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Old Man with Pneumonia Case Study Assignment Sample


Task: This assessment task gives you the chance to read extensively about the health status of a critically ill patient. You must choose a case for analysis that either had shock, acute respiratory failure, or heart failure. We are looking for evidence of at least one management strategy that has been presented, as well as a demonstration of a thorough comprehension of the applied pathophysiology that supports the patient's primary condition.

Please be aware that we are not searching for extensive information about the patient. The message can be communicated in one or two sentences (see the example). Since no patient information would be presented in the manuscript, institutional approval is not necessary. It is not sufficient to just list test results if you desire to incorporate them; a list does not express your opinion and does not thus contribute to the grading. Instead, you must offer the test findings in the context of your analysis. You could say, for instance:

The patient's symptoms included hypotension (mean arterial pressure of 48), hypoxia (low oxygen saturations), acidosis (pH of 7.16), and hypocapnia (55 mmol/L of carbon dioxide).

In terms of case selection, if you feel as though you are at a loss for what to choose for review, please speak with your instructor to go over your possibilities. Heart failure is not an acceptable topic choice for cardiovascular students. Positive pressure ventilation cannot be discussed by intensive care students.

Examples of instances and subjects for review

It is not necessary for the subject or case to be complex. Simple examples include
• lowering of blood pressure
• decreased oxygen saturations
• the vasovagal episode
• gastric contents being aspirated
• pneumonia
• hypertension
and so forth

No of the subject, it is your responsibility to describe the compensating processes that are engaged in reaction to the issue. Then you make at least one management strategy a link to the associated physiology.


1. Introduction:

The pathophysiological issues of James, a gentleman of 57 years old, will be critically discussed in the pneumonia case study. Due to abrupt hypoxemic respiratory failure brought on by severe pneumonia, he was sent to the intensive care unit (ICU) (Mansour et al., 2015). After seeing Japan and New Zealand, James had just returned from a two-week trip abroad. James had been healthy for the 21 days before to admission and had just recently started experiencing modest symptoms. However, two days ago, his condition quickly deteriorated, leaving him with a 39.2-degree fever, shivering, hypoxia, arthralgia, myalgia, and persistent shortness of breath. Since the patient needs some supportive care and has been diagnosed with influenza. Additionally, the acute clinical management strategy for the pneumonia case study will be critically analysed. James will receive additional tests and chest X-rays as his condition worsens in the intensive care unit, and it will be determined whether the clinical management plan is supported by the most recent evidence-based literature.

2. Ethical Use of Patient Healthcare Data:

In terms of ethics, the patient is responsible for allowing the use of their data in research studies. When any type of research is conducted using patient data, ethical problems typically surface. To ensure that patient data is evaluated ethically and that outside assistance is only sought when necessary, it is the patients' and the healthcare department's obligation.

3. Pathophysiology Problem and Treatment Analysis

The human respiratory system typically involves the passage of air through the nose, nasal cavity, pharynx, larynx, trachea, and bronchi after passing through the nose and nasal cavity (Luo, 2016). The Nares is the name of the aperture to the nose. The Nasal cavity has a mucous membrane lining it, along with cilia and blood vessels. The proposed Biology case study shows that there is a cilia where some air filtration is done, warmed by the blood, and moistened by the mucous membranes. A portion of the throat, sometimes known as the pharynx, is where air passes. Williams and Tordoff (2018). The food and air typically go along this route. The air then keeps moving through the larynx. The epiglottis is a flat piece of tissue that is visible on the other side of the larynx and is closed when swallowing anything to keep it from getting into the alveoli. A vocal fold is located in the larynx, or voice box. The bronchial tree and larynx are joined by the windpipe, often known as the trachea. To keep the trachea from collapsing, it features a cartilage ring. The pneumonia case study investigates the fact that the lungs' spongy tissues are also connected to blood capillaries and alveoli in the respiratory system. Human bodies begin to breathe when their lungs dilate and then expand. The smaller bronchi, known as bronchioles, are carried by the air through larger bronchi. At the ends of each bronchiole, there are alveolar sacs. The Alveolar Sacs have blood capillaries that surround them, contain a single layer of millions of alveoli cells, and carry out gas exchange functions. When air is inhaled through the nose, oxygenated air first travels through the pharynx before moving through the larynx, trachea, bronchi, and finally the alveoli. When capillaries process the fusion, oxygen from the air is transferred to the alveoli. In order to exhale carbon dioxide, the capillaries push the gas to the alveoli. Respiration is the name given to such a procedure.

The exchange of gases between the bodily cell and the atmosphere occurs during respiration. In it, numerous things happen, one of which is breathing. The Alveolar Sacs transport air to the Alveoli, where gas exchange is processed and easily absorbed (De Giacomi et al., 2018). Alveoli perform the gas exchange between epithelia capillaries and alveoli when they are filled with air during an inspiration. The blue gas over here is the carbon dioxide that has been exhaled, and the white gas over here is inspired oxygen. Red blood cells ultimately change colour after a gas exchange is completed. The red blood cells are altered in the capillaries such that the alveoli release carbon dioxide before binding oxygen.

An inflammation in the lower respiratory tract and a deadly infection were discovered in a case study of a patient with pneumonia. This infection is brought on by pneumococcus streptococcus pneumonia, which is a combination of a virus, bacteria, mycoplasma, and pathogens that can be breathed. The infection increases the amount of fluid that is secreted, and this extra fluid pools and gathers in the lungs' air sacs (Dumas et al., 2019). Pneumonia is associated with the air space in the lungs when excaudate is present, which produces coughing, acute chest discomfort, shortness of breath, and a high temperature. When the patient was first admitted to the hospital, the same situation was seen in him as well (Dickson et al., 2017).

