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จงอ่านข่าวต่อไปนี้แล้วตอบคำถาม Nineteen-year-old Antonio is about to take his first plane flight. Shortly after he boards the plane and sits down, a man in his late sixties sits next to him n the aisle seat. About half an hour after the plane takes off, the pilot announces that she is turning the seat belt light off and that “it is now safe to move about the cabin.” The man in the aisle seat, who has introduced himself to Antonio as Ahaya, immediately unbuckles his seat belt and paces up and down the aisle a few times before returning to his seat. After about forty-five minutes, Ahaya gets up again, walks some more, then sits back down and does some foot and leg exercises. After the third time, Ahaya gets up and paces the aisles, Antonio asks him whether he is walking so much to accumulate steps on a pedometer or fitness tracking device. Ahaya laughs and says no, he is trying to do something even more important for his health- prevent a blood clot from forming in his legs. อยากทราบว่า Ahaya เป็นโรคอะไร เพราะเหตุใด

In this question, there are two possible choices left to answer which are 2. Cholesterol In The Blood and 5. Deep Vein Thrombosis, due to the reason that the article says that the man does some foot exercise and to prevent blood clots in his legs That means 1. Heart Attack , 3. Diabetes and 4. Heart Failure are incorrect. In this case I chose Deep Vein Thrombosis because there are ways to help prevent it which is to exercise the lower parts of the body.

Deep vein thrombosis occurs when a blood clot (known as thrombus) forms in one or more of the deep veins in the body, usually in the legs. Despite deep vein thrombosis can occur without noticeable symptoms, common warning signs and symptoms of deep vein thrombosis include pain or soreness in the affected leg that usually starts in the calf, swelling or a feeling of warmth in the affected leg and red or discolored skin on the leg. Deep vein thrombosis can potentially develop due to certain conditions that affect how blood clots. It usually happens after prolonged immobilization periods, such as sitting in a long travel journey and deskbound habits that limit leg movement longer than 4-8 hours. A potentially life-threatening complication associated with deep vein thrombosis is a pulmonary embolism (PE). It occurs when a blood vessel in the lung becomes blocked by blood clots that travel to the lungs from deep veins in the legs. Symptoms and severity of a pulmonary embolism depend on the size of the clot and where it lodges in the lung. If the blood clot is considerably large enough to completely block the vessels in the lung, it can possibly lead to sudden death.

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จงอ่านข่าวต่อไปนี้แล้วตอบคำถาม A 54- year-old man complains of recurrent burning epigastric pain for the past six weeks and, during the past two weeks, the pain has often awakened him during the night. The pain lessens after meals but gets worse if he fasts for several hours. He has not been experiencing nausea or vomiting. His vital signs are: T = 37.1 ºC, P = 90/min, RR = 16/min, BP = 130/80 mm Hg. The physical examination is unremarkable except for some slight epigastric tenderness. When asked about his family’s medical history, the patient indicates that his mother and one of his two siblings have had recurring symptoms similar to those he is experiencing now. จากข่าวข้างต้น อยากทราบว่าผู้ป่วยมีภาวะใด เพราะเหตุใด

The symptoms are suggestive of peptic ulcer disease (PUD), which encompasses both gastric ulcers (GUs) and duodenal ulcers (DUs). This case most likely involves a DU. Abdominal pain is common to many gastrointestinal disorders, including PUD, but has poor predictive value for the presence of DU or GU. Nevertheless, one should always carry out a careful history and physical examination when dealing with a patient who may have PUD. Epigastric pain may manifest as a burning or gnawing discomfort, or as an ill-defined, aching sensation that resembles hunger pain. The typical pain pattern in DU occurs 90 min to 3 h after a meal and is often relieved by antacids or food. Pain that awakens the patient from sleep is the most discriminating symptom, with two-thirds of DU patients describing this complaint. In contrast, discomfort in GU patients may actually be precipitated by food. Also, nausea and weight loss are more common in GU patients.

The physical exam is often unremarkable with PUD. Epigastric tenderness is the most frequent finding. Although not seen in the present case, additional symptoms may be indicative of complications associated with peptic ulcers. Dyspepsia that becomes constant, is no longer relieved by food or antacids, or radiates to the back may indicate a penetrating ulcer (pancreas). Sudden onset of severe, generalized abdominal pain may indicate perforation, as does a severely tender, board like abdomen. Pain that worsens with meals, nausea, and vomiting of undigested food suggests gastric outlet obstruction, as does the presence of a succussion splash (indicative of retained fluid in the stomach). Tarry stools or coffee ground emesis indicate bleeding. Tachycardia and orthostasis suggest dehydration secondary to vomiting or active gastrointestinal blood loss.

