NORWICH NR548 2022 January Week 7 Discussion Latest

NR548 Advanced Pathophysiology

Week 7 Discussion

Question(s):

Pick one of the following three cases and present your case summary:

Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. Although she did her best to run errands for her husband, she got tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha's voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow.

You as the provider suspect low thyroid hormone levels were causing the signs.  What would you suspect the TSH and T4 test results would be for this patient?

Using your knowledge of the function of thyroid hormone in the body,explain why Bertha's respiratory rate was decreased? Why might pleural a effusion be present in someone with hypothyroidism?

Marcee is a 52-year-old woman who worked at a reception desk at a company's main office. She took some time off when she was treated for colorectal cancer. The Dukes classification was stage I, and the treatment protocol involved surgery and radiation therapy. No one in her family had a history of the disease. Marcee does not drink or smoke, but she does not pay close attention to her diet. At work, her meals consisted mainly of the foods she got from vending machines at the cafeteria. At home, she preferred to heat up frozen dinners or any prepackaged food that required minimal preparation time.

Review Marcee's diet. What factors in her dietary choices might contribute to the development of colorectal cancer?

Colorectal cancer often arises from adenomatous polyps. What are the development and histologic features of these polyps?

Colorectal cancer may be a complication in individuals with ulcerative colitis. How are the "pseudopolyps" seen in this disease different from the polyps discussed above?

Robert is a 68-year-old who has dealt with alcoholism for over 30 years. He has cirrhosis and is anemic. His appetite has declined, and he regularly complains of abdominal pain. Recently, while preparing himself a sandwich, he cut his finger deeply with a knife. The wound bled profusely, and he used a kitchen towel to stop the flow. Refusing to go and seek medical assistance, he put ice on his finger and wrapped the towel around it. He sat down in his recliner with his hand over his head and fell asleep.

Anemia and clotting disorders are common features of alcoholic liver disease. What are the mechanisms that cause these hematologic disorders?

What gastrointestinal bleed is associated with a high mortality rate in those with advanced cirrhosis? What is the pathophysiology of this condition?

Acute pancreatitis is sometimes seen in the alcoholics, particularly after binge drinking. Why are tachycardia and hypotension indications of this condition?