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Instructions End-of-semester worksheet · To identify which question you answer, please write Q1/1 answer..., Q1/2 answer...., and do not repeat/copy the questions. This is requested to ensure you do not generate a high similarity score in Turnitin. Note that if we cannot unambiguously identify the questions your answers address, we will not be able to mark your submission. · To show your understanding of the content, and that you are answering the questions asked (rather than adding all the information you can find about a topic), make sure that your answers are concise and to the point. Make sure you follow instructions regarding the length of the answer – if a question states that it is to be 3 sentences long, than assessors will not read/mark more than three sentences. These sentences need to be grammatically correct and not 7 sentences for the price of 1. · The questions presented in your worksheet require you to reflect on and piece together information you have learnt throughout the semester. To get full marks, you need to clearly demonstrate that you understood the learning material and are able to apply the acquired knowledge. When marking, we are looking for connections to be clearly stated, unambiguously written, and well-reasoned. We expect high-quality and convincing writing, where the meaning is clear, relevant terminology is used, and which reflects engagement with the unit. Do not be afraid of using dot points wherever you can; simple, concise, and clear writing is far superior to a word salad or to several paragraphs without essence. · All questions can be answered based on the learning material that we have discussed in the LEO modules and workshops, and if that is where your information comes from, no referencing is needed. However, if you present any information that has not been written or communicated to you by BIOL122 staff, you must indicate its source. Without adequately indicating where such information has been sourced from, it will not be considered when marking. Hints/feedback from previous semesters · Take care that your answers have the expected level of depth—it will not be enough, for example, to state that ‘drug X decreases blood pressure’; we expect you to explain the mechanism of action and describe the chain of events leading to the desired/known effects. · Any form of academic misconduct (e.g., plagiarism, collusion, or poor paraphrasing) will be subject to academic misconduct investigations resulting in mark deductions, cancellation of the assessment task, and/or disciplinary hearings. In addition to the formal penalties as an outcome of the academic misconduct investigation, is the additional consequence of results delayed for weeks as the academic integrity investigations take time. · We are particularly keen on seeing evidence of your critical thinking skills. For full marks, you are expected to answer all questions from Case studies 1–4, and then, depending on the topic you created your vodcast presentation on, you need to complete either Case Study 5 or Case study 6. Therefore, · If your vodcast covered diabetes, you should complete Case studies 1–4 and Case study 6. · If your vodcast covered cancer, you should complete Case studies 1–4 and Case study 5. · If you have not submitted vodcast presentation, you can choose either Case study 5 or 6 presented in this worksheet. The first line of your submission should state the topic of your vodcast presentation. If you do not complete the appropriate case study as instructed above, then you will be awarded no marks for case study 5 or 6. 1 Case Study 1 (3 questions, 5 marks total) John is given a newly developed, experimental medication. The medication is taken orally, each tablet contains 250 mg of active ingredient, which is absorbed from the small intestines, and has a bioavailability of 0.32. It is also known that, of the active ingredient that enters the hepatic vein, 42% undergoes hepatic first pass effect. (1) Based on the parameters provided, calculate the amount of drug that does not get absorbed from a single tablet swallowed. Show your calculations and explain your thinking. (3 marks) This medication is excreted by the kidneys, and the research team responsible for the development of this new drug found that the rate of its excretion was too high. Therefore, they combined the drug with another ingredient, which inhibited the transporters in the kidney that were responsible for the tubular secretion of Johns’s drug. (2) Name the type of drug interaction between the active ingredient of Johns’s medication and the other compound the developers added to the final product and give your rationale. (1 mark) (3) Explain if the combination of the two ingredients is advantageous for John and justify your answer. (1 mark) Case Study 2 (7 questions, 20 