Regarding the discussion of Case 2: Urea Cycle Disorders in Neonates: Six Case Reports. In patients with hyperammonemia, oral sodium benzoate was applied at 250-500 mg/kg/day. The rationale is that O Sodium benzoate interacts with glycine to form hippurate, which then provides a non-urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with glycine to form N-Acetyl Glutamate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with glutamate to form N-Acetyl Glutamate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys. O Sodium benzoate interacts with Carbamoyl Phosphate Synthase to form Carbamoyl Phosphate, which then stimulates the urea cycle pathway to remove excessive nitrogen waste by the kidneys
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- A 31-year-old white male patient with known type 1 diabetes mellitus, end-stage renal disease secondary to diabetic nephropathy, and a history of alcoholism was admitted with acute abdominal pain in the mid-epigastrium, with a blood gas values of pH of 7.48, poz of 121 mm Hg, 02 saturation of 99%, pCO2 of 30 mm Hg, and bicarbonate of 20 mE q/L. What is a possible compensatory mechanism? A. Decreasing H* ion retention B. Increasing bicarbonate retention C. Increasing the respiratory rate D. Decreasing the respiratory rateSituation: Mrs. Corona was diagnosed of Diabetes Mellitus Type II. She was admitted to the Emergency due to dizziness, headache frequency of urination at night and complained of very hungry. Her weight suddenly decreases for the past months from 140 lbs to 110 lbs also feeling tired and having dry skin. She sought admission due to the following signs and symptoms. Her hemogluco test (blood sugar) level is from 180 - 200mg / dl 2 hours after eating. The best and correct ecologic model for Mrs. Corona? a. Web Model b. Triangle model c. Wheel model d. All the choicesof Which ONE of the following statements is TRUE? OA The Flomax Relief symptoms check questionnaire can be used to assess the appropriateness of prescribing tamsulosin for cystitis OB A 45-year old man with fever due to an upper respiratory tract infection may take Flomax Relief for the treatment of benign prostatic hypertrophy. OC. In patients with swallowing difficulties, tamsulosin may be crushed and mixed with orange juice to increase its absorption O D. O E Tamsulosin is an alpha-reductase inhibitor which acts by relaxing certain muscles of the prostate and bladder. Tamsulosin should ideally be taken at night to prevent nocturia symptoms, which are common in patients with benign prostatic hypertrophy.
- Many older adults are on multiple medications. Take for example Ms. Jones. She is on metformin 1 gram po twice a day, Lantus 20 units SQ daily, Lisinopril 10mg po daily, metoprolol 50mg po twice a day, simvastatin 20mg po qHS, Eliquis 5mg po BID, Calcium 600mg daily, Vitamin D 2000IU daily, baby aspirin 81mg po daily. Define polypharmacy and discuss important prescribing points for safety medication in aging adults. What are some ways to determine if the medications listed is safe for the patient to take? What tools are available to use for safe administration? What questions would be important to ask the patient about her medication?Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…
- Pt is a 55 y.o female with past medical history of end-stage renal disease on hemodialysis via perm catheter, hypertension, hyperlipidemia, type 2 diabetes, anemia of chronic disease, peripheral neuropathy, recurrent C.Difficile. History of Acinetobacter bacteremia come into the hospital as direct transfer from Newport given worsening pleural effusion of importance. Pt was recently admitted at Rhode Island Hospital and discharged a few weeks ago after being diagnosed with necrotizing pneumonia. lung disease abscess on CT scan. She underwent BAL and culture grew klebsiella oxytocin which she was treated with Augmentin for 6weeks duration. She had elevated 1,3 Beta D flu an but was deemed to be potentially false positive. She was also found to have Acinetobacter growing from dialysis catheter too and the catheter was removed on 3/8 and a new one was replaced on 3/9. Unfortunately came back from Newport hospital because of progressively worsening shortness of breath as well as well as…Below are three case scenarios. For each scenario determine:1. Most likely enzyme deficiency and which amino acid(s) is no longer metabolized2. If any amino acids become essential as a result of the deficiency3. Potential vitamin supplementsthat may be useful for the condition and whatstepsin themetabolism they could potentially help with Scenario 1: A full-term girl was born by normal vaginal delivery and was released from thehospital at three days of age. At nine days of age a screening test for branched-chainamino acids came back positive and the child was readmitted to the hospital for furtherevaluation. There was no history of any genetic disease in either family, and both oldersiblings were well. Scenario 2: A 69-year-old woman presented with a 30-year history of lower back andlarge joint pain of the hips and shoulders. On examination blue-grey, pigmented maculeswere present over the cartilaginous portions of the ears and on the sclera. Past medicalhistory included aortic…A patient of 28 years old complains of pains in the spine, persistent arterial hypertension. On examination: obesity of the face and trunk with disproportionately thin extremities, acne. Blood revealed hyperglycemia, hypercholesterolemia. It was diagnosed Itsenko-Cushing's disease. Questions: 1. What are the causes of Itsenko-Cushing's disease? 2. Indicate the characteristic changes in concentrations of corticotropin and glucocorticoids in the patient's blood. 3. Explain the pathogenesis of arterial hypertension in the patient. 4. What are the mechanisms of violation of carbohydrate, fat and protein metabolism. 5. How can be explained the pain in the spine of the patient? 6. Describe the changes in the adrenal glands in Itsenko-Cushing's disease. 7. Describe the pathology of the patient's pituitary gland according to the different classifications.
- Given these conditions I. Blood glucose levels are very high I1. Excessive thirst is shown II. Glucose is present in the urine in a large amount IV. Decrease urine output In assessing the patient with untreated diabetes mellitus, which one is LEAST to be manifested by the patient? OIV O IIYour unknown patient is patient 3. Here is the data that will enable your diagnosis: Unknown Case #3: Glucose (blood): normal Glucose (urine): normal CK: abnormal LD: normal Protein: normal Specific Gravity: elevated pH: high, alkaline Ions: increased K+ Urine observation: light to medium yellow Ketones: normal Urobilinogen: normal Include the following information: A sufficient overview/background information to introduce the unknown case. An assessment of the patient history information provided to the student and a hypothesis based on the information contained within the patient history. Data obtained from each of the tests performed (organized in charts or graphs) Discussion of each of the clinical tests performed, what that test can reveal about the health of a patient, the chemistry behind each of the clinical tests completed (i.e. how that test works), and an explanation as to why each of the tests completed would be valuable to the diagnostic process. Evaluation…Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15% His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs . Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet (empagliflozin 5mg, metformin 500 mg), twice daily, with or after food ramipril 5 mg, daily Rosuzet (rosuvastatin…