This assessment involves addressing aseries of generic questionsin the form of an essay. The questions relate directly to the case studies presented. Key points to note are below:
- Your answers must be incorporated into sentences and paragraphs that include facts from the case study.
- All answers must be specific for the person in the case study; marks will not be given where your essay does not relate to the person in the case study.
- The answers to the questions in the case study must be integrated into an essay, which should include an appropriate introduction and conclusion; your written communication mark will be heavily penalised if a question-answer style presentation will be .
- You can present the information in the order that you feel flows best; you don’t have to present it in the order of the questions.
- The information you present must be synthesised from reliable sources (e.g. peer-reviewed articles in the scientific and clinical research literature, and textbooks).
- Care must be taken in all aspects of the essay, including spelling and grammar.
Do I need to reference my case study essay?
Yes, you must include appropriate in-text citations and a reference list in APA style (7th edition). Penalties will be applied as per the marking criteria for inadequate and/or incorrect referencing. You can find resources to assist you with correct APA referencing o
©ACU 2022 1 BIOL121 ASSIGNMENT 3: Written assessment Case Study: Blair Blair is a 22-year-old transgender female. As part of the medical treatments for transitioning, she is currently taking 17-beta estradiol and spironolactone (blocks androgen receptors and alters testosterone production). Blair has come to see her GP today as she has had several episodes where she felt faint, and “may even have passed out on a couple of occasions”. It is some time since Blair attended the clinic, and you note when weighing her that she has lost a significant amount of weight and does not present as the active person you remember. Blair mentions she doesn’t cook much and relies on the takeaway shop around the corner for most food these days. Physical examination: Height 178 cm Weight 65 kg Appearance Clean, dry skin, thin, significant muscle wastage Temperature 37.6◦C Blood Group AB+ HR 80 bpm BP 105/66 mm Hg Respiratory rate 22 bpm Diet Low fibre, high fat Past patient history History of depression Social status Living alone, lonely, lately has occasional sexual contact Urinalysis Blood - Bilirubin - Urobilinogen 0.1 mg/dL Ketone + Protein - Nitrite - Glucose - pH 6.0 Specific Gravity 1.005 Leucocytes + ©ACU 2022 2 All topics and their key points listed below must be discussed in your essay Topic 1: Reproduction (10 marks total) Prostate tissue contains glandular structures relevant to Blair’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 that are specific to Blair’s transition and the associated treatment. (4 marks) Considering Blair’s current circumstances, describe the role of testosterone prior to the commencement of estradiol and spironolactone therapy and explain whether you expect her testosterone levels to be different to normal because of the therapy. Your discussion should include the homeostatic regulation of male reproductive physiology and the relevant, glands, cells, and hormones. (6 marks) Topic 2: Cardiovascular system (5 marks total) Consider Blair’s blood pressure result and discuss whether the mean arterial pressure is likely to be varied from normal. Blair has mentioned she sometimes feels ‘light-headed’ when standing quickly. Explain the role of baroreceptors in this situation. (5 marks) Topic 3: Digestion/metabolism (8 marks total) The night after consuming more carbohydrate in the one meal than the last month combined, Blair has abdominal cramps, flatulence, and diarrhea and quickly needs to find a toilet. Link these symptoms to undigested carbohydrate and explain the defecation reflex. (4.5 marks) State the hormone that would have been MOST active in maintaining Blair’s blood glucose levels after her carbohydrate loaded dinner. Explain your answer. (3.5 marks) Topic 4: Pharmacology (7 marks total) Blair is taking spironolactone (which is considered a prodrug) tablets for androgen blocking as part of hormone replacement therapy. Discuss the route of administration of spironolactone, and its likely bioavailability. Justify your response by explaining how bioavailability is impacted by hepatic first pass metabolism, and whether first pass metabolism is beneficial or detrimental to the function of spironolactone within the body. (4 marks) Discuss the effect of spironolactone on elimination of other drugs. In your answer, you will need to relate back to the case study and clinical results for Blair. (3 marks) BIOL121 ASSIGNMENT 3: Written assessment Case Study: Blair Physical examination: All topics and their key points listed below must be discussed in your essay Topic 1: Reproduction (10 marks total) Topic 2: Cardiovascular system (5 marks total) Topic 3: Digestion/metabolism (8 marks total) Topic 4: Pharmacology (7 marks total) ©ACU 2022 1 BIOL121 ASSIGNMENT 3: 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 - ©ACU 2022 2 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. (10 marks) Topic 2: Respiratory system (5 marks total) 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). (5 marks) Topic 3: Digestion/metabolism (8 marks total) 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. (4.5 marks) State the hormone that is MOST active in maintaining David’s blood glucose levels at this time. Explain your answer. (3.5 marks) Topic 4: Pharmacology (7 marks total) 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. (4 marks) 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? (3 marks) ©ACU 2022 1 BIOL121 ASSIGNMENT 3: Written assessment Scenario: Eshma Eshma is a 42-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. Eshma has experienced light-headedness and significant muscle pain after her last three runs. Whilst talking to the clinic nurse, Eshma 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 is still eating well and drinking adequate fluids, her caloric intake has been less than usual. She has lost 2 kg in the last month, and her last period was 5 months ago. Blood and urine tests ruled out pregnancy as a cause of amenorrhea. Eshma applied Voltaren Emulgel, a topical non-steroidal anti-inflammatory drug (NSAID), to her quadriceps and calves immediately after this morning’s run, hoping to relieve some of her muscle soreness. 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 O- HR 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 14 years ago. Takes fish oil and calcium supplements. Relies upon barrier methods for contraception. Social status Married with two teenage 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 2022 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 Eshma’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 Eshma. (4 marks) Considering Eshma and