LSD -NOV-DEC 2024 AU QP ANS

 

5. Define Coronary Atherosclerosis.

Coronary atherosclerosis is a condition in which fatty deposits, cholesterol and other substances accumulate inside the walls of the coronary arteries, forming plaques and narrowing the arteries. This reduces blood flow to the heart muscle and may lead to coronary artery disease.

6. What are the causes of Coronary Artery Disease?

Major causes/risk factors include:

·         High blood cholesterol

·         High blood pressure

·         Smoking and tobacco use

·         Diabetes mellitus

·         Obesity

·         Lack of physical activity

·         Unhealthy diet

·         Stress

·         Family history and increasing age

7. What is Type II Diabetes?

Type II diabetes mellitus is a chronic metabolic disorder in which the body becomes resistant to insulin and/or does not produce sufficient insulin. This results in increased blood glucose levels. It is commonly associated with obesity, physical inactivity and unhealthy lifestyle.

8. What is Body Mass Index?

Body Mass Index (BMI) is a measure used to assess body weight in relation to height.

BMI= Weight in kg / (Height in metres)²
For adults, a BMI of 18.5–24.9 is generally considered normal.

9. List out the causes of Asthma.

Common causes/triggers of asthma include:

·         Dust and dust mites

·         Pollen

·         Smoke and air pollution

·         Pet allergens

·         Respiratory infections

·         Exercise

·         Cold air

·         Chemical fumes

·         Certain medicines

·         Stress and emotional factors

10. Write a note on Chronic Obstructive Pulmonary Disease.

Chronic Obstructive Pulmonary Disease (COPD) is a long-term lung disease that causes persistent airflow limitation and difficulty in breathing. The major forms are chronic bronchitis and emphysema. Smoking is the major risk factor. Symptoms include chronic cough, sputum production, wheezing and breathlessness. Treatment includes smoking cessation, inhaled medicines, pulmonary rehabilitation, oxygen therapy when required, vaccination and regular medical care.

PART B-(5x1365 marks)

PART B – 13-Mark Answers

11(a). Explain how diet and exercise avoid the risk factors of lifestyle diseases.

Lifestyle diseases such as obesity, diabetes, cardiovascular diseases and hypertension are strongly influenced by diet and physical inactivity.

Role of a healthy diet

1.      Balanced nutrition: Provides carbohydrates, proteins, healthy fats, vitamins and minerals.

2.      Weight management: Appropriate calorie intake prevents obesity.

3.      High-fibre foods: Fruits, vegetables and whole grains help control blood glucose and cholesterol.

4.      Reduced saturated fat: Helps reduce LDL cholesterol and cardiovascular risk.

5.      Reduced salt: Helps control blood pressure.

6.      Limited sugar: Reduces the risk of obesity and Type II diabetes.

7.      Adequate water: Maintains proper hydration and supports metabolism.

8.      Avoid processed foods: Reduces excess salt, sugar and unhealthy fats.

Role of regular exercise

1.      Helps maintain healthy body weight.

2.      Improves insulin sensitivity.

3.      Reduces blood pressure.

4.      Improves HDL cholesterol and lipid profile.

5.      Strengthens the heart and lungs.

6.      Improves muscle strength and endurance.

7.      Reduces stress and improves mental health.

8.      Improves sleep quality.

Conclusion: A balanced diet combined with regular physical activity helps prevent obesity, diabetes, hypertension and cardiovascular diseases and promotes a healthy lifestyle.

 

11(b). Illustrate various risk factors of lifestyle diseases with suitable examples.

Lifestyle disease risk factors can be classified as follows:

1. Unhealthy diet

Excess consumption of sugar, salt, saturated fat and processed foods increases disease risk.
Example: Excess fast-food consumption may lead to obesity and hypertension.

2. Physical inactivity

Lack of exercise increases obesity and cardiovascular risk.

3. Smoking

Smoking damages blood vessels and lungs and increases the risk of heart disease, COPD and cancer.

4. Alcohol consumption

Excess alcohol can cause liver disease, hypertension and cardiovascular problems.

5. Obesity

Excess body fat increases the risk of Type II diabetes, hypertension and heart disease.

6. Stress

Chronic stress may contribute to hypertension, anxiety and cardiovascular problems.

7. Poor sleep

Insufficient sleep is associated with obesity, diabetes and cardiovascular disorders.

8. Genetic factors

Family history can increase susceptibility to diabetes, hypertension and certain cancers.