The next day, an x-ray of the chest revealed pneumonia in the left upper lobe. Due to his acute hypoxemic respiratory failure, the patient was prescribed an albuterol inhaler and azithromycin. He also received an intravenous stat dose of ceftriaxone and azithromycin before being discharged and allowed to return home (Ramos-Rossy et al., 2018). After two days, the patient began to have chronic symptoms, for which cough syrup and prednisone were recommended. The patient from the pneumonia case study reported exhaustion. His temperature had risen to 38.8°C. Since he took acetaminophen, he was unable to fall asleep. He also had a persistent cough that occasionally produced blood-tinged sputum, as well as pleuritic chest pain. He had dyspnea when I was assessing his health (Kazzaz et al., 2017). As a nurse, I evaluated the patient's vital signs and discovered that their blood pressure was 148/72 mm Hg, their breathing rate was about 26 breaths per minute, their pulse rate was 88 beats per minute, and their oxygen saturation level was 94%. Some crackles had been observed in the left axillary region and left lung base (Serota et al., 2018). A significant infiltration is visible on the left side of the chest radiograph.

The left upper lobe of the chest was observed to have a severe consolidation on the lateral and posteroanterior chest radiographs, whereas the right upper lobe had a mild consolidation and a faint left pleural effusion. Lymphadenopathy was absent, nevertheless.

Prior to admission, a portable anteroposterior via the chest radiograph was taken to check for more lung opacification. The left upper lobe showed the most involvement, and the right upper lobe of the right lung showed multifocal consolidation (Sanz-Herrero et al., 2016).

The doctor started a Vancomycin therapy on the third day, and on the fifth day, he started an imipenem therapy. However, the patient developed hypoxemia on the sixth day, for which he required four litters of oxygen therapy delivered through nasal prongs. Around 270 mg per deciliter of?1-antitrypsin was present (Kawakami et al., 2019). IgM, IgG, and total bilirubin levels in the blood as well as their anion gaps were all within normal ranges.

According to the readings generated in this case study on pneumonia, the patient was transferred to the intensive care unit (ICU) for additional assessment and maintained there for two days. A bronchoscopy was performed, and the results showed a purulent discharge without any mucous plugs. The left ventricular's ejection fraction ranged from 60 to 65%. The cultures of the sputum samples were unfavourable (Kushwah et al., 2018). It was discovered that the echocardiography had biventricular function and wall motion.

By the ninth day, the airway pressure that was prescribed to have positive bi-level had gradually improved. Methylprednisolone was given at the precise moment the trachea was intubated voluntarily on the same day. The sputum cultures had produced species of candida while the blood cultures came back negative (Park et al., 2016).

The patient needs to be admitted to the ICU once more on day ten. Norepinephrine, fentanyl, and midazolam intravenous infusions, as well as moxifloxacin, vecuronium, vancomycin, imipenem, ondansetron, sodium succinate, acetaminophen, pantoprazole, enoxaparin, ondansetron, albuletrol, nystatin suspension, and fluticasone nasal spray, were among the medications the doctor The patient also had indomethacin for his gout and received an influenza vaccination. The administration of drugs revealed no allergy symptoms in his body, nonetheless. He informed me about himself and the places he had lived and worked as I was watching him. He also revealed that he used to smoke 40 packs of cigarettes every two weeks, but for the past six months, he had quit before falling ill and being brought to the hospital (Ivanick et al., 2019). He doesn't use any illegal substances, and he used to drink alcohol very infrequently or on special occasions.

His mother and sister both had a?1 - antitrypsin deficiency, and his mother also had chronic obstructive lung disease, it was discovered when he spoke about his family history (Hirai et al., 2017). At the age of 63, his father passed away from a myocardial infarction. He was afebrile, sedated, and intubated as the patient studied for the case study on pneumonia was being examined. His heart rate was 50 beats per minute, his respiratory rate was 38 breaths per minute, and his blood pressure was measured at 89/22 mm Hg. He received ventilator assistance during this stage (Orsini et al., 2020). It had normal heart and bowel sounds, but there was considerable swelling in the limbs and legs indicative with 2+ edoema, as well as bilateral breathing noises. Plasma anion gap and serum protein electrophoresis were both found to be within normal ranges. hazy looking urine After urine examination, it revealed that there was 1+ albumin and 2+ urobilinogen (Yoshimi, Satou and Mori, 2018). Additionally, according to his report, he has 3 to 5 white cells, 5 to 15 red blood cells, very few renal tubular cells per high power field, few squamous cells, few reparative cells, 30 to 90 granular casts per low-power field, 20 to 100 hyaline cast, and mucus (Mangioni et al., 2019).

It is necessary to insert the esophagogastric and endotracheal tubes in the chest radiography that was shown in the pneumonia case study scenario. Additionally, there was a significant rise in bilateral multifocal consolidation without pleural effusion and pneumothorax. The oxygen inspired has a proportion of oxygen growing toward 1, the arterial partial pressure of oxygen (PaO2) rises to 93 mm Hg, and the oxygen saturation is 95%. (Wang et al., 2018). He received infusions of fentanyl, propofol, vasopressin, meropenem, and methylprednisolone. Later, I discontinue delivering imipenem. When the sputum sample was stained with gram's solution, it became apparent that the polymorphonuclear leukocyte count was moderate. The test came back negative for adenovirus, respiratory syncytial virus, and parainfluenza antigens (Furumido et al., 2019). Nucleic acid testing was done for the influenza A and B viruses.

A two-drug antifungal chemotherapy regimen is necessary for the patient's treatment. As part of the treatment, corticosteroids will be given. Exercise-induced hypoxemia and restrictive ventilator dysfunction continue a year after therapy is finished.

4. What conclusions were drawn from the investigation on the pneumonia case study?

Pneumonia is quite common in people between the ages of 66 and 88, and it's more likely to be acquired in the community, according to one of the research taken into account when creating this case study on pneumonia (Sonaglioni et al., 2019). Another study indicated that approximately 14,069 Medicare recipients older than 65 who had a severe case of community-acquired pneumonia were admitted to the hospital. The geriatric age group difference was between 78 and 8 years, according to a different study used to construct this case study on pneumonia (Kwon et al., 2018). This could be as a result of the varying older population's hospitalisation rate and access to healthcare. Most cases of pneumonia in elderly patients are brought on by the lungs' loss of elastic recoil, the mechanical clearing of the airways, the weakening of the respiratory muscles that cause coughing, the aging-related decline in mucociliary clearance, the cumulative effects of coexisting chronic diseases, defects in cell-mediated immunity, and humoral immunity (Prendki et al., 2018).
When analysing the cases with sex distribution to support the pneumonia case study scenario, it is found that more males than females are affected, with the percentage of females being around 30% (lès-Nancy and Vandoeuvre-lès-Nancy, 2019). The fact that smoking and drunkenness are more prevalent among men may be to blame for this. Additionally, it could be a result of worsening COPD or heart failure.

