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A patient with history of ankle edema, shortness of breath and orthopnea, is probably suffering from:

 # A patient with history of ankle edema, shortness of breath and orthopnea, is probably suffering from:
A. Asthma
B. Emphysema
C. Cardiac decompensation
D. Constrictive pericarditis



The correct answer is C. Cardiac decompensation. 

Ankle edema is a common sign of fluid accumulation in the body, which can occur in a variety of conditions. Shortness of breath and orthopnea, or difficulty breathing when lying down, can be indicative of heart failure or other cardiac issues. Asthma and emphysema are respiratory conditions that can also cause shortness of breath, but they do not typically present with ankle edema or orthopnea. Constrictive pericarditis is a rare condition characterized by inflammation and thickening of the pericardium, the sac surrounding the heart, which can cause heart failure-like symptoms, but it is less common than cardiac decompensation.

Reference: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine, 20th Edition. New York, NY: McGraw-Hill Education; 2018. Chapter 298, Heart Failure and Cor Pulmonale.

Not true about Hashimoto’s thyroiditis:

 # Not true about Hashimoto’s thyroiditis:
A. Organ specific immune disorder
B. Serum thyroid microsomal antibodies
C. Male predominance
D. Treatment is thyroxine


The correct answer is C. Male predominance.

Hashimoto's thyroiditis is an autoimmune disorder that affects the thyroid gland, resulting in inflammation and damage to the gland. It is characterized by the presence of serum thyroid microsomal antibodies, also known as thyroid peroxidase antibodies. It is an organ-specific immune disorder, meaning that it is specific to the thyroid gland.

Hashimoto's thyroiditis is actually more common in females than in males, with a female-to-male ratio of approximately 10:1. The treatment for Hashimoto's thyroiditis is thyroxine replacement therapy, which can help to restore normal thyroid hormone levels and prevent the development of hypothyroidism.

Reference: Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J. Harrison's Principles of Internal Medicine, 20th Edition. New York, NY: McGraw-Hill Education; 2018. Chapter 332, Hashimoto's Thyroiditis.

Pulmonary surfactant is:

 # Pulmonary surfactant is:
A. Lecithin
B. Dipalmitoyl phosphatidyl choline
C. Dipalmitoyl phosphatidyl serine
D. Sphingosine


The correct answer is B. Dipalmitoyl phosphatidyl choline. 

Pulmonary surfactant is a complex mixture of lipids and proteins that is produced in the lungs and helps to reduce surface tension in the alveoli during breathing. Dipalmitoyl phosphatidyl choline (DPPC) is the most abundant lipid in pulmonary surfactant and is the primary component responsible for its surface tension-lowering properties.

Reference: Hall, J. E. (2016). Guyton and Hall textbook of medical physiology (13th ed.). Philadelphia, PA: Elsevier. Chapter 44, Pulmonary Ventilation.

Branches and Scope of Orthodontics

Orthodontics is a branch of dentistry that deals with the diagnosis, prevention, and correction of irregularities in the teeth and jaws. The main aim of orthodontics is to improve the appearance and functionality of the teeth, as well as the overall health of the patient.

The history of orthodontics can be traced back to ancient times. The ancient Greeks, Romans, and Egyptians used various methods to straighten their teeth, such as gold wires and crude braces made of animal teeth. However, it wasn't until the 18th century that the first orthodontic textbooks were written and the field began to take shape.

One of the most significant figures in the history of orthodontics was Edward Angle, who is often referred to as the "father of modern orthodontics." He developed the first classification system for malocclusions, or irregularities in the teeth and jaws, and introduced the use of braces and wires to correct them. Since then, orthodontics has continued to evolve, with advances in technology leading to the development of new treatments and techniques.

The aims and objectives of orthodontics are multifaceted. One of the primary goals is to improve the appearance of the teeth and face. By correcting malocclusions, orthodontists can create a more aesthetically pleasing smile, which can boost a patient's self-confidence and improve their overall quality of life.




Another important objective of orthodontics is to improve the function of the teeth and jaws. Malocclusions can cause a range of problems, including difficulty chewing, speaking, and breathing. By correcting these issues, orthodontists can improve the patient's ability to eat, communicate, and breathe properly.

Orthodontics also plays a crucial role in the prevention and treatment of dental problems. By correcting malocclusions, orthodontists can help prevent tooth decay, gum disease, and other oral health issues. Additionally, orthodontic treatment can help prevent further damage to the teeth and jaws, such as jaw pain, headaches, and tooth wear.

In summary, orthodontics is a vital branch of dentistry that focuses on improving the appearance, function, and health of the teeth and jaws. Its history dates back centuries, and it continues to evolve with advances in technology. The aims and objectives of orthodontics are multifaceted, and they play a critical role in improving the overall health and well-being of patients.

Definition, History, Aims and Objectives of Orthodontics

 Orthodontics is a branch of dentistry that deals with the diagnosis, prevention, and correction of irregularities in the teeth and jaws. The main aim of orthodontics is to improve the appearance and functionality of the teeth, as well as the overall health of the patient.

The history of orthodontics can be traced back to ancient times. The ancient Greeks, Romans, and Egyptians used various methods to straighten their teeth, such as gold wires and crude braces made of animal teeth. However, it wasn't until the 18th century that the first orthodontic textbooks were written and the field began to take shape.




One of the most significant figures in the history of orthodontics was Edward Angle, who is often referred to as the "father of modern orthodontics." He developed the first classification system for malocclusions, or irregularities in the teeth and jaws, and introduced the use of braces and wires to correct them. Since then, orthodontics has continued to evolve, with advances in technology leading to the development of new treatments and techniques.

