ENGLISH FOR PHARMACOLOGY

UNIT 7
Created by :
Selvi Elsa Triany May Delvionita Citra Raesti Dwiky Laksita Ariep Aulia Rakhim Artalia (0661 13 098) (0661 13 099) (0661 13 100) (0661 13 101) (0661 13 102)

Typhoid Mary
Mary Mallon (1869-1938) was an irish immigrant who was the first known healthy carrier of typhoid in the USA. She probably contracted a mild case of typhoid, although she may not have been aware of it, and was never cured(1). In this way, she became a carrier, and spread the desease.

Typhoid is an infection of the digestive system caused by a bacterium, Salmonella typhi. Among other sympthoms, it cause(2) weakness, high fever, a rash of red spots, chills, sweating, and in serious cases inflammation of the spleen and bones, delirium, delirium, and erosion of the intestinal wall leading to haemorrhage. It is transmitted(3) through contaminated food or drinking water.
Mary of the cause of several outbreakks of typhoid in the New York City area between 1900 and 1907. She worked as a cook in a number of different households, and on each occasion, members of the family of other servants developed(4) typhoid. 22 people became ill, and one died. At the time, typhoid was a serious problem, especially in cities, and killed around 10% of sufferers.

In the summer of 1906, New York banker Charles Henry Warren hired Mary to be a cook for his family at their rented summer house. When six of the eleven members of the household became ill with typhoid, the owners of the house employed George Soper, a sanitary engineer with experience in typhoid outbreaks, to look for the source.

After some months of careful investigation(5) into Marys background and her previous jobs, George Soper was certain that she was the cause of the outbreak, and so he asked her for blood, urine, and stool samples(6). She did not believe him in fact, she resisted violently and attacked him with a large fork. At that time, the idea that a person could spread a disease and still remain healthy was not widely known.
Mary resisted two other visits from health official, shouting and swearing at them and running away. Mary was a strong-minded woman, but it must also have been very frightening for her to be confronted in this way. Eventually the New York City Health Department sent five police officers and an ambulance and forcibly(7) took her to hospital.

The New York City health inspector carried out some tests and confirmed(8) that Mary was a carrier. In 1910 she was transferred to an island near New York City, where she lived in isolation for three years. She was then released but told that she should not work with food again. However, in 1915 she took a job as a cook in a hospital and infected(9) 25 doctors, nurses, and other hospital staff two of them died. Mary was then seized again and kept in quarantine(10) for 23 years, living alone in a one-room cottage.

In December 1932, Mary suffered a massive stroke, which left her paralysed. She died in 1938 of pneumonia.
Today Typhoid Mary is a term used to describe a carrier of a dangerous disease(11) who refuses to take precautions or co-operate(12) with the authorities.

Decide if these sentences are true (T) or false (F) 1. Mary Mallon was born in the US (F)

2.
3. 4.

Mary was often ill (F)

George Soper discovered that Mary was a typhoid carrier (T ) Mary wanted to help the authorities (F)

5.
6. 7.

After 1910, Mary did not work with food again (F)
Mary was kept in hospital for a total of 26 years (F) Mary died of typhoid (F)

THE RETURN OF THALIDOMIDE

Read the article and decide if the entences are true (T) or false (F) One of the side effects of thaliodomide was ausea (F) 40 % of mothers who took Thalidomide had normal children (F)

The tests carried out on thalidomide were not strict enough (T)
Thalidomide can cure leprosy (T) Thalidomide can damage the autoimmune system (F)

We still dont know exactly how works (T)

Add these sentences to the end of one paragraphs (A-E) where they best It has been so successful in many cases, that it is seen by some as a wonder drug (C) At least this drug, which caused such tragedy when introduced can now offer hope to suffrrers of conditions that are otherwise incurable (E) Investigations began immediately into what had gone wrong (A) However, Garry does suffer from side effects of the drug such as muscle pain, and numbness in the hands and feet (D) Drugs must now undergo thorough testing on human subjects before being made available for general use (B)

A.

