Riley has been hospitalized following a motor vehicle...

Riley has been hospitalized following a motor vehicle accident. He has several broken bones, including his left jaw, two ribs on the left side, and a compound fracture of his left leg. According to his chart, he is 38 years old, his height is 5'11", and his weight is 186 pounds. His current medications include Lovastatin to lower his cholesterol and a monoamine oxidase inhibitor (MAOI) to treat depression. Before leaving the hospital, Riley will need nutrition education on: a. a pureed diet b. iron deficiency. c. weight gain. d. food-medication interactions. e. how to use a blender.

Transcript

00:01 Okay this question says george is a 50 year old man that has that had a severe motorcycle accident 12 years ago.

00:06 As a result of the accident george had one kidney and part of his small intestine removed because they were hemorrhaging.

00:14 Immediately following recovery george had some weight loss that he was told to expect because of malabsorption caused by having his intestine removed.

00:22 George has never returned to work due to his injuries and mostly sits inside and watches tv and reads.

00:28 Recently however george broke his wrist trying to catch himself from falling.

00:33 When he was examined he was told that his bones had become weak.

00:37 Explain how vitamin d, calcidiol and calcitriol are synthesized.

00:41 So vitamin d is synthesized by the skin okay through a process that requires exposure of ultraviolet a ultraviolet b radiation.

01:01 Once synthesized this vitamin d is transported to the liver it is going to go to the liver to the liver where it is converted into calcidiol into calcidiol by the enzyme you have the enzyme here 25 hydroxylase.

01:24 Now after this calcidiol is then transported to the kidneys to the kidneys where it is further metabolized by the enzyme 1 alpha hydroxylase that is going to convert this calcidiol into calcitriol.

01:45 Okay that in calcitriol is the biologically active form of vitamin d that is responsible for increasing intestinal absorption of calcium so this is going to increase intestinal absorption of calcium and also phosphorus and promoting bone growth in mineralization.

02:22 So this is the answer for the first question.

02:24 Now the next question says how could george's missing kidney be related to to his decreased decreased bone strength? well remember that the function of calcitriol is to intestinal absorption of calcium...

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