she is beginning to get short-term reminiscence loss from the alcohol consumption. She forgot her brother’s birthday, an essential work assembly, and what day of the week it was. She stops mid-sentence as she can't discover the best phrases to speak her ideas, and she or he is taking double the time to now full a activity. She is turning into very annoyed with herself and lashes out on the folks round her. Her sister decides it's time to e book an appointment with the GP to work out what has been happening with Cheryl.
On the medical clinic, the GP listens to all of Cheryl’s indicators and signs. She prescribes a benzodiazepine (Xanax) and a selective serotonin reuptake inhibitor (Zoloft). She additionally prescribes an acetylcholinesterase inhibitor after finishing up bodily, neurological, and cognitive checks. Cheryl can be given info on counselling and is referred to a counsellor to speak by way of her issues and assist her with coping methods.
Query 1/1. Determine one illness/situation Cheryl has and justify your reply. (2 marks)
Query 1/2. Utilizing the illness/situation you've got recognized in Query 1/1, clarify the hyperlink between the medical manifestations of the illness and its pathophysiology. (2 marks)
Query 1/three. Focus on the advantages of administration of an SSRI in Cheryl’s situation. To get full marks, you should clarify the pharmacodynamics and pharmacological results of SSRIs and relate them to Cheryl’s medical image. (three marks)
Query 1/four. Describe the impact of power alcohol consumption on liver operate and clarify its consequence on the distribution of water between the interstitial and intravascular compartments. (three marks) Cheryl’s household was pleased with the administration plan established by the physician as Cheryl was progressing fairly effectively. She was feeling a lot happier and didn't must depend on alcohol to fall asleep. Cheryl was in a position to catch up for lunch along with her sister, Rose, who talked about she was experiencing ache in each palms, which now took on a deformed look. Actually, Rose’s palms appeared fairly swollen as did her knees. She doesn’t perceive how this might have occurred as she continues to be fairly younger on the age of 50. She wonders whether or not it's her sort 1 diabetes mellitus which has brought on these issues. She tells Cheryl that she will’t sew as a lot as she used to because the ache will get worse the extra she sews. Cheryl asks her whether or not she has a chilly as she seems to be a bit of beneath the climate, and Rose tells her that she has been felling unwell recently. She admits that she has had so many viruses in the previous couple of years, she simply can’t appear to catch a break.
Query 1/5. Title the musculoskeletal dysfunction Rose suffers from, justify your reply, and determine a threat think about her historical past that's particular to the illness you specified. (2 marks)
Query 1/6. Evaluate and distinction the aetiology of Rose’s joint illness with the opposite joint illness we lined in BIOL122. In your reply, identify each ailments and describe two similarities and three variations. (three.5 marks)
In a quiet Sunday morning, Rose tripped and fell, which resulted in excruciating ache in her again. She couldn't even rise up; her husband referred to as the ambulance and tried to consolation her till they arrived. She was taken to hospital, the place the X-ray confirmed compression fracture on the T11 vertebral degree. A bone density check was additionally accomplished, which indicated that Rose had a T-score of -2.9.
Query 1/7. Interpret the results of the bone density measurement, point out what studying can be thought-about physiological, and identify the situation Rose’s discovering is related to. (1.5 marks)
Query 1/eight. Describe the aetiology and pathogenesis of the illness you specified within the earlier query. (6 marks)
Query 1/9. Title and outline the kind of fracture you recognized in Rose’s case and describe the most probably hyperlink between the situation you named beneath Query 1/7 and her vertebral fracture. (three marks)
Cheryl approaches you along with her considerations in regards to the COVID19 vaccination. She argues that there isn't a must get the jab — the truth is, it will make extra hurt than good — as a result of (i) the possibilities of dying from COVID19 are very low as it's nothing greater than a kind of flu, and (ii) there are recognized problems related to the jab, together with latest emergencies and potential fatalities attributable to irregular blood clotting. Cheryl argues that it's an unacceptable threat to vaccinate the whole Australian inhabitants as a result of the potential hurt way more outweighs the anticipated advantages.
Query 1/10. Primarily based on what you learnt about vaccinations and an infection management in BIOL122, and utilizing another sources of data you deem related and dependable, describe your reply to Cheryl and justify your conclusion. (four marks)
Case Examine 2 (30 marks complete)
Greg is a 42-year-old IT-specialist, who lives alone. He has at all times taken care of his weight loss program and life-style; he's on a nutritious diet, doesn't smoke, doesn't drink excessively, and workouts at the very least thrice every week. He has not had any main medical points other than his tonsillectomy that was carried out when he was 6 years previous. His father has been lately recognized with hypertension (which is beneath management, happily). His mom has been combating sort II diabetes, however her oral treatment and nutritious diet management it fairly effectively.
