Help me study for my Health & Medical class. I’m stuck and don’t understand.

Case study: Maria is a sedentary, 68-year-old woman who is overweight. She complains that her hands and feet are always cold, and she tires quickly when cleaning the house. At her most recent visit to her doctor, her blood pressure was 184/98 mm Hg. She has edema around her ankles and legs, and her physician is concerned about an echocardiogram that indicates Maria has an enlarged heart.

• Identify two reasons why Maria will have tissue ischemia. How might this lead to hypoxia?
• What two early and reversible changes occur to tissue cells when they are hypoxic?
• What specific type of cellular adaptation has taken place in Maria’s enlarged heart? What made you come to this conclusion?

Predict why Maria’s heart has become enlarged. Why doesn’t this enlargement give her the same cardiac strength and endurance as a well-trained athlete?

Use at least 5 references no more than 5 years old.

This can be use as a guide to answer the questions:

Identify two reasons why Maria will have tissue ischemia. How might this lead to hypoxia?

Maria’s tissue ischemia is a result of impaired circulation and her edema. In this situation, the tissue hypoxia results from the inability of oxygenated blood to reach the tissue cells.

2. What are the two early and reversible changes that occur to tissue cells when they are hypoxic?

Two early and reversible cellular changes seen with hypoxia are the following:

• Anaerobic metabolism and the production of lactic acid
• The failure of Na⁺/K⁺ pumps resulting in cellular swelling

1. What specific type of cellular adaptation has taken place in Maria’s enlarged heart? What made you come to this conclusion?

Adaptive pathologic hypertrophy. Hypertrophy occurs instead of hyperplasia in the heart because muscle fibers are unable to undergo mitotic division.