Good Example Of Course Work On Pathophysiology Questions

Published: 2021-06-21 23:46:04
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- The differences between the cardiovascular diseases and the coronary heart diseases

The major differences between these two types of diseases relates to the vascular components of the cardiovascular system. This simply means that the cardiovascular diseases do not only involve the heart alone but also involves all the heart linked vessels. i.e all arteries, veins and lymphatics found to be associated with the heart and blood passes to and from the heart. However, the coronary heart diseases only relate to the vessels that are within the heart itself and supply the heart itself and also the muscles of the heart.

- Discuss the difference between the left sided and right sided heart failure. Discuss the primary consequences and major symptoms associated with each.

Left-sided heart failure

Oxygen rich blood coming from the lungs moves the left atrium by the pumping action of the heart. If is from the left atrium this oxygen rich blood then moves to the left ventricle. The left ventricle now does the main job of pumping this oxygen rich blood to the rest of the body. “The left ventricle supplies most of the heart's pumping power, so it's larger than the other chambers and essential for normal function. In left-sided or left ventricular (LV) heart failure, the left side of the heart must work harder to pump the same amount of blood” (American Heart Association, 2013).
Systolic failure and diastolic failure are the two major types of left sided heart failure. In the systolic failure involves the left ventricle losing its ability to contract normally. This simply means that heart can't pump with enough force to push enough blood into circulation.

Diastolic failure (also called diastolic dysfunction): The left ventricle loses its ability to relax normally (because the muscle has become stiff). The heart can't properly fill with blood during the resting period between each beat (American Heart Association, 2013).

Right-sided heart failure

The heart's pumping action moves "used" blood that returns to the heart through the veins through the right atrium into the right ventricle. The right ventricle then pumps the blood back out of the heart into the lungs to be replenished with oxygen.
“Right-sided or right ventricular (RV) heart failure usually occurs as a result of left-sided failure. When the left ventricle fails, increased fluid pressure is, in effect, transferred back through the lungs, ultimately damaging the heart's right side. When the right side loses pumping power, blood backs up in the body's veins. This usually causes swelling in the legs and ankles” (American Heart Association).

- What are symptoms and consequences that may be associated with reduced blood flow to the GI tract?

- Ischemia of the intestine occurs when there is reduce or stopped blood flow towards the intestine. Symptoms may be classified as either acute symptoms or chronic. The acute symptoms are related to sudden abdominal pain, urgent need for bowel movement, frequent and forceful bowel movements, tenderness, blood in stool, nause and vomitting and fever. Chronic symptoms abdominal cramps, pain, diarrhea, nausea and vomiting, and bloating. The consequences are usually related to experience of intermittent pain post eating. This leads to fear of eating. There is also weight loss.

- What occurs with reduced perfusion of the kidneys? Discuss the organs and hormones involved, and the physiological responses that will occur.
Renal failure is what is usually associated with prolonged reduced perfusion of the kidney. The associated organs are is that of the heart, adrenal cortex and ureter. This is from the perspective of how the coronary heart disease state causes the low blood flow to the renal tissue hence causing reduced perfusion. This will damage the tissue and result in poor urinary output. The hormones involved are the renin-angiotensin-aldosterone system. Since there is reduced perfusion, the hormones will be activated. Once the hormone has been activated, there is compensation for the hypovolemia, hyponatremia and hypotension resulting from the lowered perfusion. This activation results in certain cascade which eventually results in sodium reabsorption, potassium excretion and water retention.

- Mechanism of action of two medication used in congestive heart failure
Beta blocker use in congestive heart failure works majorly by influencing the renin/angiotensin systems of the kidney. This is done by causing a reduction in the renin secretion hence ensuring that there is reduction in the heart demand for oxygen with subsequent increasing oxygen carrying capacity of the blood. Bisoprolol is a beta blocker for CHF.
Lisinopril is an Angiotensin converting enzyme inhibitor (ACE inhibitor). It helps relax the blood vessels and prevent enzyme in the body to produce angiotensin II.

