Mark Corson

By B. Dawson. Illinois Institute of Technology. 2018.

A child comes and goes cheap 250mg diamox visa, typically felt while walking order diamox 250mg visa, and with this disorder can bring his or her shoulders usually subsiding with rest buy discount diamox 250 mg on line. The gene for cleidocranial tion can be due to temporary artery narrowing due dysostosis has been found on chromosome 6 in to vasospasm, permanent artery narrowing due to band p21. Also known as cleidocranial dysplasia atherosclerosis, or complete occlusion of an artery and craniocleidodysostosis. The prognosis is generally favorable because the condition often stabilizes or improves click-murmur syndrome See mitral valve with time. If conservative therapy is inadequate and time corresponding to menopause in the life of claudication is severe and persistent, correction of men. The term comes from the French “clinique” (at the claudication, venous Limping and/or pain bedside). The from a single somatic (nongerm) cell from a par- term clinical depression is commonly used to ent, representing an exact replica of that parent. In severely affected patients, the inner lining of the colon clinical trial See clinical research trial. For example, a surgical clip may be used Clostridium perfringens A bacterium that is to prevent a blood vessel from bleeding into the the most common cause of gas gangrene, a lethal brain, or in a vasectomy to pinch together the sides infection of soft tissue, especially muscle. Before the introduction of antibiotics, a of the clitoris to reduce a woman’s ability to be sex- significant percentage of battlefield injuries were ually stimulated during intercourse. Like the penis, the clitoris is highly sensitive to clot-dissolving medication An agent such as stimulation during sex. The foot is turned in sharply so that the person seems to be walking on his or her coagulation, blood See blood coagulation. Clubfoot can sometimes be corrected with a combination of surgery, bracing, and physical ther- coal miner’s pneumoconosis See black lung apy. The sides of the vessel at the point birth defect, or headaches, closely grouped in time of a coarctation appear to be pressed together. The most common cluster below the level of the constriction and increases headache pattern, acute cluster headache, is char- blood pressure above the constriction. Symptoms acterized by one to three short attacks of pain each may not be evident at birth but may develop as soon day around the eyes, clustered over a stretch of 1 to as the first week after birth, with congestive heart 2 months, and followed by a pain-free period that failure or high blood pressure that can require early averages 1 year. For example, propranolol is effective in usually just after an angioplasty has been done, to treating migraine but not in treating cluster keep open the vessel. The stent slowly releases the headache, whereas lithium is beneficial for cluster drug with which it is coated. Also known as ciliary the risk of artery re-narrowing (restenosis) after neuralgia, erythroprosopalgia, histamine cephalgia, angioplasty. Also known as a medicated stent, drug- migrainous neuralgia, Raeder syndrome, coated stent, drug-eluting stent, eluting stent. Safer anesthetics bles stuttering, in which only sounds or parts of than cocaine were developed in the 20th century, words are repeated. They may do so by taking courses, attending med- coccus A bacterial cell that has the shape of a ical conferences where they learn about new devel- sphere. Coccus is part of the name of a number of opments, or by reading and taking tests. Cochlear implants rarely cure severe or profound However, about 1 patient in 10 has recurrent ero- deafness, but they can help some hearing-impaired sion of the cornea that generally begins after age 30. For phy and map-dot-fingerprint type corneal dystrophy children who are congenitally deaf (born deaf), a and microcystic corneal dystrophy. Cogan syndrome causes problems of hearing cockroach allergy A condition that manifests as and balance and also inflammation of the cornea an allergic reaction when one is exposed to cock- and often fever, fatigue, and weight loss. Joint and roach allergens, tiny protein particles shed or muscle pains can also be present. Asthma can be triggered the arteritis can involve blood vessels elsewhere in by exposure to these cockroach allergens. Treatment is directed toward code, genetic The instructions in a gene that tell stopping the inflammation of the blood vessels. Severe