Posted: May 30th, 2023

Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower

Urinary Function:
Mr. J.R. is a 73-year-old man, who was admitted to the hospital with clinical manifestations of gastroenteritis and possible renal injury. The patient’s chief complaints are fever, nausea with vomiting and diarrhea for 48 hours, weakness, dizziness, and a bothersome metallic taste in the mouth. The patient is pale and sweaty. He had been well until two days ago, when he began to experience severe nausea several hours after eating two burritos for supper. The burritos had been ordered from a local fast-food restaurant. The nausea persisted and he vomited twice with some relief. As the evening progressed, he continued to feel “very bad” and took some Pepto-Bismol to help settle his stomach. Soon thereafter, he began to feel achy and warm. His temperature at the time was 100. 5°F. He has continued to experience nausea, vomiting, and a fever. He has not been able to tolerate any solid foods or liquids. Since yesterday, he has had 5–6 watery bowel movements. He has not noticed any blood in the stools. His wife brought him to the ER because he was becoming weak and dizzy when he tried to stand up. His wife denies any recent travel, use of antibiotics, laxatives, or excessive caffeine, or that her husband has an eating disorder.

Case Study Questions
1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.
2. Create a list of risk factors the patient might have and explain why.
3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

Reproductive Function:
Ms. P.C. is a 19-year-old white female who reports a 2-day history of lower abdominal pain, nausea, emesis and a heavy, malodorous vaginal discharge. She states that she is single, heterosexual, and that she has been sexually active with only one partner for the past eight months. She has no previous history of genitourinary infections or sexually transmitted diseases. She denies IV drug use. Her LMP ended three days ago. Her last intercourse (vaginal) was eight days ago and she states that they did not use a condom. She admits to unprotected sex “every once in a while.” She noted an abnormal vaginal discharge yesterday and she describes it as “thick, greenish-yellow in color, and very smelly.” She denies both oral and rectal intercourse. She does not know if her partner has had a recent genitourinary tract infection, “because he has been away on business for five days.
Microscopic Examination of Vaginal Discharge
(-) yeast or hyphae
(-) flagellated microbes
(+) white blood cells
(+) gram-negative intracellular diplococci

Case Study Questions
1. According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.
2. Based on the vaginal discharged described and the microscopic examination of the sample could you suggest which would be the microorganism involved?
3. Name the criteria you would use to recommend hospitalization for this patient

Submission Instructions:
• You must complete both case studies.
• Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources.

____________________-

Urinary Function

Case Study Questions

1. The attending physician is thinking that Mr. J.R. has developed an Acute Kidney Injury (AKI). Analyzing the case presented name the possible types of Acute Kidney Injury. Link the clinical manifestations described to the different types of Acute Kidney injury.

There are three main types of acute kidney injury (AKI): prerenal, intrarenal, and postrenal.

Prerenal AKI is caused by decreased blood flow to the kidneys. This can be due to a number of factors, including dehydration, heart failure, and sepsis. Clinical manifestations of prerenal AKI include decreased urine output, elevated blood urea nitrogen (BUN) and creatinine levels, and high blood pressure.
Intrarenal AKI is caused by damage to the kidneys themselves. This can be due to a number of factors, including infections, toxins, and autoimmune diseases. Clinical manifestations of intrarenal AKI include decreased urine output, elevated BUN and creatinine levels, and low blood pressure.
Postrenal AKI is caused by a blockage of the urinary tract. This can be due to a number of factors, including kidney stones, tumors, and enlarged prostate. Clinical manifestations of postrenal AKI include decreased urine output, elevated BUN and creatinine levels, and high blood pressure.

In Mr. J.R.’s case, the most likely type of AKI is prerenal. This is because he is experiencing dehydration and diarrhea, both of which can decrease blood flow to the kidneys. The clinical manifestations of prerenal AKI that are present in Mr. J.R.’s case include decreased urine output, elevated BUN and creatinine levels, and high blood pressure.

2. Create a list of risk factors the patient might have and explain why.

The following are some of the risk factors for AKI:

Age
Hypertension
Diabetes
Heart disease
Stroke
Kidney disease
Liver disease
Cancer
Medications (e.g., antibiotics, chemotherapy drugs)
Toxins (e.g., lead, mercury)
Infections
Trauma

Mr. J.R. has several of these risk factors, including age, hypertension, and diabetes. These risk factors increase his chances of developing AKI.

3. Unfortunately, the damage on J.R. kidney became irreversible and he is now diagnosed with Chronic kidney disease. Please describe the complications that the patient might have on his Hematologic system (Coagulopathy and Anemia) and the pathophysiologic mechanisms involved.

Chronic kidney disease (CKD) is a progressive condition that damages the kidneys. As the kidneys become damaged, they are less able to remove waste products from the blood. This can lead to a number of complications, including coagulopathy and anemia.

Coagulopathy is a condition in which the blood does not clot properly. This can be caused by a number of factors, including low levels of clotting factors, abnormal platelets, and damage to blood vessels. In patients with CKD, coagulopathy can be caused by a number of factors, including low levels of clotting factors, abnormal platelets, and damage to blood vessels.
Anemia is a condition in which the body does not have enough red blood cells. Red blood cells carry oxygen to the body’s tissues. In patients with CKD, anemia can be caused by a number of factors, including decreased production of red blood cells, increased destruction of red blood cells, and decreased absorption of iron.

The pathophysiologic mechanisms involved in the development of coagulopathy and anemia in patients with CKD are complex. However, some of the key factors involved include:

Decreased production of red blood cells: The kidneys produce a hormone called erythropoietin, which stimulates the production of red blood cells. In patients with CKD, the kidneys may not produce enough erythropoietin, leading to decreased production of red blood cells.
Increased destruction of red blood cells: The kidneys also filter waste products from the blood. In patients with CKD, the kidneys may not be able to filter all of the waste products, leading to increased destruction of red blood cells.
Decreased absorption of iron: The intestines absorb iron from food. In patients with CKD, the intestines may not be able to absorb enough iron, leading to decreased levels of iron in the blood.

Reproductive Function

Case Study Questions

1. According to the case presented, including the clinical manifestations and microscopic examination of the vaginal discharge, what is the most probably diagnosis for Ms. P.C.? Support your answer and explain why you get to that diagnosis.

The most probable diagnosis for Ms. P.C. is

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