Reference no: EM132902881

BIOL122 Human Biological Science - Australian Catholic University

Case Study

Greg is a 42-year-old IT-specialist, who lives alone. He has always taken care of his diet and lifestyle; he is on a healthy diet, does not smoke, does not drink excessively, and exercises at least three times a week. He has not had any major medical issues apart from his tonsillectomy that was performed when he was 6 years old. His father has been recently diagnosed with hypertension (which is under control, fortunately). His mother has been struggling with type II diabetes, but her oral medication and healthy diet control it reasonably well.
One day, without any warning, Greg felt really unwell so decided to see his GP right away. It took only a short, 5-minute walk to get to there, but Greg was struggling to make it. His GP instantly noticed that Greg, looked really unwell-he appeared to be a little flushed, looked very skinny, and was feeling a little breathless. On questioning, Greg explained that he had been feeling nauseous and unusually fatigued. He also explained that he had been very thirsty over the past couple of weeks, which he attributed to his unusually intense exercise routine and the unseasonably high temperatures. He also explained that he had recently lost over 8 kg in weight, but again, he had attributed this to his exercise and healthy diet. On questioning, he admitted that he had to get up at night to pass urine almost every hour, but he was not at all surprised about this as he had been drinking copious amounts of water. He also confessed that he had been feeling always thirsty and that his vision often became somewhat blurred. When he was asked about his family history, he could not recall if he had any siblings, which his GP found quite strange. The GP also noticed that Greg's breathing was laboured; his breathing rate seemed to have increased, and he was taking deeper breaths.

One of the tests that were instantly performed was a urine dipstick test, which was highly positive for glucose and ketones. A subsequent blood test showed a plasma glucose concentration of 16.8 mmol/L, his arterial blood pH was 7.22 (pCO2 = 20 mmHg; bicarbonate: 14.7 mmol/L), and his serum osmolarity was 304 mOsm/L.

After considering his clinical picture and laboratory findings, Greg's attending physician told him that he had diabetes mellitus, and he required immediate treatment.

Question 1. State four pieces of evidence from Greg's clinical picture/laboratory findings that support the GP's suggestion.

Question 2. Name the complication Greg was suffering from when he visited his GP and identify two laboratory or clinical findings that support your conclusion.

Question 3. Identify the type of diabetes Greg is suffering from and justify your answer.

Question 4. Explain the link between Greg's present condition and his breathing pattern. In your answer, you must also (i) name the characteristic breathing pattern observed in Greg's case and (ii) explain the consequence of this type of breathing.

Question 5. One of the long-term complications of Greg's condition is accelerated rate of atherosclerosis. Explain three reasons for the increased rate of atherosclerosis in diabetic patients.

Greg's diabetes is now successfully managed, and everything returned to normal for him. However, one day he is found on the floor, lying unconscious.

Question 6. Assuming that Greg's present state is related to his plasma glucose concentration, identify the reason for Greg's unconscious state and outline the best course of action in the present scenario.

Greg's work colleague, Cindy, is a 38-year-old married mother of three girls, who was diagnosed with stage 3 infiltrating ductal cancer of her left breast. Cindy underwent left mastectomy and axillary lymph node dissection 7 weeks ago and is currently undergoing chemotherapy.

Question 7. Describe three cancer cell characteristics that allow them to become invasive and metastatic.

Question 8. Discuss three potential clinical manifestations that can result from bone marrow suppression and explain how this condition may be linked to Cindy's treatment.

A few weeks into her treatment, Cindy has contracted a nasty bacterial skin infection, which resulted in a massive swelling of her right hand. In addition to this, since the mastectomy and lymph node dissection, she has also been experiencing an uncomfortable swelling in her entire left arm.

Question 9. Considering their most likely aetiology, name the types of swelling in Cindy's right hand and left arm and describe three differences between them.