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Fatigued: A Case on Blood Harold is a 67-year-old male who has had regular physical exams, is a non-smoker, and who has been in good health for most of his life. In recent years, he has been experiencing symptoms of heartburn, nausea, and indigestion after eating certain foods. Although he experienced some relief after changing his diet to avoid those foods, the symptoms did not completely subside. Harold was eventually diagnosed with having a form of chronic atrophic gastritis (an inflammation of the stomach lining).

          Fatigued: A Case on Blood
Harold is a 67-year-old male who has had regular physical exams, is a non-smoker, and who has been in good health for most of his life. In recent years, he has been experiencing symptoms of heartburn, nausea, and indigestion after eating certain foods. Although he experienced some relief after changing his diet to avoid those foods, the symptoms did not completely subside. Harold was eventually diagnosed with having a form of chronic atrophic gastritis (an inflammation of the stomach lining).
        
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fatigued a case on blood harold is a 67 year old male who has had regular physical exams is a non smoker and who has been in good health for most of his life in recent years he has been expe 10991

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Fatigued: A Case on Blood Harold is a 67-year-old male who has had regular physical exams, is a non-smoker, and who has been in good health for most of his life. In recent years, he has been experiencing symptoms of heartburn, nausea, and indigestion after eating certain foods. Although he experienced some relief after changing his diet to avoid those foods, the symptoms did not completely subside. Harold was eventually diagnosed with having a form of chronic atrophic gastritis (an inflammation of the stomach lining).
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Read the case study below, then answer the questions that follow. Harold, a fifty-eight-year-old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. This was happening several nights a week. He was also experiencing occasional discomfort in the middle of the afternoon. The pain finally becomes so severe that he comes into the ER. You listen as Harold describes his symptoms and then ask Harold some questions. You note that Harold's appetite has suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. Otherwise, Harold seemed fine. You refer Harold to get an endoscopy. The endoscopy was performed at a hospital later that week. The endoscope was equipped with a small claw-like structure that the doctor could use in order to obtain a small tissue sample from the lining of Harold's stomach if required. Diagnosis: Peptic Ulcer Questions for understanding: 1) What is a peptic ulcer? What are most of them caused by? What is the most common treatment for this disorder? 2) What is the body's natural protection against peptic ulcers? b. Answer the following questions: Trace blood flow in the kidneys starting from the renal artery and ending in the renal vein. Trace the path of blood starting from the collecting duct to the urethra.

Luke H.

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Harold, a fifty-eight-year-old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. This was happening several nights a week. He was also experiencing occasional discomfort in the middle of the afternoon. Harold decided to schedule an appointment with his physician. The doctor listened as Harold described his symptoms and then asked Harold some questions. He noted that Harold's appetite had suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. Otherwise, Harold seemed fine. The doctor referred Harold to a physician that specialized in internal medicine and had Harold make an appointment for a procedure called endoscopy. The endoscopy was performed at the hospital later that week. During the procedure, a long, thin tube was inserted into Harold's mouth and directed into his digestive tract. The end of the tube was equipped with a light source and a small camera which allowed the doctor to observe the interior of Harold's stomach. The endoscope was also equipped with a small claw-like structure that the doctor could use in order to obtain a small tissue sample from the lining of Harold's stomach, if required. The endoscopy revealed that Harold had a peptic ulcer. Analysis of a tissue sample taken from the site showed that Harold also had an infection. QUESTIONS What is an endoscopy? How would this procedure help diagnose this patient's condition? What organism or type of infection do you think is the root of Harold's pain? What is normally preventing stomach acid from damaging stomach mucosa? What treatment would you prescribe? How/Why would your treatment be successful? Would a proton pump inhibitor be a useful treatment? If so, why?

Sri K.

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Transcript

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00:02 So for this case study, we're talking about peptic ulcers, which a peptic ulcer is a sore or hole that can form in the lining of the stomach, the lower part of the esophagus or the small intestines.
00:20 They're painful and they can have symptoms like abdominal pain, discomfort and change in appetite.
00:31 What are their causes? so that can be a bacteria called helicobacter pylori.
01:11 And it can also be non -steroidal inflammatory drugs like ibuprofen or aspirin.
01:20 Treatment could be like lifestyle, like avoiding nsaids, antibiotics if helicobacter pylori is involved.
01:35 And it could also be medications to reduce stomach acid.
01:43 So that could be like a proton pump inhibitor or an h2 receptor blocker.
01:52 But there's also natural protection against this that our bodies have.
02:01 So this could be like mucus, which is just a thick layer that lines our organs to keep from stomach acid damage.
02:16 Bicarbonate, which is a base which can neutralize stomach acid.
02:23 Prostaglandins, these help maintain blood flow to the stomach.
02:34 Tight junctions, which are junctions in our cells that keep acid from entering in.
02:44 And then regeneration.
02:45 The stomach, esophagus, intestines, the lining, these linings can regenerate themselves to basically repair any damage caused by acid.
02:58 So now let's talk about blood flow to the kidney.
03:05 So blood enters in through the renal artery.
03:13 It branches into smaller arteries, including interlobar arteries.
03:29 These travel through the renal medulla and then curve into the renal cortex.
03:32 Renal medulla, renal cortex...
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