8.3 Explain why the leafy shoot should be cut underwater.   (1)

1.4 To test for the presence of starch in a food, which of the following reagents should be used? (1)       A) Biuret   B) Benedict’s reagent   C) Ethanol   D) Iodine  

Use the following patient vignette to answer questions 7 – 8. A 65-year-old woman is evaluated for a week-long fever, productive cough with purulent sputum, and increasing dyspnea. She smokes one pack of cigarettes a day. Her medical history includes hypertension and hypercholesterolemia, for which she is treated with simvastatin, hydrochlorothiazide, and aspirin. On physical examination, the patient is in mild respiratory distress. Temperature is 38.5°C (101.3°F), blood pressure is 145/85 mm Hg, pulse rate is 92/min, and respiration rate is 21/min; BMI is 28.  Oxygen saturation is 92% with the patient breathing ambient air and 95% on oxygen, 2 L/min by nasal cannula. Pulmonary auscultation reveals bilateral expiratory wheezes, and rhonchi. Physical exam reveals no digital clubbing but 1+ ankle edema. Lips are slightly bluish.  Chest radiograph shows increased bronchovascular markings. Laboratory values indicate normal CBC, except an increase in neutrophils and hemoglobin. Arterial blood gases while the patient was breathing ambient air are pH 7.40, PCO2 41 mm Hg, and PO2 53 mm Hg. Spirometry shows an FEV1 of 45% of predicted and an FEV1/FVC ratio of 52%. 7. Which is the most likely diagnosis for this patient?

3. The table contains names of vitamins and minerals and the deficiency that results if the vitamin or mineral is lacking in the body. Match the name of the vitamin or mineral with the correct deficiency.   (5)   VITAMIN/MINERAL DEFICIENCY 3.1.  Iron A. Rickets 3.2.  Iodine B. Blindness 3.3.  Vitamin C C. Goitre 3.4.  Vitamin D D. Anaemia 3.5.  Vitamin A E. Scurvy

Study the table below and answer the questions that follow: Farmers in Asia add fertiliser to their crops to increase the yield. Fertilisers usually contain nitrate, phosphate and potassium. The table shows the farmers’ crop yield when the crops are given a fertiliser lacking one of these three minerals. A figure of 100% is the maximum yield with all three minerals given. Right-click on the button below to open the image in a new tab:

Use the following patient vignette to answer questions 11 – 13. A 35-year-old man presents with sputum producing cough and dyspnea at rest.  Past medical history is significant for a previous diagnosis of premature emphysema at age 28.  The patient denies smoking and excessive alcohol intake or exposure to dust and mold.  Family history is significant for coronary artery disease and pulmonary disease in the patient’s father and only brother.   Vital signs are within normal limits except for blood pressure of 160/120 mmHg on three readings.  Physical examination reveals an ill-appearing man with prolonged expiratory time.   Auscultation of the lungs reveals end-expiratory wheezing.  ECG is within normal limits. 12. Which pathophysiological changes do you expect to observe in the lungs of this patient at the CXR/CT scan tests?

6.1 Identify parts labelled C, F and K. (3)   C –     F –     K –  

17. Which of the following statement(s) best define(s) the term Oxygenation?

6.6 Suggest two consequences of having a diet that contains too much fat. (2)

A 57-year-old woman visits her primary care provider (PCP) complaining of chronic shortness of breath, at rest and with exertion, and a productive cough with sputum.  The patient reports having smoked since age 16, and is currently smoking 1.5 pack/week. She denies drinking alcohol.  Past medical history is significant for bouts of untreated essential hypertension.  Vital signs reveal blood pressure 165/100 mm Hg. 88 HR, 21 RR. Physical exam reveals pronounced wheezing on lung auscultation.  ECG is normal, and CXR shows no lung consolidation.  Spirometry reveals low FEV1 & FEV1/FVC.  Inhalation of a bronchodilator does not improve FEV1 or FEV1/FVC.  Her peak flow meter reading is 110 L/min. The patient’s PCP prescribes Ipratropium bromide (Atrovent®), administered through a metered dose inhaler.  After 1 week of treatment, the patient’s peak flow velocity improves to 220 L/min. 14. Which of the following mechanisms explains the therapeutic effect of Ipratropium bromide in this patient?