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Questions and Answers

What is a significant characteristic of a shuffling gait?

Long, confident strides

Hesitant steps with reduced arm swing (correct)

Fast, running movement

Smooth, fluid motion

Which non-motor symptom is commonly associated with advanced stages of a disease?

Sleep disturbances (correct)

Improved cognitive function

Increased physical strength

Heightened mood stability

What is a key indicator that symptoms have a unilateral onset?

Symptoms start on one side and are more severe there (correct)

Symptoms worsen gradually over time without clear side preference

Symptoms present in the upper body only

Symptoms affect both sides equally

What distinguishes Anorexia Nervosa from other eating disorders?

Body weight less than 85% of the expected level due to intake restriction Signup and view all the answers

How does a significant response to dopaminergic medication support diagnosis?

It strongly supports the diagnosis due to symptom improvement Signup and view all the answers

What is the primary function of anti-diuretic hormone (ADH)?

Regulates water balance in the body Signup and view all the answers

Where is anti-diuretic hormone (ADH) synthesized?

Hypothalamus Signup and view all the answers

Which medication is commonly used to terminate acute seizures?

Lorazepam Signup and view all the answers

What is the purpose of a Fine Needle Aspiration (FNA) Biopsy when evaluating a lump on the trachea?

To obtain cells for cytological examination Signup and view all the answers

What characteristic should be assessed during a physical examination of a lump on the trachea?

Size and consistency Signup and view all the answers

What is a common symptom to check for if you find a lump on the trachea?

Dysphagia Signup and view all the answers

In addition to evaluating the lump, what other underlying management may be necessary for seizures?

Adjusting antiepileptic medications Signup and view all the answers

Which imaging study is particularly useful for differentiating between solid and cystic masses in the neck?

Ultrasound of the Neck Signup and view all the answers

Which cells are primarily responsible for recognizing harmful agents through pattern recognition receptors?

Macrophages Signup and view all the answers

What role does the complement system play in immune response?

It identifies and marks pathogens for destruction. Signup and view all the answers

Which immune cells are considered the first responders to an infection?

Neutrophils Signup and view all the answers

What is one of the functions of macrophages during an immune response?

They engulf and digest pathogens and dead cells. Signup and view all the answers

How do mast cells contribute to the inflammatory response?

By promoting blood vessel dilation and permeability. Signup and view all the answers

What mechanism does the complement system use to directly destroy bacterial cells?

Formation of membrane attack complexes Signup and view all the answers

Which cells are involved in regulating the inflammatory response?

T Cells and macrophages Signup and view all the answers

What cytokines do macrophages release to regulate inflammation?

IL-1, TNF-alpha, and IL-6 Signup and view all the answers

What is a common ocular symptom of Myasthenia Gravis (MG)?

Diplopia Signup and view all the answers

In the diagnostic approach for Myasthenia Gravis, which test is characterized by a decremental response?

Nerve Conduction Studies (NCS) Signup and view all the answers

What is the role of acetylcholinesterase inhibitors in the diagnosis of Myasthenia Gravis?

They increase availability of acetylcholine at the neuromuscular junction. Signup and view all the answers

Which symptom is a bulbar symptom associated with Myasthenia Gravis?

Dysarthria Signup and view all the answers

What finding in single-fiber electromyography (EMG) is indicative of Myasthenia Gravis?

Increased Jitter Signup and view all the answers

Which respiratory symptom is commonly associated with severe cases of Myasthenia Gravis?

Dyspnea Signup and view all the answers

Which imaging result might suggest a diagnosis of Myasthenia Gravis?

Thymic Abnormalities Signup and view all the answers

What is a common symptom of meningitis that is not typically associated with Myasthenia Gravis?

Fever Signup and view all the answers

Which medication is specifically designed to break down mucus for easier clearance?

DNase (Pulmozyme) Signup and view all the answers

What dietary approach is recommended to support growth and weight gain in patients?

High-Calorie Diet Signup and view all the answers

Which treatment is utilized for managing allergic bronchopulmonary aspergillosis (ABPA)?

Oral Prednisolone Signup and view all the answers

Which of the following is a common risk factor for lung cancer?

Asbestos Exposure Signup and view all the answers

What is the role of CFTR modulators in the treatment of cystic fibrosis?

They improve the function of the defective CFTR protein. Signup and view all the answers

How does pancreatic enzyme replacement therapy assist patients with cystic fibrosis?

It aids digestion and improves nutrient absorption. Signup and view all the answers

What type of antibiotics are particularly important for preventing lung infections in patients with cystic fibrosis?

