PBL Trigger 2: FILA TABLE (Task 10)
A 23 YEAR OLD MAN DEVELOPED AN IRREGULAR HEART RHYTHM, COMPLAINED LETHARGY, TREMOR OF HANDS AND ARMS. HE COMPLAINED ABOUT ANXIETY, SWEATING AND HUNGER. BIOCHEMICAL INVESTIGATION ON BLOOD REVEALED BLOOD SUGAR LEVELS IS 2.7 MMOL/L.
Discuss the process of metabolism, glycolysis, kreb cycle and electron transport system.
FACTS
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IDEAS
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LEARNING ISSUES
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ACTION PLANS
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REFERENCES
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1.A 23 year old man developed an irregular heart rhythm.
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A 23 year old man has a heart problem
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1) What cause the irregular heart rhythm?
2) How metabolic changes affect the heart rhythm?
3) What is the normal average heart rate?
4) What diseases related to irregular heart rhythm?
5) What are the symptoms of irregular heart rhythm?
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1) A number of things may cause an abnormal heartbeat, including high blood pressure. Other common causes are:
*Coronary heart disease
This serious heart problem occurs when cholesterol and other deposits block the coronary arteries.
*Medications
Some medications or substances may cause your heart rate to change. These include:
*Other causes
A number of other factors can also cause alterations in your heart’s rhythm. These include:
2) Metabolic changes affect the heart rhythm because of a progressive impairment of cardiac and skeletal muscle in high energy phosphate production. This is because the consequence of impairs cardiac metabolism, other processes are activated in failing heart that increase the progression of it.
3) The normal heart rate for adult when resting is in range from 60 until 100 beats per minute. This heart rate will increase follow by age.
4) Arrhythymia that can be silent and only can be detected by doctor during a physical exam like pulse or ECG which is electrocardiogram.
5) The symptoms are a slow heartbeat chest pain which is bradycardia, a fast heartbeat which is tachycardia, irregular pulse feel dizzy, sweating and shortness breath.
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2.Complained
lethargy.
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A 23 year old man wondering why he always tired
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1) What are the causes of lethargy?
2) How is the production of glucose in blood cells?
3) How does the anaerobic glycolytic system work?Relate it with lethargy.
4) Does the glycolysis affects the kerb cycle process?
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1) What causes lethargy?
*Many kinds of acute illnesses can make you feel lethargic. This includes the flu or a stomach virus. Other physical or medical conditions can also cause lethargy, such as:
*Lethargy can also be the result of mental health conditions. These include:
*Lethargy can also be a side effect of taking certain medications, such as narcotics.
2) When the blood glucose rises after we eat, the beta cells release insulin into our bloodstream. The insulin acts as a key, unlocking muscle, fat and liver cells so glucose can get inside them. When your blood glucose level drops, the pancreas stops production of beta insulin. The alpha insulin cells in the pancreas produce glucagon which stimulate the liver to break down stored glycogen into glucose back. This glucose travel in our blood until the blood glucose rises.
3) Anaerobic glycolysis which break down carbohydrates into ATP in the absence of oxygen when the glucose in the bloodstream while glycogen are break down into ATP, water and lactate. Continued anaerobic metabolism will lead to fatigue due to large changes in the cellular environment that impairs energy production and muscle contractibility.
4) The anaerobic glycolytic process result in pyruvate binding with H2 ions and converting them in lactate. Pyruvate is a by product of ATP and it can used as fuel in aerobic metabolism which is in Krebs cycle. Krebs cycle is a process where acetyl CoA, produce citrate by adding its carbon acetyl group to oxaloacetate.
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3.Tremor of hands and arms.
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A23 years old man hand is shaking
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1) What is tremor?
2) How does it occur?
3) What are the causes of hands and arms tremor?
4) Is there any treatments for this symptoms?
5) What are the difference between essential tremor and Parkinson’s disease?
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1) Tremor is an involuntary, rhythmic muscle contraction that lead to shaking movements in one or more parts of the body. It is a common disorder that often affects the hands but can also occur in arms, head and legs.
2) It occur sporadically which on its own or happen as a result of another disorder. It can occur in any part of body and at anytime. It occur at middle-aged and also at older adults. It effect man and woman equally.
