Josie Bechler and Emilie Konen
Part 1
1. Are any of the lab values in Table 1 out of normal range? Do you see some that are too high or too low? The serum creatine levels, the BUN, the urinary potassium, the serum pH and sodium clacium are high.
The sodium levels were low.
2. Which of the lab values gives you information about how Mrs. Burroughs’ kidneys are functioning?
The BUN and creatine levels
3. Does Mrs. Burroughs have acidosis or alkalosis? Why do you think this?
She has alkalosis based on her high pH level.
4. Why is the physician interested in Mrs. Burroughs’ kidney function?
All the symptoms that were described were based on the kidney functions, so more and further examination on the kidneys is needed
5. What else
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5. What are normal levels for PTH?
150-300 pg/ml
Part 31. What enzyme catalyzes the formation of H2 CO3 from CO2 and H2O? (This enzyme also catalyzes the formation of H2 O and CO2 from H2 CO3 .)
It is carbonic anhydrase.
2. The diagram above (Figure 1) outlines the mechanism by which H+ is actively secreted into the PCT of the kidney nephron. What other substances must be transported from the tubular fluid into the PCT cell
(across the apical or luminal membrane) or from the PCT cell into the interstitial fluid (across the basolateral membrane) as part of the transport of the H+?
Potassium ions, Hydrogen ions, Ammonium ions, creatinine, urea, and hormones.
3. What would happen to the amount of H+ secreted into the renal tubule if the activity of the Na+ /K+
ATPase were increased? Are there diseases or other conditions that might enhance the activity of this sodium pump?
If there is more NA it the ATPase will have trouble pumping correctly causing problems in the kidneys and urination.
Part 41. Is there a problem with Mrs. Burroughs’ breathing? What kind of change (if any) do you expect to see in the respirations of a person with metabolic alkalosis?
There is no problem in her breathing at this time, but eventually there may be shortness in breath which can cause apnea and cyanosis.
2. Can you draw a diagram that shows how the respiratory system, under the control of the central nervous system, responds to
Consequently, the efferent arteriole, which filters blood away from the glomerulus, is tinier in diameter than the afferent arteriole, which carries blood into each glomerulus. This puts blood under high pressure in the glomerulus; thus it forces tiny molecules and liquid out of the capillary and into the Bowman’s capsule. Soon afterwards, the tiny and liquid molecules cross the epithelium of the Bowman’s capsule, the basement membrane and capillary wall in order to get into the Bowman’s capsule and to arrive in the nephron tubules. The consequence of this is that the filtrate (the tiny and liquid molecules) pass along the remainder of the nephron and helpful substances are reabsorbed along the route. Last of all, “the filtrate flows through the collecting duct and passes out of the kidney along the ureter” as mentioned by (Parson’s, R: p128).
13. Understand the transportation of potassium and sodium across plasma membranes. (p. 10 bottom right, p. 20 bottom right, p. 21 diagram)
The decrease in her PCO2 and pH will cause her central nervous system to slow down causing her breathing to slow down to try to give her body more carbon dioxide to level out the amount of oxygen/carbon dioxide ratio.
Due to the mechanical ventilator, it is able to assist in oxygen perfusion to all of her tissue. Thus, the lungs will be able to expand appropriately.
10. What structural modification of certain tubule cells enhances their ability to reabsorb substances from the filtrate?
