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Case Study Assignment BIOM3200DE Fall 2020 Declaration of Academic Integrity Academic integrity in writing is important because of its link to ethics (justice, equity, respect for self and others, trustworthiness, and intellectual property). Acts of plagiarism devalues the work submitted students as...

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Case Study Assignment – BIOM3200DE Fall 2020 Declaration of Academic Integrity Academic integrity in writing is important because of its link to ethics (justice, equity, respect for self and others, trustworthiness, and intellectual property). Acts of plagiarism devalues the work submitted by students as well as the academic unit and the University. Self-plagiarism, the act of submitting portions of one’s work from another course, is also considered plagiarism. Students must include the following declaration (signed and dated) when the written assignment is to be submitted on Dropbox. I declare that this paper is my original work. This paper in its entirety, or any portion thereof, has not been submitted to meet the requirements of any other university course. Student Name (type your full name): Julian Ionescu Student ID: 1035796 Date: 2020/09/11

***Please answer questions related to the four Case Studies to which you were assigned on the pages below.***

Format Instructions 1. 2. 3. 4.

When answering questions, please use Arial font, point size 11 to 12. You may answer in bullet points or sentences, but please type single-spaced. Please keep your answers to each case study limited to one page. You may re-submit your assignment on Dropbox as many times as you wish before the deadline if you need to re-format your answers. Only the latest submission will be graded.

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Case Study #1 Please copy the questions from Case Study #1 below and include your answers. 1. If Mark had a secondary adrenocortical deficiency, his endogenous ACTH levels would be low and his aldosterone levels would be normal. Why? (2 marks) A secondary adrenocortical deficiency would result from inadequate stimulation of the adrenal cortex by ACTH. Mark’s endogenous ACTH levels would be low because it takes more ACTH to stimulate the adrenal cortex than normal and his aldosterone levels would be high because the excess ACTH would lead to more overall aldosterone produced 2. Given that ACTH in high amounts can have MSH-like action, which of Mark’s symptoms would result from abnormally high ACTH secretion? (2 marks) An increase in MSH can cause darker skin therefore the symptom that would result from abnormally high ACTH secretion would be the darker pigmentation that mark is showing especially around his elbows. 3. How does the ACTH stimulation test differentiate primary from secondary adrenocortical deficiency? (3 marks) The ACTH stimulation test differentiates from primary and secondary adrenocortical deficiency by measuring the endogenous ACTH levels. If the endogenous ACTH levels are high, then it is primary adrenocortical deficiency but if the endogenous ACTH levels are low then it is secondary adrenocortical deficiency 4. Why did the physician ask Mark if he had been taking exogenous glucocorticoid medications, and how would such medications influence the pituitary-adrenal axis? (3 marks) The physician asked mark if he had been taking exogenous glucocorticoid medications because and ACTH deficiency can be produced by taking glucocorticoids for a prolonged period. When glucocorticoids are used in excess, they can suppress the pituitary-adrenal axis rendering it unable to produce cortisol, which is consistent with mark’s test results.

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Case Study #2 Please copy the questions from Case Study #2 below and include your answers. 1. How do diuretics and ACE inhibitors act to lower blood pressure? (2 marks) Diuretics reduce blood pressure by helping your kidneys release more sodium into your urine which takes water from the blood with it, thus lowering the amount of fluid flowing through your veins lowering BP. ACE inhibitors lower BP by preventing the body from producing angiotensin II, which narrows blood vessels. 2. What is the mechanism that causes heart rate to increase upon standing? (3 marks) The mechanism that causes heart rate to increase upon standing is the release of norepinephrine from the sympathetic nervous system which binds to β-adrenergic receptors in the heart and increases the heart rate. 3. How does eating influence blood flow? (1 mark) When you eat extra blood is directed to your stomach and small intestine and your heart beats harder and faster, increasing blood flow. 4. How does the autonomic system affect blood pressure? (2 marks) The autonomic system affects blood pressure through the baroreceptors. These are the sites that act as pressure receptors, with increased signalling when BP is high and decreased signalling when BP is low, thus allowing the autonomic system to provide the appropriate responses. 5. What is the most likely explanation for Edward’s symptoms is? (2 marks) The most likely explanation for Edwards symptoms is that his blood pressure is too low due to his medications and that when he stands up the blood rushes away from his brain and has too hard a time getting back and he becomes dizzy and ultimately faints.

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Case Study #3 Please copy the questions from Case Study #3 below and include your answers. 1. What is the function of the cerebellum as it relates to limb movements and gait? (2 marks) The major function of the cerebellum is to coordinate the timing and force of the different muscle groups to create a steady step and step pattern. 2. How does the vestibular apparatus in the inner ear, responsible for equilibrium, relate to the cerebellum and motor control? (3 marks) Because the vestibular apparatus is responsible for balance and aids in the coordination of movement. If your vestibular apparatus is not functioning properly then it will be harder to keep your balance resulting in an improper step pattern and an altered gait to try and maintain balance 3. What symptoms might implicate the vestibular apparatus when a person has ataxia? (2 marks) The symptoms that might implicate the vestibular apparatus when a person has ataxia are symptoms of vertigo and dizziness. 4. How does the sense of proprioception relate to Phillip’s ataxia and the observed degeneration of the cerebellum vermis? (3 marks) Because Philips stride varies irregularly it is safe to say that he probably has poor proprioception as he cannot properly sense his body position due to his ataxia. Because alcohol can affect your proprioception it is not surprising to see that his proprioception is poor and the degradation of his cerebellum vermis to be alcohol caused.

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Case Study #4 Please copy the questions from Case Study #4 below and include your answers. 1. Which abnormal functions of the parasympathetic and sympathetic divisions would be responsible for the sicca complex, tonic pupils, and intestinal abnormalities? (3 marks) The preganglionic fibres of both the parasympathetic and sympathetic divisions are cholinergic and release acetyl choline. The muscarinic receptors present on salivary glands increase secretion, so if there was less secretion then it would lead to sicca symptoms. Cholinergic stimulation also causes miosis of the pupil. So, if the parasympathetic innervation is reduced in the eye it constricts poorly to light, resulting in tonic pupils. Cholinergic stimulation also causes contraction of the intestine, so if the cholinergic stimulation is greatly reduced it would result in ileus. 2. Which abnormal functions of the parasympathetic and sympathetic divisions would be responsible for the inability to sweat? (2 marks) The inability to sweat is linked to a decreased activation of the post ganglionic sympathetic cholinergic axon. 3. Which abnormal functions of the parasympathetic and sympathetic divisions would be responsible for the low blood pressure and orthostatic hypotension? (2 marks) Reduced adrenergic stimulation of the arteries and heart lead to low blood pressure and orthostatic hypotension. Stimulation of the beta-1 receptor in the heart causes vasodilation, so if there is a reduced stimulation of the beta-1 receptor then it would cause a decreased heart rate and stroke volume resulting in decreased BP and orthostatic hypotension 4. How could antibodies that attack the nicotinic receptors in autonomic ganglia be responsible for Jennifer’s condition? (3 marks) The disease is autoimmune meaning that the antibodies produced attack the own bodies antigens, thus the nicotinic receptors of parasympathetic and sympathetic systems are damaged, producing symptoms with decreased activity of the nervous system.

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