Case Studies

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Case Scenario:

A 20-year old female college-student is admitted to the campus clinic after passing out in the general chemistry lab.  She states that she is concerned about her body image, having reduced her bodyweight by 55 lbs from when she left for summer vacation after her freshman year. In your taking of her medical history, she admits that her food intake is erratic (due to her class and work schedule) with a diet that consists mainly of vegetables and fruits. She consumes little meat, or table salt, because of a family history of dyslipidemia and hypertension. On top of which she runs on average 35-miles per week and takes the fat loss tablet that is obtained from the local “health-food” store. Results of her medical examination show:

Height: 65 in

Weight: 105 lbs

HR: 55 bpm

BP: 100/60

RR: 9 rpm

Blood and Urine Analysis show the following:

Na+

Plasma: 138 mEq

Urine: 63 mEq

K+

Plasma: 2.7 mEq

Urine: 34 mEq

Cl-

Plasma: 96 mEq

Urine: 0 mEq

HCO3-

Plasma: 30 mEq

Urine: 0 mEq

Osmolarity

Plasma: 287 mOsm/L

Urine: 563 mOsm/L 

pH

Plasma: 7.45

Urine: 5.65

Creatinine

Plasma: 1.2 mg/dL

Urine: 0.3 mg/dL

Based on your current understanding of Human Anatomy and Physiology, and with the use of correct medical/scientific  terminology, generate a 2-3 paragraph response with a diagramed feedback loop describing the physiology of the case, that  indicates the systems of the body that are impacted and the physiology of that system which was impacted, include in your  response:

• What is abnormal in the readings from the examination?

• What is the most likely cause for this young woman's abnormal reading?  

• What can she do to alleviate the abnormal readings and ensure that she won’t pass out again?

In your discussion, be sure to cover the role of the neuroendocrine function that the dietary supplement is mimicking and what health issues it might develop should the consumption of the dietary supplement continue.  

In 1 paragraph, and using lay terminology and your understanding of human Anatomy and Physiology, walk the student through the findings and treatment options.

Google Document Form

Case Scenario:

A friend of yours on the football team knows that you are taking anatomy and physiology and asks for your opinion on the subject.  He is in the offseason currently and is attempting to meet the performance goals that his tight-end position coach has established for him in the offseason. This includes adding 15-lbs of body mass, an increase in his strength measures by 20% and a reduction in all of his speed and agility tests by 15%.  He knows that there are three returners competing for two positions. He tells you about an article he read on a fitness blog that says consuming large amounts of protein will assist athletes and bodybuilders add lean body mass and improve their competitive performances.  You said you’d be able to help but need some basic information.  He provides the following information:

Age: 20 yr

Height: 75 in

Weight: 240 lbs

Strength Measures: (1RM)

Bench Press: 415 lbs

Squat: 510 lbs

Power Clean:280lbs

Vertical Jump: 37 in

Speed & Agility Times:

40 yrd: 4.67 sec

3-cone: 3.33 sec

Based on your current understanding of Human Anatomy and Physiology, and with the use of correct medical/scientific  terminology, generate a 2-3 paragraph response with a diagramed feedback loop describing the physiology of the case. Include in your  response: 

• What would you tell him about the need to consume protein?  

• What would be acceptable minimal and maximal levels for protein consumption?

• Where in the metabolism would proteins be used that can be attributed to the claim of benefit from protein consumption?

• Why is it recommended that athletes specifically consume protein in their diets?

In your discussion, be sure to cover the role of the neuroendocrine function that exercise would contribute to allow for adaptations to occur and if the changes that the coach wants would be realistic.  

In 1 paragraph, and using lay terminology and your understanding of human Anatomy and Physiology, walk your friend through your findings and options.

Google Document form

Case Presentation:  

You are doing a rotation as a high school nurse and notice that a number of student-athletes are undergoing drastic weight loss over a short period of time. You decide to call in the student-athletes and talk with each about the dangers of drastic weight loss. In  your consultation, you notice that a number of the student-athletes are taking 6 diet pills (Xena-Trim)/day but are eating regularly and consuming fluid that appears to equal what has been lost (approximately 3.5 L/day) from their everyday activities, athletics and workouts. A quick internet search of Xena-Trim is a thermogenic dietary supplement with its principal active ingredient being indicated as Caffeine Anhydrase and a “proprietary blend” of natural stimulant herbs.

But one female is taking 9 diet pills (Xena-Trim)/day and only eats once per day (approximately 425 kcal/day) that is predominantly composed of a large amount of protein with ½ a head of lettuce and drinking electrolyte fluid that is approximately 1.0 L/day.  She indicates doing this over the last 2-weeks so that she will be able to make the cheer-team weight limit as tryouts are taking place next week. She is having trouble paying attention to you and an examination reveals: 

Body Mass: 45 kg (~102 lbs.) 

