contractions 20-21

20. Ang unang yugto sa pagbuo ng Community-Based Disaster Risk Reduction Management (CBDRRM) Plan ay tinatawag na ________. A. pagtugon sa sakuna B. paghahanda sa pagtugon C. pagsasaayos at pagbangon D. pagtataya ng panganib at paghahanda ANSWER: D 21. Ang gawaing ito ay isinasagawa upang maging handa ang komunidad at maiwasan ang malawakang pinsala nito sa pamamagitan ng aktibong pakikibahagi ng mamamayan. Ito ay nakapaloob sa _______. A. Philippine Disaster Risk Management B. Philippine Disaster Risk Reduction Management Council C. Community Preparedness and Risk Management Approach D. Community-Based Disaster Risk Reduction Management Approach ANSWER: D 22. Bahagi ng rehabilitasyon at pagbawi mula sa kalamidad ang mga hakbang at gawain na nakatuon sa pagsasaayos ng mga nasirang pasilidad at estruktura. Ano ang pangunahing gampanin ng yugtong ito? A. Mabigyan ng sapat na proteksiyon ang mga nasalanta ng kalamidad. B. Manumbalik sa dating kaayusan at normal na pamumuhay ang mga nasalantang komunidad. C. Makapagbigay ng mga inaasahang serbisyong panlipunan at paglilingkod sa pamahalaan. D. Maipagkaloob sa mga nasalantang komunidad ang mga pangunahing pangangailangan at gamot. ANSWER: B 23. Alin sa sumusunod na mga sitwasyon ang nagpapakita ng Top-Down Approach sa pagbuo ng Disaster Risk Reduction and Management (DRRM) Plan? A. Pinamunuan ni Kerwin, isang lider ng Non-Government Organization (NGO) ang pagtukoy sa mga kalamidad na maaaring maranasan sa kanilang komunidad. B. Ipinatawag ni Kapitan Capin ang kaniyang mga kagawad upang bumuo ng plano kung paano magiging ligtas ang kaniyang nasasakupan mula sa panganib ng paparating na bagyo. C. Hinikayat ni Albert ang kaniyang mga kapitbahay na maglinis ng estero upang maiwasan ang pagbara nito na maaaring magdulot ng malalim at matagalang pagbaha sa darating na tag-ulan. D. Nakipag-usap si Kelly sa mga may-ari ng malalaking negosyo sa kanilang komunidad upang makalikom ng pondo sa pagbili ng mga first aid kit at iba pang proyekto bilang paghahanda sa iba’t ibang kalamidad. ANSWER: B 24. Bakit mahalaga ang pagkakaroon ng community engagement o kolaborasyon sa pamayanan at iba pang katuwang na sektor? A. Makatutulong ito upang makalikom ng mas maraming pondo. B. Magiging makabuluhan ang plano kung ang gagawa nito ay ang mamamayan. C. Malaki ang posibilidad na maging matagumpay ang proyekto kapag pinagplanuhan. D. Mas magiging komprehensibo at matagumpay ang plano kung binubuo ito ng iba’t ibang sektor. ANSWER: D 25. Sa pagbuo ng CBDRRM Plan, ano ang PINAKAMABISA mong nararapat gawin bilang mamamayan ng isang lugar upang maging handa sa pagdating ng iba’t ibang panganib at kalamidad? A. Maging aktibong kabahagi sa pagbubuo ng plano para sa buong pamayanan. B. Makibahagi sa gawaing panrehabilitasyon at tulungan ang mga naapektuhan. C. Magsagawa ng personal plan para matugunan ang pangangailangan ng lipunan. D. Magkaroon ng planong pampinansiyal upang matustusan ang pangangailangan ng mga tao. ANSWER: A 26. Ang pinuno ng mga bansang kasapi ng organisasyon ay nagpupulong-pulong upang magtulungan para sa kapakanan ng kanilang pangangailangan. Anong anyo ng globalisasyon ang tinutukoy nito? A. ekonomiko B. kultural C. politikal D. teknolohikal ANSWER: C 27. Alin sa sumusunod ang buhay na manipestasyon ng globalisasyon? A. ekonomiko B. OFWs C. sosyo-kultural D. teknolohikal ANSWER: B 28. Ang brain drain ay tumutukoy sa mga propesyonal na manggagawa, samantalang ang brawn drain ay tumutukoy sa ___________. A. construction workers B. domestic workers C. overseas workers D. skilled workers ANSWER: A 29. Alin sa sumusunod ang negatibong epekto ng paglitaw ng maraming multinational companies at transnational