Jane is a 23 year compulsive jogger. She jogs everyday for 2 hours. She has slim

Question

Jane is a 23 year compulsive jogger. She jogs everyday for 2 hours. She has slimmed down and is underweight for her height and age. You would expect Jane to have: a) Heavy menstrual flows b) Painful cramps c) Amenorrhea d) Elevated levels of LH, FSH & Cortisol c) None of the above Dan was lost in the desert for two days during the Gulf war. He had lost his water bottle in the sand storm. As a result he could not drink fluid for almost 54 hours. After rescue he was brought to the mobile hospital. His diagnostic evaluations will reveal: a) Increased blood volume b) Elevated level of ADH c) Normal urine production d) Decreased blood osmolarity e) Elevated levels of BUN, Na^+ & K^+. Jill suffers from anorexia nervosa. One evening she was rushed to the emergency room because of cardiac arrythmias. Blood & urine specimens indicated Ketonemia and Ketonuria. Jill is having arrythias due to: a) Elevated levels of Plasma pH b) Metabolic alkalosis c) Ketoacidosis d) High blood pressure e) Hypoglycemia Joe is playing football. During tackle he breaks a rib and is having difficulty in breathing Joe is probably suffering from: a) Collapsed trachea b) A bruised diaphragm (c) Pneumothorax d) Obstruction of the bronchi e) All of the above Dr. H prescribed a broad spectrum antibiotic for Kim's nose infection. Three weeks late Kim complains of frequent nose bleeds. Which one of the following is the possible a) The treatment caused widespread damage to nose vessels b) The antibiotic caused damage to the nose epithelium (c) Board spectrum antibiotic killed the normal microbial flora that synthesize vitamin K, a precursor of prothrombin used for blood clotting d) A) All of the above e) None of the above

Explanation / Answer

47. Jane is expected to have amenorrhoea. Absence of menstrual period in woman of reproductive age is known as amenorrhoea. Amenorrhoea can be primary or secondary. Primary amenorrhoea is due to congenital defects such as the absence of uterus, failure to receive or maintain eggs by ovary. Secondary amenorrhoea is caused due to disturbances in the hormones secreted from the hypothalamus and pituitary gland. Compulsive jogging by Jane resulted in the development of functional hypothalamic amenorrhoea. Jane must not have taken enough calories in diet to expend on her exercise and to maintain her normal menstrual cycles. This might have resulted in weight loss leading to decreased production of LH and FSH hormones thus causing amenorrhoea. So, the correct option is option C, amenorrhoea.

48. Dan’s diagnostic evaluations will reveal elevated levels of ADH. Antidiuretic hormone (ADH), also known as Vasopressin, is synthesized in hypothalamus and stored in the posterior pituitary vesicle of the brain. The function of ADH is water retention in the body and blood vessel constriction. ADH regulates water retention by enhancing the water reabsoption in the collecting ducts of kidneys. Sine Dan could not drink fluid for almost 54 hours; his ADH levels must have been increased to retain water in the body. So, the correct option is option B, elevated level of ADH.

49. Jill is having cardiac arrhythmias due to hypoglycaemia. Aneroxia nervosa is a condition in which people eat less due to fear of gaining weight. As a result their blood glucose levels are low resulting in hypoglycemia. In order to supply her body’s energy needs, fats are metabolized resulting in the build-up of ketone bodies in the blood. This is the reason for the indication of ketonemia and ketonuria in Jill’s blood and urine specimen. Hypoglycemia causes cardiac arrhythmias. This is linked to reduced potassium levels and increased catecholamine levels. So, the correct option is option E, hypoglycemia.

50. Joe is probably suffering from pneumothorax. In pneumothorax, the lung gets uncoupled from the chest wall due to abnormal air collection in the pleural space. This results in difficulty in breathing, and sharp, one-sided chest pain. So, the correct option is option C, pneumothorax.

51. Broad spectrum antibiotics are those antibiotics that are effective against a wide range of disease causing bacteria which includes both Gram positive and Gram negative bacteria. Use of broad spectrum antibiotics destroys the normal bacterial flora of the body. The normal flora in the human body synthesizes and secretes vitamin K that is essential for blood clotting. Prescribing a broad spectrum antibiotic to Kim’s nose infection resulted in the destruction of normal flora of Kim resulting in deficiency of vitamin K. As a result blood clotting mechanism was affected leading to frequent nose bleeds. So, the correct option is option C, broad spectrum antibiotic killed the normal microbial flora that synthesize vitamin K, a precursor of Prothrombin used for blood clotting.

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