Patient Pathophysiology - Case Study Example

Name xxxxxxx Title: Patient Pathophysiology Institution xxxxxxx Professor xxxxxxx Course Date xxxxxxx Introduction Pathophysiology is a field of study that examines the body functional changes emanating from in reaction to an illness or accident. The field of study is designed in such a way that the specialists in the field are able to study the progress of the ailment so that a remedy can be identified quickly for the disease and the possible treatment options explored (Silverthorn, 2007). The medical doctors, nurses, the medical technicians and all the profession require the skills to work effectively in their respective fields as they carry out their various in services to the people and clients in the society. Most of the professions gain the pathophysiology expertise during their work and this is fundamental in understanding g the development of the disease (Silverthorn, 2007). Pathophysiology consists of two separate medical fields and they include physiology which looks at the study of the body and its functions. The second part is the pathology which interests on the study of the disease and the associated impact on the body of the patient. Pathophysiology looks at how the progress of the disease affects or the changes in the body and how the given changes can be taken care of or reversed. Pathophysiology cannot be considered to be academic and knowing the way the disease is developing can guide the doctor in giving substantial prediction of the next move of the ailment thus provide the essential and appropriate protection to the patient (Kearney, 2005). The pathophysiology skills are essential further since doctors must choose the optimal procedure and medications to administer to their patients. Pathophysiology knowledge is critical in the end life care as the signs can easily be identified by the doctors and thus prepares accordingly and also provide the appropriate care needed to make the patient comfortable. The major challenge in pathophysiology is the fact that every human being or body is different. One may be normal to one person may be abnormal to another and the way disease behave in different people also differs. And this is the basis as to why the professionals in the field need to be exposed to wide range of cases of patients and diseases so that they are in touch with the diversity of situations and come across real-world instances of the physiological and pathological differences. Misleading or wrong diagnosis to the patients can be in cases where the doctors are not exposed to the diverse medical knowledge and acquisition of the technical expertise to keenly analyze and administer the ailments effectively. Discussion With case at hand, the 81 year old Jack is a hypertension patient. It will be essential to understand the hemodynamic determinants of systemic hypertension, getting to identify and recognize the primary and secondary forms of hypertension get the insight of the role of the kidney in the systematic hypertension and appreciate the role of the sympathetic nervous system in the pathogenesis of hypertension (Silverthorn, 2007). Hypertension is also referred the high blood pressure that results into serious life threatening incidents such as stroke, heart failure or even renal failure when sustained for a long time (Kearney, 2005). The disease is associated with one’s lifestyle and the dietary imprudence, lack of exercise that mostly results in one being obese. The hemodynamic determinants of the systematic include the blood pressure which results from the pressure generated when the hearts contracts against the resistance of the blood vessels (Martini, 2009). The systematic hypertension is found to be necessary in increasing the cardiac output and also make significance contribution to the systematic vascular resistance. Primary hypertension also known as the “essential’ hypertension accounts for over 90% of all the reported hypertension cases and it has strong family history links with over 70% positive family history witnessed. The secondary hypertension is reported to have identifiable underlying cause which can either include renal artery stenosis, kidney disease, pheochromocytoma or hyperaldosteronism. The secondary hypertension represents 10% of the reported hypertension cases. The secondary hypertension can be differentiated from basic hypertension on medical grounds and mostly it has a specifiable therapy and it’s possibly curable. The kidney has been shown to be playing an essential role in the systematic hypertension. It has been demonstrated and evidence exists to the fact that the progressive kidney failure results to patients being 100% hypersensitive, the chronic kidney disease is the frequently reported form of the secondary hypertension and the hypertension is usually cured or improved by hemodialysis. Atrial fibrillation (AF) is abnormal heart rhythm that involves the two atria of the heart (Porth, 2008). These results in the quivering of the muscles of the heart also known as the atria instead of the synchronized contraction of the heart muscles. The Atrial fibrillation can be identified by taking the pulse and closely observe the heart beats of the patients for any irregular intervals noted. AF is mostly indicated by the lack of the P waves in the electrocardiogram (EKG or the ECG) which are usually present whenever a well coordinated atrial contraction at the start of each heart beat. The risk is reported to