companies? A. pagkakaloob ng hanapbuhay B. pagbaba ng presyo ng produkto C. pagdami ng produkto at serbisyo D. pagkalugi ng multinational companies at transnational companies ANSWER: D 30. “Ang globalisasyon ay laganap na noon pa man at naging mas malawak sa kasalukuyang panahon.” Ang mahihinuha natin sa pahayag na ito ay _______. A. ugnayan ng mga bansa sa daigdig na walang pagitan o hadlang B. suliraning panlipunan na pumipigil sa kaunlaran ng mga bansa sa daigdig C. bagong anyo ng malayang kalakalan, pagpapalitan ng produkto, impormasyon at tao, dahil sa pag-unlad ng teknolohiya sa komunikasyon at transportasyon D. isyung panlipunan na tumatalakay sa pamahalaan, ekonomiya, relihiyon, teknolohiya, kapaligiran, komunikasyon at kultura ng mga bansa sa daigdig ANSWER: C 31. Alin sa dalawang pahayag ang nagsasaad ng PINAKAANGKOP na konsepto ng globalisasyon? I. Ang globalisasyon ay proseso ng mabilisang pagdaloy o paggalaw ng tao, bagay, impormasyon at produkto sa iba’t ibang direksiyon na nararanasan sa iba’t ibang panig ng daigdig. II. Ang globalisasyon ay may iba’t ibang pagkakakilanlan tulad ng ekonomiko, teknolohikal, sosyo-kultural at politikal. A. Mali ang nilalaman ng una at ikalawang pahayag. B. Tama ang nilalaman ng una at ikalawang pahayag. C. Tama ang nilalaman ng una at mali ang ikalawang pahayag. D. Mali ang nilalaman ng una at tama ang ikalawang pahayag. ANSWER: B 32. Alin sa sumusunod na mga pahayag ang nagsasaad ng dahilan sa pag-usbong ng globalisasyon? A. pagbuti ng mga lokal na kompanya sa presyo at kalidad ng serbisyo at produkto upang maging kompetitibo laban sa mga banyagang kompanya B. pagpapalitan ng impormasyon at teknolohiya at paggalaw ng mga tao dulot ng migrasyon C. pagbaba ng sahod ng mga manggagawa at pagdami ng mga taong walang trabaho dahil nalulugi ang maliliit na negosyo D. paglaganap ng biological weapons dulot ng mabilis na pagkalat ng impormasyon sa iba’t ibang panig ng mundo at pagdami ng pamilihan ng materyales na ginagamit dito ANSWER: B 33. Alin sa mga sektor ng manggagawa ang madalas nakararanas ng pang-aabuso at hindi pantay na oportunidad sa pagtratrabaho? A. agrikultura B. industriya C. pamahalaan D. serbisyo ANSWER: A 34. Ano ang tawag sa anyo ng subcontracting kung saan ang mga subcontractor ay may sapat na puhunan para maisagawa ang trabaho ng mga manggagawang ipinasok nila? A. iskemang subcontractor B. job mismatch C. job contracting D. labor-only contracting ANSWER: C 35. Bakit hindi maitaas ang pasahod, maipagkaloob ang kasiguraduhan sa trabaho, at madagdagan ang benepisyo ng mga manggagawa sa bansa? Ito ay dahil_____ A. sa sistema ng kontraktuwalisasyon. B. puro regular na ang mga manggagawa. C. mataas na ang pasahod sa ating manggagawa. D. marami ang benepisyong natatanggap ng ating manggagawa. ANSWER: A 36. Bilang tugon sa suliraning nararanasan ng mga manggagawa, mayroon silang karapatang hindi dapat malabag upang masabi na sila ay may disente at marangal na hanapbuhay. Alin sa sumusunod ang HINDI kabilang sa mga karapatan ng manggagawa? A. Karapatan sa pantay na suweldo para sa parehong trabaho. B. Karapatang sumali sa marahas at mapanganib na uri ng unyon. C. Karapatang maging ligtas at malayo sa panganib ang kalagayan ng pagtatrabaho. D. Karapatan na makatanggap ng sapat at karapat-dapat na suweldo para sa makataong pamumuhay. ANSWER: B 37. Halos mapudpod na ang sapatos ni Justin sa paghahanap ng trabaho ngunit hindi pa rin siya natatanggap. Maraming job fairs na rin ang kaniyang pinuntahan ngunit bigo siyang makakuha ng trabaho. Bakit kaya ito nangyayari kay Justin? A. Kulang pa ang kaniyang lakas ng loob. B. Kulang siya sa aspekto ng personal relations kaya hindi siya nagugustuhan. C. Hindi kaaya-aya ang kaniyang pisikal na