marks total) Joanne is a 26-year-old former elite netball player, who had been playing in a top-tier netball league until about a year ago, when her successful life was shattered by a life-changing accident. After a particularly well- fought and prestigious win over their main netball rivals, both Joanne and her de facto drank a lot of alcohol and snorted some cocaine to celebrate Joanne’s team’s success. Regrettably, they also decided to go for a joyride, during which they did not care about speed limits, traffic regulations, or anything at all. They were travelling at high speed south of Ballina, where Joanne’s partner, Stephanie, who was driving the car, lost control of the vehicle, veered off the road, and hit a massive gum tree at a speed of 130 km/h. Stephanie was thrown out of the vehicle and lost her life before help arrived. Joanne survived, but she sustained severe lower abdominal and leg injuries, which resulted in her right leg to be amputated above the knee joint and her uterus and ovaries being removed. One year after the accident, Joanne is still undergoing counselling and physiotherapy, and she has not yet managed to get used to her prosthetic leg. In addition, she has nightmares, feels that she cannot create meaningful connections with anyone, can’t forget the accident, and got clinically depressed. She has also developed bulimia, and to cope with her pain and sorrow, she tends to drink at least half a bottle of Jack Daniel’s every day, which seems to help her with her insomnia, too. She cannot quit drinking even though she has just started to take Prozac (a selective serotonin reuptake inhibitor) and was explicitly told by her therapist that she should never mix this medication with alcohol. However, she feels that her drinking should not matter at all because her medication does not seem to work, anyway: although she started this new treatment exactly 2 weeks ago, she has not noticed any change in her condition whatsoever. Joanne complains about the lack of effect of her new medication to her neighbour, Caitlin, who has been treated for depression as well. Unknown to Joanne, Caitlin was prescribed with an anti-depressant medication with a different mechanism of action to that of Joanne’s. Caitlin mentions that besides helping with her depressive symptoms, she’s also lost some weight because — as per her GP’s instructions — she is no longer allowed to consume any vintage cheese and red wine she loves so much. After a short discussion, Caitlin suggests to Joanne that she should be trying her tablets. Joanne thinks there is nothing to lose in trying, and combines Caitlin’s red, round, film-coated tablets with her own in the hope that her depression would get better. Eight hours later, Joanne develops severe muscle cramps and tremor, becomes febrile, and complains about fast heart beats. The arriving paramedics note cardiac arrhythmia and find Joanne confused and profoundly agitated. (1) By addressing the points specified below, describe some central and peripheral effects of alcohol. (5 marks) Your answer should address all of the following points along with adequate rationale for your answer. None of your answers must be no longer than two sentences per point. Answers will not be assessed after this. · The effect of alcohol on either GABAergic or glutamatergic synapses. · The effect of alcohol on neuronal activity. · The effect of alcohol on intellectual and motor performance. · The effect of alcohol on water homeostasis. · The effect of alcohol on temperature regulation. (2) In a single sentence, describe the similarity between the mechanism of action of ethyl alcohol and benzodiazepines. (1 mark) (3) Name and briefly describe the aetiology of the condition Joanne developed when she took the tablet recommended by her neighbour. (3 marks) (4) Name the most likely class of medication Joanne got from her neighbour and describe it mechanism of action. (1 mark) Joanne is now out of hospital and her depression has got better. She is of Caucasian origin, not pregnant, 178 cm tall, has a body weight of 78 kg, and her waist circumference is 85 cm. (5) Discuss the implications of Joanne’s anthropometric parameters. In particular, your answer should address if—based on her anthropometric data and clinical history—she is at risk of cardiovascular diseases. Your answer must not be longer than 4 sentences. Answers will not be assessed after this. (3 marks) Six months ago, Joanne developed atrial fibrillation, which—despite warnings from her medical practitioner—she chose to ignore. One day she experienced a sudden dizziness and nausea, which was quickly followed by a profound weakness in her right arm to the point that she could not move it at all. When she looked in the mirror, her face was asymmetrical, and her mouth showed drooping on the right could not articulate at all. It was a