Patho Case study chap 21-30

Syndrome of Inappropriate Anti-Diuretic Hormone (SIADH) Middle-aged man with pancreatic cancer had a convulsion and was rushed to the ER. He has felt very weak and nauseated lately. Frequent muscle twitching and headaches. Seems confused and has gained weight since last visit to doctor. BP was low. Blood work shows decreased levels of serum sodium concentrations and hematocrit. Urine samples showed a decreased in sodium. Both of these tests imply there's an excess amount of total body water. CT scan shows cerebral edema. Diabetes Insipidus 56 y.o. woman complains of increased urination and increased thirst (~30 days). PT also experiences nocturia. Urine was "not very yellow" and craved "very cold drinks" 00:30 01:23 Hyperthyroidism-Graves Disease 28 y.o. female experiences pain and irritation in her eyes and swelling in her neck after she had a baby. The doctor also notes swelling in her neck that may be an enlargement of the thyroid gland (goiter). The patient complains that the itchiness in her eyes is often accompanied by blurry and double vision. She also noticed that her eyes appear larger than before she had a baby. Blood tests were performed and the results were positive for thyroid-stimulating immunoglobulins. Radioactive iodine uptake was observed as elevated. Hypothyroidism 32 y.o. female complains of a swollen face and large puffy bags under her eyes. She also notes cold intolerance, lethargy, tiredness, and a small mass over her thyroid bone. Her doctor notes bradycardia, hypoventilation, and slow movement, slow tendon jerk reflexes, myxedema (nonpitting, boggy edema around the eyes, hands, feet, and subclavicular fossae). The patient's thyroid seems to be smaller than normal, but of normal shape. The patient also complains of coarse brittle hair accompanied by hair loss, constipation, weight loss, joint stiffness and muscle weakness. She also notes having difficulty speaking and hoarseness due to thickening of the tongue. An EKG indicates sinus bradycardia and enlarged heart. Blood tests show abnormal readings associated with the heart failure along with decreased thyroid hormone (TH) levels and slightly elevated thyroid stimulating hormone (TSH) levels. Type I Diabetes Mellitus 15 y.o. male has shows severe fatigue and dramatic weight loss. Interrupted sleep due to frequent urination. Physician notices heavy breathing, and mildly sweet scented breath. The blood glucose was critically elevated at greater than 500mg/dl. The urinalysis showed high levels of glucose and ketones in the urine. The doctor followed these tests with a hemoglobin A1c, which was also elevated. Type 2 Diabetes Mellitus 60 y.o African American female presents to her doctor with fatigue, visual changes, pruritis and polyuria. She also has a history of hypertension and obesity.Her blood pressure is elevated at 140/100. All other physical findings are normal. The patient's blood work showed hyperlipidemia and hyperglycemia. Visual tests also showed retinopathy, or damage to the blood vessels in the retina Cushing Syndrome 52 y.o. female admitted to the hospital for evaluation with complaints of fatigue, weakness and lethargy. Facial hair growth is displayed, thinning of the hair on her head, spontaneous bruising, and a recent diagnosis of diabetes. Patient also has a buffalo hump and exhibits signs of psychosis. Her physical examination showed a body weight of 211 lbs (gain of 40 lbs over the last two months with central distribution of weight gain and neck obesity), palmar erythema and hirsutism and an elevated blood pressure. Her face was moon-shaped with acne and pigmented knuckles and purple, livid striae on the abdomen and around the shoulder girdle. Test results indicated high cortisol level and presence of an adrenal adenoma. Hyperaldosteronism Female patient presented with dehydration and frequent urination. Patient has elevated blood pressure, temperature is normal, some neuromuscular manifestations. She complains of constantly feeling thirsty and that her muscles seem weaker. Test shows low plasma renin activity and elevated urinary potassium. Serum aldosterone is greater than 15 ng/dl as measured by radioimmunoassay. CT scan is used to locate an aldosterone-secreting adenoma. Addison Disease 40 y.o. female feeling weak to the point where she can no longer function at her job and was fired. She also has been feeling nauseous, fatigued, and a loss of appetite. Her body weight decreased a lot since last year, and her blood pressure is low. She has not been out in the sun much, but her skin has gotten a lot darker. She also has been losing pubic hair and armpit hair. Tests show low level of corticosteroid and a high level of serum ACTH. Primary Dysmenorrhea An 18 year old female presents with severe cramping and vomiting over the past 4 months during her menstrual cycle since discontinuing oral contraception 5 months ago. She is currently taking no other medications. Sx: Normal vitals, but cramping and back pain. High amounts of endometrium prostaglandin in PAP test. Patho: More progesterone leads moreprostaglandin F (PGF2α) and leukotrienes. Leads to increased sensitivity of pain fibers and vasopressins and ultimately pain. Amenorrhea Sarah is a 16 year old girl who is starting high school this fall. Throughout the school year she notices all the girls in her 10th grade class are developing breast and sometime would even talk about their cycle at lunch. Sarah hadn't experienced any changes of such. It didn't worry her as her mother told her every girl develops at different times. Sx: Normal vitals, but no breast development and short. Lack of menstrual cycle. Patho: Compartment III disorder of the anterior pituitary. Low LH, FSH and estrogen. Polycystic Ovary Syndrome A 22 year old female presents to her doctor's office concerned with her lack of ovulation because she is trying to get pregnant. She has had intermittent regularity with her menstruation prior to this year. She is currently not taking any medications or over the counters. Sx: Normal vitals, but unable to get pregnant, facial hair, and acne. Patho: Increased androgen and insulin levels. Increased ovary size. More androgen means more follicle growth. More insulin inhibits apoptosis.