Application Assignment 5

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School

Pennsylvania State University, World Campus *

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Course

220W

Subject

Medicine

Date

Dec 6, 2023

Type

docx

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Uploaded by AgentDinosaurPerson678

Application Assignment 5 In this assignment, we will return to the case study that we began at the start of the module. First, please re-read the introduction to the case study (“The Hot Tub Mystery”). Then continue reading here: Part II—The Investigation Saturday, 9:30 AM “120 degrees! What is this thing doing so hot?” Sam Garrison asked Kavita as he removed the thermometer from the water. He was investigating the death of Roma and Clint Underhill, prominent real estate brokers in Desert Palm. “This hot tub should be no more than 109 degrees.” He remembered reading a Consumer Product Safety Commission flyer on hot tubs and wondered if the tub was associated with the death. The bodies were being taken away for autopsy as he took in the scene. “Hmm. What about these bottles of wine? It looks like they had a party—all by themselves! The medical examiner will check their blood alcohol level (BAC, or blood alcohol concentration) and we’ll be able to see his complete report on Monday. We may even be able to determine their cause of death with that information. I’ll ask the maid about any medications.”

He went into the sunroom off of the patio to where the maid was being consoled by another officer. “Ma’am, can you tell me if the Underhills were taking any medicine?” “Well, sir, I know Mr. Underhill was complaining about the stress of his job, so his doctor prescribed him something for it about two weeks ago. You might look in the cabinet over the sink where they keep aspirin and such.” Sam looked where she indicated and found a recently-filled bottle of Xanax. Monday Afternoon Monday afternoon, the medical examiner phoned Sam with the following information:  BAC of the couple was 0.20%  Roma weighed 110 lbs; Clint weighed 160 lbs  Time of death estimated at 2 AM Saturday morning  A drug screen was positive for Xanax in Mr. Underhill’s blood, but negative for Mrs. Underhill Part III—The Final Report Later Monday Afternoon Detective Garrison returned to police headquarters and, after reading the medical examiner’s complete report, began the process of writing his own explanation of what happened to the Underhills. As he wrote, he thought about all that had happened and began to wonder about the physiology associated with the couple’s death. The level of alcohol found by the medical examiner was high but was not necessarily sufficient to cause their death, but was it a contributing factor? Sam knew that Xanax was used to treat anxiety and that it, alcohol, and heat will reduce blood pressure, but he was unsure of the mechanism. He decided to go to Noletown University and talk to Dr. Renee Volenbach, a physiologist in the biology department, in her office in the McWhirter Biology building. Renee patiently explained her answer to each of the following questions posed by the detective.

Please answer the following: 1. What are the general effects of alcohol on the brain and other parts of the body? Specifically, what are the effects of a 0.20% BAC on a 160-lb man and a 110-lb woman? (you may have to Google the answer) (2 points) Men who weigh 160 pounds may experience mood swings, decreased vision, hearing, speech, motor skills impairment, and other symptoms after consuming enough alcohol to achieve a blood alcohol concentration of 0.20%. Women who weigh 110 lbs. may develop gag reflex failure and choking on vomit if they have consumed enough alcohol to reach a blood alcohol content level of 0.20% 2. What were the specific effects of the Xanax, hot water, and alcohol on the couple’s blood pressure? (again, Google is your friend) (2 points) The internal organs' body temperatures can rise above safe levels due to high temperatures. No one should use a hot tub if they have recently consumed alcohol. Alcohol causes the body's blood vessels to dilate and its core temperature to rise, which can quickly reach deadly levels. Alcohol use often causes loss of consciousness, heart attacks, injuries from passing out, and falling when using a hot tub. 3. What could the body have done to reverse the decreasing blood pressure, if it had been possible to do so in time? If this response was not sufficient, how might this have led to the death of the couple? (2 points) The body's natural reaction to a decline in blood pressure is to speed up heartbeat and constrict blood arteries to restore more blood to the heart. For more blood to return to the heart for pumping, veins constrict. Arterioles are capable of expanding and contracting. Expanded arterioles reduce blood flow resistance and lower blood

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pressure, where narrowed arterioles increase blood flow resistance and increase blood. blood pressure. The kidney can produce more or less urine depending on changes in blood pressure . 4. Identify several procedures that might have helped save the couple if they had been found by EMT unconscious but still above water and alive. Make sure to include in your answer what might have been done to restore cardiac output and blood pressure? (2 points) The first step would have been to take them out of the water and lay them flat. Giving IV fluids to rehydrate and boost blood volume would be the next step. The legs could have been raised to increase venous return. Another option is to provide an adrenaline shot. 5. Reflection (you only need to answer this question in your final draft, 2 points). Please respond to at least two of the following questions: What was something you learned this week that surprised you, and why? What was a misconception that you previously had about this week’s topic? What was the most confusing topic this week, and why? What is a question that you still have about this week’s topic?

Case study adapted by John Neisser, MD, Penn State University, from the original by Herbert House, Biology Department, Elon University, Elon, NC Copyright © 2005 by the National Center for Case Study Teaching in Science. Originally published 1/17/05 at http://www.sciencecases.org/blood_pressure/blood_pressure.asp (Links to an external site.) Please see our usage guidelines (Links to an external site.) , which outline our policy concerning permissible reproduction of this work.

Application Assignment 5

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