A patient comes into the office complaining of daytime sleepiness, fatigue, and snoring. On physical exam you notice a large neck and note that the patient is overweight. What is the most likely cause of his symptoms and what is the pathology of the disorder?
The patient described has the classic symptoms of obstructive sleep apnea. Patients with OSA are usually fatigued during the day and when they are asleep there is an obstruction such as a large tongue which prevents them from breathing. This will cause a decrease in gas exchange and the patient typically presents with a high PCO2 and low O2 saturation at night. Obstructive sleep apnea can be contrasted with central sleep apnea where there is damage to the CNS so that no signal is sent to take a breath. The method for treatment of OSA is CPAP machine but weight loss is also recommended.
What is the most efficient way to maximize learning and retention of material?
Each individual has their own learning style and the best method for mastery of material varies for each subject. Repeated exposure and recall of material is a great way to learn and solidify facts where memorization is required and doing practice questions and problems is important for testing your knowledge and gaining experience when learning mathematical concepts or applying systematic approaches to problems. One great way to test yourself to see what you know and don’t know is to take a blank sheet of paper and write down from memory everything you know about a subject, this is important for recall and the things that weren’t recalled is where study time now needs to be focused.
Compare and contrast the process of eukaryotic DNA synthesis on the leading vs the lagging strands.
Because DNA synthesis always goes from 5’ to 3’ DNA Polymerase is able to replicate the leading strand in one continuous strand while the lagging strand has to be formed in small segments called Okazaki fragments. Therefore the leading strand synthesis is done in the direction of the opening of the replication fork and follows DNA helicase as it unzips the parent DNA. The lagging strand synthesizes DNA 5’ to 3’ in the opposite direction and then uses DNA ligase as the glue to connect each adjacent segment so that a continuous strand of DNA is created.