1. Explain the mechanism of action of one drug type Mary-Lou is prescribed with and describe how these drug actions help mitigate some of her symptoms. In you answer, make references to the pathophysiology of the relevant disease and relate the chosen drug’s mechanism of action to the aetiology/pathogenesis of the disease.
2. The following questions relate to a drug called MedZ:
a. MedZ contains 200 mg of the active ingredient in an intestine-solvent capsule. The active ingredient is effectively transported across the intestinal mucosa, which ensures that 78% of the drug is absorbed and enters the portal circulation. The drug undergoes a significant degree of first-pass metabolism, in which process 55% of the drug passing through the liver gets metabolized and therefore degraded to an inactive product. Calculate MedZ’s bioavailability and show your calculations.
b. When administered alone, 82% of MedZ is bound to plasma albumin. However, because of the higher plasma protein binding affinity of another drug, called MedY, when MedZ and MedY are administered together, the bound fraction of MedZ decreases to 35%.
i. Identify the type of drug interaction between MedZ and MedY in the present scenario and give your rationale.
ii. Assuming that MedZ and MedY are administered together in an elderly patient, explain if the dose of MedZ should be decreased, increased, or left unchanged and give your rationale.
3. Name the disease affecting Mary-Lou’s left knee and describe two characteristic clinical manifestations of this pathology (2 mark). Explain the aetiology and pathophysiology of the disease
4. Considering Mary-Lou’s T-score, identify the disease she suffers from, briefly describe the pathogenesis of this disease, describe the mechanism of action of bisphosphonate administration, and explain the benefits of this treatment in her present condition.
5. Discuss why Mary-Lou’s fracture may take longer to heal than it would for someone who was half her age. In your answer, you are expected to name and discuss three physiological factors that are needed for healing to take place and explain how each of the factors you identified is affected by ageing.
6. Choose one of Hilda’s triggers and explain how it contributes to the pathophysiology of her asthma.
7. Hilda has been told to take her ‘preventer’ medication everyday.
a. Name the broad drug category preventer medications belong to, describe their mechanism of action, and explain their benefits in Hilda’s case. (2 marks)
b. Describe the method and one benefit of topical administration of preventer medications
8. Hilda has been advised to get the AstraZeneca vaccine to reduce the risk of contracting coronavirus.She is hesitant as she has heard that the Pfizer vaccine is ‘better’.
She doesn’t understand the doctor’s explanation of the two vaccines. Using terms a patient can understand, describe one difference and one similarity between the mechanism of action of the Pfizer and AstraZeneca COVID vaccines.
9. Describe two similarities and two differences between hyperplasia and cancer.
10. On follow-up examinations, Bruce is found to have a brain tumour. Biopsy results reveal that the cancer cells taken from his brain tumour have the morphological characteristics of colorectal cancer. Considering brain cells are permanent cells, explain the most likely reason for this finding.
11. Explain why patients who have leukaemia may have excessively high numbers of white blood cells in their blood, yet they are immunocompromised.
12. Assuming that Greg’s present symptoms are associated with his underlying disease, name the condition responsible for his numbness and tingling, and explain the link between type II diabetes and the condition you identified.
13. Greg takes an oral anti-hyperglycaemic medication. Explain why insulin administration is not recommended in his condition.
14. Explain how glucose uptake of Greg’s (i) endothelial and (ii) resting skeletal muscle cells changes when he is experiencing a hyperglycaemic episode and give your rationale.
15. Before her current problems, Maria was prescribed a beta blocker for her hypertension. Explain the benefits of beta blocker administration in the treatment of hypertension with specific emphasis on how this treatment reduces blood pressure.
16. A couple of weeks before her current episode, Maria noticed that ‘she was short of breath and was feeling a slight pain in her chest, but when she sat down for a few minutes, she felt much better and the pain disappeared.’ Name the condition Maria was most likely experiencing and explain its pathogenesis.
17. Considering her clinical symptoms and laboratory findings, name the disease Maria is suffering from when admitted to the hospital and explain the benefits of heparin administration in her present state.