MN551 unit 7 Discussion

  

 Topic: Case Study

Case Study Posting Requirements 

1. Make sure all of the topics in      the case study have been addressed. 
2. Cite at least three      sources—journal articles, textbooks or evidenced-based websites to support      the content. 
3. All sources must be within five      years. 
4. Do not use .com, Wikipedia, or      up-to-date, etc., for your sources. 

Case Study 1 

Mechanisms of Endocrine Control 

Leda is a 38-year-old woman who began to experience weight gain, mood swings, and weakness. When her periods became irregular, she went to her physician. Leda’s physician heard the symptoms Leda was concerned about and then ordered a 24-hour free cortisol urine test and an overnight dexamethasone suppression test and measured her serum ACTH levels. The results indicated that Leda had Cushing disease, a condition caused by the hypersecretion of ACTH by the anterior pituitary and resulting in elevated cortisol levels. To confirm the diagnosis, Leda’s physician ordered a cranial MRI to identify the presence of a pituitary tumor. 

1. The dexamethasone test involves      the administration of a synthetic glucocorticoid ( i.e., cortisol).      Knowing what you do about negative feedback mechanisms, how might this      test be used to assess pituitary function? 
2. Describe how the steroid      hormones, like cortisol, are metabolized in the body. What are the      advantages of using a 24-hour urine test to measure this hormone? 
3. Protein-based and steroid-based      hormones trigger cellular responses in different ways. What are the      differences between the mechanism of action of ACTH and cortisol on target      cells? 

Case Study 2 

Disorders of Endocrine Control of Growth and Metabolism 

Bertha is a 71-year-old woman who takes daily medication for Hashimoto thyroiditis. Last winter, she developed pneumonia. While she did her best to run errands for her husband, she got tired easily and needed to rest frequently. One day, after shoveling the snow outside, her husband came inside to find Bertha lying on the sofa covered in blankets. Her face appeared puffy and her eyelids hung. When he spoke to her, Bertha’s voice was hoarse and her words did not make sense to him. Her respirations were also shallow and slow. Suspecting low thyroid hormone levels were causing the signs, her husband called for an ambulance. 

1. When testing for      hypothyroidism, why is the free T4 level an important measurement? What      would the TSH and T4 test results indicate in someone with primary      hypothyroidism? 
2. Using your knowledge of the      function of thyroid hormone in the body, explain why Bertha’s respiratory      rate was decreased? Why might pleural effusion be present in someone with      hypothyroidism? 
3. What factors in Bertha’s      history leave her susceptible to myxedematous coma? What are the      physiological aspects involved in myxedematous coma? 

Case Study 3 

Diabetes Mellitus and the Metabolic Syndrome 

Juan is a 44-year-old who works in a warehouse. He is 5′8″, weighs 185 pounds, and has a waist circumference of 41″. At his last visit to the health clinic, Juan’s blood pressure was 140/60 mm Hg. Shortly after having a series of blood tests, his physician called him in to talk about the results. Juan had a fasting plasma glucose level of 107 mg/dL, an HDL level of 37 mg/dL, and a serum triglyceride level of 210 mg/dL. 

1. What condition is Juan likely      presenting with? What are the spectrum of physiological abnormalities that      occur with this disorder? 
2. What is the significance of      Juan’s waist diameter? How is truncal obesity hypothesized to increase      insulin resistance in the body? 
3. In type 1 diabetes, there are      hypoinsulinemia and hyperglycemia. In type 2 diabetes, it is common to see      hyperinsulinemia and hyperglycemia. Why do the differences exist? 

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home. 

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