Question 1
\nScenario 1: Syndrome of Antidiuretic Hormone (SIADH)
\nA 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\u2019s name, so she thought she better bring her to the clinic.
\nHPI: Type II diabetes mellitus (DM) with peripheral neuropathy x 30 years. Emphysema. Situational depression after death of spouse 6-months ago
\nSHFH: – non contributary except for 40 pack\/year history tobacco use.
\nMeds: Metformin 1000 mg po BID, ASA 81 mg po qam, escitalopram (Lexapro) 5 mg po q am started 2 months ago
\nLabs-CBC WNL; Chem 7- Glucose-102 mg\/dl, BUN 16 mg\/dl, Creatinine 1.1 mg\/dl, Na+116 mmol\/L,
\nK+4.2 mmol\/L, CO237 m mol\/L, Cl-97 mmol\/L.
\nThe APRN refers the patient to the ED and called endocrinology for a consult for diagnosis and management of syndrome of inappropriate antidiuretic hormone (SIADH).
\nQuestion:
\n1. Define SIADH and identify any patient characteristics that may have contributed to the development of SIADH (100 words)<\/p>\n
Question 2
\nScenario 2: Type 1 Diabetes
\nA 14-year-old girl is brought to the pediatrician\u2019s office by his parents who are concerned about their daughter\u2019s 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.
\nPMH: noncontributory.
\nAllergies-NKDA
\nFH:- maternal uncle with \u201csome kind of sugar diabetes problem\u201d but parents unclear on the exact disease process
\nSH: denies alcohol, tobacco or illicit drug use. Not sexually active.
\nLabs: random glucose 244 mg\/dl.
\nDIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan.
\nQuestion
\n1. Explain the pathophysiology of the three P\u2019s for (polyuria, polydipsia, polyphagia)\u201d with the given diagnosis of Type I DM. (150 words)
\nQuestion 3
\nScenario 2: Type 1 Diabetes
\nA 14-year-old girl is brought to the pediatrician\u2019s office by his parents who are concerned about their daughter\u2019s 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.
\nPMH: noncontributory.
\nAllergies-NKDA
\nFH:- maternal uncle with \u201csome kind of sugar diabetes problem\u201d but parents unclear on the exact disease process
\nSH: denies alcohol, tobacco or illicit drug use. Not sexually active.
\nLabs: random glucose 244 mg\/dl.
\nDIAGNOSIS: Diabetes Mellitus type 1 and refers to an endocrinologist for further work up and management plan.
\nQuestion
\n1. Explain the genetics relationship and how this and the environment can contribute to Type I DM. (100 words)<\/p>\n
Question 4
\nScenario 3: Type II DM
\nA 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 \u201cstrange\u201d \u201clike ants crawling on them\u201d and noted his vision is blurry sometimes. He has increased an increased appetite, but still losing weight. He also complains of \u201cswelling\u201d and enlargement of his abdomen.
\nPMH: 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.
\nDiagnosis: Type II DM and prescribes oral medication to control the glucose level and also referred the patient to a dietician for dietary teaching.
\nQuestion:
\n1. How would you describe the pathophysiology of Type II DM? (125 words)<\/p>\n
Question 5
\nScenario 4: Hypothyroidism
\nA 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.
\nPMH: Non-contributory.
\nVitals: Temp 96.4\u02daF, pulse 58 and regular, BP 106\/92, 12 respirations. Dull facial expression with coarse facial features. Periorbital puffiness noted.
\nDiagnosis: hypothyroidism.
\nQuestion:
\nWhat causes hypothyroidism? (75 words)<\/p>\n
Answer 1
\nSIADH is a condition characterized by excessive secretion of antidiuretic hormone (ADH), also known as vasopressin, leading to water retention and dilutional hyponatremia. ADH normally regulates water excretion by the kidneys, but in SIADH, the body produces too much ADH, leading to increased water reabsorption and decreased urine output. This results in hyponatremia, as the excessive water dilutes the sodium concentration in the blood. Patient characteristics that may contribute to the development of SIADH include advanced age, certain medications (such as SSRIs), underlying malignancy, pulmonary or central nervous system disorders, and electrolyte imbalances. In this case, the patient’s age, emphysema, and recent situational depression may have contributed to the development of SIADH.<\/p>\n","protected":false},"excerpt":{"rendered":"
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 […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[994,4486],"tags":[10427,10395],"class_list":["post-121496","post","type-post","status-publish","format-standard","hentry","category-nursing-case-study-help","category-case-study-homework-help","tag-scenario-1-syndrome-of-antidiuretic-hormone-siadh","tag-write-my-assignment-help"],"_links":{"self":[{"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/posts\/121496","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/comments?post=121496"}],"version-history":[{"count":1,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/posts\/121496\/revisions"}],"predecessor-version":[{"id":121497,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/posts\/121496\/revisions\/121497"}],"wp:attachment":[{"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/media?parent=121496"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/categories?post=121496"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.colapapers.com\/assessments\/wp-json\/wp\/v2\/tags?post=121496"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}