Mr. H is a 70 yr old man who was in a car accident and has suffered severe fract

Question

Mr. H is a 70 yr old man who was in a car accident and has suffered severe fractures of the ethmoid, vomer and the sphenoid bones. His factures were repaired, but he is still in a comatose state. On the second day in the hospital his nurse reports Mr. H is breathing irregularly, his skin is dry and flaccid, and he is producing copious amounts of urine. The doctor orders blood and urine tests for ketones and glucose. The tests come back negative for sugars and ketones. What is Mr. H's hormonal problem and what arc 2 possible causes for it? What blood disorder would you expect to see in a patient after a total gastrectomy (stomach removal)? Explain. June is a 28 year old woman who is pregnant for the first time. She wants a completely natural pregnancy and delivery. She sees no need to visit a doctor for prenatal care since she is young and healthy. She also mentions something about her mother having to have shots during and after some of her pregnancies and June hates needles. What physiological information would you educate June about to encourage her to seek prenatal treatment and medical attention after delivery? Burton is a 68 yr old male complaining of difficulty breathing, a racing heart, and swelling of his feet and ankles. When the doctor examined his heart she found it to be enlarged. Herman has had hypertension for many years which has increase on the heart. Explain the probable cause of Herman's symptoms. A friend tells you that her son had an ECG, and it revealed he has a slight heart murmur. Should you be convinced that he has a heart murmur? Why or why not?

Explanation / Answer

1.Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless.

Central diabetes insipidus happens when damage to a person's hypothalamus or pituitary gland causes disruptions in the normal production, storage, and release of vasopressin. The disruption of vasopressin causes the kidneys to remove too much fluid from the body, leading to an increase in urination. Damage to the hypothalamus or pituitary gland can result from the following:

Here the case is of skull injury as vomer,sphenoid and ehmoid are the skull bones which were fractured and then repaired.The other cause may be-

Dipsogenic Diabetes Insipidus

A defect in the thirst mechanism, located in a person's hypothalamus, causes dipsogenic diabetes insipidus. This defect results in an abnormal increase in thirst and liquid intake that suppresses vasopressin secretion and increases urine output. The same events and conditions that damage the hypothalamus or pituitary—surgery, infection, inflammation, a tumor, head injury—can also damage the thirst mechanism. Certain medications or mental health problems may predispose a person to dipsogenic diabetes insipidus.Again in this case skull bone damage is the cause.

2.The blood disorder in case of gastrectomy is anaemia.

One function of your stomach is to absorb vitamins, particularly vitamins B12, C and D, from the food you eat.

If your entire stomach has been removed, you may not get all the vitamins your body needs from your diet. This may lead to certain health conditions, such as:anaemia

The body requires vitamin B12 to make healthy blood cells. Without enough healthy blood cells, you could develop symptoms of anaemia, such as tiredness and breathlessness.

3.Prenatal care involves regular visits to the doctor so that any complication is prevented .Also doctor presribes folic acid,calcium and iron supplements needed for proper development of both the mother and the child.Regular visits also helps in monitoring the blood and blood pressure ,various tests are performed which are used to assess and ensure the proper growth of the child.

After pregnancy alsocare is needed .For eg, in a cesarean section lot of precautions are told by the doctor and in normal delivery also proper care and attention is neede for few days that can be best provided in a hospital under the guiadance of health care professionals.

4.The cause of hypertensive heart disease is chronically elevated blood pressure (BP); however, the causes of elevated BP are diverse. Essential hypertension accounts for 90% of cases of hypertension in adults. Secondary causes of hypertension account for the remaining 10% of cases of chronically elevated BP.

Uncontrolled and prolonged elevation of BP can lead to a variety of changes in the myocardial structure, coronary vasculature, and conduction system of the heart. These changes in turn can lead to the development of left ventricular hypertrophy (LVH), coronary artery disease (CAD), various conduction system diseases, and systolic and diastolic dysfunction of the myocardium, complications that manifest clinically as angina or myocardial infarction, cardiac arrhythmias (especially atrial fibrillation), and congestive heart failure .

5. In this noninvasive test, a technician will place probes on your chest that record the electrical impulses that make your heart beat. An ECG records these electrical signals and can help your doctor look for heart rhythm and structure problems.A heart murmur is an extra sound that the blood makes as it flows through the heart.are very common, especially in children, and are usually harmless. These normal murmurs are called "innocent" heart murmurs. There is nothing wrong with your heart when you have an innocent murmur. Up to half of all children have innocent murmurs. They usually go away as children grow.

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