At some point, with none warning, Greg felt actually unwell so determined to see his GP straight away. It took solely a brief, 5-minute stroll to get to there, however Greg was struggling to make it. His GP immediately observed that Greg, appeared actually unwell—he gave the impression to be a bit of flushed, appeared very skinny, and was feeling a bit of breathless. On questioning, Greg defined that he had been feeling nauseous and unusually fatigued. He additionally defined that he had been very thirsty over the previous couple of weeks, which he attributed to his unusually intense train routine and the unseasonably excessive temperatures. He additionally defined that he had lately misplaced over eight kg in weight, however once more, he had attributed this to his train and nutritious diet. On questioning, he admitted that he needed to rise up at night time to go urine nearly each hour, however he was in no way shocked about this as he had been ingesting copious quantities of water. He additionally confessed that he had been feeling at all times thirsty and that his imaginative and prescient usually turned considerably blurred. When he was requested about his household historical past, he couldn't recall if he had any siblings, which his GP discovered fairly unusual. The GP additionally observed that Greg’s respiration was laboured; his respiration fee appeared to have elevated, and he was taking deeper breaths.
One of many checks that have been immediately carried out was a urine dipstick check, which was extremely optimistic for glucose and ketones. A subsequent blood check confirmed a plasma glucose focus of 16.eight mmol/L, his arterial blood pH was 7.22 (pCO2 = 20 mmHg; bicarbonate: 14.7 mmol/L), and his serum osmolarity was 304 mOsm/L.
After contemplating his medical image and laboratory findings, Greg’s attending doctor instructed him that he had diabetes mellitus, and he required speedy remedy.
Query 2/1. State 4 items of proof from Greg’s medical image/laboratory findings that assist the GP’s suggestion. (2 marks)
Query 2/2. Title the complication Greg was affected by when he visited his GP and determine two laboratory or medical findings that assist your conclusion. (1.5 marks)
Query 2/three. Determine the kind of diabetes Greg is affected by and justify your reply. (zero.5 marks)
Query 2/four. Clarify the hyperlink between Greg’s current situation and his respiration sample. In your reply, you should additionally (i) identify the attribute respiration sample noticed in Greg’s case and (ii) clarify the consequence of such a respiration. (6 marks)
Query 2/5. One of many long-term problems of Greg’s situation is accelerated fee of atherosclerosis. Clarify three causes for the elevated fee of atherosclerosis in diabetic sufferers. (three marks)
Greg’s diabetes is now efficiently managed, and every part returned to regular for him. Nonetheless, at some point he's discovered on the ground, mendacity unconscious.
Query 2/6. Assuming that Greg’s current state is said to his plasma glucose focus, determine the explanation for Greg’s unconscious state and description the perfect plan of action within the current state of affairs. (2 marks)
Greg’s work colleague, Cindy, is a 38-year-old married mom of three ladies, who was recognized with stage three infiltrating ductal most cancers of her left breast. Cindy underwent left mastectomy and axillary lymph node dissection 7 weeks in the past and is at the moment present process chemotherapy.
Query 2/7. Describe three most cancers cell traits that enable them to grow to be invasive and metastatic. (6 marks)
Query 2/eight. Focus on three potential medical manifestations that may consequence from bone marrow suppression and clarify how this situation could also be linked to Cindy’s remedy. (four marks)
A couple of weeks into her remedy, Cindy has contracted a nasty bacterial pores and skin an infection, which resulted in a large swelling of her proper hand. Along with this, for the reason that mastectomy and lymph node dissection, she has additionally been experiencing an uncomfortable swelling in her complete left arm.
Query 2/9. Contemplating their most probably aetiology, identify the varieties of swelling in Cindy’s proper hand and left arm and describe three variations between them. (5 marks)
Case Examine three (30 marks complete)
Twenty-one-year-old Lisa lengthy has been affected by bronchial asthma and is now experiencing an bronchial asthma assault whereas taking a day stroll along with her sister. It's a chilly, windy, early spring weekend. She complains of acute shortness of breath and has audible wheezing, episodic cough, and chest tightness with itchy crimson watery eyes and a stuffy, runny, itchy nostril. These signs grow to be worse inside 5 minutes. Her sister referred to as 000 and paramedics promptly attended to Lisa, who was totally acutely aware, appeared wide-eyed and frightened, and unable to breathe successfully. She was instantly transferred to the closest hospital for full respiratory operate evaluation and remedy of acute bronchial asthma.
A bodily examination reveals a HR of 120/min, RR of 38/min, with indicators of accent muscle use. Chest auscultation reveals decreased breath sounds bilaterally, with inspiratory and expiratory wheezes. Lisa is coughing up small quantities of skinny, clear sputum and has an arterial oxygen saturation of 90%.