be increasing with age (Porth, 2008). When the normal electrical impulses that result from the sinoatrial node are weighed down by the unsystematic electrical impulses that emanate in the atria and the pulmonary veins resulting in the transmission of the asymmetrical impulses to the ventricles that generates the heartbeat. This results in irregular heartbeat, which appear periodically lasting from minutes to weeks and it can also last for years (Kearney, 2005). AF naturally has a tendency of becoming chronic and this leads to an increase in the risk of death. To be able to effectively evaluate the AF, the case has to be diagnosed, the etiology of the arrhythmia has to be determined and it has to be classified. The minimal evaluation should be performed to all the persons diagnosed with AF. The evaluation process includes the physical examination, the patients’ history, the ECG, the routine blood check work and the transthoracic echocardiogram, the valuation of heart rate response to exercise, the stress level testing, trans-esophageal echocardiography and possibly chest X-ray. Reported as the most common cardiac arrhythmia, AF is linked with high risk of morbidity and mortality. so far , despite the notable advancements in the treatment, AF remains the major determinant of the morbidity and mortality among the population. Morbidity results in recurrent hospitalization as a result of life threatening symptoms such as stroke, heart failure and systematic thromboembolism. There is significant increase of the elderly patients admitted in hospitals with AF worldwide and this striking observation has significant implication of how much it is costing the society in general when it comes to managing the aging population in our society as the prevalence tendency are increasing for the AF illness (Lawes, 2006). Presently there is not substantial evidence of the research on the AF progression and the further linked dangers that will require evaluation to establish the potential benefits of the catheter ablation on the evolution and clinical assessment of the arrhythmia. Depression is another aspect that we see associated with Jack. Depression is reported to be affecting millions of the world population and it occurs at any age of life from early childhood to late age in life (Porth, 2008). Depression is found to be very costly to the society as the disorder results in tremendous distresses and disturbances of life and if not measures are taken on time to tame may result in fatal effects. The symptoms for a depressed person include low moods, low energy and fatigue, sleep disorder and disturbances, suicidal tendencies, low self esteem, autonomic and intestinal disturbances. The cases of depression are not homogenous but a complex occurrence with many subtypes and more than one etiology. And this includes a penchant to sporadic and often progressive frame of mind instability. The symptom differences ranges from mild to sever symptoms with or without psychotic characteristics and interactions with other psychiatric and somatic disorders. Depression is reported to be having a great impact on the patient’s life and this entails the personal, social and family attainments. Major depressions are associated with physical or comorbid mental conditions that are likely to result in the decline in the life expectancy. Reactive emotional component and the behavioral responses to unpleasant life events is one of the major components of the pathogenesis of the depressive states. The other component is the inborn dissimilarities in physiology. This paradigm was initially used by the philosophers then followed by psychologist and physicians for decades now. The approach is wrapped up with the characteristics between endogenous and reactive dejection subtypes. The dichotomy is no longer the foundation of the current characterization since it has proved to be far more graphic and could not accommodate the patients with both a high reactivity to distressing and an inclination to impulsive mood fluctuations. It is still acknowledged that depression engages reactive behavior models that are accompanied by short and also long-term biological changes (Lawes, 2006). Inborn structural and also metabolic dissimilarity can result in mood instability and changes that can partly be independent of the individual`s environment and surrounding. There is a better understanding of the relationship of the endogenous and reactive factors. There is a clear understanding of the association linking the pathogenesis of depression to the mechanisms of action and reaction of the treatments in a given biochemical and neural modification resulting from the medication. Currently the biologists and therapeutics have failed in coming up with a diagnostic system that defines the patients groups to allow for standardized research in the field. The patient’s reaction to medication is still unpredictable using the existing models and thus the call for further research that will validate the existing medical markers, test the new models, make sense of clinical appearance, confirm treatment methods and comprehend the pathogenesis of depression. Patient assessment In the patient assessment segment, it is essential to have a vivid understanding depression. Most of the depression disorder results in serious medical situation that can influence the way one feels and acts towards others (Porth, 2008). Many victims of depression feel that life is no longer worth living and they