Obesity: BMI of 33

Cholesterol: 280 mg/dL, Triglycerides: 180, LDL 180, HDL 25 Bruises and puncture wound in the left ankle caused my misplaced wire

Increased Insulin Resistance

Decreased amount of insulin (Hypoinsulinemia)

Little breakdown of fat in cells (lipolysis)

Breakdown of glycogen into glucose

Decreased peripheral use of glucose

Protein breakdown

Activation of immune system and inflammatory response against infection WBC: 28 x 109/L with bandemia Temp: 39C UA - Pus cells: over 100/hpf UA - RBC: 20/hpf (+) Proteinuria Release of epinephrine, glucagon, growth hormone, and cortisol

Some free fatty acids are transported to the liver

Formation of new glucose from proteolysis HYPERGLYCEMIA FBS: 180 mg/dL HYPEROSMOLARITY

Increased serum creatinine: 8.9 mg/dL

Oxidized LDL Little or (-) ketone bodies Oxidative Stress

Stimulation of inflammatory cytokines

Endothelial Dysfunction Kidneys will normally excrete extra glucose and fluid from the body through the urine (Osmotic diuresis)

Expression of adhesion molecules from the endothelium Adhesion and subendothelial migration of macrophages

Extracellular dehydration

Accumulation of Foam Cells in the endothelium

Smooth muscle cell migration and proliferation Extracellular matrix production

Renal Insufficiency BP: 210/100; Crea: 8.9mg/dL; (+) glucosuria and proteinuria

Severe hyperosmolality and hemoconcentration (Hgb: 110 and Hct: 28)

Potassium shifts from the ICF to the ECF. (Hypokalemia : 2.7 mg/dL) Water retention is low because of low sodium levels in the ECF. (Hyponatremia: 123 mg/dL)

Formation of FIBROUS PLAQUE

Complicated Atherosclerotic Lesion Impaired blood flow to the left ankle because of hemoconcentration or viscous flow of blood

Intracellular fluid shifts to extracellular space to compensate for EC dehydration

Progressive edema

Vomiting because of increased potassium in circulation

Intracellular dehydration

Bluish discoloration and numbness

Thirst center stimulation in the hypothalamus Increased oral fluid intake by the patient

Decreased supply of essential electrolytes to the brain Severe headache, slurred speech, weakness, Left-sided weakness, 40% sensory deficit

Tissue necrosis

Hyperglycemia

Increased Viscosity of the Blood Increased Cardiac Output (Starling Law)

Increased resistance of the blood itself to flow Hemodynamic Dysfunction

Hypertension Arteriolar Vasoconstriction

Decreased Perihpheral Blood Flow (Hagen-Poiselles Law) Decreased Renal Blood Flow Renal Insufficiency Decreased Kidney Function

Increase Crossbridge Formation Augment Muscle Mass to bear extra Load Recruit Hormonal Mechanisms to increase contractility

Concentric Left Ventricular Hypertrophy

To Compensate For Glycosuria & Proteinuria Hematuria Regulation of Blood Volume & Pressure Excretion

Hypokalemia & Hyponatremia

Regulation of the concentration of solutes in the blood

Regulation of extracellular fluid pH. Decreased HGB Regulation of red blood cell synthesis