• Subject Code : BIOL121
  • Subject Name : Human Biology

Case Study: Nevaeh – A Teenage Pregnancy 

Question 1

A. The enlargement of mammary glands takes place during the high-estrogen stage of pregnancy, and it is at this state that the glandular tissues completely develop for milk production. The growth of Breasts Ductal system is stimulated by estrogen. In the entire period of pregnancy, estrogen in its large quantities secreted by the placenta makes the breasts ductal system to enlarge and branch (Srivastava & Dhagga, 2019). Concurrently, the breasts stroma increases in quantity, allowing for large fat quantities to be laid down in the same stroma. The growth of the breasts ductal system is also supported by other hormones including prolactin, insulin, growth hormones, and adrenal glucocorticoids.

B. Milk secretion is happens continuously into the breast alveoli. However, the same milk flows slowly into the breasts ductal system, and that is why it does not leak out of the nipples continuously. For the baby to obtain breast milk therefore, it has to be let down into the ductal system from the alveoli (Sammut, Sammut, Chetcuti & AGIUS, 2018). This is made possible by the help of neurogenic and hormonal reflex combined which comprises the posterior pituitary hormone oxytocin. Upon suckling, the baby may virtually not receive milk in the first minute of so.

The transmission of sensory impulses must first be done through somatic nerves to the spinal cord of the mother from nipples, and then to the hypothalamus of the mother, where prompt nerve signals to promote secretion of oxytocin and also cause secretion prolactin. The oxytocin is transported to the breasts by blood and on arrive, it triggers myoepithelial cells (bordering the alveoli to the outer wall) to contract, hence, squeezing out milk from the alveoli to the ducts at +10 to 20 mm Hg pressure (Sammut, Sammut, Chetcuti & AGIUS, 2018).

Question 2

A. The kidney performs very critical role in the maintaining of the fluids in the body. The kidney is able to discharge its roles with the help of the antidiuretic hormone. The hormone is responsible for the regulation and the balancing of the amount of water in the human blood system, and balancing of the water in the body. It is important to note that the body needs to maintain an optimum level of water in the body for proper functioning of the body systems. If there is too much water concentration in the body, it means that the body is likely to experience higher blood pressure which is dangerous to the body of an individual. The patients’ blood pressure is above the normal blood pressure level. The normal blood pressure is normally 120/80 while the patients B.P is at 138/87mm hg. Therefore, it means that Nevaeh is at great risk of not maintaining the homeostatic fluid mechanism. In the Nevaeh case, the condition may have been caused by the stress which the young girl was exposed to. She must have gone through some stress being that she is still a young girl she has no home to settle down. She sleeps in the streets and has no partner and thus the cause of the stress.

B. Urinalysis is a medical term which is used to explain the process of testing samples from the urine. It is a test which is very critical in determining the pregnancy test. During the early periods of pregnancy especially after the 10th day after missing the first period, the urinalysis is the most accurate test which can prove if one is pregnant or not. With the high level of sugar in the urine, it indicates that the patient is suffering from type 2 diabetes which is highly associated with pregnancy. The high levels of protein in the urine is also used to ascertain whether the patient is pregnant and thus leading to high BP.

Question 3


Gut motility may be defined as the expansion and contraction of the muscles which are located in the gastrointestinal tract which aids in the movement of food from the mouth to the stomach. As a result of the contraction and expansion of the muscles, that movement is referred to as peristalsis. With the increase in the level of progesterone hormone, the gut motility is also reduced greatly. The hormone is also responsible for the slowing of the digestion system.


Protein intake is very important for the pregnant women. It is important for the growth and development of the fetus. The protein also helps in the repair of the worn-out tissues of the fetus. The proteins also help in the manufacture of the hormones, enzymes and antibodies which helps the fetus to develop the immune systems. Therefore, pregnant women should consider taking diets with proteins to protect their fetus from developing some complications as well as for the effective growth and development of the fetus. The consumption of protein rich diet by the pregnant women helps them deliver babies of the required weight and therefore, the baby is stable. In the brain development, the protein is very essential and thus the pregnant women should take it as much as possible in their diet.

Question 4

A. Paracetamol is disseminated in the entire fluids of the body in a uniform manner.

Half-life = t1/2: 2.5 hours.

Distribution volume (VD): 65 L

Oral bioavailability (F): 70%-90%

Rectal bioavailability: 30%-70

Absorption of paracetamol is homogenously done in the gastrointestinal tract (GIT).