kaanyuan kaya hindi siya natatanggap sa trabaho. D. Biktima si Justin ng job mismatch kung saan hindi tugma ang kaniyang kakayahan at kasanayan na hinahanap ng mga kompanya. ANSWER: D 38. Ayon sa tala ng Department of Labor and Employment (DOLE), maraming job fairs noong 2010 ngunit kakaunti lamang ang mga natanggap na kalipikadong aplikante mula sa maraming bilang ng mga nag-apply. Alin ang HINDI angkop na dahilan nito? A. Ang mga aplikante ay hindi interesado sa mga trabaho sa bansa. B. Kapansin-pansin ang patuloy na paglaki ng bilang ng job skills mismatch ng mga aplikante sa bansa. C. May patuloy na mismatch sa kasanayan at kakayahan mula sa tinapos na kurso at sa hinihinging kalipikasyon ng mga employer. D. Maraming kurso sa higher education institutions sa bansa ang hindi na tumutugon sa pangangailangan ng mga pribadong kompanya na nagtatakda ng mga pamantayan sa pagpili ng mga manggagawa. ANSWER: A 39. Alin ang angkop na salita na tumutukoy sa sitwasyon kung saan inaako na ng lalaki ang mga gawain sa tahanan dulot ng migrasyon? A. helper B. house boy C. house father D. house husband ANSWER: D 40. Ang sumusunod ay mga ahensiya ng pamahalaan na nangangalaga sa kapakanan ng migrante MALIBAN sa __________________. A. Commission of Filipino Overseas B. Philippine Overseas Labor Offices C. Department of Labor and Employment D. Department of Science and Technology ANSWER: D 41. Isang epekto ng migrasyon ay ang pagtanggap o pagpapadala ng mga lakas-paggawa sa ibang bansa. Alin sa sumusunod ang HINDI nagpapakita ng magandang benepisyo ng brain gain? A. Malaki ang posibilidad ng promotion ng manggagawa. B. Gastusin ng kompanya ang pagpapadala ng manggagawa sa ibang bansa. C. Maaaring magtrabaho sa ibang bansa ang empleadong ipinadala upang matuto. D. Magiging asset ang migranteng manggagawa sa nagpapadala at tumatanggap na bansa kahit saan man sa mundo. ANSWER: B 42. Matagal na naghanapbuhay si Ginoong Pascual sa Australia, kaya sa kaniyang pag-uwi sa pamilya ay hindi siya pinansin ng kaniyang mga anak at nagtago ang mga ito sa kuwarto. Ano ang iyong mahihinuha rito? A. Malaki ang takot ng mga anak sa kanilang ama. B. Walang pasalubong si Ginoong Pascual sa mga anak. C. Hindi kilala si Ginoong Pascual ng kaniyang mga anak. D. Nagkakahiyaan ang mag-aama sa kanilang pagkikita. ANSWER: C 43. Paano nakaaapekto ang pangingibang-bansa sa estado ng ekonomiya ng bansa? A. Madaragdagan ang populasyon ng bansa. B. Mapananatiling matatag ang palitan ng piso at dolyar. C. Mahihirapan ang mga Pilipino na makisama sa mga dayuhan. D. Mas maraming papasok sa bansa na mga imported na produkto. ANSWER: B 44. Marami sa mga OFW na nasa Middle East ang napag-alamang nakararanas ng mga pang-aabuso mula sa kanilang mga amo tulad sa Saudi Arabia. Kung ikaw ang ambassador ng Pilipinas sa Saudi, alin ang pinakamabisa mong gagawin upang matulungan at maprotektahan sila? A. Pababayaan sila hanggang matapos ang kanilang kontrata. B. Maglulunsad ng rally sa embahada ng Saudi Arabia sa Pilipinas. C. Hihingi ng tulong pinansiyal at pauuwiin ang mga manggagawa sa Saudi. D. Maglilikom ng mga ebidensiya ng mga pang-aabuso at isusuplong ang mga amo sa kinauukulan. ANSWER: D 45. Alin sa sumusunod ang konseptong tumutukoy sa slavery? A. pang-aalipin B. sitwasyong payapa C. sapilitang pagtatrabaho D. pagpupuslit ng mga tao ANSWER: A 46. Kung ikaw ay opisyal ng pamahalaan na nangangalaga sa kapakanan ng mga OFW, alin sa sumusunod ang dapat mong gawin sa mga kaso ng pang-aabuso sa mga Pilipino? A. Pauuwiin ang lahat ng OFW at bibigyan na lamang ng trabaho sa Pilipinas. B. Pababayaan na lamang ang mga OFW dahil isolated cases lang naman ang mga ito. C. Ipauubaya na lamang ang mga gagawing aksiyon sa pamahalaan ng bansa