9. Age

The risk of many chronic diseases increases with age.

10. Environmental factors

Air pollution and exposure to harmful chemicals may contribute to respiratory diseases and cancer.

 

12(a). Write a detailed note on Skin cancer and its types.

Detailed note on Skin Cancer and its Types

Skin cancer is the abnormal and uncontrolled growth of skin cells. Excessive exposure to ultraviolet (UV) radiation from sunlight is a major risk factor.

Risk factors

·         Excessive UV exposure

·         Frequent sunburn

·         Fair skin

·         Family history

·         Use of tanning beds

·         Exposure to certain chemicals

·         Weakened immune system

Major types

1. Basal Cell Carcinoma (BCC)
It develops from basal cells of the epidermis. It usually grows slowly and rarely spreads to other organs.

2. Squamous Cell Carcinoma (SCC)
It develops from squamous cells. It can grow more rapidly and may spread if untreated.

3. Melanoma
It develops from melanocytes, the cells that produce melanin. It is less common but more dangerous because it can spread rapidly.

Prevention

·         Avoid excessive sunlight.

·         Use sunscreen.

·         Wear protective clothing.

·         Avoid tanning beds.

·         Examine unusual skin changes.

·         Seek medical advice for suspicious lesions.

Treatment

Treatment may include surgical removal, cryotherapy, radiation therapy, immunotherapy, targeted therapy or other treatments depending on the type and stage.

 

12(b). Describe the causes and treatment of Lung cancer

Causes and Treatment of Lung Cancer

Lung cancer is the uncontrolled growth of abnormal cells in the lungs.

Causes and risk factors

1.      Smoking – the most important risk factor.

2.      Passive smoking.

3.      Exposure to radon gas.

4.      Occupational exposure to asbestos and other chemicals.

5.      Air pollution.

6.      Family history.

7.      Previous radiation exposure.

Symptoms

·         Persistent cough

·         Coughing up blood

·         Chest pain

·         Breathlessness

·         Unexplained weight loss

·         Fatigue

·         Recurrent respiratory infections

Diagnosis

Diagnosis may involve chest X-ray, CT scan, bronchoscopy and biopsy.

Treatment

Treatment depends on the type and stage and may include:

·         Surgery

·         Chemotherapy

·         Radiation therapy

·         Targeted therapy

·         Immunotherapy

Prevention: Avoid smoking and tobacco, reduce occupational exposure to harmful substances and maintain a healthy lifestyle.

 

13(a). Explain the recent advancement in the diagnosis of Coronary Artery Disease.

Recent Advancements in the Diagnosis of Coronary Artery Disease

Modern diagnosis of Coronary Artery Disease (CAD) uses both non-invasive and invasive techniques.

Major advancements

1.      High-sensitivity cardiac troponin tests – help detect heart muscle injury more accurately.

2.      Coronary CT angiography (CCTA) – provides detailed images of coronary arteries without conventional catheterization.

3.      CT calcium scoring – detects calcium deposits and helps estimate coronary risk.

4.      Stress echocardiography – evaluates heart function during stress.

5.      Cardiac MRI – provides detailed information about heart structure, function and tissue damage.

6.      Nuclear cardiac imaging – assesses myocardial blood flow and ischemia.

7.      Intravascular ultrasound (IVUS) – provides images from inside coronary arteries.

8.      Optical coherence tomography (OCT) – provides high-resolution images of coronary plaques.

9.      Fractional Flow Reserve (FFR) – helps determine whether a coronary blockage significantly affects blood flow.

10.  Artificial intelligence-assisted imaging – supports image analysis and cardiovascular risk assessment.

Conclusion: These technologies allow earlier, more accurate and less invasive detection of coronary artery disease.

 

13(b). Explain how the fat, lipids and alcohol increase the risk of cardio vascular diseases.

How Fat, Lipids and Alcohol Increase the Risk of Cardiovascular Diseases

Fat

Excess consumption of saturated and trans fats can increase LDL cholesterol. High LDL promotes plaque formation in arteries and increases the risk of coronary artery disease.

Lipids

Abnormal blood lipid levels, particularly:

·         High LDL cholesterol

·         High triglycerides

·         Low HDL cholesterol

can contribute to atherosclerosis, narrowing and hardening of arteries.

Alcohol

Excessive alcohol consumption can:

·         Increase blood pressure

·         Increase triglyceride levels

·         Contribute to obesity

·         Cause heart rhythm abnormalities

·         Increase the risk of cardiomyopathy and stroke

Prevention

A healthy diet, regular exercise, weight control and limiting alcohol consumption can reduce cardiovascular risk.

