BIOL121 ASSIGNMENT 3: Written assessment Scenario: Galadriel Galadriel is a 31-year-old marathon runner, who has presented to her GP clinic after completing a training run. She runs four to five...

BIOL121 ASSIGNMENT 3: Written assessment Scenario: Galadriel Galadriel is a 31-year-old marathon runner, who has presented to her GP clinic after completing a training run. She runs four to five times per week and does yoga or Pilates on the other days. Galadriel has experienced light-headedness and significant muscle pain after her last three runs. Whilst talking to the clinic nurse, Galadriel admits to feeling lethargic and like her “heart is racing”. She has also been a little unsteady on her feet and stumbled climbing the stairs in her home the previous evening. She reveals that, although she tries to eat well and is drinking adequate fluids, her caloric intake has been less than usual, and she has been experiencing gastric reflux quite regularly. She has lost 2 kg in the last month, and her last period was 5 months ago. She has also been taking Nexium® to alleviate her gastric reflux (active ingredient: esomeprazole). Blood and urine tests ruled out pregnancy as a cause of amenorrhea. A medical history was taken, and urinalysis conducted, identifying the following: Height 173 cm Weight 61 kg Appearance Pallor, dark circles under eyes Temperature 38.6◦ C Blood Group OHR 86 bpm BP 87/58 mm Hg Respiratory rate 25 bpm Diet High protein, high intake of fruit and vegetables; high carbohydrate after marathon Body composition Low body fat Past patient history Torn meniscus in right knee, surgically repaired; one caesarean delivery 5 years ago. Takes fish oil and calcium supplements. Relies upon barrier methods for contraception. Social status Married with two children. Urinalysis: Colour Straw coloured Blood - Bilirubin - Urobilinogen 0.2 mg/dL Ketone + Protein ++ Nitrite - Glucose - pH 5.5 Specific Gravity 1.015 Leucocytes - ©ACU 2023 2 All topics and their key points listed below must be discussed in your essay Topic 1: Reproduction (10 marks total) Endometrial tissue contains glandular structures relevant to Galadriel’s reproductive function. Explain the role of this glandular tissue in reproductive function, including any likely changes from normal in the secretion and resultant effects for Galadriel. (4 marks) Considering Galadriel and her current circumstances, describe the role of oestrogen and explain whether you expect her oestrogen levels to be different to normal. Your discussion should include the homeostatic regulation of female reproductive physiology and the relevant glands and hormones. (6 marks) Topic 2: Respiratory system (5 marks total) Describe the changes in volume and pressure that will be occurring in Galadriel’s chest cavity to achieve inhalation during a long run. Explain why these changes are occurring, and the effect upon airflow. (5 marks) Topic 3: Digestion/metabolism (8 marks total) The active ingredient of Nexium® (esomeprazole) is a proton pump inhibitor. Digestion of which macronutrient would be MOST affected by administration of this medication. Explain your answer. (4.5 marks) Will insulin or glucagon be MOST active in maintaining Galadriel’s blood glucose levels during a marathon? Explain your answer. (3.5 marks) Topic 4: Pharmacology (7 marks total) Galadriel is regularly taking Nexium® to alleviate her painful gastric reflux in the form of an enteric-coated capsule. (7 marks) • Where will this drug be absorbed? • Will this drug be susceptible to the hepatic first-pass effect? If so, explain the effect it will have upon the drug’s bioavailability. • What is the purpose of the enteric coating in this context? • Do enteric-coated capsules need to be swallowed whole? Justify your answer