Question

Please rephrase answers in the questions 5–10

5) Explain the cause of her elevated ADH and glucose levels.

Elevated ADH may be caused by the disease known as SIADH which is the syndrome of inappropriate ADH. Furthermore, the presence of lung carcinoma can also account for the elevated ADH; the patient shows a history of smoking. There is a history of diabetes mellitus so that glucose levels will be increased due to insulin deficiency. The glucose level is elevated due to the patient's response to insulin and glucose utilization is impaired. Antidiuretic hormone is elevated because of the dilution. In diabetes mellitus, the flow of urine is increased, as such fluid movement in the body is accelerated because of the glucose- triggered or induced an osmotic diuresis or water loss. (Calhoun, 2017) On the other hand, plasma vasopressin (VP) is elevated in both type 1 and type 2 DM. This elevation seems to be due to a resetting of the osmostat. A high VP level is beneficial in the short term because it limits to some extent the amount of water required for the excretion of a markedly enhanced load of osmoles (mainly glucose). However, in the long run, it may have adverse effects by favoring the development of diabetic nephropathy.

6) What is the correlation between her illnesses and the low vitamins (D, K, E, and A), renin, and aldosterone levels?

Low levels of renin results in hypotension. Renin plays a vital role in activation of angiotensinogen to angiotensin II, a vasoconstrictor which is needed for maintenance of blood pressure. As a result of reduced or low levels of renin, she has hypotension. (Calhoun, 2017)

The hormone aldosterone triggers the kidneys to reabsorb sodium. Low levels of aldosterone results in a reduced level of sodium (hyponatremia) in the body.

The elevated levels of ADH result in high rate of retention of water which occurs in low sodium level in blood. This is responsible for bilateral edema.

The patient’s physical assessment reveals that she has skin discoloration possible jaundice, yellowish sclera, and multiple bruises. This is as a result of the deficiency of or low vitamin A. Furthermore; the patient lab values shows hypocalcemia; this may be as a result of lack of vitamin D as earlier discussed which is useful and vital in the absorption of calcium from the intestine. (Albert, 2013) Low levels of calcium can also be associated with Vitamin K deficiency also because of blood clotting factor functions based on the calcium level in the body.

The patient’s weakness may be associated with vitamin E deficiency. The absence of vitamin E can be problematic to the body as it is an excellent and vital antioxidant needed in the body

7) Which hormone would the body elevate in response to her low calcium levels? Why

There is a low level of calcium in the body. The level of calcium can be regulated and controlled by parathyroid hormone (PTH) (Calhoun, 2017). This hormone helps in decalcification of bones that triggers the release of calcium into blood, t as such increasing reabsorption of calcium in the kidneys. The parathyroid hormone will be elevated or high in response to low calcium levels. This is because parathyroid hormone increases phosphate excretion and increases serum calcium by increasing renal calcium reabsorption. (Silverthorn, 2019)

8) Explain the physiological reason behind her physical findings (yellowish of the skin, sclera, multiple bruises, weakness, and edema).

Jaundice is referred to as discoloration of the skin; it presents itself as yellowish skin, mucous membrane, and sclera. Resulting from high or increased levels of bilirubin in the blood.

Yellowish discoloration of skin, sclera - it is suggestive of icterus. Icterus is a condition caused by hyperbilirubinemia. The presence of this suggests liver pathology.

Skin bruises - this may be due to Vitamin A deficiency or inadequacy as Vitamin A helps in maintaining the integrity of the skin. (Silverthorn, 2019)

Weakness could be as a result of anemia. Weakness is one of the significant symptoms of weakness, and also weakness could be a result of low levels or decreased Vitamin E.

Edema - Aldosterone, and renin play a significant role in edema. Edema is most of the time caused by excessive retention of salt and water in the body. Increased ADH and decreased levels of Renin and Aldosterone can affect the body and cause it to swell

9) Explain the cause of her abnormal stool and urine sample.