disease can require immuno- the chemicals adenine, thymine, guanine, and cyto- suppression medications, such as cyclophos- sine, respectively. Each gene’s code combines these four chemicals in various ways to spell out three-letter cognition The process of knowing. Cognition “words” that specify which amino acid is needed at includes both awareness and judgment. The discovery of the genetic code ranks as one of the premiere events of cognitive Having to do with thought, judgment, biology and medicine. One characteristic (sometimes called a “code team”) to rush to the technique is exposure and response prevention, in specific location and begin immediate resuscitative which a patient with a phobia deliberately exposes efforts. Cognitive behavior code pink A hospital or institution alert to secu- therapy is used to treat obsessive-compulsive disor- rity that a baby is missing from the hospital nursery. There are 64 different codons, of which 61 indicates that over time this therapy can sometimes specify the incorporation of an amino acid into a create actual changes in brain and neurotransmitter polypeptide chain; the remaining 3 are stop codons, function. A number of the water-soluble vitamins, such tions that chronically affect a certain type of as vitamins B1, B2, and B6, serve as coenzymes. Cognitive with a slit-lamp, which focuses a high-intensity light dulling can occur due to a medical condition or as beam through a slit while the examiner uses a mag- a side effect of medication. Common loca- chology, philosophy, computer science, artificial tions for cold sores are the lips, chin, cheeks, and intelligence, and linguistics.

A tion may be acquired from contaminated food and Heberden’s node is a calcified spur of the bone of water or through person-to-person contact generic diamox 250mg with amex. It is that joint (distal interphalangeal joint) and is asso- common in people who live in crowded conditions ciated with osteoarthritis purchase diamox 250mg otc. Infected persons which short purchase 250mg diamox with mastercard, tight muscles make it impossible to usually carry H. Also known as trismus pseudo- down of red blood cells (hemolysis; the H in the camptodactyly syndrome. Heimlich maneuver An emergency treatment Increased fluid in the tissues (edema) is also com- for obstruction of the airway in adults. Occasionally, coma can result maneuver may be needed when someone chokes on a piece of food that has “gone down the wrong way. To perform the Heimlich maneuver, a rescuer Treatment depends upon the stage of pregnancy, the severity of the condition, and the overall health sta- stands behind the victim, wraps his or her arms around the victim’s waist, makes a fist with one tus of the patient and may include corticosteroid hand, and holds the fist with the thumb side just medications, blood transfusions, antihypertensive medications, and antiseizure medications. The rescuer places his or her other hand over the delivery is required if the health of the fetus is com- fist and uses it to pull sharply into the top of the vic- promised or if the mother’s health is at serious risk. The Heimlich maneuver should can also develop during the early period after be repeated as necessary. The breakage may be spontaneous, as in the case of an aneurysm, or caused by trauma. The hemangioma, capillary A type of hemangioma blood is usually clotted or partially clotted, and it that is composed almost entirely of tiny capillary exists within an organ or in a soft tissue space, such vessels. Treatment depends on the location and where on the body but are most common on the size of the hematoma but usually involves draining face, scalp, back, and chest. They usually grow quickly and then remain fixed in size and, with time, spontaneously subside. The vast hematoma, epidural A hematoma between the majority are gone by the time the patient is age 10. Epidural hematoma is usually include strawberry hemangiomas, strawberry caused by a full-on blow to the head and is often marks, and salmon patches. Treatment is trepanation: hemangioma, cavernous A type of heman- drilling through the skull to drain the excess blood. A cavernous henangioma is raised and red or hematoma, intracerebral A hematoma within purplish. The normal hematoma, subdural A hematoma between the ranges for Hct depend on the age and, after adoles- brain and its covering, the dura. The values returned impaired gait, and dizziness may result and on Hct tests may vary slightly between laboratories. Subdural An abnormally