In 1961 an Australian doctor, William McBride, noticed a sudden increase in the number of babies being born with one or more limbs missing. He realized that all their mothers had taken the same drug during pregnancy. And he alerted the medical world. The drug, Thalidomide, had been used since the late 1950s to combat nausea during pregnancy. When its catastrophic effects were realized 40% of affected children died in their first year it was withdrawn from use. The drug had been believed safe, as it had been thoroughly tested on animals. Tests had shown that rats could be given massive doses without any ill effects. Todays strict rules for drug-testing owe a great deal to Thalidomide. The drug remained out of use until 1964, when Dr Jacob Sheskin found some old boxes of it in his French clinic, and decided to try it as a sedative to relieve the suffering of apatient with leprosy, a disease that eats away at the flesh and bones. Within three days, lesions had healed and the leprosy disappeared. Since than, the drug has cautiously been trialled as atreatment for a wide range of conditions. The powerful anti-inflammatory properties of the drug make it effective at treating arthritis, AIDS, multipe sclerosis and over 100 other conditions, including many autoimmune disorders. It is also believed to restrict the growth of blood vessels in cancerous tumours. Garry Edlin, a patient whose rare form of cancer, mantle cell lymphoma, has been successfully treated by Thalidomide at Derriford Hospital in the UK, said, Within ten deys the huge lumps had gone its like a miracle cure. Although Thalidomide is known to be effective, we do not fully understand how it works. For this reason, and because of the memories of its devastating introduction, it will take some time before Thalidomide is widely accepted as a treatment.

B.

C.

D.

E.

A. Measurement 2 Quantity
Section 1 Presentation

2. Read this:
A pregnant woman needs as much vit. C as an average woman.

3. Look and Read :

Compared with an average woman, a pregnant woman needs much more vit. D. considerably more calcium and vit. C, and slightly more carbohydrate, fat and protein. Complete these: a) Compared with an average woman, a lactating woman requires much more carbohydrate ,fat vitamin A, protein and hiamin.

b) Compared with a pregnant woman, a lactating woman needs much more carbohydrate, fat, protein, iron c) By comparison with an average woman, an old woman needs much more Vitamin D, Calcium

4. Compare the amounts in this table with the recommended daily intakes in exercise 1:

Beef contains a significant amount of thiamin. The vitamin C content of beef is negligible. Vitamin A is present in particulary high concentrations in halibut liver oil. Now identify this: a) b) c) d) These contain significant quantities of vitamin C only Citrus fruits These are found in significant amounts in eggs and halibut liver oil Vitamin A This contains a particulary high concentration of vitamin D Milk This contains a negligible quantity of vitamin D and a small but significant amount of vitamin A Halibut liver oil This is present in significant amounts in eggs and particulary in wheat germ Thiamin

e)

Section 2 : Development
5. Look and read: Biochemical aids in diagnosing nutritional deficiency (adult values)

Now choos the correct word or phrase to complete these sentences: a) A laboratory finding of 68 g/100 ml serum indicates that there is .. copper in the body. A. a deficiency B. an adequate amount of b) When the plasma value for vitamin A is 19 g/100 ml there is probably .. vitamin A. A. a sufficient quantity of B. a lack of c) A laboratory finding of 025 mg locopherol per 100 ml plasma suggests that the vitamin E level is .. A. adequate B. inadequate d) If the serum iron level is between 55 and 75 g/100 ml then there is probably .. in the body. A. enough iron B. a shortage of iron e) If the concentration of pyruvate in the blood is more than 1 mg/100 ml then .. A. the thiamin level is adequate B. there is not enough thiamin.

Now comment on these findings: f) Serum copper level 43 g/100 ml There is not enough copper

g) Blood ascorbate level 09 mg/100 ml Adequate of blood ascorbate h) Plasma tocopherol level 09 mg/100 ml Enough Plasma tocopherol i) j) Serum protein level 49 g/100 ml Not enough protein Serum iron level 4348 g/100 ml Inadequate of serum iron

6. Look and read:

If the plasma calcium exceeds 20 mg/100 ml Then there is calcium

And clinical signs will be evident (e.g. thirst, weakness) This condition is known as hypercalcaemia. Note: calcium, blood, etc. cells, tablets, etc.