frightening experience. Joanne was preparing for the worst, but—to her surprise—this awful incident was over in about 9 minutes. By this time, she was able to call for help, and the arriving paramedics did not identify any abnormalities apart from her atrial fibrillation. She was taken for a neurological examination and a brain scan, and neither of those established anything noteworthy. (6) Name the condition Joanne experienced before the paramedics arrived and describe its most likely aetiology. Provide a convincing justification for your answer; note that your answer cannot be more than 4 sentences. Answers will not be assessed after this. (4 marks) (7) The attending physician ordered a low-dose acetylsalicylic acid treatment for Joanne. Explain the rationale for the physician decision. Your answer should refer to the mechanism of action of the prescribed medication, and it should also make it clear how this medication (and its mechanism of action) benefits Joanne. Your answer must not be longer than 3 sentences. Answers will not be assessed after this. (3 marks) Case Study 3 (6 questions, 15 marks total) Sarah is a 45-year-old woman, who first experienced bilateral joint pain and stiffness in her fingers, wrists, and knees about three years ago. Initially, she dismissed these symptoms as signs of getting older or overexertion due to her physically demanding job. However, her symptoms have worsened over time. The range of motion in her joints has decreased significantly, and she is experiencing intense fatigue as well as flu-like symptoms. Sarah's doctor collected a comprehensive health history and conducted a physical assessment. She also ordered a series of blood tests to establish whether rheumatoid factor (RF) and c-reactive protein (CRP) were present in Sarah’s blood. Sarah’s test results showed elevated levels of both RF and CRP, which were consistent with her clinical symptoms of joint swelling and pain. After Sarah’s diagnosis, she was referred to a specialist, who prescribed disease-modifying antirheumatic drugs (DMARDs), including methotrexate, and nonsteroidal anti-inflammatory drugs (NSAIDs) to manage her pain and inflammation. Sarah was also prescribed corticosteroids to provide immediate relief from the pain and inflammation and prevent flare ups. (1) Identify the condition Sarah has been diagnosed with. In your answer, you must provide 3 clinical findings that have led you to this conclusion. (2 marks) (2) By making meaningful references to the pathophysiology of the condition you identified above, discuss why the range of motion in Sarah’s joints has decreased significantly. (2 marks) (3) Discuss the significance of elevated levels of rheumatoid factor and c-reactive protein in Sarah’s blood. Discuss the relationship between these two factors and Sarah’s condition. (4 marks) Sarah, now 70, has been living with her condition for many years. She has managed her condition with DMARDs, NSAIDs, and corticosteroids. She has maintained a relatively active lifestyle through regular exercise and anti-inflammatory diet. One evening, Sarah had a fall at home, resulting in a hip fracture. She was rushed to the emergency room, where she underwent surgery to repair the fracture. Post-surgery, Sarah's healthcare team conducted a dual- energy X-ray absorptiometry (DEXA) scan to assess her bone density, and the results revealed significant bone loss. Sarah was prescribed bisphosphonates and was advised to increase her calcium and vitamin D intake. (4) Discuss the relationship between Sarah’s decades-long use of pharmacological agents and her low bone density and the resulting hip fracture. (3 marks) (5) When Sarah fell, she also scraped off a large chunk of skin on her leg, and she feels like it is taking a very long time to heal. Considering the nature of her wound and the processes involved in wound healing,
Answered 2 days AfterOct 13, 2023

Answer To: question attached in files

Dr Insiyah R. answered on Oct 15 2023
30 Votes
Case Study 1    2
Case Study 2    3
Case Study 3    5
Case Study 4    7
Case Study 6    8
Case Study 1
(1) To determine the amount of the drug that doesn't get absorbed from a single tablet when ingested, we consider both its bioavailability and the hepatic first-pass effect. Here are the calculations:
- Total drug content in one tablet = 250 mg
- Bioavailability (F) = 0.32
- Hepatic first-pass effect (H) = 42%
Amount of drug absorbed from the small intestines = Total drug
amount × Bioavailability
= 250 mg × 0.32
= 80 mg
Amount of drug undergoing hepatic first-pass effect = Amount absorbed × Hepatic first-pass effect
= 80 mg × 0.42
= 33.6 mg
Amount of drug not absorbed = Total drug amount - Amount absorbed + Amount undergoing hepatic first-pass effect
= 250 mg - 80 mg + 33.6 mg
= 203.6 mg
So, 203.6 mg of the drug remains unabsorbed from a single swallowed tablet.