low level of Hct is referred to as ane- hematomas can be caused by minor accidents to the mia and can come from bleeding, iron deficiency, head, major trauma, or the spontaneous bursting of breakage of red blood cells (hemolysis), and many a blood vessel in the brain (aneurysm). An abnormally high level of Hct is dural hematomas are usually due to severe head http://www. Chronic subdural hematomas may be very to 50 years of age in males and after menopause in insidious. The excess iron gives the skin a bronze 2 to 4 weeks: When they do cause problems, the color and damages the liver, causing liver scarring incident that caused the bleeding is often long past. Symptoms include increasing daily headache, fluc- Diabetes also occurs due to damage to the pan- tuating drowsiness or confusion, and mild weakness creas. Early diagnosis and treatment before symp- drilling through the skull to drain the excess blood. Hemochromatosis is inherited in an auto- hematopoiesis The production of all types of somal recessive manner. Also known as bronze dia- blood cells including formation, development, and betes and hereditary hemochromatosis. Prenatally, hematopoiesis occurs in the yolk sack, then in the hemodialysis See dialysis. In the normal situation, hematopoiesis in adults occurs in the hemoglobin The oxygen-carrying protein pig- bone marrow and lymphatic tissues. All types of ment in the blood, specifically in the red blood blood cells are derived from primitive cells (stem cells. Hb is usually measured as cells) that are pluripotent (they have the potential to total Hb expressed as the amount of Hb in grams develop into all types of blood cells). The normal ranges are approximately 14 to 17 gm/dl for adult hematuria See blood in the urine. Values returned on Hb tests may vary slightly between lab- hematuria, gross Blood in the urine that can be oratories. Hematuria may or may not be accompanied by pain, but it is always abnormal hemoglobin A Normal adult hemoglobin, the and should be further investigated. The left concentration: The higher the glucose concentra- hemidiaphragm is more often subject to rupture tion in blood, the higher the level of HbA1c. See also diaphragm; of HbA1c are not influenced by daily fluctuations in diaphragmatic hernia. Measurement of HbA1c is a useful indicator of how well the blood glucose level has been controlled in hemiplegia Paralysis on one side of the body. Also known as glycosy- hemizygous Having only a single copy of a gene lated or glucosylated hemoglobin. All the genes on the single X chromosome in the male are hemoglobin E Normal embryonic hemoglobin, hemizygous. The E stands for embryonic and also for hemochromatosis An inherited disorder char- epsilon, a chain that is unique to embryonic hemo- acterized by abnormally high absorption of iron by globin. Common early symptoms include main type of hemoglobin found in the fetus and abdominal pain, weakness, lethargy, and weight newborn baby. It differs Salmonella, or it may be related to other conditions from hemoglobin A only by a single amino acid sub- and infections.

Some diets emphasize eating only whole grains while others might eliminate carbohydrates al- together proven 250 mg diamox, especially from grains cheap 250 mg diamox overnight delivery. No diet that I have ever heard of encourages refined cheap diamox 250mg mastercard, processed carbohydrate consumption. If you think about it, and if you look at the food patterns over the last century in the United States, with the increase in refined grain con- sumption along with added fat and sweet calories, then you can see where excess carbohydrate consumption has had an adverse - 79 - staying healthy in the fast lane effect on weight. If you were only eating whole grains, beans, un- processed starchy vegetables, and fruit, there would be a dramatic shift to better weight control. Second, all diets—vegan, vegetarian, carnivore, or omnivore, low-fat or high-fat—encourage the consumption of vegetables. If everyone strictly adhered to the “no refined carbohydrates” and “eating lots of vegetables” components in almost all the popu- lar diets, there would be a dramatic change in the health of our country and in other developed and developing countries. There would be a dramatic reduction in weight and excess calories, which are main causes of chronic disease. You might have observed that I keep repeating the words “un- refined,” “unprocessed,” and “whole. If you use these three simple words as the basis for all of your food choices, then