A 55yearold man with no history of illness suffered a blow t

A 55-year-old man with no history of illness suffered a blow to the head. He was unconscious when admitted to the hospital and remained in that state until his death 15 days later. A nasogastric tube was inserted to administer the required nutrients (protein, carbohydrates, fat, minerals, and vitamins). The total water intake was 1, 500 mL/d. Starting on day 5, his blood pressure gradually fell. The 24-hour urine volumes recorded from an indwelling catheter were as follows: The patient\'s hemoglobin and hematocrit were elevated. Blood chemistry analysis on day 13 revealed the following. What is the probable cause of the elevated proteins? What other results support this conclusion? Why is the BUN elevated?

Solution

1. The elevated proteins in the blood stream is a result of the following

i) Blow to the head might have affected neuro vascular unit causing the proteins pertaining to central nervous system to cross the blood brain barrier thereby appearing in the bloodstream.

ii) There is a glymphatic system, which facilitates the bulk fluid movement in the brain flushes ot the brain derived proteins from the central nervous system after an injury.

2. Elevated Hemoglobin and hemotocrit supports above.

3. BUN (Blood urea nitrogen) is elevated as there is a reduction in the volume of urine and urination is the process through which urea nitrogen is excreted from the body.

References

1. Kawata, K.,Liu,C, L., Merkel, S, F., Ramirez, S, H., Tierney,R, T., & Langford, D. (2016).Blood biomarkers for brain injury: What are we measuring? Neurosci Biobehav Rev, 68, 460-73.

2.