Physiology Questions :Blood pressure Scenario Friday, 7pm: Roma and Clint Underh
ID: 38674 • Letter: P
Question
Physiology Questions :Blood pressure Scenario
Friday, 7pm: Roma and Clint Underhill had both had a long day. They were the owners of a successful real estate company in Desert Palm. Each had several clients, and the strain of the current real estate market was getting to them. It had been an unusually cool day for January, with temperatures hovering around 60 degrees. On coming home they decided to relax in their hot tub with some wine. While Roma changed from her work clothes, Clint said that he would join her in the hot tub after he took his Lasix.
Saturday, 8am
911 Please state your emergency.
Oh, Oh, I I
Maam, please calm down and tell me the address.
I think, yes, OK, its its 2560 Oak Creek Drive.
What is the problem, please?
Im the maid for Mr. and Mrs. Underhill and and I didnt find them in the house when I came in this morning, so I looked around outside. I just found them in their hot tub out back. They are under the water. Please come, please come now!
Yes, maam, Im alerting the EMTs and an ambulance will be on the way. Please go out front and wait, so the paramedics can find the address quickly.
Saturday, 8:10am: Paramedics Kavita Dickson and Larry Gonzales brought the ambulance to a stop at the end of a long driveway next to an impressive two-story mansion. The maid was on the front steps and quickly directed them to the back patio where the hot tub could be seen.
Empty bottles of wine were on the ledge surrounding the hot tub. Kavita quickly climbed up the steps and saw the bodies of the Underhills on the bottom of the hot tub. As she got into the water, she exclaimed, This water seems really hot. Lets see if we can get them out. Larry climbed in after her and together they dragged the bodies out of the hot tub and onto the patio. It was obvious that both had been dead for some time. Kavita called the dispatcher.
Listen, Linda, this hot tub case is a DOA, but something is not right. How about sending the medical examiner and a detective out to look the situation over. Tell them to bring a thermometer
Saturday, 9:30am : 115 degrees! What is this thing doing so hot? Sam Garrison asked Kavita as he removed the thermometer from the water. This hot tub should be no more than 109 degrees. He remembered reading a Consumer Product Safety Commission flyer on hot tubs and wondered if the tub was associated with the death. The bodies were being taken away for autopsy as he took in the scene.
Hmm. What about these bottles of wine? It looks like they had a partyall by themselves! The medical examiner will check their blood alcohol level and well be able to see his complete report on Monday. We may even be able to determine their cause of death with that information. Ill ask the maid about any medications. He went into the sunroom off of the patio to where the maid was being consoled by another officer. Maam, can you tell me if the Underhills were taking any medicine?
Well, sir, I know he was complaining about having to use the bathroom a lot since he returned from the doctors office about two weeks ago. You might look in the cabinet over the sink where they keep aspirin and such. Sam looked where she indicated and found a recently filled bottle of Lasix.
Monday Afternoon: Monday afternoon, the medical examiner phoned Sam with the following information:
? Blood alcohol level (BAL) of the couple was 0.20
? Roma weighed 120 lbs; Clint weighed 160 lbs
? Time of death estimated at 2am Saturday morning
? There was a therapeutic level of Lasix in Mr. Underhills blood, but none in Mrs. Underhills blood
Questions
1. What effect would Lasix have on Mr. Underhills mean arterial pressure, and how would it exert this effect?
2. What are 3 physiological responses that normally occur to reverse a decrease in blood pressure?
3. Identify two procedures that might have helped save the couple if they had been found unconscious but still above water and alive. Do NOT list CPR.
4. a) Summarize how the combination of alcohol and hot water affect cardiac output.
b) Summarize how the combination of alcohol and hot water affect mean arterial pressure.
5. In one to two sentences, conclude how you think the Underhills died, specifically including the role of alcohol. Make sure to include the disturbance to homeostasis, and failure to compensate for that disturbance
Explanation / Answer
1) Lasix (furosemide) is a loop diuretic, and is very much useful in preventing your body from absorbing excess of salt. The dose over 120mg of Lasix can bring a fall in arterial blood pressure and the hypotensive actions will begin in 30 to 45 minutes and this condition likely going to last for 10 to 12 hours. On administration of furosemide, the patient will lose weight, his urinary volume increases and urinary potassium and sodium and a decrease in plasma volume, all these things will leads to a fall in mean arterial pressure.
2) Our normal blood pressure if 120/80 mmHg and when it go below than this, hypotension condition will arise and our body is very sensitive to changes in blood pressure.
The body will created certain responses throughout the body to bring the blood pressure back.
During hypotension condition, the body employs a number of physiological mechanisms (neural, biochemical and hormonal mechanisms) to bring back the pressure.
a)Whenever baroreceptors present in arteries detect a fall in blood pressure, it will stimulate the release of epinephrine and nor epinephrine.
Epinephrine- causes an increase in heart rate and nor epinephrine- induces vasoconstriction by slightly increasing the heart rate. These changes will bring back the blood pressure.
b)The activation of renin-angiotensin axis and the release of arginine vaso pressin will cause the vasoconstriction of the kidneys, gastrointestinal tract, and other organs and will divert the blood to the heat, lung and brain, thus tries to bring back the blood pressure.
c)The body can also bring back the pressure, by increasing the heart rate and its contraction and so that the heat can eject more blood with each contraction. This will increases the flow of blood into the arteries and thus blood pressure rises.
d)The veins can become narrow, so that it will store less blood and return more blood to the heart for pumping into the arteries, so the blood pressure can rise.