A 30-year-old female presents with muscle weakness and fatigue. Abnormal electromyography testing and a positive acetylcholine receptor antibodies test is reported. Her final diagnosis is Myasthenia Gravis.

  1. Describe the normal synaptic transmission at the Neuromuscular Junction  (NMJ).
  2. Why is the ACh level increased?
  3. Explain why the patient with myasthenia gravis cannot generate consistent action potentials in the muscle fiber.  
  4. Treatment for the patient involves pyridostigmine—what does this drug do and how would it benefit our patient?

An 80-year-old male presents with resolving decubitus, that is now oozing and red. The wound team has been involved.  His daughter wants information regarding his skin condition.

  1. Describe the phases of wound healing.
  2. What is resolution, regeneration and replacement?
  3. What is the significance of the oozing and discoloration?
  4. What factors impede the healing process and why?

A 65-year-old male presents with a painful left finger, he is unable to bend it and it is significantly swollen.  He has a history of osteoarthritis.

  1. OA is a disease of articular cartilage and subchondral bone in diarthrodial joints.  Explain this.
  2. What is the role of osteophytes in OA?
  3. How do NSAIDS affect OA?
  4. How does weight loss affect OA?

A 6-year-old male fell out of a tree and broke his left ulna.

  1. What is the significance of a growth plate?
  2. How is bone formed?
  3. What is the role of the following bone formation: hormones (GH + sex hormones), Ca2+, stress; low Ca2+ increases PTH.
  4. Compare and contrast the various types of fractures.

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