?Need to write a CASE STUDY for the following data. Chief Complaint: RM an 8-yea

Question

?Need to write a CASE STUDY for the following data.

Chief Complaint: RM an 8-year-old girl is taken to the local clinic and presents with excessive thirst, frequent urination, and weight loss. History: RM, an 8-year-old girl in previously good health, has noticed that, in the past month, she is increasingly thirsty. She gets up several times a night to urinate, and finds herself gulping down glassfuls of water. At the dinner table, she seems to be eating twice as much as she used to, yet she has lost 5 pounds in the past month. In the past three days, she has become nauseated, vomiting on three occasions, prompting a visit to her pediatrician.

Explanation / Answer

A. Rise in blood phosphate levels (due to end stage renal failure in this case) results in fall in blood calcium levels mediated by rise in Calcitonin levels (which increases calcium deposition in bones) and reduction of Parathromone that leads to decrease in blood calcium and increase in the phosphate levels. The renal tubular reabsorption of phosphate is inversely regulated by calcium levels thus an increase in phosphorous causes decrease in calcium

B. Hyperphosphatemia causes soft tissue calcification, Hypocalcemia and bone fracture. The danger presented to the soft tissue is Calcification.

C. Endocrine system in order to compensate the low levels of calcium, stimulates the Parathyroid glands which release Parathormone which in turn activate osteoclasts that degrade bone tissue to release calcium ions in the blood to maintain homeostasis. (Increase in parathormone is accompanied by reduction in calcitonin)

D. Effect on skeletal system: As bones are decalcified, it may lead to bone fractures due to bone resorption by parathormone.

Renal Osteodystrophy: As phosphate levels are high and it is inveresely regulated to calcium reabsorption in renal tubules, it leads to failure of calcium absorption. This inturn activates the parathormone which causes hyperparathyroidism causing bone deformation which is termed as Renal osteodystrophy.

E. The term for high phosphate levels in the blood is Hyperphosphatemia and the term for high calcium levels in the blood is Hypercalcemia

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