Question

14. In 2017, Kim Jong Nam, a North Korean man traveling at Malaysia's Kuala Lumpur's airport was attacked and received a lethal exposure to VX (a very potent acetylcholinesterase inhibitor) to his face. Based on what you've learned already of the pathophysiology of the nervous system signal transmission, describe how this toxic substance (which is oily and easily penetrates skin) could be responsible for this man's death based on the pathophysiologic effects, signs and symptoms would be expected from this type of exposure Who was this man, how old was he and why is this now considered to have been an assassination? 15. Case Study Question: Mr. H is a 30-year-old man who reported to his physician that he has recently lost weight, always seems tired, and has experienced night sweats. A few months ago, he noticed a small firm lump on his neck that was painless and not tender, so he ignored it. Closer physical examination revealed a swelling of several lymph nodes in the neck and throat region. A blood test indicated a decreased lymphocyte count and a lymph node biopsy revealed the presence of Reed-Stemberg cells, confirming the diagnosis of Hodgkin's lymphoma. Bricfly descibe: i. The four stages of the disease based on the Ann Arbor staging system, and ii. Briefly describe the prognosis, imaging techniques that might be valuable and ii. According to the article in The Oncologist for your reading, how might PET determine which stage the patient is probably in current, standard of care, treatments for this condition. imagine he effectivelv ined in this cse?

Answer 1

14,VX poisoning extend depend on how new VX a person was exposed and length of time of the exposure..symptoms will appear immediately after exposure to the vapor form of VX and upto 18 hours after exposure to the liquid form..VX is the potent nerve agent,it is more toxic by enter through skin and by inhalation.Nerve agent cause this toxic effect by preventing enzyme action and acts as the glands and muscle off switch..It reduce the breathing function..VX is the least volatile of the nerve agent it slow down to evaporate from liquid in to a vapor..After VX exposure signs and symptoms include blurred vision,confusion,cough,diarrhea,high or low blood pressure,chest tightness,more sweating,drowsiness ,rapid breathing ,nausea,head ache,slow or fast heart rate,small pinpoint pupils,weakness and watery eyes..Large VX exposure results life threatening condition like loss of consciousness ,convulsions,paralysis,respiratory failure and death..
Kim Jong -nam was the older half-brother of north korea's authoritarian ruler Kim jong -un..Two women are being tried for this murder due to Kim against his family's dynastic control of North Korea and in a 2012 book was stated that he believed his half-brother lacked leadership qualities..
15,i, There are four stages of Hodgkin's lymphoma
stage I: The cancer found in 1 lymph node region or the cancer extended with 1 extra lymphatic organ or site,but not in any lymph node region.
Stage II: The cancer in 2 or more lymph nodes on the same side of the diaphram
Stage II E: the cancer involve 1 organ and 1 regional nodes and same sides of the diaphram
Stage II bulky:More in the chest either large than one third the diameter of the chest or more than 10cm .
Stage III: Cancer in lymph nodes area both sides of the diaphram above and below it involved
stage IV: It spread more than 1 or more organ usually spreads to cerebrospinal fluid,liver,bone marrow or lungs..
Mr.H in stage II Hodgkin's lymphoma which showing his swelling of several lymph nodes (2 or more lymph nodes on the same sides) involved..
ii, Prognosis:Amount of time survival usually 5 years after they were diagnosed,stage of lymphoma and other factors can affect a prognosis..being male and decrease lymphocyte count is a main factor for him he is in stage II lymphoma..
Imaging techniques chest radiography initial technique chest radiography initial information of mediastinum and lung involvement..CT scan provide detailed evaluation of the mediastinum ,chest walls,pulmonary parenchyma,pleura ..contrast chest CT recommended always for the clear view..CT of the neck in cervical node involvement ..Abdominal CT for abdominal and pelvic nodes involvement with liver,spleen,kidney..
Magnetic resonance and imaging (MRI) useful for evaluating the central nervous system..
Galliun scanning useful for whole body scanning.
Fluorodeoxyglucose (FDG) and positron emission tomography(PET) important to found out all sides initial involvement by the disease..radiation therapy which make the cure rate high..
iii,PET:
PET scan is the most treatment option for lymphoma .it clearly impact the way lymphomas are staged and treated and it is potential for uses..PET scan enhanced sensitivity and convenience ,replaced gallium scan..It is a altered treatment approach..The advent of the PET scan engendered a rethinking of this disease activity approach..in this case this scan useful for detecting involvement in the sites..