Reference no: EM132902875

BIOL122 Human Biological Science - Australian Catholic University

Case Study 1

Cheryl is a 55-year-old woman, who works long hours for a publishing company. She likes to have a couple of drinks when she gets home from work every night with the take-away meals she picks up on her way home. She loves her job as an editor, but finds it very stressful, and so, has taken to smoking cigarettes to help her relax. What started as a couple everyday has now become a packet a day. She has also increased her alcohol intake to 4 glasses of vodka every night as she has noticed that she no longer gets the same pleasurable feelings from a couple of glasses. Her friends have noticed that she stumbles quite often, forgets things, is moody and is flushed in the face almost all the time. When questioned about the amount she drinks, she denies excessive use.

In the last couple months, Cheryl has lost interest in many things she once enjoyed; dancing, going to the movies, and art class. She finds that she cries at the drop of a hat. She finds it difficult falling asleep at night, and so has started to drink more and more until she passes out. She has no energy to get up for work and wants to stay in bed all day. Her sister is worried she is relying too heavily on alcohol, and fears that she is starting to get short-term memory loss from the alcohol consumption. She forgot her brother's birthday, an important work meeting, and what day of the week it was. She stops mid-sentence as she cannot find the right words to communicate her thoughts, and she is taking double the time to now complete a task. She is becoming very frustrated with herself and lashes out at the people around her. Her sister decides it is time to book an appointment with the GP to work out what has been going on with Cheryl.

At the medical clinic, the GP listens to all of Cheryl's signs and symptoms. She prescribes a benzodiazepine (Xanax) and a selective serotonin reuptake inhibitor (Zoloft). She also prescribes an acetylcholinesterase inhibitor after carrying out physical, neurological, and cognitive tests. Cheryl is also given information on counselling and is referred to a counsellor to talk through her problems and help her with coping strategies.

Question 1. Identify one disease/condition Cheryl has and justify your answer.

Question 2. Using the disease/condition you have identified in Question 1, explain the link between the clinical manifestations of the disease and its pathophysiology.

Question 3. Discuss the benefits of administration of an SSRI in Cheryl's condition. To get full marks, you must explain the pharmacodynamics and pharmacological effects of SSRIs and relate them to Cheryl's clinical picture.

Question 4. Describe the effect of chronic alcohol consumption on liver function and explain its consequence on the distribution of water between the interstitial and intravascular compartments.

Cheryl's family was happy with the management plan established by the doctor as Cheryl was progressing quite well. She was feeling much happier and did not have to rely on alcohol to go to sleep. Cheryl was able to catch up for lunch with her sister, Rose, who mentioned she was experiencing pain in both hands, which now took on a deformed appearance. In fact, Rose's hands appeared quite swollen as did her knees. She doesn't understand how this could have happened as she is still quite young at the age of 50. She wonders whether it is her type 1 diabetes mellitus which has caused these problems. She tells Cheryl that she can't sew as much as she used to as the pain gets worse the more she sews. Cheryl asks her whether she has a cold as she looks a little under the weather, and Rose tells her that she has been felling unwell lately. She admits that she has had so many viruses in the last few years, she just can't seem to catch a break.

Question 5. Name the musculoskeletal disorder Rose suffers from, justify your answer, and identify a risk factor in her history that is specific to the disease you specified.

Question 6. Compare and contrast the aetiology of Rose's joint disease with the other joint disease we covered in BIOL122. In your answer, name both diseases and describe two similarities and three differences.

In a quiet Sunday morning, Rose tripped and fell, which resulted in excruciating pain in her back. She could not even get up; her husband called the ambulance and tried to comfort her until they arrived. She was taken to hospital, where the X-ray showed compression fracture at the T11 vertebral level. A bone density test was also completed, which indicated that Rose had a T-score of -2.9.

Question 7. Interpret the result of the bone density measurement, indicate what reading would be considered physiological, and name the condition Rose's finding is associated with.

Question 8. Describe the aetiology and pathogenesis of the disease you specified in the previous question.

Question 9. Name and define the type of fracture you identified in Rose's case and describe the most likely link between the condition you named under Question 7 and her vertebral fracture.

Cheryl approaches you with her concerns about the COVID19 vaccination. She argues that there is no need to get the jab - in fact, it would make more harm than good - because (i) the chances of dying from COVID19 are very low as it is nothing more than a type of flu, and (ii) there are known complications associated with the jab, including recent emergencies and potential fatalities caused by abnormal blood clotting. Cheryl argues that it is an unacceptable risk to vaccinate the entire Australian population because the potential harm far more outweighs the expected benefits.

Question 10. Based on what you learnt about vaccinations and infection control in BIOL122, and using any other sources of information you deem relevant and reliable, describe your answer to Cheryl and justify your conclusion.