kung saan nagtatrabaho ang mga OFW. D. Magtatatag ng mga mekanismo upang ma-monitor ang kalagayan ng mga OFW at gagawa ng kaukulang hakbang kung may pang-aabuso. ANSWER: D 47. Bilang isang mag-aaral sa kasalukuyan, alin sa sumusunod ang maaari mong magawa upang masigurong makaaangkop ka sa pangangailangan ng ating bansa na umunlad sa kabila ng globalisasyon? A. Magpalipas ng panahon at umasa na lamang sa pamilya. B. Tumigil sa pag-aaral at magtrabaho na upang kumita ng pera. C. Magsumikap sa pag-aaral upang makatapos at magkatrabaho. D. Maging layunin ang makapagtrabaho sa ibang bansa upang yumaman. ANSWER: C 48. Alin sa sumusunod na mga pangungusap ang tumutukoy sa konsepto ng fair trade? A. Itinatakda ng mga bansa ang pamantayan ukol sa mga kakayahan ng mga manggagawa. B. Ang mayayamang bansa ay nagbibigay ng tulong sa pinakamahihirap na tao sa mundo lalo na sa Aprika at Asya. C. Sinisiguro ng mga bansa ang patas o pantay na kalakalan gaya ng pagbabantay sa tamang presyo ng mga produkto. D. Ang pamahalaan ay nakikialam sa kalakalang panlabas na may layong protektahan ang mga lokal na namumuhunan. ANSWER: C 49. Marami sa mga pamilya ng OFWs ay nakararanas ng pangungulila sa kanilang kaanak na humahantong sa pagkawasak nito. Paano kaya sila matutulungan? A. Makisimpatiya sa kanila. B. Bigyan sila ng sulat isa-isa. C. Bigyan sila ng load pantawag sa kanilang kaanak. D. Magtayo ng isang samahan ng mga pamilya ng OFW upang gumabay sa kanila. ANSWER: D 50. Sa Pilipinas ay marami ang nangangarap na mangibang-bansa dulot ng kahirapan sa buhay. Nangangamba naman ang mga ekonomista dahil naaapektuhan ng brain drain at brawn drain ang ekonomiya. Bilang ekonomista, ano ang maaari mong gawin upang masolusyunan ang isyung ito? A. Pigilan ang mga nais mangibang-bansa. B. Hayaang umalis ang mga nais na magtrabaho sa ibang bansa. C. Bigyan ng suportang pinansiyal ang mamamayan na walang trabaho. D. Gumawa ng isang development plan na tutugon sa mga isyu ng migrasyon. ANSWER: D

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

1. SA node sends an impulse causing the atria to contract 2. Blood moves from the right atrium into the right ventricle past the tricuspid valve 3. Blood moves from the left atrium into the left ventricle past the mitral or bicuspid valve 4. Impulse pauses at AV node to allow for maximum blood to be squeezed into the ventricles 5. Impulse travels to the AV bundle (or bundle of His) and down the bundle branches 6. Impulse travels out Purkinje fibers causing the apex to contract 7. The apex contraction increases the blood pressure in the ventricles causing the Mitral and Tricuspid (AV) valves to close. 8. Atria repolarize and begin to fill 9. Purkinje fibers cause the ventricle walls and papillary muscles to depolarize (contract) 10. Papillary muscles hold the AV valves shut (keep them from prolapsing) through the chordae tendineae connection 11. The aortic and pulmonary semilunar valves open when the pressure is higher in the ventricles than in the major arteries 12. Blood moves from right ventricle to pulmonary trunk/arteries past the pulmonary semilunar valve 13. Blood moves from left ventricle to aorta past the aortic semilunar valve 14. Blood pathway is arteries to arterioles, to capillaries (or capillary bed), to venules, veins and vena cava back to the right atrium 15. The ventricles start to repolarize (relax) which decreases the pressure in the ventricles 16. When the pressure is lower in the ventricles than in the major arteries, blood moves back toward heart shutting semilunar valves 17. When the aortic valve closes, the openings to the coronary arteries are exposed 18. Back pressure in the aorta pushes blood out the left and right coronary arteries supplying the heart with oxygenated blood 19. The AV valves open and blood moves from the atria into the ventricles when the ventricular pressure falls below atrial pressure. 20. The process starts again when the SA node fires causing the atria to contract.

