A 38-year old man was admitted with a 3-day history of severe diarrhea with some nausea and vomiting. During this period his only intake was water. He was weak, unable to stand and when recumbent his pulse was 106/minute and blood pressure was 110/50 mmHg. On admission, his biochemistry results were: Analyte Result Reference range Na+ 129 135-145 mmol/l K+ 2.9 3.5-5.0 mmol/l Cl- 85 95-105 mmol/l HCO-3 18 21-28 mmol/l Urea 19 2.5-8.0 mmol/l Creatinine 160 40-130 mmol/l 2. What is the most appropriate treatment for this patient and comment on the patient’s results
- A 38-year old man was admitted with a 3-day history of severe diarrhea with some nausea and vomiting. During this period his only intake was water. He was weak, unable to stand and when recumbent his pulse was 106/minute and blood pressure was 110/50 mmHg. On admission, his biochemistry results were:
|
Analyte |
Result |
Reference range |
|
Na+ |
129 |
135-145 mmol/l |
|
K+ |
2.9 |
3.5-5.0 mmol/l |
|
Cl- |
85 |
95-105 mmol/l |
|
HCO-3 |
18 |
21-28 mmol/l |
|
Urea |
19 |
2.5-8.0 mmol/l |
|
Creatinine |
160 |
40-130 mmol/l |
2. What is the most appropriate treatment for this patient and comment on the patient’s results
3. Briefly explain the various types fluid spacing
4. A 27-year old man is admitted to Sunyani regional hospital with a week long history of severe vomiting. He appeared clinically severely dehydrated with shallow breathing. Initial biochemistry results were:
|
Analyte |
Result |
Reference range |
|
Arterial blood gases |
|
|
|
H+ |
27 |
35-45 mmol/l |
|
PCO2 |
8.1 |
4.6-6.0 kPa |
|
HCO-3 |
46 |
21-28 mmol/l |
|
Serum results |
|
|
|
Na+ |
148 |
135-145 mmol/l |
|
K+ |
2.2 |
3.5-5.0 mmol/l |
|
Cl- |
83 |
95-105 mmol/l |
|
HCO-3 |
43 |
21-28 mmol/l |
|
Urea |
29 |
2.5-8.0 mmol/l |
|
Creatinine |
136 |
40-130 mmol/l |
5. What is the acid-base disorder and comment on the results?
6. Establish the relationship between kwashiorkor and edema.
7. Briefly explain the Renin-angiotensin mechanism indicating the treatment or drug target sites of hypertensive patients in regulating blood pressure.
8. A 63-year old man took four bottles of Kasepreko, an alcoholic beverage at a funeral ceremony and refused to eat my food. He wakes up early morning at the funeral grounds feeling very hungry but again refused to eat but rather ordered for alcohol. Hours later, after he had drunk the alcohol, he became unconscious and was rushed to the nearest hospital and later developed coma. A request by the clinician and a blood analysis by the laboratory scientist revealed low blood glucose levels. Briefly explain the mechanism behind the low blood glucose level and the development of coma by the patient.
9. A 72-year old female diabetic patient in a state of ketoacidosis and was found to be breathing rapidly. Laboratory investigations revealed low HCO-3, low PaCO2 and high PaO2. Briefly explain what account for the low HCO-3, low PaCO2 and PaO2.
10. Establish the link between prolonged use of aspirin and damage to the kidneys and stomach ulcer.
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