End of Semester Worksheet

End-of-semester worksheet

1/1 The one disease Cheryl is definitive to be suffering from is major depressive disorder. In major depressive disorder, the person shows symptoms of uncontrolled emotions, insomnia, extreme tiredness, slowed thinking and others (Hasin et al., 2018). In case of Cheryl, she is mentioned to show loss of interest in many things, express to be too much emotional and failure to control tears, has disturbed sleeping regime and others which are like the symptoms of the major depression that confirm her to be suffering from the condition.

1/2 The case study of Cheryl informs her to be suffering from major depression and she shows symptoms of emotional outbursts, weakness and others. The pathophysiology of depression informs that depression is developed due to the depletion of major neurotransmitters in the brain such as serotonin, dopamine and norepinephrine. The serotonin is responsible to stabilise the mood of individual and make them remain happy but its depletion in depression makes the person show emotional distress as seen in Cheryl (Liu et al., 2017). The role of non-epinephrine is to control increased energy levels, stress reaction, manage attention, support enhanced memory and others (Sun et al., 2019). However, its depletion as seen in depression leads to failure of memory, attention and others. The normal level of dopamine helps individuals show enhanced motivating behaviour, but its depletion leads individual to feel low in motivation to work as seen in depressed patients (Pizzagalli et al., 2019).

1/3 The benefit of administering SSRI to Cheryl is that assist in treating severe and persistent depression which she is currently suffering as seen from her expressed symptoms. The SSRI work to manage depression by increasing serotonin level in the brain that is the key neurotransmitter in supporting carrying of signal between brain nerve cells for enhanced working of the brain. They execute it by blocking the serotonin reuptake process in the brain that causes increased serotonin to remain in the cleft rather been absorbed (Vadodaria et al., 2019).

1/4 The chronic alcohol consumption leads the liver to get swollen and inflamed with the presence of the damaged cell. The impaired liver shows inability to detoxify endotoxins and supports to cause oxidative damage in the body (Younossi et al., 2019). The consequence of the damage of the liver cell due to chronic alcohol consumption is that it creates high intrahepatic pressure which creates imbalance across of the surface of the liver leading to hindered water balance in interstitial and intravascular compartment (Hajifathalian et al., 2019).

1/5 The symptoms of rheumatoid arthritis include swelling and redness of joints that results in pain, joint stiffness and inactivity (McInnes and Schett, 2017). Rose is suffering from rheumatoid arthritis as she represents all the symptoms similar to the disease such as pain in the joints, swollen joints and reduced capability to move hand due to pain. One of the risk factors of rheumatoid arthritis is continued viral infection as increased infection leads to trigger immunity of the body to act against joints (McInnes and Schett, 2017).

1/6 The three-key different between rheumatoid arthritis (RA) and osteoarthritis (OA) is that RA initiates at the age of 30-50 whereas OA develops at age of 65 years and above, RA affects symmetrical and polyarticular joints whereas OA affects unilateral joint, RA includes the symptom of fatigue and malaise whereas OA does not represent the symptoms (NHS, 2021; NHS, 2019). The two similarity of RA which is affecting rose and OA is that both causes pain and impaired functioning of the joint (NHS, 2021; NHS, 2019).

1/7 The T score of -1.0 or more is physiologically considered to be normal (NHS, 2020). Rose has T score of -2.9 which indicates she is suffering from osteoporosis.

1/8 The symptoms of osteoporosis are back pain, stopped posture, brittle bone and others (Sinaki, 2021). The aetiology of osteoporosis mentions that it is caused due to aging. This is evident as the bones in the body remains in a constant state of renewal till 20s after which they slower the renewal process leading the bone mass to be reduced making people develop osteoporosis (Sinaki, 2021). The women after menopause are vulnerable to develop osteoporosis due to increased loss of calcium and minerals from the body caused by low amount of oestrogen that are essential in support bone mass management for healthy bone (Sözen et al., 2017). The pathogenesis of osteoporosis is considered to be multifactorial and considers deficiency or excess of presence of certain hormones and environmental factors in resulting the disease (Chotiyarnwong and McCloskey, 2020). For instance, excess presence of parathyroid hormones in the body leads to lo of calcium from the bones making the person develop brittle bone condition as seen in osteoporosis (Leder, 2017).

1/9 Rose has suffered compression fracture which is the type of fracture in which the bone collapses with one another. The osteoporosis leads to compression fracture as in such condition the bones are weak and brittle which with simple force may break to collapse with one another (Sinaki, 2021). Rose is seen to have fall which acted as pressure on the vertebrae that is weakened due to presence of osteoporosis to develop the fracture.

