Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient. Three (3) resources after 2008 are required along with APA format.
Jane and Jackie, 30 year old twin sisters, adopted when they were two years old, lived mirrored lives to this point. They do everything together, from having a double wedding, living next door to each other, and making any appointments, medical or social together.
Today they made an appointment with their OB/GYN. Information was as follows:
Jane Information: Jackie’s Information:
BP 115/70 BP 165/96
HR 70 HR 96
Resp. 20 Resp, 22
Temp 98.6 Temp 99.2
N/A Normal U/A + Hematuria
+ Proteinuria
Weight No gain Weight +15 pounds
C/O Intermittent Headache C/O Has lower back and stomach
at times relieved with pain at times and is relieved also
Tylenol by Tylenol.
Other: This individual is noted to have
some loss of muscle mass in her
arms and legs and less subcutaneous
tissue overall.
- At this point what do your think is the problem with Jackie? Why is this problem co common in women? What test would you request to confirm your diagnosis?
The physician uses the ultrasound to assess Jackie’s back and abdomen. He finds that her kidneys are about 4 times larger than normal and appear to have numerous fluid filled cysts noted. At this point he asks BOTH sisters to see a nephrologist and to be scheduled for MRI’s of the kidneys. The MRI showed that Jackie’s kidneys were indeed larger and filled with cysts. Jane’s kidneys were somewhat larger than normal, and no cysts were present at this time.
- What problem do you anticipate that Jackie has now? How was it acquired?
- Why did Jackie gain so much weight over the last year?
- Why does Jackie have high blood pressure and the UTI?
- Why were both sisters requested to have this test.
The sisters went to see the nephrologists who requested that they have MRI’s of the brain and an echocardiogram. Jane’s MRI and echocardiogram were normal. Jackie’s brain MRI and echocardiogram were not. Jackie had a cerebral angiogram that followed which confirmed complications of her disease process, an Intracranial aneurysm and Mitral regurgitation. Jackie undergoes a procedure called Coil Embolization Therapy to resolve the aneurysm.
- What is an Intracranial aneurysm? How does Coil Embolization Therapy resolve the problem.? Please be specific of the procedure.
- What is Mitral Valve Prolapse and how will it affect Jackie’s health care needs before procedures in the future?
- What education is needed to be shared with these sisters related to their children having this condition in the future?
Neafsey. P. (2010).Sisters for life: Case Mysteries in Pathophysiology. Englewood:
Morton Publishing Company
gmt/2015
- Jackie’s Problem and Its Commonality in Women: Based on the provided information, it appears that Jackie may have a condition known as Polycystic Kidney Disease (PKD). PKD is common in women and is characterized by the formation of fluid-filled cysts in the kidneys. To confirm the diagnosis, the physician may request a kidney ultrasound or abdominal CT scan, which can visualize the cysts in the kidneys.
Why it’s common in women: PKD is an inherited condition, and the specific genes involved can be inherited from either parent. Hormonal factors, such as estrogen, may play a role in the progression of PKD, which could explain why it is more common in women.
- How Jackie Acquired PKD: PKD is typically an inherited condition. Given that Jane has somewhat larger kidneys but no cysts, it’s possible that both sisters inherited the PKD gene(s) from their biological parents, but Jackie’s condition has progressed to the point of cyst formation, while Jane’s has not.
- Jackie’s Weight Gain: Jackie’s weight gain could be related to her PKD. PKD can lead to the enlargement of the kidneys due to cysts, which may cause abdominal distension. Additionally, the loss of muscle mass in her arms and legs could be related to complications from PKD.
- High Blood Pressure and UTI in Jackie: High blood pressure (hypertension) is a common complication of PKD. The enlarged cyst-filled kidneys can press on blood vessels, leading to increased blood pressure. The presence of hematuria (blood in the urine) and proteinuria (protein in the urine) suggests kidney dysfunction, which can make Jackie more susceptible to urinary tract infections (UTIs).
- Both Sisters Requested to Have Tests: Both sisters were likely requested to undergo MRI scans and other tests because PKD is a genetic condition. Since they are identical twins and share the same genetic background, it is important to assess both of them for the presence and progression of the disease. Additionally, some forms of PKD can affect other organs and systems, as evidenced by Jackie’s brain and heart complications.
- Intracranial Aneurysm and Coil Embolization Therapy: An intracranial aneurysm is a bulging, weakened area in the wall of an artery within the brain. Coil Embolization Therapy is a minimally invasive procedure used to treat aneurysms. During the procedure, a catheter is inserted into the blood vessels, guided to the aneurysm, and coils (small metal wires) are placed within the aneurysm to block blood flow. This prevents the aneurysm from rupturing.
- Mitral Valve Prolapse and Its Impact on Jackie’s Health Care Needs: Mitral Valve Prolapse (MVP) is a condition where the valve between the left atrium and left ventricle of the heart doesn’t close properly. This can lead to Mitral Regurgitation, where blood flows backward into the atrium. Jackie’s MVP and Mitral Regurgitation may require periodic monitoring by a cardiologist. She may need antibiotics before certain medical or dental procedures to prevent bacterial endocarditis, a potential complication of MVP.
- Education for Future Generations: The sisters should be informed that PKD is a genetic condition, and there’s a risk of passing it on to their children. Genetic counseling can help assess the risk and provide guidance on family planning options. They should encourage their children to be aware of the possibility of inheriting PKD and to undergo appropriate screening and monitoring as recommended by healthcare professionals.
Remember to consult the specific sources you mentioned for more detailed and up-to-date information on these topics, and ensure that you follow APA formatting guidelines for your references.