Mrs. Gardner is 48 years old woman diagnosed with breast cancer. She has been enrolled in...

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Mrs. Gardner is 48 years old woman diagnosed with breast cancer. She has been enrolled in...

Mrs. Gardner is 48 years old woman diagnosed with breast cancer. She has been enrolled in a

clinical research trial testing the effectiveness of a new chemotherapeutic agent. After her

second dose of the agent, she complains of feeling light-headed when she gets out of bed

in the morning. Her blood pressure is found to fall from 135/80 to 105/70 when she goes from

a supine to a standing position (i.e., orthostatic hypotension). She also complains of frequent

urination and nocturia. Routine urinalysis reveals her urine contains large quantities of

sodium. However, her serum creatinine level is within normal limits at 1.0 mg/dl.

Why do you think Mrs. Gardner has orthostatic hypotension? (Hint: think about the kidney’s role in maintaining blood pressure.}

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Answer 1

Answer #1

Orthostatic hypotension characterized by sudden drop of blood pressure when a person standing from sitting or from a lying down face-up (supine) position. It can cause light headedness and dizziness.

Kidneys main function is to maintain blood pressure. When there is a drop in blood pressure due to decreased circulatory blood volume, kidney reabsorb water and sodium by renin angiotensin aldosterone mechanism.

The patient has complaints of increased urination with large amount of sodium excretion probably due to effect of chemotherapeutic drug on normal function of kidneys. This cause decreased circulatory volume and decreased sodium level in blood leads to orthostatic hypotension.

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Answer 2

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