Reference no: EM133653668
Assignment:
Case Study 1: A 30 yr old woman is admitted to the hospital. she has truncal obesity, buffalo humpback, moon face, purple striae, hypertension, hyperglycemia, increased facial hair, acne, and amenorrhea. the physician orders endocrine testing. Results are:
Urine free cortisol- increased; Serum cortisol (8am)- increased; Plasma ACTH- decreased;;
Dexamethasone Supression test:
- Overnight low dose- no supression of serum cortisol
- High Dose- no supression of serum cortisol
- In your opinion what is the probable diagnosis of the woman's condition
Case Study 2: In a patient, the concentration of vancomycin is 20 ug/mL at 1200. At 1600, the vancomycin concentration is 12 ug/mL. What is the elimination constant for this patient? What is the vancomycin's half-life?
Case Study 3: Alan, 40, has bipolar disorder, which is controlled on lithium (slow-release preparation, 450mg bd). He presents to the surgery feeling tired, weak, shaky and complaining of nausea. Your first thought is that he has flu and has been overdoing things. The plasma lithium concentration result is available the next morning and is 1.6mmol/L (therapeutic range for chronic maintenance 0.6-1.2mmol/L). The comment on the report draws your attention to the time of the last dose and of sample collection, stating it to be about eight hours post dose.
The previous lithium concentration 12 months earlier was 0.8mmol/L. You wonder about the possible explanations for an increase of Alan's lithium concentration into the toxic range. What medical causes might result in this change? A review of his medications shows no obvious candidates for a drug interaction. Further questioning reveals that to lose weight, Alan has taken up jogging every morning, with predictable aches and pains in muscles and joints. In response, he has been taking ibuprofen bought from the local supermarket. Is the ibuprofen significant in this case? Why?
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