A 67-year-old retired male went to his doctor, complaining initially of leg pain

Question

A 67-year-old retired male went to his doctor, complaining initially of leg pain that started in his lower back, which then radiated down across the side of his thigh and over the front of his knee. Subsequently he developed pain that radiated from his back to his front at two different levels: at the chest through the level of his nipples and also at the umbilicus His physician performed a history and physical, followed by laboratory tests. He discovered a hard nodule on his prostate and an elevation in several of the blood tests. His PSA (prostate specific antigen). an enzyme secreted by normal prostate tissue (0-4 ng/ml) was 450. Alkaline phosphatase was also elevated at 157 U/L, an indication of bone involvement. A bone scan was ordered to visualize the bone involvement. (This test uses a calcium analogue attached to a radioactive tag. A special scanner can pick up images of this radioactivity and create an anatomical picture of the skeletal system. The radiation shows up as black spots on the film.) Usually prostate cancer's growth is initially influenced by the presence of testosterone. If testosterone is removed by castration, the cancer will often shrink for some period of time before the remaining fraction of testosterone-independent cancer cells grow. This gentleman was not interested in castration and asked if there was another way to treat this. He was treated was a single shot of a drug which is slowly released into the body over a three month time period. Within that time the patient noticed marked relief in his pain. 1. What is the diagnosis of this gentleman? 2. Which endocrine organs are responsible for serum calcium levels? 3. Describe a mechanism by which a drug could act on the anterior pituitary to lower the testosterone level in the human body

Explanation / Answer

Ques 1 Ans.

The diagnosis for this retired gentleman is Prostate Cancer.

Prostate cancer is the type of cancer which develop in the prostate gland in the male reproductive system. The cells may spread from the prostate to other area of the body like bones and lymph nodes.In this cancer it may initially cause no symtoms, but later it can lead to difficulties in urination, pelvic and back pain.

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Ques 2 Ans.

Parathyroid glands releases parathyroid hormone (PTH) causing the rise calcium level in plasma and Thyroid gland is the organ responsible for hormone calcitonin is a hormone produced that decrease the absorption of calcium and phosphate form the bones to the blood for lowring the plasma calcium levels of blood. The hormone calcitonin which helps to maintaining normal blood levels of calcium and phosphate.

So we can say both Thyroid and Parathyroid glands plays an impartant role to maintain serum calcium levels.

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Ques 3 Ans

Testosterone is the primary male sex hormone and an anabolic steroid. In human body testosterone hormone plays key role in the development of male reproductive tissues such as testes and prostate and promoting secordary sexual characterastics.

Testosterone is used as a medication for instance in the treatment of low testosterone level in men and breast cancer in women.

Mechanism:- Testosterone can activate the androgen receptor itself or after conversion to 5-alfa dihydrotestosterone (DHT) by the enzyme 5-alfa reductase. Testosterone can also be converted into the sex hormone. The most impartant of the estrogen in reproductive function and bone health.

testesterone is secreted into the blood and carried to target cells in the male reproductive organs. Testesterone is transported bound to a specific plasma protein called sex hormone binding glubulin, rest testosterone converted into 5-alfa dihydrotestosterone (DHT).

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