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patient presents to doctor w/ urine in blood. Hx of osteoperosis, Type 2…
patient presents to doctor w/ urine in blood. Hx of osteoperosis, Type 2 DM, and HTN
Anatomy of Urinary system
Kidneys
Ureters
Bladder
Urethra
Specific Reabsorption, Filtration and Secretion of molecules from the nephron
Reabsorption- Proximal Convulated Tubule
Amino Acids, salts, phosphate, potassium, water, glucose, and urea
Filtration-Glomerulus
Vitamin B, C, amino acids, ketones, hormones, water, glucose, urea, and some proteins.
Secretion-Proximal/Distal Convulated Tubule
Drugs/toxins/waste, hydrogen, some ions, and creatine
Functions of the Urinary System
production of ESP
eliminates waste
increase/decrease/control of blood pressure
aids in formation of calcitonin
increase/decrease of acid/base balance
Structures of a Nephron
Renal Corpuscle
Renal Tubule
Glomerus
Glomerular Capsule
Capsular Space
Vascular Pole
Afferent Arteriole
Efferent Arteriole
Tubular Pole
Proximal Convulated Tubule
Nephron Loop
Descending Limb
Thick and Thin Segment
Ascending Limb
Thick and Thin Segment
Principal Cells
Intercalated cells
Collecting Duct
Collecting Tubule
Distal Convulated Tubule
General info on osteoporosis, hypertension, and type 2 DM.
Osteoperosis
Weak & brittle bones; poor bone density in which the bone deteriorates. Can lead to fractures easily, as the disease progresses over time. Medication, weight bearing activities, and a good diet can all help strengthen weak bones.
The patient very well could have had kidney issues that caused her poor bone density. The kidneys not being able to filter properly may have caused mineral imbalance that affected the bones depending what stage of kidney disease she has and the duration.
Hypertension
High blood pressure. Can cause heart attack, stroke, heart disease, and even death if not controlled over long periods of time. Technically anything over "140/90" certain medications can be taken in order to manage.
Long term or out of control blood pressure causes extra strain on the vessels surrounding and feeding your kidney. The harshness of having consistent high BP could cause the vessels to harden or become so weak the kidneys don't have proper blood flow resulting in loss in function over time.
Type 2 DM
"Adult on-set diabetes" is one that is normally pronounced later on in life when said patient has abused their glucose levels for long periods of time and they have a decrease in insulin receptors therefore they can have hyperglycemia due to the lack of production of insulin. can be managed with medications, diet and exercise, and regular checks with your PCP in order to monitor A1C.
Can damage the urinary system by damaging the blood vessels in the kidney. Long term affects can be dialysis, edema, poor kidney function/filtration, and weight gain.
Ultimately if the patient doesn't abide by her ongoing health concerns and see specialists to find ways to manage them the patient could end up with end stage renal failure and have a lot of edema, be wheelchair/bed bound, poor circulation, develop wounds from her type 2 diabetes that is out of control, become non compliant (a stretch possibly) and go into septic shock (at some point, in an extreme case) and death.