Dr. ramos discussed how difficult it could be to treat infection
in the brain and spinal cord because of how efficiently the
blood-brain barrier protects vulnerable nervous tissues, even from
lie-saving antibiotics. the barrier is mostly simple squamous
endothelial cells, their basal laminae, and astrocytes. which of
the following statements is false with regard to how this thin
layer of cells creates such and efficient barrier?
a. the endothelial cells contain more tight junctions than are
found in the endothelial cells in capillary walls in other regions
of the body.
b. extra tight junctions force molecules to pas between
endothelial cells, which reduce the amount of substance entering
the cell by endocytosis.
c. the combination of barrier endthelial cells, the extra tight
junctions, and very selective barrier that is only a few cell
layers thick leads to a limited ability to transport substances
into and out of the cell.
d. protein channels selectively allow for the transport of vital
substances, such as glucose and amino cids that are unable to pass
into the brain extracellular fluid without assistance.

The nurse working at the senior center notices mrs jones, a 78-year old crying. the nurse approach mrs jones and asks if she needs . mrs jones stars “ i am so embarrassed. i had another accident and my pants are all wet. it’s like i’m a baby. i never should have come to the senior center." whar factors may be contributing to urinary incontinence? how should the nurse respond to mrs jones?

A10-year-old girl suffered from a rare malignancy in her brain and around her spinal cord. she had surgery, and most of the tumor mass was removed, but residual tumor remained in the brain and around the spinal cord. the girl's doctors informed her parents that chemotherapy and radiation were possible treatment options but could cause serious problems such as sepsis, a permanent loss of iq and stature, and even death. the parents wished to proceed with the therapy. while their child was undergoing aggressive chemotherapy and radiation, the parents did independent research and read of several drugs being administered for cancer in other states that were unapproved by the federal drug administration (fda) and were illegal in their home state but were touted by physicians using them as miracle cures." furthermore, one of the girl's doctors released the girl's medical records to another physician to get a "second opinion" without informing the parents. this particular physician is a member of the same country club as the parents. he happens to share facts from the medical records with other members who end up telling the girl's parents. the couple sued their child's physician for failure to disclose alternative treatments, thus depriving them of informed consent. the couples also sued the child's physician for sharing their daughter's records in violation of the girl's privacy. how should the court rule in both cases? did the child's physician involved follow the law? did he act ethically in either situation? explain your answer. under the doctrine of informed consent, should a physician be responsible for informing patients of all treatment options, even if some of the treatments are illegal or not yet proven effective?

Harold, a fifty-eight year old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. this was happening several nights a week. he was also experiencing occasional discomfort in the middle of the afternoon. harold decided to schedule an appointment with his physician. the doctor listened as harold described his symptoms and then asked harold some questions. he noted that harold's appetite had suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. otherwise, harold seemed fine. the doctor referred harold to a physician that specialized in internal medicine and had harold make an appointment for a procedure called an endoscopy. the endoscopy was performed at a hospital later that week. during the procedure, a long, thin tube was inserted into harold's mouth and directed into his digestive tract. the end of the tube was equipped with a light source and a small camera which allowed the doctor to observe the interior of harold's stomach. the endoscope was also equipped with a small claw-like structure that the doctor could use in order to obtain a small tissue sample from the lining of harold's stomach, if required. the endoscopy revealed that harold had a peptic ulcer. analysis of a tissue sample taken from the site showed that harold also had an infection that was caused by helicobacterpylori bacteria. the doctor who performed the endoscopy gave harold prescriptions for two different antibiotics and a medication that would decrease the secretion of stomach acid. the doctor also instructed harold to schedule an appointment for another endoscopy procedure in 6 months. 1. list the subjective findings in this case study. 2. what is an endoscopy? (2 points) what is a biopsy? 3. how was a biopsy performed on harold? 4. differentiate between gastric and duodenal ulcers by location. 5. what role does h. pylori play in the formation of peptic ulcers? 6. define occult and frank blood. (4 points) what is a guaiac test? 7. how can peptic ulcers cause bleeding? 8. why were antibiotics prescribed? 9. why would a medication that would decrease the secretion of stomach acid be beneficial?