Human Physiology Case Study, OUM, Malaysia: A 55-year-old woman reports intense thirst and recurrent vaginal thrush infections
| University | University of Malaya (UOM) |
| Subject | Human Physiology |
CASE STUDY 1
A 55-year-old woman reports intense thirst and recurrent vaginal thrush infections. On further questioning, she describes frequent trips to the toilet and blurring of her vision.
A physical examination reveal a height of 5’3” (1.60m), weight of 12 stone 9lbs (80kg), and blood pressure of 160/100mmHg (normal <140/90). A simple “pin-prick” blood test reveals a random blood glucose of 17mmol/ L (normal < 11.1 mmol/ L).
A provisional diagnosis of type 2 diabetes is made.
- Comment on the presenting symptoms, and explain the physiological processes that lead to their presentation in this patient.
- How would you interpret the physical examination and blood test?
(BMI = weight (kg)/height (m)2 Ideal 18.5 – 25; overweight 25 – 30; obese 30 – 40
- If left untreated, this patient is at increased risk of which of the following (circle all those that are appropriate):
nephropathy, hypoglycemia, retinopathy, myocardial infarction, stroke, neuropathy, diabetic ketoacidosis, muscle-wasting, hyperglycemia, cold intolerance, postural hypotension
- How should this patient be managed?
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CASE STUDY 2
A 50-year-old man reports weight loss, despite increased appetite and more frequent bowel movements over the recent weeks. His resting heart rate is 82bpm and his blood pressure is 110/76. He complains of palpitations. The doctor notices that there is also a slight bulging of the eyes and firmness around the front of the neck.
- What is your initial diagnosis?
- Which symptoms are consistent with your diagnosis? Explain how these symptoms arise.
- Regarding your diagnosis, is this a primary or secondary endocrine disorder? Explain your answer.
- What would you expect the levels of T3, T4, and TSH to be in this patient?
Finally, in a second patient with a lack of iodine in the diet:
- a) Thyroid hormones: high or low?
- b) Is this hypothyroidism or hyperthyroidism?
- c) Levels of TSH – low, normal, or high?
- d) Presence of a goitre?
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