George discussion questions

  1. What is the likely explanation of George’s nearly fainting on standing? What is the specific term used for this phenomenon that is related to his posture or position?
  2. Name at least three different body systems that, if affected by some disorder, could be responsible for George’s sensations of fatigue and weakness.
  3. What are some of the long-term effects of smoking on organ systems other than those already mentioned in Question 2 above?
  4. Thinking about the physiology of blood pressure, what is the significance of the postural changes in George’s blood pressure and pulse? What are some possible causes?
  5. What might account for the combination of epigastric tenderness and a positive guaiac test (blood in the stool)? List 2 possibilities.
  6. Upon arrival at the emergency room, how do George’s vital signs compare with normal values? Identify the abnormals.
  7. Based on your knowledge of physiology, what is the rationale for treating George with IV fluids and oxygen?
  8. Why is George’s hematocrit lower following administration of IV fluids? Why do you suppose his blood pressure is more stable immediately following fluid administration?
  9. What is a nasogastric tube? Why would the physician decide to use a nasogastric tube?
  10. Why was water used to flush the stomach? Is it significant that the suctioned fluid clears?
  11. What is the preliminary diagnosis when the gastroenterology consult is ordered? (You can use layman's terms) Why are both acid inhibitors and antacids administered?
  12. What disorders may account for George’s symptoms of chest pain, diaphoresis and shortness of breath?
  13. George's condition had improved significantly and he was moved out of the ER. He was sitting up and visiting with family in his hospital room, when his condition suddenly changed. What do you think precipitated George’s crash or abrupt change in condition?
  14. Why are nitroglycerin and antacids administered to George after he experiences chest pain?
  15. When George's condition took an abrupt turn for the worse after being moved out of the ER, physiciansadministerd nitroglycerin and antacids. Neither had any effect on George. What does the lack of effect of each indicate diagnostically? (Think about the mechanism behind each treatment and in what situations they would be helpful.)
  16. What specific physiological mechanism(s) would account for the decline in blood pressure in spite of the therapies administered, including a blood transfusion near the end? (Remember your formulas, CO = HR x SV and BP = CO x TPR)
  17. What is the specific cause of death in this case? Discuss the physiologic mechanisms responsible for the progression of this case.
  18. In hindsight, think about the physiology involved in George's deteriorating condition and discuss how you might have handled this case differently to provide a better outcome. Explain the rationale for any changes in treatment that you would have made.