- Episode of acute back pain, pathologic fracture or groin or thigh pain. 3 factors increasing the risks are sex, age, and family history.

- Drop in oestrogen level after menopause result in bone loss hence making bone become thiner with subsequent increase risk of osteoporosis.

- Weight bearing exercise and resistance training in osteoporosis. The mechanism of impact on bone health.

The exercise strengthens bones and muscles, and improves balance, coordination, and flexibility.

- Osteoarthritis is the musculoskeletal disorder involving the breakdown of the cartilage. It is a degenerative condition. Bony enlargement at affected joints and limitation of range of motion are two important signs associated with the osteoarthritis.
- Secondary ostheoarthritis refers to those that are of the synovial joints resulting from predisposing condition while the primary is that is caused by aging process.
- IL-1beta is important in cartilage destruction while the TNF-alpha contribute to the inflammatory process which tends to induce the joint articular cells to produce other interleukins. The cytokines now drive a balance between anabolic and catabolic process related to the cartilage. The cytokines also activate the enzymes that may cause digestion of the cartilage.
- The two factors research has show may contribute to etiology of paget disease are;
- Slow virus
- Hereditary
- Factors in muscle that contribute to the fatigue and pain associated with fibromyalgia
- Hypoxia
- Substance P
- Type of exercise that may be recommended for patient with fibromyalgia is;

Light aerobic exercises which include walking

- Definition of osteomyelitis
- Inflammation of bone tissue resulting from an infection

The most common causes of osteomyelitis

- Bacterial blood stream infection (in case of infants and children)
- Staphylococcus Aureus (Adult)
- The bone disease in children that can result from a vitamin D deficiency is Rickets

The adult form of this disease is the Osteomalacia.

- Exposure to sunglight or eating diet rich in vitamin
- Discuss the primary cause of peptic ulcer disease and the mechanism of pathology
- H. pylori is the primary cause
- “H. pylori evade attack by the host immune system and causes chronic, indolent inflammation by several mechanisms. H. pylori can damage the mucosal defense system by reducing the thickness of the mucus gel layer, diminishing mucosal blood flow, and interacting with the gastric epithelium throughout all stages of the infection. H. pylori infection can also increase gastric acid secretion; by producing various antigens, virulence factors, and soluble mediators, H. pylori induces inflammation, which increases parietal-cell mass and, therefore, the capacity to secrete acid. The H. pylori cytotoxin-associated gene CagA also has an important role: it interferes with gastric epithelial cell-signaling pathways, thereby regulating cellular responses and possibly contributing to apical junction barrier disruption, interleukin-8 secretion and phenotypic changes to gastric epithelial cells” (Yuan et al, 2006).
- The most susceptible part of the GIT to peptic ulcer is the
- Antrum of stomach
- First few cm of duodenum

The ulceration is more invasive simply because it’s below the epithelium

- The drug works by inhibiting the proton pump. This works to suppress the gastric acid secretion hence reducing the problem. This is done by inhibition of the inhibition of the H+/K+-ATPase in the gastric parietal cell. By acting specifically on the proton pump, omeprazole blocks the final step in acid production, thus reducing gastric acidity (Drugbank, 2013).

“ Tetracycline passively diffuses through porin channels in the bacterial membrane and reversibly binds to the 30S ribosomal subunit, preventing binding of tRNA to the mRNA-ribosome complex, and thus interfering with protein synthesis” (Drugbank, 2013).

“Famotidine binds competitively to H2-receptors located on the basolateral membrane of the parietal cell, blocking histamine affects. This competitive inhibition results in reduced basal and nocturnal gastric acid secretion and a reduction in gastric volume, acidity, and amount of gastric acid released in response to stimuli including food, caffeine, insulin, betazole, or pentagastrin” (Drugbank, 2013).