The cytoskeleton is a network of thin tubes and filaments that crisscrosses the cytosol. The tubes and filaments give shape to the cell from the inside in the same way that tent poles support the shape of a tent. The cytoskeleton also acts as a system of internal tracks, shown in Figure 4-18, on which items move around inside the cell. The cytoskeleton’s functions are based on several struc- tural elements. Three of these are microtubules, microfilaments, and intermediate filaments, shown and described in Table 4-2. Microtubules Microtubules are hollow tubes made of a protein called tubulin. Each tubulin molecule consists of two slightly different subunits. Microtubules radiate outward from a central point called the centrosome near the nucleus. Microtubules hold organelles in place, maintain a cell’s shape, and act as tracks that guide organelles and molecules as they move within the cell. Microfilaments Finer than microtubules, microfilaments are long threads of the beadlike protein actin and are linked end to end and wrapped around each other like two strands of a rope. Microfilaments con- tribute to cell movement, including the crawling of white blood cells and the contraction of muscle cells. Intermediate Filaments Intermediate filaments are rods that anchor the nucleus and some other organelles to their places in the cell. They maintain the inter- nal shape of the nucleus. Hair-follicle cells produce large quantities of intermediate filament proteins. These proteins make up most of the hair shaft. 84 CHAPTER 4 TABLE 4-2 The Structure of the Cytoskeleton Property Microtubules Microfilaments Intermediate filaments Structure hollow tubes made of two strands of intertwined protein fibers coiled into coiled protein protein cables Protein subunits tubulin, with two subunits: å actin one of several types of and ∫ tubulin fibrous proteins Main function maintenance of cell shape; cell maintenance and changing of maintenance of cell shape; motility (in cilia and flagella); cell shape; muscle contraction; anchor nucleus and other chromosome movement; movement of cytoplasm; cell organelles; maintenance of organelle movement motility; cell division shape of nucleus Shape Microtubules provide a path for organelles and molecules as they move throughout the cell. FIGURE 4-18 Microtubules Nucleus Endoplasmic reticulum Mitochondrion Ribosomes Copyright © by Holt, Rinehart and Winston. All rights reserved. Copyright © by Holt, Rinehart and Winston. All rights reserved. CELL STRUCTURE AND FUNCTION 85 1. Explain how the fluid mosaic model describes the plasma membrane. 2. List three cellular functions that occur in the nucleus. 3. Describe the organelles that are found in a eukaryotic cell. 4. Identify two characteristics that make mitochon- dria different from other organelles. 5. Contrast three types of cytoskeletal fibers. CRITICAL THINKING 6. Relating Concepts If a cell has a high energy requirement, would you expect the cell to have many mitochondria or few mitochondria? Why? 7. Analyzing Information How do scientists think that mitochondria originated? Why? 8. Analyzing Statements It is not completely accurate to say that organelles are floating freely in the cytosol. Why not? SECTION 3 REVIEW During cell division, centrioles organize microtubules that pull the chromosomes (orange) apart. The centrioles are at the center of rays of microtubules, which have been stained green with a fluorescent dye. FIGURE 4-20 Cilia and Flagella