Pathophysiology Assignment 3 Case Study, Chapter 42, Acute Renal Injury and Chronic Kidney Disease Will is a 68-year-old male with a history of hypertension. Eight months ago, he started regular dialysis therapy for ESRD. Before that, his physician was closely monitoring his condition because he had polyuria and nocturia. Soon it became difficult to manage his hypertension. He also lost his appetite, became weak, easily fatigued, and had edema around his ankles. Will debated with his physician about starting dialysis, but she insisted, before the signs and symptoms of uremia increased, the treatment was absolutely necessary. (Learning Objectives: 1, 2, 3, and 4) 1. What is the difference between azotemia and uremia? 2. Two years ago, Will's physician told him to decrease his protein intake. In spite of what the physician ordered, Will could not stop having chicken, beef, pork, or eggs at least once a day. Why did his physician warn him about his diet? 3. Will's feelings of weakness and fatigue are symptoms of anemia. Why is he anemic? 4. Knowing what you do about Will's history, why is left ventricular dysfunction a concern for his physician?
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Azotemia is an increase in the amount of azote in the blood. Uremia is an increase in the amount of urea in the blood. Show more…
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Pathophysiology/Immunology and Biochemistry Case I – Sugar Kills Melissa Bankole, a patient with a long-standing history of type 2 diabetes mellitus, has been feeling progressively weaker over the past few months. She has also been feeling generally ill and has been gaining weight, although she has not changed her eating habits. During her routine visit to her family doctor, some standard blood and urine tests are ordered as an initial evaluation. In addition, her previously diagnosed mild high blood pressure has gotten significantly worse. The physician is concerned when the testing shows an increase in levels of creatinine in her blood and microalbumin in her urine. The patient is referred to a nephrologist for further evaluation. 1. What disease condition is Melissa Bankole suffering from? Explain the pathophysiology and symptoms associated with this disease state? Use additional resources to collate information. 2. Discuss the various laboratory tests done to diagnose this disorder. 3. Describe the biochemical phenomenon that is responsible for vascular complications associated with chronically elevated levels of glucose in the circulation.
Case-2: Patient History A 58-year-old obese woman with hypertension, type 2 diabetes, and chronic kidney disease is admitted to hospital after a right femoral neck fracture sustained in a fall. Recently, she has been complaining of fatigue and was started on epoetin alfa (erythropoietin) subcutaneous injections. Her other medications include an angiotensin-converting enzyme inhibitor, a β-blocker, a diuretic, calcium supplementation, and insulin. On review of systems, she reports mild tingling in her lower extremities. On examination, her blood pressure is 148/60 mm Hg. She is oriented and able to answer questions appropriately. There is no evidence of jugular venous distention or pericardial friction rub. Analyze this case study and answer the next two questions that follow. Case-2: Question-1 Which of the following is true of the pathogenesis of bone disease in chronic kidney disease? (select all that apply) A) In this patient, low serum calcium and hyperphosphatemia trigger PTH secretion, which depletes bone calcium and contributes to osteomalacia and osteoporosis. B) This patient probably suffers from osteoporosis, accelerated by her underlying renal failure. The pathogenesis of bone disease is multifactorial. C) In this patient, hypocalcemia results and is further exacerbated by high serum phosphate levels from impaired phosphate excretion by the kidney. D) In this patient, calcium is poorly absorbed from the gut because of decreased renally generated vitamin 1,25-(OH)2 D3 levels.
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