Answer these case study question for 1A and 1B in essay format. Make sure to include lots of details for each question with in text citations and sources at the end. Include a title page, 4 pages of essay, and the references pages. I have provided a sample case study for you to see the format of this paper. Please use it and be as detailed as possible for each question, with 6-8 sentences per question.
1A. A 50-year-old male had a total thyroidectomy followed by thyroid hormonereplacement therapy. Thirty-six hours later he developed laryngeal spasms, a mild
tetany, and cramps in the muscles of the hands and arms. The following tests were
performed:
Urine calcium 20 mg/dL
Urine phosphorus 0.1 g/day
Plasma calcium 7.0 mg/dL
Plasma phosphorus 5.0 mg/dL
Calcium gluconate and vitamin D (calcitriol) were given orally each day and the tetany
and laryngeal spasms were alleviated.
1. What endocrine disorder is present in this person?
2. What is the purpose of vitamin D administration with the calcium?
3. What caused the tetany and laryngeal spasms?
4. How is blood calcium normally maintained at its physiological level?
1B. A 45-year-old male from the Midwest presented with the following symptoms
during February: weakness, fatigue, orthostatic hypotension, weight loss,
dehydration, and decreased cold tolerance. His blood chemistry values follow:
Serum sodium 128 mEq/L
Serum potassium 6.3 mEq/L
Fasting blood glucose 65 mg/dL
BUN 4.5 mg/dL
Serum creatinine 0.5 mg/dL
Hematology tests resulted in the following values:
Hematocrit 50%
Leukocytes 5000/cu mm
Cont. of 1B: He also noticed increased pigmentation (tanning) of both exposed and
nonexposed portions of the body and back. A plasma cortisol determination indicated a
low cortisol level. Following administration of ACTH, plasma cortisol did not rise
significantly after sixty and ninety minutes. Endogenous circulating levels of ACTH were
later determined to be significantly elevated.
1. What endocrine organ is the site of the malfunction?
2. Is this a primary or secondary disturbance?
3. What is the name of this disorder?
4. Discuss the electrolyte disturbances resulting from this disorder.
5. Discuss the metabolic disturbances resulting from this disorder
6. What is the cause of the tanning?
7. What type of replacement therapy would be required for this individual?
8. Describe the feedback loop for this endocrine disorder.
