what is  Renal insufficiency ? what are causes? symptoms , pathology and trearment

introduction

discussion

conclusion

Scenario: DW is a 65-year-old, 135 kg male who visited his primary care physician for a routine examination. His blood pressure was 158/100 mmHg and his heart rate was 71 bpm. Stroke volume and cardiac output were normal. Serum renin levels were in the normal range.   A chest x-ray revealed left ventricular hypertrophy. Other clinical findings were unremarkable.

For this problem, pharmacologic therapies include diuretics, ACE inhibitors, beta-adrenergic receptor antagonists, and vasodilators. Explain the physiological effects on the cardiovascular system for each of these 4 classes of drugs and why these could be helpful.

1. Do professionals have to have a knowledge of understanding of both biomechanics and kinesiology? Why or Why not?
2. How can each discipline impact the movement of athletes, clients and students?

Case presentation:  Mrs. Lianne Thomson, a Caucasian female of 45 years old with a BMI of 26, presents to the office with dull ache pain and tingling over the right hand, wrist and elbow.  She is a full-time massage therapist with a career of 15 years  and her pain is gradually getting worse during the last month. Symptoms started about two months ago apparently during her long shifts while she is working. This pain is rated as a 5 or 6 out of 10 and increases in intensity specially after a long day at work. Patient have not experienced this type of pain before and there a remarkable past medical, social and family history.  

List 3 Elbow orthopedic test you think would be positive for this case

“My Brother Calls Me ‘Bug Eyes’”: A Case Study on the Endocrine System

Nineteen-year-old Krista waited impatiently as Dr. Weisman scribbled in his chart. She hoped he was scribbling an explanation of what was wrong with her. She was tired of not feeling like herself and tired of being so stressed about it. She was particularly tired of how her eyes seemed to bulge outward, so much that her 10-year-old brother had started calling her “Bug Eyes.”

Dr. Weisman finally put down his pen and looked at Krista. “Well, your blood pressure and pulse are elevated. You’ve lost weight without trying, you have difficulty sleeping, you perspire more than usual and you’ve had continuing bouts of diarrhea. Those things, combined with the swelling in the front of your neck, suggest that you may be suffering from more than the stress of college life. I think we need to run some blood tests to check your thyroid function.”

Krista blinked in surprise. “All of those things can be caused by a problem with my thyroid? Even the way my eyes look?”

Dr. Weisman nodded. “Your thyroid secretes several hormones that have widespread and varied effects. The protrusion of your eyes is a condition called exophthalmos – it is an inflammatory response to abnormal levels of thyroid hormones. The fact that you have this condition in addition to your other symptoms makes me fairly certain this is a thyroid problem.”

Krista hoped Dr. Weisman was right. Having a medical explanation for her symptoms would mean that she wasn’t losing her mind. Several days later, Krista met again with Dr. Weisman.

“Let’s talk about your test results,” he said. “Your thyroid hormone levels are elevated, but your level of thyroid-stimulating hormone (TSH) is lower than it should be. Those results suggest that you probably have Graves’ disease, which means that your thyroid is overactive. But there’s good news too—this is a condition that we can treat relatively easily.”

Krista felt a twinge of relief at the doctor’s words, but a flurry of questions poured out of her mouth. “What made my thyroid go crazy? And what is TSH? If it’s a thyroid hormone, why is it low instead of high like everything else? And what kind of treatment do I need? Will it fix my thyroid? Will I…”

Dr. Weisman laughed and held up his hand to stop the barrage of questions. “Hold on, Krista. I’ll explain everything, and with the right treatment, your brother may not be able to call you ‘Bug Eyes’ much longer.”

Post-Study Questions

1. Name the two hormones commonly referred to as “thyroid hormone” and describe their general actions.

2. Why would an overactive thyroid cause Krista’s weight loss, sweating, and elevated heart rate?

3. Krista wonders if TSH is a “thyroid hormone,” and Dr. Weisman explains that it is not. State the action of thyroid-stimulating hormone (TSH) and name the gland that secretes it.

