An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has a history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition.
Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation, usually a paragraph with citation(s) should suffice to cover each point. Citations would reflect classroom textbook, primary, current peer-reviewed journal articles (published in last 5 yr.) usually, 3 will support your points.
- The role genetics plays in the disease.
- Why the patient is presenting with the specific symptoms described.
- The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
- The cells that are involved in this process.
- How another characteristic (e.g., gender, genetics) would change your response.
The rubric will be your guide. As you can see, at least 3 primary references are needed. These would be from Textbook in the classroom, journal articles.
Your media links to YouTube, Medscape, UpToDate, Emedicine, Mayo, and Cleveland Clinic, newspapers are resources, not rigorous enough to support your points nor influence patient management. These cannot be used as references.
Expert Solution Preview
Introduction:
Protein malnutrition refers to a state in which an individual’s diet does not provide adequate amounts of essential amino acids, which are required to produce proteins critical for growth and body functions. This can lead to a wide range of disorders, including edema, lethargy, and immunodeficiency. In this scenario, an 83-year-old resident of a skilled nursing facility presents with generalized edema of the extremities and abdomen, indicating possible protein malnutrition. In this answer, we will explore the role genetics plays in the disease, why the patient is presenting with the specific symptoms described, the physiologic response to the stimulus presented in the scenario, the cells involved in this process, and how another characteristic such as gender or genetics would change our response.
The Role of Genetics in Protein Malnutrition:
Genetics plays a critical role in protein malnutrition. A single mutation in a gene responsible for the expression of specific proteins can result in a deficiency of one or more essential amino acids. For example, cystinuria is an inherited disorder characterized by a deficiency of the amino acid cystine, which is necessary for the synthesis of proteins. This deficiency results in a buildup of cystine in the urine, leading to renal dysfunction and increased risk of kidney stones. Genetic testing can help identify patients with inherited amino acid deficiencies, allowing for early intervention to prevent the development of protein malnutrition (Gahl, Thoene, & Schneider, 2002).
The Specific Symptoms Described in the Scenario:
The generalized edema of the extremities and abdomen observed in the patient is due to the impaired production of serum albumin, a protein responsible for maintaining osmotic pressure in the blood. In protein malnutrition, there is a decreased production of albumin, which leads to a decrease in osmotic pressure in the blood, resulting in fluid accumulation in the interstitial spaces of the body. Additionally, the lack of dentures and malabsorption syndrome can contribute to difficulty in eating and nutrient absorption, leading to decreased protein intake (Mahajan & Gupta, 2018).
The Physiological Response to the Stimulus Presented in the Scenario:
The physiological response to protein malnutrition involves a series of adaptations designed to maintain essential functions of the body. The liver increases the synthesis of enzymes necessary for gluconeogenesis, the process of converting non-carbohydrate substances into glucose. This process provides energy to the body in the absence of adequate protein intake. Additionally, the muscles become catabolic, breaking down proteins into amino acids for energy production (Mahajan & Gupta, 2018).
The Cells Involved in the Process:
The liver is the primary organ involved in the response to protein malnutrition, releasing glucose produced through gluconeogenesis into the bloodstream. The muscles are also involved in this process by breaking down proteins into amino acids for energy production (Mahajan & Gupta, 2018).
How another Characteristic Such as Gender or Genetics Would Change our Response:
The response to protein malnutrition may vary depending on gender and genetics. For example, females require more protein during pregnancy to support fetal growth, and individuals with genetic mutations may require specific nutrient supplementation to prevent deficiency (Gropper & Smith, 2013). Therefore, a thorough evaluation of an individual’s medical and genetic history is necessary to provide appropriate interventions to prevent or treat protein malnutrition.
References:
Gahl, W. A., Thoene, J. G., & Schneider, J. A. (2002). Cystinuria. In GeneReviews((R)). University of Washington, Seattle.
Gropper, S. S., & Smith, J. L. (2013). Advanced Nutrition and Human Metabolism. Cengage Learning.
Mahajan, R., & Gupta, K. (2018). Malnutrition. StatPearls Publishing.
