Exercise 16-4 n this exercise you will be playing the role of \"endocrine detect
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Exercise 16-4 n this exercise you will be playing the role of "endocrine detective" solve endocrine disease mysteries. In each case you will have a victim Endocrine "Mystery Cases" who has suddenly fallen ill with a mysterious malady. You will be presented a set of "witnesses,"each of whom will give you a clue as to the nature of the illness. Other clues will come from samples you send off to the lab for analysis. You will solve the mystery by provnding the victim a diagnosis. You may wish to use your textbook for assistance with these cases. When you have completed the cases, answer Check Your Understanding question 7 (p. 444), Case 1: The Cold Colonel You are called upon to visit the ailing Col Lemon. Before you se him, you speak with three him when he fell ill. three witnesses who were with Witness statements: 1 Ms. Magenta: "Col. Lemon has been hot-blooded for as long as I've known him. But I noticed that he couldn't seem to keep warm. He kept complaining about being cold... Mr. Olive"Just between you and me, I've noticed that the old chap has put on quite a bit of weight lately. Professor Purple. "The colonel and I used to go on major expeditions together. Now he just doesn't seem to have the energy to do much of anything." What are your initial thoughts about the witnesses' statements? Does one hormone come to mind that may be the cause? Explain Hg Path yrodism You see the colonel and collect some blood to send off to the lab. The analysis comes back as follows T3 (triiodothyronine): 0.03 ng/dl (normal: 0.2-0.5 ng/dl) T4 (thyroxine): 1.1 pg/dl (normal: 4-7 pg/dl) TSH (thyroid-stimulating hormone): 86 mU (normal: 0.3-4.0 mUn) Analyze the results. Why do you think the T3 and T4 are low and the TSH is elevated? Based upon the witness statements and the laboratory analysis, what is your final diagnosis? Explain Col. Lemon's symptoms Endocrine System UNIT 16Explanation / Answer
Case 1. Col. Lemon is suffering from Hypothyroidism, and ofcourse the hormone mitigating the symptoms are thyroid hormones. Hypothyroidism is characterised with extremely low thyroid hormone leves, either as a result of direct or indirect effect on thyroid glands. Since the thyroid hormones are associated with crucial functions of the body, as growth, development, temperature regulation, metabolism and other vital cellular process. Anomaly in their levels gets reflected in symptoms, as fatigue, weight gain, cold intolerance, increased cholesterol levels and so on, as evident with case study 1.
The blood reports indicate exceptionally lower levels of interconvertible active T3 and T4 levels and higher TSH levels. T3 is the active form of thyroid hormone that facilitates the optimal cellular metabolism, whereas T4 serves as repository converting into T3, as per the requirement. TSH (Thyroid Stimulating Hormone) is secreted by pituitary to enhance the levels of T3/ T4 in blood. This report indicates that working of pituitary is fine, and thyroid gland is primarily affected (due to one of the undermentioned reasons) producing extremely lower levels of thyroid hormone.
Final Diagnosis: Col. Lemon is suffering from Hypothyroidism (which may be either due to severe iodine deficiency, or an inherited condition called Hashimoto's thyroiditis, or lymphocytic thyroiditis). Cold intolerance in Col. Lemon is due to his inability to regulate his body temperature, and weight gain/ fatigue is due to lower rate of metabolism as a result of low T3/ T4 levels in his blood.
Case study2. The initial thoughts looking at the symptoms of high fatty deposits on face and trunk, high blood pressure and increased incidences of infections point towards the possibility of Cushing Syndrome, and the hormone that strikes as causitive is cortisol.
The lab reports that indicate her prescriptions to be prednisone are extremely significant because long term usage of such glucocorticoid/ cortisol like medications are one of the most prominent causes of Cushing Syndrome occurence.
Final Diagnosis: Mrs. Blanc is suffering from a condition called Cushing's Syndrome, also referred to as hypercortisolism (arisen as a result of elevated levels of cortisol). The optimal levels of cortisol (secreted by adrenal glands) regulate the blood pressure, retard the immune system inflammatory response, balance the effects of insulin and other such vital functions. On the other hand exceptionally elevated levels of cortisol are accompanied with high bp, swelling, fat accumulation (moon shaped face/ buffalo hump) and compromised immune responses, the symptoms are same as those of Mrs. Blanc, and the fact that she had the prednisone (cortisol) as her regular medication, further confirms the diagnosis since the longterm/ overuse of corticosteroid medications are one of the prominent causes of this disease.
Case study3. The first thoughts are that Prof. Purple is suffering from Diabetes insipidus, and the hormone responsible is Vasopressin. It is also referred to as Anti Diuretic Hormone (ADH), produced by hypothalamus and released by posterior pituitary (in blood/ brain), it enhances the water retention by increasing the water resorption in kidney's collecting Duct.
The lab reports that indicate the overly dilute urine/ overly concentrated blood/ but normal blood glucose concentration further strengthen the prediction. Vasopressin functions by Increasing the water permeability of distal convoluted tubule and collecting duct cells in the kidney, and therefore facilitating water reabsorption and excretion of more concentrated urine. Besides it also regulates the serum osmolarity/ osmolality by maintaining the adequate electrolytic balance in the blood stream. Therefore decreased ADH (vasopressin) release would not only affect the rention of water (hence overly dilute urine) but also affect blood osmolarity (hence concentrated blood).
Final Diagnosis: Prof. Purple is suffering from Diabetes insipidus, caused by lower levels/ release of vasopressin in the human system. His symptoms as thirst (Polydipsia), excessive urine production (Polyuria), increased blood sodium concentration ( hypernatremia) and fatigue are the charactristic features of Diabetes insipidus caused by lack / reduced levels of vasopressin (ADH).
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