Write similar sentences, using these notes to help you. a) Blood glucose > 180/.. glycaemia = Hyperglycaemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is generally a glucose level higher than 180 mg/100ml. Leucocyte count > 11 x /leucocytosis = Leucocytosis is a leucocyte count above the normal range in the blood. Plasma vitamin A > 165 g/100 ml/toxic effects/..-vitaminosis A = Hypervitaminosis A is having too much vit. A in the body. Because beta carotene is not converted to Vit. A except as the body requires it, you cant get toxic levels of vitamin A (hypervitaminosis) from it.

b) c)

Complete these:
d) e) f) g) Oedema can be defined as hoarding water in the tissue fluid; by which we mean that caused too much water. (> normal amount of water). Polycythaemia is a disease of the blood in which there are too many red cells; Hyperplasia refers to abnormal growth of tissue by multiplication of its cells. Hypertrophy is mechanism of tissue growth by enlargement (without multiplication) of cell.

7. Complete this sentences, using information from the two previous exercises: a) If the plasmacalcium level fills below 5 mg/100 ml , then there is thirst and weakness this is known hypocalcaemia.

Write similar sentences about: b) c) Blood glucose level is the amount of glucose (sugar) present in the blood of a human or animal. Leucocyte count (leucopenia) may be caused by diseases, medications, and genetic deficiencies.

Complete these sentences: d) e) Anaemia literally means lack of blood, but in fact it caused less of Haemoglobin or deficiency of erythrocytes. Anoxia is a condition in which there is a shortage of oxygen; that is so say the supply of oxygen to the tissues are too slowly. An overdose of a drug occurs when a patient takes too much of a particular drug, or too much consumed tablets; i.e .. The pancreatic hormone insulin helps the uptake of glucose from the blood by the tissues. In diabetes mellitus there is a deficiency of insulin, which means that the blood sugar level is too high because glucose is taken up too slowly by the tissues and therefore accumulates in the blood. But in hyper-insulinism, or after an overdose of insulin in a diabetic, the blood sugar leves is de-creased. Hyper-glycaemia is the main clinical sign of diabetes. Hypoglycaemia, on the other land, can result from too much production of insulin.

f)

g)

h)

8. Look at this diagram of a capillary:

Water molecules are small enough to pass through capillary walls. Protein molecules are to pass through capillary walls.

Note: = small enough to = CAN pass through; (reason) small

so small (in relation to the size of the gap) that they can pass through
too large to = cannot pass through; (reason) large

so large (in relation to the size of the gaps) that they cannot pass through

Now make similar sentences about: a) Amino acids are biologically important organic compounds composed of amine (-NH2) and carboxylic acid (-COOH) functional groups, along with a side-chain specific to each amino acid. b) Sugars describes the group of carbohydrates that can converted to be energy using hormon insulin. c) Erythrocytes also known as red blood cells, function to transport oxygen in the blood throughout the body. d) Salts contain sodium that have function to help maintain normal blood pressure and normal function of muscles and nerves. (note: cf. Unit B, exercise ???)

9. Look and read:

The proteins in the plasma exert an osmotic pressure of 25 mm/Hg. At the arterial end of the capillaries blood pressure is 32 mm/Hg. Therefore: The blood pressure is high enough to force water into the tissue fluid. Or: The osmotic pressure is prevent water being forced into the tissue fluid.

Choose the correct answer(s) : a) At the venous end, the pressure has fallen to 12 mm/Hg. Therefore the blood pressure is .. to force more water out. A. Too high Or in other words: b) The osmotic pressure is .. to draw water back into the blood from the tissue fluid. A. Too high B. too low C. high enough D. low enough B. too low C. not high enough D. not low enough

Now complete these sentences: c) d) e) If the blood pressure falls below a critical level, it is then high enough to force water, etc. into the tissue fluid. In hypocalcaemia there is too little calcium for proper bone development. When the blood glucose level exceeds the normal limit, the kidneys cannot handle all the glucose, and some glucose appears in the blood (glycosuria); i.e. when the blood glucose exceeds a critical level, its too hard for the kidneys to reabsorb.

f)

