ENGLISH EXAM

Rheumatoid arthritis (RA) is an autoimmune disease in which the body's

immune system mistakenly attacks the joints, leading to chronic inflammation.
It primarily affects the synovial joints, causing pain, swelling, stiffness, and
eventually joint deformity. RA can also affect other organs in the body, such as
the lungs, heart, and blood vessels. The exact cause of RA is unknown, but
genetic and environmental factors are believed to play a role. Treatment for RA
aims to reduce inflammation, manage pain, and prevent joint damage.
Medications, physical therapy, and lifestyle changes are commonly used to
manage the symptoms and improve the quality of life for individuals with RA.
Gout, on the other hand, is a type of arthritis caused by the accumulation of uric
acid crystals in the joints. Uric acid is a natural waste product that forms when
the body breaks down purines, which are found in certain foods. When there is
an excess of uric acid or the body is unable to eliminate it effectively, it can lead
to the formation of sharp urate crystals in the joints, most commonly affecting
the big toe. Gout attacks are characterized by sudden and intense joint pain,
swelling, redness, and warmth. Risk factors for developing gout include
genetics, diet, obesity, certain medications, and underlying health conditions.
Lifestyle modifications, such as dietary changes and weight management, along
with medications to reduce uric acid levels and control pain during acute
attacks, are typically recommended to manage gout.
1. Disease: A disorder or abnormal condition that affects the body's normal functioning.
2. Symptoms: Physical or mental manifestations experienced by a person that indicate
the presence of a disease or condition.
3. History: The information about a person's past and current health, including medical
conditions, treatments, and relevant events.
4. Examination: A systematic assessment of a person's body or specific areas to evaluate
their physical condition and identify any abnormalities or signs of disease.
5. Prevention: Actions taken to avoid or reduce the risk of developing a disease or health
condition.
6. Consultation: A meeting or discussion between a healthcare professional and a patient
to seek medical advice, discuss symptoms, and determine appropriate treatment.
7. Abnormality: A deviation from the normal or expected state, often used to describe an
unusual finding or characteristic in the body or its functions.
8. Sequelae: The after-effects or consequences of a disease, injury, or medical condition.
9. Complications: Additional health problems or conditions that arise as a result of a
primary disease or its treatment.
10. Prognosis: The likely course and outcome of a disease, including the expected
recovery or progression of the condition.
11. Signs: Objective, observable indications of a disease or condition that can be detected
by a healthcare professional during a physical examination.
 12. Syndrome: A group of symptoms and signs that occur together and are characteristic
of a specific disease or condition.
13. Differential diagnosis: The process of distinguishing between two or more possible
diseases or conditions that share similar symptoms to determine the most likely cause.
14. Diagnosis: The identification of a specific disease or condition based on the
evaluation of symptoms, medical history, examination findings, and diagnostic tests.

a) The heart circulates blood through the arteries to the tissues. b) One function of the
kidneys is to regulate the amount of water in the body. c) The kidneys are involved in the
excretion of a number of waste products. d) The kidneys filter the blood. e) The kidneys play
an important part in the excretion of urea. f) The liver synthesizes proteins from amino acids.
g) One function of the pancreas is to secrete enzymes. h) The spleen helps to remove and
destroy faulty red blood cells. i) The liver is concerned with storing proteins and glycogen. j)
The pancreas is involved in digestion as well as producing hormones. k) The small intestine
functions as an organ of both digestion and excretion. l) The lymph nodes play a part in
forming antibodies. m) The pancreas is concerned with the regulation of the level of glucose
in the blood.

SKIN
The skin is a vital organ that serves various crucial functions. Firstly, it acts as a protective
barrier, shielding the underlying tissues from injury and preventing the entry of harmful
bacteria. Secondly, it contains nerve endings that transmit sensory information to the brain,
allowing us to perceive touch, pain, and temperature. Another significant role of the skin is
temperature regulation, helping to maintain a stable internal body temperature. Additionally,
it serves as an excretory organ by eliminating water, sodium chloride, and some urea through
sweat glands. Lastly, the skin can function as a unique means of identification due to the
distinct patterns of fingerprints. Overall, the skin's multifaceted functions contribute to its
indispensable role in maintaining overall health and well-being.