Prophylactic Antibiotics Signup and view all the answers

Regular monitoring for bacterial colonization specifically looks for which organisms in cystic fibrosis patients?

Pseudomonas aeruginosa and Burkholderia cepacia Signup and view all the answers

What is a characteristic feature of a shuffling gait in patients?

Short, hesitant steps Signup and view all the answers

Which non-motor symptom can develop in advanced stages of a disease?

Cognitive decline Signup and view all the answers

What defines Anorexia Nervosa?

Limitation of food intake and fear of weight gain Signup and view all the answers

How does postural instability affect patients as their condition progresses?

Increases the risk of falls due to balance issues Signup and view all the answers

What is an indicator of asymmetry in symptom presentation?

Symptoms initially developing on one side Signup and view all the answers

What is a characteristic feature of edema in Type I hypersensitivity reactions?

Fluid leakage into tissues Signup and view all the answers

What differentiates active immunity from passive immunity?

Active immunity involves the creation of memory cells, while passive immunity does not Signup and view all the answers

Which statement about natural active immunity is correct?

It is developed after recovering from an infection Signup and view all the answers

How long does passive immunity generally last in the body?

As long as the antibodies are present Signup and view all the answers

Which is an example of artificial active immunity?

Receiving a flu vaccine Signup and view all the answers

What type of immunity is provided when a newborn receives antibodies through breast milk?

Natural passive immunity Signup and view all the answers

What is the primary reason that passive immunity does not provide long-term protection?

The body does not produce any memory cells Signup and view all the answers

Which of the following activities is related to the role of B cells in active immunity?

Producing specific antibodies Signup and view all the answers

What is the primary purpose of CT or MRI scans in the assessment of a lump on the trachea?

To provide detailed imaging of the trachea and surrounding structures Signup and view all the answers

What can thyroid function tests help determine if a lump is suspected to be associated with the thyroid gland?

Thyroid hormone levels Signup and view all the answers

What is a significant characteristic of insulin resistance in type 2 diabetes mellitus?

Less responsiveness of cells to insulin secretion Signup and view all the answers

What is the consequence of beta cell dysfunction in type 2 diabetes?

Inability of beta cells to increase insulin production Signup and view all the answers

What is the main goal of bronchoscopy when evaluating a lump on the trachea?

To visualize the internal structure of the trachea and bronchi Signup and view all the answers

Which associated condition can a chest X-ray help identify when evaluating a lump on the trachea?

Respiratory conditions such as lung masses Signup and view all the answers

Which factors contribute to beta cell dysfunction in type 2 diabetes mellitus?

Obesity, glucotoxicity, and lipotoxicity Signup and view all the answers

What is the role of fine needle aspiration (FNA) biopsy in the evaluation of a tracheal lump?

To obtain a sample for cytological examination Signup and view all the answers

What is reached when the membrane potential hits around -55 mV, leading to a significant change in voltage?

Action potential Signup and view all the answers

Where is most of the cell's DNA primarily located?

Nucleus Signup and view all the answers

What type of RNA is synthesized in the nucleus during transcription?

Messenger RNA (mRNA) Signup and view all the answers

What is the role of ribosomes in the cytoplasm?

Protein synthesis Signup and view all the answers

What is absent from the rough endoplasmic reticulum in terms of RNA?

RNA storage Signup and view all the answers

What type of DNA is found in the mitochondria, which has roles related to energy production?

Mitochondrial DNA Signup and view all the answers

What type of RNA is described as having a crucial role in protein synthesis, found in the cytoplasm?

Ribosomal RNA Signup and view all the answers

What is synthesized in the mitochondria essential for its own functions?

Mitochondrial RNA Signup and view all the answers

What indicates a likely urinary tract infection when combined with symptoms such as pain during urination?

Positive result for Nitrites Signup and view all the answers

Which finding on a chest X-ray may suggest emphysema?

Hyperinflation Signup and view all the answers

Which of the following conditions is most closely linked to long-term GERD?

Esophagitis Signup and view all the answers

What is the significance of measuring the Diffusion Capacity of the Lung for Carbon Monoxide (DLCO)?

Evaluates gas exchange efficiency Signup and view all the answers

Which result from a dipstick test is indicative of the presence of bacteria in urine?

Positive for Leukocyte Esterase Signup and view all the answers

What outcome can result from Barrett's esophagus due to chronic GERD?

Esophageal adenocarcinoma Signup and view all the answers

What can elevated WBCs in a microscopic examination of urine indicate?

