Topic 1: Reproduction (10 marks total)
Considering Shela Sexton’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. (10 marks)
Topic 2: Urinary system (5 marks total)
Describe the role of the kidneys in maintaining fluid balance with reference to the role of antidiuretic hormone (ADH). Considering Shela Sexton’s circumstances and urinalysis results, discuss whether she is at risk of not maintaining homeostatic fluid mechanisms. (5 marks)
Topic 3: Digestion/metabolism (8 marks total)
The night after consuming more carbohydrate in the one meal than the last month combined, Shela Sexton 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 Shela Sexton’s blood glucose levels after her carbohydrate loaded dinner. Explain your answer. (3.5 marks)
Topic 4: Pharmacology (7 marks total)
Shela Sexton 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 discussing whether the drug would be subjected to hepatic first pass and how this is a benefit for spironolactone. In your answer, you will need to relate back to the case study. (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 Shela Sexton. (3 marks)