1/10 The case study of Cheryl mention that she has wrong perception regarding Covid-19 and its vaccination. This is because Covid-19 is not just a flu but a viral infection which is caused by new strain of coronavirus that can be easily transmitted through air droplet and cause serve damage to the respiratory tract making individuals face fatal consequences if not managed at the earliest (Bogart et al., 2021). There are few cases of blood clotting in patients receiving Covid-19 vaccine, but the condition is rare. The benefits of the vaccine outweigh its harm as the vaccine helps in protecting people from facing fatal condition if been affected by Covid-19 because it creates antibodies within the body that assist in fighting with the disease (Hotez et al., 2020). Therefore, for better protection from Covid-19, Cheryl need to take the Covid-9 vaccine.

2/1 The four key evidence that support GP’s suggestion for Greg’s condition is his blurred vision, sudden loss of weight, extreme thirst and frequent passage of urine. The blurred vision is common in diabetes as body water is pulled to the lens making it swell and develop hindered vision (Mustafa et al., 2018). The sudden loss of weight is diabetes develops due to incapability of the body to use glucose in firming energy to maintain healthy weight (Owusu et al., 2018). The presence of diabetes led to increased presence of glucose in the body which makes the kidneys feel forced to work overtime in filtering the excess glucose leading to frequent urination and development of thirst out of increase water loss from the body (Dhanavelu et al., 2019).

2/2 Greg was suffering from diabetes mellitus when he visited the doctor which can be identified from his high plasma glucose level that is 16.8 mmol/L (7.8 mmol/L normal) and increased serum osmolarity that is 304 mOsm/L (285-295 mOsm/l normal) (Abu-Libdeh et al., 2017).

2/3 Greg is suffering from diabetes mellitus which is evident as he expresses key symptoms such as weight loss and polydipsia related with the condition (Nigro et al., 2018).

2/4 Greg is currently suffering diabetes mellitus which has leads to his laboured breathing. This is because in diabetes mellitus the body is incapable to normally respond to insulin to be used to convert glucose as energy. It causes the body initiate to breakdown fats as fuel in producing energy leading to accumulation of ketones in the bloodstream that makes the body develop diabetic ketoacidosis (Wang et al., 2017). The diabetic ketoacidosis cause disarrangement of electrolytes, metabolic and acid-base in the body which adversely affect the respiratory system to make them incapable to use enough oxygen making the patient develop laboured breathing as seen in Greg (Bedaso et al., 2019). Greg is suffering from Kussmaul breathing condition. The consequence of Kussmaul breathing is that the person would develop increased heartbeat, chest pain and light-headedness. In the long-term it would led to impair blood flow to the brain and cause hypoxia making the person to develop slow death (de Moraes and Surani, 2019).

2/5 The two reason of the increased atherosclerosis rate in diabetic patients like Greg are inflammation of arteries and inability of the arteries to dilate effectively due to damaging effect of increased blood glucose. The other reason is high glucose level supporting the development of high cholesterol level in the blood that contributes to plague formation leading to narrowing of arteries as seen in atherosclerosis (Orekhov et al., 2020).

2/6 Greg may have been unconscious due to sudden increase in the blood glucose level which is to be lowered immediately. The best course of treatment for the condition is administration of insulin to help tissue absorb the increased glucose in the body (Evans et al., 2017).

2/7 The three characteristics of cancer cell which makes them become invasive and perform metastasis are loss of their ability to make cell adhesion, develop mobility and efficiency to digest the basement membrane in the body for entering the circulation to be transported to other parts of the body (Yamagishi et al., 2019).

2/8 The three potential manifestations which occur due to bone marrow suppression are faster dizziness, shortness of breath and fatigue due to low level of blood cells in the body (Qu et al., 2017). The bone marrow suppression is linked with chemotherapy that is current done to Cindy. The chemotherapy causes bone marrow suppression leading to less red blood cell presence in the body which can be alerted through altering the dose of medicine used for the patient’s treatment (Banach et al., 2017).