Kidney infection Signup and view all the answers

What is a common limitation in peak expiratory flow rate (PEFR) due to pulmonary conditions?

Airflow obstruction Signup and view all the answers

Study Notes

Immune Response to Harmful Stimuli

Macrophages and dendritic cells utilize pattern recognition receptors (PRRs) to identify harmful agents.
Toll-like receptors (TLRs) are examples of PRRs involved in pathogen recognition.
The complement system consists of blood proteins that can activate in response to pathogens, aiding in marking them for immune destruction.

Recruitment of Immune Cells

Neutrophils are the first responders at infection sites, rapidly arriving to combat harm.
Macrophages follow neutrophils to maintain the inflammatory response.
Mast cells release histamine, enhancing blood vessel permeability for easier immune cell movement.
Activated complement proteins such as C3a and C5a serve as chemoattractants for immune cell recruitment.

Removal of Harmful Agents

Neutrophils ingest and digest pathogens through phagocytosis.
Macrophages continue phagocytosis, clearing pathogens and dead cells, including neutrophils.
The complement system can form membrane attack complexes (MACs) that lyse bacterial cell walls.

Regulation of Inflammatory Response

T cells utilize cytokines to either enhance or suppress inflammation.
Macrophages also release cytokines like IL-1, TNF-alpha, and IL-6 to modulate inflammation duration and intensity.

Ocular Symptoms of Disease

Ptosis refers to drooping eyelids, often worsening throughout the day.
Diplopia indicates double vision, which can increase with prolonged visual activities.

Bulbar Symptoms

Dysarthria presents as slurred or slow speech caused by muscle weakness.
Dysphagia results in swallowing difficulties, with risks of choking or aspiration.

Respiratory Symptoms

Dyspnea, or difficulty breathing, may lead to respiratory failure if respiratory muscles weaken severely.

Diagnostic Approaches for Neuromuscular Disorders

Nerve conduction studies can show decremental responses, indicating weaker responses on repeated stimulation.
Electromyography often detects increased jitter, revealing variability in muscle fiber response timing.
A positive response to acetylcholinesterase inhibitors, like pyridostigmine, supports a diagnosis of myasthenia gravis (MG).
Chest imaging can reveal thymic abnormalities, such as thymoma or hyperplasia associated with MG.

Signs and Symptoms of Meningitis

Severe headache is common, described as diffuse and persistent.
Neck stiffness, or meningismus, presents as difficulty flexing the neck forward.
Fever typically occurs alongside chills.
Nausea and vomiting often arise due to increased intracranial pressure.

Symptoms of Progressive Disease

Postural instability increases fall risk, generally noticed in later stages.
A shuffling gait features short, hesitant steps and reduced arm swings, complicating movement initiation or cessation.
Non-motor symptoms may include mood changes, cognitive decline, and sleep disturbances.

Diagnostic Clues for Neurological Conditions

Asymmetry in symptoms typically appears on one body side and stays more pronounced there.
Improvement with dopaminergic medication, like levodopa, strongly indicates the diagnosis of certain movement disorders.

Anorexia Nervosa Overview

Anorexia nervosa involves restricting food intake, leading to body weight below 85% of expected levels.
Patients exhibit intense fear of weight gain and distorted body image perceptions.

Management of Seizures

Airway management is critical, especially if seizures involve oral trauma.
Immediate administration of missed antiepileptic drugs and possible benzodiazepines are essential for acute seizure control.
Long-term management involves adjusting antiepileptic medications and treating underlying conditions.

Anti-Diuretic Hormone (ADH) Details

ADH, or vasopressin, primarily regulates bodily water balance.
Synthesized in the hypothalamus, it is stored and released from the posterior pituitary gland.
ADH acts on kidney collecting ducts, increasing water reabsorption and concentrating urine.

Evaluation of a "Lump on the Trachea"

Physical examination assesses lump characteristics and checks for symptoms like dysphagia or hoarseness.
Ultrasound visualizes the lump to distinguish its origin related to thyroid or other neck structures.
Fine needle aspiration biopsy helps analyze lump cells through cytological examination.

Respiratory Care in Cystic Fibrosis

Daily physiotherapy is essential for mucus clearance from lungs.
Medications include bronchodilators, nebulized saline, DNase, prophylactic antibiotics, and CFTR modulators like Ivacaftor.
Lung transplantation may be considered in severe lung disease cases.

Nutritional Support in Cystic Fibrosis

Pancreatic enzyme replacement aids in digestion and nutrient absorption.
Dietary supplements, including fat-soluble vitamins, ensure adequate nutrient intake.
High-calorie diets support growth and prevent weight loss.