5. Conclusion

According to the critical examination of the case study on pneumonia, the condition is a major issue for older individuals and is frequently encountered in clinical settings. The most typical signs of pneumonia in older patients include respiratory symptoms, gastrointestinal symptoms, tachypnea, tachycardia, and crepitation. When collecting sputum from an old patient, it is frequently difficult to pinpoint the etiological agents. The process of isolating the responsible microbes might occasionally be complex. Empirical therapy may therefore be required in this situation. The results of the pneumonia case study show that environmental factors, such as climate, play a major role in raising the risk of pneumonia, which affects the respiratory system and causes inflammation and infection of the alveolar spaces in the lungs.


1. De Giacomi, F., Ryu, J.H., Yi, E.S., and Vassallo, 2018. eosinophilic pneumonia acute. the diagnosis, treatment, and causes. Pneumonia case study American journal of respiratory and critical care medicine, 197(6), 728–736.

2. Immunocompromised Pneumonia, 2017 by R.P. Dickson. The Critical Care Evidence-Based (pp. 215-220). The Springer, Cham.

3. Pène, F., Kontar, L., Bruneel, F., Klouche, and Barbier, 2019. Dumas, G., Demoule, A., Mokart, D., Lemiale, V., Nseir, S., Argaud, L., and F. Acute hypoxemic respiratory failure in critically ill immunocompromised patients: centre effect in intubation risk. 23(1), page 306 of Critical Care.

4. It was published in 2019 by Furumido, M., Takamura, K., Nakakubo, S., Kikuchi, H., Yamamoto, M., and Kikuchi, K. Pseudomonas aeruginosa Was Found to Be the Cause of a Case of Fulminant Type Community-Acquired Pneumonia at Autopsy, Archives of Clinical and Medical Case Reports, 3, pp. 451-456.

5. Yamagishi, Y., Mikamo, H., Haranaga, S., Kinjo, T., Hashioka, H., Kato, H., Sakanashi, D., and Fujita, 2017. Daptomycin-induced eosinophilic pneumonia: six instances from two institutions and a review of the literature. 23(4), 245-249, Journal of Infection and Chemotherapy.

6. 2019 Ivanick, N.M., Moh, M., Seeley, E.J., and Benn Endobronchial masses on both sides and severe hypoxemic respiratory failure. Journal of Bronchology & Interventional Pulmonology, 26(4), pp. e65–e67, case study on pneumonia.

7. It was published in 2019 by Kawakami, H., Miyabayashi, T., Tsubata, C., Ota, K., Ishida, T., and Kobayashi, O. A case series on the spontaneous remission of organising pneumonia brought on by thoracic radiation therapy. Case report on pneumonia in respiratory medicine, volume 26, pages 180–184.

8. N.M. Kazzaz, A.M. Wilson, R. Kado, G.D. Barnes, and J.S. Knight, 2017. A 37-year-old man with primary antiphospholipid syndrome who was experiencing breathing problems and developing toe ischemia presented. The arthritis journal, 69(8), 1253.

9. 2018; Kushwah, M.S., Verma, Y.S., and Gaur, A. Clinical indicators of hypoxemia in children with pneumonia recognised as such by the WHO. Int J of Contemp Pediatr, 5(4), pp. 1178–82.

10. 2018: Distinguishing Respiratory Features of Category A/B Potential Bioterrorism Agents from Community-Acquired Pneumonia. Kwon, E.H., Reisler, R.B., Cardile, A.P., Cieslak, T.J., D'Onofrio, M.J., Hewlett, A.L., Martins, K.A., Ritchie, C. and Kortepeter, M 16(4), 224–238. Health security

11. F. lès-Nancy and F. Vanduvre-lès-Nancy, 2019. Varnish Particle-Induced Acute Eosinophilic Pneumonia: A Diagnostic Challenge. Journal of Investigative Allergy and Clinical Immunology, 29(1), pp. 46–83.

12. In children with severe pneumonia and respiratory failure after NCPAP therapy, Luo, Y. 2016. Assessment of blood gas analysis results and degree of infection. 22(18), pp. 52–55 in Journal of Hainan Medical University.

13. Muscatello, A., Gori, A., Abbruzzese, C., Mangioni, D., and Bandera, A. 2019. asthma case study Intravenous immunoglobulins that are specific to the varicella zoster virus are used as an adjunctive therapy for severe varicella pneumonia. Infectious Diseases International Journal, 85, pp. 70–73.

14. 2015 study by Mansour, M.K., Ackman, J.B., Branda, J.A., and Kradin, R.L. Case 32-2015: A 57-year-old man who had severe pneumonia and hypoxemic respiratory failure. asthma case study 373(16), pages 1554–1564 of the New England Journal of Medicine.

15. J. Orsini, H. Gawlak, V. Sabayev, K. Shah, L. Washburn, K. McCarthy, A. Courey, E. Mouyeos, and S. Pangallo, 2020. Phlegmonocystis jiroveci Pneumonia-Associated Acute Respiratory Distress Syndrome in a Patient with Non-Human Immunodeficiency Virus Infection Complicated by Pneumomediastinum and Pneumopericardium 12(3), pages 209–213, Journal of Clinical Medicine Research.

16. 2016 publication by Park, D.W., Lim, D.H., Kim, B., Yhi, J.Y., Moon, J.Y., Kim, S.H., Kim, T.H., Shon, J.W., Yoon, H.J., and Shin, D.H. A case report and literature analysis on extracorporeal membrane oxygenation for acute respiratory distress syndrome after HAART Initiation in an HIV-infected patient being treated for severe Pneumocystis jirovecii pneumonia. ?????????, 31(2). (2).

