BIOL121 ASSIGNMENT 3: Written assessment
Scenario — Elastigirl
Elastigirl is a 30-year-old female, who has presented to the antenatal clinic for a routine prenatal visit. She has generally felt very well throughout her pregnancy and exercised regularly but is starting to feel more and more tired as her pregnancy progresses. Elastigirl reports she has been suffering from severe headaches over the last week or so and has been taking paracetamol tablets to dull the pain. She also reports some discomfort in her upper abdomen after eating and drinking and swelling in her feet and ankles. Elastigirl is vegan and, although she considers her fluid and caloric intake to be adequate, admits that she probably isn’t careful enough when ensuring she eats enough high calcium foods.
A physical examination and urinalysis were conducted. Results below.
Physical examination:
Height 164 cm Weight 63 kg Appearance Clean, neat appearance, mild oedema in feet and ankles Pregnancy status 34 weeks pregnant Temperature 36.2 C Blood work Blood group: 0-Fasting blood glucose = 6 mmol/L BP 150/95 mm Hg Respiratory rate 22 bpm Diet Vegan, low calcium intake Past patient history Non-smoker. Regular check-ups during pregnancy. All previous screenings of blood, urine, and blood pressure within normal ranges. Exercises regularly. Social status Works as a customer Helpant and lives with her husband and their daughter, Violet.
Urinalysis:
Blood
Bilirubin
Urobilinogen
0.4 mg/dL
Ketone
Protein
Nitrite
Glucose
pH
6.5
Specific Gravity
1.015
Leukocytes
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All topics and their key points listed below must be discussed in your essay
Topic 1: Reproduction (10 marks total)
A simple pregnancy test using Elastigirl’s urine helped to confirm her pregnancy. Which hormone is detected by a typical home pregnancy test? Discuss the role of this hormone in pregnancy. (5 marks)
Considering Elastigirl’s circumstances, describe the future role of oxytocin on uterine tissue during childbirth. (5 marks)
Topic 2: Respiratory system (5 marks total)
Describe the changes in volume and pressure that will be occurring in Elastigirl’s chest cavity to achieve inhalation while she is sitting in the examination room. Explain why these changes are occurring, and the effect upon airflow. (5 marks)
Topic 3: Digestion/metabolism (8 marks total)
Elastigirl enjoyed her favourite tofu scramble for breakfast today. Unfortunately, painful indigestion meant she had to promptly follow her meal with a couple of Mylanta® chewable tablets. Discuss how Mylanta® would affect digestion of the protein in Elastigirl’s meal. (4.5 marks)
State the hormone that will be MOST active in maintaining Elastigirl’s blood calcium levels if adequate calcium is not obtained from her diet. Explain your answer. (3.5 marks)
Topic 4: Pharmacology (7 marks total)
The antenatal nurse mentions to Elastigirl that the doctor might prescribe her Dithiazide tablets, which act as a diuretic.
Discuss the route of administration of Dithiazide, where the drug is likely to be absorbed after administration, and its likely bioavailability. Justify your response by discussing whether the drug would be subjected to hepatic first pass. (4 marks)
What effect will the thiazide have on other drugs that Elastigirl may take, such as paracetamol? In your answer, relate to the mechanism of action of thiazide. (3 marks)
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Topic 1: Reproduction
A typical home pregnancy test detects the hormone human chorionic gonadotropin (hCG). hCG is produced by the placenta after implantation occurs. It is secreted into the woman’s bloodstream and can be detected in urine as early as 10 days after conception. The presence of hCG in the urine indicates a positive pregnancy result.
The role of hCG in pregnancy is crucial. It helps to maintain the corpus luteum, a temporary structure that forms in the ovary after ovulation. The corpus luteum produces progesterone, which is necessary to support the early stages of pregnancy. hCG stimulates the corpus luteum to continue producing progesterone until the placenta is fully developed and can take over its role.
Additionally, hCG plays a role in the development of the fetus. It promotes the production of other hormones, such as estrogen and progesterone, which are essential for the growth and development of the placenta and the fetus. hCG also helps to suppress the mother’s immune response to prevent rejection of the fetus.
During childbirth, oxytocin plays a crucial role in uterine tissue. Oxytocin is a hormone produced by the hypothalamus and released by the posterior pituitary gland. It stimulates uterine contractions during labor. In Elastigirl’s case, oxytocin will act on the uterine tissue, causing rhythmic contractions to help facilitate the progress of labor. These contractions, along with other physiological changes, will ultimately lead to the delivery of the baby.
Topic 2: Respiratory System
During inhalation, several changes occur in the chest cavity to facilitate the entry of air into the lungs. When Elastigirl is sitting in the examination room, the following changes will occur:
Diaphragm contraction: The diaphragm, a dome-shaped muscle separating the chest cavity from the abdominal cavity, contracts and moves downward. This action increases the volume of the thoracic cavity.
Intercostal muscle contraction: The intercostal muscles between the ribs contract, pulling the ribs upward and outward. This action further expands the volume of the thoracic cavity.
These changes in volume lead to a decrease in intra-thoracic pressure. As the pressure inside the lungs becomes lower than the atmospheric pressure, air flows into the lungs due to the pressure gradient. This process is called inspiration or inhalation.
Topic 3: Digestion/Metabolism
Mylanta® is an antacid medication that contains aluminum hydroxide and magnesium hydroxide. It helps to relieve symptoms of indigestion, including heartburn and acid reflux.
Regarding the digestion of protein in Elastigirl’s meal, Mylanta® may affect it indirectly. Mylanta® works by neutralizing excess stomach acid, thereby reducing the acidity of the stomach contents. This can impact the activity of pepsin, an enzyme responsible for breaking down proteins.
Pepsin works optimally in an acidic environment. By reducing stomach acidity, Mylanta® may decrease the activity of pepsin and potentially slow down protein digestion. However, it is important to note that the effect of Mylanta® on protein digestion may be minimal since the stomach acid is not completely neutralized by the antacid.
The hormone that will be most active in maintaining Elastigirl’s blood calcium levels if adequate calcium is not obtained from her diet is parathyroid hormone (PTH). PTH is produced by the parathyroid glands, which are located in the neck. When blood calcium levels are low, PTH is released to stimulate several processes:
Increased calcium absorption: PTH enhances the absorption of calcium from the intestines, ensuring
