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Potassium permangante 20 min = 9/16 inch

40 min = 22-23/32 inch

60 min = 25/32 inch

Methylene blue 20 min = 17/30 inch

40 min = 1/2 inch

60 min = 17/32 inch

Potassium dichromate: 20 min= 5/8 inch

40 min = 3/4 inch

60 min= 3/4 inch

Explain the results of diffusion of the three coloredsolutions.

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Keith Leannon
Keith LeannonLv2
28 Sep 2019

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Related questions

Case Study 1:

Medical History:
Ms. JR is a 22 yr old Caucasian college senior. Throughout high school she was active in competitive sports including soccer, swimming, and field hockey. On occasion throughout high school she would develop an increase in shortness of breath and a cough. Her primary care physician told her that she had bronchitis and that she should not worry about it. After entering college, she continued with competitive soccer and swimming. At the end of a long run during soccer games she would note an increase in cough and slight wheeze. She did not note any symptoms following her swimming practice. She continued to exercise but noticed an increase in coughing and wheezing over the ensuing year.

Diagnosis:
Her parents became concerned about her discomfort and tried to convince her not to exercise because “it makes you feel much worse and could be dangerous.” With ongoing symptoms, she withdrew from soccer. She sought advice of the college physician, who told her that she might have asthma given the symptoms of wheezing. Spirometry revealed an FEV1 of 3.09 L (96% predicted), an FVC of 3.54 L (95% predicted), a peak expiratory flow rate (PEFR) of 6.97 L (95% predicted), and an FEV1/FVC ratio of 87%. Given these results, showing “normal” pulmonary function, the patient was told that she did not have asthma but rather bronchitis and was advised to continue her exercise (after a course of antibiotics). She continued to swim but would note that at the end of a training session she was slightly more short of breath than usual and had anterior chest heaviness.

Exercise Test Results:
Ms. JR sought the advice of another physician, who ordered an exercise test with the measurement of expired gases during progressive incremental bike exercise. Spirometry was performed at 15, 30, and 60 min following the exercise test. Maximal oxygen consumption was 3.13 L · min−1 (52.2 ml · kg−1 · min−1). Flow rates were as follows:
• FEV1 (L): preexercise = 3.09; 15 min postexercise = 2.87; 30 min postexercise = 2.20; 60 min postexercise = 2.24
• FVC (L): preexercise = 3.54; 15 min postexercise = 3.32; 30 min postexercise = 2.97; 60 min postexercise = 3.03
• PEFR (L/s): preexercise = 6.97; 15 min postexercise = 6.00; 30 min postexercise = 5.25; 60 min postexercise = 5.26

Exercise Prescription:
As a result of these studies, a diagnosis of asthma (exercise induced) was made. The patient was started on a short-acting b-agonist (albuterol sulfate) administered 30 min before exercise. She was instructed to warm up for 15 min with low- to moderate-intensity exercise or swimming before starting a high-intensity swim practice. Exercise tolerance subsequently improved while exercise-associated symptoms became rare (for the most part abated).

Questions:
1. Why was the initial diagnosis of asthma not entertained?

2. How was the actual diagnosis of asthma (exercise induced) made? What tests should be useful in this determination?

3. How did the recommendations improve the patient’s exercise tolerance? Why was swimming initially better tolerated than soccer?

4. Discuss the intensity, frequency, and duration of exercise training for patients with asthma.

5. How would the development of asthma symptoms at the end of a 3 h practice session influence the choice of medication (e.g., short-acting vs. long-acting b-agonist)?

Medical History:
A 31 yr old man, a two pack per day smoker, presented to the emergency department complaining of sudden-onset, 10/10 crushing substernal chest pain associated with shortness of breath and diaphoresis that began 30 min prior to arrival. He had no previous history of cardiovascular disease.
Physical exam: Height 192 cm, weight 153.8 kg, BMI 41.6 kg · m–2 (class III obesity); blood pressure 178/101 mmHg, pulse 75 beats · min–1, respiratory rate 20 breaths · min–1, temperature 36.7 ∞C; normal heart sounds, lungs clear to auscultation, normal peripheral pulses
Electrocardiogram: Normal sinus rhythm, rate 72 beats · min–1; ST-segment elevation V1-V4
Chest radiograph: Normal Blood work: Elevated cTn and CK-MB; glucose normal; blood lipids: total cholesterol 200 mg · dl–1, HDL-C 45 mg · dl–1, LDL-C 134 mg · dl–1, triglycerides 104 mg · dl–1
Chest CT: No evidence of aortic dissection Echocardiogram: Left ventricular ejection fraction 45%, hypokinesis of the anteroseptal wall, borderline left ventricular enlargement, normal diastolic function, normal cardiac valves

Diagnosis:
Acute anterior wall STEMI.

Treatment:
1. Emergent cardiac catheterization (began 46 min after initial presentation to the hospital): total occlusion of the proximal left anterior descending (LAD) coronary artery, mild diffuse narrowing of the circumflex and right coronary arteries. The LAD occlusion was treated with thrombectomy, percutaneous coronary angioplasty, and placement of a drug-eluding stent, with good result.
2. Medical treatment: Aspirin, heparin, intravenous nitroglycerin, clopidogrel, abciximab, atorvastatin, carvedilol, lisinopril, nicotine patch.
3. Nicotine dependence consultation.
4. Referral to outpatient cardiac rehabilitation. Complications: None Hospital dismissal: Occurred approximately 48 h after admission; appointments made to see primary physician and to begin outpatient cardiac rehabilitation program in 5 d; follow-up blood work, ECG, and cardiology appointment in 8 wk Dismissal medications: Carvedilol, aspirin, clopidogrel, lisinopril, nicotine patch, simvastatin

