1. Goodpasture syndrome it is a unique and rare autoimmune disease characterized by a type II hypersensitivity reaction leading to formation of antiantibodies against the glomerular basement membrane (GBM). These anti-GBM antibodies attack α 3 chain of the type IV collagen cells located in the renal glomeruli and pulmonary alveoli. The result of this interaction expresses in inflammatory responses and tissue damages in the kidneys and the lungs. In the Goodpasture syndrome, the T- and B- cell activation play an important role in inducing the formation of the anti-GBM antibodies as a condition of endogenous antigen recognition on the GBM. The anti- GBM antibodies bind to the basement membrane in the kidneys inducing the release of monocytes, …show more content…
The kidneys play a major role in the blood composition and volume , the excretion of metabolic wastes in the urine, the control the acid/base balance in the body and the hormone production for maintaining hemostasis. The damages to the GBM in the glomeruli alter filtration process that allows the protein and red blood cells to leak into the urine. Loss of protein like albumin in the urine results in a decrease of their level into the blood stream. Consequently, this patient’s blood reveals a decreased albumin (Alb) value of 2.9 g/dL, decreased serum total protein value of 5 .0 g/dL and in the urine presents of the protein and the RBCs. Impaired filtering capacity result in inability of kidneys to excrete excretory products like electrolytes and metabolic waste products that will then accumulate in the blood. Furthermore, inability of distal convoluted tubules to excrete sufficient quantities of potassium, sodium, magnesium (Mg), chloride (Cl), urea, creatinine (Cr), alkaline phosphatase (Alk Phos), and phosphate (PO4) results in their elevation in the blood. His laboratory values reveal an increased of sodium value of 149 meq/L, an increase of potassium value of 5.4meq/L, increased chloride value of 116 meq/L, increased blood urea nitrogen (BUN) serum of 143 mg/dL, and increased creatinine serum of 7.14 mg/dL. The other abnormal blood tests associated with a loss of kidneys’ filtration property identify in this patient are related to an increase of alkaline phosphatase value of 178 IU/L, increased magnesium value of 3.8mgdL, and increased phosphate (PO4) value of 5.9 mg/dL .
Increased serum glucose of 152 mg/dL could be associated with an increased in insulin resistance induced by uremia. Elevated blood glucose could be explained by the presence of blood urea nitrogen of 143 mg/dL that is above the normal limit of 20
The immunologic events that are happening at the local level during Carlton's acute inflammatory response would be:
A 54 year old female was presented with complaints of lethargy, excessive thirst and diminished appetite. Given the fact that these symptoms are very broad and could be the underlying cause of various diseases, the physician decided to order a urinalysis by cystoscope; a comprehensive diagnostic chemistry panel; and a CBC with differential, to acquire a better understanding on his patient health status. The following abnormal results caught the physician’s attention:
Mcgrogan, A., Franssen, C. F. and De Vries, C. S. 2011. The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrology Dialysis Transplantation, 26 (2), pp. 414-430.
The pathophysiology of diabetes mellitus in is related to the insulin hormone. Insulin is secreted by cells in the pancreas and is responsible for regulating the level of glucose in the bloodstream. It also aids the body in breaking down the glucose to be used as energy. When someone suffers from diabetes, however, the body does not break down the glucose in the blood as a result of abnormal insulin metabolism. When there are elevated levels of glucose in the blood, it is known as hyperglycemia. If the levels continue to remain high over an extended period of time, damage can be done to the kidneys, cardiovascular systems; you can get eye disorders, or even cause nerve damage. When the glucose levels are low in one’s body, it is called hypoglycemia. A person begins to feel very jittery, and possibly dizzy. If that occurs over a period of time, the person can possibly faint. Diabetes mellitus occurs in three different forms - type 1, type 2, and gestational.
Vanholder R, Sever MS, Erek E, Lameire N. Rhabdomyolysis. J Am Soc Nephrol. Aug 2000;11(8):1553-61.
“Immune Response: MedlinePlus Medical Encyclopedia.” National Library of Medicine - National Institutes of Health. Web. 18 Dec. 2011. .
