The Biologic Basis For Disease in Adults And Children Discussion Paper

The Biologic Basis For Disease in Adults And Children Discussion Paper

All answers need to be at least 6 sentences with sources cited

 

 Question 1

Scenario 1: Syndrome of Antidiuretic Hormone (SIADH)

A 77-year-old female was brought to the clinic by her daughter who stated that her mother had become slightly confused over the past several days. She had been stumbling at home and had fallen twice but was able to walk with some difficulty. She had no other obvious problems and had been eating and drinking. The daughter became concerned when she forgot her daughter’s name, so she thought she better bring her to the clinic.

HPI: Type II diabetes mellitus (DM) with peripheral neuropathy x 30 years. Emphysema. Situational depression after death of spouse 6-months ago  The Biologic Basis For Disease in Adults And Children Discussion Paper

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SHFH: – non contributary except for 40 pack/year history tobacco use.

Meds: Metformin 1000 mg po BID, ASA 81 mg po qam, escitalopram (Lexapro) 5 mg po q am started 2 months ago

Labs-CBC WNL; Chem 7- Glucose-102 mg/dl, BUN 16 mg/dl, Creatinine 1.1 mg/dl, Na⁺116 mmol/L,

K⁺4.2 mmol/L, CO₂37 m mol/L, Cl^–97 mmol/L.

The APRN refers the patient to the ED and called endocrinology for a consult for diagnosis and management of syndrome of inappropriate antidiuretic hormone (SIADH).

Question:

1. Define SIADH and identify any patient characteristics that may have contributed to the development of SIADH 

 

Question 2

Scenario 2: Type 1 Diabetes

A 14-year-old girl is brought to the pediatrician’s office by his parents who are concerned about their daughter’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with her school activities. She had been seemingly healthy until about 4 months ago when her parents started noticing these symptoms. She admits to sleeping more and gets tired very easily.  The Biologic Basis For Disease in Adults And Children Discussion Paper

PMH: noncontributory.

Allergies-NKDA

FH:- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process

SH: denies alcohol, tobacco or illicit drug use. Not sexually active.

Labs: random glucose 244 mg/dl.

DIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan.

Question

1. Explain the pathophysiology of the three P’s for (polyuria, polydipsia, polyphagia)” with the given diagnosis of Type I DM.

 

Question 3

Scenario 2: Type 1 Diabetes

A 14-year-old girl is brought to the pediatrician’s office by his parents who are concerned about their daughter’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with her school activities. She had been seemingly healthy until about 4 months ago when her parents started noticing these symptoms. She admits to sleeping more and gets tired very easily.

PMH: noncontributory.

Allergies-NKDA

FH:- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process

SH: denies alcohol, tobacco or illicit drug use. Not sexually active.

Labs: random glucose 244 mg/dl.

DIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan. The Biologic Basis For Disease in Adults And Children Discussion Paper

Question

1. Explain the genetics relationship and how this and the environment can contribute to Type I DM.

 

 

Question 4

Scenario 3: Type II DM

A 55-year-old male presents with complaints of polyuria, polydipsia, polyphagia, and weight loss. He also noted that his feet on the bottom are feeling “strange” “like ants crawling on them” and noted his vision is blurry sometimes. He has increased an increased appetite, but still losing weight. He also complains of “swelling” and enlargement of his abdomen.

PMH: HTN – well controlled with medications. He has mixed hyperlipidemia, and central abdominal obesity. Physical exam unremarkable except for decreased filament test both feet. Random glucose in office 333 mg/dl.

Diagnosis: Type II DM and prescribes oral medication to control the glucose level and also referred the patient to a dietician for dietary teaching.

Question:

1. How would you describe the pathophysiology of Type II DM?  

 

 

Question 5

Scenario 4: Hypothyroidism

A patient  walked into your  clinic today with the following complaints: Weight gain (15 pounds), however has a decreased appetite with extreme fatigue,  cold intolerance, dry skin, hair loss, and falls asleep watching television. The patient also tearfulness with depression, and with an unknown cause and has noted she is more forgetful.  She does have blurry vision. The Biologic Basis For Disease in Adults And Children Discussion Paper

PMH: Non-contributory.

Vitals: Temp 96.4˚F, pulse 58 and regular, BP 106/92,  12 respirations. Dull facial expression with coarse facial features. Periorbital puffiness noted.

Diagnosis: hypothyroidism.

Question:

What causes hypothyroidism?

Knowledge Check

Q1

             SIADH describes a healthcare scenario whereby an individual’s body tends to produce excess extents of antidiuretic hormone (ADH). The excess extents of ADH lead to the body retaining higher extents of water over the required threshold. A possible characteristic that may have led to the development of SIADH is emphysema (Wang et al., 2022). The context is aligned with situational depression after the patient suffered the loss of her spouse. Another characteristic is frequent tobacco use. Another context is the medications being used.

Q2

            Polydipsia takes place due to elevated extents of blood sugar. In this regard, the kidneys tend to generate higher extents of urine. The basis is for eliminating the excess glucose, thereby causing the brain to compel the body to take in more fluids. In Polyuria, the body’s glucose extents tend to be elevated, which compels the body to attempt to eradicate them through passing urine. Consequently, the kidneys tend to filter out more water extents causing elevated extents of the need to pass urine. Polyphagia is attributed to increased hunger feelings due to a failure of glucose to effectively penetrate cells for energy utilization (Bettencourt-Silva et al.). The context is due to reduced insulin extents coupled with resistance. The Biologic Basis For Disease in Adults And Children Discussion Paper

Q3

            Underlying immune reactions towards extracellular vesicles tend to be regulated by alleles. The alleles are highly attributed to the increased threat of the development of Type I Diabetes. Additionally, polymorphisms within genetic make-up that are expressed within β-cell together with the immune system can cause abnormalities in reactions towards environmentally-founded elements. In this regard, Anti-Melanoma Differentiation-Associated gene 5 can trigger the pathogenesis of Type I Diabetes (Esposito et al., 2019). The context is through the modification of β-cell reaction toward extracellular vesicle infections. The triggers include a sedentary lifestyle and eating refined sugars.

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Q4

            The development of Type II Diabetes is attributed to peripheral insulin resistance. Another context is an impairment of the underlying regulation of the generation of glucose. Another context is the reduced functionality of β-cells, which in turn causes their operational failure. The β-cell reduced functionality leads to glucose intolerance and a consequent reduced trans-membranous transportation of glucose. The context is reliant on the glucose-to-glucose sensor complex (Galicia-Garcia et al., 2020). The basis elevates glucokinase levels through the stabilization of proteins together with related impairment of the degradation. The Biologic Basis For Disease in Adults And Children Discussion Paper

Q5

            Hypothyroidism is related to the reduced capability of the thyroid gland to effectively generate sufficient thyroxine. The basis is due to the individual’s immune system attacking the thyroid gland. The context causes harm to the thyroid gland. Another context is due to underlying treatments for thyroid cancer. Another reason is the treatment for an overactive thyroid (Chiovato et al., 2019). The reduced capability of generating thyroxin causes the developed symptoms of the underactive thyroid. The Biologic Basis For Disease in Adults And Children Discussion Paper