For most Americans, the words "Alzheimer's disease" (AD) ?often mispronounced purposefully or accidentally as "old timers' disease" ?signify devastating memory loss and stigma. The information about AD ?often learned solely through the media ?may lead individuals to believe that AD is inevitable (it isn't), and possibly think that all AD patients receive poor care (there are many remarkably good AD units). Many individuals may envision a future burdened with more dementia patients and fewer societal resources to help support them (a real possibility). In general, pharmacists are well aware of what AD is and isn't. AD is complex and relentlessly progressive; it affects patients, loved ones, and caregivers adversely. Pharmacists can provide pertinent information about AD's myths, realities, and available symptomatic treatments. AD's harbinger is language difficulties, which include aphasia (language disturbance), apraxia (inability to carry out motor functions), and agnosia (failure to recognize or identify objects). Consequently, those with AD will often create new words for items. They may call a pencil a "list writer," or a key a "door turner." Clinicians stage AD as mild, moderate, or severe depending on the patient's cognitive and memory impairment, communication problems, personality changes, behavior, and loss of control of bodily functions. People often dismiss mild AD as normal cognitive decline or senility ?in other words, "normal" aging. For this reason, most people don't seek treatment and are diagnosed in the late-mild to early-moderate stage. In the severe stage, difficulty swallowing elevates the risk of aspiration pneumonia, which often marks the beginning of the downward spiral that ultimately ends with death; AD has no cure. A handful of pharmacologic treatments ?acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists ?alter the decline trajectory. These treatments slow disease progression, enhance cognitive function, delay cognitive decline, and decrease disruptive behaviors. Not all patients respond to these medications, but experts generally believe that those who do will show mild to moderate improvements for 6 months to a year. Although the drugs' effects are short-lived, they improve patients' quality of life and briefly enable independence. Determining when medications stop providing a therapeutic benefit and should be discontinued is challenging. Clinicians use various methods to monitor decline, including mental status tools, patient self-report, and loved ones' observations. Most clinicians continue drug treatment if the patient seems to tolerate the medication well, can afford it, and if there seems to be a benefit. With disease progression, specific behavioral symptoms including depression, agitation, hallucinations, and sleep disturbances become concerns. Antianxiety drugs, antipsychotics, and antidepressants are sometimes used to alleviate symptoms, but effective behavioral strategies are much preferred.
The tone of the passage could best be described as?
A. erudite
B. gloomy
C. intimate
D. didactic
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
Which of the following is NOT a possible cause of chronic pain in SCD patients?
A. aseptic necrosis
B. leg ulcerations
C. changes in altitude
D. osteomyelitis
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
The passage as a whole can best be described as a:
A. Narrative
B. Persuasive essay
C. Expository essay
D. Scientific article
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
According to the passage, the major difference between acute pain and chronic pain is:
A. The severity of the pain involved
B. The duration of the pain involved
C. The side effects of the pain involved
D. The methods of managing the pain involved
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
What steps can health care professionals take to help patients and their families cope with SCD?
A. Raising awareness and advocating patient education
B. Overestimating the number of individuals affected by SCD
C. Focusing on the potential for addiction and adverse effects
D. Distinguishing the difference between chronic and acute pain
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants. In response to a doctor's question, a patient says, "It usually occurs all of a sudden, but I've noticed it happen when I'm stressed out and tired from work. And I'd say that it's been ongoing for a few months now."
Of the following, which is this patient probably describing?
A. Acute pain
B. Chronic pain
C. Mixed pain
D. Severe pain
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
The word "hallmarks" in paragraph 2 most likely means?
A. labels
B. signals
C. features
D. badges
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year.
Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
Out of this group, which of the following demographic is the LEAST likely to have SCD?
