BIOL 2120 CH. 16 Case Study

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BIOL 2120, Morgan, Chapter 16, Page 1 Case Study- Chapter 16 Part I: Hormones – too much or too little! In preparation for the following case studies, let’s brainstorm what could happen if you had too much or too little of a certain type of hormone. This will help us review the hormones and their function(s). 1. Fill in the chart below. Hormone Organ where Produced Consequences of Surplus/Deficit Aldosterone Adrenal Cortex; zona glomerulsa Too much? Blood pressure increases, blood volume increases, and potassium levels decrease. Too little? Weakness, muscle spasms, and tingling. Thyroxine Thyroid Too much? Losing too much weight, fast and/or irregular heartbeat, anxiety, tremors, sweating, change in menstrual cycles, fatigue, etc. Too little? Tiredness, dry skin, sensitivity to cold, constipation, weight gain, puffy face, muscle weakness, thinning hair, slowed heart rate, and memory problems. Insulin Pancreas Too much? Low blood sugar can lead to type 1 diabetes. Too little? High blood sugar can lead to type 2 diabetes. Parathyroid Hormone (PTH) Parathyroid Too much? High levels of blood calcium – inhibits osteoblasts so bone thinning occurs. Too little? Low levels of blood calcium – inhibits osteoclasts, and phosphorus levels rise. Cortisol Adrenal cortex; zona fascicularis Too much? Weight gain in specific areas, like face and trunk, lump between the shoulders, acne, pink or purple stretch marks. Too little? extreme fatigue, weight loss and appetite, low blood pressure, abdominal pain, areas of darkened skin.

BIOL 2120, Morgan, Chapter 16, Page 2 Part II: Mary Keeper’s Aching Head This morning at 4 am, Mary Keeper woke up with yet another throbbing headache and decided she couldn’t stand it anymore – she needed to see a physician. She took some Tylenol and then spent the rest of the morning lying on her couch until the physician’s office opened that morning. During the initial examination by the physician, the following observations were made:  Pulse was slightly elevated (95 bpm)  Patient had slightly low blood pressure in the office (95/65), but reports dizziness when standing  Patient’s skin was warm and moist  Patient appeared fatigued (patient reports lack of sleep due to recurring headaches)  Patient has lost 10 pounds since her last appointment 10 months ago (patient reports no loss of appetite)  Patient has a slight hand tremor  Patients reports more frequent bowel movements 1. Brainstorm possible endocrine deficiencies that Mary may have. Use the chart you made in Part I to help you. Too high levels of thyroxine. 2. After a couple of days, Mary’s blood work results come in. On her results, there were asterisks by the T 3 and T 4 values, both of them being very high above the normal limits. Does this support your conclusion from Question #1? If not, would you have a new suggestion for Mary’s problem given these results? Are any of Mary’s symptoms not explained by your suggestion? Yes, this does support my conclusion from question #1. I had mentioned pretty much all the symptoms Mary was experiencing. All the symptoms are explained by my suggestion. 3. Mary’s lab results also showed lower than normal TSH levels. Explain why TSH levels would be low when T 3 and T 4 levels are high. This is because the higher levels of T3 and T4, the more decreased TSH levels being released from the anterior pituitary. This happens when your thyroid is making an excessive amount of thyroid hormone thus causing higher T3 and T4 levels, which then make TSH levels go down.

BIOL 2120, Morgan, Chapter 16, Page 3 4. Interestingly, Mary’s blood work also showed lower than normal ACTH and GH levels, but normal CRH levels. How could this be explained? Does this provide a reason why Mary is having headaches and low blood pressure? This could be because low ACTH levels could also cause fatigue, low er blood pressure and weightless, and then low GH levels could cause decreased bone density. This could be a reason she is experiencing headaches and low blood pressure. 5. What is the function of thyroxine (T 4 )? What is necessary for the production of thyroxine? Describe thyroxine production, storage, and release by the follicle cells of the thyroid gland using the picture provided below. The main function of T4 is metabolism. Iodine is required for thyroxine to be produced. First thyroglobulin is made into the follicle lumen, and iodide is trapped. Next, iodide is turned into iodine by oxidation, and it attaches to tyrosine. When attached, these tyrosine’s come together to form T3 and T4. This leads to thyroglobulin to be combined with a lysosome so the enzymes can take t3 and t4 from thymoglobulin, and from there forth the hormones diffuse into the bloodstreams.

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BIOL 2120, Morgan, Chapter 16, Page 4 6. Which cells in the body are targeted by T 3 and T 4 ? Even more specifically, where in the cell do these hormones act and what is the ultimate outcome? They act on the thyroid hormone receptors, and the ultimate outcome is the metabolism and balance of our body’s functions. 7. Mary’s friend Tom has many symptoms that are opposite to Mary’s symptoms. He has dry, scaly skin, fatigue, low pulse rate (60 bpm), constipation, weight gain, and hypothermia. Tom’s medical examination revealed low levels of T 3 and T 4 , and elevated levels of TSH. When administered an injection of TSH, this did not increase the levels of T 3 and T 4 . What could be Tom’s problem? Would you expect to find a palpable goiter? Why or why not? Tom might just have other issues with his thyroid gland. Yes, I could expect to find a palpable goiter because it can arise from having either too much or too little levels of thyroid hormone. Part III: Eric and Sam – New A&P Study Partners Eric and Sam met in their A&P class and decided to form a study partnership. They both had similar schedules and liked to study the material in similar ways. As the semester progresses, both Eric and Sam notice that they are becomingly increasingly thirsty. They both start drinking much more water throughout the day, which also results in increased urination. Both men decide to go to the doctor, but first they use their A&P knowledge to brainstorm possible causes for these symptoms. 1. What are two possible endocrine dysfunctions that could be affecting Eric and Sam? What test could be run to help distinguish between these two conditions? What endocrine organ is responsible for releasing the hormones that may be dysregulated? Two possible endocrine dysfunctions that could be affecting Eric and Sam are both related to diabetes. The first one is Diabetes Mellitus and the second one is Diabetes insipidus. A urine test won’t immediately distinguish the 2 from each other, but it is able to tell if it is diabetes mellitus by “the presence of urine.” The endocrine organs responsible for releasing these organs are the pancreases (diabetes melllitus), and the posterior pituitary gland (diabetes insipis).

