Medical-Surgical Nursing Endocrine System Reviewer Endocrine system 1. 2. 3. 4. 5. hormones released into the bloodstream travel throughout the body target is usually far from site of synt…Full description
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ENDOCRINE BLOCK CASE 1 A 37 years old woman presents to your clinic complaining of fatigue and thinning of her hair. While discussing her health further, you find that she has gained 20 pounds over the past 6 months with no change of diet and exercise. During physical exam, you note that she had a mildly enlarged thyroid gland and coarse facial features 1.
Describe briefly anatomy of thyroid gland
2.
Draw the hypothalamo-pituitary-thyroid axis
3.
List 3 causes of hypothyroidism
4.
Compare and contrast cretinisme and myxoedema
CASE 2 A 32 years old woman presented to your office complaining of milky discharge from both of her nipple. Upon further questioning, you discover that her menstrual period has become irregular and that her last menstruation was over 7 months ago. PE reveals bitemporal hemianopia. (Relate this condition with endocrine block) 1.
State your diagnosis
2.
State 3 investigations to confirm your diagnosis
3.
Briefly describe physiology of menstrual cycle
4.
Describe the pathophysiology of irregular menses in this patient
5.
State 2 histopathological findings in this patient pituitary
6.
With the aid of diagram, state how this patient develop bitemporal hemianopia
CASE 3 A 29 years old man pr esents to the emergency department complaining of a crushing headache and heart palpitations. He tells you that he has had similar episodes in the past. Physical exam reveals a pulse of 140 and a BP of 200/110. A 24-hour urine collection reveals increase VMA and metanephrine levels and blood tests demonstrate increase plasma catecholamine levels. 1.
State 4 hormones release by adrenal gland, their site of release and their function
2.
State you diagnosis
3.
State 3 condition associated with your diagnosis
4.
State pathological findings in this patient’s adrenal gland
CASE 4 A 47 years old man presents to your office complaining of occasional loss of vision in his lateral visual fields. Upon directed history, you learn that he has had to buy larger gloves and shoes and has gained 25 pounds over the past couple of months. Lab test reveals hyperglycaemia and increase growth hormone levels. 1.
State 2 functions of growth hormone
2.
Differentiate gigantism and acromegaly
3.
State 3 pathological findings in this patient’s p atient’s pituitary
4.
Explain pathophysiology of hyperglycaemia in this patient
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CASE 5 A 35 years old woman presents to your office complaining of palpitations and increased heat intolerance. Upon further questioning, you learn that she has developed an increase appetite and her husband mentioned that she is quite irritable lately. During physical exam, you note that she has protruding eyeball, moist skin, a pulse of 110 and a diffusely enlarged thyroid gland. 1.
List 4 functions of thyroid hormone
2.
Outline the metabolism of thyroid hormone
3.
State 3 other causes of hyperthyroidism
4.
List 4 other clinical features of hyperthyroidism
5.
What is the medical term for protruding eyeball and state 1 other cause of protruding eyeball
CASE 6 A 28 years old woman presents to your clinic complaining of amenorrhoea and fatigue over the past year. A pregnancy test is negative. However, she tells you that she has a 14 months old child, during whose birth she suffered severe haemorrhage. Further evaluation reveals loss of pubic hair, delayed deep tendon reflexes and hypotension. 1.
List 6 hormones that is released by anterior pituitary and state the functions
2.
List 3 causes of pituitary cachexia
3.
State 4 relevant investigations in this patient
CASE 7 A 45 years old woman presents to your office complaining of increased ur ination over the past several months. Upon further questioning, you learn that she has gained 35 pounds over the past year, bruises easily and has grown hair on her chin. While talking to her, you note that she has moon facies and increased fat pads on the back of her neck. She wa s diagnosed to have Cushing syndrome 1.
State 4 types of cushing syndrome
2.
State 3 other major features o f cushing syndrome
3.
State 3 functions of cortisol and how it is regulated
4.
State 3 investigations in this patient
CASE 8 A 65 years old man brought to the emergency department by his daughter because of confusion. He was recently diagnosed with small cell bronchogenic carcinoma and will be beginning chemotherapy shortly. Lab tests reveal decreased serum sodium levels, decreased osmolality a nd increased urine osmolality. As you admit him to the hospital, you suspect that his condition is directly related to his lung cancer 1.
State your diagnosis
2.
State 3 other causes of your diagnosis
3.
Explain why the patient has decrease serum osmolality
4.
Explain the molecular basis on how cancer cells are form