17. As of 2018, Prendki, V., Scheffler, M., Huttner, B., Garin, N., Herrmann, F., Janssens, J.P., Marti, C., Carballo, S., Roux, X., Serratrice, C., and Serratrice, J. An interventional, prospective cohort study examined the use of low-dose computed tomography to diagnose pneumonia in older adults. 51(5), p. 1702375, European Respiratory Journal.

18. A study by J. Ramos-Rossy, J. Flores, Y. Otero-Domnguez, J. Torres-Palacios, and W. Rodrguez-Cintrón was published in 2018. failure of the respiratory system due to hypoxia brought on by zika virus infection. Journal of Puerto Rico Health Sciences, 37, pp. 99–101.

19. Gimeno-Cardona, C., Tormo-Palop, N., Fernandez-Fabrellas, E., Briones, M.L., Cervera-Juan,., and Blanquer-Olivas, J., 2016. asthma case study The potential benefit of the 13-valent pneumococcal conjugate vaccine in avoiding respiratory issues in pneumococcal community pneumonia. 34(15), 1847–1852, Vaccine.

20. 2018 March, Serota, D.P., Sexton, M.E., Kraft, C.S., and Palacio Acinetobacter baumannii-caused severe community-acquired pneumonia in North America: case report and literature review. Open forum infectious diseases case study of pneumonia (Vol. 5, No. 3, p. ofy044). Oxford University Press (US).

21. Anzà, C., Sonaglioni, A., Lombardo, M., Rigamonti, E., Vincenti, A., Nicolosi, G.L., Trevisan, R., Zompatori, M., Cassandro, R., Harari, S., 2019. A patient with hypertrophic cardiomyopathy and bilateral pneumonia presents with an unusual presentation of acute pulmonary hypertension. 20(12), pages 853–856, Journal of Cardiovascular Medicine.

22. A. Tordoff and L.A. Williams, 2018. Adults with community-acquired pneumonia: The diagnostic validity of physical examination procedures and the academic dissemination of these procedures.

23. 2018; Wang, Y.; Zhao, S.; Du, G.; Ma, S.; Lin, Q.; Lin, J.; Zheng, K.; Zhang, G.; Matucci-Cerinic, M. A case report and literature analysis describe acute fibrinous and organising pneumonia as the initial manifestation of primary Sjögren's syndrome. 37(7), 2001–2005, Clinical Rheumatology

24. 2018; Yoshimi, M., Satou, Y., and Mori, M. sputum cytodiagnosis revealed a case of herpes simplex virus pneumonia. Case report on a case of pneumonia, Clinical Case Reports, 6(1), p.

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Constantina Case Study: Adult Female Marathon Runner Assignment Sample



Question 1 (8 marks total)

A. Endometrial tissue contains glandular structures relevant to Constantina’s reproductive function. Note the role of this glandular tissue in reproductive function, including any likely changes from normal in the secretion and resultant effects for Constantina.

B. Considering Constantina and her current circumstances describe the role of oestrogen and discuss how the levels of this hormone may vary from normal.

Question 2 (8 marks total)

A. Describe the role of the kidneys in maintaining fluid balance with reference to the role of antidiuretic hormone (ADH). Is Constantina at risk of not maintaining homeostatic fluid mechanisms? Why/why not?

B. What is a urinalysis and what is its significance for this case? With respect to the specific gravity (SG) component of Constantina’s urinalysis result, and using your knowledge of normal kidney function, would you expect this result? Why /why not?

Question 3 (8 marks total)

A. What is gut motility? Is it likely that Constantina’s gut motility has increased or decreased from normal? Discuss EITHER peristalsis OR segmentation in your response.

B. Why is it important for Constantina to maintain adequate protein intake? Discuss its importance in cellular recovery in your response.

Question 4 (8 marks total)

A. Constantina has used Voltaren Emugel (containing a NSAID) to ease her aching muscles. Identify the route of administration and discuss how the drug is likely to be absorbed after administration and its likely bioavailability. Justify your answer by discussing whether the drug would be subjected to hepatic first pass.

B. What is the importance of the half-life of a drug? Assuming 100% absorption and the half-life of an NSAID is 8 hours; calculate the % amount of drug that is likely to be present in the blood after 24hours.

Question 5 (8 marks total)

A. Consider Constantina’s blood pressure result and discuss whether the mean arterial pressure is likely to be varied from normal. In your answer you must include reference to a possible change in blood viscosity and briefly mention the consequences of any change in BP upon kidney function B. Discuss the role of the renin-angiotensin-aldosterone system in the maintenance of blood pressure in Constantina’s circumstance.


The Constantina biology assignment case study seeks to critically examine the clinical data provided by Constantina, a 38-year-old adult female marathon runner who visited a GP office in post-training run state.

Constantina's reproductive function may be considered in the context of endometrial tissue, which has glandular structures important for the release of glycogen, which enhances blood flow in the spiral arteries and raises progesterone levels (Lessey & Young, 2019). According to study by Brame, Macedo, and Klein (2017), high-intensity exercise in women lowers progesterone levels, which in turn lowers glycogen release from the glandular structure of endometrial tissue and may lead to poor endometrium tissue maintenance and monthly imbalance. Regarding the Constantina case study, Constantina engages in vigorous exercise, which has reduced progesterone production and caused glandular tissue to perform poorly in the release of glycogen, adversely impacting the reproductive system and menstrual cycle.

The release of oestrogen, which is crucial for maintaining reproductive health, raising cholesterol levels, and strengthening bones, is connected to the reproductive process (Vellanki, K., & Kramer, 2019). The secretion of luteinizing hormone and follicle-stimulating hormone is stimulated by an increase in oestrogen during the follicular phase of the menstrual cycle, which also maintains the growth of the endometrium. However, Nagai et al. (2016) suggested that excessive exercise may result in an abnormal variation in oestrogen secretion and a decrease in oestrogen secretion. Thus, it may be claimed that Constantina's three days of intense exercise each week decreased the oestrogen hormone's release from the usual level, which led to amenorrhea and impaired reproductive function.