BLOOD
The blood transports oxygen from the lungs to the tissues and carbon dioxide from the tissues
to thelungs. Itcarriesfoodmaterialsfromtheintestinestoallpartsofthebodyandreturnswastesto
thekidneystobeexcreted. Thebloodaidsintheregulationofbodytemperaturebydistributingthe
heat produced in active muscles. It plays a vital part in the maintenance of water and salt
balance. It is concerned with immunity to disease and protection of the body against invading
bacteria.
SPLEEN
The spleen is a vascular organ with lymphoid tissue that functions as part of the
reticuloendothelial system (RES) and the hematopoietic system. It plays a crucial role in
filtering and eliminating abnormal blood cells while allowing normal cells to pass through. In
certain conditions like hereditary spherocytosis, the spleen selectively retains and destroys
abnormal red blood cells. It also traps immature red blood cells, aiding in their maturation
before returning them to circulation. In the fetus, the spleen contributes to blood cell
formation, but in adults, it mainly focuses on lymphocyte production. The spleen is composed
of red pulp and white pulp, with the white pulp containing lymphatic tissue responsible for
lymphocyte production. The red pulp consists of erythrocytes, lymphocytes, and
macrophages surrounding vascular sinusoids. The exact pathway of blood flow within the
spleen is still debated among researchers.
CANCER
Cancer is a widespread and significant disease, ranking second only to cardiovascular disease
as a leading cause of death in Western countries. It is not limited to older individuals; in fact,
it is the most common cause of death in children over the age of one year in Britain.
The most prevalent types of cancer are carcinomas, which are malignant neoplasms that
originate from the epithelial linings of organs such as the gut and bronchi. Sarcomas, which
arise from the mesenchyme, are less common except in children. Leukemia and lymphoma
form another important group of cancers. Managing cancer often requires the expertise of
multiple specialists, including surgeons, radiotherapists, and medical oncologists.
The etiology of cancer involves a wide range of factors, but for the majority of commonly
occurring tumors, a single cause has not been identified. Various factors, such as genetic
predisposition, environmental exposures, and lifestyle choices, contribute to the development
of cancer. It is likely that multiple factors interact to induce tumor formation, such as the
synergistic effect of asbestos exposure and cigarette smoking in causing lung cancer.
Changes in the incidence of major cancers are observed over time. For instance, the increase
in lung cancer cases is directly linked to the number of cigarettes smoked, highlighting the
impact of tobacco consumption. On the other hand, the reason for the decline in stomach
cancer incidence remains unknown.
Geographical factors may also play a role in cancer incidence. Scotland, England, and Wales
have the highest cancer death rates globally, largely due to the contribution of bronchial
carcinoma. The variation in cancer incidence related to geographic location is evident, as
seen in the high occurrence of liver cancer, specifically hepatoma, in certain parts of
Mozambique. This particular case has been attributed to the ingestion of aflatoxin, a toxic
substance formed by a mold on groundnuts consumed as part of the diet.
Clustering of certain malignancies in specific regions can provide valuable insights into the
etiology of the condition. For example, the identification of T cell leukemias in southern
Japan and the West Indies helped determine that a virus was responsible for the disease.
Occupational factors have also been linked to cancer development. As early as 1775, Percival
Pott observed scrotal epitheliomas in young chimney sweeps, which were later attributed to
carcinogenic hydrocarbons in soot and poor personal hygiene. Various industrial-related
cancers have since been identified, emphasizing the impact of occupation on cancer risk.
iagnosing malignancy typically requires a biopsy of the tumor. Malignant cells exhibit
distinct differences from their normal counterparts, as outlined in Table 4. Cancer
development typically begins with a single abnormal cell, which may gradually transform
over years, leading to the formation of a carcinoma in situ. As the tumor grows, it becomes
more aggressive and invades blood vessels, followed by tumor-induced angiogenesis. This
enables rapid tumor growth and clinical detectability. The tumor eventually invades its local
surroundings and spreads through circulation to other tissues, resulting in micrometastatic
disease.
