Jamie Richards is a 20 year old junior in college. She is majoring in biology and...

     

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Jamie Richards is a 20 year old junior in college. She is majoring in biology and hopes someday to be a pediatrician. Beginning about a month ago, Jamie noticed that she was waking up once, sometimes twice a night, by the need to go to the bathroom. More recently, she has noticed that she needs to go to the bathroom during her school day much more frequently than before, sometimes as often as once every hour. At first, Jamie thought that her increased frequency of urination was due to all the coffee she drank, but when she reduced her coffee consumption to one cup in the morning, she still needed to go to the bathroom just as often. In addition, Jamie was buying bottled water by the case, and she found herself never without a beverage in her hand or nearby. She also noticed that her urine seemed pale and colorless. When Jamie told her mother or her problem, her mother became very concerned and arranged for Jamie to see the family physician. Her physician found no abnormalities on physical examination. However, a blood chemistry profile revealed the following Plasma sodium level 149 mEq/kg Plasma osmolality 308 mOsm/kg Fasting plasma glucose 85 mg/dl Urine osmolality 200 mOsm/kg Urine glucose: negative O AT&T 9:19 PM dcccd.blackboard.com Next, a glucose tolerance test was performed. On the day of the exam Jamie was told to refrain from eating for 8 hours. Water was allowed but no other beverages. Jamie was scheduled for a 3 hour test. Her weight was recorded at 122 lbs. She was given a solution of concentrated glucose to drink. It contained 100 gram of glucose. Blood samples were taken at the beginning of the test and hourly thereafter for 3 hours. The results were as follows: 24% Initial blood glucose level: 80 mg/dL 1 hour: 160 mg/dL 2 hour: 120 mg/dL 3 hour: 95 mg/dL A blood sample was also checked for A1C. The value was 5.4. .. a Next, her doctor conducted a carefully monitored water deprivation test. The morning of the test Jamie was weighed at the doctor's office. Her weight was recorded as 122 lbs. Jamie was to remain at the doctor's office for the duration of the test. She was put on fluid restriction. A urine and plasma osmolality chart was started. VVA Hourly, the weight of the patient, and her urine and plasma osmolality were measured, and recorded on the chart. Nurses were instructed to terminate fluid restriction if: Patient's weight fell by > 5% Plasma osmolality increased to > 300 mOsm/kg. If urine osmolality increased by <30 mOsm/kg (in total) over three successive urine samples patient would proceed to DDAVP test DDAVP test should be terminated if urine osmolality rose to >750 mOsm/kg Jamie's results were as follows: Time Weight 8:00 122 lbs 9:00 121.5 lbs 10:00 120 lbs 11:00 plasma 283-293 293 >293 <293 <293 293 Post-dehydration osmolality (mOsm/kg) urine >750 <300 <300 Post Dehydration Osmolality mOsm/kg Urine osmolality 300-750 300-750 300-750 urine >750 <300 >750 200 200 Post DDAVP osmolality (mOsm/kg) <750 <750 750 200 Plasma osmolality 287 290 Post DDAVP Osmolality mOsm/kg DDAVP 298 administered Urine Diagnosis 815 Plasma normal nephrogenic diabetes insipidus cranial diabetes insipidus chronic polydipsia partial nephrogenic DI or primary polydipsia partial cranial DI 290 .... AT&T ? 9:20 PM dcccd.blackboard.com 8. Based upon the results above, and Jamie's medical history, and the results of the MRI: Does Jamie have Diabetes insipidus? If so-which type? 24% U 9. Write a short synopsis of the tests, the results, your diagnosis. What are your recommendations to Jamie? Develop a treatment plan? Jamie Richards is a 20 year old junior in college. She is majoring in biology and hopes someday to be a pediatrician. Beginning about a month ago, Jamie noticed that she was waking up once, sometimes twice a night, by the need to go to the bathroom. More recently, she has noticed that she needs to go to the bathroom during her school day much more frequently than before, sometimes as often as once every hour. At first, Jamie thought that her increased frequency of urination was due to all the coffee she drank, but when she reduced her coffee consumption to one cup in the morning, she still needed to go to the bathroom just as often. In addition, Jamie was buying bottled water by the case, and she found herself never without a beverage in her hand or nearby. She also noticed that her urine seemed pale and colorless. When Jamie told her mother or her problem, her mother became very concerned and arranged for Jamie to see the family physician. Her physician found no abnormalities on physical examination. However, a blood chemistry profile revealed the following Plasma sodium level 149 mEq/kg Plasma osmolality 308 mOsm/kg Fasting plasma glucose 85 mg/dl Urine osmolality 200 mOsm/kg Urine glucose: negative O AT&T 9:19 PM dcccd.blackboard.com Next, a glucose tolerance test was performed. On the day of the exam Jamie was told to refrain from eating for 8 hours. Water was allowed but no other beverages. Jamie was scheduled for a 3 hour test. Her weight was recorded at 122 lbs. She was given a solution of concentrated glucose to drink. It contained 100 gram of glucose. Blood samples were taken at the beginning of the test and hourly thereafter for 3 hours. The results were as follows: 24% Initial blood glucose level: 80 mg/dL 1 hour: 160 mg/dL 2 hour: 120 mg/dL 3 hour: 95 mg/dL A blood sample was also checked for A1C. The value was 5.4. .. a Next, her doctor conducted a carefully monitored water deprivation test. The morning of the test Jamie was weighed at the doctor's office. Her weight was recorded as 122 lbs. Jamie was to remain at the doctor's office for the duration of the test. She was put on fluid restriction. A urine and plasma osmolality chart was started. VVA Hourly, the weight of the patient, and her urine and plasma osmolality were measured, and recorded on the chart. Nurses were instructed to terminate fluid restriction if: Patient's weight fell by > 5% Plasma osmolality increased to > 300 mOsm/kg. If urine osmolality increased by <30 mOsm/kg (in total) over three successive urine samples patient would proceed to DDAVP test DDAVP test should be terminated if urine osmolality rose to >750 mOsm/kg Jamie's results were as follows: Time Weight 8:00 122 lbs 9:00 121.5 lbs 10:00 120 lbs 11:00 plasma 283-293 293 >293 <293 <293 293 Post-dehydration osmolality (mOsm/kg) urine >750 <300 <300 Post Dehydration Osmolality mOsm/kg Urine osmolality 300-750 300-750 300-750 urine >750 <300 >750 200 200 Post DDAVP osmolality (mOsm/kg) <750 <750 750 200 Plasma osmolality 287 290 Post DDAVP Osmolality mOsm/kg DDAVP 298 administered Urine Diagnosis 815 Plasma normal nephrogenic diabetes insipidus cranial diabetes insipidus chronic polydipsia partial nephrogenic DI or primary polydipsia partial cranial DI 290 .... AT&T ? 9:20 PM dcccd.blackboard.com 8. Based upon the results above, and Jamie's medical history, and the results of the MRI: Does Jamie have Diabetes insipidus? If so-which type? 24% U 9. Write a short synopsis of the tests, the results, your diagnosis. What are your recommendations to Jamie? Develop a treatment plan?

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along with islet amyloid polypeptide or amylin This active insulin will be released into the blood stream by cellular vesicular trafficking A high aff... View the full answer