Pathophysiology Matters

PATHOPHYSIOLOGY• LB is a 68-year-old male who is suffering from diabetes and hypertension. He is being admitted to the hospital with an elevated K+ level (hyperkalemia) and a low calcium level (hypocalcemia).1. LB is getting started on dialysis emergently because of the elevated K+ level. Knowing that K+ has a major impact on the myocardial muscle cell, explain how K+ affects the resting membrane potential and what effect you would see in his heart with an elevated level and a low level.2. Calcium is a major cation. What effect will a high calcium level have on myocardial contraction?KS comes for a clinic visit to determine whether she is pregnant. She is very concerned because she suspects there may be a genetic disease in her family. On further questioning, you find out that her brother’s son has the disorder. Her brother’s other children (a boy and a girl) are unaffected. KS’s parents, grandparents, and other siblings (a brother and two sisters) do not have manifestations of the disorder. Her brother’s wife has said that she thinks one of her distant relatives may have had the disease.3. If the disorder is indeed inherited as a single-gene defect, do you think it is autosomal dominant, autosomal recessive, or X-linked?4. Construct a pedigree chart and predict the likelihood that KS has the defective gene.

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