Mr. Heyden, 72, is brought to the emergency room after an accident at his farm. The...

Mr. Heyden, 72, is brought to the emergency room after an accident at his farm. The paramedics report that his left side was pinned beneath his tractor, and that when he was freed, his left lower quadrant appeared to be compressed. His blood pressure is 90/50 mm Hg and falling, and his heart rate is 116 beats/min. His pulse is thready. Mr. Heyden complains of pain in his left side and then loses consciousness.

1. Mr. Heyden's low blood pressure will trigger certain compensatory mechanisms. Which statement below best reflects the changes in hormone levels that will occur?

Mr. Heyden's ADH, aldosterone, and renin will increase.

Mr. Heyden's ADH and renin will decrease, and his aldosterone will increase.

Mr. Heyden's ADH will decrease, his aldosterone will increase, and his renin will be unchanged.

Mr. Heyden's ADH will increase, and his aldosterone and renin will decrease.

2. Mr. Heyden's blood K+ levels are high. Which of the following best explains his high K+ levels?

Mr. Heyden's increased secretion of aldosterone will cause his K+ levels to increase.

Mr. Heyden's damaged kidneys can no longer adequately remove K+ from his blood.

The loss of Mr. Heyden's spleen means that his aged and fragile erythrocytes are not being removed, and so are rupturing in his blood vessels and releasing K+.

Mr. Heyden's increased secretion of ADH will cause his K+ levels to increase.

Solutions

Expert Solution

1. low blood pressure triggers all the hormones that causes vasoconstriction and water retention

ADH by acting on collecting tubule causes water retention .

Aldosterone causes vasoconstriction and increases sodium and water reabsorption and hence increased blood volume.

Renin converts angiotensinogen into angiotensin 1 which further get converted into angiotensin 2 which causes vasoconstriction and aldosterone release.

therefore 1st option is correct. all hormone levels increases.

a. wrong : because aldosterone causes potassium excretion.

b. wrong because according to case there is history of injury to on left lower quadrant therefore there is chance to damage to either spleen or one /left kisdney

if the left kidney is damaged than its function is compensated by right kidney.

c. right it is the most possible cause .

d.wrong ADH doesn't increases k+ levels it causes dilutional hypokalaemia or no change in k+ levels.

Sydney Mullin answered 4 months ago

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