Focusing on the Constantina case study once again, it is found that Constantina exhibits lethargy and a reduction in fluid consumption, both of which may be connected to renal function. In relation to the antidiuretic hormone, it is essential for maintaining fluid balance by controlling the concentration of urine and its excretion by reabsorption of bodily fluids. The anti-diuretic hormone operates on the late distal tubules of the kidneys and the collecting duct to stimulate re-absorption of water, which helps the body retain water (Cuzzo & Lappin, 2019). Aquaporin-2, which tends to increase water transport over the osmotic gradient and preserve hemostasis, is phosphorylated by it. In the provided case study with Constantina, Constantina is at risk of not maintaining fluid balance since her water consumption has apparently been lower than normal, which increases the likelihood that she may get dehydrated. It is also clear from her physical exam, which is depicted in the Constantina case study, that she is dehydrated, as evidenced by her dry lips, dark circles under her eyes, poor skin turgor, and high urine specific gravity. As a result, the fluid imbalance that results from Constantina's dehydration is not corrected.

A urinalysis was performed on Constantina in order to examine the urine sample, which is important for diagnosis. Urinalysis is the process of examining the colour, consistency, and concentration of urine. It is used to diagnose and treat a variety of illnesses, including kidney problems, UTIs, and diabetes (Free, 2018). The specific gravity (SG) of the urine in the Constantina case study is stated to be 1.035, indicating a value in the upper range. Due to the malfunction of the renal tubules and the production of the ADH hormone, it is thus suggestive of impaired kidney functioning. Due to an increase in urine output and a rise in solute concentration brought on by the inhibition of water reabsorption, there is an excessive loss of water and dehydration (Perrier et al., 2017). Therefore, a high SG is anticipated in the urinalysis because Constantina runs the risk of not maintaining a fluid mechanism.

Another element essential to preserving a person's health is their gastrointestinal motility. Simply put, peristalsis, or the movement of the contents inside the digestive system, is a result of the contractions and relaxations of the muscles of the gastrointestinal (GI) tract, which are referred to as gut motility (Beckett et al., 2017). According to Wood (2019), dehydration causes the gut to absorb a lot of water from food being digested, making it harder to excrete the food and obstructing peristalsis movement, which may be helped by a high water volume. Since dehydration is a problem in Constantina, it may be assumed that peristalsis movement will be less than usual.

Maintaining daily calorie intake, repairing cells and tissues, and promoting muscle and body development are the three major purposes of protein in the diet. Constantina competes in marathons, which are basically endurance sports that may cause discomfort and tissue damage. According to Eddens et al. (2017), eating a diet high in protein is necessary to promote cellular recovery, repair damaged tissue, and preserve the integrity of cells. As a result, she must maintain her protein consumption to satisfy her daily calorie demands. Protein also promotes muscle repair, which assists in cellular healing and facilitates the process of restoring strength (Cintineo et al., 2018).

Constantina was found to have severe muscular discomfort and soreness, according to the Constantina case study. Constantina turned to the NSAID-containing Voltaren Emulgel to soothe her sore muscles. Diclofenac is the NSAID component and the active ingredient in this emulgel, and it works by lowering inflammation and alleviating pain. Topical application through the skin is more likely to be absorbed systemically from the GI tract and first pass via the liver. Diclofenac sodium's relative bioavailability is thus related to the size of the region treated, dependent on the total applied dosage as well as the degree of skin moisture, and was 6% of the systematic exposure, indicating 94% lower than oral diclofenac (Gopalasatheeskumar et al., 2017).

It would be appropriate to discuss the significance of a drug's half-life in this situation. According to the definition, it refers to the length of time needed for a drug's plasma concentration to reach 50% of its whole body concentration (Binder & Skerra, 2017). This drug's half-life, which is important in addition to the two other critical parameters of strength and length, is intended to show if drug buildup may arise as a result of numerous dosage practise. Assuming complete absorption and an NSAID's 8-hour half-life, 50% of the medication will be absorbed in the first 8 hours, and the remaining 50%, or 25%, will be absorbed in the following 8 hours (16th hours). Additionally, half of 25%, or 12.5%, will still be present in the blood after 24 hours.

Constantina's blood pressure was again examined and determined to be 87/58 mm of Hg. Typically, the normal blood pressure ranges from 110/70 mm Hg to 120/80 mm Hg. As a result, it was anomalous in the case study situation for Constantina. Mean arterial blood pressure (MABP), which should typically range from 70 to 110 mm Hg, deviated in this situation and showed a lower result. According to study by Zimmerman et al. (2017), a condition where blood viscosity increases results in an increase in total peripheral resistance (TPR), which obstructs blood flow. The relationship between MABP and cardiac output and TPR shows that raising systolic blood pressure is necessary to maintain blood volume. As a result, low BP in the Constantina case study causes the TPR to drop, which in turn causes the blood viscosity to decrease. It results in a rise in blood flow and a decrease in MABP. According to Larsson et al. (2018), a drop in MABP will also result in a drop in blood volume, which will impede blood flow to the glomerulus. As a result, it affects how well the kidneys reabsorb substances.

For Constantina, a quick decrease in blood pressure triggers the renin-angiotensin-aldosterone pathway, which releases renin from the kidney (RAAS). Through activation of the angiotensinogen, which then transforms into angiotensin II, it causes the synthesis of angiotensin I. Aldosterone hormones are released, and they directly affect the kidney (Ghazi & Drawz, 2017). It works by enhancing salt absorption and releasing it into the bloodstream. Therefore, the conclusions drawn from the examination of the Constantina case study make it clear that in Constantina's circumstance, the production of the hormone aldosterone raises the salt level and blood volume, which ultimately raises the blood pressure.

The medical history, physical examination, and pathological tests, including a urinalysis, performed on Constantina provided crucial information concerning the problem of dehydration and hypotension, it can be inferred from the discussion above based on the case study of Constantina. The execution of these basic pathological tests may help to simplify the treatment plans in a manner that will effectively promote her health and wellness.


