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INSTRUCTIONS FOR THE MID TERM EXAM TO RECEIVE FULL CREDIT FOR THIS EXAM, YOU MUST DO ALL OF THE FOLLOWING:  It must be in complete sentences, paragraph form, and grammatically correct.  Answers that are word for word from a source or in long quotes will not be accepted.  It must be in Times Roman with minimum font of 12.  No abbreviations will be accepted. Incorrect = Pu Correct = Polyuria  It must be turned in by the due date and time EXAMS WILL BE ACCEPTED PAST THE DUE DATE and TIME!  It must be submitted through the assignment feature attached as a file. Make sure that you name the file as , “Last Name_ MIDTERM EXAM  Your documents should be in doc or docx format.  Include any sources used to answer the questions using APA format  Answer all of the questions correctly! MIDTERM EXAM CASE #1 Maria is a sedentary, 68-year-old woman who is overweight. She complains that her hands and feet are always cold, and she tires quickly when cleaning the house. At her most recent visit to her doctor, her blood pressure was 184/98 mm Hg. She has edema around her ankles and legs, and her physician is concerned about an echocardiogram that indicates Maria has an enlarged heart. 1. Identify and discuss two reasons why Maria will have tissue ischemia. How, specifically, might this lead to hypoxia? (10 points) 2. What two early and reversible changes occur to tissue cells when they are hypoxic? (5 points) 3. What specific type of cellular adaptation has taken place in Maria’s enlarged heart? What made you come to this conclusion? (5 points) 4. Predict why Maria’s heart has become enlarged. Why doesn’t this enlargement give her the same cardiac strength and endurance as a well-trained athlete? (10 points) CASE #2 You are working in a community health center and caring for a 5-year-old child who was diagnosed as having a right ear infection. When collecting the history, the mother states the child has had a fever of 102°F for 2 days, has been irritable, and complained of feeling tired. The child has been drinking fluids well but not eating. The physician describes the tympanic membrane as erythematous, bulging with fluid levels, and dull. You collect the following vital signs: Temperature 102 Pulse. 110, and Respiration rate 18. 1. Which of the clinical manifestations given are associated with a localized inflammatory response? What physiological factors are responsible for the development of these manifestations? (15 POINTS) 2. If the physician ordered a complete blood count, what would you expect to see if there is a bacterial infection? (10 POINTS) CASE #3 Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient, she was reluctant about the treatment. She was convinced she was overweight because her clothes felt tight on her. She complained that even her hands and feet were fat. Her physician explained that a protein in her blood was low. It was further explained that, as difficult as it may be to believe, eating a normal healthy diet would make the “fat hands and feet” go away. 1. What protein do you suspect the nurse was referring to? How would a deficiency in this protein contribute to edema? (15 points) 2. Because of her weakened condition, Amanda was moved around the ward in a wheelchair when she wasn’t on bed rest. Explain how this might affect her edematous tissues. (10 points) CASE #4 Leona is 52 years old and smokes. She is also overweight and has atherosclerosis. When she was given a 2-week vacation from work, she packed up her bags and flew from Minnesota to Sydney, Australia for the trip she always wanted to take. Unfortunately, just 3 days after she arrived, she was hospitalized when her left calf became inflamed, causing her considerable pain. Compression ultrasonography revealed popliteal vein thrombosis. Doppler color flow imaging depicted absent flow in the area. 1. Explain, using you knowledge of hypercoagulability, what condition does Leona have and why was the trip to Australia a contributing factor to Leona’s condition? Why was Leona already at risk for this condition? (10 points) 2. How does Leona’s atherosclerosis affect platelet function? Conversely, what is the effect of increased platelet activity on the development of atherosclerosis? (5 points) 3. Compare and contrast how atherosclerosis and immobility promote changes in blood coagulation. (5 points) 4. When Leona was in the hospital, she received heparin therapy. Explain why this course of action was taken to treat her condition? (5 points)