Cilia (SIL-ee-uh) and flagella (fluh-JEL-uh) are hairlike structures that extend from the surface of the cell, where they assist in movement. Cilia are short and are present in large numbers on certain cells, whereas flagella are longer and are far less numerous on the cells where they occur. Cilia and flagella have a membrane on their outer surface and an internal structure of nine pairs of micro- tubules around two central tubules, as Figure 4-19 shows. Cilia on cells in the inner ear vibrate and help detect sound. Cilia cover the surfaces of many protists and “row” the protists through water like thousands of oars. On other protists, cilia sweep water and food particles into a mouthlike opening. Many kinds of protists use flagella to propel themselves, as do human sperm cells. Centrioles Centrioles consist of two short cylinders of microtubules at right angles to each other and are situated in the cytoplasm near the nuclear envelope. Centrioles occur in animal cells, where they organize the microtubules of the cytoskeleton during cell division, as shown in Figure 4-20. Plant cells lack centrioles. Basal bodies have the same structure that centrioles do. Basal bodies are found at the base of cilia and flagella and appear to organize the devel- opment of cilia and flagella.

A solution is composed of a solute dissolved in a solvent. In the sugar water described in Figure 5-1, the solute was sugar and the solvent was water, and the solute molecules diffused through the solvent. It is also possible for solvent molecules to diffuse. In the case of cells, the solutes are organic and inorganic compounds, and the solvent is water. The process by which water molecules diffuse across a cell membrane from an area of higher concentration to an area of lower concentration is called osmosis (ahs-MOH-sis). Because water is moving from a higher to lower concentration, osmosis does not require cells to expend energy. Therefore, osmosis is the passive transport of water. Direction of Osmosis The net direction of osmosis depends on the relative concentra- tion of solutes on the two sides of the membrane. Examine Table 5-1. When the concentration of solute molecules outside the cell is lower than the concentration in the cytosol, the solution outside is hypotonic to the cytosol. In this situation, water diffuses into the cell until equilibrium is established. When the concentration of solute molecules outside the cell is higher than the concentration in the cytosol, the solution outside is hypertonic to the cytosol. In this situation, water diffuses out of the cell until equilibrium is established. Observing Diffusion Materials 600 mL beaker, 25 cm dialysis tubing, funnel, 15 mL starch solution (10 percent), 20 drops Lugol’s solution, 300 mL water, 100 mL graduated cylinder, 20 cm piece of string (2) Procedure 1. Put on your disposable gloves, lab apron, and safety goggles. 2. Pour 300 mL of water in the 600 mL beaker. 3. Add 20 drops of Lugol’s solution to the water. CAUTION: Lugol’s solution is a poison and eye and skin irritant. 4. Open the dialysis tubing, and tie one end tightly with a piece of string. 5. Using the funnel, pour 15 mL of 10 percent starch solution into the dialysis tubing. 6. Tie the other end of the dialysis tubing tightly with the second piece of string, forming a sealed bag around the starch solution. 