A. African-American men
B. Mediterranean women
C. Middle Eastern women
D. Caucasian men
Sickle cell disease (SCD) affects millions of individuals worldwide, and the Sickle Cell Disease Association of America estimates that 70,000 to 100,000 individuals have SCD and 3 million individuals have the sickle cell trait. While SCD is known to primarily affect individuals of African American descent, individuals from South America, the Caribbean, Central America, the Middle East, and the Mediterranean can also have SCD or the SCD trait. SCD is estimated to affect 1 in 500 African American infants, and 1 in 12 African Americans are estimated to have the sickle cell trait. SCD is characterized by episodes of acute and chronic pain. By increasing awareness about SCD and promoting patient education, health care professionals can help patients and their families cope with SCD and better manage the associated pain. Recurring episodes of acute and/or severe pain are hallmarks of SCD. SCD pain can often be debilitating, and episodes of pain vary from patient to patient in both frequency and intensity. SCD pain can be classified as acute, chronic, or mixed. At some point, most SCD patients experience episodes of pain often referred to as vaso-occlusive crisis (sickle cell crisis), the duration of which may range from hours to days. Some patients seldom have a sickle cell crisis, while others may experience crises several times a year. Some episodes may be so severe that hospitalization is warranted to manage the pain. An acute pain event is the most common type of pain, and the onset is typically abrupt. It is often the result of an ischemic tissue injury, which is due to the occlusion of microvascular beds by sickled erythrocytes during an acute crisis. Acute pain episodes can also be triggered by factors including extreme temperature changes, changes in altitude, physical and emotional stress, illnesses, infections, dehydration, cold climates, menstruation, and fatigue. Chronic pain is pain that lasts for 3 to 6 months or longer. Chronic pain often results from the destruction of bones, joints, and visceral organs due to recurrent crises. Sources of chronic sickle cell pain include aseptic necrosis, leg ulcerations, and osteomyelitis. Unfortunately, acute and chronic pain associated with SCD are commonly undertreated or inappropriately managed due to patient fear of potential addiction and adverse effects. Many studies report that some health care professionals are also concerned about the potential for addiction. When appropriate, pharmacologic management of SCD pain may involve the use of 3 major pharmacologic classes: nonopioids, opioids, and adjuvants.
Which statement from the passage is an opinion of the author?
A. "...some health care professionals are also concerned about..." in paragraph 4
B. "Chronic pain is pain that lasts for 3 to 6 months..." in paragraph 4
C. "...episodes of pain vary from patient to patient..." in paragraph 2
D. "By increasing awareness ... and promoting..." in paragraph 1
The primary seat of tubercular infection is generally in the upper part of the lung. The invading organisms settle on the surface here and cause a multiplication of the cells and an inflammatory exudate in a small area. With the continuous growth of the bacilli in the localized region, adjoining areas of the lung become affected, and there is further extension into the immediate vicinity by means of the lymphatics. Small nodules form and then coalesce to create a larger area. The body primarily defends itself with the formation of dense masses of cicatricial tissue, which function to wall off the affected area. This results in unfavorable growth conditions for the bacilli. This mode of defense, combined with the production of substances antagonistic to the toxins produced by the bacilli, is so efficacious that in the great majority of cases no further extension of the process takes place. In certain cases, however, the growth of the bacilli in the focus area is unchecked, then the surrounding tissue is killed and converted into a soft semi-fluid material; further extension then takes place. All parts of the enormous surface of the lungs are connected by a system of air tubes or bronchi, and as a result, the bacilli have favorable opportunity for distribution. This opportunity is facilitated by sudden movements of the air currents in the lung produced by coughing. The body's defense; however, can still keep pace with the attack, and even in an advanced stage, the infection can sometimes be permanently checked; in other cases, the check is temporary, the process of softening continues, and large cavities are produced by the destruction of the tissue. On the inner surface of these cavities there may be a rapid growth of bacilli. From the lungs, the bacilli are carried by the lymphatics to the lymph nodes at the root of the lungs, in which a similar process takes place; this, on the whole, is favorable, because further extension by this route is for a time blocked. The extension across surfaces continues and the abundant sputum, which is formed in the lungs and contains large numbers of bacilli, becomes the vehicle of transportation. The windpipe and larynx may become infected, as the back parts of each are more closely in contact with the sputum and are the parts most generally infected. A large part of the sputum is swallowed and infection of the intestine takes place with the lesions taking the form of large ulcers. From the intestinal ulcers there is further extension by means of the lymphatics to the large lymph nodes in the back of the abdominal cavity.
According to the passage, which of the following is true about tubercular infection?
A. It can be stopped in the lungs, but not once it attacks the rest of the body.
B. It can always be stopped before fatality.
C. It can be checked until it reaches the intestines, but not after.
D. It can sometimes be checked in an advanced stage, but not always.
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