Beckett, E. A., Young, H. M., Bornstein, J. C., & Jadcherla, S. R. (2017). Development of Gut Motility. In Pediatric Neurogastroenterology (pp. 21-37). Constantina case study Springer, Cham. Retrieved from https://doi.org/10.1007/978-3-319-43268-7_3

Binder, U., & Skerra, A. (2017). PASylation®: a versatile technology to extend drug delivery. Current Opinion in Colloid & Interface Science, 31, 10-17. Retrieved from https://doi.org/10.1016/j.cocis.2017.06.004

Bramer, S. A., Macedo, A., & Klein, C. (2017). Hexokinase 2 drives glycogen accumulation in equine endometrium at day 12 of diestrus and pregnancy. Reproductive Biology and Endocrinology, 15(1), 4. Retrieved from Retrieved from https://doi.org/10.1186/s12958-016-0223-4

Cintineo, H. P., Arent, M. A., Antonio, J., & Arent, S. M. (2018). Effects of protein supplementation on performance and recovery in resistance and endurance training. Frontiers in nutrition, 5, 83. Constantina case study Retrieved from https://doi.org/10.3389/fnut.2018.00083

Cuzzo, B., & Lappin, S. L. (2019). Vasopressin (antidiuretic hormone, ADH). In StatPearls [Internet]. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK526069/

Eddens, L., Browne, S., Stevenson, E. J., Sanderson, B., van Someren, K., & Howatson, G. (2017). The efficacy of protein supplementation during recovery from muscle-damaging concurrent exercise. Applied Physiology, Nutrition, and Metabolism, 42(7), 716-724. Retrieved from https://doi.org/10.1139/apnm-2016-0626

Free, H. M. (2018). Urinalysis in clinical laboratory practice. Crc Press. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=ipxGDwAAQBAJ&oi=fnd&pg=PT11&dq=Free,+H.+M.+(2018).+Urinalysis+in+clinical+laboratory+practice.+Crc+Press&ots=wWf8iUwdAu&sig=WmMnaDceVrHxJliPg7_Xvp1RsB4&redir_esc=y#v=onepage&q=Free%2C%20H.%20M.%20(2018).%20Urinalysis%20in%20clinical%20laboratory%20practice.%20Crc%20Press&f=false

Ghazi, L., & Drawz, P. (2017). Advances in understanding the renin-angiotensin-aldosterone system (RAAS) in blood pressure control and recent pivotal trials of RAAS blockade in heart failure and diabetic nephropathy. Constantina case study F1000Research, 6. Retrieved from https://dx.doi.org/10.12688%2Ff1000research.9692.1
Gopalasatheeskumar, K., Komala, S., Soundarya, R., Parthiban, S., Bharathi, B. D., & Elango, S. (2017). Review on Emulgel Formulations with Non-Steroidal Anti-
Inflammatory Drugs for Topical Administration. Pharma Science Monitor, 8(1). Retrieved from https://www.academia.edu/34559197/review_on_emulgel_formulations_with_non-steroidal_anti-inflammatory_drugs_for_topical_administration

Larsson, J. S., Krumbholz, V., Enskog, A., Bragadottir, G., Redfors, B., & Ricksten, S. E. (2018). Renal blood flow, glomerular filtration rate, and renal oxygenation in early clinical septic shock. Critical care medicine, 46(6), e560-e566. Retrieved from doi: 10.1097/CCM.0000000000003088

Lessey, B. A., & Young, S. L. (2019). Structure, function, and evaluation of the female reproductive tract. In Yen and Jaffe's Reproductive Endocrinology (pp. 206-247). Content Repository Only!. Retrieved from https://doi.org/10.1016/B978-0-323-47912-7.00009-3

Nagai, S., Ikeda, K., Horie-Inoue, K., Shiba, S., Nagasawa, S., Takeda, S., & Inoue, S. (2016). Constantina case study Estrogen modulates exercise endurance along with mitochondrial uncoupling protein 3 downregulation in skeletal muscle of female mice. Constantina case study Biochemical and biophysical research communications, 480(4), 758-764. Retrieved from https://doi.org/10.1016/j.bbrc.2016.10.129

Perrier, E. T., Bottin, J. H., Vecchio, M., & Lemetais, G. (2017). Criterion values for urine-specific gravity and urine color representing adequate water intake in healthy adults. European journal of clinical nutrition, 71(4), 561-563. Retrieved from https://doi.org/10.1038/ejcn.2016.269

Vellanki, K., & Kramer, H. (2019). Amenorrhea and Estrogen Disorders in Women with Kidney Disease. In Endocrine Disorders in Kidney Disease (pp. 127-138). Springer, Cham. Retrieved from https://doi.org/10.1007/978-3-319-97765-2_10

Wood, J. D. (2019). Normal Anatomy, Digestion, Absorption. In Adult Short Bowel Syndrome (pp. 1-16). Academic Press. Retrieved from https://doi.org/10.1016/B978-0-12-814330-8.00001-9

Zimmerman, R., Tsai, A. G., Vázquez, B. Y. S., Cabrales, P., Hofmann, A., Meier, J., ... & Intaglietta, M. (2017). Post-transfusion increase of hematocrit per se does not improve circulatory oxygen delivery due to increased blood viscosity. Constantina case study Anesthesia and analgesia, 124(5), 1547. Retrieved from Retrieved from https://dx.doi.org/10.1213%2FANE.0000000000002008

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Biology Case study Assignment Sample



Case Study: Jane

After finishing a practice run, 38-year-old marathon runner Jane showed up at her doctor's office. She works out three days a week, but the previous three runs have left her feeling dizzy and with severe muscle pain. Jane acknowledges to the clinic nurse that she is feeling tired and that her "heart is racing." She was a touch shaky on her feet the night before and stumbled as she climbed the stairs of her house. She admits that she has been consuming fewer calories and less hydration than usual, but continuing to eat properly. In the previous month, she lost 2 kg. She adds that her Garmin watch showed that her resting heart rate used to be 51 bpm.

After her morning run, Jane immediately applied Voltaren Emulgel, a topical NSAID, to her calves and quadriceps in an effort to lessen the pain.

Answering the following question while keeping in mind the case study above

Describe the variations in pressure and volume.

Question 1, will be happening in Jane's chest cavity, in order to achieve exhalation during a lengthy run. Give a justification for these modifications and how they affect airflow.

A. Describe the gas exchange that takes place between the air in Jane's alveoli and the blood in her lungs. Will exercise affect the rate of gas exchange? Justify your response.