4. How is the secretion of TSH regulated under normal conditions?

5. In Graves’ disease, the immune system makes antibodies that stimulate TSH receptors on the thyroid gland. What effect does this have on Krista’s thyroid?

6. Why is Krista’s TSH level low instead of high?

1. What is the term for the equilibrium of the body's internal environment due to the interaction of multiple regulatory processes?
2. Which part of a feedback system receives output from a control center and creates a response or effect to change a controlled condition?
3. The standard position by which all anatomical descriptions are expressed in relation to each other is known as which of the following?
4. Which type of feedback system tends to strengthen or reinforce a change in a controlled condition?
5. Which type of tissue creates movement in the body and generates heat?
6. Which type of tissue connects, protects, and supports organs and distributes blood vessels to other tissues?
7. Which structural level of organization includes atoms and molecules?
8. Which type of tissue produces chemicals and fluid that digests food in the stomach?
9. Which anatomical name for the major region of the body known commonly as the neck?
10. Which type of feedback system reverses changes in a controlled condition?
11. Which structural level of organization encompasses the entire body and all levels of organization within it?
12. What is composed of two or more different types of tissues?
13. The respiratory system transfers oxygen from inhaled air to the blood. What does it transfer from the blood to exhaled air?
14. Which system of the human body breaks down food physically and chemically and absorbs nutrients?
15. Which of the following is a component of the lymphatics system? 1- Epididymides 2- thymus 3- parathyroid gland 4- gallbladder
16. Which system of the human body houses the cells that produce blood cells?
17. Which system of the human body releases hormones to regulate body activities?
18. The urinary system includes which of the following components? 1- Urethra 2- Uterus 3- Uterine tubes 4- Thymus
19. Which of the following systems produce sounds via air passing out of the lungs through the vocal cords? 1- Nervous 2- Integumentary 3-Lymphatic 4- Respiratory
20. The muscular system includes which type of voluntarily controlled muscle tissue? 1- cardiovascular 2- Skeleton
21. Within the thoracic cavity, which of the following is the space surrounding the heart? 1- Pericardial cavity 2- pleural cavity 3- mediastinum 4- diaphragm
22. Which of the following organs is included in the pelvic cavity? 1- Urinary bladder 2- Liver 3- kidney 4- Spleen
23. In the system of dividing the abdominopelvic cavity into nine regions, what line is drawn through the midpoint of the left clavicle, just medial to the left nipple?
24. Which of the following is the dome-shaped structure separating the thoracic and abdominopelvic cavities? 1- Mediastinum 2- Diaphragm 3- Pericardium 4- Pleura
25. The protective tissues surrounding the brain and spinal cord are known as what?
26. The dorsal cavity includes the cranial cavity and what?
27. Which of the following is a term for one of the nine regions of the abdominopelvic cavity? 1- Mediastinum 2- Right upper quadrant 3- Hypogastric 4- parietal
28. Within the thoracic cavity, what is the term for the spaces surrounding the lungs?
29. What type of movement is characterized by an increase in the angle between the articulating bones of a synovial joint?
30. What type of movement is characterized by a lateral movement of the sole of the foot, away from the midline?
31. Which directional term means on the opposite side of the body from another structure?
32. Which directional term means nearer to the attachment of a limb to the trunk or nearer to the origination of a structure?
33. A transverse plane is also known as what?
34. Which directional term means on the same side of the body as another structure?
35. Which directional term, also known as DORSAL, means nearer to or at the back of the body?
36. Which movement is characterized by a decrease in the angle between the articulating bones of a synovial joint?
37. Which movement is characterized by a movement of the forearm in which the palm is turned anteriorly, a position that is one of the defining features of the anatomical position?
38. A midsagittal plane is also known as what?
39. Which movement is characterized by the movement of a body part in a circle?
40. Which regions of the upper limb is also known as the fingers?
41. The spinal column is also known as what region?
42. The sternal region is a component of which body regions?
43. Which region of the lower limb is also known as the space behind the knee?
44. The cheeks are also known as which region?
45. The chest is also known as which region?
46. The cranial and facial regions are parts of which major region of the body?
47. The region known as the lower limb is attached to the trunk and includes a thigh, leg, ankle, foot, and what?
48. Which of region of the upper limb is also known as the forearm?
49. Which region is also known as the navel?
50. The eyes are also known as what region?