There is insufficient excretion of the bilirubin from the liver, due to some obstruction. Due to the inadequate excretion colors of our excreted waste products can change in color. The regular brown color of stool is due to an excretory product of bilirubin, called stercobilin, which is metabolized from bilirubin.

The fat in the stool may also be due to the bile obstruction or gallbladder malfunction. The regular yellow color of urine is as a result of the urobilinogen, which is also an excretory product of bilirubin, as the bilirubin excretion is decreased, the color of output will change. (Silverthorn, 2019)

10) What cell does Glisten work on? Explain how this medication can stimulate insulin secretion

Glisten work on the beta cells of the pancreas. Beta cells secrete insulin which increases glucose metabolism while alpha cells release glucagon. The secretion of insulin is an ionic and electrical event in the membrane. Of the beta cell. If there i no glucose, membrane potential remains stable (-65mV). ATP from the glucose metabolism blocks or closes the K+ ion channels in the membrane. Therefore, more the glucose, more will be the closure of K+ ion channels.

The decreased permeability of K+ ions in the cell will cause depolarization and opening of voltage-gated Ca2+ ion channel opening.

Glisten also function by closing the ATP dependent K+ion channels to close, as such inducing the release or let out of insulin from the beta cells.

Answer 1

5.Explain the cause for her elevated ADH and glucose levels?

A. The cause for her elevated ADH may be any head injury or brain tumor because both hypothalamus and pituitary glands are both in the brain. very high levels of ADH causes fluid imbalances that lead to seizures or cerebral edema.  The presence of lung carcinoma can also be the cause for elevated ADH.smoking habit also leads to it. Another way is also due to diabetes mellitus . The glucose level is elevated due to the patient's response to insulin . Due to diabetes mellitus, the flow of urine is increased, as such fluid movement in the body is accelerated because of the glucose- triggered or induced an osmotic diuresis or water loss.

6. What is the correlation between her illnesses and the low vitamins (D, K, E, and A), renin, and aldosterone levels?

A. Low levles of vitamin D leads to Rickets, low level of vitamin K causes hemorrahagic disease, excessive bleeding and bruising,Low level fo vitamin E causes nerve and muscle damage ,loss of body movement control muscle weakness and vision problems, low level of vitamin A leads to Xerophthalmia,in ability to see in low light.  low levels of renin causes hypotension.  Low levels of aldosterone results in a reduced level of sodium (hyponatremia) in the body.

7. Which hormone would the body elevate in response to her low calcium levels? Why

A.The parathyroid hormone will be elevated or high in response to low calcium levels.This is because parathyroid hormone increases phosphate excretion and increases serum calcium by increasing renal calcium reabsorption.

8. Explain the physiological reason behind her physical findings (yellowish of the skin, sclera, multiple bruises, weakness, and edema).

A. Increased levels of bilirubin in the blood is thephysiological reason for yellowish of theskin..sclera may be due to icterus. Icterus is a condition caused by hyperbilirubinemia. The presence of this suggests liver pathology. Skin bruises may be due to Vitamin A deficiency . weakness could be a result of low levels or decreased Vitamin E.Edema is caused by excessive retention of salt and water in the body. Increased ADH and decreased levels of Renin and Aldosterone can affect the body and cause it to swell

9. Explain the cause of her abnormal stool and urine sample.

A.The fat in the stool may also be due to the bile obstruction or gallbladder malfunction.The regular yellow color of urine is as a result of the urobilinogen, which is also an excretory product of bilirubin, as the bilirubin excretion is decreased, the color of output will change.

10. What cell does Glisten work on? Explain how this medication can stimulate insulin secretion

A.Glisten work on the beta cells of the pancreas. Beta cells secrete insulin which increases glucose metabolism while alpha cells release glucagon.Glisten causes ATP sensitive potassium channels to close thereby releasing insulin.