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จงอ่านข่าวต่อไปนี้แล้วตอบคำถาม A 53- year- old man starts to experience bifrontal headaches. The headaches are relieved by aspirin, but they recur periodically over the next two weeks. The man and his wife begin to wonder what is going on because he has no previous history of persistent headaches. As a matter of fact, his health has been very good. He has never smoked, drinks only in moderation, and is not taking any medications. Nevertheless, the man’s periodic headaches persist for another week, at which point he suddenly starts to have focal seizures with involuntary movement of the right side of his face and arm. His wife rushes him to the ER where, While awiting treatment, he suffers a generalized seizure that is controlled with intravenous diazepam, phenytoin, and phenobarbital. The man’s vital signs are T = = 37 ºC, P = 110/min, RR = 18/min, BP = 140/80 mm Hg. On physical examination, he is sleepy and has a decreased attention span. He can move all of his extremities, although he moves his right arm less than his left. His left optic disk is slightly blurred, but there are no other remarkable physical findings. The ER physicians ask the man’s wife about his medical history. She says that, aside frome the headaches, his only recent complaint was a painfully sore tooth that resulted in an extraction and bridge work about five weeks ago. จากบทความข้างต้น อยากทราบว่าผู้ป่วยคนนี้เป็นโรคอะไร เพราะเหตุใด

The MRI suggests a brain abscess, a focal suppurative lesion within the parenchyma of the brain, with ring enhancement and adjacent edema, that is almost always caused by a bacterium. Moreover, the patient's symptoms are generally consistent with this diagnosis. The most common symptom of a brain abscess (70% of cases) is a dull, aching, poorly localized headache. Focal neurologic symptoms depend primarily on the location of the lesion and develop in 30-50% of cases. Fever is seen about 50% of cases, whereas papilledema appears in only 25% of cases. WBC counts are usually normal, and blood cultures are positive in only 10% of cases.

The blurring of the left optic disk implies increased intracranial pressure, which can be caused by a wide range of problems. The combination of persistent headaches followed by focal seizures is suggestive of a parameningeal infection, such as a subdural empyema, brain abscess, epidural abscess, or thrombophlebitis of the major dural venous sinuses and cortical veins. The history of a recent dental procedure might also support one of these diagnoses. Other possible causes of the patient's condition might include viral encephalitis, parasitic infections (e.g., toxoplasmosis and cysticercosis), acute hemorrhagic leukoencephalitis, a cerebral infarction, neoplasm, or a chronic subdural hematoma. More information is needed to make a definitive diagnosis in this case.

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จงอ่านข่าวต่อไปนี้แล้วตอบคำถาม Hakeem is concerned about his health – he has been unusually tired, has been losing weight and most recently, found an unexpected lump on the side of his neck Dr. Hayes precribes an antibiotic in case Hakeem has a bacterial infection, and advises him to return in a few weeks if his lymph node does not shrink, or if he is not feeling better. Hakeem returns a few weeks later. He is not feeling better and his lymph node is still enlarged Hakeem ป่วยเป็นโรคอะไร เพราะอะไร

Swollen lymph nodes can also be a sign of cancer, including a type of blood cancer called lymphoma.

The initial results of the biopsy indicate that Hakeem does have lymphoma. Although lymphoma is more common in older people, young adults and even children can get this disease. There are many types of lymphoma, with the two main types being Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. Non-Hodgkin lymphoma (NHL), in turn, has many subtypes. The subtype depends on several factors, including which cell types are affected. Some subtypes of NHL, for example, affect immune system cells called B cells, while others affect different immune system cells called T cells.

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จงอ่านข้อความต่อไปนี้แล้วตอบคำถาม A 57-year-old woman presents to her gynecologist with the complaint of postmenopausal bleeding. During her workup, a CT scan of her abdomen shows a 12-cm right ovarian mass. อยากทราบต้องตรวจหาอะไรเพิ่มเติมจากเคสนี้

The diagnosis is adult granulosa cell tumor. This patient depicts classic histology: neoplastic cells arranged in sheets with characteristic focal follicle-like structures arranged around acellular pink material, known as Call-Exner bodies. The tumor cells show characteristic “coffee bean” nuclear grooves. The positive immunohistochemical staining confirms that this tumor overexpresses inhibin, which corresponds to the elevated blood level. The nonneoplastic granulosa cell is a normal component of the ovarian follicle, which supports the oocyte.

The presentation of this patient with postmenopausal bleeding highlights one of the important clinical implications of adult granulosa cell tumor. In addition to producing inhibin, occasionally granulosa cell tumors also produce estrogen. In a postmenopausal woman, unopposed estrogen stimulation can lead to proliferation of the endometrial lining which can be premalignant or malignant, and can present with abnormal uterine bleeding (AUB). Before operating on this patient’s ovarian mass, an endometrial biopsy would be obtained to rule out a concurrent malignancy of the endometrium.

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จากการอ่านบทความเรื่อง Effects of short-term exposure to air pollution on hospital admissions of young children for acute lower respiratory infections in Ho Chi Minh City, Vietnam อยากทราบว่าในฤดูแล้ง มีสารใดที่มีปริมาณสารเพิ่มขึ้นเป็นพิเศษ จากเหตุใด

Levels of NO2 demonstrated the most consistent relationships to hospital admissions for ALRI, and the results were broadly consistent with results from studies of respiratory morbidity from other countries. The excess risks of hospitalization associated with an increase of 10 µg/m3 in NO2 concentration were significant and equivalent in magnitude for lag days 2 and 3 and in both types of analyses. Except for lag day 3, these associations were also found in the overall time-series analyses (in which rainy and dry season data were combined). In the rainy season NO2, like PM10, showed a negative association with ALRI hospitalization for some lag periods, but only in the case–crossover analyses.

