Posted: April 12th, 2022

A 19-year-old patient

Please respond to the following two Discussion threads:

Requirement

APA style with in-text citations
A minimum of 150 words is required for each post.
At least one high-level scholarly reference each post from the last five years, in APA format.
There is no plagiarism.
Receipt from Turnitin.

 FIRST DISCUSSION POST

Celiac Disease Case Study
The case study chosen is of a 19-year-old patient who arrives at the hospital complaining of increased diarrhea and constipation. The patient also has a history of celiac disease.
The Immune System and Celiac Disease
Immunity is important in celiac disease. Celiac disease develops as a result of an immunological reaction to gluten, a protein found largely in wheat, barley, and rye that causes an immune response in the small intestine after eating gluten. Adaptive immunity, according to Anderson (2020), plays a vital role in the early and late effects of gluten, where the adaptive immunity response selectively engages gluten and the effects that result from its effect on the body.
Celiac Disease and Gluten
Celiac disease develops as a result of gluten ingestion, and the body begins attacking its own tissues once the patient consumes gluten. This occurs as a result of the immune system reacting to gluten, causing damage to the gut and making it difficult to absorb nutrients. According to Caio et al. (2019), the only treatment for celiac disease is a lifelong strict gluten-free diet, which can ultimately improve quality of life and prevent further complications of the condition, such as cancer.
Diarrhea and Constipation Pathophysiology
Diarrhea is caused by an increase in the water content of the stool as a result of an imbalance in the regular functioning of the physiological processes of the small and large intestines due to a failure to absorb various nutrients, ions, and water (Nemeth & Pfleghaar, 2022). Water content is typically 10mL/kg/day in newborns and early children and 200g/day in teenagers and adults. Constipation may develop from the absorption of water from the stool in this patient. Furthermore, a gluten-free diet might reduce the fiber content of meals, resulting in constipation.

Second discussion post

Diabetes Insipidus Case Study

Diabetes Insipidus and Sodium Level (DI)
Patients with DI have increased urine flow, which causes thirst. Blood salt levels of the patient in the scenario can be normal if she was able to drink enough fluid to compensate for the excessive urine production, or somewhat elevated if she was unable to drink enough fluid.
Osmolarity Increase
If the patient’s osmolarity is high, it indicates that her fluid intake was insufficient to compensate for the extra urine production. Urine with an abnormally low osmolarity appears pale or colorless. Low osmolarity urine resulting in high serum osmolarity if adequate fluid intake is not consumed.
Nephrogenic DI vs. Central DI
DI is classified into four types: central DI, nephrogenic DI, gestational DI, and dipsogenic DI. Central DI is linked to the hypothalamus or pituitary gland and manifests as excessive antidiuretic hormone (ADH) levels in the blood. ADH is a key hormone in water homeostasis. ADH is produced by the hypothalamus and stored in the posterior pituitary gland. The hypothalamus also regulates ADH release and monitors serum osmolarity in the body. ADH instructs the kidneys on how much water to store in order to maintain serum osmolarity within a healthy range. Nephrogenic DI occurs when the kidneys do not properly respond to ADH, resulting in increased urine flow and extreme thirst.
Desmopressin Acetate Mechanism (DDAVP)
DDAVP imitates ADH. DDAVP is a hormone analogue that is selective for ADH V2 receptors (Vassiliadi & Tsagarakis, 2018). These receptors regulate renal water retention by increasing the permeability of the renal tubule cells to water (McCarty & Shah, 2021). This reduces urine volume while raising urine osmolarity.

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