Oral bioavailability depends on the dose. When the dose in large quantity, this decreases the effects of the hepatic first pass to the overwhelming enzymatic capacity of the liver, increasing bioavailability in the long run. Rectal paracetamol administration is also possible, and bioavailability in this case is unpredictable and decreased in overall, as a result of partial suspension of the suppository in the rectum (Zhang et al., 2016). The time taken for absorption when paracetamol is administered through this route is long. The analgesic activity results from the minor friction that enters the brain. When paracetamol is administered at therapeutic doses will bind to the plasma of proteins at 20% or less.

Metabolism of Paracetamol is basically done in the liver by the conjugation of 55% glucuronic acid and 35% sulfuric acid. The cytochrome P450 yields hepatotoxic metabolites in smaller amounts. In salutary plasma concentration range, the hepatotoxic metabolite is detoxified by conjugation with glutathione. When intoxication happens, this toxic metabolite in its quantity rises and surpasses available glutathione amounts, something that can lead to renal tubular necrosis and hepatic failure.

Route of administration is oral route.

Yes it will undergo hepatic first pass.

B. Importance of half-life of drug eradication is an important pharmacokinetic parameter given it offers a precise sign of period of time that the drug effect endures in a person (Zhang et al., 2016). The half-life of a drug also indicates if a drug accumulation may occur with numerous dosing routine.

Percentage of drug after 24 hours when half-life is 6 hours

Will be - after 6 hour - 50%

After 12 hours - 25%

After 18 hours - 12.5%

After 24 hours - 6.25% final answer

Question 5

A. Hypertension or high blood pressure diseases associated with pregnancy usually occur after the 20th week of pregnancy. High blood pressure in pregnancy ought to be monitored closely so as to do away with possible complications. For the case of Nevaeh, a caregiver should recommend regular visits to monitor the foetus, and also carry out tests to do with blood and urine. The nurse or doctor will possibly require Nevaeh to record how often the baby will be kicking every day. It is problematic if the movement of the baby decreases indicating the need for premature delivery. The provider is also required to carry out ultrasounds during pregnancy so as to ensure Nevaeh’s baby is developing properly. Treatments may also be suggested subject to the type and severity of hypertension problems. During pregnancy, the kidney will increase 30% of its volume. Dilation of calyceal systems and kidney pelvis occurs with the help mechanical compressive forces on the uterus also because of progesterone effects. Progesterone can also decrease uteral tone, contraction pressure, and peristalsis.

B. Approximately 1.8% of all pregnancies are affected by chronic hypertension (cHTN) defined as hypertension detected before 20 weeks of gestation or predating pregnancy. The risk for significant maternal and fetal morbidity and death is increased in women with cHTN, and is in part related to the severity of maternal hypertension (Karaboyas et al., 2018). Although some women with preexisting hypertension experience a decrease in blood pressure (BP) during pregnancy, the risk for superimposed preeclampsia (SPE) is increased five-fold, which amplifies the risk of adverse outcomes. BP regulation during pregnancy is not fully understood. Vasodilation and lower BP may be caused by hormonally mediated increases in nitric oxide, accompanied by resistance to the vascular effects of angiotensin II. All components of the renin-angiotensin aldosterone system (RAAS) are elevated beginning in early pregnancy, likely in response to vasodilation and lower BP.

During gestation period, the renin-angiotensin-aldosterone system (RAS) plays an important role in balancing salts and ensuring the wellbeing of the fetus as well as the mother. In this balance, both the classical renal renin-angiotensin-aldosterone system and the uteroplacental unit, contribute to the gesturing cascade of the both maternal and fetal tissues (Vaduganathan et al., 2020). Various researches have indicated that in normal pregnancy, all components of the RAS increase in size. In pregnancy imbalances, this frail equilibrium may become deranged. One such case is preeclampsia, and it refers to a pregnancy disorder characterized by high blood pressure, placental abnormalities, and proteinuria accompanied with shallow trophoblastic invasion and damaged spiral artery remodeling.

Even if it is a leading cause of death and the main contributor of perinatal and maternal; indisposition, little research has been conducted to identify the mechanisms that cause preeclampsia pathogenesis. The RAS and immunological mechanisms have been linked to preeclampsia and its development. Many studies carried out lately have shown the presence of the angiotensin II type I receptor agonistic autoantibody (AT1-AA) (Karaboyas et al., 2018). This autoantibody can prompt several other disorder features as well as free molecules engaged in the preeclampsia pathogenesis. The RAS has been, time and again, been believed to be vital in placentation, preeclampsia pathogenesis, and normal pregnancy.


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