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Running Head:Biological Science For Practise BIOLOGICAL SCIENCE FOR PRACTISE
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2 Biological Science For Practise Table of Contents Answer to Question 1.................................................................................................................3 Answer to Question 2.................................................................................................................3 Answer to Question 3.................................................................................................................3 Answer to Question 4.................................................................................................................4 Reference list..............................................................................................................................5
3 Biological Science For Practise Answer to Question 1 Circulating monocyte, changes into foam cell and leads to occurrence of atherosclerosis. Intimal penetration of monocyte indicates that circulating monocytes are responsible for formation of foam cells. In addition, preferential adherence of monocytes proves that monocyte helps in creation of foam cells, which leads to occurrence of atherosclerosis. Monocytes might scavenge dead cells and researches have shown that it can be differentiated into foam cells for doing this action (Hilgendorf, Swirski & Robbins, 2015). As foam cells cause fat deposition in blood cells, it can be stated that monocyte plays important role in occurrence of atherosclerosis. Answer to Question 2 Mr. Scott has a history of atrial fibrillation. However, this atrial fibrillation (AFib) can lead to permanent heart failure. This can occur because during atrial fibrillation heart did not pump enough blood, which can meet need of body (Connollyet al.2010). AFib leads to heart failure because beating of heart is fast that prevents in filling of heart chambers with enough blood for pumping out to body. As a result, blood can back up in pulmonary veins. If heart doesn't pump blood efficiently then fluid in lungs can cause fatigue and shortness of breath that Mr. Scott is facing currently. Answer to Question 3 Paroxysmal nocturnal dyspnoea (PND) generally occur due to depression of respiratory center when sleeping. This reduces arterial tension of oxygen and it occurs in patients who have reduced pulmonary compliance (Tortora & Derrickson, 2017). A patient with congestive heart failure if lies down then left ventricle fails to match output with normally
4 Biological Science For Practise functioning right ventricle. This causes pulmonary congestion, which can be decreased if patient takes an erect position while sleeping. Mr. Scott is facing a problem that may be considered as a symptom of heart failure. Failure of heart muscles to pump blood throughout the body can lead to this disease and problem during sleeping can occur. Answer to Question 4 Calculation of NNT= 1/ARR (Absolute Risk Reduction) (Schulmanet al.2009) =1/ (CER-EER) [CER=Event rate of Control group, EER=Event rate of Experiment group) NNT calculation to prevent 1 bleeding (Event), 25 patients administered with dabigatran (150 mg) and 25 patients were treated without dabigatran. EER observed 15% and CER 65%. ARR= (0.65-0.15)= 0.5 NTT= 1/0.5=2 for Dabigatran (150 mg) 25 patients administered with Warfarin (150 mg) and 25 patients were treated without dabigatran. EER observed 40% and CER 65%. ARR= (0.65-0.4) = 0.25 NTT= 1/0.25=4 for Warfarin (150 mg) Hence, Dabigatran is more effective than Warfarin in preventing bleeding.
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5 Biological Science For Practise Reference list Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Reilly, P. A., & Wallentin, L. (2010). Newly identified events in the RE-LY trial.New England Journal of Medicine,363(19), 1875-1876. Retrieved from: https://www.nejm.org/doi/full/10.1056/NEJMc1007378 Hilgendorf, I., Swirski, F. K., & Robbins, C. S. (2015). Monocyte fate in atherosclerosis. Arteriosclerosis, thrombosis, and vascular biology, 35(2), 272-279. Retrieved on 18th April 2019, from https://www.ahajournals.org/doi/full/10.1161/ATVBAHA.114.303565 Schulman, S., Kearon, C., Kakkar, A. K., Mismetti, P., Schellong, S., Eriksson, H., ... & Goldhaber, S. Z. (2009). Dabigatran versus warfarin in the treatment of acute venous thromboembolism.New England Journal of Medicine,361(24), 2342-2352. Retrieved from:https://www.nejm.org/doi/full/10.1056/nejmoa0906598 Tortora, G. J., & Derrickson, B. (2017).Principles of anatomy & physiology. US: John Wiley & Sons, Incorporated.