you will dramatically change your health. You don’t need a calorie counter or fifteen rules on a par- ticular diet or excessive menus. They may not be easy initially, but they are very, very simple rules for a healthy diet. What these rules result in if applied are the elimination of added calories to foods, an increase in protective phytochemicals, and a reduction in the glycemic response of foods resulting in low- ered blood sugar and insulin levels, which reduce inflammation and risk to virtually all disease. Any dietary pattern that cuts calo- ries, increases protective micronutrient intake, and controls blood sugar is going to do a lot of good in the modern world. You can live off plant foods and not eat another ounce of animal products and be abso- lutely and wonderfully healthy. Plant foods have protein, fat, car- bohydrate, fiber, and almost all the life-preserving phytochemicals, vitamins, and minerals. If you are a strict vegan, meaning you eat no animal products, you should supplement with vitamin B12, for insurance. If you don’t eat a lot of greens, sea vegetables, or nuts and seeds, you may need to take some omega-3 fatty acids. When I get confused about nutrition (yes, I do at times, from all the media and Internet medical “experts”), I consider two things. First, I tend to think of animals that are closely related to us and what they are eating. If a gorilla can be almost completely vegan (some eat termites and ants, along with whatever bugs are on the plant they are eating) and survive without consuming animal products (and dairy) for their strong muscles and bones, then so can I. The second thing I do when confused is look at what healthy aging cultures eat, like the Okinawans, Sardinians, Nicoyans, Hun- zas, Abhkasians, Vilcabambans, Seventh Day Adventists, Tarahu- mara Indians, or the cultures in the “Cold Spots” or “Blue Zones” of the world. You see very similar dietary patterns: They eat local fresh fruit and vegetables; a staple, unrefined grain (starch) usu- ally; some beans, lentils or root vegetables; and maybe some nuts and seeds. The animal products they eat are generally more of a condiment than a big part of their plate. It may not be eaten every day, maybe only on special occasions or once or twice per week— and it is usually a free-ranged, grass-fed animal eating local vegeta- tion (with an anti-inflammatory fat profile) and lean overall. This is a much different way of eating than the typical consumer of the Western diet. About fifteen or so years ago, I became a vegetarian, and around ten or more years ago, I became what I call a “sloppy” vegan. A vegetarian eats plant foods but can also, depending on the type of vegetarian, eat eggs (ovo-) or dairy products (lacto-). I call myself a “sloppy” vegan because I still have leather shoes, once a month or so I might have some type of dairy food or maybe something with eggs in it. I might have veg- etable soup at a restaurant that might be made with chicken broth. I don’t go out and buy animal foods for my home use, nor do I go out and order animal foods. I would say that I am a 99 percent-plus vegan; “sloppy” is a pretty good description! Once you start, it grows on you, and aspects of it become more important to you and you continue to change. Health and Weight Control Being a Vegetarian Before I describe the benefits of vegetarianism on weight con- trol, I want to make it clear that I am talking about whole-food vegetarians, eating the majority of their diet as vegetables, fruit, beans, nuts and seeds, whole grains and minimal or no refined or processed foods. There is nothing worse for the cause of encour- aging plant-based diets than a “loud” vegetarian who is eating refined-grain products, rich in fats and added sugar; processed vegetarian foods; and virtually no vegetables and fruit—one who looks shriveled up, pale, and has to have his or her caffeine fix in order to walk. Or, a vegetarian who is overweight, eating all kinds of refined, sweet-fat-enriched flour “animal-free” foods. Please, please, my vegetarian brothers and sisters—eat whole, unrefined plant foods with tons of vegetables, fruit, beans, nuts, seeds, and moderate amounts of whole grains. Cor- dain, the author of The Paleo Diet, so aptly calls these types of veg- etarians, “breaditarians. The easy access to food (calories) makes our survival- oriented “thrifty genes” work overtime, storing excess calories as fat to protect us from when we don’t have enough calories, which in modern, urbanizing life is usually never.

