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By: William A. Weiss, MD, PhD

  • Professor, Neurology UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA

https://profiles.ucsf.edu/william.weiss

A 45-year-old man with abdominal pain generic 300mg urso treatment narcolepsy, (C) Loss of cornea sensation kidney stones cheap 150 mg urso overnight delivery symptoms 0f ms, and peptic ulcer disease may (D) Dryness and damage to buy urso 300 mg mastercard medications via g tube the cornea very likely require which A fracture of the femur occurs through the dia (A) Mucinous cystadenocarcinoma physis of the femur buy urso 300mg low cost medications on carry on luggage. He was just weaned from (F) Is associated with hyperchlorhydria mechanical ventilation. A 28-year-old, 70-kg man who was shot in the subtotal gastrectomy for carcinoma of the abdomen underwent a resection of his pancreas stomach 6 days ago. She had been recovering and duodenum for a shattered head of the pan well except for persistent ileus. The most likely later he has hypoxemia and bilateral fluffy infil diagnosis is: trates on chest x-ray. Which of the following orders (B) Wound infection for ventilator settings is most appropriate A 38-year-old woman underwent an open (C) Repair the wound in two layers with cholecystectomy a week ago. The (D) Resect the segment of sigmoid and per preliminary blood culture report states that the form a primary anastomosis organism cultured is an aerobic gram-negative (E) Resect the wound and perform a rod. Of the antibiotics listed below, which Hartmann procedure would be the best choice An elderly woman underwent a radical mas tectomy with radiation to the axilla 20 years (B) Clindamycin ago. A 63-year-old man is admitted for an elective (A) Recombinant activated protein C colon resection for recurrent attacks of sigmoid diverticulitis. The patient no (C) Pseudomonas species longer requires sedation and is being consid (D) Bacteroides species ered for weaning from the ventilator and pos (E) Enterobacter cloacae sible removal of the endotracheal tube. The (A) PaO /FiO ratio of 230 best method of rewarming the extremity is: 2 2 (B) Rapid shallow breathing index of 125 (A) Forced warm air convection (C) Minute ventilation of 8. A 19-year-old male is admitted with a 2-cm stab wound of the sigmoid colon on the 64. A small amount of solid tachypnea, tachycardia, diaphoresis, and cya feces is noted. Workup reveals a patent ductus arterio Vital signs are stable throughout the case. This can be closed with the use of: correct procedure is: (A) Indomethacin (A) Repair the wound in two layers (B) Acetaminophen (B) Exteriorize the wound as a colostomy Questions: 57–68 317 (C) Aspirin 67. The treatment of choice for this cancer is: (A) Radiation (B) Chemotherapy (C) A & B (D) Abdomino-perineal resection (E) Wide local excision 66. Note the long segment of narrowing, the spasm, and the deformity (arrow) produced by an have a splenic artery aneurysm. This finding is most commonly second resection of the ulcer ary to excess administration of: (E) Total gastrectomy (A) Glucose (B) Fat 73. He is scheduled (C) Fine needle aspiration for an elective femoral-popliteal bypass. A (D) Incisional biopsy good way to reduce the risk of infection would (E) Observation be to: (A) Irrigate the wound with bacitracin during 74. A 44-year-old woman is found to have an ele (C) Imipenem/cilastatin vated serum calcium of 11. The biopsy report shows the initial wrist x-rays are read as normal, pain adenocarcinoma of the stomach. He had undergone a vago ents with pain and swelling of the right lower tomy and antrectomy 18 years ago for a bleed extremity. An organism found more not appear ill and has no significant physical commonly than in the general population in findings. The patient should now be: these cases is: (A) Treated with a proton pump inhibitor (A) H. After a course of treatment painful, erythematous left breast which does with H -blockers failed and abdominal ultra not repond to a 10 day course of oxacillin. The scan was negative management should be: except for the presence of a 3-cm mass in the (A) Begin a 10-day course of vancomycin left adrenal gland. Urine (B) Workup the patient for an and serum biochemical studies for a function immunosuppressive disease ing adrenal tumor are negative. A 79-year-old man had a chest x-ray because of (A) Insertion of a nasogastric tube a history of smoking. However, a calcified gall (B) Administration of an emetic agent bladder was noted. The patient is asymptomatic and (C) External pressure on the cricoid cartilage has no medical illnesses. The sigmoid colon is inflamed but mobile airway pressure was 55 cm H2O and abdomi and the mesentery contains a perforated abscess. A 10-month-old boy has recently been weaned (Hartmann procedure) and placed on solid food. Following ade you note bright red blood in the nansogastric quate hydration, this condition should be tube. Laboratory tests (A) Laxatives and type and crossmatch were sent, but the (B) Gastrojejunostomy results are still pending. The first therapeutic option you would choose is to: (C) Laparotomy and manual reduction (D) Radiologic reduction by barium with (A) Lavage the nasogastric tube with cold measured pressure control of column of saline.