  • INSTRUCTIONS FOR THE MID TERM EXAM
    TO RECEIVE FULL CREDIT FOR THIS EXAM, YOU MUST DO ALL
    OF THE FOLLOWING:
     It must be in complete sentences, paragraph form, and
    grammatically correct.
     Answers that are word for word from a source or in long quotes
    will not be accepted.
     It must be in Times Roman with minimum font of 12.
     No abbreviations will be accepted.
    Incorrect = Pu
    Correct = Polyuria
     It must be turned in by the due date and time
    EXAMS WILL BE ACCEPTED PAST THE DUE DATE and TIME!
     It must be submitted through the assignment feature attached as
    a file. Make sure that you name the file as , “Last Name_ MIDTERM
    EXAM
     Your documents should be in doc or docx format.
     Include any sources used to answer the questions using APA
    format
     Answer all of the questions correctly!
    MIDTERM EXAM
    CASE #1
    Maria is a sedentary, 68-year-old woman who is overweight. She complains that her
    hands and feet are always cold, and she tires quickly when cleaning the house. At her
    most recent visit to her doctor, her blood pressure was 184/98 mm Hg. She has edema
    around her ankles and legs, and her physician is concerned about an echocardiogram
    that indicates Maria has an enlarged heart.
    1. Identify and discuss two reasons why Maria will have tissue ischemia. How,
    specifically, might this lead to hypoxia? (10 points)
    2. What two early and reversible changes occur to tissue cells when they are
    hypoxic? (5 points)
    3. What specific type of cellular adaptation has taken place in Maria’s enlarged
    heart? What made you come to this conclusion? (5 points)
    4. Predict why Maria’s heart has become enlarged. Why doesn’t this enlargement
    give her the same cardiac strength and endurance as a well-trained athlete?
    (10 points)
    CASE #2
    You are working in a community health center and caring for a 5-year-old child who
    was diagnosed as having a right ear infection. When collecting the history, the mother
    states the child has had a fever of 102°F for 2 days, has been irritable, and complained
    of feeling tired. The child has been drinking fluids well but not eating. The physician
    describes the tympanic membrane as erythematous, bulging with fluid levels, and
    dull. You collect the following vital signs: Temperature 102 Pulse. 110, and
    Respiration rate 18.
    1. Which of the clinical manifestations given are associated with a localized
    inflammatory response? What physiological factors are responsible for the
    development of these manifestations? (15 POINTS)
    2. If the physician ordered a complete blood count, what would you expect to see if
    there is a bacterial infection? (10 POINTS)
    CASE #3
    Amanda is an 18-year-old with anorexia nervosa. She was recently admitted to an
    eating disorders clinic with a BMI of 13.9, and although she was a voluntary patient,
    she was reluctant about the treatment. She was convinced she was overweight because
    her clothes felt tight on her. She complained that even her hands and feet were fat.
    Her physician explained that a protein in her blood was low. It was further explained
    that, as difficult as it may be to believe, eating a normal healthy diet would make the
    “fat hands and feet” go away.
    1. What protein do you suspect the nurse was referring to? How would a
    deficiency in this protein contribute to edema? (15 points)
    2. Because of her weakened condition, Amanda was moved around the ward in a
    wheelchair when she wasn’t on bed rest. Explain how this might affect her
    edematous tissues. (10 points)
    CASE #4
    Leona is 52 years old and smokes. She is also overweight and has atherosclerosis.
    When she was given a 2-week vacation from work, she packed up her bags and flew
    from Minnesota to Sydney, Australia for the trip she always wanted to take.
    Unfortunately, just 3 days after she arrived, she was hospitalized when her left calf
    became inflamed, causing her considerable pain. Compression ultrasonography
    revealed popliteal vein thrombosis. Doppler color flow imaging depicted absent flow
    in the area.
    1. Explain, using you knowledge of hypercoagulability, what condition does
    Leona have and why was the trip to Australia a contributing factor to Leona’s
    condition? Why was Leona already at risk for this condition? (10 points)
    2. How does Leona’s atherosclerosis affect platelet function? Conversely, what is
    the effect of increased platelet activity on the development of atherosclerosis?
    (5 points)
    3. Compare and contrast how atherosclerosis and immobility promote changes in
    blood coagulation. (5 points)
    4. When Leona was in the hospital, she received heparin therapy. Explain why
    this course of action was taken to treat her condition? (5 points)

  • ANSWERS

  • NAME OF STUDENT:

                 COURSE CODE:

                COURSE TITLE:

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    Case 1

    Her hands and feet are cool, weakened flow may be expected diminished perfusion of tissue – her expanded heart (hypertrophy of the cells) that impacts cardiovascular yield; or edema.

