Case study: a 55 year old man with no history of illness suffered a blow to the head. He was unconcious when admitted to the hospital and remained in that state until his death 15 days later. A nasogastric tube was inserted to administer the required nutrients (protein, carbohydrates, fat, minerals and vitamins). The total water intake was 1,500 ml/d. Starting on day 5, his blood pressure gradually fell. The 24 hour urine volumes recorded from an indwelling catherter are listed below: Day After admission urine volume (ml/24 h) 6 1,500 8 1,300 10 1,200 12 1,100 14 900 Patients hemoglobin and hemtocrit were elevated Laboratory results for blood chemistry on day 13 are shown Test Results Reference Intervals total protein 9.4 g/dL 6.5-8.3 g/dL Albumin 6.0 g/dL 3.5-5.0 g/dL Blood Urea Nitrogen(BUN) 80mg/dL 5-20 mg/dL Sodium 175 mmol/L 136-145 mmol/L Potassium 4.0 mmol/L 3.5-5.1 mmol/L Chloride 134 mmol/L 98-107 mmol/L 1. What is the most likely explanation for the elevated total protein concentration? 2. What other results support this conclusion? 3. What is the blood urea nitrogen result elevated?
Case study:
a 55 year old man with no history of illness suffered a blow to the head. He was unconcious when admitted to the hospital and remained in that state until his death 15 days later. A nasogastric tube was inserted to administer the required nutrients (protein, carbohydrates, fat, minerals and vitamins). The total water intake was 1,500 ml/d. Starting on day 5, his blood pressure gradually fell. The 24 hour urine volumes recorded from an indwelling catherter are listed below:
Day After admission urine volume (ml/24 h)
6 1,500
8 1,300
10 1,200
12 1,100
14 900
Patients hemoglobin and hemtocrit were elevated
Laboratory results for blood chemistry on day 13 are shown
Test Results Reference Intervals
total protein 9.4 g/dL 6.5-8.3 g/dL
Albumin 6.0 g/dL 3.5-5.0 g/dL
Blood Urea Nitrogen(BUN) 80mg/dL 5-20 mg/dL
Sodium 175 mmol/L 136-145 mmol/L
Potassium 4.0 mmol/L 3.5-5.1 mmol/L
Chloride 134 mmol/L 98-107 mmol/L
1. What is the most likely explanation for the elevated total protein concentration?
2. What other results support this conclusion?
3. What is the blood urea nitrogen result elevated?
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