Bio – patient scenario (upstream/downstream) assignment





Affected particular person State of affairs (Upstream/Downstream) Activity




Addresses Learning Outcomes:




  • Use information of natural guidelines and the Scientific Methodology to ask and reply associated questions on human properly being and sickness
  • Analyze data to inform aside between diseased and healthful development and functioning.
  • Analyze how inside and exterior parts set off disruption of healthful physique carry out, leading to sickness and issues.








Mr. Smith is 60 years earlier. He was recognized with prostate most cancers 5 years prior to now. Over the previous couple of days, Mr. Smith has been feeling increasingly more drained and has moreover been affected by a headache that did not reply to over-the-counter medicines. He scheduled an appointment alongside together with his physician.




His physician carried out a bodily examination and actually helpful a battery of laboratory assessments and imaging procedures.




His blood pressure is 165/100 mmHg.  MRI reveals metastasis of prostate most cancers to osseous tissue. Abdomen CT reveals obstruction of intestine ensuing from nodular enlargement of adrenal glands.




The desk beneath reveals Reference values inside the right-hand column. These values mirror the traditional differ of values for victims with out sickness or illness.  The center column shows the following values for medical check out outcomes obtained for Mr. Smith.




Take observe whether or not or not Mr. Smith’s values are inside common limits.




Laboratory outcomes from Mr. Smith’s second hospital admission and medical assessments current following findings: 





Mr. Smith

Reference Values


2.6 mmol/L



7.Three g/dl

13.Eight to 18.2 g/dL




Platelet Rely




38 mmol/l

22-26 mmol/L

Urinary Okay+

70 mmol/L/24 hr

25-120 mmol/L/24 hr

Blood Glucose

460 mg/dl

64.Eight-104.4 mg/dL

Serum Aldosterone

1 ng/dl

 <31 ng/dL

24 hour Urinary Aldosterone

Eight.4 mcg/24 hr

2.Three-21.Zero mcg/24 hr


2.1 ng/ml/hr

Zero.65-5.Zero ng/ml/hr

ACTH (Adrenocorticotropic Hormone)

1082 pg/ml

9-46 pg/ml


155.5 microg/dL

Zero-25 microg/dL












Laboratory findings, MRI and CT confirmed metastatic prostate adenocarcinoma, hypertension and refractory hypokalemia ensuing from ectopic ACTH manufacturing. Extreme ranges of circulating cortisol precipitated regular activation of mineralocorticoid receptors resulting in hypokalemia, metabolic alkalosis and hypertension.








After learning provided state of affairs, reply the following questions:




1.  1.What are the weather of bodily examination? Describe each component. (See Module 1, Matter Eight, Half B.2)




2.  2.Mr. Smith’s blood pressure was 160/100 mmHg.




a. How does a medical provider take or measure blood pressure?




b.  What do the best (numerator) and bottom (denominator) numbers suggest inside the natural sense?




c.  What is the significance the size of these two numbers?




d.  Is Mr. Smith’s blood pressure inside common differ? Make clear the way in which you concluded whether or not or not Mr. Smith’s blood pressure is/should not be inside common differ.




e.  Discuss concerning the attainable properly being factors anticipated for a person with a blood pressure of 165/100 mm Hg.




Three.   Three.Based mostly totally on the data provided, what laboratory assessments have been carried out and what samples have been taken from the affected particular person?  Select one in all many laboratory assessments ordered for Mr. Smith and speak about why Mr. Smith’s physician may have ordered the check out and the information she may have anticipated to accumulate from that particular check out.




4.   4. Analyze Mr. Smith’s values




 a.Consider Mr. Smith’s values with reference values and level out whether or not or not Mr. Smith’s values are beneath, above, or inside common differ (consider Mr. Smith’s values with the Reference values) for each laboratory assessments inside the desk above from the second set of assessments. 




b. Select one in all many values exterior of normal differ from the desk above and speak about attainable medical points related to the acknowledged change in Mr. Smith’s values.




5.  5.  What imaging procedures did Mr. Smith bear? Discuss concerning the distinctions and similarities between the two completely completely different imaging approaches. What have been the outcomes of imaging procedures in Mr. Smith’s case?




6. Select one in all many medical phrases from the CONCLUSION and DIAGNOSIS half above and description what it means.  Moreover, speak about, in your private phrases and primarily based totally on what you presumably can gather about Mr. Smith’s scenario, how the laboratory or imaging assessments helped with drawing a conclusion or making the prognosis. In your private phrases, speak about how medical suppliers use the scientific methodology to return to work through the examination and prognosis of a affected particular person.




It is best to put in writing a short paper addressing all 5 questions and submit it beneath “Assignments”. Your grade will rely on the content material materials, readability and originality of responses written in your private phrases. Good writing practices, along with utilizing proper grammar, sentence and paragraph development, and punctuation, and presence of logical reasoning, will account for a portion of your grade.




Cite all sources in APA format inside your reply textual content material along with full citations in APA format on the end of the duty.




Your grade for the fast paper primarily based totally on launched state of affairs shall be primarily based totally on the following parts:




  1. Answered all six questions and all sub-parts of each question and provides proper or logical options to each question—as a lot as 60 elements
  2. Pupil provides genuine, detailed responses, written in scholar’s private phrases, displaying presence of logical reasoning – as a lot as 24 elements
  3. Pupil incorporates phrases and concepts found from assigned provides – as a lot as Eight elements
  4. Pupil appropriately cites property in APA format – as a lot as 4 elements
  5. Sort – grammar, spelling, kind – as a lot as 4 elements