An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition.
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.
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.
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your responses.
Based on the information provided in the scenario, the disease suggested is Kwashiorkor. Kwashiorkor is a severe form of malnutrition that occurs due to a deficiency of dietary protein. It commonly affects children in developing countries but can also occur in adults under certain circumstances, such as in the case of the elderly patient described.
Role of Genetics: Genetics do not play a direct role in the development of Kwashiorkor. The disease primarily occurs due to inadequate protein intake in the diet, rather than being a genetic disorder. However, genetic factors can influence an individual’s susceptibility to malnutrition and the severity of its consequences. Genetic variations in nutrient absorption, metabolism, or appetite regulation may impact an individual’s ability to obtain and utilize dietary protein effectively.
Presenting Symptoms: The patient is presenting with generalized edema of the extremities and abdomen. These symptoms are characteristic of Kwashiorkor. Inadequate protein intake leads to a decreased production of plasma proteins, particularly albumin. Albumin is responsible for maintaining the osmotic pressure in the blood vessels, preventing the leakage of fluid into the interstitial spaces. When the level of albumin decreases, fluid leaks out of the blood vessels, resulting in edema in various body tissues, including the extremities and abdomen.
Physiologic Response: In response to protein malnutrition, the body initiates several physiological adaptations. One of the main responses is the redistribution of available protein resources to essential organs, such as the heart and brain, at the expense of peripheral tissues. This adaptive mechanism aims to ensure the survival of vital organs despite inadequate protein intake. As a result, non-essential tissues, including skeletal muscles and adipose tissue, undergo degradation, leading to muscle wasting and weight loss.
Cells Involved: Several cells are involved in the pathophysiology of Kwashiorkor. Hepatocytes in the liver are responsible for the synthesis of plasma proteins, including albumin. Inadequate protein intake and malnutrition can impair hepatic protein synthesis, leading to decreased albumin production. Endothelial cells lining the blood vessels are also involved. The decrease in plasma proteins, particularly albumin, disrupts the balance of osmotic pressure between the blood vessels and surrounding tissues, causing fluid to accumulate in the interstitial spaces, resulting in edema.
Impact of Other Characteristics: Another characteristic, such as gender or genetics, may influence the responses and manifestations of Kwashiorkor. For example, gender differences in body composition and protein metabolism may affect the severity and distribution of muscle wasting and edema. Additionally, certain genetic variations in protein metabolism or absorption may influence an individual’s susceptibility to developing Kwashiorkor or affect the response to nutritional interventions. However, it’s important to note that the scenario does not provide any specific information regarding the patient’s gender or genetic background, so it is not possible to make further assessments based on those factors in this case.