Noninvasive cardiac imaging/stress testing should be pressure check considered in patients with how many of the following six B buy diamox 250 mg on-line. Initiate an angiotensin-converting enzyme inhibitor proven risk factors (high-risk surgery purchase diamox 250mg without a prescription, ischemic heart dis- C cheap 250 mg diamox free shipping. Initiate a beta blocker ease, congestive heart failure, cerebrovascular disease, di- D. Recheck her blood pressure in the seated position in abetes mellitus, and renal insufficiency) for perioperative 6 h cardiac events (including pulmonary edema, myocardial E. Which cardiac valvular disorder is the most likely to dyspnea at 70% maximal expected dosage, requiring early cause death during pregnancy? Family history of diabetes mellitus in a first-degree foot placement but no subjective dizziness characterizes relative which type of gait ataxia? Which of the following criteria best differentiates epi- closed and notes frequent falls. Concurrent connective tissue disease such as lupus normal, and there is no tremor. Cerebrovascular disease ral conjunctivitis and is a major cause of blindness in the D. Stereognosis (the ability to recognize common ob- after a new diagnosis of anterior uveitis. All of the follow- jects, such as coins, by palpation) ing diseases should be screened for by history and physi- C. A 22-year-old female is referred to your clinic after there most likely to be anatomic damage? No further evaluation unless symptoms recur particularly in the periphery with the right being worse E. Visual field examination with finger con- frontation reveals a decreased vision in the left periphery I-82. A 69-year-old male dialysis patient with poorly con- in the left eye and right periphery in the right eye. Where trolled diabetes, heart failure and chronic indwelling is there most likely to be a lesion? Lid eversion for foreign body examination would result in thermal injury and burns but would not D. Oculoplegia and dilation cause damage to internal organs because the particle size E. Neutron particles urine sample is positive for the presence of radioactive iso- E. X-rays topes, which are determined to be polonium-210, a strong emitter of alpha radiation. What is the best approach to the The bomb was composed of cesium-137 with trinitro- treatment of this patient? In the immediate aftermath, an estimated 30 people were killed due to the power of the blast. Several victims are brought to the emergency room after is the most appropriate approach to treating the injured a terrorist attack in the train station. All individuals who have been exposed should be station, but several people reported a smell like that of treated with potassium iodide. All individuals who have been exposed should be emergency room, exposed individuals had their clothing re- treated with Prussian blue. All individuals should be decontaminated prior to On initial presentation, there was no apparent injury except transportation to the nearest medical center for eye irritation. Over the next few hours, most of those ex- emergency care to prevent exposure of health care posed complain of nasal congestion, sinus pain, and burn- workers. Severely injured individuals should be transported of the exposed individuals began to notice diffuse redness of to the hospital for emergency care after removing the skin, particularly in the neck, axillae, antecubital fossae, the victims’ clothes, as the risk of exposure to health and external genitalia. He met with an informant 2 days previously at a attack in the food court of a shopping mall. Several victims hotel bar, where he drank three cups of coffee but did not who were close to the site of the release of the gas died eat. He does state that he left the table to place a phone call prior to arrival of the emergency medical teams. Upon ar- during the meeting and is concerned that his coffee may rival, the survivors were complaining of difficulty with vi- have been contaminated. He otherwise is quite healthy sion and stated that they felt the world was “going black. On physical examination, he The victims were also noted to be drooling and have in- appears ill. A few individuals were dyspneic mmHg, heart rate 112 beats/min, respiratory rate 24 with wheezing. The most severely affected victims fell un- breaths/min, SaO2 94%, and temperature 37. What ears, eyes, nose, and throat examination shows pale mu- medication(s) should be administered immediately to the cous membranes. The parents are disease (debranching deficiency), for which she takes a concerned that there is something wrong; he is very hy- high-protein, high-carbohydrate diet. On exami- physical examination except for short stature, mild weak- nation the child is found to have mild microcephaly, ness, and a slightly enlarged liver. Laboratory studies are trative assistant and is planning to be married in the next 6 sent and a diagnosis is made. Her child will not have the disease unless her fiancé glutamine synthase is a carrier.