8 online scientific sources if possible please.
1. Sandra is 50 years old. She has gained weight over the last year but has felt too tired and weak to exercise. She takes no medicine, but has tried taking vitamins with no response. During a physical examination, her physician notes the following signs:
Rounded “moon-shaped” face
Obesity of the trunk
Slender limbs
Muscular weakness
Blood pressure: 140/95 (normal = 120/80)
On the basis of these signs, which of the following ONE disorders would you suspect AND WHY? RULE OUT the OTHER FOUR disorders by providing detailed anatomical & physiological descriptions based on the clinical diagnostic data provided, along with specific clinical manifestations.
a. Addison’s disease
b. Cushing’s disease
c. Pheochromocytoma
d. Hypoaldosteronism
e. Hyperthyroidism
Diagnostic and laboratory tests are ordered, and an appointment with an endocrinologist is arranged. A few of the pertinent test results are listed below:
Plasma cortisol levels: 40 g/dL (taken at 7:00 am)
Plasma ACTH: 100 pg/mL (taken at 7:00 am)
X-ray of skull: erosion of the sella turcica (sphenoid bone)
MRI of pituitary gland: abnormal mass detected
What is the probable cause of Sandra’s disorder? WHY?
2. Describe the specific physiological, anatomical and DETAILED genetic LOCI etiology of BOTH sickle cell anemia AND ALL TYPES OF thalassemia (α and β). Also, detail the exact clinical manifestations & potential treatment options for these medical pathologies.
3. A 20-year-old woman lost consciousness while in a shopping mall. She had no identification with her. In the emergency room, the physician assessed her comatose state, noting among other physical findings, rapid respirations, and then ordered blood and urine studies. The physician obtained the following laboratory test results:
Blood Studies:
Complete blood count (CBC): within normal limits
Serum electrolytes:
Sodium: 135 mEq/L
Potassium: 4.1 mEq/L
Chloride: 100 mEq/L
Blood glucose: 800 mg/dL
Blood pH: 7.23
PaCO2: 30 mm Hg
HCO3- : 12 mEq/L
Blood urea nitrogen (BUN): 9 mg/dL
Urinalysis:
pH: 4.6
Glucose: (+)
Protein: (-)
Blood: (-)
Ketones: (+)
The physician ordered IV fluids containing another medication; the patient soon regained consciousness. What was the diagnosis? WHY? What drug was given intravenously?
4. Jane, 33, awakens one morning with blurred vision and pain in her right eye. She sees her family physician, who determines that her sclera, conjunctiva, cornea and ocular tension are normal, but that her visual acuity is markedly reduced in that eye. An ophthalmologist is consulted and, after an exam, diagnoses optic neuritis. Jane is then referred to a neurologist, who learns that she had an earlier, previously forgotten episode of weakness and clumsiness of her left arm. That problem persisted for only two days, and Jane attributed it to lifting heavy suitcases on a trip. An MRI of her brain reveals several plaque-type lesions in the white matter of the brain but no other abnormalities. A lumbar puncture is performed, and the results are as follows:
a. Pressure: 150 mm/H2O
b. Color: clear, colorless
c. Glucose: 50 mg/dL
d. Protein: 50 mg/dL
e. Cells: no RBCs; WBC count of 6/mm3
f. IgG: high ration of IgG to other proteins
g. Culture: no bacteriai
What is Jane’s preliminary diagnosis? Explain IN DETAIL WHY?; mentioning absolutely ALL the lumbar puncture lab results in your answer/diagnosis.
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