Question 2

A. Which ANS reaction would you predict would predominate throughout Jane's runs? Justify your response.

B. Which glucose homeostasis hormone would you anticipate being most active during this ANS response? Why? Explain your response using what you know about glucose homeostasis.

Question 3

A. Describe the function of the kidneys in maintaining fluid balance with reference to the function of antidiuretic hormone in question 3A. (ADH). Is Jane susceptible to failing to sustain homeostatic fluid mechanisms? Whether or not

B. What is a urinalysis and how important is it in this case? Would you anticipate this outcome based on Jane's urinalysis's specific gravity (SG) component and your understanding of typical kidney function? Whether or not

Question 4

A. Take into account Jane's blood pressure reading and examine if the mean arterial pressure is likely to differ from normal. You must indicate a potential change in blood volume and briefly discuss the effects of any BP change on renal function in your response.

B. Which system will be more important in maintaining Jane's blood pressure in this situation, the renin-angiotensin-aldosterone system or natriuretic peptides? Explain your response by describing how the system you choose contributes to blood pressure equilibrium.

Question 5

A. A major hemorrhage occurred during Jane's caesarean delivery, necessitating a blood transfusion. What blood type or types may have been safely given to Jane? Describe what may have happened if Jane had been given A+ blood.

B. Jane had a calcium shortage at the time of her caesarean delivery, it was discovered. What impact would this have had on her blood's ability to clot? Explain your response.



The newest case study in this biology assignment is about Jane, who is brought to the GP clinic at the age of 38 after finishing a training run. She has recently had dizziness, severe muscle pain, and reports of being lethargic, having a racing heart, being unsteady, and other dehydration-related symptoms. She used Voltaren Emulgel to sooth her painful muscles. The case study investigates bodily changes by looking at pertinent homeostasis, the function of the kidney in maintaining fluid balance, and Jane's blood pressure analysis.


Long-term adjustments will be made to Jane's chest cavity's pressure and volume to facilitate exhalation. The muscles in the thoracic cavity and the pressure differential between the lungs and the atmosphere both have a role in exhalation. The slightly negative pressure in the chest cavity helps to keep the lungs' airways open. As a result, during exercise, the volume of the chest will significantly expand during inhalation and decrease during exhale. The intercostal muscles are relaxed as a result of the lung recoil, which forces air from the lungs (chest) outside during exhalation. This relaxes the diaphragm, which is located higher in the thoracic cavity and brings the chest wall back to its natural place. The gradient of pressure between the atmosphere and thoracic activity causes the pressure in the thoracic activity to rise in relation to the environment as air rushes out of the lungs (Shao et al., 2014). Since no muscles are contracted to remove air from the lungs, these alterations are thought of as a passive event.

Gas exchange between alveolar air and pulmonary blood takes place over the long term and changes during activity. Inhaled oxygen travels via the lungs to the alveoli. There, the capillaries encircling the alveoli and the layers of cells that line them continue to be in intimate contact with one another. Jane will carry through this procedure quickly while running or exercising to allow for more oxygen and rid the blood of carbon dioxide. The blood in the capillaries' air-blood barrier allows oxygen to travel through quickly. After that, the blood transports the carbon dioxide to the alveoli for exhalation. The oxygenated blood travels from the lungs through the pulmonary veins to the left side of the heart, where it is then pumped to the rest of the body (Qureshi, 2011). After that, blood will be pumped down the pulmonary artery to the lungs, where it will be used to take in oxygen and release carbon dioxide.

The ANS response during Jane's runs comprises the control of the cardiovascular response, which will predominate. The commencement of the somatomotor signal is accompanied by the creation of a cardiorespiratory pattern by the central nervous system (CNS), which is thought of as a central command. This central order causes the heart's parasympathetic activity to decrease, resulting in increased breathing rates, and also resets the arterial baroreflex, resulting in higher pressure. When Jane is jogging, the cardiorespiratory system's main goals are to provide enough oxygen to the bodily tissues and remove waste. Normative blood flow is maintained between all bodily tissues by cardiovascular controls. Running while exercising increases the demand for oxygen to the muscles by 15 to 25 times compared to resting (Liu et al., 2013). The heart cannot function alone because it would be unable to carry out its tasks. Heart rate, blood pressure, and respiratory rates all rise as a result of an increase in the body's need for oxygen. This necessitates significant changes in the blood flow from numerous inert organs towards the skeletal system's active muscles.

The fundamental function of the brain is to control peripheral glucose metabolism via signalling mechanisms and metabolic pathways. Exercises have an effect on several areas of the brain, changing how genes express proteins involved in synaptic plasticity, cellular bioenergetics, neurotrophic factor signalling, cellular stress tolerance, and the removal of harmed organelles and proteins. When the pancreas maintains blood glucose levels that vary within a relatively small range of 4-6 mM throughout the ANS response, the glucagon and insulin hormones are most active (Mitrakou, 2011). The maintenance of glucose homeostasis is accomplished by opposing the balanced activities of glucagon and insulin. The ANS response will cause the glucose homeostasis response to be most active in order to achieve a balance of glucagon and insulin for the maintenance of blood glucose levels.

The kidneys' job is to regulate the urine's concentration so that it reflects the body's demand for water. They do this by creating more diluted urine when the body needs to eliminate surplus water, or they do it by conserving water when the body is dehydrated. Because Jane is dehydrated, her kidneys will retain more water, and the ADH hormone helps the body retain water by improving the kidneys' ability to reabsorb water. By inserting water channels in the kidney tubule membranes, ADH promotes water absorption. The channels subsequently return solute-free water to the blood through the tubular cells, reducing the osmolarity of the plasma and raising the osmolarity of the urine (Cuzzo, & Lappin, 2019). Given that Jane is already dehydrated, she is more likely to fail to maintain a homeostatic fluid mechanism. Osmoreceptors in the hypothalamus monitor the concentration of electrolytes in extracellular fluid to regulate the body's level of hydration. When excessive sweating causes water loss, which causes neuronal signals from osmoreceptors to be transmitted from hypothalamic nuclei, the concentration of these electrolytes in the blood rises. Aldosterone, a steroid hormone generated by the adrenal cortex, is in charge of maintaining the electrolyte concentrations in extracellular fluids. Aldosterone, as opposed to ADH, promotes NA+ reabsorption and K+ secretion from the extracellular fluid in the cells of the renal tubules, assisting in maintaining adequate water balance (Zittema et al., 2012). A drop in blood potassium levels triggers the release of this hormone, halting the loss of Na+ through sweat, saliva, and gastric juice.