The aims and objectives of orthodontics are multifaceted. One of the primary goals is to improve the appearance of the teeth and face. By correcting malocclusions, orthodontists can create a more aesthetically pleasing smile, which can boost a patient's self-confidence and improve their overall quality of life.

Another important objective of orthodontics is to improve the function of the teeth and jaws. Malocclusions can cause a range of problems, including difficulty chewing, speaking, and breathing. By correcting these issues, orthodontists can improve the patient's ability to eat, communicate, and breathe properly.

Orthodontics also plays a crucial role in the prevention and treatment of dental problems. By correcting malocclusions, orthodontists can help prevent tooth decay, gum disease, and other oral health issues. Additionally, orthodontic treatment can help prevent further damage to the teeth and jaws, such as jaw pain, headaches, and tooth wear.

In summary, orthodontics is a vital branch of dentistry that focuses on improving the appearance, function, and health of the teeth and jaws. Its history dates back centuries, and it continues to evolve with advances in technology. The aims and objectives of orthodontics are multifaceted, and they play a critical role in improving the overall health and well-being of patients.

Different Phases of Swallowing or Deglutition

Swallowing, or deglutition, is a complex process that involves several stages to move food or liquid from the mouth to the stomach. There are four stages of deglutition: the preparatory phase, the oral phase, the pharyngeal phase, and the esophageal phase.

The first stage of deglutition is the preparatory phase. This phase occurs before the food or liquid enters the mouth and involves a sensory assessment of the food or beverage. We use our senses of taste, smell, and touch to determine the texture, temperature, and consistency of the food or liquid. The muscles of the lips, cheeks, and tongue work together to position the food or liquid in the mouth for the oral phase. The tongue forms a bolus, or a compact ball of food, by pressing the food or beverage against the hard palate, making it easier to swallow.




The second stage of deglutition is the oral phase. This phase begins when the food or liquid enters the mouth. The tongue and cheek muscles work together to move the bolus toward the back of the mouth. During this stage, the food or liquid is mixed with saliva, which helps to moisten and lubricate the food, making it easier to swallow. The soft palate also rises to close off the nasal passage, preventing food or liquid from entering the nasal cavity.

The third stage of deglutition is the pharyngeal phase. This stage begins when the bolus reaches the back of the mouth and triggers a reflexive swallowing response. The epiglottis, a flap of tissue at the base of the tongue, closes off the entrance to the trachea, or windpipe, to prevent food or liquid from entering the lungs. The pharyngeal muscles then contract, pushing the bolus down the pharynx and into the esophagus.

The final stage of deglutition is the esophageal phase. This stage begins when the bolus enters the esophagus, a muscular tube that connects the pharynx to the stomach. The muscles in the esophagus contract in a coordinated wave-like motion, called peristalsis, to move the bolus down the esophagus and into the stomach. The lower esophageal sphincter, a muscular ring at the bottom of the esophagus, then relaxes to allow the bolus to enter the stomach.

In conclusion, deglutition is a complex and coordinated effort involving four stages to move food or liquid from the mouth to the stomach. The preparatory, oral, pharyngeal, and esophageal phases all play a crucial role in ensuring that we can take in nutrients and maintain our bodily functions. Any disruption in the swallowing process can lead to dysphagia, or difficulty swallowing, which can have serious consequences for our health. Understanding the steps of deglutition can help us appreciate the importance of this essential process and the role it plays in our daily lives.

Medicare vs Medicaid - Who are the beneficiaries?

 Medicaid and Medicare are two distinct healthcare programs in the United States that provide assistance to eligible individuals. Medicaid is a needs-based program primarily designed to provide healthcare coverage for low-income families, while Medicare is an entitlement program that provides healthcare coverage to individuals aged 65 or older, as well as individuals with certain disabilities.

One of the key differences between Medicaid and Medicare is the source of funding. Medicaid is jointly funded by the federal government and individual states, while Medicare is funded entirely by the federal government. The federal government sets minimum standards for Medicaid coverage, but individual states have the flexibility to set their own eligibility criteria, benefits, and reimbursement rates. Medicare, on the other hand, has a uniform set of benefits and eligibility criteria that are determined by the federal government.




Another significant difference between Medicaid and Medicare is the population they serve. Medicaid primarily serves low-income families, pregnant women, children, and individuals with disabilities who meet specific income and asset requirements. Medicare, on the other hand, serves individuals aged 65 or older, as well as individuals with certain disabilities, regardless of income.

In terms of benefits, Medicaid covers a wide range of services, including hospital stays, doctor visits, prescription drugs, and long-term care services. Medicare also covers a range of services, including hospital stays, doctor visits, and prescription drugs, but has different coverage options known as Medicare Part A, B, C, and D. Medicare Part A covers hospital stays and some skilled nursing facility stays, while Part B covers doctor visits, medical equipment, and some preventive services. Part C, also known as Medicare Advantage, allows beneficiaries to choose a private insurance plan that provides additional benefits, such as dental and vision care. Part D covers prescription drugs.

Medicaid and Medicare also differ in terms of cost-sharing. Medicaid generally requires little or no out-of-pocket expenses from beneficiaries, with some exceptions depending on the state and the type of service. Medicare, however, has cost-sharing requirements for most services, including deductibles, co-payments, and coinsurance.

In conclusion, Medicaid and Medicare are both crucial healthcare programs that provide coverage to different populations and have different funding sources, eligibility criteria, and benefits. Understanding the differences between these programs is essential for individuals seeking healthcare coverage and for policymakers seeking to improve the healthcare system in the United States.