A 49-year-old male farmer presents to the emergency department with intractable nausea and vomiting, dyspnoea on exertion, and dizziness. The nausea began about two weeks prior to admission. There is no history of medication or toxin exposure. He has lost some weight recently and his current body weight is 52 kg. His past medical history is positive for hypertension diagnosed 4 years ago with no follow-up. He has smoked 1 packet per day for 20 years.
The attending nurse in the emergency department reports his blood pressure to be 160/120
mmHg, temperature 36.7°C, pulse 93/min. His skin is pale with numerous areas of
spontaneous bruising. Chest x-ray shows increased pulmonary vascular markings and hazy obliteration of the lower lung bases. Abdominal ultrasound examination shows a right kidney size of 7 cm and a left kidney size of 6.8 cm (normal kidney size approx. 10 cm).
Laboratory evaluation reveals:
Blood report Reference range
WBC 10.7 x 109/L 4.5-11 x 109/L
Platelets 245 x 109/L 150-400 x 109/L
Haematocrit 0.31 0.40-0.54 (adult male)
Creatinine 540 umol/L 60-110 umol/L (adult male)
Urea 35.2 mmol/L 3.0-8.0 mmol/L (adult)
Calcium 1.75 mmol/L 2.10-2.60 mmol/L
Uric Acid 0.68 mmol/L 0.20-0.45 mmol/L (male)
He's admitted to the nephrology ward for further evaluation and management of his condition.
Please answer the following TWO questions:
QI. What is the pathophysiological basis of hypertension in a patient with chronic kidney disease?
Q2. Based on the clinical picture and laboratory investigations provided, what stage of chronic kidney disease this patient is in and what will be the main management approach at this stage?
Support your answers with appropriate evidence (references). This assignment tests your ability to search scientific literature and present your answer in a scientific language. CDU library has heaps of resources to support you. Please make full use of these helpful resources:
Tips on academic/scientific writing:
General Guidelines on how to write your assignment
.. The word limit for this assignment is 450 to 550 words, this does not include references. Please stick to word limit, failing to do so will result in losing marks.
:• Only word and pdf formats are acceptable. Do not copy the case study questions in your file, just write QI, Q2 and provide your answer.
. This assignment must be submitted via Safe Assign/Turitin on Learnline. No other form of submission is acceptable including email, hand delivery or post.
. It is advised to have a foot note on your assessment containing your name, student
number and unit code. No COVER PAGE REQUIRED.
Please note there is NO DRAFT SUBMISSION for this assignment. Once you upload your file and click submit, it will be submitted for grading.
All the information about the assignment is available on Learnline; please take time to locate the necessary documents prior to sending an email to me enquiring about the assignment details.
7. Proof reading or feedback of any kind of ASSIGNMENT QUESTIONS will not be provided prior to submission.
8. Please contact the Learnline technical support if you have problems submitting the assignment.
1. Font size 12; Font type: preferably Calibri or Arial.
2. Line spacing 1.5 to 2.
Please use APA referencing style (7th edition). Number of references: between 5-10. Please refer to CDU library for referencing guide.
You will have to submit an official extension request with supporting documents at least 5 days before the deadline.
ASSIGNMENT MARKS RELEASE:
It is expected to take around 2 weeks or more to get your assignment marks being released after submission.