A urine test called a urinalysis is used to diagnose and treat a variety of illnesses. The look, concentration, and urine content are all examined. An illness or disease may develop as a result of an abnormal urinalysis. In this instance, the importance of urinalysis is in identifying elevated protein levels or identifying symptoms of kidney disease (Callens & Bartges, 2015). According to Jane's urinalysis results' specific gravity of 1.035 and knowledge of typical kidney functions, an increase in specific gravity in the urine is a sign that the adrenal glands are underproducing hormones, that there is a lot of sodium in the blood, that the person is dehydrated from a loss of body fluids, that the kidney artery is narrowed, or that there is an associated syndrome of inappropriate ADH secretion (Ristic, & Skeldon, 2011). These are the cases that were discovered as a result of Jane's elevated levels of physical activity, together with her ingestion of protein and dehydration.
Given Jane's dehydration, it is more possible that Jane's blood pressure will vary from normal ranges. Due to a reduction in blood volume, dehydration can cause blood pressure to drop. Dehydration causes the blood volume to decrease, which lowers blood pressure since adequate blood volume requires that the blood be able to reach all body tissues. The organs won't obtain the necessary amounts of oxygen and nutrients at such a reduction in pressure levels. The kidneys will lessen the amount of urine produced, which tightens the capillaries in the heart and certain parts of the brain (Daugirdas et al., 2013). It can put a great deal of pressure on the kidney walls since the kidneys won't be able to filter out urine as they normally would under conditions of low blood pressure. Renal disease can result from kidney damage caused by urine retention.

The condition calls for the renin-angiotensin-aldosterone pathway to predominate over natriuretic peptides in maintaining Jane's blood pressure. The RAS controls the fluid balance in the blood as well as blood pressure. Blood potassium levels rise and kidney cells produce the enzyme renin when blood volume or sodium levels in the body fall. Due to the hormone angiotensin I, renin transforms the angiotensinogen generated in Jane's liver. Angiotensin I is converted into angiotensin II by the lung-located enzyme ACE (Provenzano, & Sparks, 2020). In order to restore the potassium, sodium, and fluids and return blood pressure to normal ranges, aldosterone and angiotensin II work to increase blood volume, sodium levels in the blood, and blood pressure.

The blood type that can be safely given to Jane in the event that she haemorrhages during her caesarean delivery and needs a blood transfusion is her blood group. If Jane had received A+ blood, she would have quickly recovered. If Jane had a calcium shortage at the time of her caesarean delivery, it would have prevented her blood from clotting (Fyfe et al., 2012). Calcium ions, the most significant mineral in blood, are required for clotting.


In conclusion, Jane has experienced significant difficulties with her dehydration, which has had a significant negative influence on her kidneys. She needs medical care right away to get her water levels back to normal so that her kidneys and other organs can start working again and her blood pressure will return to normal.


Callens, A. J., & Bartges, J. W. (2015). Urinalysis. Veterinary Clinics: Small Animal Practice, 45(4), 621-637. https://doi.org/10.1016/j.cvsm.2015.02.001
Cuzzo, B., & Lappin, S. L. (2019). Vasopressin (antidiuretic hormone, ADH). Europe PMC. Accessed from [https://europepmc.org/article/NBK/NBK526069]

Daugirdas, J. T., Greene, T., Rocco, M. V., Kaysen, G. A., Depner, T. A., Levin, N. W., ... & Kliger, A. S. (2013). Effect of frequent hemodialysis on residual kidney function. Kidney international, 83(5), 949-958. https://doi.org/10.1038/ki.2012.457

Fyfe, E. M., Thompson, J. M., Anderson, N. H., Groom, K. M., & McCowan, L. M. (2012). Maternal obesity and postpartum haemorrhage after vaginal and caesarean delivery among nulliparous women at term: a retrospective cohort study. BMC pregnancy and childbirth, 12(1), 112. https://doi.org/10.1186/1471-2393-12-112

Liu, Q., Yan, B. P., Yu, C. M., Zhang, Y. T., & Poon, C. C. (2013). Attenuation of systolic blood pressure and pulse transit time hysteresis during exercise and recovery in cardiovascular patients. IEEE Transactions on Biomedical Engineering, 61(2), 346-352. DOI: 10.1109/TBME.2013.2286998

Mitrakou, A. (2011). Kidney: its impact on glucose homeostasis and hormonal regulation. Diabetes research and clinical practice, 93, S66-S72. https://doi.org/10.1016/S0168-8227(11)70016-X

Provenzano, A. M., & Sparks, M. A. (2020). The renin-angiotensin–aldosterone system update: full-court press. Nephrology Dialysis Transplantation, 35(9), 1488-1490. https://doi.org/10.1093/ndt/gfz123

Qureshi, S. M. (2011). Measurement of respiratory function: an update on gas exchange. Anaesthesia & Intensive Care Medicine, 12(11), 490-495. https://doi.org/10.1016/j.mpaic.2011.08.006

Ristic, J., & Skeldon, N. (2011). Urinalysis in practice–an update. In Practice, 33(1), 12-19. http://dx.doi.org/10.1136/inp.c7446

Shao, D., Yang, Y., Liu, C., Tsow, F., Yu, H., & Tao, N. (2014). Noncontact monitoring breathing pattern, exhalation flow rate and pulse transit time. IEEE Transactions on Biomedical Engineering, 61(11), 2760-2767. DOI: 10.1109/TBME.2014.2327024

Zittema, D., Boertien, W. E., van Beek, A. P., Dullaart, R. P., Franssen, C. F., de Jong, P. E., ... & Gansevoort, R. T. (2012). Vasopressin, copeptin, and renal concentrating capacity in patients with autosomal dominant polycystic kidney disease without renal impairment. Clinical Journal of the American Society of Nephrology, 7(6), 906-913. DOI: https://doi.org/10.2215/CJN.11311111

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