Question

A) Joe is a high-powered executive with a highly stressful job. For six months she has suffered from and increasingly intense abdominal pain, which subsides when, he takes antacids. However, this does not seem to help lately. He notices that his stools are a darker color than usual. He is feeling more fatigued each day. His doctor does blood work and orders an endoscopy to look inside his stomach.
LAB RESULTS:
Hematocrit – low
Blood present in stools
Endoscopy results reveal a bleeding gastric (peptic) ulcer. A peptic ulcer is an inflammation and erosion of the stomach mucosa.

He is given medication to suppress acid production and bismuth to coat the stomach. This will help the ulcer to heal. He is also given a blood transfusion and is told that he has to reduce the stress in his life.

Discuss the following:
1) RBC – structure and function – ABO system
2) Stomach – structure and function
3) Cell types present in stomach and function
4) Digestion – enzymes and functions
5) Absorption – if any
6) Regulation of gastric emptying.

B) Mary had one kidney removed due to cancer. Five weeks later, she was taken into the emergency room with severe fatigue and muscle weakness. Her heart rhythm is abnormal and her blood pressure is 160/100. Blood tests reveal that her remaining kidney is not functioning normally and that renal failure is a real possibility. Her breathing rate has increased and she has peripheral edema.
The results of her blood tests are as follows:
Hyperkalemia
Hypernatremia
Anemia – low hematocrit
pH 7.32 (normal 7.35-7.45)
PCO2 – 30 mmHg ( normal 34 - 45 mmHg)
HCO3 – 15mEq (normal 22-26 mEq)

Use this information to discuss the following:
1) Urinary system structure and function (filtration, reabsorption, and secretion, hormones released by the kidneys)
2) Acid base balance – sequence of systems involved in resolving and how – compensation
3) Fluid/electrolyte balance – how kidney helps to regulate each electrolye – specifically Na+ & K+
4) Role of electrolytes in maintaining normal cell function – like resting membrane potential
5) RBC – structure/function – relate to symptoms
6) Define hypernatremia and hyperkalemia
7) BP – definitions and regulation
8) ECG (EKG) – normal reading – what do peaks stand for? Relate to what is happening in the heart.

Answer 1

A)Bleeding Gastric Ulcer

1. RBC: This is a biconcave or disc shaped with a lifespan of 120 days.It has a protein called haemoglobin responsible for transportation of oxygen .It is also involved in the exchange of carbondioxide.Due to bleeding there is loss of this cells made the patient to be transfused with blood for saving his life.When there is bleefing the RBC level are decreased resultiong in low hematocrit level.ABO is the group of blood available A group ,B group,AB group,Ogroup (Positive or Negative).
2. Stomach : It is a main part of gastrointestinal system which accommodates the food and aides in digestion and distribution of nutrition. It lies between the oesophagus an duodenum in the right upper quadrant of the abdomen.The Secretary and motor activity of the stomach are looked by the sympathetic and parasympathetic plexus.The capacity of an adult stomach is approximately 1litre.There two sphinters namely lower esophageal sphincter and pylotic sphinter.Blood supply is by gastric artery.Tgebmain functions are digestion,absorpt,control and secretion of digestive hormones. Errosion of the layers in stomach has lead to bleeding and dark stools
3. Cell types in stomach and functions :

• Foveolar cells which produces mucus from the gastric mucosa
• The parietal cells responsible got the production of main gastric acid called as hydrochloric acid also helps in absorption of vit B12, pH buffering systrm
• Entetochromaffin like cells store and release histamine level even there is elevation of pH level .
• G cells produces gastrin
• The chief gastric cells produce and releases pepsinogen for the release of pepsin

The destruction of these cells enables the meeting of gastric juices directly on it causing pain

4.Digestion

Food》bolus》enters stomach》stomach releases protease and hydrochloric acid》bacteria are either killed or inhibited》peristalsis occurs》chime production 》chyme enters duodenum and nutrients are extracted

5.Absorption .It is completely done by the small intestine but a few molecules are slow absorbed by stomach during certain occasions likevshen having medications like aspirin,on dehydration water is absorbed,alcohol,caffeine and water soluble vitamins

6.Gastric emptying tGe average gastric emptying time us 4 hours and controlled by gastric nerves.