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Which of the following are MOST important to ensure healthy development of the fetus's neural and skeletal structures? (Select all that apply.)

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Märta, 81, bor ensam i en servicelägenhet. Hon får dagligen besök av hemtjänsten och hjälp med att planera, handla, städa och laga mat. Ibland brukar hemtjänsten stanna kvar och dricka kaffe med henne. Hon småpratar ofta om sin avlidne man och hur det var förr. Hon har inga barn, men en brorsdotter i samma stad, som nyligen har fått en liten son.Brorsdotterns pojkvän är oberäknelig och vill inte vara pappa, han har alldeles nyss lämnat brorsdottern. De senaste månaderna har hon några gånger med sänkt röst och bekymrad uppsyn, i samband med fikastunderna med hemtjänsten, berättat hur en hemlig liga borrat hål iväggen, att man släppt in gas samt haft samlag med henne. Hon visar på några fläckar på sängöverkastet. I övrigt är hon som vanligt, leende och lite småpratande. Hemtjänstens personal är fundersamma, de vänder sig till en av VC:s läkare, det råkar bli du som vikarierar och ännuinte hunnit börja på den AT du vill göra på orten. Du lovar att följa med en hemvårdare till Märta för att försöka förstå vad man kan göra för henne. När Du kommer hem förstår hon inte varför Du kommer med, hon verkar lite misstänksam och undrar om inte hennes vanliga kvinnliga husläkare är kvar på VC? Hon vill inte prata om hålet i väggen, säger viskande att hon inte vågar här. När du frågar hon varit utsatt för angrepp av något slag säger hon ingenting. Efter en stund har du egentligen bara fått fram att hon har sömnproblem och att hon är orolig ibland, särskilt på nätterna. Hon verkar inte nedstämd.a. Vilken diagnos sätter du? Motivera kort. (4 p)b. Kan man finna ett samband med pats höga ålder? Ge förslag på faktorer som kan ha bidragit till sjdsutvecklingen. (2 p)c. Vilken möjlighet till beh är indicerad? Hur kan du motivera Märta att medverka i beh? (3p)

dissolved many tribes as legal entities, wiped out tribal ownership of land, and set up individual Indian family heads with 160 free acres. If the Indians behaved like "good white settlers" then they would get full title to their holdings as well as citizenship. The Dawes Act attempted to assimilate the Indians with the white men. The Dawes Act remained the basis of the government's official Indian policy until the Indian Reorganization Act of 1934.

- Exotoxin - necrotising and neurotoxic effectso fragment A - (action, activity) ® inhibition of protein synthesiso fragment B - (binding) i) ® entry of the toxin into the cell through receptor-mediated endocytosisTheir role in the pathogenesis of infections:- C.diphtheriae typically is not invasive (does not invade deep tissues and does not enter the bloodstream- Transmission - by air droplets or contact with respiratory secretions or contaminated skin abrasions of a symptomatic infected person- C.diphtheriae colonises mucosa or skin- Toxigenic strains (temperate bacteriophage infects C.diphtheriae) produce exotoxin with necrotising and neurotoxic effects ® Destruction of epithelium, superficial inflammation response- Grayish pseudomembrane- Regional lymph nodes in the neck enlarge, and marked oedema of the entire neck may be present- Distant toxic systemic damage (parenchymatous degeneration, fatty infiltration, necrosis) affectingo heart muscle (myocarditis)o livero kidneys (tubular necrosis)o adrenal glandso nerves (demyelination → resulting in paralysis of the soft palate, eye muscles, or extremities)- Wound or skin diphtheria Primary (pustule→ulcer covered by a pseudomembrane)- Respiratory diphtheria (Sore throat, low-grade fever- Cutaneous diphtheria (May involve any area of the skin (usually the legs)

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