Question-Mini-Case:

On a routine exam, an apparent 58-yr old Caucasian male statesthat he has been extremely fatigued following any type of activity,having a constant “pounding headache,” pain in his joints and along“his side” (points to the abdominopelvic region near his spleen).He has recently arrived to the area (elevation of 5,500 feet) forvacation, from the coast (elevation 10 feet). During hisexamination you obtain the following measures:

Blood Pressure: 146/100 mm Hg;

Pulse rate: 95 beats/min;

Respiration rate: 18 breath/min;

Heart Sounds: systolic murmur;

Lung sounds: Slight Rail;

ECG: No deviation;

CBC: Hct: 57%; Erythrocyte: 5.1x106 cells/μL; Leukocytes: 4,000cells/μL; Hb: 15 g/dL; pO2: 85 mm Hg; saO2: 80%; pCO2: 28 mm Hg;[HCO3-]: 28 mM; pH: 7.25; EPO: 30 mU/mL.

You decide that a treatment of bicarbonate (pushed via saline)and supplemental oxygen (100%). After 60-minutes of treatment, hispO2 rises to 97 mmHg and saO2 to 95% with normalization of pCO2 and[HCO3-].

In a well-formulated response, and using correctmedical/scientific terminology, generate a presentation of thiscase include in your response:

The possible etiology (reason/rationale) for the occurrence ofthe abnormal findings and any possible innate underlying issuesthat you must advise the male about. What other test isnecessary?

Indicate the physiological responses that are the possiblereason for the responses seen to treatment and what long-termtreatment might be required for this issue.

Add feedback loop to the answer.