This week, you examine cellular processes that are subject to ✓ Solved

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease. Scenario: 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 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: Each bullet point should be a subject heading and submit in APA format. Each bullet point should reflect a subject heading followed by subsequent content reflective of primary source(s) of reference published within the last 6 years.

  • 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.

Paper For Above Instructions

Protein malnutrition, also referred to as protein-energy malnutrition (PEM), is a significant health concern, especially among elderly populations. It can arise from inadequate dietary intake, malabsorption, or increased metabolic demand. This paper examines the disease highlighted in the scenario of an 83-year-old nursing facility resident diagnosed with protein malnutrition.

The Role Genetics Plays in the Disease

Genetics plays a vital role in determining an individual’s susceptibility to malnutrition. Genetic variations can influence metabolic pathways, nutritional needs, and the ability to absorb and utilize nutrients effectively (Barker et al., 2020). Some individuals may have specific genetic polymorphisms that impair protein metabolism, increasing their risk of malnutrition. Additionally, hereditary conditions affecting the gastrointestinal system, including conditions like celiac disease, can lead to malabsorption syndrome, exacerbating protein malnutrition (Pérez-Guisado & Jakubowski, 2017). In the case of the patient in this scenario, genetic factors may contribute to their malabsorption syndrome, making them particularly vulnerable to protein deficit and its associated complications.

Why the Patient is Presenting with Specific Symptoms

The patient exhibits generalized edema in the extremities and abdomen, which are common signs of protein malnutrition. Edema occurs when the body retains fluid due to low levels of albumin and other proteins in the blood, a condition known as hypoalbuminemia. Albumin, a vital plasma protein, helps maintain oncotic pressure, preventing fluid from leaking out of blood vessels into surrounding tissues (Müller et al., 2021). In this patient’s case, malabsorption of essential nutrients and proteins due to their dental issues and resulting dietary restrictions likely led to insufficient protein levels, culminating in the edema noted upon examination.

The Physiologic Response to the Stimulus

Upon presenting with generalized edema and protein malnutrition, the patient's body likely responded with several physiological changes. One key response involves the activation of the renin-angiotensin-aldosterone system (RAAS) due to low vascular volume and decreased perfusion pressure (Khan et al., 2022). The resulting retention of sodium and water as a compensatory mechanism can lead to swelling and increased blood pressure. This response is an attempt to restore homeostasis in a malnourished state, demonstrating the body’s ability to adapt to significant nutritional deficiencies. However, inadequate protein intake can persist, leading to a vicious cycle where physiological compensations further exacerbate the underlying condition.

The Cells Involved in This Process

Several cell types are crucial to the processes involving protein malnutrition. Endothelial cells lining blood vessels play a direct role in regulating vascular permeability and understanding how serum albumin levels maintain fluid balance. While low albumin levels increase permeability, they also facilitate the outflow of fluid into surrounding tissues, causing edema (Schnabl et al., 2018). Additionally, liver hepatocytes are vital in synthesizing plasma proteins such as albumin. In cases of malnutrition, reduced hepatic function can impair the production of necessary proteins, further complicating the patient's condition. Immune cells, such as lymphocytes, may also be affected, resulting in a weakened immune response and increased susceptibility to infections (Kacker et al., 2020).

Impact of Another Characteristic on Response

Gender could significantly affect the response to protein malnutrition. Research indicates that women often have different protein and caloric needs compared to men due to variations in muscle mass, hormonal levels, and overall metabolic rates (Sattler et al., 2021). For instance, post-menopausal women may experience increased susceptibility to muscle wasting and loss of lean body mass, complicating the effects of malnutrition. Moreover, genetic predispositions can interact differently with gender, where hormonal fluctuations in women can impact metabolism and nutrient requirements, further emphasizing the importance of tailored nutritional assessments and interventions based on individual characteristics.

Conclusion

In summary, the case of the 83-year-old patient presents several critical aspects of protein malnutrition. The interplay of genetic predisposition, physiological responses to inadequate nutrition, and the specific cellular mechanisms involved in maintaining homeostasis underscore the complexity of this condition. Recognizing the multifactorial nature of protein malnutrition is essential in creating effective interventions aimed at restoring nutritional balance and improving patient outcomes.

References

  • Barker, M. E., Wainwright, P., & Roderick, P. (2020). Genetic predisposition to malnutrition: A systematic review. Nutrition Reviews, 78(7), 676-691.

  • Kacker, R., Jain, R., & Gaur, S. (2020). Immune response in protein-energy malnutrition. Journal of Nutrition, 150(2), 123-130.

  • Khan, A., Karbasi, A., & Rugny, E. (2022). Homeostatic mechanisms in protein malnutrition: Insights from the renin-angiotensin-aldosterone system. Clinical Nutrition, 41(3), 514-523.

  • Müller, M. J., Bosy-Westphal, A., & Kreienbrock, L. (2021). Malnutrition in the elderly: A clinical overview. Gerontology, 67(6), 605-618.

  • Pérez-Guisado, J., & Jakubowski, J. (2017). Genetic factors in the malabsorption syndrome: A literature review. Journal of Clinical Gastroenterology, 51(5), 387-396.

  • Sattler, R., Alpers, D. H., & Paul, F. (2021). The impact of gender on protein requirement in elderly patients. Nutrition, 85, 111145.

  • Schnabl, B., Bäume, H., & Ochs, H. (2018). Endothelial function and protein malnutrition: The role of endothelial cells in vascular permeability. American Journal of Physiology-Heart and Circulatory Physiology, 314(5), H1058-H1071.