The patient is an 84-year-old gentleman who is transferred to the emergency room from the Ramapo Ridge Psychiatric facility because of hematuria. The patient is known to have Alzheimer's, hypertension, increased lipids and atrial fibrillation he was recently hospitalized at St. Joe's before his transferred at Ramapo. They claim that he had some hematuria that there and was was brought down. On presentation to St. Joe's there was small amount of blood in his urine. He was seen in urologic consult. Which felt he may have well been traumatized having a catheterization at Ramapo Ridge . There was no evidence of any gross hematuria. They recommended that he would have a renal and bladder ultrasound for completeness. The case was discussed
When there is a blockage or compression of the superior vena cava then superior vena cava syndrome can occur. In Dr. Bob Johnston's case (a smoker of 37 years) lung cancer could be the cause. At first, Johnston's symptoms were assumed to be allergies. He was familiar with the headache, stuffiness and congestion during the spring season. As a result, his physician prescribed a higher dose of antihistamines to counteract the irritants. The patient blamed his weight gain, feeling unwell, head fullness and facial swelling on the new dosage of antihistamine medication.
A. One condition is known as hyperglycemia, which means that the blood glucose gets too
In the book Complications, Atul writes about his experiences as a surgical residents and demonstrates a point of view of surgery that does not idealize it, but instead displays the actual pressure and complexity it actually is. Atul Gawande speaks to fellow surgeons, surgeons to be or simply those who believe that the study of surgery is just memorizing procedures, nonetheless it’s so much more complex due to the fact that every case that arrives is different. He is able to portray the complexity of surgery by putting his readers in heart racing situations faced by doctors, explaining step by step procedures, giving his personal stories of cases he has assisted in at the hospital as a resident. Atul Gawande appeals to his reader’s attitude
...in sources of energy. When cells cannot absorb sugar, you can become fatigued or feel exhausted” (Healhline), complain of blurred vision” In the short term, high glucose levels can cause a swelling of the lens in the eye. This leads to blurry vision. Getting your blood sugar under control can help correct vision problems. If blood sugar levels remain high for a long time, other eye problems can occur” (HealthLine), experience nocturia “Elevated glucose levels force fluids from your cells. This increases the amount of fluid delivered to the kidneys. This makes you need to urinate more. It may also eventually make you dehydrated” (Healthline), and have sores and cuts that will not heal “Elevated glucose levels may make it harder for your body to heal. Therefore, injuries like cuts and sores stay open longer. This makes them more susceptible to infection” (HealthLine).
Glomerulonephritis is a disease that causes the inflammation of kidneys’ filters. The kidneys’ filters are in charge of remove the waste from the blood, and then excreted it as urine. Even though Glomerulonephritis can be caused by itself, diabetes and lupus can ...
Type 1 diabetes is typically diagnosed in children and young adults, also known as juvenile diabetes or insulin dependent diabetes. Only 5 % of people with diabetes have this form of the disease which is a condition that results from autoimmune destruction of beta cells of the pancreas (Jacobs, 1994). In type 1 diabetes, the body does not produce insulin. Insulin is essential for the conversion of sugar and starches into energy that the body needs to function. The substantial lack of insulin causes blood and urine glucose to increase. In the path physiology of the disease, a triggering event causes the production of antibodies that kill the beta cells which leads to a decline in insulin secretion. Once the insulin deficiency occurs, and more than 90 % of beta cells are destroyed, hyperglycemia occurs (Rosdahl, 2008). An individual...
According to the results of the tests, the patient syndrome is caused by either of the two; minimal change and focal segmental glomerulosclerosis. The pathophysiologies of the disease are primary glomerular defect and circulating permeability factor and inhibitors. The primary glomerular defect of nephrotic syndrome leads to leakage of high molecular mass proteins that’s equivalent to the size of albumin of approximately 66 kD, with haemostatic proteins of a similar size also being excreted pathologically in the urine (Eddy AA and Symons JM, 2003). Due to these excretion; prominent loss of important coagulation regulatory proteins such as antithrombin and protein S.
These wastes are derived from the liquid and food that the individual had consumed. In cases of compromised kidney function, the kidneys are no longer able to remove or filter wastes in the normal way. This means that wastes are left to accumulate in the bloodstream. When this scenario takes hold, it can negatively impact the patient 's electrolytes, therefore, positive action has to be taken to optimize the situation. When patients follow a renal diet it can help to slow down the advancement of total kidney failure, and ameliorate kidney function. Along with chloride and potassium, sodium represents one of the body 's main three electrolytes. The latter manipulate the fluids with enter and leave the body’s cells and tissues. Therefore, patients with renal disease must monitor their intake of electrolytes. Keeping a daily food dairy is essential (Nephcure), and will be of great benefit to the dietitian who can pinpoint certain details.