Task 3. Case Study: Mateo Mateo is a 72yo male who lives alone since their partner died 2 years ago. They have come to see their GP today as they have had several episodes where they felt faint, and “may even have passed out on a couple of occasions”. It is some time since Mateo attended the clinic and you note when weighing them that they have lost a significant amount of weight and do not present as the robust, active older person you remember. Mateo mentions they don’t cook much and rely on the takeaway shop around the corner for most food these days. Mateo explains they have been very lonely since losing their partner but is excited to reveal a new zest for life after meeting a new friend, whom they are seeing a least once a week. This relationship has developed sexually, but Mateo has had some difficulty performing. Mateo thought it was their prostate giving them trouble but has also bought some Viagra nasal spray over the internet at the urging of their new partner. Physical examination: Height 178 cm Weight 70 kg Appearance Clean, dry skin, thin, significant muscle wastage Temperature 37.6?C Blood Group AB+ HR 80 bpm BP 105/66 mm Hg Respiratory rate 22 bpm Diet Low fibre, high fat Past patient history Mobility issues due to osteoarthritis, previously hypertensive Social status Living at home, lonely, lately has occasional sexual contact Urinalysis Blood – Bilirubin – Urobilinogen 0.1 Ketone +++ Protein – Nitrite – Glucose – pH 6.0 Specific Gravity 1.035 Leucocytes + All topics and their key points listed below must be discussed in your essay Topic 1: Reproduction Prostate tissue contains glandular structures relevant to Mateo’s reproductive function. Explain the role of this glandular tissue in reproductive function, including any likely changes from normal in the secretion and resultant effects for Mateo. Considering Mateo’s current circumstances, describe the role of testosterone and explain whether you expect their testosterone levels to be varied from normal. Your discussion should include the homeostatic regulation of male reproductive physiology and the relevant, glands, cells, and hormones in your response. Topic 2: Renal Describe the role of the kidneys in maintaining fluid balance with reference to the role of antidiuretic hormone (ADH). Considering Mateo’s circumstances and urinalysis results, discuss whether they are at risk of not maintaining homeostatic fluid mechanisms? Topic 3: Digestion/metabolism Considering Mateo’s circumstances, discuss why maintenance of adequate protein intake is important for their muscle function. Mateo has had a large box of potato fries for lunch. Discuss the mechanical and chemical events required for Mateo to absorb the ingested carbohydrates. State the hormone that is most active in maintaining Mateo’s blood glucose levels at this time. Explain your answer. Topic 4: Pharmacology Mateo has used a nasal Viagra spray improve sexual performance. Discuss the route of administration, 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. Discuss the importance of the half-life of a drug. Assuming there is 100% absorption, and the half-life of Viagra is 4 hours, calculate the % of drug that is likely to be present in Mateo’s blood after 20 hours.
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