1. Richard Neis had symptoms of excessive secretion of PTH (high blood calcium levels), and his physicians were certain he had a parathyroid gland tumor. Yet the surgery was performed on his neck, the surgeon could not find the parathyroid glands at all. Where should the surgeon look next to find the tumorous parathyroid gland? (4 points).
Answer: The surgeon should next look to the thorax to find the tumorous parathyroid gland (pg. 612 in Marieb).
2. Mary Morgan has just been brought into the emergency room of City General Hospital. She is perspiring profusely and is breathing rapidly and irregularly. Her breath smells like acetone (sweet and fruity), and her blood glucose tests out at 650 mg/100 ml of blood. She is in acidosis. What hormone should be administered, and why? (4 points).
Answer: Insulin should be injected because ketones accumulated in her blood, which caused her blood pH to drop resulting in acidosis, and the ketone bodies began to spill into her urine (pg. 622in Marieb).
3. Johnny, a 5-year-old boy, has been growing by leaps and bounds; his height is 100% above normal range for age. He has been complaining of headaches and vision problems. A CT scan reveals a large pituitary tumor. (a) What hormone is being secreted in excess? (b) What condition will Johnny exhibit if corrective measures are not taken? (c) What is the probable cause of his headaches and visual problems? (4 points).
Answer: (a). The pituitary tumor is secreting out excessive amounts of the growth hormone. (b). Johnny will exhibit structural abnormities, namely gigantism, if the proper corrective measures are not taken. (c). The probable cause of Johnny’s headaches and visual problems is that the pituitary gland is protruding inferiorly and compressing the optic chiasma (pg. 593-604 in Marieb).
4. Sean, a 42 year old single father, goes to his physician complaining of nausea and chronic fatigue. He reports having felt fatigued and listless for about half a year, but he had attributed this to stress. He has lost considerable weight and strangely, his skin has a healthy tan, even though he spends long hours at work and rarely ventures outside. His doctor finds very low blood pressure and a rapid, weak pulse. Blood tests show that Sean does not have anemia, but his plasma glucose, cortisol, and Na+ are low, and his plasma K+ is high. His doctor orders an ACTH stimulation test, in which Sean’s secretion of cortisol is measured after he is given a synthetic form of ACTH. (a) What would account for Sean’s low plasma Na+ and high plasma K+? (b) What is the reason for doing an ACTH stimulation test? (c) What gland is primarily affected if ACTH does not cause a normal elevation of cortisol secretion? (d) What gland is primarily affected if ACTH does cause an elevation of cortisol secretion? (4 points). Answer: (a). Low levels of the mineralocorticoid aldosterone would account for Sean’s low plasma Na+ and high plasma K+. (b). Sean was given an ACTH stimulation test so that the doctor can see how well the adrenal glands respond to the hormone. (c).The adrenal cortex is primarily affected if ACTH does not cause a normal elevation of cortisol secretion. (d).The pituitary gland is primarily affected if ACTH does cause an elevation of cortisol secretion (pg. 614-18 in Marieb).
5. Roger Proulx has severe arthritis and has been taking prednisone (a glucocorticoid) for two months. He isn’t feeling well, complains of repeated, “colds,” and is extremely puffy (edematous). Explain the reason for these symptoms. (4 points). Answer: The reasons for Mr. Proulx symptoms is that he might’ve been given a much higher dose than those found in the body of glucocorticoid. Or he may have a Cushing’s disease, caused by a pituitary tumor that’s releasing too much ACTH, by an ACTH releasing malignancy of the lungs, pancreas or kidneys, or by a tumor of the adrenal cortex (pg. 617-18 in Marieb).
Chapter 17, page 660, Questions: (1, 2, 4, 5 and 8)
1. Cancer patients being treated with chemotherapeutic drugs designed to destroy rapidly dividing cells are monitored closely for changes in their red and white blood cell counts. Why so? (4 points). Answer: The patient is being monitored closely for changes because, with some chemotherapy drugs there is a decrease in blood cells, so they want to watch the red blood cells to see if the patient is anemic, and the white blood cells to see if they have enough to ward off infections
Chemotherapy Facts (n.d.). Glossary. Retrieved from
https://www.cancerfacts.com/glossary_popup.asp?DiseaseTypeId=1&CancerTypeId=8&CB=7&ExternalTypeId=, on January 15. 2012
2. Mary Healy, a young woman with severe vaginal bleeding is admitted to the emergency room. She is three months pregnant, and the physician is concerned about the volume of blood she is losing. (a) What type of transfusion will be probably be given to this patient? (b) What blood tests will be performed before starting the transfusion? (4 points). Answer: (a). The type of blood transfusion that will most likely be given to Ms. Healy is a whole blood transfusion. (b). Test that will be performed before Ms. Healy is blood typing and an Rh factor (pg. 654-56 in Marieb).
4.A young child is diagnosed as having acute lymphocytic leukemia. Her parents cannot understand why infection is a major problem for Janie when her WBC count is so high. Can you provide an explanation for Janie’s parents? (4 points). Answer: Although Janie’s WBC is high, they are nonfunctional and cannot defend her body in its usual way and this may be the cause of her infections (pg. 648 in Marieb).
5. Mrs. Ryan, a middle-aged woman, appears at the clinic complaining of multiple small hemorrhagic spots in her skin and severe nosebleeds. While taking her history, the nurse notes that Mrs. Ryan works as a rubber glue applicator at a local factory. Rubber glue contains Benzene, which is known to be toxic to red marrow. Using your knowledge of physiology, explain the connection between the bleeding problems and Benzene.
(4 points). Answer: The petechiae on Mrs. Ryan skin says that she has a deficiency in the number of circulating platelets called thrombocytopenia, which causes bleeding from small blood vessels all over the body. Thrombocytopenia can arise from any condition that destroys red blood marrow, such as the Benzene in the rubber glue at her work place (pg. 653 in Marieb).
8. Jenny, a health young woman, had a battery of tests during a physical for her new job. Her RBC count was at the higher end of the normal range at that time, but four weeks later it was substantially elevated beyond that. When asked if any circumstance has changed in her life, she admitted to taking up smoking. How might her new habit explain her higher RBC count? (4 points). Answer: Smoking causes low blood oxygen levels, which is the reason why her RBC count is continuously rising.
Mayo Clinic (2010). High Red Blood Cell Count. Retrieved from
http://www.mayoclinic.com/health/high-red-blood-cell-count/MY00111/DSECTION=causes, on January 15, 2012
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