2/9 The swelling on the right hand caused by bacterial infection is known as Cellulitis and the uncomfortable swelling in the left arm is called Lymphoedema (Chien et al., 2019; Webb et al., 2020). The difference between cellulitis and lymphoedema is that lymphoedema occurs due to development of fluid in the body tissue out of damage to the lymph nodes in the body during dissection of breast in cancer treatment (Chien et al., 2019). However, Cellulitis occurs due to entry of the bacteria like streptococcus and staphylococcus through crack of the skin which damages the deep skin layer of the skin to cause swelling (Webb et al., 2020). The treatment of cellulitis is use of antibiotics to destroy the bacteria whereas treatment for lymphedema is to exercise in easing the accumulated fluid in the lymph node to spread in the body (Chien et al., 2019). Moreover, Cellulitis is curable, but lymphedema is incurable and required to be controlled for life (Webb et al., 2020).

3/1 The two factors that may have triggered Lisa’s asthmatic condition are airborne allergens and cold. The allergens cause acute asthma attack by acting as a virus or bacteria that irritates the respiratory tract and impact the immune system to work in a hinder manner leading to asthmatic attack (Bashir et al., 2018). The cold triggers asthma attack in similar way by irritating the respiratory tract which makes the muscles in the spasms of the airways to make it harder to be controlled to support normal respiration (Skappak et al., 2017).

3/2 In acute asthma attack, the bronchoconstriction is the dominant physiological event which leads the clinical symptoms of the attack. The entry of allergens in the respiratory system leads to type-1 hypersensitivity which is immediate reaction to support immunoglobulin E release mediated by the antibody release from the body against the soluble antigen that has entered the body. It leads to increased mast cell degranulation and increased release of histamine along with other inflammatory mediators which contract the smooth muscle cells in the airways and inflame the bronchioles leading to hindered breathing faced during the asthmatic attack (Kemp, 2020).

3/3 The mechanism of action of salbutamol includes intracellular cyclic adenosine monophosphate (cAMP) production which lowers calcium concentration and relaxation of smooth muscles in the airways leading to bronchodilation (Al-Azzawi et al., 2018). The mechanism of corticosteroids includes diffusion through the cell membrane to bind with the glucocorticoid receptors that leads to conformation change in inflammatory receptor to inhibit inflammation and ease bronchodilation (Wadhwa et al., 2019). The benefit of salbutamol and corticosteroids for Lisa is that it would ease his breathing efficiency and resolve asthma attack.

3/4 The mechanism of action of anticholinergic/anti-parasympathetic in asthma is that they act to block the parasympathetic nerve causing the airway to constrict and to allow air passages to remain wide open to allow enhance entry and exist of air for respiration (Gosens and Gross, 2018). It would benefit Lisa to resolved shortness of breath.

3/5 Maria’s current blood pressure 140/95 suggest she is suffering from high-normal blood pressure. The two risk factors which has contributed to the problem are lack of exercise and unhealthy diet of increased wine and chips.

3/6 The pharmacodynamics of ACE inhibitors informs that they work by interfering with the renin-angiotensin-aldosterone system (RAAS) in the body which leads to dilation of veins and arteries in the pathway angiotensin II formation is blocked and the metabolism of bradykinin is inhibited. It leads to the ACE inhibitors to present the pharmacological effect of reduced blood pressure and easy flow of blood to the heart (Gómez Díez, 2017).

3/7 Maria is suffering from coronary heart disease in which one of the arteries is already blocked. The two clinical findings which support the claim are high blood pressure and increased level of troponin in the blood (De Hert et al., 2018).

3/8 The dose reduction of MedX for Maria is required because she is elderly and with age the blood flow to the digestive tract decreases, high free plasma concentration, subcutaneous fat decreases and decreased drug elimination through renal parts. In patients, after the age of 40, it is seen that their creatinine clearance lowers by 8 mL/min/1.73 m2/decade on an average due to damage to the kidney cells out of aging. In this condition, without reduction the dose of MedX would led towrads its accumulation in body leading to hindered effect (Seiberth et al., 2020). In elderly like Maria, the free plasma concentration in the body is increased indicating the drugs stay for longer time in the body to show its activity due to which the drug concentration in case of Maria is to be lowered to avoid overactivity of the drug in the body (Schmith et al., 2020). Moreover, with aging the subcutaneous fat surrounding organs is lowered which leads increased sensitivity of the organ to any drug (Serra et al., 2017). Thus, to avoid overactivity of MedX due to lower subcutaneous fat presence, the dose is to be reduced. The elderly like Maria develop reduced hepatic blood flow in the body leading the dose of drug MedX that rely highly on renal elimination to be reduced so that it does not get accumulated in the body that may cause harmful impact on the health (Chetty et al., 2018).

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References

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