ames Scott that went to Nepal, India for his training. On a hike in the Himalaya
ID: 3472665 • Letter: A
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ames Scott that went to Nepal, India for his training. On a hike in the Himalayan Mountains he became lost for 42 days due to a snow storm. He had not taken food, water or survival gear for this type of emergency. On presentation to the hospital in Nepal he was considered gaunt and emotionally labile. Overall he needed several weeks of care; however, after one or two days of care he had the following values: Weight: 61 kg, Estimated normal: 80 kg Temp: 98.2F Tenting of skin, edema of ankles BP 114/70 and HR 108 while supine, BP 60/52 and HR 120 while sitting. Hct: 44%, WBC: 4,400 Sodium 128 mMol/L, Potassium 3.0 mMol/L, Glucose 5.11mMol/L (92 mg/dl), Urine Ketones + Albumin: 44 g/L Prothrombin : +3sec, Creatinine day 1: 0.1mMol/L, day 4 0.06mMol/L BUN 30 After 1 day of fluids, 2000ml/24hr IV, 1500ml/day per os, urine output was 80ml/hour.
5. Thinking about edema, we think of capillary permeability, low osmotic pressure, heart failure, lymph obstruction, and renal failure and a patient can be “over hydrated”. He had edema, tachycardia and odd BP readings before the “iatrogenic over hydration”. What does Iatragenic mean? ____________________________________________
What is nystagmus and what does it indicate? ______________________________________________________
Thiamine is vitamin ___________ and is a coenzyme used to breakdown pyruvate to Acetyl CoA.
Thiamine is given to alcoholics too because typically they don’t have a good diet. Giving a starving person glucose and no thiamine can result in brain cell damage and even death! James was given food before thiamine and this is when a candy bar is a ‘bad thing’ in the Martha Stewart College of Medicine.
6. Please give a definition for the term Refeeding Syndrome: _______________________________________
_________________________________________________________________________________________
They were concerned he could have hypophosphatemia. What is that? _____________________________
Given his nutritional deficits, would you choose to give him a diet high in carbs, protein or fats?
_________________________________________________________________________________
Explanation / Answer
5.Latragenic is related to a medical disorder caused inadvertently by a physician or a surgeon during diagnostic procedures or during treatment.
Nystagmus means involuntary movement of eyes. It could be from infancy or acquired later in life. It may result in limited or reduced vision.
Thiamine is a vitamin B1.
Refeeding syndrome is found in malnourished patients who are subjected to artificial feeding. This could lead to fatal shift in electrolytes and metabolic disturbances. This may have serious clinical problems.
Hypophosphatemia can be defined as low levels of phosphorus in blood.
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