may feel dejected and hopeless with no way out of the situation. Research has indicated that majority of the victims of depression, over 67% of the people with depression feel that the antidepressant offers some symptoms relief that is far much less than what they would have expected. Though there is possibility for further treatment to patients, the rate of response to treatments differ and may take possibly more than one medication for the realization of substantial improvement. Being open to the doctor and the doctor`s ability to explore the medical options will be essential in realizing the kind of healing one desires. Though it is a recurrent ailment, depression symptoms may remain after an episode and further occurrences may occur more quickly and may be more severe. Appropriate measures can make it possible to handle the symptoms associated with depression. Differential diagnoses In the medicine practice, there is a growing concern regarding the irrational prescription pattern and use of antihypertensive drugs. Studies on the population has hinted that blood pressure (BP) being a continuous variable with no definite difference between the normal and abnormal values. BP is leading the cause of heart diseases, the promiscuous kidney failure and stroke. This is more evident systolic than with diastolic blood pressure (Lawes, 2006). There exists a misconception that alluding hypertension to be a single disease with single recipe, the hypertension is a diverse disorder where the patients can be categories by pathophysiologic features that directly impact the usefulness of specifying the aimed antihypertensive prescription on the discovery of the manageable forms of the hypertension and the possible danger of vascular impediment. The main features of the hypertension suffered by systolic pressure larger than 140mmHG and diastolic blood pressure more than 90mmHg. In examining the pathophysiologic features that are necessary for hypertension, they include the absence of the cause, increased absolute marginal resistance, greater than 90mmHg of repeated diastolic pressure, normal cardiac output, increased cardiac work which is noted in early stages of the disease, evident increased or decreased pulse pressure, the renal physiology may be altered, normal blood flow associated with reduced renal blood flow, reduced plasma volume, Hyper-reactivity of pressure to stress, irregular ;vascular reactivity and weaken or damaged circulatory homeostasis (Martini, 2009). The cardiac output and peripheral resistance provide the required pressure to allow for the flow of blood in the whole of the body circulation system. Pre-hospital intervention Most of the neurological impediments run into during the neuroendovascular processes result from the thromboembolic occurrences (Lawes, 2006). The evolution of the techniques have seen the incorporation of the increasing capacity of the temporary and permanently well established adjunctive strategies that have effectively guaranteed the optimization of the thrombotic execution strategies that have improved the potential for the safety of the given procedure. Selecting the appropriate anti-thrombotic procedure is accompanied with distinctive deposit of challenges when measuring up with the endovascular interventions in other vascular regions. An increase in the cardiac output has been displayed by patients with hyperkinetic circulation and it results to hypertension and it results from the preload or from the rise of the contraction as a result of the neural stimulations in the heart. In cases where the increased cardiac output is drawn into the launch of hypertension, the increase in cardiac output is expected not to be continuous this is due to the fact that haemodynamic result in well-known hypertension is high peripheral conflict and the regular cardiac output. The overindulgence in the consumption of sodium provokes the hypertension by increasing the fluid capacity and preload thus increasing the cardiac output (Lawes, 2006). The excess sodium amplifies the blood pressure in a couple of ways as it affects the renal function and vascular reaction. Physiologic and pathological renal changes pave way for the changes seen in other organs when dealing with essential hypertension (Martini, 2009). Conclusion Getting the insight of the major biology of the most important depression is the key difficulty in the scientific fraternity with various sociological and clinical importances. The unearthing of antidepressant drugs and the further examination of the mode of action has transformed the whole understanding of the neural functioning the existing underlying factors and mechanism of depression. It is highly advocated that any hypotheses on hypertension should incorporate of consider the various connection with the brain network and the complex central Nervous system regulation mechanism. Despite the advancement, today there still exists definite problem in understanding and administering the severe depression and getting to the bottom of the cause in cases of the treatment resistant depression. In the modulation of the systematic blood pressure, the kidney plays a crucial role by regulating the sodium excretion rate. The continued systematic hypertension is said to be able to initiate the interruption of the phenomena that results in impaired sodium excretion. Reference Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J, 2005. 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