    Two early and reversible cell changes seen with hypoxia are the accompanying:

    Anaerobic digestion system and the generation of lactic corrosive

    The disappointment of Na+/K+ pumps bringing about cell swelling

    Versatile pathologic hypertrophy. Hypertrophy happens rather than hyperplasia in the heart in light of the fact that muscle strands are not able to experience mitotic division.

    Maria heart has extended because of her larger than usual weight and for the blood to be pumped all through the body the heart utilizes a considerable measure of power bringing about its extension for the blood discovers vacuum space in it, because of her weight the heart is secured with a great deal of fat and the additional vacuum space the blood discovers give her the vitality and additional quality

     

    Case 2

    It is said to be the right ear’s disease the ear protruding is being brought about by the level of liquid since the kid has been taking a great deal of water than eating and has been bad tempered bringing on his bluntness

    The blood comprise of red platelets and white platelets and because of the contamination the blood number results would demonstrate the kid invulnerability is low because of less white platelets in the body subsequent to the vast majority of them are tainted by the contamination this will results to powerless safety in the body which help to battle the contamination and ailments in the body, the feeble white platelets is brought on because of most white cells are exhausted

     

    Case 3

    Amanda was giving low serum egg whites. Egg whites has a low atomic weight and high focus in the plasma, permitting it to make an in number colloidal osmotic weight. At the point when egg whites

    levels are diminished, the serum osmotic slope decreases. Liquid along these lines leaves the vessels to the encompassing interstitial space.

    Setting edema is an aftereffect of an expanded level of interstitial liquid that surpasses the absorptive limit of the tissue gel. The edema is portable and can move with weight. Nonpitting edema includes the relocation of hair like liquid and plasma proteins into the tissue space. The protein coagulates and makes a firm edema that does not move with weight.

    Edema expands the separation between tissue cells and course. The dissemination of gasses, supplements, and squanders between tissue cells and vessels is thusly diminished. Edema can likewise mechanically pack tissue vessels. Both circumstances leave tissues inclined to ischemic harm and, when the patient is fixed, weight ulcers.

     

    Case 4

    At the point when going via plane, especially for long stretches, the individual is generally stable. Stasis prompts an aggregation of actuated coagulating elements and platelets. Idleness likewise diminishes compound cooperation’s with coagulation inhibitors. The finished result is an expanded danger for thrombus development. In Leona’s circumstance, her weight and smoking propensity were extra hazard elements for the condition.

    Atherosclerosis irritates the stream of blood and harms vessel endothelium bringing on an increment in platelet adherence. There is additionally an expanded affectability by platelets to variables that cause adhesiveness and accumulation.

    Following platelets discharge development considers that upgrade smooth muscle expansion in the vessel divider. Thus, platelet total has the capacity add to the advancement and movement of atherosclerosis.

    Both conditions build coagulability. Atherosclerosis builds platelet capacity by empowering collection and adherence. Fixed nature, conversely, adds to hypercoagulability by expanding procoagulation variables.

    Heparin viably supports the inactivation of thickening components, in this manner hindering fibrin development. Heparin can’t be consumed through the gastrointestinal framework and must be controlled by infusion or IV implantation.

     

    REFERENCES:

    McGuire, J. (2008, October 21). Blood pressures, heart rate and locomotor activity during salt loading and angiotensin II infusion in protease-activated receptor 2 (PAR.sub.2 ) knockout mice.(Research article)(Report). BMC Physiology.

    Petrovic, J. (2007, May 2). Hypoxia-inducible factor-1 (HIF-1) is involved in the regulation of hypoxia-stimulated expression of monocyte chemoattractant protein-1 (MCP-1/CCL2) and MCP-5 (Ccl12) in astrocytes. Journal of Neuroinflammation.

    Fowler, J. (2010, June 1). Case of the month.(Clinical report). JAAPA-Journal of the American Academy of Physicians Assistants.

    Lucas, A. (2004). Demystifying anorexia nervosa an optimistic guide to understanding and healing. New York: Oxford University Press.

    Tate, G. (1990). The blood coagulation mechanism and hypercoagulability. University of Leeds.