10 0.2 points Would Lacy expect to have changes in blood pressure and why? Increased blood pressure because of increased blood volume due to water gain Increased blood pressure because of decreased blood volume due to water loss Decreased blood pressure because of decreased blood volume due to water loss Decreased blood pressure because of increased blood volume due to water gain
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Case 1 — Jeff Jones is 19 years old. He notices that he has increased urine output, increased appetite, and excessive thirst. He has also experienced unexplained weight loss. Case 2 — Mr. Thompson is 60 years old and has been unusually tired for several weeks. He occasionally feels dizzy and lately he finds it increasingly difficult to sleep at night. He has swollen ankles and feet and his face looks puffy. He experiences a burning pain in his lower back, just below the rib cage. He also notices that his urine is dark in color. He goes to see his physician, who finds that he has elevated blood pressure, and that the kidney region is sensitive to pressure. Case 3 — Ms. Smith is 27 years old and has been experiencing painful and difficult urination (dysuria), frequency of urination and urgency. Her urine has a milky color. She also has fever and malaise, which is evidence of infection. Upon seeking treatment, she is given antibiotic therapy. After a few days on antibiotics, her symptoms disappear. Case 4 — Normal sample (control) 1. What disorder does Jeff Jones probably have and why do you think it is? 2. What are the terminologies for the given conditions for Jeff Jones? A. Increased urine output: B. Increased appetite: C. Excessive thirst: 3. Why is it important to perform tests on a control urine sample not containing any chemical substances? 4. What is the name of the reagent used to detect protein in the urine? 5. What is the name of the reagent used to detect glucose in the urine?
Adi S.
Case Study #3: R.F., a 23-year-old female, felt puffy, weak, and tired for several months. She suddenly noticed her urine had a red to brown discoloration and the volume was minimal. She also experienced nausea and vomiting. She went to the emergency room of a nearby hospital, and the following data were obtained upon examination and testing: Hematology: - Serum creatinine: 2.6 mg/dL (Normal values: 0.6-1.5 mg/dL) - BUN (Blood Urea Nitrogen): 24.0 mg/dL (Normal values: 7-21 mg/dL) - pH (arterial): 7.32 (Normal values: 7.35-7.45) - Hematocrit: 25% (Normal values: 37-46%) Urinalysis: - Color: Red to brown (Normal values: Straw) - Blood: Positive (Normal values: Negative) - Glucose: Negative (Normal values: Negative) - Protein: Mild (Normal values: Negative-trace) Renal Function Tests: - GFR (glomerular filtration rate): 40 mL/min (Normal values: 90-120 mL/min) - RBF (renal blood flow): 280 mL/min (Normal values: 1200 mL/min) Questions: 1. What is the primary diagnosis based on R.F.'s hematology test results (specifically her serum creatinine and BUN values)? 2. What likely caused R.F.'s low hematocrit? Explain how her disorder leads to a low hematocrit. 3. R.F. has blood in her urine. Explain how R.F.'s condition could lead to blood entering the kidney filtrate. 4. What do the renal function tests for this individual indicate? How do the results relate to her urine output? 5. What caused the puffy feeling? 6. What type of treatment does R.F. need?
Madhur L.
CLINICAL CASE STUDY Winifred, a 38-year-old female, is seen at City Hospital emergency department (ED). She has a history of hypertension, obesity, and unsuccessful weight loss attempts. She loves fried foods, soft drinks, beer, and pretzels. She has a history of binge eating. Winifred is required to have a yearly physical by her employer but has put off scheduling the appointment until she can lose some weight. She fell down some stairs in a work-related accident and was sent to the ED for observation. The emergency department doctor determined that Winifred has no broken bones but is concerned about her elevated blood pressure, 185/98. The doctor orders laboratory tests, and Winifred is admitted to the hospital. Her medical profile today is: Age: 38 years old Height: 5'1" Weight: 285 lb Glucose: 142 mg/dL; 7.8 mmol/L Calcium: 9.1 mg/dL; 2.27 mmol/L Sodium: 140 mEq/L; 140 mmol/L Potassium: 3.6 mEq/L; 3.6 mmol/L CO2: 25 mEq/L; 25 mmol/L Chloride: 96 mEq/L; 96 mmol/L BUN: 30 mg/dL; 10.7 mmol/L Creatinine: 0.9 mg/dL; 79.6 µmol/L Albumin: 3.8 g/dL; 38 g/L Total protein: 8.0 g/dL; 80 g/L ALP: 35 U/L; 0.5 kat/L ALT: 28 units/L; 28 units/L AST: 23 units/L; 0.38 kat/L Bilirubin, total: 1.5 mg/dL; 25.65 µmol/L RBC: 5.1 x 10^6 mL; 5.1 x 10^12 L Hgb: 11 g/dL; 7 mmol/L Hct: 30%; 0.30 MCV: 78 mm^3; 78 fL MCH: 23 pg MCHC: 40 g/dL; 40% WBC: 8 x 10^9 Total cholesterol: 245 mg/dL LDL: 145 mg/dL HDL: 30 mg/dL Triglycerides: 210 mg/dL Winifred is referred for medical nutrition therapy. NFPA indicates a robust female, with excessive fat stores, normal muscular development, and no fluid accumulation. Assess her nutrition status using the data provided. Nutrition Diagnostic Statement Altered laboratory values related to disordered eating pattern as evidenced by signs of nutritional anemia and dyslipidemia.
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