..........Myspace Codes An Extraordinary Life: Ageing & Endings 1

Thursday, April 26, 2007

Ageing & Endings 1

Just finished my Ageing & Endings 1 paper on Tuesday, so, once again, here’s another post-exam rant…

Firstly, I had a really rough time doing the paper. The night before the exam, I had a cough and sore throat. I popped a Panadol CF, thinking I was coming down with the chills. Because it was labeled “drowsy”, I asked Lou Lynn to give me a wake-up call in the morning in case I oversleep. Lo and behold, not only was I not drowsy but on the contrary, I flipped and turned in bed the whole night not getting any sleep! You may say that it’s nerves but it isn’t (I know it!) so when I got up, I was already in a state of fatigue. What a “great” way to start the day of your exam! To make things greater, I developed a new set of symptoms over the night. I got up with a headache, nausea as well as pressure and aching in my left ear; all of which persisted throughout the entire day. As I walked to the racecourse (yup, that’s my exam venue!), I suffered from muscle weakness in both legs. As you can probably tell, I was very restless and couldn’t concentrate at all while I was sitting for my exam. I kept shifting my sitting posture and couldn’t sit still. On my way back after the paper, I conveniently puked at the roadside near Doncaster Avenue – how nice! The day after exam day, I woke up feeling much better but with this contusion-like feeling as though I had been punched in my head. Once again, this was on the left side – just like the ear problem and also the sore throat (just the left side). All you fellow medics out there, can someone diagnose this problem and tell me what the heck I’ve come down with? Another symptom to help you with your diagnosis – on the exam day, I was shivering in my room despite already wearing jeans and a jacket when the room temperature was only 22°C – I had alternating feelings of hot and cold. Now, those of you who really know me will be able to tell that this is absolutely abnormal in my case coz I can still wear a short-sleeved T-shirt and shorts and thongs out in the air of less than 20°C and still feel fine instead of shivering! In case if you’re still wondering, I’m way much better now though the cough and left-sided sore throat still persist…

Ok, now for the usual dose of what-I-got-for-exam questions:

1. A 50 year old woman consulted her GP, presenting menopausal symptoms such as hot flushes, night sweats and insomnia.

(a) Describe the physiological changes that caused such symptoms.

(b) What other symptoms may appear with menopause? Explain the physiological basis for these symptoms.

(c) What kind of treatments are there available for this woman? What factors should you consider in recommending one treatment over another?

2. A 75 year old man with long-standing hypertension and previous ischaemic heart disease was admitted to a hospital for a stroke. Upon further examination, his left posterior cerebral artery was found to be occluded.

(a) Explain, with the aid of a diagram, the origins and distribution of the left posterior cerebral artery. Which areas of the cortex does this artery supply? What clinical effects may be presented as a result of the occlusion of this artery?

(b) What might be the possible causes of the occlusion of this artery? What clinical effects may be presented as a result of such an occlusion?

(c) List three possible fatal complications that this man may suffer within the first few weeks after the episode of stroke. Explain why these complications may occur.

3. An 82 year old man presented with the usual signs and symptoms of Parkinson’s disease. He finds it difficult to initiate and carry out voluntary movements, is rigid in his movements, stoops in his posture and has tremors which improve when he’s carrying out motor tasks.

(a) Describe the anatomical structures that are affected in Parkinson’s disease. How do these influence the set of signs and symptoms given?

(b) Suggest possible interventions that can help this patient?

4. A 72 year old woman is suffering from Alzheimer’s disease. She is often forgetful and can sometimes wander off and get lost. Her daughter lives with her at home and cares for her.

(a) What are some of the issues that the daughter may face in deciding whether to continue caring for her mother at home?

(b) Who decides if the mother should be cared for at a nursing home instead? What are the issues that should be considered here?

(c) What kind of services can community-based support offer to assist this family?

There you have it, my 4 short answer questions in the paper (remember, they’re all from memory so don’t take them word-for-word!). These plus about 50 MCQs (30 objective + about 20 written ones), all in 2.5 hours… Enjoy… :p

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