Role of gallbladder
Number 1 post: PG
What is the role of gallbladder?
Gallbladder is an organ that located underneath the liver. Liver produces bile and the gallbladder stores bile, which is essential for digestion of fat (Johns Hopkins Medicine, n.d.). The liver produces bile about 800 to 1000 milliliters (about 27 to 37 ounces) everyday, which is yellow, brownish, or olive-green liquid; “Liver discharges the bill into small canals that guide to the common bile duct and then lead to the gallbladder in order to store and concentrate the bile between the meals time or fasting; gallbladder release bile to digest fat after consuming fatty food”(NCBI, 2010, 2018, 2021). Therefore, main role of the gallbladder is holding bile and release it into the duodenum that is the first part of small intestine after consuming fatty meal.
How do gallstones form?
According to O’Dougherty& Galhoun (2019), “components of bile are cholesterol, bile salts certain fats, water, and bile pigment (bilirubin). Gallstones exist when component of bile remain in the gallbladder and stored in it and bile become solid and place in the bile duct and block the secretion of bile to the duodenum and cause the gallbladder to become inflamed that is calling cholecystitis” Low fat diet recommend for people who have gallbladder issues such as the Mediterranean diet (fish instead of fried chicken. Brown rice instead of a white-flour roll. A handful of nuts instead of chips. Olive oil instead of butter. And plenty of vegetables and fruit) in order to prevent an existing of gallstones (Efron, n.d.).
Thus, excessive produce of bile and store in the gallbladder lead to form gallstones.
Why does the patient have referred pain?
Patient is suffering of sharp pain due to block the outflow of bile, when gallstones travel through the duct to the stomach, they block bile duct and cause the gallbladder to spasm. Pain usually is sharp in the upper right side and under the ribs or center of the abdomen (Efron, n.d.). Pain might radiate to the right shoulder and severe pain may last 30 minutes to several hours, and pain increases with breathing (Johns Hopkins Medicine 2022).
Would you expect her to have nausea and vomiting? Defend your answer.
The answer is yes, nausea or vomiting may occur due to severe pain in patients with acute cholecystitis. According to John Hopkins medicine (n.d., 2022), “symptoms that happen in patient with acute cholecystitis are sever pain, nausea and vomiting, fever, chills, jaundice, and intolerance of fatty food. Diagnostic tests are ultrasound, CT or CAT scan, blood tests, ERCP, and treatment in acute cholecystitis is cholecystectomy” (Gallbladder removal).
Number 2 post: AB
1. What would you expect her sodium level would be, high or low? Defend your answer.
Diabetes insipidus is a disease process in which the body losses the function of retaining water (Hui et al., 2022). The kidneys are responsible for regulating fluid volume and electrolytes. One hormone that assists in this process is the antidiuretic hormone (ADH) or vasopressin. When fluid volume decreases in the blood, it affects the concentration and therefore the osmolality. This signals the release of ADH which binds to receptors on the kidneys to stimulate the conservation of water. However, in diabetes insipidus ADH level is diminished, or the kidneys are desensitized to it. The result is that there is a large loss of fluid volume through urination. This leads to different electrolyte imbalances such as hypernatremia (Breault, 2019). The fluid volume in lost in the blood, the concentration of sodium increase.
2. Her osmolarity is elevated. Why?
Osmolarity is a laboratory study which evaluates the concentration of a given solution (Dlugasch & Story, 2019, pp. 7). High osmolarity means that the concentration of solute is high. In diabetes insipidus, fluid volume is diminished in the vascular system due to lack of fluid retention and increased urination. This leads to an increase in solute concentration of the blood. Thus, osmolarity is elevated.
3. Compare and contrast central vs. nephrogenic Diabetes Insipidus.
As mentioned previously, diabetes insipidus is the result of decreased levels of ADH or decreased sensitivity to ADH. Central diabetes insipidus is when hypothalamus does not produce an adequate amount of ADH needed for the body to function (Hui et al., 2022). In nephrogenic diabetes insipidus, there is an adequate level of ADH in the system, but the kidneys have become desensitized to the hormone and stop responding.
4. Explain the mechanism of dDAVP.
Treatment of central diabetes insipidus involves the administration of dDAVP. This medication is a synthetic equivalent to ADH but differs in two key areas (Garrahy & Thompson, 2020). First, ADH is has a short half life whereas dDAVP has a six to eight hours half-life. This allows for less frequent administration of this medication. Secondly, ADH affects the blood vessels and causes constriction, whereas dDAVP does not.