Nebulised salbutamol, oxygen by facial masks, and systemic corticosteroid have been administered. A second small-volume nebuliser remedy was ordered 20 minutes later. Chest auscultation revealed diminished wheezes; RR was 24 at the moment and HR was 102. Over the following 24 hours Lisa confirmed regular enchancment and was discharged for follow-up along with her native GP to assessment her bronchial asthma motion plan and alter any drugs as wanted to assist forestall future exacerbations.
Query three/1. Checklist two elements that might have triggered Lisa’s acute bronchial asthma assault and clarify the hyperlink between the named elements and her bronchial asthma. (four marks)
Query three/2. Clarify the pathophysiological steps resulting in acute bronchial asthma assault. In your reply, you might be anticipated to hyperlink sort 1 hypersensitivity response to the function of histamine in acute bronchial asthma. (four marks)
Query three/three. Briefly clarify the mechanisms of motion of (i) salbutamol and (ii) corticosteroids within the remedy of acute bronchial asthma and describe their advantages in Lisa’s situation. (four marks)
Query three/four. Clarify the mechanism of motion of anticholinergic/anti-parasympathetic drugs and their potential profit(s) in bronchial asthma remedy. (three marks)
Lisa’s grandmother, Maria, is a 67-year-old retired, overweight girl, who lives along with her husband Max. She enjoys sitting all the way down to a film each night time with a bottle of Shiraz and a big packet of salt and vinegar chips or tub of cookies and cream ice cream. She has at all times liked a glass or two of wine with dinner however now figures she will have a couple of extra since she not has to rise up for work. Maria doesn’t prefer to train; her solely type of train is strolling round Coles on Friday while doing her weekly purchasing. Her sister has requested her to affix her strolling group on quite a few events, however Maria would moderately keep house and bake. Maria’s mom moved in along with her a few years in the past when her father handed away from a coronary heart assault on the age of 60. Her mom isn’t in the perfect of well being, she has sort II diabetes and hypertension, which she controls with treatment.
At some point Maria decides to go to her neighbour, taking along with her a batch of freshly baked cookies. While strolling to her neighbour’s home, she notices that she is in need of breath and is feeling a slight ache in her chest, however when she sits down, she feels wonderful, so she dismisses it as soon as once more, placing it all the way down to her poor health. Nonetheless, on her means house she begins to really feel light-headed and weak and appears like she goes to be sick. She notices that she has been feeling like this quite a bit recently, even when resting within the night, so she decides to make an appointment along with her GP for later within the week.
On the medical clinic, the GP takes Maria’s blood stress studying. It has been elevated on plenty of events, and immediately is not any totally different—the studying exhibits 140/95 mmHg. The GP prescribes an ACE inhibitor and tells Maria she actually must make some life-style adjustments. He writes a referral for her to see a cardiovascular specialist for an ECG and a coronary angiogram to find out why Maria has been in need of breath and unwell.
At some point, while ready for her outcomes, Maria begins to really feel extra nauseous and dizzier than standard. She begins to really feel clammy and sweaty, and her face appears grey in color. The chest ache returns however now appears like a crushing ache, and she will’t breathe. Her husband, Max, dials 000, and she or he is rushed to hospital. An ECG exhibits that Maria has an ST elevation, and a blood check signifies that she has excessive ranges of troponin in her blood. Maria is given heparin intravenously in addition to an anti-platelet and a fibrinolytic drug. She is taken into surgical procedure, the place a coronary angioplasty is carried out.
Query three/5. Clarify what Maria’s blood stress readings counsel and focus on two threat elements which may have contributed to Maria’s current situation. (three marks)
Query three/6. Clarify the anticipated advantages of ACE inhibitors within the above case research by referring to their pharmacodynamics and pharmacological results. (four marks)
Query three/7. Title the situation Maria was affected by when she was rushed to hospital and focus on two medical findings that assist your declare. (three marks)
As a part of her remedy, Maria takes a brand new, hypothetical treatment (referred to as MedX), which has slender therapeutic index, subsequently you (as a well being care skilled) must train particular care in the case of the willpower of her required dosage.
MedX is taken orally and has the next options:
• In wholesome adults, the absorbed MedX is topic to first go liver metabolism, which decreases its bioavailability to 10%.
• The energetic ingredient that enters the systemic circulation is water-soluble and exhibits very excessive protein binding: 98% of the drug molecules current within the plasma are sure to albumin and, to a smaller extent, a1 globulin.
• A lot of the drug is excreted by the kidneys, the place it's each freely filtered and actively secreted within the proximal tubule.
Query three/eight. Primarily based on the above properties of the drug, clarify why you'll suggest dose discount in Maria’s case. In your reply, clarify 4 age-related adjustments within the pharmacokinetics of MedX to justify why dose discount is important within the current state of affairs. For every of these age-related adjustments described, you'll need to contemplate how the free plasma focus of the drug is predicted to vary in Maria's case in comparison with that of a younger or middle-aged particular person. (5 marks)
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