Unit Title :- Biological Manner The Process
Assessment Type :- Assignment
Biological Manner The Process Assignment – Australia.
Case study 1 part 1- Neurological disorders
Mary-Lou is a 75-year-old widow who lost her husband to cancer over a year ago. Her family and friends have noticed that she has been very teary has low self-esteem and has lost interest in the things she used to love such as going to bingo with her friends and gardening. Her family initially put this down to the loss of her husband and thought it would pass with time. However they are now getting really concerned as they have noticed that her mood is not improving still. When asked by her daughter if she is sleeping well she says she has been drinking wine every night to help her go to sleep. It also makes her feel happy and relaxed. However what started as one glass a night has now increased to two or three glasses a night and she has also started drinking during the day. Her daughter has noticed that her mum s face always appears flushed and that she has had quite a few colds lately. Mary-Lou is also losing her balance and experiencing mood swings. Her daughter is worried that she is relying too heavily on alcohol and fears that she is starting to get short-term memory loss from the alcohol consumption. She has been for getting things such as where she put her keys whether she turned on the washing machine or why she opened the fridge. She also tends to forget the topic of conversation when talking with her daughter on the phone. Mary-Lou has also been getting disorientated and getting lost when she goes out on her daily walks. A neighbor rang her daughter one day to tell her that she found Mary Lou wandering around aimlessly and when. Her daughter decided it was time to take Mary-Lou to the local GP to work out what was going on with her.
After listening to the signs and symptoms Mary-Lou was experiencing the GP diagnosed her with several condition and prescribed 50 mg of Fluoxetine Prozac daily a cholinesterase inhibitor 10 mg of Valium diazepam daily. She was also given information on support groups and tips on what to do given her conditions.
Question 1
Based on the clinical picture presented above you should have identified several diseases conditions we have covered in BIOL122.
• Name two of the diseases/conditions you identified and
• List two characteristic signs or symptoms per disease that you noted in Mary-Lous history and clinical picture.
• Finally explain the pathophysiology of both diseases conditions you named (i.e., explain the changes that cause the disease and relate the typical signs and symptoms of the disease to the clinical picture).
Question 2
Explain the mechanism of action of two drug types Mary-Lou is prescribed with and describe how these drug actions help mitigate some of her symptoms. In you answer make references to the pathophysiology of the relevant diseases.
Question 3
Based on her clinical picture and history, explain if Mary-Lou suffers from alcohol addiction. Support your answer with relevant evidence from the case study. In your answer you should define physical and psychological dependence and explain if signs and symptoms of either can be observed in Mary-Lou’s case.
Question 4
As part of her therapy Mary-Lou takes a new hypothetical medication (called MedX) which has narrow therapeutic index therefore you (as a health care professional) need to exercise special care when it comes to the determination of her required dosage.
Med X is taken orally and has the following features:
• In healthy adults, the absorbed Med X is subject to first pass liver metabolism, which decreases its bio availability to 10%.
• The active ingredient that enters the systemic circulation is water-soluble and shows very high protein binding: 98% of the drug molecules present in the plasma are bound to albumin and to a smaller extent, α1 globulin.
• Most of the drug is excreted by the kidneys, where it is both freely filtered and actively secreted in the proximal tubule.
Based on the above properties of the drug, explain why you would recommend dose reduction in Mary-Lou’s case. In your answer explain four age-related changes in the pharma cokinetics of Med X to justify why dose reduction is necessary in the present scenario. For each of those age-related changes described you will need to consider how the free plasma concentration of the drug is expected to change in Mary-Lou’s case compared to that of a young or middle-aged individual.
Case study 1 part 2- Musculoskeletal disorders
Mary-Lou’s family was happy with the management plan established by the doctor as Mary Lou was progressing quite well. She was using notepads to jot down reminders a pill box to keep her medication organized and a calendar to record appointments. Her family members were helping her with routine tasks such as cooking and paying bills. She was feeling much happier and did not have to rely on alcohol to go to sleep. On one particular day she was feeling so good she decided to walk to her GP appointment alone. On her way there she stumbled over a branch and fell. She felt excruciating pain in her hip. A passer by called an ambulance and she was taken to the emergency department at the Royal Melbourne hospital. An X-ray revealed that she had broken the neck of her femur and had to have surgery to repair it.
Mary-Lou wondered whether this was linked to the crepitus she had been experiencing in her joints. Her joints did feel quite stiff and painful lately. The specialist explained to Mary-Lou that the crep it us was likely due to degeneration of her cartilage and said that the fracture might have been due to weakened bones. He told her he would like her to have a bone mineral density test to measure her bone density. The DEXA scan gave a T-score of -3.0. Mary-Lou is now given bis phosphonates and told to increase her daily intake of calcium.
Question 5
Discuss the pathophysiology of the condition causing the crepit us Mary-Lou is experiencing in her joints. In your answer list at least two more signs and symptoms associated with the disease.
Question 6
Discuss how the aetiology of Mary Lou’s joint disease differs from the other joint disease we covered in BIOL122.
Biological Manner The Process Assignment – Australia.
Question 7
Discuss why Mary-Lou’s fracture may take longer to heal than it would for someone who was half her age. In your answer, you are expected to name and discuss three physiological factors that are needed for healing to take place and explain how each of the factors you identified is affected by ageing. Finally name two complications of hip fracture that are prevalent in the elderly.
Question 8
Considering Mary-Lou’s T-score, identify the disease she suffers from, briefly describe the pathogenesis of this disease and explain why bis phosphonate administration is helpful in this condition.
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