Scenario – Elastigirl Elastigirl is a 30-year-old female, who has presented to the antenatal clinic for a routine prenatal visit. She has generally felt very well throughout her pregnancy and...

Scenario – Elastigirl Elastigirl is a 30-year-old 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. Elastigirl reports she has been suffering from severe headaches over the last week or so and has been taking paracetamol tablets to dull the pain. She also reports some discomfort in her upper abdomen after eating and drinking and swelling in her feet and ankles. Elastigirl 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 34 weeks pregnant Temperature 36.2◦ C Blood work Blood group: OFasting blood glucose = 6 mmol/L BP 150/95 mm Hg Respiratory rate 22 bpm Diet Vegan, low calcium intake Past patient history Non-smoker. Regular check-ups during pregnancy. All previous screenings of blood, urine, and blood pressure within normal ranges. Exercises regularly. Social status Works as a customer assistant and lives with her husband and their daughter, Violet. Urinalysis: Blood - Bilirubin - Urobilinogen 0.4 mg/dL Ketone - Protein ++ Nitrite - Glucose - pH 6.5 Specific Gravity 1.015 Leukocytes - ©ACU XXXXXXXXXXAll topics and their key points listed below must be discussed in your essay Topic 1: Reproduction (10 marks total) A simple pregnancy test using Elastigirl’s urine helped to confirm her pregnancy. Which hormone is detected by a typical home pregnancy test? Discuss the role of this hormone in pregnancy. (5 marks) Considering Elastigirl’s circumstances, describe the future role of oxytocin on uterine tissue during childbirth. (5 marks) Topic 2: Respiratory system (5 marks total) Describe the changes in volume and pressure that will be occurring in Elastigirl’s chest cavity to achieve inhalation while she is sitting in the examination room. Explain why these changes are occurring, and the effect upon airflow. (5 marks) Topic 3: Digestion/metabolism (8 marks total) Elastigirl enjoyed her favourite tofu scramble for breakfast today. Unfortunately, painful indigestion meant she had to promptly follow her meal with a couple of Mylanta® chewable tablets. Discuss how Mylanta® would affect digestion of the protein in Elastigirl’s meal. (4.5 marks) State the hormone that will be MOST active in maintaining Elastigirl’s blood calcium levels if adequate calcium is not obtained from her diet. Explain your answer. (3.5 marks) Topic 4: Pharmacology (7 marks total) The antenatal nurse mentions to Elastigirl that the doctor might prescribe her Dithiazide tablets, which act as a diuretic. Discuss the route of administration of Dithiazide, 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. (4 marks) What effect will the thiazide have on other drugs that Elastigirl may take, such as paracetamol? In your answer, relate to the mechanism of action of thiazide. (3 marks