Diseases

  • Super mesozoic-dysentery complex
  • Pseudoachondroplasia
  • Chordoma
  • Familial colorectal cancer
  • Wiedemann Grosse Dibbern syndrome
  • Dextrocardia with situs inversus
  • Chromosome 20 ring
  • Lupus anticoagulant, familial
  • Taybi Linder syndrome

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Technique Sense Involved Skill Example Inspection sight Eyes are used to cheap 150 mg urso free shipping aquapel glass treatment Checking for skin color observe generic urso 300mg free shipping medications requiring central line. Palpation touch Hands­are­used­to­feel­ Feeling for lumps for the texture 150mg urso fast delivery medications going generic in 2016, size generic 300 mg urso otc medicine lock box, con sistency, and location of body parts. Percussion hearing The­fst­or­fngertips­are­ Performing­“kidney­ used to tap the body part punch”­ to determine the size, borders, and consistency of body organs. Auscultation hearing A stethoscope is used to Listening for breath listen for sounds within sounds the body. It makes use of an endoscope (endo + scope) to view the internal body cavities or organs. Both instruments are hollow­and­fexible­and­have­several­purposes,­such­as­withdrawal­and­instillation­of­fu ids, or visualization of vessels or cavities. Diagnostic Radiology the domain of medicine related to the diagnosis of diseases with the use of x-rays, radio active substances, and radiant energy is known as radiology. Combining Form Meaning Example ech/o, son/o sound echocardiogram, sonography electr/o electricity electroconvulsive fuor/o emitting­or­refecting­light fuoroscopy radi/o radiant energy radiography tom/o to cut tomography ultra (prefx) excessive ultrasonography Diagnostic imaging modalities include: a. However,­radiotherapy­not­only­destroys­cancer­cells,­but­it­also­ leads to destruction of normal cells; hence, the client may present with side effects such as hair loss, nausea and vomiting, bone marrow suppression, and drying of the mucous membranes. The procedure in which the image is digitized and immediately displayed on a monitor­or­recorded­on­flm­is a. The surgeon tells his mother that excellent healing had resulted, the small­scar­will­fade­signifcantly­with­time,­and­this­should­cause­no­additional­ problems for Sean. Lisa visits her obstetrician, who uses a stethoscope to listen to the heart rate of her 38-week developing fetus. A term that means pertaining to a procedure that uses an illuminated instrument for the visualization of the interior of a body cavity or organ is ­ a. Objectives When you complete this section, you’ll be able to build and identify medical terms related to body structures. These structures start from the smallest unit, which is an atom, to the largest, most complex unit, the human organism. The body is made up of many levels of structural organization: cells make up tissues, tissues form organs, organs form body systems, and the body systems make up an organism. There are four types of tissues according to function: connective, epithelial, mus cular, and nervous. Organs are formed when two or more tissue types work together to accomplish a particu lar function. Ana means upward, excessive, or again, while -plasia refers to development or formation of tissue. The follow ing word parts are frequently used to describe abnormal tissue development. The­anatomical­position­is­defned­as­ the body standing erect, eyes directed forward, hands at the side, palms turned outward, and lower limbs parallel with the toes pointing forward. Directional Terms Directional terms denote the position of a structure in relation to another structure. The two major body cavities are the dorsal (located near the posterior part of the body) and ventral (located near the anterior part of the body) cavities. The dorsal cavity is subdivided into the cranial and spinal cavities, while the ventral cavity is subdivided into the thoracic and abdominopelvic cavities. Vulnerability to a disease or disorder is known as susceptibility, while resistance refers to­the­body’s­natural­ability­to­fght­microorganisms­or­toxins. The following categories have been identi fed­by­several­government­agencies: B Biological N Nuclear I Incendiary C Chemical E Explosive Using pathogenic biological agents to cause panic, fear, and terror in a population is bio terrorism. Microorganisms are used as weapons of mass destruction because they can easily be transmitted, have high chances of causing death, may lead to panic, and lastly, would require extraordinary attention. What’s the name of the membrane that lines the abdominal cavity and invests the internal organs Immunoglobulins that are formed to act against foreign cells or substances are called a. This section will discuss medical terminologies related to the musculoskeletal, circulatory, and respiratory systems. Chapters 6, 7, and 8 of your textbook will provide comprehensive discussion on these systems. Objectives When you complete this section, you’ll be able to build and identify medical terms related to the musculoskeletal system. The musculoskeletal system pro tects, supports, and aids in the movement of body parts. Apart from these functions, the musculoskeletal system, particularly the bones, are essential in hematopoiesis or blood production (hemat/o = blood, -poiesis = production). The bones also function to store fat in the bone marrow and to store and release minerals. The branch of medicine that aims to prevent and correct problems concerning the bones and the muscles is known as orthopedics (orth/o = straight, ped/o = child, -ic = pertaining to). As one matures, the cartilage is replaced with bones, except for some structures such as the external ear and the nasal septum. Tendons, on­the­other­hand,­are­tissue­fbers­that­con nect the muscles to the bone. Articulations that have cavities between adjoining bones are known as synovial joints. Ligaments are bands of connective tissues responsible for connecting bones and carti lages and, at the same time, are essential in supporting and strengthening joints. Fractures and dislocations are the most common traumatic injuries sustained by the bones.

