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Marketing case study. Many standards apply to the design of buildings, including windows and doors.

The new ISO 23045: 2008 establishes specific guidelines applicable to the design

of buildings, to improve energy efficiency. To this end, the ISO covers the choice of

the raw materials and components used, the location of the building, and the energy

sources used. In theory, the ISO enables the transmission and sharing of information

about a building's energy efficiency by standardizing its energy statement. It also

defines objectives specific to each construction project from the design stage

onwards (source: ISO Standards habitat).

Question 1

A 25-year-old woman, pregnant in her second trimester, starts to

experience chorea and bilateral ankle arthralgia but has no past history of

rheumatic chorea. In the first hour, her erythrocyte sedimentation rate is

70. Could this be no more than chorea gravidarum?

Question 2

Is valproate as equally effective as haloperidol in the treatment of chorea,

in particular rheumatic chorea?

Question 3

Does a lesion of Guillain-Mollaret's triangle in the brain stem cause a

type of myoclonus other than symptomatic palatal myoclonus?

Question 4

1. In West's syndrome, after the fits have been suppressed, for how

long should treatment with adrenocorticotrophic hormone (ACTH)

continue?

2. Does complete suppression of resistant infantile myoclonic jerks by

ACTH characterize West's syndrome?

Question 5

Are anticholinergics the first line of treatment for primary torsion

dystonia?

Question 6

Can multiple sclerosis (MS) be associated with lack of vitamin D,

lack of sunlight or low fish/cod-liver oil in the diet? By looking at the

epidemiology (none at the equator; more outside 40 latitude, both north

and south; less on top of Swiss mountains than in the Swiss valleys; more

in fishing coastal towns and in Eskimos) this seems to be very important.

Vitamin D modulates the immune system and active vitamin D given

to rats with experimental MS (acute encephalomyelitis) lowers the

monocyte count in cerebrospinal fluid (CSF) by 90% in 72 hours with

return of power to their limbs. Japanese MS patients who ate plenty of

fish were found to have vitamin-D-receptor pleomorphism. The staple

grains and cereals (wheat, barley, oats) eaten in Scandinavian and

northern European countries contain phytic acid, which blocks vitamin D

absorption, and rice is the only cereal free of phytic acid.

Are there any studies where low vitamin D levels in blood are

associated with MS relapse?

Question 7

What are the diagnostic criteria of 'definitive' multiple sclerosis (MS) - as

taught to a medical student? We have found different information from

different sources.

Question 8

How reliable is a CT-brain scan with contrast in showing MS lesions as

enhancing lesions in the presence of a contraindication to use MRI?

Question 9

Is magnetic resonance (MR) spectroscopy of value in differentiating

multiple sclerosis from cerebral autosomal dominant arteriopathy with

subcortical infarctions (CADASIL)?

Question 10

Does hemiplegia due to multiple sclerosis present with hemiparesis

rather than dense hemiplegia (which is more characteristic of a stroke)?

Other than age, what are the clinical signs that would help differentiate

between the two?