7. Place the bag into the solution in the beaker, and observe the setup for a color change. Analysis What happened to the color in the bag? What happened to the color of the water around the bag? Explain your observations. Quick Lab www.scilinks.org Topic: Osmosis Keyword: HM61090 mb06se_homs01.qxd 11/27/07 8:52 AM Page 98 HOMEOSTASIS AND CELL TRANSPORT 99 When the concentrations of solutes outside and inside the cell are equal, the outside solution is said to be isotonic to the cytosol. Under these conditions, water diffuses into and out of the cell at equal rates, so there is no net movement of water. Notice that the prefixes hypo-, hyper-, and iso- refer to the relative solute concentrations of two solutions. Thus, if the solution outside the cell is hypotonic to the cytosol, then the cytosol must be hyper- tonic to that solution. Conversely, if the solution outside is hypertonic to the cytosol, then the cytosol must be hypotonic to the solution. Water tends to diffuse from hypo- tonic solutions to hypertonic solutions. How Cells Deal with Osmosis Cells that are exposed to an isotonic external environment usually have no difficulty keeping the movement of water across the cell membrane in balance. This is the case with the cells of ver- tebrate animals on land and of most other organ- isms living in the sea. In contrast, many cells function in a hypotonic environment. Such is the case for unicellular freshwater organisms. Water constantly diffuses into these organisms. Because they require a relatively lower concentration of water in the cytosol to function normally, unicel- lular organisms must rid themselves of the excess water that enters by osmosis. Some of them, such as the paramecia shown in Figure 5-2, do this with contractile vacuoles (kon-TRAK-til VAK-y ̄ ̄o ̄ ̄o-OL), which are organelles that remove water. Contractile vacuoles collect the excess water and then contract, pumping the water out of the cell. Unlike diffusion and osmosis, this pumping action is not a form of passive trans- port because it requires the cell to expend energy. Copyright © by Holt, Rinehart and Winston. All rights reserved. (a) (b) Vacuole filling with water Vacuole contracting TABLE 5-1 Direction of Osmosis Condition External solution is hypotonic to cytosol External solution is hypertonic to cytosol External solution is isotonic to cytosol Net movement of water into the cell out of the cell none H2O H2O H2O H2O H2O H2O The paramecia shown below live in fresh water, which is hypotonic to their cytosol. (a) Contractile vacuoles collect excess water that moves by osmosis into the cytosol. (b) The vacuoles then contract, returning the water to the outside of the cell. (LM 315) FIGURE 5-2 100 CHAPTER 5 (a) HYPOTONIC Cell walls (b) HYPERTONIC (a) ISOTONIC (b) HYPOTONIC (c) HYPERTONIC Other cells, including many of those in multicellular organisms, respond to hypotonic environments by pumping solutes out of the cytosol. This lowers the solute concentration in the cytosol, bring- ing it closer to the solute concentration in the environment. As a result, water molecules are less likely to diffuse into the cell. Most plant cells, like animal cells, live in a hypotonic environ- ment. In fact, the cells that make up plant roots may be surrounded by water. This water moves into plant cells by osmosis. These cells swell as they fill with water until the cell membrane is pressed against the inside of the cell wall, as Figure 5-3a shows. The cell wall is strong enough to resist the pressure exerted by the water inside the expanding cell. The pressure that water molecules exert against the cell wall is called turgor pressure (TER-GOR PRESH-er). In a hypertonic environment, water leaves the cells through osmosis. As shown in Figure 5-3b, the cells shrink away from the cell walls, and turgor pressure is lost. This condition is called plasmolysis (plaz-MAHL-uh-sis), and is the reason that plants wilt if they don’t receive enough water. Some cells cannot compensate for changes in the solute con-

Contractions

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