3) Generally it caused by problem in deep parts of brain that control movement which is cerebelum. Tremor can occur own its own or by a symptom associated with a number of neurological disorders including stroke, traumatic brain injury, multiple sclerosis, anxiety or panic, use of certain medicines and muscle fatigue.
4) Most tremor cannot be cured and a mild tremor do not requires the treatment. For essential tremors treatment, doctor will prescribe beta-blockers such as propranolol, metaprolol and nadolol. For Parkinson’s disease treatments, usually doctor will prescribe disease with spesific drug such as levadopa and carbidopa. The other treatment are by doing surgery like thalamotomy and deep brain stimulation(DBS), anti-seizure medications, botulinum toxin and through tranquilizers.
5) The differences between essential tremor and Parkinson’s disease are essential tremor doesn’t cause associates health problem while Parkinson’s carries other symptoms such as stooped posture and balance problems. Essential tremor may affect voice box while Parkinson’s does not affect voice box. Essential tremor usually felt more when in motion while Parkinson’s are felt when at rest.
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4.He complained about anxiety.
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A 23 year old having anxiety
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1) What are the effects of anxiety towards glycolysis enzymes levels?
2) What happens if glycolysis change?
3) What are the effects of anxiety towards electron transport system?
4) What are the treatments option?
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1) Anxiety can distrupt the blood glucose level. It is called as hypoglycemia. Hypoglycemia is abnormally low level sugar. If the blood glucose level drops, the pancreas release glucagon to stimulate the liver to convert the glycogen back into glucose. It also decrease the production of glucolysis enzyme. Hypglycemia is the most common among diabetec patient.
2) Glycolysis is the first stage in cellular respiration. If the glycolysis cannot break down glucose into energy, therefore, the blood cannot uptake sufficient energy. The glycolysis cannot produce two pyruvate molecules, two ATP molecules two NaDH molecules. Where all of this product is important in the next cellular respiration process which is in Krebs cycle. Therefore, if there is changes in glycolysis it also affect Krebs cycle because pyruvates are in Krebs cycle.
3) High anxiety increase expression of electron transport chain components and higher expression of proteins participating in transportation into and within mitochondria. These could lead to oxidative stress.
4) the treatment are uptaking medication such as antide pressants and sedative. This prevent anxiety which balance the brain chemistry and activities. They also can meet with psychologist to learn the strategies to cope with anxiety. By eating healthy diet, avoid caffein, getting enough sleep also can reduce anxiety
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5.Sweating and hunger.
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Sweating and hunger relates to each other
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1) What are the causes of sweating?
2) Can anxiety cause sweating?
3) What causes of hunger?
4) What are the hormones that regulate sweating and hunger?
5) What are the relation between hormonal imbalance and secretion of insulin?
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1) The causes of sweating stated that blood level for that man are low or can known as hypoglycemia, therefore it trigger a fight-or-fight response in the body. As the result, the body produces additional norepinephrine
And adrenaline which lead to heavy sweating as well as tremor and anxiety.
2) Yes. This is because anxiety and sweating can occur at the same time. Certain type of anxiety can cause hyperhidrosis or you might experience feelings of anxiety if excessive sweating interfere in your daily activities. In conclusion, anxiety and sweating relates to each other.
3) People who experience hunger can develop into heart disease. This is because when a person struggling with hunger over long term. The body will pumping out a ton of cortisol and can cause dyregulation of its release. This lead to an increase risk of heart health.
4) Ghrelin is a hormone that increase appetite while adrenaline is a hormone that regulate sweating. There is another hormone which is leptin made by fat cell that decrease the appetite.
5) It will give an effect to blood sugar level. For example, if increase the hormone insulin, it will increase the individual that having low blood level and have hypoglycemia disease.
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6.Biochemical investigation on blood revealed blood sugar levels is 2.7 MMOL/L .
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It is importance to keep a normal blood sugar levels
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1) What is the normal average for blood sugar level?
2) How to increase his blood sugar level back to normal?
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1) Normal average blood sugar level, if fasting is less than 100mg/dL which is 4.0 until 5.4 mmol/L for at least 8 hours. Less than 140mg/dL which is up to 7 until 8 mmol/L after 2 hours eating.
2) Since blood sugar level is low, so he need eat about 15g of carbs or a piece of fruit like banana or apple or 2 tablespoons of raisins or 1 tablespoon of honey
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