Sarah is a 28yo female who has presented to the antenatal clinic for a routine prenatal visit. She has generally felt very well throughout her pregnancy and exercised regularly but is starting to feel more and more tired as her pregnancy progresses. Sarah reports she has been suffering from severe headaches over the last week or so and has been taking paracetamol capsules to dull the pain. She also reports some discomfort in her upper abdomen after eating and drinking and swelling in her feet and ankles. Sarah is vegan and, although she considers her fluid and caloric intake to be adequate, admits that she probably isn’t careful enough when ensuring she eats enough high calcium foods.A physical examination and urinalysis were conducted. Results below.
Physical examination:
Height 164 cm
Weight 63 kg
Appearance Clean, neat appearance, mild oedema in
feet and ankles
Pregnancy status Primigravida 34/52
Temperature 36.2◦C
Blood work Blood group: O-
Blood glucose = 6 mmol/L
BP 150/95 mm Hg
Respiratory rate 22 bpm
Diet Vegan, low calcium intake
Breast tissue contains glandular structures relevant to Sarah’s reproductive function. Note the role of this glandular tissue in reproductive function. Discuss any likely changes in the activity and regulation of this tissue, in relation to Sarah. Ensure you include discussion of relevant hormones in your response. Considering Sarah’s circumstances, describe the future role of oxytocin on uterine tissue during childbirth. (4 marks)
Evaluate Sarah’s urinalysis. Using your knowledge of normal kidney function and urine formation, explain any abnormal values, and the possible underlying mechanisms. Given Sarah’s pregnancy, discuss any changes you would expect to see in her glomerular filtration rate.
Discuss whether you would expect Sarah’s gut motility to have increased or decreased from normal. Include discussion of EITHER peristalsis or segmentation in your explanation.Sarah had avocado on toast at her favourite café before attending her clinic appointment. Discuss the mechanical and chemical events required to absorb the ingested fats in Sarah’s meal. State the hormone that will be MOST active in maintaining Sarah’s blood calcium levels if adequate calcium is not obtained from her diet? Explain your answer.
Sarah indicated that she has taken paracetamol capsules for her headaches over the last week Discuss the route of administration, where the drug is likely to be absorbed after administration, and its likely bioavailability. Justify your response by discussing whether the drug would be subjected to hepatic first pass. Discuss the importance of the half-life of a drug. What is the estimated half-life of paracetamol? Using this estimate, calculate the amount of time it would take to achieve steady-state concentration and explain the importance of achieving steady state.
