case_study_answers_male - Interactive Case Studies and the...

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Interactive Case Studies and the Human Body (11-20) The Male Body Case Study 11 Hematology Polycythemia Answers: 1. The disorder of this individual is polycythemia. 2. The arterial O 2 saturation and erythropoietin levels are important in confirming that the increased hematocrit is not due to hypoxemia or an abnormally elevated erythropoietin level. The O 2 saturation level would indicate if there is a physiologic stimulus for the increased erythrocyte production. 3. Phlebotomy is the letting of blood for transfusion pheresis, diagnostic testing, or experimental procedures. 4. Phlebotomy (removal of the whole blood) removes both blood cells and plasma. The plasma volume is replaced within days, whereas the erythrocytes take several weeks to be replaced. 5. Myelosuppressive therapy is therapy for the suppression of the bone marrow's production of blood cells and platelets. 6. Myelosuppressive therapy may be needed to suppress the erythrocyte production in the myeloid tissue if the hematocrit continues to rise after the phlebotomies. Case Study 12 Cardiovascular Primary Hypertension Answers: 1. This individual has primary hypertension. (If this person had an elevated plasma renin level, he would be diagnosed as having renal hypertension.) 2. The ideal body weight for a 5-foot 6-inch male of medium frame is 140-160 lb. 3. The sites of action for the pharmacologic agents prescribed for this individual follow: Oral diuretic : acts on the kidney to increase urinary output and therefore decrease the circulating fluid volume and decrease blood pressure. Beta-blocker : blocks the beta receptors on the heart to decrease the work of the heart. Vasodilator : relaxes vascular smooth muscle to decrease the total peripheral resistance.
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4. A vasodilator is not used initially because dilatation would cause a reflex vasoconstriction and set the RAA (renin-angiotensin-aldosterone) system into motion. This would elevate the blood pressure. By adding a vasodilator after a beta depressant, this reflex would be avoided. 5. Steps in the medical treatment of hypertension: a. Give an oral diuretic (although in some patients a beta-blocker is preferred). b. Add a sympathetic depressant (blocker). c. Add a vasodilator. d. Add another sympathetic depressant (blocker). Treatment is usually started with an oral diuretic. The antihypertensive action of diuretics seems to be due to a modest reduction in plasma volume. If the diuretic does not adequately control the hypertension, a sympathetic depressant drug is added to the regimen, usually in the form of a beta-blocker because its effects are better tolerated. A vasodilator is added as a third agent for added support. This vasodilator is one that acts directly on the vascular smooth muscle, not on the autonomic nervous system centrally or peripherally. 6. The cause of the retinal hemorrhages is the elevated systemic blood pressure.
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This note was uploaded on 02/09/2012 for the course BIO 102 taught by Professor William during the Spring '11 term at Harvard.

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case_study_answers_male - Interactive Case Studies and the...

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