Height: 167 cm (~66 inches) 

HR: 170 bpm 

BP: 160/110 mm Hg 

SaO2: 82%,  

Shell TB: 38.9oC (103oF) 

Based on your current understanding of Human Anatomy and Physiology, and with the use of correct medical/scientific  terminology, generate a 2-3 paragraph response with a diagramed feedback loop describing the physiology of the case, that  indicates the systems of the body that are impacted and the physiology of that system which was impacted, include in your  response: 

• How is the supplement impacting the energetic pathways that might explain the drastic loss of body mass? 

• Are there any issues with the student-athletes consuming the diet supplement and why? 

• What about the cheerleader? 

• What are probable reasons as to why she is exhibiting the symptoms, and what do the signs indicate? 

• What treatments might be required? How would you follow-up on this case? 

In your discussion, be sure to cover the role of the neuroendocrine function that the drugs are mimicking and what health issues it might develop should the consumption of the dietary supplement continue.  

In 1 paragraph, and using lay terminology and your understanding of human Anatomy and Physiology, walk the cheerleader  through the findings and treatment options.

Google Document Form

Case Presentation:

A 19-year old African-American female basketball player complains of extreme fatigue, an inability to "catch her breath," and “legs that feel like JELLO” after a preseason conditioning practice. In her examination you note: 

• SaO2: 77% 

• RR: 22 rpm 

• HR: 96 bpm 

• BP: 150/90 mm Hg 

• [glu]pl: 130 mg/dL 

• pH: 7.25

•  pHCO3-: 9 mm Hg 

• pCO2: 22 mm Hg 

• USG=1.024

Symptoms were alleviated after 60-minutes of supplemental oxygen and ingestion of bicarbonate (via baking soda solution). Subsequent testing by a cardiologist via ultrasound analysis for both the heart and femoral arteries, which indicates slight hypertrophication of the left ventricle myocardium and associated diminishment of the ventricular volume, but no visible atherosclerosis is noted in the femoral artery. She has a normal diet that does not restrict any kind of meat or dark green vegetables. Because she gets tired after practices, she has begun to eat a "King Sized" Snickers bar every day that is split to ½ before and ½ after practice. Her mom has also recently made sure that she supplements with iron due to having a heavy flow during menstruation. 

Based on your current understanding of Human Anatomy and Physiology, and with the use of correct medical/scientific terminology, generate a 2-3 paragraph response with a diagramed feedback loop describing the physiology of the case, that indicates the systems of the body that are impacted and the physiology of that system which was impacted, include in your response:

• What is the most likely cause for the symptoms? 

• What other information would be necessary for diagnosing these symptoms? 

• What treatment would be recommended? 

• How would you follow-up on this case? 

• What role does environmental stresses and genetics play in the symptoms that are being presented? 

In 1 paragraph, and using lay terminology and your understanding of human Anatomy and Physiology, walk the patient through your findings, conclusions, and a possible treatment options. 

Google Document Form

Case Presentation:

A 58-year old Italian-American female is having her routine annual physical exam. She has no history of bone fractures, has never smoked and drinks almost no alcohol. She has a prescription for a statin to control cholesterol and reports taking a daily multivitamin and a Calcium with Vitamin D supplement, but takes no other medications or dietary supplements.

Physical Examination show:

• Weight 187 lbs.

• Height of 65.6 in 

• Waist-to-Hip Ratio 0.99

• HR 79 bpm

• BP 108/62 mmHg

• RR 14 rpm

Clinical Laboratory results:

• Total Estrogen 9 pg/mL 

• FSH 92.5 mIU/mL 

• Vit D 24 ng/mL

• Total T3 7.2 µg/mL 

• Total T4 110 ng/mL 

• Insulin, Leptin, [glucose]pl, and, A1c are within normal limits

• Calcium and Phosphate levels are within normal limits

DXA Scan Results

• Bone Mineral Density, averaged across all points, 1.05 g/cm2 (expected 1.181 g/cm2+/-0.11)

• Total Fat Mass 70.125 lbs, no abnormal fat depositing in viscera, liver or in skeletal muscle

During her follow-up to go over clinical results, she indicates gaining a little more than 35 lbs over the last 7 months which she wants to lose. She is highly motivated to lose about 65 pounds, because she and her sisters are planning a family reunion that is happening 6 months from today and “needs to be slimmer” to fit into a dress that has been made specifically for all the women to wear at the reunion. You know that she has been relatively inactive for most of her life, and has indicated an aversion to doing exercise. In an effort to help her lose the weight and get generally more healthy, her daughter recently added her to the gym membership at a local women’s-only gym. 

Based on your current understanding of Human Anatomy and Physiology, and with the use of correct medical/scientific terminology, generate a 2-3 paragraph response with a diagramed feedback loop describing the physiology of the case, that indicates the systems of the body that are impacted and the physiology of the systems impacted.

Then based on these findings and her desire to lose weight, develop a comprehensive nutrition and exercise treatment plan that would allow for her to reach the weight loss goal while also treating abnormalities found in her medical examination.