 

14(a). Elaborate on blood glucose regulation and the mechanism behind the regression of diabetes.

Blood Glucose Regulation and Mechanism Behind the Progression of Diabetes

Blood glucose is mainly regulated by the hormones insulin and glucagon, produced by the pancreas.

After a meal

1.      Blood glucose increases.

2.      Pancreatic β-cells release insulin.

3.      Insulin promotes glucose uptake by muscle and fat cells.

4.      It promotes conversion of glucose into glycogen in the liver and muscles.

5.      Blood glucose therefore decreases toward normal.

During fasting

1.      Blood glucose decreases.

2.      Pancreatic α-cells release glucagon.

3.      Glucagon stimulates breakdown of liver glycogen.

4.      It also promotes glucose production by the liver.

5.      Blood glucose increases toward normal.

Progression of Type II Diabetes

Insulin resistance → increased insulin production → pancreatic β-cell dysfunction → inadequate insulin → persistent hyperglycaemia → diabetes complications

Long-term high blood glucose may damage the:

·         Eyes

·         Kidneys

·         Nerves

·         Heart and blood vessels

 

14(b). Explain the different ways of weight control in paediatric and adolescent obesity.

Weight Control in Paediatric and Adolescent Obesity

Weight management in children and adolescents should focus on healthy growth rather than rapid weight loss.

Important approaches

1.      Provide a balanced diet with fruits and vegetables.

2.      Reduce sugary drinks and processed foods.

3.      Control portion sizes.

4.      Encourage regular physical activity.

5.      Limit excessive screen time.

6.      Maintain adequate sleep.

7.      Involve parents and family members.

8.      Encourage healthy eating habits at home.

9.      Monitor growth, BMI and overall health regularly.

10.  Provide behavioural counselling when required.

11.  Manage underlying medical conditions.

12.  Specialist treatment may be considered for severe obesity.

Conclusion: Early lifestyle modification and family support are important for preventing long-term complications.

 

15(a). a) Write a detailed note on chronic lung diseases and its types

 Chronic Lung Diseases and Their Types

Chronic lung diseases are long-term disorders that affect the lungs and respiratory system. They may cause persistent breathing difficulties and reduced lung function.

Major types

1. Chronic Obstructive Pulmonary Disease (COPD)
Includes chronic bronchitis and emphysema. Smoking is the major risk factor.

2. Asthma
A chronic inflammatory disease characterized by variable airway narrowing, wheezing and breathlessness.

3. Bronchiectasis
Permanent widening and damage of the airways, often associated with recurrent respiratory infections.

4. Interstitial Lung Diseases
A group of disorders causing inflammation and/or scarring of lung tissue, leading to reduced oxygen transfer.

5. Pulmonary Hypertension
Increased pressure in the blood vessels of the lungs.

Common symptoms

·         Breathlessness

·         Chronic cough

·         Wheezing

·         Sputum production

·         Fatigue

·         Reduced exercise tolerance

Prevention and management

Smoking cessation, avoiding pollutants, vaccination, regular exercise, appropriate medication and medical follow-up help manage chronic lung diseases.

 

15(b). Explain the importance and procedure involved in the pulmonary function teat.

 

Importance and Procedure of Pulmonary Function Test

Pulmonary Function Tests (PFTs) are tests used to evaluate how well the lungs work.

Importance

PFTs help to:

·         Diagnose respiratory diseases.

·         Differentiate obstructive and restrictive disorders.

·         Assess severity of lung disease.

·         Monitor disease progression.

·         Evaluate response to treatment.

·         Assess lung function before certain surgeries.

Common measurements

·         FVC: Forced Vital Capacity

·         FEV₁: Forced Expiratory Volume in one second

·         FEV₁/FVC ratio

·         PEF: Peak Expiratory Flow

Procedure

1.      The patient is seated and instructed about the test.

2.      A nose clip is usually applied.

3.      The patient breathes through a mouthpiece connected to a spirometer.

4.      The patient takes a deep breath.

5.      The patient exhales forcefully and completely into the device.

6.      The manoeuvre is repeated to obtain reliable measurements.

7.      In some cases, the test is repeated after giving a bronchodilator.

8.      The results are compared with predicted values based on factors such as age, height and sex.

Conclusion: PFT is an important non-invasive method for diagnosing and monitoring respiratory disorders.