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New cases in Pous 2064, HIV = 175, AIDS = 26, Death = 2. HIV rate is very high in Housewives than sex workers in Nepal ! ! ! HIV status in Nepal till 2005: Total Adult=70000, Adult Prevalence (15-49)=0.55%, Number of Women (15-49) LWHA=15,310 (22%), HIV Prevalence rate in IDUs=32.7%, HIV prevalence rate in sex worker=3.8%, HIV prevalence rate in client of SW=2.1%. The latest U.N. report shows that 65 million people have been infected with HIV since it was first identified 25 years ago. Twenty five million people have died of AIDS.

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Clinical Vignette A clinical vignette is a concise presentation of an interesting or challenging patient encounter that stimulated an interesting learning issue.

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Clinical MCQs 8 - 10-06-2006, 08:43 PM

In which of the following ways does the sleep pattern of a 78-year-old differ from that of a younger individual?
A. Increased need for sleep
B. Increased REM sleep
C. More arousal and awakening at night
D. More total nighttime sleep
E. Significant sleep disturbances are more common


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Re: Clinical MCQs - 10-06-2006, 08:58 PM

मलाई त C जस्तो लाग्यो किनभने मेरो हजुर बुवा राती पनि ढिलो सुतनु हुन्छ अनि बिहान पनि छिटो उथ्नु हुन्छ.....

Answer के हो Oak


I Love walking in the Rain cz Nobody see me CRYING

मलाई पानी परेको बेला हिंड्न मन लाग्छ किनकी म रोएको कसैलाई पनि देखाउन चाहन्न...
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Re: Clinical MCQs - 10-06-2006, 09:11 PM

I go with Embolus.
But I am little bit confused with option E, which; I think is also true about the elderly people.
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10-06-2006, 09:35 PM

हेरुम के रहिछ Answer


I Love walking in the Rain cz Nobody see me CRYING

मलाई पानी परेको बेला हिंड्न मन लाग्छ किनकी म रोएको कसैलाई पनि देखाउन चाहन्न...
[ Download Nepali Fonts ] [नेपाली मा टाईप गर्ने सजिलो तरिका]

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The correct answer is C. - 10-06-2006, 09:38 PM

The correct answer is C. Sleep patterns differ from person to person, however some generalizations can be made regarding age and sleep. Elderly individuals have more awakening and arousal at night, they tend to awaken earlier, and have less total sleep. Multiple factors can contribute to sleep disturbances in the elderly, including primary sleep disorders, sleep disorders secondary to other physical and psychiatric conditions, as well as medication-induced sleep problems.

With increased age, the needs for sleep decreases (compare with choice A). A newborn might sleep up to 22 hours daily, but an adult can generally feel rested with 6 to 8 hours of sleep.

The amount of time spent in REM sleep decreases with age (compare withchoice B), starting at about age 50.

The elderly generally achieve less total nighttime sleep (compare with choice D).

Mild sleep disturbances (compare with choice E) can be associated with normal aging, however any significant sleep disturbance that impairs daily activity or causes increased daily sleepiness requires further evaluation.


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