Admission Lab Work Sodium 135 mEq/L Potassium 3.4 mEq/L Chloride 99 mEq/L BUN 18 mg/dL Creatinine 1.0 mg/dL Hemoglobin 11 g/dL
His vital signs are as follows: BP 172/100, heart rate 92 beats per minute, and a temperature of 102.2 F. There have been some labs done. His red blood count is 3.1 million cells, white blood count is 22,000 cells, potassium is 5.4 mEq/L, calcium is 6.8 mg/dL, phosphate is 4.3 mEq/L, urea is 37 mg/dL, creatinine 2.0 mg/dL, albumin is 2.9 mg/dL, and pH is 7.29. With labs like these, more testing was done. A chemistry panel which showed protein 1.7
What level of [H+] was present in the urine at each of these PCO2/pH levels? Pco2- 35/ H+ normal, Pco2-30/ H+ decreased, Pco2-20/H+ decreased
In patients with renal failure the two most common electrolyte abnormalities are hyperkalemia and hypermagnesemia. Hyperkalemia results due to decreased renal excretion resulting from renal failure. Both of these abnormalities are initially treated with IV calcium gluconate if the patients are symptomatic. The calcium is given to antagonize the effects of hyperkalemia and hypermagnesemia. The calcium acts to protect the heart muscle temporarily until other treatments can be administered. It is imperative to monitor the patient closely with and ECG when IV calcium is administered due to calcium induced
The drug that do not enter the glomerular filtrate leaves the glomeruli though efferent arterioles. The arterioles divide to form a capillary plexus surrounding the nephric lumen in the proximal tubule. The occurrence of secretions mainly occurs in the proximal tubule. This happens by active transport, one for anions and one for cations. Active transport requires energy. The two systems have low specificity and can transport many compounds. [2]
In addition, DEX exposure may contribute to renal apoptosis and impaired expression of genes involved in nephrogenesis leading to reduced nephron number (Tain et al., 2014). On the other hand, sodium transport regulation in the kidney is important to maintain the regulation of extracellular fluid volume and arterial blood-pressure (Knepper and Brooks, 2001). Some studies showed that DEX-induced programmed hypertension can be the result of alteration in the kidney transporters including increase in the protein expression of type 3 Na+/H+ exchanger (NHE3), Na+-K+-2Cl− cotransporter (NKCC2), and Na+-Cl− cotransporter (NCC). The upregulation of two critical renal Na transporters Na-K-2Cl and Na-Cl in prenatally programmed hypertension suggested that increased Na+ reabsorption in thick ascending limb and distal convoluted tubule plays an important role in the development of hypertension (Manning et al.,
In this assignment I will be explaining the physiology of the cardiovascular system and the respiratory system. Whilst explaining the two body systems I will be explaining energy production, process of cellular respiration, the role of enzymes within these body systems, the way that these systems absorb food and the products of digestion.
The amount of glucose detected in the urine was 500 mg/d, measuring above the norm of 130-180 mg/d. A high glucose concentration could be associated with calcium oxalate and calcium phosphate. High levels of glucose may occur with diabetes, renal glycosuria, and pregnancy. A follow-up test for diabetes may be given for these reasons. There was a small indication of bilirubin in the urine sample which should normally pass into the liver. Presence of bilirubin cold indicate live damage or diseases such as hepatitis. No ketones were found in the urine we sampled which is normal. The specific gravity of the urine reflects the patient’s hydration status and the sample measured a normal 1.030. In the urine sample there was a trace amount of blood found. This could require additional resting for a sign of kidney damage or infection, kidney or bladder stones or cancer, and blood disorders. Blood also creates a change in the color of urine, perhaps this had something to do with the abnormal coloring of the urine sample. The PH and urobilinogen were both identified as normal by the test. A trace amount leukocytes were identified in the urine. A small amount of leukocytes are normal and expelled in the urine when they are damaged or killed when fighting an infection. A high number of leukocytes may show signs of infection in the urinary system and create cloudy and foul smelling urine. A positive
Increase in serum creatinine (SCr) by > 0.3 mg/dl (> 26.5 µmol/l) within 48 hours. OR
The next assessment would consist of biochemical parameters, which are laboratory tests. The lab tests that Josephine participated in include albumin, sodium, potassium, iron and vitamin B12. Her results show a decreased value in albumin, sodium, iron and vitamin B12. Albumin is a test that provides the measurement of visceral protein stores in the body. Low albumin levels can be caused by malnutrition caused by difficulty absorbing and digesting protein. These types of issues are usually signs of Crohn’s disease or Celiac disease. A sodium test is used to determine if the body is experiencing abnormal levels of sodium. Being a salsa instructor, Josephine needs to stay hydrated, meaning she would increase her intake of water during her time of exercise whether it be during a dance class or in the gym.