Complications Management in Cystic Fibrosis

Regular monitoring for lung bacteria colonization, especially Pseudomonas aeruginosa.
Aggressive antibiotic treatment is crucial for any signs of lung infection.

Risk Factors for Lung Cancer

Cigarette smoking significantly increases lung cancer risk.
Asbestos exposure is linked to specific types of lung cancer, such as mesothelioma.

Edema and Hypersensitivity Reactions

Edema in Type I hypersensitivity results from fluid leakage into tissues due to increased vascular permeability and vasodilation.

Active vs. Passive Immunity

Active Immunity

Pathophysiology: Immune response activated when exposed to pathogens or vaccines; B cells produce specific antibodies, T cells may destroy infected cells.
Duration: Long-lasting, potentially for years or a lifetime, due to the formation of memory B and T cells.
Examples:
- Natural: Recovery from chickenpox leads to long-term immunity.
- Artificial: Receiving flu vaccine induces specific antibody production.
Mnemonic: "Active = A for Army" (body builds its own defense).

Passive Immunity

Pathophysiology: Antibodies are provided externally; immediate protection, but no creation of memory cells, meaning immunity is temporary.
Duration: Short-term; protection diminishes as antibodies are broken down.
Examples:
- Natural: Newborns receiving antibodies through breast milk for temporary immunity.

Non-Motor Symptoms of Disease

Postural Instability: Balance issues developing later in disease progression, increasing fall risk.
Shuffling Gait: Characteristic walking pattern with short, hesitant steps and reduced arm swing, difficulty starting or stopping.
Mood Changes: Commonly includes depression and anxiety.
Cognitive Decline: Advanced stages may show cognitive symptoms, such as dementia.
Sleep Disturbances: Frequent issues with sleep patterns, including REM sleep behavior disorder.

Diagnostic Clues for Disease

Asymmetry: Symptoms typically begin on one side and remain more severe there.
Response to Medication: Significant symptom improvement with dopaminergic medications like levodopa supports diagnosis.

Anorexia Nervosa vs. Bulimia

Anorexia Nervosa

Definition: Characterized by extreme food intake restriction, resulting in weight below 85% of expected; intense fear of weight gain; distorted body image.

Imaging and Diagnostic Tests

CT or MRI Scan: Provides detailed imaging of the trachea and surrounding structures; assesses lump extent and potential invasion.
Chest X-ray: Evaluates lungs and mediastinum for abnormalities; helps identify respiratory conditions.
Thyroid Function Tests: Assesses thyroid hormone levels; includes tests like TSH and Free T4 for thyroid-related lumps.
Bronchoscopy: Allows direct visualization of the trachea and bronchi, useful for examining inner structures.

Pathogenesis of Type 2 Diabetes Mellitus (DM)

Insulin Resistance: Cells become less responsive to insulin, necessitating higher insulin levels, leading to hyperglycemia.
Beta Cell Dysfunction: Early insulin production increase, declining capability over time due to glucotoxicity and lipotoxicity.

Storage of RNA and DNA

DNA

Location: Primarily stored in the nucleus; a small amount present in mitochondria (mtDNA) for energy production.

RNA

Location: Synthesized in the nucleus; functions in the cytoplasm.
Roles: mRNA carries genetic information to ribosomes for protein synthesis; tRNA and rRNA also play critical roles.

Lung Function Tests

Residual Volume (RV) and Total Lung Capacity (TLC): Increased in conditions like emphysema due to air trapping.
Diffusion Capacity of the Lung for Carbon Monoxide (DLCO): Reduces in emphysema; normal in chronic bronchitis.
Peak Expiratory Flow Rate (PEFR): Decreases due to airflow obstruction.

Urinalysis (UA) for Urinary Tract Infections (UTIs)

Appearance: Cloudy urine may indicate infection.
Dipstick Test:
- Positive leukocyte esterase indicates WBC presence; suggests infection.
- Positive nitrites indicate bacterial presence, particularly E. coli.
Microscopic Examination:
- High WBCs (pyuria) suggest infection; presence of bacteria confirms it.
- Hematuria indicates blood in urine; WBC casts may suggest kidney infection.

Risks of Chronic Gastroesophageal Reflux Disease (GERD)

Esophagitis: Persistent acid reflux can lead to esophageal inflammation, causing pain, bleeding, and difficulty swallowing.
Barrett's Esophagus: Changes in lower esophagus lining increase the risk of esophageal adenocarcinoma.

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