“As an antidiarrheal, the exact mechanism has not been determined. Bismuth subsalicylate may exert its antidiarrheal action not only by stimulating absorption of fluid and electrolytes across the intestinal wall (antisecretory action) but also, when hydrolyzed to salicylic acid, by inhibiting synthesis of a prostaglandin responsible for intestinal inflammation and hypermotility. In addition, bismuth subsalicylate binds toxins produced by Escherichia coli. Both bismuth subsalicylate and the intestinal reaction products, bismuth oxychloride and bismuth hydroxide, are believed to have bactericidal action. As an antacid, bismuth has weak antacid properties” (Drugbank, 2013).

- Low hemoglobin indicate a problem with oxygen carrying ability of the blood
- Vertical Banded Gastroplasty

Roux-en-Y Gastric Bypass

Gastric Sleeve

- Roux-en-Y gastric bypass is the fastest of the surgical procedure that help in the weight loss.
- Chest discomfort and malaises are two other symptoms that need to be ask from the patient.
- Angina can be described as chest pain or discomfort that relates to the area of the heart muscle where there is shortage of oxygen supply.
- The general etiology relates to smoking,
- high amount of cholesterol,
- high blood pressure, and
- High amount of sugar are the most common etiology of angina.
- Shows that Jones s at the risk of increase coronary heart diseases. Atherosclerosis relates to Myocardial infarction simply because it leads to increase plaque formation. The increase plaque formation cause the blockage or reduce blood flow inside the vessels relating to the heart hence can lead to myocardial infarction.
- Ezetimibe oral

Zetia oral

The rationale for the drugs relates to control of the lipid level
- The physiology aspect of omega-3 that place it to be recommended above omega-6 is simply because omega-3 is an anti-inflammatory while the omega-6 is pro-inflammatory. The fact that people consume more of omega-6 put them at risk of inflammatory conditions but the omega-3 is much better.
- Similarities between Crohn's disease and ulcerative colitis
- “Crohns disease and ulcerative colitis occurs is commoner in teenagers and young adults although the disease can occur at any age
- Both affect men and women equally
- The symptoms of ulcerative colitis and Crohn's disease are very similar
- The causes of both UC and Crohn's disease are not known and both diseases have similar types of contributing factors such as environmental, genetic and an inappropriate response by the body's immune system”(UCLA, 2013).
c. The loss of weight, fever with minimal bowel sound
D. “Serum levels of CRP are useful for assessing a patient's risk of relapse. High CRP levels are indicative of active disease or a bacterial complication. CRP levels can be used to guide therapy and follow-up” (Patient.co.uk, 2013)

References

American Heart Association, (2013). Types of Heart failure. Conditions.
Retrieved 21 November, 2013 from http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/Types-of-Heart-Failure_UCM_306323_Article.jsp
Drugbank. (2013). Pharmacology. Home.
Retrieved 22 November, 2013 from http://www.drugbank.ca/drugs/DB01294
Jacobs-Kosmin, D. (2013). Osteoporosis. Medscape.
Retrieved 22 November, 2013 from http://emedicine.medscape.com/article/330598-overview
MayoClinic. (2013). Treatment. Congestive Heart Failure.
Retrieved 21 November, 2013 from http://www.mayoclinic.org/congestive-heart-failure/treatment.html
MayoClinic. (2013). Intestinal ischemia. Diseases and condition.
Retrieved 22 November, 2013 from http://www.mayoclinic.com/health/intestinal-ischemia/DS00459/DSECTION=symptoms
Manski, D. (2013). Physiology of the kidney (6/7): Renin-Angiotensin-Aldosterone System. Urology.
Retrieved 21 November, 2013 from http://www.urology-textbook.com/kidney-renin-aldosterone.html
Martel-Pelletier, J., Alaaeddine, N. & Pelletier, J. (1999). Cytokines and their role in the pathophysiology of osteoarthritis.
Retrieved 20 November, 2013 from http://www.bioscience.org/1999/v4/d/martel/fulltext.htm
Patient.co.uk (2013). Crohn's Diseases.
Retrieved 25 November, 2013 from http://www.patient.co.uk/doctor/crohns-disease-pro
UCLA, 2013. Ulcerative Colitis vs Crohns' Disease. UCLA Health.
Retrieved 25 November, 2013 from http://gastro.ucla.edu/body.cfm?id=169

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