Outpatient Exercise Test Results (Performed 8 D after Hospital Dismissal)
8.0 min duration (treadmill), normal blood pressure and electrocardiographic responses, peak heart rate 164 beats · min–1, V.O2peak = 3.04 L · min−1 (20.8 ml ∑ kg−1 ∑ min−1; 47% of expected), no angina reported
Exercise Prescription:
Outpatient cardiac rehabilitation program: Began 5 d after hospital dismissal; initial evaluations included assessments of neuromuscular function (normal), depression (normal), and potential sleep apnea (abnormalBerlin questionnaire, abnormal overnight oximetry resulted in referral for a sleep consultation); meeting with registered dietitian.
Exercise prescription: Goals included weight loss, increased aerobic and muscular fitness; frequency of three supervised sessions per week in cardiac rehabilitation facility plus three or four independent sessions per week (total frequency of six or seven sessions each week); average intensity using target heart rate 130 to 140 beats · min–1 (60-70% heart rate reserve), RPE 12 to 14; high-intensity intervals (to begin 2 wk after starting cardiac rehabilitation) using RPE 17, heart rate <160 beats · min–1; duration initially set at 10 to 15 min (not including warm-up, cool-down, strength training), gradually increasing to 45 to 60 min per session; types of exercise to include outdoor or treadmill walking, elliptical trainer; resistance training (to begin 2 wk after starting cardiac rehabilitation) using free weights and weight machines, initially one set of 8 to 15 slow repetitions, exercises for the major muscle groups, two or three sessions per week; lifestyle or general physical activity including walking short distances during the day, yard work, physical activity at work (return to work as restaurant equipment installer 4 wk after myocardial infarction).

Outcomes from 11 WK of Cardiac Rehabilitation Program
Medication compliance: Excellent (self-report) Exercise training: Frequency six or seven sessions per week (two or three supervised sessions per week); aerobic exercise duration 50 to 60 min per session; aerobic interval training two or three sessions per week (initially treadmill grade walking for 30 s progressing to slow jogging on treadmill for up to 4 min, three to five high-intensity intervals per session); resistance training two or three sessions per week, two or three sets of 8 to 15 repetitions, major muscle groups. Body weight: Stopped eating fast food and desserts, had more fruit, vegetables, poultry, fish; weight loss = 20.8 kg (BMI still excessive, 33.8 kg · m–2). Repeat cardiopulmonary exercise test: 10.5 min duration (treadmill), normal blood pressure and electrocardiographic responses, peak heart rate 162 beats · min–1, V.O2peak = 4.16 L · min−1 (31.2 ml ∑ kg−1 ∑ min−1; 71% of expected), 37% increase in V.O2peak (L · min−1), no angina reported. Tobacco use: One or two cigarettes daily. Blood pressure: 126/80 mmHg. Blood lipids: Total cholesterol 126 mg · dl–1, HDL-C 33 mg · dl–1, LDL-C 80 mg · dl–1, triglycerides 65 mg · dl–1. Recommendations: Stop smoking; continue medications, exercise program, and heart-healthy eating habits; continue efforts for weight loss; return appointment with cardiac rehabilitation team in 3 mo.

Discussion:
This patient was extremely young and was fortunate to realize the importance of promptly seeking medical attention with the onset of symptoms. His hospital course included standard diagnostic testing for acute myocardial infarction with subsequent timely coronary angiography with PCI of the infarct-related artery. Fortunately he did not develop serious complications and was discharged from the hospital after only 2 d. He enrolled in outpatient cardiac rehabilitation 1 wk after his MI. Of concern, he was markedly obese and may have had obstructive sleep apnea based on his abnormal Berlin questionnaire; he was referred for further evaluation in the Sleep Clinic. His course during rehabilitation was very favorable, and he did not experience post-infarction angina. He was successful in exercise and weight loss and demonstrated a remarkable increase in aerobic capacity. His challenge will be to continue taking his medications, stop smoking completely, eat a healthy diet, maintain his exercise program, and control his other coronary risk factors.

Questions:
1. What were this patient’s coronary risk factors?

2. What clinical tests were used to make the diagnosis of an acute ST-segment elevation anterior wall myocardial infarction?

3. What classes of cardiovascular medications were prescribed for this patient?

4. Compare the two cardiopulmonary exercise tests for this patient. What were the similarities? What were the differences?

5. Review the patient’s exercise prescription and program. Were the established goals achieved? Would you alter the exercise program in any fashion?

6. How effective was the patient in controlling his coronary risk factors by the time he completed 11 wk in the outpatient cardiac rehabilitation program?

7. What is his most important remaining coronary risk factor?

8. What component of the recommendations given to him at the completion of 11 wk of cardiac rehabilitation will potentially help him in sustaining his efforts at secondary prevention?

Question 18

The process that forms new glucose in the liver is called ...

A.

glycogenolysis

B.

Krebs cycle

C.

lipolysis

D.

gluconeogenisis

E.

oxidative phosphorylation

A marathoner expends ~3000 kcals of energy over the course of 26 miles. Assuming that the marathon was run at an RQ of 0.85 what is the total O2 uptake in L over the course of the marathon?

A.

158 L

B.

617 L

C.

541 L

D.

625 L

Question 20

Fatty acids are allowed to enter the mitochondria only when they have a CoA group attached to them.

True

False

Question 22

How long would it take to burn 100 grams of carbohydrate while exercising at a VO2 of 1.5 liters/min and an RER of 0.77?

A.

1 hour, 32 minutes

B.

3 hours, 20 minutes

C.

4 hours, 11 minutes

D.

5 hours, 17 minutes

Question 23

The electron transport is not utilized to make ATP when at rest.

True

False

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