Ch. 14 The Autonomic Nervous System
Chapter 13, Problem 21
Mrs. Jones has had a progressive decline in her mental capabilities in the last five or six years. At first her family attributed her occasional memory lapses, confusion, and agitation to grief over her husband's death six years earlier. When examined, Mrs. Jones was aware of her cognitive problems and was shown to have an IQ score approximately 30 points less than would be predicted by her work history. A CT scan showed diffuse cerebral atrophy. The physician prescribed an acetylcholinesterase inhibitor and Mrs. Jones showed slight improvement. What is Mrs. Jones's problem? Why did the acetylcholinesterase inhibitor help?
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A 32-year-old woman complains of intermittent aching pains in the medial two fingers of both hands. During such episodes, the fingers become blanched and then blue. Her history is taken, and it is noted that she is a heavy smoker. The physician advises her that she must stop smoking and states that she will not prescribe any medication until the patient has discontinued smoking for a month. What is this patient's condition, and why was she told to stop smoking?
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In the Netherlands a young man named Jan was admitted to the emergency room. He and his friends had been to a rave. His friends say he started twitching and having muscle spasms which progressed until he was 'stiff as a board.' On examination, staff found a marked increase in muscle tone and hyperreflexia involving facial and limb muscles. In his pocket, he had unmarked dark yellow tablets with dark flecks. Analysis of the tablets showed them to contain a mixture of ecstasy and strychnine. Ecstasy would not cause this clinical picture, but strychnine, which blocks glycine receptors, could. Explain how.
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