Sectiоn C - Pаthоphysiоlogy You only need to аnswer two of the three questions from this section. Two аnswer boxes will be beneath this box - please indicate which question you are answering, for example: 'My Answer to Question X is...' Questions are as followed: Question 6: Read the case details below (in italic font) and then answer both parts of the question. A patient has entered the Emergency department with chest pain. The pain has been described as a burning pain in the centre of the chest that has been constant for the last hour. The patient has tried three attempts at easing the pain with GTN spray and when they did not resolve the pain he contacted emergency services as directed by his doctor. The 12 lead ECG performed in the Emergency department is inconclusive, there are some inverted T waves however no evidence of ST elevation. A blood test is performed to measure the levels of troponin in the patient’s blood and this returns significantly elevated leading to a diagnosis of non-ST elevation myocardial infarction. Please answer both parts of the question. a) What is the purpose of measuring serum troponin levels and what is the significance of the raised values in the patient’s blood? (20%) b) Explain the underlying pathophysiological mechanisms and the timeline of events that occur within the coronary arteries that leads to a non-ST elevation myocardial infarction (NSTEMI). (80%) Question 7: Read the case details below (in italic font) and then answer both parts of the question. A 62-year male is brought to the Accident and Emergency department after suddenly developing weakness on the right side of his body, facial drop and slurred speech. In addition, he complained of feeling tired and confused. The patient’s symptoms started 45 minutes earlier and were noticed by his son who was visiting at the time and called the ambulance immediately. His son also reported having difficulty understanding his dad’s speech. The patient was immediately brought to the Accident and Emergency Unit for assessment. On examination, the patient’s blood pressure was 210/115 mmHg, however there was no loss of consciousness or severe headaches. The patient is a smoker on a high fat diet with ongoing treatment for hypertension, hyperlipidaemia and was diagnosed with type 2 Diabetes at the age of 55 and is on medication. a) Discuss the underlying pathophysiological mechanisms associated with the patient’s symptoms, taking into consideration their medical history (70%). b) Discuss the diagnostic investigations that can be performed to assess the patient’s condition (30%). Question 8: Explain the pathophysiology of cystic fibrosis, including in your answer: details of the disease and symptoms (30%), underlying molecular pathophysiology (40%) and genetics (30%).