The case study essay allows you to demonstrate your integrated knowledge of the anatomical and physiological workings of the healthy human body. Instructions: Choose ONE of the three case studies provided. Carefully read all materials provided for your chosen case study. Use the Word template provided to complete your essay on your chosen case study. You will need to research the topic beyond your lecture and workshop material. It is highly recommended that you start with the textbook. Include in text citations in your essay and a reference list at the end. How to submit: Submit online through the Turnitin link provided on LEO. For submission please name the file with your student number and case study topic e.g. S00123456_JANE Important to note: You MUST write an essay and your answers MUST relate to the person in your chosen case study • This assessment involves addressing a series of generic questions in the form of an essay. The questions relate directly to the case studies presented. • All of your 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. • 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. • Your answers must be incorporated into sentences and paragraphs that include facts from the case study. If presented in question-answer style no marks will be given for quality of essay. The purpose of this assessment is for you to demonstrate your knowledge and understanding of NORMAL anatomy and physiology. • Do not become distracted describing pathophysiological changes • Do not simply list clinical signs and symptoms. • Ensure you adequately explain relevant underlying anatomy and physiology. ©ACU 2020 2 Case Study: Stuart Stuart is a 72yo male who lives alone since his partner died 2 years ago. He has come to see his GP today as he has had several episodes where he has felt faint, and “may even have passed out on a couple of occasions”. It is some time since Stuart attended the clinic and you note when weighing him that he has lost a significant amount of weight, and he doesn’t present as the robust active older person that you remember. He mentions that he doesn’t cook much and relies on the take-away shop around the corner for most of his food these days. He explains that he has been very lonely since he lost his partner but is excited to reveal a new zest for life now that he has met a new friend, with whom he recently travelled to Cusco, Peru (3400 m above sea level). While he thoroughly enjoyed the trip, he did mention he found it more difficult than normal to breathe there. His relationship has developed sexually, but he has had some difficulty performing. Stuart thought it was his prostate giving him trouble, but with urging from his new partner he bought some Viagra nasal spray over the internet. Physical examination: Height 178 cm Weight 70 kg Appearance Clean, dry skin, thin, significant muscle wastage Temperature 37.6? C Blood work Blood type = A+ Plasminogen levels are low HR 80 bpm BP 105/66 mm Hg Respiratory rate 22 bpm Diet Low fibre, high fat Past patient history Mobility issues due to osteoarthritis, was hypertensive for many years, aspirin in morning. Previous history of hepatitis. Social status Living at home, lonely, lately has occasional sexual contact Urinalysis: Blood – Bilirubin – Urobilinogen 0.1 Ketone +++ Protein + Nitrite – Glucose + pH 6.0 Specific Gravity 1.015 Leucocytes + ©ACU 2020 3 Guiding Questions Question 1 (8 marks total) A. Describe the changes in volume and pressure that will be occurring in Stuart’s chest cavity to achieve inhalation at rest. Explain why these changes are occurring, and the effect upon airflow B. Describe the gas exchange occurring between air in Stuart’s alveolar air and pulmonary blood. Would the rate of gas exchange have changed when Stuart was in Cusco at high altitude? Explain your answer. Question 2 (8 marks total) A. Which ANS response would you expect to dominate after Stuart has had a large bowl of pasta for lunch? Explain your answer. B. Which hormone associated with glucose homeostasis would you expect to be most active during this ANS response? Why? Using your knowledge of glucose homeostasis, explain your answer. Question 3 (8 marks total) A. Describe the role of the kidneys in maintaining fluid balance with reference to the role of antidiuretic hormone (ADH). Is Stuart at risk of not maintaining homeostatic fluid mechanisms? Why/why not? B. What is a urinalysis and what is its significance for this case? With respect to the glucose component of Stuart’s urinalysis result, and using your knowledge of normal kidney function, would you expect this result? Why/why not? Question 4 (8 marks total) A. Consider Stuart’s blood pressure result and discuss whether the mean arterial pressure is likely to be varied from normal. In your answer you must include reference to a change in vessel diameter with age and briefly mention the consequences of any change in BP upon kidney function. B. In this circumstance, do you think the renin-angiotensin-aldosterone system or natriuretic peptides will dominate in the maintenance of Stuart’s blood pressure. Discuss the role of your chosen system in blood pressure homeostasis to explain your answer. Question 5 (8 marks total) A. Stuart is considering knee replacement surgery as a result of his osteoarthritis. If, during the surgery, Stuart suffered a significant haemorrhage and required a blood transfusion, which blood type(s) could be safely administered? Explain the potential consequences if Stuart was administered B- blood. B. Stuart has been found to have low plasminogen levels. How would this effect the ability of his blood to clot? Explain your answer
