case

 Length: A minimum of 280 words, not including references

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Citations: At least one high-level scholarly reference in APA from within the last 5 years

MSN570 Week 7 Case Studies

A 23-year-old female presents with urinary frequency absent of infection. The final diagnosis is Diabetes Insipidus. She is treated with dDAVP.

1. What would you expect her sodium level would be, high or low? Defend your answer.

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2.

Her osmolarity is elevated. Why?

3. Compare and contrast central vs. nephrogenic Diabetes Insipidus.

4. Explain the mechanism of dDAVP.

A 13-year-old female presents with malaise, facial edema and decreased urinary output. Prior history is positive for strep throat, previously treated. Her work-up revealed severe abnormal lab values. Her final diagnosis is post streptococcal glomerulonephritis.

1. What specific lab values would you suspect are abnormal? Defend your answer.

2. What is the significance of a positive strep infection?

3. Compare and contrast acute vs chronic glomerulonephritis.

4. Does glomerulonephritis resolve? Defend your answer.

A 19-year-old co ed presents with increasing diarrhea and constipation over the last 2 weeks. She has a history of celiac disease.

1. What is the role of immunity and celiac disease?

2. What is the effect of gluten on celiac disease?

3. Describe the pathophysiology of the diarrhea and constipation.

A 32 year-old-female who recently delivered twins presents with colicky type pain, URQ pain radiating to the shoulder. After workup, she is diagnosed with cholecystitis.

1. What is the role of the gallbladder?

2. Would you expect her to have nausea and vomiting? Defend your answer.

3. Why does the patient have referred pain?

4. How do gallstones form?

A 34-year-old female with celiac disease is brought to her nurse practitioner for evaluation of non-resolving sores at the corners of the mouth bilaterally.  On
examination, her NP notices a smooth reddened appearance to the tongue with several sores on the oral mucosa and lips. Dietary deficiency of which of the following would most likely produce these symptoms?

A. Vitamin B1
B. Vitamin B2
C. Vitamin B3
D. Vitamin C
E. Vitamin E

A  27-year-old male presents to an acute care clinic.  He reports that for the last five months he has had intermittent episodes of abdominal pain and diarrhea. He says that recently the diarrhea has appeared very fatty, and been difficult to flush.  He is referred by his nurse practitioner to a gastroenterologist who performs an EGD with biopsies.  The biopsy shows absence of villi and a lymphoid infiltrate in the submucosa. Of the following, what is the most likely diagnosis?

A. Whipple’s disease
B. Giardiasis
C. Pseudomembranous colitis
D. Celiac disease
E. Ménétrier’s disease

A 25-year-old white male presents to his family nurse practitioner.  Over the past six months, he has had multiple episodes of watery diarrhea.  The diarrhea
has been associated with bloating, excessive flatulence, and some abdominal cramps.  The symptoms occur frequently in the late morning, after he eats
breakfast.  Most frequently for breakfast he has cereal and a piece of fruit. His physician orders a 24-hour stool collection specimen for electrolytes and osmolality.  The test results from the collection are that his sodium is 8.1 mmol/24 hr, his potassium is 19.3 mmol/24 hr, and his measured osmolality is 123.3 mmol/24.  Of the following, what is the most likely cause of the patient’s symptoms?

A. Celiac disease
B. VIPoma
C. Disaccharidase deficiency
D. Inflammatory bowel disease
E. Rotavirus

Please discuss the rationales for your selected answer choices.

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