Treatment response can be subjective or objective. Subjective response refers to the patient's
perception of relief from symptoms such as pain, malaise, or depression, while objective
response is assessed by observers using measurable indicators like tumor size or imaging
findings.
The primary goal of cancer treatment is to achieve complete response in solid tumors or
complete remission in hematological malignancies. Complete response indicates the clinical
disappearance of all signs of malignancy, supported by appropriate investigations. Cure rates
have traditionally been associated with survival for five years, particularly when tumors are
amenable to surgery. However, the terms "median survival" and "median duration of
remission" have gained prominence, providing a better understanding of treatment outcomes.
Statistical methods, such as life table curves, play
STOMACH
he stomach is a dilated section of the digestive tract located between the esophagus and the
duodenum. It typically has a J-shaped structure, although its size and shape can vary. The
stomach consists of three main parts: the fundus, body, and pyloric portion. It has anterior
and posterior surfaces, as well as lesser and greater curvatures. The fundus is the upper
portion above the opening of the esophagus, while the body extends from the fundus to the
angular notch. The pyloric portion extends from the notch to the pyloric sphincter, which
separates the stomach from the duodenum. The pyloric part is further divided into a proximal
dilated pyloric antrum and a distal tubular pyloric canal. The lesser curvature is the upper
medial border, running from the right of the esophagus to the pylorus, while the greater
curvature extends from the left of the esophagus along the lateral border of the stomach.
NERVOUS SYSTEM:
The nervous system is divided into two main components: the central nervous system (CNS)
and the peripheral nervous system (PNS). The CNS consists of the brain and the spinal cord,
both of which are comprised of nerve cells and fibers. The brain is further divided into three
parts: the forebrain, the midbrain, and the hindbrain. The hindbrain consists of the pons, the
cerebellum, and the medulla oblongata.
TISSUE:
he outer layer of the skin, called the epidermis, is made up of epithelial tissue, which is also
found lining various systems in the body. Epithelial tissue can be classified as simple (one
layer of cells) or stratified (more than one layer), and can have different cell shapes like
squamous, cubic, or columnar.
The skin consists of two layers: the epidermis, derived from ectoderm, which has a deep layer
of growing cells covered by dried dead cells, and the dermis, made of vascular connective
tissue derived from mesoderm.
There are two types of membranes in the body: epithelial and fibrous membranes. Mucous
membranes are wet and slippery, consisting of epithelial tissue and underlying connective
tissue. They line the body tracts that open onto the body surface. Serous membranes, on the
other hand, are thin and transparent. They line closed body cavities and have two walls
(parietal and visceral) with a potential cavity between them containing fluid. Serous
membranes are rich in nerves, blood vessels, and lymph vessels.
Fibrous membranes are composed solely of connective tissue. Examples include the
superficial fascia, a sheet of loose connective and adipose tissue beneath the skin, and
periosteum, which surrounds bones and consists of dense connective tissue and a deeper layer
of loose connective tissue containing collagenous and elastic fibers.

EYE

The eye is a spherical organ located in the orbit, closer to the roof and lateral wall. It has
three coats: the fibrous outer coat (sclera and cornea), the vascular middle coat (uveal tract),
and the nervous inner coat (retina). The cornea is transparent and allows light into the eye,
while the sclera provides strength and protection.
The eye is divided into compartments by the lens, with the space in front filled with aqueous
humor and the space behind filled with vitreous humor. The cornea has a curved shape that
helps focus light onto the retina. Refraction errors can be corrected with lenses.
The cornea lacks a blood supply and receives nutrients from the aqueous humor and tears. It
is innervated by branches of the trigeminal nerve and is sensitive to touch. Tenon's capsule is
a fibrous membrane that covers the back of the eye and allows for its movement within the
orbit.
