Mr. Jones, a 58-year-old sales executive has arrived in Washington DC  for a convention. He decides to go out with his colleagues and has a  heavy dinner. He wakes up in the middle of the night with a dull ache in  the center of his chest. He initially thinks, it is indigestion from  the heavy meal that he had, but the chest pain gets worse and now starts  radiating to the left shoulder, left jaw and left arm. He remembers  seeing on TV, that what he is experiencing could be symptoms of a  Myocardial infarction (heart attack). He immediately calls 911. Once, the ambulance arrives, the EMT notices that Mr. Jones is  sweating profusely and he is pale. The EMT immediately gives Mr. Jones,  Aspirin, puts a oxygen mask and starts IV normal saline. If needed,  other drugs can be given via the IV access. As soon as Mr. Jones is brought to the Hospital, the ER nurse takes  the vital signs and a brief history. An EKG is done and shows  abnormalities, suggesting a MI.  Blood is drawn to look for cardiac  enzymes. Blood results are back and show elevated Troponin and Creatine  Kinase, confirming that Mr. Jones is having a MI. His past medical  history is significant for poorly controlled essential hypertension,  poorly controlled Diabetes mellitus, Poorly controlled  Hypercholesterolemia. His family history is unremarkable. He is a  current smoker, has smoked 2 packs of cigarettes for the last 25 years  and drinks beer on the weekends.     Vital signs Complete blood count Cardiac enzymes   BP- 160/110 mmHg Hemoglobin:  19 gm/dl Troponin I: 0.030 (normal < 0.012)   HR- 97 bpm Hematocrit : 60% Creatine kinase:  120 U/L (normal 25-90 U/L)   Temperature- 98 F Leucocytes: 5800 cells/mm3   Platelets: 300,000 cells/mm3 Jones is immediately taken to the operating room to do an Angiogram  (procedure to visualize his coronary blood vessels) The doctors find a  block in one of the major blood vessels and decide to do a angioplasty  (minor surgery done to open blocked arteries). After the Angioplasty, the, EKG comes back to normal and his cardiac  enzymes are trending down. So, the physician decides to observe him in  the hospital for 2 days. He is discharged on 3rd day, with  advice to make life style changes and start medications: Aspirin,  Metoprolol (Beta blocker), Simvastatin (for his high cholesterol) and  follow up with his physician in his home town. Mr. Jones was not compliant with his medications, made no changes to  his life style.  3 months later, he visits his physician and complains  of easy fatiguability, headaches, shortness of breath, unable to lie  flat on the bed at night. He says that he has to sit up propped up  against 4 pillows in order to sleep. On Auscultation of the chest, there  are bilateral crackles heard. The physician concludes that Mr. Jones is  in heart failure. He now prescribes Diuretics for Mr. Jones. Questions:     1a What are the normal values for PH, Erythrocyte count, Leucocyte count, Platelet count. ( 1 point each)   1b What are the terms used for increase  and decrease in PH? ( 1 point each)   1c What are the terms used for Increase and decrease in Erythrocyte, Leucocyte, Platelet   count? ( 1 point each)       2a From the complete blood count reading, what can you infer about the hemoglobin and hematocrit? ( high/ Low) ( 1 point)   2b From the history of the patient, explain along with the  mechanism, why Mr. Jones has abnormal hemoglobin and hematocrit? ( 2  points)       3a In the ambulance, why did the EMT give oxygen as soon as he suspected  that Mr. Jones could be having a myocardial infarction? ( 1.5 point)    3b What is the  mechanism of action of Aspirin that is advantageous in Myocardial infarction?  ( 1.5 points)       4a Does giving isotonic saline change the osmolarity of Mr. Jones’s blood? Why/Why not?       ( 1 point)   4b What is the effect of istonic saline on the intravascular compartment and intracellular compartment? Explain ( 1 point)   4c In this patient, what cardiac enzymes were elevated? Explain why  troponin level is elevated in a Myocardial infarction? ( 1 point)       5 Mr. Jones’s EKG shows electrical abnormalities.   5a In a normal EKG, what are the different waves, intervals, segments that you expect to see? ( 1 point)   5b What does each wave represent?( 1 point)   5c What is the significance of PR interval?( 1 point)       6a What are coronary arteries? What are the branches of right and left coronary arteries? (1 point)   6b If the angiogram showed a embolus in the left anterior  interventricular artery, which part of the heart would be effected? ( 1  point)   6c If the ventricle of the heart is damaged, in which wave/ waves of the EKG will you see changes.( 1 point)       7 As a result of the Myocardial infarction and death of the effected cardiac muscle,   7a What happens to the stroke volume of the ventricle and why? ( 1 point)   7b As a result of the change in stroke volume, what happens to the cardiac output and total peripheral resistance (R) ( 1 point)   7c Why is giving a Beta blocker advantageous in Myocardial infarction ( 1 point)       8 Because, Mr. Jones, was not compliant with his medication and life style changes, he ended up in heart failure.   8a Which side of the heart has failed in MR. Jones? ( 1point)   8b Name a signs and symptoms of left sided heart failure ( 1 point)   8c Explain in detail the mechanism of development of pulmonary edema in  this patient. How do diuretics help in his treatment? ( 3 points)       9a If the person is refractory to the heart failure medications, he can  go into shock. What is the type of shock that you can expect in this  person. What are some of the signs and symptoms of Shock? ( 1 point)   9b Explain in detail the short term and Long term compensatory  mechanisms that come into play as a result of the condition in question  9a.( 2 points)

Has to have refirences and somewhat be in your own words. They are scanning the papers submitted to Assignment ContentYour local newspaper has asked you to write at least a 700-word, two-part article regarding the National Park closest to your location.Part 1Identify the National Park. Describe its location, its general habitats, and briefly describe at least two plants and two animals found within the National park.Part 2Examine how these plants and animals adapt to their environment within the park versus outside the park in terms of population growth or reduction, as well as speciation.What is adaptation?What kinds of factors affect population growth/reduction?What is speciation? What causes speciation?Consider the following questions regarding changes in the National Park as you write your article: What has changed over the last 10 years? You can investigate temperature, habitat changes, invasive species, accessibility to natural resources, and so on. Have the changes been positive or negative? How have the animals or plants been affected by the changes? How has competition for resources affected the change? Submit your assignment.ResourcesCenter for Writing ExcellenceReference and Citation GeneratorGrammar and Writing GuidesLearning Team ToolkitCopyright 2019 by University of Phoenix. All rights reserved.