(2) The type of interaction between the active ingredient of John's medication and the additional compound, which inhibits kidney transporters responsible for the drug's tubular secretion, is a "Pharmacokinetic Drug-Drug Interaction." This occurs at the level of drug absorption, distribution, metabolism, or excretion, specifically affecting drug excretion in this case.
(3) The combination of these two ingredients benefits John. By inhibiting the kidney transporters responsible for eliminating John's drug, the additional compound reduces the rate at which the medication is excreted. This leads to greater retention of the active ingredient in John's body, resulting in a prolonged therapeutic effect. This is advantageous for John as it helps maintain the drug's effectiveness and potentially allows for less frequent dosing. However, careful monitoring is essential to watch for any potential side effects or adverse reactions due to the extended presence of the drug in the body.
Case Study 2
(1) Alcohol exerts both central and peripheral effects on the human body:
- Regarding its impact on GABAergic synapses, alcohol enhances the inhibitory actions of gamma-aminobutyric acid (GABA) neurotransmission, ultimately leading to central nervous system (CNS) depression.
- In the context of glutamatergic synapses, alcohol inhibits glutamate neurotransmission, thereby contributing to CNS depression.
- Alcohol significantly suppresses neuronal activity, consequently resulting in impaired cognitive and motor functions.
- Impairments in intellectual and motor performance are induced by alcohol, characterized by disruptions in coordination and judgment.
- Alcohol functions as a diuretic, prompting increased urine production and dehydration.
- While alcohol may induce a sensation of warmth, it actually induces heat loss by dilating blood vessels and elevating heat dissipation.
(2) The commonality between the mechanisms of action of ethyl alcohol and benzodiazepines lies in their shared capacity to potentiate the inhibitory effects of GABAergic neurotransmission, ultimately leading to CNS depression.
(3) Joanne experienced serotonin syndrome, a condition characterized by symptoms including muscle cramps, tremors, fever, confusion, agitation, and cardiac arrhythmias. This syndrome results from an excessive accumulation of serotonin in the central nervous system, which ensued from the concurrent use of Joanne's selective serotonin reuptake inhibitor (Prozac) and the neighbor-recommended antidepressant with a differing mechanism of action.
(4) The class of medication Joanne received from her neighbour is most likely a serotonin-norepinephrine reuptake inhibitor (SNRI) or a distinct type of antidepressant. SNRIs function by elevating serotonin and norepinephrine levels within the brain.
(5) Considering Joanne's anthropometric data and clinical history, she stands at an elevated risk of cardiovascular diseases. Notably, her waist circumference of 85 cm suggests abdominal obesity, a recognized cardiovascular risk factor. Additionally, her previous diagnosis of atrial fibrillation, coupled with her decision to disregard medical counsel, underscores her heightened susceptibility to cardiovascular complications.
(6) Joanne encountered a transient ischemic attack (TIA), colloquially termed a "mini-stroke." The aetiology most likely involves the temporary disruption of blood flow to a cerebral region, yielding neurological symptoms. Given her history of atrial fibrillation, it is plausible that an embolus or clot dislodged from her heart obstructed a cerebral artery transiently. The brief duration of symptoms aligns with this diagnostic interpretation.
(7) The physician prescribed low-dose acetylsalicylic acid (aspirin) due to its antiplatelet properties. Aspirin functions by inhibiting platelet...
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