Answer 10

These disturbances observe in diabetes mellitus, because of deficiency of biological effect of insulin, in diabetes mellitus decrease of permeability of cellular membranes for glucose, infringe phosphorylation of glucose, oxidative catabolism, transformation of products of catabolism of glucose in the lipids, proteins, formation of excess of products and increase excretion of glucose from liver to blood a the result of intensification of gluconeogenesis and increase activity enzyme gl-6-phospahate. A the result is developed the hyperglycemia. The disturbance of phosphyrylation of glucose is the decrease of reabsorption of glucose in the kidneys, later is developed glucosuria. Multiplication of concentration (N.E.F.A) non etirification fatty acids or free fatty acids in the blood is compensation, which allow using of fatty acids in disturbance of utilization of carbohydrates. Intensification of catabolism of fatty acids in the liver, repression of catabolism of formation ketone bodies in the Kreb’s cycle and transformation of fatty acids is result of ketosis (hyperketonemia and ketonuria). Increase of amount acetyl CoA and acetoacetic acid, later is increased the synthesis of cholesterol, that is explanation of hypercholesteremia. Increase of anaerobic catabolism of glucose in diabetes mellitus happens with hyperlactatemia, excess of lactate and ketone bodies leads to metabolic acidosis and hyperketonemia, glucosuria and ketonuria, is decreased amount of bicarbonates in the blood. Hyperglycemia, hyperketonemia, glucosuria and ketonuria lead to increase of specific gravity and acidity pH of urine, dehydration of tissues. A the result is developed thirst (polydipsia), polyuria (the excretion of urine is increased), is appeared the itch of skin (glucose influences on the nerve-endings ). Disturbance of utilization of glucose of tissue leads to catabolism of lipids, proteins and loss of weight of organism. Because of increase of catabolism of amino acids is developed the hyperazotemia, that explains the excess of amount of urea in the blood.

Answer 4

These changes can be observed at children due to hypothyroidism and they connected with deficiency of thyroid hormones, which influence on the gravity the and on the differentiation of tissues. they influence on the energy production, on the development of sreleto6 on the CNS, on the mental development

Answer 9

At patient is observed the increase of hemotocrit Hb quantity, urea quantity and proteins of blood serum, hyperkalemia the decrease of bicarbonates in the blood plasma. It can be observed due to deficiency of hormons of adrenal cortex, such as glucocorticods (cortisol, corticosterone) and mineralcorticoids. The lack of glucocorticoids leads to muscular weakness, low blood pressure, to increased sensitivity to insulin, may be hypokalemia, the change of adaptive possibility of organism. The patient can be exposed to diseases, are desturbed : the proteins formation, glycogen formation and detoxicative function in the liver. The lock of mineralocorticoids leads to disturbance of Na reserve in the body. The loss of Na is due to disturbance of its reabsorbtion in the renal tubules, therefore by this reason in the urine is a high NA+ level, which is not appropriate to deplection degree of fluid volume.

The loss of Na+ leads to action of homeostatic mechanisms

loss of Na in the body

The decrease of osmomolality of blood plasma

Is stopped the secretion of ADH

L oss of water

The decrease of blood plasma volume

Therefore the excretion of Na in the kidney, is accompanied with excretion of water while between these processes is preserved parallel . If the blood volume is more decreased may cause the stimulation of ADH secretion, as a result the water reabsorbtion is increased in the great measure then NA+, this leads to development of hyponatriemia . The deplection of blood volume in the body leads to concentration of blood, to decreas of blood plasma volume to development of anadequacy circulation in kidney, this is accompanied by a decrease of filtration rate in the renal corpuscle and it rate accompanied by it is moderate increase of urea quantity in the blood plasma. As the Na reabsoption in the renal corpuscle occurs and in exchange of K+ and H+ , so is observed the increase of K+ level in the blood plasma and is development metabolic acidosis with hypoxia,which connected with decrease of blood plasma volume, with changes of NA , K level in the body and with disterbance of heart .

These changes lead to disterbance of function of gastrointestinal tract . The pigmentation is developed due to a high concentration of ACTH in the blood in may be due to absence of inhibition by cortisol of mechanism feed bock regulation

Clinical situation 1

Patient, 50 years old, man has pains in right hypocondrium with irradiation in back and right scapula, low appetite, weakness also nausea, vomiting and skin itch.

Blood test:

Hb –135 g/l

Total protein – 65 g/l

Total cholesterol – 12 mcmol/l

Bilirubin total – 100 mcmol/l

Unconjugated – 19 mcmol/l

Conjugated – 81 mcmol/l

Rest nitrogen – 23 mmol/l

Urine test:

Diuresis – 1200 ml

Color – brown

Transparency – transparent

Glucose-negative

Protein- negative

Urobilin - negative test

Specific gravity of urine – 1.020

What are the changes in blood and urine test?

Which metabolic processes are damaged?

With which pathological conditions it may be?

What is it mechanism of this malfunctions.