Signature Assignment: End Stage Kidney Disease Case Analysis The goal of this assignment is to show that you understand the importance of the liver, pancreas, and kidneys in the proper functioning of the human body. Sarah, a 63-year-old female with a past medical history significant for diabetes mellitus, cirrhosis, gout, and a 30-pack a year smoking history, presents to the emergency room with chest pain revealing pericarditis in the echocardiogram, secondary to recently diagnosed end-stage renal disease. Physical examination reveals yellowish discoloration to the skin and sclera, multiple bruises, and 2+ bilateral edema. Sarah reports weakness lasting more than three weeks. Her medications include Glisten, a new drug for diabetes that causes ATP sensitive potassium channels to close, thereby releasing insulin. Her recent laboratory results are as follows: CBC Sodium 126 mEq/L Glucose 220 mmol/L Calcium 7.1 mg/dl Red blood cell count 3.9 cells / ul Vitals Blood pressure 92/64 mmHg Blood Gases pH 7.28 CO2 30 mmHg HCO3 12 mmol/L Hormone Panel Renin Low ADH Elevated Aldosterone Low Vitamins Vit D low Vit K low Vit E low Vit A low Urine and Stool Sample Stool color Gray Stool content Increased fat content Urine color White Address each of the following regarding Sarah’s case: Explain the cause for her low calcium and sodium levels. Explain the cause of her anemia. What laboratory test should indicate she is suffering from anemia? Explain the cause of her hypotension. How will her body attempt to establish homeostasis?
Signature Assignment: End Stage Kidney Disease Case Analysis
The goal of this assignment is to show that you understand the importance of the liver, pancreas, and kidneys in the proper functioning of the human body.
Sarah, a 63-year-old female with a past medical history significant for diabetes mellitus, cirrhosis, gout, and a 30-pack a year smoking history, presents to the emergency room with chest pain revealing pericarditis in the echocardiogram, secondary to recently diagnosed end-stage renal disease. Physical examination reveals yellowish discoloration to the skin and sclera, multiple bruises, and 2+ bilateral edema. Sarah reports weakness lasting more than three weeks. Her medications include Glisten, a new drug for diabetes that causes ATP sensitive potassium channels to close, thereby releasing insulin.
Her recent laboratory results are as follows:
|
CBC |
|
|
Sodium |
126 mEq/L |
|
Glucose |
220 mmol/L |
|
Calcium |
7.1 mg/dl |
|
Red blood cell count |
3.9 cells / ul |
|
Vitals |
|
|
Blood pressure |
92/64 mmHg |
|
Blood Gases |
|
|
pH |
7.28 |
|
CO2 |
30 mmHg |
|
HCO3 |
12 mmol/L |
|
Hormone Panel |
|
|
Renin |
Low |
|
ADH |
Elevated |
|
Aldosterone |
Low |
|
Vitamins |
|
|
Vit D |
low |
|
Vit K |
low |
|
Vit E |
low |
|
Vit A |
low |
|
Urine and Stool Sample |
|
|
Stool color |
Gray |
|
Stool content |
Increased fat content |
|
Urine color |
White |
Address each of the following regarding Sarah’s case:
- Explain the cause for her low calcium and sodium levels.
- Explain the cause of her anemia. What laboratory test should indicate she is suffering from anemia?
- Explain the cause of her hypotension. How will her body attempt to establish homeostasis?
- What type of acid-base disorder has she developed, and how will her body compensate?
- Explain the cause of her elevated ADH and glucose levels.
- What is the correlation between her illnesses and the low vitamins (D, K, E, and A), renin, and aldosterone levels?
- Which hormone would the body elevate in response to her low calcium levels? Why?
- Explain the physiological reason behind her physical findings (yellowish hint of the skin, sclera, multiple bruises, weakness, and edema).
- Explain the cause of her abnormal stool and urine sample.
- What cell does Glisten work on? Explain how this medication is able to stimulate insulin secretion.
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