BIOL 2120, Morgan, Chapter 16, Page 5 2. Sam is told that he has Type II diabetes. How does this form of diabetes differ from Type I diabetes? What are some dangers of untreated diabetes? Type 1 diabetes are insulin dependent which means that the beta cells that are present are incapable of producing insulin. Type 2 diabetes are the opposite because they are insulin independent. This leads to insulin resistance which means that the cells in your body don’t really respond well to insulin; they are unable to use glucose from your blood for energy. It could be very dangerous if diabetes to go untreated as it can lead to heart attacks, kidney problems, eye problems, foot amputations etc.. Part IV: Homeostasis and Other Endocrine Questions 1. Fill in the blanks below to describe calcium homeostasis in the body. When blood calcium levels become elevated, the ___ thyroid gland ____ releases the hormone ____ calcitonin ________________. This hormone inhibits __ osteoclasts _______ (causing calcium to remain deposited in the bone) and causes the kidney to ____ excrete _______ calcium. Both of these actions lower blood calcium levels. If blood calcium levels become too low, the ___ parathyroid gland ___________ releases the hormone ___ parathyroid hormone ______. Directly, this hormone inhibits ____ osteoblasts _________ and increases the number of ____ osteoclasts __________ (causing calcium to be released from the bone). This hormone also causes the kidney to ___ reabsorb _____________ calcium and to secrete the hormone ____ calcitriol _______. This second hormone causes ______ absorption ________________ of calcium by the digestive system. All of these actions result in higher blood calcium levels. 2. Fill in the blanks below to describe glucose homeostasis in the body. When blood glucose levels fall, the ____ pancreas _____ releases the hormone ____ glucagon ______ from the ___ alpha ______ cells. This hormone causes an increase breakdown of ____ _glycogen __________ to glucose and an increased breakdown of fat to fatty acids. It also results in the synthesis of new glucose by the ____ liver _______. When blood glucose levels rise, the ___ pancreas _______ releases the hormone _____ insulin ____________

BIOL 2120, Morgan, Chapter 16, Page 6 from the ___ beta ___________ cells. This hormone causes cells to ___ take up glucose _______ from the blood. It also causes excess glucose to be converted into ____ glycogen ____________________ for storage. It also increases glucose usage by cells, increases protein synthesis, and increases triglyceride synthesis. 3. Ellen is an avid sports player. She loves to work out in her spare time, and she plays on her college’s soccer and basketball teams. Ellen notices that her periods are very irregular, and some months she doesn’t even have a period. Explain why Ellen’s menstrual cycle is dysregulated. Be sure to mention ALL of the relevant hormones. The reason that Ellen may have irregular could be because she works out very often, as it can cause changes in normal hormone levels. Relevant hormones include TSH, PRL, Cortisol, and FSH. 4. You are working in a lab that helped to discover the new hormone X. X is a water-soluble hormone. Where would you look for receptors for this new hormone? What types of cells in the body would be affected by this new hormone? Describe a possible mechanism for how this hormone sends a signal to a cell and what effect(s) it could ultimately have on the cell (think in general terms). I think that since this a water- soluble hormone, these are amino acid-based hormones. These would be best found at the plasma membrane. Thyroid Hormones, Melatonin, Thyroxine, TSH, LH, FSH, ADH, Oxytocin, GH are some of these. hormones and they effect target cells. They can send a signal by binding to these specific receptors on target cells. 5. When you are stressing out about homework assignments and exams, you are activating the slower, longer-lasting stress pathway. Describe this pathway (be specific about how the message travels from organ to organ). What are some implications for “chronic stress”, or for having this pathway be continually activated? This is the hypothalamic pituitary adrenal (HPA) axis. It's starts with the hypothalamus and then leads on to releasing the hormone CRH. It will then travel to the pituitary gland and therefore prompt it to release ACTH which will travel in the bloodstream. Once it gets to the adrenal glands, they will synthesize cortisol, and it will be released in response to ACTH. I believe that having this pathway continually continued can lead to things like anxiety, headaches, depression, sleep issues, etc.

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BIOL 2120, Morgan, Chapter 16, Page 7 Links used: https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284 https://www.mayoclinic.org/diseases-conditions/addisons-disease/symptoms-causes/syc-20350293 https://www.mayoclinic.org/diseases-conditions/cushing-syndrome/symptoms-causes/syc-20351310 https://www.medicalnewstoday.com/articles/diabetes-mellitus-vs-insipidus#diagnosis https://www.webmd.com/diabetes/insulin-resistance-syndrome https://www.nationwidechildrens.org/conditions/sports-medicine-menstrual-dysfunction-in-the-athlete#:~:text=Any %20changes%20in%20normal%20hormone,energy%20taken%20in%20through%20nutrition . https://www.thyroid.org/goiter/

BIOL 2120 CH. 16 Case Study

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