病理生理案例分析Case anaysis f pathphysigy.doc

病理生理案例分析（Case analysis of pathophysiology） Medical records analysis of pathophysiology Case thinking (hydropower) A 16 year old female patient was admitted to hospital for 1 years due to palpitation and shortness of breath, cough, hemoptysis, abdominal distension and oliguria for 2 weeks. After admission, all patients were diagnosed as rheumatic valvular disease, cardiac function class IV, pulmonary infection by various examinations. Laboratory examination: blood K+4.6mmol/L, Na+144mmol/L, Cl-90mmol/L, HCO-329mmol/L. After admission, the patients were given cardiac, diuretic (hydrochlorothiazide 25mg/ times, 3 times / day), anti infection treatment, and low salt food. After 7 days of treatment, abdominal distension, edema of lower limbs were basically lost, and heart failure was improved obviously. After 18 days of treatment, heart failure control, but the general condition was not improved, and the spirit of low-spirited, saliva, body, weak and feeble abdominal distension, nausea and vomiting, do not think of eating and oliguria, and dehydration; blood K+2.9mmol/L, Na+112mmol/L, Cl-50.9mmol/L, HCO-335.7mmol/L. Intravenous administration of glucose saline containing potassium chloride was given immediately. After 5 days, the general condition improved significantly, appetite increased, muscle tone recovered, urine volume gradually became normal; blood K+4.4mmol/L, Na+135mmol/L, Cl-91mmol/L, HCO-330mmol/L. Discussion questions: 1. What are the causes of hypokalemia and hyponatremia in patients? 2. What are the symptoms associated with hypokalemia? Explain why. Why does it take 5 days to improve the condition? 3, whether patients with acid-base balance disorders? What causes it? Why types? Two, case thinking (acid-base) No longer added cases. Type selection questions 30, 31 and 32 were found in cases one or two and three, respectively. Please analyze the acid-base balance of these patients separately. The results of blood gas analysis and electrolyte determination we