BIOL121: Written assessment
Scenario: David
David is a 41-year-old male, who has made an appointment to see his GP for his biannual health check. He
tells the doctor that he has been feeling “a bit puffed” walking around the course during his weekly game of
golf and that he seems to be urinating more frequently of late. David reports he has gained nine kilos since
his 30th birthday, and his waist measurement has expanded. He laughs this off as “middle-aged spread” and
says his wife tells him he needs to watch what he eats and drink less alcohol. David works as a software
engineer, which he has been finding very stressful of late, and spends a lot of his time in the office sitting in
front of a computer, snacking on his favourite salt and vinegar chips. David and his wife are keen to start a
family but have not yet been successful in conceiving.
On the advice of his doctor, David has been taking aspirin in the evenings for the past 18 months to lower his
risk of heart attack and Zocor® to address cholesterol.
Physical examination:
Height 174 cm
Weight 94 kg
Appearance : Neat appearance, overweight, pale
Temperature 37.1◦
C
Blood work
Blood type = O+
Blood glucose = 10 mmol/L
Blood Testosterone levels = 154 ng/dL
GnRH = low
BP
155/99 mm Hg
Respiratory rate 19 bpm
Diet Mostly healthy meals. Snacks on high
fat & sugar, processed foods. Heavy
alcohol consumption.
Past patient history Ex-smoker. Regular check-ups every six
months. Cholesterol levels have been
high at the last three check-ups. Takes
Aspirin in the evenings. Gall bladder
removed 5 years ago.
Social status Lives with his wife and mother-in-law.
Sexually active.
Urinalysis:
Blood -
Bilirubin -
Urobilinogen 0.1 mg/dL
Ketone -
Protein -
Nitrite -
Glucose ++
pH 6
Specific Gravity 1.035
Leukocytes -
All topics and their key points listed below must be discussed in your essay
Topic 1: Reproduction (10 marks total)
David and his wife are keen to start a family but have had no success so far. Considering David’s blood test
results, indicate whether there is need for further investigation. Your discussion should include the
homeostatic regulation of male reproductive physiology and the relevant glands, cells, and hormones.
Topic 2:
Respiratory system
David is late for work and the lift is broken; he must run up six flights of stairs to make it on time.
Describe the gas exchange occurring between David’s blood and the skeletal muscles in his legs. Discuss how
the rate of gas exchange was affected during the run up the stairs (i.e., during exercise).
Topic 3:
Digestion/metabolism
After speaking to his doctor, David has decided to try to lose weight and he going to start a diet…tomorrow.
Tonight, David is enjoying his last high carbohydrate/high fat meal for a while.
Discuss the potential impact of David’s gall bladder removal upon his ability to digest his dinner.
State the hormone that is MOST active in maintaining David’s blood glucose levels at this time. Explain your
answer.
Topic 4:
Pharmacology
Under the advice of his doctor, David has taken Zocor® tablets each evening for the past 18 months.
Discuss the route of administration, which route the drug is likely to be excreted after administration, and its
likely bioavailability. Justify your response by discussing whether the drug would be subjected to hepatic first
pass.
To help with weight loss, a friend has advised David to drink grapefruit juice with his meals.
As a health care professional, would you consider this to be a good idea for David? In your answer, discuss
the role of the liver in the administration of Zocor and grapefruit juice?