The study focused on the short-term effects of daily average exposure to NO2, particulate matter (PM) 10 µg/m3 (PM10), sulfur dioxide (SO2), and ozone (O3) in Ho Chi Minh City. Its specific aims were to assess the effects of such exposure on the hospitalization of young children for ALRI and to compare these effects in poor children with those in other children.

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จากการอ่านบทความเรื่อง Long-term effects of radiation exposure on health อยากทราบว่าค่า ERR กับ EAR เหมือนกันหรือไม่

Increased risks of solid cancers have been reported since about 10 years after the bombings and continue at present.19,28,29 The ERR of all solid cancers combined increased linearly with radiation dose, about 40–50% per Gy for both mortality and incidence for the sex-averaged risk at an attained age of 70 years after exposure at age 30 years.28,29 The ERR was higher in those exposed in childhood (about 15–30% per 10 years), suggesting that children have a generally higher sensitivity to radiationinduced cancer than do adults (panel 3).30–37 ERR decreased with attained age, but the excess absolute risk (EAR) of cancer increased, which is due to the increased background rate of cancer with older age.28,29 The increased risk becomes statistically significant at a dose of 0·1–0·2 Gy, and the modelled dose–response relation (figure 1) suggests that the threshold is around 0, with an upper limit (95% CI) of about 0·15 Gy.28 The risk of radiation-induced cancer at high doses (1 Gy or higher) is statistically significant, whereas at low doses (<100 mGy), the risk is uncertain. The effect of radiation is much smaller at low doses, leading to increased relative effects of statistical fluctuations and other risk factors and reducing statistical power.

The radiation-related risk of cancer varies between organs and tissues: the risks of cancer of the bladder, female breast, lung, brain, thyroid, colon, oesophagus, ovary, stomach, liver, and skin (excluding melanoma) increased signifi cantly in atomic bomb survivors in the LSS, whereas risks of cancer of the pancreas, rectum, uterus, prostate, and kidney parenchyma did not (figure 2). ERR was higher in women than in men, but EAR was similar in men and women since the background rate of cancer was low in women compared with men. Age at time of exposure modified radiation-induced cancer risk in a site-specific manner: the risk was largerin those exposed in childhood for cancers of the thyroid, skin, breast, and brain, but tended to be lower for lung cancer.

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จากบทความเรื่องวิตามินดี สรุปได้ว่าการใช้วิตามินดี สามารถช่วยให้การหลับมีคุณภาพมากขึ้น โดย P = 0.04 หมายความว่าอย่างไร

This study indicates that vitamin D insufficiency is an extremely frequent condition in patients with CKD, especially in those with an estimated GFR of less than 30 mL/min/1.73 m2. In addition, there is a decrease in the concentration of serum 25(OH) D with increase blood pressure and blood glucose.

Vitamin D deficiency is an emerging global health problem. As such, vitamin D deficiency has various adverse consequences, including detrimental impact on the renal and cardiovascular system. Prevalence of vitamin D deficiency in patients with chronic kidney disease (CKD) varies in different countries. Therefore, the current study was designed to assess vitamin D status in CKD patients in Thailand.

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จากบทความในหัวข้อ Climate change อยากทราบว่ากล่องสีฟ้าในภาพหมายถึงสิ่งใด

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จากบทความในหัวข้อ Risk factors from environment อยากทราบว่า noise pollution จะทำให้เกิดโรคใดที่ยังต้องการหลักฐานเพิ่มเติม

Ischemic heart disease can lead to Cardiac Arrest.

The noise was another environmental risk factor that was found to be associated with non-communicable diseases. In particular, noise exposure from any source was found to be a risk factor for diabetes, and each increment of 5 decibels of ambient noise was associated with an increased risk of hypertension. In addition, road traffic noise increments were associated with diabetes, hypertension in men, and ischemic heart disease.

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ข้อใดคือผลจากการผิดพลาดของกระบวนการ DNA replication

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มีงานวิจัยใหม่ว่าระบบ CRISPR-cas system สามารถใช้เพื่อ mosquito control ได้ นักเรียนคิดว่าทำได้อย่างไร

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ยีน CMPK2 มีผลกับ function ของ mitochondria อยากทราบว่าหากยีนนี้เกิดการ mutation จะสามารถเกิดผลกับสมองอย่างไรได้บ้าง

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ข้อใดไม่ใช่การทดลองโดยอิงหลักการ Epigenetics

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ข้อใด เกี่ยวข้องกับ P53 น้อยที่สุด

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จากบทความ cancer ที่ให้ไป การรักษา TNBC ควรทำอย่างไร

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จากบทความเรื่อง COVID-19 relationship ระหว่าง COVID-19 &Obesity เป็นอย่างไร

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ข้อใด คือ Infectious disease ที่มีผลจากด้านสังคม

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ข้อใดไม่ใช่ความสัมพันธ์ระหว่าง cancer& nervous system

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“Epicardial adipose tissue” มีหน้าที่ใด