Provide an example for a virulence bacteriophage, and name the species of the bacterial host and function of that carried bacteriophage?

(A generic example and definition is sufficient)

1. Most of us produce about _?_ of filtrate per day.

   		180 liters
   		180,000 gallons
   		2.5 liters
   		0.8 liters
   		None of these are correct

filtration in the many glomerular capsules is somewhat constant except for certain conditions.  Which of the following may alter GFR?

Which choice represents an accurate route for urine?

Why does aldosterone secretion help during periods of dehydration?

The capillaries that surround the renal tubules originate at the....

1. Blood supply TO the kidneys comes from the....

   		Renal vein
   		Abdominal aorta
   		Azygos vein
   		Thoracic Aorta
   		Inferior Vena Cava

Why would sodium reabsorption help maintain body fluid volume?

The loop of the nephron is primarily located in which 'layer' of the kidney?

Describe how water is distributed in the body (which compartments have the water and what proportion do they have). What is a typical blood volume for a person? What is a typical plasma volume. List the main routes of water gain and loss for the body. Of the ways a person gains or loses water, which are normally the most important (targets of physiological regulation).

What are the four component proteins of muscle cells, which compose the sarcomere? Describe how they interact with one another and allow for muscle contractions.

Describe in detail the anatomy and how the brain functions in of the awareness of sensory input, the control of skeletal muscles, and memory.

16. upon recognition of pathogen, b cells will trigger

a.antibody production and formation of memory cells

b. cell destruction via cytotoxic t cells

c. inflammation and interferon cascades

d. all of the above

17. an infected body cell will display __ and be recognized by __

a. MHC I and MHC II surface markers; cytotoxic and helper t cells

b. MHC I surfacee markers with an antigen; cytotoxic t cells ( CD8)

c. MHC II surface markers with ana antigen; helper t cells (CD4)

d. MHC X surface markers with an antigen; cytotoxic and helper t cells

19. what is one example of the fate of a pathogen after it has been tagged by an antibody?

a. antibodies carry the pathogen to lymphoid tissues for destruction

b. antibodies quickly bind to and degrade the pathogen surface

c. antibodies remove and destroy cellular proteins inside the pathogen

d. antibodies trigger the complement system to lyse the pathogen

20. Upon recognition of a pathogen, the role of the helper t cell (CD4) is to:

a. activate b cells

b. activate cytotoxic t cells

c. attract neutrophils and macrophages

d. all of the above

21. memory b cells within the immune system will respond during the ___

a. innate immune response

b. intermediate immune response

c. primary immune response

d. secondary immune response

23. which of the following contains all of the correct structures in the conducting zone?

a. bronchi, terminal bronchioles, respiratory bronchioles, alveoli

b. nasal cavity, pharynx,larynx, trachea, bronchi, terminal bronchioles

c. pharynx, larynx, trachea, bronchi

d. respiratory bronchi, alveoli

24. the function of cilia and mucus in the respiratory tract is:

a. facilitate movement of particles into the lungs

b. increases surface area for diffusion in the lungs

c. trap and remove debris from the respiratory passageways

d. all of the above

1. An individual has an excess of glucose and converts the glucose into fatty acids for better storage capacity. Briefly review the steps required. Can the opposite occur?
2. An individual has an excess of amino acids and converts the amino acids into fatty acids for better storage capacity. Briefly review the steps required. Can the opposite occur? Why or why not?