Overall, the eye's structure and positioning provide a wide field of view, although the lateral
side is less protected.
EPITHELIAL TISSUE: pithelial tissue is a versatile tissue that lines the body internally and
externally. It is attached to a basement membrane and forms both mucous and serous
membranes. Externally, it forms the epidermis, the outer layer of the skin.
Epithelial tissue is composed of cells that are closely packed together with little intercellular
matrix. It can be classified as simple (single layer) or stratified (multiple layers). Simple
epithelium can be further categorized based on cell shape.
Pavement epithelium is a simple epithelium with flattened cells that line serous membranes
and thin membranes. Columnar epithelium, composed of column-shaped cells, lines the
mucous membrane of various organs. Cuboidal epithelium refers to low-height columnar
cells, while columnar ciliated epithelium has cilia and is found in the nasal cavities.
Stratified squamous epithelium, the most important type of stratified epithelium, forms the
epidermis. As cells approach the surface, they become flatter and scale-like. Keratinization
occurs in some regions. Stratified squamous epithelium also lines the oral cavity, pharynx,
esophagus, anal canal, and vagina.
Other types of stratified epithelium exist, such as conical and oval cells beneath columnar
ciliated cells in the trachea and bronchi's mucous membrane.
PARKINSON:
Parkinson's Disease is a degenerative nervous system disorder that primarily affects
individuals over 40 years old. It progresses slowly and is characterized by tremors, muscle
stiffness, and slow movement. Some patients also develop senile dementia, and complications
from the disease can lead to death. Symptoms vary among patients and include tremors,
muscular rigidity, and slowness of movement. Parkinson's is relatively common, with
120,000 individuals in the UK affected, and 10,000 new diagnoses each year. The disease is
believed to be caused by a chemical imbalance in the brain's coordination center, resulting in
the death of cells that produce dopamine. Treatment involves dopamine replacement therapy
and sometimes surgical interventions. Experimental treatments such as deep brain stimulation
and transplantation of fetal tissue are also being explored. New drugs, including dopamine
agonists, COMT inhibitors, and growth factors, are being developed as well.
HELICOBACTER:
H. pylori infection is the main cause of stomach and duodenal ulcers. It can also contribute to
non-ulcer dyspepsia. The infection can be confirmed through tests on fecal samples, breath
tests, blood tests, or biopsy samples taken during an endoscopy. Treatment typically involves
a one-week course of two antibiotics and an acid-suppressing drug, which helps eradicate the
H. pylori infection and prevent ulcer recurrence. H. pylori is a common bacterium, with over
a quarter of people in the UK being infected at some point in their lives. While most infected
individuals don't experience symptoms, H. pylori can lead to stomach and duodenal ulcers.
The exact mechanism by which H. pylori causes ulcers is not fully understood, but it likely
involves disrupting the balance between stomach acid and the protective mucus barrier. In
addition to ulcers, H. pylori has been linked to non-ulcer dyspepsia, stomach cancer, and a
rare type of stomach cancer called gastric mucosa-associated lymphoid tissue lymphoma.
Various tests, such as breath tests, stool antigen tests, blood tests, and biopsies, can be used to
diagnose H. pylori infection. Treatment involves a combination of antibiotics and acid-
reducing drugs, known as combination therapy. It is recommended for individuals with
recurring dyspepsia, ulcers, a family history of stomach cancer, or certain conditions
associated with H. pylori infection. Follow-up tests are often performed after treatment to
confirm eradication of the infection. Side effects from combination therapy can occur but are
generally manageable.
UREA TEST:
The urea test, or urea breath test (UBT), is a reliable and non-invasive diagnostic tool used to
detect Helicobacter pylori (H. pylori) bacteria in the stomach and duodenum. Patients
consume labeled urea, and if H. pylori is present, it breaks down the urea into carbon dioxide
(CO2) and ammonia. The labeled CO2 is exhaled and measured in a breath sample,
indicating the presence of H. pylori. The test is accurate, convenient, and helps monitor
treatment effectiveness for H. pylori-related gastrointestinal conditions