Syndicate Session – May 11, 2006
Scenario One
a) What is the likely diagnosis?
Scurvy.
b) What measures were taken to prevent these problems?
Dietary measures: increase in fruit and vegetable intake, and hence intake in vitamin C. Citrus fruits in particular had a long life and good effect.
c) How did Captain Cook avoid this problem on his ships?
Captain Cook used ‘portable soup’, vinegar and malt, along with Sauerkraut. This was believed to combat the problem of gaining vitamins without fresh fruit.
d) What is the chemical basis for this problem?
Normal collagen synthesis depends upon the hydroxylation of proline and lysine. These are non-standard amino-acids and are found abundantly in collagen and hence confer strength to collagen fibrils. The enzymes which catalyse these reactions require vitamin, and therefore, without ascorbic acid, hydroxyproline and hydroxylysine are not formed, and the collagen fibrils are considerably weaker than normal.
Scenario 2
a) What are the underlying principles which must be considered in the management of a compound fracture?
The most important principle is the aiding of the inflammatory response, by the removal of infection and foreign matter.
b) The fracture does not heal, and a chronic inflammation occurs. Pus is constantly discharged, and after seven months it has not healed. What is the likely diagnosis?
Due to the nature of the wound, and the underlying tissue being exposed to the environment, due to penetration of the skin, a foreign body is likely to be causing chronic infection.
a) What is the likely diagnosis?
Scurvy.
b) What measures were taken to prevent these problems?
Dietary measures: increase in fruit and vegetable intake, and hence intake in vitamin C. Citrus fruits in particular had a long life and good effect.
c) How did Captain Cook avoid this problem on his ships?
Captain Cook used ‘portable soup’, vinegar and malt, along with Sauerkraut. This was believed to combat the problem of gaining vitamins without fresh fruit.
d) What is the chemical basis for this problem?
Normal collagen synthesis depends upon the hydroxylation of proline and lysine. These are non-standard amino-acids and are found abundantly in collagen and hence confer strength to collagen fibrils. The enzymes which catalyse these reactions require vitamin, and therefore, without ascorbic acid, hydroxyproline and hydroxylysine are not formed, and the collagen fibrils are considerably weaker than normal.
Scenario 2
a) What are the underlying principles which must be considered in the management of a compound fracture?
The most important principle is the aiding of the inflammatory response, by the removal of infection and foreign matter.
b) The fracture does not heal, and a chronic inflammation occurs. Pus is constantly discharged, and after seven months it has not healed. What is the likely diagnosis?
Due to the nature of the wound, and the underlying tissue being exposed to the environment, due to penetration of the skin, a foreign body is likely to be causing chronic infection.
posted by timfazio at
9:16 am
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