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Posted: March 3rd, 2022
Discussion: Alterations in Cellular Processes
At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.
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Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.
For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.
please respond to both colleague response. please add two scholarly articles and 2 apa in test citatation and references. this is a discusssion at least 250 words.
By Day 6 of Week 1
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Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not
Colleague1
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This patient has malabsorption syndrome meaning that the intestinal mucosa has failed to absorb the digested nutrient (McCance and Heather, 2019). Possible causes among other things are Celiac disease, lactose disease, lactose milk protein intolerance, soy milk protein intolerance, cystic fibrosis, biliary atresia and Whipple disease (John Hopkins Health System, n.d).
Because there is cellular injury, the normal sodium ion transportation out of the cell is impaired leading to the retention of sodium in the cell with consequent increased osmotic pressure resulting in water being drawn into the cell causing cellular retention. This is what caused the abdominal swelling McCance and Huether (2019) noted that cellular injury results in water retention. Malabsorption may result from disturbances in the secretory, motor and absorptive functions of the gastro intestinal tract [GIT] and from certain diseases (Keller and Layer,2014). Because digestion starts from the mouth with mastication of food and mixing with salivary enzymes, patients’ inability to chew food may lead to food not digesting well which could also be a possible cause of the patient’s malabsorption. This patient may have lactose intolerance or other enzyme related conditions that caused protein malnutrition. Protein malnutrition leads to a deficiency of albumin in the blood. Albumin helps to maintain sodium and water in the blood vessels thereby preventing its leakage into the tissue (Harvard University,2018). Protein malnutrition in this patient contributed to his developing oedema because albumin a blood protein will be lacking resulting in fluid retention with resultant oedema (Harvard Medical,2022). According to Wedro (2021), protein prevents water molecules from leaking into the surrounding tissues from blood capillary vessel. Protein helps to maintain oncotic pressure therefore low protein results in low oncotic pressure with water leaking into the surrounding tissues including the peritoneum, extremities and other parts of the body (Wedro (2021).
Certain genetic conditions are associated with mal absorption syndrome like Abetalipoproteinemia, Congenital sucrase-isomaltose deficiency, Glucose-galactose malabsorption, Hereditary folate malabsorption and Lactose intolerance (National Institute of Health,2021). Others are celiac disease, Schwachman-Diamond syndrome (John Hospitals Health systemin’s).
In a study on Fructose Malabsorption May Be Gender Dependent by Szilagyi et al. (2007) it was discovered that Fructose maldigestion was found to be more in women than men.
Colleague 2
ndividuals with scarce macronutrients are prone to experience protein malnutrition. Commonly, genetics contribute to many illnesses, protein malnutrition being one of them. A person's preference for particular foods is partially dictated by genetics. Duggal and Petri (2018) explain that genetics affect macronutrient intake, affecting malnutrition. They explain that studies had identified a single-nucleotide polymorphism (SNP) located close to the FGF21 locus, resulting in reduced intake of proteins and fat while promoting the increased intake of carbohydrates. Therefore, an individual genetically predisposed to eating protein may develop protein malnutrition.
The case scenario shows that individuals with protein malnutrition experience generalized edema. This condition manifests itself similar to kwashiorkor. The edema typically occurs when water gets decompartmentalized into the extracellular space (Bæk et al., 2019). Most often, the process occurs due to damage of glycocalyx oxidatively. Compromised glycocalyx thus allows the fluids to leak into the tissues, and the patient experiences swelling of extremities and the abdomen.
The malabsorption syndrome is a possible stimulus that triggers the loss of appetite. Another physiological response possibly experienced is the loss of muscle mass. Protein is necessary for the growth of muscles. Muscle wasting will thus be triggered due to malnutrition (Benjamin & Lappin, 2020). Consequently, an individual would experience fatigue due to a lack of enough energy in the body. The cells involved in protein malnutrition are mostly epithelial cells. The epithelial cells of the intestinal villi are involved in the absorption of small molecules of proteins like dipeptides and single amino acids. When their functionality is affected, it can result in malabsorption.
Other factors such as age and gender impact protein malnutrition. Reinders et al. (2019) state that older people are more susceptible to protein malnutrition due to the anorexia of aging. Despite having reduced appetite, they also need protein to maintain their bone health, strength, and muscle mass and facilitate critical physiological functions. Unlike older adults, young individuals will have an appetite, thereby reducing the likelihood of malnutrition. Crichton et al. (2019) also found that females have higher chances of being malnourished than males. Males generally require more protein than women because they have larger bodies, muscle mass, and calorie intake.
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