Howard Community College Urinalysis Case Study Discussion All references must be cited, and direct quotes from the references must be indicated as such, using quotation marks.Please refer to book titled ” Human Anatomy & Physiology” by Elaine N. Marieb BIOL 204 Lab Case Study
Martin Cullinan is a 57 year old man who came to the emergency room, with 2 weeks of worsening leg
swelling, fatigue and eye swelling. He has diabetes, which he has been poorly controlling over the last
ten years or so.
1. What is a nephron? Draw and label the parts of a nephron. Name the three processes of urine
formation and indicate where they occur in the nephron.
2. Which substances are filtered across the glomerular membrane? Is glucose filtered? How and
where is it reabsorbed?
3. In addition to glucose, which substances are reabsorbed and where in the nephron?
Which substances are secreted by which regions of the nephron?
4. This patient’s urinalysis showed > 1g/dL of glucose. Why do diabetic patients have glucosuria?
5. Classically, diabetics present with increased urination and, subsequently, increased thirst. Why
would increased glucose levels in the tubules cause increased urination?
In diabetics, the kidney loses its ability to concentrate the urine in part due to high glucose
levels in the tubules. Generally, how does the kidney normally concentrate urine?
7. Why does the countercurrent mechanism fail to concentrate urine in diabetics (Hint: Consider
the change in tubular osmolarity)?
Lab tests obtained during this clinic visit show: pH 7.21; sodium ion or Na+ 131 mEq/L; bicarbonate
ion or HCO3- 12 mEq/L.
8. What can you say about Mr. Cullinan’s blood pH?
Mr. Cullinan is admitted for initiation of dialysis. His admission vitals are temperature 36.80 C, heart rate
94/min, BP 160/50mmHg, respiratory rate 30/min.
9. Briefly describe the process of dialysis and why you think this patient was placed on it.
10. What can you say about this patient’s respiratory rate? Why do you think that is so? (Hint:
consider the mechanism behind his compensation for his acidosis.)
Note: In completing this case study, just list the question numbers (1-14) and give the answers. Do
not repeat the question wording! When done, upload to Canvas.
All papers will be checked for plagiarism. All references must be cited, and direct quotes from the
references must be indicated as such, using quotation marks. Academic Honesty is expected of all
students, and it is described in the student handbook thusly:
“Academic Honesty means the use of one’s own thoughts and materials in the writing of papers, taking
of tests, and other classroom related activities. Any student intentionally aiding another student in any
infraction of the Academic Honesty Policy is considered equally guilty.
Students are expected to give full credit for the borrowing of other’s words or ideas. Intentional or
unintentional use of another’s words or ideas without acknowledging its use constitutes plagiarism.
The four common forms of plagiarism:
a) The duplication of an author’s words without quotation marks and accurate references or
b) The duplication of author’s words or phrases with footnotes or accurate references but without
c) The use of an author’s ideas in paraphrase without accurate references or footnotes.
d) Submitting a paper in which exact words are merely rearranged even through footnotes.
Misrepresentation is the submission of materials for evaluation that are not the student’s own.
Unauthorized use of notes or another individual’s materials, copying, using another individual’s
materials, or unauthorized prior knowledge of the contents of tests, quizzes, or other assessment
instruments shall be considered a violation of the Academic Honesty Policy.
For the first infraction of the academic honesty policy, the faculty member shall give the student a ‘0’
…on the paper, examination, or presentation in question.”
Reference: 10.02 Academic Honesty Policy
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