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Babies whose mothers Pregnancy Complications smoked during pregnancy More than 400 generic 300mg urso with visa medications for schizophrenia,000 babies born in the United or who are exposed to buy cheap urso 300mg on-line medicine you take at first sign of cold States every year are exposed to discount urso 300 mg on line medicine 666 chemicals in secondhand smoke after cigarette smoke before birth because their birth are more likely to buy urso 300 mg overnight delivery medicine 7 day box die mothers smoke. Ectopic pregnancy almost always causes the fetus to die and poses a serious risk to the health of the mother. Preterm delivery is a leading cause of death, disability, and disease among newborns. Mothers who smoke during pregnancy are also more likely to deliver babies with low birth weight, even if they are full term. Smoking during pregnancy can also cause tissue damage in the fetus, especially in the lungs and brain. A person with diabetes who smokes is more likely to have trouble regulating insulin and controlling the disease than nonsmokers with diabetes. Both smoking and diabetes cause problems with blood fow, which raises the risk of blindness and amputations. Smokers with diabetes are also more likely to have kidney failure than nonsmokers with diabetes. Smoking and the Immune System The immune system is the body’s way of Smokers are 30% to 40% protecting itself from infection and disease. Smoking compromises the immune system and can make the body less successful at fghting disease. Smokers have more respiratory infections than nonsmokers, in part because the chemicals in cigarettes make it harder for their immune systems to successfully attack the Smoking and Diabetes viruses and bacteria that can cause respiratory infections. In fact, smokers generally are much Diabetes—a disease that causes blood sugar less healthy than nonsmokers. Teir overall levels in the body to be too high—is a growing health is worse, they need to go to the doctor health crisis around the world. In the United more often, and they are admitted to the States, more than 25 million adults sufer from hospital more often. We now know that smoking causes type 2 diabetes, also known as adult-onset Smoking also causes autoimmune disorders. Smokers are 30% to 40% more likely Autoimmune disorders occur when the to develop type 2 diabetes than nonsmokers. Smoking and Eye Disease Chemicals in cigarette smoke restrict blood fow to important organs by causing blood vessels to narrow. Chemicals in tobacco smoke damage these blood vessels and prevent them from carrying enough oxygen throughout the eye. Studies show that quitting smoking may reduce that risk, but it might take 20 or more years clouding prevents light from passing through after smokers quit for the risk to go down. Every day 3,200 youth under 18 smoke their frst cigarette, and another 2,100 youth and young adults who have been occasional smokers become daily smokers. Saving Millions of Lives Tere are many ways to reduce smoking rates quickly and dramatically. Among the strategies proven to work are: l Afordable smoking cessation treatments that are easily available to people who want to quit; l Comprehensive smokefree and tobacco-free policies in public places that protect nonsmokers and make smoking the exception rather than the norm; l Higher prices on cigarettes and other tobacco products that discourage young people from starting in the frst place and that encourage adult smokers to quit; l Continued mass media campaigns that inform people of the dangers of smoking and tell them about resources to help them quit; and l State and community programs that help integrate tobacco control into medical, retail, education, and public health environments that reach groups of people who might not otherwise be exposed to tobacco control initiatives. Although we have cut smoking rates in half since 1964, the current rate of progress is not fast enough. The death and disease from tobacco—which claim nearly 500,000 lives each year—are overwhelmingly caused by cigarettes and other burned tobacco products. We can break the cycle of sickness, disability, and death caused by smoking if we: l Extend proven programs and policies to more states and cities to make smoking less accessible, less afordable, and less attractive; l Help everyone who wants to quit by providing cessation resources that are readily available and afordable; l Make cigarettes less addictive and less appealing to youth by using federal regulatory authority; and l Work to rapidly eliminate the use of cigarettes and other forms of burned products. Tese steps can save millions of lives in the coming decades and eliminate smoking as the leading preventable cause of death and disease. Hinton was 15 when she started writing the novel, but did most of the work when she was sixteen and a junior in high school. The book follows two rival groups, the Greasers and the Socs who are divided by their socioeconomic status. The book takes place in Tulsa, Oklahoma, in 1965, but it is never stated in the book. I wish they were more gray, because I hate most guys that have green eyes, but I have to be content with what I have. My hair is longer than a lot of boys wear theirs, squared off in back and long at the front and sides, but I am a greaser and most of my neighborhood rarely bothers to get a haircut. I had a long walk home and no company, but I usually lone it anyway, for no reason except that I like to watch movies undisturbed so I can get into them and live them with the actors. Anyway, I went on walking home, thinking about the movie, and then suddenly wishing I had some company. Not like the Socs, who jump greasers and wreck houses and throw beer blasts for kicks, and get editorials in the paper for being a public disgrace one day and an asset to society the next. Greasers are almost like hoods; we steal things and drive old souped-up cars and hold up gas stations and have a gang fight once in a while. Since Mom and Dad were killed in an auto wreck, the three of us get to stay together only as long as we behave. I only mean that most greasers do things like that, just like we wear our hair long and dress in blue jeans and T-shirts, or leave our shirttails out and wear leather jackets and tennis shoes or boots. Or I could have gotten one of the gang to come along, one of the four boys Darry and Soda and I have grown up with and consider family.

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