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L&K academy problem 1 . Kat’s case history. Lung disease data. Age: 30 Occupation: Singer Hobbies: Dancing Symptoms Admitted to hospital 12 June after fainting at home.
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L&K academy problem 1 Kat’s case history Lung disease data Age: 30 Occupation: Singer Hobbies:Dancing Symptoms Admitted to hospital 12 June after fainting at home. Has experienced mild breathlessness over the last year. Describes increasing difficulty with breathing out. Has a cough. Medical notes Heavy smoker (cigarettes and cannabis). Bronchitis Main airways infected. This makes the tubes narrower. Patients often feel unwell with a temperature, cough and cold-like symptoms. Patients usually feel better after 2–3 weeks. Croup Inflammation of windpipe. Thick mucus produced. Rare in patients over 6 years old. windpipe 1 DiagnosisUse the lung disease data to decide what is wrong. 2 SymptomsDescribe how the disease could produce Kat’s symptoms. 3 Advice to patientIf lung function tests confirm your diagnosis, you will need to advise Kat how to manage the disease. Suggest how she could modify her lifestyle to reduceher breathlessness, and what she could do to get more oxygen into her blood. Make sure you explain in detail why each of your suggestions would work. Emphysema Structure of airways and alveoli gradually destroyed. Lung tissue elasticity lost making it harder to push out air. alveoli in emphysema patient normal alveoli Air in Air in Air out Air out
L&K academy problem 1 Teachers’ guide • Goal • The problem targets understanding part of the Big Idea: Cells. • Your respiratory and circulatory systems are specialised to deliver oxygen to cells. • Small molecules, like oxygen, diffuse into your blood quickly because your lungs have a large surface area and a good blood supply. • APP links • The problem could be used to assess achievement against criteria in the ‘explanations’ strand of AF1. • MissionIf you are using the APPREND Mission Booklets, the student outcomes will allow you to give feedback on the ‘What if?’ and ‘Solve it’ sections of the L5H–7 mission: ‘Master cells’. • Marking guide • APP L5Uses abstract ideas or models or more than one step when describing processes or phenomena, e.g. • emphysema is causing Kat’s symptoms • her alveoli are being destroyed • so she feels breathless. • APP L6 • Uses abstract ideas or models or multiple factors when explaining processes or phenomena, e.g. • emphysema is causing Kat’s symptoms • her alveoli are destroyed so she has a reduced surface area for gas exchangeor it is harder to push stale air out of her lungs so less fresh air enters • so she struggles to top up her red blood cells, or she feels breathless • and offers straightforward advice like: • she should stop smoking to prevent further damageor she could give up singing, dancing and other exercise to reduce her body’senergy needs, so she needs less oxygen for respiration. • APP L7 • Makes explicit connections between abstract ideas and/or models in explaining processes or phenomena, e.g. • emphysema is causing Kat’s symptoms • alveoli are made of thin cells surrounded by capillaries to allow fast diffusion but Kat’s are damaged so she has less surface area for gas exchangeor it is harder to push stale air out of her lungs so less fresh air enters and the airspaces in her lungs contain less oxygen • the changes make diffusion slower, so she struggles to keep her red cells topped up, or deliver oxygen to cells for respiration • and advice that would help Kat cope, for example: • use an oxygen mask to increase the amount of oxygen in the alveoli, which will give faster diffusion so more oxygen can be delivered to her cellsor use medication to open her airways • or exercise her breathing muscles to strengthen them so that more air passes in and out of her lungs,which will give faster diffusion • or, use medication or a blood transfusion to increase her red cell countso that oxygen is picked up from her lungs faster.
L&K academy problem 2 Matt’s case history Damage Normal small intestine Matt is a promising 400m runner, but since he joined the Academy his body mass has plummeted and he is constantly tired. Matt’s doctor asked him to swallow a ‘pill cam’. This took a series of photos as it moved through his intestines. The inside of Matt’s small intestine is not as it should be. Matt’s doctor used these diagrams to explain what was wrong. But he went too fast, and Matt couldn’t take it in. It’s your job to make sure he understands what’s wrong. Make some notes to cover everything you need to tell him. images courtesy of Coeliac UK. Matt’s small intestine 1 DiagnosisWhat do the images show? 2 SymptomsHow could the damage produce his symptoms? 3 Advice to patientMatt needs to increase his body mass and energy levels. Advise him how that could be done.Explain in detail why your suggestions would work. ExtensionMatt’s problem began when he joined the Academy. He started eating more foods containing gluten, but didn’t realise he was allergic to it. Find out what sorts of food he should avoid in future to ensure his small intestine recovers.
L&K academy problem 2 Teachers’ guide • Marking guide • APP L5Uses abstract ideas or models or more than one step when describing processes or phenomena, e.g. • lack of villi is causing Matt’s symptoms • he can’t take in nutrients fast enough. • APP L6 • Uses abstract ideas or models or multiple factors when explaining processes or phenomena, e.g. • lack of villi is causing Matt’s symptoms • his villi are destroyed so he has a reduced surface area for nutrient uptakeand can’t absorb all the nutrients from his food • and offers straightforward advice like: • feed ready digested food straight into his bloodstream or get him to keep warm and rest so he can manage with fewer nutrients. • APP L7 • Makes explicit connections between abstract ideas and/or models in explaining processes or phenomena, e.g. • lack of villi is causing Matt’s symptoms • the small intestine wall is normally folded into villi, which are filled with capillaries, and the cells that cover the villi are covered with microvilli • nutrients should diffuse into blood rapidly across this large surface area • the changes in Matt’s intestine make diffusion slower, so he can’t get the nutrients he needs for growth and repair or to release energy by respiration • and advice that would help Matt increase his body mass: • feed ready digested food straight into his bloodstream like glucose, amino acids, fatty acids, glycerol, vitamins and mineralsor get him to keep warm and rest so he doesn’t need to release so much energy from respiration and can manage with fewer nutrients. • Goal • The problem targets understanding part of the Big Idea: Cells. • Your digestive and circulatory systems are specialised to deliver nutrients to cells. • Small molecules, like glucose, diffuse into your blood quickly because your small intestine has a large surface area and a good blood supply. • APP links • The problem could be used to assess achievement against criteria in the ‘explanations’ strand of AF1. • MissionIf you are using the APPREND Mission Booklets, the student outcomes will allow you to give feedback on the ‘What if?’ and ‘Solve it’ sections of the L5H–7 mission: ‘Master cells’.