In tissue hypoxia, when the tension of the gas is low, the pressure head of oxygen in the capillaries too short to provide distant cells with sufficient oxygen for their metabolic needs. Normal erythrocytes can transport sufficient of oxygen in the blood to pass through the filtering mechanism of the spleen, where as abnormal erythrocytes cant transport sufficient of oxygen in the blood Oedema, or capillary tissue fluid, can occur when the plasma protein falls below a critical level with the result that the osmotic pressure is too low to draw the water back into blood. Oedema also occurs in cases of high venous blood pressure because then the blood pressure at the venous end of .., with the result that .. Oedema can also becaused by capillary damage, because damaged capillaries are permeable to roteins and therefore ..

g)

h)

i) j)

Read this:
At the arterial end of the capillaries the blood pressure is high enough into the tissue fluid.

Section 3: Reading
10. Read the passage and choose a title for it:
If you think a title is not suitable, say whether it is too general, too limited, or not sufficiently accurate. a. b. c. d. Lack and excess of oxygen The effects of no oxygen not sufficiently accurate Oxygen deficiencies too limited Obstructions of the respiratory system too general The term anoxia literally means without oxygen and is commonly used to indicate conditions in which there is a shortage of oxygen. It is more appropriate to refer to a condition of too little oxygen as hypoxia. There are four commonly defined causes for lack of sufficient oxygen fo the cells of the body, which will be stated in the commonly used terms. Anoxic anoxia, or hypoxic hypoxia, refers to decreased oxygen saturation of blood haemoglobin because of insufficient oxygen in the alveolar air. It is associated with low tension of oxygen in the arterial blood. This condition will be produced by obstructions of lung passages or situations where the oxygen supply is inadequate.

The second type of anoxia is anaemic anoxia which occurs in individuals whose haemoglobin content is too low to carry the required amount of oxygen. The oxygen tension will be normal but there will be a shortage of oxygen carried by the blood due to the lack of haemoglobin. 15 The third type of anoxia is stagnant anoxia. This is due to the lood flowing too slowly round the circulation. Although the oxygen tension and oxygen Content leaving the lungs are normal, the supplies of fresh oxygen are delivered too slowly to provide the tissues with sufficient oxygen. 20 The fourth type of anoxia is histotixic anoxia, of which cyanide poisoning is the only important example. The cyanide destroys the enzyme system of the cells and prevents their utilization of the oxygen present in the blood. 25 Anoxia is more dangerous than asphyxia, in which not enugh oxygen reaches the tissues and carbon dioxide is not expelled quickly enough. The accumulation of carbon dioxide produces a marked stimulation in respiration. In pure anoxia, however, although respiratory stimulation may initially be produced, there is no accumulation of carbon dioxide and in severe cases respiration subsequently ceases altogether.

The following sentences have been omitted from the passage. Say which sentences each should follow: f. This type of anoxia can also be caused by carbon monoxide poisoning, because this gas forms a bond with haemoglobin (carboxyhaemoglobin) leaving less haemoglobin available to transport oxygen. This will occur in cases where there is reduced cardiae output or arterial obstruction locally.

g.

h.

These include insufficient partial pressure of oxygen, such as occurs at high altitudes, and breathing a agas mixture which contains insufficient oxygen.
This is a condition which can arise when, for example, one is breathing in a contined space so that the expired air is reinhaled.

i.

11. Copy this table and indicate whether or not the four situations described below are valid for each type of anoxia by putting a tick or a cross:
Anoxic
Sufficient O2 in lungs Sufficient O2 content of blood Sufficient O2 reaches tissues Sufficient O2 metabolised

Anaemic

Stagnant

Histotoxic

11. These diagrams show the causes of the different types of anoxia. Match the letters A to J with the phrases (a) to (j):

a) b) c) d) e) f) g) h) i) j)

Insufficient blood haemoglobin

(J)

Inability of cell enzymes to metabolise (H) Respiratory blockage CO bonding with haemoglobin Insufficient haemoglobin content Cyanide poisoning Living on a mountain Decreased cardiae output Inhaling air deficient in Arterial blockage (I) (C) (E) (A) (G) (D) (F) (B)

THANK YOU